Anybody else worrying about how bad the potential second wave of coronavirus could get after hearing Trump making suggestions about injecting disinfectant? I am an international student and I have already accepted my offer at Columbia for this fall. I considered deferring for a year but I really want to start studying this MPH as soon as possible, which is why I accepted the offer instead of deferring in the first place. However, after watching that briefing, I was just wondering whether I will be putting myself and my studies in danger by moving to NYC at this point in time...
I don't think that Trump, by virtue of occupying the White House, necessarily has privileged or more detailed information about what is going to happen with coronavirus versus what you can conclude from what the CDC and researchers are saying, if you were implying that he secretly knows that an enormous second peak is coming? I don't think anybody knows exactly what will happen, and you don't need to read the tea leaves to know that life won't be completely normal for a while, but many of the enjoyable social aspects of life may trickle back into place. Trump had a reality show and it seems like he still has a need to be at the center of attention, maybe even to entertain people, I don't think there will be bags of "Lysol" hanging from IV poles in hospitals anytime soon.
I haven't watched a full Trump or Cuomo briefing, most of that information, if there is any new information, is condense in written form which can be more quickly read. I'll read on article on what Fauci or Birx said, rarely see a video clip of them talking.
There is a lot of information specific to NYC via the Cuomo briefings, but also remember that this is a fluid situation and a couple months ago people in NYC weren't sure how much of society to shutdown and there was even a big fight in NYC about if the public schools should be closed. Some points to consider:
1. There was a second peak to the 1918 flu pandemic which was worst than the first, and the computer models and common sense seems to indicate that if a majority of the susceptible population starts doing what they were doing in NYC before the coronavirus pandemic started, then yes, you'd probably have a lot more cases, people dying in higher numbers and hospitals clogged. So, while a second coronavirus peak could theoretically happen if we go back to life as normal, and be even more devastating, things won't be switched on like a light switch, you'll probably have certain areas open up slightly with big restrictions such as everybody wears a mask in public, physical (social) distancing, and other such measures and researchers will wait and see what happens and continuously analyze the data. So . . . even if Columbia is open in the fall, classes will be much different, probably won't be physical office hours, a portion of classes might be online, you might not have an internship with certain NGOs or the health department depending on what is going on.
2. Coronavirus spread like wild-fire because we're all super interconnected, more so than in 1918, I think going forward there will be an emphasis on limiting physical interactions to what is necessary, if you are in school, maybe you go to 1-2 in-person classes per week, but the rest of the time you are mostly in your apartment, you aren't participating in other social activities as much in NYC, you might have to walk versus ride the subway, you might meet up with friends for study groups online, so if coronavirus spreads into the Columbia school population, it spreads much less slowly into other social circles such as nursing homes or first responders in NYC. I could see Columbia partially re-starting some classes, doing an online/in-person hybrid only to have a cluster of coronavirus cases and deciding to shutdown again in November.
3. Nobody is 100% sure why coronavirus is so severe in NYC, there have been a higher absolute number of cases at this point in time, and there are still cases trickling in. Maybe in California there were less than a dozen initial cases imported from China, whereas in New York there were maybe hundreds coming from Europe, so possibly more infection chains were started simultaneously in New York, less likely possibility is that the mutations in the different COVID-19 strains actually make the Italian strain somehow slightly more contagious or virulent? NYC is a super dense metropolis, and isolation of very sick patients from contact with others might be harder than in California just due to physical crowding. It was thought that the 1918 flu pandemic second peak was much worse as the very sick soldiers were transported from the frontlines of world war 1 and came into contact with more people, such as healthcare providers, versus the mildly sick who pretty much stayed home, so a more virulent/deadly 1918 flu strain passed around the world in the second peak. If so, having adequate PPE for healthcare workers in NYC is critical not just for saving their lives, but also recognizing that hospitals concentrate the sickest coronavirus patients and that infection can bounce back between the hospital and the community several times, there are huge populations in NYC, as wells as dozens of hospital overflowing with coronavirus patients, it is a positive feedback loop that can only be stopped by getting population immunity through a vaccine or herd immunity or social distancing, one is a longterm proposition, one (social distancing) can be implemented quickly as we've seen.
4. If coronavirus infections continue in NYC in the coming months, and certain sectors of the economy open up and the cases don't dramatically fall-off, which looks like it might happen, then I don't think Columbia will have in-person classes. Even if Cuomo eventually opens public schools a couple days a week, if the subways are down and there are other issues with students at Columbia they might decide to shift things online. If there is a cheap coronavirus test Columbia might combine that with a health questionnaire every month to monitor the student population, but NYC might not be there yet as so many people have had the virus and it is still passing around the community. Nobody knows if you can get coronavirus within a couple of weeks or months of having had it, or if a second infection with coronavirus is worse, as happens with dengue, probably not, but this disease has surprised a lot of people.
5. Who knows if there are going to be sufficient public health jobs in two years, it looks like we're going into a recession/depression, doubtlessly public health related jobs will be lost, not sure how many permanent positions would open up in two years, definitely pays to ask for lower tuition if classes aren't fully in-person, or if they are online.
6. There are some people in their 20s in NYC hospital ICUs who needed to be intubated, surprising doctors, chances for everybody of whatever age group that you'll survive infection, but still if Columbia reopens, they get 400 students in the fall and then that semester 1-2 of them die of coronavirus or are hospitalized, and it starts half a dozen community chains of infection in NYC anew and a dozen people are hospitalized, a lot of people would say that it isn't worth it to reopen school then.
7. Public health schools in the coming years no doubt with look at their curriculum and how well it and the school's focus meet the needs of society, currently you've got public health concentrations centered around global warming and all sorts of topics which might be less pressing at least in the next couple of years if people aren't driving as much. There is a resurgence of STIs like gonorrhea and chlamydia, malaria might resurge in Africa, in addition to obviously coronavirus which might become a chronic problem, but you've also got billions of people walking around with a smartphone in their pockets that has more computing power than computers from decades ago used in research institutions, hopefully governmental public health budgets will increase while obviously private institutions employing public health people will lay some people off.
8. The CDC made a lot of mistakes early on, that's OK, but they've (we've) got to learn from their mistakes. One was having the ability to test for emerging diseases in a scaleable fashion, that didn't happen, also getting tests ready befor the virus hits, instead of hoping they don't hit the US didn't happen, at least as far as I know. Simple facemasks might be able to reduce transmission by some percentage, not as perfect as an N95 or better, but reducing the spread of coronavirus early on would have saved thousands of lives without a doubt, having a standing national system for quickly getting the public to wear masks in case of a viral flare up would have bought us more time. I think people look at the pictures of people from 1918 wearing masks made of gauze and there is almost laughter as they look primitive, but even if something has a modest effect for a single person, it can have a big public health effect, especially if it pushes R naught below one. I think the CDC needs a new branch dealing with pandemic response and having resources in place ahead of time, I'm talking about warehouses with PPE, like masks, production areas for making tests and specialists in biological sciences they can mobilize like the National Guard. I've felt for a longtime that there needs to be a national center of vaccinology, dedicated to making vaccines to everything, even rare stuff, as you never know when you're going to need it, and also to study how vaccines work and why some vaccines fail. So, yes, the CDC messed up in their budgeting, for many years, at least a decade ago, the WHO's primary concern was that pandemic flu would return and kill hundreds of millions of people, CDC should focus on that (emerging viruses, flu, coronavirus) as well in terms of funding basic research and clinical trials.
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