Looking forward: School of Public Health professors weigh in on the future of the pandemic
Professors at the Yale School of Public Health explain the pandemic’s implications, evaluating how we can better prepare for the next one.
Yale Daily News
After nearly two years of life upended by the coronavirus pandemic, four of Yale’s public health experts analyzed lessons learned to end the current pandemic and prevent the next one.
Looking to the future, each expert explained that ensuring equitable distribution of vaccines while battling misinformation is of the utmost importance for global health. Akiko Iwasaki, professor of epidemiology and immunobiology, said that Yale as an institution handled vaccinations well. The University instituted a mandate for students, faculty, staff and postdoctoral trainees. Yale now has a 99.5 percent vaccination rate among students. But as students move into the winter season, when there is an increased risk of transmission due to indoor activities and holiday travel, the four Yale experts discussed public health measures that should be taken on a national and global level to address the future of the pandemic.
“Going forward, we need to do a much better job of educating and communicating with the public,” Iwasaki said. “Even if we do produce excellent vaccines, if half the population doesn’t want to take it, we’ll still be in the same position.“
According to Iwasaki, there are two main reasons that individuals might not be vaccinated. In some populations, the problem is a lack of accessibility. Other populations with access to vaccinations may experience hesitancy due to misinformation.
Albert Ko, professor of public health and epidemiology, explained that populations experiencing poverty, both around the world and on a local level in New Haven, have been disproportionately affected by new COVID-19 variants.
These pockets of unvaccinated individuals are areas of concern, not only because of the risk of outbreaks, but also because of the potential for new variants to emerge, he explained. According to Ko, variants such as Alpha and Delta have emerged in populations that had uncontrolled transmission of the virus. Although vaccines remain effective against existing variants, there is the dangerous possibility that a vaccine-resistant strain develops in the future.
“I think for the world, the big issue is how fast we can get vaccination programs out, and particularly to our poorest countries,” Ko said.
In terms of vaccination rates among students at Yale, Iwasaki, Ko and Saad Omer — the director of the Yale Institute for Global Health — agreed that Yale as an institution mitigated COVID-19 using successful public health policies. Over the last academic year, before mRNA vaccines became widely available, the University instituted a twice-a-week COVID-19 testing policy, along with stringent face masking and social distancing rules.
“Yale has had a pretty good response in terms of vaccination,” Omer said. “It was both the policies, but also the compliance of the students, especially the undergrads.”
Although Yale has successfully implemented its vaccination requirements, Omer pointed out that many other universities have not reached the same levels of immunization among students.
He specifically noted that many state schools have been prohibited from mandating vaccination against COVID-19 due to political reasons.
“There may appear a disparity in risk because of higher pockets of vulnerability in state schools, especially the ones who are prohibited from having a vaccine mandate,” Omer said.
According to Omer, this risk is especially concerning looking ahead to the winter months. There may be a higher risk of transmission once activities and gatherings move indoors, especially at state schools that already have higher density gatherings due to larger student populations.
Ko echoed Omer’s concerns, noting that there was a surge in cases across the country last winter, including in New Haven. In addition to increased time spent inside, both Ko and Omer said that holiday travel could play a role in spreading COVID-19.
In order to reduce the transmission of COVID-19 in the upcoming months, Omer suggested that policymakers institute a vaccination mandate for airlines and other forms of travel. With the knowledge that holiday travel could contribute to a surge in cases nationwide, he said that instituting such a mandate in anticipation is a good opportunity to minimize the damage. Currently, airports have a mandated mask policy through January 2022.
Professor of epidemiology Robert Dubrow emphasized the importance of taking action on a global level to combat the pandemic.
“One of the most important steps the world can take to deal with the current and future pandemics more effectively would be for the nations of the world to agree to provide substantially greater resources and authority to the World Health Organization, which needs to grow in stature to be universally recognized as the premier public health agency in the world,” Dubrow wrote in an email to the News.
Although 99.5 percent of Yale College students are vaccinated, Ko noted that the vaccines are not 100 percent effective against infections. He said that Yale might see breakthrough COVID-19 cases occur, but emphasized that vaccination does prevent severe forms of infection. Additionally, he said that increasing the vaccination rates across the wider population will reduce the risk of these breakthrough cases.
Although Yale might see small clusters of COVID-19 cases in the future, Ko said that he does not anticipate a large outbreak disrupting classes. The most important thing is educating students, he said, and it is unlikely that changes in infection rates or policies will have an impact on education.
Ko speculated that Yale may implement more conservative guidelines for winter gatherings in response to increased infections, although he noted that the highly-attended Harvard-Yale game is currently scheduled to occur on Nov. 20.
“The winter is going to pressure-test us, but I think the vaccinations, with the face masks, are going to go a long way,” Ko said. “And I think we’re just going to need to see if we’re going to need to have testing weekly of vaccinated people.”
According to Ko, looking ahead to the next semester and beyond, people will have to learn to live with the virus on an endemic level. Iwasaki agreed that the pandemic will eventually become an endemic situation — most people will have immunity. However, she said that it may take some time before most people have developed some immunity from either infection or vaccination.
Although Ko is optimistic about the future at Yale, he said that he is concerned about the low vaccination rates across the country.
“There’s going to be transmission of COVID,” Ko said. “What we can hope for is low-level transmission or clusters and not large outbreaks, and certainly not the large surges that we’ve experienced in the past.”
Yale saw 23 positive cases in the last seven days, according to the University’s COVID-19 dashboard.