102: Recalling COVID-19’s First Case Part 2

Dr. John Wiesman, the former Secretary of Health in Washington state, gives his assessment of the nation's pandemic response since the first COVID-19 case was discovered in his state two years ago this week. He discusses what has worked, what remains...

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Dr. John Wiesman, the former Secretary of Health in Washington state, gives his assessment of the nation's pandemic response since the first COVID-19 case was discovered in his state two years ago this week. He discusses what has worked, what remains a challenge, and what to do next; Katey Redmond, a public health specialist in Alaska, says the announcement of crisis standards of care in a community can cause anxiety among people living with disabilities; and ASTHO offers a blog article describing the goals of a new partnership with the EPA and the Environmental Council on States.

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This is Public Health Review Morning Edition for Friday, January 21st, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


When the first case of COVID-19 was confirmed by the CDC two years ago this week, Dr. John Wiesman was at ground zero, serving as Washington state secretary of health. Today, he teaches public health to students attending the University of North Carolina at Chapel Hill. In part two of our morning conversation, Dr. Wiesman gives his assessment of the pandemic response since that time—what's worked, what's challenging, and what to do next.

Considering all that's happened, what have we done right?


I think one of the things we've done right is really mobilized our local resources. We certainly, quickly out of the gate, took the initial plans and reactions that we needed to. And I think, you know, we implemented community mitigation measures in a reasonable pace and at the reasonable intensity to try and slow down the virus and certainly flatten the curve in that first wave. And all of that really was to buy time to get the resources we needed to really respond to this—whether that's personal protective equipment, whether that was human resources, people to do case and contact investigations. So I think, you know, those initial pieces of that did right.

And, you know, frankly, the federal government's response to work quickly to develop a vaccine—incredibly important. I mean, we all knew the limitations of our public health measures—you know, you can only close down businesses for so long, and that that's gonna, you know, try and help slow the spread. So, I think that and the treatments, you know, those things were the right things to do.

And I'm still amazed at the speed of which, you know, we produced a vaccine—but probably shouldn't be, because it's decades of research that people have been doing on messenger RNA vaccines, and, you know, that laid the groundwork for the basic science so that they could mobilize quickly.


On the flip side, what do you think we could've done better these last 24 months?


Well, certainly I think, over time, definitely speaking with one voice and being clear in our messaging, clear in the response—things obviously became very politicized after that initial first wave, which is highly unfortunate. I think clearly the mobilizing of resources and supplies took way too long—whether that was testing resources and supplies, whether that was personal equipment—all of those things just didn't happen quickly enough. And other countries managed to do, you know, some of that much better than we did.

I think support for people who needed to be an isolation and quarantine, you know, those wraparound services—again, way too slow to be mobilized and developed.

I think the lesson out of this is public health and pandemics are a national security issue and we must develop and support that infrastructure in a smarter way than I think we have in the past.


Finally, if the phone rang today and the caller on the other side of the line was asking you for advice about how to move forward into what is now the third calendar year of the pandemic, what would you recommend?


Well, one, I'd say we're at a point where we need to learn how to live with this virus. It's going to be like the flu—you know, it is with us to stay. As time goes on, you know, that will probably be less deadly, and we'll have more of these vaccines and tools that we can use and tools for treatment if people do become ill. So, it's now, I think, learning to live with the virus.

And so, I'd say do what you can—which is, number one, get vaccinated, get boosted. If more boosters are required down the road, then, you know, make yourself available to those things. Be smart about your risk: mask up when you're in public at this point in time, given the surge we have. And I guess be prepared to know that we will have points where there's less virus around and we can maybe relax some of our masking and some of our social interactions; and then there will be times again where, you know, we have another variant or we have just an uptick in cases like the flu every year, right?

I mean, in my mind, even if I think just about the flu and what we might do differently, in the past during flu outbreak season, we didn't think about wearing masks, right? That just wasn't part of our culture. But I would hope now that it would be that we would say, "Oh, we have an uptake in a viral transmission, so let's wear our masks." So, I think it's this balance now between living with our control measures and trying to get our life back to as much of normal as we can.

And I guess I'd also say part of this is now trying to take care of ourselves, to stay active. I know these messages sound weird or, you know, just basic good nutrition, but a lot of us weren't taking care of ourselves well before the pandemic and some of us who were really sort of stopped taking good care of ourselves. And that's, I think, critical to the mental health and behavioral health piece to this that we see.

And to that, I guess my last point would be, what makes your heart sing? Try and find that thing, and do that, you know, at least once a week, if you can't do something every day to make your heart sing.


On Monday, Dr. Wiesman offers a final thought—his thanks for those still battling to control and contain the virus.


The news that hospitals might invoke crisis standards of care during the pandemic has created some anxious moments for people living with disabilities. Several jurisdictions have had to allow healthcare facilities to limit care after they've been overrun by COVID-19 patients.

Katey Redmond, a public health specialist in Alaska, understands why it happens, but says it's hard on members of the disability community.


People with disabilities have often had to be in survival mode and advocacy organizations, so they automatically assume the worst because, unfortunately, that's been the precedent.

So, what people interpret when they hear crisis standards of care, "We're in crisis, healthcare is impacted. This is obviously going to impact the disability community, and we need to be prepared to fight for survival." And it's unfortunate, again, and I see where people are coming from on both sides of this.

But it's that lack of support, and that lack of just government oversight for decades.


Redmond tells us how to calm these fears during a new episode of the Public Health Review podcast, now available everywhere you stream audio.


Finally this morning, partnerships are considered a powerful tool in response to public emergencies like the pandemic or the recent spate of wildfires and strong thunderstorms around the country.

A blog article outlines the goals of a new collaboration between ASTHO, the EPA, and the Environmental Council on States. The work includes listening sessions, new tools, and briefings.

You can read more about the partnership and its products using the link in the show notes.


That'll do it for today's report.


We appreciate having you along each day. We'd also love it if you could tell your public health colleagues about the newscast.

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Be sure to join us again Monday morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.

Katey Redmond MPH CPH

Public Health Specialist, Alaska Department of Health and Social Services

John Wiesman DrPH MPH

Professor of the Practice & Director, Executive Doctoral Program in Health Leadership, University of North Carolina