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Podcast: CU Anschutz Experts Share Ups and Downs of Controlling a Pandemic

Therapy breakthroughs, political roadblocks, impending flu season focuses of talk

minute read

by Debra Melani | August 5, 2020
Doctors

Other than halting it in its tracks, if experts on the University of Colorado Anschutz Medical Campus could wave a wand and change something about their battle against the coronavirus pandemic, it might be taking the politics out of the picture.

Guiding state mandates, pondering back-to-school logistics, and prepping for the duo threat of a bad flu season provide enough challenges for the health experts, who have been working tirelessly for nearly five months now to control the spread of COVID-19.

“We need the public to trust those who are doing science and their healthcare providers and public health professionals,” said Jonathan Samet, MD, MS, dean of the Colorado School of Public Health on the CU Anschutz Medical Campus. “Pandemics have generally come with political implications and overlays, but never so prominently as with this one.”

Calling a recent Colorado-wide mask mandate “an important step” in the fight against SARS-CoV-2, Samet and colleagues talked about the many challenges they face, including the politization of masks, and how far science has come during a recent podcast.

Michelle Barron, MD, and Thomas Campbell, MD, two CU School of Medicine infectious disease experts at the forefront of the effort to rein in the virus, joined the discussion.

Listen to what the experts had to say about everything from an uptick in cases, a flattening of death rates, the promise of new treatments, and how everyone needs to jump on board as they navigate the trying course that lies ahead.

 
 

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    Episode Transcript

    [Music]

    Deb Melani Welcome to CU Anschutz 360, a podcast about the CU Anschutz medical campus. We feature faculty, staff, and students, and their interesting and innovative work. I'm Deb Melani, a science writer in the Office of Communications. 

    Today I'm honored to be here with three distinguished guests who graciously agreed to donate their time to a discussion on the status of COVID-19. First, we have Dr. Jonathan Samet, Dean of the Colorado School of Public Health, possibly better known as Colorado's Dr. Fauci. Dean Samet has headed the ship since before COVID became a household word, leading a group of experts in creating models to guide the state through the pandemic.

    Next we have Dr. Michelle Barron - a top infectious disease expert, and professor in our school of medicine. While Dr. Samet steered the ship, Dr. Barron rallied the crew using education and guidance to help providers overcome the fear and the unknowns in order to provide the best care possible on our dual hospital campus.

    Finally, we have Dr. Thomas Campbell - a key leader in the innovative research emerging from this campus in response to the pandemic. A top infectious disease expert, Dr. Campbell was a pioneer in our initial and highly successful HIV therapy research.

    Good morning to all of you. Thank you so much for being here. 

    I'll start with Dean Samet. I have to ask: have you ever consulted with your new namesake - our nation's top health advisor - during the pandemic?

    Jonathan Samet Well, I've been flattered by the analogy. And no, not during this pandemic. I think my path has not crossed with Dr. Fauci for quite some years, but certainly he's had a critical national role.

    Deb Melani From a national health perspective: how concerned are you about government and public criticism being leveled at Dr. Fauci right now?

    Jonathan Samet I think what's going on with Dr. Fauci is unfortunately going on at all levels. We could start right here in Colorado at the local level, where some important public health directors at the local public health agency have left. Of course that goes right up through the states and to the national level. 

    It's unfortunate to see this epidemic politicized. Pandemics have generally come with political implications and overlays, but never so prominently as with this one. I think looking back over the last few weeks, the efforts to discredit Dr. Fauci now seemingly set aside, were unfortunate. We need the public to trust those who are doing science and their healthcare providers and public health professionals.

    Deb Melani Colorado's governor (Jared Polis) issued a statewide mask mandate this month. What led him to finally make that decision? And how important do you see that?

    Jonathan Samet Masks turn out to be an important part of the toolbox for handling the epidemic and mask orders have been left to the local public health agency level, but we're all in this state together. We are connected, we mix, and it's not that one county, Broomfield, can do something different from say, Boulder County next door, and it not make a difference. Having a statewide order was an important step, something that we had not yet used. And he did this at a time where there was concern that we might be facing a true uptick in the epidemic within the state.

    Deb Melani How well do mask mandates work? It appears there's still a lot of people not wearing them.

    Jonathan Samet Unfortunately, masks have been politicized and that never should have happened. Here's a basic public health tool that's become a political symbol and we need to reverse that. There's two things, do masks work? And second, do mask orders get people to wear masks?

    I think on the side of do masks work - it's clear that they deal with the larger infectious particles, the particles that people are calling droplets, what happens when we cough and sneeze. Whether they also work for some of the smaller particles that may be infectious, we're still sorting out. I think mask orders are part of bringing this issue right to the front for the public and should have consequences. Many retailers are now of course, having mask orders, Target, Walmart, Home Depot, the list goes on. I think we need to make masks part of the norm for a while, and I don't know how long a while is, but they need to be part of our lives.

    Michelle Barron I would just add that there is some data that's been published recently, looking at orders that have been implemented in various states where they took a statewide initiative and then looked at the impact that had on their rates. Of course you can't always say direct correlation, but it certainly did seem to improve the overall curves that they were looking at. A lot of that data obviously is still forthcoming, but it's still, I think another sort of way to say, "okay, there is some science behind this as well, and it's not just limited to public opinion or what people view as politicization." There is good science behind this too.

    Deb Melani Great. Because at the beginning there was some question of the message coming out. We weren't so clear how effective masks were. Have we learned anything more about the droplets or the social distancing?

    Jonathan Samet I think we're learning about both. And certainly social distancing, which really encompasses all the things we do, to reduce infectious contacts is essential. In a sense masks figure into that. There's still an awful lot of work going on, on understanding airborne transmission. We're learning more. 

    The question of 'what particles' of 'what size' are infectious is something to sort out, particularly if these smaller particles that will hang around in the air for a longer time are infectious. That will have some implications for control. Science is starting to come together, and I hope we'll have better answers from research over the next couple months.

    Deb Melani The mandate did come in part because of an uptick in cases in the state, how serious is that? And what do you think is leading the surge?

    Jonathan Samet We're at an interesting point right now in Colorado's epidemic, case numbers have been going up, particularly in younger people, 20 to 29 year olds in the lead. Hospitalizations, fortunately, were looking like they were turning up a little bit, but now we seem to be on a plateau, and we're not having many deaths. So it's some sort of turning point. I'm not sure we know which way we're turning. I think there've been a lot of drivers. We've had a holiday season. We've had too many large gatherings. Probably too many young people not doing enough distancing. I think we'll have to see where we're going now, but perhaps my colleagues want to weigh in on this.

    Thomas Campbell I think it is interesting that even though the cases have gone up that, as you mentioned, the hospitalizations may be up a little bit, but pretty flat and deaths are pretty flat. It makes me wonder what the driving factors are. Is it that more people are getting tested and we're detecting milder cases that we weren't detecting before? Is it a different demographic of people who are getting infected or has there been a change in the virus that's altering its ability to cause disease?

    Deb Melani So we just don't know.

    Jonathan Samet and Michelle Baron: (Laughter)

    Thomas Campbell I don't know, perhaps my colleagues know, but I'm raising the question. (Laughs)

    Deb Melani I mean, there was a lot of talk about the increase must be related to an increase in testing. (Crosstalk).

    Michelle Barron I was going to say, but if you look at overall positivity rate, which would sort of account for the increased testing, we're still going up. And so if you look at the percentage of positive tests, our numbers are going up, it's not dramatic, but it's definitely trending upward. That would suggest that while sure people are getting tested more, the positivity rate would be diluted out if that was purely a factor of that. There's still more people infected along with people being tested.

    Thomas Campbell But Michelle, our positivity rate has been fairly flat about four to 5%.

    Michelle Barron Yeah, again, not dramatic.

    Thomas Campbell Compared to 25% early on.

    Michelle Barron Correct. So it's all relative, right? It's all sort of looking back where we were, where we are now. We're definitely not where we were in March when this started. There has been a change. I always say that it's too soon to tell. These age groups that he mentioned that are seeing the uptick in terms of the numbers of positives: Who do they live with?

    Thomas Campbell Right.

    Michelle Barron Have they gone to see people that are older? Are we going to start seeing sort of the shift in those? Because it takes - the average is somewhere between five to 14 days. And so we may not quite be seeing that impact. Maybe we won't. And I really hope we don't.

    Jonathan Samet Case counts are going up in the 40 plus, just not as steeply of course as in the under 40 age range. And as Tom mentioned, there's a lot of factors in play here and we can't tease them out individually one by one. I wish we could, but we can't say, "here's going to too many parties" and "here's bars" and so on. The governor has taken some steps like closing bars June 30th, that are really intended to reduce too much mixing among likely younger people.

    Deb Melani Are the contact tracing procedures in place helping with all this?

    Jonathan Samet Contact tracing is coming into place and it's coming into place at the state and local public health agency level. I think people are being recruited and trained - a number of our students from the School of Public Health have been hired. We have to have case numbers low enough that contact tracing can work, we have to have a large enough workforce, and we have to have the data systems in place to support contact tracing. I think all those things are sort of happening now. Hopefully, we will see contact tracing ramping up. Which is what the state says it's in the process of doing.

    Thomas Campbell I think if anything, the recent uptick here in Colorado just tells us this isn't going away anytime soon. And it's going to be with us for quite a while longer and we have to be prepared for that. These issues, contact tracing, are important. I worry what's going to happen when the weather changes. Right now it's a very nice time in Colorado. People have their windows open and are eating outside and so forth. But come November when the weather turns cold and the nights grow long, it may be quite different.

    Deb Melani What are the predictions for the fall - as far as hospitals? (crosstalk).

    Thomas Campbell That's Jon's...(laughs)

    Michelle Barron (Laughs) Yeah. We're going to put it on him.

    Jonathan Samet (Laughs) Thanks. One of the key markers that we don't want to reach is not having enough ICU beds. As we track and project out where the epidemic could go we keep a close eye on that number. Right now the state says roughly we have 1800 bed capacity for COVID-19 patients alone. We haven't come close to that. There's some surge capability. 

    I think there are other things also for the fall. One scary possibility is that we have a serious influenza epidemic and that leads to hospitalizations and need for critical care potentially. Flu varies from year to year in how virulent it is, and the vaccine varies from year to year in how well it works. Again, I'll turn to my colleagues for this, but a bad flu and a bad vaccine would not be a good overlay on the COVID-19 epidemic.

    Michelle Barron That's certainly the things that we've been preparing for in terms of trying to take that out of the equation, that even if the flu vaccine isn't perfect, even if we knocked half the cases of flu down in this state - that would be half the cases that then maybe wouldn't get hospitalized or have severe enough complications that would need an ICU bed. Certainly still on that same spectrum, my triple threat of nightmares is - COVID, flu, and then a measles outbreak or some vaccine preventable disease, because there's so many children right now that have probably missed some of their standard visits that normally would have happened.

    And if you look at some of the data across the nation, vaccine rates amongst children is down significantly just because they missed those visits in the timeframe in which everybody was staying home. Schools are being delayed potentially in terms of opening so some of those requirements are also sort of missed. It just takes one and Colorado could be ripe for something like that as well. That's, again, in our thought processes - we've tried to think about all these things to try and see how can we mitigate that sooner. Rather than watching it happen and try to deal with the consequences?

    Thomas Campbell Yeah, I think another way that there could be very bad synergy between a bad flu season and COVID is that the symptoms are much the same: fever, cough, chills, muscle aches. And so if there's a lot of flu or other respiratory viruses being transmitted, then more people are going to want testing. And rightly so, because they have symptoms. 

    We can't distinguish these infections just on clinical grounds, we have to rely on testing and even right now in the summer when our levels of other respiratory virus infections are fairly low, we are seeing a big strain on our capacity to provide the testing that's needed. And so if we go up from where we are now in terms of the numbers of tests that are being run, that will just add additional strain on our capacity to test.

    Deb Melani If you're on the fence ever about getting the flu shot, this year would be a good year to get it.

    Michelle Barron I think we would all agree on that. (Crosstalk, laughter) More so than ever, yes.

    Thomas Campbell For sure.

    Deb Melani Let's ask Dr. Barron about some of the hotspot states right now, some of them still don't have mask mandates, including at the time of this interview, Arizona and Florida. Other hotspots include California and your home state of Texas. What's going on in these hot spots with these notable surges?

    Michelle Barron I think it's a lot of what sort of drove some of the cases here in Colorado, obviously at a different magnitude in terms of people having mass gatherings. We've all seen the pictures of people crowded on beaches and people at bars packed in. I think the lack of mask mandates probably is just sort of a symptom of all the other things people are just not necessarily adhering to in terms of restrictions. Certainly in those states too, in addition to no masks, they also don't have all the other restrictions of closing bars or limiting to outdoor dining and physical distancing. 

    I think it was just the perfect storms and then population density. The other thing we were talking about, it's hot in those places, (laughs) on top of that, they don't have the ability to be outdoors and have the air exchanges. They're all cramped in air conditioned buildings with likely poor, not necessarily poor, but inadequate enough to be able to filter out all the virus that's in the building.

    Deb Melani How do we compare here in Colorado as far as following these mandates and keeping our numbers down?

    Jonathan Samet How compliant are we? I think as we talk about our models and we put different measures into them, we're in part taking guesses at how well we think we're doing. We have a little bit of mask data from about a month ago. One of our colleagues at the School of Public Health had some survey data from about 500 people and estimated about 70% were wearing masks when they were inside public places. The governor would like to see that at 90%.

    I think what we really lack is the detailed data we need, because I'm sure that people in the older age ranges or those who have underlying conditions that would make them susceptible are probably being careful. I suspect the data would tell us that those who are in younger age ranges aren't. So what we really need is good data by age to understand what's going on and who we need to target to sort of get in line with what they need to do to protect all. It's true that if somebody 20 (years old) gets infected, they're far less likely to be symptomatic, they're far less likely to be seriously ill or to die. But they infect others who are at risk. I think, we don't have the data, maybe one message out of this is everybody has to do their part.

    Deb Melani Do you think that testing asymptomatic people is something we should do that could help?

    Thomas Campbell Michelle will weigh in I'm sure. But my opinion is that testing does not perform as well as needed in asymptomatic people to be of great use.

    Michelle Barron I think there could be potential value in certain instances. If you're in a nursing home and there's an outbreak, that is of tremendous value to know if there's anybody else there that needs to be out of that environment so that they don't inadvertently pass it on. But I think there are some pitfalls to that. I think it gives some people false assurance and it sort of reminds me in the HIV era when people would go get tested and say, "Woo hoo! I don't have HIV. Now I don't have to follow my normal precautions because I don't have HIV right now."

    I feel like some people and I won't name names, but I know individuals who have gotten tested and said, "Okay, now I can go to this party." Even though I've counseled and said, "This is just this instant and this test is not that great in people that are asymptomatic and so you could be positive. And if you go to this environment, you still need to follow the same precautions. It's not license to just do what you want."

    Deb Melani That brings me to a question about the 'can we get it again' debate? Can you address that at all, Dr. Campbell?

    Thomas Campbell I can give an opinion, which is, we don't know. The simple reason we don't know is the virus hasn't been with us that long. It's only been in most of the U.S. since March, so roughly four months. We haven't gone far enough out from the time when people got infected to really know if they can get it again. I think most of the reports that I've seen of potential re-infections are really just persistent shedding of a viral nucleic acid, particularly in some individuals that can persist for weeks or even months after the initial infection. 

    That doesn't, in of itself, mean that they've been reinfected. I think in order to really know the answer to that, we need to go further in time from when the epidemic hit the United States to know if people who were infected initially and then truly recovered are getting infected again. And if so, to what extent is that happening? And is their illness any different if they get a second infection? From what we know from other coronaviruses, it's entirely possible that re-infections can occur at years past the first infection.

    Deb Melani Bummer (laughs).

    Michelle Barron: (Laughter)

    Deb Melani All right, Dr. Barron, you touched on the hot weather, keeping people inside on one of the last questions. There was hope early in the pandemic that warm and wet weather would help curb the spread, but that doesn't seem to have been the case.

    Michelle Barron (Laughs) I honestly am not sure where that ever sort of came out of. I think there was sort of an idea of some seasonality that flu comes in the winter months and maybe this. But there are respiratory viruses that circulate year round. Sort of ironically, if you think about where the pandemic started, those are not necessarily cool climates like the Philippines parts of Southeast Asia, which these have high temperatures, and yet it spread like wildfire. I think there was maybe some crazy optimism, but I don't know that there was ever any science behind that prediction.

    Deb Melani What are your concerns, if any, about the addition of baseball, and back to school, on top of the flu season?

    Michelle Barron (Laughs) Who wants to start?

    Jonathan Samet I'll say a few things. I think the answer is easy, there are many concerns 

    (Multiple people laugh). 

    Jonathan Samet And there are such different sorts of mixing and implications. I will say, I've been writing a weekly column about this, and I took on schools in this week's and read a lot - read the CDC guidance, what the American Academy of Pediatrics is saying. 

    Part of the problem here is that - school reopening is an experiment on a grand scale. Because we really lack the data that we need to know about likelihood of transmission within schools, from children infected within schools, to adults working in schools, and what the kids are going to bring back to their families and the broader implications. The easy answer to so many of the questions you've posed is what we don't know and we need more data. Fair enough. That's true here. What I'm concerned about is we have to learn quickly, while we're opening the schools about what is going to work.

    About a week ago, I did a panel for the chamber of commerce and I was on with the superintendents for Denver and Aurora. The things they were talking about just wouldn't occur to me: how many children can you put on a school bus? A school bus designed for 77 - the answer: 24. How do you get all the kids to school? I mean, the complexities of this are huge. If you look at what CDC says in their new guidelines - fine there's general principles there. But boy, there's not the protocols that you're really going to need to run schools. 

    We need those and then we need to figure out if they're working. I mean, baseball's already failed, hasn't it? I think we have 17 Marlins who are infected in today's so-called sports section. We'll have to see. And of course, the NBA shut down during a game in March, there goes another experiment. I think we're going to have to learn.

    Michelle Barron Yeah, I agree completely. We're learning on the fly. I think the only way for us to know if all our testing protocols or our mandates is to see, well, that didn't work. So you pivot and start on some other avenue. Certainly if you look at some of the initial recommendations that I was even making for the hospital initially, they evolved, sometimes daily, they evolved based on the information. I think that sometimes causes the public to feel like we don't know what we're doing. We have to make the decisions based on what evidence we have on any given day. 

    Fascinating with this is how quickly the information does change. We take that into account, we make those new decisions, but I think everybody wants to anchor on something just because it's so chaotic. It's like being in a terrible storm, you want to anchor and be safe. I don't know that we're going to be at that place for a very long time.

    Deb Melani It's obvious that frustration with isolation and mandates is growing in some circles. Can you explain somehow for the public, Dr. Campbell, what the end goal is here, or how are we going to conquer this virus? And what role do we as citizens need to play to help?

    Thomas Campbell I perhaps wouldn't choose the word 'conquer' the virus. I think 'control' the virus would be my hope. I think to control the virus, we need more tools in our toolbox. Dr. Samet already mentioned masks being a tool that we have. I think we need to use the tools that we have more effectively, and more uniformly, across not just Colorado, but across the entire country. And then we need to work to get more tools and better tools. Certainly, vaccination is one tool that we don't have, which is very successful in controlling other viral epidemics. And if we have a safe and effective vaccine, it could be a very valuable tool in controlling this pandemic.

    Deb Melani What are your thoughts about the Moderna trial in particular. Which is being conducted with volunteers around the U.S., including here at CU Anschutz, correct?

    Thomas Campbell That's correct. The Moderna vaccine trial just started this past week on Monday (July 27, 2020), so three days ago. It is not yet open here in Colorado, but we're working on getting it open as soon as we can. The Moderna trial is the first large scale, what we call phase three, study in the United States of a COVID vaccination. So it's the first, and it's not going to be the last, there will be many more that come after this. 

    There are over a hundred candidate COVID vaccines that are in various stages in the developmental pipeline. And we'll see other phase three trials coming on board throughout the rest of the summer, into the fall, and even into the winter and beyond. The Moderna trial is a very important experiment to see if a vaccine can provide protection against a COVID-19 illness.

    Deb Melani As far as the end goal goes, do we believe that we can get herd immunity with SARS-CoV-2? And is that part of the reason for the vaccine?

    Thomas Campbell If the vaccine is effective, then it could contribute to developing so-called herd immunity. I guess there's two ways to get herd immunity. One is sort for the virus to spread across the population to a large enough extent that there's enough protection within the general population. John can correct me, but I think the general rule of thumb is that it needs to be about 60% or more of the population. I've seen some modeling studies that have suggested that even 45% might have an effect. 

    That's a lot of people getting infected and it's a lot of people dying from infection given a 5% mortality rate, if 60% of the U.S. population had to get infected to have heard immunity, then a lot of people will have lost their lives to COVID.

    A vaccine is a way to potentially induce immunity without the risk of contracting a fatal illness. That is why a vaccine would be very important, and it would be important to be able to implement it and disseminate its use across the population.

    Jonathan Samet Just one further comment - if the percentage that has to be protected is 60 to 70%, right now about 5% of Coloradans have perhaps had the infection. That leaves most of us still susceptible. And if we're going to get to herd immunity by enough people getting infected safely, that's a long time out. Then I think the vaccine is the hope to get to herd immunity, realistically.

    Yeah. The other important thing about herd immunity, if we got there to 60%, we have to stay there. As we were talking about before, we don't know how long either recovering from natural infection or a vaccine will be protective. And if protection wanes over time then it's not just getting a vaccine once, but potentially even like a flu vaccine - getting it fairly frequently in order to keep that level of immunity in the population.

    Deb Melani Apparently Dr. Fauci believes that we can have an effective vaccine by November and Moderna says it can provide up to 500 million doses a year. What do you think about those assertions?

    Thomas Campbell (Laughs with Michelle Baron) I'm not going to second guess Dr. Fauci. I think that would be the best case scenario, if the Moderna vaccine out of the gate is a home run. So if our first batter at the plate puts it over the fence, then that's great. 

    One of the advantages of the technology that Moderna is using for their vaccination approach is that it is very rapidly scalable, so if they say they can have that many doses, I wouldn't argue with them. It's much more scalable than other vaccine approaches, but scalability is only important if it works. We need to find out if it's safe and if it works.

    Deb Melani You were talking about we need more tools and you were highly involved in the HIV antiviral therapies. Can you touch on - are we seeing any progress in that area for COVID?

    Thomas Campbell We've made a lot of progress in COVID treatment in a fairly short period of time, and we've made progress in determining what doesn't work, as well as what works. We have two treatments that have good evidence to support that they work. One targets the virus directly. It's an antiviral called remdesivir, and it's being widely used now. The second is an approach that targets the body's inflammatory response against the virus that drives the respiratory failure that occurs in advanced COVID, and that's a medicine called dexamethasone, which is a type of a corticosteroid, a very potent anti inflammatory medicine. When given to people with COVID, it improves outcomes and decreases time to improvement as well as decreases mortality. We have both an antiviral approach and an anti-inflammatory approach that work very well.

    Early on, hydroxychloroquine, sometimes given with an antibiotic called azithromycin, were potential COVID treatments, but we've learned from several very good studies that that approach does not work. We do not use hydroxychloroquine anymore, and there are other approaches that are being evaluated.

    One promising approach is monoclonal antibodies that target the virus spike protein and prevent the virus from infecting cells. This approach with monoclonal antibodies is actually important for two reasons. One, is it could be a good antiviral therapeutic being used to treat people with COVID-19, but it can also potentially serve as a type of prophylaxis against COVID-19 in people who are exposed to it.

    An approach, in what we would call passive immunization, people who are exposed to COVID-19, could be given an antibody preparation to protect them from getting infected. That could be particularly important in nursing home outbreaks, in first responders, emergency room workers. And if it works for that purpose, it would also provide some proof of principle that antibodies themselves are protective against COVID, which is what the vaccine strategy is trying to elicit. It might provide some early encouraging information about whether or not a vaccine is possible.

    Deb Melani That's exciting. What do you say to people who believe that the pandemic is being overblown and that we should just let it happen?

    Michelle Barron (Laughs) I would say that if they have anyone that they love or care about that they wouldn't just let them walk in front of a freight train without sort of trying to keep them from getting hit. It's sort of that effect that we're having right now is that there's this huge amount of people being affected by this. To dismiss and say, "Ah, whatever," really is to say that you don't care about humanity as a whole, especially when it becomes personal. I think everybody at some point will know somebody who's had COVID and had an outcome that was unfavorable and could have been potentially prevented.

    Thomas Campbell I think that we should care about others and to say that we just want to let the epidemic run its course is not in line with caring for others. COVID affects certain parts of our population disproportionally and people who are more vulnerable to COVID, the elderly, people in certain occupations, people with certain medical conditions. To say that those lives don't matter, I think is very selfish and sort of gets to the reason that we wear masks. We wear a mask to protect others, not necessarily just to protect ourselves and to say that you don't want to wear a mask or to say that you don't care what happens to others is a very selfish approach.

    Jonathan Samet My colleagues have said almost all. I might whisper Sweden. And Sweden of course undertook the experiment of sort of letting the epidemic run its course and not so vigorously pursuing lock downs and other measures. For a while, their approach was thought to perhaps be something special and working, but that proved not to be the case. I think the other piece to take out of this is for those skeptics, we need to worry about them because when we have vaccines, we need people to take the vaccines and we can already anticipate so called vaccine hesitancy or whatever is a problem.

    Part of what may drive some not to take vaccine, beyond concerns about risks and other reasons, people won't have vaccines themselves or for their children is disbelief in science. I think we just have to come back and reinforce all over again that we do know a lot. In fact, considering how many months we are into this pandemic, we know a huge amount about the virus and it only reinforces what Michelle and Tom said, this is a killer and it's killed. It just has to come to an end.

    Deb Melani I want to thank you all for being here and we definitely appreciate all you do every day. Thanks so much.

    Jonathan Samet Thank you.

    Michelle Barron Thank you.

    Thomas Campbell You're very welcome, thank you for having us.

    [Music - Acknowledgments and Credits]

    CU Anschutz 360 is produced by the University of Colorado Anschutz Medical Campus. Story editing and production by Deb Melani and Chris Casey. Mix and tech production by Kelsey Pieters and Matt Hastings. Digital design by Sarah Adams and Jenny Merchant. Thanks to the rest of the Office of Communications team for support and edits. 

    We'd also like to thank our guests this week. Dean Samet, Dr. Barron and Dr. Campbell for their insight, expertise and leadership. You can read more on the University's research in response to the COVID-19 pandemic - and the other latest stories and breakthroughs on our campus - at news.cuanschutz.edu. 

    This is CU Anschutz 360.

    Disclaimer: Transcripts are generated using a combination of speech recognition software and human transcribers. It may contain minor differences from the audio, including some edits for clarity in print. Please check the recording and with the Communications team before quoting.