COM Outlook Summer/Fall 2020

24 | DR. KIRAN C. PATEL COLLEGE OF OSTEOPATHIC MEDICINE A s an epidemiologist with a strong background in finance, I under- stand a lot more than I want to about the COVID-19 situation. I teach epidemiology every semester to undergraduate and graduate students. Our first class in the winter semester began on January 7, where we talked about coronavirus. I had just flown back from Los Angeles, California, where my husband and I travel each week to visit our teenage daughter. I shared with my students that, while I am not a germaphobe, I bought a box of face masks and was extra careful on the plane the following week, because it was abundantly clear to me that there must have been people traveling from the virus’ epicenter to the United States. With no precautions occur- ring in our country at that time, community spread was just a matter of weeks away. I asked my students why we should care about a novel coronavirus that, at the time, seemed to only strike the elderly and had a mortality rate of about 2.6 percent. Many responses were provided, from saving lives to overwhelming our health care system, which are true. However, I was looking for the one response that would explain why I knew the United States wouldn’t act until it was too late. One student called out, “Workers won’t be able to go to work.” This was close enough for me to jump in with a questioning “And?” Finally, I couldn’t restrain myself any longer. “The economy!” I exclaimed. “We have to think about the economy.” I shared that, in my opinion, decisions our federal government will make going forward will likely prioritize the economy—not our health care infrastructure. As the weeks passed, there was no communication about cases in the United States, no Centers for Disease Control and Prevention (CDC) sur- veillance systems in place to monitor cases, and no additional training for our health care workforce. Additionally, there were still no meaningful screenings at airports, which I witnessed first- hand when I continued to fly weekly from Fort Lauderdale, Florida, to Los Angeles. There was no protection for those working in trans- portation and no public health messaging about handwashing. Then, in late February, it became clear we had no capacity for testing beyond the CDC—and, soon after that, beyond the initial 84 public health labs that could process results. As of early April, testing in Broward County was still severely limited, and there was a national backlog on processing tests. How is it possible that we did not use those two-and- a-half months to prepare for the obvious? I feel like I let my community and country down by not being more vocal. As a public health professional who also teaches disaster epidemiology, I was appalled, but understood, why the Trump administration continued to minimize the impact of COVID-19, even as cases rose around the world. Still, I had faith in our scientists and public health professionals, who are government BY NICOLE COOK, PH.D., M.P.A. Decision Dynamics EPIDEMIOLOGIST Nicole Cook