Public Health On Call

A potentially landmark battle is in play over abortion rights, and it's headed to the U.S. Supreme Court on December 1. In a special episode of the podcast, guest hosts Annalies Winny and Alissa Zhu explore the real life public health impacts of abortion policy on parents and families and how the upcoming Supreme Court case Dobbs v. Jackson Women's Health Organization could have major stakes for the future of abortion rights in the U.S. Read more about the public health case for abortion rights here.

Throughout the COVID-19 pandemic, Principal Matt Hornbeck of the award-winning Baltimore City public school Hampstead Hill Academy has been on the podcast to talk about how the school community coped with closures, virtual and hybrid learning, scheduling changes, learning losses and more. Today for a very special episode, Principal Hornbeck invites Dr. Josh Sharfstein to visit the school in person and see how things are going. Note: This episode was recorded before vaccines were authorized for children 5-11 years old. Special thanks to Hannah Bennett and Caroline Wang for co-producing this episode.

SARS-CoV-2, like other zoonotic diseases, originated in animals before "spilling over" into humans. Dr. Raina Plowright of Montana State University studies these events and the complex series of things that have to happen for them to take place. Dr. Plowright talks with Dr. Josh Sharfstein about how these occur, why these events are relatively rare, and what's important to understand about them so we can learn how to prevent them from happening.

Today's episode is a collaboration with one of Baltimore's top podcasts, No Pix After Dark, and host Aaron Dante. No Pix After Dark is a culture and community-based podcast sharing real people's stories, and has been the Baltimore Sun's Best Podcast for the last two years. For this episode, Aaron's listeners submitted questions about COVID-19 and Dr. Josh Sharfstein talks through some answers. They also discuss Baltimore's unique response to the pandemic and how to think about safe gatherings during the holidays. Check out Aaron's podcast at nopixafterdark.com.

Throughout the pandemic, public health officials have been threatened, assaulted, fired, or forced to resign. Lindsay Smith Rogers speaks with Dr. Beth Resnick, senior scientist at Johns Hopkins and the cofounder of the STOP! Partner Group, and Dr. Nilesh Kalyanaraman, Health Officer of Anne Arundel County in Maryland, about the treatment of some officials and their teams, how some states have passed laws restricting public health authority, and why it's critical to address these issues now before the next public health crisis. Learn more about STOP! at standwithpublichealth.jhsph.edu.

Most adults consume 50% more than the daily recommended amount of salt which, in excess, contributes to hypertension, cardiovascular disease, cognitive decline, sexual dysfunction, pregnancy complications and more. Dr. Susan Mayne, Director of the Center for Food Safety and Applied Nutrition at the FDA, talks with Stephanie Desmon about a change in guidelines for sodium intake and how even a modest reduction by food producers can mean huge impacts for public health.

Thanks to widespread testing, vaccinations, and adherence to masking and social distancing, Denmark was able to lift most COVID restrictions in late summer. Now, with a recent uptick in cases the country considers next steps. In a bonus episode, Dr. Gunhild Waldemar, a health care advocate for the elderly in Denmark, talks with Stephanie Desmon about the country's successes, what's behind some of the regional variations in vaccinations, and lessons learned about elder care from the early days of the pandemic.

Admiral Rachel Levine, MD, is the Assistant Secretary for Health in the Department of Health and Human Services—the "connective tissue" of all the divisions of HHS including the FDA and CDC—and a four-star admiral for the Public Health Service Commissioned Corps. As assistant secretary, Dr. Levine focuses on coordinating the HHS response to priorities like COVID-19, health equity, mental health and substance abuse, and climate change. Dr. Levine is also the first transgender official to serve in this capacity.

From the first Taliban government exit in 2001 to 2015, Afghanistan went from having some of the worst indicators for health in the world to dramatic improvements in maternal mortality and childhood malnutrition. But when the Taliban stepped back into power in August of this year, thousands of health clinics were shuttered almost overnight and outcomes for women and children already look much worse. Afghanistan-born Dr. Nadia Akseer, a Johns Hopkins scientist in International Health, talks with Stephanie Desmon about the country's post-Taliban health system, and why the international community will need to wait and see what might happen under this "new Taliban" coming to power 20 years later.

Back in February, Jim Golen, a nurse in Minnesota, was on the podcast talking about his agonizing experiences as a COVID-19 long-hauler. Today, Stephanie Desmon checks in with Jim to see how he's doing nearly 19 months after contracting COVID in March 2020. If you or someone you know if suffering from long COVID, please consider taking a short survey as part of the Johns Hopkins COVID Long Study: https://covid-long.com/

Dr. Preeti Malani, the University of Michigan's Chief Health Officer, was a guest on the podcast back in the spring of 2020 and again in the fall of that year talking about how COVID-19 had affected Michigan's oldest university. Dr. Malani returns to talk with Dr. Josh Sharfstein about how vaccines have made a stark difference for a return to campus this fall, what life looks like on the North Quad and in the residence halls, and how the school is centering the well-being of students who have had to miss out on so much the last two years.

If a vaccinated person is exposed to COVID but doesn't get sick, does that affect that person's immunity? Is weekly testing for unvaccinated coworkers really sufficient to protect everyone? Are any new variants keeping you up at night? Should people switch vaccines for their booster doses? Amesh Adalja of the Johns Hopkins Center for Health Security and Josh Sharfstein address COVID-19 questions submitted to [email protected].

Children miss out on opportunities when they're not in school, and chronic absenteeism can actually affect their health and well-being throughout their lives. Guest host Andrea McDaniels, the Director of Communications for the Bloomberg American Health Initiative, talks with two leaders at Children's National Hospital who are part of an innovative program to share absenteeism data with pediatricians: Dr. Danielle Dooley, a pediatrician and Medical Director of Community Affairs, and Tonya Vidal Kinlow, Vice President of Community Engagement, Advocacy, and Government Affairs. The Chronic Absenteeism Reduction Effort (CARE) is a high-impact project of the Bloomberg American Health Initiative.

A few months ago, the state of Idaho declared Crisis Standards of Care when COVID cases peaked and hospitals were full. Dr. David Pate, a member of the governor's Coronavirus Working Group, talks with Stephanie Desmon about the difficult decisions health care workers have to make during Crisis Standards of Care, how this is and isn't the same as rationing care, why vaccination status shouldn't come into play for those decisions, and what has contributed to Idaho being the state with the lowest vaccination rates in the U.S.

After months of scrutinizing data from clinical trials, the FDA granted Emergency Use Authorization of Pfizer's COVID-19 vaccine for children 5-11. Many parents and guardians are eager for their child to be first in line but what do those who might feel hesitant need to know? Dr. Gigi Gronvall, parent and immunologist at the Center for Health Security, returns to the podcast to talk with Stephanie Desmon about the importance of vaccinating kids, why it's not worth it to wait for the "adult" dose for kids who are 11, and why authorization took longer for children than for adults.

Fear of COVID exposure and overflowing hospital units are two of the known stressors contributing to burnout among nurses and doctors. But there are a slew of other factors exacerbating health care workers' distress—many of which don't just affect clinical staff. Researchers Dr. Johannes Thrul and Dr. Svea Closser talk with Stephanie Desmon about a recent report from the Center For Health Security looking at the pandemic burnout and anxiety on people often left out of the "Health Care Heroes" narratives—and lower on the payscale—such as security staff, cleaners, and food workers in hospitals.

Happy Halloween! Today, epidemiologist Dr. Emily Gurley talks with Dr. Josh Sharfstein about bats and why they are so critical for public health. They also discuss theories of why bats tend to harbor viruses capable of infecting humans, how we can coexist with bats, why some people consider bats cute, and what it's like to actually work with bats.

Where are we now on combating mis- and disinformation about COVID and vaccines that has run rampant online since the early days of the pandemic? Clint Watts and Rachel Chernaskey of Miburo, a digital consulting company that focuses on misinformation and extremism, talk with Dr. Josh Sharfstein about the current ecosystem of persisting misinformation, where we are in terms of combating purveyors, and what can be done on the individual, local, and societal level to drown out harmful noise.

Across the US, 84% of residents in nursing homes and long-term care facilities are vaccinated for COVID-19, but only 64% of staff. Federal mandates could help but it's unclear when or how those would be enforced and, in the meantime, the industry is already suffering from a severe staffing shortage. Dr. David Grabowski, a health policy researcher and professor at Harvard, talks with Dr. Josh Sharfstein about this largely underpaid and overworked group of people, how vaccine mandates could play out, and what can be done to prevent a staffing and care crisis.

At this point in the pandemic, what do we need to know about masks? Dr. Amesh Adalja from the Center for Health Security talks with Stephanie Desmon about a new report, "Masks and Respirators for the 21st Century: Policy Changes Needed to Save Lives and Prevent Societal Disruption." They talk about which masks are best for day-to-day use and why innovation is necessary to develop masks that are comfortable and wearable. They also talk about HOW to overcome supply chain issues and why it's critical to start solving these problems now before the next infectious disease outbreak. Read the report here: https://www.centerforhealthsecurity.org/our-work/publications/masks-and-respirators-for-the-21st-century

On a special episode, Tradeoffs host Dan Gorenstein talks about how the pandemic has affected the public health workforce: More than 300 officials quit, were fired, or retired while, at the same time, applications to public health programs jumped 40%. Gorenstein introduces a conversation between Jen Miller, who left her job with the Montana Department of Public Health after constant harassment and conflict, and Nicole Snyder, a first-year master's student at UNC Chapel who was called to public health after seeing impacts of the pandemic—two individual examples of a nationwide trend in public health. Learn more here: https://tradeoffs.org/

There was virtually no flu in the U.S. last year thanks to a confluence of factors including COVID-related mask wearing and social distancing. But, now that more and more of life is "back to normal," what can we expect to see this year? Virologist Dr. Andy Pekosz returns to the podcast to talk with Stephanie Desmon about why a resurgence of flu could complicate the COVID pandemic, how virologists can make predictions about flu when there was so little virus circulating last year, and why it's more important than ever to get your flu shot.

School closures and unprecedented screen time may be contributing to vision problems for kids. Pediatric ophthalmologist Dr. Megan Collins talks with Dr. Josh Sharfstein about a rise in near-sightedness in children, why vision problems are often missed without school screenings, potential health and learning effects, and how vision problems in kids can be addressed on the individual and national levels.

In this episode, Dr. Josh Sharfstein talks with researchers who break down two papers in the news. Dr. Nikolas Wada talks about a study led by researchers in Bangladesh and the U.S. which tested whether masks really help to reduce the spread of COVID-19. Dr. Kate Grabowski discusses a Lancet paper from the U.K. about "test to stay" programs in schools and whether the use of rapid tests is better than quarantining when a child tests positive. These researchers are part of the Hopkins novel coronavirus research consortium, with many summaries of new studies available at http://ncrc.jhsph.edu.

This week, Merck applied for FDA Emergency Use Authorization for its COVID-19 oral antiviral drug, molnupiravir. Dr. Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, talks with Stephanie Desmon about how the drug works to help people recover from COVID-19 quicker and the drug's history starting a decade ago as an experimental treatment for Ebola. Dieffenbach talks about how the drug could complement pandemic response and why it's not a substitute for vaccination. *Note: This podcast was recorded on October 6.

Dr. Jay Varma, physician and advisor for New York Mayor Bill DeBlasio on the pandemic response authored an Atlantic called "Not Every Question Has a Scientific Answer." In the article, Varma talks about the critical role of politicians in determining difficult COVID-19 policy questions. In this special bonus episode, Dr. Josh Sharfstein talks with Varma about the intersection of public values, politics, and science in responding to COVID-19.

Monday, October 11 is Indigenous Peoples' Day in the U.S.—a day previously recognized as Columbus Day that is now reserved for reflection, education, and untangling the false narrative of discovery. Dr. Sophie Neuner of the Center for American Indian Health and co-host of a new podcast, Indigenae, talks with Dr. Josh Sharfstein about how non-Indigenous people can think about this observance and how Indigenous people are leading on health practices and environmental revitalization. Learn more about Indigenae: https://caih.jhu.edu/programs/indigenae-podcast. Find your area on the Native Land map: native-land.ca

During the pandemic, many found solace outdoors on hikes and in city parks. Dr. Mamie Parker, ecologist, activist, and the first Black Head of Fisheries for the U.S. Fish and Wildlife Service talks with Josh Sharfstein about how getting back in touch with nature offers an opportunity to see just how connected we are to the earth, how much we depend on a healthy environment for our own physical and mental well-being, and how critical it is for us to take action on conservation.

As a zoonotic disease, COVID-19 can infect animals. Some, like farmed mink, are more susceptible to disease while others, like white-tailed deer, may only be carriers. But there's always the chance that a new variant of COVID could impact more animals, potentially endangering wild and captive creatures. Veterinarian Dr. Meghan Davis returns to the podcast to talk with Stephanie Desmon about what we now know about the risks for our pet dogs and cats as well as protected species like wild gorillas, and why some zoos are using an experimental vaccine for their animals.

How does a health department cope with a pandemic surge that coincides with one of the largest hurricanes to make landfall in 150 years? State health commissioner Dr. Joseph Kanter talks with Dr. Josh Sharfstein about the challenges of dual emergencies, how the pandemic and storm responses impacted one another, and how the health department is coping nearly 19 months into the pandemic.

Where are we with our mental health these days given that we're past the initial panic of the COVID-19 pandemic and into a more long-term fallout phase? Clinical psychologist Dr. Laura Murray returns to the podcast to talk with Stephanie Desmon about COVID as a collective trauma; overlap with other "high impact events" like Afghanistan, hurricanes, refugee crises, and more; what's contributing to fractures in society; and how to pad our "mental bank account" to better manage ongoing stress and trauma.

Dr. Shaun Truelove, an infectious disease epidemiologist, talks with Dr. Josh Sharfstein about the COVID-19 Scenario Modeling Hub's models for the next six months into early 2022. Researchers projected what could happen under four scenarios of vaccination rates, including authorizing vaccines for children, and the possibility for new variants. Spoiler alert: It's not all bad news. Learn more: https://covid19scenariomodelinghub.org/

What, exactly, is a booster shot? For which groups has the FDA authorized Pfizer boosters? What about boosters for Moderna and J&J? Will we need a fourth shot in the future? Will there be a delta-specific booster? Would it make a difference in world vaccine supply if the US refrained from giving any boosters? Stephanie Desmon interviews cohost Dr. Josh Sharfstein about these and more COVID-19 booster questions.

Last spring, India experienced a catastrophic wave of COVID-19 infections with more than 100,000 cases per day, exceeding hospital capacity in some areas and leading to oxygen shortages. What has happened since? From their homes in India, infectious disease researchers Dr. Vidya Mave and Dr. Brian Wahl talk with Dr. Josh Sharfstein about the state of the pandemic and the return to daily life.

With the rollout of vaccines earlier this year, the concept of "herd immunity"—the idea that enough people would become immune to COVID-19 that we could more or less "return to normal"—seemed plausible. But a number of factors are complicating the US's fight against the pandemic and we're still seeing thousands of people dying every day. Epidemiologists Amber D'Souza and David Dowdy return to the podcast to talk with Stephanie Desmon about vaccinations and the delta variant, what the future might look like and why we may need to accept that COVID-19 is here to stay.

Where are we with testing technology? Why is the demand for testing surging and are there enough tests? When is the best time to use at-home testing given the cost? What's the difference between PCR and rapid antigen tests and how accurate are they in different circumstances? Dr. Gigi Gronvall gives an update on testing and answers questions with Stephanie Desmon. Note: Dr. Gronvall references the Center For Health Security's Testing Toolkit resource, which you can find here https://www.centerforhealthsecurity.org/covid-19TestingToolkit/.

Mississippi is leading the nation in the rate of COVID deaths. Dr. Thomas Dobbs, the state's health commissioner, talks with Dr. Josh Sharfstein about the state's pandemic crisis, including its impact on pregnant women, the role of misinformation, and the impact on the health care system.

How can we help the planet by rethinking our diets? In a new book, Can Fixing Dinner Fix the Planet?, Dr. Jessica Fanzo, a Bloomberg Distinguished Professor of Global Food Policy and Ethics points out how our food options are often unhealthy for human bodies—and for the planet. Dr. Fanzo talks with Dr. Josh Sharfstein about making changes at both policy and individual levels, from the responsible use of genetically modified organisms to redesigning "choice architecture" in grocery stores and restaurants.

There is a long history of protecting health care workers during conflict, beginning with an 1859 battle in Italy that gave rise to the first Geneva Convention. But there's never been a "golden age of compliance" and health care workers continue to face considerable risk while trying to reduce human suffering in war zones. Len Rubenstein, a public health and human rights lawyer and faculty at the Johns Hopkins Berman Institute for Bioethics, talks with Dr. Josh Sharfstein about his new book that examines the history of health care in armed conflict, how the Conventions have evolved, and where things are today with notable conflicts erupting around the world.

For a year and a half, Johns Hopkins infectious disease doctor Kelly Gebo has been working with people who have been diagnosed with COVID-19. Gebo and a team of medical professionals triage COVID outpatients in a "pod" outside of the hospital where people diagnosed with COVID can come for convalescent plasma and care. Gebo talks about seeing patients in sleet and extreme heat, the parallels of her work with HIV patients in the 1990s, and how while many patients are appreciative, some are angry or frustrated and may have been exposed to misinformation that makes care more difficult.

There are over 50 million Americans who are eligible to vote but are not registered. VoteEr is an organization at the intersection of health and voting, providing kits for health care offices and ERs that help patients check their registration status or easily register via a text message code while waiting to be seen. Dr. Alister Martin, VoteER's founder and executive director, talks with Dr. Josh Sharfstein about the program and why reaching people in health care settings can make a difference.

In recognition of the 20th anniversary of the 9-11 terrorist attacks and the Anthrax events in the weeks that followed, Dr. Josh Sharfstein talks with Dr. Tom Inglesby of the Center for Health Security about the transformational impacts these events had on public health. They discuss what the attacks revealed about the US's vulnerabilities, how an influx of funding helped establish better public health preparedness, and the impacts these may have had on the US's response to COVID-19—for better or worse.

Stephanie Desmon talks to Dr. Stephen Patrick, a pediatrician at Vanderbilt University Medical Center in Tennessee, about why the focus of COVID-19 right now needs to be kids, who have suffered mightily since the pandemic began and who are now filling up children's hospitals as many are sickened by the Delta variant. They discuss how politicians and religious leaders need to step up to protect children instead of downplaying the risks.

This year, National Suicide Prevention Week coincides with the 20th anniversary of 9-11. Amelia Noor-Oshiro, a Hopkins PhD candidate, is conducting research at the intersection of suicide prevention and Muslim Americans' experiences with trauma, violence, and oppression. Stephanie Desmon talks with Noor-Oshiro about the importance of studying this underrepresented population, unique risk factors for Muslim Americans in terms of suicide, and Noor-Oshiro's own experience as a survivor of a suicide attempt.

Bloomberg Assistant Professor of American Health Tiara Willie studies the HIV epidemic among Black women in the American South, particularly among those in abusive relationships. In conversation with Dr. Josh Sharfstein, Dr. Willie discusses how to make HIV prevention a standard of care to help women by improving and expanding access to trauma-informed services.

What is a microbiome? Are they helpful or are they harmful? Do they cause disease or can they cure disease? And what does diet soda have to do with them? In this episode, Dr. Joshua Sharfstein speaks to Dr. Jotham Suez from the W. Harry Feinstone Department of Molecular Microbiology and Immunology about the trillions of microorganisms that live inside us and all over our skin.

Research shows that conservatives are significantly less likely to get a COVID vaccine than liberals. Timothy Callaghan of Texas A&M's school of public health tells Stephanie Desmon about the impact this has right now, given the Delta variant, and the implications for the future in a country where politics and science are at odds in many circles. What are the best strategies to decouple partisanship from sound science and why is it so crucial to our health?

This week, Stephanie Desmon and Josh Sharfstein are teaming up to talk to experts about COVID-19 vaccine mandates. Today, they look through the ethical lens with Nancy Kass, a leading ethicist at Johns Hopkins. They discuss why vaccine mandates should never be Plan A, when mandates can become critically necessary and how mandates shouldn't be put in place for frivolous reasons or settings, just when public health is at stake.

As pandemic-related, federal unemployment insurance is set to expire, Stephanie Desmon talks to Mallika Thomas, PhD, of Brookings Institution about its impacts, what will happen to those who remain unemployed but will no longer be eligible for weekly checks, and how the program was actually designed to keep people at home during the early days of COVID-19 so they'd be less likely to spread the virus.

What goes into the decision to mandate a vaccine? Today, Dr. Joshua Sharfstein and Stephanie Desmon continue the conversation on COVID-19 vaccine mandates and speak to the senior director of infection prevention at Johns Hopkins, Dr. Lisa Maragakis, who is leading the implementation of the COVID-19 vaccine mandate at Johns Hopkins. Dr. Maragakis explains the history of vaccine mandates, the decision to create such mandates, and how it's going.