Public Health On Call

Why has it come to mandates as a way to get people vaccinated against COVID-19? Stephanie Desmon and Dr. Joshua Sharfstein talk to Saad Omer, MBBS, MPH, PhD, FIDSA, director of the Yale Institute for Global Health, about vaccine hesitancy, as well as the benefits and risks of vaccine mandates.

I am fully vaccinated with the Moderna vaccine. If I catch the delta variant will I acquire additional immunity—in addition to the immunity to the vaccination? If I received the COVID-19 vaccine and I'm now breastfeeding, will my baby receive antibodies? Do masks get less effective depending on how long they're worn? Dr. Amesh Adalja of the Johns Hopkins Center for Health Security addresses your questions submitted to [email protected].

Caring for Kids with COVID-19 in Florida. There are more children sick with COVID-19 in Florida today than ever before. Joseph Perno is an emergency department physician and the chief medical officer of Johns Hopkins All-Children's Hospital in St. Petersburg. He speaks to Dr. Josh Sharfstein about why the rising number of sick children has yet to change many minds about measures to combat the pandemic.

Public Health On Call producer Lindsay Smith Rogers speaks with Elinor Cleghorn, author of the book Unwell Women: Misdiagnosis and Myth in a Man-Made World. The book covers how misogyny and mythology were baked into western medicine and has attributed to gender bias on women's health, how some of these biases remain today and what needs to be done to create a more equitable health system for all people.

It's back-to-school time and the COVID-19 pandemic is still raging in many places. Stephanie Desmon talks to Keri Althoff and Elizabeth Stuart of the Johns Hopkins Bloomberg School of Public Health about how important it is for K-12 students to get back into the classroom, how safe it is to do so right now, how to navigate masking for kids too young to be vaccinated and how to talk to your kids about any worries they may have about returning to in-person learning.

2020 marked a historically high number of overdoses with more than 93,000 deaths in the United States. A particular risk for overdose is recent incarceration, yet few people who are incarcerated have access to effective, life-saving treatment. Dr. Brendan Saloner, talks to Dr. Josh Sharfstein on the urgency of jails and prisons providing needed care.

Overdose death rates in the U.S. reached record highs during the pandemic. Stephanie Desmon talks to Sika Yeboah Sampong about a recent report from the Legal Action Center about the role of emergency departments in saving lives from overdose. Clinicians can screen for and diagnose addiction, provide life-saving therapy, and refer to ongoing care. Many emergency departments, Yeboah Sampong argues, are failing to provide care backed by evidence -- and could be in legal jeopardy as a result. Read the full report here: https://americanhealth.jhu.edu/addiction-emergency

Recent research led by Craig Pollack of Johns Hopkins and Kathryn Leifheit of UCLA suggests that more than 433,000 excess cases and 10,700 excess deaths from COVID-19 in 2020 were associated with the lifting of eviction moratoriums in various states. They talk to Stephanie Desmon about the impact of a recently reinstated eviction moratorium, the staggering amount of back rent owed in the United States, and how much the pandemic has exposed larger problems in the housing market.

With a string of massive climate crises seemingly ever-present in the news, Dr. John Groopman, an environmental epidemiologist at the Johns Hopkins Bloomberg School of Public Health, talks to Public Health on Call Producer Lindsay Smith Rogers about their link to climate change and aging infrastructure, the history of how we got here and why there are reasons for optimism.

With so much news about the Delta variant and calls for many vaccinated people to mask up again, Gigi Gronvall of the Johns Hopkins Center for Health Security talks with Stephanie Desmon about what we know right now about breakthrough COVID-19 infections and how worried the vaccinated should be about getting sick from COVID-19. "The more people who get vaccinated, the fewer chances the virus that causes COVID-19 has to mutate into an even deadlier virus," Gronvall says.

In the early days of the pandemic, Australia kept COVID cases low by closing its borders and instituting rigorous public health measures like contact tracing. Now, however, low vaccination rates and the delta variant have forced communities back into lockdown. Dr. Patricia Davidson, vice chancellor of the University of Wollongong—and former dean of the Johns Hopkins School of Nursing—talks with Dr. Josh Sharfstein about the COVID-19 experience of Australia, how it is similar in some respects and different in others from that of the US.

Until recently, Dr. Michelle Fiscus served as the Medical Director for Immunization Programs at the Tennessee Department of Health. But after sending out a factual memo explaining the law about vaccinating teenagers caused a backlash among conservative lawmakers, Fiscus was fired. Dr. Fiscus talks with Dr. Josh Sharfstein about her background in public health, her recent painful experiences, and her next chapter. This interview was recorded on July 21, 2021.

After a drop in COVID hospitalizations and deaths over the spring and early summer, hospitals in southwest Missouri are at capacity again. Steve Edwards, president and CEO of Cox Health which has six hospitals in the region, talks with Stephanie Desmon about why things are so much more extreme now than they were last winter, how the politicization of public health has choked efforts to make vaccines more accessible, and why this fight is so personal for him.

In this episode, Dr. Josh Sharfstein talks with researchers who break down three papers about the delta variant. Carli Jones, a PhD student at Hopkins School of Medicine talks about a preprint study on the emergence and spread of the delta variant in India. Wendy Grant-McAuley, also a PhD student, talks about an Oxford University paper on how the delta variant responds to various antibodies in a lab setting. Shirlee Wohl, a post-doctoral fellow at the Bloomberg School talks about a preprint looking at an outbreak of the delta variant among vaccinated people at a Texas wedding. These researchers are part of the Hopkins novel coronavirus research consortium, with many summaries of new studies available at http://ncrc.jhsph.edu.

Dr. Stephen Thomas, the director of the University of Maryland Center for Health Equity, works with barber shops in the African-American community to offer health services. Mike Brown, a barber and a certified community health care worker, works with Dr. Thomas to provide vaccines in his barber shop. They talk with Dr. Josh Sharfstein about the community role of barber shops, the importance of community trust, and lessons for other public health efforts.

Dr. Joshua Sharfstein speaks to Jason Dearen, author of the book Kill Shot: A Shadow Industry, A Deadly Disease. The book covers the nationwide meningitis outbreak caused by the New England Compounding Center, which sold medications contaminated with mold and fungi for injection into joints, the spine, and other sterile spaces. They discussed what led to this catastrophe, the legislation that passed in its aftermath, and the future of oversight in this area.

Fungal diseases are rare but, once diagnosed, incredibly hard to treat and often fatal. The overwhelming surge of COVID-19 cases in India has given rise to mucormycosis, also called "black fungus" for the appearance of the lesions caused by the infection. Dr. Arturo Casadevall talks with Stephanie Desmon about this and other fungal diseases, why COVID patients in India are particularly vulnerable, why treatments are slow and often ineffective, and why the pharmaceutical industry hasn't invested more in treating these often deadly infections.

The pandemic has caused trauma, grief, and stress leading to depression, anxiety, and worsening of other mental health conditions. Dr. Adam Karpati, former executive deputy commissioner for mental hygiene at the New York City Health Department and currently the Senior Vice President of Public Health Programs at Vital Strategies, talks with Dr. Josh Sharfstein about the profound mental health impact of the pandemic, in the context of prior failures to support people with mental illness. Dr. Karpati sets out a vision for a more organized, caring, and effective system of mental health care.

Will we need COVID-19 booster shots and, if so, when? Where is the FDA in its approval process of the vaccines currently under emergency use authorization? What goes into this process? Why, if the current vaccines are so good, are companies still trying to make new ones? Dr. Anna Durbin returns to the podcast to talk with Stephanie Desmon about all things COVID-19 vaccines.

Vermont has had far fewer COVID cases, hospitalizations, and deaths than many other states, and health commissioner Dr. Mark Levine credits a number of reasons why. Dr. Levine talks with Dr. Josh Sharfstein about Vermont's response to the pandemic, how the state is now addressing gaps in vaccination, and why it's so important for all decisions to be driven by data and science, not politics.

The COVID-19 pandemic will change our culture in all kinds of ways, both concrete and conceptual. Coming to work if you're sick, for example, may hopefully be a thing of the past while normalizing mask use during COVID surges may become part of our new future. Conceptually, our culture is changing as more people become aware of how social determinants of health like housing, employment, and education are directly tied to people's wellbeing. Former New York City health commissioner Dr. Oxiris Barbot talks with Dr. Josh Sharfstein about these and other cultural changes we may see in the aftermath of the pandemic.

On June 5, 1981, the CDC identified a cluster of five cases of a rare pneumonia occurring in previously healthy young, homosexual men in the US. Forty years later, despite great advances in therapies for prevention, and extending life expectancy and quality of life, the pandemic is still growing in some places and killing millions around the world. Epidemiologist Dr. Chris Beyrer, associate director of the Johns Hopkins Center for AIDS research, talks with Stephanie Desmon about the work that still needs to be done, what we've learned from the AIDS pandemic, and how we need to apply these lessons to the global COVID-19 response.

The US is not the only country facing COVID-19 vaccine hesitation. Around the world, public health officials are grappling with this issue that has the potential to slow or even derail efforts to end the pandemic. Dr. Saad Omer, director of the Yale Institute for Global Health, talks with Stephanie Desmon about the spectrum of vaccine hesitancy, the promise of continuing medical education for doctors as a helpful tool, why it's crucial to address vaccine demand AND supply, and why there's no "silver bullet" despite the urgent need to get as many people vaccinated as possible.

Youths 12 and older have been eligible for COVID-19 vaccines since March, but clinical trials are still ongoing for kids under 12. Dr. Kawsar Talaat, who led one of Pfizer's COVID-19 vaccine trials in adults, and Dr. Odis Johnson, executive director of the Johns Hopkins Center for Safe and Healthy Schools, return to the podcast to talk with Stephanie Desmon about whether schools may require vaccines, the ethics of immunizing children when so many high-risk adults around the world don't have access to shots, risk factors for serious disease among children, and what is known currently about vaccine hesitancy among parents.

In this episode, Dr. Josh Sharfstein talks with researchers who break down three papers looking at what happens to patients with COVID over the longer term. Dr. Lauren Peetluck, an epidemiologist at Vanderbilt University, talks about the risks of long-term complications of COVID. Dr. Heather McKay, an epidemiologist at Hopkins, talks the risks of negative neurological and psychiatric outcomes of patients diagnosed with COVID-19. Danny Sack, an MD/PhD student at Vanderbilt, talks about post-COVID multisystem inflammatory syndrome in children. These researchers are part of the Hopkins novel coronavirus research consortium, with many summaries of new studies available at http://ncrc.jhsph.edu.

On a special episode, Tradeoffs host Dan Gorenstein talks with a host of experts about screening for lung cancer, America's number one cancer killer. While CT scans have provided early insights into a cancer that previously wasn't caught until far too late, this tool has also led to unnecessary procedures, costs, and even disability and death for patients that may not have even been sick. You'll hear from pulmonologist Dr. Gerard Silvestri; behavioral scientist and nurse practitioner Dr. Lisa Carter-Harris; Dr. Cherie Erkmen, surgeon and director of Temple University's Lung Cancer Screening Program; Johns Hopkins oncologist Dr. Otis Brawley; Ida Pittman, a lung cancer patient, and Helena Price, her cousin and health care advocate. If you like this episode, check out the Tradeoffs' podcast www.tradeoffs.org

There are a lot of worrying headlines about the delta variant and outbreaks of COVID-19 around the world. Lindsay Smith Rogers talks to Dr. Jennifer Nuzzo from the Center for Health Security about the variant, how much more transmissible it is, whether it causes more serious disease, what the variant means for vaccinated and unvaccinated populations, and what people should be most concerned about.

Epidemiologists, community health workers, laboratory professionals, data analysts, and a whole spectrum of public health workers rose to the challenges of the COVID-19 pandemic. At the same time, years of underinvestment in public health departments undermined the response. New York City Health Commissioner Dr. Dave Chokshi talks with Dr. Josh Sharfstein about what the pandemic has taught about urgently needed investments in public health workforce.

Native American communities were especially hard hit during the pandemic with COVID cases 10 times that of the rest of the US. Dr. Allison Barlow talks with Stephanie Desmon about how the Native Americans went from the highest rates of cases, hospitalizations, and fatalities to the highest vaccination rates in the US with 70-95% of the community fully vaccinated. They also talk about how much the rest of the US can learn from these successes, and how the intrinsic values of indigenous communities can mean better health for all people.

According to a new report by the Network for Public Health Law, several states are considering or have passed legislation to limit the ability of public health agencies to respond to infectious disease and other emergencies. At stake are the ability of health departments to impose quarantine to save lives or require masks for any conditions, including infectious tuberculosis. Donna Levin, National Director for the Network, talks with Dr. Josh Sharfstein about the history of public health authority, what's happening now in North Dakota, Kansas, and elsewhere; and the dangers of these ill-considered laws.

As a 2004 Olympic silver medalist in swimming and public health expert at the Center for Health Security, Dr. Tara Kirk Sell is uniquely positioned to talk about what to expect at next month's Olympics. Dr. Sell talks with Stephanie Desmon about how the Olympic committees are working to keep athletes safe, what could go wrong, and why we need the Olympics now more than ever.

With millions of Americans still unvaccinated and dangerous variants continuing to spread, the footrace against the virus continues into the summer months. Want to help? The Made to Save Coalition is a national grassroots effort to ensure communities hardest hit by COVID-19 have access to vaccines and accurate, timely information. Chris Wyant, executive director, and Alice Chen, senior advisor, talk with Dr. Josh Sharfstein about what's behind this effort—and how you can join. Learn more here: madetosave.org/act

The Bloomberg American Health Initiative offers full scholarship for MPH and DrPH degrees to people working on the front lines of key challenges to health in the United States. This special episode of the Initiative's American Health Podcast features an interview with host Shane Bryan and scholarship recipient and "Bloomberg fellow" Julianah Marie, the Waste Reduction Programs Coordinator with the City of Frisco, Texas. They discuss Marie's work with the Frisco school district, the history of America's growing pollution issues, and ways to reduce the amount of waste coming from our households. To learn more about the Bloomberg American Health Initiative and the Bloomberg Fellows Program, visit https://americanhealth.jhu.edu/.

Maryland's new Health Equity Resource Act will provide more than $50 million to support community-led plans that advance health equity. What might these plans include? Where did this idea come from? Dr. Josh Sharfstein interviews Michelle Spencer, a faculty member at the Johns Hopkins Bloomberg School of Public Health who previously led the development of a similar program to establish "Health Enterprise Zones" across the state. They discuss the concept of place-based programs, share examples of community investments in health, and talk through what to look for as this new law is implemented.

The Baltimore Convention Field Hospital was established in the spring of 2020 by the state of Maryland, Johns Hopkins, and the University of Maryland to fight COVID. A few weeks ago, Dr. Josh Sharfstein was invited inside the 100,000 square foot field hospital's command center to meet with Director Dr. Jim Ficke and Deputy Director Dr. Chuck Callahan. He also speaks with Dr. Mindy Kantsiper, Dr. Sophia Purekal, Dr. Zishan Siddiqui, John Fickel, and Laura Wortman. They talk about what the last year has been like, how lessons from the military-inspired design and logistics, and how this field hospital now responds to COVID on four fronts: testing, patient care, monoclonal antibody treatment center, and vaccinations.

After being fully vaccinated, only 50% of people who are immunocompromised show an antibody response against COVID-19, compared with 100% of those with a typical immune system. Hopkins transplant surgeon Dr. Dorry Segev talks with Stephanie Desmon about how the immune response is blunted in individuals taking medications for organ transplants or who have overactive immune systems, what antibody tests can and can't tell us, and whether a third dose of vaccines could help the millions of Americans who remain unprotected from COVID despite being fully vaccinated.

While gun violence has increased in most cities, Richmond, California, has seen a marked decrease in the last decade thanks to an organization that works with the people most likely to be the victims of gun violence: the shooters themselves. Guest host Dr. Daniel Webster, director of the Johns Hopkins Center for Gun Violence Prevention and Policy, talks with DeVone Boggan, founder, and CEO of Advance Peace. They discuss how the organization's fellowship system engages young people involved in lethal firearm offenses, approaches to violence that center wellbeing, and how investment in programs like these translates not only to saving millions of public dollars, but truly disrupting cycles of violence. Learn more here: https://www.advancepeace.org/

In this episode, Dr. Josh Sharfstein talks with Hopkins researchers who break down three papers looking at the effectiveness of different COVID-19 vaccines against variants of concern. Carli Jones, a graduate student at the Johns Hopkins School of Medicine, talks about some good news from a study looking at the effectiveness of Pfizer's vaccine against the variants found in the UK and South Africa. Greg Rosen, a PhD candidate, discusses a preprint study that assesses the effectiveness of the Chinese CoronaVac vaccine against the variant identified in Brazil. Dr. Nikolas Wada talks about a lab-based study assessing the potential effectiveness of mRNA vaccines against the B.1.617 variant discovered in India. These researchers are part of the Hopkins novel coronavirus research consortium, with many summaries of new studies available at http://ncrc.jhsph.edu.

The Bloomberg American Health Initiative offers full scholarships for MPH and DrPH degrees to people working on the front lines of key challenges to health in the United States. This special episode of the Initiative's American Health Podcast features an interview with host Shane Bryan and "Bloomberg fellow" Ashley Hickson, a senior policy associate at the Center for Science in Public Interest, a nonprofit consumer advocacy group that advocates for safer and healthier foods. They discuss Hickson's work examining the difference in food retail quality between high and low-income communities in the South. To learn more about the Bloomberg American Health Initiative and the Bloomberg Fellows Program, visit https://americanhealth.jhu.edu/.

At the beginning of the pandemic, it seemed like COVID-19 didn't really affect young people. But a recent uptick in cases and hospitalizations among younger adults could point to the transmissibility of newer variants. Dr. Emily Martin, an epidemiologist at the University of Michigan's School of Public Health, talks with Dr. Josh Sharfstein about how the variants may be changing the risks for young people and why a virus that moves faster underscores the importance of vaccinations.

The Bloomberg American Health Initiative offers full scholarship for MPH and DrPH degrees to people working on the front lines of key challenges to health in the United States. This special episode of the Initiative's American Health Podcast features an interview with host Shane Bryan and scholarship recipient and "Bloomberg fellow" Katherine Chon, the Director of the Office on Trafficking in Persons for the Administration for Children and Families at the US Department of Health and Human Services (HHS). They discuss the public health response to human trafficking and hear how healthcare providers act as first responders for those experiencing human trafficking. To learn more about the Bloomberg American Health Initiative and the Bloomberg Fellows Program, visit https://americanhealth.jhu.edu/.

Dr. Justin Lessler, an infectious disease epidemiologist, returns to the podcast to talk to Dr. Josh Sharfstein about the Scenario Modeling Hub's models for the fall of 2021. Researchers projected what could happen under four scenarios of vaccination rates and viral control measures. The upshot? As has been the case since the beginning, what happens next is up to us.

Police violence is one of the most observable manifestations of structural racism in the US, but is addressing this a matter of finding the "bad actors" or rethinking the system altogether? Guest host Dr. Daniel Webster, director of the Johns Hopkins Center for Gun Violence Prevention and Policy, talks with Tracey Meares, professor of law and founding director of The Justice Collaboratory at Yale Law. They discuss why America's approach to public safety must be examined, how some jurisdictions are implementing change, and suicide prevention.

After 9-11, the US government convened a crisis commission to investigate what happened and why, and to glean lessons to inform crisis prevention and response in the future. Philip Zelikow, the executive director of the 9-11 Commission, talks with Stephanie Desmon about laying the groundwork for a COVID-19 Commission. They talk about why it's so important to take stock of what's happened and create an informed story, the differences between a one-time attack like 9-11 and a sustained disaster like COVID, and how the commission could mean a better response to a future pandemic.

According to the ACLU, Black students are arrested, suspended, and expelled from school at higher rates than other students and far more likely to wind up in the juvenile justice system. Guest host Dr. Chidinma Ibe talks with Dr. Odis Johnson, director of the Johns Hopkins Center for Safe and Healthy Schools about how to end the "school to prison pipeline" and help all kids feel safe, secure, and valued at school.

A recent survey found that 90% of young people support the Black Lives Matter movement's work to end racism in policing. Guest host Dr. Chidinma Ibe talks with youth leader Jada Johnson and with Joni Holifield, the founder of Heart Smiles, about how they experienced George Floyd's murder and Derek Chauvin's conviction. You can read more about Heart Smiles' work with Baltimore youth here: https://magazine.jhsph.edu/2021/heartbeat-baltimore

Guest host Dr. Chidinma Ibe talks with Joe Jones, executive director of the Center for Urban Families about the economics of racism in the United States. They discuss how discrimination in education, housing, health care, and jobs keep Black people from success, and how much of this gets attributed to individual decision making without recognizing the larger context. They also talk about what it takes to undo these barriers and create "conditions for hope."

In the year since George Floyd's murder, there have been calls for police reform, record voter turnout for a Presidential election, and 360 bills with restrictive voting provisions introduced by legislators in 47 states. Guest host Dr. Rachel Thornton of the Johns Hopkins Center for Health Equity talks with democracy and elections expert Kareem Crayton about which elected officials are in positions to enact police reform, how community members can hold those officials accountable, the challenges of redistricting, and the importance of protecting voter rights.

George Floyd's murder had an impact on our collective consciousness, and racism by itself is a "biopsychosocial stressor." Guest host Dr. Rachel Thornton of the Johns Hopkins Center for Health Equity talks with Dr. Wizdom Powell of the UConn Health Disparities Institute about the potential for mental health fallout from increased racialized violence, the impacts of trauma, the "adultification" of Black youths, and how the concepts of radical love and radical healing can help mend America's deep wounds associated with the legacy of racism.

Graduation is May 25 at the Johns Hopkins Bloomberg School of Public Health. Dr. Josh Sharfstein talks with soon-to-be Dr. Asari Offiong, an expert in the health and wellbeing of adolescents. Dr. Offiong talks about how she came to study public health, how she experienced the tragedy of the pandemic, and how she sees the future.