Public Health On Call

Communicating evidence-based COVID-19 prevention measures like mask-wearing and hand washing has been a challenge. What's further complicated buy-in are public health officials and politicians creating policies that are not backed in science like closing parks in Spain or banning the sale of open-toed shoes in South Africa. Science journalist Roxanne Khamsi talks with Stephanie Desmon about the harm of imposing policies that aren't evidence-based. They also discuss the consequences of trying to communicate about a virus with devastating effects that are largely invisible from the public eye. KEYWORDS: health communication; policy

What goes into Public Health On Call? Had you ever hosted a podcast before? Who would you most want to interview? Have there been any "oops" moments? Public Health On Call, which has been downloaded more than 3 million times since March, receives a lot of questions from our dedicated listeners. For this special bonus episode—and our last of 2020—producer Lindsay Smith Rogers asks co-hosts Josh Sharfstein and Stephanie Desmon questions from our curious listeners.

Why do COVID-19 vaccines require two doses? Will I still have to wear a mask and social distance once I get the vaccine? If my friends and I had COVID, can we get together for the holidays? Are people who wear a face covering with their nose exposed at higher risk of getting COVID? Dr. Josh Sharfstein and Dr. Caitlin Rivers answered frequently asked questions about COVID-19 and vaccines sent to [email protected]. KEYWORDS: vaccine trial; vaccine authorization; immune response

While there's light at the end of the tunnel with the first COVID vaccines being administered to US health care workers, the next few months will be difficult in terms of sickness and loss of life. Dr. Michael Osterholm, an infectious disease expert and part of President-Elect Biden's COVID-19 Advisory Board, talks with Stephanie Desmon about the critical place we're in now, the sacrifices necessary for this "COVID Christmas," and ways to safely get as many people as possible to a time with widespread vaccination and low community transmission of COVID-19. KEYWORDS: vaccine authorization; health communication; vaccine hesitancy

As part of a periodic series on overdose and the pandemic, guest host Susan Sherman speaks with Monique Tula, executive director of the National Harm Reduction Coalition, and Louise Vincent, executive director of the North Carolina Survivor's Union about the role of harm reduction in both the COVID and overdose crises. In an extended conversation, Tula and Vincent talk about harm reduction as a strategy for reducing suffering among people who use drugs, centering health and dignity in services, and how the "syndemic" of drug use, COVID-19, and racism are converging in a moment that requires a fundamental restructuring of services related to substance use in the US. KEYWORDS: substance use; policy; racial disparity

Thanks to an early warning system that was put in place for Ebola and other infectious disease outbreaks, countries across Africa acted swiftly to respond to COVID-19—actions that have resulted in many fewer cases and deaths than in other parts of the world. Tolbert Nyenswah, former Deputy Minister of Health for Liberia, talks with Stephanie Desmon about Africa's experience during the pandemic. KEYWORDS: policy; supply chain; health equity

As part of a periodic series on overdose and the pandemic, guest host Susan Sherman speaks with Chauncey Parker, director of the New York/New Jersey High-Intensity Drug Trafficking Area. HIDTA is a federally funded program that invests in public safety and public health partnerships designed to "bring everyone to the table" in unique collaborations that help facilitate better policy and data collection. Parker also talks about how COVID-19 has—and hasn't—impacted the drug market in New York. KEYWORDS: substance use; policy; harm reduction

The Public Health On Call podcast is wrapping up Season Two with our final episode on December 18. We'll return for Season Three on January 4 with more evidence and experts to help unpack the days COVID-19 and public health news. Listen here for more on what's to come.

The CDC has been hailed as the world's leading public health agency, but throughout the COVID-19 pandemic—a time when the agency should have been leading the charge—its responses have fallen short of expectations. Dr. Ali Khan, dean of the College of Public Health at the University of Nebraska and a former top CDC official, talks with Dr. Josh Sharfstein about what went wrong despite decades of preparation. Dr. Khan also shares what needs to happen for the agency to regain credibility and meet the pressing challenges of COVID-19 and other public health crises. (This interview was recorded on November 6.) KEYWORDS: health communication; policy

The health impacts of climate change can be severe: asthma attacks triggered by mold from flooding, infectious diseases spread by mosquitoes which thrive in warmer and wetter climates, and violent conflict over dwindling clean water sources. Dr. Megan Latshaw talks with Stephanie Desmon about a new report card grading states on how well they are prepared to protect people from health effects linked with climate change, showing which states are most vulnerable and how a coordinated national response could help prevent catastrophic impacts. For more information, visit www.climateandhealthreport.org. KEYWORDS: natural disaster; policy; environmental health

Elizabeth Letourneau, director of the Moore Center for the Prevention of Child Sexual Abuse, talks with Stephanie Desmon about a groundbreaking new report to help youth serving organizations prevent child sexual abuse. For more information, visit https://americanhealth.jhu.edu/youth-serving-organizations KEYWORDS: policy; child health

Although there's enough data to show that K-12 schools are not driving COVID-19 transmission, many are still closed even though bars, restaurants, and gyms are open. Brown economist Dr. Emily Oster returns to the podcast to talk with Stephanie Desmon about the latest data on schools and COVID-19, why many places haven't prioritized reopening schools, and what might get us out of this situation. KEYWORDS: schools; student life; pandemic response

Treatment for opioid use disorder can be highly effective in preventing overdoses, but only if it's easily accessible. Last spring, Dr. Chinazo Cunningham's health clinic in the South Bronx found itself in the "epicenter of the epicenter" of the COVID-19 outbreak that devastated New York. Dr. Cunningham talks with guest host Brendan Saloner about how the clinic adapted to continue providing patient-centered care during shutdowns, the uptick in overdoses in 2020 that predated the pandemic, and the need for urgent policy changes from the Biden administration to stem the opioid epidemic.

With COVID-19 cases on the rise, the CDC and other health authorities are urging people to avoid nonessential travel in the coming weeks. But there are also concerns about the physical and emotional health of those who may be isolated during the pandemic, and some may be determined to travel to see a loved one face to face no matter what. Epidemiologist Keri Althoff and mental health expert Elizabeth Stuart talk with Stephanie Desmon about the logistics of pandemic travel, quarantine and testing protocols, important conversations to have starting now. KEYWORDS: community mental health; testing methods; social distancing

While clinical trials are a "gold standard" to indicate if a vaccine's benefits outweigh its risks, safety monitoring doesn't stop there. Dr. Daniel Salmon, director of the Johns Hopkins Institute for Vaccine Safety, helped lead federal efforts to monitor the H1N1 vaccine's safety once it became widely used in 2009. Dr. Salmon talks with Stephanie Desmon about what goes into monitoring a vaccine for safety, identifying coincidental vs. uncommon effects, and what the public needs to know to enhance trust in COVID-19 vaccines. KEYWORDS: vaccine authorization; vaccine trial; vaccine hesitancy

After a decade of work, COVID-19 vaccines are the first RNA vaccines to be put through the paces of clinical trials. But what sets RNA vaccine technology apart from more traditional methods and how might this new platform be used going forward? Hopkins immunologist Dr. Diane Griffin talks with Stephanie Desmon about RNA vaccines, what they are and why they're different, complications that still need to be worked out, and how this groundbreaking new platform could help vaccinate us against future outbreaks. KEYWORDS: vaccine development

As part of the continuation of the series on racism as a public health crisis, Dr. Keshia Pollack Porter talks with Hopkins professor Dr. Roland J. Thorpe, Jr., and Dr. Marino A. Bruce, faculty at the University of Mississippi Medical Center, about the impacts of racism on black men's health. They discuss what stands in the way of basic care for many black men to have a good quality of life and their focus is not only on making sure black men survive, but also thrive. KEYWORDS: health equity; racial disparity; community mental health

Prior to Thanksgiving, the city of Philadelphia announced new COVID-19 restrictions to last for six weeks until January 1—some of the strictest recommendations the country has seen since the spring. Health commissioner Dr. Thomas Farley talks with Stephanie Desmon about these targeted restrictions the city hopes will prevent the current surge from overwhelming hospitals or killing large numbers of people, what contact tracing data are saying about how and where most people are getting infected, and why there's more pushback now even though cases are exponentially higher than they were in the spring. KEYWORDS: pandemic response; pollicy; contact tracing

Throughout the COVID-19 pandemic, rates of opioid overdose have increased dramatically but this is only due in part to disruption of services and increased isolation. Michael Botticelli, former head of the Office of National Drug Control Policy in the Obama administration and 32 years into his own recovery, talks with guest host Brendan Saloner about how America's opioid epidemic was already on a terrible trajectory prior to the pandemic, policy solutions to address overdose, the importance of combating stigma against addiction, and what needs to happen next. KEYWORDS: substance use; policy; harm reduction

How can people think about safety for holiday travel during the COVID-19 pandemic? Are some means of transport safer than others? What about safety during day-to-day transportation on school buses and trains? Dr. Mark Rosekind, a former administrator of the National Highway Traffic Safety Administration, and a Distinguished Policy Scholar at the Johns Hopkins Bloomberg School of Public Health talks with guest host Dr. Colleen Barry about these and other questions of road safety during this and future pandemics. KEYWORDS: public transit; policy; road safety

Last week, Nebraska ICU nurse Lacie Gooch recorded a video of herself after a long shift talking about the overwhelming number of people dying in hospitals from COVID-19. In a bonus episode of the podcast, Gooch talks with Stephanie Desmon about the viral video, and why frontline health care workers are taking to social media to describe the desperate situation and to beg people to wear masks and social distance, especially ahead of the holidays. Gooch also talks about how the overwhelming rise of COVID cases could mean hospitals will be unable to provide care for other emergencies like heart attacks or car accidents.

Last week, a judge approved the $8.3 billion settlement between the Department of Justice and OxyContin manufacturer Purdue Pharma. Hopkins opioids researcher Dr. Caleb Alexander talks with Stephanie Desmon about expected fallout from the settlement as well as how the COVID-19 pandemic is exacerbating the crisis by disrupting drug markets, shuttering treatment centers, and reducing the chances of Naloxone administration in overdose emergencies. KEYWORDS: substance use; policy

The Johns Hopkins Center for Communication Programs has worked for more than 30 years on health communication in at least 60 countries for issues like breastfeeding, HIV, and family planning. This experience meant they were well positioned to work with partners around the globe on messaging for COVID-19 prevention. Deputy director and COVID team leader Alice Payne Merritt talks with Dr. Josh Sharfstein about crafting COVID messages for different countries and breaks down the details with some clips of radio and TV spots from Nigeria, Ethiopia, the Phillippines, and Guatemala. KEYWORDS: international health; misinformation

If I test positive for COVID-19, could my name and phone number be reported to the health department? How does closing bars at 10pm help? How will we know if COVID-19 vaccines work for children? My roommate and I have both tested positive—can we be in the same house together? Do I still have to wear a mask if I've recovered from COVID? Does mouthwash help prevent COVID? Dr. Jennifer Nuzzo from the Center for Health Security and Dr. Josh Sharfstein discuss troubling trends and solutions for professional Santas, and answer more of your questions sent to [email protected] KEYWORDS: contact tracing; social distancing

Pollution and racism go hand in hand: low-income, predominantly non-white communities with less capital and political power become dumping zones for hazardous waste and other toxic environmental exposures. As part of an ongoing series on structural racism and public health, Keshia Pollack Porter dives into the topic of environmental injustice with Hopkins environmental epidemiologist Dr. Aisha Dickerson and EPA Environmental Health Fellow Dr. Dana Williamson. KEYWORDS: health equity; racial disparity; environmental racism

November 18 is the first National Injury Prevention Day. Injuries like burns, falls, and poisonings are the leading cause of death in the US for children over the age of 1 and most are preventable. Prevention experts Dr. Barbara Barlow, founder of a national coalition to prevent childhood injuries, Injury Free Coalition of Kids, and Eileen McDonald, director of Baltimore's local coalition, talk with Dr. Josh Sharfstein about awareness of pediatric injury issues, the history of initiatives, and solutions to keep children safe like window bars, bike helmets, stair gates, smoke alarms, and more. Learn more with #BeInjuryFree on social media.

Denmark, one of world's leading pelt producers, is culling all of its farmed mink after evidence that a different variant of SARS-CoV-2 might be circulating among the animals. Veterinary expert Dr. Meghan Davis returns to the podcast to talk with Stephanie Desmon about whether or not mink pose a danger to humans, what the news means for disease surveillance, and an update on household pets and COVID-19. KEYWORDS: zoonotic virus; contact tracing; animal health

Once COVID-19 vaccines are widely available, could they be made mandatory and, if so, what entities could enforce this? Legal and public health expert Joanne Rosen talks with Stephanie Desmon about the legislative precedent for mandatory vaccinations that dates all the way back to a 1905 Supreme Court case after a smallpox outbreak in Massachusetts. They also discuss other strategies states could consider to achieve widespread vaccination for COVID-19. KEYWORDS: vaccine mandates; policy

Kaiser Permanente, the largest not-for-profit health system in the US, has mobilized in response to COVID-19. Senior vice president and chief health officer Dr. Bechara Choucair talks with Dr. Josh Sharfstein about coaching for patients who test positive, contact tracing partnerships with local health departments, and a focus on addressing patients' social needs like rent and food so they can isolate and quarantine safely. KEYWORDS: household transmission; pandemic response; health equity

This week, Pfizer reported some encouraging early results from Phase III of it's COVID-19 vaccine clinical trials. Dr. Josh Sharfstein talks with Stephanie Desmon about what might happen next, when we could see the first doses of vaccines available, and how we should continue vigilance with masks, distancing, and handwashing while waiting for widespread vaccination to bring the pandemic to a heel.

High profile instances show up in the news as "super spreader" events, but there's evidence that the phenomenon of "overdispersion" could be much more common. Infectious disease epidemiologist Dr. Justin Lessler and doctoral student Kyra Grantz talk with Dr. Josh Sharfstein about the biological and social contributors to overdispersion, and what it could mean for public health strategy. KEYWORDS: pandemic response; contact tracing; viral shedding

Pneumonia is the leading killer of children under 5 around the world with most deaths in low- and middle-income countries. But it's not just a problem of developing countries: pneumonia is also the most common reason for hospitalization of children in the US. In recognition of World Pneumonia Day, pediatric infectious disease specialist Dr. Anita Shet and Leith Greenslade, coordinator of the Every Breath Counts Coalition talk with Stephanie Desmon about World Pneumonia Day, how COVID-19 is impacting efforts to reduce childhood deaths, and how the pandemic may have brought attention to one significant problem: access to oxygen in lower- and middle-income countries.

We're closer to safe, effective COVID-19 vaccines, but what will the actual rollout look like? Dr. Ezekiel Emanuel, a bioethicist and health policy expert recently appointed to President-elect Joe Biden's coronavirus task force, talks with Stephanie Desmon about the challenges in distributing a vaccine in the US. They discuss which groups might get access first, logistical challenges including cold chain and glass supply concerns, and the steps needed between concluding clinical trials and actually distributing a vaccine. They also talk about the formidable efforts that will be needed to advocate for getting vaccinated which could include a massive campaign with endorsements from trusted celebrities and thought leaders. KEYWORDS: supply chain; health communication; vaccine approval

After the National Basketball Association shut down on March 11, the league was able to resume play and complete both its season and postseason without interruption from COVID-19 from the safety of "the bubble." Pete Meisel, the NBA's senior manager for player health and an alumnus of the Johns Hopkins Bloomberg School of Public Health, talks with Dr. Josh Sharfstein about what went into the bubble, how they maintained the players' physical and mental health and safety, and what we can learn from the bubble's success. KEYWORDS: athletes; pandemic response; testing methods

A disproportionate number of women in the U.S. appear to be "dropping out" of the workforce during the pandemic, presumably to care for children or because they are more likely to have jobs that cannot be done remotely. Stefania Albanesi, an economist at the University of Pittsburgh who studies women in the workforce, talks with Stephanie Desmon about this phenomenon and what it could mean long-term for both their careers and the economy. KEYWORDS: gender equity; unemployment

Before the pandemic, we didn't know as much about how infectious respiratory diseases spread. New knowledge about COVID-19 can help us make informed decisions about risks but it has also led to mixed messages. Hopkins environmental epidemiologist Dr. Tom Burke and dean of the University of Colorado School of Public Health Dr. Jon Samet talk with Stephanie Desmon about a panel they recently led on airborne transmission of COVID-19. They talk about everything we've learned about how COVID spreads, the CDC's changing guidance on "close contacts," the riskiest settings for transmission, and how current guidance may be even more effective than a vaccine. KEYWORDS: aerosols; health communication; social distancing

The pandemic has revealed major deficits in public health infrastructure and a lack of prioritization of prevention efforts: only 3% of all health dollars are spent on prevention. Dr. Ellen J. MacKenzie, dean of the Bloomberg School of Public Health, and Dr. Shelley Hearne, director of the School's Center for Public Health Advocacy, talk with guest host Dr. Colleen Barry about how disinvestment in public health has left a system that is at times unable to respond effectively to today's crises. They discuss what's broken and what needs to be fixed – both to better respond to current challenges and to prepare for the future.

New York City's contact tracing program, officially launched on June 1, is one of the largest in the nation. Dr. Jay Varma, the mayor's senior adviser for public health, talks with Dr. Josh Sharfstein about the trained workforce of 4,000 people that is now reaching more than 90% of new cases in the city. The program also helps provide services like dog walking and grocery delivery so that people can isolate safely at home. As COVID cases start to climb again in New York, contact tracing and robust testing remain critical aspects of the city's public health response that can help delay or avoid shutdowns. KEYWORDS: pandemic response; policy

In the first of a periodic series on racism and health, Dr. Keshia Pollack Porter, vice dean for faculty and professor in Health Policy and Management, talks with Taylor Porter, a principal at Gamble Montessori High School in Cincinnati with a unique approach to learning that prioritizes the health and well-being of the whole child. Porter talks about COVID-19's impacts on students and families and how the school has responded. Porter also talks about "pandemic #2" of racial injustice and how he has spearheaded efforts to train staff while letting youths lead the conversation. KEYWORDS: student life; health equity; racial disparity

In this episode, Dr. Josh Sharfstein talks with Hopkins researchers who break down three new COVID-19 research papers: Dr. Andrew Redd talks about COVID-19 vaccines and whether they will work in older adults; Dr. Sheree Schwartz talks the about the implications of COVID-19 for pregnancy; and Dr. Denali Boon discusses a preprint paper about the potential use of rapid COVID tests. All three Hopkins faculty are part of the novel coronavirus research consortium, with many summaries of new studies available at http://ncrc.jhsph.edu KEYWORDS: testing methods; vaccine authorization; immune response

The pandemic has elevated many of the risk factors of suicide, including loneliness, grief, economic distress, and a record number of people requesting new access to firearms which are involved in 50% of suicides. Hopkins suicide prevention expert Dr. Holly Wilcox talks with Stephanie Desmon about these risks, what the data are showing so far, and potential solutions. They also discuss the particular risk of youth suicide and interventions. KEYWORDS: community mental health; policy; violence prevention

COVID-19 mortality rates are falling and better treatments are one of the main reasons why. Dr. Arturo Casadevall returns to the podcast to talk with Stephanie Desmon about where we are with different treatments and their successes, ongoing clinical trials, why some treatments are harder than others to produce, and whether we'll continue to see investments in treatments when a vaccine is available. KEYWORDS: COVID-19 therapy; vaccine authorization; immune response

How can we deal with election stress and uncertainty? How should we think about hard decisions like traveling for the holidays? How can we balance the health and safety risks of visiting with friends and family with concerns about mental health and loneliness if we stay home? What can we do to prepare for an overlap of COVID fatigue and seasonal affective disorder? How do we know if we're just feeling down or if it's something more serious? Clinical psychologist Dr. Laura Murray returns to the podcast to answer your mental health questions. KEYWORDS: stress management; child health

As part of our election series, guest host Dr. Colleen Barry talks with Josh Horwitz, executive director of the Coalition to Stop Gun Violence about what's at stake for gun policy in this election. They also talk about how 2020 is shaping up to be a grim year for homicides and gun violence, the rise of gun sales and suicides, which gun policies garner majority support and which are more contentious, and how the pandemic's focus on public health prevention methods could impact future gun policy. KEYWORDS: firearms; violence prevention; state government

As part of our election series, Stephanie Desmon talks with Dr. Gerry Anderson, an expert in health policy at Johns Hopkins. They discuss what the election could mean for the coverage of preexisting conditions, Medicaid expansion, and drug pricing. They also talk about a Supreme Court hearing in November that may determine the future of the Affordable Care Act, the similarities and differences between the candidates' views of the ACA, and a fact check on whether insulin really is as cheap as water. KEYWORDS: chronic disease; state government; health equity

As part of our election series, Stephanie Desmon talks with Dr. Tom Burke, the EPA's science advisor during the Obama administration. They discuss this critical moment after huge reversals of environmental gains in the US, how the reputation of science has affected critical policy decisions, and what's at stake for everything from the quality of drinking water to the dangers of forest fires and hurricanes if regulation continues to be relaxed. They also talk about who is impacted the most from climate change regulation in the US and how rollbacks of regulations have made some communities even more susceptible to the harms of COVID-19. KEYWORDS: renewable energy; natural disaster; health equity

As part of a pre-election series, Stephanie Desmon talks with Dr. Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health, and Katherine Narvaez, a Hopkins student and researcher and DACA recipient from Guatemala. They talk about Narvaez's experience as a "Dreamer" and what's at stake for her and other families who are at risk of separation and deportation. They also discuss the current administration's policies and erosion of pathways to citizenship, how migrants and refugees contribute to the US's economy, and how COVID-19 opened the door for much stricter immigration policies. KEYWORDS: migration; policy; misinformation

What do we know about reinfection? Can adults get the rare inflammatory syndrome that was infecting some children? If guidelines say "close contact" is being within six feet of someone for 15 minutes, is it OK to be close to someone for less time? If someone quarantines for 14 days with no symptoms, do they need a test to be "clear"? If my child is sent home from school after possibly being exposed, do I have to quarantine too? Can waxing your nose hair put you at risk of COVID-19? Dr. Amesh Adalja and Dr. Josh Sharfstein answer more of your COVID-19 questions sent to [email protected] KEYWORDS: antibodies; child health; testing methods

With the possibility of a spike in COVID-19 cases this fall and winter, doctors, nurses, and medical staff may be coming in feeling already depleted from an uncontrolled pandemic. Guest host Dan Gorenstein of the Tradeoffs podcast talks with Dr. Albert Wu, co-director of RISE—Resilience in Stressful Events—which provides emotional support to health system staff. Gorenstein and Wu talk about why health care workers may have low reserves right now, how COVID may be changing perceived stigma around mental health support for frontline workers and what institutions can do to ensure the well-being and resilience of all staff. KEYWORDS: burnout; stress management

Today's episode is audio from a webcast recorded on October 15 with Dr. Anthony Fauci and Bloomberg School dean Dr. Ellen MacKenzie as part of the inaugural Johns Hopkins Health Policy Forum. They discuss Fauci's background with the HIV/AIDS epidemic and parallels to COVID-19, the state of the U.S. coronavirus response, and how implementing better controls doesn't necessarily mean brutal lockdowns. Fauci also talks about how we as individuals have an obligation to protect ourselves as well as others to get the pandemic under control.