Public Health On Call

Does the virus cause male sterility? Are false negatives a problem with COVID tests? Is there a connection between how much virus you're exposed to and how serious the illness is? Should people on immunosuppressive drugs stop taking them? Does the virus "reactivate?" Can people really become immune? Why are there so many more cases in the northern hemisphere? Why will a COVID-19 vaccine take so long when we come up with a new flu vaccine every year? Tom Inglesby, director of the Johns Hopkins Center for Health Security, answers a grab bag of listener questions. Learn more: jhsph.edu/covid-19

Bare shelves in grocery stores feed pandemic anxiety but Roni Neff, an expert on food systems and public health at the Johns Hopkins Center for a Livable Future, says this is not the biggest concern. Neff talks to Stephanie Desmon about how our robust food industry depends largely upon keeping its workers safe and well, how a pandemic completely shifts the model of emergency food access, and what's being done to address these unique challenges to ensure everyone is fed. Learn more about CLF's COVID-19 response: https://clf.jhsph.edu/projects/clf-and-food-systems-response-covid-19 (This episode was recorded on March 30, 2020)

Contact tracing is a core tool of public health. Now, it could be a way to reopen the world. Crystal Watson of the Center for Health Security is the lead author of a recent report with a national plan to scale up our capability to conduct contact tracing. Watson talks to Stephanie Desmon about what contact tracing entails, how technology could help, how to approach privacy concerns, and why the plan could help employ thousands of people with some basic training. Learn more: jhsph.edu/covid-19

Poor health care, lacking infrastructure, and generational poverty combine to make Native Americans especially vulnerable to COVID-19. With previous infectious respiratory illnesses like H1N1, mortality rates were sometimes four to five times higher than US averages among tribal communities. Allison Barlow, director of the Center for American Indian Health, talks to Stephanie Desmon about COVID-19's particular threats to Native Americans, what's being done to help mount a "culturally informed" response, and how the virus is "revealing the cracks in our systems." Learn more: jhsph.edu/covid-19

The COVID-19 dashboard run by the Johns Hopkins Center for Systems Science and Engineering has been a critical source of near real-time tracking of the spread of the novel coronavirus since it first emerged. Beth Blauer, executive director of Centers for Civic Impact and an expert on the public's use of data and analytics, is part of the team that manages the map. Blauer talks to Dr. Josh Sharfstein about how the global dashboard originated, what new features have been added, and how the data can help individuals and officials make informed decisions for COVID-19 response. Learn more: jhsph.edu/covid-19

Most new diseases originate from "spillover events" where humans come into contact with wild animals. Veterinarian and scientist Meghan Davis talks to Stephanie Desmon about the rise of infectious diseases and what is being done to prepare for future spillover events. She also covers how a tiger in the Bronx Zoo got a test, and the threats COVID-19 may pose to your own pets. Learn more: jhsph.edu/covid-19

The historical context of 1918 shaped much of the response to the flu pandemic in the US—just it will with COVID-19. Dr. Paul Spiegel, director of the Center for Humanitarian Health, talks with historian and author John Barry about how an absence of credible leadership and messaging hindered response efforts then and what lessons we can apply today. Learn more: jhsph.edu/covid-19

What did we learn this week? Is there a connection between 5G cell phone towers and the novel coronavirus? How often should you wash a homemade cloth mask? Is there any truth behind using hydroxychloroquine as a treatment? Will people on ventilators have permanent lung damage? What's it like for doctors and nurses in the hospitals right now? Dr. Amesh Adalja of the Johns Hopkins Center for Health Security addresses your questions submitted to [email protected] Learn more: jhsph.edu/covid-19

Development of a COVID-19 vaccine is an essential part of halting the pandemic. But will it be months or years before we see one? Vaccine expert Dr. William Moss talks to Stephanie Desmon about the complexities of vaccine development and manufacturing, potential hold ups, how opponents of vaccination may come into play, and why COVID-19 may threaten current immunization programs. Learn more: jhsph.edu/covid-19

Fallout from COVID-19 goes beyond case counts—we are facing "an epidemic of isolation and loneliness," says Councilman Zeke Cohen. The Baltimore Neighbors Network is a virtual community of trained volunteers who are available to listen to city residents and provide resources for follow-up if needed. Councilman Cohen, Shantay Jackson, executive director of the Baltimore Community Mediation Center, and Amy Greensfelder, executive director of Pro Bono Counseling, talk to Dr. Josh Sharfstein about how the network is addressing the mental health risks. Learn more: jhsph.edu/covid-19

What will need to happen for businesses and schools to reopen, and what might the future look like with COVID-19? Former CDC director Tom Frieden talks to Stephanie Desmon about what governments and individuals should be doing right now to help curb the spread of the virus and move America closer to reopening. Learn more: jhsph.edu/covid-19

There have been varying responses to COVID-19 carried out across local, state, and federal governments in the US. But what powers does the government have at various levels in a pandemic and how does the law work when an enemy like COVID-19 "does not respect jurisdictional boundaries?" Law expert and Hopkins professor Dr. Lainie Rutkow talks to Dr. Josh Sharfstein about a range of legal issues, including what happens if states start suing each other. Learn more: jhsph.edu/covid-19

Why was the US slow to stand up testing and is this improving? Should you wear a cloth mask in your daily activities? Jason Farley, an infectious disease-trained nurse epidemiologist at the Johns Hopkins School of Nursing, talks to Stephanie Desmon and breaks down the complications of testing for COVID-19 and why recommendations on the public's use of masks may be evolving. Learn more: jhsph.edu/covid-19

Early on in the COVID-19 outbreak, Singapore quickly launched a robust response which included widespread testing, diligent contact tracing and quarantining, and isolation of all sick persons, even those with mild symptoms. Alumnus Dr. Vernon Lee, Director of Communicable Diseases at the Ministry of Health of Singapore, talks to Dr. Josh Sharfstein about how lessons from the 2003 SARS outbreak informed Singapore's risk-based approach to staying a few steps ahead of the novel coronavirus. Learn more: jhsph.edu/covid-19

Globally, more men are dying from COVID-19 than women. But is this due to sex (biological differences), gender (social and contextual differences), or something else entirely? Stephanie Desmon talks to virologist Sabra Klein and social scientist Rosemary Morgan about risk factors associated with COVID-19.

In 2014, Tolbert Nyenswah, then an assistant minister of health in Liberia, was tapped to lead the nation's response to the Ebola epidemic. Under his leadership, an Incident Management System deployed thousands of epidemiologists, case managers, and contact tracers in a technical response that brought the outbreak under control. Nyenswah talks to Dr. Josh Sharfstein about what the US can learn from Liberia's experience and what needs to happen soon to get ahead of the curve. Learn more: jhsph.edu/covid-19

Una entrevista entre Monica Guerrero Vazquez, una graduada de La Escuela De Salud Publica de Johns Hopkins y Dra. Kathleen Page del Hospital Johns Hopkins sobre el virus que está afectando al mundo, incluyendo lo que podemos hacer para protegernos.

What does a global pandemic mean for the world's drug supply chain? Howard Sklamberg, lawyer and former FDA deputy commissioner, talks to Dr. Josh Sharfstein about the threats that COVID-19 poses to medications for everything from cancer to diabetes to hypertension. Learn more: jhsph.edu/covid-19

The Center for Health Security is back with another round of expert answers to your most-asked COVID-19 questions. If we reopen everything back up, what is the risk that we'll have a new surge of infections? As China considers loosening restrictions, how are they making those decisions? Why aren't there human temperature monitors in public places like airports, hospitals, and grocery stores? Is anyone considering breast milk for antibody therapy? Can two positive people quarantine together? How many people will actually get COVID-19? What are the most important unanswered questions right now? Eric Toner of the Johns Hopkins Center for Health Security addresses questions submitted to [email protected].

As public health experts stress the importance of hygiene and social distancing to slow the spread of COVID-19, what does this mean for the 2.3 million people incarcerated in the U.S.? Johns Hopkins Infectious disease epidemiologist Dr. Chris Beyrer talks to Stephanie Desmon about the difficulties of protecting people in these facilities, the low-risk/high-reward strategy of releasing those held on administrative misdemeanors, and how undocumented people may be one of our most vulnerable populations. Learn more: jhsph.edu/covid-19

Caring for patients with COVID-19 requires a new playbook in many ways. Dr. Brian Garibaldi, a pulmonologist in the ICU at Johns Hopkins Hospital and the medical director of the biocontainment unit, talks to Stephanie Desmon about his observations of COVID-19 patients including new challenges, changes to protocols, and coping with fears about he and his colleagues getting sick themselves. Learn more: jhsph.edu/covid-19

Equal access to resources, care, and information is a substantial problem for at-risk groups such as older adults, ethnic minorities, or those with low incomes even in the best of times. In this pandemic, where it's critical to "flatten the curve" among all groups, these barriers cannot be ignored. Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity, talks to Dr. Josh Sharfstein about what needs to be done to address these significant, persistent challenges. Learn more: jhsph.edu/covid-19

Like many, epidemiologist Keri Althoff and biostatistician Elizabeth Stuart are juggling different responsibilities and precautionary measures in the "new normal" of COVID-19. They talk to Stephanie Desmon not about their day jobs, but about play dates, community building while social distancing, ordering takeout, and how they're managing COVID-19 as parents, neighbors, and friends. Learn more: jhsph.edu/covid-19

What does it take to stand up a makeshift hospital—and enough people to staff it—in order to address critically ill patients of COVID-19? Dr. Cyrus Shahpar, Director of Prevent Epidemics team at Resolve to Save Lives talks to Dr. Josh Sharfstein about how to quickly scale up medical responses in a crisis. Learn more: jhsph.edu/covid-19

Dr. Bin Cao, vice president and director of Respiratory and Critical Care Medicine at the China-Japan Friendship Hospital in Beijing, has worked on the front lines of patient care in Wuhan for the past few months. By closely monitoring the disease, he and his team are beginning to unlock some of its secrets. Cao talks to Dr. Josh Sharfstein about how the situation has changed in Wuhan, what we can learn about safeguarding providers, the primary risk factors for death, and ongoing research. Learn more: https://www.jhsph.edu/covid-19/articles/public-health-on-call-bin-cao-a-brand-new-virus.html

What do we know this week that we didn't know last week? What's the status of serologic testing and can it be useful in helping to end social distancing practices? How good is the current evidence on chloroquine? Should COVID-19 patients avoid taking ibuprofen? What happens next if we are successful with social distancing? If you are older but have no chronic illness, are you still at high risk? More information: jhsph.edu/covid-19

COVID-19 is often compared to the 1918 flu pandemic that claimed millions of lives and caused massive social disruption. But to what extent is the novel coronavirus different and what lessons can we learn from the successes and failures of previous epidemics? Medical historians Jeremy Greene and Graham Mooney talk to Stephanie Desmon about this comparison, the history of quarantines, and what we will learn from what we are living through right now. More information: jhsph.edu/covid-19

Dr. Judy Melinek is a forensic pathologist in the San Francisco Bay Area. She explains the role of autopsies in the public health response to COVID-19 and how her work also plays a difficult but vital role in disposing of remains when health care systems become overloaded. Warning: This episode contains some graphic descriptions of autopsy procedures and bereavement that some listeners may find upsetting. More information: jhsph.edu/covid-19

In the midst of a pandemic, resilience is key for health care workers. Dr. Albert Wu, co-director of RISE—Resilience In Stressful Events—an emotional peer support structure at Johns Hopkins Hospital, talks to Dr. Josh Sharfstein about the importance of supporting hospital staff and what can be done to mitigate anxiety and stress in this unprecedented situation. Learn more: jhsph.edu/covid-19

The threat of COVID-19 presents a new challenge for citizens of many countries who are not used to government entities directing their behavior. It's also an ideological shift for many: Change your individual behavior for the good of the greater community. Monica Malta, an alumna of the Johns Hopkins Bloomberg School, is a social epidemiologist and a global health researcher at the University of Toronto. She examines how responses at local, national, and regional levels—along with individual and community behavioral changes—can change the pace of an outbreak. Malta talks to Stephanie Desmon of the Center for Communication Programs about effective response strategies, why the outbreak looked so different in Italy and Japan despite both countries having aging populations, and what the US and Canada can do to prepare for an uptick in cases.

There are so many unknowns around COVID-19, so how can we find credible sources of information? What is the role of communication in the pandemic and how can authorities get it right? Susan Krenn, executive director of the Johns Hopkins Center for Communication Programs, talks to Stephanie Desmon about how communication can combat fear if it's credible, transparent, timely, and gives people the resources they need. More information: jhsph.edu/covid-19

For many, COVID-19 has revealed an anxiety-ridden world of unknowns. Protecting our mental health is just as important as protecting our physical health in this pandemic. But how can we find comfort if we're inundated with scary messages and physically cut off from people we love? Dr. Monica Schoch-Spana of the Center for Health Security talks to Dr. Josh Sharfstein about caring for ourselves and for vulnerable populations like frontline healthcare providers, friends and neighbors in quarantine, and those with underlying health conditions like anxiety or depression.

Why is the response to COVID-19 so much more severe than the response to other outbreaks like H1N1 or SARS? Will a vaccine be more effective than the usual flu vaccine? Has the shortage of available testing been resolved? Are we seeing more cases because of increases in transmission or testing? Why does COVID-19 cause shortness of breath? Can drinking cold water increase your risk of infection? Jennifer Nuzzo of the Johns Hopkins Center for Health Security addresses some myths and questions submitted to [email protected] More information: jhsph.edu/covid-19

Recent volatility in the financial markets have shaken investors and left everyone asking: Are we currently in a financial crisis? Author and expert on financial crises Kathleen Day of the Johns Hopkins Carey Business School talks to Stephanie Desmon of the Johns Hopkins Center for Communication Programs about how the novel coronavirus is affecting local and global economies, and what consumers should do right now. More information: jhsph.edu/covid-19

What are the human rights considerations in the response to COVID-19? How can societies move to control the spread of the virus in ways that do not create panic or unnecessarily restrict communities? What are critical considerations as governments try to strike the right balance between restrictions and depriving people of the ability to live their lives? Dr. Josh Sharfstein talks to Len Rubenstein, Conflict and Health program director of the Center for Public Health and Human Rights. More information: jhsph.edu/covid-19

What is #FlattenTheCurve? Caitlin Rivers, senior scholar at the Center for Health Security talks to Dr. Josh Sharfstein about this response strategy, what it means for you, and how staying home can help ensure that everyone who needs healthcare in an outbreak will be able to get it. More information: jhsph.edu/covid-19

Is there potential for using antibodies generated by people who have recovered from COVID-19 to prevent infection and treat those who are sick? Dr. Josh Sharfstein talks to Arturo Casadevall, chair of Department of Molecular Microbiology and Immunology at the Bloomberg School of Public Health, about a landmark 1934 case where antibodies helped stopped a measles outbreak. More information: jhsph.edu/covid-19

Is it right to publicly disclose information about people who get sick with COVID-19? What are society's obligations to people who are quarantined? Is it time to start thinking about how to allocate critical healthcare resources in case this epidemic stretches the healthcare system beyond its capacity to care for everyone? Dr. Josh Sharfstein speaks with renowned ethicists Jeffery Kahn and Nancy Kass, the director and deputy director of the Johns Hopkins Berman Institute of Bioethics. More information: jhsph.edu/covid-19

Dr. Lucy Wilson, professor of Emergency Health Services at University of Maryland Baltimore County, talks with Dr. Josh Sharfstein about why the Seattle outbreak is an important bellwether for the rest of the country in terms of protecting vulnerable populations, and what facilities and first responders can do to control and stop outbreaks like COVID-19. More information: jhsph.edu/covid-19

Can people without symptoms spread COVID-19? Can children get COVID-19? Should you cancel an upcoming gathering? Are school closures helpful? If you've had COVID-19, are you immune? Are men more affected than women? Dr. Tom Inglesby from the Center for Health Security answers these and some of the most asked questions sent to [email protected]. More information: jhsph.edu/covid-19

Weak points in the U.S.'s health and social policies—like paid sick leave and universal health coverage—disproportionately affect underserved communities. COVID-19 may present added challenges for these populations. Dr. Josh Sharfstein talks to Dr. Georges Benjamin, executive director of the American Public Health Association, about public health's role in preventing communities from being left behind. More information: jhsph.edu/covid-19

What role do local health departments play in outbreaks and how are they preparing for COVID-19? As Commissioner of the Cuyahoga County Board of Health in Ohio, Terry Allan is responsible for the well-being of over 850,000 people. Allan talks to Dr. Josh Sharfstein about public trust and the importance of open information sharing, and how ongoing relationship building and past experience help set the stage for protecting people in their communities. More information: jhsph.edu/covid-19

Why the director of Hopkins' Office of Critical Event Preparedness is preparing but not panicking: Dr. Gabor Kelen, Director of the Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR) talks to Dr. Josh Sharfstein about what's contributing to public fears about COVID-19, how the institution assesses what actions to take, and his one piece of advice for people experiencing mild symptoms. More information: jhsph.edu/covid-19

COVID-19 presents new challenges for health care providers in the midst of respiratory virus season. Dr. Lisa Maragakis, Senior Director of Infection Prevention at Johns Hopkins University School of Medicine, talks to Dr. Josh Sharfstein about standard precautions, protecting hospital staff while ensuring coverage, how previous outbreaks have laid some groundwork to address this one, and what you can do to help. More information: jhsph.edu/covid-19

Is hand sanitizer effective? Will this spread throughout the US? Should I cancel my upcoming travel plans? Can COVID-19 tests tell the difference between someone who has had the virus and someone who currently has it? Are face masks effective? Jennifer Nuzzo of the Johns Hopkins Center for Health Security answers these and some of the most asked questions submitted to [email protected] More information: jhsph.edu/covid-19

An interview with Professor Andrew Pekosz of the Johns Hopkins Bloomberg School of Public Health, an expert in the basic science of respiratory viruses, including influenza and SARS. Dr. Pekosz shares what's known and what is yet to be discovered about the novel coronavirus. More information: jhsph.edu/covid-19

Dr. Josh Sharfstein interviews infectious disease epidemiologist Dr. Justin Lessler on the features of viruses that lead to worldwide contagion, how COVID-19 compares with the flu in terms of speed, and where the evidence now points for this novel coronavirus. Dr. Justin Lessler is an Associate Professor in Epidemiology. Dr. Josh Sharfstein is the Vice Dean of the Johns Hopkins Bloomberg School of Public Health and former secretary of Maryland's Department of Health. More information: jhsph.edu/covid-19 KEYWORDS: asymptomatic, influenza, transmission

With COVID-19 beginning to spread via community transmission in the U.S. and the WHO raising its risk assessment to "very high," experts from the Johns Hopkins School of Public Health and Johns Hopkins University School of Medicine offer insights on the growing global public health concern. Featuring Dr. Jennifer Nuzzo and Dr. Tara Kirk Sell of the Johns Hopkins Center for Health Security and Lauren Sauer of the Johns Hopkins Office of Critical Event Preparedness and Response; moderated by Dr. Josh Sharfstein, Vice Dean of the Johns Hopkins Bloomberg School of Public Health and former secretary of Maryland's Department of Health. More information: jhsph.edu/covid-19 KEYWORDS: coronavirus facts, pandemic, crisis response