Public Health On Call

It's graduation time at the Bloomberg School! Doctoral candidate Francesca Marino joins the podcast to talk about how her interest in neuroscience led her to pursue a degree in epidemiology, and about her research looking into whether and how daily patterns of physical activity tracked through a wearable device could indicate cognitive health or decline. Guest: Dr. Francesca Marino is a recent graduate of the Johns Hopkins Bloomberg School of Public Health whose research focuses on the epidemiology of aging. Host: Dr. Josh Sharfstein is vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, a faculty member in health policy, a pediatrician, and former secretary of Maryland's Health Department. Show links: Associations of Physical Activity and Heart Rate Variability from a Two-Week ECG Monitor with Cognitive Function and Dementia: the ARIC Neurocognitive Study—PubMed Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Activity, Sleep & Dementia—Hopkins Bloomberg Public Health Magazine Get the transcript for this episode (PDF) Contact us: Have a question about something you heard? Want to suggest a topic or guest? Contact us via email or on our website. Follow us: @‌PublicHealthPod on X @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed

Armed internal conflict in Sudan has created a humanitarian crisis with millions of people displaced both internally and to neighboring countries. Dr. Salim Mohamednour, a medical epidemiologist with expertise in emergency response and the national health coordinator at the WHO country office in Sudan, talks with Dr. Josh Sharfstein about the unfolding catastrophe and what needs to be done. Special thanks to Aseel Salih, Hassan Salih, and Laila Zomorodian, Johns Hopkins Bloomberg School of Public Health students who assisted with the production of this podcast. A note that Dr. Mohamednour is not representing the WHO on the podcast. Content warning: this episode contains depictions of violence. Listeners interested in contributing can consider supporting the World Food Program, the Sudanese American Physicians Association, and Sadagaat. Get the transcript for this episode (PDF)

The planetary health crisis can't be ignored in hospitals where patients are sick from climate-driven things like asthma from air quality emergencies, COVID-19 from a zoonotic spillover event, and cardiovascular complications from heat waves. Chris Lemon, an ER doctor and Bloomberg Health Initiative fellow who focuses on the intersection of climate change and health, talks with Stephanie Desmon about his work bringing planetary health dialogue to hospital staff while also looking at ways health systems can lower their massive carbon footprints. Get the transcript for this episode (PDF)

From mushrooms to microscopic organisms, fungi represent a serious—and still relatively unexplored—threat to human health. Dr. Arturo Casadevall returns to the podcast to talk about his new book, What If Fungi Win? which looks at why certain fungal infections take off, why they're so hard to treat, and why we will most certainly see more of them with climate change and treatment-resistant strains. Learn more. Get the transcript for this episode (PDF)

Johnson v. Grants Pass, a case before the U.S. Supreme Court, raises the question of whether homelessness can be criminalized. Ashley Meehan, a doctoral student at Johns Hopkins, talks with Dr. Josh Sharfstein about the public health dimensions of this issue. They discuss her research looking into what happens to people after encampment sweeps and what policies would benefit not only people experiencing homelessness but their communities and cities as well. Listen to our previous episode on this issue. Get the transcript for this episode (PDF)

Dengue, or "break-bone fever"—a disease transmitted by mosquitoes that can cause serious fever, rash, muscle and joint pain and even problems with bleeding and shock—is surging around the world and popping up in new places like the U.S. Vaccine expert Anna Durbin returns to the podcast to talk with Stephanie Desmon about these trends and the general status of vaccines, treatments, and prevention. Learn more. Get the transcript for this episode (PDF)

More than a decade after electronic cigarettes became broadly available in the United States, their merits are still being debated. Do these products help people quit smoking? How serious are the health risks associated with these products? In a two-part series, we hear from two researchers in tobacco control about their views. In part two, Stan Glantz, the Truth Initiative Distinguished Professor of Tobacco Control at the University of California San Francisco talks with Dr. Josh Sharfstein about his research into the harms of electronic cigarettes and the dangers of "dual use" of electronic cigarettes and traditional cigarettes. In an epilogue, Public Health On Call audio producer Matt Martin talks with Lindsay Smith Rogers about his personal history of tobacco use – including his efforts to quit with electronic cigarettes. Read Glantz's paper in New England Journal of Medicine Evidence. Listen to part one of the series. Get the transcript for this episode (PDF)

More than a decade after electronic cigarettes became broadly available in the United States, their merits are still being debated. Do these products help people quit smoking? How serious are the health risks associated with these products? In a two-part series, we hear from two researchers in tobacco control about their views. In part one, Dr. Nancy Rigotti, Professor of Medicine at Harvard Medical School talks with Dr. Josh Sharfstein about the use of e-cigarettes for smoking cessation. Read her editorial in the New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMe2314977

Virologist Dr. Andy Pekosz and public health veterinary expert Dr. Meghan Davis return to the podcast to talk with Stephanie Desmon about what we've learned so far from viral sequencing of H5N1, its presence in milk, what we know about infections in humans, the status of the overall response to a major pathogen of concern on the heels of COVID-19, and more. Read Dr. Davis's recent New York Times essay on protecting the dairy workforce. Download the transcript of this episode (PDF)

An alarming and dangerous syphilis surge across the Great Plains Region, an area spanning North Dakota, South Dakota, Nebraska, and Iowa, has prompted tribal officials to urge HHS Secretary to declare a public health emergency. Dr. Meghan Curry O'Connell, chief public health officer at the Great Plains Tribal Leaders Health Board and a member of the Cherokee Nation, talks with Lindsay Smith Rogers about the outbreak and why public health officials are struggling to respond. Learn more: Tribal Leaders Urge HHS Secretary to Declare Syphilis Emergency How a fight over data made South Dakota's bad syphilis outbreak worse Download the transcript for this episode.

In part two of a two-part series about the crisis of health care for immigrants and refugees at the U.S.-Mexico border, Dr. Alexander Tenorio, a neurosurgical resident at the University of California, San Diego, talks with Dr. Josh Sharfstein about the influx of traumatic brain and spinal injuries his team has seen from people attempting to climb the border wall. They discuss the scope of the problem and the policies behind it, and why it often takes hours for victims to get critical care. They also talk about Dr. Tenorio's personal connection to the situation as a first-generation American born to Mexican immigrants. Download the transcript for this episode.

In part one of a two-part series about the crisis of health care for immigrants and refugees at the U.S.-Mexico border, Dr. Janine Young, a pediatrician at the University of California, San Diego, talks with Stephanie Desmon about the tenuous situation for children and families. More and more people are showing up at the border in poor health—dehydrated, malnourished, some severely injured and many traumatized—without any adequate care to meet them. They talk about the immigration policies that have led to a system ill-equipped to properly triage and treat the children and families seeking refuge in the U.S., and the misconceptions around people who are fleeing for their lives.

Methadone is a highly effective treatment for substance use disorder but strict regulations like daily clinic visits have led to its nickname, "liquid handcuffs." Dr. Yngvild Olsen, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services administration, talks with Lindsay Smith Rogers about new federal regulations that expand access to this life saving medication. They talk about how the COVID era showed that changes can make methadone much easier to prescribe and access, and how these updates are part of a critical cultural shift towards making substance use treatment more reasonable, equitable, and compassionate. Resources for this episode: https://www.samhsa.gov/medications-substance-use-disorders/statutes-regulations-guidelines/methadone-guidance https://findtreatment.gov/

World Malaria Day is April 25. Today, guest host Thomas Locke takes us to Capitol Hill where we meet malaria scientists who have joined an advocacy group to lobby members of Congress to fund critical interventions against malaria. They talk about their work and what scientific messages they bring to DC to impart on policy makers who play a major role in efforts to combat this preventable and deadly disease. This special episode is an extended version of Malaria Minute, a podcast from the Johns Hopkins Malaria Research Institute. Learn more: https://publichealth.jhu.edu/malaria-research-institute https://publichealth.jhu.edu/events/2024/world-malaria-day-symposium https://publichealth.jhu.edu/malaria-research-institute-1

Humans are transforming, degrading, and altering Earth's natural life support systems so profoundly that our actions have created an existential crisis. For Earth Day, Sam Myers, founding director of the Planetary Health Alliance and director of the brand new Johns Hopkins Institute for Planetary Health, talks with Dr. Josh Sharfstein about the concept of planetary health, an interdisciplinary approach to understanding how the state of the earth affects the health of us all. Learn more: http://Planetaryhealthalliance.org https://planetaryhealth.jhu.edu/

The presence of infectious diseases can be picked up through wastewater surveillance but how can this data be useful in predicting future outbreaks? Dr. Dylan George, director of the Center for Forecasting and Outbreak Analytics at the CDC, talks with Dr. Josh Sharfstein about how the Center's forecast for the 2023-2024 respiratory virus season performed and the role of wastewater surveillance as part of a multifaceted approach to aggregating data. Resources from this episode: https://johnshopkinssph.libsyn.com/699-an-update-on-the-cdcs-new-center-for-forecasting-and-outbreak-analytics https://magazine.jhsph.edu/2020/cloudy-chance-covid https://www.theinvisibleshieldseries.com/

There's a lot of research around Type 2 diabetes that has informed patient care when it comes to diagnosis, treatment, and lifestyle management. But much less is known about Type 1, long mislabeled "childhood diabetes." Johns Hopkins epidemiologists Elizabeth Selvin and Michael Fang talk with Stephanie Desmon about new research debunking a lot of previously held assumptions about Type 1 diabetes, the prevalence of adult onset and correlation with obesity, and why different approaches to diagnosis and management are necessary. They also discuss the cost of insulin and why more research is needed around medications like Ozempic for Type 1 diabetes.

Cigarette butts are the most littered object in the world. With their plastic filters and toxic substances, they are a significant source of contamination for soil and water. Grazi Grilo, a researcher at the Global Institute for Tobacco Control, talks with Stephanie Desmon about her work quantifying the scope of the problem, and why some of the very things that make cigarettes so environmentally hazardous also provide enormous benefits for the tobacco industry.Read more about her work here: https://publichealth.jhu.edu/institute-for-global-tobacco-control/2024/assessment-of-littered-cigarette-butts-in-brazil-informs-strengthening-of-global-treaty

Dr. Antonia Novella served as the 14th Surgeon General under President George H.W. Bush from 1989 - 1993. She is the first female and first Hispanic Surgeon General in U.S. history. Dr. Novella talks with Dr. Josh Sharfstein about her life and career, from being born with a rare condition called Hirschsprung's disease to her childhood in Puerto Rico and her notable career in medicine and public health. She also discusses facing prejudice, staring down Big Tobacco, and even buying support hose for a U.S. Senator. You can read more in her new autobiography: https://www.fulcrumbooks.com/product-page/duty-calls-lessons-learned-from-an-unexpected-life-of-service Read more about the epic surgeons general event here: https://pages.jh.edu/gazette/aprjun98/apr1398/13surgen.html

Much research has been dedicated to the long-lasting negative impacts of adverse childhood experiences—far less has focused on the powerful effects of positive experiences. Dr. Melissa Walls, co-director of the Center for Indigenous Health and a member of the Bois Forte and Couchiching First Nation bands, talks with Lindsay Smith Rogers about her research with benevolent childhood experiences among Indigenous communities. They discuss the importance of researching the positive, not only for public health, but in celebrating the inherent strengths of Indigenous individuals, their families, and culture. Read more: https://pubmed.ncbi.nlm.nih.gov/38419503/

On March 26, Baltimore's iconic Francis Scott Key Bridge was hit by a cargo ship and collapsed, killing six people. Since then, many have found themselves watching endless loops of the video and ongoing coverage, and some are feeling symptoms of anxiety or even intense fear. Dr. George Everly, a Johns Hopkins psychologist, talks with Stephanie Desmon about the phenomenon of "psychological contagion" and how something so rare but so spectacular can suddenly make us question our sense of safety. They also discuss how to talk to kids about events like these and what to do when healthy curiosity becomes problematic. Read Dr. Everly's Psychology Today piece here: https://www.psychologytoday.com/us/blog/when-disaster-strikes-inside-disaster-psychology/202403/the-dangers-of-the-baltimore-bridge

Recent reports of spillover of avian virus H5N1 into cows, cats, and even one human are concerning to the scientific community for a number of reasons. But what does the public need to know? Virologist Dr. Andy Pekosz and public health veterinary expert Dr. Meghan Davis return to the podcast to talk with Stephanie Desmon about these spillovers events and what they mean for biosecurity and our safety.

Per- and polyfluorinated substances are in all kinds of products from waterproof makeup to fire retardants. Dr. Ned Calonge, co-author of a new report from the National Academies of Sciences, Engineering and Medicine, talks with Stephanie Desmon about these "forever chemicals" and what is known about their impact on health, who is most at risk, and what people should do if they have high levels of exposure. Read the report here: https://nap.nationalacademies.org/catalog/26156/guidance-on-pfas-exposure-testing-and-clinical-follow-up

Xolair is the first FDA-approved therapy to prevent severe and potentially life-threatening reactions in adults and children who are allergic to dairy, eggs, wheat, nuts and other foods. Dr. Robert Wood, the director of pediatric allergy and immunology at Johns Hopkins, talks with Lindsay Smith Rogers about this drug that has the potential to make life a little easier for patients and parents of children with severe allergies.

A hidden population of children serve as caregivers for family members who are chronically ill, elderly, disabled or injured. Left out of the systems that support adult caregivers, these youths often sacrifice their education, health, well-being, and childhoods. Connie Siskowski, founder and president of the American Association of Caregiving Youth, and Dr. Julie Belkowitz, a pediatrician at the University of Miami School of Medicine talk with Dr. Josh Sharfstein about these young people and the enormous responsibilities they take on, and what is needed to help support them so they can thrive. Learn more: https://aacy.org/

How can a play about rural Norway in 1882 help us process the trauma of the COVID-19 pandemic? That's the question posed by Theater of War Productions, which is hosting readings of The Enemy of the People, by Henrik Ibsen—and then is leading intense community conversations immediately following the productions. Bryan Doerries, artistic director of Theater of War Productions, speaks to Dr. Josh Sharfstein about how this old Norwegian play speaks to the trauma experienced by the public health field and by community members during the pandemic. You can watch the Ohio productions live via Zoom and participate in the conversation afterwards on April 6 and 7 at 6pm. You can sign up for free under the events tab at http://theaterofwar.com. If you missed our first conversation about the parallels between the COVID-19 pandemic and The Enemy of the People, you can listen here: https://johnshopkinssph.libsyn.com/132-the-enemy-of-the-people-by-henrik-ibsen-and-parallels-to-the-covid-19-pandemic

Despite a national plan to eliminate syphilis by 2010, the sexually transmitted infection has reached the highest rates since the 1950s. Dr. Khalil Ghanem, a researcher of sexually transmitted infections at the Johns Hopkins Bloomberg School of Public Health, talks with Stephanie Desmon about syphilis infections and the disease course, and why rates are so high not just in the US but around the world. Learn more: https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us

The 2010 passage of the Affordable Care Act marked a major change in health insurance coverage and care for millions of Americans. Department of Health and Human Services Secretary Xavier Becerra talks with Stephanie Desmon about the remarkable changes "Obamacare" has brought about, why it's important for all Americans not to take these for granted, and the next set of challenges in mending a health care system that's still too focused on treatment of complications, not prevention.

More than 2 billion people lack access to safe drinking water, and more than 3 billion are living without safe sanitation systems. For World Water Day, Ken Conca, a professor of international relations at the School of International Service at American University, joins the podcast to talk with Dr. Josh Sharfstein about the state of the world's water. They discuss how some of the biggest challenges to water access and quality are political and legal, rather than technical, in nature. They also discuss how water, which knows no jurisdictions, can bring people and nations together. Learn more: https://www.un.org/en/observances/water-day

Menopause: inevitable, stigmatized, mysterious, and bringing a broad range of symptoms and experiences. Dr. Martha Hickey, a menopause researcher at the University of Melbourne, talks with Stephanie Desmon about a new Lancet series on menopause. They discuss how ageism and sexism come into play, the vast array of experiences women may have, and how individual circumstances can impact symptoms. They also talk about why it's time to stop referring to menopause as a medical disorder and think more broadly about the need to provide better support and high-quality information for women during this life transition. Learn more: https://www.thelancet.com/series/menopause-2024

Four years after the early days of the pandemic, how are hospitals thinking about infection control, how much has changed, and to what degree have things returned to "normal"? Dr. Lisa Maragakis, the head of infection control at Johns Hopkins Hospital, returns to the podcast to talk with Dr. Josh Sharfstein about this "post-pandemic phase" and why health care has not fully recovered from pandemic disruptions.

A new report models projections of the human costs of conflict in Gaza over the next six months across several scenarios. Paul Spiegel, director of the Center for Humanitarian Health, and Tak Igusa, professor of Civil and Systems Engineering at the Johns Hopkins Whiting School of Engineering talk with Dr. Josh Sharfstein about the project they developed with the London School of Hygiene and Tropical Medicine. See the full report here: https://gaza-projections.org/

In his new book Within Reason: A Liberal Public Health for an Illiberal Time, Dean Sandro Galea of the Boston University School of Public Health challenges closed-mindedness and invective in public health. In this special, extended bonus episode, Dr. Galea and his friend and colleague Dr. Josh Sharfstein discuss—and debate—the fairness of his critique.

Condoms were once an essential part of the public health toolkit to fight HIV and STIs. But over the last decade, and coinciding with the rise of medication that prevents HIV infection, condom use among men who have sex with men has declined. Steve Goodreau, an expert in mathematical modeling and HIV and STIs at the University of Washington, talks with Stephanie Desmon about his research on declining condom use and why public health should be doing more to tout the advantages of what was once one of the most ubiquitous tools in safer sex. Read his op-ed here: https://journals.lww.com/aidsonline/citation/9900/bringing_back_condoms.458.aspx

Health misinformation is rampant—online and through rumors—but there are steps people can take to help stamp them out. Aishwarya Nagar and Tara Kirk Sell from the Center for Health Security are co-authors of a new playbook aimed at helping public health practitioners, medical professionals, and health communicators recognize and respond to health-related rumors and misinformation. They talk through some specific tactics with Lindsay Smith Rogers and also discuss how we can all help improve our own health information literacy. Learn more: https://centerforhealthsecurity.org/2024/center-launches-new-practice-oriented-playbook-for-addressing-health-misinformation

When Sue Baker started her research career in the 1960s, there was no field devoted to injury prevention despite accidents being a leading cause of death in the US. In honor of Women's History Month, Stephanie Desmon talks with injury prevention pioneer Baker about her half century of research looking at everything from aviation safety to hot dog choking deaths, and her hands-on approach to research which included getting her pilot's license, working in a medical examiner's office, and driving a commercial truck.

The CDC announced new isolation guidelines last week that bring COVID-19 in line with recommendations for other viral respiratory diseases. Virologist Dr. Andy Pekosz returns to the podcast to talk with Stephanie Desmon about what this means in the contexts of vaccines, variants, and protecting the most vulnerable.

Food insecurity uniquely impacts youth ages 14-18 but it's largely a hidden problem. Kristen Mmari, an adolescent health researcher at Johns Hopkins, talks with Lindsay Smith Rogers about the long-term impacts being hungry can have on young people and why most programs aimed at relieving food insecurity don't help this age group. They also discuss false claims that nutrition assistance programs contribute to childhood obesity. Learn more: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2023.307489

Opioid use disorder is a major contributor to maternal mortality in the US. The gold standard of care is medication like methadone, but for incarcerated pregnant people, treatment can be difficult to access and highly stigmatized. Johns Hopkins obgyn and reproductive health researcher Dr. Carolyn Sufrin and Bloomberg Fellow Camille Kramer talk with Lindsay Smith Rogers about their new study that shows not only just how difficult OUD medication is to access behind bars for anyone, let alone pregnant women in the prison system. https://arrwip.org/projects/management-of-pregnant-people-with-opioid-use-disorder-in-jail/

The manslaughter conviction of Jennifer Crumbley, whose son shot and killed four students at his school, is unprecedented. But will it be a watershed moment for gun violence in schools? Tim Carey, law and policy advisor at the Johns Hopkins Center for Gun Violence Solutions, talks with Stephanie Desmon about the unique facts of this case, larger implications, and why Child Access Prevention laws are an important part of the conversation. Please note that since this podcast was recorded, a man in Michigan became the first person to be charged under the state's new firearms storage law. The law requires gun owners to store firearms unloaded and secured with a locking device or in a lockbox if a minor lives at or is likely to visit their property.

Imagine going to the pharmacy to buy a needed medicine and then finding out you purchased a falsified product that was, at best, ineffective, but at worst contained something toxic or deadly? This is the unfortunate reality in many places worldwide. Dr. Murray Lumpkin, who leads global regulatory systems for the Bill & Melinda Gates Foundation, talks with Lindsay Smith Rogers about the substantial problem of substandard and falsified drugs, and what the world's watchdog systems are trying to do to counter them.

The Alabama Supreme Court issued an extraordinary ruling on February 16 that embryos that are the result of in vitro fertilization are "children." Public health law expert Joanne Rosen returns to the podcast to talk with Dr. Josh Sharfstein about the case and its implications for IVF, how it connects to the larger context of post-Roe litigation, and what's at stake as anti-abortion sentiment crashes up against medical technology designed to facilitate pregnancies.

Measles outbreaks can quickly spread like wildfire. Vaccination expert Dr. Saad Omer returns to the podcast to talk with Dr. Josh Sharfstein about the threat posed by this highly contagious and potentially lethal virus – especially when communities let their guard down. They discuss the situation in Florida, misinformation spreading on social media, and what's needed to minimize the threat.

What's the state of the evidence on the impact of social media on the mental health of adolescents? Dr. Ceren Budak, a computational social scientist at the University of Michigan, talks with Dr. Josh Sharfstein about a new report from the National Academies of Science, Engineering, and Medicine. The report finds a gaping need for more evidence – and for participation by social media companies in supporting research. They discuss recommendations for caregivers, Congress, and social media companies to help maximize the benefits of social media while minimizing potential harms.

Deadly hepatitis C is curable, but 2.5 million Americans remain infected without treatment. Dr. Francis Collins, longtime director of the National Institutes of Health, is now serving as a special advisor to Present Biden for an effort to eliminate hepatitis C in the US. He speaks with Stephanie Desmon about why hepatitis C has been so tricky to diagnose and treat and what it will take to launch a coordinated effort to cure every American living with the disease.

From a 2019 school shooting in West Baltimore, Healing City Baltimore was born. The program aims to help city agencies train their employees, reform stigmatizing policies, and build new response programs—all with a goal of helping to improve mental health and well-being. Councilman Zeke Cohen and executive director Reverend Kim Lagree talk with Dr. Josh Sharfstein about this initiative, which recently won the Culture of Health prize from the Robert Wood Johnson Foundation and is now a model for other cities. Learn more: https://www.rwjf.org/en/grants/grantee-stories/2023/2023-winner-baltimore-md.html

Alcohol use is the fourth leading cause of death in the US, but there are evidence-based approaches to preventing alcohol misuse and deaths and treating use disorders. Dr. Cara Poland, an addiction medicine specialist at Michigan State University, talks with Stephanie Desmon about excise taxes, evidence of the harms of alcohol, and her personal connection to the topic. They also discuss the differences between misuse and disorders and challenging false notions around alcohol's health protective effects.

Missed diagnoses account for 800,000 deaths or permanent disabilities among Americans every year. Johns Hopkins neurologist Dr. David Newman-Toker talks with Stephanie Desmon about the consequences of missed opportunities and diagnoses, especially for vascular events, infections, and cancers. They also discuss why solutions are complex and will require major efforts in terms of research and resources.

In the Dobbs decision, the SCOTUS majority hoped to return legal issues around abortion back to the states. But since overturning Roe v. Wade, a flurry of litigation has now put two consequential cases before the Supreme Court. Public health law expert Joanne Rosen talks with Dr. Josh Sharfstein about these two cases and the wide-ranging impacts they could have. They also discuss why abortion health care, largely an issue governed by individual states, keeps finding its way back into conversations about federal oversight.

When the FDA approved an RSV vaccine for infants in July of 2023, parents and pediatricians rejoiced. But product shortages and a patchwork of insurance coverage throttled the rollout, leaving many babies still unprotected this winter. Pediatrician and Internist Dr. Wendie Grader-Beck talks with Dr. Josh Sharfstein about her frustrations around implementation, and what needs to be done before the next RSV season for this lifesaving technology to fulfill its promise.