Published November 3, 2020
Last week’s fifth annual Richard V. Lee, MD, Lecture in Global Health, presented by noted COVID-19 expert Ashish K. Jha, was a study in dichotomies.
Jha, dean of Brown University’s School of Public Health, leads national analysis of key COVID-19 issues and appears frequently in national news outlets. While predicting that the world is entering an “age of pandemics,” he also made a “bold and risky” prediction that the lifespan of the COVID-19 pandemic would be around 18 months. And, although the popular Lee Lecture traditionally takes place in person, this year’s virtual event allowed more than 500 people from around the globe to hear Jha speak.
Jha’s prediction of an “age of pandemics” emerges from his work co-leading an international panel looking at the world’s response to the Ebola outbreak. “It became clear that a big pandemic was coming,” he said. So, in 2015, he created a course about preventing the next pandemic, which included asking a panel of experts if the world would be ready if a global pandemic occurred in five years.
“Everyone said no,” he recalled, noting that every factor that led to the COVID-19 pandemic will be around for a long time. For instance, novel viruses almost always spread from animals to humans, and humans are more frequently coming into contact with animals for a range of reasons, like climate change. As well, growing globalization drives the spread of local outbreaks around the world — a defining characteristic of a pandemic.
Jha quickly put his stake in the ground with an admittedly “bold and risky” forecast that COVID-19 will be an 18-month pandemic. Right now, he said, “We’re at the bottom of the fifth inning of a nine-inning game.” Placing the beginning of the pandemic as Jan. 1, 2020 — the day after China informed the World Health Organization of a new source of viral pneumonia of unknown cause in Wuhan — Jha believes the pandemic will be under reasonable control by, “optimistically,” June 2021.
November 2020 through January 2021 will be difficult: “Cold weather is driving [infection] because it’s hard for people to be outdoors anymore, and the virus spreads better when air is cold and dry,” he said. (Given the latest infection statistics, Jha’s calculation that the United States will be first country to see 100,000 cases in one day seems likely.)
By February and March, new technologies will lead to widespread testing, which will make an “enormous difference” in terms of how much protection exists in the community. Next, Jha said, is the emergency-use designation for possibly three or more vaccines. If 60%-70% of people decide to get a vaccine that is 70%-80% effective, with front-line and high-risk people getting vaccinated first, by June “things could be measurably better.”
His timeline is specific to the U.S. and Europe. The timeline is longer for the rest of the world and largely depends on vaccine development. “Our ability to make billions of doses is an enormous challenge,” he said. And progress could also stall if the vaccine isn’t as effective, or if people decide not to take it. But, Jha pointed out, “Even if, by February, 10%-15% of people get vaccinated, we might get to a point where we start seeing a slowing of the virus.”
The development, manufacture, distribution and delivery of a vaccine or vaccines is a vital link in the chain of success, and Jha emphasizes the need to get it done right. “It's very complicated, and there’s a lot of logistical and supply chain issues that are going to hamper us,” he explained.
Another key link is the public health field itself. While the whole world now understands the importance of the public health field, public health professionals also have to make sure to work with people outside of their discipline — education specialists, economists, sociologists and others. The world is not going to leave the ultimate solution to the pandemic just to public health experts, so “we need to broadly engage people outside our field,” he added.
Jha thinks the greatest failure of the U.S.’s federal response to the pandemic was the failure to take the virus seriously and communicate that effectively to the country.
“If we had federal leadership in March that said this is a very serious thing … we have a lot of work to do. But we're America. We can do hard things, and we can get going,” Jha said. “That would have made an enormous difference because I think Americans would have been able to mentally prepare.”
Jha ended his talk by recommending two ways to get through COVID-19 fatigue. First, he urged using technology like Facetime as a way of connecting and staying engaged with people. His second piece of advice: “See each other. We shouldn’t be locked down. Even on cold days, put on some warm clothes, and go for a walk with a friend if you can. It’s incredibly safe ...
“I do believe we will get through this; pandemics do come to an end, and this one will as well. While we might deal with this virus for a long time, lives will go back to a new version of normal. That might even be a better version, and it’s up to us to take care of each other.”
The Richard V. Lee Lectureship in Global Health is presented by the School of Public Health and Health Professions in memory of Lee, a former UB faculty member. “Dr. Lee was a giant in many areas and, certainly, in global public health,” Jha said. “It’s an honor to be part of anything associated with him.”