Public Health On Call

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.