Public Health On Call

After public health measures helped stem a massive first wave of infections, fatigue set in, and Brazil is now facing the worst moment of the pandemic so far. Dr. Luana Araujo, a public health consultant in Brazil, talks with Dr. Josh Sharfstein about why Brazil is struggling despite a robust universal health care system. She also makes the case for greater inclusion of Brazil in discussions of global health. KEYWORDS: pandemic response; health communication; vaccine approval

Even after the 1918 pandemic supposedly "ended" a significant number of people continued to die from "flu-like illnesses" for years. So do pandemics really "end" or do they fade from the public's consciousness? Medical historians Jeremy Greene and Graham Mooney return to the podcast to talk with Stephanie Desmon about how we really mark the "end of a pandemic", why today's vaccine hesitancy is strikingly similar to resistance to smallpox inoculations a century ago, and the hope that a focus on health disparities due to structural racism—not individual behaviors or innate characteristics—will endure through whatever the "end" of COVID-19 looks like. KEYWORDS: health equity; racial disparity; health communication

In this episode, Dr. Josh Sharfstein talks with Hopkins researchers who break down three COVID-19 research papers: Dr. Sheree Schwartz talks about a preprint study of a healthcare worker who experienced COVID-19 twice; Dr. Nikolas Wada talks about a study of why some people, especially men, may have more serious disease from COVID-19; and Dr. Ashwin Balagopal talked about a clinical trial for an inhaled Interferon treatment. 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: COVID-19 therapy; immune response

Until 2020, PIVOT, an NGO in Africa, had an operations model that looked much like many organizations of its type: a 200-person team on the ground in Madagascar and a 10-person administrative team in the US. But early in 2020, the organization decided to let the majority of US employees go and shift operations to Madagascar and the communities that PIVOT serves. Executive director and Hopkins alum Tara Loyd talks with Lindsay Smith Rogers about how this transition was managed and what the change means not only for the organization, but for global health care. You can read Loyd's commentary in Stanford Social Innovation Review: https://ssir.org/articles/entry/moving_closer_to_the_problem_and_closer_to_the_solution KEYWORDS: international health; community health workers

How do I find out where to get vaccinated? How much flexibility in timing is there for the second dose? If I've gotten vaccinated, can I be infected by one of the new variants? Should I get the vaccine if I currently have COVID? Can the vaccine alleviate long-hauler symptoms or long-term loss of taste or smell? Dr. Josh Sharfstein talks with Stephanie Desmon to answer listener questions about COVID-19 vaccines. KEYWORDS: long-term symptoms; viral mutation; household transmission

Once vaccines are more widely available, employers may start requiring their workers to be vaccinated. Employment law expert Karla Grossenbacher talks with Dr. Josh Sharfstein to break down vaccine mandates, how these work with the Americans With Disabilities Act, Title VII, and other federal laws, and what questions employers are asking before they make a decision to move forward. KEYWORDS: policy; vaccine hesitancy; vaccine authorization

In a special two-part episode, we look at the landscape of vaccine hesitancy and what can be done to address it. In part one, Hopkins vaccine safety expert Dr. Dan Salmon talks with Stephanie Desmon about his new and ongoing research on acceptability of COVID-19 vaccines in minority communities and the importance of listening to understand hesitancy to help people feel more confident. In part two, Dr. Rupali Limaye, a Hopkins expert in vaccine behavior and decision-making talks with Dr. Josh Sharfstein about misinformation, why hesitancy around COVID-19 vaccines is different from anti-vax groups like measles, and creative strategies like "prebunking" to address misinformation. KEYWORDS: health communication; herd immunity; risk perception

In a special two-part episode, we look at considerations of ethics and equity in vaccinating a nation. In part one, Stephanie Desmon talks to Johns Hopkins ethicist Dr. Ruth Faden about the ethics of COVID-19 vaccine distribution and choosing who is and who isn't eligible to be vaccinated in the near term. They also talk about what happens when someone jumps the line to get what is, for now, a scarce commodity. In part two, Dr. Josh Sharfstein speaks with Dr. Chidinma Ibe, an assistant professor of medicine and the associate director for stakeholder engagement of the Center for Health Equity at Johns Hopkins. They discuss equity in vaccine distribution, or why we have to do more than just count the number of vaccinations. KEYWORDS: supply chain; vaccine hesitancy; social determinants of health

Why is it so hard to get vaccines to people who need them? Maine's CDC Director Dr. Nirav Shah talks to Stephanie Desmon about the massive logistical challenges with COVID-19 vaccines: identification of groups, notification to let groups know when it's their turn, and then actually registering, scheduling, and vaccinating people with two doses—all while not being able to anticipate supply more than one week out. They also talk about the troubling realities of vaccine hesitation which may not be as visible right now with demand far outpacing supply. KEYWORDS: supply chain; policy

2021, so far, looks a lot like 2020 in terms of pandemic fatigue. What are signs of burnout and mental exhaustion? What can we do about anger? How can we "just hang on" until the pandemic is under better control? How can we deal with the stigma and shame around getting sick with COVID? Clinical psychologist Dr. Laura Murray returns to the podcast to talk through these and more questions with Stephanie Desmon. KEYWORDS: community mental health; stress management