September has been a busy month for ASPHER and its members, and for COVID-19. The virus continues to rise in familiar u-shaped curves that some call ‘second wave’ and some call ‘the continuation of the first wave…’ In some countries it appears like there is even a third wave. So while epidemiologists like to debate these things, it seems, to me, we just have to describe what we see in the epicurves – they look like waves to me!
They do look a bit less wavey in log scale though, as Henrique Barros showed us for Portugal at the ASPHER COVID-19 Task Force recently But as a US scientist was quoted, ‘when you are underwater it doesn’t matter how many waves are going over you’.
The summertime observation of a younger group being ill with mild infections and less need for hospitalisation is giving way to a rise in intensive care admissions and deaths, especially in France, Spain, UK and Israel.
In some countries which managed well earlier in the year, there is a surge. You can never believe you have this virus beaten – as the New Zealanders discovered two days after their 100 days-COVID free national celebration, and the Czechs are now finding after their Charles Bridge street party.
Everyone is getting excited by the US President’s COVID-19 and conspiracy theories, and media management. The reality of the President’s condition may never be known. But for me, it is clear the whole era of fake news, digital disruption and manipulation and surveillance capitalism is something we must address as a major threat to the public’s health. We are looking to develop an ASPHER team to look at mass communication – how to make it work for health in the era of fake news and social media. If you have that knowledge join us. But will we believe you?
The real bombshell study of the month is the Laxminarayan, et al. study published in Science which will make us all reappraise our assessment of testing and tracing strategies and the resources we commit to them - the most intensive contact tracing programme on the planet – in Tamil Nadu and Andhra Pradesh in Southern India has confirmed the importance of super-spreading events and also the potential of children to spread the infection. Our Task Force subgroup led by Henrique Lopes (Catholic University of Portugal) and Severine Deguen (EHESP) are rapidly re-assessing cross-country policies on mask use in the classroom.
We are also repeating our survey of our Member Schools’ policies through our young professionals group led by Ines Siepman (ScHARR, Sheffield University). This is a vital survey to help our members judge their own policies. Many are now observing that universities have put monetary considerations ahead of student wellbeing – forcing students to return to campus only to have them ‘imprisoned’ in their halls of residence. There is widespread concern about universities as potential sources of infection in their local communities. On the other hand, a recent global study has shown young people are only slightly less concerned about staying safe and protecting people around them, than over 45 year olds. The UK Independent SAGE group have proposed actions for COVID safe universities. And not to be outdone – the official UK SAGE group has also published guidance. All our members need to be actively involved in this vital area of public health protection. Please respond to our surveys when you get them.
In September, ASPHER activities included the General Assembly, at which we welcomed ten new Member Programmes, reported and celebrated the achievements of our Member Schools, our COVID-19 Task Force and our young professionals, reported improvements in governance and financial management and agreed our Strategy to 2025. Professor Carlo Signorelli from University Vita-Salute San Raffaele, Milan, Italy was acclaimed as our new President-elect from May 2021. Nadav Davidovitch (Ben-Gurion University of the Negev, Be’er Sheva, Israel) and Carla Lopes (ISPUP, Porto, Portugal) were also acclaimed as new ASPHER Executive Board members to serve from May 2021. Congratulations to you all – you are already major assets for ASPHER and I look forward to working with you.
The following day we held a successful webinar with WHO Europe colleagues, progressing the WHO-ASPHER Competency Framework for the Public Health Workforce in the European Region. I am most grateful to Natasha Azzopardi-Muscat, Anna Cichowska and Martin Krayer von Krauss from WHO Europe and ASPHER Vice President Kasia Czabanowska from Maastricht University for making this happen. There is much to be done on competencies and this was just one step further down the road. A related activity is the ASPHER-ECDC project - Updating Core Competencies for Applied Infectious Disease Epidemiology (UCCAIDE), announced in the September Newsletter, which is being led for us by Mary Codd and her team at University College Dublin.
It was a great pleasure to join colleagues at the National School of Public Health (ENSP) and Nova University, Lisbon for their 52-25 Years Celebration last week. Thank you to Carla Nunes for the invitation. It was also great to be part of a celebration of nursing and midwifery in Slovenia with Angela Boškin Faculty of Health Care and to share some of my thoughts on how nursing disciplines are such a crucial part of public health systems and services. Thank you to Sanela Pivač and colleagues for this invitation.
To round off the month was the most virtually excellent European Health Forum Gastein at which I was part of a high level dialogue on the proposed European Health Union – never more necessary. I have said from the start that Ursula Von der Leyen’s European Commission President’s manifesto ‘A Europe that strives for more’ is a public health agenda. We need to see that it is delivered and becomes a reality. Likewise the EU4Health programme is vital as well – health problems do not respect borders – international cooperation and action is needed. Countries can also pool their resources for example, in procurement of vaccines and medical equipment as in the current COVID-19 pandemic.
My thanks again to you all for your interest and enthusiasm. Thanks particularly to Robert Otok and Lore Leighton for all their hard work this month.
If you need some more to read, try these publications new this month:
Middleton J, Lopes H, Michelsen K, Reid J. Planning for a second wave pandemic of COVID-19 and planning for winter. Int J Public Health (2020).
DOI: https://doi.org/10.1007/s00038-020-01455-7
McDonald E, Middleton J, Lalloo D, Greenhalgh T. Safely returning clinically vulnerable people to work. BMJ 2020; 370.
DOI: https://doi.org/10.1136/bmj.m3600
Martin-Moreno J, Laham S, Dhonkal R, Green M, Middleton J. vaccines for COVID-19, reasons for hope- but first, for concern. BMJ Opinion, September 30th 2020.
https://blogs.bmj.com/bmj/2020/09/30/vaccines-for-covid-19-reasons-for-hope-but-first-for-concern/
Yours in health,
John Middleton, President, ASPHER