On December 15, 2019, W. Ian Lipkin, MD, the John Snow Professor and director of the Center for Infection and Immunity (CII) at Columbia University Mailman School of Public Health, was informed of an outbreak of an unexplained respiratory disease. By December 31st, 2019, the Wuhan Municipal Health Commission, China, reported a cluster of cases of pneumonia in Wuhan, Hubei Province. That very same evening, Colombia’s Center for Infection and Immunity Director Dr. Lipkin received confirmation that the causative agent was a novel coronavirus. That Dr. Lipkin was contacted in the early stages by his Chinese colleagues is a testament to his longstanding relationship with the Chinese scientists, having collaborated with them in 2003 to identify and control the SARS coronavirus outbreak.
One of the foremost authorities on infectious agents, Lipkin has hopscotched the globe helping tamp down outbreaks over three decades. In late January, as concern was increasing across the world about this unknown pathogen, Dr. Lipkin traveled to Guangzhou and Beijing to consult with Chinese scientists and public health officials and serve as an intermediary with the NIH and the CDC. After returning from China, Lipkin made television appearances to sound the alarm. His advice for the United States was prescient: promoting isolation of patients, testing and contact tracing, among other critical containment measures he had seen in China. His first-hand knowledge was valued by colleagues at Columbia Mailman and the University as reports continued to emerge during January and February.
Says Dean Linda Fried, “As the urgency of the situation became more clear, we were concerned about the impact on our community of students, faculty, staff – and the community in which we work, which was already vulnerable to health inequities. Our first actions were taken out of an abundance of caution, which turned out to be just the beginning of the steps needed to confront the crisis.”
Informed by Dr. Lipkin’s first-hand experience in China, Columbia University formed in February 2020 the President’s Advisory Task Force on COVID-19, which by early March was meeting on a daily basis—often two times a day. From its inception, the task force included Columbia Mailman School Dean Linda Fried and faculty member Wafaa El-Sadr, University Professor Dr. Mathilde Krim-amfAR Chair of Global Health and founding director of ICAP. The group also included Mailman School alumnae Melanie Bernitz, senior vice president of Columbia Health, and Donna Lynne, senior vice president and chief operating officer of Columbia University Irving Medical Center, as well as leaders from across the University who were responsible for academics, housing, operations and more to steer every action of the University in response to the crisis. Under their leadership, the University developed protocols for moving classes online, students out of campus housing and non-essential staff to remote work, as well as developing a COVID testing program, including everything from the actual mechanics of where they would analyze the test to the operation of the centers and the scheduling system, and a contract tracing program. The testing and the tracing programs, which helped to rapidly break chains of infection, made a significant difference as Columbia’s numbers fell well below New York City’s as well as those in the surrounding areas.
The School worked at the forefront of developing the science to understand and identify the virus, modeling to inform policy decisions, and programming and communications to prevent the spread. A sampling of the work and recognitions of the School’s faculty includes:
- When the sequence of SARS-CoV-2 was released on January 11, 2020, Dr. Lipkin and the Center for Infection and Immunity (CII) team, including Nischay Mishra, Ph.D., an assistant professor in epidemiology, working in CII’s high-security, pressurized biosafety level 3 laboratory, developed an antibody test for SARS-CoV-2 as well as a PCR assay that can simultaneously detect influenza A, influenza B, and SARS-CoV-2 viruses. It was employed by the Los Angeles Unified School District and Santa Clara County in California and Rockefeller University.
- Dr. Lipkin also consulted for the Democratic National Convention in 2020 and the Oscars in 2021 and, together with Larry Brilliant, developed the biosafety protocols used by the film industry.
- Prior to the crisis, Jeffrey Shaman, professor of environmental health sciences, had conducted a groundbreaking study that examined how disease is transmitted, even by seemingly healthy people. Tapping into those findings and applying them to the current situation, Shaman and his team concluded by late February 2020 that “stealth transmission” by asymptomatic yet unidentified carriers was driving the spread of SARS-CoV-2, a headline-making turning point in understanding the virus. They determined that in China, a stunning 86% of early infections were not documented. Shaman and his team, including Sen Pei, Ph.D., associate research scientist in environmental health sciences, then built models projecting the disease’s spread in the United States using data provided by The New York Times. The calculations laid bare the destructive potential of the virus and exposed the fact that had mitigation measures been used just one week earlier, 36,000 lives could have been saved.
- From early 2020, Wan Yang, assistant professor of epidemiology, worked with academic and NYC DOHMH colleagues to model the spread of COVID-19 in New York City and assess its health risks, demands on the health care system and the effectiveness of various public health interventions. Late last year, the New York City Department of Health and Mental Hygiene (NYCDOHMH) honored her team of researchers for their disease modeling and epidemiology work on COVID-19 that helped inform city policy with the Community Partner Award for Excellence in Response.
- In September 2021, the New York City Economic Development Corporation (NYCEDC), and New York City Department of Health and Mental Hygiene (DOHMH) announced their selection of Columbia University to launch and operate the Pandemic Response Institute (PRI) in partnership with the City University of New York (CUNY) Graduate School of Public Health and Health Policy (CUNY SPH). The $20 million grant is “dedicated to preparing New York City for future health emergencies and epidemics in a more effective and equitable manner while positioning the city as a global leader to serve as a model for public health response.”
Still, there were numerous challenges, from training faculty to providing an education to students now situated all over the world to continuing research that required in-person interaction. From a public health perspective, two of the biggest challenges were the rampant misinformation in the public sphere and witnessing the glaring inequity of how COVID impacted communities. To help combat the issue of misinformation, the School partnered with several stars of the movie Contagion, including Matt Damon, Lawrence Fishburne and Kate Winslet, to produce a series of evidence-based PSAs to explain what individuals can do to protect themselves from COVID-19. The videos were produced by Contagion director and screenwriter Steven Soderbergh and Scott Burns, along with the movie’s scientific advisor, Dr. Lipkin.
Dean Fried notes we have lessons to learn: “After more than a million deaths in the United States alone, it is clear that this country’s disinvestment in its public health system left it insufficiently able to provide the essential public health expertise and leadership needed during this pandemic. The longstanding pandemic control methods were inadequate to meet the needs of our 21st-century demography of an aging population; the prevalence of chronic disease and health disparities; community health realities and inequities; and changing global threats.”
She continues, “At the Mailman School of Public Health, we believe that the time is ripe for an insightful conversation on the question — or urgency — of reframing public health as a vital public good necessary for the successful function of societies. If the country is to be prepared for the next inevitable pandemic, the public health system’s mission, capabilities and responses must be reimagined and reinvested in, creating an updated system with modernized infrastructure integrated across federal, state, and local levels of government. The investment would include rebuilding a depleted public health workforce that is fully trained in the expertise needed to conduct surveillance and develop rapid responses, and to further protect the vulnerable in ways that mitigate infection. In sum, the United States must value public health as a public good and invest in it as such.”