In January 2020, University of Michigan School of Public Health epidemiologists began responding to media requests on COVID-19, communicating with reporters and the public on what they knew about the novel virus. Says Dean F. DuBois Bowman, “As the world watched the virus advance globally throughout February, it became clear that the spread spanned far beyond any particular country or region. The changing landscape of our understanding of the breadth of the virus’ impact evolved rapidly as we watched shutdowns cascade across the Asian continent to Europe and into North America. As we witnessed the devastation unfold in coastal cities like Seattle and New York City, it was clear that COVID-19 had already established a significant foothold in North America.”
Like many campuses, the University of Michigan quickly moved to cease all in-person activity in mid-March 2020. With other university leaders, Dean Bowman grappled with the unprecedented question of “how do we fulfill our academic and research mission while keeping our faculty, staff and students safe?” He says, “We knew we needed to shut down in-person activities, but how long would it last? When and how could we resume some in-person activity safely? How can we support our community through this? Developing responses to these questions required broad teamwork and innovative solutions from many on our campus and in the public health community. Our school worked with numerous groups from across campus and the Washtenaw County Health Department to determine how to move forward. To do this work effectively, we had to be well-coordinated with critical stakeholders.”
He continues, “As a biostatistician, my first reaction is to examine the data to understand a problem. As I think back to early 2020, there was still a lot of uncertainty about what the coronavirus was, how transmissible it was, how it spread and how severe its health impacts could be. Cases began to pop up globally at an alarming rate, and legal restrictions on movement were imposed in many places hit early by the pandemic. In Michigan, cases were rising faster than in many other states in the Midwest.”
In collaboration with the Michigan Department of Health and Human Services and Governor Gretchen Whitmer’s office, Michigan Public Health faculty began using data to model projected case counts in the state. Says Bowman, “Our team shared data, modeled projections and outlined the potential devastation of COVID-19 if we did not take quick action. State policymakers considered the guidance from our school and ultimately decided to take proactive measures to mitigate the spread of the virus.”
In late March, Governor Whitmer issued an executive order called “Stay Home, Stay Safe,” which outlined protective measures for businesses and activities across the state. Bowman says, “We continued to track and analyze COVID-19 cases across the state after the order was in place. The measures led to a steady decrease in cases, ultimately helping to save lives and mitigate the spread throughout Michigan.”
The natural next question became, “When and how can we begin to safely reopen businesses and the economy?” To answer this, Michigan Public Health began working with a group of business leaders and colleagues from the Michigan Department of Labor and Economic Opportunity. Bowman explains, “The economy could not simply be turned back on like a light switch. Our approach had to be more like a gradual turning of a faucet. We supported the state in establishing which data points we would need to reach to move to each subsequent step toward more in-person activity. Our framework became known as the Michigan Safe Start Plan, which helped our state gradually and safely reopen the economy and resume in-person activity.”
Meanwhile, Michigan Public Health Associate Professor of Epidemiology Dr. Marisa Eisenberg led a project to develop a dashboard that showed Michigan COVID-19 cases and hospitalizations by race, ethnicity and gender. The dashboard provided more data to Michigan residents and enabled experts to identify trends early and make informed decisions about public health measures.
Bowman says that although this was clear to those in public health, imposing significant restrictions on in-person activity in any community is not a decision that can be made lightly. “Few Americans had ever lived through a pandemic, much less restrictions on movement and government-mandated shut-downs due to a virus. We knew we needed data to convince people that these measures were critical for the public’s health and to buy time for us to learn more about how to mitigate the impact of this novel virus. We used the data available to model a variety of estimates and projections about the trajectory of the virus’s spread. We worked to pull all the data we could find from numerous sources — some gathered by us but other data that came from local, state and national efforts. It was immediately apparent that we could not easily predict what would happen because we were working with imperfect and incomplete data. We knew that time was of the essence — we needed to act fast or there would be serious and fatal consequences.”
Another Michigan Public Health faculty member who has made a significant impact throughout the pandemic is Dr. Arnold Monto, professor of epidemiology. Since 2020, Monto has chaired the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), which reviews the safety, effectiveness and appropriate use of vaccines and advises the FDA. Says Bowman, “His expertise and leadership in this space have been critical to ushering in the prompt approval of safe, effective vaccines. But this is just one example of Dr. Monto’s impact. He is passionate about combating misinformation and informing the public about the safety and efficacy of COVID-19 vaccination, participating in countless media interviews and other public engagement activities.”
Bowman notes that “COVID-19 will not be our last pandemic. We live in a global society where the ease of travel enables viruses to spread quickly and easily. Additionally, as our climate continues to grow unstable due to warming, the mass migration of animals will increase, thereby escalating the chance of a viral jump to humans. We can see the devastation of climate change already happening around the world, and most recently, with the shocking flooding in Pakistan. We can also anticipate major human migrations as parts of our planet become uninhabitable for humans. The human density refugee centers and increases in population in urban areas will only make the need to be prepared to mitigate and protect from viral outbreaks all the more critical. It is imperative that the public health community prepare for this future by identifying effective methods to establish community trust in order to deploy protective measures quickly and efficiently. This is a rapidly approaching reality for which the field of public health cannot afford to fail.”
