At the Yale School of Public Health (YSPH), there were many signs that COVID had become a dire threat. Nathan “Nate” Grubaugh was active on Twitter very early on, warning that what was happening in Wuhan looked ominous. YSPH faculty realized relatively quickly that this was another “SARS,” but one that was less lethal per infection. The fact that SARS CoV-2 appeared to be infectious prior to the onset of symptoms was a surprise as this was not the case with SARS. This, combined with high infectiousness and the lack of immunity in the population, created a strong sense of urgency for a vigorous response.
Experienced pandemic responder Professor Albert Ko had gone through Zika virus in Brazil and had responded to dengue and leptospirosis outbreaks. In April, Dr. Ko accepted a temporary assignment with the state government to co-chair the ReOpen Connecticut Advisory Group for the governor, alongside Ms. Indra Nooyi, board co-chair of AdvanceCT, and former CEO of PepsiCo. Professor Linda Niccolai and her Emerging Infections Program colleagues mobilized volunteer teams for contact tracing on behalf of New Haven and the state. Meanwhile, a YSPH team joined economists from the Yale School of Management to publish a mask study suggesting the benefits of cloth masks in the absence of KN-95 or surgical masks in late March of 2020. Their team of Anne Wyllie and Nathan Grubaugh developed a saliva-based PCR by May 2020 — Saliva Direct™ — that became a low-cost backbone for labs around the world without any patent claims from Yale when it received emergency use authorization from the U.S. Food and Drug Administration in August 2020.
Yale’s top vaccine researchers included Saad Omer and Jason Schwartz, who became consultants in 2020 to the WHO, the National Academies of Sciences, Engineering, and Medicine, the State of Connecticut, and others. By April 2020, Professors Krystal Pollitt and Sten Vermund began intensive engagement of schools, arts, and health care organizations in CT, NY, RI, KY and CA for risk mitigation and safe reopening.
Their public health modeling teams worked tirelessly on estimating transmission dynamics, forecasting how transmission would spread or contract with time and interventions, guiding schools and universities as to best practices to keep them open and safe, costing out interventions and other vital roles. The university made the decision to move all classes online in early/mid-March. Prior to the pandemic, the vast majority of teaching was in-person. The office of academic affairs quickly came up with plans to train and support the faculty for remote learning and to triage technical issues. It is estimated that half of the 152 faculty in YSPH pivoted part or most of their efforts toward COVID-19 in 2020-2022.
There were challenges, though. Says Anna M.R. Lauder Professor of Public Health Sten Vermund. “Vaccine hesitancy and misinformation loomed large in January 2021. Fortunately, experts like Professors Saad Omer and Jason Schwartz had worked in the field and even in 2020 had started working on this challenge. Connecticut benefited enormously from their initiatives and consultations; it is plausible that Connecticut rates of vaccination, among the highest in the nation, were nurtured by the preemptive counsel from Professors Omer, Schwartz and colleagues.”
Professor Vermund continues, “Uncertainty as to where viral transmission was going and how to stop it was right in the wheelhouse of our modelers. Professors Ted Cohen, Alison Galvani, Gregg Gonsalves, David Paltiel, Virginia Pitzer, Jeff Townsend, Dan Weinberger and members of their teams all contributed.” A number of these papers were highly influential to policymakers and won “impact” awards from several journals.
There were multiple stressors that affected all members in the community in different ways. Members of the community lost loved ones and there was a good deal of anxiety and uncertainty. Many of YSPH’s international students faced visa and travel issues, and there were students who could no longer afford to study.
Vermund points to lessons learned. “Schools of Public Health are too valuable to the commonwealth to only be schools. They should be linked to local and state health departments for emergency response, whether mitigating weather events, pandemic threats or toxic exposures. Existing legal obstacles should be addressed, work contracts established, and emergency authorization and credentials should be in place and able to be activated on short notice. Hospitals affiliated with medical schools serve such roles as a matter of course and this should be generalized to academic public health. This will take new understandings from universities and state and local governments alike. Health communications are inadequate to meet the public’s needs. Vaccine and mask hesitancy, wild rumors about viral origin and spread, and hostility toward public health officials are all widespread. We must do better in educating the public and our policymakers about the importance of public health, well before crises kick in.”