Public Health On Call

Fire season in the western US is starting earlier and ending later each year and has seen larger, more intense fires in the last 10 years. How do these fires impact the health of people living nearby and, as smoke plumes spread across the US, can they impact the health of people further away? In this bonus episode, Dr. Kirsten Koehler, an expert in air pollution, talks with Dr. Josh Sharfstein about the massive fires currently burning on the west coast, the impacts on human health, how individuals can protect themselves, and what the rest of the US can expect as the smoke spreads.

What we are learning from universities that are opening their campuses for in-person schooling? Are rapid COVID tests as accurate as PCR tests? Can asymptomatic people experience heart and lung damage and other long-term health issues? If only some people are being tested, what does the positivity rate really tell us about community spread? If a student is symptomatic, should the entire class be quarantined? Can trick-or-treating or holiday caroling be done safely this year? Dr. Tom Inglesby and Dr. Josh Sharfstein answer more of your COVID-19 questions sent to publichealthquestion@jhu.edu. KEYWORDS: testing methods; student life

Iceland, an island nation of about 400,000 people, has seen fewer than 2,500 COVID-19 cases and only 10 deaths. Dr. Thorolfur Gudnason, Iceland's chief epidemiologist, talks with Dr. Josh Sharfstein about how the country's pandemic strategy meant they never had to close schools or restaurants, and how its research with genomic sequencing helped shed light on COVID-19 transmission and immunity. Gudnason also talks about the public's response, how the country's vital tourism industry has been affected, and his outlook on the next year. KEYWORDS: contact tracing; antibodies; pandemic response

Chicago has seen drastic increases in opioid-related overdoses and deaths compared to 2019—an uptick that started prior to the arrival of COVID. Dr. Wilnise Jasmin, Medical Director for Behavioral Health, talks with Dr. Josh Sharfstein about how the pandemic has exacerbated the opioid epidemic while, at the same time, opening up new opportunities, and how Chicago's response to COVID-19 includes addressing the mental health needs of its citizens. KEYWORDS: stress management; substance use; community mental health

A cohort of COVID-19 patients—mostly middle-aged women—who experience "mild" disease not only don't seem to be getting better, they're developing new symptoms like debilitating cognitive fog, dizziness, and palpitations that linger for months after diagnosis. Dr. David Putrino, the Director of Rehabilitation Innovation at Mt. Sinai Health System in New York, talks with Stephanie Desmon about the emerging phenomenon of "long-haulers," expectations around recovery, why the term "mild COVID disease" is problematic, and why this group is vulnerable to medical gaslighting. KEYWORDS: long-term symptoms; post-viral syndrome

Flint's water crisis, which exposed thousands of children to excess levels of lead, is far from over, but the city is making progress. Dr. Mona Hanna-Attisha, the Michigan State pediatrician who exposed the crisis, talks with Dr. Josh Sharfstein about how an "unfair and preventable health crisis" became an opportunity to address disparities and do better. This focus on secondary prevention actually helped build up public health infrastructure that's now being used in the COVID-19 response. Hanna-Attisha also talks about how COVID-19—another preventable health crisis—could be a wake-up call for the rest of the nation to hold leaders accountable, address disparities, and invest in public health. KEYWORDS: health equity; racial disparity

Why would a virus that primarily affect the lungs also cause a heart attack? How do you treat injury to the heart and is recovery expected? Is there evidence that people with asymptomatic COVID cases could still experience injury to the heart and lungs? Should athletes who have had severe COVID seek a cardiac assessment before returning to sports? Hopkins cardiologist and myocarditis expert Dr. Nisha Gilotra talks with Dr. Josh Sharfstein and answers questions about COVID-19's impact on the heart. KEYWORDS: heart attack; cardiomyopathy; cardiac health

Outdoor interactions are safer when it comes to COVID-19, but what can be done to improve ventilation in buildings? Dr. Ana María Rule, a Hopkins ventilation expert, talks with Stephanie Desmon about how ventilation systems can reduce the risk of exposure, whether heating or air conditioning are different, and whether airplane ventilation systems are better or worse than buildings. Dr. Rule also breaks down a case study of a restaurant in China which led to an outbreak of COVID-19 due to poor ventilation. KEYWORDS: filters; aerosols

Why are Black people so much more likely to die from COVID than whites in Louisiana and elsewhere? Dr. Tom LaVeist, dean of the Tulane University School of Public Health and Tropical Medicine, talks with Dr. Josh Sharfstein about misconceptions and misunderstandings about race and health. Dr. LaVeist also talks about his work on a COVID-19 task force to make permanent policy changes that will help towards building a healthier and more equitable society after the pandemic. KEYWORDS: racial disparity; social determinants of health; health equity

Thousands of COVID-19-related papers are released every week. But the information is of varying quality and health care workers don't have time to sift through the deluge. Johns Hopkins epidemiologist Dr. Kate Grabowski talks with Stephanie Desmon about the Novel Coronavirus Research Compendium, a literature curation effort by more than 50 people across collaborating institutions. Every week, the group reviews and summarizes the newest and most exciting COVID-19 research to help those on the front lines working with testing, contact tracing, and other public health responses. Grabowski also talks about how COVID-19 has meant more public scrutiny of research, how mistakes are inevitable and expected, and that retractions and corrections are part of the usual publication process. KEYWORDS: peer review; misinformation