COVID-19 shows public health has lots to learn

The U.S. Food and Drug Administration’s recent approval of two updated COVID-19 vaccines came after regulators attempted to speed up the process in response to the ongoing summer surge.

But it wasn’t fast enough.

The continuing rise of COVID-19 infections shouldn’t be a surprise; surges have emerged every year since COVID first struck in 2019. But this year’s strain has been particularly powerful, as most Long Islanders sidelined with it the past few months know. With testing data no longer a reliable measure, the Centers for Disease Control and Prevention looks to wastewater levels, and is finding the virus at high or very high levels in nearly every state, including New York.

So the newly-approved vaccines arrive too late for the many Americans who’ve already gotten sick. And, since it takes two weeks before anyone who’s vaccinated is fully protected, the surge may be over by the time the booster is fully effective.

That opens a key question for federal regulators and researchers: Should the CDC and FDA consider a different timetable for COVID-19 vaccination?

It also highlights larger concerns regarding the ability of the CDC, FDA and other regulators, along with scientists, researchers, private companies and others, to stay nimble in addressing fast-moving scientific developments in an ever-changing public health landscape.

PUBLIC HEALTH INERTIA

Change doesn’t come easily in the labyrinth of public health. Federal regulators tend to stick with what they know, following past patterns of response as they try to fit new viruses, diseases and challenges into old rubrics. But as threats evolve rapidly, federal bureaucrats must find a way to keep up.

That won’t happen without attention from elected officials and others. Unfortunately, public health has been overshadowed by political talking points. It should be front and center. Without a spotlight on the shortcomings in the federal response to old and new public health crises, we’re doomed to repeat the mistakes of the past.

That’s particularly dangerous when we consider what lies beyond the world of COVID. In battling the ongoing bird flu outbreak, for instance, public health officials have faced challenges that may sound extraordinarily similar to what we experienced during COVID — ineffective or unavailable tests, a lack of protective equipment, and most concerning, a lack of any real plan. Much the same is happening as the World Health Organization tackles mpox; it’s now considered a global health emergency, but a path to meet the need for enormous amounts of money, millions of vaccines, and a way through massive amounts of red tape remains elusive.

COVID, too, is a challenge we’ve yet to fully meet. The latest strain seems to last longer and make people sicker, although deaths and hospitalizations thankfully remain relatively low. Protection is key; everyone who is able to get the vaccine, should.

Too often, federal officials put COVID-19 in the same context, and its vaccines on the same timetable, as the flu. That connectivity requires rethinking, especially in terms of whether COVID-19 vaccines can and should be made available earlier, to allow for protection against a summer surge.

That idea comes with a word of caution. The COVID-19 vaccine’s highest levels of protection last about four months. Anyone who takes the vaccine earlier in the summer may not be well-protected for a winter surge unless they get a booster, now only recommended for those who are 65 and older or immunocompromised. Nonetheless, the CDC and FDA should find ways to provide Americans with options, limit the summer surge, and protect more vulnerable residents, even if it means offering a summer vaccine and making a fall booster necessary for a wider swath of people.

NASAL VACCINE TRIAL

Further change might be needed pending the results of a clinical trial that began last month of a nasal COVID-19 vaccine that could be more effective than injections. Similarly, the FDA last year began a review of a self-administered nasal flu vaccine. These promising steps are signs of how vaccination could improve and hopefully become more ubiquitous in the future.

But a growing, gnawing fatigue has pervaded most Americans’ thinking when it comes to all things COVID and to vaccination more broadly. They don’t want to hear about it, talk about it, even think about it.

We ignore or dismiss it at our peril.

As COVID and other public health challenges ebb and flow, federal officials, including the CDC, must offer a more agile yet steady hand. They must do a better job of outlining plans, providing information and context, guiding Americans on what they need to know and what they need to do, shifting strategies when warranted, and explaining those changes as they come. Right now, too much seems like guesswork — without any clear communication behind it. That leads to a dangerous distrust and dismissal of anything public health leaders do or say.

We must keep striving to overcome that challenge. And we still have a lot to learn to be ready for the next pandemic. Until we prioritize pandemic preparedness, vaccine awareness, and public health as we do with other forms of public safety and well-being, we are and will be at risk.