The importance of public health in the year ahead

Our daily lives continue to be directly affected by the pandemic. The increasing amount of new infections and hospitalizations have reached a crisis level that is once again overwhelming the capacity of hospitals of many communities in the country. People are dying at a lower rate than this past spring because of improved treatment, but the number of people dying daily nationwide is expected to double and triple by 2021 if public health measures are not followed or enforced.

The public health system of this country has been attempting to lower the incidence of coronavirus by encouraging public health practices in all communities (masking, hand disinfecting and physical spacing, etc.). Other tools we have are new treatments that decrease the mortality and morbidity of this condition. Unfortunately, there has been no centralized federal guidance; states and communities have had to do the best they can to control infection levels.

Generally, we’re all feeling a great deal of optimism because of the recent announcement by Pfizer/BioNTech of the preliminary findings of their Phase 3 studies. (Read more about how vaccines are developed.) The results from 35,000+ test subjects show that their vaccine is 95 percent effective in protecting people from COVID-19. It appears that, in the next few weeks, there will be emergency approval of this Pfizer vaccine, accompanied by several U.S. companies finalizing their reviews for its effectiveness and safety. It will take a number of different types of vaccines to help control this worldwide pandemic.

What is public health?

Public health institutions promote and protect the health of people and the communities where they live, work and play. Accomplishing this requires the coordination at many levels of health care and public health groups to track outbreaks, prevent injuries and promote healthy lifestyle practices that keep people healthy. It also involves vaccinating children and adults to stop the spread of infectious diseases, educating people about the risks of alcohol and tobacco, promoting school nutrition programs and preventing work- and recreation-related injuries. Public health workers can be first responders, community planners, health educators, social workers, epidemiologists and public health nurses and physicians.

The three main public health organizations in the U.S. are the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH) and the Federal Drug Administration (FDA). Each organization has overlapping functions that, in addition to promoting healthy lifestyles, all strive to protect the public from situations like this pandemic. In addition to these three organizations, there are a number of other governmental organizations at the federal, state and local levels that rely on the above organizations for guidance in developing public health policies and legislation.

The new COVID vaccines

By the time this article reaches newsstands, there is a good possibility that the FDA will have approved a COVID vaccine; it will first be used to vaccinate health care and support personnel, along with first responders and people at high risk for developing complications from a COVID infection.

There are several other companies also completing their Phase 3 studies (AstraZeneca, Moderna and the University of Oxford). All of these vaccines utilize various methods to instruct our immune cells (Macrophages, B-lymphocytes and T-lymphocytes) to produce antibodies against COVID-19 when the person is exposed.

What is important to know is that this type of vaccine is being used for the first time in humans (successful in animal studies) and appears to be effective in producing good protection. Another thing to know is that this type of vaccine requires special handling and temperature storage. The Pfizer/BioNTech vaccine will have to be administered in special facilities that have refrigeration capable of keeping the product at -100+  degrees (about the temperature of dry ice). Also it takes two injections three weeks apart with adequate immunity occurring about one week after the second injection.

Because this is a pandemic, creating an adequate supply of vaccines will require a significant ramp-up time. It is estimated that it will take at least 30 million doses to complete the first phase in the U.S. Ultimately, in order to suppress COVID-19, billions of doses will be needed to immunize our country and the rest of the world. The complex logistics of distributing this vaccine with its required refrigeration will take time to plan and implement—again, a public health responsibility.

It is certainly encouraging that the early vaccines show promise of being effective and safe. What people have to remember is that it will take at least another six to seven months after the release of the COVID-19 vaccine for it to be available to many of us, so we must continue to follow public health measures such as wearing masks, frequent hand decontamination and staying away from large gatherings until there is a true decrease in the virus count.