Covid at One Year: Looking Back and Looking Ahead

This month marks one year since the Covid pandemic truly hit the Bay Area and the United States. In this UCSF Department of Medicine Covid Grand Rounds, we’ll reflect on the past year, describe our current situation, and predict where we may be in a year. We’ll do this in a fireside chat format with three of UCSF’s most astute Covid thought leaders: Kirsten Bibbins-Domingo, Peter Chin-Hong, and George Rutherford. All of them have spent countless hours in the past year analyzing and describing the state of the pandemic across a range of issues, including epidemiology, virology, clinical medicine, and equity. The session is moderated by UCSF Department of Medicine Chair Bob Wachter.
Program
Bob Wachter: Introduction
00:02:08-01:01:55 - Fireside chat with Kirsten Bibbins-Domingo (Chair, Dept. of Epidemiology & Biostatistics; Vice Dean for Population Health and Health Equity), Peter Chin-Hong (Professor of Medicine, Division of Infectious Diseases at UCSF Health), and George Rutherford (Professor, Dept. of Epidemiology & Biostatistics; Director of the Prevention and Public Health Group)
Bob Wachter: Closing
See previous Covid-19 Medical Grand Rounds:
• February 18: The 23rd Annual Reza Gandjei Memorial Lecture: A Conversation with Atul Gawande • The 23rd Annual Reza G...
• February 11: The New Vaccines, Attitudes Toward Vaccination, and the Biden Covid-19 Task Force • The New Vaccines, Atti...
• January 28: Covid-19: Vaccine Roll-out, the State of the Pandemic, and Variants - in the U.S. and U.K. • Covid-19: Vaccine Roll...
• January 14: Covid-19: Update on Vaccines and Implications of the New Variants • Covid-19: Update on Va...
See all UCSF Covid-19 grand rounds, which have been viewed over 1.66M times, here: medicine.ucsf.edu/covid-19-ne...

[@ffeller1442]

As a civilian, thank you very much for these videos. You cover a lot of information that reassures our lives. I share them with family and friends.

[@cmorth2413]

I’m a total groupie of grand rounds! Kudos to UCSF for giving the general public a source to wrap our arms around the pandemic policies and science. I’m an extremely proud to be a San Franciscan and Californian with UCSF at my back!

[@vickyhestad75]

Making your grand rounds available to the public has been wonderful. I really appreciate it and I have eagerly awaited each new ‘episode.’ Thank you very much!

[@melissaanderson3238]

Thank you George for putting Roslyn Franklin in with Watson & Crick!

[@christopherrobinson7541]

Triple-helix?

[@22cjk22]

These grand rounds have been great. So informative and insightful. I really appreciate them. Thank you UCSF.

[@Spottedhorse55]

I work in a school health office in Colorado and there has not been one positive case traced back to a transmission happening in the whole school district. In regard to George’s comment about getting it wrong keeping the schools closed in California, and learning that this virus is not like how influenza rages through an elementary school. Don’t forget that influenza is virtually nonexistent during this pandemic! That coronavirus AND flu are not being spread in schools is a tribute to masks & other layers of protection being implemented in schools. Thank you for a great grand rounds!!!

[@BlakeSuperior_Beats]

I’m not sure the school issue is quite as simple as they are making it out to be. The whole reason it has worked in many (not all) places is the extraordinary measures taken to protect students and teachers, along with many students staying home that allowed otherwise packed classrooms to space out desks and provide better resources to the often limited number of students on campus. Simply opening schools is not feasible until you consider and appreciate what it really takes to limit spread of disease. If only we could take similar precautions every winter to limit severity of cold and flu transmission!

[@mizmercer]

There is still no meeting of minds on the issue of school opening with educators and public health folks. I'm in a district about to return, and the only thing making it possible is that we're vaccinated. If I posted this video on my FB feed and said, the doctors/public health folks here think we should have reopened in the Fall, they would have more than a few choice words. If this happens again in the next decade, you will have a very difficult time convincing teachers that it's safe to teach, as the information ecosystem each group inhabits, if it were a Venn diagram, would have a thin sliver of shared data.

[@Cathy-xi8cb]

It hit me later than George, and for the same reason (SARS, MERS) but I had EXACTLY the same reaction: "Rut-Ro!!" We now understand that the public has very little willingness to sacrifice to protect the vulnerable. Until they become vulnerable. I will never look at patients in the same way again.

[@calvaryassemblyofgodsouthi8046]

Thank you

[@sherylleighton9225]

Thank you for this deeply insightful discussion!

[@dontworrybehappy5139]

Why aren't we prioritizing vaccines by age? Age appears to be the biggest risk factor, but not the biggest priority for vaccination in SF. It seems like the older crowd under 65 with risk factors are getting screwed.

[@jhtv5757]

Idk wtf youre talking about, thats how vaccines have been prioritized in the last 3 months

[@dontworrybehappy5139]

@@jhtv5757 Not true, in CA we've been vaccinating healthy 18 year old Safeway workers while denying 64 year olds. Even this week after we've opened it up to those with health conditions, healthy, honest 64 year olds are still not eligible. I believe age is the biggest risk factor for serious and fatal cases. It is sad we have not prioritized our 50-64 year old population in CA.

[@josefinagalera9550]

Hi, thanks for your information. I have a question. When do you think will be safe to travel abroad?

[@punkrachmaninoff]

Dr. George Rutherford is the Clark Griswold of the Dept. of Epidemiology... 42:50

[@punkrachmaninoff]

Dr. George Rutherford is the Hunter S. Thompson of the Dept. of Epidemiology... 58:50

[@Diego-fb5fq]

Public health is very much a project of logic and common sense, which most people are incapable of. Isn't the overall question that of getting and keeping the R-zero below 1 for a long enough interval? The farther below 1, the quicker this will be over. Now, various groups and localities (lookin' at you, Texas) may choose to reach "H-I" (being truly part of a herd) the hard way, by personal experience and loss. And others the easier way, with shots in arms. But eventually, all will reach it. Remember, H-I can continue on, past 80%. That is simply the threshold at which it becomes unlikely for any infected person to find and inoculate a naive victim. Also, variants will arise in un-H-I populations, proportional to the number of still-infected persons. 10 million active cases will produce 90% fewer variants than 100 million actives. So the odds of a vaccine-evading variant drop proportionally. With one-tenth the active cases, it will take ten times as long for any such variant to arise, giving us time to round off the vaccination of remote or recalcitrant populations. Those who are skeptics can enjoy their own outbreaks as we watch them burn out. People may be entitled each to their own opinions, but hammering the active cases down as much and as quickly as possible is the solution we are seeking, giving us a chance at the exponential reduction of the virus before such a new variant can sweep us back to square one. This is not a mosquito, or a rat, or a flea that is perpetuating this disease. It is the human being, exhaling in the vicinity of another human. And that is cause for both hope, and despair.

[@kw7807]

I might suggest in terms of the racism against Asian Americans that it was there before-it didn’t evolve overnight. 😐😔

[@kamwolf3960]

These guys NEVER talk about New Zealand and why they are THE success story. It's all about vaccines and treatments here in the u s.

[@The_903_usmc]

4 blind sheep

[@michaelkass5105]

The jolly memory philly alert because computer ethnically cheer upon a warlike centimeter. different, natural anethesiologist

[@margartroger513]

The evasive work simultaneously tick because freckle coincidentally measure as a witty kilogram. addicted, mature cloth

[@patriciahoke4722]

Remdesivir seems overrated. Is it?

[@kw7807]

Clinical trials indicate minimal efficacy regarding remdesivir.

[@patriciahoke4722]

@@kw7807 That's what I thought I'd heard. Meantime, we have been hearing about other repurposed drugs that are working but have not gotten the groupthink approval (a certain SSRI, Ivermectin, among others). What's almost always (exception: dex) talked *approvingly* about are the drugs that can be manufactured by the reliable pharma companies.

[@kw7807]

@@patriciahoke4722 it’s not group think it’s the double blind clinical trials-which are the gold standard. That said, Remdesivir is approved for emergency use.

[@patriciahoke4722]

@@kw7807 It's group think.

[@kw7807]

@@patriciahoke4722 it’s clinical trials and excellent science.