Two years into the pandemic, we asked 3 questions: Does a mask work? Does social distancing work? Can you get COVID-19 from a surface?
Dr. Angela Dunn answers questions about where we are at and where we are going. Here’s that conversation.
At the beginning of the COVID-19 pandemic, Dr. Angela Dunn, the state epidemiologist, became the voice of the medical community’s response in Utah, frequently speaking at news conferences along with the governor and other state leaders.
As the Deseret News said in a profile of her earlier this year:
“While many raved about her concise and jargon-free media briefings ... Dunn also faced many naysayers and even threats. But through it all, she continued to emphasize information over politics.”
Now the executive director of the Salt Lake County Health Department, Dunn may no longer be a daily presence on television screens, but she remains an influential voice in the state’s response to the pandemic.
This week, the Deseret News/KSL editorial board sat down with Dunn to discuss the current state of the pandemic and the outlook for the future. Here is an edited and condensed transcript of that discussion.
Q: We’ve just come through this milestone of 1 million deaths in the U.S. What’s your perspective when you hear that number?
Dunn: It’s definitely tragic, especially in the wake of having effective vaccinations and seeing that a majority of these deaths are in individuals who are not up-to-date on their COVID vaccine. It makes me question what we could have done better or what we need to do differently moving forward for all things vaccine related.
Q: Where did we lose the public trust, or how could we have built it differently?
Dunn: It goes back prior to COVID. Public health relies a lot on data. We think when someone disagrees with us, we can just give them more data and change their minds. ... We’ve had people against vaccination way longer than COVID, and we would always just show them the data. And COVID is an acute example of how public health needs to build trust with individuals beyond data and get on the personal level of what is really going on: Why do people mistrust government in general, and how can public health separate itself from the elected official machine to show that we’re truly part of the greater well-being?
Q: Are we in another COVID-19 wave right now, and how will we know that if people are doing unreported at-home testing?
Dunn: I finally got COVID; it was two weeks ago now that I finally tested negative. ... Numbers wise, our cases are going up and our leading indicators that are testing-independent are going up — that’s our waste-water surveillance and individuals who are seeking care for COVID-like illness. Those leading indicators are definitely going up, but not to the extent of the delta or omicron surges. It is a slow, very mild increase up, and in Utah, what we have going for us ... is that our hospitalizations continue to decrease, and that’s really good news.
My son and I had very mild illness ... and that’s what we want; that’s what we’ve been striving for for two years. ... And we are there if you’re up-to-date on your vaccinations. But unfortunately, the other side of that coin is that we have less than 50% of Salt Lake County residents up-to-date on their vaccines which is not enough to prevent another surge.
Q: Does being up-to-date on your vaccines provide any protection against the new omicron subvariants we are seeing in other countries?
Dunn: Vaccines do still protect against severe disease. You can still get infected, but we are finding that it’s still very good at protecting against being hospitalized or needing to seek care. So while the vaccines aren’t as effective as they were against delta — we’re not seeing the 98% protection rate now — it’s still in the 80s, and even in the 70s it’s great. ... So we are still in good shape, even against the new omicron variants. But people need to be up-to-date and getting their boosters when they’re eligible.
Q: Are immunity and vaccination really protecting us from getting infected and getting sick?
Dunn: In order to prevent a new surge, we all need to be up-to-date on our vaccines. Even though you still might get COVID, you won’t be hospitalized, and you won’t pass it to other people who could be hospitalized. We really need to continue the message that it will protect you against severe disease. That’s what the flu vaccine does too; it protects us from being hospitalized and dying.
Q: Are we back to normal now if we are staying up-to-date on our vaccinations?
Dunn: I think we are almost there. It’s still a pandemic because it’s still spreading in various countries across the world. But we in the U.S. are in a better place than we were six months ago or three months ago. The pandemic’s not over, but we’re at a different phase largely because of our vaccinations and because of our natural immunity from the omicron wave. ... If you’re up-to-date on your vaccinations, you can make the personal choice to go about your normal life, whatever that looks like for you, and largely be protected against severe disease. So ... any large mandates, closing of restaurants and bars, that type of thing ... we are past that point because we have such effective vaccinations.
Q: As we look at the next couple of months with July 4, graduations, big summer events, what concerns you about social gatherings?
Dunn: There is a lot of talk about a summer surge, but I’m most worried about fall. We have not gotten through a fall without a huge surge. ... We need to get through fall of 2022 without feeling like we need to shut down schools again. ... Coming up on summer is definitely concerning given the waning immunity for a lot of people. For those of us under 50 who can’t get a second booster yet, our immunity from our booster is waning as well, so it could be the perfect storm this summer to see that increase in cases.
My biggest concern is our hospital capacity. Right now, our ICUs are pretty full, but not with COVID patients. Our COVID patients take up about 2%-3% of all our ICU beds right now ... yet the ICUs are still about 80%-90% full. ... Even a tiny surge due to COVID could overwhelm our hospitals again.
Q: Looking back at the pandemic, what lessons have we learned?
Dunn: It is very clear that at the beginning of this pandemic, public health and elected officials need to work more side-by-side prior to a pandemic, and especially during times of crisis. ... Seeing them as a partner in pursuing common priorities and common goals is going to be beneficial moving forward. But this is way bigger than public health. The divided country was divided prior to the pandemic, but we set ourselves up for a perfect storm. ... And unfortunately public health will probably bear most of the negative effects from that in terms of trust.
Q: Are you concerned about the loss of respect for public health in this highly politicized climate?
Dunn: Absolutely. You see it at all levels. ... In some ways, public health could have done things better, but we always can, no matter what the crisis is. But in some ways, it does feel like public health is a scapegoat. ... A lot of misinformation and different things were being said from the federal government versus the CDC or the state government versus public health.
Q: What missteps did Utah take during the pandemic?
Dunn: Everyone had the best interests at heart, but ... it did feel at times that it was definitely public health versus the economy and public health versus politics rather than “we’re all on the same team.” We don’t want to crash the economy, and we also don’t want people to die unnecessarily. Had we been able to be more cohesive, we could have given the public a clearer answer about what we did and didn’t know and a way forward. I don’t think that’s unique to Utah. ... What we’ve really taken away from this is the need to continuously partner with individuals outside of the health sector because health touches everything.
Dunn: (She pauses briefly) Yes, definitely. ... I hesitated because at the beginning ... I actually wasn’t a mask believer. I was like, there’s no way. You’re going to be touching your face and it’s a false sense of security and it’s just not worth it. But then the data started showing that once you reach a certain level of disease in your community, where the person next to you in the grocery store is more likely to have COVID than not, masks definitely help there. ... It’s not going to prevent it 100%, but it’ll decrease it.
Q: Have social distancing and surface disinfecting been effective strategies against COVID-19?
Dunn: What I think social distancing did is it made less people congregate so that you had less chance of coming into contact with COVID. Knowing that COVID is airborne ... the molecule can hang in the air for a longer period of time, but it did limit how many people we came into contact with.
It turns out that COVID ... doesn’t really live long on surfaces, but it certainly is hanging in the air longer, so you’re better off not coming into contact with people who are sick and also wearing a mask than you are wiping down your groceries.
Q: Are cloth masks less effective than N-95 masks in protecting us from COVID-19 infection?
Dunn: When we had alpha, it wasn’t as transmissible as omicron, so a cloth mask did a good job at preventing the spread because you had to have a lot of droplets in order to get infected. But with omicron, it’s much more transmissible, so fewer droplets could infect someone, so you needed a better mask. ... Now where we are in the pandemic, if you would like to protect yourself with a mask, it’s important that you get a really high filtration respirator.
Q: What is the main takeaway people need to know going forward?
Dunn: It’s fine if you get COVID and you’re vaccinated, for the most part. ... To feel fine at the end of it is a luxury, but it shouldn’t be. We should all be up-to-date on our vaccines, and those who can’t get vaccinated or the more vulnerable should be comforted by the fact that the vast majority of people around them are vaccinated — we’re just not there yet.