Adelphi’s disaster epidemiologist and clinical associate professor K.C. Rondello, MD, shares his expert insights and predictions about how the COVID-19 virus might alter the track of the virus.
K.C. Rondello, MD, clinical associate professor in Adelphi’s College of Nursing and Public Health, has found his work as a disaster epidemiologist take on new significance during the COVID-19 crisis.
He is frequently sought out by the national media for his expertise, quoted frequently by The New York Times, Newsweek, Men’s Health and other publications. At the same time, he has helped prepare nursing students to care for the patients flooding New York hospitals with each wave of the illness. From My Desk talked to him to get his insights into the rollout of the COVID-19 vaccine in the United States, efforts to stem the spread of the illness and his thoughts on the future path of the pandemic.
These are busy times to be a disaster epidemiologist. You must go nonstop.
Yeah, there are no easy days. It’s been exhausting and overwhelming to be in the middle of a once-in-a-lifetime global pandemic. I studied pandemics the entirety of my professional life, but I never imagined that such a public health crisis of this magnitude would occur in my lifetime.
Are you seeing parallels to pandemics you’ve read about and studied?
Oh, yes. One of the classes I teach at the University is called Epidemic Planning and Response. In it, I talk about how, during the Spanish flu pandemic of 1918, places of assembly were closed and sporting events canceled. Before the current pandemic, students would always look at me cross-eyed and say, “They canceled sporting events?!” That was such an extraordinary thing for them to wrap their heads around—that they would do something so drastic to protect public health when dealing with a disease for which there was no treatment or a vaccine. They couldn’t imagine such a thing happening. Now, we’re in a world in which those mitigation strategies of a century ago are key to managing a pandemic that has killed more than 400,000 Americans and is still going.
Have we seen the worst of this yet?
When the history of COVID-19 is written in textbooks years from now, it will be known that January 2021 was the worst month of the pandemic. January has been brutal. That’s due to a confluence of circumstances happening at once, but the biggest reason for all the cases and deaths and hospitalizations is the activity of Christmas to New Year’s. We knew that was going to happen, that people would travel and spread the disease. We’re seeing the elevation in cases we thought that we would, and that’s not a good thing.
Hopefully, we’ll see the number of cases and deaths plateau in February. By March, you’ll start to see a slow decrease. Once more vaccines become available—like the Johnson & Johnson one that requires just one dose—the decrease will gain momentum and snowball. People will spend more time outdoors as the weather warms and less time in crowded indoor environments. That will help lessen the cases because we know the pathogen flourishes in colder climates. Warm weather will mark the beginning of the last chapters of this whole saga.
The course of the pandemic is very much dependent on the speed of the vaccine rollout. What’s your view on how that’s going? We’re hearing a lot of stories about people not being able to get vaccines in some places, while in other places there are vaccines to spare.
There’s been a lack of coordination at the national level. The federal government has had a hands-off approach and has put the vaccine in the hands of the states. This has caused confusion that could have been avoided with a unified, coordinated national effort instead of having 50 different departments of health trying to figure it out on their own. You have different states making the call as to who gets vaccinated first, so no one knows what is going on. The reason for this unevenness around the country is because there are no clear answers coming from a single source. This patchwork approach to distributing and administering vaccines has been a big problem and it’s slowed our response. We’re behind where we should be right now.
Here in New York, there are about 7.5 million individuals eligible for the vaccine. But New York state receives an allocation from the federal government of approximately 300,000 doses a week. You don’t have to be a disaster epidemiologist to see that this does not calculate. Complicating matters further, states do not learn their allotment of vaccine until seven days before it shows up. So the logistics of attempting to plan in a vacuum, when you don’t have even the most rudimentary understanding of how many vaccines you’re going to have to give, causes enormous confusion. People have signed up for these precious, limited vaccine slots, only to have them canceled when the state finds out that they’re not getting as much vaccine supply as they expected.
Do you see the vaccine distribution improving? President Joe Biden has promised a “full-scale wartime effort” to administer 100 million vaccines in 100 days. Think it will happen?
The [Biden] administration is placing a far higher priority on taking ownership of the process than the previous administration. Those of us who are on the front lines and dealing with this are quite optimistic that there will be a level of leadership and accountability that has thus far been largely absent. I have a level of hope that I didn’t have before.
To stop the pandemic the fastest, who should get the vaccine first?
There are a lot of competing views on this. I think we need to get our frontline healthcare workers first, because if they go down, the whole system collapses. Once you’ve done that, then you have to prioritize who goes next: teachers versus those with preexisting conditions versus those who are 65 and over. That’s where it gets murkier, and the decision-making becomes more challenging because you’re trying to figure out how to best use this resource to limit morbidity as much as you possibly can.
Can we take off our masks once we get the vaccine?
No. The vaccine is not a silver bullet. It’s just one more public health protection that is going to help us eventually end the pandemic. Granted, it is a critical piece of the puzzle. But it alone does not negate the need for all the other mitigation strategies. We have no idea if the vaccine affects COVID’s transmissibility. You could get the vaccine and still carry the virus and transmit it.
When will the pandemic end? When can we throw away our masks and hug one another again?
We’re getting there. I’m optimistic that we’ve finally reached a plateau, and over the coming months, cases, hospitalization and deaths will continue to drop. As things stand now, my best guess is that the most invasive COVID-19 protections—things like bans on indoor dining, crowd limits, masks, physical distancing, etc.—will be able to be lifted by mid- to late-summer. The challenge will be for all of us to stay vigilant and maintain our physical and mental well-being until then. I know many people are struggling with the open-endedness of it all, but we all need to remember: none of this is forever, and there’s an end in sight.