With no vaccine for COVID-19 available until December 2020, public health measures were our strongest defense. Faculty from Adelphi's College of Nursing and Public Health—especially K.C. Rondello, MD, and Maria-Pilar Martin, MD— played critical roles as advocates at the height of the crisis—both in the United States and around the world.

For more than a year, Dr. Rondello has informed the public and worked with government officials on disaster planning, while Dr. Martin has been supporting relief efforts across four continents, including in hard-hit Spain, Latin America and New York’s Hispanic communities.

K.C. Rondello, MD, Cautiously Optimistic on the Ongoing Fight Against COVID-19, Policies, Fear and Misinformation

by Caitlin McElroy

In a wide-ranging interview, K.C. Rondello, MD, University epidemiologist and clinical associate professor, touched on a variety of topics as the United States and the world moved hopefully toward an end to the COVID-19 pandemic. The disaster epidemiologist observed, “COVID-19 and emerging novel virus threats were always going to be a problem. The rate of the emergence of new threatening pathogens has been dramatically accelerating over the last decade. We’ve seen more emerging and reemerging infections in the last 10 years than we have in the last 100 years—so it’s a growing threat.”

On Public Health as the New Frontier in Healthcare

For Dr. Rondello, “Public health has been and always will be at the center of human beings’ health and wellness. Consider that, over the course of history, more lives have been saved by public health measures than by all other treatment and medical interventions combined—yet public health only receives a fraction of the attention. While the pandemic has brought public health to the forefront of the public’s attention, this is work we’ve been doing for hundreds of years.”

He added, “To Adelphi’s credit, they have been a leader in championing the discipline of public health for years. One way in which Adelphi demonstrated their commitment to the field was that they embedded the language ‘public health’ in the name of the College itself [in 2013]—demonstrating that both nursing and public health are equally vital.”

Armed with Vaccines, Where Do We Go From Here?

“In the case of the three vaccines currently available in the U.S., when it comes to minimizing the risk of death or serious illness,” Dr. Rondello maintained, “the vaccines are equally comparable. They all have outstanding safety and efficacy against the wild strain, and thus far are holding up well against new variants.”

To Dr. Rondello, “There’s so much reason for optimism on the vaccine front.” Still, much remains to be done. “Frustratingly, I don’t think most people understand just how miraculously safe and effective these vaccines are,” he said.

A major problem is misinformation. “One of the ways in which public health was not well equipped to deal with this pandemic,” he observed, “was in managing the vast amount of misinformation and disinformation that has emerged. This will continue to be a challenge for public health into the future. Being able to better manage social media in communicating reality to the public is going to be vital. We must be better at addressing that challenge.”

On Variants and Mandates

“There are many reasons in the data for cautious optimism,” he said. But, he added, “As new variants emerge, there’s the possibility that our progress is going to experience a setback. We’re heading in the right direction, but that does not mean we are ready to go back to preCOVID normal.”

The decision by some states to “aggressively roll back public health measures…is not supported by the science. When mask mandates are put in place, cases go down—it’s just that simple. I believe that abandoning public health measures now will result in prolonging this pandemic over the long term.”

Three main lessons learned

First, Dr. Rondello said, we learned from the COVID-19 experience that “we do not live on an island—we are a global, interconnected society. What’s happening elsewhere on Earth will inevitably impact the U.S., and it’s not practical to think any other way.” That means we need “extraordinarily diligent surveillance, actively monitoring trends and new pathogens when they occur.”

The second lesson is that “future epidemic responses need to be quick and aggressive,” he said. “During the early days of COVID in the U.S., denialism and inaction cost us vital time. Had we acted sooner and more robustly, we would have prevented thousands of unnecessary deaths and hundreds of thousands of cases. Taking appropriate, even if unpopular, actions would have made an enormous difference.”

As for “lesson three,” he said, “An optimal response necessitates a coordinated effort.” Citing “a tremendous lack of coordination,” Dr. Rondello recalled, “You had 50 different state governments adopting 50 different approaches and, given how nationally interconnected we all are, it was a recipe for disaster. …What we need in the future is uniformity and constancy of action early on and throughout.”

Dr. Rondello concluded, “Had we had all those pieces in place, the COVID-19 pandemic wouldn’t have been prevented, but deaths and infection rates would have been substantially less than they turned out to be. There is no good reason that the country with the largest reserve of financial, healthcare and government resources on Earth had to be the epicenter of this disease.”

The Pandemic’s Impact On Him Personally

“I saw a quote a few months ago: ‘I thought 2020 would be the year I got everything I wanted. It turned out to be the year I appreciated everything I had.’ That really resonated with me. After earning my graduate and medical degrees, I [chose] public health because I felt that in this discipline I could do the most good for the most people.” He added, “To be honest, over the years, I’ve occasionally wondered if it was the best decision to become a disaster epidemiologist. COVID validated my decision to enter this field. I’m confident that this is the place I was meant to be, and all the years of education and career building best prepared me to meet the challenge of this moment in time.”

Dr. Rondello disclosed, “COVID-19 proved to be the greatest personal and professional demand of my life. After several overwhelming months of ceaseless pressure, I needed to actively create opportunities to physically and psychologically turn off COVID, so that I could be in the right mental space to be most effective. When I disconnected, I would use that time to reestablish important social connections [to those] with whom I had lost touch. …That action proved to be one of the greatest benefits of COVID—I have rekindled several valued relationships and, in the process, bolstered my support system and reenergized my mind.”

Maria-Pilar Martin, MD: Helping and Listening to the “Voiceless”

by James Forkan

Assistant Professor Maria-Pilar Martin, MD, when asked about public health being the new frontier of healthcare, said, “Public health professionals are a frontline workforce, now and before [the pandemic]. PH professionals work in close contact with the population, mobilize the community, implement preventing measures, screening programs, address outbreaks and epidemics. We can’t imagine the current world without the contribution of public health work in the eradication of smallpox, control of tuberculosis, the HIV epidemic, maternal and child health, among many other conditions.”

Dr. Martin, also director of the CNPH Master of Public Health program, said, “COVID-19 put the spotlight on a profession that has been working behind the scenes for centuries. Public health professionals work in the local and state health departments and in community-based organizations, addressing the health needs of the most vulnerable populations.

Throughout the pandemic, she has been collaborating with the Spanish Medical Association (Madrid branch) and the Spanish Society of Epidemiology on the recruitment and screening of qualified healthcare volunteers to support disease prevention efforts throughout Spain. She has also been working on COVID-19 research with the Indigenous populations around Quito, Ecuador.

In addition, she has been involved in qualitative research using focus groups in the Hispanic community in central Queens, New York. “This,” she said, “is one of the most enlightening and rewarding experiences—listening to their perspectives and learning about the barriers to accessing healthcare among segments of the population that are voiceless.”

Due to interest sparked by the COVID-19 pandemic, the public health minor has become quite popular at CNPH. In Fall 2020, roughly six months into the pandemic, she said, “The number of students registered grew 80 percent, compared to Spring ’20.”

Based on the inquiries and interest received thus far, Dr. Martin said, “We foresee a steady increase. The new class that opened in Spring ’21, Social and Behavioral Aspects of PH, is overenrolled and we had to accommodate some students in the equivalent class in the Master of Public Health program.”

Dr. Martin observed, “The jump in interest in public health reflects a broader surge of interest in healthcare careers. We hope that this uptick of interest can contribute to filling the shortage of healthcare providers (physicians and nurses) and public health professionals,” which she said are contending with shortages of 400,000 and 250,000, respectively.

As for its impact on its public health minor and MPH courses, Dr. Martin said, “COVID-19 is everywhere in our PH education.”

This virus “has been a unique opportunity for our students to learn public health based on an unprecedented and real situation and from many different angles,” she said.

“COVID-19 is part of all our classes. Students learned to assess how COVID-19 was depicted in the mass media, as well as the many errors we find among journalists and politicians using epidemiological terms.”

Using real data, students learned how an epidemic can amplify the health inequalities in our communities, Dr. Martin said.

Such socioeconomic inequalities have long been an issue in the health of minority communities, a point emphasized at various CNPH speaking events in recent years.

At the 2017 Buckley Scholars’ Lecture, for instance, Diana Mason, PhD, senior policy service professor at George Washington University School of Nursing, said, “Your ZIP code may be more important to your health than your genetic code.”

Similarly, during a 2016 MPH panel discussion, “Is Inequality Making Us Sick?” Tonya Samuel, EdD, assistant professor at CNPH, said that social conditions in which people live and work every day, according to their economic situation, are bigger determinants of their health than their behavior and habits.

Dr. Martin said, “Our students also learned about cost-effective interventions and how politics can determine different health outcomes in our communities. We trained many students to become contact tracers and many of our students do the practicum in COVID-19 data collection.”

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