Last month, the Texas A&M University Health Science Center and the Brazos Valley Health District announced plans to team up to form the COVID Investigation Operations Center. At its core, it’s a contact tracing operation: a team that will grow to sixty employees and is set to include contact tracers, case investigators, and epidemiologists. It will confirm positive COVID-19 cases, notify others that they may have been exposed, and provide access to resources for testing. Dr. Rebecca Fischer, an assistant professor at A&M’s School of Public Health, has been working out of the COVID Investigation Operations Center and says that at top of mind is the fall return of A&M students for a combination of in-person and remote learning. The challenge, Fischer says, is educating college students about their chances of contracting the disease and the risk that they may pose to others if they do become infected.
“With college students, there’ s often a sense of invincibility,” says Fischer, who teaches epidemiology and biostatistics and has focused her research efforts on tropical diseases, epidemic investigations, and infectious disease diagnosis and surveillance. “Plus, this age group is suffering mostly mild symptoms—although hospitalizations and fatalities do occur in the college age group, they might have the perception that the disease is not so severe. We also need to destigmatize this disease, because there’s fear among students that they will be shamed for doing something risky or not complying fully with the guidelines and recommendations. There’s a fear that they would be sent home from their college or university if they report they have a fever. So we’re worried about them actually presenting themselves to be tested, which of course we want them to do, and we want to help them through the process.”
On Wednesday by phone from the COVID Investigation Operations Center, Fischer detailed plans for the COVID Investigation Operations Center, weighed in on the return of college athletics, and expressed concern for the continuing politicization of the pandemic.
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Three takeaways from our conversation:
While it’s still unclear whether Texas A&M University intends to play football games in front of fans, and even then at what attendance capacity, Fischer said that sports—both college and professional—are shaping up to be a collision of public health and economics, with a difficult-to-predict outcome.
“With football, it’s not just students at the games, but also their parents. And there might be a safe way that we can start to engage in these activities. We are learning how to be careful and protect ourselves from the virus and to protect others, but certainly throwing our arms up and throwing everybody back in the field or back in the stadium together without taking measured precautions is not the right answer. As an epidemiologist, I am going to err on the side of caution in terms of making public health recommendations. [Canceling] football would certainly be safer from the pandemic perspective. But is that the right move? I don’t know. We certainly don’t want to keep school shut down. We know now more than ever that, particularly for the younger age individuals, there’s social, emotional, and educational fallout that can happen from keeping everything closed down or keeping activities from happening. I don’t know what that fallout would be for football, except for a lot of sad fans and then potentially some careers impacted—particularly those of student athletes. There’s an economic piece as well when we don’t have fans coming into the games. So there’s a lot to unpack here from a disease transmission standpoint. We certainly don’t want fans in a situation where they can be passing the infection on to others. And let’s be clear, many people are infected and spreading to others and do not know it—they’re completely unaware that they have been exposed to the virus. They may not have symptoms, or they may not have symptoms yet. This is why precautionary measures are so important.”
As early as January, epidemiologists across the country were debating the efficacy of combating COVID-19 with “herd immunity”—the notion that if enough of a population is immune to an infectious disease, the disease has virtually no way to propagate. Fischer believes that is not an option anytime soon.
“Herd immunity is a useful thing to talk about with diseases that have vaccines available that we can implement. But it’s not really useful for us to think about in terms of COVID-19, where we don’t have that yet. The number of people, the sheer number of individuals that would need to be infected for us to be able to reach herd immunity, is just unfathomable and unpalatable. The death toll would be immense. I think most experts are suggesting that at least 70 percent, but more likely 80 percent, of individuals in the community would need to have immunity to COVID-19 for that herd immunity to be protecting the other 20 percent to 30 percent. [But] 70 percent of Texans being infected with COVID-19 would take our death tolls off the charts to a place that we simply can’t get.”
Fischer is concerned about young children returning to school this fall unvaccinated because they may not have seen a pediatrician during quarantine.
“With our measles vaccine, you also get mumps and rubella. And they’re so vital to protecting the health of our community, although we think mostly about children. But measles is no joke. This is a severe disease, a killer. And it is prevented largely by vaccinations. When we have families afraid to go to health care because they might encounter coronavirus disease, or health care facilities that are so over overburdened with treating infections or screening for what may or may not be coronavirus disease, we’re really expecting a failure of our vaccine clinics and this system that we have spent so many decades building up. And that herd immunity that people talk about is so important with measles because it’s a highly infectious disease. It’s airborne, so it’s more transmissible than coronavirus disease, and it will affect our children and we will see children die if we cannot get our vaccination rate up to where it needs to be with measles. For those places where vaccines are required—for safe schools and camps—we hope that they will be caught there and there will be catch-up. But it’s certainly a concern.”
(Excerpts have been condensed and edited for clarity.)