Epidemiologist with close ties to CB studying COVID-19

“We may soon be in a position that public health can do the job that it was hoping to do from the beginning”

By Katherine Nettles

For Robert Haley and his family, erring on the side of caution and deciding to cancel a trip to Crested Butte from their hometown of Dallas last month was more than simply following public health orders. It was a matter of his own science as well.

Haley is an epidemiologist, a professor of internal medicine and director of epidemiology in the internal medicine department at the University of Texas Southwestern Medical Center. Having studied communicable diseases throughout his career, he is working actively along with his colleagues across the world to study and stop the spread of the coronavirus.

Haley said the occurrence of COVID-19 is not surprising. “These will pop up periodically—they always have. There have been plagues every hundred years or so.” However he believes this disease could have, and should have been, prevented from reaching so many Americans.

“I mean, we’ve been expecting this. The public health community has been preparing for something like this really since the anthrax letters, the bird flu, SARS [Severe Acute Respiratory Syndrome], MERS [Middle East Respiratory Syndrome] and others. Each one of these has heightened the concern among the public health community that a major pandemic that would be difficult to control would come along,” explains Haley. He spent more than a decade as an epidemic investigator for the U.S. Center for Communicable Diseases and Prevention (CDC) and has received several awards for his research on disease prevention.

Haley said while these coronaviruses pop up regularly, the difference is how deadly COVID-19 has proven to be, and how poorly we have done at preparing for it and isolating it.

“Every year, we are visited by seasonal influenza, which kills between 20,000 and 80,000 each year [20,000 to 40,000 on average years], and many people don’t realize that. The difference, of course, is that we have influenza vaccines, and we come out with vaccines for new strains that evolve over each summer. Unfortunately, so many people don’t take it seriously and don’t get vaccinated. And it’s not always 100 percent accurate, either,” said Haley.

The difference is that not taking COVID-19 seriously is a much deadlier mistake. “COVID-19 is about 10 times more likely to be fatal than influenza… And with influenza people tend to die at home and not realize how sick they are. But [COVID-19] brings people into the hospitals. And that means that people who should be in intensive care will die because the ICU will be too overrun… That’s a very disturbing, attention-grabbing situation,” he said.

COVID-19 first caught Haley’s attention in January as it became widely recognized in public health. “At that time, public health officials stood up and said, ‘Gosh, this could be the one we’ve all been waiting for. Let’s get the tests, let’s prepare.’”

Despite Haley’s plans to visit Mt. Crested Butte in March, he canceled his travel arrangements well in advance of the Gunnison County public health restrictions on tourism and the ski area’s closure. He wishes that many others had done the same.

“We were going to be there in the middle of March and it was just the wrong time to go,” he said simply. “The ski areas attract people who travel widely, and it was already clear this was a huge problem.”

He is seeing similar outbreaks in Dallas, although Dallas is doing fine so far. “We’ve got our share of cases, but we’re not anywhere near our hospitals being overrun. Our county department has very wisely mandated self-isolation. However, we do have some hot spots in town. And it’s very obvious that the hot spots in Dallas are the most affluent areas, where people have travelled and did not prevent their children from travelling to dangerous areas over spring break. So we are hoping that the social distancing will aid in preventing this, but I’m concerned that those same populations might also be prone to disregarding that… These are the people who were also at the ski areas over the last month when everyone was being advised not to be.

“Of course we also have the problem that our national leadership obstructed the public healthcare system for two months,” continues Haley. “In a normal scenario we would have been stocking up on supplies, getting enough tests… and implementing all the usual methods to contain things like this. SARS and MERS were potentially just as bad as this, and were introduced throughout Europe. But the leadership of the public health community was able to test, identify the travelers and their contacts, isolating them, and preventing them from spreading it.”

Haley maintains that the current administration “did not believe the science,” which had a domino effect. “That allowed the virus to get loose so it cannot be contained, and that is why the economy has been shut down. This is now the only way to prevent hundreds of thousands of deaths… So, lesson learned. Or so we hope.” He said throughout the public health world, “That is a widespread observation.”

Haley said it is very difficult to make any predication about COVID at this point. “It really has only existed for two and a half months,” he said, echoing the World Health Organization’s findings that the virus originated in Wuhan, China in mid-December. “I am expecting the social distancing to contain the spread, but the question is whether [the virus] will restart when it looks like the number of cases dwindles and we can ease up… We don’t have enough experience with this one to know. We are counting on the social distancing to buy time so we can get the testing done—that should have been done in January—to be able to test everybody we suspect so we can use the standard testing and tracing to isolate the spread to eventually eradicate the virus.”

Haley said in many instances a new virus becomes less virulent as the season goes on. “So the longer you delayed it the better off you were. And it gives time to amass resources to eradicate it. Maybe a vaccine can be developed,” he said.

However, that arc is not proven yet with COVID-19. “The case fatality rate is a measure of the virulence of the organism. We need more data. But I would rather get [the disease] in six months than right now.”

He said the many people in the Gunnison Valley who get outside regularly, while maintaining social distance, are right on track. “The best thing you can do is get outside, really,” he said. “The virus cannot survive in direct sunlight. Especially at your altitude, where the sun is even more intense. And the open air dissipates the virus, so we are all safer outside than even in our own homes,” he said.

Haley concluded, “The expertise to actually control something like this is at the local health department level. The federal level has an important role in orchestrating, ordering equipment. But that’s not what actually does it. It’s the local departments. Unfortunately, those have been getting defunded for past 20 years, so that’s a little troublesome, but they know what they are doing. Presumably, everybody has gotten the message. We may soon be in a position that public health can do the job that it was hoping to do from the beginning.”

Haley hopes to visit Crested Butte again, once it is appropriate. He is one of four brothers, including Charles Haley, a retired epidemiologist who serves on the Rocky Mountain Biological Laboratory board of directors. “I’ve been coming to Crested Butte for about 40 years, as have my brothers. We love the Crested Butte opera,” he said of the music festival opera workshop each summer. “Every year at the end of that workshop these young, talented opera singers perform. It’s a small venue so it’s really personal, and the operas there have been wonderful over the years.”

Haley said he also used to ski here, and various members of the family, including children and grandchildren, still carry the torch.

“It’s a favorite summer and winter haunt for all of us.”