Ryan Lindsay began talking to his students about COVID-19 in his epidemiology class in mid-January at Idaho State University’s Meridian campus.
The coronavirus outbreak was a faraway real-world situation centered in China that the epidemiologist could use as teaching material.
Two months later, the subject matter became close to home for the ISU assistant professor, as a student from his Meridian campus became the first Idahoan to test positive for COVID-19.
“It just made it very real. You hear things in the news and you think it’s going to be somewhere else,” Lindsay said. “Studying this stuff your whole life, you hope it never happens.”
Lindsay said the evolution of periodic COVID-19 discussions in his classroom went from where the virus originated, is it containable, its high reproduction rate to how they might not be able to have these conversations anymore in his classroom.
ISU stopped holding classes on its campus March 16, and Lindsay is now doing remote learning for his Meridian students and continuing to do so for his students from the Pocatello campus for his graduate-level epidemiology class.
Lindsay noted that not everything he said in his class about the coronavirus outbreak has been correct — not for a lack of research but because public health officials were originally saying something different than what they are now.
“It’s obviously been a great case study for our students to be involved in something that’s current,” said Lindsay, ISU Department of Community and Public Health chair. “We’ve been talking about coronavirus, but there’s been things in that setting that I’ve said that I was completely wrong about and one of those was the effectiveness of masks, which I think lately has been talked about a lot more.”
He had reiterated what public health authorities were saying, which was masks were ineffective against the coronavirus, but that conclusion is changing.
It has been reported this week that the Centers for Disease Control and Prevention is reconsidering its stance on non-medical masks and will possibly expand the pool of those who should use them to more than sick people or caregivers of sick people who cannot wear a mask.
Amid contradicting information circulating, Lindsay explained a couple things that are definitive, such as that the virus spreads easily and the number of cases are greatly unreported in Idaho and elsewhere.
Idaho reported 891 confirmed COVID-19 cases and nine deaths as of Thursday. That was an increase of 222 cases from the day before. The White House predicts 100,000 to 240,000 Americans will die from the virus.
Ultimately, Lindsay said the state is in good hands with Idaho state epidemiologist Christine Hahn, and he applauded Idaho Gov. Brad Little for listening to experts like Hahn.
But he added that Idaho’s 21-day shelter-in-place should be extended past the April 15 end date.
“By then, we still won’t know that it won’t come roaring back,” Lindsay said. “When you flatten the curve, the idea is you shelter-in-place even longer.”
Just because Idaho was one of the last states in America to have its first confirmed coronavirus case, Lindsay said that does not mean the state is in the clear of a severe outbreak.
Furthermore, Lindsay said there are rural places in this state in danger because hospitals are far away. To add to the problem, rural citizens may postpone their visit to the hospital too long, which is troublesome because severe COVID-19 symptoms can arise quickly, Lindsay said.
“From what I’ve been hearing from doctors that are working in places where they have reached capacity, some folks are waiting too long to go to the hospital because they are afraid of going into the hospital because there’s infection there,” Lindsay said. “They also may be altruistic and think they don’t want to spread that to the healthcare workers if they don’t have to.”
Another concern Lindsay has is about a problem that stretches beyond Idaho borders: the lack of tests.
The problem is multiplied because data from insufficient testing was used to make decisions in Idaho. So before there was a coronavirus case confirmed in Idaho, some had the false belief it wasn’t already spreading in the state and made decisions based on that idea, Lindsay said.
“School districts and businesses, they were all saying they would take certain measures when that first case was confirmed,” Lindsay said. “Yet, we had so much evidence on a national level that (firstly) this coronavirus was popping up everywhere, even in rural states like South Dakota, and (secondly) we knew testing was an issue all over the state and the nation.”
Lindsay said there are a lot of needs that have to be met to weather the storm besides having a large quantity of tests, including having an adequate number of hospital beds, ventilators, respiratory therapists as well as maintaining the health of the medical workforce.
Lindsay said the Idaho public health system is already behind without the appropriate amount of governmental investment in that sector, which could use additional health district epidemiologists.
“This epidemic is really highlighting some real weaknesses in our health system and part of that is investment in public health,” Lindsay said. “I always stress that a health system is more than health professionals and hospitals and clinics. It includes the public health. … They don’t have the investment in surveillance and prevention and emergency preparedness and all of those regards that they really need.”
As much as he concerns himself with the health system, he also worries about the public’s commitment to social isolation.
“My biggest concern is folks won’t be patient enough as the weather gets good, it’s even better and we get sort of cabin fever to want to get out of the house and move about more,” Lindsay said. “I’m worried that we may open up society too quickly again and still have a surge that comes after, that overwhelms our system and that was something that certainly happened in the Spanish influenza epidemic. There were certain cities that relaxed social distancing mandates too early.”