May 2021 - The Epidemiology Monitor by The Epidemiology Monitor

Suddenly, The Shine Is Off Herd Immunity

In This Issue

Expectations Are Changing With New Thinking Returning To Pre-Pandemic Normal Life No Longer An Option Throughout the COVID-19 pandemic, epidemiologists and other scientists have proposed different thresholds as target levels we should aim for to achieve herd immunity. The notion being put forth was that once this level of immunity was reached, everyone in the population would be protected because the virus would be unable to find enough susceptibles to spread any further. Thus, as described in a recent 2 article by Malia Jones, “the phrase Slate ‘herd immunity’ has become our utopia—a promised land where we can

live life as it was before the pandemic.” Not Clear Cut Now many observers are examining the concept of herd immunity more closely and coming to the conclusion that the concept is not as clear cut or simple as has been portrayed by many science spokespersons in the media. Even the threshold levels have changed. These were initially thought - Herd con't on page 2

WHO Independent Panel Diagnoses 13 Key Failings In Pandemic Preparedness And Response To COVID-19 An independent panel of experts from around the world convened by the World Health Organization released its findings in May 2021.

In reviewing the events of the pandemic, the panel identified 13 key failings at critical points in time as the outbreak and the response to it led to a full-blown outbreak. Had different actions or decisions been taken, the experts believe, significantly less morbidity and mortality would have occurred or would not be still occurring.

In blunt language, the panel calls the pandemic a “preventable disaster” and says the world quickly needs a new international system for pandemic preparedness and response.

- WHO cont'd on page 3 May 2021

-5WHO Panel Formulates Pandemic Recs

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Volume Forty Two •

Number Five

-7Wastewater Epi Commonplace During COVID Pandemic -8Near Term Epi Calendar -12Notes on People 50 Greatest Leaders -14Marketplace

-Herd cont'd from page 1 The Epidemiology Monitor ISSN (0744-0898) is published monthly by Roger Bernier, Ph.D., MPH at 7033 Hanford Dr,, Aiken, SC, 29803, USA. Editorial Contributors Roger Bernier, PhD, MPH Editor and Publisher

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to be between 60-70% and are now being set closer to 80% and even 90% by at least one investigator. If for no other reason, these higher thresholds should serve to warn that attaining such high levels will be nearly impossible. But as many observers have now noted, there are plenty of other reasons why we should stop thinking about achieving herd immunity as a magic moment when everyone is protected and things can return to normal. Stanford University epidemiologist Julie Parsonnet told local media “Herd immunity is a nice idea but in reality it’s a concept best applied to cow herds—or perhaps to nursing homes, ships, boarding schools, or islands but not to an entire country or the world.” Questioning Herd Immunity Among the reasons to question the feasibility of herd immunity are: The transmissibility of a disease will impact the possibility of reaching herd immunity. As reported in a guest essay by Erin Mordecai and colleagues in the New York Times, transmissibility is not fixed and can change based on characteristics of the population or its behaviors. Also, the virus characteristics can change and the virus can become more transmissible as has occurred with the SARS-CoV-2 variants which have emerged. World Situation

The US does not exist in isolation. The virus is circulating in other countries and the prospect of manufacturing enough vaccine and distributing it

wide enough to protect the world population is years away, if it can ever be achieved. In the meantime, the virus will continue to circulate and may produce new variants which can threaten any protection level achieved in the US or elsewhere. Vaccination Feasibility Another reason to question herd immunity is the percentage of adults who are vaccine hesitant or refuse to be vaccinated is unlikely to decrease to negligible levels. For example, the concept of herd immunity itself may be causing people to reject vaccination because they are waiting for others to get vaccinated and create a safe zone for the unvaccinated. This is the “free rider” problem in which some persons benefit from public goods without having to pay for them. And there will always be pockets of susceptibles where low coverage exists. Just as there may be a herd immunity threshold there is also a maximum feasible level of the population that can be vaccinated in a free society. Endemicity Herd immunity, at whatever level may be required, will not be enough to eradicate the virus as most experts expect the virus will become endemic rather than disappear completely. As described during a panel discussion about herd immunity at Stanford University, it is likely that “there will be a plateau in infection with a decrease in prominence over time but continued circulation. It will not be as prominent but will continue to circulate. There will be no clear cut endgame. This endemic situation will require maintenance via ongoing - Herd con't on page 6

-WHO cont'd from page 1 The panel issued a separate set of 7 recommendations to address these failings (see related article in this issue). Bright Spot The bright spot in the response is the rapid development and deployment of highly effective and safe vaccines against SARS CoV-2. The speed of development was unprecedented and the development of these vaccines is widely considered to be a major scientific achievement. Unfortunately, the same level of effort and financing did not go into the distribution and administration of the vaccine and the inequitable utilization of the vaccine has been one of the key failings. Useful Framework Many of these failings will be recognized by epidemiologists and other health professionals who have been involved with or followed the evolution of the pandemic. The list by the panel provides a framework for dissecting the response to the pandemic as will likely happen frequently over the next months and years as analysts and observers seek to identify the lessons learned from the pandemic. The critical failings according to the panel were: 1. Despite warnings about the risk of a pandemic and what needed to improve in order to be prepared, “the world had not taken these issues seriously” and the world was not prepared. One striking finding is that preparedness metrics gathered ahead of time failed to predict weaknesses. The panel states “the thing that all these

measures had in common was that their ranking of countries bore no relation to the countries’ success in containing COVID-19.” 2. The alert or surveillance system to detect novel fast-moving respiratory pathogens is not fast enough, has legal constraints, and is not premised on applying the precautionary principle.

"...the world had not taken these issues seriously...”

3. Countries had to experience the cases and deaths in their own locations before taking serious action. According to the panel, “It was not until the number of COVID-19 cases increased dramatically at home that governments took serious action to prevent transmission. February was a lost month of opportunity to contain the outbreak, even as the evidence of infections spreading globally was apparent. Timing mattered—early recognition of the COVID-19 threat and quick responses kept the epidemic small.” 4. The health system’s front line was not ready. Missing elements according to the panel were adequate supplies, proper protective equipment, better staffing, childcare support, mental health support, and income support for those whose risk from working was too high.

“February was a lost month of opportunity..."

5. There was a scramble and competition for supplies “There was a lack of rapid and dedicated financing at the right scale and decentralized manufacturing and procurement capacities. - WHO con't on page 4

-WHO cont'd from page 3 6. Improved means of communication were both an asset and a liability.

“...rapid and clear communication has been a matter of life and death during this pandemic..."

While the world now has the capacity to communicate rapidly through multiple platforms, social media also was the source of disinformation and misinformation. According to the panel, “rapid and clear communication has been a matter of life and death during this pandemic and will continue to be with the intensification of vaccination and public health control measures.” 7. The speed of the scientific and R&D response to COVID-19 was unprecedented but had limited participation from low and middle income countries 8. Countries failed to act together in their mutual interest

“The multilateral system as a whole failed to take collective responsibility."

According to the panel’s report, “The multilateral system as a whole failed to take collective responsibility. There is no alternative to multilateral cooperation.” Despite this reality, rivalries prevailed. The report continues, …”Understanding the political economy of incentives and barriers to international agreement is a vital task that needs to draw on research disciplines much wider than done today.” 9. Economies took major hits

“The US$22 trillion impact of the COVID-19 pandemic is the biggest shock to the world’s economy in threequarters of a century. The return on investment in pandemic preparedness is vast. The US$72 billion estimated cost for preparedness corresponds to less than 1% of the total cost as we know it right now”, according to the

report. 10. The pandemic affects everyone, but not everyone is affected equally. Inequality has been the determining factor explaining why the COVID-19 pandemic has had such differential impacts on peoples’ lives and livelihoods. 11. Vaccine nationalism prevailed According to the report, effective vaccine allocation and distribution based on public health needs has failed. There is an immediate need for political agreement for redistribution of available and soon-to-come vaccine doses. 12. Building forward better, realizing the sustainability vision The present global socioeconomic crisis has its root causes in the failure to pursue sustainability and resilience as our main objectives. 13. An uncertain future with mutant SARS-CoV-2 Moving from the mindset of fighting to stop a pandemic to acknowledging it will be with us for the future is going to be difficult. It requires judgments as to what level of ongoing COVID-19 spread and disease impact would be acceptable, and whether to tolerate different degrees of impact in different communities and countries. Countries which have adopted elimination strategies are unlikely to want to abandon them. A world living with endemic, seasonal SARS-CoV-2 infection will require continuous, vigorous, and effective surveillance - WHO con't on page 6

WHO Expert Panel Formulates Recommendations To Curb Current Pandemic And Avert A Future Pandemic Catastrophe The WHO’s Independent Panel for Pandemic Preparedness and Response issued two sets of recommendations in May designed 1) to lessen the impact of the current COVID-19 pandemic and 2) to create a truly international system that can effectively prevent any future outbreaks from escalating into pandemics. The panel of 11 experts, described as highly experienced, skilled, and diverse, worked for eight months to provide a definitive account of what happened and why it happened and analyzed how a future pandemic can be prevented. To read an account of the panel’s diagnosis of how the world allowed the current pandemic to unfold, see the related article in this issue. To curtail the current pandemic, the panel calls for: 1. One billion vaccine doses from high income countries to low to middle income countries by September of this year and another billion doses by mid-2022. 2. Vaccine producing countries should agree to voluntary licensing and technology transfer for COVID-19 vaccines. 3. G7 countries should commit to provide 60% of the US$19 billion required for The Access to COVID-19 Tools Accelerator (ACT-A) collaboration in 2021 for vaccines, therapeutics, and diagnostics. 4. Every country should apply nonpharmaceutical public health measures systematically and rigorously.

5. WHO should develop a plan with clear goals, targets, and milestones to guide and monitor bringing the COVID-19 pandemic to an end. To prevent a future pandemic and create a new international system, the Independent Panel crafted the following recommendations. Each of these recommendations is tied to the evidence the panel found for the failings in response to the current pandemic. The new recommendations should be implemented as a package to assure they create the new system needed.

“...provide a definitive account of what happened and why it happened..."

According to its report, the Panel “has assessed the set of recommendations against one criterion only: if they had been in place, would they have stopped the COVID-19 pandemic? We believe the answer is yes, and therefore urge their implementation as a whole and in a timely manner.” 1. Elevate pandemic preparedness and response to the highest level of political leadership. The idea behind this recommendation is to gain the attention of the leaders of each country and get them to commit to transforming pandemic preparedness and response from its current inadequate to a future adequate level. The recommendation calls for the creation of a Council of Leaders which would adopt a political declaration at a special session of the UN General Assembly in 2021. - Formulate con't on page 6

“...if they had been in place, would they have stopped the COVID-19 pandemic?"

-Formulate cont'd from page 5

-Herd cont'd from page 2

2. Strengthen the independence, authority, and financing of WHO.

vaccination because immunity will wane and new susceptibles will be constantly entering the population.

3. Invest in preparedness now to prevent the next crisis

“Leaving out countries will not only be inequitable, but a danger to public health."

This the panel seeks to accomplish in part by having all national governments update their pandemic preparedness plans and have them peer reviewed at regular intervals. 4. Create a new agile and rapid surveillance information and alert system. 5. Establish a pre-negotiated platform for tools and supplies. 6. Raise new international financing for pandemic preparedness and response. 7. National pandemic coordinators should have a direct line to Head of State or Government ■

“...to reach a level of virus circulation and virus impact that is acceptable..."

-WHO cont'd from page 3 and public health measures. There will be challenges of both logistics and equity— viral variation will in all probability produce the need for repeated vaccinations. Leaving out countries will not only be inequitable, but a danger to public health. To read the report, visit: https://bit.ly/2TsutMF ■

Level of Acceptability Some experts see a solution in calling for a more targeted rather than universal approach to vaccination. This would involve focusing on vaccination of people who are most likely to have an impact on the level of disease at the overall population level. This would include persons who can transmit the virus such as young adults with multiple contacts, people who live in multigenerational households, or people most like to be hospitalized or die from COVID-19. This more targeted vaccination approach seeks not to ever eliminate the virus completely or keep it totally out of the population but to reach a level of virus circulation and virus impact that is acceptable even if not totally satisfactory. In short, there may be a level of COVID endemicity that populations are willing to tolerate or have to tolerate given the realities of what is achievable. ■

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Doing Wastewater Epidemiology Becoming Commonplace During COVID Pandemic “Did you know you might be taking a COVID test every time you poop? That’s the leadoff question in a compelling news article from the University of British Columbia that claims “wastewater epidemiology is changing the world”. The evidence for the widespread analyzing of sewage samples for traces of the SARS-CoV-2 virus comes from major cities around the world. According to UBC assistant professor Mohammed Rafi Arefin, this technology and technique were rolled out in almost every major city in the world within one year. Partly, that’s because the testing is relatively easy to put in place using auto-sampling devices in the wastewater and using a lab to detect and sequence the virus. The results have proven useful at detecting community spread of the virus, according to the article, and in doing so relatively quickly within a day after the virus is excreted and enters the sewage system. The technology has also spread widely because it is precise and affordable, according to Arefin. Use in New Zealand An example of the use of the new technology come from Wellington New Zealand where the test was able recently to pick up virus fragments and provide two weak positive results taken at short intervals of each other, according to a report from RNZ. The results were interpreted to suggest the virus fragments may have come from recently recovered cases that are still shedding the virus rather than from new cases. The technology is that sensitive.

Meaning Of Virus Fragments Otago University epidemiologist Michael Baker told local media “This is evidence that there are people in Wellington who are shedding fragments of the virus and they’re being picked up by the system. In some ways it’s a good finding because it’s showing that the system can detect fragments of the virus when they’re being passed out into the sewage system…At the moment the role of sewage testing is still a bit unclear in terms of whether it is going to give us a big edge, or whether it wil mainly pick up outbreaks that are already apparent through other means.”

“...it is precise and affordable..."

Unvetted Technology For Arefin, the questions about the technology are different because new technologies rolled out like this in a crisis aren’t vetted for their ethical or political, or social implications. This raises questions about, privacy, surveillance, and who owns the data. His goal is to learn more about how this rapid shift in public health technology has affected us all and how we can best aim to direct this newfound capability in the future.

“The technology is that sensitive."

Baker agrees about the need for review and stated “I do think we’re probably at the state of hopefully doing a major review of this system, and I guess continually reviewing of all our surveillance systems to see what’s the best mix of approaches.” ■

Near Term Epidemiology Event Calendar Every December The Epidemiology Monitor dedicates that issue to a calendar of events for the upcoming year. However that often means we don't have full information for events later in the upcoming year. Thus an online copy exists on our website that is updated regularly. To view the full year please go to: http://www.epimonitor.net/Events The events that we are aware of for the next two months follow below.

June 2021 June 1-4 https://bit.ly/2IrMuWg Conference / 2021 Annual Conference / Society for Prevention Research / Location TBA June 1-30 https://bit.ly/2WdMtIy Summer Program / Episummer@Columbia / VIRTUAL June 4 http://bit.ly/37u0852 Conference / 8th annual Symposium on Advances in Genomics, Epidemiology and Statistics (SAGES) / University of Pennsylvania - CCEB / Philadelphia, PA June 5-16 http://bit.ly/2Kxw9QD Short Course / Epidemiological Evaluation of Vaccines / London School of Hygiene & Tropical Medicine / London, England June 7-9 http://bit.ly/2K4p3Dl Short Course / Causal Inference in Epidemiology: Concepts and Methods / University of Bristol / VIRTUAL June 12-15 http://bit.ly/3h0U1bh Conference / 2021 Annual Research Meeting / Academy Health / TBA (may be virtual) June 13-17 http://bit.ly/2Pkd8Q4 Conference / 2021 CSTE Annual Conference / Council of State & Territorial Epidemiologists / Pittsburgh, PA June 14-15 http://bit.ly/2Rvu2y4 Short Course / Introduction to Rates and Survival Analysis / University of Bristol / VIRTUAL June 14 - July 2 http://eepe.org/ Summer Program / 33rd Residential Summer Course in Epidemiology / EEPE - European Educational Programme in Epidemiology / Florence, Italy June 15-18 https://bit.ly/2INiyE6 Conference / NAACCR Summer Forum / NAACCR - North American Association of Central Cancer Registries / VIRTUAL June 21-22 http://bit.ly/2RyvIGU Conference / 34th Annual SPER Meeting / Society for Pediatric and Perinatal Epidemiologic Research / San Diego, CA June 21-25 http://bit.ly/3poaZn0 Summer Program / Real World Epidemiology / University of Oxford / Oxford, England

June 2021 continued June 22-24 http://bit.ly/38mi8wf Conference / Brain Tumor Epidemiology Conference / BTEC / Lyon France June 22-25 https://bit.ly/2LsgmTo Conference / 2021 Annual Conference / Society for Epidemiologic Research / San Diego, CA June 28-30 http://bit.ly/36c2Ubi Conference / APIC 2021 / Association for Professionals in Infection Control / Austin, TX June 29 - July 1 http://bit.ly/3mgiL0k Conference / 2021 NACCHO 360 - "Driving Public Health Forward" / NACCHO / Detroit, MI & Virtual

Help complete the epi calendar for 2021 The events listed on the next page in blue have traditionally run in June each year. As of the date of publication, we cannot locate updated information for these specific events for 2021. We will be updating our calendar monthly throughout 2021. If you have any information on these events please contact us at events@epimonitor.net Please check our website and newsletter issue often for new information.

Short Course / Epidemiology in Action w/"R" Studio / Emory University SPH / http://bit.ly/2scdrVb Short Course / Intl Course in Applied Epi w/"R" Studio / Emory University SPH / http://bit.ly/2Edn7BX Short Course / Evidence Based Clinical Practice Workshop / McMaster University / http://bit.ly/2LARbvo Summer Program / Summer Program in Epidemiology / Harvard University / http://bit.ly/368xRgK Conference / 6th World One Health Conference / Multiple / http://bit.ly/35iHxFd Conference / 2021 ACHI National Conference / Association for Community Health Improvement / http://bit.ly/2Rvu2y4 Summer Program / Pharmacoepidemiology Summer School / Aarhus University / https://bit.ly/2ru6Kud Short Course / Intro to Infectious Disease Modelling / London School of Hygiene & Tropical Medicine / http://bit.ly/38mlLCo Short Course / Causal Inference in Epidemiology / University of Bristol / http://bit.ly/2E2pDL6 Short Course / Intro to Qualitative Research Methods / University of Bristol / http://bit.ly/2RwI4zn Short Course / Psychiatric Epidemiology / Erasmus MC / http://bit.ly/36mvib7

July 2021 July 5

http://bit.ly/2K4p3Dl

Short Course / Advanced Survival Analysis / University of Bristol / VIRTUAL July 6-7

http://bit.ly/2K4p3Dl

Short Course / Introduction to Research Governance / University of Bristol / VIRTUAL July 7-23 https://bit.ly/2RWT7iZ Summer Program / 12th Annual Summer Institute in Statistics and Modeling in Infectious Diseases (SISMID) / University of Washington / VIRTUAL

July 2021 July 7-30 http://bit.ly/2LSdUmP Summer Program / 7th Annual Summer Institute in Statistics for Clinical & Epidemiological Research (SISCER) / University of Washington / VIRTUAL July 8-9 http://bit.ly/2K4p3Dl Short Course / Introduction to Diagnostic Research / University of Bristol / VIRTUAL July 9-12 https://bit.ly/2DnMCBW Conference / 30th European Congress of Clinical Microbiology & Infectious Diseases / ESCMID / Vienna, Austria July 12-14 https://bit.ly/2VOPv61 Conference / Inaugural ISPE Africa Section Conference / Multiple / Accra, Ghana July 12-15 http://bit.ly/2RB5xja Summer Program / 27th Annual RAND Summer Institute / RAND / Santa Monica, CA July 12-16 http://bit.ly/3mY8tSN Short Course / Exploring the Linkages Between Mental Well-Being & Physical Health Outcomes / University College London & Harvard University / London, England (may also be offered virtually or in a combination format - check back in early 2021 for an update) July 12-23 http://bit.ly/3mOlFtn Summer Program / 7th Annual Summer Institute in Statistics for Big Data (SISBID) / University of Washington / VIRTUAL July 12-31 https://bit.ly/2QnqkHv Summer Program / 56th Summer Session in Epidemiology / University of Michigan / VIRTUAL

Help complete the epi calendar for 2021 The events listed on the next page in blue have traditionally run in July each year. As of the date of publication, we cannot locate updated information for these specific events for 2021. We will be updating our calendar monthly throughout 2021. If you have any information on these events please contact us at events@epimonitor.net Please check our website and newsletter issue often for new information.

Conference / IGES 2021 / International Genetic Epidemiology Society / http://bit.ly/2s9SgmP Conference / 7th International Conference on Public Health (ICOPH 2021) / Multiple / http://bit.ly/356q2In Summer Program / 3rd Manchester Digital Epi Summer School / Centre for Epi Versus Arthritis / http://bit.ly/3484U2W Short Course / Integrative Molecular Epidemiology / American Association for Cancer Research / http://bit.ly/2Psf4q3 Short Course / Statistical Methods for Mediation Analysis / University of Bristol / https://bit.ly/2UxLYaj Short Course / Analysis of Repeated Measures / University of Bristol / https://bit.ly/2DnMCBW Summer Program / Summer Institute of Advanced Epidemiology & Preventive Medicine / Tel Aviv University & a partner university / http://bit.ly/2WO6wOg Summer Program / 31st International Summer School of Epi at Ulm University / Ulm University / http://bit.ly/38Agng0

Notes on People Do you have news about yourself, a colleague, or a student? Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Editor’s Note: The following three epidemiologists were singled out by Fortune magazine for stepping up in truly unprecedented times to make the world better and inspiring others to do the same.

Named: Jessica Malaty Rivera, an infectious disease epidemiologist and the science communication lead for the COVID Tracking Project, to the list of Fortune magazine’s 2021 list of the World’s 50 Greatest Leaders. According to Fortune, she regularly answers ask-me-anything Q&As via her Instagram stories, where she dispels common misconceptions and empathetically shares how her young family is adapting. She was 45 th on the list with Ellie Murray included below. Both were named as "social media epidemiologists".

Named: Ellie Murray, associate epidemiology professor at Boston University, to the list of Fortune magazine’s 2021 list of the World’s 50 Greatest Leaders( #45). According to Fortune, Ellie Murray a.k.a. @EpiEllie, is known for animating simple illustrations in her educational videos. Throughout the past year-plus, she has, among other activities highlighted by Fortune, outlined a #ContactBudget points system that individuals can use to assess exposure risk.

Named: Seth Berkley, American epidemiologist who has led the Global Alliance Vaccine Initiative since 2011 to Fortune magazine’s 2021 list of the World’s 50 Greatest Leaders (#14). During the COVID-19 pandemic, according to Fortune, Berkley has championed the COVAX partnership to bring vaccines against the SARS-CoV-2 virus to every corner of the planet, not just the wealthy ones. As of mid-May, the COVAX partnership had already delivered 59 million vaccines to more than 120 countries, and it has raised nearly $7 billion so far to secure some 2 billion doses.

- People cont'd on page 13

Notes on People, continued from page 11 Do you have news about yourself, a colleague, or a student? Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Newsmaker: Alvina Chu, Orange County Florida infectious disease epidemiologist, called “one of my secret weapons,” by Raul Pino, director of the Orange County Health Department. Pino told local media, Chu is someone he can trust, often tapping her to help lead the coronavirus weekly briefings for the county. Reflecting on the recent attacks on Asian Americans during May, which is Asian American Pacific Islander heritage month, provoked by reactions to the pandemic, Chu said harmful rhetoric toward the Asian community has made battling the pandemic tougher, personally. Appointed: Jasmine Zapata, pediatrician and public health physician as Wisconsin’s new chief medical officer and epidemiologist for community health at the Wisconsin Department of Health Services. Dr Zapata told Madison 365. “What really excited me about this position was that the vision of DHS is ‘everyone living their best life,’ and their mission is to protect and promote the health and safety of the people of Wisconsin…I felt like every aspect of my medicine and public health training, every person I ever connected with, everything just lined up for me to fit in well for this role. I was so excited because I felt like this was the next right step in my purpose.” Newsmaker: Emily Smith, assistant professor of epidemiology in Baylor's Department of Public Health, and founder of Your Friendly Neighbor Epidemiologist page on Facebook which now has close to 100,000 followers, approximately half of whom are Evangelical Christians. Her surprising and frightening challenges with the Facebook page during the pandemic in the form of threats and pushback were the subject of an article by Interfaith America entitled “Meet the Friendly Neighbor Epidemiologist Encouraging Her Fellow Christians To Get Vaccinated”. Speaking about her view of what it means to “love thy neighbor”, she said “Hopefully, it can give people hope there’s more to Christianity than what is being shown on Fox News.” https://bit.ly/3yNGjRG

Elected: Johanna Ravenhurst, to the South Hadley Massachusetts Board of Health. Ravenhurst is a doctoral candidate in epidemiology at UMass and the lead epidemiological data analyst for the UMass Amherst Public Health Promotion Center. She told Inside UMass “My training has inspired me to seek opportunities to complement my ongoing academic work with practical public health work in my own community…. I look forward to leading and supporting initiatives that will improve the health and wellbeing of people living locally.”

Deputy Director with possibility to become Associate Professor 50-100%

The Institute of Primary Health Care of the University of Bern (BIHAM) is dedicated to train and foster the next generation of primary care physicians and to carry out research in primary health care, epidemiology, and public health. The BIHAM offers a lively, interdisciplinary environment with excellent methodological support and access to a large network of primary care physicians and data.

Duties and responsibilities     

Supervise health researchers in their research projects, mainly for the research, statistical and career units Develop/pursue own research agenda and projects, as well as obtaining grants Prepare or help prepare research protocols and manuscripts for peer‐reviewed journals Participation in the recruitment of new institute members Possibility of teaching to medical students or pharmacy students

Qualifications and skills  Highly motivated with a strong expertise in clinical research and/or clinical epidemiology, including in the conduction of large

research projects  Holding a Master or PhD in clinical research, epidemiology, health service research or any training considered as equivalent (e.g. CAS in clinical research and training abroad)  Independent academic track record in epidemiological research and health services, ideally with a focus on clinical trials, cohort studies, or meta‐analyses  Strong knowledge of epidemiology concepts  Several publications in peer‐reviewed journals and experience with extra‐mural funding for research  Ability to work cooperatively in a team as well as independently, attention to record keeping, detail and quality  Strong interpersonal and written communication skills and excellent organizational skills.  Advantage if research linked to primary care or general internal medicine  High level of English proficiency, fluency in German and French is an advantage What do we offer  Highly stimulating clinical, epidemiological, and health services research center within the academic network of Switzerland  Access to large amounts of patient‐level longitudinal data  Support by a PhD student

Starting date is negotiable. The salary is based on training and experience, according to the university regulations. The BIHAM at the University of Bern offers an international and interdisciplinary environment, closely related to the Institute of Social and Preventive Medicine (ISPM; www.ispm.unibe.ch) and Clinical Trial Unit (www.ctu.unibe.ch ), and free access to the courses proposed by the Swiss School of Public Health+ (SSPH+; www.ssphplus.ch). It encourages independence and flexible working models. It is an equal opportunities employer. With a view towards increasing the proportion of female professors, the University of Bern specifically encourages female candidates to apply. Job sharing is possible and will be supported. For further information on the position, please contact Prof Nicolas Rodondi (Nicolas.Rodondi@biham.unibe.ch), Director of the BIHAM. Please send your application including a letter of motivation and curriculum vitae in English to Human Resources administration: hr@biham.unibe.ch . Applications are considered until May 24th, 2021.

University of Bern, Institute of Primary Health Care of the University of Bern (BIHAM), Mittelstrasse 43, 3012 Bern, Switzerland www.biham.unibe.ch

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