A Year Apart: Epidemiologist Reflects On What We Got Right — And Wrong — In The Pandemic Response
In March 2020, the first COVID-19 cases were reported in Utah. Now, after a year apart, KUER is sharing stories about how the coronavirus changed everything.
In February 2020, epidemiologist Dr. Andrew Pavia weighed in about how COVID-19 might play out in Utah. Pavia is chief of the division of pediatric infectious diseases at the University of Utah and he serves on a number of pandemic task forces for Utah’s hospitals. KUER’s Caroline Ballard checked back in to talk about what he got right — and wrong — last year.
This interview has been edited for length and clarity.
Caroline Ballard: We spoke in February of 2020 about COVID-19. You said then this was not Ebola or the Andromeda strain of science fiction fame, and that it wouldn’t kill tens or hundreds of thousands of Americans. That unfortunately was not the case. If you could go back to February 2020, before the coronavirus was declared a pandemic, what would you tell yourself?
Andrew Pavia: The sheer toll of the pain has been so frustrating. I said it wasn’t going to be tens or hundreds of thousands of deaths. By later in March, I thought 40, 50 — 100,000 deaths were really possible. But here we are, well past 550,000 deaths, more than any other developed country in the world. We couldn't prevent 50,000 or 100,000 deaths, but we really didn't need to see the kind of toll that we've seen.
CB: What could have been done to avoid the outcome that we saw? Not just with deaths, but also for people whose lives have been permanently changed, people who are still dealing with long-term effects.
AP: We needed a lot better leadership and better messaging at all levels of government. We needed to speak with a consistent voice. We needed to maintain restrictions a little bit longer and then when we loosened them up, do it much more gradually.
We needed to prepare for vaccination in the same way we put effort into the science of developing vaccine. I think the Biden administration really has been doing a good job of doing that. Gov. [Spencer] Cox has been doing a good job, but that work should have been going on in September and October so that we hit the ground running.
And one of the great sins of this pandemic has been the politicization, the fact that we had anti-mask movements, that we had people saying it was a hoax. Those caused untold damage, and I wish there was some way we could have undone that.
CB: What do you think Utah broadly got right in its response to COVID-19?
AP: The early response was brisk. It was all hands on deck, and we did a lot of the right things. We shut down mass gatherings, we stopped sporting events The Church [of Jesus Christ of Latter-day Saints] stepped forward and put rules in place to keep religious gatherings safe. We closed the schools early, which when we knew very little was really the right thing to do. And that worked really well. In March and April, we actually started to see the numbers go down pretty dramatically.
Things started to go very much wrong in May. There was a lot of pressure to open up very quickly, despite the fact that things had only improved slightly, and we saw the summer surge in part as a result of that.
CB: What was your feeling as we went through that fall surge and around the holidays when numbers just spiked?
AP: The early fall is when I began to become very discouraged, because at that point mask use had become a political issue. Just when we needed to pull together the way we did so well in the spring, we started to really pull apart, and the numbers accelerated in ways that we really didn't expect or predict.
CB: You mentioned that you were feeling pretty dismayed and discouraged in the fall. Are you still in that place?
AP: No, I am cautiously optimistic. If we were totally rational and we were able to curb our enthusiasm and just not rush into reopening, continue doing the good job we're doing of getting vaccines out and encourage those who are vaccine hesitant to get vaccinated, I think the potential is there to really get things under good control. We just have to hang in there. It can be done. We can really have a great summer.
But I'm also a little bit worried. I'm seeing signs like we did in May of  of political pressure to reopen too soon. There are politicians out there saying that it's over and we can go back to normal. They're dead wrong. It's not over. It ain't over till it's over.
CB: How will we know when it's over?
AP: We don't think that this is going to disappear forever. We think this virus has found a niche in humans, and I suspect that we're going to deal with this virus for decades. But what we need to stop is the pandemic, this disastrous spread that is killing so many people and bringing economies to their knees. That is going to be over when spread is controlled, when we see only a small number of sporadic cases. If we can get the case counts [in Utah] down to the range of 100 per day or fewer, that's a level we can live with and that we can sustain. And if we can get the deaths down to a few a week instead of 10 or 12 a day, that would signify to me that we're really in a good place. Life can return to the new normal.