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Dean Brown Discusses Pandemic With DLSPH Alumni

July 21/2021

Ontario stands at a turning point in its progress against COVID-19, says Prof. Steini Brown, co-chair of the Ontario COVID-19 Science Advisory Table. If the province continues rolling out vaccines in a thoughtful and equitable way, we will see a strong return to normalcy. But stumbling could bring in a fourth wave – and bring out a bitter societal divide.

Brown, the Dean of the Dalla Lana School of Public Health (DLSPH), outlined two stark scenarios during a wide ranging online conversation for the School’s alumni with incoming DrPH student Sabina Vohra-Miller.

“I believe if we continue to drive the vaccination as strongly as we can and we are in line with our numbers and progress, we can look at an increasingly normal Fall,” said Brown. “The disease will be endemic but we have the tools to deal with an endemic disease. You could and you should look at a Fall with schools open…where going out before the holidays to do some shopping is a lot more fun again and the idea of getting together with loved ones is not fraught with peril or risk.”

But “if we falter on vaccination, if we relax things wildly or quickly without thought, you could see a fourth wave,” Brown added. “I think it would bring a fundamentally divisive point in our society, where a number of people will want to increase [public health measures]. And a number of people will say I just can’t do this again.”

The hour-long conversation, titled “One on One With Steini,” was a chance for DLSPH alumni to ask Brown questions about the pandemic — and to hear from the professor who has become the very public face of the scientists advising Ontario’s government on its pandemic response.

Brown has been lauded for his clear communication style during press conferences, even as he shares complex and often dispiriting data about the pandemic’s progress. So Vohra-Miller, herself a rising public health voice on social media, was curious about his approach to the unvaccinated people in his own life.

“The more you can provide information to people, the more you can keep them in the loop and treat them as partners, the better you’ll do,” said Brown, adding that he has convinced 90 percent of his vaccine-hesitant friends to take a COVID vaccine using this philosophy. The idea of patients as partners – not as passive recipients of information and directives —  is “an interesting revolution that is slowly sweeping through the health system,” he added.

Brown emphasized the massive inequities of the pandemic, but pointed to a bright spot – Ontario’s quick pivot away from mass vaccination clinics toward targeted “hot spot” approaches that put more vaccines into the arms of essential workers and racialized people.

But on a larger level, Brown said, Ontario’s health system needs massive change to catch up with the missed treatments and tests, and the physical and mental health impacts that may be felt for decades.

Calling for a Marshall Plan for the health system, Brown, a former assistant deputy health minister for Ontario, said more money will be the easy part. He believes culture change will be much harder – shifting from treating disease to promoting health, for example, or truly tackling the social determinants of health such as poverty and housing. These challenges are one reason he encourages public health and health systems alumni to run for public office.

When he looks to the next pandemic – and both Brown and Vohra-Miller agreed there will be a next one  – Brown believes the biggest challenge is complacency. Despite the devastating effects of COVID-19, he pointed out, history teaches that other priorities will come along, and the need for strong public health systems will fall to the side. Brown is particularly proud that DLSPH has responded by establishing the Institute for Pandemics, which will keep planning and preparing for future public health crises long after the world has moved on.  (Vohra-Miller’s Vohra Miller Foundation made a 2020 gift to help establish the Institute.)

“That’s all about making sure we’ve got the tools so that as we get close to the next one….we’re not starting from scratch again,” he said. “When we get to the next health crisis, we won’t have to start from zero. We’ll have faculty, students, the network of experts ready to go.”