Without doubt, the Covid-19 pandemic requires urgent action: to protect the vulnerable from severe disease and death; to prevent the overwhelming of the health-care system; and to keep businesses, schools, and ordinary life humming. But the sense of panic infusing traditional and social media outlets as they report on the pandemic is out of all proportion to the reality of the situation

For the last 15 to 20 years, there has been widespread use of the term “population health.” Though it is often used, there has been debate about its definition.

The Dartmouth College Center of Excellence defines a health system as an organization that consists of either at least one hospital…

Nowadays, these players in the healthcare system expect higher quality at a lower cost, reflecting the dynamism of the industry and the increasing knowledge of healthcare consumers.

Stakeholders in healthcare (e.g., payers, consumers, and providers) are ferociously pursuing value defined as the highest quality care at the lowest cost achievable.

As we get closer to full approval of one or more of the promising candidates for a Covid vaccine, it’s becoming clear that we will not quickly have an adequate supply to vaccinate the entire adult U.S. population, and that many will forego this first round of vaccination. As such, it’s unlikely that an emergency vaccine will allow us to stop the spread of infection through herd immunity.

An effective vaccine can still fit into a broader transmission-control strategy, however. A few months back, I wrote that it’s “reasonable to conclude that we may see continued outbreaks for more than one to two years,” and that the U.S. needs to learn how to coexist with the virus. Even a moderately effective vaccine of limited availability and acceptance can significantly improve our ability to do this.

In the next six to eight weeks, the FDA is likely to review an interim analysis of the results of one or more of the Phase 3 trials underway. Many assume that this review will result in FDA approval of vaccine for emergency use; full approval will most likely come in the first quarter of 2021, after six months of follow up.

If emergency use of the vaccine is granted, the highest risk and most vulnerable individuals will be among the first vaccinated. While it’s not yet clear exactly who will fall into these categories, they will likely include health-care personnel, first-line emergency responders, those with chronic disease, and the elderly. (With luck, they will also include those living in communities hit hardest by the virus.) But even if only elderly people receive the first round of vaccinations, it will significantly change the risk-benefit equation for controlling the spread of Covid.

Early in the COVID pandemic, there was much discussion of super-spreaders — a single individual attending a routine and harmless event such as a birthday party, church service, or dinner party who caused many other people to become infected. As the pandemic has evolved and started significantly infecting young adults, we have become more focused on mass-gathering places such as bars and beaches.

Both super-spreaders and places for mass gatherings share something in common: multiple individuals coming into contact with multiple other individuals in a relatively short period of time. This type of mixing pattern is termed “concurrency” and has been used to explain how many infectious diseases such as HIV spread through a community. A correlate of this model is that in settings where individuals have high levels of concurrency, there is the opportunity for them to infect more than one person, causing exponential growth in the infection (e.g., an outbreak). In contrast, without concurrency, one person may not infect anyone else and the spread slows.

However, concurrency alone does not lead to continued transmission or outbreaks of COVID. Other factors need to be present. Public-health and government officials need to take the combination of factors beyond concurrency into account when making recommendations about events and settings. If one dives deep into the White House’s plan for the phased reopening of the country and watches the current policy reactions of government officials to the emerging hotspot, the influence of this multifactorial perspective on the growth in COVID infections is apparent.