Interview with Chad Cotti, 01/11/2022

UW Oshkosh Campus Stories
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´╗┐GL: This is Grace Lim interviewing Chad Cotti on Tuesday, January 11, 2022, for Campus COVID Stories. Campus COVID Stories is a collection of oral stories from students and staff at the University of Wisconsin Oshkosh about their experiences in the time of COVID. Thank you for sharing your stories with us. Before we before we get started, could you please state your name and spell it for us?

CC: Chad Cotti C H A D C O T T I

GL: Now for the purposes of getting good audio recording tell us again who you are and what your title is here at UW Oshkosh.

CC: Professor Chad Cotti. I'm a professor in the Department of Economics. And I guess that's my official title.

GL: And before we dive into your campus COVID story, we'd like to get to know you a little bit a little better. Tell us where you grew up a little bit.

CC: So I grew up in the Chicago suburbs until I was 13. Then my family moved to 00:01:00Fort Atkinson, Wisconsin, just east of Madison and that's where I went to high school.

GL: And where did you earn your degree or degrees.

CC: So my bachelor's degree is actually from here University Wisconsin Oshkosh, I graduated in 2000. I have a Master's in Public Policy from the University of Wisconsin Madison's LaFollette, school, graduate 2002. And then I have a doctorate in economics from University of Wisconsin, Milwaukee 2006.

GL: Hold on, you said you came here in 2000. And you graduated.

CC: I came here in 1996 to UWO as a freshman and graduated in 2000. In with a bachelor's degree in economics, then left here to go to UW Madison for a master's degree in Public Policy, finished that in 2002. And then worked as a fraud analyst for a Medicare contractor in Milwaukee and while there, started taking classes at UW Milwaukee for a grad- graduate classes in economics, and 00:02:00then eventually left my employment to pursue the doctoral degree in economics there and I finished that in 2006.

GL: And how did you come to UW Oshkosh?

CC: So I was on the faculty at the University of South Carolina after graduating from UW M. And my wife and I are both from Wisconsin, the department here. I knew people in department in a couple of ways. So obviously I was a student here. But then when I was taking graduate classes at UW Madison, right between finishing at Madison when I had my master's degree actually, so I'd finished my master's degree, but I was just about to start my doctoral degree. The chair of the department here needed somebody to teach an interim class asked me if I would be willing to teach an interim class. So I came up here, I taught an interim class. And that's I kind of got a little bit to know more of the department from a kind of faculty instructor kind of perspective. And then I ended up teaching another one next year while I was doing my doctoral studies. 00:03:00And so I kind of had some connections with the department we went in. And so I think it was my second year at South Carolina. The economics partner here was going to be looking for an economics professor, and they needed somebody that in particular, did kind of health applied micro economic things, which are what my background my research background is. So we ended up coming up, and I ended up getting that position and coming up here in the summer of 2008.

GL: Alright, so tell me, um, you know, what is your day-to-day work like, pre COVID?

CC: Well, so I guess I would say my principal role in the department prior to COVID, in through COVID. Till this past summer was I was the department chair. So my day to day was, you know, I would teach a couple of classes a year, focusing on a lot of administrative duties with or helping run the department also working as the director of budget finance for the College of Business, so 00:04:00that in support of the dean's office. So those are probably my principal tasks, you know, just as a normal instructor, department chair and then helping in the Dean's office in the College of Business.

GL: Are you still the chair?

CC: I was until this past summer; I ended a six-year term in summer 2021.

GL: How big is your department?

CC: I think currently we have a 11 faculty, and we're currently hiring an IHS teaching professor.

GL: Okay. All right. So let's move to move to the early days of COVID. Do you remember the first time you heard of this virus?

CC: I do very clearly actually. So it was January of 2020. I was on a family cruise with my wife kids and her parents, her sister, her sister's family etc. We were on a Disney cruise in the Caribbean. And the kids were Doing something I 00:05:00don't remember if they were with grandma and grandpa or if they were in one of the play centers or whatnot, they were doing something and my wife and I were just on a walk around the deck of the ship while it was sailing, and she had her phone out. And she was just while we were walking, and she said, oh, there's a some kind of bad, like pneumonia outbreak happening in China. And she showed it to me. And as a somebody who has a background in health economics, it's not we're not really epidemiologists, but we overlap in some, some fundamental areas. And I remember taking note of it quite clearly Coronavirus at that spot, my son in 2000. And I'm going to get this wrong too, maybe around 2016. He had Kawasaki disease, which is a post infection inflammatory syndrome that children sometimes get from an essence having a cold sort of thing and it comes down three or four weeks afterwards. Now it's analogous to what we know today is 00:06:00MIS-C in children from COVID. And so anyway, back in 2016, when he had this inflammatory reaction, we went he had to go in however, he was hospitalized for a week. And then after that, after he left the acute phase, there's a chronic phase shift to be monitored repeatedly by a pediatric cardiologist. So we were going to the Children's Hospital and they're the chief of pediatric cardiology. It talked to us about this, and I asked him I said, What's the source virus because it is the sort of thing that is apparent if you don't know a lot about virology? I didn't about this virus. They would be like, well, he has this condition. It's not contagious. I'm like, Well, how do you get it if it's not contagious, but it comes from another it comes from a viral infection that is contagious and he said, we're not positive what causes this Kawasaki syndrome in children, but we think it's from a virus called a Coronavirus, which there's four endemic strains of Coronavirus that existed prior to COVID that have been circulating, you know, for a long, long time. So I was aware of coronaviruses in 00:07:00this kind of way from some of the other strains. So when my wife talked to me showed me this article about you know, they were suspecting it was a Coronavirus, related infection it I remember it sticking with me as kind of like, Oh, that's interesting. And it was on our return flight again, in January, we flew into Chicago, before taking our connection to Appleton and just down maybe two or three gates from us was a flight coming in from China. And other thing that struck me was all the people getting off the plane were wearing masks, and they were all very, very urgently trying to get away from that. That point, like it was clear something was going on in China that was just that the passengers of that plane, were really happy to not be on that plane anymore. So I remember very vividly sitting waiting for our next flight thinking this is potentially not going to be very good.

GL: How old was your son when he contracted that?

CC: Five? He was in kindergarten. Okay, so it was it was like I said, maybe four 00:08:00or so years ago? Yeah.

GL: And just to how's he doing?

CC: Oh, he's fine. Yeah, we were very fortunate. Kawasaki is, is a virus that is extremely hard for doctors to diagnose. It eventually will start affecting, it has the potential to start affecting children's hearts. And you can create aneurysms in their blood vessels or on their hearts, which could create lifelong problems for those kids. But if it's caught, if it's identified successfully, within about a week to 10 days, they can give children IVIG treatment, which helps reduce the probability of complications and he was able to get a diagnosis of a- right around the cutoff time for this treatment. And they gave him the treatment and he's had no issues now he may not have had issues either way. It's just a- it's a risk thing, but the treatment reduces those risks.

GL: You mentioned an NIS-C [sic]?

00:09:00

CC: MIS-C is the analogous version from SARS-CoV-2 that affects children.

GL: So as an M

CC: So M as in Mary.

GL: Okay.

CC: So it's a it's a multi system inflammatory condition, multi, how they how they run it all out, but MIS-C is a such so there's a very small percentage of children who when they contract COVID After they recover, and they can have extremely mild COVID, like almost asymptomatic COVID and still have this reaction. It's a small percentage of children and they can be teens. Technically, even adults get it on rare occasions. But what happens is it again there's nothing there's not as much definitive knowledge about some of these things, but their immune system may fight off the virus and then three or four weeks later, their immune system has a reaction like it become they become very inflamed, and with MIS-C, It turns out some of the characteristics are even much 00:10:00more severe than with Kawasaki's; high percentage of children who present with MIS-C need to be in put in to the hospital, a high percentage of those need to be put into intensive care and there are a fair number of fatalities. It's a so COVID, in general is an inflammatory disease. And then the MIS-C is a post inflammatory reaction to it. So it's like their immune system kind of freaks out.

GL: I remember actually seeing some photos at the very beginning of that attacking children.

CC: Right. So in New York, they, one of the things that happened is obviously New York City was one of the first major areas of the United States that was hit. And the number of cases that we had in New York when COVID first hitter, dramatically undercounted. We know this because otherwise, the mortality rate would be significantly higher, because the number of cases that we have, we can count mortality somewhat more accurately, and even then, they were missing a lot of mortality and a lot of strokes and heart attacks and things that were only 00:11:00after the person had the incident, did they know that they had COVID. But in New York, there was a huge spike in this condition. And we saw it coming out of London, just slightly before it came out of New York. And so that's kind of where this condition was kind of identified from.

GL: And then tell me when, when COVID-19 became something that you were more concerned about, rather than just looking at news or just sort of in the back of your mind.

CC: So by late February became very clear to me that this wasn't going to be something we could contain it. As soon as it basically became a big problem in mid-February in Italy, I think I was very concerned about it at that point, once it got out of China. And it was pretty obvious that it was well out of China, there was no stopping it. The global and globalized nature of our society means that you weren't going to be able to stop it. I also remember reading an article from a conference that had taken place in Germany, where there was a person at 00:12:00the conference, who had clearly spread the virus to people before they were symptomatic. And that is a benchmark problem for viruses. If a virus can be highly contagious prior to people being symptomatic, asymptomatic transmission makes control extremely difficult. And so that that is a is I remember very vividly being like, Okay, we're going to have a real problem now, because it was outside of China that was spreading, and it was something that was spreading with people not knowing they were infected, and that creates major containment problems.

GL: And when did it start affecting the way you do your work? I mean, what did you know, do some teacher hold meetings with people what happened?

CC: I would say the first time that it affected my day-to-day behavior, rather than kind of like my expectations, it had been affecting my expectations for a while. But when it started to affect my day-to-day behavior was right around the 00:13:00first week of March, we had a department meeting, I can't remember exactly what Friday it was and what it was like maybe the maybe the fourth of March, 5 of March. And it was the last in person department meeting we've had. And at that point, I remember we had our EDA, who was quite sick with the respiratory virus, we had another person in department quite sick with a respiratory virus. And while I didn't suspect that they had, I wasn't overly concerned that they had COVID. What it said to me was that I couldn't know for sure. And so I remember thinking, especially for some of the people who are maybe a little bit older or have weakened kind of Health have underlying health conditions. This is not a we're iterating very quickly to an environment where this isn't a good idea, just to keep having in person meetings. We and that wasn't like I said that was the last meeting we had I remember talking to people after the meeting about their spring break plans and advising them that they were almost surely not going to be able to have their spring break. And they kind of looked at me incredulously like I don't I don't see that happening. But there's just the 00:14:00level of connectivity I had to it, just based on my background, and kind of my research and the sorts of people I know, gave me a little bit more insight into kind of what was coming. And an academic department assistant.

GL: So at that meeting, at that point, did you have any inkling that we were going to be shut down?

CC: Yes. I remember talking to one of the Vice Chancellors about student plans. In terms of what is your plan for the students in the vice chancellor said, well, we have a good plan for how to handle the international students. And I said no, no, the domestic students and he said do you think we're going to need a plan for the domestic students? I said, I don't think you will. You're going to need a plan for what to do with the students. In terms of how, how we manage this for the rest of the semester.

GL: When were you notified? I mean, did you get advance notice that we are 00:15:00actually going to shut down.

CC: I don't know that I got advanced notice. I wasn't on the EOC. At the time. I don't know that I got advanced notice as much as I just, I remember telling people we're not I remember telling people we're not going to have, it was the week before spring break. And I didn't know if we were going to shut down. If we were going to make it to spring break, if we were just going to go through to spring break. If we were going to make it to Wednesday or Monday. I didn't know when that was going to happen. But I knew we weren't going to come back after spring break. Whether or not the administration had decided that or not, I just knew that wasn't gonna happen.

GL: I think at that time other universities were closing, we saw it. And you know, you know, did you have any conversations with the administration regarding that or anything?

CC:

I think at one point, I may have talked with the chancellor as they were making their decisions, just they were soliciting feedback from different people. And 00:16:00we don't have a medical school, we don't have epidemiologists. So I'm probably one of the two or three people who's just about as close as you're going to get. I'm not truly like an expert in that area, as much as I now know a lot more than I did then. But even then, I guess I had better instincts and understanding and background about how these things are going to transmit from a social or public health perspective. Not really so much about a diagnostic, like what you do when you're sick sort of thing as much as this is how this is going to spread sort of thing.

GL: So once the word officially came down, how did you approach your department? You were the chair, then

CC: yes, I was department chair. I tried to remember I remember that. I'd sent emails out about you know; what the processes were I know that we worked through like what would happen if somebody was to got sick? And in terms of administratively, how do we handle their classes and the students and things 00:17:00like that. But to be honest, except for answering kind of general questions. And a lot of veterans in the department and people actually handled it quite well. One kind of silver lining of going online was that the sort of the Business School has a lot of, they tend to be more MBA oriented. But as a lot of programs that have online, they're either completely online or are partially online or occasionally online that that while most of our undergraduate education isn't that way, a lot of the graduate education is and so people I think, have a strong comfort level with things like Canvas and teaching online or at least strong earth, then maybe the median instructor, and so the transition wasn't quite as challenging. I mean, it was still challenging, but it wasn't as maybe it wasn't quite as unknown.

GL: So you, what did you take from your office? I mean, you know, he had to leave. Did you take anything with you?

CC: You know, honestly, very little. When I went back to my office for the first time.

00:18:00

GL: When would that have been?

CC: I can't recall exactly. It may have been January of 21. I don't think I went before then. I don't have all like they're all my plants were dead. And you know, but there were still like notes and stuff on the tables. And from the last day I was there. Wow. Okay. It was kind of like a time capsule in some ways.

GL: So you went home? And, you know, some people have said that they thought that they're going to we're just going to be gone for two weeks. What were you thinking?

CC: I thought that there was a possibility that they could bring back students, but I considered it to be extremely remote. And in mostly because this when you have a naive population meeting, naive meeting, immune, immune, naive, the virus 00:19:00is you can flatten the curve, which is what we did by having lockdowns, but that that's which was a good thing, because the goal of flattening the curve is to not overwhelm the hospitals, which is something that we're dealing with right now. But it causes the virus, the outbreak to prolong in some ways, right? So it's the right thing to do. It's the smart choice as a community it saves lives. It prevents the hospital infrastructure getting crushed, but the idea that we were going to be able to lock down for two or three weeks and then come out and it would all be gone. That's not how viruses work unless you have a lot of background immunity to begin with. So

GL: So tell me what was the like at home? I mean, you started working from home?

CC: Yep. Yeah, I basically worked exclusively from home. Now I didn't have so as department chair, and then and I'm sure get to this but then when I was asked to join the EOC after recovery Task Force and after implementation I was asked to join the EOC in an official capacity as the Academic Affairs lead in August of 00:20:0020. So between that my department chair responsibilities, my director responsibilities, I didn't actually have any classes that fall.

GL: Were you teaching that spring.

CC: Yes, but I was teaching an MBA class, which is always online, it always had been online, and, and then Executive MBA classes. But those were put online that spring. So I was teaching that spring of 2020. And then in fall of 2020, I did teach Executive MBA classes, but those were also put online. But those are only like on Saturdays.

GL: So what was your other? Were you able to do your other duties remotely?

CC: Yes, I actually didn't. I mean, everybody was remote. So it wasn't 00:21:00complicated. I just I have a small office in my home. So it worked out, it was quite an easy transition from that perspective. Our kids were online. And of course, in March, April, May of 2020, and then their schools date online through January of 2021. And then they had the choice to stay after and we just kept them home until March. And then we sent them in for the fourth quarter. Once the rates were low, and it seemed reasonable.

GL: As a member of EOC, what were your specific tasks?

CC: Right, so I guess, I could walk through kind of how I got onto that way. So I was asked to be on the recovery Task Force. And then after the recovery Task Force, I was asked by the Provost, I think based on the experience with the recovery Task Force to be the lead implementation officer for Academic Affairs. 00:22:00So working with the deans, the register a lot with the registrar, and even coordinating with DW system on modality transition, flipping over the campus, all of those kinds of things like developing safety protocols for the classroom developing. Like even a, you know, a sight, what was our spacing going to look like in the classrooms? What were the different modality choices? What did they mean? How do we define them answering faculty questions, working with the dean, so they could do those things, working with the registrar to determine and make recommendations, these were all recommendations, of course, but make recommendations about what was the most students were willing to put into a classroom. And then after which it has to be online, all those kinds of things. So we did that as part of, of recovery taskforce and implementation. And then at the conclusion of that process, the Chancellor and the chief asked me to join the EOC as the Academic Affairs kind of person. And so in that role, I kind of 00:23:00served three or four kinds of roles. So, you know, as the Academic Affairs lead, I worked with communicating with the deans, again, the registrar, and then also with Dr. Scribner, who's the faculty senate president about faculty prospective faculty issues and just consulting her getting her impressions, sharing information with her getting the provost impressions or an impression with him, the Deans etc. So in some ways, kind of an information conduit both ways. I would gather information from them to bring the EOC from a faculty staff instructor, Dean's perspective registers perspective, or I would share information from the EOC down to them. So they had some awareness about things that were coming or how we clarified issues or, you know, what's the policy approach to this just so that they knew so there was clear communication channels. Second thing I did was, in some ways, along with Kim Langolf, I 00:24:00acted as the Science Officer for some of the information that we were getting about, you know, just in the summer of 2020, I actually was called as an expert witness to testify and COVID transmission and two different federal cases. So in federal court, so bringing that kind of understanding about how COVID transmits and what some of the issues are to the to the committee so that there was a stronger scientific approach to things. And I still do both of those roles. Although I work a lot less, I've had a lot less communication needs with the dean of the register in the last in this school year than I did last school year, because it's just things are a lot well under more well understood. And then I also all through the entirety of the 2020 2021 period, I helped to track our data and communicated daily. The data updates about COVID cases, testing cases, etc. to UW system so I would actually fill out the actual forms every 00:25:00day, every morning, I would get a request in the email, I'd click on the email, and I'd have to go back and fill it the prior days forms. At one point I even had to work with some of the leadership at UW GB to help them understand because they were the other campus that worked with Prevea directly as their as the testing provider. And so kind of helping them understand how to read the Prevea data. So you have to, so part of the problem is in trying to get the case, numbers correct is that PCR positives come back later than the test date, where antigen positives are the same day. So if you want to get your cases per day, correct, you have to know when the PCR test was taken, not when it was returned in prevail, will provide you the data based on what was returned, not based on when it was taken. So there's a way you have that you can adjust that. But if you don't do that your numbers aren't right. Right. Right. Anyway, so details like that. So I did the, the kind of the liaison administrative stuff, I did the science stuff, I did the data and statistics. I think those are my kind 00:26:00of like three main roles, and then otherwise just helped with just like everybody else on the EOC reflecting on the different issues and comments and tasks,

GL: all those committees that you were on, they were not paid positions, correct?

CC: No. The our recovery Task Force and implementation team, which was made to electively May 2020 through August, I don't believe there was any compensation. There may have been some very nominal thing for the summer, but I don't recall it. If there was for the EOC work for 2020 2021, I was given a three-course reduction, which was nice. It was more of a thought that counts based on the hours that we were working, but it was still nice to have.

GL: Give me the timeline for this one. Were you which committee did you serve on first,

CC: So that recovery task force was first that was May of 2020. And that transitioned into the summer, which was the implementation process, which would have been mostly June, July. But that went into August. I remember. I took the 00:27:00family to a small lake in northern Wisconsin in the middle of August. And I remember having conversations with Lisa Danielson while I was up there, I remember having quick conversations with Kim Langolf. I was up there as we were trying to Lisa had to report. So one of the things we had to report to UW system was what percentage of our classes were going to be in person, what percentage were going to be online and what percentage were going to be hybrid. But I remember trying to figure out what were we going to call what because we didn't, we had classes that were high flex, and then we had classes that were modified tutorial. And you know, our high flex classes are always in person, but offer virtual option for students. Modified tutorial classes are sometimes in person with a with a virtual option. And sometimes we're all online. So what do you which one's hybrid? Like, is a high flex class an in person class? Because you 00:28:00can take it fully in person? Or is it hybrid class? Because some students are on it? You know, like these kinds of things are the boxes didn't exactly that we were given. So I remember her, and I haven't figured out and then in terms of percent, do you account, like so like, when the register pulls the list of courses in independent study comes up as a course? Do we count those graduate classes? How do we count those right labs, music, kind of their kind of the lessons that they do, how is all that count, so that we're giving the most fair and accurate representation? So what we needed to try to do is figure out what was the spirit of the question so that the numbers we were reporting the system? Were as accurate as they could be, from the system's perspective, meaning how were they reading them? Not what? So that we you might not technically be exactly. If you downloaded the spreadsheet of the classes. And you calculated the number, like so we had to make judgment calls, you know, the provost, the registrar, and the EOC. About what were we counting as what so that we were 00:29:00trying to meet the spirit of the question, as much as possible.

GL: Were you part of the group that created those modified courses, or the names of those modify courses?

CC: So the names I think were drawn out of kind of other, like those are a pre-established kind of modality. So we didn't come up with that. I was part of the team that did that. That was within the implementation process. There was a committee that was all the academic deans, the registrar. There were other people on that group. I apologize. I can't remember everybody in that group was kind of presented with options, which came from the recovery Task Force, and then kind of had to like, work through the process. It was difficult, right? Because you were making had to make choices and, in some cases, we were kind of looking at what other schools were doing. as inspiration in other cases, we had 00:30:00to kind of figure out what worked for us. And but then the harder part was, wasn't coming up with the choices. The harder part was communicating in providing faculty and instructional economic staff the feedback so that they could relate to like, what are these things mean? How do I interact with them? How do I use them? What worked best for me? What are my choices? How much flexibility do I have, like these kinds of things? It's a natural process. So it was really an evolving process.

GL: What did you find most challenging during the during that time? I mean, you were working very hard with these, you know, groups of people trying to get us back on campus, open us up, be set as safe as possible, what were some of your biggest challenges?

CC: I think honestly, some of the biggest challenges we had were sometimes the public health guidance is based on and this I get this, but lots of times public 00:31:00health guidance is based on what's perfect. But because humans don't behave in a perfect way, perfect can be the enemy of good sometimes. So we were trying to come up with processes and policies that would lead to the best outcomes, we could. So let me give you an example. When you're testing, so in the fall of 2020, we were bringing the students back, we had tremendous amount of testing going on, what are the challenges we had was while UW system was said, you're gonna have tests and you're gonna have instruments, you're gonna have things to do all these testing. So we started designing policies. With that in mind, we never actually physically received the testing equipment or the tests, students arrived on a Wednesday before. So like the students who like check in, we had earlier move in. So let's say classes start the Wednesday after Labor Day, students started moving in the Wednesday, but prior Wednesday, we didn't receive any of our testing materials, or the machines to do the testing until that Monday, before that Wednesday. Now, they said they were coming, they said they 00:32:00were coming. And they said they were coming for a long, long time. But we had to bring in completely new staff, we to set up a completely ground up testing facility, train everybody, and get this operational in under 48 hours. And this is an institution that is not a medical institute. You know, we don't we're not hospitals where we have people who have a net. So it was difficult, right? So we had to bring in brand new employees' tremendous credit to Kim Langolf. She organized all of that and made that go. But then you have to divide, develop protocols and processes. And this was something I helped a lot with was what is the appropriate protocols and process? And what I mean by that is, so as you comes in, an individual comes in, and they take a test. So, you know, these rapid tests, and the rapid tests have evolved, but they're ostensibly the same kind of idea. Do you have them that what when I talk about perfect and versus good, perfect is a person comes in, they take a test, and you make them wait to 00:33:00get the results. And if they test positive, then you would give them a PCR test. So antigen tests are very effective, but they're slightly less reliable than the PCR test. So if they tested positive, you'd give them a PCR test? Well, you know, perfect is you don't want somebody wandering around that's positive, then you have to go get them and bring them back. But when you're dealing with students, you don't want to have them sit there for half an hour to 45 minutes to an hour, they won't show up. So if the higher the cost of testing, the lower the compliance, so by trying to be perfect, we ran the risk of not being good because the students would be more non-compliant. And that takes resources, the Dean of Students Office and Buzz have done a tremendous job of compliance. But there's only so much you can do if you create an environment that encourages noncompliance, right. So this is an example of what we decided to do was, come in, you get tested, we worked through Prevea to make sure the app was easy for students to use, they can make an appointment that was at their leisure, we put the testing facility in the middle of campus where it was easy for them to 00:34:00access, that created its own issues. I mean, we had we have classes and people who work in Albee. But it was about tradeoffs. So it wasn't again, perfect is the enemy of good, we couldn't do perfect, we didn't have time for perfect, we have the resources for it. So we needed to come up with a plan that was good. Albee is in the middle of campus, it's easy accessible, it's low cost for the students to go, they could go in, they could be out in five minutes. And then when they did test positive, we would contact them and bring them back. That's not perfect public health process. But it led to a much higher compliance rate, which is ends up with a better outcome. Right? If, if you're getting an 85% compliance rate, you're gonna catch way more people than if you have a 65% one that's that that holds the people so you know that that couple hours where they may be wandering around positive was worth it to get a 20 or 30% better compliance rate, you know, just get more testing. It's a tradeoff kind of battle. And so that was an example of something that we had to do on the fly. And it created. The other thing is by not having people waiting, you don't have 00:35:00a whole bunch of people standing around together, you don't have long lines. So our process for testing, for example, was based on making it convenient to access both in terms of location and to make an appointment to make it as low cost to do make it in and out simple process. And then and then have a strong follow up process to capture people and bring them back. Yeah, that that was our process and other institutions in the system that we know held people, they followed the kind of more perfect theoretical approach, and they had all kinds of problems and eventually had to abandon that and go to something like that, that we had. Another example was several of us had a phone call with the CDC right before the semester opened. Because the same along the same kind of idea was, we were hoping that instead of doing a 14-day quarantine for close contacts, we could do like a nine or a 10 day and then test. And the CDC said no, so we didn't. But we tried, we really tried. And then because of the same 00:36:00idea, when you tell a student, you know, if you quarantine for nine days, and then we'll give you a test. And if it's negative, I'll let you go, the compliance is going to be higher. If you tell students 14 days, two weeks, you get hired people will hide their illness so that they don't, or they'll hide that they were close contact, they won't share who their close contacts were. So we would have students who wouldn't tell these, they don't want their friends to have to be quarantined for two weeks. And again, this is a situation where, on paper 14 days is like the foolproof guarantee, you're going to catch all the people who are have underlying infection that hasn't presented yet. But if people are afraid, they don't if they don't want to bear the cost of that close contact, then you don't catch them. And then they're spreading it. That's worse. The CDC said no. Now subsequently, several months later, the CDC recognized the same problem nationally, and they changed the guidance to almost exactly what we were asking them to do months earlier. So you know, these kinds of things

00:37:00

GL: you're talking about, you know, giving me an example of students and their behavior around COVID. What about staff, faculty and staff? What kind of what kind of feedback were you getting based on the policies that you and your committees have come up with?

CC: I would say that, in general, faculty and staff were extremely supportive not necessarily always agree. But I think they understood that we were doing the best we could, there's always going to be anecdotal cases of people who are frustrated, I think the biggest thing that happened to instructors was, they really, really wanted to be following guidance, but then they lost, like they felt they lost a sense of confidence about making choices that they would have made on their own prior to COVID. About this student has the situation, what do I do type of thing, right. And so you know, the other thing was just like the meaning of some of the modalities, if we could have done that differently, I think we would have just had one Hybrid Type and made it more flexible, rather 00:38:00than having these two models because it created confusion. And then there was also like, I remember what it was called, there was modified tutorial, which was a teaching modality, but then there was also where some, you'd have large classes that they wanted to have in person, so then you would rotate. So like, if you had a Tuesday, Thursday class, some students would be in person Tuesdays and online on Thursdays, and they would switch and that was something else. And people got that mixed up with modified tutorial. So like that, I think, you know, in we did the best we could in a limited timeframe. But I think in hindsight, is a little bit simpler would have been better. Because you know, where we got feedback from instructors, which is the sort of feedback that was on my kind of more my role, it was just confusion, like, lack of understanding, and a lot of instructors didn't really engage. This isn't a criticism, it's that the world was kind of upside down. And a lot of instructors didn't really engage until August, because things were still changing and developing. So I don't 00:39:00really blame them. And it was easy for my perspective, because I was in the middle of all the conversations and then they plug in in the middle of August to get ready for the fall semester. And it was a lot to digest and with the different names and the, you know, the what, what is this? Like? I can't do that, or I can do that. You know, it was just it was a lot of change. But I think by and large people handled it pretty well.

GL: I think you were in most of the if not all of the town hall meetings with the chancellor,

CC: I was at a fair number of them if not speaking at least listening.

GL: And I was in some of them also, and I could hear the frustration. A number of those instructors, you know, regarding how safe is it going to be coming back? Did you get any of that?

CC: Sure. Absolutely. And still do. The one of the things that I know that the leadership did was they tried to bring in people like Dr. Newman and Dr. Rai, 00:40:00the doctor who's the CEO of Prevea Health and Dr. Newman, who has a similar role with Aurora, as consultants to the institution, especially to the Cabinet who made all the final choices on all these things would go up to the cabinet for any kind of choice of consequence. But you know, the medical community didn't have it all right at the time, but I think once the position that our institution took, which I'm very proud of the leadership did this and you know, work for a place that did this was we took the position that in the summer of 2020, if you wanted to be online, you could be online. Now, at some point, the institution has to have plans. So we have people in August, who, in June or July of 20, had not selected the to be online for the year, who then wanted to be right as the semester started, because if I think if you recall, right, at the 00:41:00end of August, just before school started open, rates started to really go up a lot. And, and so that, understandably, changed some preferences on the margin. And I know there were last minute exemptions that were made by Dean's offices that the EOC had nothing to do with that all of those things were then handled once. So the EOC basically said, the chancellor, the chancellor basically said, anybody who wants to be online can be online. And that was before schedules needed to get like kind of locked in. Because students needed to know the Registrar's Office needed to know they needed to know like, are these classes online or not. And so there was a like a, like a deadline point, I don't remember what it was July or something. And then after that, it went to the Deans and the deans kind of made those choices on one off basis. But at some point, like institutionally, we had students coming, they needed to know the students had preferences for being in person or not, people had the ability to kind of pick and choose the best choices they could, it was a little bit better in the spring, because we had a little bit more knowledge about trying to get 00:42:00the classes, so there were more choices. But then, you know, when you have to walk into the class, and stand there in front of a whole bunch of people, you know, the students are kind of spread out. But we also know we didn't, I think several has had an inkling about this, but the six-foot three foot, it, those things don't really matter. It's an airborne transmitted virus unless the person's can take like symptomatic. So if somebody is coughing and sneezing, droplets are an issue. And that's when this distance is more important. For asymptomatic transmission, or people who are only very mildly symptomatic, it's the aerosolization of their breathing. That is an issue and there's no magic six-foot line for that it builds up in an environment kind of like, I think the best analogy is like smoke. Like if you were in a room with somebody who's smoking. In the beginning, you barely notice it. But over time, it builds up in the room if the ventilation isn't good. And by having students in bigger classrooms then so you know, we would take a class and say, the classroom holds 00:43:00100, there might only be 30 people in there, that spreads people out. But it's not just the spreading out of the people, it's the space of the room that it causes. innocents' breath to not build up as quickly. We worked with facilities management to make sure that all of the air exchanges were as high as they can go so that we turn the air over in the rooms well. And so those kinds of things we did to try to make sure there wasn't high transmission on campus. And in that first year, when it was doable to track this, we track all cases of student transmission where there was more than one case in the same classroom and a similar timeframe to see if that was in class transmission. And we had one instance where we were like, this looks like in class transmission, where we had three students who all tested positive, really similar. They're all in the same class. And when we interviewed them, I didn't do any of that, by the way, the contact tracers and stuff to that, but the but when we interviewed them, they 00:44:00all said they didn't know each other. Well, the first sorry, the first two students said they didn't know the other ones. And that started really seem like, like they knew who the student was, but they weren't like friends or hung out. They didn't hang out outside of class was what they said. And that starts to suggest transmission in that classroom. But then the third one said, no, they were all good friends, and they hung out all the time. So we really had, we had no concrete evidence in the 2020 2021 year of significant or of any transmission in the classroom. Now it may have occurred, but it didn't. It wasn't something that we could see in the data. And we did look really hard. We also spent a tremendous amount of time tracking outbreaks in the residence halls where we're clearly people are in congregate living environments so that that was another issue, but we did spend an awful lot of time really studying the data and trying to understand if safety was an issue but coming into the fall. You know, your people were taking it on faith that that they had the support of their institution, the institution was doing the best it could and I really do believe it was

GL: I think one of the questions that kept occurring, during those town hall 00:45:00meetings was the whether the university was actually following the CDC guidelines about the, the classrooms, you know, the six-foot rule. And I just felt that it was just an impossible task, because there are some rooms that you just can't be six feet away from people. And that, you know, did you want to ever, like yell at these people and said, look, man, we're just trying to do what we can.

CC: No, I think that, you know, when you're dealing with uncertainty, so uncertainty is the root of all, I think, bad things in a lot of ways. So trying to give people as much certainty as they can is a good I mean, we all buy insurance because we don't like uncertainty, we all we eat at restaurants that have name brands, not because we necessarily like the quality of the food, but because it's, it's certain, like you can count on it, especially when you're traveling, right? So certain, so the more uncertainty there is in the environment, the more uncomfortable people are going to be. And that's just 00:46:00human nature. And you can't be upset at people about that. As far as the so one of the things was the our medical advisors, public health, Aurora and previa, they basically had informed us well not perfect, if people are all wearing masks, the distancing is much less relevant. Right. So if you're, if you're testing people, you don't have symptomatic people in the classroom, the masks are, are much a much superior form of, of prevention, then distancing. Right? So aerosolized transmission, the distancing doesn't matter, really. I mean, it matters to some extent, I mean, if you're 40 feet away from somebody, you're much less likely to breathe in their breath than if you're two feet away, but six feet and four feet, that's not a huge difference in terms of that kind of transmission. It was the masking that our health advisors gave us was like, that's the thing you have to have. And we've had the masking in the classrooms. 00:47:00And we will always continue to have the masking in the classrooms as long as transmission is high. And hot. And you know, we've reached a place now where I think, sitting here in January of 22, we're what this is really what the pandemic is really kind of boiled down to now is more about the hospitals, which is interesting is that's kind of what it started to be about.

GL: So let's talk about the- How has COVID changed the way you do your work?

CC: Well, I'm, I guess, much. I always thought there was a strong value in having online options as part of our curriculum at the institution, because they're students who value that I'm, personally though, was more apprehensive about me teaching in that environment. And that being something that I was comfortable with, I'd done it for many years before COVID. But I'd always found 00:48:00it to be somewhat unsatisfying. I've personally feel like I can teach online much better. Because I was forced to do it. I was more willing to embrace it as an issue. Oh the chief actually-- I'll call him back.

GL: Do you want to stop?

CC: No, no, no, I'll call him back. Sorry, that's distracting, I have to think about what that's about. Anyway, the- But my day-to-day job, I came into work, basically every day and worked in my office, he mean, whether it was teaching or doing my research, or his department chair, I found that I can work pretty successfully on my research and advise students and teach. And most of them, I would say, my true faculty role was, I adapted to working at home pretty easily where it really affected me the most was as department chair, I felt very disconnected from the department by not being in the office with everybody. Because I guess I didn't appreciate this before. But after a lot of the 00:49:00connectivity and the understanding about what's going on in their part, and what the needs are, how to advocate best as a department chair, or understand kind of the small stuff. I lost the ability to have that connection when everybody was at home because we just didn't have the hallway conversations that you would normally have. And I didn't realize how valuable those were as a department chair to kind of knowing what's going on. The only thing that I think affected me is when you have all this significant upheaval of society happening all around you the small things that kind of need some attention. It's hard to really concern yourself too much with them, but they still need attention. And so you know, as a department chair, I found I found that that job got to be a lot more difficult for me.

GL: Did you in your role in the various committees? Check with other institutions? I mean, was UW Oshkosh doing something different? or were we 00:50:00following same protocols at other universities?

CC: Yeah, we did follow up in different members of the EOC would do this in their own ways. I have colleagues who work at different UW System schools, and I would ask them, and some of them are in Milwaukee and Madison. So they're much bigger schools, others are similar to us like La Crosse. And I've routinely had many conversations throughout the whole pandemic about where they are, you know, both in terms of like, what the choices they were making going into the 2020 2021, school year, and then what choices they were making, as things seem to be lightening up. And in some ways, I feel like our operations, not entirely but our operations has been a bit more proactive and a little bit quicker to act than some of the other. So for an example, and I won't say what institution is, but I know one of the other UW institutions, we decided to do it- coming into the summer of 2021, COVID, rates were very low, vaccination was very prevalent, and we relaxed the masking on campus. And then as delta started to emerge, we 00:51:00were having conversations about are we going to have to put masks back in and that was right about the time other schools were just getting to the place where they were making choices about removing masks. And I remember having a conversation with a colleague of mine at one of the other four years, comprehensive institutions in Wisconsin, and they had just removed their mask mandate in July, when I was like, I, I don't think you're gonna be able to do that for, you're going to have that that's not going to last very long. They were just there was more, I think, deliberate. And in a pandemic environment. So Dr. Mike Ryan from the World Health Organization, is somebody that I've always felt in the very beginning, the very, very beginning of COVID, had the right advice, which is, when you're dealing with a pandemic, speed is more important than being 100% accurate, like you, if you don't move quickly, the virus will 00:52:00win no matter what you do. And so you have to be willing to make choices much faster than I think institutions like ours are historically used to doing and to the successes that Oshkosh has had, in dealing with the pandemic, come down to, I think, using common sense, trying to communicate as best as we could with both- collecting information and communicating information, and then making choices, and then changing our choices, once we realized they weren't the right choices, right. And so, you know, we had to make a choice, we made it rather than like, in a non-pandemic environment, we would have a committee meeting and then they would have another committee and then there'd be a third committee, and then they'd make recommendations, and then we would think about it, and then maybe we would make a choice. Now, we just had no choice, we had no choice but to make choices, and we made them.

GL: So if you could, would that be one of the things that you could point to as something you're proud of regarding the COVID response here?

CC: Very much so. I think the EOC is maybe the most effective group of people 00:53:00I've ever worked with, in any in any kind of way, because we could disagree and talk through a topic, nobody took it personally, everybody understood that we had to make hard choices. We had to make choices that had some balance, we had to consider all tradeoffs, we couldn't always be perfect. And we have people on the EOC. And sometimes I'm in that role. And sometimes I'm not where we play devil's advocate about what's safer versus more reasonable versus more realistic, versus maybe the best thing economically and we have to weigh those things. Right. So, you know, early on in the pandemic, we were receiving a lot of resources from UW system, but that ended after the fall of 2020. So then the institution had to start bearing more of the cost. And while the institution didn't sacrifice safety to do that, we still had to understand like, what were extras that we were providing to the community, maybe for example, that were 00:54:00costly. And then what's the cost of having that, you know, another huge undertaking which was coming into the spring of 21 was which was the vaccination process. And the institution and led by the EOC took a tremendous role about huge support from the, the Chancellor's cabinet on this, to be a vaccination site for the community, and to be well organized at it and to be real communicative about it and to make smart choices, right? So initially, there was an idea like maybe we would do vaccinations out of our student health services, but that there's only so much scale there. Right and so if you really want to make a difference, it's is this going to be a are we trying to look like we're helping, or are we actually trying to help? And we could look like we're helping by saying, oh, we're vaccinating people would help but that would have been dozens of people. If you want to do hundreds and 1000s of people, you need to have a huge operation like Can true community vaccination process and that's 00:55:00where we engage the Culver Center. That's where we brought in, you know, actual health providers from externally and set it up through previa. And, and we had, I think one of the best vaccination sites in the area, that that was a commitment by this institution to do something. And that was a community thing. But it also was good for the school too. Right? So we could get access. Health care, workers could get access first responders could get access. And so that that I think was maybe one of the more meaningful things that we did. And in that school year,

GL: I got to tell you, when I was able to get my vaccine, I look at that I'm already getting goosebumps thinking about again, I cried.

CC: Yeah, it was a big thing too. And we had access early because we were proactive, as soon as we knew. And again, tremendous credit to Kim Langolf and Chief Leibold. As soon as we knew that there was any chance for us to be a community vaccination site. They move very quickly to go to the Chancellor and 00:56:00say we should do is the chancellor was extremely supportive. They got the paperwork done. They got in, they worked with Prevea had the site set up. An Aurora. Sorry, it was a Prevea and Aurora. So Aurora was our original vaccination partner on campus Prevea was our was still doing our testing. Okay, got that backwards? Yeah, Aurora was our original partner for vaccination. Either way. They got it done. They worked with Dr. Newman, and they got they got it done in in such a quick period of time. Yeah, it was incredible.

GL: Kim would have the numbers regarding the number of people that went to the site, right. Yeah, yeah, sure. Okay, so, um, how do you know we're down talking January of 2022? How much do you think? Do you feel like things are getting back to normal?

CC: Well, I mean, obviously, right now, things are very far from normal because of the Omicron outbreak. But I was just yesterday. How do you see this wrapping 00:57:00up? Like, what's the where do we go back to some sense of normal, new whatever new normal is? And of course, I don't know, I don't think anybody knows for sure. But I can give you my, like best projection, which is, things will start to feel more normal, when hospitals situation is more normal. And so it's, if you want, I think the best kind of like, common-sense measure for how a pandemic is going is, what is the hospital situation look like? If hospitals look a lot like they did in 2019, then you're going to be in a more normal situation, if they don't, if they look pretty crowded, and overwhelmed. And healthcare workers are feeling tremendous types of stress and anxiety and, and people are dying, and excess deaths are very high. You the pandemic isn't over and you're not going to be normal. So two things I'll say about that. One is, there's been, of 00:58:00course, a lot of like, politicalization and culturalization, about COVID, and the pandemic. And that's created a lot of misunderstandings and confusion and tribalism around the virus, which is unfortunate and completely unnecessary. But you don't have to think very hard to understand what the real effects of COVID are. If you just want to think about let's not talk about long COVID or disability associated just talk about it binary way, mortality. You don't even have to know if people are counting COVID deaths, right? If they're, some people say, oh, they're over counting them because this individual died of something else. And they had it incidentally, some people say all they're under counting them, because there's all these people who didn't get counted, especially in the beginning, all you have to do is look at excess deaths. excess deaths is a is a measure of, we can measure roughly what the number of people who should die every year based on the ten year, what was the 10 years prior to COVID look like every year, you can look at the annual and it's a very stable number, you get a 00:59:00couple little tiny peaks. And then you can look at the mortality since COVID started. And we've had roughly 950,000 excess deaths. So again, it doesn't matter what you don't have to look at death certificates to know this, we've had roughly 950,000 excess deaths between 2020 and 21 combined. That is an astronomically high number compared to some bad years, you might have 20,000 excess to us to have a million in two years. It's less than two years really, but we'll just call it two. Is such clear evidence of a massive something massively happened here, right? If we were looking at this historically, like almost like, you know, archaeologists or something, we'd be like, well, something happened right here. Right. And so that that's pretty clear. So when the excess deaths start to return to normal that that's what I'm talking about the hospitals. That's the- and how do we get there? Omicron is going to create a tremendous amount of background immunity in the population so people who are 01:00:00vaccinated are at much lower risk of situation, we should think about your immune response, based on number of exposures to the virus or its facsimile in the vaccine. It's not. Currently everything is vaccinated versus unvaccinated. But really the right number is how many times somebody's been exposed to the to COVID. One way or the other. So if you have somebody who's been had three shots, and you compare them to somebody who's had two shots and a prior exposure, their immunity may be slightly different. But it's, it's, it's a difference without a distinction, it doesn't make a huge amount of difference. On average, we step back from it, right, you can parse it out and look at studies are like, oh, this is a little better, that's a little worse. But in the grand scheme, if we just counted exposures, one type of exposure is safe. And the other type is risky. But the more exposures people have, the stronger their immune response is all else equal. Omicron is going to create is a very, it's got a tremendous amount 01:01:00of antigenic drift, it's very different than the other variants. It's not I mean, it's very different. That's why, like the Regeneron, monoclonal antibodies don't work anymore. It's why it's so easy to get an infection, even if you've had three doses of the vaccine. It's just it's evolved and mutated to such an extent. But that will, it's still COVID. It's still SARS-CoV-2, it will still add to that layering of background immunity, it spreads so fast that so many people are going to get it. I mean, estimates today are that maybe 10% of the US population that currently has it like presently is currently infected. So that's just a staggering number of people. So that that created though what the outcome of the effect of that is, yes, that's going to create tremendous pressure over the next two or three weeks into the hospital system. And I have significant concerns about that. But if we go pay on the short run, it's going to invest even a lot more background immunity into the population, which is going to not 01:02:00necessarily long term prevent spread, the virus will continue to evolve just like the flu virus influenza does. But the stronger and more persistent the backend immunity the less effects on the hospital. So even for people who are unvaccinated, if they've had a couple infections and haven't, and hasn't had major issues for them, which is the majority of people this is true for most viruses, even polio. They they've developed background immunity to and they're less likely to put stress into the hospitals is more likely to be potentially a very bad cold. I'm not trying to suggest that Omicron is mild, it's milder than delta. It's milder if you're vaccinated, it's milder, or if you're boosted, but if you're unvaccinated, the risks are actually similar to Alpha variant, less than delta, but not anyway. So that kind of combined with persistent and continued development of antiviral medicines, Paxlovid from Pfizer, and other corresponding sorts of drugs, remdesivir, etc., which they're putting into 01:03:00tablet form right now. Those the combination of having a lot more resistance to COVID. And having better treatments. I think that's the end, right? Because the end is when it's no longer a high risk of ending up in the hospital for a lot of people. And that that's the end like but right now, you know, we've got 40 or 50 million people in the country who they're at significant risk. And you know, that may be that could end up being a million hospitalizations, which if spread out over six months wouldn't be so bad. But if they all occur in a three-week window, that's very bad. That those are the kinds of things that we have to deal with. Before we get there.

GL: I want to go back to your own background. I mean, tell us a little bit more about how why you know so much about viruses are your economist, right? Yeah,

CC: I'm a I'm a health economist. But so my training is, so I'm a health economist, which but I largely study risky behaviors. So substance abuse, public 01:04:00policy related to these things, is kind of I would say like, I do other things, too. But that's like my main line of research. But the sorts of models that are a lot of health economists work in public health schools, right. So like, those are routes that would have been available to me had I not come here in health economics, a lot of so you know, you see a lot of health economists who publish in the journal, the American Medical Association. So there's, there's more overlap there, I think, than people think I had a publication this summer that was published in tobacco control, which is a journal that's part of the British Medical Journal system. So these are more healthy social science and medicine, things like that. And so there's a lot of health economists who are very familiar with epidemiological spread models. And so it's easy. It's not necessarily something that we do a lot on ourselves, but it's not so far from what we do that it's difficult to connect into. And so with the presentation of 01:05:00COVID, I was kind of both naturally interested in it, it's easy for me to read the articles that are related to it at the Science level, not newspaper articles, but the actual scientific peer reviewed journals, I can connect with it. Most of its really functionally based on statistics, which I teach statistics. So it's I can read, where I think a lot of medical research study science studies become hard for people to access is it's the statistics that create a barrier for the general public in a lack of understanding of understand epidemics are about probabilities. It's just all masks reduce the probability that you're going to catch it being in a highly ventilated environment reduces or being outdoors reduces the probability. So like, if you have a good sense that it's about probabilities in terms of how infection spreads, right, the epidemiology of it, then that I think makes it easy to connect to. And then I 01:06:00just as you get into the rabbit hole, you start finding your way into studying the actual virus itself. Right. And so why, how does it create problems for people? Why is it that you know, people who are diabetic have a harder time with it, for example, and part of reason is, so what SARS-CoV-2 does to our system, is it, it's a vascular endothelial disease, so people think of it as like a respiratory disease, like in your lungs, and it does affect your lungs, and that's a major issue. But it also does is, so it binds to us. You've heard this Ace II? the Ace II is, anyway, it's how it's how it attaches itself and spreads within our system. Ace II stands for angiotensin converting enzyme. And so it converts, we have an angiotestiness- angiotensin system in our bodies. And anyway, angiotensin two gets converted by Ace II. Well, the virus, it like in 01:07:00essence, makes it difficult for our systems to convert angiotensin two into a more benign substance and angiotensin two causes inflammation our system, so if the virus prevents us from reducing that inflammatory process in our bodies, our bodies get a lot of inflammation, and in particular, in our endothelial system, which is like the lining in like your veins, or vascular, and that causes all kinds of issues like you can get von Willebrand factor, which is a that makes our blood clot when you get a cut, to leak into your system that can lead to blood clots. And that's where you see your strokes and heart attacks, and all these things that have come with COVID that are besides the respiratory issues. So it's a full body inflammatory disease, right. And there's learning more about that process. From a medical science thing, I didn't really need to know that for any of my work, but you just end up when you start reading about transmission, then you end up finding yourself into that world pretty quickly, about learning about how it affects people, because then it helps you understand who's vulnerable. The other thing I'd say is that there's a lot of discussion 01:08:00about well, like you see this right now, because of all the breakthrough infections. Well, if you can easily catch it, if you're vaccinated and easily catch it if you're not vaccinated, why get vaccinated? So well, the two answers to that one is the risk of hospitalization from for vaccinate person is so many times lower than it is for an unvaccinated person. So it's, it's kind of like, you know, both LeBron James and I can both play basketball, one's not the same as the other right kind of thing. So you know that that's a good thing. But the other thing is, is that there's this comment that vaccines don't work, because a lot of vaccinated people still die or are hospitalized. But largely, vaccines don't cause, the vaccine itself isn't what makes your immune system. Another way to put vaccines stimulate your immune system, you have to have an immune system. So if you're immunocompromised, or you're a very old senior citizen, your immune system is compromised, you can put all the gas you want into a car, but if the 01:09:00car doesn't have an engine, it still won't run. Right? And so vaccines can't make you have an immune system. It just makes the existing immune system resists SARS better. And so these outcomes, though, cause it's easy for people to create dissidents about vaccination, when vaccinated people do die, especially if they have a weakened immune system. It doesn't matter if you have cancer, it doesn't matter as much. It still helps. But it's just, you know, there's only so much you can do if and in the fact that you it's easy to get infected with Omicron. But the vaccines were built on the original Wuhan strain. And so as the virus evolves, it's evolved in a way that makes antibodies difficult to bind. The same reason the monoclonal antibodies stopped working the Regeneron because they were designed to match this shape and now the shapes a little different, they don't match as well and so boosted people can still resist, to some extent, still much less than they were before because of the degree of antibodies that they can create. anyway.

GL: So the You sound very calm about this. I mean, were you at any point, 01:10:00feeling worried or even scared, I know that I've talked to my colleagues were in the beginning days, I was like a little freaked out about this. Were you at any point and especially with your, your history with your own son?

CC: Yeah. Two instances, I would say in which I was reasonably uncomfortable. But not scared, is maybe too strong of a word uncomfortable. But we're my family. We're very fortunate. So my wife, even though she's a schoolteacher, she's been at home since our kids were born, and worked from the home in terms of taking care of the household and everybody else making sure the rest of us were okay. And so as a unit when the lockdown happened, we just hung out at home, she took care of the kids, she's a schoolteacher by training, so it was easy for arc for us. Our kids didn't have the sorts of situate, we didn't have 01:11:00to go out of the house. We are fortunate that not only do we not have to leave to go into the world for work purposes, or to take care of other things. But our kids also had a built-in teacher at home. So it just extremely fortunate given the situation. So that allowed us to insulate much more than I think most of Americans would have been so that alleviates some anxiety in the early stages. But I was very concerned about just most of my concern came actually as we left lockouts, and we moved to this tribal politicalization process because the problem with a virus that only I'm gonna put this in quotes "only" kills half a percent of the people who get it is that most people are fine. So most people's anecdotal relation to it is that it's fine. Most people would have it 01:12:00themselves. And they'd be like, Yeah, I mean, I didn't feel good for a few days, but I was fine. So then it created this natural environment where people be like, this is an overreaction. Not very many people are dying. But when you lock down and you shut everything off, not a lot of people will die. Like so the counterfactual wasn't well known. Right. And while I think HIPAA is a good policy, it is also prevented us from being able to share what the environments in the hospitals are actually like. And so like, if you think about the Vietnam War, when the public opinion turned against the Vietnam War was when the realities of what was happening came into people's homes, on their news, and the inability to show what the realities of the hospitals have been during the Alpha outbreak during the Delta outbreak, and now currently with the Omicron outbreak has caused people to have a sense of if they want to not believe that it's an issue and that it's some kind of other thing. It's easy for them to believe that because there's no evidence to show them to the contrary, it's the don't look up kind of or if I don't see it, I don't believe it. And there's a lot of people telling me not to that it's overblown and now we will have in this world where 01:13:00people like what did I read today that people are think they can sit in a tanning booth, and that'll get rid of their COVID? And, and they drink their own urine? And this is now the thing I saw this morning, so but yeah, anyway,

GL: Aside from the cases here on campus, and everything, did you know anyone who had COVID and was very sick from it.

CC: I've known a few people I've known a lot of people have had COVID, I have not personally known many people who have been very sick. I'm trying to think I have friends who've had family who've been very sad, but not people I knew specifically, I think the most anxiety I had about COVID was actually the Delta variant. Because it's more severe effects children, much more than alpha did, might, my son has the had this background, which it gives you concern. And then 01:14:00it's also it's a genetic kick, siblings are more likely to have it too. So my worried about my daughter. And so like, I wasn't that concerned about them in 21- 2021, because they didn't have to mix that much. During the winter, we just kind of were very to ourselves. And in the summer, there was almost no spread. It was when it came back in the fall of 21. They were yet to be vaccinated, they're under 12. But it was very prevalent in their age group at that point. Like if you look at the data, for example, look at Wisconsin children until August of 20 until August 29 of 2021. So just this past August, were children under 18 Were the had the lowest rate of COVID per 100,000. So like they were the least likely in the state of Wisconsin we've had COVID in the past of all age groups in the entire country entire state. By November they were number one. So they went for from the lowest prevalence to the highest prevalence, and they 01:15:00are still the highest prevalence. As soon as schools opened, it wasn't so much an issue in in 2020-2021, because there wasn't a lot of COVID. In their age group, a lot of their activities were gone. A lot of schools were online through most of the winter. So it just didn't spread the same way. People were much more careful with their kids. But then by the time we got through summer, summer of 2021, people were like, it's over, it's gone. And then, when it came back schools were largely in a normal mindset. You had much less masking and but not only that, you had a lot of it's not so much the masking in the schools as much, it was just a lot of other things. A lot of the mixing that goes on otherwise was occurring. So it's spread pretty dramatically through the population of children, five to 17. Throughout the fall, started with the high schoolers in September, and then, and then middle schoolers, and then you hit saw it at the 01:16:00elementary schools pretty hard in October, November. And so now to the point, like I said, we're kids have the most recorded cases, and they're the probably the least tested age group, them and maybe 20-year-olds, so if anything, they're also the most undercounted or potentially undercounted group so that that gave me some anxiety. And so when my children were able to get vaccinated, I guess it was early November-ish. They got their first doses that that was a time when I was dealing, I didn't I didn't like the anxiety it was giving me about my kids, much less than I had about myself, I guess.

GL: I just wanted to check our actual numbers on campus. We're, I think we were lower than the counties in the States. Is that correct?

CC: Yeah, I think for most of the outbreak, most of the entire pandemic, except for September of 2020. We've always been way below. We got a little bit of flack when we open school in 2020, that we had rates that were higher than the community and then the community rates went up. And there was a lot of 01:17:00suggestion that the universities had seeded kind of the fall 2020 outbreak, but if you actually look at the data, you can see that the cases are going up, even in Winnebago Outagamie. County, for example, prior to us opening that that's actually when the spikes came. There's some pretty strong evidence that the northern Midwest outbreak was actually seeded by the Sturgis rally that happened in early August in the Dakotas, you can actually track by cell phone data, people spreading out and look at how the density of people from Sturgis where they went to afterwards. And then what happened with the case numbers in those locations. And are the factuality is actually one of those places that our numbers started to go up about 10 days before campuses open. I don't think that campuses opening helped. But it wasn't the main kind of driving force in a lot of places

GL: Where did the flak from?

CC: Just cases had been pretty low. Right. And so relatively what we're seeing 01:18:00now, the sorts of things that got people kind of concerned, or shockingly low numbers, in terms of what we were seeing in the community, I mean, Wisconsin's almost at 200 per 100,000 per day, right now as a state and back then we were people were getting really concerned about 18 or 19. Now know, technically, those are pretty high numbers, but it was all relative, right? So we went from like 10, to 20 cases per 100,000. In. So people were like, that's we've doubled. That's really bad. Now, historically, you don't even notice if you were to look at a graph of the spread in Wisconsin today, for the whole pandemic, you would not even barely September of 2020 Wouldn't even jump out at you. But at the time, you know, things were held in check pretty well.

GL: How would you explain why our numbers are low during the academic year, you know, compared to what was happening in even in county and the state?

CC: Oh, so I guess a couple things. In the summer of 2020, one of the most prolific 01:19:00groups or spread were college age students and people in their 20s. A lot of them got sick in the summer. So you know, I think, I think the CDC, so they did some testing here, we worked with them closely in the fall 2020. And they did some cohort testing. And I can't remember what the actual number was, but I want to say they estimated that 30% of the students had COVID When they arrived. So that's a pretty good percentage. Not great, but I mean, that's a that's a- you had some more immune wall than you think you had. And then we did have a notable outbreak on campus and that September, not in the classrooms, but we did have it in in the student body. I mean, they were going to mix with each other. So we may have had 50% of the students have had prior immunity by the time January of 21 came around. But the other thing is on campus. It was a very de-densified campus environment; the classrooms were we took super caution when watching the classroom, so we didn't create a lot of opportunity for the campus to be a 01:20:00problem. There weren't a lot of social events, students, I think were still a lot more careful. At that time, they hadn't quite given completely up on worrying about this, which I think is now totally the case. Most of society, I think is just kind of like moved on. And, you know,

GL: So tell us what why- did you know the Tommy Thompson, the, you know, the interim regent's presidents, and then the CDC and also the Surgeon General came and praised our COVID response.

CC: Yeah, so I think that the response was just very proactive, right. So when you look at what we did, as an institution, we lead in terms of making choices, we lead in terms of being like we're gonna aggressively test people, we lead and saying, we're going to have masks, we lead in saying, you know, we're going to be aggressively vaccinating. We tried to be creative. And there were a lot of 01:21:00things the UW system was asking us to do in the spring, which are good things that we were doing in the fall, like, like they wanted to, they were, there were a lot of things that they were like, we really, these are some best practices we think the schools need to do, but those were things that we'd put in in August. It wasn't necessarily because we were so smart, it was just like, we as a group walked through the scenarios, we looked at what other you know, some of the public health advice was, and most of the time, we just stuck with what the CDC guidance was. And I think that's generally the CDC isn't always gonna be right. But you have to trust somebody. Right. And so we generally follow the CDC guide, but then we would modify it to fit our situation, because CDC guidance wasn't necessarily for schools or universities, in terms of it wasn't very institutions like ours as much they were giving general guidance, like, this is what the isolation period is, this is what the quarantine period is, this is, you know, we recommend masks, we do this. And so, we would follow that type of advice. But then when it came to like situational awareness, like, Listen, what are we seeing in the data? What is the data telling us? Is the data telling us we're 01:22:00having a classroom problem? No, if it was, we would have changed the environment of the classrooms. You know, it's it was using kind of facts to drive the decision making, keeping a level head, we met a lot, fall 2020, I think the EOC met four times a week, three times if we didn't have something and then by spring, I think we were twice a week. But we met a lot. And the meetings can be two hours long as we would go over the data, as we would think through situations. And then as we came out of 2021. It was like, well, what are the sorts of things we can relax? And then we were coming back in? I mean, I remember, late July, early August, having we had a difficult meeting where we was, I think it was pretty clear to everybody, we were going to have to go back to masking for the fall. But nobody wanted to do it. Not that not that we nobody, it's not that people didn't want to do it, because they were opposed to masks. They were just like it was this like, sense of defeat, like, here it comes again, why is this happening? Cause we all kind of think mentally been 01:23:00really good, it's over. Like, we're not gonna have to have masks in the fall. And then just having that that small thing have to go back into place, and we're all resigned, that it was the right thing to do. We all knew we were gonna do it just there was this meeting, we were like, is this Do we really have to do this? Like is maybe if we just hope it won't, won't be bad, but it was so obvious that it was going to be needed. And so I think there was like a week there where we just decided not to decide. We had some disagreements about whether or not that week was gonna matter or not. And then the week later, we made the choice.

GL: Knowing what you know, now, was there something that you would have done differently, even as an instructor, as a dean, as a chair, as a member of the committee's

CC: I'm sure there are trying to think of a specific example. But I think it's probably the one time in my life where I've had a lot of clarity about what was going to happen in the future many, many times. And in the beginning, you have 01:24:00to it's one thing when you kind of feel like, you know, I really feel like I know what's happening here, but then you don't necessarily feel brave enough to say, because I'm not an epidemiologist, I'm not a neurologist or an immunologist. But I like I remember people talking about droplet transmission, early on, when I knew that it was aerosol-based transmission, but you know, you're listening to the people who are saying it are much more credentialed in the area, they should know much more than I would, right. And so having to you know, if I could be different about, I would have more bravery about that, but it's a lack of confidence right now in terms of my job, my day-to-day kind of thing. In hindsight, you know, people have different levels of understanding of what's happening around them. So it's, it's, again, I think, difficult to know where You draw a line in terms of my as department chair, if I want to talk to 01:25:00people about the realities of getting vaccinated, if they're hesitant about at what point am I stepping over the line in terms of you know, as a supervisor saying, you really should go get vaccinated, right. And so you just can't do that. Right. You can eat, you can provide people with the best information you can and hope they make good choices. And so I don't know. It's difficult. I, I, I guess I'm sure I would make different choices. If I was presented with specifics. I can't think of anything important at this point.

GL: You, he referred the data a lot. I mean, the Have you ever just wanted to tell people just look at the data, trust the data or, you know?

CC: Sure.

GL: As opposed to just,

CC: I share data with people all the time, like when it came like recently with the boosters, I was sharing people data with about the boosters because there's money unless people are boosted, then you would think I mean, I got boosted the 01:26:00first second that I could.

GL: Rather than then rely on the emotional.

CC: Yeah, it turns out that I think there's a lot of like, people will trust the data to a point. And then there's just kind of like, again, it kind of this feeling about we had like with EOC, with going back with the masks, we did it. But people just didn't want to have to think about it, right. And so like with the boosters, like, it's your data with the boosters and a lot of people were like, Yeah, but I just don't want to think about it anymore. You know, and so I'm a big data person. And I basically always start arguments with data, but what I recognized is that people only have so much of an appetite for wanting to engage with it. And at some point, they're like, I just, I need a break from COVID. So I'm just gonna not gonna think about it. Right, you know, they make up their minds.

GL: Alright, so, um, what was living and working in the time COVID taught you about yourself?

CC: About myself. I guess that maybe I had too much faith in humanity. Like, I 01:27:00just assumed that everybody would recognize the, and I don't know how much of this to blame on opportunistic media and politicians and Facebook. But like the degree of disk of disagreement and discord over things that are obviously true, is not something that I perceived, I always kind of felt like in a, an information-based society where we have all the facts and the knowledge. I saw this a little bit, I've seen this a little bit in our society as an academic and that, so I'm an economist, and people would tell me things about economics, they would find out your you know, they find out what your background is, and then you're at a cocktail party, or you're at a social setting, and people know what 01:28:00you do. And then they give you their opinions on the thing. And then on your top on your discipline, like, oh, this or that about unemployment rates, or minimum wages, or whatever it is for in my case. And then, you know, I've learned to just kind of nod and smile to the best I can, but in the past, they would be like, well, that's actually doesn't work that way. And then they would say things like, well, no, I work in, I work in the real world. So I know, I'm like, Well, this like disregard for, like, expertise, right? But I never perceived that that would be a big issue with science and medicine, right? Because it's so concrete, like the rejection of science that shows that masks work the rejection of A, but like in this like weird, like vaccines, right? So people are like very opposed to vaccine, but they'll take other drugs, like this argument about natural immunity, getting sick is better than having a vaccine that wasn't really better than the other one is more dangerous. But this idea that I would take monoclonal like monoclonal antibodies don't seem to be seem to be fine with 01:29:00people who are opposed to vaccination. But they're made in the same labs with the same technique. I don't understand how there's like such a disconnect. It doesn't make any sense. That kind of thing. has kind of shaken my like, personal faith that the in society somehow I don't, I don't know how to put it, but like, I just, it took most of the summer of 2020, for me to just get over the fact that we weren't going to learn that like, actually, we were going to take all the information about failures the wrong way, rather than learning from mistakes. And moving on as a culture. We chose to use the mistakes as evidence that these weren't real problems.

GL: Yeah, that sounds really sad. Yeah, I guess it's defeating or I

CC: I guess what I would learn about myself is that I'm not as much of an optimist as I used to be. You know, like, I usually would think that is a culture And I still think this that we have the ability as a species to be, you 01:30:00know, utopian in our, in our goals. I just think that there's too much this utopian corruption in our kind of I think, like so I've always known this, like human beings, we like our species, especially homosapiens. We've kind of are successful because of our tribalism, like that's like evolutionarily like, but that's kind of built into our DNA a little bit. And we're super susceptible to it. And so when you start getting kind of these very mixed messages, it's very easy for people to be very tribal about their thoughts. I just never perceived that we would be that way about something like viruses, it's just so obviously, it's so easy to be like, well, these are the facts. People in the hospital people are dying, what is causing this, it's, you know, people telling me, there's no that the flu last year was all COVID. I'm like, like the level of conspiracy this would require.

GL: How are you going to teach your students going moving forward to, you know, 01:31:00as if they want to be a health economist like you? What, what are you gonna tell them without saying something despairing?

CC: Oh, I don't know that. I'm despairing about my discipline. I think that the things that we know and do, you know, those ideas, those thoughts, that they're, I think, enlightening, you know, like I'm, I actually find that, you know, that kind of enlightenment is, I'm more excited to try to provide that to them and give them a nonpartisan. Just fair view of it. You know, I just this is my disparagement comes to the fact that I wish to feel like things like vaccines were not a not that there was no culture war about it, right. They just worked. And so I'm going to give you an example of something that I find to be disheartening is we have some close friends who they're all vaccinated, their 01:32:00kids that are all of age are all vaccinated. But when their 12-year-old, became eligible, in, I guess it was like June-ish of 21. They were getting some advice from a different circle of friends, that was more opposed to like, very opposed to vaccines, that their daughter wouldn't be able to have children if they get her vaccinated. Now, these are the sorts of like, statements that when you hear from people, one of which was a nurse. I know, right? It's like an engineer who doesn't believe in physics. But anyway, the that caused parents, even if you rationally are like, that's not true, it still caused you as a parent to be hesitant. You're talking about your kids. And so we know them well. And they talked to me about it. They know that I study this stuff. And I said to them, I said, well, first of all, the vaccine trials are extremely carefully done, the FDA is overly cautious. I've thought about the FDA and drug approval processes 01:33:00in my healthy class for a decade. If I have a criticism of the age, that they're actually too conservative, I don't mean that politically. I mean, they're too conservative in terms of they, they don't weigh things like the pandemic in the background, when they were making choices with children's vaccines, they waited way too long. Even the American Association of Pediatrics was like, you're going too slow. Because kids are hospitalized and dying, while you're wringing your hands about whether or not there'll be a two hundredths of a percent myocarditis rate or 100%. Risk America, you know, like these kinds of like tradeoffs anyway, I digress. But I told them, I said, you know, I tried to give them confidence. And like, first of all, the fertility thing about vaccines where that came from, was it came from the HPV vaccine, not that the HPV vaccine does that it doesn't. But the anti Vax movement when the HPV vaccine came out, this was their line was, if you think about like how you can try to get to people's reason centers, it's like, okay, this is a vaccine that affects a virus, that the virus affects your reproductive system. So it was easier to convince people that the vaccine 01:34:00could therefore affect your reproductive system. Then when we moved to COVID, that myth about the HPV vaccine got transported over to the COVID vaccine. But HPV is a children's vaccine, largely so they transported it. They tried with adults, and we had people here who were like, I'm worried, I won't be able to have kids. By the way, if the COVID vaccine prevented you for having kids, I would just do more of the benefit for me, I would just happy to have as much of it as possible. But the idea was that, you know, they were like, well, what is there any validity of this? I said, one vaccines don't work that way, too. There's no theoretical reason to believe that would be true and three, were all the people who got the COVID vaccine as children have now grown up and can't have kids. There's no evidence and not only is it not theoretically possible, it's not how vaccines work. But there's no evidence that this I mean, there's no way to know there's more likelihood that COVID would cause this problem and there's more research to suggest that that's possible than there is from the vaccine. So You know, he just needed some comfort. But my point was is like the 01:35:00fact that this is a conversation and the fact that it was a nurse who was giving them this information. I mean, nurses aren't signing their practitioners, they're not science scientists in the same way where they would even know. But it's still somebody from medicine that's giving you this information, that that caused a lot of like, Yeah, where are we? You know, that so that you can see, that's where there's some loss of faith.

GL: Chief Leibold had said, When I spoke with them that in the EOC meetings, at some point, somebody would actually have a breakdown. Yeah, like they just got so frustrated or, and including himself, or, you know, was there was there a point in your, you know, in this journey that you just got incredibly frustrated? Was that one of the

CC: Yeah, I mean, I lots of times, right, like the, again, in the summer of 2020, I was I was looking around and seeing people, the lack of willingness to 01:36:00be part of the community. And in feeling like, you know, like this medical freedom sort of stuff. It feels very selective. Now, the idea that people are going to try to use religious exemptions where it's not truly a religious exemption. It's just super frustrating. The lack of consistency and thought, is super frustrating as somebody who works in an institution of higher learning this idea that I don't know what's in it, I'm going to do my own research. Yet. You're like drinking a five-hour energy and taking 15 Tylenol pills a day? Like, what's the what's in any of that, like? And what is doing your own research even mean? Like do you have a lab? what people mean is, is that they're reading Facebook, and taking advice from, you know, their uncle Rick, who is taking advice from a Russian robot. And they're using, they're valuing that judgment 01:37:00over the judgement of like, the Director of the CDC or something who is not perfect person or Anthony Fauci, who is one of the most well-regarded scientists in history yet, you know, has become kind of this villain for no reason, except for just trying to be honest. And is he always been right? No, he was. Him and his team was wrong about the masking in the beginning, not that they thought the masking was bad, but they were trying to preserve masks for healthcare workers when that was the wrong messaging, because it led people to believe that it was more of a context surface thing than it was an air thing. But nevertheless, they're not perfect people. But the fact that like we, as we would have a segment of our society that would see them as villains, is difficult.

GL: All right, well, we touched on a lot of things, is there anything else you'd like to add?

CC: The pandemic will end when exactly is unclear, but it will end is not going to go on forever, will keep getting variants, but they'll matter less, maybe 01:38:00there's always a chance that they'll get one that's really bad, but the variants are, every single time a person gets infected, the virus mutates, it's just the vast, vast 99.9999999% of the mutations are either harmful to the virus spread, or useless or less of an improvement. So we can get small, there's always gonna be a chance and with all the outbreak we're having right now, the odds are better than they normally would be, that we'll get an even worse version of it. But all in all, it's likely that it will dissipate and so I have optimism that at some point we may be able to return to normalcy to some extent.

GL: Thank you for sharing your stories with us. We appreciate your contribution to the campus COVID stories at UW Oshkosh.