State public health official warns about rise in seasonal illnesses

Mark Herz: You may have been hearing we’re having a lot of seasonal illness cases across the country, including the nasty stomach bug norovirus, and certainly, speaking of illnesses, bird flu — or avian flu, as it’s more technically known — has been sparking concerns. Also, there’s been a worrying trend of cases of childhood illnesses being on the upward swing, with vaccinations for them going down. Here to delve into and clarify all that and more is our state’s top expert in this realm, the commissioner of Massachusetts Department of Public Health Robbie Goldstein. Commissioner, thanks for joining us.

Robbie Goldstein: Great to be here.

Herz: So let’s start with this surge in seasonal illnesses. How bad is it? How concerned are you? And hence, how concerned should the rest of us be?

Goldstein: So as you noted, we are seeing an increase in seasonal respiratory viruses. So those include influenza or the common flu, that includes COVID-19, it includes RSV as well, and then we’re seeing this spike in norovirus caes. This is about the time of year when we would expect to see an increase in COVID, flu, RSV — the respiratory ones — and also norovirus. When we look at our data that comes in to the Department of Public Health on a weekly basis, we are seeing that we’ve been on an upward trajectory for all of these viruses over the past maybe 4 to 5 weeks. For those who haven’t gotten their vaccines, if you’re eligible, you should go out and get your vaccine. But we’re also really recommending that people do the commonsense things, right? If you’re not feeling well, stay home, right? You might be OK through this virus, but you don’t want to get someone else sick. If you do have to go out, think about putting a mask on. Do the things that your mom told you to do, right? Wash your hands, cover your cough or your sneeze, make sure that you’re not infecting other people. Those commonsense things can actually really reduce the spread of all of these viruses, including norovirus.

Herz: Disinfecting your hands with like alcohol-based stuff, that’s not really the way to go, right?

Goldstein: Yeah, for norovirus, you really need soap and water. You want to wash your hands like you would as your mom told you to do: Go and sing "Happy Birthday" as you’re washing your hands for a long period of time. Because that virus is pretty hardy and we want to make sure that you get it completely off your hands.

Herz: OK. And I mentioned bird flu. Two weeks ago, the U.S. had its first fatal human case. That was in Louisiana. And some have called our response in this country to bird flu a national embarrassment. Before you were our public health commissioner, you were a top official at the CDC. Have we gone wrong on bird flu? And if so, how do we course correct?

Goldstein: I think we’ve done a lot to address the threat of avian influenza or bird flu. H5N1 is the technical term of the virus. We have a really great surveillance network, especially here in Massachusetts. And I really want to call out our colleagues in agriculture at the Massachusetts Department of Agricultural Resources. They have been great collaborators and with their help since the summer. We’ve been monitoring our dairy cattle here in Massachusetts for avian influenza. We know that avian influenza exists in the flocks, the birds that are here, the wild birds that exist here in Massachusetts. But we have been testing monthly the dairy cattle, and we have not identified a single farm here in Massachusetts that has avian influenza in their cattle. That’s great. And this surveillance has now been picked up by the federal government. And USDA is actually developing a very similar program to monitor dairy cattle all across the country. But we have to pay attention to this, right? Avian influenza — I remember before COVID-19, back in 2018, 2019, the biggest threat that infectious disease doctors thought about was avian influenza jumping from birds into mammals and eventually into humans. But right now, the risk to us is very low. And really, this is a job for agriculture and public health to maintain vigilance, to stay alert.

Herz: I’d like to turn to vaccinations for childhood diseases. Immunizations have been falling. Last year, there were more than 32,000 cases of whooping cough — that’s the highest we’ve seen in a decade. Vaccinations for measles and polio have also been dropping. How are things going in Massachusetts?

Goldstein: So the numbers you cited are looking at national numbers, and it is worrisome. It’s worrisome to anyone in public health. It should be worrisome to all of us that we’re seeing these drops in vaccine rates. Here in Massachusetts, we’re doing pretty well. So we have really for a long time been the leader in childhood vaccination. But we have work to do, right? We have work to do to make sure that we’re reaching all communities, in particular our rural communities here in Massachusetts, where we sometimes see lower vaccination rates. We certainly have work to do to address the inequities or the disparities in vaccination. We know that our Black and brown communities have lower rates compared to white communities.

Herz: Robert F. Kennedy Jr. is President Trump’s pick to lead the Health and Human Services department. I wanted to ask you about him. He’s a polarizing figure. He’s been accused of spreading misinformation about vaccines, including the measles vaccine that we mentioned briefly before, and he has some niche concerns like advocating for raw milk. Some say his overall negative take on how the department has been run and the health of the population at large are not all wrong. What do you think about this nomination?

Goldstein: I think we have a lot to learn about Robert F. Kennedy Jr.’s nomination, and he’ll go through a hearing process just like the rest of the nominees in the Trump administration. And I’ll say this, that we are looking forward to working with the incoming administration, and that includes the Department of Health and Human Services, in areas where we align. What I do think is important to say is that we in public health and we as a department of public health are invested in data, in science, and in evidence. We need to be careful that we don’t lean in to myths and disinformation, and that we always come back to what do the data tell us about this particular disease or this particular intervention? And when we think about the areas where Robert F. Kennedy Jr. has spoken in recent months and even in recent years, he has talked about some things that are very important to the Department of Public Health: better nutrition for our kids and in their schools, making sure that people are thinking about chronic disease prevention and chronic disease management. So as I said, we’re going to work with the administration in the areas where we find alignment. And I think there are some we can find them in Robert F. Kennedy Jr.’s agenda.

Herz: Robby Goldstein, the commissioner of Massachusetts Department of Public Health. Thanks for joining us.

Goldstein: Thanks for having me.

Herz: This is GBH.