October 2021 - The Epidemiology Monitor

Total Deaths In US Have Exceeded The Expected Level For 80 Consecutive Weeks Excess Deaths Are Declining But Are Not Yet At “Normal” Levels When will life return to the normal, prepandemic level of risk? This a question which has been on everyone’s mind during the COVID-19 pandemic.

One possible measure to use in making this determination about normalcy is the weekly number of excess deaths obtained by comparing the observed number of deaths to the expected number based on an average number of deaths that occurred each week in the years before COVID-19. In theory, when the percentage of excess deaths (the number of excess deaths divided by the expected number) falls to zero, then risk has returned to “normal”

prepandemic levels.

Previous waves In each of the three previous waves of COVID cases and deaths since early 2020, the numbers of weekly deaths have dropped from their peaks but remained well above the expected number, according to data maintained by the Centers for Disease Control and Prevention. There has been an unbroken pattern of deaths above the expected average level for at least 80 consecutive weeks. At the time of

System Facing A Long Litany Of Old And New Realities Which Further Threaten Its Ability To Protect The Public’s Health

October 2021

-5COVID Monthly Recap Guest Columnist Katelyn Jetelina, MPH PhD

-8Notes On People

- Deaths con't on page 2

Public Health Officials Offer Grim Testimony Saying The Public Health System And Workforce Are In A Seriously Compromised State And Crumbling

The Select Subcommittee on the Coronavirus Crisis met on September 29, 2021 and members of Congress heard a disturbing litany of old and new realities being faced by the US public health system and the public health workforce. These realities add up to a “wake up” call that the public

In This Issue

health system is seriously ailing.

Entitled a Hearing On “Upgrading Public Health Infrastructure: The Need To Protect, Rebuild, And Strengthen State And Local Public Health Departments”, members of Congress - Crumbling cont'd on page 3 •

Volume Forty Two •

Number Ten

-9Near Term Epi Event Calendar -10Career & Event Marketplace

-Deaths cont'd from page 1 The Epidemiology Monitor ISSN (0744-0898) is published monthly

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the peak number of cases and deaths in the third wave in early January 2021, approximately one half of all deaths were excess deaths when compared to the average number in the years immediately before COVID. Fourth wave In the current fourth wave of the COVID-19 pandemic, the peak number of cases occurred in late August and early September 2021. According to CDC, the number of excess deaths has decreased from 71,828 for the week of September 4, 2021 to 61,188 for the week of October 2, 2021. (Table 1). The percent excess deaths has decreased from 37.8% to 14.5% over the same five week period. Data from more recent weeks in October are still incomplete as of this writing. While there are advantages to using excess deaths as a measure of the burden of mortality because it is not subject to the level of testing for for COVID-19, a disadvantage is the delay in the completeness of reporting.

non-COVID-19 deaths not directly attributable to COVID has also been elevated above the expected number during parts of the earlier waves and during the fourth wave. However, these non-COVID deaths have now returned to the expected level and even below as of the week of October 2, 2021. (Table 2).

Significance In media interviews, epidemiologists have expressed uncertainty about how low the current downward trend will go or if another wave will occur this winter. If deaths decline to expected levels, and remain that way for several weeks, this pattern could be interpreted as signaling a return to a normal level of prepandemic risk.

However, because COVID-19 is a new cause of death, and may remain endemic even if not epidemic, baseline or expected levels of mortality risk may have to be revised upward. In short, returning to “normal” may require a new definition of normal. ■ [Data below adapted from CDC]

Excess non-COVID deaths Interestingly, the number of excess

TABLE 1 - Excess Deaths from all causes during COVID-19 pandemic Week of

Expected

Observed

Excess

Percent Excess

Sept 4

52,111

71,828

19,717

37.8

Sept 11

52,453

71,291

18,838

35.9

Sept 18

52,800

70,215

17,515

33.0

Sept 25

52,869

66,794

13,925

26.3

Oct 2

53,459

61,188

7,729

14.5

TABLE 2 - Excess Deaths from all causes excluding COVID-19 during COVID-19 pandemic Week of

Expected

Observed

Excess

Percent Excess

Sept 4

52,111

56,170

4,059

7.8

Sept 11

52,453

56,004

3,551

6.8

Sept 18

52,800

55,379

2,579

4.9

Sept 25

52,869

53,397

528

1.0

Oct 2

53,459

50,303

(-3,156)

0.0

-Crumbling cont'd from page 1 heard from four public health officials in leadership positions in various parts of the system and with knowledge about frontline workers and the challenges they face.

Two witnesses, Mysheika Roberts, Health Commissioner of Columbus Public Health and Jennifer Bacani McKenney, Wilson County Kansas Health Officer provided some of the most disturbing examples of the negative consequences of the COVID pandemic at the local level.

Local Public Health Dr Roberts told the committee “This is not easy work. I sit here before you today as an exhausted, overwhelmed and overworked public health official. I am not alone…my staff is burnt out, overworked, and underpaid.”

She described the situation she faces by stating “Here in Ohio, we have had our share of harassment and intimidation targeting public health officials. Our previous director of the state department of health was subject to threats and anti-Semitic slurs at her home. Her designated replacement never assumed the job after her contact information become known and she was subject to harassment. In January of this year, the state Department of Health’s assistant medical director had shots fired at her home. We are not immune.”

She added, “the bottom line is, the largest public health crisis in over 100 years has created an unprecedented challenge for those of us working in public health and we need the support of lawmakers and leaders now more than ever. Unfortunately however, lawmakers in many states are actively

working against public health and our authority to protect the health and safety of the communities we serve.”

Rural Public Health The situation appears to be even more dire in rural communities as described by Dr McKenney. She told the committee “Every public health or health care professional I’ve spoken with is discouraged and exhausted. They’re working impossibly long hours to care for patients who are mostly unvaccinated, and they’re reaching a breaking point…some have been fired for promoting interventions we know will save lives.”

“...the largest public health crisis in over 100 years has created an unprecedented challenge..."

She added, “Some of the rural citizens we are working so hard to protect distrust government as well as public health institutions and the science of public health. Even though the virus is the enemy, their anger and frustration are often directed toward public health officials like me.”

She continued, ” Nearly 100% of the public health officials I have talked with across Kansas have seen their county commissioners make decisions based on political beliefs and anecdotal stories rather than on the scientific facts. Right now, most COVID decisions are being made by individuals without any medical or public health training or experience.”

"Every public health or health care professional I’ve spoken with is discouraged and exhausted.“

State Public Health Joseph Kanter, State Health Officer and Medical Director of the Louisiana Department of Health, focused his testimony on workforce and funding issues. cont'd He stated “Let us - Crumbling on page 4

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-Crumbling cont'd from page 3 be frank: stress fractures in our human public health infrastructure have been visible for years. In many departments across the country these fractures have become gaping holes.” And he noted that while the burden of COVID on health care workers has been well publicized, the public health workforce has also worked “long hours and weekends under incredibly stressful circumstances.”

“Imagine if a legislature passed a law prohibiting the fire department from using hoses."

Dr Kanter called the current methods of funding public health “no way to do business” and he urged “long term, sustainable, predictable funding via a public health infrastructure fund.” He closed his testimony by calling for a joint congressional inquiry or commission similar to the one after 9/11 to examine the deficiencies in the health and public health systems which led to the COVID crisis.

Research Findings and Recommendations

“We are better than this.”

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Beth Resnick, a senior scientist at Johns Hopkins Bloomberg School of Public Health worked previously for the National Association of County and City Health Officials (NAACHO) and has done research on the public health infrastructure and workforce. Dr Resnick’s March 2020 to January 2021 study of media reports and a survey of public health officials identified at least 1,500 incidents of harassment and violence against public health workers.

Further, she reported that state legislatures in over 20 states have passed and all 50 states have considered at least one law to undermine public health authority. She used a telling analogy to describe these actions, stating “Imagine if a legislature passed a law prohibiting

the fire department from using hoses.

Clearly, this does not make any sense.

Yet, no hoses to put out fires is the same as taking emergency authority away from health departments aiming to stop the spread of deadly diseases.”

Reminding members of Congress that over 700,000 Americans have lost their lives to COVID,, Resnick quoted the late congressman Elijah Cummings saying “We are better than this.”

Resnick offered six recommendations to stop harassment and violence against the public health workforce, protect the statutory authority of public health, and rebuild the public health system. She defined a robust public health system as having strong, well-trained, and stable leadership who work closely with elected officials and the community, having essential statutory authority, adequate staffing, modern technology, and timely, accurate, and complete data that can be shared across all levels of government.

Summary In summary, the challenges enumerated at the hearing included the following: 

chronic underfunding,



chronic understaffing because over 40,000 state and local public health jobs were eliminated in the last decade, which is 15-20% of the total workforce.



large leadership losses with more than 300 state and local leaders resigning, retiring, or being fired since the pandemic began

- Crumbling cont'd on page 7

COVID Monthly Recap By invited columnist Katelyn Jetelina, MPH PhD, aka, Your Local Epidemiologist [Editor’s Note: We have been following the blog posts created by University of Texas Health Science Center epidemiologist Katelyn Jetelina during the COVID pandemic. Calling herself Your Local Epidemiologist, Katelyn has garnered hundreds of thousands of followers among both lay and professional readers for her science-based yet timely, clear and easy to understand descriptions and visualizations of the latest findings and recommendations about COVID-19.

Given the pace of new developments over the last 19 months, and the regular frequency of her posts, this is no small accomplishment. She has become internationally recognized for her skillful communication of the science around COVID with her newsletter reaching 27 countries and actively translated into 6 languages. The Epidemiology Monitor has invited Dr Jetelina to recap the key developments she reports on each month, beginning in this month with a recap of the main findings from September. Please look for these summary reports over the coming months as COVID developments continue to unfold. Let us know your thoughts about these recaps. Send comments to editor@epimonitor.net

“Severe cases, at this point of the pandemic, are largely preventable."

COVID-19: September Summary State of Affairs Thankfully, in mid-September, the United States’ Delta wave peaked and the national average of cases decreased 30% by the end of the month. In September we also saw the dominant hot spot migrate: It moved from the South to the mid-Atlantic (South Carolina, Tennessee, and Kentucky) and ended September in in Alaska.

And, although severe indicators lag, we’ve seen hospitalizations and deaths make their descent too. As of September 30, there were 83,224 people hospitalized with COVID compared to103,006 hospital admissions at Delta’s peak. By the end of September, we were averaging 1,927 deaths per day due to COVID19 (Delta’s peak was 2,087).

Severe cases, at this point of the pandemic, are largely preventable.

But,

But, regardless, in September COVID19 was the leading cause of death in the United States. According to the Kaiser Family Foundation, 49,800 deaths in September would have been prevented with vaccines.

We are hopeful, though, that case, hospitalization, and death trends will continue to decrease. Interestingly, Delta waves across the globe had a distinct pattern: 2.5 month flare of virus until retreat. So why doesn’t the virus just spread and spread until it has no more people to infect? It’s a simple, legitimate question with a very complicated answer: We don’t know.

There’s no scientific consensus on why this happens. We hypothesize it’s largely driven by the combination of four factors: 1) human behavior; 2) social networks; 3) seasonality; and 4) level of vaccination/natural immunity.

There has been much discussion - COVID Monthly con't on page 6

"...49,800 deaths in September would have been prevented with vaccines."

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-COVID Monthly cont'd from page 5

“We continue to live in a reactive (rather than proactive) society."

"This vaccination rate ranked the United States as #48 in the world..."

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whether this is the last wave of the COVID19 pandemic. At this point it’s certainly partially (if not fully) dependent on the durability of natural immunity.

Vaccines There was one silver lining to the Delta wave, though: vaccination rates increased. This uptick was due to Delta, hospitals filling up, knowing someone who got seriously ill or died, or wanting to participate in activities (like a concert). We continue to live in a reactive (rather than proactive) society.

At the end of September, 55% of Americans were fully vaccinated (64% with at least one dose). 65% of the eligible population (12+ years) was fully vaccinated. This vaccination rate ranked the United States as #48 in the world despite leading the science, manufacturing the vaccines, and having plenty of supply.

September was also the start of a contentious debate about boosters.

Many scientists argued that we don’t need boosters because we haven’t seen waning protection in hospitalizations

and deaths in the United States. On the other side, scientists argued that we shouldn’t have to wait if we’re seeing robust evidence of waning immunity in Israel (the first country to vaccinate a majority of their population).

This debate was put under the spotlight on September 17 when the external scientific committee to the FDA (called VRBPAC) met to discuss Pfizer’s application for a booster. After reviewing the data and voicing frustration with the lack of data in the United States, VRBPAC ultimately decided that a Pfizer booster was safe and effective. The committee recommended that those 65+, those with chronic diseases, and those with certain occupations should get a a booster. The FDA agreed with its advisory board.

Then the ball was punted to ACIP (the external scientific advisory committee to the CDC). Because these boosters are under Emergency Use Authorization and funded by the government, the CDC has ultimate policy decision making power. After 2 days of deliberations, ACIP decided that only 65+ and 18+ with chronic diseases - COVID Monthly con't on page 7

-COVID Monthly cont'd from page 6 should get a booster. The next day, CDC modified the advice of their external advisory committee and also approved the booster for high exposure occupations. This is a highly unusual move, but it aligned FDA and CDC recommendations for a Pfizer booster.

-Crumbling cont'd from page 4 

limited disease monitoring and surveillance capabilities,



testing and reporting deficiencies,

Variants



outdated technology,

Also, in September, a new variant came onto our radar: Mu. On August 31, the WHO announced this new SARS-CoV2 variant as a “Variant of Interest”.



reckless politicization of public health,



unprecedented levels of harassment, threats, and attacks from members of the public,



passage of laws and executive orders limiting public health officials’ authority to issue commonsense control measures such mask requirements or quarantine and isolation orders in current and in any future infectious disease outbreak. ■

Briefly, Mu was first discovered in Colombia in January 2021. It since spread across the globe, including the United States. There was considerable interest in this variant because, as the WHO stated, it has a “constellation of mutations that indicate potential properties of immune escape”. In other words, there are number of changes on the virus in which our treatments and vaccines may not recognize, and, thus not work.

In September, the WHO announced it was closely watching how Mu competed with Delta in Colombia and Ecuador. Can Mu outcompete (i.e. more transmissible) Delta? Because if it can, we may be in trouble.

"...it has a constellation of mutations that indicate potential properties of immune escape..."

“October will be a big vaccine month..."

What to look for in October?

We hope to watch trends continue to decrease and hope to watch Mu not overtake Delta. October will be a big vaccine month, as we will get a lot of questions answered about boosters for other vaccines and, finally, will the FDA and CDC recommend a vaccine for 5-11 year olds?

Join us on our Facebook page at: https://bit.ly/2U29gUA

Stay tuned. ■

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Notes on People Do you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Died: Robert Rinsky, at age 70, after an extended illness. Dr Rinsky was formerly a research epidemiologist at the National Institute for Occupational Safety and Health. A recent testimonial for Dr Rinsky written by Laurence Reed, former editor of Public Health Reports, focused on his research showing that the risk of death from leukemia rose with increasing workplace exposure to benzene. Dr Rinsky was a former editor of Public Health Reports where he was credited with enhancing the journal’s scientific rigor and respect in the public health field.

Profiled: Ana Diez Roux, Dean and Distinguished Professor of Epidemiology at Drexel University’s Dornsife School of Public Health in AL DIA news media. Born in Argentina and educated in both her native country and in the US, Dr Diez Roux became very interested in understanding how social and economic things affect health. During her time at Johns Hopkins, according to AL DIA, she told the media “So epidemiology is a perfect tool for that because you can study differences in health across different population groups and… what we can do to [create] change”. She described her work as very interdisciplinary. “It integrates things from sociology, from psychology, from medicine, from biology…to understand what the main drivers of health are.”

Appointed: Theoklis Zaoutis, as the new president of EODY, The Hellenic National Public Health Organization. It is responsible for surveillance and control of infectious diseases in Greece and functions under the supervision of the Ministry of Health and in close collaboration with the local public health authorities. Dr Zaoutis is Professor of Pediatrics at the National and Kapodistrian University of Athens and Professor of Epidemiology at the Perelman Medical School of the University of Pennsylvania and the Children’s Hospital of Philadelphia.

2022 Epidemiology Event Calendar Are you planning an epidemiology event for 2022? We have started to build our calendar issue and we want to make sure your event is included. To submit your event CLICK HERE or contact

Linda Bernier

770.533.3436

linda@epimonitor.net

8 Near Term Epidemiology Event Calendar Every December The Epidemiology Monitor dedicates that issue to a calendar of events for the upcoming year. However that often means we don't have full information for events later in the upcoming year. Thus an online copy exists on our website that is updated regularly.

To view the full year please go to: http://www.epimonitor.net/Events The events that we are aware of for the next two months follow below.

November 2021 Nov 2-5 http://bit.ly/2KfVzlJ Conference / 15th International Conference on Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases / Tulane University & others / New Orleans, LA Nov 6-7

http://bit.ly/3alftGJ

Conference / 2021 Global Conference on Health and Climate Change / WHO / Glasgow, Scotland Nov 10-13 http://bit.ly/2s78HjZ Conference / 16th World Congress on Public Health / European Public Health / Dublin, Ireland Nov 22-23 http://bit.ly/3p0xazj Conference / Infectious and Chronic Disease Conference / Pharmaweb / Capetown, South Africa Nov 30 - Dec 8 http://bit.ly/2K5CCm0 Conference / 8th Intl Conference on Infectious Disease Dynamics / Elsevier / Bologna, Italy

December 2021 December 8-10 http://bit.ly/35hZRhG Conference / 2020 CityMatCH Leadership & MCH Epi Conference / CityMatch / New Orleans, LA

2022 Epidemiology Event Calendar Are you planning an epidemiology event for 2022? We have started to build our

calendar issue and we want to make sure your event is included. To submit your event CLICK HERE or contact

Linda Bernier 770.533.3436 linda@epimonitor.net 10

Post-Doctoral Fellow – Maternal & Child Health Epidemiology Kaiser Permanente Southern California’s Department of Research and Evaluation (R&E) conducts high-quality, innovative translational research that benefits the health of its members and the communities from which they come. At Kaiser Permanente, research helps us learn what we need to do to provide better care for our members and promote better health in the community.

More than 450 people work at the Pasadena, California-based Department of Research & Evaluation. The department is the primary hub of research for Kaiser Permanente Southern California (KPSC), supporting research by full-time faculty members as well as medical center-based clinician researchers.

The Department of Research and Evaluation is seeking Post-Doctoral Research Fellows interested in maternal and child health epidemiologic research studies.

This one-year renewable position (funding and performance dependent) will provide mentored experience in field work, proposal development and scientific publication, designed to prepare the incumbent for a productive career as an independent researcher.

Essential Responsibilities:  Designs, develops and directs well-defined research with supervision from a R&E Research Scientist.  Prepares grant proposals and publications independently and collaboratively.  Provides consultation and direction to programmer/analysts with regard to data management and analysis strategies.  May perform subject assessments or chart reviews or provide direction to research support staff performing these tasks.  Submits abstracts to and presents papers at national scientific meetings.  Seeks consultation from research scientists for specific scientific and administrative issues.  Participates in R&E department meetings and projects as appropriate.

Preferred Qualifications:  Track record of publication in the peer-reviewed literature and grant-writing experience.  Doctoral degree (Ph.D., Dr.P.H., M.D., Sc.D.) in epidemiology, preferably in maternal and child health epidemiology, or clinical doctoral degree + master's degree with formal research training in epidemiology.  Competent in advanced research methods, including statistical techniques and study design commonly used in epidemiologic research or related fields.

KPSC is a leading managed health care organization with 4 million members of diverse race/ethnicity living throughout Southern California. They are attended by over 6,000 physicians practicing in an integrated, pre-paid delivery system that provides comprehensive health care and pharmaceutical benefits to members of the non-profit Kaiser Foundation Health Plan and Hospitals. KPSC has deployed an extensive clinical information system, including a fully automated medical record system. A description of the Department of Research & Evaluation is available on the web (http://www.kp-scalresearch.org/). It is the home to nearly 30 doctorally prepared investigators and over 300 support staff. The Department is located in Pasadena, a community of 143,000 residents and the home of the California Institute of Technology, the Rose Bowl, the Jet Propulsion Lab, and other historical and cultural sites. Information about the community can be found online at www.visitpasadena.com. Pasadena is in the San Gabriel Valley 15 minutes north of downtown Los Angeles in sunny southern California.

For more information or to apply for this position, please click below Please click here for Kaiser Permanente SC R&E Post-doc Maternal & Child Health Epidemiology or visit the Kaiser Permanente job website at https://www.kaiserpermanentejobs.org/ and search 895949 in the keyword field.

Please also email your CV with a cover letter to allan.slatkin@kp.org

KPSC is an Equal Opportunity/Affirmative Action Employer and offers competitive salary and comprehensive benefit packages.

Post-Doctoral Research Fellow, Cancer Epidemiology & Infectious Disease Epidemiology The Department of Research and Evaluation (R&E) of Kaiser Permanente Southern California (KPSC) is seeking a Post-Doctoral Research Fellow interested in cancer epidemiology & survivorship, pharmacoepidemiology, or infectious disease epidemiology.

Scientists in the Department of R&E conduct research involving large, diverse populations, providing timely evidence to decisionmakers and the public. The research teams have expertise and experience in performing a vast array of population-based epidemiologic cancer research and infectious disease research, including HIV/STI. Projects range from large, multisite epidemiologic studies on cancer and HIV/STI prevention, diagnosis, molecular markers, treatment and clinical outcomes, and survival. The overarching goal of these studies is to use our large membership and extensive data to generate results that will improve cancer care and contribute to scientific knowledge about cancer outcomes.

The research teams work with partners from government, industry, academia, and other health care systems.

This one-year renewable position (funding and performance dependent) will provide mentored experience in field work, proposal development and scientific publication, designed to prepare the incumbent for a productive career as an independent researcher.

Essential Responsibilities:  Designs, develops and directs well-defined research with supervision from a R&E Research Scientist.  Prepares grant proposals and publications independently and collaboratively.  Provides consultation and direction to programmer/analysts with regard to data management and analysis.  May perform subject assessments or chart reviews or provide direction to research support staff performing these tasks.  Submits abstracts to and presents papers at national scientific meetings.  Seeks consultation from research scientists for specific scientific and administrative issues.  Participates in R&E department meetings and projects as appropriate.

Preferred Qualifications:  Doctoral degree (Ph.D., Dr.P.H., M.D., Sc.D.) in epidemiology, preferably in cancer and/or infectious disease epidemiology, or clinical doctoral degree + master's degree with formal research training in epidemiology and/or biostatistics.  Track record of publication in the peer-reviewed literature.  Research experience in epidemiology or biostatistics and track record of publishing in peer-reviewed journals.  Competent in advanced research methods, including statistical techniques and study design commonly used in epidemiologic research or related fields.

A description of the Department of Research & Evaluation is available on the web at http://kp.org/research.

It is home to 30+ doctorally-prepared investigators and over 350 support staff. The Department is located in Pasadena, California, a community of 140,000 residents and the home of the California Institute of Technology, the Rose Bowl, the Jet Propulsion Lab, and other historical and cultural sites. Information about the community can be found at https://www.visitpasadena.com.

KPSC is an Equal Opportunity/Affirmative Action Employer and offers a comprehensive compensation package, including employer-paid medical, dental and coverage for eligible dependents. Competitive wages, generous paid time-off and a comprehensive retirement plan are just part of the exceptional benefits offered to Kaiser Permanente employees.

For immediate consideration, interested candidates should submit their letter of interest, CV and references to Dr. Kristi Reynolds, Director of Epidemiologic Research (email: allan.slatkin@kp.org) and by visiting www.kp.org/careers, referencing position number 961052.

KPSC is an Equal Opportunity/Affirmative Action Employer and offers competitive salary and comprehensive benefit packages.

Post-Doctoral Research Fellow, Infectious Disease Epidemiology The Department of Research and Evaluation (R&E) of Kaiser Permanente Southern California (KPSC) is seeking a Post-Doctoral Research Fellow interested in infectious disease epidemiology and vaccine safety and effectiveness.

The R&E of KPSC conducts high-quality research involving large, diverse populations, providing timely evidence to decisionmakers and the public. The research team has expertise and experience in performing a vast array of infectious disease research, including vaccine research studies. Studies range from large, multisite epidemiologic studies on a variety of topics including antibiotic resistance, hospital infections, tuberculosis, COVID-19, and vaccine preventable diseases, to Phase IV vaccine postlicensure observational studies. The research team works with partners from government, industry, academia, and other health care systems. Our vaccine research consists of topics including vaccine safety and effectiveness, vaccines in special populations (e.g., pregnant women, immunocompromised individuals), vaccine uptake and compliance with recommendations, and methodologies for vaccine studies. Findings from studies guide KPSC clinical care improvement efforts, as well as immunization policy and regulatory decisions and provide the public with information regarding risks and benefits of immunization.

This one-year renewable position (funding and performance dependent) will provide mentored experience in field work, proposal development and scientific publication, designed to prepare the incumbent for a productive career as an independent researcher.

Essential Responsibilities:  Designs, develops and directs well-defined research with supervision from a R&E Research Scientist.  Prepares grant proposals and publications independently and collaboratively.  Provides consultation and direction to programmer/analysts with regard to data management and analysis strategies.  May perform subject assessments or chart reviews or provide direction to research support staff performing these tasks.  Submits abstracts to and presents papers at national scientific meetings.  Seeks consultation from research scientists for specific scientific and administrative issues.  Participates in R&E department meetings and projects as appropriate.

Preferred Qualifications:  Doctoral degree (Ph.D., Dr.P.H., M.D., Sc.D.) in epidemiology, preferably in infectious disease epidemiology, or clinical doctoral degree + master's degree with formal research training in epidemiology.  Track record of publication in the peer-reviewed literature.  Research experience in infectious disease epidemiology or vaccine safety and effectiveness.  Competent in advanced research methods, including statistical techniques and study design commonly used in epidemiologic research or related fields.

A description of the Department of Research & Evaluation is available on the web at http://kp.org/research.

It is home to 30+ doctorally-prepared investigators and over 350 support staff. The Department is located in Pasadena, California, a community of 140,000 residents and the home of the California Institute of Technology, the Rose Bowl, the Jet Propulsion Lab, and other historical and cultural sites. Information about the community can be found at https://www.visitpasadena.com.

KPSC is an Equal Opportunity/Affirmative Action Employer and offers a comprehensive compensation package, including employer-paid medical, dental and coverage for eligible dependents. Competitive wages, generous paid time-off and a comprehensive retirement plan are just part of the exceptional benefits offered to Kaiser Permanente employees.

For immediate consideration, interested candidates should submit their letter of interest, CV and references to Dr. Kristi Reynolds, Director of Epidemiologic Research (allan.slatkin@kp.org) and by visiting www.kp.org/careers, referencing position number 961068.

KPSC is an Equal Opportunity/Affirmative Action Employer and offers competitive salary and comprehensive benefit packages.

DEPARTMENT OF EPIDEMIOLOGY AND PUBLIC HEALTH DIVISION OF GERONTOLOGY - SEARCH REOPENED The Department of Epidemiology and Public Health of the University of Maryland School of Medicine is seeking a division director at the associate or full professor rank for an exciting opportunity to expand and accelerate the growth of the Division of Gerontology. A generous and competitive start-up package will be provided to support the division director’s research initiatives and growth of the division.

The successful candidate for the division head position will be a national leader with commitment to conducting and fostering interdisciplinary research in the epidemiology of aging and gerontology, will have a record of extramural research funding, and leadership and management capabilities.

The division director is expected to develop and enhance collaborative research within the division, department, and medical system, and actively teach and participate in the department’s training programs for graduate students and post-doctoral fellows. Opportunities to teach medical students and students in other professional schools on our health services campus also are possible.

The division’s seven faculty members have ongoing multidisciplinary research and collaborations across campus, focused on strategies to prevent and improve outcomes from disabling conditions among older persons.

Gerontology division faculty collaborate with others throughout the University of Maryland Baltimore campus, which includes six professional schools (medicine, nursing, pharmacy, dentistry, social work, and law), other University of Maryland campuses, as well as those in other academic and industry settings. The division also is the administrative home for the campus-wide Center for Research on Aging, the Claude D. Pepper Older Americans Independence Center – funded since 1994, the Gerontology Doctoral Program, and the federally funded Research Training in the Epidemiology of Aging (T32).

The department, which is ranked first in NIH funding for like-departments in public schools of medicine, comprises 45 full-time faculty members, has strong research programs in cancer epidemiology, genomic and infectious disease epidemiology, translational toxicology, biostatistics, preventive medicine, and health disparities and population health. The department is also the home for doctoral degree programs in Epidemiology and Human Genetics, and in Gerontology, as well as master’s programs in epidemiology, clinical research, and public health.

Qualifications: Ph.D. and/or M.D. with significant experience collaborating in an interdisciplinary research setting, background in epidemiology and/or gerontology, and an established record of extramural research funding are required.

For confidential inquiries, please contact Dr. Jack Guralnik at jguralnik@som.umaryland.edu or Dr. Ann GruberBaldini at abaldin@som.umaryland.edu.

TO APPLY: Please submit applications online at: https://umb.taleo.net/careersection/jobdetail.ftl?job=170001XK&lang=en#.WjliERVAqss.email Applications should include a cover letter indicating research interests, CV, and names of 3 references.

Reference position # 03-307-143.

The University of Maryland, Baltimore is an Equal Opportunity, Affirmative Action Employer. Minorities, women, veterans, and individuals with disabilities are encouraged to apply.

Tenure Track Assistant/Associate Professor of Epidemiology The Department of Epidemiology and Biostatistics in the Arnold School of Public Health (ASPH) at the University of South Carolina (UofSC) invites applications for a tenure-track faculty position in Epidemiology at the rank of either Assistant or Associate Professor. Candidates from all areas of epidemiology will be considered, and particularly encouraged to apply are those with research expertise in infectious disease epidemiology, environmental epidemiology, genetic epidemiology, epidemiology of aging, perinatal epidemiology, social epidemiology, or epidemiology of cardiometabolic outcomes.

The successful applicant will be expected to maintain an active research program, teach courses in advanced epidemiologic research methods and other epidemiology courses, mentor graduate students, and contribute to the department and school through professional service. A qualified candidate for the rank of Assistant Professor will have an earned doctoral degree in epidemiology by the beginning date of employment, the potential for excellence in teaching and for external research funding, and demonstrated evidence of high-quality scholarly research. A qualified candidate for the rank of Associate Professor will have an earned doctoral degree in epidemiology plus at least 5 years of experience as a faculty member by the beginning date of employment, a successful track record of competitive external funding in support of research, and a teaching record commensurate with academic rank.

Qualified candidates will be capable of 1) teaching doctoral-level courses in the theory and application of epidemiologic research methods that include causal inference, 2) enriching our curriculum in substantive and methodologic applications of epidemiology, and 3) developing an independent research program. Examples of existing epidemiology faculty expertise are nutrition, cancer, perinatal epidemiology, infectious and parasitic diseases, health disparities, genetic epidemiology, social epidemiology, and cardiometabolic outcomes (e.g., diabetes). Abundant collaborative opportunities exist for community-based and clinical research.

The Department of Epidemiology and Biostatistics seeks to promote a diverse and inclusive campus climate and aims to identify suitable candidates with a breadth of scholarly and lived experiences. Home to 30 faculty members, 20 in the Division of Epidemiology and 10 in the Division of Biostatistics, the faculty’s robust research portfolio includes funding from a broad spectrum of federal agencies (e.g., NIH and CDC) and non-profit organizations. More information about ASPH and the Department of Epidemiology and Biostatistics can be found at www.sph.sc.edu.

How to apply: Applications require: 1) letter of application; 2) curriculum vitae; 3) research statement; 4) teaching statement; 5) diversity statement that describes how your approach to research, teaching, and service activities contribute to enhancing diversity, equity, and inclusion, and 6) contact information for three references. Submit your application at the following link: https://uscjobs.sc.edu/postings/104470.

For additional information please contact Emily Tedesco, tedescel@mailbox.sc.edu, Department of Epidemiology & Biostatistics, 915 Greene St., Columbia, SC 29208, Telephone: (803) 777-7353, Fax: (803) 777-2524. Review of applications will begin immediately and continue until the position is filled. The anticipated start date is August 16, 2022.

The University of South Carolina is an affirmative action, equal opportunity employer. The University of South Carolina and ASPH condemn racism and injustice in all its forms and actions. The University of South Carolina does not discriminate in educational or employment opportunities on the basis of race, sex, gender, gender identity, transgender status, age, color, religion, national origin, disability, sexual orientation, genetics, protected veteran status, pregnancy, childbirth or related medical conditions.

Physician-Scientist Faculty Position The Department of Obstetrics, Gynecology, and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School, NJ invites applications for a tenured or tenure-track faculty position at the associate professor or professor rank. Candidates with research interests in the category of physicianscientist, with expertise in reproductive or perinatal epidemiology, or women’s health are preferred. The ideal candidate should have a broad understanding of epidemiologic methods, and those with interests in causal inference are preferred.

The Department of Obstetrics, Gynecology and Reproductive Sciences is comprised of seven divisions, including the General Division, Female Pelvic Medicine and Reconstructive Surgery, Gynecologic Oncology, Family Planning, Maternal-Fetal Medicine, Reproductive Endocrinology and Infertility (Reproductive Medicine Associates of NJ) and Epidemiology and Biostatistics. The Department has an ABOG-accredited residency program in obstetrics and gynecology (5 residents per year), as well as a maternal-fetal medicine (1 fellow per year), urban global scholar (1 fellow per year), and reproductive endocrinology and infertility (2 fellows per year) fellowship programs. There are approximately 50 fulltime faculty members in the Department.

The ideal candidate The successful applicant will have completed training and board certified in obstetrics and gynecology (sub-specialty training will be an advantage although not required) and doctoral training either in epidemiology or in the basic sciences from an accredited school, with a strong commitment to teaching, mentorship and advising students. Excellent track record of strong peer-reviewed publications, and successful current extramural funding are required. Evidence of well-rounded academic scholarship is essential. Candidates with sustained national and international collaborations are preferred.

We are particularly interested in candidates with a passion for clinical care and research in a broad and sustainable focus to understand and advance women’s health, and factors that affect health during pregnancy. Applicants interested in studying mechanisms of obstetrical complications or women’s health, as well as understanding health disparities are encouraged to apply.

Applicants should respond via email with an updated CV and letters of reference along with a one-page statement of interest. Please send these materials to: Cande Ananth, PhD, MPH Professor, Obstetrics, Gynecology and Reproductive Sciences 125 Paterson Street, CAB 2150 New Brunswick, NJ 08901 Contact Name & Email Address: Beth Dillon, MS/Program Administrator: beth.dillon@rwjms.rutgers.edu

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