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Leading through Uncertainty


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When Dr. Jeff Coben looks back on the last few years, knowing then what he knows now about the novel coronavirus would have been valuable. But the dean of West Virginia University’s School of Public Health knew two things going into the chasm of the fast-spreading virus that killed millions, left others with long-term chronic symptoms and became a flashpoint of political division.

The tenets for treating a pandemic are long-established protocols and people have to be met where they are. 

Coben, whose medical career spans 34 years, including the last 18 at WVU, became senior adviser to Dr. Clay Marsh, who stepped into a statewide leadership role for Gov. Jim Justice during the COVID-19 pandemic. Coben, too, was in on the initial gathering to formulate a statewide response, and while almost everyone at WVU Health Sciences pitched in to keep the schools and the WVU Hospitals running, Coben was tapped to lead the University-wide plan. 


That meant strategic planning for day-to-day operations, and mustering the considerable expertise at the School of Public Health to both devise and implement procedures. 


“We’re the School of Public Health; that’s what we do,” Coben said. “We were one of the very first universities to launch a training program for contact tracing (and) one of our faculty members, Diane Gross, really served as the regional epidemiologist for the Mon(ongalia) Health Department and in that capacity she was working directly with the state.” 


Many School of Public Health faculty members were thrust into practical applications of their professions from fit-testing for N95 masks for people who were decontaminating buildings or moving potentially infected people from one location to another for isolation or quarantine and on to setting up a data dashboard that showed people where to get tested and where to get a vaccine. 


As the state, country and world watched the evolution of the science behind how to fight a new virus, one with a seemingly endless list of symptoms — or none at all— that could spread so quickly that even people who weren’t sick could carry a highly contagious viral load, a virus so deadly that highly-populated areas were placing the dead in refrigerated trucks, Coben and his team relied on what they knew best.


“The question was how best to approach it in different settings. What I learned in the process was that being part of a team, being part of a larger effort, means you have to first seek to understand then seek to be understood,” Coben recalled. “I had to spend a lot of time listening —what other leaders were concerned about, what they were hearing from different constituents of the University.” 


The quiet-spoken Coben said it was important for him to express best practices from a public health and medical perspective, but it was also important for him to understand the range of concerns about implementing those practices, everything from financial concerns to personal freedoms and restrictions. 


Although feeling the “push and pull” of his medical colleagues who wanted mandates for closure or masks or vaccines, Coben chose to not be dogmatic but to stay at the table to accomplish what he could to keep WVU’s students, faculty and staff safe. Had he not been there to guide the protocols that were implemented, Coben said the outcomes may have been very different. 


“Still, to my knowledge, there hasn’t been a single fatality amongst any University employee or student from COVID, at least during the school year, as we monitored it,” Coben said. “And I think that is just a great success; I think that’s something we ought to be really proud of.” 


Coben said one of the things that COVID revealed is that over the years — and not just in West Virginia, but throughout the nation — there has been a weakening of the public health system, the public health infrastructure. In other words, when people are healthy and there’s no imminent, detectable health threat, people forget about public health. 


“It’s easy to cut budgets (then). And when budgets get cut, then people get cut and when people get cut, services get cut, and you end up in a situation where you have very small local health departments that serve the entire population of the country and that doesn’t work,” Coben said. “Public health threats are going to continue whether it’s COVID, or monkeypox or another infectious disease and it could be climate change or water pollution. 


“If anything, they’re only going to continue and escalate over the years, so we can’t try to address public health on an episodic basis. We have to have a sustained infrastructure development, develop the public health workforce and we have to continually have some important level of investment in public health in order to keep all of us safe and healthy for the future.”