When Falk College Chair and Professor was notified that he had received a Fulbright U.S. Scholar Award to teach and continue his wastewater surveillance research at the Medical University of Innsbruck in Austria this spring, the academic in him was rightfully excited and proud to receive this prestigious honor.
But Larsen is also a father of four children, and that side of him had a slightly different reaction.
鈥淚 didn鈥檛 expect to get it because the European posts are quite competitive. When I received the email notification, it was kind of an 鈥榦h, crap鈥� moment. What have I done?鈥� Larsen says, smiling.
What Larsen and his wife, Natalia, did was pack up their four children鈥擨sabel, 13; Sophia, 11; Madeline, 8; and Teddy, 5鈥攁nd travel roughly 6,500 miles to a house they鈥檙e renting in Birgitz, a village outside of Innsbruck, from January through July. Their daughters are attending English-speaking schools, while their son is attending a German-speaking preschool (German is the primary language in Austria).
鈥淭heir schooling is going to be a bit disrupted, but they鈥檙e good students who read a lot and we鈥檒l keep on top of it and fill in the gaps they might miss,鈥� Larsen says. 鈥淚t is a ski town, so we鈥檒l spend some time skiing, and the schools for the older girls had London excursions last year so perhaps they can do trips like that.鈥�
Public Health Chair and Professor David Larsen is among a select group of leaders and world-known experts in academia who received a 2024 Fulbright Scholar Award.
are competitive fellowships that provide students, scholars, teachers, artists and professionals of all backgrounds and fields the opportunity to study, teach and conduct research abroad, exchange ideas, and play critical roles in U.S. public diplomacy as they seek to find solutions to shared international concerns.
Since its establishment in 1946 under legislation introduced by the late U.S. Senator J. William Fulbright of Arkansas, the Fulbright Program has provided more than 390,000 scholarships and its alumni include 62 Nobel Laureates, 89 Pulitzer Prize winners, 78 MacArthur Fellows, and thousands of leaders and world-renowned experts in academia and many other fields across the private, public and nonprofit sectors.
At the outset of COVID in 2020, Larsen, an epidemiologist, led an interdisciplinary team of experts in coordination with the New York Department of Health to create a wastewater surveillance system throughout New York state. Today, the is testing for COVID in at least one wastewater treatment plan in all 62 of the state鈥檚 counties, covering a population of 15.3 million. The provides the most recent statistics regarding the network.
Before Larsen and his family traveled to Austria, we asked him about the Fulbright Award, what he鈥檒l be doing in and outside of Austria, and why a wastewater surveillance system to test COVID and other infectious diseases is crucial to worldwide health. Here鈥檚 that conversation:
Q: Why did you want this fellowship?
A: You submit for a specific award, and I submitted for a position at the Medical University of Innsbruck. I had reviewed their papers and there was good science coming out of there, so I reached out to their scientists who are working on wastewater surveillance in Austria and created their own network in the Tyrol region where Innsbruck is located.
I told them about my work in New York state and the wastewater surveillance network here, and they were supportive of my application.
Q: What will you be doing at the Medical University of Innsbruck?
A: I鈥檓 a visiting professor and they鈥檝e asked me to teach two courses that meet once a week and are equivalent to a 3-credit course here. I鈥檓 teaching a condensed version of my 鈥淪patial Statistics for Public Health鈥� course, and I developed an overview course for public health surveillance. Those were selected in brainstorming with my colleagues at Innsbruck who thought those would be of most value to their students.
In addition, I鈥檓 working with the wastewater-based epidemiologists there, and the research project attached to the Fulbright is the comparison of the networks in New York state and Tyrol.
Q: Will you be working outside of Austria?
A: There鈥檚 a national wastewater network in Austria, and initiatives to establish a global network being led by Europeans. Europeans have been doing wastewater surveillance for drugs since 2010, and they鈥檝e got a great model of collaboration across the different nation states. So, I hope to connect with that team and learn more about it, in addition to working with the Austrians.
I鈥檓 working here in New York state, primarily, and others are working across the globe on the same issue and building a global system. So, we鈥檒l take the lessons we鈥檝e learned and the challenges we鈥檝e overcome here in New York and go to Austria, share those, and I hope to learn lessons they鈥檝e learned and the challenges they鈥檝e overcome in Austria, and then Europe, and more broadly. Hopefully, we鈥檒l have a greater understanding and improved wastewater surveillance systems as a result.
At the outset of COVID in 2020, David Larsen led an interdisciplinary team of experts in coordination with the New York Department of Health to create a wastewater surveillance system throughout New York State.
Q: Why is this collaboration so important?
A: 聽We built this (network) with COVID, but we also built it for the future. Right now in New York state, local health departments are using the data we produce鈥損articularly the sequencing data to track variants鈥揵ut also the hospitalization forecasting that we provide them. Our aim is to provide the local health departments and the public with robust understanding of COVID-19 risk.
At the same time, COVID is not the only infectious disease, and there鈥檚 always potential for what we call “Disease X,” which is the next emerging infection. It could be another coronavirus, it could be an avian influenza, it could be something we鈥檙e not thinking about right now. The goal is to make this system ready and prepared to empower the public health response to whatever comes in the future.
In New York state, we supported the polio response in 2022 and made a huge impact on understanding how many people were at risk of polio. We are piloting influenza, RSV, Hepatitis A, Norovirus, and Antimicrobial Resistance (which occurs when a virus doesn鈥檛 respond to medicine). Antimicrobial resistance is a looming public health threat and could be very impactful. We do support the COVID response, but that鈥檚 the tip of the iceberg of where we hope the wastewater surveillance network goes.
The idea here is that perhaps most, if not all, infectious diseases can be surveilled or found in wastewater. Beyond that, drugs and environmental toxicants and pollutions and other measures of non-communicable diseases can be measured. How do we build this system to make the world a better place?
Q: What motivates you to do this?
A: This came about because I wanted to safely open my kids鈥� schools. I wanted to get back to normal. When COVID hit, we shut down and I supported the response鈥擨 still support the response we had鈥攂ut it was a response made without local understanding of risk.
Infectious diseases are local. You have travelers that take them from community to community, but you can have little enclaves of safe places. We had one at 黑料不打烊 in the fall of 2020. It was safe from COVID because of the aggressive public health measures and the aggressive infectious disease surveillance we were doing with wastewater and testing.
Could we have a situation where infectious disease is threatening, but we have these little pockets of freedom? And that鈥檚 informed a lot of my work: How do we live a free life in a world affected by infectious disease? The way to do that, in my view, is to fight these diseases so they鈥檙e no longer a threat and then you have to be able to confirm that they鈥檙e not affecting people. That鈥檚 where infectious disease surveillance comes in.
Q: Vaccinations are down, and a new COVID variant is on the rise. What鈥檚 your message to people as we approach the four-year anniversary of COVID?
A: People associate COVID with public health restrictions: masks, closed restaurants, closed schools, quarantine, isolation. But at its best, public health is empowering. Freedom from polio, the ability to drink tap water, the trust we have in our food system, the long-term health care as we get older. That is public health. And if we are on the front foot鈥攊f we prevent the disease鈥攖hen we can avoid the restrictions that happen. The shutdowns are a last resort when we have overflowing morgues and overflowing hospitals and it鈥檚 a panic button. It was the last resort and that鈥檚 the situation we found ourselves in.
Real public health is, how do we build a system so we don鈥檛 get into that position again? Vaccines are part of that toolkit; clean air, air filtration, environmental adjustments are also part of that toolkit and infectious disease surveillance is definitely part of that toolkit.
