5 ways we can prepare for coronavirus
This week, the CDC warned Americans that the coronavirus illness-, COVID 19, may soon spread in communities across America.
More than 40 new infectious diseases have emerged since the 1960s, but it seems that we have amnesia about the international impact of these outbreaks. This underscores why public health preparedness plans are needed to fight infectious diseases that threaten health, economies and global security.
As of Feb. 26, over 81,172 people globally have been infected with COVID-19 with more than 2,768 deaths. As compared to SARS with a 10 percent mortality rate, and seasonal flu with a 0.1 percent rate, an estimated 2 percent of infected people with this coronavirus have died. In America, 57 cases have been reported thus far.
South Korea has experienced a 20 fold surge in infections over the past week; Italy is now managing over 300 cases and infections in the Middle East are escalating. This surge in COVID-19 worldwide forebodes that this disease could soon become a pandemic.
A comprehensive public health preparedness plan is needed now for this outbreak and for future ones that will invariably occur with the following components:
- Establish permanent pandemic preparedness infrastructure
The appointment of an experienced manager as a “pandemic preparedness coordinator (czar)” in a permanent position at the White House would be an important step. This expert would work across government agencies, with other nations, and the private sector to ensure that our country’s pandemic response infrastructure remains resilient to infectious disease threats. A trusted figure, such as a high-ranking government physician, must provide frequent updates to the public and media. A strong and resilient health system made all the difference in containing the SARS and Ebola outbreaks in America. Instead of the “boom and bust” funding provided each time, there’s an outbreak, countries must proactively commit the funds to build and support permanent emergency preparedness infrastructure.
- Prevention and early detection
Problems with the CDC’s coronavirus test kit have impeded the expansion of screening to state and local public health laboratories so that infected people can be identified quickly. A rapid swab test, similar to what is used for identifying flu would be very helpful for speedy diagnosis in clinical settings.
- Invest in Research
Fast track vaccines and anti-viral development: As a result of scientific advances, the COVID-19 genome was rapidly sequenced facilitating efforts to develop a vaccine and anti-viral medications. Pursuing an accelerated timeline, several vaccine candidates at the NIH and in the private sector are under development, but clinical trials with subsequent production and distribution of this immunization could still take one to two years.
A Cambridge, Mass., biotech company shipped to the NIH the first potential coronavirus vaccine created in record speed for safety and effectiveness testing in humans. With three serious global coronavirus outbreaks occurring over the past two decades, exploring the feasibility of a universal coronavirus vaccine and establishing a national vaccine production center would be worthwhile investments. Incentives should be provided to support public-private partnerships that help to mitigate the financial risks of developing vaccines.
- Harness social media and the internet
Public health officials must work closely with the media to ensure accurate reporting of outbreaks and counter disinformation that can occur in social media. Mobile devices present important platforms for instantaneously sharing information, tracking disease spread in real-time, facilitating professional training and research collaboration across communities and countries.
- Legal, ethical and cultural considerations
Global travel restrictions and quarantine are being used to slow the transmission of the virus while more information on its transmissibility, severity, and lethality is collected. In America, thousands of people have volunteered to self-quarantine for 14 days following their return home from China before the travel ban was implemented.
Over 150 million people in China (about 10 percent of the population) are living under government restrictions on how often they can leave their residences. This public health lockdown is among the largest in history, generating panic and despair among the country’s citizens. While appearing to slow viral spread in China, these measures may result in unintended consequences including cross-infection, deaths from lack of access to medications for other diseases, and mental health effects.
As transportation to the isolated region is limited, medical supplies are scarce and food shortages are occurring affecting China as well as other countries. For example, more than 150 prescription medications used by Americans are produced in China. Disruptions in the supply chain could result in limited access to these drugs with health-damaging effects for people in the U.S. Past quarantines have resulted in public mistrust, violence, and xenophobia. As the trajectory of this novel coronavirus is better understood, policies related to quarantine, trade and travel to and from endemic regions will need to be reassessed.
Let’s remember that throughout history, infectious diseases have killed more people than wars and therefore are decisive shapers of history.
Making significant investments now to increase the scientific knowledge base, developing new technologies that can be deployed in combination with proven public health practices, as well as strengthening health systems, businesses and schools with coordinated, permanent public health preparedness plans, will boost our ability to better contain spread of this coronavirus outbreak as well as fight other emerging disease threats more swiftly and effectively in the years ahead.
Rear Admiral Susan Blumenthal Markey, M.D. is a senior fellow in Health Policy at New America, former U.S. assistant surgeon general, senior medical advisor at amfAR, The Foundation for AIDS Research, and a Clinical Professor at Tufts and Georgetown University Schools of Medicine. Matina Kakalis is a research associate in Health Policy at New America.