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COVID-19 is still spreading — is your city ready?

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While the coronavirus has hit the United States with a vengeance, some lucky cities have escaped unharmed thus far. However, even if your city has 0 or few known cases, the threat COVID-19 poses remains large. We all need to be prepared for the next phase of this pandemic that’s looming around the corner, which will likely spread more widely within states, hitting areas that have so far been unscathed.  

Several tactics can help communities prepare for the coming wave of COVID-19. To start, hospitals must expand the beds available for patients at any given time. One simple solution is to limit or postpone elective surgeries. Additionally, care centers, such as sterilized convention centers or hotelscan be created to treat mild and asymptomatic COVID-19 cases. Not only does this action free up valuable space for critical patients, but it also slows community spread by isolating patients with milder symptoms. As some patients’ conditions worsen, healthcare officials can admit them to the hospital for standard care with specialized wards for COVID-19. This also reduces the amount of personal protective equipment and number of personnel needed to care for patients. 

Another idea is to increase the number of people who can care for patients. Frontline medical personnel have been or will be hit by the disease themselves. States can compile lists of retired personnel who are willing to serve, allow service by qualified people who are licensed in other states or countries and expand practice to temporarily allow some types of care by expanded health care personnel (dentists, veterinarians, pharmacists, medical and nursing students). States and cities can prepare and train a force of volunteers to provide supportive care. This could also be a chance to shore up temporary employment for those who are out of work due to COVID-19. 

As the virus surges on, it is essential to creatively obtain an increased supply of critical items like masks, ventilators and medicines. Local drives can collect masks for frontline medical personnel. At NC State, our university is using 3D printing to manufacture face shields and filters for N95-like masks. Officials should check with local universities and companies for this capability before the onslaught hits. Cities should continue to purchase masks and ventilators. If there are enough, find ways to distribute them to other areas of critical infrastructure like transportation and utilities, as well as members of the public. Households and organizations should have a one-month extra supply of pharmaceuticals in case the supply chain has extra delays.

Cities and counties can work closely with hospitals and local businesses to prepare for a local shelter-in-place as cases rise in the area. To slow the spread, consider closing in-person services like salons, restaurants, bars and places of worship. Though the majority of states have implemented stay-at-home orders that require these businesses to close, not all followed suit. States holding out should get on board. Pair this with financial policies to help small businesses and their workers who are hardest hit. 

It is important to develop a system to conduct drive-thru testing for current cases of COVID-19 as well as past cases as new antibody tests roll out. This will allow for more complete isolation of people who may be infectious while identifying people who are likely to have developed some immunity for the disease and can join the frontline as needed. 

Officials need to develop or revise plans for distributing new treatments or vaccines as they become available. Critical factors for success include speed, access and visibility. The speed with which you can get products to your community helps increase uptake in critical times. Access to the public should account for populations who are most vulnerable, but broad access should be given to as many people as possible, when possible. Information visibility across the system should be transparent about what has been distributed, where and to whom, including where there is a surplus or unmet demand. Fairness and transparency are critical in the stewardship of a public resource. 

It is critical to find ways to mitigate the impact on populations in poverty or left financially insecure. This includes stocking up food pantries, bridging the digital divide for children out of school without Internet and enhancing employment when possible. 

Lastly, households should ensure they have supplies to care for those in their family if they become ill, as well as find ways to stay calm and patient through this long ordeal. 

The big takeaway: don’t get complacent. Plan ahead, then leave interventions in place until well after the peak. After that, slowly and selectively lift interventions while monitoring for second and third waves that may appear over time. Remember, what you do today affects cases approximately 14 days from now and potential deaths about a month from now. 

If your state and city haven’t been hit hard yet, count yourself lucky. This is your chance to get ahead of the virus and show other states what can be done when you have a few more days or weeks to prepare. 

Julie Swann is department head and the A. Doug Allison Distinguished Professor in the Edward P. Fitts Department of Industrial and Systems Engineering at North Carolina State University. In 2009, she was on loan as a senior science advisor for the H1N1 pandemic response at the Centers for Disease Control and Prevention. Dr. Swann works in the area of mathematical modeling to enable supply chain systems and healthcare to become more efficient, effective, or equitable. She is also an active member in the Institute for Operations Research and the Management Sciences (INFORMS).

Tags community spread Coronavirus COVID-19 COVID19 disease Epidemiology N95 masks Pandemic Rural America Social distancing spread

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