US President Donald J. Trump holds a press conference on COVID-19 in the Rose Garden of the White … [+]
China News Service via Getty Images
Now that U.S. President Donald Trump has declared the COVID-19 coronavirus pandemic a national emergency, what specifically should our country do now? After all, calling something an emergency is rarely never enough. You’ve got to have a clear plan of what to do next. It’s not as if the virus even cares whether you call something an emergency. The virus will just keep infecting and reproducing, treating people’s bodies like cheap motels.
Here is a clip from ABC News of Trump announcing the emergency:
Sergei Klebnikov has already described for Forbes what, in general, this declaration will allow the Trump administration to do. Of course, time will tell what the administration and government does exactly. But in the meantime, here are 12 recommendations:
1. Make it very clear that this is a public health emergency and not a hoax or someone else’s problem.
It is time to make combating this pandemic a clear top priority. For example, all of this hoax talk should have been quashed back in January. The World Heath Organization (WHO) doesn’t do hoaxes. On January 30, Tedros Adhanom Ghebreyesus, MD, the WHO Director-General, declared the COVID-19 causing coronavirus outbreak a public health emergency of international concern (PHEIC). With limited resources and an overstretched staff, why in the world would the WHO have declared a PHEIC for only the sixth time since 2005 just to support a possible hoax? The SARS-CoV2 is pretty single-minded. It wants to infect cells and doesn’t care about politics. A strong statement from all leaders that the COVID-19 coronavirus pandemic is not a hoax and should be taken very seriously could go a long way.
2. Cooperate with other countries.
Founder of Alibaba Group Jack Ma has pledged to donate masks and COVID-19 testing kits to the U.S. … [+]
The COVID-19 causing coronavirus is a common enemy that is spreading globally and thus requires different countries to cooperate. Countries around the world will need to share data on the virus, its spread, and what has worked and hasn’t worked as well as other scientific expertise. Blaming other countries for the situation is neither an accurate nor effective approach. Calling the virus the “Wuhan Virus” or the “Chinese Virus” is inflammatory and creates more problems rather than solves anything. Plus, back in 2015, the WHO made it very clear that new disease names should not include specific geographic regions, cultures, or populations. Just because something was done in the past, doesn’t make it right. Exhibit A: leg warmers.
Keep in mind that smallpox was successful eradicated because countries had the insight to overlook Cold War differences and instead cooperate against a mutual enemy. Similarly, different countries and people from different countries can help each other with problems such as alleviating shortages of essential items. For example, Chinese billionaire and Alibaba co-founder Jack Ma has pledged to donate 500,000 coronavirus testing kits and 1 million masks to the United States to alleviate shortages of both.
3. Establish clear guidance on what social distancing measures need to be implemented when and how.
MIAMI, FLORIDA – MARCH 11: A general view of American Airlines Arena after the game between the … [+]
Currently, many organizations and local governments are deciding individually what to do. This will result in rather incomplete and haphazard social distancing, which is a bit like using a volleyball net as toilet paper and underwear. Such an approach will leave far too many holes. If people are still mixing heavily in some locations, this will reduce or even negate the benefits of social distancing measures. The federal government should come up with very clear recommendations for all types of social distancing such as whether all schools should close, when, and for how long and clearly broadcast them.
4. Solve the SARS-CoV2 testing kit shortage problem as soon as possible and establish a very clear testing and surveillance strategy.
During his briefing in which he announced that the COVID-19 coronavirus has become a pandemic, the WHO Director-General warned, “We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic.”
He added, “If countries detect, test, treat, isolate, trace, and mobilize their people in the response, those with a handful of cases can prevent those cases becoming clusters, and those clusters becoming community transmission.”
That’s pretty loud and clear. Ah, but in the U.S., there’s one problem: it appears that many people who want to or need to get tested for the COVID-19 coronavirus can’t, such as:
And doctors are not getting testing kits or answers such as:
This is happening in the U.S., the country that has had the largest economy in the world for well over a century? Huh? Is the U.S. economy not strong enough to solve this problem?
This test kit shortage needs a-fixing now, whether it’s via getting some companies to step up, finding ways to fund more production, or getting testing kits from other countries. At the same time, there needs to be a clear testing surveillance strategy to track where the virus is spreading to better head it off at the pass so to speak or at least get people prepared.
5. Fix the mask shortage and establish a plan to protect health care professionals.
Speaking of shortages, word is that health care professionals are having to deal with face mask shortages. Yeah, a face mask shortage in hockey is one thing. A face mask shortage in health care is a completely different level of urgency. Because what would make a virus happier if a virus had feelings? How about giving health care professionals, those on the front line, no way of protecting themselves from getting infected? This way they can not only get sick and not be available to take care of patients, but they can also spread the virus to many other patients. There needs to be a clear plan on how to ramp up the production and delivery of face masks specifically for health care professionals, not the person who wants to buy them up and scalp them. Telling people not to buy masks alone is not going to work. That’s like telling college students not to drink alcohol or have sex.
6. Develop and roll out a national health care surge capacity plan.
Speaking of telling, health care experts have been telling everyone for years that our health care system is broken. When a couch is broken, you don’t just get more people to sit on it. One of the biggest concerns is that the broken U.S. health care system won’t be able to handle the surge in cases from COVID-19 on top of all the diseases that regularly need to be handled.
So hospitals will need to do what they can to free up resources. For example, those botox injections can wait. Also, hospitals and health care systems that have more resources such as ventilators could donate or loan some of these resources to systems and locations that have shortages so that more of the population is covered. Our study published in Health Affairs showed that if you don’t protect people in low income neighborhoods, they can help spread a virus because they often live in more crowded areas and travel to high income neighborhoods to work.
Individual hospitals may be reluctant to take all of these steps because they may lose revenue and incur more cost. The following poll, although not a scientific study by any means, does suggest discrepancies in how health care facilities may be preparing:
For the record, “chaos” is not a good way to prepare. Dr. Salles, a bariatric surgeon, a physician-scientist, and founder of Times Up Healthcare, followed up her poll’s findings with the following assessment:
This why broader guidance needs to come from the federal government. The government is the one entity that is supposed to keep the public good in mind during an emergency. This tweet from Jerome Adams, MD, MPH, the U.S. Surgeon General, is a good start:
7. Establish and broadly circulate treatment guidelines.
Patients need to know what to do if they have a fever or a cough. Doctors need to know the latest evidence in terms of what anti-virals may work. There should be a central government clearinghouse for all of this information to be shared. Otherwise, practices may vary substantially, and patients may get confused.
8. Establish a very clear plan to support the research and development of a vaccine and various possible SARS-CoV2 treatments.
A vaccine likely will not be available soon. This CNBC report mentioned some of the vaccine development efforts underway and potential timelines:
New more targeted therapies may take some time to develop as well. Regardless, it would be helpful to have even more clarity on specific plans and how these will be coordinated with the rest of the world. This way the entire scientific community and those providing resources can have clearer paths to work together.
9. Bolster local public health systems.
If the local public health systems are the backbone of the response to an epidemic, then our country is at risk of being a sea cucumber. Our country is depending on local health departments to do a wide variety of things, ranging from keeping track of cases, to providing information to the public to helping manage cases to alerting everyone else if dramatic changes occur. Many local health departments are chronically underfunded and short on personnel on resources. If anyone needs a bail-out, it is the local health departments.
10. Establish emergency food and supply delivery systems.
If no toilet paper is available, you may need more than just a hand. Scenes like the following can get people worried:
Even though it may not get to a point where people are without essential supplies, people need to know what to do in case real shortages happen. They need to feel secure that someone will take care of them throughout the emergency or real panic may ensue.
11. Make all decisions clearly based on science and establish and facilitate scientific priorities.
This is an emergency folks. Lives are at stake. This is not the time to try to make decisions based on profits or political agendas. Remember the Paul Reiser character in the Aliens movie? He jeopardized everyone’s safety because making money was driving his decision making. Yeah, that didn’t work out to well for everyone, including him.
Instead, science needs to guide all major decision-making. Leaders should provide the clear scientific rationale behind any major decisions. Cite the studies. Cite the evidence. In fact, let the scientists who generated the evidence explain directly.
There are many unanswered scientific questions about the virus. For example, I described in another article for Forbes about how knowing more about the immune response to SARS-CoV2 could significantly affect the public health response to the pandemic. It would be helpful to assemble a list of such questions and establish emergency mechanisms to provide rapid funding and other resources to address these questions. Our country has many experts who just need the appropriate support to do what they do best.
In general, tell everyone to stop any anti-science talk. In fact, do the opposite. Encourage everyone to listen to real scientists. Find the best scientists and health care professionals and put them in charge and help them interface directly and openly with the media and public.
12. Clearly communicate to everyone plans for all of the above.
This is not to suggest that none of the above are currently in the works. Each and every day, new information emerges about the virus and what people are doing for the national response. When there isn’t an emergency, certain kinds of surprises can be nice such as an unexpected cake or a little extra avocado on the toast. However, during a public health emergency, minimizing surprises, even good ones, is important. Think of the country as gigantic basketball team, with over 327 million people on the court against an even bigger team of viruses. Even if you make the nicest pass, it won’t help if your teammate isn’t looking for the pass and gets bopped in the face instead.