Earlier this month, a 136-page report on a COVID roadmap was published by 23 public health experts and included the work of many other contributors and reviewers. The authors present what they think the “next normal” could look like in three scenarios and emphasize strategizing for respiratory illnesses on the whole in addition to focusing on living with COVID-19.
One of the major points the authors make in the report is that there is a need to shift focus to major respiratory viral illnesses at large like flu and respiratory syncytial virus (RSV), rather than focusing mainly on the coronavirus. Other areas the authors list are the need for a “transparent” dashboard to disseminate information, increased surge capacity for at-home rapid tests to 1 billion per month, better indoor air quality and a permanent group of health care workers dedicated to support vulnerable populations. They also call for more involvement in global vaccine access and research on long COVID.
A goal of the roadmap is to lay out how we can get to and sustain a “next normal” where what that means is defined and specific indicators to monitor the country are identified. It also attempts to be explicit on steps to get there and learn from past failures and successes. “It’s an attempt to have a more disciplined approach to dealing with this crisis, providing a vision for what ‘next’ might look like,” says Luciana Borio, who is one of the authors and a senior fellow for global health at the Council on Foreign Relations, to STAT.
The current numbers in the U.S. are trending better than earlier this year. “But while optimism is justified, inaction is not,” write the authors. In a chapter on potential scenarios, variations in attack rate or incidence of infections and infections fatality rate affect outcomes in optimistic, intermediate and pessimistic scenarios. Population immunity and viral virulence also affect potential levels of annual deaths.
In additional chapters, the experts touch on other topic areas such as the health care workforce and how it has been strained by the pandemic, as well as supply chain and capacity for manufacturing respirator masks. They also emphasize that vaccine research should be sustained and enhanced.
This report comes at a time when government funding for the pandemic response may run dry. Congress voted on a spending bill last week which did not include the full amount of $22.5 billion requested for COVID spending.
This week, a few of the authors took part in a panel discussion to urge Congress to pass additional funding to fight the COVID-19 pandemic. “We have had a once-in-a-century pandemic. We are breathing easier. The mortality rate is coming down, the case rate is coming down, and hospitalizations are coming down. But let’s remember we’ve been here before,” says Ezekiel J. Emanuel, who is Vice Provost of Global Initiatives at the University of Pennsylvania and also a former member of President Biden’s Transition COVID-19 Advisory Board, on the press call. “The last thing we need is to hesitate in our response to COVID. If we want to get to the ‘next normal’ and not have another deadly surge, we need to be prepared. Being prepared in America takes money.”
If new funding is not approved by Congress, it could have immediate effects on surveillance, testing and therapeutic treatments. “As we’re moving to this ‘next normal’, we have testing, vaccines, and therapeutics,” says report author Howard Forman, who is a professor at Yale School of Medicine, on the press call. “If we allow those things to fall by the wayside, even to a small degree, harm will occur to large swaths of the population that should not happen. We’re talking about the potential for tens of thousands of unnecessary deaths.”
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