IN SUPPORT OF A MOBILIZED NATIONAL RESPONSE
This Straight, No Chaser from Dr. Jeffrey Sterling, discusses combating Coronavirus in the midst of the current pandemic. Here’s the question of the day: What’s the best public health response? What’s not being done that should be done?
HOW WE GOT HERE
Let’s begin by acknowledging that much of this has become necessary because of the failure to have testing and treatment available. As such, we have been placed in a situation that most Americans would find abhorrent. We’re particular when it comes to our freedom and suspicious of government power expansion that tends to occur during crises. Similarly, the “best” and “most practical” actions aren’t necessarily the same thing; this is often the tug of war that occurs between the public health and political communities. However, here we are.
PUBLIC HEALTH VS POLITICAL APPROACHES
Beginning the conversation with identifying the most effective path of care and making practical (or political) adjustments based on that is a prudent approach. This is logistically more difficult now because of the misinformation and denials that haven’t paved the way for decisive action. Such action now may seem to be panic or overreaction. However, we must move past political posturing and move toward epidemiology as the way forward in promoting best practices. The science of data analysis, model formulating, predictions and deriving public health policy based on these considerations is incredibly effective.
Look at the attached chart. It’s incredibly instructive. Basically, there are two groups of countries: those with a high rate of new cases and those with a very low rate. Unfortunately, the trajectory of the US is consistent with those having a high trajectory – in fact, our trajectory is virtually the same as Italy’s, and we know how that turned out.
What does this mean? Simply put, act now, or we will suffer the consequences. The trajectory can be shifted.
How do we accomplish this? As I’ve said before, half-measures are inadequate. The data is in. It’s time to define the parameters of a total, temporary lock down of the U.S. Yes, that’s a national quarantine. Despite what you think, this isn’t that radical a proposition and would only represent an adjustment from current recommendations.
COMBATIVE CORONAVIRUS: STRAIGHTFORWARD BEST PRACTICES
The formal governmental apparatus should consider from among the following options. These are meant to be samples of options, not an exhaustive list. To the extent necessary, our military is going to have to participate in enforcing this process. For the purpose of discussion, let’s assume these measures will be implemented for 14 days and when applicable will apply to groups over 50 people. These recommendations are meant to be taken in isolation as public health measures. Additional societal and economic matters need to be addressed.
PREVENTION
- Canceling local and international travel outside of that deemed essential to considerations of public health, medical and national security interests. This includes train, bus and train travel.
- Postponing events that involve mass assembly. Eliminate public congregation. Schools, universities, churches, shopping malls and large community centers need to be closed. Restaurant activity needs to be exclusively converted to drive through offerings.
HEALTH PROMOTION
- Improve the supply chain. Mass production of masks, gloves and hand sanitizers must be fully increased in the way production occurs during war economies. Similarly, the supplies of medical equipment and supplies must occur, both for home and hospital use.
- Engage in food promotion to the most vulnerable communities and citizens. Maintaining health and immunity are vital to arresting the spread of the disease and survival of those obtaining it.
- Continue and expand upon current public information and education campaigns.
TESTING
- Allowing for full, widespread testing. The prior focus on deaths as the prime metric needs to change to the identification of cases. Doing so would allow for greater prevention of downstream clusters and additional deaths.
- Centers and shelters must have immediate testing and treatment capacity.
- Establish regional drive-through testing centers across the nation.
- Create a mandatory testing protocol for healthcare workers and other key societal figures (e.g. those continually exposed to multiple people).
TREATMENT
- Empower hospitals and other healthcare facilities to expand supportive and critical care capacity.
- Empower expedited testing of existing and newly created antiviral medicines and immune enhancing medicines and remedies to combat Covid-19.
- Fast track vaccination development.
Coronavirus (Covid-19) needs to be cut off at the head. A few decisive measures would go a long way to both reducing the risks and shifting the curve away from ongoing increases in cases. This type of plan would address current fears, plan the path forward and make clear to citizens what’s required. Do your part. Follow the recommendations. We’re in this together.
About Dr. Jeffrey E. Sterling
Jeffrey E. Sterling, MD, MPH, FACEP is a physician, speaker, author, executive and international leader in community-based medicine, health care, and public health. He serves as President & CEO of Sterling Initiatives (SI), a healthcare consulting and implementation firm, assisting entities incorporate best practices. For more information, visit Dr. Sterling’s website at https://www.jeffreysterlingmd.com/speaker/.
