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Fifteen things we want to know about the coronavirus.
By Tom Frieden and Cyrus Shahpar
Dr. Frieden, former Director of the Centers for Disease Control and Prevention, leads the nonprofit Life-Saving Resolution, where Dr. Shahpar is the director of an epidemic prevention team.
Doctors who treat patients control critical symptoms of temperature, blood pressure, breathing, and pulse. Public fitness doctors who batter epidemics do something similar: they adhere to and control the maximum critical symptoms of the spread of a disease.
During the Ebola outbreak in West Africa, for example, with the coordination of the White House National Security Council, the Centers for Disease Control and Prevention produced a weekly scoreboard that assessed each country’s progress on how to prevent the disease. This focus was on where Ebola spreads and what needed to be done to prevent it. But today, the White House is not guiding our reaction to Covid-19, nor the C.D.C. No other component of government has been empowered to play this role.
We do not adhere to the public equivalent of fitness of important signs. This is one of the main reasons why the United States lost the war as opposed to Covid-19.
We have a capillary mortality rate five times higher than the global average, the instances are expanding and our economy and school systems will not recover until we have the virus. Last week’s abrupt resolution through the Trump administration to prevent data on Covid-19 patients being sent to the C.D.C. and instead sending it to the Department of Health and Human Services reflects this lack of national coordination.
For the past 3 weeks, researchers at our initiative, Resolve to Save Lives, have been looking for all the knowledge they can publicly locate on Internet sites in all 50 states. They found it incredibly incoherent, incomplete and inaccessible.
No single state has published the time required to complete the tests, the rate at which patients are isolated, nor the proportion of diagnosed cases among others who have been in contact with a Covid-19 patient. In peak states, there is no way to follow the trend of blacks and Hispanics suffering from hospitalizations and deaths at higher rates than whites.
Only two states, Oregon and Virginia, even reported data on whether patients had been temporarily interviewed for contacts. Indicators like that are key to knowing how we are fighting the virus so that we can do better.
It’s the state’s fault, it’s a federal failure. While it is difficult to download knowledge temporarily and accurately, the underlying challenge is the lack of unusual standards, definitions, and liability. This reflects the lack of national strategy and leadership. Unless we are on the same page, we will face continuous and avoidable disorganization, economic degradation and death.
There is a better way. Our group — along with a coalition of national, state and academic partners including the American Public Health Association and the Johns Hopkins Center for Health Security — has developed a list of 15 indicators. Every state and county should be able to collect and publish nine of these immediately and the other six within a few weeks.
The bases are the first emergency signals that can alert us if instances increase; Information on cases, trials and deaths over time across age, gender, race and ethnicity; and data on outbreaks in nursing homes and elsewhere, as well as epidemiological links between instances.
Indicators that can be published in a few weeks include functionality measures for testing, case interviews, and touch search; fitness staff infections and an objective assessment of the proportion of other people dressed in masks in indoor public spaces such as department stores and public transport. (This can be monitored through human researchers or security cameras for thorough analysis, while protecting people’s privacy)..
The full list should be taken here.
The greatest merit of intelligent data is knowledge, it’s action. Among other things, these signs would give us:
An early precautionary formula to prevent case explosions by cutting off physical connections as soon as instances begin to increase.
More incentive for the time it takes to run the tests, which is very important to avoid spreading (there is little price for tests that return more than two or 3 days later).
Information on the size, lethality and prestige of each outbreak, adding those of each nursing home, shelter for homelessness, correctional facilities and meat packaging plant.
The opportunity to increase and oppose the unequal burden that the pandemic places on black, Hispanic, Native American and other communities.
Responsibility for the number of weeks of inflamed fitness personnel; if we publish this, we’d lower that number to zero.
Joshua Lederberg, the wonderful microbiologist and Nobel laureate, said microbes outnumber us: it’s our intelligence in relation to their number. But today, despite too much data, we are at a disadvantage of intelligence. These signals would begin to solve this challenge by letting others know what their threat is and the extent to which their network handles the virus, and for the government to know what it wants to do. What is measured, publicly, can be managed.
The federal government has something like that, at least one way or another. This will be made public immediately, as will hospitalization data. All states and counties provide this form, and we are encouraged by the fact that several states have already told us that they will begin to do so. Journalists ask. And the public, adding educators looking to reopen schools, business owners who make plans for their monetary future, and parents looking to protect their children, ask for it.
Tom Frieden (@DrTomFrieden), Director of C.D.C. from 2009 to 2017, he is the president and CEO of Resolve to Save Lives, of the global public fitness organization Vital Strategies. Cyrus Shahpar, former director of the C.D.C. Global Rapid Response Team, is the Director of the Epidemic Prevention Team at Resolve to Save Lives.
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