Prevent Epidemics • April 17, 2020
COVID-19 plan to “Box It In” includes strategic expansion of testing and building a corps of hundreds of thousands contact tracers in the United States
17 April 2020 – As states roll out plans to gradually re-open society,Dr. Tom Frieden, former CDC Director and President and CEO of Resolve to Save Lives, an initiative of global health organization Vital Strategies, today released a detailed report outlining critical actions governments and society must commit to – and invest in – to get ahead of the COVID-19 pandemic.
“Since the novel coronavirus started circling the globe, it has forced much of the world’s population into hiding, shutting economies and travel.,” Dr. Frieden said at a media briefing. “In order to go back out and reopen, we need to put the virus in a box. We’ve developed this strategy based on the extensive input from around the world as well as work of many dedicated public health professionals in the US and globally. There are four essential actions to box the virus in. All four are crucial: if any one is lacking, the virus can escape and spread explosively again.”
The report, based on a systematic review and first-hand experience in the U.S. and around the world by Dr. Frieden and colleagues at Resolve to Save Lives, outlines a roadmap to protect our healthcare systems, stop the spread of the virus, save lives, and help us gradually reopen society as safely and soon as possible.
The four essential actions of the plan are:
- Strategic expansion of testing. We must make diagnostic tests widely available and faster in order to quickly identify newly infected people. Depending on the level of control, number of cases and contacts identified, and decisions about the frequency and extent of testing in nursing homes, hospitals, and essential services, the number of tests being done per day could need to increase by a factor of 3 to as much as a factor of 20 compared with the number done in mid-April, which has been less than 150,000 per day. The top priority is to test every person with pneumonia, every sick health care worker, every ill person in nursing homes and other congregate facilities, their contacts, and people in clusters of disease that could be Covid-19. Ideally, every person with symptoms of COVID-19, and many more at risk would be tested.
- Isolate infected people. We must support every infected person so the virus stops with them – regardless of the setting. Those who do not require hospitalization but cannot be cared for in their homes safely will need supportive housing until they are no longer infectious. Each community must make hotels, dormitories, or other facilities that are safe and available for these people to isolate. Hospitals must safely care for and isolate patients and reduce health care workers’ risk of infection. And the nation’s 15,000 nursing homes need to take extraordinary action to prevent and stop spread of the virus, including screening staff and visitors regularly for illness and ensuring staff have paid leave so they stay home if they are sick.
- Trace contacts of people with COVID-19 through hundreds of thousands of contact tracers. To get ahead of the pandemic, we must trace all the contacts of infected people and warn them of their exposure to the coronavirus so they don’t spread the infection. For this unprecedented effort, we need to build, train, and supervise a corps of contact tracers nationwide and address the public’s concerns about confidentiality and privacy. Some technologies may be able to improve efficiency—although new digital tools are likely to supplement but not supplant traditional public health processes.
- Quarantine contacts. People who came into contact with cases and may have been infected are the leading edge of the pandemic. We must provide them with wraparound services so they can quarantine themselves at home until infection is ruled. Quarantining people who have been exposed to Covid-19 for 14 days after exposure prevents spread of the virus from those individuals and breaks the chain of transmission. Although some people can easily stay home and work or attend school remotely, others will require special support. We must ensure medical and social services are readily available so they can be tested and isolated at the first sign of illness, and provide appropriate temporary housing if this is required.
These four key actions will require U.S. officials to “revolutionize our public health infrastructure so that it is agile, data-driven” to address long-standing challenges, including mass incarceration, homelessness, mental illness, continuity of care, transfer of medical records and efficient care. The report notes that, “we have the resources to build the world’s strongest public health system, one that can curb this pandemic and effectively respond to future ones.”
The report also provides illustrative examples of global success stories, including testing expansion in Germany, health care policies in Singapore that protected healthcare workers, contact tracing in Wuhan City, China, and support systems for quarantined contacts in South Korea.
“Having a clear plan does not diminish its difficulty,” Dr. Frieden added. “We need real-time, accurate data to track the virus, and the people enlisted to find and respond to cases, clusters, and outbreaks swiftly and successfully must be highly trained and well supervised. Building this system will require leadership and a nationwide effort — but the health of our people and the wealth of our economy depend on it.”
The full report is available at: https://preventepidemics.org/coronavirus/insights/box-it-in/
To watch the full video and view the transcript from today’s media briefing, click here.
Christina Honeysett, Vital Strategies: firstname.lastname@example.org; +1.914.424.3356
Erin Sykes, Resolve to Save Lives: email@example.com; +1.646.612.0001
About Dr. Tom Frieden
Dr. Tom Frieden is former director of the US Centers for Disease Control and Prevention and former commissioner of the New York City Health Department. He is currently president and CEO of Resolve to Save Lives, a global non-profit initiative funded by Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill and Melinda Gates Foundation and part of the global non-profit Vital Strategies. Resolve to Save Lives works with countries to prevent 100 million deaths and to make the world safer from epidemics. @DrTomFrieden
About Resolve to Save Lives
Resolve to Save Lives is a five-year, $225 million initiative funded byBloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation. Resolve received additional funding from Bloomberg Philanthropies for the COVID-19 response. It is led by Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention, and is part of the global organization Vital Strategies. To find out more visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL
Resolve to Save Lives created a website called PreventEpidemics.org that shows how prepared each country is for an epidemic, including COVID-19, and how many flights are coming and going from infected countries. This site is also a resource for current coronavirus statistics and resources.
About Vital Strategies
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.