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Breaking the Chain of COVID-19 Transmission Begins at Home

Isolation of Mild Cases Can Save Lives by Breaking the Chain of COVID-19

In recent days, the rhetoric around the COVID-19 pandemic has shifted, from this being a problem that will solve itself to urgent calls to “flatten the curve.” That is, save as many lives as possibly by slowing the uptick of new infections to prevent health systems from becoming overwhelmed over a short period.

In the short history of this crisis, only two countries have successfully flattened the curve of new infections, thus breaking the chain of COVID-19: South Korea and China. Because they were prepared to take extreme measures that other countries are still not courageous enough to do.

One of those steps was to dramatically expand free testing and refine procedures for reporting new cases. The other key strategy was to isolate people with mild COVID-19 illness cases in hotels and dormitories instead of sending those sick and infected people back into shared accommodations or their family homes.

Household transmission is very difficult to prevent, and in multigenerational living situations, it threatens those populations most likely to die from the virus. Breaking the chain of household transmission is key, according to the World Health Organization. Isolation of infected people is one leg of a three-legged stool that also includes testing all suspected cases and properly quarantining close contacts.

Rapid Testing, Isolation Key to Breaking the Chain of COVID-19

Isolation of mild cases is a hard sell for families, friends and partners.

At a time of stress and uncertainty, we want to be with our loved ones. Isolating alone in an unfamiliar place can be painful, lonely and boring, especially if your symptoms are mild. You may even feel fine. But it is a critical step for interrupting transmission and ultimately saving lives.

Isolation seems to be working in South Korea and China, where COVID-19 transmission rates are declining. In Wuhan, China, the epicenter of the outbreak, no new daily infections were reported for the first time.

Here in the U.S., we are weeks behind–in both the curve of the outbreak and the response. Cases of COVID-19 are about to surpass South Korea, and our rate of new infections now closely follows countries where thousands have already died from the virus. Testing is still not universally available, as both anecdotes and data have shown.

Here in the USA, aggressive isolation of mild cases is something we can do right now. It’s tough, but temporary.  And it’s logistically feasible and affordable.

People with mild cases can be housed comfortably in university dormitories, hotels, or other available locations currently sitting empty.  Both public and private universities, and potentially the hospitality industry, could contribute to this effort while also freeing up urgently needed medical resources to be deployed for those at greatest risk. Leaders at all levels of government should immediately develop plans to launch this strategy as fast as possible.

We have the means, but do we have the will? Now is the time to be courageous. And courage requires both sacrifice and optimism, as I explained in my recent prescription for the troubled times of the COVID-19 pandemic.

We must believe in the best of ourselves as humans and members of a shared society. And that means believing that the hardest, most counterintuitive human response—going it alone­—will ultimately be the best choice for saving as many lives as possible.

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Moment of Truth for America: Coronavirus Epidemic Needs a United, Cross-partisan Crisis Response

The global response to the coronavirus health crisis has reached it’s moment of truth.

As an epidemiologist, I am no stranger to global pandemics. During my career, I have battled hantavirus and meningitis outbreaks in the USA and HIV and AIDS, tuberculosis and malaria across the world. Today, against all odds, we are winning: Almost two-thirds of people living with the HIV virus are receiving lifesaving treatment, and more than 30 million lives have been saved. 

This turnaround came about thanks to smart science and the dedication of individuals who did not flinch in the face of overwhelming denial and inaction.

One of those individuals is Ambassador Deborah L. Birx, M.D., who last week was chosen to lead the White House response to the coronavirus epidemic, reporting directly to Vice-President Pence. 

Cross-partisan approval: Birx the right choice to lead coronavirus effort

This was the right move for these uncertain times. Debbie is the Coordinator of U.S. Government Activities to Combat HIV/AIDS and U.S. Special Representative for Global Health Diplomacy. She has served under three Administrations, and is one of the few high-ranking Obama appointees to continue in her position under the Trump Administration.

I worked alongside Debbie at the State Department for years. I believe her data-driven, evidence-based approach and her knowledge of global health equips her to navigate the scientific and epidemic control issues within the federal bureaucracy.  She is honest, smart and a true cross-partisan leader.

My confidence in the Ambassador assures me that we will come through the coronavirus crisis with smart leadership–although we don’t yet know how serious the damage will be. But what about the next one? And the one after?

Climate Emergency and pandemics linked

This will not be the last pandemic. The climate emergency, along with unprecedented levels of global mobility, means that disease patterns are changing. We are not ready.

We see evidence of U.S. unpreparedness almost every hour as the current crisis unfolds. Our public systems are stumbling, testing kits are missing, essential supplies are unavailable and scientists are being muzzled. In a time of epidemic crisis, we must change gears and come together as a society to help each other, tempering our partisan reflexes.

Every person in America needs to wake up and get ready­—for coronavirus and what comes next.

My advice as an epidemiologist is to create a plan for preventing infection, illness and social disruption. Know what to do if your child’s school or your work close for a lengthy period. Make sure the elders in your family, pregnant women and vulnerable people in your lives are protected. Consider having extra food supplies and nonperishables on hand. These are good ideas even when no crisis is present.

My advice as a physician-activist is to call on our political leaders to stop blaming and start acting. Fortunately, Congress approved $8.3 billion of emergency funding to mitigate the potentially devastating health, security, and economic impacts of COVID-19 to the United States.  This large infusion of resources – and before a larger crisis unfolds – is vital to ensure that U.S. domestic responders are adequately preparing, support the global response needs, and develop a vaccine and countermeasures to ultimately end the pandemic. 

As we continue the full-throttle implementation of our current coronavirus crisis, let’s also take a longer view, as we will surely have to respond to new and resurgent emerging infectious diseases.  Preparing for the worst is a cross-partisan challenge and requires an apolitical response.

This is about policy, not politics.

Interconnected  pillars for global change

Last year when we launched Build a Movement 2020, we built it on five interconnected pillars of change. Today, I’m writing about one of those pillars, Gender and Health, and it’s impossible to disconnect it from two others: Restoring Democracy and Climate Restoration.

By building a cross-partisan movement of change we can collectively raise our voices about emerging threats like the coronavirus. By demanding our political leaders invest boldly in climate restoration, we can likely prevent and mitigate future outbreaks.

Comprehensive change demands comprehensive solutions. At this critical moment in history calls for us to leave behind segmented, partisan approaches of the past and forever change how we operate. Our goal is simple: ensure the survival of humanity. We do this with a comprehensive approach through prevention and rapid response to emerging threats. We do this by restoring trust with our government by healing our democracy.

No matter what comes next, I believe we will thrive, heal and strengthen our epidemic response systems–if we act with unity and compassion. Together, we can create a culture of trust, openness, and cooperation. 

This is our moment of truth. So what will we choose?