A recent viewpoint piece in JAMA presents three experts’ opinions about what officials should focus on as countries learn to move forward with COVID-19.
Dr. Ezekiel J. Emanuel, an oncologist and bioethicist at Perelman School of Medicine at the University of Pennsylvania, who has served as special advisor for health policy to the director of the Office of Management and Budget in the White House.Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis.Dr. Celine R. Gounder, an infectious disease physician and epidemiologist at Grossman School of Medicine, New York University, New York, and a medical journalist.
For this reason, some experts are advocating for a reevaluation of goals and public health strategies moving forward. The authors of the recent article advocate for strategies that improve data collection, health response, and public trust.
Many scientists believe it is impossible to eradicate COVID-19. The authors of the JAMA article explain that “Infectious diseases cannot be eradicated when there is limited long-term immunity following infection or vaccination or nonhuman reservoirs of infection.”
COVID-19 has affected many countries of the world immeasurably. Governments are coming to terms with the fact that SARS-CoV-2 may not go away, and countries face the need to consider their national strategies and implement appropriate risk assessments.
Three experts penned the piece:
The authors believe that humility is critical when creating and changing COVID-19 policies.
They note that there are multiple unknowns and that data will continue to evolve. A few key uncertainties include:
How long immunity from vaccinations or previous infections lasts.Whether or not the virus will become seasonal.The effectiveness of antiviral therapies in preventing long COVID.Whether new variants, which may be more transmissible, virulent, or immune-evading, will arise. The authors note that “[t]he goal for the ‘new normal’ with COVID-19 does not include eradication or elimination, e.g., the ‘zero COVID’ strategy.”
They explain that neither vaccines nor acquiring infection with the virus appear to give anyone lifelong immunity. According to the long-term aspects of SARS-CoV-2, they note that nations need to look at SARS-CoV-2 in relation to the impact of other respiratory viruses. Policymakers then need to consider strategies that will help reduce the impact of these viruses overall.
The authors recommend establishing a risk threshold in line with other respiratory illnesses in years where the severity of these illnesses was high. They note that this threshold at peak weeks would help agencies know when to implement emergency measures. It would also help healthcare systems plan what they need for surges and at a maintenance level. A risk threshold needs to consider three main factors:
The authors note that policymakers need to determine their goals in relation to COVID-19 and then communicate them clearly to the public. Local governments can then adapt national recommendations at the local level. Their piece notes four main components to help respond to the COVID-19 pandemic.
Considering these factors, the experts recommend several vital elements for public policy and overall health promotion. weekly deathshospitalizationscommunity prevalence