Well being consultants need to give attention to ‘new regular’ with the coronavirus
On Thursday, the Journal of the American Medical Association (JAMA) published three opinion pieces from six former advisers to the Biden administration. They were part of the transition team about a year ago when President Biden took office, and include people like Luciana Borio, a former acting chief scientist in the Food and Drug Administration and oncologist and former Obama Administration advisor Ezekiel Emanuel, who is a medical ethicist and professor at the University of Pennsylvania.
Each opinion article deals with a different aspect of a national strategy: a “new normal” life with COVID-19, Testing and mitigation, and Vaccines and therapeutics. In the first article, which outlines a “new normal”, the authors write: “When designing a national strategy, humility is essential. The exact duration of immunity to SARS-CoV-2 through vaccination or previous infection is not known. “
They continue: “It is imperative to public health, economic and social functioning that US leaders set specific targets for COVID-19 management, benchmarks for imposing or easing public health restrictions, investment and reform and communicate what is needed to prepare for future SARS -CoV-2 variants and other novel viruses and clear strategies to achieve all of this. “
The experts write that the goal of a “new normal” is not the eradication of SARS-CoV-2 and COVID-19 or what other countries call “zero COVID”. They are calling for recognition that this coronavirus is one of the many types of viruses that regularly circulate in our population and saying we should focus instead on “the overall risk of all respiratory virus infections”.
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In the JAMA article on testing, surveillance and containment strategies, the experts urge the Centers for Disease Control and Prevention to “collect and disseminate accurate, real-time population-based incidence data on COVID-19 and all respiratory viral diseases.” They say the U.S. needs a comprehensive testing and reporting system and needs to be linked to sociodemographic, vaccination, and clinical outcome data. The authors also point out the need for inexpensive tests like rapid antigen at home, the administration plans to use 500 million of them to distribute, but experts doubt whether this will be enough and whether the process for running the tests will be clear and fair.
With regard to monitoring, the experts emphasize the need for environmental monitoring with waste water and air sampling. They are also calling for more genomic monitoring to look out for new variants. “The US needs to set up a real-time digital surveillance system with opt-out to monitor all vaccinated individuals for the frequency and severity of side effects, post-vaccination infections, and deteriorating immunity,” the authors write. “Two years into the pandemic, the US still relies heavily on data from Israel and the UK to assess the effectiveness and shelf life of COVID-19 vaccines and the rate of breakthrough vaccine infections.”
The former advisers believe that updated vaccines will eventually be needed, but they also say the government needs to do more to develop them and use them efficiently. “Mandates are required to achieve a vaccination coverage of 90% of the population,” the authors write. “Few countries have ever achieved this level of immunization coverage for a non-vaccine vaccine.”
These JAMA opinion articles were shown to White House officials prior to their publication, and the authors say they wrote them in part because discussions with them went nowhere, like that The New York Times. According to the Times, Borio says, “From a macro perspective, it feels like we’re always battling yesterday’s crisis and not necessarily thinking about what needs to be done today to prepare for what’s to come.”
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