A draft national strategy to reopen the country in phases, developed by the Federal Emergency Management Agency and the Centers for Disease Control and Prevention, emphasizes that even a cautious and phased approach “will entail a significant risk of a resurgence of the virus.”
The internal document, obtained by The Washington Post, warns of a “large rebound curve” of novel coronavirus cases if mitigation efforts are relaxed too quickly before vaccines are developed and distributed or broad community immunity is achieved.
About 26,000 people have now died from the coronavirus in the United States, and more than 608,000 cases have been reported.
The framework lays out criteria that should be in place before a region can responsibly ease guidelines related to public gatherings: a “genuinely low” number of cases; a “well functioning” monitoring system capable of “promptly detecting” spikes of infections; a public health system able to react robustly to new cases and local health systems that have enough inpatient beds to rapidly scale up in the event of a surge in cases.
This would seem to necessitate ramping up testing and production of personal protective equipment at levels not currently being done.
Trump said during Tuesday night’s briefing that “the plans to reopen the country are close to being finalized,” but he has not committed to following these or other recommendations, according to Lena Sun, Josh Dawsey and William Wan. Others involved in the administration’s response are apparently drafting their own plans, part of the patchwork of groups and task forces tackling what’s undeniably the biggest challenge facing the country right now.
Reading the 10-page executive summary of the proposed public health response offers a window into the discussions happening inside the government about how to practically and responsibly ease toward reopening. For example, the document says the first priority should be reopening places where children are cared for – including K-12 schools, daycares, and summer camps – so parents can return to work.
The report outlines three levels of mitigation: low, moderate and significant.
In areas of moderate risks, for instance, schools would be advised not to hold assemblies or sporting events while staggering start times to minimize concentrations of people.
Trump noted Tuesday, April 14, 2020, that about 20 states have avoided the worst of the outbreaks and suggested that governors in these places may be able to restart parts of their economies even before May 1 – something the CDC-FEMA document does not appear to envision.
The CDC also wants to create a COVID-19 Response Corps.
The draft envisions hiring 670 people to help state and local health departments quickly scale up contact tracing. Tracking down people an infected patient interacted with so that they can self-quarantine and thus not further transmit the disease, is a deeply labor-intensive process.
Considering the large number of continuing infections expected, 670 people are a relatively small number.
To augment that, CDC officials imagine using “app-based case and contact investigations.” Countries like South Korea have done that, by using someone’s cellphone to track their movements, in ways that would provoke high-stakes civil liberties debates in this country.
Immunity to the virus remains a big question mark amid these deliberations.
One idea being discussed at the highest levels of government is that people who appear to have recovered from COVID-19 should be granted a certificate of immunity, which would give them clearance to work and do other activities. “But the proposal is mired in the slippery science of this new virus,” Joel Achenbach, Carolyn Johnson, and Paige Winfield Cunningham report. “No one knows whether a recovered COVID-19 patient is actually immune to a new infection — or if they are immune, how complete or long-lasting that might be. Some kind of immunity post-infection is the most plausible scenario for COVID-19 patients.
That’s the pattern with most infectious diseases. Yet there are preliminary reports out of South Korea and China, not yet peer-reviewed but gaining broad attention, that has surprised and baffled scientists. Some survivors test positive after they’ve been officially cured. They also have widely varying amounts of antibodies — abundant in some survivors, undetectable in others.”
That’s why serology testing, which looks at blood serum to determine the presence or absence of certain blood proteins to show if a person has developed antibodies to the virus, is so important. This could help policymakers answer some of the questions that will determine the pace of reopening. Thousands of volunteers across Major League Baseball, including players, will participate in what’s believed to be the largest antibody study in the country.
The number of coronavirus tests being analyzed daily by commercial labs plummeted more than 30 percent over the last week. It’s not clear if the drop-off maybe because of the narrow testing criteria that the CDC revised in March, prioritizing hospitalized patients, health-care workers and those thought to be vulnerable, Politico reports. But after being overwhelmed for weeks, commercial labs say they’re now sitting with unused testing capacity waiting for samples to arrive.
Sources:
Washington Post: The Daily 202: Leaked CDC and FEMA plan warns of ‘significant risk of resurgence of the virus’ with phased reopening
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