State officials are meeting to decide when to re-open Florida as the number of new coronavirus cases starts to go down. But public health experts say doing so too soon could be dangerous.
Health News Florida's Stephanie Colombini talked about what the next steps are with Dr. Marissa Levine, a professor in the University of South Florida’s College of Public Health and former state health commissioner of Virginia.
You worked in health departments for 16 years. What do they need to do to get communities up and running again, where we won't have to completely shut down every time there's more cases? And are departments prepared to do it?
That's a great question. So even before the pandemic, public health departments were dealing with disease outbreaks. They were doing identification of cases, isolating them if needed – tuberculosis would be a good example – finding all of the contacts of that individual and appropriately managing them. In this case, it would be quarantine, but in other cases, maybe provide treatment if treatment is available. Those things happen every day in public health.
The problem is that the community in general and policymakers don't appreciate how that is the foundation then to ramp up for bigger things like pandemics. And I would hope that one of the lessons from this is that we realize we can't underfund that infrastructure, that public health infrastructure, because we need it going forward.
Right now, we have to do two things: we have to build that infrastructure in some places, and then we have to ramp it up even further.
There's some estimates that somewhere between 15 and 81 additional staff per 100,000 population may be necessary to do the case identification and contact tracing that will be necessary to continue. It's going on now, but it's going to need to be ramped up.
How does continuing to test for the virus play a role?
If we can settle down COVID-19 in our communities to a low enough level that we start getting people moving around, then we're going to have to know where new cases pop up, and we're going to have to know that rapidly. So we're going to need testing that provides a rapid reaction or result. We don't have that as extensively as we need it.
And then we're going to have to have a much better idea of who out there is already immune to COVID-19 and might be able to go back to work and not have to be as concerned about their own health. So that's a whole other testing piece that we're going to need.
It’s hard to see how reopening in, say, a month is possible if all of this stuff has to happen first. I know this is unprecedented, but are there any examples you can share of governments sort of finding a way to pull it together?
Societies, when they're challenged, can either rise to the occasion or they fold. I think we easily can rise to the occasion here.
I'll just take South Korea as an example. A lot of people talk about their response as a really excellent response. Their response capability grew out of the Middle Eastern Respiratory Syndrome, ‘MERS’, that happened a number of years ago.
They were really caught off guard and had a significant number of deaths and faced a lot of criticism. But they said to themselves we’re never going to let this happen again. And so when COVID-19 came about, they were actually incredibly prepared. They had all the things that I was talking about. And so they've been able to manage it.
Now they're a much smaller country. But it really was more of an appreciation of the lessons learned and having the political will to move forward and do what they need to do. I would think our country with our resources, with our ingenuity, we should be able to figure this out.
And maybe lots of good things will come out of it, including reevaluation of how we set up access to health care, for example, how we connect people in our communities, and generally how we make political decisions about these critical infrastructures that we need.
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