According to Health Experts, Fighting and Preventing Pandemics Will Rely on Data and Funding

Key Takeaways:

• Data and information play an important role in preparing, identifying, responding, and recovering from global or national health crises.
• Diagnostic testing, contact tracing and health care capacity are critical to safely reopening the nation.
• To prepare for potential future pandemics, the U.S. should consider developing capabilities for predicting and tracking diseases, medical countermeasures, and protected federal budgets for public health efforts.

Dr. Tom Frieden, President and CEO of Resolve to Save Lives, and former Director of the Centers for Disease Control and Prevention, along with Dr. Caitlin Rivers, Senior Scholar at the Johns Hopkins Center for Health Security testified before the House subcommittee yesterday to give their views on how the country should safely reopen and how to prevent future pandemics.

In his opening statement, Frieden said, “until we have a vaccine, we must have a comprehensive strategy and use data to drive our policies and programs in order to save lives and restore the economy.” He gave three core concepts for pandemic response:

• Adaptive Response – which recognizes the need for different approaches to reducing COVID-19 infections, in different areas at different times.  
• Box It In – which is an approach to test, isolate infected people, and warn and quarantine people who have come in contact with infected people.
• Finding the Balance

Friedman expounded upon ten truths that he believes about COVID-19:

1. It’s really bad.
2. As bad as this has been so far, we’re just at the beginning.
3. We need to be guided by the data.
4. We will be able to begin to reopen as soon and safely as possible by basing decisions on data and creating a new normal.
5. We need to find the balance between restarting our economy and letting the virus run rampant.
6. It’s crucially important to protect the health care workers and other essential staff.
7. We must protect our most vulnerable people.
8. Vaccine and therapeutics.
9. We must heighten, not neglect, our focus on non-COVID health issues in order to increase personal and community resilience.
10. Never again!

According to Friedman, “We need accurate and real-time monitoring to track trends in symptoms, emergency department visits, tests, cases, hospitalizations, deaths, community mobility, and more.” Additionally, Friedman stated that after flattening the curve, testing, isolation, contact tracing and quarantine are essential next steps to “box the virus in.” He believes, “If we do all of these four things well, even if we don’t have a vaccine, we can begin to return our society and economy to a more normal footing.”

Friedman stated that future outbreaks are inevitable. However, to his tenth truth of “never again,” it’s not inevitable that we are unprepared.” He commended the supplemental funding provided in the federal stimulus packages, but advocates for sustained support for “specific public health programs that are critical to prevent, detect, and respond to health threats.”  Friedman referred to this concept as the Health Defense Operations (HDO) budget designation, which would exempt these programs from budget control efforts such as sequestration. He suggests that HDO programs submit a “bypass professional judgment budget” to Congress annually, similar to the three that NIH currently delivers to explain true resource needs for cancer, HIV/AIDS, and Alzheimer’s research.

In River’s testimony, she stated that the U.S. still faces 25,000 to 30,000 new cases and approximately 2,000 deaths per day. Now that the U.S. is gradually transitioning to reopening, she believes there are three capabilities that are needed to do this safely: diagnostic testing, contact tracing, and health care capacity.  

Rivers stated that contact tracing is the mechanism by which data is gathered that provides critical information about how and where the virus is spreading.  “The Federal government should provide guidance around what data should be collected during contact tracing, and states should be encouraged to follow that guidance and publish data about who is getting infected, and in what settings,” advised Rivers.

For the future, Rivers believes that outbreak science and medical countermeasures for unknown threats need to be prioritized. Both these measures would better equip the nation for future pandemics.  Infectious disease modeling, also known as outbreak science, is guiding current COVID-19 response efforts, but that expertise is not an on-going capability within the current federal structure. Rivers stated that HHS currently has a few small teams with this expertise, but not enough capacity needed during a pandemic. Rivers advocates that the federal government establish an organization to perform epidemic forecasting and analytics, much akin to the National Weather Service. “Such a center could be relied upon to produce disease forecasts and analytics to support high-consequence policy decisions made by federal and state officials who are working to protect the public,” she stated.

According to Rivers, “Our best defense, in addition to a strong and well-funded public health system, is safe and effective medical countermeasures.” Medical countermeasures are FDA-regulated biologics, drugs, or devices that may be used in the event of a potential public health emergency. Rivers recommends funding and developing a strategy for accelerating the development of medical countermeasures for unidentified infectious disease threats.

Data, information, and funding will allow the nation to properly test, trace, diagnose, increase health care capacity in order to reopen safely.  Additionally, expanded or new federal capabilities for predicting and tracking diseases, and rapid medical countermeasure development, backed by secure budgets will help prepare the U.S. for future potential pandemics.