Jim Yong Kim, MD, emphasized in last week’s relevant reading that it is not too late to go on the offensive in fighting COVID-19. In his article, Dr. Kim emphasized five elements for containing COVID-19: social distancing, contact tracing, testing, isolation and treatment.
South Korea and Germany have thus far proven successful at flattening the curve and point to their ability to quickly create, produce and administer high volumes of SARS-CoV-2 tests. Testing was pursued in tandem with quick isolation and social distancing protocols. Recently, Anthony Fauci, MD, announced that the United States was going to be able to double its current testing capacity over the coming weeks.
A key component in testing strategy is the creation and administration of serology tests. The Infectious Diseases Society of America (IDSA) states that serology (antibody) tests “may be better suited for public health surveillance and vaccine development than for diagnosis.” However, serology tests are only one component, and the IDSA cautions that the “current antibody testing landscape is varied and clinically unverified, and these tests should not be used as the sole test for diagnostic decisions.” Adding to the difficulty are reports that a number of recently approved tests are resulting in false-positives. It should be noted that Wisconsin is nearing the Department of Health Services’ stated goal of 12,000 tests per day, although issues with access and awareness of available tests persist.
Contact tracing is also prominent in the fight against COVID-19. Earlier this week, a bipartisan coalition of former Bush, Obama and Trump administration officials called on Congress to scale up contract tracing and self-isolation capacity in the United States. Multiple health officials are emphasizing contact tracing as a major component of not only slowing the spread of COVID-19 but also for beginning to relax safer at home orders and reopen the economy. The coalition estimates that “the necessary contact tracing workforce needs to be expanded by 180,000 until such time as a safe, effective vaccine is on the market.” Additionally, they emphasized the need to ensure the health of primary care practices. Along with increased isolation capacity the coalition estimates, the proposal requires $46.5 billion in additional funds from Congress to achieve the level of contact tracers necessary. Current CDC Director Robert Redfield has also called for substantial expansion of contact tracing, and former CDC Director Tom Frieden estimates the overall need is 300,000 contact tracers. Last week, DHS announced its intention to hire an additional 1,000 contact tracers.
Treatment so far remains the most elusive component in the fight against COVID-19. Multiple clinical trials are beginning to produce their first results albeit with inconclusive, anecdotal or controversial conclusions. Remdesivir, chloroquine, hydroxychloroquine and azithromycin have been the most frequently mentioned possible treatments. Additionally, vaccine development is proceeding at a pace in tandem with clinical treatment trials. Multiple vaccine trials for COVID-19 are still in development or only recently begun, however a study from Oxford University is optimistic about having a vaccine ready by September. Pfizer also announced this week it hopes to have a vaccine ready by the fall.
Such trials and announcements are promising, but until an appropriate treatment and/or vaccine is developed, social distancing, testing, tracing and isolation will remain the best tools for fighting COVID-19 and flattening the curve.
Please contact HJ Waukau with questions.
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