With evidence of local transmission in multiple US states, it’s time to end quarantine of well travelers. These measures are not working as divert sorely needed public health resources from community preparedness
I’m often asked if travel bans and associated can buy time to get ready. The answer is they only help if we know what countries have disease and what don’t. And if we use that time to actually prepare.
But with cases in US being reported in people who never traveled and people who traveled to countries other than China, it shows us that we have NO IDEA where in the world the virus is and where it isn’t
In many countries, including US, myopic focus on travelers from China for screening and testing for #COVID19 means we miss cases who were infected elsewhere.
We are find cases in MULTIPLE US states at once because we just expanded who can get tested. This tells us that other cases may have been occurring before these particular ones were found.
How many #COVID19 cases have occurred in the US to-date? We simply don’t know. Ask clinicians if they’ve seen patients that could have have been cases, but weren’t diagnosed because of overly restrictive testing criteria. You’ll probably hear a bunch of yes’s.
This is why it is so essential that we expand access to testing. To empower clinicians to treat their patients, to understand where and how many #COVID19 cases are out there.
And we need to do more testing to inform our understanding of where, whether and how to implement measures to reduce the impact of virus on our communities.
As for protecting communities, it is important that we end the practice of quarantining well travelers from China. The list of countries reporting transmission is growing by the day. We cannot possibly think a China-focused strategy is still relevant.
We can’t expand quarantine policies to include other countries because even focusing on JUST China has been incredibly disruptive to our preparedness efforts. Health departments have had to devote extraordinary resources to these efforts and that’s hurt preparedness
In light of local transmission in US, we need to free up public health workers to act to protect our communities. Let them find cases & isolate them at home, identify and monitor contacts of cases, prepare health system, protect vulnerable populations like nursing homes.
Case counts are going to increase rapidly in the US. Some measures like contact investigations can only be done while we have small numbers of cases. But it’s essential we do them to learn about disease—aspects like its attack rate, severity, incubation period.
The knowledge that these investigations will provide will help to inform plans for what, if any, community level measures we could take to slow spread of virus. Should we close schools, cancel gatherings,etc? Whether we should do this depends on knowing more about cases in US
But the investigations we need to do, the planning that we need to protect communities is made harder when we continue to divert public health officials from these jobs by making them quarantine and monitor plane loads of well people.
With cases spreading in US it is time to end this disruptive practice of large-scale quarantine of travelers. We need to reapply public health resources towards activities that are more likely to be effective and are now very much needed.
