THREAD: Our path to safety rests on massive support for our healthcare system to care for sick, and forceful steps by local leaders to break chains of transmission and quell epidemic spread. If we’re smart and aggressive across nation, cases nationally could peak by late April.
Then what’s next? We’ll be able to transition away from population based tactics aimed at keeping people at home, to more case based interventions that target people with disease. But we’ll need new public health tools, technology, and tactics to make this transition work.
What is that toolbox? 1. We need a massive sentinel surveillance system that identifies outbreaks early, serology testing to understand background risk and patterns of spread, and point of care diagnostics with liberal use by providers and tools for rapid reporting of results.
I outline some of the regulatory and policy steps needed to achieve this surveillance framework in a paper published tonight along with Mark McClellan and Lauren Silvis: healthpolicy.duke.edu/news/covid-19-…
2. Next, we need a therapeutic. We should be able to develop a recombinant antibody by summer that directly targets the virus. This can be both a prophylaxis and a treatment. Regeneron is one group developing this. They successfully made such a drug against MERS and Ebola.
We may also have by summer or fall an anti-viral drug that acts directly against the virus. Remdesivir by Gilead is one of many agents showing preliminary activity. Such a drug can be used as both treatment and potentially post exposure prophylaxis if side effect profile is good
If we can couple massive surveillance to identify sparks of transmission early, before they become fires; and couple that with a therapeutic to prevent infection in those at highest risk or treat early those who may get into trouble, we can turn COVID-19 in a a manageable threat.
As we get control of the current epidemic, we can transition away from the onerous population based mitigation and toward more fine tuned interventions; and ultimately use our exquisite technology to make sure that #coronavirus is never able to threaten us in the same way again.
