I'm being asked about whether US Congress should convene a "911 commission" for the #COVID19 epidemic in the US?
My ANS: Certainly not now when we're still fighting the virus, maybe next year or after that. Also should it be the congress that convenes vs National Academies?
My ANS: Certainly not now when we're still fighting the virus, maybe next year or after that. Also should it be the congress that convenes vs National Academies?
Reason I say that is because I believe the focus of a commission should be to understand what went wrong (and a few things we did right). I don't think it should focus on assigning blame or send subpoenas flying. Here are the questions I think we might consider:
1. By January we knew what this virus was and that it was spreading through asymptomatic individuals. What did we do in January to get our public health infrastructure ready, and our nursing homes and meat packing plants prepared?
2. How did we miss the importation of the SARS CoV2 virus from Europe into New York City and miss transmission all through the month of February? We did not pick up our first case in NY until March 1.
3. What could we have done to halt the subsequent aggressive spread of the SARS CoV2 virus into neighboring NJ CT MA PA, the northeast?
4. Based on crowding in low-income neighborhoods and high rates of diabetes, HTN, obesity, renal disease among populations in poverty what could have done to protect African American and Hispanic communities? Why didn't we protect New Orleans, Detroit in the early days?
5. We knew from SARS CoV (and learned quickly with SARS CoV2) to achieve protective vaccine immunity we need high levels of virus neutralizing antibodies. Did we prioritize unproven vaccines that don't generally induce high VNA over more traditional vaccines approaches that do?
6. What could have done to better prepare and protect our highly populated southern states, FL, TX, AZ? We knew opening up these economies early would bring COVID19 back with a vengeance and now we're stuck.
7. Why wasn't there a centralized epidemiologic model based at CDC, why did we have to rely on UW, Penn, UT, other univs? Why weren't there models that broke it down by state and metropolitan areas coming out of the federal govt, or at least as a public private partnership?
8. Why wasn't there a well engineered national app based syndromic surveillance network done as a public private partnership with Google, Apple, or Kinsa?
9. Why wasn't there a national plan for recruiting contact tracers, focused on jobs for those unemployed by the epidemic who might be interested in this type of work, a WPA type program?
10. Why was public communication so awful? Why did we have to depend on uninformative and poorly organized White House briefings that never provided timely and urgent information.
11. Finally how can we address these issues so we never again have to face such a cataclysmic national public health collapse. How can we restructure pandemic preparedness? Do we need to reinvent the CDC or White House involvement? A new Dept. of Epidemics similar to DHS?
