Published by the Students of Johns Hopkins since 1896
May 26, 2020

Guiding documents suggest policies as states slowly re-open

By AMRITA BALRAM | April 30, 2020

As the number of coronavirus (COVID-19) cases is steadily declining in some states, restrictions are slowly being lifted. President Donald Trump recently released a three phase approach called “Opening up America Again” for state governors to follow at their own discretion. 

On April 10, experts in the Bloomberg School of Public Health collaborated with the Hopkins Center for Health Security (JHCHS) and the Association of State and Territorial Health Officials to release “A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the U.S.” The document contains guidelines to ensure that testing and case-by-case intervention increase as social distancing measures ease.

The document begins with the main takeaways from previous outbreaks around the world, such as South Korea’s extensive contact tracing in response to the Middle East respiratory syndrome outbreak. The document describes how successful efforts to trace Ebola cases in the U.S. are important to consider with COVID-19 but must be applied on a larger scale. 

The authors of the guiding document also urge other states in the U.S. to follow an initiative in Massachusetts to expand the public health workforce to trace the spread of cases. The document also details the necessary training, management and technology for contact tracing to be effective.

Mathew Watson, a senior analyst at the JHCHS and a senior research associate at the Bloomberg School of Public Health, is a contributing author to the document. He was a part of the team that wrote a section of the document that outlines how contact tracing can be executed on a local, state and national scale. 

“Our goal with this and other reports that we’ve been producing is to inform government policy such that we save the most lives and prevent the most infections,” he said in an interview with The News-Letter.

On the national level, the documents recommend that Congress should increase energy function to state and local health departments, aid public health agencies to increase their workforce and provide liability protections. An estimated $3.6 billion is the recommended amount in the next stimulus package in order to initiate training and expand the workforce. 

Watson’s team used policy analysis in order to determine these specific guidelines for the government. In order to make reasonable recommendations, Watson said that analyzing historical data was imperative.

“We relied heavily on our existing knowledge base, a sense of how we’ve responded to past high-consequence epidemics and pandemics, as well as our read of the current situation to achieve some measure of pandemic control,” he said.

Experts at the JHCHS have studied the public health sector for years and believe that the U.S. is not prepared at the local, state or federal level to contact-trace every case of COVID-19. 

Personally, Watson is interested in how technologies can be developed and used to control outbreaks. He was responsible for the analysis of the federal budget in health security and estimating the funding needed to implement effective contact tracing in order to flatten the curve. 

The JHCHS, Watson noted, has been working on pandemic preparedness since 1998. 

“Our team is very multidisciplinary, and as a result can come to a more holistic and informed view on what the issues are and the most effective ways to address them,” Watson said.

In order to move forward toward reopening states, cautionary recommendations in this guiding document should be followed. By upscaling the public health workforce, contact-tracing every positive case will slow the spread and end social distancing sooner. Recommendations from Hopkins and similar academic institutions to focus on case-based intervention, Watson argued, should be taken seriously.

“Academic centers like ours are well positioned to provide our advice and council to governments, as we're able to be authoritative, responsive and unbiased,” Watson said.

He anticipates that similar guiding documents will be released in the future, suggesting policies that are rooted in medical and scientific recommendations. 

“In an event like this, there’s going to be a constant need to translate the science of health security into actionable policy. That’s a unique skill set that I and my colleagues at the Center have spent years honing,” he said. “We hope it’s of service, both now and into the future.”

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