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PUBLIC HEALTHQ: How quickly do we need this program?
A: What I ɿnd very frustrating right now is
that there’s a lot of appetite, particularly in
Congress and at the federal level, to open
things up and provide as much money
as possible to help people who’ve lost
their jobs and small businesses, which is
absolutely important. %ut so far, we’re not
willing to allocate a fraction of the amount
of money that is being dedicated to eco-
nomic issues to actual public health and
managing this pandemic, without which
we are going to be in big trouble.Q: What do you mean by “big trouble”?
A: If we open everything up without
restrictions and without the capacity to
test and isolate cases and contact-trace
and put people in quarantine in their
homes, we’re going to see a large
resurgence of the virus, possibly much
worse than we have seen already.
If we open things up without
protections in place, without capabil-
ities to manage the virus, then it will
burn through our population. We’ll
see many, many more deaths. Thethose jobs right now. It would be an
opportunity to bring them in as part of
the workforce. I’ve had so many emails
from people with an interest in contrib-
uting to this. I think there’s this feeling
around the country that they want to be
able to give back and to do something
that can help control this pandemic.
Q: Can technology be used as a
workforce multiplier?
A: Technology [such as smartphones
and apps] potentially can help us iden-
tify who might have been in your close
vicinity when you went to the grocery
store and had mild symptoms, and
maybe didn’t even understand that you
were sick. That can help public health
see who those people are, but then also
notify them and follow up with them.
Q: What about privacy?
A: The desire to keep people totally
anonymous is understandable. We
don’t want unauthorized sharing of
potentially sensitive information about
people. %ut we need to make sure that
any applications that are helping with
contact tracing are accessible and
usable by public health to actually ɿnd
people, notify them and take steps that
they need to help control the spread.
Public health does contact tracing with
very sensitive information all the time
and this is what they’re used to doing.
Q: How many tests per day would we
need for contact tracing?
A: At least million a week. %ut it’s hard
to put a ɿrm number on it, and it’s going
to change as the epidemic changes in
different parts of the country, because
the less spread we have, the fewer tests
we’ll actually need. It’s a moving target.
Right now, the White House has said
we’re doing something like a million tests
per week. Even though we have all those
tests, they’re not being used to their
greatest extent. There are lots of bottle-
necks—limits on the numbers of swabs
and reagents. There may be excess ca-
pacity in some places but problems that
are preventing them from being used.
One problem we’re running into
now, though, is that the testing isn’t fast
enough. Even if someone gets a test,
they may wait for days before we get the
results. We have to act faster than that.
death rate might skyrocket because
hospitals will become overwhelmed.
That’s what we’ve seen in other parts
of the world, when we let this get out of
control. Hospitals cannot care for the
people who need care in the way that
they need it and many more people die.
Sorry. It’s pretty stark.Q: How much higher are mortality
rates when emergency rooms are
overwhelmed?
A: In some locations that have managed
this well, the mortality rate could be un-
der 1. In Sweden, where they have not
had the same kind of social distancing
measures in place, the last ɿgure I saw
was that the crude mortality rate was
9 . In the north of Italy, where hospitals
were very overwhelmed, mortality
sometimes reaches double digits.Is your report getting traction in
Washington?
A: Congress is debating the next pack-
age of emergency funding. We’ve had a
lot of discussion.“IF WE OPEN THINGS UP WITHOUT
PROTECTIONS IN PLACE,
WE’LL SEE MANY, MANY MORE DEATHS.”
MAY 22, 2020