IDSA calls on White House to support guidance from public health experts on reopening US
As states begin to reopen despite the ongoing pandemic, the Infectious Diseases Society of America, or IDSA, released a statement calling on the White House to follow advice from public health experts when developing federal strategies to safely reopen school and businesses.
“We understand the economic pressures to reopen, but until we have widely available effective treatments and a safe and effective vaccine, policies that promote physical distancing are our best defense,” the statement said. “When it is safe to reopen, state and local governments need specific, evidence-based guidance from our nation’s top public health agency outlining the steps necessary to keep our population safe.”
More than half of states have eased social distancing measures, but many have not met the appropriate criteria, including the 14-day decrease in cases previously laid out by the White House.
“To backpedal now from the public health measures recommended by administration experts, without evidence or resources indicating it is safe to do so, would be dangerously irresponsible,” the statement said.
Plans for reopening
In addition to the 14-day downward trend in cases, the White House guidelines, “Opening Up America Again,” require states to have a similar downward trend in influenza-like and COVID-like illnesses reported over a 14-day period. These guidelines also state that hospitals should be able to treat all patients without crisis care and have robust testing programs for health care workers considered “at risk.”
A draft of the CDC’s full national guidance for reopening was set to be published last week. Parts of the guidance already appear on the agency’s website, but a source told AP News that CDC researchers were told that the full, detailed guidance “would never see the light of day.”
The full draft of the guidance — which the AP News source said was not cleared for public release — included information on reopening a variety of business and services, including child care programs, schools and day camps, faith organizations, and bars and restaurants.
Politico reported that a White House spokesperson said the draft guidance was “too prescriptive,” and the CDC was asked to revise its guidance.
However, Deborah Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health, stated in an interview with CNN that “no one has stopped those guidelines,” noting that the guidance is still being edited.
“It was more about simplification,” she said.
Tina Q. Tan, MD, a member of the IDSA Board of Directors and professor of pediatrics at Northwestern University Feinberg School of Medicine, told Healio Primary Care that the CDC’s draft guidance is “very detailed and comprehensive in addressing multiple different scenarios as to how to safely reopen various areas of the country.”
“It is extremely unfortunate that personal politics and beliefs, which do not take into account public safety, are overshadowing the CDC guidance — which is based on the best science available to protect the public,” Tan, who is also an attending physician in the division of infectious diseases and medical director of the International Patient Services Program at Ann & Robert H. Lurie Children’s Hospital of Chicago, said.
Considerations for reopening guidance
Several specific factors need to be considered before states and regions reopen, including widespread COVID-19 testing, particularly in rural communities and in populations with health and geographic disparities, Tan said.
In addition, states and regions must have the ability to diagnose, treat and isolate patients with COVID-19 safely, quickly and effectively, and test and trace patients’ contacts. They should also have health infrastructures with the ability to increase their capacity in the event of recurrent outbreaks, which Tan said includes having adequate personal protective equipment, as well as critical supplies and equipment like ICU beds and ventilators.
She stressed that efforts such as distancing measures, wearing masks and limiting public gatherings will be needed until effective therapeutics and a vaccine are available. States and regions should also experience a sustained decrease in COVID-19-related deaths and percentage of new cases identified, according to Tan.
“The goal of the CDC guidance should be to provide the best available scientific information to safely reopen various areas of the country while protecting the health and well-being of the population,” Tan said. “The goal should not be to change the guidance provided because it is not in agreement with the current administration’s guidelines.”
States planning, already reopened
Tan noted that as some CDC guidance is already available online, governors should work with their public health experts and the CDC to evaluate the guidelines and determine whether certain regions can safely begin reopening.
The CDC website currently offers guidance on reopening buildings after the shutdown and cleaning and disinfecting public spaces, workplaces, businesses, schools and homes that are reopening.
“For public safety reasons, states that have reopened before meeting the minimal requirements should reconsider reversing their decisions, especially in areas where there is a high risk of a resurgence of disease, which will have the potential to cause a large number of persons to be infected, an increase in hospitalizations and deaths, and the potential to overwhelm the health care system in those areas,” Tan said. – by Erin Michael
References:
AP News. Trump administration buries detailed CDC advice on reopening. https://apnews.com/7a00d5fba3249e573d2ead4bd323a4d4. Accessed May 11, 2020.
CNN. Birx: We're working with CDC to edit reopening guidelines. https://www.cnn.com/videos/health/2020/05/08/cdc-guidelines-birx-sanjay-cooper-intv-vpx.cnn. Accessed May 11, 2020.
Politico. White House says it ordered CDC to revise reopening guidelines. https://www.politico.com/news/2020/05/07/white-house-cdc-reopening-guidelines-243778. Accessed May 11, 2020.
White House. Opening up America again. https://www.whitehouse.gov/openingamerica/. Accessed May 11, 2020.
Disclosure: Healio Primary Care was unable to confirm Tan’s relevant financial disclosures at the time of publication.