key: cord-0955780-7qsa3tom
authors: Solano, Joshua J.; Maki, Dennis G.; Adirim, Terry A.; Shih, Richard D.; Hennekens, Charles H.
title: Public Health Strategies Contain and Mitigate COVID-19: A Tale of Two Democracies
date: 2020-08-15
journal: Am J Med
DOI: 10.1016/j.amjmed.2020.08.001
sha: b0efe964a79591d17204c076f174aef315976cc9
doc_id: 955780
cord_uid: 7qsa3tom

nan

UpToDate; receives royalties for authorship or editorship of 3 textbooks and as co-inventor on patents for inflammatory markers and cardiovascular disease that are held by Brigham and Women's Hospital; has an investment management relationship with the West-Bacon Group within SunTrust Investment Services, which has discretionary investment authority; does not own any common or preferred stock in any pharmaceutical or medical device company. populations, the US has 47X the number of cases and 79X the number of deaths.

(1)

In South Korea, immediate containment strategies included widespread, free and rapid, point of care testing, as well as meticulous tracing and quarantine of all contacts. In addition, effective mitigation strategies included masking, social distancing, crowd avoidance, and frequent hand and face washing. South Korea continued these effective containment and mitigation strategies until new cases and deaths were practically nonexistent, which followed well accepted public health principles (4). The time period for these mitigation efforts extended far beyond the flattening of the curve.

In the US, in 2013, the Bill and Melinda Gates Foundation conducted a comprehensive review of worldwide data and predicted that a pandemic would occur during the next decade, most likely due to coronavirus. In 2015, the US government created a Pandemic Emergency Response Task Force which was disbanded in 2018. Ironically, in early 2016, the World Health Organization noted that the US was in the best position of any country to address any future pandemic. This continued politicization of the US CDC is producing further harm to its longstanding reputation and role as the model for disease control and prevention activities throughout the world. (7) In COVID-19, South Korea has served as a model for the world, as have million Americans developed the Spanish flu, of which 675,000 died. In that pandemic, whose epicenter originated and remained in Europe, the US accounted for >9% of cases and >1.5% of deaths. (2) We strongly concur with all responsible health professionals that there is an urgent need for a unified national approach to implementation of effective public health mitigation strategies including social distancing, masking, avoidance of crowds, as well as frequent hand and face washing. These simple measures are likely to be at least as effective as any safe vaccine that may be developed and approved for widespread use by the general public. While the public health strategies of containment and mitigation were effectively implemented in a nationally coordinated effort in South Korea, the current trajectories in the US may no longer be materially alterable by anything less than a coordinated national shutdown of sufficient duration which was not achieved previously. Without these efforts it is plausible, if not likely, that the exponential growth of the virus will continue as reflected by the markedly decreasing number of days to achieve each million case in the US from 97 to 44 to 28 to 15 days. Last but not least, the failure to mitigate COVID-19 in the US will paralyze the healthcare delivery system and decrease the ability to provide lifesaving measures for patients with COVID-19 or other serious conditions. Thus, it is now imperative that the US abandon "pandemic politics" and focus on effective public health strategies.

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Republicans and Democrats even more far apart in coronavirus concerns

Facebook deleted a viral video full of false coronavirus claims: Then Trump shared it on Twitter

The best global responses to COVID-19. Time Magazine

We are indebted to Peter Grossman for his advice.