All the evidence suggests that the COVID-19 Pandemic will eventually result in community spread in Arizona. The question is when. When it arrives, the response measures should change significantly from things like travel restrictions to activities like laboratory testing and capacity, hospital preparedness and other mitigation strategies.
Here’s a quick summary of some of the top priorities as I see it:
Laboratory Testing
Having the ability to test patient specimens in-state at the ADHS’ State Laboratory should be a top priority right now. Right now, specimens need to be sent to Atlanta at CDC which creates an unacceptable turn around time. Clinicians will need to know the results of tests quickly so they can make treatment and patient isolation decisions.
I saw an email from the ADHS suggesting that at least some testing capability will be available this week (Monday it says). Let’s hope it’s substantial and the capacity is adequate to meet the coming demand for tests.
Partner and Public Communications
Communicating with partners and stakeholders should be a top priority in response to any epidemic. Community partners like hospitals, primary care physicians, EMS, schools, health plans and businesses are starved for information at the beginning of an epidemic- and good information is needed in order for them to do proper planning.
PPE Inventory, Distribution and Conservation
There will be increased demand for personal protective equipment (PPE) for heathcare workers when community spread begins. Healthcare workers at every level will need to know what kinds of PPE are needed under what circumstances. Institutions of all types will need access to appropriate PPE and there should be an inventory tracking system that allows the sharing and bartering of PPE resources. PPE inventory tracking and resource allocation should also be a priority so there’s good information when PPE from the Strategic National Stockpile becomes available.
Discuss Mitigation Strategies
Discussions should be happening within the public health and health care communities about alternate standards of care and potential waivers of targeted regulations in case they’re needed. Additional discussions about which non-pharmaceutical interventions are likely already happening among health officials.
This week the CDC issued Interim Guidance for Administrators of Childcare and Schools to Prepare for and Respond to the Coronavirus“. Thankfully, it stops short of recommending school closures per-se, and makes it clear that those decisions are up to local authorities. We urge any school or pre-school to talk with your county health officials before even considering closing your school or pre-school as a result of a COVID-19 case.
Information about the evidence base for each NPI and considerations for their implementation is available in: Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017.
I’ll have more on the evidence base for school dismissal interventions in next week’s update.
Funding
There will be significant federal funds coming from the US government (via CDC) to assist with the response. Officials at the state and county levels are probably already discussing how to most effectively use those funds so that decisions aren’t being made at the last minute.
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