A growing understanding of the unique features of COVID-19 is making it possible for policymakers to develop strategies that safeguard public health while allowing people to get back to work, concludes a study-in-progress by a group of prominent physicians and researchers.
The study, “A New Strategy for Bringing People Back to Work During Covid-19,” initially published on April 14 by the Foundation for Research on Equal Opportunity (FREOPP), is regularly updated to account for new data and posted at freopp.org. Its five authors and contributors are experts in medicine and public policy.
First and foremost, the authors point out, is COVID-19’s “heavy skew toward bad outcomes in the elderly and near-elderly who also have other chronic diseases. With the proper precautions and tools like contact tracing, self-quarantines, and telemedicine, we can continue to protect the most vulnerable, while returning as many Americans as possible to work.”
Tailoring Orders
Much of the pushback against reopening has been the idea another surge in COVID-19 cases could occur and a second shutdown would be more economically devastating than the first. Targeting protection for the vulnerable would solve that problem, says Avik Roy, cofounder and president of FREOPP and one of the study’s authors.
“States should be thinking about a tailored approach to stay-at-home orders rather than a shutdown for everyone,” Roy told Health Care News. “The purpose of the lockdown was not to prevent every American from contracting the virus, but instead to prevent our health care system from becoming overwhelmed.”
That has been accomplished, says Roy.
“It’s now time to reopen businesses, schools, and workplaces,” said Roy. “Individuals who are most at risk based on their age or underlying health conditions, as well as any family members who live with them, should continue to take extra precautions to avoid getting sick. The economy should reopen for everyone else.”
‘Exacerbated the Outbreak’
Forty percent of COVID-19 deaths occurred in nursing homes and assisted living facilities, according to FREOPP, which suggests the broad-based shutdowns may have come at the expense of vulnerable populations.
“Rather than using blanket shutdowns, much more attention should be paid to the risk of infection in nursing homes, especially through nursing home staff who work at multiple facilities,” said Roy. “Employees should be limited to working at one facility to avoid spread.
“A big problem is that some states have forced nursing homes to accept patients who had been discharged from hospitals after being infected, which has exacerbated the outbreak by bringing the infection back to the most at-risk population,” said Roy. “States should instead contract with empty hotels to house COVID-19 patients until they are no longer contagious.”
Huge Economic, Health Effects
The study notes the mass shutdowns have had major economic and public health consequences.
An analysis by Moody’s Analytics found the stay-at-home orders have reduced U.S. economic output by 29 percent in just a few weeks. The study quotes research by the University of Illinois, Harvard University, and the University of Chicago estimating 100,000 small businesses have already closed permanently, with more closures to come.
On the public health side, much care has been ignored or neglected. The study notes organ donations and transplantations have declined precipitously during the outbreak, harming those with serious health problems such as end-stage liver disease.
“The public health impact of a shutdown, including fewer vaccinations, diagnostic screenings, and doctors’ visits for treatment of other diseases, is yet another reason why we can’t afford to stay shut down,” said Roy.
Putting Off Cancer Screenings
The study’s concerns about people foregoing examinations in the midst of the pandemic are supported by findings just released by the IQVIA Institute for Human Data Science. As a result of a sharp decline in cancer screenings nationwide, the report projects more than 80,000 diagnoses of five common cancers will be lost from March through early June.
Citing data from the study, the Washington Times reported on May 15 the number of mammograms has dropped by 87 percent since February. Colonoscopies declined by 90 percent, and pap smears decreased by 83 percent. Testing for prostate cancer is down by 60 percent, and the number of CT scans for lung cancer has been reduced by 39 percent.
Sense of Urgency
The FREOPP blueprint for reopening the economy is an evidence-based work-in-progress, incorporating refinements as more information about COVID-19 becomes available.
“It has been updated many times, and revisions are noted at the end [of the document,” said Roy. “We have learned a lot in the past couple of months about how the virus is transmitted and who it affects most severely, which informs the FREOPP guidelines for a strategic reopening of the economy.”
Proposals to sustain government restrictions until a vaccine is developed are unrealistic, says Roy.
“We can’t wait until [that happens],” said Roy. “In fact, we’ve never developed vaccines for other coronaviruses like SARS and MERS. The fastest vaccine prequalification process that the World Health Organization has ever conducted was for the Ebola vaccine, which took five years.
“We don’t have that kind of time to wait,” said Roy.
Bonner R. Cohen, Ph.D., (bcohen@nationalcenter.org) is a senior fellow at the National Center for Public Policy Research and a senior policy analyst with the Committee for a Constructive Tomorrow (CFACT).
Internet Info:
Lanhee Chen, Bob Kocher, Avik Roy, Bob Wachter, “A New Strategy for Bringing People Back to Work During COVID-19,” Foundation for Research on Equal Opportunity, April 14, 2020: https://freopp.org/a-new-strategy-for-bringing-people-back-to-work-during-covid-19-a912247f1ab5