Can the US learn from others’ successes to manage this COVID-19 public health crisis?

Whenever I face a problem at work or in my personal life I have learned to ask others what they have done when faced with similar situations and what was the result and what they learned from the experience. People are wired as social beings. People want to help people. People will share their experiences if you ask them for help.

This concept of sharing information and results is used in Public Health.

1. To contain the community spread – US public health agencies need to follow Taiwan’s lead and success

A friend of mine is an MD and after reading one of my posts, she informed me her mother was visiting family in Taiwan and how safe she feels about her mother being there and how well Taiwan is managing the COVID-19 outbreak.

Taiwan, which currently ranks 29th on the list of infected areas, with 45 cases, 29 still active and one death, as of Monday March 9, 2020.

The Taiwan Public Health Department has undertaken some very clear steps articulated in this article in ZME Science:

  1. Early Preparation,
  2. Using health insurance and big data,
  3. Regular, accurate updates, and
  4. Prepared, proactive, and clear

Today NBC News reported on several reasons have been cited for Taiwan’s success in limiting the coronavirus’ impact despite obvious disadvantages.

  1. PREPARATION: Perhaps foremost among them is preparation. Following the 2003 epidemic of severe acute respiratory syndrome, which killed 73 in Taiwan, the highest number outside China and Hong Kong.
  2. LEGISLATION: the government passed legislation to facilitate a more effective response to future outbreaks.
  3. COMMAND CENTER: Notably, the National Health Command Center was established to coordinate efforts in a variety of rapid onset scenarios like the one that now threatens.

Why were they so prepared…my friend told me about an article she had read in JAMA and it is found here. A Highlights are:

Taiwan’s government learned from its 2003 SARS experience and established a public health response mechanism for enabling rapid actions for the next crisis.

Well-trained and experienced teams of officials were quick to recognize the crisis and activated emergency management structures to address the emerging outbreak.

Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing, by Wang et al, JAMA, March 3, 2020

The Journal of American Medical Association, JAMA, viewpoint concludes:

In a crisis, governments often make difficult decisions under uncertainty and time constraints. These decisions must be both culturally appropriate and sensitive to the population.

Through early recognition of the crisis, daily briefings to the public, and simple health messaging, the government was able to reassure the public by delivering timely, accurate, and transparent information regarding the evolving epidemic. Taiwan is an example of how a society can respond quickly to a crisis and protect the interests of its citizens.

Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing, by Wang et al, JAMA, March 3, 2020

Yesterday a television station in Taiwan reported:

In the months since reports began to emerge about a new coronavirus outbreak in the Chinese city of Wuhan, over 100,000 cases have been confirmed worldwide, a figure many agree is far below the actual number. Nearly 4,000 people have died, the large majority in China, although with infections there beginning to subside, while dozens of new hotspots have appeared in Europe, North America, the Middle East and Asia.

Surprisingly, one of these hotspots is not Taiwan, which currently ranks 29th on the list of infected areas, with 45 cases, 29 still active and one death, as of Monday.

Taiwan beating the odds on COVID-19, by Ko Shu-ling, March 9, 2020

I would argue that US Public Health officials are prepared. Some politicians are not enabling the public health officials to carry out their jobs of protecting and advising the US public in the time of a public health crisis.

Instead of discussing a tax relief package for hotels, cruise ships and airlines, Congress needs to look at passing legislation that enables public health officials to respond in the US as they have in Taiwan. AND Congress needs to look at the financial relief that local mayors and governors are putting into place and harnessing local energy to adopt federal legislation that protects poor and middle-class Americans, who live paycheck to paycheck.

The US needs a Public Health Command Center.

2. To provide financial relief to the majority of Americans, states and feds need to follow the locals – cities and states:

I write this as today’s COVID-19 numbers are released by King County: officials confirm 74 additional coronavirus cases today, bringing the total for King County to 190. Two new deaths were reported, bringing the total number of COVID-19 fatalities in King County to 22 people.

As test kits become available, the numbers of infected in the US continue to rise. To keep up to date with the national reporting of confirmed cases of COVID-19 in the US, see my post on the need for mandatory community mitigation to see John Hopkins University’s live map of reported cases.

I was appointed by a governor and served the people of Minnesota for four years. I respect the power of the National Governor’s Association, NGA. Let me share some successes in Seattle and Washington State that need to be replicated by the governors NOW.

Some of these protections only apply to the City of Seattle. We need protections in all of King County and throughout Washington State and throughout all 52 states.

FYI “52 states” = 50 states plus the District of Columbia and Puerto Rico!

Let’s have a planwe all need to do our part to get this information in the lands of mayors and governors. We need mayors to take action within their jurisdications. We need the governors to replicate these changes in the 52 states NOW.

Who do you know that knows a mayor? a governor? Reach out to them and share this information now… Let’s Have a Plan!!

  1. Keep Utilities On During the COVID-19 emergency: The Mayor of Seattle announced that the Seattle Public Utilities and Seattle City Light will provide immediate utility relief for customers, both residential and commercial, financially impacted by the COVID-19 outbreak. Effective immediately, all SPU and SCL customers can set up deferred payment plans if their financial stability has been jeopardized by COVID-19. Utility service will stay on as their deferred payment plans are developed and implemented.

2. Small Business Relief and Protections: Seattle Mayor announced protections for small businesses including a $2 million relief fund and streamlined and reduced permitting fees.

3. State Medical Insurance Coverage of COVID-19 testing and required healthcare: Faith leaders met with Governor Inslee last week and the next day Washington State Governor Inslee announced insurance coverage for COVID-19 testing and Washington State Insurance Commissioner announced the waiving of co-pays and deductibles for patients tested for COVID-19 by Washington State licensed medical insurance companies.

4. Protection of hourly workers: Some big companies announced protection of their hourly workers, including Amazon and Microsoft. A day after the big three tech companies (Amazon, Facebook and Microsoft) announced that many of their workers could work at home, I wrote a post highlighting that not all workers can work from home, highlighting the need for paid sick leave and a fund to help hourly workers pay the rent, their mortgages and buy food. On March 6th, Amazon announced that it’s nearly 10,000 hourly workers would be paid. This relief does not address the nearly 30 million service workers and those in our gig economy who do not have paid sick leave and needs to be expanded to include them – by the 52 states, if the federal government will not act.

5. Seattle Health Care System Offers Drive-Through Coronavirus Testing For Employees and Students of the University of Washington’s UW Medicine system: The system’s medical center in northwest Seattle has turned a hospital garage lot into a drive-through clinic that can test a person sitting in their car every five minutes. They typically get results within a day or so.

But the idea involves more than convenience. It’s also about safety.

In the last four days we read about how South Korea is using fast food style drive- thrus to test people in their cars. UW Medicine is doing a pilot in Seattle.

Wondering WHY we can’t we do this in every major city in America?

Let’s have a plan – we all need to do our part to get this information in the lands of mayors and governors. We need the governors to replicate these changes in the 52 states NOW.

Who do you know that knows a mayor? a governor?

Reach out to them and share this information now… Let’s Have a Plan!!

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