Scott Gottlieb, Mark McClellan publish road map to national COVID-19 recovery

With the COVID-19 pandemic sweeping across the country, the American Enterprise Institute published a report outlining a path for public and private health to recover from the pandemic.  

“In each phase, we outline the steps that the federal  government, working with the states and public health and health care partners, should take to inform the response,” the authors explain.  

The National Coronavirus Response: A Road Map to Recovering, was written by former FDA Commissioner Scott Gottlieb, MD, former CMS Administrator Mark McClellan, MD, former FDA medical device center Deputy Director Lauren Silvis, Johns Hopkins epidemiologist Caitlin Rivers and Johns Hopkins professor and health security expert Crystal Watson. 

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The report lays out a phased approach that begins with slowing the spread, then transitions into state-by-state reopening, followed by establishing immune protection and reducing physical distancing and, ultimately, includes preparing for the next pandemic.  

1. Slow the spread.The U.S. is currently amid this phase to varying degrees with shelter-in-place orders, school closures, non-essential workerstelecommuting and gatherings limited or banned. “These measures will need to be in place in each state until transmission has measurably slowed down and health infrastructure can be scaled up to safely manage the outbreak and care for the sick,” the authors wrote.  
2. Reopen on a state-by-state basis.When a state has achieved the first phase and clinicians have the ability to diagnose, isolate and treat COVID-19 patients, businesses and schools can reopen — but the authors recommend keeping physical distancing and limited gatherings measures in place, especially for high-risk populations. They also recommend that shared surfaces continue to undergo routine deep cleaning and frequent sanitization. People may also be asked to wear non-medical face masks and, of course, anyone who is sick should stay home. “States may move forward at a county or regional level if these conditions vary within the state and coordination on reopening among states that share metropolitan regions will be necessary,” the authors wrote. 
3. Remove physical distancing and put immune protections in place.The authors explain that when the surveillance tools, therapeutics or a vaccine exist to mitigate COVID-19 risks, it will be safe to remove the remaining physical distancing restrictions. 
4. Prepare for the next pandemic.“After we successfully defeat COVID-19, we must ensure that America is never again unprepared to face a new infectious disease threat,” the authors wrote. Achieving that begins with investing in research and development, expanding public and private health infrastructure, establishing governance and creating effective pandemic preparedness plans. 

“Properly implemented, the steps described here provide the foundation for containing the damage that future pathogens may cause,” the authors wrote. Gottlieb, McClellan and the others also noted that this approach will take time. “Planning for each phase should begin now so the infrastructure is in place when it is time to transition.”