Specialist
Former director at the Office of Public Health Preparedness and Response at the Centers for Disease Control and Prevention t
Agenda
- COVID-19's expansion in the US
- Assessment of US response and preparedness plan
- Criteria and timeline for potential city-wide lock downs
- Public health measures and challenges in treatment and containment
- 3-5-month outlook
Questions
1.
How would you assess the US’s response to the novel coronavirus COVID-19 pandemic? Where are there pitfalls or loopholes you believe are not being addressed?
2.
You mentioned a lack of urgency and the ramifications of that as the situation worsens. Why do you believe there wasn’t a sense of urgency, and how far from an optimal response do you think it was?
3.
There was a large delay in testing for COVID-19, and a lot of media commentary has focused on South Korea as an example of the measures the US should put in place. What is your take on that comparison, and what do you think still stands in the way of scaling the testing capacity?
4.
Could you estimate a range for the number of cases that could be reported in the US after testing capabilities increase? What criteria would inform your estimate?
5.
How would you assess the estimate that over 40% of the US population will get infected? Do you think that is an extreme or an eventuality worth being prepared for?
6.
What is your opinion on the partnership between public and private sectors – particularly involving LabCorp, Quest and large retailers – to expand testing capacity? Is the partnership sufficient, and how do you expect it to develop or expand to meet the testing requirements?
7.
What expansions or improvements would you expect in the testing plan, and when would you expect more pressure on academic labs to participate?
8.
How would you assess the relationship between the CDC [Centers for Disease Control and Prevention], the FDA [Food and Drug Administration] and CLIA [Clinical Laboratory Improvement Amendments]? What are the strengths or weaknesses of that relationship and how has it led to where we are now?
9.
To what extent do you think the criteria of who is tested was due to the lack of testing capacity, and how might that criteria shift now that there is a plan to increase that capacity?
10.
What is your take on the predictions for the positive test rate in the US, and what assumptions inform those estimates?
11.
How would you characterise the national hospital supply and capacity? Can the healthcare system ramp up supplies if needed?
12.
The national emergency declaration opens up a myriad of other options for planning, coordination and logistics. How might that shape the CDC’s strategy for supply?
13.
During the Ebola outbreak, distributors were told when and where to send necessary materials. Would you expect a similar situation for COVID-19, if it hasn’t already been implemented?
14.
You mentioned the importance of visibility on gaps in materials and supply to make decisions. What is still missing to inform these supply strategies?
15.
What would you say is the strategy for minimising cases in hospitals and determining the criteria for patients to seek medical treatment? How can hospital admissions be managed to ensure capacity for the most severe cases?
16.
What percentage of the US population getting infected do you think would stretch the healthcare system in the same way it is in Italy? You mentioned even 30% would crash the system.
17.
What are your thoughts on the CDC’s flattening of the curve strategy? Do you believe, as a nation, we are doing enough to ensure the curve is flatted, and if not, what steps do you believe are missing to minimise that effect?
18.
Could you elaborate on the need for a surge of public health personnel?
19.
What is the economic cost of the testing and patient care? Would you say estimates of USD 60,000-80,000 per patient for care and USD 3,500 for testing are reasonable?
20.
What criteria would warrant city-wide lockdowns, and to what extent would you expect these to happen in the US?
21.
When, if at all, would you expect more of a national strategy rather than state-based?
22.
What else might a lockdown entail? New York and Boston, for example, have already taken some measures. How would you foresee those developing?
23.
What strategy might be most appropriate for the most at-risk cities or counties in the US? Is New York’s lockdown on bars and restaurants enough, considering your comments that flattening the curve requires a multi-layered effort?
24.
How would you assess the effect of the travel restrictions so far, and what considerations factor into expanding restrictions to other regions?
25.
What are the challenges of potential screenings of people travelling from abroad, particularly Europe? How effective is that?
26.
Are there any considerations for the US demographics that might skew the data? The large population of men who smoke in China might have affected the death rate there, for example.
27.
Are there any expectations for additional regional outbreaks in China now that people are coming out of a lockdown and going back to work?
28.
What do you think should be the strategy to prevent repeat outbreaks or potential reinfections after the end of a lockdown? What could minimise that?
29.
Do you think there are other challenges or potential effects from the COVID-19 pandemic that the government or public are overlooking?
30.
How would you assess the media coverage so far? Is there anything concerning about this overload of information?
31.
Is there anything about the COVID-19 pandemic and its short-term and long-term effects that you believe might be misunderstood by the public or investment community?
32.
What is the current consensus of COVID-19 as a virus that can eventually get to zero vs persisting in the population in the long term? How are these assumptions shaping policy decisions?
33.
What is your outlook for the next 2-3 months? What information would you watch out for, and what further restrictions would you expect from the US government?
34.
What clarity or guidance would you expect from the US government about maintaining the economy during a potential lockdown?
35.
What is your outlook for a steady-state base after the peak of the COVID-19 pandemic in the US?
36.
What is your take on the commentary around a potential treatment or vaccine, and the suggestion that the pandemic might subside with warmer weather? What assumptions would you make assessments under?
