Eight months into the pandemic, nations around the world continue to scramble to contain COVID-19 infections. Spikes are now emerging in countries that had gotten ahead of their epidemics months ago, such as New Zealand. In the U.S., COVID-19 is now the third leading cause of death, behind heart disease and cancer. It is clear that countries must have strong systems in place to test, trace, and isolate effectively to prevent further spread and reverse the course of the pandemic.
This week’s edition of Rabin Martin’s COVID-19 Briefing spotlights the need for a suite of measures to control the pandemic and mitigate the impact of a potential second wave. How are countries managing their response when their health systems are overwhelmed by cases? How will countries with weak infrastructure address these challenges? Please find our earlier COVID-19 Briefings here.
Containment: Test, Trace, Isolate
The U.S. remains a COVID-19 battleground. With only 4 percent of the world’s population, the U.S. now accounts for almost 25 percent of COVID-19 cases. On Monday, August 17, Dr. Deborah Birx, Coordinator of the White House Coronavirus Task Force, said she wished the U.S. lockdown had been more strict and similar to the approach adopted by Italy, where people were permitted to leave their houses only for essential activities and local authorities enforced lockdowns with financial penalties. Also on Monday, Dr. Tom Frieden, President and CEO, Resolve to Save Lives and former Director of the U.S. Centers for Disease Control and Prevention (CDC), commented on the U.S.’s high COVID-19 death rate, noting, “Last week, Americans were eight times more likely to get killed by COVID-19 than were Europeans.”
Despite a rise in outbreaks, the rate of testing is declining in the U.S. According to the COVID Tracking Project, the average number of daily tests conducted in August fell to 733,000, from 750,000 in late July – even as new cases continued to climb. This week, testing rates actually decreased in 18 states even as the percentage of positive tests remains high, with 33 states above the 5 percent positivity rate recommended by the World Health Organization (WHO) before reopening.
Lack of sufficient testing runs counter to the multi-step method – test, trace, and isolate – necessary for containment. Experts say this multi-pronged approach is key to “getting countries out of lockdown.” However, a country’s ability to implement these life-saving strategies depends on a centralized, well-resourced, and evidence-based public health system – challenging even for high-income countries. Also, these three measures must be executed simultaneously: without one, the strategy as a whole may falter. For example, countries having difficulty meeting the demand for testing have been unable to provide positive test results in time for individuals to quarantine appropriately.
Innovations in containment measures are emerging, including efforts to accelerate testing. Countries are taking creative approaches, ranging from the use of drive-throughs, to pooled testing, to robots. In the U.S., there have been new advances in diagnostics. On Saturday, August 15, the U.S. Food and Drug Administration (FDA) approved a rapid, saliva-based diagnostic test for nationwide use. The test had gained attention as the preferred method for testing players in the National Basketball Association, and public health experts lauded the decision to expand access to the general population. FDA Commissioner Dr. Stephen Hahn said, “Providing this type of flexibility for processing saliva samples to test for COVID-19 infection is groundbreaking in terms of efficiency and avoiding shortages.”
Dr. Michael Mina, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health
Following testing, contact tracing is recognized as the next critical step to prevent disease spread. Contact tracing refers to the process of identifying people who have had recent contact with someone with a confirmed diagnosis. Contact tracers reach out to those who may have been exposed to the coronavirus and encourage them to self-isolate and get tested for COVID-19. WHO Director-General Dr. Tedros Adhanom Ghebreyesus has emphasized the value of contact tracing, regardless of the stage of an epidemic: “Contact tracing is essential for every country, in every situation. It can prevent individual cases from becoming clusters, and clusters [from] turning into community transmission.” Contact tracing has been credited as a crucial tool in ending the 2014-2015 Ebola outbreak in Liberia.
CDC Director Dr. Robert Redfield has said that widespread contact tracing is “critical” to stopping the spread of COVID-19 within the U.S., but the country has struggled to meet capacity as cases grow exponentially. A recent survey by National Public Radio and Johns Hopkins University revealed that only three states (Maine, New Hampshire, and Vermont) and Washington, D.C. have enough contact tracers per capita to respond adequately to their epidemics. Inaccessibility of testing and backlogs in providing test results have led to delays in informing individuals of possible exposure, risking further disease spread. Other challenges to contact tracing include reluctance to interact with contact tracers, often out of fear.
From the Experts
“You look at the United States of America: with our epidemic of obesity… with the number of people with hypertension, with the number of people with diabetes. If everyone got infected [to achieve possible herd immunity], the death toll would be enormous and totally unacceptable.”
Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Disease
Friday, August 14
“The U.S. has been completely lacking [in] leadership on [COVID-19]. And because of that, we have put our children and our elderly at the greatest risk in the world. And that is a crime.”
Melinda Gates, Co-founder, Bill & Melinda Gates Foundation
Sunday, August 16
“While there is a wish amongst leaders to protect their own people first, the response to this pandemic has to be collective. This is not charity, we have learned the hard way that the fastest way to end this pandemic and to reopen economies is to start by protecting the highest risk populations everywhere, rather than the entire populations of just some countries.”
Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO
Tuesday, August 18
“This virus is unrelenting and requires the same from us: we must stay vigilant and keep transmission under control.”
Dr. Carissa Etienne, Director, Pan American Health Organization
Tuesday, August 18
“We are in the middle of the pandemic. The virus is out there, even if you can’t see it… There can be no more loosening [of the rules] at present.”
Angela Merkel, Chancellor, Germany
Tuesday, August 18
“Anyone who is following will quite easily see that New Zealand’s nine cases in a day does not compare to the United States’ tens of thousands.”
Jacinda Arden, Prime Minister, New Zealand
Tuesday, August 18
What We’re Reading
- Coronavirus Doctors Battle Another Scourge: Misinformation – Adam Satariano, The New York Times
- Seven Months Later, What We Know about COVID-19 — And the Pressing Questions That Remain – Andrew Joseph, Helen Branswell, and Elizabeth Cooney, STAT News
- The U.S. Can Only Defeat COVID-19 Through Global Solidarity – Ndileka Mandela, Time Magazine
- Fearing a ‘Twindemic,’ Health Experts Push Urgently for Flu Shots – Jan Hoffman, The New York Times
- COVID-19 Has Accelerated the Adoption Of AI. Executives from Google Cloud, Suki And Olive Spell Out Why – Heather Landi, Fierce Healthcare
- Female-Led Countries Handled Coronavirus Better, Study Suggests – Jon Henley, The Guardian
- To Fix the US Coronavirus Response, Start with Culture – Sarah McCool, Global Health Now
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: August 17
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT News COVID-19 Tracker
- Global Health NOW’s COVID-19 Expert Reality Check
- International Association of National Public Health Institutes COVID-19 Resources
- Center for Strategic and International Studies The Reopening and Take as Directed Coronavirus Crisis Update Podcast
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
- COVID-19 Watch Weekly Updates
For more information or should you have any questions, please contact us.
About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
About Omnicom Public Relations Group
Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.