5 things the United States should do – besides the COVID-19 vaccination


With over 300 million COVID-19 shots administered and dining scenes at full capacity, oversold planes and a crowded Madison Square Garden, the United States is feeling much more normal. Stores have changed “mask required” to “mask optional if you are vaccinated”. Even the Biden administration signaled a return to pre-pandemic life with the announcement of a large outdoor July 4 celebration, although it simultaneously acknowledged it would miss its goal of vaccinating 70% of the country to the same date. As desperate as many of us are to remove the past 18 months, we are doomed to repeat our failures if we do not act with humility and haste in five critical areas.

1. Clear communication regarding the threat of the Delta variant and the Delta variant “plus”

Americans noticed when the former FDA commissioner Dr Scott Gottlieb reported strong concern about the rapid proliferation of cases caused by the Delta variant, now a variant of concern, which means it is of clinical importance. Dr Anthony Fauci also recently stated that the Delta variant poses the greatest risk for COVID-19 elimination. But it’s unclear why this is the case – we know very little about the variant, other than its rapid rise as the dominant variant for new cases of COVID-19, but does that mean it? is more deadly?

Some studies indicate that it might have different symptoms as well – if so, how should we navigate when looking for tests and for that matter, are all tests equal to detect the variant? Are all current vaccines equal in effectiveness? Will a recall be inevitable as soon as possible? Initial studies to suggest that the mRNA vaccines (Pfizer and Moderna) are more effective against the Delta variant compared to the Johnson and Johnson vaccine. Whenever the audience has more questions than answers, disinformation and doubt tends to proliferate at a faster rate than the virus itself.

2. Set up a “robust surveillance system” – a real

Recent cases of myocarditis (inflammation of the heart muscle) in young adults after mRNA vaccination have highlighted how fragmented our surveillance mechanism is to detect events as they occur – most of our information to date comes from largely voluntary reporting mechanisms such as VSAFE, which is a voluntary app that patients must download and then agree to use in order to report any adverse events, and VAERS (Vaccine Adverse Events Reporting System), who also depend on individual clinicians to report most of the data with significant loads to enter that information into the system.

There is a network of nine health systems that have been used since 1990 to monitor real-time clinical record data to examine any adverse events related to many vaccines, but the scale and speed of COVID-19 vaccination efforts also make this inadequate. The first important steps would be to tap into clinicians’ social media (#medtwitter) and consider a partnership between major electronic health records, which together provide the infrastructure for nearly all Americans in all settings.

Social media in this pandemic has become a rapid, participatory database that has helped communicate how to care for COVID-19 patients and has also donated some of the first canaries to a coal mine. This would involve partnerships that are not traditional for the CDC, but if there ever was a time, it’s now to perform the kind of real-time surveillance that countries with more nationalized health systems have been able to do. in a few days.

3. Children and vaccines (or lack thereof)

Incredible advances in our case rates have led many to argue that those who are vaccinated should “will make up for lost time. “However, for more 50 million homes with children under 12 or with medical conditions that are a contraindication to vaccination, they remain in a pandemic waiting pattern. For these households, there is very little guidance and even more confusion as to how to assess the risk of various environments and situations.

The masks are also unfortunately politicized and controversial, but families and individuals struggle to balance conflicting messages about their usefulness against their potential to save lives. Even simple, clear graphics showing the spectrum of risk to children could be helpful. For example, emphasizing that obese children are at higher risk being sick and hospitalized from COVID-19 and how to determine if your child meets the medical criteria for obesity.

4. Technical support for businesses, schools and other environments

Federal dollars were allocated in silos due to normal budgeting and appropriation constraints, but dollars should be targeted for interagency and interministerial grants to municipalities, counties and local community organizations. These funds should be used to rapidly develop and expand technical support for various environments such as businesses, places of worship, and schools, with advice on how best to navigate return to work, testing, finding school or employer contacts if necessary, as well as thresholds or measures to reduce any reopening.

The CDC has given advice for larger communities, but most of these issues and situations are happening locally. In a Chamber of Commerce poll, a majority of members said they still feel insufficiently prepared to protect their workforce. Such a subsidy program could be overseen by the COVID-19 Commission suggested by legislation presented by Sens. Bob menendezRobert (Bob) MenendezSchumer says Senate to vote on repeal of 2002 war permit The Hill’s Morning Report – Biden-Putin meeting to dominate week Sanders drops offer to block Biden arms sale to Israel MORE (DN.J.) and Susan collinsSusan Margaret Collins Senators Said White House Advisers Accepted Infrastructure “Framework” The Hill’s Morning Report – Brought to you by Facebook – GOP torpedo election bill; infrastructure talks stall White House sinks as infrastructure talks halt MORE (R-Maine).

5. Immediately implement a sustainable and long COVID-19 program

There is growing evidence of the impact of long COVID-19, or the symptoms and effects of a COVID-19 infection weeks or months later. This is no longer a debate among scientists and for millions of Americans, it is reality, but a debate that is akin to looking for crumbs in total darkness. A long-term commitment to caring for long-term COVID-19 patients must be a priority.

A recent Senate hearing highlighted the mental health issues of COVID as well as the practical implications for other aspects of health. Yet our current approach depends on traditional models of medical care and social services. Medical societies issuing guidelines, regulators and government agencies should work with a COVID-19 commission to chart the course for a new discipline or field in medicine, which integrates the training and care of similar way to what has been established for other chronic diseases. diseases such as diabetes, obesity or developmental disabilities.

The political scientist John kingdon famously described a framework for a narrow window for policy making – a framework where the process can be located in issues, politics and politics. Political entrepreneurs can be the most important actors in this framework and COVID-19 is a perfect illustration of such a need – solutions that balance politics, problems and politics – the vaccination effort is one of the higher priorities, but we must not lose sight of the other issues that require entrepreneurship at the national level.

Kavita K. Patel is a physician at Mary’s Center, a federally licensed health care facility in Washington DC. She was the policy director of the Obama administration and deputy director of personnel in the United States Senate.


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