Quite understandably, the coronavirus pandemic at first was a dire emergency. But it can’t be one forever. The crisis will have to shift to a manageable health threat without massive disruption and overwhelming anxiety. President Biden has been fighting the virus as an emergency in his first year, but a shift must come before too long.
Sound advice on how to do this has been provided by six public health and medical experts who took part in his presidential transition. They have published three articles in the Journal of the American Medical Association saying that covid “is here to stay” and the nation needs a strategy for a “new normal.” This is a marked shift from the message Mr. Biden delivered in his early months in office, promising to tamp down the virus with vaccines. But it was clear even before the delta and omicron waves that the pandemic would not screech to a halt. Last summer, several prominent public health experts warned, in an article titled “The Forever Virus,” that covid “is not going away.” They were right then, and the subsequent articles sketch out a road map for necessary systemic changes.
High on their list is to build a genuine public health data infrastructure, after two years of stress on the fragmented, imprecise system. They propose widespread access to low-cost diagnostic testing, accompanied by a comprehensive system for reporting all viral respiratory illnesses to a central location. The experts also call for three new systems for getting ahead of potential viral and bacterial illnesses. One would be a nationwide environmental monitoring network keeping an eye on wastewater and air sampling, providing early warning of a potential outbreak. Another is a genomic surveillance system — a kind of public health radar — that would spot emerging virus variants and new pathogen dangers. A third idea is to establish real-time digital surveillance of vaccinated individuals (with an opt-out) to track adverse effects and waning immunity, so the United States would not have to rely on Britain and Israel for such data. The experts also lay out important initiatives to improve ventilation and filtering and upgrade face masks.
To reach the new normal, they envision continued reliance on vaccines and vaccine mandates. They envision annual shots tailored to strains and urge accelerated efforts to develop a universal coronavirus vaccine, one shot that would hit all variants. They call for an electronic vaccine platform to replace the paper cards, and they suggest that no-cost, convenient outpatient treatments for covid be made widely available for anyone testing positive. They also point out that trust in public health institutions needs to be rebuilt after two bruising years of crisis.
It should not be difficult for the president or Congress to see the need for these changes. The investment will be well worth it if the result is to take covid from being a dire emergency to just another manageable malady.
