Last week, Nancy Messonnier, Director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, released a statement on coronavirus’s likely spread to the United States, saying that “It’s not a question of ‘if,’ but rather a question of ‘when’ and how many people in this country will have severe illness.”
Coronavirus is coming to Ohio. The question is what we will do about it as a state.
While the federal government has done a commendable job of chipping in to fund programs to reduce opioid overdoses as a part of what many are calling the worst drug epidemic in U.S. history, many public health officials have had trouble figuring out how to effectively spend money to reduce deaths.
For infectious disease, though, we have a playbook. Below are four tools policymakers have for reducing the impacts of infectious diseases, roughly in order of cost-effectiveness.
Vaccination
We’ve all heard it: vaccination is the best way to protect yourself and others from infectious disease. The problem we currently have with the coronavirus is that a vaccine will not be created at least for a few months and will not be widely available for as many as a few years.
When this vaccine is made available, vaccination campaigns and interventions to make them available and cheap will be a cornerstone of the response, but vaccines will be little help to battle the disease in the short term.
Screenings
Screening for illness is an important practice for all kinds of disease, ranging from substance abuse to genetic disease to infectious disease. Screenings can take place during routine or other examinations or can be administered as a standalone service as is commonplace with sexually transmitted infections.
Ohio Department of Health programs that support targeted screenings, especially in elderly population centers since coronavirus is especially deadly for people older than age 65, could help identify cases early and provide targeted treatment to help the person infected and appropriate social distancing to reduce spread of the disease.
Social distancing
Social distancing interventions such as isolation of suspected cases, school closures, travel restrictions, and cancellation of public events are a quite extreme and costly way to reduce spread of disease.
While voluntary quarantines can be effective in some cases, it is unlikely a highly communicable disease such as coronavirus that spreads faster than influenza can be stemmed by targeted quarantine.
That being said, Department of Health officials promoting limited social distancing methods in locations like long-term care facilities could be an effective way to protect the most vulnerable populations from infection.
Treatment
Currently, the CDC recommends no specific antiviral treatment for coronavirus. Doctors can do their best to relieve symptoms and in the most severe cases support vital organ functions. Besides promoting seeking treatment, the state has little it can do on this front compared to a disease like opioid use disorder where interventions like medication-assisted treatment have been shown to be much more effective than alternatives.
All in all, it seems that public information campaigns and building infrastructure for screenings are the top tools the state currently has to fight coronavirus.
Future medical science progress may lead to effective vaccination and treatment interventions, but social distancing interventions need to be taken lightly, since the personal liberty and economic consequences of such interventions can be severe.
Like any new disease, the role of the state is to provide support without overshooting the mark and doing harm through its interventions.
This commentary first appeared in the Ohio Capital Journal.