How America Can Beat Covid-19

The next great American economic revival depends on defeating Covid-19

Credit: National Institute of Allergy and Infectious Diseases, NIH

When Americans cast their ballots — by mail, with early voting, and in person on November 3 — they made those heady decisions based on three major issues.

The economy (the primary issue for one out of every three voters) and racial equality (a chief concern for one out of five voters) dominated most people’s minds. Right after them: beating Covid-19 — the issue most impacting the votes of 17% of Americans.

Donald Trump won voters whose chief concern was the economy by a 65-point margin, yet voters trusted President-elect Joe Biden to deliver on both racial equality in America and Covid-19 relief by even wider margins. Even those voters most concerned about the economy indicated that true economic recovery hinges on successfully combating the coronavirus pandemic.

Voters recognized a complex — and controversial — truth: to get America’s economic engine booming again, we have to get Covid-19 under permanent control. We may not need to resort to the repeated, drastic shutdowns that some nations have endured — but we require the appropriate tools to succeed in stopping this pandemic.

What’s clear: President-elect Joe Biden and Vice President-elect Kamala Harris have internalized that truth. More critically, they are also devoted to listening to clinicians and scientists — their Covid-19 plan mirrors the policies many of us in medicine and public health have sought since February.

As physicians at the Covid-19 front line, we applaud the Biden-Harris administration’s nuanced plan to restore America’s greatness:

First: Invest in a world-class national testing infrastructure, with a quick ramp-up of domestic production to attain the millions of Covid-19 tests we need to better identify and isolate new cases. Operational rigor with an eye to access is crucial here: Ensuring that Americans can obtain testing in settings as varied as drive-up locations, health care facilities, and their own homes will reduce the myriad barriers we face today when searching for a test.

Second: Get ahead of the supply-demand mismatch with personal protective equipment (PPE). Even our most robust national organizations matching PPE needs with donated supplies are only able to accommodate 10% of the demand for masks, face shields, and other critical equipment requested by communities in need, leaving far too little supply for essential workers (such as doctors, nurses, home health workers, janitors, cops, and teachers).

Third: Fuel the economy and treat the pandemic through a new Public Health Job Corps. By hiring over 100,000 people to serve as contact tracers and public health workers in American communities hit hardest by the pandemic, the president-elect returns us to the bread and butter of effective public health policy. Contact tracing was long ago abandoned by the Trump administration as futile, with countless communities lacking the tracing staff they need to effectively mitigate the risk of superspreader events. A renewed commitment to that diligence will bolster our ability to interrupt Covid-19 case eruptions before they get out of hand.

In our clinical practice, we see what works to control the pandemic: universal masking, widespread and frequent Covid-19 testing, and rigorous contact tracing to squelch outbreaks. We also see where the pandemic hits hardest. While the coronavirus can impact any life dramatically, we know where it hits hardest: Black, Latinx and Native communities.

To truly control this pandemic, then, we have more to do. Up-front, novel investments in the communities and professions hit hardest by Covid-19 will unlock the tools needed to defeat this invisible enemy. While the Biden-Harris economic recovery plan is undeniably robust, we argue that a few key strategic investments will turn the tide:

Pay our restaurants, nail salons, and small businesses to reduce operations. Our nation’s barbershops, nail salons and restaurants have endured repeated cycles of closures during stay-in-place orders, dramatic drops in foot traffic amid social distancing efforts, and high levels of worry over how to keep their doors open. Any renewal of Covid-19 financial support for individual Americans should include structured programs to pay those businesses most dependent on heavy, crowded foot traffic — our beloved bars, coffee shops, and cafés — to stay closed, tying steady financing to the mitigation efforts we need to stamp out the coronavirus. By doing so, we can keep millions of our fellow Americans in service industries financially afloat — and allow them to keep up their usual spending across all other parts of the economy.

Close the broadband internet gap. Significant investments in universal broadband are needed in both rural and urban communities to enable children to study from home during spikes in Covid-19 spread — and to allow workers exiled from tight office spaces and classrooms alike to work safely and productively from home.

Get creative in unleashing American manufacturing. American ingenuity is one of our nation’s greatest gifts. Taking a page from Blue Cross Blue Shield North Carolina’s successes in coalition-building to produce upwards of 200,000 N95 masks each month in the Carolinas, the next administration should incentivize cross-sector collaborations to produce the crucial supply of personal protective equipment that our national health care workforce, police officers, firefighters, teachers, and grocers need. Whether through targeted grant funding, activation of the Defense Production Act, or innovation challenges, we can — and must — get the PPE we need to keep America safe.

Leverage telemedicine expansion to pandemic-proof our health systems. The myriad gains made in patient experience and patient safety by the health care sector amid this spring’s rapid transition to telemedicine should be bolstered and made permanent, in order to incentivize further investment in the expansion of high quality, easy-to-use, and effective virtual care. Left unaddressed, it is likely that those telehealth capabilities will be slowly stripped away by insurance companies who surprisingly made billions in profits as patients and health care workers suffered this spring and summer.

The messaging from the American electorate was clear: We fix the American economy by fixing the pandemic first. We call on our elected officials in the White House, Congress, and in statehouses across this land to immediately focus on building the infrastructure to combat this pandemic.

Through a laser-focused response in the communities most in need for that investment, we can rapidly assemble the building blocks of that future state: a more robust, more powerful economic engine that will build America back to greatness — and beyond — once we defeat the scourge of Covid-19.

Although it is a universal truth that a house divided cannot stand, a nation, standing apart, can heal together.

Cedric Dark, MD, MPH, is an emergency physician in Houston.

Ali Khan, MD, MPP, is a general internist in Chicago.

The views expressed in this article are the authors’ own and do not necessarily reflect the official opinions of the institutions at which they work.

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A blog from Medium for Covid-19 news, advice, and commentary.

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Cedric Dark & Ali Khan

Cedric Dark & Ali Khan

Cedric Dark, MD, MPH is an emergency physician in Houston. Ali Khan, MD, MPP is a general internist in Chicago.

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