Watching frontline health care workers and other volunteers receive their first doses of the COVID-19 vaccine, there is reason to believe after months of uncertainty that this pandemic will indeed end. The challenge now, though, is to keep ourselves safe until enough of us have been inoculated and possess protective immunity.
It will not be easy. As we write this, more than 21 million Americans have been diagnosed with the coronavirus that causes COVID-19, and more than 365,000 have died. Across the nation, hospital intensive care units are at or even beyond capacity. In California, state officials have ordered thousands of additional body bags and refrigerated storage units to serve as portable morgues. San Diego County escaped the worst of the summer COVID-19 surge, but the current situation is not good. Case and mortality rates in the county continue to rise, each day seemingly worse than the last. Our hospitals and health systems are stressed to the breaking point.
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But we are fortunate that the countys hospitals have a long history of close cooperation and coordination and that they have worked through these difficult times to provide and process lab tests, review predictions for hospital needs and revamp in-patient processes to effectively meet ever-increasing patient loads and needs.
In addition to its strong Health & Human Services Agency, San Diego County enjoys abundant public health expertise at San Diego State University, University of California San Diego and other local institutions. Experts at these institutions have been involved from the beginning in helping predict and map viral spread and supporting county contact tracing efforts, and they have offered guidance and services to other institutions, such as local school systems. The pandemic has strengthened and deepened these inter-institutional partnerships and called on us to find new ways to prioritize the needs and health of those most vulnerable.
But more can be done, and more could be better coordinated, including nationwide public health efforts to provide messaging aimed at reducing transmission through early diagnosis, case investigation and contact tracing. We offer some suggestions on how.
Efforts must shift to prioritizing the rapid identification of cases among those who have symptoms or have known exposures, so they can be isolated and treated if positive. The focus needs to be on making sure that those who have positive tests are quickly informed and appropriate actions taken to prevent further spread of the disease, with contact tracing performed only for cases with a high risk of spread to multiple individuals. Finally, but no less importantly, we must reimagine the public health messages about facial coverings and distancing so that they resonate in a time when we are grappling with frustration and fatigue.
Public health professionals at UCSDs Herbert Wertheim School of Public Health and Human Longevity Science and the SDSU School of Public Health urgently call for a convening of stakeholders to discuss how we can pool and reallocate resources at institutions across San Diego County to meet the current crisis. We must prioritize our needs based on the most acute stresses to systems, institutions and communities. We must come together with tangible offers of available capacity to test, trace and treat our families, friends and neighbors and new, innovative ideas for effective prevention strategies and public health messaging that connects us all.
We can do this. UC San Diego alone has the capacity to conduct at least 10,000 COVID-19 tests per day. It conducts routine testing of thousands of on-campus students and staff every week and, under contract from the county, has traced thousands of COVID-19 contacts. Similarly, SDSU, which has developed exceptional skills in community health worker-led contact tracing and testing through its Communities Fighting COVID! program, could expand it to meet near-term needs throughout the region. Immediate efforts should be directed to reaching positive cases within 24 hours. This may require shifting of staffing priorities to ensure prompt containment of COVID-19. Our local universities have deep knowledge about public health messaging and communication, which could be leveraged to create new connections to populations at greatest risk.
It is critical that we identify and consider possibilities now before we find ourselves overwhelmed. Lets bring our strengths to a virtual table so that we those of us with the most protections and those of us with the least outlast these dark times and reach a brighter future of immunity.
Anderson is dean of the Herbert Wertheim School of Public Health and Human Longevity at UC San Diego and lives in Del Mar. Madanat is a distinguished professor of public health and interim vice president for research and innovation at SDSU. She lives in Sabre Springs.
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Commentary: Health experts and other San Diego leaders must unite to better coordinate pandemic response - The San Diego Union-Tribune
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