Health experts want to focus on ‘new normal’ with the coronavirus | TheHill – The Hill

January 10, 2022

On Thursday, the Journal of the American Medical Association(JAMA)published three opinion articles by six former advisers to the Biden administration. They were part of the transition team about a year ago when President Biden took office and include people likeLuciana Borio, a former acting chief scientist at the Food and Drug Administration and oncologist, and former adviser in the Obama administrationEzekiel Emanuel, who is a medical ethicist andprofessorat theUniversity of Pennsylvania.

Each opinion article addresses a different aspect of a national strategy:a new normal life with COVID-19, testing and mitigation, andvaccines and therapeutics.In the first piece outlining a new normal, the authors write, In delineating a national strategy, humility is essential. The precise duration of immunity to SARS-CoV-2 from vaccination or prior infection is unknown.

They continue, It is imperative for public health, economic, and social functioning that US leaders establish and communicate specific goals for COVID-19 management, benchmarks for the imposition or relaxation of public health restrictions, investments and reforms needed to prepare for future SARS-CoV-2 variants and other novel viruses, and clear strategies to accomplish all of this.

The experts write that the goal for a new normal is not eradication of SARS-CoV-2 and COVID-19, or what other countries are calling "zero COVID." They call for the recognition that this coronavirus is one of many types of viruses that circulate regularly in our population, saying we should focus instead on the aggregate risk of all respiratory virus infections.

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In theJAMApiece about testing, surveillance and mitigation strategies,the experts call for the Centers for Disease Control and Prevention to "collect and disseminate accurate real-time, population-based incidence data on COVID-19 and all viral respiratory illnesses.They say the U.S. needs a comprehensive testing and reporting system and needs to be linked to sociodemographic, vaccination, and clinical outcomes data.The authors also point out the need forlow-costtesting, such as rapid at-home antigen tests. The Biden administration does have plans to distribute 500millionof these, but experts question whether it will be enough and whether the process for getting the tests will be clear and equitable.

Regarding surveillance, the experts highlight the need for environmental surveillance with wastewater and air sampling. They also call for more genomic surveillance tomonitor fornew variants. The US needs to establish a real-time, opt-out digital surveillance system to monitor all vaccinated individuals for the frequency and severity of adverse effects, postvaccination infections, and waning immunity, write the authors. Two years into the pandemic, the US is still heavily reliant on data from Israel and the UK for assessing the effectiveness and durability of COVID-19 vaccines and rate of vaccine breakthrough infections.

The former advisers think that updated vaccines will eventually be necessary, but they also say that the government will need to do more for the developmentand efficient deployment of them. Achieving 90% population vaccination coverage will require mandates write the authors. Few countries have ever achieved such levels of coverage of any vaccine without vaccination requirements.

TheseJAMAopinion articles were shown to White House officials before they were published, and the authors say that they wrote them partly because discussions with them had not led anywhere, according to The New York Times.Borio says, according to the Times,From amacroperspective, it feels like we are always fighting yesterdays crisis and not necessarily thinking what needs to be done today to prepare us for what comes next.

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