Georges C. Benjamin, MD, MACP, FACEP (E), FNAPA, is the executive director of the American Public Health Association
Public health leadership has been a force for more than half a century to navigate pandemic threats and its vital work is urgent against the turbulence of the COVID-19, which has led to thousands of deaths and about 130 million Americans are under some form of lockdown.
While social distancing and stay-at-home orders are significant containment strategies, fact-based science and a public health focus are crucial to curtail the number of deaths by tracking as many COVID-19 cases as possible, improve hospital care, allow for much-needed supplies and equipment, and open the door for lengthy studies and eventual discovery of vaccines.
The “outbreak of pneumonia of an unknown cause” was reported in Wuhan, China on Dec. 31, 2019, and was in the U.S. by mid-January. Since then, the virus causing the outbreak was quick to be determined a novel coronavirus, later named COVID-19, and related to the Middle Eastern Respiratory Syndrome virus (MERS-CoV) and the Severe Acute Respiratory Syndrome virus (SARSCoV). The coronaviruses are a family of viruses whose symptoms can range from the common cold to a severe respiratory illness.
The novel coronavirus is considered the worst pandemic since the 1918 Influenza Pandemic infected one-third of the world’s population and killed 50 million people. According to data from Johns Hopkins University Coronavirus Resource Center, there are more than 4.5 million COVID-19 cases and 308,000 deaths worldwide. The United States now leads the world with more than 1.4 million confirmed cases. The U.S. death toll is nearly 90,000.
During the outbreak, public health officials have been a major force in discussions and development of policy, from the White House and other federal agencies to state and local governments.
Public health officials have directed the containment of emerging pandemics for decades and our importance became more significant with the growth in the number of emergency infectious diseases including anthrax, Dengue, Zika, SARS-1, H1N1 Influenza and Ebola. Public health has taken critical action to contain and eliminate these threats.
Today, public health officials again are on the front line in developing a range of nonpharmacological interventions to control COVID-19 and are performing the science to improve testing, contract tracing, antiviral therapeutics and eventually a vaccine.
COVID-19 has put a considerable strain on the health system and wide spread physical distancing strategies have contributed to economic tradeoffs that are unprecedented in our history. Still, the mitigation strategy is working, and we are beginning to bend the curve to enable our health care system to handle the epidemic and reduce the associated morbidity and mortality. The next steps in managing this outbreak is to step up the use of the core public health disease control tools we already are using: the testing, contract tracing, isolation and quarantine. These will form the bedrock of our response until a vaccine is ready. At that point we will add vaccination to what is our most effective intervention against COVID-19.
While the future of this outbreak is unclear, the public health practitioner’s role as the crucial centerpiece of this response stands without question.