Step 1: Have a realistic communications plan. Daily briefings, led by the vice president and a trusted scientist, such as Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases, should update the public on the national and global status of the coronavirus. They need to be factual and accurate, as any concealment or manipulation of data will erode public trust. In addition, the president needs to acknowledge — very clearly — that he understands the situation, and lay out the concrete steps being taken to mitigate it. Here’s a potential start: “This is a new virus with many unknowns. We are expecting the situation will get worse, with many more Americans infected and some even dying, before it gets better. Here is what the administration is doing in a concerted manner to address the situation,” followed by the concrete steps being taken.
Step 2: Establish a White House Coronavirus War Room as soon as possible. Draft a dozen officials from the Centers for Disease Control and Prevention, National Institutes of Health, the departments of State and Homeland Security, and other agencies such as the U.S. Agency for International Development to help ensure that robust plans are coordinated, communicated and executed with the full breadth of the government’s resources. Coronavirus is a health issue. Adding more Cabinet secretaries to a task force is not appropriate. We need a war room of scientists and health experts.
Step 3: Convene a White House meeting with public health officials from all 50 states. To improve outcomes, make sure that containment, testing and treatment efforts are clearly communicated and uniformly executed across the country.
Step 4: Invite the director-general of the World Health Organization to the White House to coordinate national and international response plans. Publicly announce that the U.S. government will financially support the WHO in the coronavirus fight, using congressionally allocated funds.
Step 5: Distribute coronavirus testing kits across the country. We have had too many problems with testing, and these problems seem to be ongoing. We need to lower the barrier to testing so that thousands of tests are being done each day to enable scientists to understand the real prevalence and trajectory of the virus.
Step 6: Urge President Xi Jinping of China to allow U.S. and WHO public health officials free access to his country. To enrich our understanding of the disease and bring the epidemic to a faster close, we need to verify epidemiology data and conduct trials of therapeutic drugs — preferably under the watchful eye of NIH.
Step 7: Task the Food and Drug Administration with delineating and securing alternative supply chains for drugs and raw chemicals for drug manufacture. The global drug supply chain relies heavily on China both for raw materials and finished drugs, especially generics. In light of the virus’s impact there, we must ensure that drugs can continue to be produced. Convening drug and chemical company executives at the White House and assigning the FDA responsibility for their collaboration will minimize downstream disruption of drug delivery.
Step 8: Call producers of personal protective equipment, such as gowns and masks, to the White House. It is good that the White House has secured tens of millions of masks. But there is more to personal protective equipment (PPE), including gowns and gloves. The government must secure supplies of all PPE and guarantee their availability to hospitals first, as well as ensure their distribution to public health officials and necessary sites. We should also investigate the possibility of increased domestic, or at least North American, production of these essential items.
Step 9: Task the CDC with devising a feasible response to a surge in the need for hospital beds. The government may have to requisition spare space or pitch hospital tents in the event of large-scale infections. The CDC should study Canadian efforts during the SARs epidemic and adapt what is effective.
Step 10: Define a clear rule for school and public event cancellation. Public reassurance depends upon decisive action — clear and uniform guidance will help local public health officials make judgment calls. The CDC should establish guidelines for when a community should recommend canceling school and stopping sporting and other mass meeting events.
These 10 steps do not cover everything, but they are a logical place to start in addressing current threats and building public trust in the government’s response to covid-19. Such trust is essential to avoid panic; if the circumstances become worse, it is important that the public generally adhere to the government’s advice. Playing down a problem that rapidly grows worse will foster fear and skepticism and will ultimately cost lives.