By Veronica Perry
USC Price students are proposing solutions to the COVID-19 pandemic as America considers its next-steps. The suggestions stemmed from a simulated case competition, hosted by the Graduate Policy and Administration Community, in which masters students sought to identify the best healthcare and administrative mechanisms to most effectively respond to the pandemic and prevent further spread. The challenge required students to develop a memo addressed to the Center for Disease Control (CDC) as well as a final presentation.
In total, nine teams signed up for the competition, six teams submitted their memo, five teams advanced to the final presentation round, and one team walked away the winner: two second-year Master of Public Health students from USC Price. The winners, Xi Chen and Zhizhi Min, both completed their undergraduate education in China before attending Price for their graduate degrees.
As students studying public affairs, Min and Chen regularly discussed the Chinese government’s policies, effectiveness, disadvantages, transparency and human rights. Min was upset to see how COVID-19 spiraled out of control in her home country. “I doubted the transparency of those policies, as well as the reliability of the released data, and the necessity of cities’ being locked-down,” she said.
When the competition was announced on February 7, the pair agreed it would be a perfect chance to learn, explore the public health system of the United States and share their experience with their community in China. Min and Chen focused on how critical it is that countries learn from each other. Here are their recommendations, submitted February 28th – since then, many of their ideas match the strategies recommended by policy leaders and medical professionals as key strategies for moving forward:
1. Screening – Min and Chen identified loopholes in the CDC’s interim guidance. At that time, the CDC only tested those who (1) had either been to China in the past 14 days or had close contact with those who were known to have COVID-19, and (2) had fever or symptoms of lower respiratory illness. Min and Chen advised that the CDC expand relevant destinations to countries and regions where there were already COVID-19 outbreaks (i.e. Italy and Korea). They also recommended recognition of an extended incubation period, since reported cases in Wuhan, China showed that this period could be as long as 21 days. The CDC revised its guidance shortly after the competition and addressed these loopholes.
2. Testing Capacity and Accuracy – As false-negative cases began to emerge, the accuracy of reverse transcription polymerase chain reaction laboratory testing, a widely used testing method, was questioned. Knowing that many labs were working together on developing reliable testing methods, Min and Chen advised the CDC to conduct follow-ups with people who had negative test results until they passed the incubation period. Before a more reliable method becomes available, the pair also advised the CDC to consider misoperation in tests that could lead to false-negative cases.
3. Strategies for Domestic Surges –
3.1 Challenges for Medical Supplies
When Min and Chen competed in the case challenge competition, there were only 60 cases in the U.S. Today the number has surged beyond 86,000*. At the time, the team recommended preparing for a shortage in medical supplies (e.g., masks, ventilators, gloves) after seeing that China – a major producer of these supplies – was already experiencing an extreme shortage. Min and Chen also noted that funding presented an issue because funding for public health has seen a decline year over year in America. They noted it was high-time to deploy strategic stockpiles.
3.2 Challenges for Medical System
In Wuhan, emergency rooms were flooded with people and the health system was critically taxed. The death rate began to drastically increase when those who were seriously ill couldn’t receive necessary medical attention. Min and Chen advised the CDC to make sure that hospital resources are available to those whose situations are deteriorating. The team recommended that the CDC prioritize “flattening the curve.” One recommendation from Min and Chen included working with tech firms to establish a remote diagnosis system to help people treat minor illnesses in their homes. Since it is also cold and flu season, and similar symptoms to COVID-19 may be present, Min and Chen suggested that the CDC advise people to get flu vaccines to decrease hospital visits, which may also help relieve the pressure on COVID-19 test capacity.
4. Cope with Public Fears –
Last month, the vast majority of Americans were still working in offices, going to restaurants and gathering with friends and family as usual. Collective worries and anxiety were not as obvious or widespread. However, Min and Chen learned from China’s response and saw what would soon happen among the public. The team felt it was urgent for the CDC to work with multiple agencies, such as companies, schools and community NGOs, to provide useful information for people to prepare, self-protect and to help them stay calm. The team also advised the CDC to work with social platforms like Facebook and Twitter to deliver science-based information that could address any circulating false information.
One month later, Min suggests that the government’s focus should be very different. “They have to put their eyes on issues like quarantine and hospital supplies for health care workers. Right now, the people infected are mostly self-quarantined, but this could put others who live with them at risk,” Min explained. She discussed other issues the government should consider, such as the effectiveness of current quarantine policies and whether or not to impose broad quarantines like China and Italy. Min also emphasized the importance of social distancing and other avoidance behaviors.
Lastly, she touched on the social significance of the pandemic. “The emerging discriminations against Asians and suspicions between people are dangerous. People should refrain discrimination and enmity, and support the community that we all live in,” she said. “Although most of us remain in isolated conditions, treating each other with kindness, compassion and understanding during this time are imperative now, more than ever.”
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*The number of COVID-19 cases continues to change