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Posted on March 9, 2020 at 7:52 PM

by Arthur Caplan, Ph.D.

As the new coronavirus begins to spread widely in the USA and as the slowly increasing availability of tests reveals more actual infections we continue to hear a lot about preparation.  Much of this involves advice about thoroughly washing our hands, not touching our faces and social distancing.  Many businesses and groups have imposed travel bans of various sorts.  The White House continues to insist that all is well and everything is under control while the stock market has conniptions and the public grows more and more anxious.  If this constitutes preparation then we are headed in a very bad direction given what may come.


If that is so then what do we really need to do in Americas to prepare for the worst of new corona virus?  Here are some actions that constitute real preparation.

  • So far, little data on who is infected or possibly exposed has been supplied by airlines, trains, buses and other modes of public transportation. Get ready to see what little has been released to be blocked.  Public health authorities need to know what the dangers are from the infected traveling public.  Either the data gets acquired and transparently made available or we won’t be moving around much in the weeks to come.
  • Provide immediate amnesty from legal repercussions to anyone, primarily the 19 million undocumented, to go to a doctor or hospital without fear or hesitation.  Having a huge segment of the population ducking the health care system will kill a lot of people.
  • Plan to manage outbreaks among the homeless.
  • Create a program and supplement existing ones with safety training to get food and medicines to those who need to isolate or quarantine especially the elderly, the disabled and pregnant women.  Current advice is store up on both to go it alone for two weeks.  That is unrealistic logistically for many Americans.
  • Tell people who are isolated or quarantined if they can they walk their dogs, go out to the barn to care for animals, go for a run or a hike in their local park as long as they stay 6 feet away from other people and wear a mask or, is it indoors always end of story? What about roommates if you’ve still got to share a bedroom and a bathroom, can your partner still go to the store for you, let in workmen, accept deliveries? Few seem to know what to do if they are advised or ordered to stay home.  And if they don’t—tasered, arrested, fined or cited?
  • Make sure no one goes without some pay during a pandemic if they cannot be in the office or on the job.  No one should have to starve themselves or their kids for the public good.
  • Figure out how to provide some financial support for those in the gig economy or who work off the books.  No money means people will not socially isolate and they are less likely to report illness.
  • Remove all co-pays and charges for seeking diagnosis and treatment during this pandemic.  Do you really want those without insurance or lousy insurance to avoid the health care system?  And once this pandemic is over can we fix this problem before the next one?
  • Tell people where to go (or not go), when and how to get there if they feel sick—they still don’t know!
  • Figure out regional sharing plans for overwhelmed hospitals and nursing homes including VA, DOD, Indian Health Service private and public facilities.
  • Insist those treating the sick immediately share their treatment protocols with others including new experimental drugs so that we can figure out if anything works
  • Set up a registry to ensure that the 14 day incubation period for getting sick is valid and track some percentage of the recovered  sick to see if they can become reinfected.
  • Prepare a plan for distributing any drug or vaccine that looks promising since demand will be off the charts but supply will initially be very limited.
  • Prepare those who deal with the injured or dead to manage those who are infected including police, fire, funeral homes, community volunteers, ambulance, EMTs and first-responders.
  • And last, have an expert group start now to think about what we will do if and when the virus comes back and we still lack a treatment or a vaccine.

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