A Bold Response to the COVID-19 Pandemic

Abstract

Over the next few months it is likely that the coronavirus disease 2019 (COVID-19) pandemic that has surged in New York City, Seattle, New Orleans, and Detroit will move from city to city and state to state.After the initial peak, absent highly effective medical interventions, the US will likely experience outbreaks of lingering disease for months and potentially years to come.As the US enters the next phase of COVID-19, critical questions will involve the nation's capacity to respond to outbreaks, protect high-risk populations, and limit community spread.Because of inadequate and continued lack of testing for COVID-19, a depleted and overworked public health workforce, lack of sophisticated integrated public health and clinical health information technology, and substantial cultural issues, the US has yet to implement an effective disease control strategy.Rather, the US has moved quickly from focused isolation and quarantine at a large scale to mitigation, largely focused on a single approach-social distancing.The fundamental question is whether the US can build a more targeted response capability so that the country can return to work, school, and other normal activities.A key milestone is the fall of 2020.If the initial social distancing and perhaps warmer temperatures reduce the scale of the outbreak this summer, there is a major risk of a resurgence during the traditional season of respiratory viruses.As a possible approach to respond to this challenge, the US should consider suspending the first year of medical school for 1 year and giving the incoming 20 000 medical students the opportunity to join a national service program for public health.Hopefully the vast majority of students would participate.Such a bold approach may be needed to ensure that the US has an adequate response to the next wave of disease and does not enter a prolonged depression that will further adversely affect the health of its citizens.The program should begin at the start of July.Incoming medical students should spend the month in online training on infectious disease epidemiology, infectious disease control in high-risk settings, and outbreak response.In August, they should deploy to state and local public health departments to enhance the capacity to support a test, trace, track, and quarantine strategy.The federal government should fund this project as a national service effort with a salary for the students and health coverage; it could be part of a larger initiative to engage other students, including those in nursing and public health, as well as out-of-work community members in the national response.Taking this bold step is justified on health and economic grounds.Today, localities have few resources available to