Commentary: Public Health Leaders Should Guide World Leaders Amid COVID-19 Pandemic

A new commentary from Researchers at the Florida Atlantic University’s Schmidt College of Medicine suggests that public health leaders should guide the nation and other comparable world leaders through the coronavirus disease 2019 (COVID-19) pandemic and ensure preparedness for the challenges ahead.

“Based on the existing totality of evidence, it appears that coronavirus is comparable in communicability to influenza but with perhaps a tenfold higher case fatality rate. The anticipated number of deaths due to coronavirus may become comparable to the most lethal epidemic of influenza in US history, which occurred in 1918 when approximately 675,000 Americans died,” said Charles H. Hennekens, MD, DrPH, first author and first Sir Richard Doll Professor in FAU's Schmidt College of Medicine, in a press release.

The authors wrote that in contrast—with respect to usual outbreaks of influenza—the 2018-2019 flu season affected about 42.9 million Americans, of whom 647,000 were hospitalized and approximately 61,200 died.

Terry A. Adirim, MD, MPH, MBA, who recently served as deputy assistant secretary of defense for health affairs at the Department of Defense and a senior medical official at the Department of Homeland Security during the 2009-H1N1 pandemic noted that US health care workers are appropriately confused about current and future issues concerning COVID-19.

“Appropriate concerns and not fear should play a major role in the emerging pandemic, and public health efforts should focus on public health issues, not political or economic considerations,” Adirim said in the press release.

According to the commentary, more than 80% of symptomatic individuals will experience only mild flu-like symptoms. However, approximately 15% will become seriously ill and 5% will need critical care. Younger and healthier people will represent a larger proportion of the population with mild to moderate symptoms. Those at highest risk include the elderly, those with certain chronic diseases—such as cardiovascular disease and lung disease—as well as those receiving chemotherapy or who are otherwise immunocompromised through illness or therapies.

“The good news is that the majority of those infected with the virus will recover, however, the most vulnerable are not projected to fare as well. It is therefore, extremely important that we all take an active role in not only protecting ourselves, but also those among us who are the most vulnerable,” said Safiya George, PhD, dean of Florida Altantic University’s. Christine E. Lynn College of Nursing, in a press release. “In only eight days, Florida went from 18 cases and two deaths on March 9 to 314 positive cases and seven deaths on March 18. However, these numbers are still less than [10%] of the rising number of cases in New York and still much less than California and Washington. Therefore, education, social distancing, staying away from others when symptomatic and continued handwashing and vigilance remain key in minimizing transmission.”

The authors noted that the staggering estimates of the potential numbers of hospitalizations could paralyze the US health care delivery system. Moreover, the overcrowding of hospitals by patients with COVID-19 could make it more difficult to provide care to those with life threatening conditions, according to the study.

Health care providers, as well as the general public, should also be aware that any vaccine is likely to emerge in 1 to 2 years. Furthermore, there is a possibility that chloroquine phosphate, a class of drugs still used to prevent and treat malaria and was formerly used to treat inflammatory arthritis, may have efficacy and an acceptable safety profile against COVID-19.

Reference

• Public Health Leadership Paramount to Emerging Coronavirus Pandemic [news release]. Florida Atlantic University website. Published March 19, 2020. http://www.fau.edu/newsdesk/articles/covid19-public-health.php. Accessed March 20, 2020.