States might be starting to reopen businesses, but the U.S must prepare for the spread of COVID-19 to pick up this fall, Dr. Leana Wen and Dr. Scott Gottlieb said during a segment of the TIME100: Finding Hope series on Thursday.
In conversation TIME Magazine senior health reporter Alice Park, Wen, an emergency physician, visiting professor at George Washington Milken Institute School of Public Health, and former Baltimore City Health Commissioner, and Gottlieb, the former head of the U.S. Food and Drug Administration and a resident fellow at the American Enterprise Institute, said it’s essential that Americans don’t become complacent about the risks from COVID-19 if the spread of the virus starts to slow during the warmer months.
Wen said that Americans should not “draw the wrong lessons” as daily case numbers start to fall. “Reopening does not mean that the virus is gone; it does not mean that it’s now safe to go out,” Wen said. Although conditions may seem to improve, the country needs to stay alert, in particular by making sure there is enough personal protective equipment for healthcare workers and have adequate contact tracing infrastructure to withstand a resurgence.
“I just worry that the American people are not ready for that type of resurgence, and potentially for having to reimplement shelter-in-place and other types of orders again. Last time, if we were not ready, we could say ‘hindsight is 20/20.’ We could’ve known better, we didn’t. This time we have no excuse,” Wen said.
Gottlieb said that while the virus’s spread will likely slow through July, August and September, it will probably pick up again in the fall and winter.
He noted that, by fall, we’ll have sufficient COVID-19 screening platforms available—including more point-of-care PCR-based tests, the current gold standard for COVID-19 screening that identifies the presence of viral genetic material, as well as antigen-based tests that look for proteins the virus produces that trigger an immune response in the body. But, he warned, it still might be tough to ensure that the right people are actually getting tested in certain communities.
“We could be thinking about how to get in place universal guidelines right now, so that doctors can do testing in their offices, without having to go through extraordinary steps if there is a positive case in the office. Those are the things we need to be thinking about—how to push screening out in the community, and not just relegate it to special sites,” Gottlieb said.
It is also vital that essential public health interventions don’t get caught up in policy or political discussions, Wen and Gottlieb agreed. Wen said that she’s worried that political rhetoric that pits public health against the economy could undermine public health.
“I am very concerned about what we’re seeing with the politicization of health and medicine,” said Wen. “So many of the things that we ask people to do at times of public health crises relies on that public trust. If we’re asking people to do things to change their behavior fundamentally— to do things like sheltering in place, and not go to work, not see their friends for prolonged periods of time, or we’re asking people for their contacts, and everywhere that they’ve been, and to go get tested and to be isolated for a period of time—all of these are quite extraordinary measures. And it does depend on the public’s trust in government institutions, public trust in science and medicine.”
Gottlieb said he is concerned that “basic public health interventions” such as contact tracing have gotten pulled into policy debates. “If we don’t get to effective case-based interventions, and get to a place where we can do very effective contact tracing in the fall, it’s going to be very hard to contain this virus, and prevent outbreaks and epidemics in the fall,” he said.