AMA: States should follow 4 signposts to safely reopen America

Kevin B. O'Reilly , Senior News Editor

What’s the news: The White House’s coronavirus task force has unveiled a three-phase approach to “opening up America again,” offering recommendations to state and local officials as they consider whether to ease the physical distancing rules that are helping to contain the spread of COVID-19.

The AMA also is weighing in with its advice on what must be in place before relaxing the stay-at-home orders that have upended American life and taken a toll on the economy yet have helped throttle the spread of the highly infectious and deadly respiratory illness.

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The goal is “to minimize the risk of another surge in COVID-19 infections and to ensure our health system’s capacity to care for newly infected patients,” said AMA President Patrice A. Harris, MD, MA. “People in our country should be confident that decisions are being made with public health as the top consideration.”

According to the AMA, the four essentials that must be in place are:

  • Minimal risk of community transmission based on sustained evidence of a downward trend in new cases and fatalities.
  • A robust, coordinated and well-supplied testing network.
  • A well-resourced public health system for surveillance and contact tracing.
  • Fully resourced hospitals and health care workforce.

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We must expand COVID-19 testing capacity before restarting the economy

Despite advancements in SARS-CoV-2 diagnostic and antibody testing, shortages of nasopharyngeal swabs and reagents have meant that in many areas of the country availability of testing is limited. National public health associations have indicated that public health agencies do not have the workforce necessary to rapidly isolate new cases and track those that have been exposed to infected individuals.

And when it comes to the personal protective equipment (PPE) that is critical to keeping doctors and other health professionals on the front lines, AMA Executive Vice President and CEO James L. Madara, MD, noted in a letter to the Federal Emergency Management Agency that “shortages have been rampant across the United States.”

Read about why it’s time for FEMA to take charge and #GetUsPPE.

Why it’s important: Decisions about how to proceed should be “based on science, evidence and data,” Dr. Harris said. “Scientists and public health experts continue to urge physical distancing as the most effective way to reduce the spread of COVID-19 until we have a vaccine or an effective treatment. Reducing or eliminating physical distancing policies prematurely—and without robust monitoring and testing in place—would likely result in a resurgence of COVID-19 that would inflict widespread illness and still more death.”

At this article’s deadline, the Centers for Disease Control and Prevention (CDC) reported nearly 27,000 confirmed deaths from COVID-19 and another 4,000-plus cases as probably attributable to the disease caused by SARS-CoV-2.

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Defending science in a time of fear and uncertainty

“People in our country should be confident that decisions are being made with public health as the top consideration,” Dr. Harris said. “We continue to urge the federal government and private sector to scale testing to the level where we can have immediate and actionable information about the prevalence of the virus to safely send people back to work, school and the activities they enjoyed before COVID-19.” 

Read Dr. Harris’ remarks at the National Press Club on the importance of science in an era of distrust and misinformation.

Learn more: Stay up to speed on the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network™, the CDC and the World Health Organization.