Advancing a Comprehensive Response to COVID-19

May 20, 2020








A summary of Duke-Margolis COVID-19 response efforts is available here. 

There are critical and immediate issues to address in the nation’s COVID-19 ongoing surge response.

One is working out large-scale diagnostic testing using polymerase chain reaction (PCR) and point of care (POC) tests. The full pathway from identifying every patient appropriate for testing to completing and communicating test results is not yet reliably available across the country. Elements of this pathway include adequate supply chains for swabs, pipettes, reagents and other needed materials; an adequate supply of safe testing facilities, such as pop-ups or drive-throughs or dedicated spaces that do not cause disruptions to health care capacity when patients test positive; and logistics solutions to identify priority patients for testing, schedule them in an orderly way, and obtain and share timely test results for appropriate treatment and public health monitoring. 

A second immediate issue is assuring adequate supply of personal protective equipment for medical personnel.

A third is the development of all levels of surge capacity to prepare for and manage the growing COVID-19 caseload. This includes telemedicine and home care surge capacity for mild cases; dedicated hospital beds, ICU beds, and ventilators for severe cases; and potential additional capacity – e.g. through unused public facilities, hotels, and other spaces – to treat moderately ill and recovering patients. These are all critical tasks for responding to the current outbreak that deserve the intense attention they are receiving.

Now is also the time to plan for the next phase of addressing the COVID-19 pandemic, as we address the current pandemic wave, accelerate recovery, and limit the occurrence and severity of future waves. As we wrote recently, it seems certain that a set of public health objectives must be achieved to safely enable a significant and sustained reduction in the intensive physical isolation measures being implemented now, with their associated impact on the well-being of Americans and on economic activity.  We believe a high-level Federal COVID-19 innovation task force or equivalent coordinated effort, supported by broad engagement of all levels of government and the private sector, can achieve these challenging goals – a collaborative, modern “Manhattan Project” to respond to this threat and create a much stronger national capacity to protect the public health.

Here, we provide additional details on how these objectives might be accomplished. We intend to add to and update these resources, and welcome additional comments and recommendations as part of that process.

Key Short-Term Objectives:

Three key COVID-19 containment capabilities that are needed and potentially feasible in a matter of weeks include:
  1. Widespread availability of COVID-19 testing with rapid results
  2. Availability of more effective prophylaxis and therapeutics
  3. Effective surveillance and response capacity
    1. Working Paper: A National COVID-19 Surveillance System: Achieving Containmen

Duke-Margolis in the News on COVID-19: View here.