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COVID-19 Requires ‘An Entire Village’ of Professionals

Diagnostic testing, medical supply shortages and how to handle potentially infected travelers were on the minds of clinicians at the Advisory Committee on Immunization Practices (ACIP) meeting in Atlanta, who got a unique opportunity to have their questions about COVID-19 coronavirus answered.

Nancy Messonnier, MD, director of CDC’s National Center on Immunization and Respiratory Diseases, and a regular fixture at ACIP meetings, took a few minutes to update clinicians in attendance about COVID-19 and how CDC is responding to it.

“I think I speak for everyone in this room, thank you for all you’re doing and the leadership you’re providing. We appreciate it enormously,” said liaison member William Schaffner, MD, representing the National Foundation for Infectious Diseases.

Afterwards, Messonnier received a standing ovation from the assembled group.

In her presentation, Messonnier said a major part of CDC’s efforts is focused on preparing first responders, healthcare providers, and health systems, with a plan to understand healthcare use and potential surges, as well as previously released guidance on infection control, hospital preparedness, and personal protective equipment.

She also discussed the need for healthcare providers to be judicious with resources now in preparation for a prolonged outbreak.

“We have the potential to have supply issues; it depends on how long the outbreak lasts,” she said, adding that they might need to ask the healthcare sector “how they might be sparing of those resources” now.

Healthcare equipment “may be a precious resource … if there are ways to conserve it, now is the time to start thinking about it,” Messonnier said.

Questions from clinicians focused on diagnostic testing, with two clinicians from separate institutions saying their labs had developed their own tests for COVID-19. They added they wanted to use these tests in “suspected cases,” but cited pushback from the FDA, which has oversight over diagnostic testing.

“We hope you would get the FDA to allow us to begin using the test on a research basis until a commercial test is available,” said liaison member David Weber, MD, representing the Society for Healthcare Epidemiology of America.

Weber also added that while there is a national stockpile of healthcare supplies, “we don’t know what’s in it.” He added that equipment such as N-95 respirators requires training to use.

“It would help if we knew what was stored, so our people could be trained instead of sitting and reading manuals the day it arrives,” he said.

Liaison member Yvonne Maldonado, MD, representing the American Academy of Pediatrics, brought up the issue of travel, stating her institution, Stanford University in California, has students returning from Italy. Given the CDC recently upped its travel advisory on Italy to a Level 2 alert (recommending extra precautions), Maldonado asked if “we should be treating [students] with self-isolation,” the way they are doing with healthcare personnel returning from South Korea.

“We are not recommending travelers from Italy be treated that way, as Italy has not shown widespread transmission,” Messonnier said.

Liaison member Christine Hahn, MD, representing the Council of State and Territorial Epidemiologists, chimed in, saying, “it’s going to get untenable at a certain point to track travelers … public health simply cannot maintain and track” them all.

Hahn added that in a day or two, “some decisions would be made” regarding this matter.

Messonnier closed the session by saying it was going to “take an entire village,” including the entire expertise of everyone at CDC, to respond to this outbreak, and told the group, “we need to prepare for something serious.”

“Many of you have been preparing for a pandemic your entire careers. All of you are going to get us ready,” she said.

Last Updated February 26, 2020