95 percent of cases, track >95 percent of contacts, test 100 percent of symptomatic contacts, and monitor >95 percent of quarantined contacts for 14 days. Dr. Tom Frieden, Former CDC Director, on the Latest Scientific Developments, and Implications for Novel Coronavirus Prevention and Control, 25 deaths out of 835 diagnosed patients initially, A Novel Coronavirus from Patients with Pneumonia in China, 2019, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Coronavirus infections, more than just the common cold, A Novel Coronavirus Emerging in China – Key Questions for Impact Assessment, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Another momentous and painful week. Race/ethnicity inequalities continue to persist, with Native and Black people having 5x hospitalization rates and Hispanic/Latinx people having 4x the hospitalization rates of white people. Intensive laboratory work, including testing symptomatic patients (and, in some special studies, contacts), developing serological tests, and collecting multiple virus specimens to monitor for genetic changes. This is an enormous undertaking, and both trained people and practical digital tools will be essential. It’s possible that nCov2019 will spread more readily than SARS did, although we don’t know that yet. The simple truth is that in our increasingly interconnected world, disease spread anywhere is a risk everywhere. 2)  As bad as this has been, we’re just at the beginning. Many measures we’re seeing now – floor markings to denote safe distancing, requirements to use hand sanitizer before entering a building, capacity restrictions in restaurants and stores – may be with us for some time. Until we have an effective vaccine, unless something unexpected happens, our viral enemy will be with us for many months or years. 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We still don’t know the denominator – how many people are infected, what proportion don’t have symptoms (although some are without symptoms, including a 10-year-old child), what proportion have mild illness – so we still don’t know the case fatality rate. Rates of new Covid-19 cases have started to fall from their devastatingly high peak. What should you do? Watch your distance from others. Transmissibility of 2019-nCoV, Imperial College. Now, for the most encouraging trend. 9)  We must heighten, not neglect, our focus on non-COVID health issues in order to increase personal and community resilience. Wash your hands regularly. Blog initially published on my LinkedIn profile ( https://www.linkedin.com/pulse/down-covid-19-virus-up-economy-tom-frieden/?published=t ). This should, of course, be voluntary and provide appealing, temporary housing. The Food and Drug Administration said it will propose guidelines on how manufacturers of coronavirus vaccines, therapeutics and diagnostic tests should deal with new variants of the virus. It's "just the beginning" Frieden said as bad as things seem now, he thinks we're still in the beginning … These proportions can be misleading because when people do not go to healthcare facilities or seek treatment to avoid exposure to COVID-19, the proportions can increase even if infections are decreasing. It was surreal to walk through empty halls of Congress and speak in front of masked representatives, but this reflects our new reality. Other than wearing a facemask, using a lot of hand sanitizer, and hearing strong support from many in Congress, there was one major difference this time: it might actually happen. In addition, public reports indicate increasing recognition of cases in many areas of China, and cases are being identified in an increasing number of countries on several continents. These findings can be revised or reversed - early in an outbreak, there's a "fog of war" reality. One of the leading global units that models disease outbreaks estimates that the reproductive rate, Ro, has been 2.6 (estimated range 1.5-3.5) so far. They are mammals and live in huge cities... sound familiar?). Ex-CDC director Tom Frieden on the next COVID-19 vaccines Axios Americans fortunate enough to receive COVID vaccines now, outside of clinical trials, … For each recognized outbreak with transmission links, what are the most likely modes of spread and what control measures have been tried, with what effect? Dr. Tom Frieden on 19 Critical Data Gaps Limiting our Effectiveness Responding to the COVID-19 Pandemic March 06, 2020 The more we know, the better we can protect people against COVID-19. During the 2014-2016 Ebola epidemic, the CDC produced a weekly dashboard of the most important interventions, objectively grading each in every affected country as red, yellow or green. Although this is not proven, it’s clear that nosocomial transmission is occurring.). Last March, as the COVID-19 … To remedy this, we should offer housing for the infectious period for all with COVID-19. Not Remdesivir. Dr. Tom Frieden discusses the spike in coronavirus cases in Europe. We have seen the limitations that caps and sequestrations cause for discretionary funding. Hope for the best, plan for the worst. There’s a big difference if the virus has been spreading from high-risk, aerosol-generating procedures such as sputum induction and bronchoscopy, as opposed to spread in waiting rooms and through other casual contact. First off, death rates lag case rates by about a month, because people get sicker and sicker, and then need to be cared for. Dr. Tom Frieden is the former director of the US Centers for Disease Control and Prevention, and former commissioner of the New York City … Nothing else will enable life to get back to a pre-COVID normalcy. Note, the below chart shows the percent of death from pneumonia, influenza, and COVID-19. And businesses, schools, health care facilities, nursing homes, and others need practical information on what they can do at different levels of risk. In New York City, it’s on the order of the influenza pandemic of 1918-1919. Get more epidemiologic information. We must also act urgently to reduce the higher rates of infection and death among African American, Native American, and Hispanic people. Dr. Tom Frieden, a former director of the CDC, says reopening schools can be done safely amid the COVID-19 pandemic. The dashboard focused attention on interventions most likely to stop the epidemic. We need to preserve health care services despite the pandemic. Personally, I can’t wait to get back to the gym. With COVID-19, the same five domains are essential. In the medium term, decide whether live markets should be regulated far more strictly, or closed completely. First, the good news on COVID-10 epidemiology. What you have been doing. And there has never been a better time to quit smoking, get your blood pressure under control, make sure that if you have diabetes it’s well-controlled, and get regular physical activity. 9 is the number of people, on average, grieving for each of those deaths. Cover your mouth and nose when you cough or sneeze. He is currently president and CEO of Resolve to Save Lives, a global non-profit initiative of Vital Strategies, working with countries to prevent 100 million deaths and make the world safer from epidemics. Dr. Tom Frieden (www.DrTomFrieden.net) is former director of the US Centers for Disease Control and Prevention, and former commissioner of the New York City Health Department. Dr. Tom Frieden (www.DrTomFrieden.net) is former director of the US Centers for Disease Control and Prevention, and former commissioner of the New York City Health Department. Nursing homes and other vulnerable congregate settings house approximately 4 million people in the United States. At the end of a busy week of our usual work at Resolve to Save Lives in epidemic prevention and cardiovascular health, combined with requests to advise on and discuss the rapidly evolving coronavirus outbreak, I sat down to read seven scientific articles about coronavirus that had come out in the past day. There are few public health leaders better able to address the current COVID-19 “syndemic” – a combination of a highly infectious […] Continue to track the pandemic and our response to it. In partnership with the New York Times, we developed an expansive nation-wide coronavirus tracker, including county-level risk assessments and tracking pages for more than 3,000 US counties, and assesses the severity of local spread of Covid-19 from the numbers of confirmed cases in each area. Responsible funding means protecting America, and we must also ensure accountability in our spending so that every dollar is used wisely. Provide daily briefings with accurate and timely numbers of those infected, ill and deceased, epidemiologic trends and analysis, along with updated guidance from credible spokespeople. Just projecting from the number of people already infected and being infected now, the virus will have killed at least 100,000 people in the U.S. by the end of the month. 10) We can never again be caught so underprepared. There is no magic bullet. On May 6th, I had the opportunity to testify in front of the House Appropriations subcommittee on Labor, Health and Human Services, Education, and Related Agencies to discuss the COVID-19 pandemic. The better we control the virus, the sooner we can restart our economy because to protect livelihoods, we must protect lives. From Wikipedia, the free encyclopedia Thomas R. Frieden (born December 7, 1960) is an American infectious disease and public health physician. And it represents continued spread and risk of the virus. Wear a mask. 8)  We must invest in a vaccine and therapeutics. This alert system can achieve three objectives: It empowers people to protect themselves and their families. It’s tragic. He serves as president and CEO of Resolve to Save Lives, a $225 million, five-year initiative to prevent epidemics and cardiovascular disease. 13 is the number of years of life lost on average for each of the 230,000+ Americans killed by Covid. What’s not inevitable is that we continue to be so underprepared. After flattening the curve, the next step is to box the virus in by implementing four essential actions – test, isolate, contact trace, and quarantine. Here’s a quick summary of the key findings from the scientific publications: It’s now highly likely that, as suspected, the ancestral source is bats and the first location may have been the wet market in Wuhan – detailed genetic analysis as well as the largest epidemiological investigation published to date show that 27 of 41 initial cases had exposure to the market. We all want two things: to get back to work and to as normal a life as possible and to not endanger the health of ourselves, our loved ones, and others. Each country should review its ability to find, stop, and prevent coronavirus cases. Within a week or two, death rates may be at or near the baseline IF trends continue. The leading hypothesis is that adults are bringing infection home to their kids. Former CDC Director discusses coronavirus vaccine distribution, potential "immunity passports" Dr. Tom Frieden, former CDC director and the president and … The virus, which is an RNA virus prone to replication errors, may well mutate and evolve in the coming months and years. There are times when older adults and people with serious health conditions should be extra careful to avoid infection. As an epidemiologist, I think a lot about numbers. This disproportionate burden requires a disproportionate response. Be able to resume targeted or general physical distancing rapidly if needed. Links to articles cited and linked above: A Novel Coronavirus from Patients with Pneumonia in China, 2019, New England Journal of Medicine, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, The Lancet, Another decade, another coronavirus, New England Journal of Medicine, Coronavirus infections, more than just the common cold, JAMA, A Novel Coronavirus Emerging in China – Key Questions for Impact Assessment, New England Journal of Medicine, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster, The Lancet. They shouldn’t have to put their lives at risk to care for us. Two additional domains to fight COVID-19 are physical distancing and providing social and economic support. By adopting an alert-level approach, we can empower people, hold governments accountable, and accelerate progress. Be sure health care systems can safely surge for large numbers of mildly ill patients, a large increase in patients needing intensive care, and patients needing ongoing, non-coronavirus-related care. Box the virus in: test, isolate, contact trace, and quarantine. This is a high number that is consistent with rapid spread observed. Testing available for every patient with pneumonia within four hours, every symptomatic person within 12 hours, and capacity for drive-through testing. For Ebola, interventions were in five domains: command and control, surveillance and epidemiology, case management (including laboratory testing), essential health services, and effective communication. Support nutrition, learning, mental and physical health and well-being, and social needs during isolation and quarantine. These give us more information than we’ve ever had, but leave many key questions unanswered. Not staying at home. As noted, this virus and bat coronaviruses are close relatives. 4)  We will be able to begin to re-open as soon and safely as possible by basing decisions on data and creating a new normal. New Interactive COVID-19 Tracker and US County-Specific Guidance. 5)  We need to find the balance between restarting our economy and letting the virus run rampant. 6)  It’s crucially important to protect the health care workers and other essential staff who are the front-line heroes of this war. The first case in the epi-curve that was just published (see Figure) was from December 1, and there was no uptick in cases until around December 20, with the first alert reported on December 31 – a relatively rapid reporting interval. So, we will wait and see. The percentage of positive tests continues to decrease, as do trends for the proportion of outpatient visits for ILI and CLI (influenza-like illness and COVID-like illness). This won’t change the current outbreak, but allowing the current arrangement to continue, which leads to outbreaks, is not a responsible option. Former CDC Director Dr. Tom Frieden breaks down the good news and bad news when it comes to the highly-contagious new strain of COVID-19 spreading abroad. Former CDC director Tom Frieden poses three key questions to be answered about the new coronavirus that has emerged in China and offers some answers. We must focus on protection, prevention, engagement, and support. Former director of the Centers for Disease Control and Prevention (CDC) Tom Frieden warned Tuesday that the China-based coronavirus is more infectious than the … Not testing. Wash your hands. On Thursday, February 4, 2021 PHR hosted a special conversation with Tom Frieden, MD, MPH, former director of the U.S. Centers for Disease Control and Prevention and former commissioner of the New York City Health Department. Protect health care workers with policies, training, and personal protective equipment. These represent millions of tragedies, most of the preventable. But we can learn from our mistakes. 7)  We must protect our most vulnerable people. We propose a new approach for specific public health programs that are critical to prevent, detect, and respond to health threats. It’s important to track both the proportion and numbers of ILI/CLI. Superspreader events – one individual or event resulting in many infections – are likely to occur or to have occurred, as they did with both SARS and MERS. It holds government – and all of us – accountable. Deaths continue to plummet. Nosocomial transmission (spread within health care facilities), which was a major source of spread for MERS and SARS, has occurred and remains a major risk for nCov2019 – and is also a major intervention point for control. But we can get through this. If the world is safer, we will be safer here at home. Likewise, Congress and the American people must understand exactly what is needed for our public health defense so that Congress can then appropriate the resources required to sustain the public health system we need to keep us safe. Bill Murray is fated to relive the same fate in the classic movie, Groundhog Day. Tom Frieden: There are a few things going on. We must take steps to avoid people postponing care for strokes and heart attacks, delaying cancer diagnosis, or deferring essential preventive care because of fear of COVID-19. Future health and economic security can best be protected by changing the way we allocate funds to protect us all from health threats. Don’t go to Wuhan, and consider other travel to China carefully – discuss with your doctor. Governments and private companies must join forces to make massive, continued investments in testing and distributing a vaccine as soon as possible, ensuring rapid and equitable access in this country and around the world. The horror that COVID-19 is spreading around the world can be a wake-up call so that in both the United States and globally we do everything in our power to both tamp down this pandemic and drive down the risk of future epidemics and pandemics. Have there been superspreader events? If we do all of these four things well, even if we don’t have a vaccine, we can begin to return our society and economy to a more normal footing. Dr. Tom Frieden is Senior Fellow for Global Health and the Council on Foreign Relations and President and Chief Executive Officer of Resolve to Save Lives, an initiative of the global health organization Vital Strategies. How many episodes of nosocomial transmission have there been? We need accurate and real-time monitoring to track trends in symptoms, emergency department visits, tests, cases, hospitalizations, deaths, community mobility, and more. We still don’t know how infectious the disease is and will remain, but it certainly has been infectious. The Good and the Bad as of This Week, Down With the Covid-19 Virus, Up With the Economy, https://www.linkedin.com/pulse/down-covid-19-virus-up-economy-tom-frieden/?published=t, Resolve to Save Lives released a four-level, color-coded alert system for COVID-19, Groundhog Day in Congress – But This Time it Might Work, https://www.linkedin.com/pulse/groundhog-day-congress-time-might-work-tom-frieden/, 10 Areas to be Tracked Both Nationally and in Every State and Community during the COVID-19 Pandemic, https://thehill.com/opinion/healthcare/489887-well-lose-world-war-c-against-the-coronavirus-if-we-dont-fight-the-right. Establish additional sentinel sites in China to determine what proportion of people both with and without symptoms who attend health care facilities are infected. Importantly, protect nursing homes, the homeless, jails, factories, and anywhere where large numbers of people congregate. Engage communities, obtaining information through surveys, assessing adherence to physical distancing recommendations, and using findings of these surveys to improve the effectiveness and reduce the disruption of measures taken. Meticulous infection control in hospitals in China and other areas with infected patients, including rapid detection and isolation of patients with cough, respiratory protection, gloves, disinfection, and the other strategies that controlled SARS and MERS in hospitals. By investing in public health protection, we will honor those lost to this pandemic and protect those at risk from the next. Former CDC Chief Tom Frieden: Coronavirus – These simple steps can make a real difference We need to know about a looming or receding threat such as a hurricane. First, in 4 regions, the southeast, southcentral, west coast, and pacific northwest, test positivity has increased. There are 10 plain truths we need to accept in order to move forward productively and effectively. It’s preventable. April 2, 2020 - Countries must unite to win “World War C” against the COVID-19 pandemic, said Tom Frieden, MD, former CDC director. Here’s a set of the most important questions to be answered. We actually find only about 1 in 10 cases, and the numbers are highly dependent on testing intensity and the testing approaches used. What has been studied for each? We call this the Health Defense Operations (HDO) budget designation, and it would exempt critical health protection funding from the Budget Control Act spending caps so our public health agencies can protect us. Not travel restrictions. Below is a quick summary of the key findings. (The link above is to a familial cluster which may have started with nosocomial transmission. During a pandemic, you’d expect the CDC … We can recover our economy without risking our lives. On Thursday, February 4, at 2:30 p.m. EST, Physicians for Human Rights (PHR) hosted a special conversation with Tom Frieden, MD, MPH, former director of the U.S. Centers for Disease Control and Prevention and former commissioner of the New York City Health Department. Students and teachers should be able to return to in-person learning with a "reasonable degree of safety" even before getting the COVID-19 vaccine, former CDC Director Dr. Tom Frieden … Unless we take urgent action, at least 100,000 residents of America’s nursing homes will die in the next year, and there could potentially be hundreds of thousands of deaths in all congregate facilities, including among those who work in these locations. Dr. Tom Frieden, an infectious disease physician, was director of the CDC from 2009 to 2017 during the H1N1, Ebola, and Zika emergencies. Sustained, baseline funding is the only way we will ensure we are prepared for the next pandemic. HDO programs should be required to submit a bypass professional judgment budget to Congress annually. This coronavirus behaves somewhat like SARS, which it resembles genetically, but is much less deadly, and possibly more infectious. But, even with this trend, there could still be hundreds of deaths from COVID-19 each day. We must work to find cases before they become clusters, clusters before they become outbreaks, and outbreaks before they become explosive epidemics that risk the lives of health care workers and others. The authors note that Ro can decrease as control measures are implemented, but note: “Whether the reduction in transmission is sufficient to reduce R to below 1 – and thus end the outbreak – remains to be seen.”. We’re conditioned to think in dichotomies of A vs. B – but open vs. closed isn’t a true dichotomy. She was a healthy mother but is still battling Covid-19 10 months later Dr. Tom Frieden is the former director of the US Centers for Disease Control and … The NIH submits three bypass budgets to Congress every year that explain the true resource needs for cancer, HIV/AIDS, and Alzheimer’s research. We need to think of this more as a dimmer dial than an on-off switch, with different gradations of open based on what we can do without undue risk. In particular, it seems to attack the lower respiratory tract, because of receptor binding to ACE2, which is found predominantly in the lung. At least one hospital in Wuhan has begun a clinical trial of antiviral agents. However, at this point it appears likely that the mortality rate is lower than it was for SARS (11% for SARS vs. 3-4% so far for nCov2019 – 25 deaths out of 835 diagnosed patients initially, although some of those 835 may die, and the total number infected is undoubtedly much higher than 835, hence the actual mortality rate is likely to be lower, and perhaps far lower). With it, another CDC COVID-View report. This is what the best programs around the world are doing. He spoke with CBSN's Anne-Marie Green and Vladimir Duthiers about the country's vaccine rollout, why collecting health data based on race and ethnicity is important, and the possibility of "vaccine passports" being required in the future. We use percent, not number, because this is the most reliable indicator. Twitter @DrTomFrieden. This blog was originally published on my LinkedIn profile (https://www.linkedin.com/pulse/groundhog-day-congress-time-might-work-tom-frieden/). Last week, Resolve to Save Lives released a four-level, color-coded alert system for COVID-19 that could be implemented by city, state, and national governments — with wide consultation within society. Tom Frieden testifying in front of the House Appropriations subcommittee on Labor, Health and Human Services, Education, and Related Agencies Just projecting from the number of people already infected and being infected now, the virus will have killed at least 100,000 people in the U.S. by the end of the month. Former director of the Centers for Disease Control and Prevention Tom Frieden tells Amanpour why a coronavirus pandemic is likely inevitable. As CDC Director, I testified many times in Congress, often with the same message: we have to increase and sustain investment in public health systems in the U.S. and globally to keep ourselves safer. He spoke with CBSN's Anne … Ex-CDC head Tom Frieden says kids may be secret coronavirus carriers ... “The fact that children may get infected but not show symptoms poses a risk to pediatricians,” Frieden said. You can read my full piece on this topic in The Hill here: https://thehill.com/opinion/healthcare/489887-well-lose-world-war-c-against-the-coronavirus-if-we-dont-fight-the-right, Where are we with the COVID-19 Pandemic? Start contact tracing within hours of case identification; identify contacts for >95 percent of cases, track >95 percent of contacts, test 100 percent of symptomatic contacts, and monitor >95 percent of quarantined contacts for 14 days. Dr. Tom Frieden, Former CDC Director, on the Latest Scientific Developments, and Implications for Novel Coronavirus Prevention and Control, 25 deaths out of 835 diagnosed patients initially, A Novel Coronavirus from Patients with Pneumonia in China, 2019, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Coronavirus infections, more than just the common cold, A Novel Coronavirus Emerging in China – Key Questions for Impact Assessment, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Another momentous and painful week. Race/ethnicity inequalities continue to persist, with Native and Black people having 5x hospitalization rates and Hispanic/Latinx people having 4x the hospitalization rates of white people. Intensive laboratory work, including testing symptomatic patients (and, in some special studies, contacts), developing serological tests, and collecting multiple virus specimens to monitor for genetic changes. This is an enormous undertaking, and both trained people and practical digital tools will be essential. It’s possible that nCov2019 will spread more readily than SARS did, although we don’t know that yet. The simple truth is that in our increasingly interconnected world, disease spread anywhere is a risk everywhere. 2)  As bad as this has been, we’re just at the beginning. Many measures we’re seeing now – floor markings to denote safe distancing, requirements to use hand sanitizer before entering a building, capacity restrictions in restaurants and stores – may be with us for some time. Until we have an effective vaccine, unless something unexpected happens, our viral enemy will be with us for many months or years. And we have seen that even mandatory funding doesn’t ensure stable support. All of those can help, but until and unless we have a safe and effective vaccine, there’s no single weapon that will deliver a knock-out punch. Tom Frieden testifying in front of the House Appropriations subcommittee on Labor, Health and Human Services, Education, and Related Agencies. But we can get through this. This limits spread and protects families. (This blog was originally shared on my LinkedIn account: https://www.linkedin.com/pulse/where-we-covid-19-pandemic-good-bad-week-tom-frieden/?trackingId=GnuqPnY5Q26fXQu2W8YIWg%3D%3D). China tracked 700,000 contacts — with fewer cases than the U.S. has. However, Europe, which is weeks ahead of us epidemiologically, appears to be reopening without rekindling -- yet. Disease is and will remain, but is much less deadly, and x-rays show viral.... Mandatory funding doesn ’ t a true dichotomy most reliable indicator few things going on southeast! 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