The spread of coronavirus in the United States has unveiled various levels of inequalities in society, including between major cities with more robust hospital systems and rural communities with less access to resources.
The COVID-19: A Frontline Guide for Local Decision-Makers, a global online tool created by the Nuclear Threat Initiative (NTI) and its partners aims “to help local leaders with easy access to checklists, decision points, and progress indicators as they begin, assess, and sustain their response” to the virus. Information on COVID-local.org, the website for the Frontline Guide, is intended to complement advice and guidance from global, federal and local public health and other authorities.
In a panel discussion late last month, public health experts outlined why this guide is critical now.
“No country is prepared for an outbreak of this magnitude,” said Ernest J. Moniz, co-chair and chief executive officer at NTI. “And this is evidently true here. There have been bright spots in Asia and Africa as they rapidly scaled up health security capacities to address the current outbreak. But years of poor investment in health security has translated in extraordinary proliferation of disease that we are seeing today.”
When U.S. federal assistance may come too slowly, the guide focuses on ways local leaders can take control, including testing to slow and reduce transmission to mitigate the economic and social consequences of COVID-19. The guide advises real-time testing and analyzing data from influenza-like illness (ILI) tracking as a proxy for COVID-19 incidence.
Early monitoring and testing pushed Seattle to take action to combat coronavirus, even before there was a single positive case in the city.
“We were really fortunate because Seattle has a number of resources that towns across America don’t have,” said Jenny Durkan, Seattle’s mayor. “We have a high-tech community that had tens of thousands of workers that could immediately stop commuting for work.”
From the beginning of this crisis, Seattle officials reduced the number of workplace commuters from entering the city by 90 percent, because, as Durkan said, “the only thing you have against this virus is to slow transmission. The only way to do that is to decrease the number of face-to-face contacts people have.”
The city convened its executive management emergency team in February to go through pandemic planning as Seattle has multiple connections with Asia. Officials started preliminary planning for the continuation of operations as a city as well as determining what they could do to maintain resiliency in Seattle’s health care and economic systems.
However, the panelists said local governments that don’t have the resources of a Seattle should partner with non-governmental organizations. Seattle officials fostered these partnerships, relying on relationships with organizations such as the Northwest Healthcare Response Network, which exists to coordinate the region’s health care system, and with Microsoft’s emergency response tool to understand and utilize hospital capacity data across the region and state.
Local mayors from smaller jurisdictions also can connect with networks at the regional and international levels, such as with the C40 cities, the Global Parliament of Mayors, and the United States Conference of Mayors, all organizations that have COVID-19 resources.
As for the Frontline Guide, it is constantly evolving based on feedback received globally and with attention placed on local leaders of smaller populations. What this feedback shows is that sometimes limited-resource environments have advantages, such as the ability to more effectively adopt physical distancing, ban close gatherings, and integrate response with frontline medical personnel.
In the midst of COVID-19, there’s cause for some optimism, especially in the countries of the global south, the panelists said.
“There’s actually extensive lab testing in the developing world because countries that have been heavily affected by HIV have had years of investments in high-volume lab capacity. So, as they get the reagents and some of the support they need, they actually have a lot of lab capacity,” said Jeremy Konyndyk, a senior policy fellow at the Center for Global Development, about the ability to test for COVID-19. “There are often much stronger health networks in the developing world because of years and years of investment in public health capacity. There are armies of public health works that dwarf what we have in the United States.”
The Frontline Guide is a joint project of the Global Biological Policy Program at NTI, the Center for Global Development, and the Georgetown University Center for Global Health Science and Security, in collaboration with Talus Analytics.