Former members of President Joe Biden's transition team are calling for a new long-term strategy that envisions a world in which humans learn to live with the new coronavirus.
Six former advisers published three opinion articles Thursday in the Journal of the American Medical Association detailing what needs to be done now to make that happen.
Dr. Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who advised former President Barack Obama, is the driving force behind the effort.
The experts suggest that the Biden administration take a broader view of the pandemic and acknowledge the virus won't be going away. They expressed concern about a "perpetual state of emergency" in response to new surges, such as the highly contagious Omicron variant.
"From a macro perspective, it feels like we are always fighting yesterday's crisis and not necessarily thinking what needs to be done today to prepare us for what comes next," one author, Dr. Luciana Borio, told the New York Times. She's a former acting chief scientist at the U.S. Food and Drug Administration.
The authors called for a "new normal" of living with the virus indefinitely. They suggested preparing for future outbreaks by creating goals and benchmarks for what metrics would set emergency measures in motion. These might include specific numbers for hospitalizations and deaths from respiratory viruses.
One of the pieces called for a new national plan. The other two suggest improvements in testing, surveillance, vaccines and therapeutics.
They also called for broader vaccine mandates, including for children, and recommended that oral treatments and N95 masks be free and readily available.
Every person in the United States should have access to low-cost testing, they added. Plans to purchase 500 million rapid tests are not enough for "comprehensive, digital, real-time" data collection by the U.S. Centers for Disease Control and Prevention. They also suggested that vaccines could be delivered through nasal sprays or skin patches.
Borio expressed frustration that no federal system links testing to treatments, so that high-risk people can get prescriptions for new antivirals right away.
The authors said they felt unheard by Biden's team.
"We understand that they have their hands full and are working to try to do everything right to get through this surge," said Rick Bright, chief executive of the Rockefeller Foundation's Pandemic Prevention Institute. He led a federal biomedical agency during the Trump administration and cowrote two of the pieces.
"But at the same time, we think a lot of work still needs to be done to see through that smoke to see how this is going to end, and start laying down steps for how we will be able to live a normal life" with the virus, Bright told the Times.
Biden had a pandemic strategy when he was inaugurated and recently released a winter strategy, the Times reported.
A first step could be retiring old and tired public health categorizations and focusing on the aggregate risk of all respiratory infections, the experts suggested. Figuring out what rates hospitalization and death will cripple hospitals could lead to a metric for when emergency measures should be taken, they added.
"The administration had a strategic plan a year ago and executed very well on it through June, with a lot of people getting vaccinated, and drove down case counts very successfully," Emanuel told the Times. "As we transition to endemic COVID, we need to change our understanding of what a success is, what target we're aiming at."
The U.S. Centers for Disease Control and Prevention has more on COVID-19.
SOURCES: Journal of the American Medical Association, Jan. 6, 2022; New York Times