The 4 benchmarks needed to end social distancing

Until there is a vaccine or effective treatment against COVID-19, states should direct efforts toward four major criteria that will help determine local progress, according to a report cited by The New York Times.

The report was written by Scott Gottlieb, MD, former FDA commissioner; Caitlin Rivers, PhD, assistant professor at Baltimore-based Johns Hopkins Center for Health Security; Mark McClellan, MD, PhD, director of the Robert J. Margolis Center for Health Policy and professor at Durham, N.C.-based Duke University; Lauren Silvis, former FDA chief of staff; and Dr. Crystal Watson, senior scholar and assistant professor at Johns Hopkins Center for Health Security. 

Criteria that will determine if and when areas can come out of lockdown: 

1. Hospitals must be able to safely treat all patients needing hospitalization without resorting to crisis standards of care. This is the first standard to meet and the focus of most health officials, according to the authors. Currently, there's no reason to believe any area meets this criteria, and many local outbreaks aren't predicted to peak for weeks.

2. A state needs to be able to test at least everyone with symptoms. Nationwide, about 750,000 tests would be needed a week, and that's not including areas with major outbreaks. On a smaller scale, states would need to test every person who may be infected and receive the results in a timely manner. The third requirement cannot be achieved until the second occurs.

3. The state can monitor confirmed cases and contacts. A robust system of contact-tracing and isolation is the only thing that can prevent outbreaks and sequential lockdowns, the authors write. Scaling up some areas' public health systems to handle such a task would take significant time and money, NYT notes. Other countries have used cellphone-tracking technology to determine who people have been near, but it's unclear if the U.S. would allow such a tactic.

4. Cases must continue to decrease for 14 days. It can take up to two weeks for COVID-19 symptoms to emerge, so if the number of cases drops steadily for that much time, officials can be reasonably sure suppression has been achieved, or that every infected person is infecting fewer than one other.  

More articles on public health:

California loans 500 ventilators to national stockpile; Navy ship to accept COVID-19 patients + 23 other updates from the 6 hardest-hit states
1 in 8 Americans know someone with COVID-19
The US populations tested most, least for COVID-19

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