Recently, the U.S. reached a grim milestone: We now have more confirmed cases of COVID-19 than any other nation, even without widespread testing. The number of confirmed cases continues to grow exponentially.
We applaud the Commonwealth of Pennsylvania for planning to enact a statewide stay-at-home order to promote social distancing and limit the spread of COVID-19. However, more needs to be done immediately to combat this severe and extremely contagious disease — which can cause irreparable lung damage and, per current estimates, kills those it afflicts at 15-20 times the rate of influenza.
Enforcement of nonessential business closures must be enhanced to make sure that the sacrifices made by our citizens who do stay at home are not in vain because a few either ignore or do not understand social distancing.
Discordance between state and city guidelines has created confusion, demonstrating a lack of coordination and understanding of the rapid disease transmission. Likewise, a lack of information presented by the state to emphasize the necessity of social distancing to slow the spread of the disease has led to a widespread misunderstanding of why we are doing this. The “Why me? I am healthy.” question still needs to be answered for many Pennsylvanians.
Since COVID-19 reached the United States, there has also been a woeful lack of testing. Pennsylvania is no exception. Without testing, Pennsylvania cannot adequately characterize the burden, breadth, and severity of COVID-19 among our 12.8 million citizens. To protect everyone, and especially our health-care providers, test results must become available more quickly. Potentially exposed health-care providers wait as long as a week before receiving their results, during which time many continue contact with patients and their families. No one needs quick testing results more than health-care providers, both to maintain their own health and because, if positive, they pose a significant threat to the health of others.
Philadelphia and Montgomery Counties have been forthcoming in providing data on neighborhoods where cases occur. Montgomery County also provides age, gender, hospitalization vs. home quarantine, and presumed point of infection. However, the Commonwealth of Pennsylvania has refused to provide this information on the basis of the Disease Prevention and Control Law of 1955. This law, intended to protect people stricken with venereal disease from public stigma, is being inappropriately applied to COVID-19, a respiratory disease. Release of descriptive data, including positive and negative results, and the location of likely clusters of infection will help guide the deployment of critical resources, alert clinicians and public health professionals in those areas, and give the public an understanding of the risk of spread.
The commonwealth must become proactive rather than reactive. Decide on metrics in advance for how long we will require social distancing and the closures of schools, businesses, and events. Provide realistic, sustainable guidance to Pennsylvanians about how to protect themselves from COVID-19, and how long we anticipate needing these practices, and give real consideration to how we eventually reopen everything without incurring a new outbreak.
We call upon the commonwealth to make available data and resources so that the academic research community can help in this fight. We stand ready to work with you to address COVID-19 in Pennsylvania, including helping to increase transparency in characterizing cases and deaths attributable to COVID-19. Together, we can expand testing resources by providing more drive-thru and walk-up clinics and mobile testing. Our faculty and students at Temple University’s College of Public Health are willing and able to assist with contact tracing and informing contacts of exposures so that they can self-quarantine and seek testing when necessary.
There is no time left to delay.