Core Elements of a National COVID-19 Strategy: Lessons Learned from the US National HIV/AIDS Strategy
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EDITORIAL
Core Elements of a National COVID‑19 Strategy: Lessons Learned from the US National HIV/AIDS Strategy David R. Holtgrave1 · Ronald O. Valdiserri2 · Seth C. Kalichman3 · Carlos del Rio4 · Melanie Thompson5
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract COVID-19 has caused devastating health consequences and social inequities globally and in the United States. Unfortunately, the US has not developed a comprehensive National COVID-19 Strategy. In this editorial, we briefly review lessons about the development, structure, implementation and evaluation of the National HIV/AIDS Strategy (NHAS) for the US, and use these lessons to inform an initial proposal for a timely, dynamic, evidence-based, participatory, comprehensive and impactful National COVID-19 Strategy. Without such a strategy, the national response to the COVID-19 pandemic will remain uneven across jurisdictions and less than optimally impactful on disease-related mortality, short- and long-term morbidity, and health and social inequities. Keywords COVID-19 · HIV · Strategic planning · SARS-CoV-2 · Health disparities
The Urgent Need for a National COVID‑19 Strategy SARS-CoV-2, the virus that causes COVID-19 disease, will have soon resulted in the death of over 200,000 persons in the US [1] and is predicted to cause at least tens of thousands and possibly hundreds of thousands more deaths yet this year based on current trends [2]. As a result, COVID-19 is on track to be the third leading cause of death in the nation in 2020 behind only heart disease and cancer [3]. Stark racial and ethnic disparities exist in COVID-19, with Black, Latinx and Indigenous communities especially disproportionately impacted [4, 5]. Further, lived experience with the disease teaches us that following acute infection, many persons
* David R. Holtgrave [email protected] 1
School of Public Health, University at Albany, 1 University Place, Suite 100, Rensselaer, NY 12144, USA
2
Rollins School of Public Health, Emory University, Atlanta, USA
3
University of Connecticut, Mansfield, USA
4
Emory University School of Medicine and Rollins School of Public Health, Atlanta, USA
5
AIDS Research Consortium of Atlanta, Atlanta, USA
experience long-term sequelae, sometimes with debilitating symptoms [6]. While SARS-CoV-2 is highly infectious with person-toperson airborne transmission being the major mechanism of transmission [7], there are highly effective, evidence-based non-pharmacologic preventive strategies that have been shown to be highly effective in areas such as New York State where numbers of cases, percent positivity, and deaths were reduced to dramatically lower levels in a few months’ time [8]. The non-pharmacologic prevention toolbox includes testing, contact tracing, the wearing of face masks, physical distancing, hand washing, disinfecting of surfaces, staying home when ill, and improved air filtration strategies, among others [9, 10]. Further, while there is currently no vaccine or cure for COVID-19, case fatalit
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