A Proposed Framework for Risk-Based Interdiction of Coronavirus
As referenced in this New York Times column by Thomas L. Friedman.
A risk-stratified, rather than population-wide, approach to COVID19 interdiction is supported by separate computer models from scientists at MIT and at University of Pittsburgh/Carnegie Mellon.
Operationally, the approach would likely involve a sequence of phases, roughly mapped out here:
Vertical Interdiction (i.e., risk-stratified) Coronavirus Response – Tactical Sequence
- Phase 1; IMMEDIATE /URGENT:
o Reaffirm value of social distancing/sheltering in place
o Announce plans for plans in phases
o Continue all forms of social distancing
o Minimize spread
o Address medical system resource shortages
o Care for those in urgent need
o Resource optimization for medical care delivery during the early surge
- Phase 2; NOW:
o Deploy widespread testing; ideally to include drive-through at pharmacies and mobile testing
o Active case ascertainment and containment
o Teams focused on data analysis and risk stratification (state and federal authorities, multidisciplinary working groups of experts; CDC, NIH, NAM, etc.)
o On-going care for those most in need of special services
o Public announcement of this multi-phasic plan so the public knows that the current shut-down is not indefinite
- Phase 3; NEXT:
o Public announcements regarding results of data analysis
o If U.S. data conform to global data, a very high percentage of all cases will be relatively mild, and only a tiny portion of the general population will be deemed at ‘heightened risk’ of severe infection
o If the above proves true, move to vertical (risk-based) interdiction strategies, and de-isolate much of the population
- Phase 4; TO FOLLOW:
o On-going monitoring/case ascertainment/containment
o Concentrated allocation of services/support measures to high-risk population still in isolation
o Work on treatments/vaccines
o On-going data analysis to refine risk criteria
- Phase 5; CLOSURE:
o Verify near-zero spread in the population
o Confirm herd immunity
o De-isolation of the high-risk population
o Global dissemination of advances, best practices: treatments, vaccine