Back to basics: the outbreak response pillars

Abstract

The Global Outbreak Alert and Response Network (GOARN), with more than 250 technical partner organisations across the world, has undertaken 150 operations in response to disease outbreaks during the past 20 years. We read with interest the Editorial entitled, COVID-19: the worst may be yet to come.1The LancetCOVID-19: the worst may be yet to come.Lancet. 2020; 396: 71Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar GOARN has learned that the worst can be avoided through rapid and robust action to minimise the transmission of severe acute respiratory syndrome coronavirus 2. This prevention and control involves the core pillars of the outbreak response: surveillance and contact tracing, testing, case management, infection prevention and control, epidemiological and outbreak analytics, logistics, risk communication, and community engagement. Lockdowns and border closures are not a desirable long-term strategy; these measures should be used to gain time for building up capacities for a public health response. To this end, the GOARN Steering Committee urges all governments and partners at a local level to (1) engage communities to build trust for evidence-based public health and encourage local ownership of outbreak control response measures; (2) discourage the politicisation of the COVID-19 response because politicisation is counterproductive and leads to poor strategic decisions; (3) leverage in-country expertise of experienced outbreak responders, including GOARN partners and emergency medical teams, because current decisions can be strengthened by expanding the advisory pool; (4) invest in the rapid expansion of the public health workforce for this response; (5) make decisions on the basis of a comprehensive strategy, the latest evidence, and the epidemiological situation (eg, supervised isolation for infectious patients and mandated mask wearing have been shown to improve outcomes), and explain these decisions clearly;2Koob SF “Very disappointing”: people with COVID-19 not staying home, going to work.https://www.theage.com.au/national/victoria/very-disappointing-people-with-covid-19-not-staying-home-going-to-work-20200730-p55gwf.htmlDate: July 20, 2020Date accessed: August 5, 2020Google Scholar, 3Ali ST Wang L Lau EHY et al.Serial interval of SARS-CoV-2 was shortened over time by nonpharmaceutical interventions.Science. 2020; (https://doi.org.10.1126/science.abc9004 published online July 21.)Crossref Scopus (172) Google Scholar, 4Lyu W Wehby GL Community use of face masks and COVID-19: evidence from a natural experiment of state mandates in the US.Health Aff (Millwood). 2020; 39: 1419-1425Crossref PubMed Scopus (380) Google Scholar (6) ensure equitable access to diagnostic tests, therapeutics, and vaccines, which should be allocated according to sound public health criteria and needs; and (7) champion multilateral action and international solidarity. WHO is key to the international response as the organisation offers both a global direction to each nation and tailored technical assistance to responders. We declare no competing interests. Download .pdf (.07 MB) Help with pdf files Supplementary appendix COVID-19: the worst may be yet to comeAs much of western Europe begins to ease countrywide lockdowns, globally the pandemic may still be in its infancy, with more than 160 000 new cases reported each day since June 25. Individual countries count cases differently, so direct comparisons are difficult, but the numbers illustrate a worrying pattern. At a subnational level the picture is nuanced, with local hotspots, but at a country level the picture is clear—the world is facing a worsening multipolar pandemic. Full-Text PDF