COVID-19 response and communications must be directed by public health officials

In a commentary in The American Journal of Medicine noted public health experts say appropriate concerns – not fear – should play a major role in the emerging pandemic, and political leaders should empower public health officials to drive the response


Philadelphia, March 19, 2020

In the United States today, healthcare providers seem appropriately confused about present and future issues concerning coronavirus disease 2019 (COVID-19). In a commentary in The American Journal of Medicine, published by Elsevier, internationally recognized public health experts say that the current, incomplete totality of evidence provides cause for serious concerns, but more importantly it creates an urgent need for public health leadership that can direct the country’s response with neither reassurance nor alarm.

“Based on the existing incomplete totality of evidence, it appears that coronavirus is comparable in communicability to influenza but with perhaps a 10 fold higher case fatality rate,” said lead author Charles H. Hennekens, MD, DrPH, First Sir Richard Doll Professor & Senior Academic Advisor to the Dean at Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, FL, USA.

In the flu season from 2018 to 2019, about 42.9 million Americans were clinical cases, of which 647,000 were hospitalized and about 61,200 died. If the epidemic continues to propagate in the US in a similar fashion, there may be 612,000 deaths and perhaps millions of hospitalizations. This staggering estimate of number of hospitalizations could paralyze the US healthcare delivery system.

Professor Dennis Maki, MD, Professor of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, and senior author stated further, “Public health considerations should govern everything we do during this pandemic, not political expediency.”

From influenza to smallpox, the authors write, the systematic collection, consolidation, and dissemination of data to all who need to know, along with robust surveillance systems, were critical factors in the control of pandemics. They cite the example of the collaboration between Alexander D. Langmuir, MD, who directed epidemiologic programs at the Centers for Disease Control and Prevention (CDC), and Donald A. Henderson, who was the chief of Virus Disease Control at CDC. Over just slightly more than a decade, and during the tenures of four Presidents – Kennedy, Johnson, Nixon, and Ford – these public health experts led both American and worldwide efforts that resulted in smallpox being the first human disease ever eradicated from earth. Both Dr. Hennekens and Dr. Maki trained under Dr. Langmuir and Dr. Henderson as Lieutenant Commanders in the United States Public Health Service Commissioned Corps (USPHS) serving as Epidemic Intelligence Service (EIS) Officers with the CDC.

The authors emphasized that collegial and collaborative multifactorial preventive and therapeutic measures in the US and throughout the world are warranted to control the COVID-19 pandemic. As to who should lead this effort, the authors have a recommendation. “We believe Anthony S. Fauci, MD, Director of the United States National Institute of Allergy and Disease, is the Babe Ruth of virology in general and influenza in particular. His proven capacity and capability for collaborative expert leadership to guide the US and the world through this pandemic and to ensure our preparedness for the challenges ahead would be beneficial to all.”

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Notes for editors
The article is “The Emerging Pandemic of Coronavirus: The Urgent Need for Public Health Leadership,” by Charles H. Hennekens, MD, DrPH, Safiya George, PhD, APRN-BC, FAANP, Terry Adirim, MD, MPH, MBA, Heather Johnson, MD, MS, FACC, FAHA, and Dennis G. Maki, MD (https://doi.org/10.1016/j.amjmed.2020.03.001). It appears in The American Journal of Medicine published by Elsevier. The article is openly available at www.amjmed.com/article/S0002-9343(20)30207-2/fulltext.

Full text of this article is also available to credentialed journalists upon request. Contact Jane Grochowski at +1 406 542 8397 or hmsmedia@elsevier.com to obtain copies. Journalists who would like to interview the study authors should contact Gisele Galoustian, Division of Public Affairs, Florida Atlantic University, at +1 561 297 2676, +1 561 985 4615 (mobile), or GGALOUST@fau.edu.

The article is part of Elsevier’s Novel Coronavirus Information Center, which provides expert, curated information for the research and health community on Novel Coronavirus (also referred to as COVID-19 and its temporary title 2019-nCoV). All resources are free to access and include guidelines for clinicians and patients. The Research presents the latest early stage and peer-reviewed research from journals including The Lancet and Cell Press, as well as a link to the Coronavirus Hub on ScienceDirect, where you will find every article relevant to Coronavirus, SARS, and MERS freely available. Under the Clinical Solutions tab you will find resources for nurses, clinicians and patients, including FAQs on symptoms. www.elsevier.com/connect/coronavirus-information-center

About the authors
Charles H. Hennekens, MD, DrPH,
is the first Sir Richard Doll Professor and Senior Academic Advisor to the Dean at the Florida Atlantic University Charles E. Schmidt College of Medicine. He was first John Snow and first Eugene Braunwald Professor of Medicine at Harvard Medical School and first Chief of Preventive Medicine at Brigham and Women’s Hospital. His 173 H-index ranks him #14 Top Scientist in World. He was 3rd most widely cited medical researcher in world and 5 of top 20 were former trainees. He is #81 in world history for saving 1.1 million lives. He is a Fellow of the American College of Preventive Medicine (FACPM) and the American College of Cardiology.

Safiya George, PhD, APRN-BC, FAANP, is Professor and Dean, Christine E. Lynn College of Nursing at the Florida Atlantic University. She previously served as a Faculty in Residence at both The University of Alabama and at Emory University where she led the “Bridging Academics, Service and Ethics” Program. In 2019, she was awarded the 2019 President’s Faculty Research Award at the University of Alabama. She is a board-certified Adult Nurse Practitioner and in 2018, she was inducted as a Fellow of the American Academy of Nurse Practitioners.

Terry Adirim, MD, MPH, MBA, was recently Deputy Assistant Secretary of Defence for Health Affairs at the Department of Defence and a senior medical official at the Department of Homeland Security during the 2009-H1N1 Pandemic. Currently she is Senior Associate Dean for Clinical Affairs, and Professor of Pediatrics and Chair of the Department of Integrated Medical Sciences at the Florida Atlantic University Charles E. Schmidt College of Medicine.

Heather Johnson, MD, MS, FACC, FAHA, is a Preventive Cardiologist/Cardiologist at Boca Raton Regional Hospital’s Christine E. Lynn Women’s Health & Wellness Institute, where she leads the preventive cardiology program at the Institute’s Blechman Center for Specialty Care and Preventive Cardiology. Dr. Johnson earned her medical degree from the University of Wisconsin School of Medicine where she also received an MS in population health and trained first in internal medicine and later in cardiology. In addition, she earned her master of medical management at the University of Southern California. She is a Fellow of the American College of Cardiology and the American Heart Association.

Dennis G. Maki, MD, is a Professor of Medicine at the University of Wisconsin School of Medicine and Public Health. An infectious disease consultant, critical care physician, and epidemiologist, he has devoted his research career to the prevention of nosocomial infections and management of life-threatening infections. A past consultant to the CDC, NIH, FDA, HHS, GAO, and the UK NHS, he is former President of the Society for Healthcare Epidemiology of America and Councillor of the Infectious Diseases Society of America. He has received numerous awards, including the CIPI Award of the International Congress on Infection Control of the Societe de Pathologie Infectioense de Langue Francise, WHO, and CDC for global contributions to the prevention of infection. In 2000 he was made a Master of the American College of Physicians and was cited by the Infectious Diseases Society of America for lifetime achievements in the field of infectious diseases. In 2002 he was named to the HHS Secretary’s Council on Public Health Preparedness. In 2019, he received the Wisconsin Alumni Association Distinguished Alumnus Award.

About The American Journal of Medicine
The American Journal of Medicine, known as the “Green Journal,” is one of the oldest and most prestigious general internal medicine journals published in the United States. The official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at 125-plus US medical schools, AJM publishes peer-reviewed, original scientific studies that have direct clinical significance. The information contained in this article in The American Journal of Medicine is not a substitute for medical advice or treatment, and the Journal recommends consultation with your physician or healthcare professional. www.amjmed.com

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. www.elsevier.com

Media contact
Jane Grochowski, Publisher
Elsevier
+1 406 542 8397
hmsmedia@elsevier.com