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Invent Nothing, Adapt Everything (again)

A few years ago, I wrote a blog for my company about our response to the Ebola crisis in West Africa. That crisis hit hard and fast in some of the poorest countries in the world. We in the global public health area responded as best we could with the resources we had at hand. What we discovered, and I noted in my blog then, was we needed to use what was currently available. 

I came up with a rubric to help people understand our approach: Invent nothing, adapt everything. The idea was that we could not bring anything new into the arena, we had to use what was already there. That was a decision forced upon us the material circumstances in West Africa. In our current crisis over COVID-19, we face a different issue. 

The United States leads the world with the greatest number of confirmed infections of SARS-CoV-2, the virus that causes COVID-19 disease. WHO conservatively reported 830,053 US cases on April 24. We also lead in the number of deaths, again by WHO's conservative report42,311. These are sobering numbers in any country, but one with the economic and medical resources of ours it moves into a realm beyond tragedy. Frankly, it is irresponsible that our response has not been more effective. 

We do not lack the scientific, manufacturing, or financial wherewithal to address the needs for personal protective equipment, testing for both diagnosis and serological evidence, and fielding trained personnel for contact tracing. These issues have been well documented elsewhere. 

What we lack is coordination and consistency. Some would call that leadership. The failures of our federal government to address the crisis are now obvious, and we should not look to them for remedies soon. We must act at a different level. 

Governors are the executives who have been struggling with the outbreaks in their states. They have relied on their own state departments of public health to understand the issues and address the needs. Sadly, their responses have not been coordinated or consistent. They often bid against each other for badly needed supplies and equipment. They have no mechanism for shifting personnel between states to address growing outbreaks. They are uncoordinated and inconsistent in their responses. This must end. 

Here are my naive ideas on a response. There are probably better ones, but these can be adopted today. They only require a few people to get the ball rolling. 

The National Governors Association offers guidance and some links to potential resources, but it has not embraced the administrative function to coordinate resources. Granted, this should be a federal responsibility, but we cannot depend on them. The NGA needs to establish an emergency operations center and work with each state to understand their needs and present them to other states and the private sector for fulfillment. Nothing need be invented. Use eBay. 

Every state has a chapter of the Medical Reserve Corps. It's supposed to be administered by the US Health and Human Services Department, but let's assume that they are not helping. Each state can connect through the NGA with information on volunteers with skills suitable for deployment to meet COVID-19 demands in hotspots. Every state has the data and can contribute it to a common information resource, so the governors can see what is available. Use Google Sheets.

Absent leadership, our states must step forward to address the pandemic. It is not going to end soon. We face months of uncertainty, fear, illness, and death. To address these challenges, we need coordination and a common resource for information. The tools have been invented. Adapt and use them. 

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