In new report, CIDRAP at the University of Minnesota outlines COVID-19 realities, advises on next steps

Seeing a need for recommendations to help navigate the COVID-19 pandemic based on current realities and restrictions — not on technology we hope to one day have — the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota yesterday published the first report in a multipart series titled, "COVID-19: The CIDRAP Viewpoint."

In the first report, "The future of the COVID-19 pandemic: lessons learned from pandemic influenza," noted CIDRAP Medical Director Kristine Moore, M.D., M.P.H., Harvard University epidemiologist Marc Lipsitch, D.Phil., and U.S. historian and 1918 pandemic influenza expert John Barry, M.A., join CIDRAP Director Michael Osterholm, Ph.D., M.P.H., to paint a picture of the pandemic and detail how it's behaving more like past influenza pandemics than like any coronavirus has to date. And, because of that, certain inferences can be drawn — such as the fact that it may well last 18 to 24 months, especially given that only 5% to 15% of the U.S. population is likely infected at this point.

Key recommendations from the report:

• States, territories, and tribal health authorities should plan for the worst-case scenario (which involves a large second peak of cases in the fall of 2020), including no vaccine availability or herd immunity.
• Government agencies and healthcare delivery organizations should develop strategies to ensure adequate protection for healthcare workers when disease incidence surges.
• Government officials should develop concrete plans, including triggers for reinstituting mitigation measures, for dealing with disease peaks when they occur.
• Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon and that people need to be prepared for possible periodic resurgences of disease over the next two years.

"We realize that other expert groups have produced detailed plans for reopening the country after stay-at-home orders and other important mitigations steps are eased," said Osterholm, University of Minnesota Regents Professor, McKnight Presidential Endowed Chair in Public Health. "So with this report we sought to add key information and address issues that haven't garnered the attention they deserve — not to duplicate efforts. And the steps we recommend are based on our current reality and the best available data.

"For example, the first CIDRAP Viewpoint report lays out three scenarios for how cases might ebb and flow in the coming months. We are now on virus time, and no one knows exactly how this virus will behave. But, based on what scientists have recorded so far and on previous influenza pandemics, we illustrate some of the possibilities.

"The goal is to help planners envision some of the situations that might present themselves later this year or next year so that they can take key steps now, while there's still time."

Osterholm added, "The key message of this report is that the COVID-19 pandemic likely will not end any time soon, if any of the scenarios we have outlined come to pass. We need to be prepared to deal with this pandemic and its 'aftershocks' for 18 months or more. It’s also likely that the virus will remain with us once the pandemic is over—likely in a less severe form and following more of a seasonal pattern."

Future reports in the "COVID-19: The CIDRAP Viewpoint" series will address crisis communication, testing, contact tracing, surveillance, supply chains, and epidemiology issues and key areas for research.

COVID-19 is a respiratory illness that was first identified in Wuhan, China, in December 2019. Just this week, confirmed U.S. cases topped 1 million, and the global total has now topped 3.2 million confirmed infections, including more than 225,000 deaths.

The Viewpoint reports are made possible with support from the University of Minnesota Office of the Vice President for Research and the Bentson Foundation.

About the Center for Infectious Disease Research and Policy
The Center for Infectious Disease Research and Policy is a global leader in addressing public health preparedness and emerging infectious disease response. Founded in 2001, CIDRAP is part of the Office of the Vice President for Research at the University of Minnesota.