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US health expert: covid-19 may permanently increase the number of diseases handled by the U.S. medical system

via:cnBeta.COM     time:2020/8/27 8:30:50     readed:502

According to the verge, the foreign media, after the first nine months of struggle with covid-19, it is clear that people will probably deal with covid-19 forever.This means that the U.S. public health system will have to adapt to it and permanently integrate covid-19 into doctors' offices, virus monitoring and hospital planning. "It will be part of our day-to-day, or certainly seasonal, within the health system and within the country ," said Megan Ranney Emergency Doctor and Associate Professor of Emergency Medicine at Brown University. And that means how to diagnose respiratory diseases, how to monitor COVID-19, and how many hospital beds are available.

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The U.S. medical system has adapted new, previously unknown viruses. HIV transition from emergency to normal care -- research has helped doctors understand the virus, and the development of new and improved treatments has greatly improved the relationship between people and disease. Influenza virus, the last pandemic virus, H1N1, become one of the regular influenza strains.

Researchers still don't know how long it will take COVID-19 transition from a sudden threat to a common, known disease, or what the new baseline will look like. All these details depend on the information that people have not yet mastered: how long people are immune to the virus after recovery, how effective the vaccine is, and whether new treatments can be developed. But eventually, COVID-19 will be part of our new normal, adding other respiratory viruses -- and changing what the system needs to be prepared to handle.

In the early days of the covid-19 pandemic, scientists and public health experts believed that the new coronavirus might take the road of SARS and mers: public health measures such as finding and isolating patients would stop the virus circulation and effectively remove it from the human population. But they no longer think it will happen. New coronaviruses are ubiquitous and can easily spread undetected. Even in places like New Zealand, where there are good public health policies aimed at eliminating it, cases will reappear: after more than 100 days of no new covid-19 cases, New Zealand has reported several new indigenous cases.

"We're going to tame the virus with vaccines and better treatments until it's reduced from emergency to more baseline things," said amesh adalja, who studies emerging infectious diseases and pandemic preparedness at the Johns Hopkins Center for health and safety. Adalja believes that although covid-19 tests are now run separately, they may be added to hospital standard tests. He believes that covid-19 will be more likely to become a routine diagnosis.

Some other public health adjustments may be permanent. The new coronavirus is already part of a surveillance network that monitors different virus levels in the United States. Erin Sorrell, an assistant research professor in the Department of Microbiology and immunology at Georgetown University, said adding the virus to standard reporting systems at the local, state and federal levels should not be logically complex. "We don't have to create it from scratch," she said. It requires money and infrastructure, but it is feasible.

Hospitals will also have to develop models that can predict the number of COVID-19 they may see in normal years. Adalja said they may need more beds than is usually needed during the flu season. Creating these models may be relatively simple, challenging hospital capabilities. Many hospitals across the country already need more space, even before the new virus emerges. The expansion of hospitals is complicated: it needs to harness zoning laws, state licensing regulations, and other bureaucratic hurdles. Adalja said that if they can not easily increase beds, hospitals will have to reconsider how to allocate existing resources every year.

If pharmaceutical companies can produce an effective covid-19 vaccine, then the list of vaccines that everyone must be vaccinated will also be expanded. Ranney said it would be a relatively easy task if the vaccine eventually became a one-off vaccine that provided long-term protection and could be added to the children's vaccination roster. But if, after the initial round of pandemic related vaccinations, it becomes something that most people have to vaccinate every year, just like the flu vaccine, it's complicated.

"We're not very good at getting most Americans vaccinated against influenza," she said. This will require another campaign by public health agencies to encourage people to get another vaccine on a regular basis, which will be a challenge - an expensive one. Despite these challenges, the transformation is in progress. Sorrell says there is no single checkpoint to mark the transition between acute threats and familiar issues. It is based more on people's perception of the threat than on its actual impact on the population. "It's a matter of comfort," she said.

Past experience with other viruses, such as HIV and polio, gives some hints of how the process might unfold. Each virus is different - but tailor-made public health measures and research help people understand the nature of the virus threat, which may reduce its threat over time. "We're going to reach a stable state of this virus," Ranney said. "The question is, what does that look like?"

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