Risk based approach will optimize socioeconomic recovery

In a recent editorial, the Editor-in-Chief, Dr. James J James states that there are currently two potential public health crises in the US. The first, COVID-19, we are all too aware of and are currently in the throes of attempting to control it through containment and mitigation. We are currently focusing on extreme containment measures, which cannot work as the transmission has already occurred nationwide. Data from South Korea and Italy indicate such measures may not even be necessary or very effective.

The side effect of these extreme measures is severe socio-economic damage realized through negative impacts on income, employment, and education, the recognized critical social determinants of health necessary for physical, mental, spiritual, and social wellbeing. This will unleash a second public crisis which , history shows, will have far greater negative impacts on overall morbidity and mortality than that which we are currently seeing from COVID-19.

To contain and mitigate both crises, we need national and state level strategies based on what we know of the epidemiological and clinical aspects of this disease. These strategies need to be targeted across individual and community risk determined by known risk factors such as age, population density, and transmission characteristics. This will enable us to begin recovery and transition back to a healthy economy while taking the necessary measures to address COVID-19.