Former FDA commissioner: 'We Are Not Opening Back Up to the Way Things Were Before'

Margolis Center Director Mark McClellan addresses media on reopening in pandemic

Part of the From Health Care to Child Care, the Impact of COVID-19 Series
Former FDA commissioner -- “We Are not opening back up to the way things were before”

As the nation continues to figure out how to reopen schools, businesses and other public spaces, citizens need to understand life won’t quickly return to how it was prior to the COVID-19 pandemic, a Duke public health expert cautioned Friday.

Progress will come gradually, with occasional steps backwards as well. The new normal won’t look like the old normal, cautioned Dr. Mark McClellan, a physician and economist who directs the Duke-Margolis Center for Health Policy.

Formerly the commissioner of the U.S. Food and Drug Administration and administrator of the Centers for Medicare & Medicaid Services, McClellan spoke Friday and took questions from reporters.

Audio and video from the event are available here.

Here are excerpts:

ON WHAT IT WILL LOOK LIKE WHEN BUSINESSES START TO REOPEN

Dr. Mark McClellan, physician and economist who directs the Duke-Margolis Center for Health Policy; former commissioner of the U.S. Food and Drug Administration.

“We are not opening back up to the way things were before.”

“We are all in this together with the virus still around us. As businesses reopen it’s not going to be under the same circumstances as before. You’ll see, hopefully, a lot of steps like we’ve seen in grocery stores and other essential businesses. Distancing, additional cleaning and disinfection.”

“Practices among employees to make sure that if they’re potentially sick they’re not coming into work, they’re practicing the same kind of isolation we’ve had universally. And new steps by customers as well. Face masks are going to be common. Respecting space. And being careful not to go out if you have any kind of COVID-19 symptoms.”

“If you’re living with people who are going out more, they need to take some extra precautions. I also want to emphasize the testing and containment part of this phase. Our test capacity is ramping up. It’s not where we’d ideally like to be but it’s getting better.”

“Steps in multiple dimensions that should happen gradually with an expectation that we may need to take a pause in some areas and maybe even go backif there are signs of the epidemic picking back up again.”

ON CONTACT TRACING CAPACITY

“It’s scaling up at different paces in different areas of the country. The volume of tracing needed will vary as well. In areas that are facing continued increases in cases … that’s more contacts to trace so those areas will need a more aggressive attention to contact and tracing. In areas with more control … it’s easier to get to the stage of being able test and trace every case.”

“If you look around the country, the New York/New Jersey region is expanding hundreds of contact tracers as part of their efforts to expand testing. In California there are some innovative, digitally-supported aided efforts. And in Texas some medical centers … have increased capacity.”

“You’re going to see around the country in the coming days and weeks hundreds and thousands of new jobs as part of these efforts towards containment.”

ON REOPENING SCHOOLS

“They are places where inherently there is close contact between children. That’s impossible to avoid, especially at younger ages. That means there’s some potential risk for spread. While the good news about the pandemic is that it does not seem to affect otherwise healthy kids very seriously at all compared to people who are older or with chronic conditions …. but kids can still be potential sources of transmission.”

“The special considerations around reopening daycares, Pre-K as well as schools involve minimizing transmission, partly for the kid’s own sake but also for preventing spread back to family members or others in the community.”

“So you’ll see some of these same steps – attention to frequent handwashing and disinfection. Maybe not as much use in the Pre-K of toys that can’t be cleaned easily. Maybe a bit more social distancing. I don’t think we’ll see 2-year-olds with masks, but maybe more games where kids are flapping their arms or doing other things that aren’t so close contact.”

“We really need to get our schools and early child programs reopened. This is so important for the development of children, so important for their wellbeing, but also so important for helping their parents and the rest of the people in the United States to get back to work. It’s a very high priority area and you’ll see a lot of effort to get this right.”

ON WHETHER IT’S SMART TO INGEST DISINFECTANT TO KILL A COVID-19 INFECTION

“That’s definitely not a good idea. People really need to understand that disinfection is very important for surfaces, for things that they may come into contact with. There are very effective disinfectants for killing the virus and that is a critical part of reopening.”

“We need to keep businesses clean and common surfaces clean.”

“That is different, that is completely different, from treatments for people who have COVID-19. Ingesting disinfectants, or anything like that, it is still poisonous, it’s not a good idea for the treatments. It’s important for people to listen to the public health authorities.”

“Disinfection is important but not for ingestion or for improving your outcome if you have COVID-19.”

Meet the expert:

Dr. Mark McClellan
Dr. Mark McClellan is a physician and economist who directs the Duke-Margolis Center for Health Policy, where he works on strategies and policy reforms to improve health care. He was commissioner of the U.S. Food and Drug Administration and administrator of the Centers for Medicare & Medicaid Services.

Read more news about Duke experts and the coronavirus pandemic here.

###