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Former FDA Leaders, Health Experts Urge Action Now to Contain COVID-19 in Future

Proponents include Dr. Mark McClellan, director of the Duke-Margolis Center for Health Policy

DURHAM, N.C. – Now is the time for the United States to start building its capabilities to test, track and trace COVID-19 in the future, according to a new working paper issued Tuesday by national leaders in public health and policy, including two former Food and Drug Administration commissioners.

The new national COVID-19 surveillance strategy is designed to ensure a swift, effective response to contain further spread of the virus. Specifics are mapped out in the paper issued by the Duke-Margolis Center for Health Policy.

Co-authors include Dr. Mark McClellan, director of the Duke-Margolis Center for Health Policy, and Dr. Scott Gottlieb, a resident fellow with the American Enterprise Institute. Both are former FDA commissioners and physicians. They and their co-authors recognize the urgency of addressing patient care and resource needs to mitigate the current outbreak.

At the same time, they understand it is vital to prevent and contain any future COVID-19 outbreaks, especially as the country reduces intensive physical distancing measures and stay-at-home rules.

“We need to implement the tools and policies to conduct more effective surveillance, containment, and case management of COVID-19 for the future,” write the co-authors. “Building these capabilities now will accelerate our ability to assure the public’s safety -- the foundation for a sustainable and secure approach to reopening our communities.”

The co-authors urge that every region of the country aim to have the following outbreak surveillance and response capabilities:

  1. Test and Trace Infrastructure: Capacity for widespread rapid diagnostic testing for everyone with COVID-19 symptoms and the ability to share data to enable swift interventions of new cases;
  2. Real-Time Surveillance:  Integration of regional virus testing and tracing into a  national surveillance system to monitor spikes and falls in COVID-19-related symptoms and to provide timely, transparent reporting of outbreaks and responses;
  3. Blood (Serological) Testing: Capacity to conduct widespread blood testing to identify reliable indicators of immunity in individuals and track virus exposure in communities;
  4. Rapid Response: Capacity for isolation, contact tracing and quarantine of new COVID-19 cases and ability to treat patients effectively at home or in a hospital.

The co-authors believe this national effort should be coordinated and largely funded through the Centers for Disease Control and Prevention, in collaboration with state and local public health authorities. The effort should leverage federal funding and oversight through COVID-19 grants to states. The Centers for Medicare and Medicaid Services and private payers should provide support for health care providers.

“The federal government should coordinate goals and resources, while state and local authorities should manage operational details of implementation,” the co-authors added.

“A National COVID-19 Surveillance System: Achieving Containment” is the third in a series co-authored by Gottlieb and McClellan since March 2020. Additional papers include:

More information about this work is available at