Standing Committee on
Emerging Infectious Diseases and
21st Century Health Threats

ANNUAL REPORT 2020

Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats

SUMMARY BRIEF: DESCRIPTION OF ACTIVITIES

In response to the COVID-19 pandemic, the National Academies of Sciences, Engineering, and Medicine (the National Academies) assembled the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats to help inform the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response and the White House Office of Science Technology Policy (OSTP) on critical science and policy issues. The standing committee includes 27 experts in emerging infectious diseases, public health, public health preparedness and response, biological sciences, clinical care and crisis standards of care, risk communication, and regulatory and legal issues.¹

Since March 2020, the standing committee has consistently generated real-time policy recommendations and paved the way for the National Academies to produce an unprecedented amount of timely, evidence-based guidance in response to the COVID-19 pandemic. Drawing on contemporary evidence and best practices from previous preparedness and response efforts, the standing committee’s work has helped to correct misinformation and provided the nation with rapid, objective, evidence-based guidance to face this pandemic.

The standing committee’s novel rapid expert consultations have covered urgent questions such as crisis standards of care, diagnostic testing, and virus seasonality. The standing committee has also contributed to related National Academies’ reports on topics such as the equitable allocation of COVID-19 vaccines and a national data infrastructure for genomic sequencing of evolving, novel viruses.

The wide-ranging portfolio of the standing committee’s work has illuminated many aspects of the COVID-19 pandemic and how best to respond. Looking ahead, the multi-disciplinary experts on the standing committee stand ready to respond to the ongoing, core challenge of emerging infectious diseases and 21st-century health threats. These are challenges in the near and long term, and for individual nations as well as the global community of nations.

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RAPID EXPERT CONSULTATIONS

The National Academies contribute to policy decisions with objective, scientific, evidence-based guidance. The standing committee and additional subject-matter experts developed rapid expert consultations to respond to urgent technical questions on the COVID-19 pandemic using publicly available evidence. The objective, evidence-based consultations have been profoundly useful and impactful in better understanding COVID-19 and many unmet clinical research needs and in illuminating public health struggles.

Prepared by the standing committee and subject to accelerated review by the quality assurance arm of the National Academies, the Report Review Committee, these rapid expert consultations are the first of their kind and represent the best evidence available at the time. The science on these issues is continually evolving, and the scientific consensus on these topics will likely evolve with it.

Harvey V. Fineberg, M.D., Ph.D.
Chair, Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats

The standing committee has produced the following 15 rapid expert consultations from March 2020 to January 2021:

Rapid Expert Consultation on Allocating COVID-19 Monoclonal Antibody Therapies and Other Novel Therapeutics (January 29, 2021) focuses on monoclonal antibodies authorized for use in patients infected with SARSCoV-2. It describes the approaches taken at the federal, state, and local/institutional levels to ensure their effective, equitable, and fair allocation. It points to challenges in reaching underserved patients and aspects of reimbursement that could be improved.

Rapid Expert Consultation on Understanding Causes of Health Care Worker Deaths Due to the COVID-19 Pandemic (December 10, 2020) examines methods to better track and evaluate deaths and mental health consequences among health care workers due to COVID-19. It also explores the ways to support health care worker well-being and safety during the pandemic.

Rapid Expert Consultation on Critical Issues in Diagnostic Testing for the COVID-19 Pandemic (November 9, 2020) examines four topics related to the use and interpretation of COVID-19 diagnostic tests: advantages and limitations of reverse transcription polymerase chain reaction testing; the status of point-of-care tests; strategies and considerations for certain types and sequences of tests; and next-generation sequencing testing.

Rapid Expert Consultation on Staffing Considerations for Crisis Standards of Care for the COVID-19 Pandemic (July 28, 2020) outlines considerations for clinical staffing needs during crisis standards of care. These include adjusting staff responsibilities; providing “hazard pay” to staff; ensuring adequate time off; offering child care and other benefits; and leveraging health care coalitions to ensure the appropriate transfer of patients between hospitals.

Rapid Expert Consultation on SARS-CoV-2 Viral Shedding and Antibody Response for the COVID-19 Pandemic (April 8, 2020) examines the duration of viral shedding based on the stage of infection, clinical signs and symptoms, and patient attributes; the levels and duration of antibody response and related resistance to illness; and the optimal duration of isolation of cases.

Rapid Expert Consultation on SARS-CoV-2 Laboratory Testing for the COVID-19 Pandemic (April 8, 2020) discusses the uses, interpretation, and future directions of laboratory testing to provide scientifically grounded principles that are relevant to decision making about the interpretation of laboratory tests, covering the current pertinent studies and research needs for the future.

Rapid Expert Consultation on the Effectiveness of Fabric Masks for the COVID-19 Pandemic (April 8, 2020) discusses the effectiveness of homemade fabric masks to protect others from the viral spread of COVID-19 from potentially contagious asymptomatic or presymptomatic individuals. The consultation does not apply to either N95 respirators or medical masks.

Rapid Expert Consultation on SARS-CoV-2 Survival in Relation to Temperature and Humidity and Potential for Seasonality for the COVID-19 Pandemic (April 7, 2020) provides scientifically grounded principles that are relevant to decision making about the potential for seasonal variation of SARS-CoV-2, particularly regarding the reduction and resurgence of cases.

Rapid Expert Consultation on the Possibility of Bioaerosol Spread of SARS-CoV-2 for the COVID-19 Pandemic (April 1, 2020) responds to questions concerning the possibility that SARS-CoV-2 could be spread by conversation, in addition to sneezing and/or cough-induced droplets.

Rapid Expert Consultation on Crisis Standards of Care for the COVID-19 Pandemic (March 28, 2020) focuses on the guiding principles, key elements, and core messages that undergird crisis standards of care decision making at all levels.

Rapid Expert Consultation Update on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 27, 2020) provides an update on the March 15 rapid expert consultation concerning issues of virus survival on surfaces and in the air and virus/disease incubation period. It provides additional information as well as caveats about the work performed so far and various unmet needs.

Rapid Expert Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic (March 21, 2020) provides necessary data elements, sources of data, gaps in collection, and suggestions for data system design and integration to improve modeling and decision making for COVID-19. It highlights three major uses for data systems: determining community spread and impact; monitoring the clinical spectrum of illness to include response to treatment; and providing accurate, up-to-date information to feed into models to forecast disease rates and clinical and logistical needs for mitigation.

Rapid Expert Consultation on Social Distancing for the COVID-19 Pandemic (March 19, 2020) responds directly to a question from OSTP about evidence on the effectiveness and costs of social distancing measures in contending with COVID-19.

Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020) responds to two questions: What is the survival of the virus on surfaces? What is the incubation period (time between exposure and onset of symptoms)?

Rapid Expert Consultation on Severe Illness in Young Adults for the COVID-19 Pandemic (March 14, 2020) addresses whether reports of severe illness in younger adults in Italy may represent a change in the pattern of susceptibility, even though early reports from China indicated that severe illness among young adults occurs at a lower frequency than among older persons.

SHORT CONSENSUS STUDY REPORTS

In addition to the rapid expert consultations, the standing committee also released two consensus study reports:

Genomic Epidemiology Data Infrastructure Needs for SARS-CoV-2: Modernizing Pandemic Response Strategies. This consensus study report presents a framework to define and describe the data needs for a system to track and correlate viral genome sequences with clinical and epidemiological data to help integrate viral evolution data with detection, diagnostic, and countermeasure efforts. It also explores data collection mechanisms to ensure a representative global sample set of all relevant extant sequences and considers challenges and opportunities for coordination across existing domestic, global, and regional data sources.

Reopening K–12 Schools During the COVID-19 Pandemic: Prioritizing Health, Equity, and Communities. This consensus study report provides guidance on the reopening and operation of elementary and secondary schools for the 2020–2021 school year. The recommendations aim to help districts and schools navigate the complex decisions around reopening school buildings, keeping them open, and operating them safely. The report was released in collaboration with the National Academies’ Board on Science Education.

MEETINGS

At the onset of the pandemic, the standing committee held several meetings with the sponsors, ASPR and OSTP, to explore research priorities arising from the emergence of COVID-19 both in the United States and globally and to outline key issues. The standing committee is divided into four working groups: (1) Viral Characteristics; (2) Patient Care and Medical Countermeasures; (3) Community Engagement and Population Health; and (4) Cross-Cutting Issues. The standing committee also interacts, engages, and collaborates with other committees and divisions of the National Academies, providing expertise on relevant requests and topics. More information on events of the standing committee is accessible here.

AFFILIATED ACTIVITIES

The standing committee works closely with the Societal Experts Action Network (SEAN),² which enables rapid and actionable responses to social, behavioral, and economic questions related to the COVID-19 pandemic via an expert network of leaders and institutions that collaborate in response to urgent policy questions, developing evidence-based guidance to support local, state, and national policy. The standing committee contributed to SEAN rapid expert consultations, including:

COVID-19 Testing Strategies for Colleges and Universities. This rapid expert consultation summarizes effective COVID-19 testing strategies for college and university campus reopening, including the types of diagnostic testing employed, testing frequency targets, metrics typically reported, responses to positive tests, and efforts to ensure compliance. The rapid expert consultation draws from a webinar where college and university representatives discussed lessons learned and best practices from the 2020 fall semester. This activity was sponsored by the David & Lucile Packard Foundation.

Strategies for Building Confidence in the COVID-19 Vaccines. This rapid expert consultation provides public engagement and communication strategies for building confidence in COVID-19 vaccines that can be implemented at the national, state, and local levels to change patterns of interaction with the public, address hesitancy about COVID-19 vaccines, and build trust. The rapid expert consultation draws from a webinar where experts discussed the current state of vaccine confidence and best practices for messaging.

LOOKING FORWARD

In this ever-evolving pandemic, the standing committee integrates science into national preparedness and response efforts and provides sound, thoughtful, timely, and useful information for the decision makers who are shaping the nation’s response to COVID-19. The standing committee provides a critical venue to enable science and policy discussions relevant to the federal government on emerging issues and stands ready to respond to the COVID-19 pandemic and to other emerging 21st-century health threats.

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SPONSORS

U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response White House Office of Science and Technology Policy

STANDING COMMITTEE ON EMERGING INFECTIOUS DISEASES AND 21ST CENTURY HEALTH THREATS

HARVEY V. FINEBERG (Chair), President, Gordon and Betty Moore Foundation

KRISTIAN G. ANDERSEN, Associate Professor, Immunology and Microbiology, The Scripps Research Institute

RALPH STEVEN BARIC, William R. Kenan, Jr. Distinguished Professor, University of North Carolina at Chapel Hill

MARY T. BASSETT, FXB Professor of the Practice of Health and Human Rights, Harvard T.H. Chan School of Public Health

TREVOR BEDFORD, Associate Member, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center

GEORGES C. BENJAMIN, Executive Director, American Public Health Association

DONALD BERWICK, Lecturer of Health Care Policy, Harvard Medical School

RICHARD E. BESSER, President and Chief Executive Officer, Robert Wood Johnson Foundation

R. ALTA CHARO, Warren P. Knowles Professor of Law and Bioethics, University of Wisconsin–Madison

PETER DASZAK, President, EcoHealth Alliance

JEFFREY S. DUCHIN, Health Officer and Chief of the Communicable Disease Epidemiology & Immunization Section, Public Health–Seattle & King County, Professor in Medicine, University of Washington, Seattle

ELLEN P. EMBREY, Managing Partner, Stratitia Inc.

BARUCH FISCHHOFF, Howard Heinz University Professor, Department of Engineering and Public Policy Carnegie Mellon University

DIANE E. GRIFFIN, University Distinguished Service Professor and Alfred and Jill Sommer Chair, W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health

ROBERT GROVES, Executive Vice President and Provost, Gerard J. Campbell, S.J. Professor, Department of Mathematics and Statistics and Department of Sociology, Georgetown University

MARGARET A. HAMBURG, Foreign Secretary, National Academy of Medicine

DAN HANFLING, Vice President, Technical Staff, In-Q-Tel

JOHN L. HICK, Faculty Emergency Physician, Hennepin Healthcare, and Professor of Emergency Medicine, University of Minnesota

KENT E. KESTER, Vice President and Head, Translational Science and Biomarkers, Sanofi Pasteur

PATRICIA A. KING, Professor of Law (Emeritus), Georgetown University Law Center

JONNA A. MAZET, Professor of Epidemiology and Disease Ecology, University of California, Davis, School of Veterinary Medicine

PHYLLIS D. MEADOWS, Senior Fellow, The Kresge Foundation

TARA O’TOOLE, Executive Vice President, In-Q-Tel

ALEXANDRA PHELAN, Assistant Professor, Center for Global Health Science and Security, Department of Microbiology and Immunology, Georgetown University

DAVID A. RELMAN, Thomas C. and Joan M. Merigan Professor in Medicine, Professor of Microbiology and Immunology, Stanford University

MARK S. SMOLINSKI, President, Ending Pandemics

DAVID R. WALT, Hansjörg Wyss Professor of Bioinspired Engineering, Harvard Medical School

PROJECT STAFF

LISA BROWN, Senior Program Officer

AUTUMN DOWNEY, Senior Program Officer

CAROLYN SHORE, Senior Program Officer

SCOTT WOLLEK, Senior Program Officer

AURELIA ATTAL-JUNCQUA, Associate Program Officer

EMMA FINE, Associate Program Officer

BEN KAHN, Associate Program Officer

JULIE LIAO, Associate Program Officer

BRIDGET BOREL, Administrative Assistant

JULIE PAVLIN, Senior Director, Board on Global Health

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats