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Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020 (2022)

Chapter:Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020

Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
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Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
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Page2
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page3
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page4
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page5
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page6
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page7
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page8
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page9
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page10
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page11
Suggested Citation:"Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020." National Academies of Sciences, Engineering, and Medicine. 2022. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats: Annual Report 2020. Washington, DC: The National Academies Press. doi: 10.17226/26715.
×
Page12

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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 I n 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. 1 A list of the committee members is available at the end of this document.

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. As the National Academies contribute to policy decisions with objective, scientific, evidence-based guidance, these rapid expert consultations stand as testimony to an additional capability of the National Academies to act as swiftly as the current crisis demands. 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 SARS- CoV-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. MEETINGS Initial Expert Call on the Rapid Response for Assessment of Data Needs for SARS-CoV-2 (February 3, 2020) Virtual Standing Committee Meeting 1 (March 11, 2020) At this meeting, the standing committee discussed its statement of task and explored potential research priorities as a result of the emergence of COVID-19 domestically and abroad. Expert Call on the Role of Academic Labs in COVID-19 Sero-Prevalence Surveillance (April 6, 2020) Virtual Standing Committee Meeting 2 (April 30, 2020) At this meeting, the standing committee discussed the progress of the standing committee’s work with the sponsor and the priorities for the four working groups: viral characteristics; patient care and medical countermeasures; community engagement and population health; and cross-cutting issues. Expert Call on Genotypic Drift and Potential Phenotypic Manifestations of SARS-CoV-2 (May 7, 2020) Joint Meeting of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats and the Roundtable on Genomics and Precision Health on Host Genomics Research and Data Collection Efforts Related to COVID-19 (July 1, 2020) This joint meeting examined the challenges faced by the field of genomics, explored innovative approaches to overcoming them, and discussed opportunities for the roundtable and the standing committee to facilitate future progress.

Joint Meeting of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats and the Forum on Drug Discovery, Development, and Translation on Envisioning a Transformed Clinical Trials Enterprise (July 9, 2020) This joint meeting explored lessons learned from the impact of COVID-19 on the clinical trials enterprise and outlined next-step opportunities for a transformed clinical trials enterprise post-COVID-19. Webinar Series on Overview of the Rapid Expert Consultation on Staffing Considerations for Crisis Standards of Care for the COVID-19 Pandemic (July 31, August 4, and August 5, 2020) This webinar series outlined considerations from a rapid expert consultation on clinical staffing needs during the implementation of crisis standards of care, including 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. Joint Meeting of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats, the Forum on Microbial Threats, and the Board on Global Health on Globalization and Future Health Crises (September 18, 2020) This joint meeting explored the impact of globalization on future health crises, such as the probability of pandemics and other infectious disease events in the future. Webinar Series on College COVID-19 Testing Strategies (October 28–29, 2020) This webinar series, sponsored by the David & Lucile Packard Foundation, examined testing strategies and capabilities at colleges and universities, hearing first-hand lessons learned, challenges, and successes. Each webinar included framing of the key issues and an overview of one or more of the major consid- erations that affect decision making surrounding testing and capabilities. The webinar series served to inform a rapid expert consultation. Expert Call on COVID-19 Monoclonal Antibody Therapies (November 15, 2020) Workshop on Allocation of COVID-19 Monoclonal Antibody Therapies and Other Novel Therapeutics (December 16–17, 2020) This workshop discussed key considerations for assisting decision makers in their efforts to equitably allocate COVID-19 monoclonal antibody therapies and other novel therapeutics at the state and local levels and examined related key issues such as barriers to access, administration capacity, cost, data collection, and equity. Webinar on COVID-19 Vaccine Confidence (December 18, 2020) To inform a rapid expert consultation, this meeting covering the current state of vaccine confidence, rea- sons for hesitancy, and best practices for messaging. Discussions also highlighted communities at higher risk of contracting and dying from COVID-19, including underserved and vulnerable communities.

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. 2SEAN is within the National Academies’ Division of Behavioral and Social Sciences and Education and is supported by the National Science Foundation and the Alfred P. Sloan Foundation.

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 ROBERT GROVES, Executive Vice President and Provost, Moore Foundation Gerard J. Campbell, S.J. Professor, Department of Mathematics KRISTIAN G. ANDERSEN, Associate Professor, Immunology and Statistics and Department of Sociology, Georgetown and Microbiology, The Scripps Research Institute University RALPH STEVEN BARIC, William R. Kenan, Jr. Distinguished MARGARET A. HAMBURG, Foreign Secretary, National Professor, University of North Carolina at Chapel Hill Academy of Medicine MARY T. BASSETT, FXB Professor of the Practice of Health DAN HANFLING, Vice President, Technical Staff, and Human Rights, Harvard T.H. Chan School of Public Health In-Q-Tel TREVOR BEDFORD, Associate Member, Vaccine and JOHN L. HICK, Faculty Emergency Physician, Hennepin Infectious Disease Division, Fred Hutchinson Cancer Research Healthcare, and Professor of Emergency Medicine, University Center of Minnesota GEORGES C. BENJAMIN, Executive Director, American Public KENT E. KESTER, Vice President and Head, Translational Health Association Science and Biomarkers, Sanofi Pasteur DONALD BERWICK, Lecturer of Health Care Policy, Harvard PATRICIA A. KING, Professor of Law (Emeritus), Georgetown Medical School University Law Center RICHARD E. BESSER, President and Chief Executive Officer, JONNA A. MAZET, Professor of Epidemiology and Disease Robert Wood Johnson Foundation Ecology, University of California, Davis, School of Veterinary Medicine R. ALTA CHARO, Warren P. Knowles Professor of Law and Bioethics, University of Wisconsin–Madison PHYLLIS D. MEADOWS, Senior Fellow, The Kresge Foundation PETER DASZAK, President, EcoHealth Alliance TARA O’TOOLE, Executive Vice President, In-Q-Tel JEFFREY S. DUCHIN, Health Officer and Chief of the Communicable Disease Epidemiology & Immunization Section, ALEXANDRA PHELAN, Assistant Professor, Center for Global Public Health–Seattle & King County, Professor in Medicine, Health Science and Security, Department of Microbiology and University of Washington, Seattle Immunology, Georgetown University ELLEN P. EMBREY, Managing Partner, Stratitia Inc. DAVID A. RELMAN, Thomas C. and Joan M. Merigan Professor in Medicine, Professor of Microbiology and BARUCH FISCHHOFF, Howard Heinz University Professor, Immunology, Stanford University Department of Engineering and Public Policy Carnegie Mellon University MARK S. SMOLINSKI, President, Ending Pandemics DIANE E. GRIFFIN, University Distinguished Service Professor DAVID R. WALT, Hansjörg Wyss Professor of Bioinspired and Alfred and Jill Sommer Chair, W. Harry Feinstone Engineering, Harvard Medical School Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health PROJECT STAFF LISA BROWN, Senior Program Officer BEN KAHN, Associate Program Officer AUTUMN DOWNEY, Senior Program Officer JULIE LIAO, Associate Program Officer CAROLYN SHORE, Senior Program Officer BRIDGET BOREL, Administrative Assistant SCOTT WOLLEK, Senior Program Officer JULIE PAVLIN, Senior Director, Board on Global Health AURELIA ATTAL-JUNCQUA, Associate Program Officer ANDREW M. POPE, Senior Director, Board on Health EMMA FINE, Associate Program Officer Sciences Policy For more information about the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats, visit our website.

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

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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. This Annual Report summarizes the committee’s work in 2020 and highlights the short consensus study reports, rapid expert consultations, meetings, and affiliated activities conducted during the year.

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