Dr. Jim Yong Kim has seen this before.
The former president of the World Bank and former director of the World Health Organization's HIV/AIDS department is also an infectious disease doctor who has studied the public response to past epidemics and pandemics. He says that while social distancing is crucial to mitigating the coronavirus outbreak, several additional measures are also needed. Kim's message is direct: It's not too late to do more.
Kim shared his insights on Covid-19 during a webinar with Fast Company editor in chief Stephanie Mehta on Thursday. Working with Partners in Health, the medical nonprofit he co-founded in 1987, Kim recently helped persuade Massachusetts governor Charlie Baker to begin implementing contact tracing--the identification of everyone who may have come into contact with the virus--across the state. But how much would such a plan cost to roll out nationwide, and would it be worthwhile?
"In the United States, we have to think in the range of hundreds of billions," Kim said, adding that Covid-19 is already a larger crisis than the global financial crisis of 2008-2009 and could lead to a 20 percent drop in global GDP. "Compared to that, how much would you be willing to spend on public health?"
Here are the five steps to Kim's plan.
1. Social distancing
The practice of maintaining six feet between individuals has been key to limiting the number of new coronavirus cases, but it's just the beginning of the necessary methods to eliminate the virus, according to Kim.
"With very draconian social distancing measures, you see a flattening of the curve," Kim said. "It's plateauing, but it's not dropping quickly, so we think all the countries will have to implement all five measures." He added that during the flu pandemic of 1918, cities that loosened social distancing measures too early had recurrent outbreaks.
The ability to test people for the virus is costly, but critical for stopping transmission. "If you had all the testing that you needed to really get after the virus [in the U.S.], it would be as much as tens of billions of dollars a month," Kim said. "To hire the contact tracers is going to be a big number, potentially in the hundreds of billions."
3. Contact tracing
The U.S. must ramp up contact tracing, where public health officials find every person who has had contact with an infected individual, according to Kim. In Massachusetts, Partners in Health is working with consultancy Accenture and business-software firm Salesforce to figure out how to efficiently increase the practice at scale.
Kim noted that South Korea changed its laws after the MERS outbreak several years ago to allow the government to access credit card records to help with contact tracing. Still, such methods are only "a way to supplement what we call shoe-leather epidemiology: people who get on phones and talk to people," Kim said. "Technology could have a great role, but we are strongly encouraging people not to think that tech in and of itself can solve this problem."
Keeping infected individuals isolated from others is crucial, but can be very challenging within households. Additionally, U.S. states do not have the resources to develop public health systems to help people quarantine away from their families. "We do it now on a voluntary basis," Kim said. "As expected, there are many people who would like to have the option of being separated from their families for some time in order to protect them from being infected."
Treating sick patients is the last line of defense until the development of a vaccine. Kim said he supported Bill Gates's proposal to begin the production of vaccines while still conducting clinical trials. "We should start manufacturing two or three of those vaccines just to get better at the production process," Kim said. "And when we find that one is better than the others, then we'll stop the others and go all-out on manufacturing the one that proves to be the best."