As a follow-up to the “Roadmap to Pandemic Resilience,” which calls for massively scaled up programs of testing, tracing and supported isolation (TTSI) as a means to safely re-open the U.S. economy after COVID-19 closures, Harvard University’s Edmond J. Safra Center for Ethics, with support from The Rockefeller Foundation, released a new supplemental report, “Pandemic Resilience: Getting It Done.” This supplement includes detailed guidance on the levels of testing and tracing needed to reopen different communities across the US, based on disease levels in distinct locales.
The report offers different TTSI program recommendations for locales that have low prevalence (Green Zones), moderate prevalence (Yellow Zones), or high prevalence (Red Zones). Green Zone communities have few active infections (a current infection prevalence of less than roughly one per 36,000). Yellow Zone communities have known active infections at a small scale (less than 1% prevalence of active virus in the population). Red Zone communities have an outbreak which public health authorities have not been able to suppress (1% or higher prevalence of virus in the population). Differences in prevalence around the country help explain the range of political response to stay-at-home orders and advisories. We demonstrate how further prioritization for resource allocation would be made possible taking into account vulnerability using the COVID-19 Community Vulnerability Index.
An illustrative list of where each U.S. metropolitan statistical area fell as of May 8 is available in the supplemental report. Two weeks ago, the country still had Green Zones, but now none remain. An interactive map with data about where each area falls is available online at pandemictesting.org.
The report supplement comes after new CDC guidance that supports broader use of testing not only for therapeutic purposes, but also for disease control and suppression. The revised guidance now includes testing for asymptomatic individuals, as directed by state and local plans. The supplemental report provides guidance for shaping those plans.