Governors across the United States have been working to determine what safe reopening might look during the COVID-19 pandemic. When the National Governors Association (NGA) needed experts to outline considerations, they reached out to UMBC’s Lucy Wilson.
For more than a decade, Wilson has served as a public health expert on disease response and public health planning at the international, national, and state levels. When the NGA called, she joined an interdisciplinary team of experts in developing “The Roadmap to Recovery: A Public Health Guide for Governors,” published this April.
Keeping Maryland safe
Wilson is an infectious disease physician who is also a professor and graduate program director of emergency health services at UMBC. Prior to coming to UMBC, she served as a medical epidemiologist at the Maryland Department of Health, as chief for the Center for Surveillance, Infection Prevention and Outbreak Response for ten years. There she oversaw Maryland’s infectious disease outbreak responses and infection control guidance in all types of settings.
She has also served on the State’s Physician on Call Team, where she was one of a small group of doctors responsible for assessing potential biological, chemical, and nuclear threats. And she currently is the co-principal investigator of the Healthcare-Associated Infections (HAI) branch of Maryland’s Emerging Infections Program (EIP). Through EIP, she conducts surveillance epidemiology and antibiotic resistance research focusing on healthcare-associated infections (including COVID-19) in hospitals and nursing homes. At UMBC, her research focuses on visualizing health outcomes across the continuum of healthcare.
“I have experience working with stakeholders throughout the state to examine different areas of response…that cut across the spectrum of emergency management and response,” explains Wilson. She notes that this could range from education to agriculture to transportation. “This gave me the perspective to help make recommendations to governors about how to create a team and what type of considerations to have for COVID-19 response.”
Learning from previous outbreaks
The NGA provides governors, cabinet members, Congress, private business, and the international community with guidance related to public policy and governance. To develop a COVID-19 recovery roadmap, Wilson helped assess the various settings impacted by COVID-19. She then applied the science of infection control and disease transmission to help develop criteria to maintain the safety of settings like schools, hospitals, prisons, and nursing homes.
Wilson’s recommendations were informed by her prior work in infection control, disease surveillance, and government response to outbreaks, diseases, and pandemics at a national and international level. These include responding to the novel influenza A (H1N1) virus pandemic of 2009, Ebola, Zika, statewide food-related outbreaks, and medication recalls.
When it comes to COVID-19, Wilson says, “This level of pandemic is unprecedented in modern times.” She explains, “We can look back to 1918 to see how social distancing worked. We can look at other countries who have had different COVID-19 strategies in terms of their response and reopening. But what we need to be prepared for is that the coronavirus is difficult to control.”
Using available tools
“Governors must respond with tools we know will work, as appropriate to their region, to try to minimize illness,” states Wilson. These tools focus on minimizing physical contact between people, from using touchless purchasing and curbside pickup at businesses to adjusting work schedules to spread out employees.
The Roadmap to Recovery report divides states’ COVID-19 responses into two stages. The first stage focused on reducing the spread of infection through mandated physical distancing in the absence of comprehensive testing, treatment, or vaccines. Closing gathering spaces like schools, businesses, places of worship, and recreation areas helped to “flatten the curve.”
The second stage involves necessary measures and infrastructure needed to safely open up society. This includes continuous assessments to determine whether to keep moving forward or to return to previous restrictions.
“This is a multifactorial situation where we will likely see more cases and potentially more waves of disease,” shares Wilson. “It will be difficult to eradicate the coronavirus until we have a vaccine or valid treatment. Hopefully, as we implement and determine best practices, we can minimize the number of infections and deaths.”
Beyond the report, Wilson also provided support to policymakers as a panelist for a Johns Hopkins University Diagnostic Excellence Summit on COVID-19. The summit focused on “Diagnostic Strategy for the COVID-19 Pandemic — Bench to Bedside to Blueprint for Policymakers.” She is currently helping to develop and implement campus policy as part of UMBC’s Incident Management Team and Fall Planning Coordinating Committee.
Informing the public
Since the start of the pandemic, Wilson has also provided guidance to the general public on how to take precautions to reduce coronavirus transmission. “People are being asked to take very drastic measures, which have radically changed their lives,” she says. She takes the time to speak with the media because she knows it is essential for people to understand the reasoning behind public health guidelines.
In March, Wilson explained the need for sufficient protective equipment for healthcare workers in the New York Times. When the virus began to impact cruises she explained the quarantine process in the Washington Post.
When COVID-19 testing became a public concern and broader restrictions began to be implemented, Wilson helped Maryland and Washington D.C. residents understand these issues. She contributed to several additional articles in The Washington Post. This included coverage on increasing restrictions, testing issues, the rising rate of infection, contact tracing, and the closing of gathering spaces.
“It is important to know what is science and what is reasonable. People want to know what actions people can take to take care of themselves,” says Wilson. Wilson was a guest on the Public Health On Call podcast, produced by Johns Hopkins. She spoke about how nursing homes and first responders can address the threat of COVID-19.
Wilson has also offered guidance on what people can do on an individual level. She addressed issues with physical activities like golfing and running. In the Huffington Post she discussed how to properly remove disposable gloves and why they shouldn’t be reused, what to do about jewelry and beards to avoid disease transmission, and reusing face masks. And in The Conversation, Wilson wrote about the matters to consider after a loved one dies from coronavirus, to avoid further infection.
How to begin reopening
Wilson has now also begun speaking with news agencies, including CNN. She shares what the process of reopening the country might look like. Leaders are learning how to manage rapid changes on a daily basis in all aspects of life, beyond just healthcare.
Wilson expects that, moving forward, some interventions will work better than others, and communities will learn from each others’ experiences. “This is an evolving process. There will be changes in recommendations and information. Our understanding of this virus is that it affects everyone and every sector of our society,” says Wilson. “We need to have patience and be flexible because we are all learning as we go along.”
Banner image: Lucy Wilson. Photo courtesy of Wilson.