88th Annual Meeting
In Support of the TTSI Collaborative's Getting to Green Plan and the "Pandemic Resilience: Getting it Done" Report
WHEREAS, all mayors are keenly focused on safely and effectively reopening our economies and civic lives with an approach that is based on science, health, security, and freedom; and
WHEREAS, this transition will require cities to massively scale-up testing, contact tracing, isolation, and quarantine; and
WHEREAS, the Edmund J. Safra Center for Ethics at Harvard University has worked in the space of ethics and public affairs for more than thirty years, and has deployed internal and external expertise in the fields of public health, economics, law, government, and ethics to publish a report titled "Roadmap to Pandemic Resilience" and a supplement titled, "Pandemic Resilience: Getting it Done;" and the Harvard Global Health Institute has done significant public health work on this epidemic; Partners in Health has led on contract tracing efforts; and they have together formed the TTSI Collaborative to build convergence among public health leaders in Massachusetts and nationally in service to state and local decision-making; and
WHEREAS, the earlier report and supplement, the more recent "Getting to Green" strategy documents, and the supporting technical advisory handbook, lay out a policy roadmap for how cities can deploy testing, contact tracing, and social isolation (TTSI) to rebuild trust in personal safety and support a renewal of mobility and mobilization of the economy, while preventing cycles of opening up and shutting down; and
WHEREAS, the roadmap contemplates a steady reopening of parts of the economy that have been shut down in a manner that protects frontline workers and contains the virus to levels where it can be effectively managed and treated until a vaccine can be developed; and
WHEREAS, the report's supplement was written with significant input from Mayors and offers guidance to help local governments develop TTSI programs for the purpose of disease control and suppression; and
WHEREAS, the supplement provides a range of recommendations that can be tailored to cities based on their particular experience with the COVID-19 pandemic, and as such eschews a "one-size-fits-all" approach in order to be more helpful to mayors; and
WHEREAS, in support of the efforts of local leaders to establish TTSI programs, the supplement calls on Congress to make a substantial investment in TTSI infrastructure, including $5.5B for local public health offices, $9B for contact tracing personnel, $4.5B for voluntary self-isolation facilities, $30B in income support for voluntary self-isolation, and $25B for test kits, test processing, and mega-labs that will be necessary to ensure the ability to permanently reopen our cities,
NOW, THEREFORE, BE IT RESOLVED, that The United States Conference of Mayors:
- Endorses the "Getting to Green Strategy" for elevating our ambition from mitigation to suppression and pursuit of near zero case incidence via testing, tracing, and supported isolation (TTSI) and the report "Pandemic Resilience: Getting it Done," and its recommendations;
- Encourages the federal government to fund and/or support through the purchase of equipment and facilities, TTSI programs as outlined in the report at the local, state and interstate levels; and
- Recommends that Mayors both encourage and implement, to the extent possible, the following steps to suppress the COVID-19 outbreak as detailed in the report:
- Utilize an ambitious surge of viral testing and tracing this summer to pursue a near-term (2 to 3 months) national target of bringing the reproduction number of the virus down to .75 (R = .75) and a long-term target (12 to 18 months) of consistent suppression to produce a context in which outbreaks will be easily containable.
- Recognize the following four primary "zones" in order to prioritize testing in accordance with disease case incidence in each metropolitan statistical area: green zones (near zero case incidence) which have a current case incidence of less than one new case per day (7 day rolling average) for 100,000 people; yellow zones (low case incidence) which have 1 < 10 new daily cases per 100,000 people; orange zones (moderate case incidence) which have 10 < 25 new daily cases per 100,000 people; and, red zones (high case incidence) which have > 25 new daily cases per 100,000 people.
- Follow the guidance to achieve: one test per day for every 10,000 people and 30 contract tracers for every 100,000 people in Green Zones; and, 300 tracers for every death/day (7 day rolling average) in the locale and testing capacity sufficient to deliver a 3% positivity rate for Yellow, Orange, and Red Zones. Testing levels are achieved by sufficient testing for therapeutic testing, hot spot testing, tracing and testing contacts of all COVID positive individuals for several links of the chain, following from an index case to further positives to their contacts, and so on; for surveillance purposes; and for critical context purposes (congregate settings with vulnerable populations, elective surgeries, etc.). Testing programs should pull in asymptomatic people with probability exposure as well as symptomatic individuals. An additional key goal is 24 hour turnaround time on test results and 24 hour trace time.
- Place high priority on minority communities experience the disparate impact of COVID-19, and higher infection fatality rates, when implementing testing regimes.
- Adopt "critical context" testing as an important element of testing policies; these critical contexts include health care settings, elder care facilities, correctional facilities, meatpacking plants and other assembly line-type conditions (e.g. retail warehouses), grocery stores, and military installations.