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Precision Public Health as a Key Tool in the COVID-19 Response

Educational Objective
To understand the key role precision public health is playing in the COVID-19 response
1 Credit CME

With more than 20 million cases of coronavirus disease 2019 (COVID-19) globally and now exceeding 5 million cases in the United States, the COVID-19 pandemic represents one of the greatest public health challenges in more than a century. To succeed against COVID-19, multiple public health tools and interventions will be needed to minimize morbidity and mortality related to COVID-19. Although extreme public health interventions, for example, lockdowns and stay-at-home mandates, were initially critical to flattening the curve, many fundamental questions remain, such as when can employees deemed nonessential return to work, how can children safely return to school, and who should be first to receive a vaccine once it becomes available. Information about who is at highest risk of hospitalization, intensive care unit admission, and death based on age, sex, race/ethnicity, and underlying conditions is now becoming available.1 In addition, the relationship between neighborhood factors (eg, increased neighborhood household crowding rate) and risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 disease outcomes are now recognized.2

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Article Information

Corresponding Author: Sonja A. Rasmussen, MD, MS, University of Florida, 1600 SW Archer Rd, PO Box 100296, Gainesville, FL 32610 (sonja.rasmussen@peds.ufl.edu).

Published Online: August 12, 2020. doi:10.1001/jama.2020.14992

Conflict of Interest Disclosures: Dr del Rio reported receiving grants from the Emory Vaccine and Treatment Evaluation Unit outside the submitted work. No other disclosures were reported.

References
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Killerby  ME , Link-Gelles  R , Haight  SC ,  et al; CDC COVID-19 Response Clinical Team.  Characteristics associated with hospitalization among patients with COVID-19—Metropolitan Atlanta, Georgia, March-April 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(25):790-794. doi:10.15585/mmwr.mm6925e1 PubMedGoogle ScholarCrossref
2.
Emeruwa  UN , Ona  S , Shaman  JL ,  et al.  Associations between built environment, neighborhood socioeconomic status, and SARS-CoV-2 infection among pregnant women in New York City.   JAMA. Published online June 18, 2020. doi:10.1001/jama.2020.11370 PubMedGoogle Scholar
3.
Khoury  MJ , Engelgau  M , Chambers  DA , Mensah  GA .  Beyond public health genomics: can big data and predictive analytics deliver precision public health?   Public Health Genomics. 2018;21(5-6):244-250. doi:10.1159/000501465 PubMedGoogle ScholarCrossref
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Oude Munnink  BB , Nieuwenhuijse  DF , Stein  M ,  et al; Dutch-Covid-19 response team.  Rapid SARS-CoV-2 whole-genome sequencing and analysis for informed public health decision-making in the Netherlands.   Nat Med. Published online July 16, 2020. doi:10.1038/s41591-020-0997-y PubMedGoogle Scholar
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Katz  I , Jha  AK .  HIV in the United States: getting to zero transmissions by 2030.   JAMA. 2019;321(12):1153-1154. doi:10.1001/jama.2019.1817 PubMedGoogle ScholarCrossref
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Smith  CD , Mennis  J .  Incorporating geographic information science and technology in response to the COVID-19 pandemic.   Prev Chronic Dis. 2020;17:E58. doi:10.5888/pcd17.200246 PubMedGoogle Scholar
7.
Mayor Keisha Lance Bottoms orders city’s phased reopening plan to be moved back to phase I. News release. Atlanta, Georgia, Mayor’s Office of Communications. July 10, 2020. Accessed July 20, 2020. https://www.atlantaga.gov/Home/Components/News/News/13408/672. 2020.
8.
Roxby  AC , Greninger  AL , Hatfield  KM ,  et al.  Outbreak investigation of COVID-19 among residents and staff of an independent and assisted living community for older adults in Seattle, Washington.   JAMA Intern Med. Published online May 21, 2020. doi:10.1001/jamainternmed.2020.2233PubMedGoogle Scholar
9.
Lasry  A , Kidder  D , Hast  M ,  et al; CDC Public Health Law Program; New York City Department of Health and Mental Hygiene; Louisiana Department of Health; Public Health – Seattle & King County; San Francisco COVID-19 Response Team; Alameda County Public Health Department; San Mateo County Health Department; Marin County Division of Public Health.  Timing of community mitigation and changes in reported COVID-19 and community mobility—four U.S. metropolitan areas, February 26-April 1, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(15):451-457. doi:10.15585/mmwr.mm6915e2 PubMedGoogle ScholarCrossref
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Oran  DP , Topol  EJ .  Prevalence of Asymptomatic SARS-CoV-2 infection: a narrative review.   Ann Intern Med. Published online June 3, 2020. doi:10.7326/M20-3012 PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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