In the fall of 2020, the National Academy of Social Insurance launched a COVID-19 Task Force drawing on the Academy’s interdisciplinary membership, to study the pandemic’s potential impacts on U.S. social insurance programs. This Task Force began with an Epidemiology Working Group, chaired by Dr. Neil Powe, and was comprised of a dozen experts from various institutions. Dr. Powe shares some of the insights from this effort to provide policymakers and government officials with an independent assessment of the pandemic’s possible trajectory through 2022. The report of the Epidemiology Working Group will be issued in late spring 2021.

Q: What challenges did you face as you reviewed the data for this report?

Predicting into the future is difficult work, especially when so many different elements, or parameters, are influencing the pandemic. That was why it was important for the Task Force to have a diverse group of contributors—social epidemiologists, clinical epidemiologists, infectious disease epidemiologists, and, I would say, “policy epidemiologists” as well. I think the diversity of the group is a model for how we might look at future disruptors that might affect social insurance programs.

The work of the Task Force was especially challenging because the situation is so dynamic. We are generating data dujour and are witnessing a learning health environment. Our working group had to evaluate and assimilate loads of data that evolved and are continuing to change today. But that hard task is essential to what we were asked to do, because someone has to give guidance to our social insurance programs so they can plan for sufficient support and funds to execute their purpose and goals.

Q: Is there anything that surprised you while working with this Task Force?

I learned that the economic, housing, food, education and employer policies we have in place have enormous effects and interact with many of the other things we are trying to do to end this pandemic. It was not only the disease itself—the biology and transmission dynamics for instance—that was important, but also the influence of well-entrenched policies we had in place before the pandemic that led to either the inadequate preparation for this event or the ongoing response to it. This is something the Task Force had considerable discussions about.

We also discussed how the uptake of public health measures, such as recommendations at the federal, state, and local levels, can affect the course of the pandemic. And how indirect effects on the economy, education, stress on families, and health care displacement for other conditions, may have long-term consequences. The task force considered all of these phenomena and how they would affect outcomes for social insurance programs.

As a huge disruptor in all our lives—and in social insurance programs—the pandemic provides an opportunity to work on the challenges of how to plan for the future and think about infrastructure in an integrated fashion. Hopefully, by working together we can put in place the strong foundation, and perhaps even new social insurance programs, so in the future we can prevent some of the damages this pandemic has caused for populations, especially vulnerable, marginalized, racial or ethnic minority ones. I think we can learn a lot from that.

More About Neil Powe, MD

Neil Powe is the Constance B. Wofsy Distinguished Professor of Medicine, University of California, San Francisco, and Chief of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital. Dr. Powe’s research unites medicine and public health with the goals of saving and improving the quality of human lives. Prior to his role as Chief of Medicine at San Francisco’s flagship public hospital, the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital, he was a professor of medicine in the Department of Medicine at the Johns Hopkins University School of Medicine, professor in the Departments of Epidemiology and Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, and director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins. He earned his medical degree at Harvard Medical School and his master’s in public health at Harvard School of Public Health. He completed his master’s in business administration at the University of Pennsylvania. He has been a Member of the National Academy of Social Insurance since 2003.

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