My entire professional life in public health and as a pediatrician has been dedicated to the prevention of disease wherever possible, and to delivering appropriate medical interventions whenever necessary.  For me, diagnosing and treating an individual patient for a disease is very rewarding.  But, even more rewarding — and the real payoff for society — is when we institute policies and organize our resources to prevent the spread of disease.

Mindful of the paramount importance of prevention in any public health strategy, I find it difficult to express in words just how appalled I am by the utter failure of our current political “leaders.”  At both the national and local levels — including right here in Orange County and Irvine — we’ve witnessed a catastrophic failure to prepare for the Coronavirus (COVID-19) pandemic, compounded by a failure to take the essential measures to contain and control the virus.

The human and economic cost of this top-to-bottom failure of leadership is almost beyond comprehension. COVID-19 has already killed more than 227,000 Americans.  Here in Orange County, we are just under 60,000 confirmed cases and more than 1,400 deaths.  In Irvine, confirmed cases are more than 1,800.  (Unconfirmed cases — many of them asymptomatic “spreaders” of the virus — are estimated at 5,000 or more in Irvine).  Mercifully, “only” 13 Irvine residents have died from COVID-19.

According to reliable projections, these horrific numbers in Orange County and in Irvine are likely to double by early next year, unless there is a radical change of public health policy, including the rapid ramping-up of public health resources to implement the changes.

Change begins with frankly acknowledging the failures of the past and charting a new path.  Here in Irvine, this means doing now what should have been done in February and March.

The biggest failure in Irvine is a continuing one.  Even with months of warning, the City has never developed a credible Strategic Plan for effectively combating the Coronavirus.  Irvine is now among the top 100 largest cities in America — 300,000 people live here, and our workday population swells to 500,000.  We are fortunate to have outstanding, world-class institutions in Irvine, including UCI and major biomedical corporations.  Yet, our Mayor and City Council have completely failed to organize these community partners to develop a clear, coordinated strategy to protect Irvine residents and workers from contracting and spreading COVID-19.

What could be done
The City itself has failed to invest available resources to create an Office of Public Health, headed by a Chief Health Officer, and staffed with public health nurses, school nurses, and other health professionals to implement all the programs essential to extinguishing the virus.  A winning strategy begins with instituting a program of repeated testing at major workplaces, including at all Irvine schools, coupled with careful contact-tracing.  Those afflicted with COVID-19 then, of course, need to be quarantined and treated for the disease, and given whatever social and financial support may be necessary.

So, what do we do right now, as a first step?  Our City, blessed with resources, needs to take the lead and hire school nurses to help our Irvine schools as they struggle to reopen — and stay open — for in-person learning.  These school nurses, in turn, should put in place a surveillance system that includes in-school testing to proactively identify COVID-19 cases and intervene to prevent spread of the virus.

As I’ve emphasized many times before, school nurses have the unique knowledge and skills to manage the COVID-19 pandemic in the school community.  It is shameful that even in the midst of this continuing emergency, Irvine schools fail to meet the national standard of having one nurse on-site at each school.  The City could remedy this needless deficit by immediately offering to hire and pay for two dozen school nurses to help both Irvine Unified School District and Tustin Unified School District as well—costing about $5 million over the course of the next two years.

Where would the money come from?  From the City’s “Rainy Day Contingency Fund,” which now has a balance of over $50 million.  In case our City officials haven’t noticed, it’s “raining.”  And it’s time to deploy our rainy-day tax dollars — right now! — for the benefit of our school community and for the benefit of our entire Irvine community.

Phyllis Agran, M.D.