SARS-CoV-2, the virus that causes COVID-19 disease, will have soon resulted in the death of over 200,000 persons in the US  and is predicted to cause at least tens of thousands and possibly hundreds of thousands more deaths yet this year based on current trends . As a result, COVID-19 is on track to be the third leading cause of death in the nation in 2020 behind only heart disease and cancer . Stark racial and ethnic disparities exist in COVID-19, with Black, Latinx and Indigenous communities especially disproportionately impacted [4, 5]. Further, lived experience with the disease teaches us that following acute infection, many persons experience long-term sequelae, sometimes with debilitating symptoms .
While SARS-CoV-2 is highly infectious with person-to-person airborne transmission being the major mechanism of transmission , there are highly effective, evidence-based non-pharmacologic preventive strategies that have been shown to be highly effective in areas such as New York State where numbers of cases, percent positivity, and deaths were reduced to dramatically lower levels in a few months’ time . The non-pharmacologic prevention toolbox includes testing, contact tracing, the wearing of face masks, physical distancing, hand washing, disinfecting of surfaces, staying home when ill, and improved air filtration strategies, among others [9, 10]. Further, while there is currently no vaccine or cure for COVID-19, case fatality rates have declined due to improved clinical treatment strategies and the availability of partially effective medicines . Trust in science and public health, however, has suffered from heavy politicization that has compromised prevention efforts and threatens to diminish uptake of upcoming vaccines and treatments.
Even prevention strategies with evidence-based efficacy are not yet being delivered at sufficient scale, or to regions and populations with greatest need. Witness, for instance, the opening of businesses in some states, such as Florida, while those jurisdictions had very high levels of community transmission with relatively few precautionary measures in place . Given this reality of uneven response to the pandemic across the US , there have been many calls in the media and literature for a truly comprehensive National COVID-19 Strategy (NC19S) to be put into place in the US . While there are elements of guidance about COVID-19 prevention and treatment available (e.g., CDC prevention guidance documents , NIH treatment guidelines , and White House Coronavirus Task Force reports ), there is no integrated document that puts into one place a coordinated national approach to fully address COVID-19. In particular, there is no NC19S that comprehensively lays out in one document the epidemiology of the challenge at hand; the evidence-base for interventions and policies to address the epidemic (i.e., in terms of preventing infections, minimizing morbidity, and addressing the substantial social disparities and disruptions that have been wrought by the pandemic); metrics and goals by which to measure progress; and processes for transparency, broad stakeholder participation, and continuous recalibration. The extant proposal in the literature that is the closest to such a plan is the call by Hotez  for the US to achieve one COVID-19 case per million residents per day (or other selected benchmark) by October 1, 2020, and that each State in the US would be required to achieve that key benchmark as well by the same date.
Clearly a comprehensive NC19S is urgently needed; at the current rate of approximately 1000 deaths per day from COVID-19, 41 Americans continue to die every hour of COVID-19 (as of the writing of this paper). Here, we propose the elements of such an NC19S, and to do so we draw on our experiences with the National HIV/AIDS Strategy (NHAS) of July 2010 , and its update in 2015 . Indeed, the NHAS provides clear, useful guidance as to the structure and elements of a potential NC19S.