COVID-19 Testing and the Way Forward on Resuming Non-Urgent Care

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America’s coronavirus testing rates have emerged as one of the enduring issues with the government’s response to the pandemic.

Following the Centers for Disease Control and Prevention’s initial missteps in February, resulting in faulty tests that were slow to run, the Trump administration pushed the Food and Drug Administration to grant numerous emergency use authorizations to enhance the testing capacity throughout the country.

As a result, the nation has tested more people than any other country, with at least 1.2 million of those tests in the past week, according to Adm. Brett Giroir, the federal official overseeing coronavirus testing efforts.

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In some areas, however, Americans are still having
difficulties obtaining tests. Even if labs have the machines and capacity to
handle the tests, the enormous demand for testing has quickly
consumed testing material
,
such as swabs, cartridges, or reagents.

In recent remarks, Dr. Anthony Fauci noted that the administration is well aware of those issues, saying that “many of those [problems] have been already corrected, and other of those will be corrected.”

Fauci, a member of the White House coronavirus task force, said that there’s sufficient supply of tests and test material, but the supply chain is not sufficiently connected to meet demand.

He and others on the task force have been working to fix those issues. The results will soon be evident, but working supply chains must be ensured before the nation can even begin to resume normal daily life.

Because of the highly infectious nature of the COVID-19
virus, the federal government released guidelines recommending non-urgent
procedures to be postponed to avoid transmitting the virus in hospitals.

Many clinical visits have become telemedicine visits,
and states have been quick to deregulate the use of telemedicine. Physical
exams and procedures, however, can only be done in person. So, in an effort to
avoid COVID-19, many patients have made do with less medical attention, and that
may be detrimental to their health.

As such, state level bans on non-urgent procedures
should be lifted as soon as it’s responsible to do so.

Health care jobs—and the ability of patients to get the
care they need, including cancer care—are also victims of the government
response to the virus.

As the pandemic spread throughout America, many states
halted procedures deemed nonessential or non-urgent to ensure capacity for
treating COVID-19 patients and to prevent spreading the virus in hospitals.

Because of the effective mitigation strategies pursued
by states, many hospitals never
saw a surge
in cases.

Low census numbers in hospital wards resulted in lower
revenues, and as a consequence, numerous hospitals across the country have been
furloughing workers. Becker’s Hospital Review maintains a daily
report of hospitals and health systems that furlough health care workers
.

To ensure we have enough capacity to treat COVID-19
patients, we may have eliminated the health care resources needed to treat us
after the pandemic. 

The Centers for Medicare and Medicaid Services took
steps this week to reverse its guidelines on canceling or postponing non-urgent
procedures. States that have counties with low-incident rates—the majority of
the country—would do well to allow facilities to practice fully if they demonstrate
they have mitigation efforts in place.

Responsibly relaxing guidelines on non-urgent procedures
and visits will require close attention paid to potential transmission of the
COVID-19 virus. If possible, hospitals should have separate wards dedicated to
COVID-19 to maintain physical separation from the virus.

Hospitals will also need to have sufficient stores of personal
protective equipment to avoid transmitting the virus from one patient to the
next via hands or clothing.

Finally, health systems working with local governments should ensure sufficient surge capacity in case of resurgence, and local leaders that anticipate an outbreak would be wise to set up isolation zones and begin a public education campaign to encourage people to use them.

There’s a lesson here. In Italy, when health systems
were overwhelmed, patients were often treated in hallways due to the lack of
beds. As a result, hospitals became main sites of infection, and the number of
cases continued to climb, which only exacerbated the situation.

If we proceed with cautious expedition, we will avoid
such a tragic situation while preserving the very health care resources we’ll
need to keep this country healthy.

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