BY MARCO SERNA
Candidate For 3rd Congressional District
The COVID-19 (coronavirus) global pandemic is unquestionably the most serious and deadly catastrophe of our lifetime. It has become increasingly apparent that we are much closer to the beginning of this crisis than the end, and that has to fundamentally alter our outlook moving forward.
As the outbreak continues, every step of the response needs to focus on preventing further spread of the infection, preventing those infected from dying, and mitigating societal (especially economic) damage. This requires a total collaborative effort between the federal government, state governments, municipal governments, NGOs, individuals, health care providers, and staff.
Federal Government Response – It’s impossible to credibly assess the federal government’s response to this crisis and how we got to this point without acknowledging the fundamental breakdown in preparedness that occurred as a direct result of President Trump’s actions. From disbanding the U.S. pandemic response team, to firing the CDC’s China-based expert on pandemic response and containment, to ignoring intelligence agency reports in January warning of the pandemic threat, to calling the pandemic the Democrats’ “new hoax,” President Trump has consistently failed at his responsibilities to the American people and continues to exacerbate the situation. The cost of this failure is measured in too many lives lost.
Congress does share some of the blame here; a national crisis like this is no time for partisan gamesmanship. What is promising is that some of the actions taken by the President and Congress have undoubtedly saved lives. The administration’s ban on travel from China likely delayed the spread of the outbreak, and the travel ban on the EU likely did the same. The aid packages passed through Congress to help the languishing economy and out-of-work Americans are a start, but not nearly enough.
In the short- and medium-term, the federal government MUST work to make testing much more widely available, and quickly. After the Trump administration promised 1 million tests would be available, only 10% of that amount has been administered, and states are lacking in critical supplies like throat and nasal swabs. According to former CDC Chief Tom Frieden, testing serves the following critical functions:
To inform containment and isolation strategies and facilitate contact tracing. Notably, Seattle would likely have had a much smaller outbreak if testing there had been widely available sooner.
In areas with community transmission, to inform treatment and protection of vulnerable groups, especially when there are outbreaks in hospitals, nursing homes, homeless shelters, and prisons.
In health care facilities treating severely ill patients, to identify those with COVID-19 in order to improve infection control, know when it is safe to discharge patients, and identify participants in clinical trials. For these reasons, every patient in the United States with severe pneumonia should be tested for SARS-Cov-2 infection.
For epidemiological investigations, to determine how widespread the infection is, facilitate surveillance, and inform situational analysis, projections, and investigations, including into how the virus is spreading and how infectious asymptomatic people are. The Centers for Disease Control and Prevention’s initiative of testing for the virus in all patients with influenza-like illness at outpatient health care providers is essential to help understand where the virus is spreading, to whom, and what the trend will be in the coming weeks and months.
It’s clear that if we want any chance at minimizing the damage, we have to make testing widely available.
Moreover, the federal government needs to tap into every resource at its disposal to aid the health care system. We have a very decentralized health care system and fewer doctors and hospital beds per capita than most European countries. If the number of hospitalized patients continues to grow exponentially, this could spell the total collapse of American health care.
While we’ve substantially increased the number of ventilators in the Strategic National Stockpile, we still don’t have anywhere near the hundreds of thousands we are likely to need. Beginning to distribute supplies from the stockpile is a start, but we must do everything we can to pressure the private sector to expand production of such supplies to give our brave and dedicated health care workers the tools they need to combat this threat.
For other supplies, streamlining of the FDA approval processes is necessary to make sure vital supply chains are being maintained. In a national crisis, we cannot allow bureaucratic red tape to be a barrier to an adequate national response.
In addition to supplies, infrastructure is an enormous concern. New modeling suggests that intensive care unit capacity could see as much as a 10-fold increase or more. We must prepare to take dramatic steps to meet capacity needs. China built a 1,000 bed hospital in just eight days. The National Guard is well-equipped to construct makeshift intensive care units, and that may be a necessity sooner than the President realizes. We cannot keep playing this game from behind; we should hope for the best, but we MUST prepare for the worst.
One thing the federal government is completely overlooking is the United States Postal Service. It should go without saying that the USPS is an essential component of our entire country’s communication system. The USPS delivers a million life-saving medications each year and represents the sole delivery chain for many of New Mexico’s rural families. Moreover, this year the USPS will be counted on to deliver the census and absentee ballots, the volume of which will surely set records. Unfortunately, mostly because of Congressional mandates, the Postal Service was already operating in the red and was projected to run out of liquidity next year. Due to the strain created by COVID-19, the USPS could run out of liquidity and shut its doors as early as June if Congress doesn’t step in. Saving the United States Postal Service must be a component of any future bailouts.
Above all, the federal government cannot focus all of its resources on high density areas where the outbreak has widely spread. We need to give those areas the help they need; we must also be proactive, so that the rest of the country a few weeks from now doesn’t look like New York City does currently.
In terms of the economic effects, the federal government must provide adequate financial relief to all workers and small business owners affected by this crisis. America’s working taxpayers and their families should never have to choose between exposing themselves to a deadly disease and being able to put food on the table. $1,200 is a start, but not nearly enough. This administration must put Main Street before Wall Street for a change.
In the long term, as we finally get a proper handle on this outbreak, it’s inevitable that we will see the world through a different lens. We’ll acknowledge the things we so often take for granted, hold our loved ones a little tighter, and view the future with less certainty. Some things haven’t changed, however, but have only been made clearer: every single American should have access to quality and affordable health insurance. It’s not just the right thing to do; it’s a matter of national defense.
I’ve been consistent in calling for comprehensive health care reform, and my resolve couldn’t be any stronger. In the wealthiest country on the planet, surely this is achievable.
Finally, it’s clear that the federal government must substantially expand its pandemic preparedness planning. If we don’t learn from our mistakes, they are bound to repeat.
State Government Response – I have found Governor Luján Grisham’s response to COVID-19 to be totally impressive. She has carefully weighed public health concerns against economic impacts, and ultimately listened to experts to make tough decisions and communicate them to the public with considerable candor. She has also fought laudably for more federal resources to aid the Navajo Nation, which is being hit particularly hard by the outbreak.
Perhaps the Governor’s most decisive move to date, the stay-at-home order, was absolutely necessary to limit the spread of the virus. At this point, social distancing and isolation are the best tools in our arsenal.
Moreover, the state providing all testing for free has been crucial in slowing the spread of the virus throughout New Mexico, as has placing people like childcare workers in the state’s high risk pool that ultimately ends up covering premiums for them and their families. Providing equal access to testing and mitigating costs for the uninsured represents the gold standard of statewide responses to COVID-19.
The Governor has also, thankfully, had a lot to work with. Our great state contains two of the nation’s five national laboratories, in addition to a number of great universities, hospitals, and research centers. We were better prepared to handle this crisis, from the outset, than most other states.
Rural New Mexico – I am particularly concerned for our rural New Mexico residents if this outbreak continues its spread outward from urban areas. As I detailed in a previous position paper, the National Rural Health Care Association recently issued a report detailing the problems associated with rural health care. They include:
Rural communities have more uninsured residents, as well as higher rates of unemployment, leading to less access to care;
Rural areas have more frequent occurrences of diabetes, coronary heart disease, and other underlying conditions than non-rural areas;
There are chronic shortages of mental health professionals as mental health providers are more likely to live in urban areas;
The patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people compared to 53.3 per 100,000 in urban areas;
People who live in rural America rely more heavily on the Supplemental Nutrition Assistance program than metropolitan households; and,
Rural residents have greater transportation difficulties reaching health care providers, often traveling longer distances to reach a doctor or hospital.
A sobering truth is our rural hospitals are not as equipped as larger hospital systems to handle the most serious COVID-19 cases. Many don’t have ICUs or enough staff to handle a significant influx of patients. That means they have to transfer those patients to larger hospitals, which at that point are likely to already be massively overburdened. Rural hospital closings were already at a crisis stage before the outbreak began. With nearly one out of every three remaining rural clinics at risk of shutting down, almost half of them operating in the red, and given the above facts, this is a disaster waiting to happen.
Mitigating this potential disaster will require a much better collaborative effort between the federal government, state governments, and health care providers. A large cash infusion for rural hospitals is a start, and should stave off mass facility closures, IF that money can get to these facilities quickly. But we will need a much more comprehensive and longer-term strategy for supporting rural health systems, and that starts with universalizing coverage.
Personal Responsibility – Each of us carry the duty to limit the spread of the virus in any way we can. I recognize these aggressive measures are extraordinarily disruptive and have dramatic effects on people’s lives, jobs, and the economy. Not everyone works in a job that can be done remotely. There will have to be policy choices ahead about how to move forward to protect all working families in New Mexico and across the country.
The bottom line is this: COVID-19 is a serious virus that has the potential to kill an extraordinary number of people, but we can all do something that makes a difference. Please follow the advice to stay home if you can and keep your distance. We have the ability, as a national community, to flatten the curve and save lives, but that relies on us all making good choices every day. It won’t be easy, but we will weather this storm together.