State economies have been in lockdown mode for months and are just now beginning to reopen, even as the COVID-19 coronavirus has become resurgent in certain regions. The reopening process is an experiment of sorts, with epidemiologists and infectious-disease experts carefully monitoring the data to determine what impact these lifted restrictions will have on disease spread.
According to a new handbook published by the nonprofit United States of Care, there are specific actions lawmakers can take to make the reopening process as safe as possible. Importantly, a successful pandemic response should focus first and foremost on the people and communities that have faced long-standing barriers in access to care.
With smart preparation now, a subsequent wave of COVID-19 doesn't need to look like the first wave, with widespread lockdowns and a scramble to build health system capacity. To that end, United States of Care outlines five steps policymakers should consider in the weeks ahead.
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WHAT'S THE IMPACT?
The first step is to simply listen to the needs of different communities. The best response will always come from listening first to the needs of people and understanding the challenges they've experienced since the pandemic began.
Step 2 is to communicate clearly and use data to guide quick decision-making. State leaders, according to the handbook, should take steps to make sure they're well-positioned to act quickly using the best information and data to inform their decisions.
In part, that entails establishing clear decision-making channels among state officials. It also necessitates the creation of an early warning system, with effective monitoring and clear benchmarks. This would allow officials to identify areas in which the virus is resurgent, with the goal of keeping any shutdowns as targeted and limited as possible. Tools to track and stop the spread, such as testing and contact tracing, are also essential, as is sharing timely and accurate information with the public about what they can expect – even if the news is bad.
The third action detailed in the handbook is to focus on protecting people and places that face the highest risks, and to plan for disruptions that could occur elsewhere if closures need to be reinstated.
This entails a number of considerations, such as comprehensively addressing disparities, with a focus on at-risk populations, including communities of color. Protecting and fortifying sites at a high risk for transmission, including nursing homes, long-term care facilities and prisons, should also be a key priority, as should planning for disruptions to key services and programs, such as mental healthcare.
Step 4 is to build health system capacity to meet people's needs – which entails the quick ramp-up and availability of personal protective equipment, strengthening the mental health safety net for the healthcare workforce, and planning a targeted approach to delaying nonessential care and procedures if and when delays are needed.
THE LARGER TREND
Waystar estimates that the cancellation of elective procedures has cost hospitals about $161 billion as of mid-May. Meanwhile, the Advisory Board has advised hospitals that they should confirm their ability to safely manage elective procedures before resuming them.
Hospitals can safely do procedures when the region is past the COVID-19 curve; when there is state and local government approval; when there are sufficient beds, supplies, including PPE, and staff; and when there is the capability to screen patients and staff for COVID-19 symptoms, Advisory Board said.