WASHINGTON — Healthcare workers are a “limited resource” in the coronavirus outbreak and therefore should be at the top of the list to get personal protective equipment (PPE) as well as a COVID-19 vaccine when and if one becomes available, Ken Cuccinelli told a Senate committee Thursday.
“Nothing any of us is going to do will make more healthcare workers to fight this battle, so they get priority,” Cuccinelli, who is performing the duties of deputy secretary at the Department of Homeland Security, said during a Senate Homeland Security and Governmental Affairs Committee hearing on the outbreak. “We need them to care for everyone else. It will be similar for first responders.”
Getting the right PPE — including respirators — will be crucial, said Robert Kadlec, MD, assistant secretary for preparedness and response at the Department of Health and Human Services. “I happened to be on the HELP [Health, Education, Labor & Pensions] Committee when PREP [the Public Readiness and Emergency Preparedness Act] was enacted,” he said. “Back then we thought a pandemic of influenza was the principal thing we’d have to confront … We focused on vaccines and therapeutics like antivirals” but not on respirators.
He thanked Sen. Kyrsten Sinema (D-Ariz.) for co-sponsoring the Health Care Workforce Protection Act, which would treat respirators as “covered countermeasures” when it applies to product liability issues. “This is vital to the producers of these products,” Kadlec said.
Sen. Maggie Hassan (D-N.H.) told Kadlec that “public health officials in my state attempted to order supplies but were told they were on back-order until May. I’m concerned the national strategic stockpile won’t be able to meet the demand.”
“Unless you have it on hand immediately, you’re going to face challenges,” Kadlec agreed. “We have a limited stockpile right now of masks, N95 respirators, and we’re in the midst of procuring more, and we introduced yesterday a request for proposals for 500 million N95 respirators to be provided over the next 6-12 months, so the intent is that will ramp up.” In addition, Kadlec said, regarding the N95 masks, in a given year only 10% are used by health professionals, while many of the rest are used in construction, mining, and manufacturing. “The FDA has given an emergency use authorization to allow non-medical mask use by a broader population, first responders included,” he said.
Committee members had several suggestions for handling the outbreak. “There is no one coordinated place where people can go to find out exactly what the government is doing” regarding the outbreak, said Sen. Gary Peters (D-Mich.), the committee’s ranking members. “My suggestion is a ‘dot-gov’ website that talks about not only what the CDC puts out, but also what the travel restrictions are, what the Homeland Security Department is doing” as well as other governmental actions. “Right now, people are searching for information.”
Cuccinelli said he liked the idea. “We heard you loud and clear, and are taking it back to the task force to talk about it,” he said, referring to the White House’s coronavirus task force.
Hassan asked when more tests for COVID-19 would be available for patients. “In public health labs, by the end of next week, you’ll probably see very high capacity and capability, and I imagine commercial labs lagging about a week behind them,” said Kadlec.
The administration should “put down a timeline — you don’t have to promise an exact date — so people could see in writing on a website when it would be reasonable to expect commercial labs to perform this testing if your doctor says to get it,” Hassan responded.
Several senators also were concerned about making sure patients would be able to afford any vaccines or therapeutics that are developed for COVID-19. “Recently, the media documented one short-term health insurance company billing a patient $3,000 for a [COVID-19] screening test,” said Sen. Tom Carper (D-Del.). “Have you asked health insurers and employers to remove financial barriers to coronavirus screenings?”
Kadlec said that was one reason that the White House task force added Seema Verma, administrator of the Centers for Medicare & Medicaid Services, “to focus in on that part of the problem … She’s been engaging with insurance companies, and she’s not someone to be fooled with.” He offered to have a briefing on the issue for members of Congress, which Carper said “would be well-received.”
(Following the hearing, America’s Health Insurance Plans, the trade group representing major insurers, promised the industry would bring down barriers to testing and treatment, including patient cost-sharing and prior authorization requirements.)
Hassan asked what the administration was doing to make sure that uninsured and underinsured COVID-19 patients would be able to receive hospital care. Kadlec said that in the supplemental funding bill passed by Congress earlier this week, “there is money to support that, about $1 billion, and I think that money will be used for that purpose, to make sure we can take care of everyone.”
Sen. Kamala Harris (D-Calif.) was concerned about workers in service industries who contract the virus and are asked to stay at home, but don’t have paid sick leave. “For them to stay at home in the interest of public safety means they may not be able to put food on their table,” she said. “What is the administration planning to do to encourage employers to provide paid sick leave for sick employees so they will stay at home?”
“In addition to accelerated communications with local and state-level officials, we’ve also been talking to non-healthcare private enterprises and encouraging them in this direction as well, recognizing the burden that asking them to stay home poses both on the business and on the employee,” said Cuccinelli.
Committee Chairman Ron Johnson (R-Wis.) wanted to make sure some false rumors about COVID-19 had been dispelled, including those about how soon a vaccine would be available. “We want to have peoples’ expectations be reasonable,” he said. Kadlec responded that “a reasonable expectation would be a year to a year and a half” before a vaccine is ready.