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Craig Brammer is president and CEO of The Health Collaborative and the Network for Regional Healthcare Improvement in Portland. Jessica Little is a director at the Network.
With the current surge in COVID-19 cases nationwide and winter just around the corner, there has been a significant increase in demand for testing in advance of families gathering for the holidays.
The U.S. is currently testing an estimated 1.5 million people per day, double the rate from July, but experts warn that testing must increase to between 4 million to 15 million tests per day to keep up with the winter surge.
Testing sites are at capacity and bracing for the challenges that winter brings, including continuing to provide drive-up, outdoor testing that is the recommended standard for patient safety. At a recent off-site testing webinar hosted by the Network for Regional Healthcare Improvement, with support from The Rockefeller Foundation, Ashley Johnson, continuous improvement specialist at Providence St. Joseph Health in Alaska noted: “Now that we are facing winter weather again, we have had staff coming from the office who weren’t prepared to be outside. We struggle with keeping people’s hands warm while performing swabbing and changing gloves frequently. Our cleaning supplies that we use to clean carts and things freeze so we need to be creative. We continue to be challenged with a somewhat temporary location that was not designed for testing outdoors and requires constant investment.”
“In the winter, it gets so cold that our equipment freezes and our batteries die. We have to wrap the equipment in hand warmers between patients to keep it operating due to the conditions,” noted Brianna Huot, clinical quality specialist for Martin’s Point Health Care in Portland in response to a survey.
Many off-site testing facilities also report difficulties in finding tents that stand up to the conditions and some have had to move sites indoors where there is more risk to both staff and patients. A growing shortage in personal protective equipment (PPE) is also an issue as cold weather requirements shift the need for PPE that is heavier duty and able to withstand the elements.
Exacerbating these challenges even further is the looming deadline for funding for COVID-19 testing. The Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed last March and was signed into law by President Donald Trump on March 27, provided $2.2 trillion in economic stimulus, including $25 billion for state and regional COVID-19 testing efforts.
That funding is scheduled to expire on Dec. 31, at a time when cases are rising across the United States and we have already reached a grim milestone of more than 290,000 American deaths.
President-elect Joe Biden has promised a national strategy to address the pandemic and just recently announced a COVID-19 task force that includes former surgeon general Dr. Vivek Murthy, former Food and Drug Administration commissioner Dr. David Kessler and Yale University professor Dr. Marcella Nunez-Smith, among others.
Federal coordination of production, distribution and supply chain management is essential to ensuring that the supplies and testing needs across all communities and in all types of weather are available. While the U.S. stockpiles in equipment are currently at a low level, Biden could evoke the Defense Production Act to expand the stockpile. The Defense Production Act was established in 1950 and authorizes the president of the United States to “expedite and expand the supply of materials and services from the U.S. industrial base needed to promote the national defense.” This includes directing businesses to convert their operations to support the development of needed supplies, such as PPE, in the case of a national emergency.
The silver lining is the recent announcements from Pfizer and Moderna that they have developed vaccines that are in the 90-95 percent effective range. They have announced a target timeline of distributing vaccines to the general public some time over the summer months.
Until then, however, Congress must extend CARES Act funding and the federal government must move quickly to replenish national stockpiles for testing supplies and PPE if we are to meet the demand needed to get us through the challenging winter ahead.