In a wide-ranging address today, the president of the American Medical Association highlighted multiple challenges posed by the coronavirus pandemic.
In an address to the National Press Club today, American Medical Association President Susan Bailey, MD, called for a coordinated and comprehensive federal response to the coronavirus pandemic.
At the beginning of her address, Bailey highlighted the epic proportions of the pandemic. She said the country is experiencing 1 million new COVID-19 cases per week and recently "reached the grim milestone" of losing 4,000 lives to the coronavirus in a single day.
"Some areas of the country are experiencing record case surges that are flooding emergency departments and intensive care units. In other areas, first responders are having to make agonizing choices about whom to treat for routine health emergencies to ease overcrowding at local hospitals. With hospitals stretched at or near their breaking point, some are even forced to treat patients in cafeterias, hallways, and conference rooms," she said.
State and local authorities are not adequately equipped to cope with the pandemic without federal help, Bailey said.
"While safe and effective vaccines are at-hand, the distribution mechanisms at state and local levels have been slow, inconsistent, and severely hampered by unrealistic expectations and a lack of coordination at the federal level. This inaction at the highest level of our government has placed yet another daunting burden on the shoulders of state and local officials who lack the resources, sufficient guidance, and the support they need to handle a health emergency of this magnitude on their own."
So far, the government response to the pandemic has been woefully fragmented, she said. "Leaving state and local officials to shoulder this burden alone without adequate support from the federal government is not going to work. Fifty different strategies across 50 states will continue to sow confusion and slow the process."
The incoming administration of President-Elect Joe Biden should focus on three areas as soon as possible, Bailey said.
1. National strategy: "I call upon the incoming Biden administration to implement a national strategy and provide states and local jurisdictions with additional resources, guidance, and support to enable rapid distribution and administration of vaccines," she said.
2. Coordination with states: "The AMA urges the Biden administration to talk with states to identify gaps in vaccine distribution and to work collaboratively to address areas of concern," she said.
3. Defense Production Act: "We call for the new administration to develop a more robust national strategy for continued COVID-19 testing and production of [personal protective equipment] by tapping into the full powers of the Defense Production Act," she said.
Pandemic big picture
Bailey said the pandemic has exposed five troubling elements of U.S. healthcare that must be addressed.
1. Importance of science: There needs to be heightened adherence to science and science-based decision making in areas related to healthcare, she said. "Whether you are a physician like me or a journalist, or whether you simply post your ideas on Facebook or Twitter, all of us share some responsibility for stopping the spread of disinformation and for creating an environment where science and evidence rule the day. We must insist that our elected officials affirm science, evidence and fact in their words and actions."
The federal government's key scientific institutions such as the Centers for Disease Control and Prevention and the Food and Drug Administration should not be subjected to political pressure, Bailey said. "Politics have no place in a pandemic; and never again should scientists, researchers, or physicians feel the weight of intimidation or have the integrity of our work questioned."
2. Access to affordable care: All Americans should have access to affordable healthcare services and health coverage, she said.
"As certain provisions of relief packages from the beginning of the pandemic expire, many Americans are still facing tremendous difficulties and hardships—some dealing with the loss of a job or a business. … In this new year, we urge the federal government to take necessary measures to protect not only lives but livelihoods at risk—measures such as a second enrollment period for the Affordable Care Act."
3. Addressing health inequities: The pandemic has revealed widespread inequity in the U.S. healthcare system, Bailey said.
"The data from COVID-19 is painfully clear. Communities of color have been disproportionately impacted by this pandemic because of systemic inequities that are rooted in racism. Heart disease, diabetes, and other chronic conditions that have led to devastating consequences for African American, Latino, and Indigenous communities … have also made them more susceptible to the dangers of COVID-19. The road ahead demands that our health system acknowledge these inequities and work to integrate new policies to level the playing field in all communities."
4. Improving public health: The country's public health infrastructure has been "gutted," she said. "In the last 13 years, we lost 40,000 jobs at the state and local public health agencies, with the local health department workforce shrinking about a quarter. We are seeing the impact of this disinvestment play out today in the slow vaccine rollout we are witnessing. Marginalized and minority communities and people living in rural areas have also suffered the consequences of this disinvestment for too long."
5. Global nature of health: The United States needs to work with other countries to address future outbreaks of disease, Bailey said.
"We cannot act as if our country exists in isolation. We must recognize the global community of health providers and healthcare institutions—and lead these efforts as we are called to do. Global alliances in healthcare are critical in helping prevent future threats before they sweep our planet. We applaud the incoming administration's commitment to rejoin the World Health Organization."
Pandemic impact on physicians
The pandemic has taken a heavy toll on physicians, Bailey said during a question-and-answer session after her address.
"The frontline doctors who are in the emergency rooms and the specialists who work in the ICUs have been running on fumes for a long time. … But on the other side, there are doctors who are having to close their practices because they don't have enough patients to see because of local shutdowns combined with fears among patients about going out into public," she said.
Physician burnout and suicide are significant concerns during the pandemic, Bailey said. "There is burnout. Many are aware of Dr. Lorna Breen—the physician in New York who committed suicide last year. We do not have good numbers on what has happened with the suicide rate among physicians and other healthcare workers during the pandemic, but I am sure it is not going down."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
The federal government must do more to support state and local authorities during the pandemic, American Medical Association President Susan Bailey says.
The pandemic has exposed five weaknesses in the U.S. healthcare system that must be addressed, Bailey says.
The physician leader says the pandemic has taken a heavy toll on physicians and other healthcare workers.