by James A. Bacon
It is entirely appropriate during a crisis like the COVID-19 epidemic for elected officials to urge calm. Panic often leads to counter-productive behavior. At the same time, it is important not to instill a sense of false confidence, which could engender complacency. Finding the right balance is difficult.
Governor Ralph Northam assured the public that the Commonwealth is well prepared for health emergencies. Virginia’s emergency preparedness, said the Governor last week in comments that Virginia Hospital and Healthcare Association chairman Michael P. McDermott echoed yesterday, is ranked in the “high performance tier,” according to the Trust for for America’s Health.
“The Virginia Department of Health has some of the country’s leading public health experts on his team, with deep experience guiding public health emergency responses, and I have great confidence in their ability to guide Virginia in this situation,” Northam said.
It is true that the Trust for America’s Health gave Virginia high overall scores for public preparedness. But what does that mean? There are many kinds of public health emergencies — hurricanes, floods, terrorist attacks, breakdown of the electric grid… and the list goes on. How well is Virginia prepared to handle pandemics?
Go read for yourself the Trust for America’s Health Report, “Ready or Not 2020: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism,” 1As it turns out, the “high performance tier” is not exactly an elite group. Twenty-five states and Washington, D.C. qualify for that rating.
Here are then 10 criteria used to compile the rating, along with the relevant Virginia metric:
Nurse licensure compact. State participated in N.C. compact (2019). (This compact permits registered nurses and licensed practical nurses to practice with a single multistate license in any state that has joined the compact.)
Hospital preparedness: 100% of hospitals participated in health care coalitions (2017).
Public Health Accreditation Board accreditation: Virginia is accredited.
Emergency Management Accreditation Program: Virginia participates.
Public health funding: 4% increase in FY 2018-19.
Water security: 2% of population who used a community water system in violation of health-based standards (2018).
Paid time off: 58% of employed population with paid time off (2018). Paid time off allows sick workers to continue getting paid if they stay home.
Seasonal flu vaccination: 54.7% vaccination rate for people 6 months and older (2018-19).
Patient safety: 56% of hospitals with an “A” grade (fall of 2019).
Public health lab capacity: Yes, public health laboratories had a plan for a six- to eight-week surge in testing capacity (2019).
So, how relevant are these criteria? A high rate of seasonal flu vaccination doesn’t do anything to protect against COVID-19. On the other hand, a high percentage of workers with paid time off is a plus in containing the coronavirus spread. In theory, sick workers are more likely to stay at home if they know they will be paid, thus avoiding infecting co-workers. Also reassuring is that fact that Virginia hospitals get a high rating for “patient safety,” which entails, among other factors, preventing secondary infections.
As for public health labs having plans for a six- to eight-week surge in testing capacity, Virginia still lacks that capacity. The latest wrinkle, according to The Virginia Mercury, is that Virginia health authorities are urging patients who don’t meet the state’s risk assessment to pursue testing through private labs.
“Currently there are limited numbers of tests available, but we have more today than we did yesterday,” said Dr. Lilian Peake, Virginia’s state epidemiologist, at a news conference Wednesday.
The Trust for America’s Health does not give any consideration to a critical issue that I have highlighted in other posts: the capacity of hospitals to handle a surge in patients.
Perhaps I am being unfair — and I would love to get other viewpoints — but the Trust for America’s Health rating does not seem to be terribly relevant to the crisis at hand.
