WASHINGTON -- Public health experts called for more funding and clear messaging from the federal government to support state and local community responses to the novel coronavirus at a House Committee on Homeland Security hearing Wednesday.
One of those requests was on the way to being met: later in the afternoon, the for the COVID-19 response. The Senate will take up the package; Sen. Lamar Alexander (R-Tenn.), who chairs a key committee, promising to speed enactment, although it gave a figure of only $7.8 billion.
As for messaging, administration officials have offered conflicting views about COVID-19 in the last few weeks and days, sometimes unintentionally, noted Tom Inglesby, MD, director of the Center for Health Security at Johns Hopkins Bloomberg School of Public Health in Baltimore.
It's important that government speak with "as much of a single, consistent voice as they can," he told the committee.
Currently, the risk to any individual in the U.S. is low, but it would be useful to explain to people their risks, such as "what do health officials believe is likely to happen in their communities," Inglesby said.
However, that messaging should not be done in an "alarmist way," but "just so that people can be informed and begin to take measures ... to try and diminish their own risks," he emphasized.
Former CDC Director Julie Gerberding, MD, MPH, who is now an executive at Merck, said that people need to understand that messaging about the novel coronavirus will change and evolve over time. Nonetheless, when people are given straightforward information, they don't panic, she added.
"You can't communicate enough," said Gerberding.
Local funding needed
Ngozi O. Ezike, MD, director of the Illinois Department of Health, said in her written testimony that responding to the virus cost Illinois more than $20 million in the first 5 weeks.
"We can't reiterate enough the need for [additional] funding," Ezike said. She said that the state has repeatedly provided funding for things like employee overtime, housing for patients, and running a lab. She said federal emergency supplemental funding needs to be large enough to reimburse her state and others for the costs of aggressively responding to the coronavirus.
Illinois was the first state to validate the CDC's coronavirus test, and began testing for the virus a few weeks ago. This week it implemented "sentinel surveillance" testing in order to help determine how much COVID-19 has been circulating in communities there.
Through these efforts, Illinois has relieved the CDC of some of the burden of its own testing. In turn, Ezike said she is asking the CDC to provide "an uninterrupted supply of testing materials" including reagent shipments, to enable the state to increase its testing capacity.
Ezike also discussed housing challenges. If a person lives alone, isolation is simple, she explained, but for patients in a household with other people, and assuming they aren't severely ill, the ideal isolation site would be a motel where there are individual rooms with separate entrances.
But finding places to house patients who need to be in isolation has become difficult, she said. In one case, the state rented a recreational vehicle because no motel would agree to take a patient who tested positive for the virus.
Also, some patients are being forced to choose between their paycheck and their public health responsibility to their families and communities, Ezike said. She said she knew of a patient who wanted to leave the hospital before getting her test results back because she was the family's primary breadwinner, and feared that the test results may prevent her from going to work.
"We need to have some kind of payback for people who are set up to stay home," she said. "If we want people to comply with our public health interventions, it can't be at [a] detrimental cost to them and their family," Ezike said, stressing the importance of making funds available to allow individuals, particularly hourly workers, to remain home or in isolation when necessary.
Inglesby agreed, noting that if people can't go to work -- either because they're in isolation or because their children are being kept home -- there must be systems to ensure they don't go bankrupt.