We need a federal task force to protect health care workers

We have never been more proud of our field as medical professionals, yet also more concerned. The COVID-19 pandemic is severely endangering the lives of frontline health care providers. 

In China where it began, thousands of health care workers were infected, of which 15 percent were seriously or critically ill, and five died. In Spain, 14 percent of its 40,000 confirmed coronavirus cases are among health care professionals, and 50 have died in France, Italy, and Spain. As COVID-19 strikes New York City and possibly many U.S. cities, we want to prevent a situation in which colleagues must take care of their colleagues in ICUs across America

Of course, medicine is not only a profession but rather a calling, for many. We have dedicated decades to train and serve in the pursuit of caring for others, treating disease and advancing science. 

Despite this pursuit, we feel it is hubristic to think we possess innate immunity to the risks of front line medicine. We are hearing from many colleagues who feel abandoned. 

We know of widespread PPE shortages in New York and throughout the country; doctors and nurses are reusing masks and are either making their own or forced to ask for donations from veterinary clinics and construction sites. 

Some are concerned these shortages are driving changes in our guidelines for protective equipment, rather than sound evidence on infection control. 

If the pandemic weren’t enough of a shock to the system, the shortages are another fault line stressing what now seems a house of cards. While we struggle to support the faltering supply chains of medical equipment, let us not neglect perhaps the most valuable and irreplaceable supply chain of all: our frontline health workers. 

We are urgently calling for executive action in the form of a federal task force to protect health care workers to oversee and drive coordinated action around 3 critical areas.  

First, we feel the federal task force should take the role of centrally coordinating procurement for personal protective equipment (PEE) at the federal level. 

Currently, there are varying layers of the procurement: federal, state, city and hospital. All of these seem to be uncoordinated and possibly bidding against each other. There is a complex web of supply and demand mismatch, all of which will be dynamically changing based on the epidemiologic trends of the virus across the country. 

There have been various centralized data clearinghouses that have been largely community-led. However, we feel the complexity and urgency requires federal leadership to keep health care workers safe nationwide. 

Second, we feel the federal task force should directly expedite biomedical research pathways to protect frontline health care workers. 

The FDA already took a major step in approving emergency approvals for the use of convalescent serum — the antibodies of those recovered — as a possible treatment. 

Similarly, this task force can lead the approval process for trials for the prophylactic use of convalescent serum for frontline health workers — to protect them from exposures, as well as critically need blood tests to determine immunity status, which might help inform human resource allocation to the front line.

Lastly, our frontline workers are stretched dangerously thin. Prior to the global pandemic, there were already health worker shortages, and now with hospital surges and many falling sick — the needs are dire. 

This federal task force could coordinate the massive demand for training and redeployment alongside the CDC and U.S. Public Health Service. 

Some have suggested a massive mobilization to possibly re-employ those laid off and train a new generation of foot soldiers as community health workers that can help with containment and mitigation efforts (ie, contact tracing and symptom monitoring). 

All three major coronavirus epidemics in the 21st century: SARS, MERS, and now SARS 2, are notorious for causing outbreaks in hospitals and attacking health care providers. In anticipation that coronavirus epidemics or even pandemics become regular occurrences, we must take steps to health care worker protection as part of our national preparedness plans.  

We are at our best, in perhaps our most dire moments. It is clear this virus is stretching our capacity, our resources, our economy and most of all our doctors and nurses. Let it equally stretch our imagination, conviction and courage to take care of those that have dedicated their lives to taking care of others.  

Dr. Akash Goel is a professor of medicine at Weill Cornell/NewYork Presbyterian Hospital and has been recognized by the U.N. and awarded a Cannes Lion for his work in human rights advocacy. Dr. Peter J. Hotez is a scientist, pediatrician, and leading advocate and expert in the fields of global health, vaccinology, and neglected tropical disease control. He serves as founding dean of the Baylor College of Medicine National School of Tropical Medicine and holds the Texas Children’s Hospital Endowed Chair in Tropical Pediatrics. 

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