PROVIDENCE, R.I. [Brown University] — As negotiations in Washington continue over the best legislative responses to the growing coronavirus pandemic, a team of public health leaders — with input from more 50 other experts in public health, health care, medicine and law — has issued to lawmakers a set of detailed policy recommendations for a comprehensive COVID-19 stimulus bill.
Dr. Megan Ranney — an associate professor of emergency medicine and health services, policy and practice at Brown University — coauthored the recommendations, which detail a set of emergency public health and financial measures that its contributors say must be at the core of any effective and equitable government response to what is already a historic health crisis.
Published in the journal Health Affairs on March 12 — with a follow-up analysis accounting for recent legislative developments published on March 18 — the recommendations came as Congress continues to debate multiple proposals on coronavirus, even as initial stages of legislation are completed.
Among the recommendations, the public health leaders say that lawmakers should boost the country’s capacity to test, treat and contain the disease; require coverage of preventive and diagnostic services with no cost-sharing; protect especially vulnerable populations; provide financial and logistical support to impacted workers and employers; expand resources for frontline health care providers; facilitate the rapid development of an affordable COVID-19 vaccine and treatment; and invest in key public health infrastructure.
“For health care providers, an effort like this is extremely expensive and difficult to coordinate,” Ranney said. “We need the federal government to step up and be flexible and forthright with financial support, supplies and communication.”
The extraordinary nature of this public health crisis heightens the urgency of this need, said Dr. Howard Forman, a professor of public health, radiology and management at Yale University, who led the group that developed the recommendations.
“What we are facing is a once-in-a-century public health challenge, and the response from our government absolutely has to reflect that,” he said. “The recommendations in this document … are the critical elements that any COVID-19 legislation must contain in order for our country to effectively battle this crisis, and then to come out on the other side better prepared to battle the next one.”
Since the recommendations were published, its authors have been approached by members of Congress and the White House, and state-level officials from around the country have consulted them in determining local responses to the pandemic, Ranney said.
In support of its major proposals, the document goes into detail about how lawmakers can use existing policy channels — such as state Medicaid expansion — to fulfill the experts’ directives and allocate the resources necessary for a robust coronavirus response.
“In terms of legislation, much of the infrastructure already exists to mount an aggressive effort against this virus and its far-reaching effects,” said Elizabeth Fowler, executive vice president for programs at the Commonwealth Fund and a member of the writing group. “It’s just a matter of pointing the right policies in the right direction.”
However, the recommendations also call for lawmakers to break new policy ground in a number of ways, especially in order to protect vulnerable populations. The experts warn about increased COVID-related risk to groups including the elderly, chronically ill and homeless, as well as individuals who are undocumented, institutionalized, incarcerated or food-insecure.
During a public health crisis, the framework’s authors suggest, the government also has an added responsibility to ensure accurate messaging, adequate nutrition and quality health care for the most vulnerable Americans.
“One of the bill’s biggest recommendations is that the federal government establish clear paths of communication to state officials, health providers and citizens,” Ranney said. “That doesn’t require legislative change. It just requires a coordinated system.”