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Emergency Providers Ask Congress to Approve Supplemental Appropriations to Battle COVID-19

By Jonathan Springston, Editor, Relias Media

In a letter sent to Congress this week, the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) asked lawmakers to approve supplemental appropriations to help frontline providers contain the COVID-19 outbreak.

Specifically, the groups asked for more funding for the Hospital Preparedness Program and Public Health Emergency Preparedness Cooperative Agreements, both of which boost integrated care, management, and response initiatives among local, state, and regional authorities. Further, ACEP and ENA requested more money dedicated to developing diagnostic tests and vaccines, along with creating a broad public awareness campaign.

“As the safety net for our communities, emergency departments across the country are filled with patients who have nowhere else to go for their healthcare needs,” ENA President Mike Hastings, MSN, RN, CEN, said in a statement. “The emergence of novel coronavirus as a possible pandemic, amid an already-challenging flu season, serves as a reminder that we must ensure our health communities — first responders, public health departments, and hospitals — have the necessary resources to prevent the spread of COVID-19 and to provide the best possible care to all patients.”

Beyond asking lawmakers for assistance, emergency medicine experts set out to offer facts about COVID-19 in a pair of papers released this week ahead of a possible public panic in the United States.

In the first paper, the authors acknowledged that it seems COVID-19 is spreading rapidly beyond anyone’s control and that there have been associated deaths. However, they explained the mortality rate for coronavirus is at 3%, much lower than the 35% and 15% for Middle East respiratory syndrome (MERS) and sudden acute respiratory syndrome (SARS), respectively. This, despite the fact there are more confirmed coronavirus cases in the world than either MERS or SARS, both of which live in the same virus family.

“The impact of coronavirus is significant but pales in comparison to global influenza,” Matthew J. Fuller, MD, assistant professor and director of global health for the division of emergency medicine, University of Utah and lead study author, said in a statement. “Lessons learned from past outbreaks are instructive while risk factors for transmission of coronavirus are still being assessed.”

The second paper addresses economic and social anxieties that are a part of widespread health crises like the COVID-19 outbreak. “Misinformation can spread just like a virus, obscuring communication from the international health community to medical professionals and the public. Everyone would like to avoid a scenario where anxiety drives public behavior change,” Christopher J. Greene, MD, MPH, assistant professor of global health and international emergency medicine, University of Alabama Birmingham and lead study author, said in a statement. “It’s important for health professionals to break through the noise to encourage people, especially those potentially at risk, to take appropriate precautionary measures and heed the recommendations of health professionals.”

The upcoming April issue of ED Management digs deeper into the triple threat that has been testing the limits of emergency providers. In addition to preparing for a possible widespread COVID-19 outbreak, providers have been managing an unusually severe flu season that started early. On top of all that, patients continue arriving with vaping-associated lung injuries, albeit at lower rates than a few months ago. Still, the symptoms of these vaping injuries may mirror those of the flu, causing further confusion.

In the cover story, author Dorothy Brooks reports on how U.S. providers are using lessons learned from the 2014 Ebola crisis to prepare for the arrival of COVID-19. Experts from the National Ebola Training and Education Center urge healthcare systems to adopt processes in line with “Identify, Isolate, and Inform,” a process for quickly identifying and managing cases of infectious disease in a way that minimizes the risk for subsequent transmissions.

Regarding influenza, Brooks notes activity spiked as early as December. B virus strains, which usually lead to worse outcomes in children, were predominant in the early part of the season. Typically, A strains emerge first, followed by B virus strains. By mid-February, flu activity remained widespread throughout the United States. As the season has progressed, cases of A(H1N1)pdm09, a strain that tends to produce worse outcomes for adults, have surged.

Along with influenza treatment and containment tips, the April issue of ED Management includes education about how to tell the difference between a patient presenting with influenza and one presenting with vaping-associated lung injuries. One vital tactic is for medical providers to reach deep into a patient’s medical history, asking detailed questions to help solve the puzzle.

For additional ongoing coverage of COVID-19, be sure to read Hospital Infection Control & Prevention and its supplemental blog, “HICprevent.”