Why the Emergency Supplemental Appropriations Bill is Needed During the Coronavirus Epidemic

On the morning post Super Tuesday, it’s likely the entire country is buzzing about the future. But, with the potential looming pandemic we have hovering over us, we must be especially mindful of how political decisions impact our citizens health and safety.

The Infectious Disease Society of America (IDSA) calls for an emergency supplemental appropriations bill that will combat the coronavirus (COVID-19). The bill, if passed by Congress, will provide adequate funding for response to COVID-19. They outlined five key areas where the funding would be allocated:

1. Public health response,
2. Hospital/health system preparedness, response and surge capacity,
3. Laboratory capacity,
4. Research
5. Global preparedness and response.

IDSA highlights that the Trump administration’s request for $1.25 billion for emergency response is inadequate. Of note funding for previous outbreaks include $5.4 billion in 2014 for Ebola, and $7.7 billion in 2009 for the H1N1 influenza pandemic. In response to President Trumps comments on preparedness, IDSA writes, “We urge the president to address this crisis in ways that unify Americans in the face of the shared challenges ahead.”

This supplemental budget chatter has opened a door for pro-telehealth groups and lawmakers to implement a “Telehealth Provision,” allowing Medicare reimbursement for Telemedicine visits during national emergencies. As coronavirus starts to seep into the United States these groups are fervently working to see an extension of funding and reimbursement for anticipated services.

What we know is that coronavirus(COVID-19) is a novel respiratory disease, from a family of viruses found in a multitude of animal species. In rare instances, the animal reservoir virus can infect people. The novel virus we are dealing with currently is named SARS-CoV-2. Many people remember the SARS(severe acute respiratory syndrome) outbreak of 2003, which was also caused by a coronavirus, both of which originated in bats. Initially COVID-19 was thought to be animal-to-person, but further research has shown that it is transmitted person-to-person. With new cases emerging everyday it has progressed to community spread, currently present in 61 countries with death toll has rising to over 3,000 globally.

In a letter from The Alliance for Connected Care to eight Congressional leaders, Executive Director Krista Drobac, said “Telehealth can help patients experiencing coronavirus symptoms access medical professionals quickly, and reduce the risk of exposing others. While physicians cannot confirm a diagnosis of coronavirus through a telehealth interface, they can screen patients, assign a risk category, answer questions and recommend the next step.” This keeps inpatient care truly reserved for critical patients. Low risk patients can have an initial virtual appointment and, if needed, go in for additional testing. This could be seen as two-fold. If an infected patient heads to their primary care physician’s office or health system we can be certain they will infect others along the way. On the other hand, having adequate telehealth assessment measures prevents uninfected patients from coming to healthcare settings where they could contract the virus.

Another group weighed in, suggesting Congress should consider modifying the enrollment process telehealth providers have to go through for Medicare payment. With the looming outbreak, they are clearly worried about response time. “If all you do is remove restrictions without addressing enrollment, you are going to significantly limit telehealth companies’ ability to respond.”

As we’ve been urged to prepare for a potential high risk outbreak in the United States, we are reminded of the global impact we’ve already seen. Rapid action in the US is warranted, especially as more cases arise. The CDC estimates that it takes approximately 36 hours for a pathogen to travel to a major metropolitan city from a remote village. This not only highlights the urgency for us to be prepared in the United States, but also the desperate need to continue to work with other countries to facilitate strength to stop the spread. If we can open the door for the telehealth provision to be added to the emergency supplemental appropriations bill, then we can be certain that we have everything implemented for positive outcomes now and in the future.