COVID-19: Washing our hands is not enough. We need the right policies.

“It will go away. Just stay calm. Be calm. It’s really working out. A lot of good things are going to happen.” President Trump, Associated Press, 3/10/2020

These are some of the not-so-reassuring comments from our president about COVID-19. Other Trump comments have contradicted infectious disease and public health experts. In a time that calls for significant federal leadership, we get false information, suppression of recommended guidelines, little transparency and minimal preparedness. Based on the response by the White House, Trump appears to care more about the virus’ impact on our economy — and, ultimately, his political fortunes —than the direct impact on people’s lives. 

Contrary to what Trump says, I don’t see a lot of good things happening as a result of COVID-19. The only silver lining is that COVID-19 will help our country and others prepare for future pandemics that could be even more fatal. 

We may soon discover our health care system is not adequately prepared to handle a pandemic that affects every state. If we are unable to contain the spread of the virus, we will likely experience a shortage of health care workers, supplies, hospital and ICU beds and ventilators. Our frontline public safety workers — law enforcement, first responders, firefighters, public health officials and health care providers —will find themselves overwhelmed. We will need to make tough decisions on how to ration life-saving care, and these are decisions no health care professional wishes to make. 

Paying to test, diagnose and treat patients is another hurdle. Approximately 250,000 individuals in our state lack health insurance. And for those with coverage, health plans may deny covering out-of-network care in cases where patients are triaged or quarantined. Some health plans are voluntarily implementing policies that waive co-pays for testing. But testing is a relatively minor cost. Patients may need intensive care at specialized facilities, which can be very expensive. The Minnesota House recently introduced a bill requiring plans to cover testing, treatment, cost sharing and out-of-network care related to COVID-19. 

If we had universal coverage where all folks could get affordable health care, we could better protect everyone from the spread of deadly viruses. How much do you value your life and the life of your loved ones? Probably much more than it costs to finance a public option in which Minnesotans could purchase affordable, high-quality care. It is an ideal time to re-introduce the MinnesotaCare buy-in option. The bill will have a large fiscal cost initially but will save the state considerable amounts in the near future — and it will save lives.

And if we had paid sick time, those who were sick could stay home and not spread the virus. People who work in leisure and hospitality, food services, community living facilities, childcare and home health should not be forced to work when they are sick. When workers do not have paid sick time or health insurance, they must consider the cost of visiting a physician, the loss of income and the risk of losing their job if they call in sick. Without paid sick leave, there is a disincentive for workers to be proactive. We are exposing people to a pandemic because we do not properly value the health and welfare of workers or their economic security. Where is our common sense and empathy? Paid sick leave is a good policy that benefits all of us. According to the Bureau of Labor Statistics, roughly 60% of low-wage workers lack access to paid sick leave.

When we think about treating the economic effects of this virus, we need to treat the people first, not the profit margins of large companies. This may entail allowing folks who do not have paid sick leave to temporarily qualify for unemployment insurance in the event of quarantine or business closure. This is financially feasible because Minnesota’s unemployment insurance fund is solvent and much healthier than other states. It would be helpful if the federal government would allocate funds for unemployment insurance rather than the recently proposed temporary payroll tax reduction that helps those with jobs. Hourly workers who are laid off or sent home without pay do not benefit from a payroll tax reduction. 

As a state we are coordinating various pieces of our health care delivery system; however, it will become clear that a true system does not exist. I am most concerned about older adults in our long-term care facilities. Many nursing homes are currently experiencing staff shortages, low inventories of medical supplies and very little reserve funding to increase services that may be necessary to protect our most vulnerable population. And assisted living facilities could be in even worse shape than nursing homes, with limited health care services available and little experience preparing for a public health emergency. Luckily, Rep. Tina Liebling, DFL-Rochester,  Sen. Michelle Benson and dedicated staff at various state agencies are working on grants and a revolving loan fund for immediate financial assistance for these facilities and hospitals. 

Overall, Minnesota is much better off than other states. We have integrated provider organizations with highly trained health care professionals. We also have the expertise of the University of Minnesota Academic Health Center and School of Public Health. And we are blessed to have the Minnesota Department of Health, one of the best in the country. The leaders of these organizations are helping shape our state response to contain the virus. This past week the Minnesota Legislature and Gov, Tim Walz approved $21 million in funding to prepare for COVID-19. This is a decent start and will help the state be proactive rather than reactive.

This is a time to be in solidarity so we can act quickly to address public health emergencies. This virus may ultimately affect millions in our country and we all need to do our part to help contain it. Follow the guidelines from the CDC, World Health Organization and the Minnesota Department of Health. Don’t panic, wash your hands, maintain safe distances and remain calm. Things will likely get worse, but we should be confident knowing that our state government leaders and state workers are going to lead us through this crisis.