When President Donald Trump declared a national emergency over the 2019 novel coronavirus on Friday, he dangled billions in new federal aid to address a cascading pandemic.
But local doctors from Oklahoma City to New York to Lansing, Michigan, have been sounding the alarm in recent days about the lack of communication—as well as supplies—they’ve received from federal and other authorities.
In other words, cash alone won’t solve the problem.
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Communication from the top through the local level about everything from testing to supplies is “almost non-existent,” said Farhan Bhatti, a family physician who runs a non-profit clinic in Lansing. Bhatti serves on the board of the Committee to Protect Medicare, a self-described public advocacy and grassroots lobbying group that works “to persuade elected officials to support health care for all Americans.”
“The president himself is patting himself on the back for finally taking it seriously,” Bhatti told The Daily Beast. “But we have not yet seen the impact of that trickle down to the physicians who are on the front lines of seeing patients.”
Perhaps the greatest scandal in a deeply troubled federal response to the outbreak has been a mix of inability and unwillingness to test patients for the deadly disease. Little about the president’s press conference, where he denied any responsibility for what his own infectious disease expert has called “a failing” on the testing front, seemed likely to change that soon.
“The coronavirus tests are basically being approved or disapproved by local county health departments, but it is already the case that there are more people we want to test than enough to test them—so the county health department is having to decide who gets tested and who doesn’t,” Bhatti said. “The farther out that you go, as you get into more rural communities, the problem is even more exacerbated.”
“We don’t really know the extent to which the virus is actually spreading,” he added. “There’s really no guidelines or consensus yet for who to test, when to test, and how to test them in a way that protects public safety.”
The latest numbers from the Associated Press on Friday afternoon put the confirmed novel coronavirus case count in the United States at 1,323, with at least 38 deaths.
One doctor based in Oklahoma City, who asked to remain anonymous because she was not cleared to speak to the press and did not want to draw undue attention to her local clinic, told The Daily Beast on Friday that she had symptoms consistent with COVID-19 and had not been tested, despite the fact that she treats high-risk patients.
“I have a minimal cough, some body aches, some fatigue and chills—but no fever, no runny nose, and I can suppress my cough,” said the doctor. “If I don’t take care of my patients, it creates a huge problem, but if this is COVID-19, I could easily kill them, no matter how well I wash my hands.”
“I am a physician whose patients are mostly very elderly with lots of complicated medical problems,” continued the doctor. “They are all at high risk of dying. I am not a high priority person to test, by most standards, but I desperately want to be tested, for the sake of my patients.”
To be clear, she said she had not tried to get a test herself but knows she does not fit the criteria, especially because she does not have a fever or serious cough.
“How am I supposed to know whether to disrupt our whole clinic?” she said. “Who will take care of people when the providers get sick?”
Rob Davidson, an emergency physician at Spectrum Health Gerber Memorial in Fremont, Michigan, said he had five patients on Thursday night he would have liked to test. But they did not meet current CDC criteria for having either traveled, been exposed to a confirmed case, or become seriously ill with other respiratory infections ruled out.
“In any other year, I’d say ‘no big deal,’ but in this case, I had to have a conversation with each of them about the fact that we don’t have testing,” he told The Daily Beast.
“One of those patients had a spouse at home with lung disease,” added Davidson. “Obviously if there was an abundance of tests, I would have swabbed every one of them.”
President Trump announced on Friday that several new diagnostic test kit-related initiatives will be rolled out in the coming days and weeks, including drive-through testing in select locations, as well as partnerships with private companies to expand the current U.S. testing capacity.
But even aside from the testing issue, it has been widely reported that, despite a national stockpile, there’s a serious lack of supplies like respirators, masks, and even beds. Vice President Mike Pence has said that private companies signed on to help produce more masks, and Trump said on Friday that his administration had ordered a “large number” of respirators to try to meet the national need.
“We’re in the process and, in some cases, have already done it, ordered a large number of respirators just in case,” said Trump. “We hope we don’t need them, but we’ve ordered a large number.”
“There’s not enough supplies, especially for medical professionals,” Bhatti told The Daily Beast on Friday. “For medical professionals to be able to do their job, I’m concerned we’re coming up to a time where physicians will need masks and not be able to obtain them.”
An internal medicine doctor and hospitalist in Ohio who asked to remain anonymous over fear of retaliation from her employer told The Daily Beast on Friday that she was personally treating a case of the virus at her facility—and feeling her own anxiety.
“Fear is certainly the best word to describe the mood in my hospital right now,” she said. “Confusion would be another good word.”
“So far the only information we've gotten from administration has been in the form of emails,” continued the Ohio-based doctor. “There have been no formal staff meetings or forums where we've gotten any solid information about how to handle this crisis.”
“My coworkers and I feel very much in the dark and like we’re ‘winging it’ until we get further instruction from the higher-ups,” she said. “Meanwhile the hospital is nearly full and every staff member seems to be working in a worried haze.”
“Multiple nurses and doctors I spoke with today reported sore throats and dry cough. Some have muscle aches and fatigue,” she added. “Many of us feel stuck and are just soldiering on. I don’t know how the next few weeks will play out, but I pray I can stay healthy and don't bring anything home to my two little boys.”
The same dynamic has been playing out across the country. As Tara O’Toole, a former undersecretary of science and technology at the U.S. Department of Homeland Security, told reporters on Friday:,“It doesn’t take a large number of people getting sick all at once to stretch or overwhelm our capacity to take care of the seriously ill.”
“What we’re trying to do is slow down the spread of the disease so everybody doesn’t get sick at once, creating a tsunami of seriously ill people slamming into our healthcare system,” said O’Toole, one that “simply does not have” the resources to handle a big surge.
O’Toole spoke during a Friday tele-briefing by the Council on Foreign Relations on the subject of American preparedness in the event of an epidemic.
“We are in the age of pandemics,” said Larry Brilliant, a world-renowned epidemiologist who previously served as chair of the National Biosurveillance Advisory Subcommittee at the CDC and was on the tele-briefing with O’Toole. He called COVID-19 the “most dangerous” pandemic of his lifetime, even if it is not the most fatal.
“It will cause global disruption on a scale we have not seen in more than 100 years,” said Brilliant.
Muni Tahzib, an attending physician at City MD in New York City, told The Daily Beast her employer had been great about giving her colleagues supplies and protection. But she said she’s in a Facebook group with tens of thousands of female physicians, and estimates that half of them have expressed worry that they don’t have enough gear.
“How can you have doctors and nurses working in the field and not give them the proper protection?" she asked.
—Gender reporter Emily Shugerman contributed to this story.