20 Coronavirus Fighting Priorities the Trump Administration Should Pursue

A daily Covid-19 update from Andy Slavitt, former head of the Centers for Medicare and Medicaid Services

Photo by Win McNamee/Getty Images

Pulled from my daily COVID-19 updates on Twitter

I spent the day trying to assess some of the greatest needs we have and what the Federal government could be solving now. My post from two days ago was about our challenges. Today is about solutions.

I’m going to begin with the priorities that the Trump Administration should announce and then turn to what they can do to address them. I’m not looking to generate “good luck” or “yeah right” responses, rather I’m doing this to report on it and push the Administration.

Here are 20 priorities:

1. Save every life possible

• Stop throwing around “acceptable” numbers
• Dramatically take up #StayHome measures with CLEAR national standards. There IS a right answer. Use it
• Use stadium capacity for ICUs everywhere
• Spread life saving best practices
• Speed therapies early

2. Feed & house Americans using our empty hotels and restaurants

• The government should buy meals from local restaurants and deliver free to low income, subsidized to millions
• Fill the hotels with housing insecure
• Buy fresh farm production surplus and deliver
• Enhance SNAP by multiples
• NO breadlines in this crisis

3. Protect our front-line care providers as a special class

• Make their safety our first priority
• Backstop 2 billion orders of N95 masks
• Make health care workers a special class eligible for benefits, child care and support
• Push Congress to pay them a $5k/month stipend
• Do not sleep until they’re safe

4. Protect the financial health of small businesses

• Prevent creditors for closing businesses
• Create grants to allow businesses to go online
• Expand the small business loans to all businesses who keep their employees hired
• Tax large employers who lay-off employees and pay exec bonuses

5. Keep primary care physicians up

• Move all non-COVID care to safe settings
• Have insurance companies pledge to front load payments to medical profession (they are flush as people avoid doctors)
• Allow every physician to join a telemedicine platform with full payment

6. Roll out a strategy to protect the most vulnerable communities

• Reinstall Obama-era nursing home infection control
• Depopulate prisons
• Provide resources to multi-generational households
• Create special resources to identify and serve chronic populations at home: group homes, foster homes, Sect 8

7. Significantly improve production of PPE

• Buy 2 billion masks and end the black market
• Stop the stupid trade wars and buy the fine mesh in China
• South Korea and Philippines have a huge surplus

8. Stamp out and jail profiteering

• As we empty the prisons there will be plenty of room to shove in the people running warehouses of N95 masks at 8x the price

9. Create national standards for distancing, essential workforce, travel and business openings

• People travel across state borders — 6 feet is 6 feet, home is home, essential is essential. Just say it. Enforce it. Save lives. Then heal together.

10. Call on American companies and philanthropists to do what it takes

• The Federal government wont meet every need. Some of the greatest fortunes ever accumulated are right here, right now
• What exactly are these fortunes for but to serve the poor NOW, to invest in big bet inventions NOW?

11. Create a national testing leadership team and strategy

• Create enough tests, two for every symptomatic person
• Put all the supplies needed behind the labs which produce the quickest, most accurate tests
• Make testing ubiquitous
• Develop a pinprick antibody test
• Contact trace like South Korea
• One czar overseeing the strategy

12. Restore dismantled command & control structure

• Start by restoring the infrastructure on readiness the Trump Administration tore down
• Treat this like a military operation where equipment and trainee personnel must be moved
• Don’t require governors to navigate and compete

13. Create transparent national reporting of cases, hospitalizations & community readiness

• The Public can handle the truth. Not a month later, but on time.
• We don’t need chosen facts by the White House. We need a consistent dashboard of facts.

14. Create the largest ever national volunteerism movement to meet the needs of people

• Millions of young people are without jobs. People who want to contribute and not feel like victims
• The homebound and isolated need things
• Hospital workers need everything
• Complement with Universal Basic Income

15. Address the non-COVID clinical needs of Americans

• Hospitals were full before COVID
• Designate non-COVID hospitals
• Create national home based, telehealth system
• Ensure drug supply for chronic conditions, insulin, chemo, etc.
• Bring back and graduate health corps

16. Launch a national mental health infrastructure

• The effects of exposure to prolonged trauma is severe
• Create and train 500,000 licensed new social worker corps
• Support front line health care workers, socially isolated
• Take steps to end stigma and address addiction
• Free access for online group therapy and recovery

17. Integrate and coordinate medical resources between community, VA, DOD hospitals

• Severe COVID patients need added resources
• Significantly expand our health care capacity
• Bring overseas medical personnel and operations home
• Set up fever tents, thermometer and testing checkpoints
• Cross licensing and admitting

18. Suspend foreclosures, evictions and bankruptcies

• People should be able to enroll in Medicaid retrospectively if they lose their jobs or can’t afford insurance

19. Meet the specific needs of the disability community

• Remember 12% of population, many already at risk and in poverty
• Paid family and medical leave
• Pay family care givers as personal care attendants
• Direct support for home and community based care
• Lift asset tests
• The next CMS Administrator (Centers for Medicare and Medicaid Services) needs to be someone living with a disability

20. Convene scientists to oversee and implement discoveries quickly, transparently, and equitably

• Give the National Academy of Sciences the lead in determining virus status/capability
• Ensure a robust pipeline of vaccines, therapies with supercomputing support
• Begin to build manufacturing infrastructure before the vaccine is ready
• Prepare for the next epidemic

There are many things that only the federal government can do well. A massive Marshall plan and call for togetherness with common facts will be necessary to defeat this. If the federal government can’t or won’t, we must. I have been spending time on each item in this agenda.

I’m a lay person in many of these areas. I see many people with real expertise able to drive these forward. But a federal government with a clear, bold, actionable agenda would allow us to race instead of zigzag.

Many actions we don’t need the federal government for. And a bunch of things we need Congress for. We have put out a set of recommendations to Congress:

United States of Care COVID-19 Policy Agenda

Every two weeks, United States of Care sends memos to each state summarizing best practices. They maintain a rapid response unit and a resource center. Every employee of the non-profit is full time on COVID response. Now it’s full time. Here’s the most recent:

COVID-19 Priorities Checklist for State Leaders

I will talk more about testing tomorrow. Sadly I don’t think we will have our crap together until the Fall Coronavirus wave (which I will write about coming up).

Read my April 2 update here:

States are Being Forced Into a Bidding War for Ventilators