Doctors for America Statement and Sign-on Letter Addressed to National, State, & Local Government Officials and Health System Leaders:
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The US is experiencing a national emergency due to the coronavirus outbreak that threatens not only the health of all Americans but our entire health care system. Outbreaks in China, Italy, Iran, Spain, and now New York have demonstrated the serious risk, where the pandemic has overwhelmed systems already stretched to the breaking point. Meanwhile, physicians, nurses, and other health workers and first responders who are on the front lines of saving lives both here and abroad are in one of the highest risk groups for contracting COVID-19 as a result.
When 1) our federal elected officials do not communicate a message consistent with scientific and medical realities, 2) our strategic stockpiles are not effectively accessed, and 3) public health recommendations for social distancing and shelter-in-place are not reinforced, then hospitals and health systems are stretched beyond their capacities and all people are threatened.
And when front-line doctors, nurses, and other health workers risk becoming patients themselves, the work of keeping the healthy from becoming sick, sick patients from becoming sicker, and the sickest patients from dying becomes even more difficult. The combined effects are disastrous to the personal and financial health of our patients, communities, and the nation.
We cannot combat COVID-19 without limiting the number of people who get sick in the first place. We also cannot combat COVID-19 without protecting health workers and supporting them so they can continue providing patient care, including through ensuring access to protective gear, providing support services such as childcare and mental health services, enacting protections such as work hour limitations and paid sick leave, and giving priority in confirmatory testing.
We call on federal, state, & local government officials and health systems to:
- Enact shelter-in-place nationwide through federal and/or state-level action.
We have already missed critical windows for action, but future scenarios of disease spread, illness, death, health system stress, and societal trauma can still be mitigated if our leaders enact public health measures now. An effective response to this unprecedented pandemic cannot occur without enacting stringent public health mandates now to reduce the number of patients needing care. Voluntary social distancing guidance is inadequate, and lockdowns reacting to disease flare-ups are not effective. A nationwide shelter-in-place order, maintained as long as is necessary to control the outbreak, identify and treat patients who need care, and protect the public’s health, is the best way to limit the number of people who are infected.
Thus, shelter-in-place should be implemented nationwide through federal and/or state-level action, and resources must be freed to pursue contact tracing and local containment once hotspots are identified. These shelter-in-place mandates should be sensitive to legitimate concerns regarding financial stressors, address basic needs of the communities affected, and avoid enforcement measures that would promote over-policing.
2. Ensure access to Personal Protective Equipment (PPE) & clear protocols on PPE use.
As an organization advocating for the health of our patients and communities, empowering physicians and other health professionals to be effective health advocates, Doctors for America (DFA) is also concerned about the health and safety of all health workers involved in managing the COVID-19 pandemic. Our teams include everyone — physicians, nurses, students, technicians, volunteers, environmental and food services workers, and more — working in hospitals, emergency rooms, outpatient clinics, nursing homes, long-term care and community-health centers, correctional facilities, and other locations. Many health workers in the US continue to have inadequate access to appropriate PPE (masks, respirators, gowns, gloves, face shields, and more).
We must protect and support health workers through the COVID-19 outbreak, and beyond, to ensure that patients have people to care for them. The US government must more effectively access and disperse National Strategic Stockpile supplies and contract with manufacturing directly via the Defense Protection Act to ensure that all workers are able to use PPE. Importantly, the US should not at this time of crisis loosen hospital safety rules and protections for essential health workers, forcing health workers to provide or feel pressure to provide care without adequately protecting and caring for themselves.
3. Ensure that our health workers will continue to be healthy and available to take care of our patients and communities.
In addition to immediate infection control through public health action and health care workforce protection, we call for measures to:
- Set minimum standards for health worker shift length, rest, and whistleblower protections, including alternative sleeping quarters for those who may need to isolate themselves (to protect their families) and a health worker safety hotline to report unsafe conditions.
- Make paid sick leave available to all health workers regardless of employment status.
- Prioritize health worker access to COVID-19 testing and treatment to keep health care workers providing care to those who need it.
- Provide safe child care options for health workers who may need them.
- Provide freely-accessible, consequence-free mental health services to health workers.
- Ensure that medical licensing and liability regulations are relaxed to allow health workers to provide care for patients wherever those patients might need them.
- Ensure that health workers-in-training — residents, fellows, medical & nursing students, and volunteers — receive protections similar to those of other health workers, especially from exploitative working conditions.
Doctors for America asks our physician and medical trainee colleagues, those in other health professions, organizations advocating for patients and communities, and our public health and science communities to join in our call for public health safeguards and protection of health workers.
Ranit Mishori, MD, MHS
Kate Tulenko, MD, MPH, MPhil, FAAP
Co-Authors, DFA Members
Justin Lowenthal, MD-PhD Candidate
Jeff Huebner, MD, FAAFP
Evan T. Saulino, MD, PhD
Co-Authors, DFA National Board of Directors
Dona Murphey, MD, PhD
Farheen Qurashi, MD
Julie Parsonnet, MD
Joe Kanter, MD, MPH
Christine Petrin, MPH, MD Candidate (recently matched!)
May Nguyen, MD, MPH, FAAFP
Cedric Dark, MD, MPH
Meenakshi Bewtra, MD, MPH, PhD
Meghana Rao, MD
Krishnan Narasimhan, MD
DFA National Board of Directors
In addition to the above and below organizations and individuals signing on to this letter, we would also like to highlight overlapping sign-on letters and petitions from our colleagues, listed below, and the number of signatures they have accumulated, to fully depict the support for these issues:
Doctors for America: Open Letter to Florida Leaders
449 signatures (as of 3/26/20 at 11:06AM)
Healthcare workers in Florida: Open letter to Florida Governor
713 signatures (as of 3/26/20 at 11:06 AM ET)
Committee to Protect Medicare: COVID-19 Letter to the Trump Administration & CDC
3,585 signatures (as of 3/26/20 10:25 AM ET)
5,000+ signatures (as of 3/25/20)
Massachusetts physicians: Letter (reported by WBUR) to Massachusetts Governor
1,000+ signatures (from report)
21,555 signatures (as of 3/26/20 at 11:06AM)
1,298,612 signatures (as of 3/26/20 at 11:21 AM)
The undersigned organizations and individuals have signed on to endorse this letter.
Individuals: View Signatures