US to Reopen Healthcare System in Regions With Few COVID-19 Cases

April 20, 2020 Updated: April 20, 2020

New guidelines have been released for the reopening of the U.S. healthcare system, the Centers for Medicare & Medicaid Services (CMS) announced on Sunday.

Seema Verma, CMS administrator, said during a press briefing with the White House Coronavirus Task Force that updated guidelines (pdf) have been released to gradually allow the healthcare system to restart elective surgeries and procedures in regions with low incidences of COVID-19.

“The reality is not everything can be addressed by telehealth,” Verma said. “Maybe a woman who needs surgery for breast cancer. Somebody who has cataracts in their eyes, and sometimes the doctor needs to be able to listen to their patient’s heart.

“You heard from the Vice President that there are many places in the country where they’re seeing a decline in cases, and hospitals are reporting that they have unused capacity,” she said. “And so as part of our opening up America, we’re issuing guidelines today about how we can reopen the healthcare systems, so these recommendations around phase one.”

Verma added that before reopening, every state and local official would have to assess the situation on the ground.

As part of the guidelines, state and local officials, for example, must be able to ensure that they can address surges in cases of the CCP (Chinese Communist Party) virus, commonly known as the novel coronavirus. They must also make sure that they have adequate supplies and a plan for conserving supplies.

Screening of patients and healthcare workers for COVID-19, the disease caused by the CCP virus, must also be ensured so that that patients feel safe in seeking healthcare services, with routine checks on patients and staff for temperature and COVID-19 symptoms.

Facilities must be appropriately cleaned, and social distancing must be observed inside the healthcare facilities, Verma said. The guidelines recommended that healthcare providers and staff wear surgical facemasks at all times, and patients wear a cloth face covering.

“This isn’t going to be like a light switch. This is more like a sunrise where it’s going to be a gradual process, and healthcare officials across the country and healthcare systems need to decide what should be made available. Ultimately, doctors and patients need to make decisions about their healthcare services,” she explained.

“We want to make sure that systems are reopening so that they can stay open and doing that in a very measured way.”

The CMS in a press release published Sunday said that the new guidelines specifically target communities with low incidence or relatively low and stable incidence of COVID-19 cases who will move to Phase 1 of the Trump administration’s guidelines to “Opening Up America Again.” This requires states or regions to pass gating criteria regarding symptoms, cases, and hospitals.

“Many parts of the country have a low, or relatively low and stable incidence of COVID-19, and it is important to allow flexibility to provide non-COVID-19 healthcare,” the CMS said.

Nursing Homes

Verma also said at the evening White House briefing that nursing homes in the United States will now be required to report cases of the CCP virus directly to the U.S. Centers for Disease Control and Prevention (CDC), and to patients and their families.

Prior to the announcement, the CDC had not officially tracked the number of CCP virus cases inside nursing homes.

“As we reopen the United States, our surveillance effort around the COVID virus will also begin in nursing homes,” Verma said. “This will support CDC’s efforts to have surveillance around the country and to support efforts around contact tracing” involving care facilities, the CMS administrator added.

At least 1,100 nursing home and adult care facility residents in New York State have died from the CCP virus since the start of the outbreak, according to data (pdf) released by the state’s department of health on Wednesday.

Nationwide, the number of COVID-19 cases surpassed 759,000 with 40,677 deaths, according to a tracking map by Johns Hopkins University, which collates official government data.