Azar warns about hospital overcrowding if the public overreacts to the coronavirus

• Hospitals could be overwhelmed if providers don’t educate patients that home care will be appropriate for most who contract the novel coronavirus.
• Federal financial assistance to hospitals will depend on the extent of any future domestic spread of the virus.
• A $2.5 billion funding package was submitted this week to Congress in preparation for a potential increase in domestic cases.

The public could swarm hospitals if the novel coronavirus spreads rapidly, even though most people could safely use the type of home-care treatment that is appropriate for the traditional flu, the federal government’s senior healthcare leader warned.

Alex Azar, secretary of the U.S. Department of Health and Human Services, warned Congress this week that misconceptions about the severity of the coronavirus could lead many who don’t need it to seek hospital care and swamp those facilities.

“Part of it is managing our patient flow so we don’t collapse our rural hospitals unnecessarily,” Azar said at a Feb. 26 congressional hearing. The same concern applies to all hospitals, he added.

The “misconception,” Azar said, stems in part from reports that the administration is using advanced hospitals designated as Ebola treatment centers to provide at least initial treatment of the 15 cases of novel coronavirus that have appeared in the U.S. But that decision was not based on the intensity of care those patients require but instead on the ability of those facilities to isolate the patients.

“Because we’re in an active containment, we don’t have another place for them to be,” Azar said. “Most people who get novel coronavirus are going to stay at home. They are going to treat it how they would treat a severe flu or cold, managing symptoms, and we will publish clear information [about] when you should seek medical attention, when you might go to the hospital in the rarer instances where that would be required.”

The public’s concerns may be fueled by the lack of understanding about the mortality rate of the virus. Azar said the data available to the federal government indicates that the virus has a mortality rate of 1% to 2%, or up to 20 times higher than the traditional seasonal flu virus.

However, Azar cautioned that the mortality rate may be overstated since China has not provided all of the infection data sought by U.S. officials.

The amount of financial assistance to providers will depend on the extent to which the virus spreads in the country, Azar said when asked how much federal funding will be available.

A $2.5 billion funding package

The Trump administration on Feb. 24 submitted a request for $2.5 billion in supplemental funds for various measures to combat the virus, including:

• Developing therapeutics
• Developing vaccines
• Buying personal protective equipment for healthcare professionals
• Funding state and local health efforts
• Conducting disease surveillance

The funding includes support for an emergency fund, distributed through the Centers for Disease Control and Prevention (CDC), to help state and local governments conduct contact tracing and testing of patients referred by providers.

An unspecified amount would go to domestic procurement of 300 million N95 surgical masks for healthcare professionals to supplement current totals of 30 million surgical masks, 12 million N95 masks and 5 million N95 masks that may be expired.

Azar warned the public against using such masks, citing concerns that poorly fitting masks will give a false sense of security while increasing the infection risk as people touch their face to adjust masks.

Instead, he urged the public to use common anti-infection methods such as those relied on to prevent flu infections, including hand washing.

The administration also has worked with two drugmakers to develop treatments, including one that shipped this week for Phase 1 trials by the National Institutes of Health and another that Azar said could be effective in treating the coronavirus.

The CDC issued specific guidance for healthcare settings, including for patient management, infection control and prevention, laboratory testing, environmental cleaning and worker safety.

A different situation than the Ebola virus

The Trump administration’s response to the novel coronavirus is fundamentally different from the Obama administration’s response to the Ebola virus, said Azar, because the latter focused on containing Ebola in Africa while the coronavirus response is focused on U.S. preparedness.

“We’re not going to help the Chinese stop this in China. The Chinese are either going to be able to do that or not do that,” Azar said.

Another difference is that the Trump administration does not plan to appoint a “czar” to coordinate the federal response. Instead, Azar will continue to lead a committee that coordinates the actions of various departments and agencies and Vice President Mike Pence will oversee the overall federal response.

Another new response is the administration’s discussions with Google about developing an epidemiological tracking tool to identify infected patients faster than providers can.