Further, the United States must maintain a real national stockpile of emergency medical equipment and supplies anticipating a future public health emergency. The reliance on China and other countries to supply us on a moment’s notice with vital equipment is a national security risk. The federal government should identify necessary medical supplies and equipment that we may need in an emergency and incentivize private sector companies to increase their capacity to assist, both to build a stockpile now and to help with rapid production during a future emergency. Robust nationwide stockpiles were created under President Bill Clinton’s administration, but recent reports found that the federal stockpile is currently “thin.”
New York State distributed tens of millions of needed supplies during the COVID crisis, and many states undertook similar efforts. This is not normally a state responsibility, but it was a necessity; many health-care facilities were in short supply. To avoid this in the future, states must enact what New York has done: Develop baseline supply and equipment requirements for health-care facilities and mandate that they maintain the supplies necessary. At a minimum, states should require that individual hospitals have a ninety-day capacity of PPE and essential pharmaceuticals on hand during crisis situations. Then states should have an additional thirty days on hand. These supplies will then be supplemented by the federal effort.
6. The country must have a health screening system as part of its border patrol control system.
The original sin in this crisis was that the federal government failed to have an early detection system in place for COVID-19. The result was the virus had moved from Asia to Europe, where it began to spread. Then the federal Department of Homeland Security failed to control the spread from Europe to the United States, when it allowed millions of travelers to come to this nation on tens of thousands of flights throughout the month of February and until mid-March, many carrying the virus. This was confirmed in reports issued by Mount Sinai as well as the CDC, which found that the virus came to New York mainly from Europe and was spreading here in early February. By the time the federal government instituted travel restrictions from Europe, it was too late.
Even after the travel bans were implemented, screening was almost nonexistent. A March 13, 2020, New York Times article, “Travelers from Coronavirus Hot Spots Say They Faced No Screening,” reported, “As thousands of Americans flee from Europe and other centers of the coronavirus outbreak, many travelers are reporting no health screenings upon departure and few impediments at U.S. airports beyond a welcome home greeting.” That must not happen again.
We need the federal government to develop a comprehensive screening system and protocol so viruses cannot enter our nation undetected. Ports of entry are a federal responsibility, and the national government must develop a screening process for the next virus. Customs and Border Protection is tasked with securing our country’s borders, but they must also have public health screening safeguards in addition to verifying citizenship or checking for contraband. Let us not waste a crisis, and let’s take this opportunity to retool Customs and Border Protection to expand its role and expertise.
7. State governments must reinvent the public health capacity.
In New York, we have one of the best health-care systems in the world with world-class physicians, nurses, and other health-care workers. But the COVID-19 situation demonstrated that we don’t have one coherent health-care system, but rather a patchwork of different health-care institutions, both private and public, with varying capacities. The hospitals that faced the greatest stress during the crisis were the public municipal hospitals, yet nearby were other hospitals with more capacity and resources to help.
Under an innovative Surge & Flex program described in more detail later in this appendix, New York built and managed a centralized system where patients were transferred from one burdened hospital to a different one with more capacity—regardless of which system a hospital was part of. In the end, the state’s program assisted in transferring approximately sixteen hundred patients from overwhelmed hospitals to hospitals with capacity. States should use their regulatory authority to institutionalize a similar program so various health-care institutions can be run as a single coherent system during an emergency.
Also under the Surge & Flex program, New York helped health-care facilities with ample surplus share supplies and equipment with other facilities that were running low. This was an effective strategy that states should adopt and institutionalize.
8. Citizen action is essential.
We have learned once again that social action is the essence of political power and social change. All government action during COVID was dependent on individual action. The individual action forged the collective movement that protected society. People bent the curve in New York. In states where the virus spread, it was the people’s actions that caused the spread. COVID illustrated clearly the strength and limitations of government as well as the power of individual action. Individual actions determine an individual’s health. Individual social and political participation determines government action. Inform yourself, protect yourself, act responsibly, and participate in democracy. On a micro level, follow the individual rules of responsibility that I include in this appendix. On a macro level, participate, advocate, vote, protest, make social change. We did and we can. Be an American in the truest sense of the word.
—
COVID-19 HAS ILLUSTRATED this country’s weakness and vulnerability. The only thing worse than having lost the lives of thousands of Americans would be for them to have died in vain. We must learn the lessons of this experience
