Two leading former federal health officials who served in recent Republican and Democratic administrations are spearheading a call for a $46 billion public health investment in a future coronavirus aid package in order to safely reopen the economy.
Andy Slavitt, former director of Medicare and Medicaid in the Obama administration, and Scott Gottlieb, a former Food and Drug Administration chief for President Trump, say that Congress needs to devote funding to help states track down people who have been exposed to the coronavirus, and to offer resources to infected and exposed individuals who wish to self-isolate.
"The existing public health system is currently capable of providing only a fraction of the contact tracing and voluntary self-isolation capacity required to meet the COVID-19 challenge," Slavitt and Gottlieb, along with a prominent group of public health officials and others, write in a letter to House and Senate leaders.
The letter was first obtained by NPR and will be released on Monday.
The officials warn that "current testing capacity and accuracy must be improved," but note that the last aid package, signed into law Friday, contained $25 billion for testing.
"We believe the next step is to complement that investment with the additional support required to allow states to track and isolate infected populations, which will be a vital part of safely reopening the economy," they write.
The Trump administration is actively trying to reopen the economy. To do so safely, the authors say Congress needs to spend $46.5 billion on three public health needs:
- $12 billion to help expand the contact tracing workforce. The officials estimate the workforce needs to increase by 180,000 until a vaccine is on the market.
- $4.5 billion to use vacant hotels so that infected and exposed people without a place to self-isolate have somewhere they can go so they don't spread the virus.
- $30 billion to offer 18 months of income support — a per-person stipend of $50 a day, like jury duty — for those voluntarily self-isolating.
The authors propose Congress appropriate this funding in the next relief package to be distributed via block grants to states and territories twice annually.
The public health officials who also signed the letter include Mark McClellan, who served as both FDA commissioner and head of the Centers for Medicare & Medicaid Services under President George W. Bush; and Vivek Murthy, former surgeon general in the Obama administration and now adviser to former Vice President Joe Biden, the presumptive Democratic presidential nominee.
But it's significant that Slavitt and Gottlieb, who have separately advised the White House, are now joining forces on what public health criteria is needed to reopen the economy.
"There is no silver bullet in the fight against coronavirus," Slavitt told NPR. "But if we want to get back to a more normal existence, we need to give states the tools they need to contain the virus."
The reopening debate hits states
The proposal comes as governors have struggled with competing interests of reopening their economies while keeping their communities safe.
A handful of states have taken steps to relax their social distancing guidelines, including Alaska, Georgia and Tennessee.
Others, like North Carolina and Michigan, have extended their restrictions into May.
Michigan Gov. Gretchen Whitmer, who has come under scrutiny from protesters, defended her stay-at-home orders Sunday while raising Gottlieb and Slavitt's main points.
"What we know is that we have to have robust testing," she said on ABC's This Week. "We have to have community tracing. We've got to have a plan for isolation for people that do get tested positive for COVID-19 in the future."
The White House has released a three-phase plan that provides guidelines for when states might reopen.
It involves the states having appropriate data regarding case levels, the capacity to treat all patients, testing of health care workers and the ability to trace contacts of those infected.
On Sunday, Gottlieb raised concerns that some states were opening their economies too soon and increasing the risk of infection.
"Georgia's certainly not out of the woods," Gottlieb said on CBS's Face The Nation. "They're only testing about 1% of the total population."
It's unclear whether the White House would sign off on the new measure, but sources familiar with the plans say the White House has been briefed on the proposals. Ultimately, the White House would have to sign off any package.
In the end, as Slavitt and Gottlieb argue, control of the outbreak will be the strongest factor in stimulating the U.S. economy.
"Testing, complemented with a full contact tracing strategy, will allow states to prevent small campfires from becoming big forest fires," Slavitt said.