Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
AMA Chief Experience Officer Todd Unger speaks with AMA Board Chair Jesse Ehrenfeld, MD, AMA Chief Health Equity Officer Aletha Maybank, MD, and AMA public health expert Mira Irons, MD, on updates regarding COVID-19 including personal protective equipment (PPE) as the pandemic continues to evolve.
Learn more at the AMA COVID-19 resource center.
Unger: Hello, I'm Todd Unger from the American Medical Association and this is the AMA COVID-19 Update. Today we'll talk about what's on everyone's mind, continuing PPE shortages. And we'll also get an update from the front lines in New York City.
I'm joined today by Dr. Jesse Ehrenfeld, AMA board chair. Dr. Mira Irons AMA's chief health and science officer and Dr. Aletha Maybank, group vice president of AMA's Center for Health Equity.
Dr. Ehrenfeld, we'll start with you. First off, AMA has been a very, very vocal leader on calling on the President and his administration to get more PPE. But yesterday we made a big ask of the American public to do their part. Can you talk about that?
Dr. Ehrenfeld: Yes, so we joined with two other leading health care organizations, the American Hospital Association, the American Nursing Association, with a very important, but simple, request to the American public which is stay home.
Look, folks, we are happy to put our lives on the line to take care of people in hospitals and clinics but we need everyone else to do their part and just stay home and not go out unless it's absolutely essential.
Unger: Excellent. Dr. Irons, you have some things to add about what kind of guidelines can we give physicians on the front lines while we are in this dire shortage?
Dr. Irons: Sure. So, we realize that the times for both patients and health care providers are more than difficult. So, until the supplies that we've been advocating for get to the health care settings, we're really focusing on appropriate use and conservation.
With regards to appropriate use, we've been publicizing the CDC guidance that is available to health care professionals and that's on our COVID-19 resource page and also being distributed through all AMA channels to everybody out there and also our partners across the health care system.
But with regards to conservation, this is really something that patients and physicians health care providers can do together. The first is to cancel or postpone non-urgent or non-emergency procedures and surgeries. This not only conserves PPE but keeps healthy people outside of the health care system. Using telemedicine and other ways to provide patient care without actually seeing patients. And also prioritizing who needs to be tested. CDC guidance came out last night that is really focused on risk and symptoms.
Unger: Telehealth has been a big strategy. We've seen that from a number of our partners. You can get more on telehealth from our guide to telehealth at the AMA COVID resource center. Any other comments on what you're hearing in the use of telehealth, Dr. Irons?
Dr. Irons: Well, I think that people are ramping up. I know some hospital systems are developing algorithms that their staff, their triage staff and their physicians can use when patients are calling their health care sites in order to provide telehealth guidance to them to not only appropriately triage them to health care but also to decide who needs to come in and who doesn't need to come in. And that information really should be shared more broadly with others in the health care system.
Unger: Yes and I know that it's been a big strategy of the Permanente Medical Group out on the west coast, one of the early locations of the pandemic. And you can find out more about their strategies for using telehealth and conserving PPE. Dr. Maybank.
Dr. Maybank: Hi.
Unger: Before joining the AMA, you were at the New York City Department of Public Health during their preparations for Ebola. Now, you're at what I'm hearing is a hot zone, the epicenter of the pandemic in the United States. What are you hearing in New York City? And what are you hearing from your counterparts across the country about the pandemic?
Dr. Maybank: Sure. Hi, everyone. Here in New York City, as many people know, we have many cases and the concern is, and really greatly, is really the health care system and the burden on the health care system at this point in time.
It is very clear that we are going over capacity to be able to manage what is happening. We know that, as an example, Jacob Javits is now really formally being set up in order to accommodate for patients potentially needing to come there. And the overwhelming public health message still is stay home, especially here in New York City.
We see it happening, people are definitely not on the streets in the way that they usually are, but it's New York City, and it's definitely a little bit more challenging.
I think what's also really helpful and critical in just thinking about across the country, New York City is really, we're beyond the point of being able to do contact tracing, able to do testing on everyone at this point in time. We need the health care system to be freed up to take care of those who are really sick at this moment in time.
And across the country, though, everybody's not experiencing this. And so there are still areas in the country that can still have strategies that are definitely focused on testing—testing as many folks as possible. Also, the containment piece. And a part to help do that is also a really strong public health method which is called contact tracing where a person who is identified as positive, the information is given to a local health department and then a local health department is able to kind of contact that person, find out what have been their different exposures, who have they been exposed to, where have they been in order to reach out to those potential exposures.
These are strategies that were used in tuberculosis and for Ebola and other places here and in other parts of the world. So I think we're really trying to figure out how do we manage this large public health problem in a way that's meaningful for different parts of the country. And so there's just a lot of conversation around that.
Unger: As you listen to your colleagues from around the country, are you hearing other things about any populations that are being affected more dramatically than others?
Dr. Maybank: Sure. There have been several articles, and there was a Twitter chat yesterday, that actually went somewhat viral elevating that in certain areas across the country—and I've heard this from several of my doctor friends in Milwaukee and New Orleans—some of the original folks, the first folks rather, who are passing away, are African American and black.
And this goes along with understanding just inequities in general across the country. Those who have greatest burdens as it relates to, inequities rather, related to economics, job, education, all of those things, also have greater burden of health as it relates to disease and disease outcomes and having worse health outcomes.
And so we really want to understand better what is happening at this point in time. And so there's been a movement and a call to action to find out race and ethnicity data, as well as other demographic data. I think that it's really important for us to understand so that we know what we can do in terms of from a communications perspective, but also just the action in public health perspective for our minoritized and marginalized populations across the country.
Unger: Thank you very much, Dr. Maybank. And tomorrow, Dr. Maybank and AMA's president, Dr. Patrice Harris, and two of the leaders of the Get Me PPE movement, Megan Ranney and Esther Choo will be having a Twitter chat and I encourage you to check that out.
That concludes today AMA COVID-19 Update. I want to thank Dr. Ehrenfeld, Dr. Irons and Dr. Maybank for joining me today. You can get more information from the AMA at ama-assn.org/COVID-19. Thank you.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.