The U.S. Is Uniquely Hamstrung on Virus Response

(Bloomberg Opinion) -- It was never a case of if, but when the novel coronavirus would start spreading in the U.S. — and now it's happening. Multiple states reported new cases over the weekend, and more are likely to emerge in the next few days. It's becoming clear that the country isn't as prepared, and its early response wasn't as robust as President Donald Trump has claimed.

The administration is starting to do some of the right things. It's working to boost testing capacity, and that will help health workers get a handle on the spread of the disease and aid in containment; health officials are also now looking for cases entering the country from outside of China. These steps came far too slowly, however, leading to missed opportunities to catch and prevent infections.

Because of the peculiarities of the American health-care system, the U.S. can't only seek to replicate measures that have worked in other countries if it's going to have the best possible chance at containing the Covid-19 virus. There is a long list of other actions worth taking within days rather than weeks.

In areas where there appears to be community spread, it's time to consider school closures, event cancellations, and to encourage people who can telecommute to do so. Considering that the virus may have been working its way through Washington state for as long as six weeks, it's worth preparing for the possibility of broader quarantines as well. These are severe and highly disruptive steps, and as my colleague Faye Flam notes, they'll be especially tricky to institute in the U.S. It's worth the disruption and potential pushback to prevent overloading hospitals and putting older adults at risk of severe disease. 

Such public health measures only succeed if people do what they're supposed to and self-quarantine when ill or seek treatment if they have severe symptoms; unfortunately, the U.S. health-care system has put barriers in the way of doing the smart thing.

Millions of Americans lack health insurance entirely, while many more face high deductibles and other out-of-pocket health costs. If a Covid-19 test costs thousands, many will avoid getting them. Meanwhile, an inpatient stay at a hospital is dramatically more expensive, which means people may put themselves in danger by delaying treatment. On top of that, America is also one of the worst developed countries in the world at making sure employers guarantee paid sick leave. Weak employee protections have spent years conditioning people to avoid care and go to work even if they're ill.

What can the government do? For one, it can potentially designate some Covid-19 treatment and tests as preventative services that will be free for people with coverage because of protections granted by the Affordable Care Act. It can also direct emergency funds toward making sure that costs don't dissuade people from seeking help and that they aren't bankrupted for doing so. The government also should encourage firms that don't provide compensated time off to make an exception for this virus; helping to pay for that leave is another good use of emergency funds. The alternative is that sick people may end up preparing your food. All of these measures have to be instituted rapidly and widely publicized if they're going to have any impact. 

Alongside these shorter-term efforts, investment in longer-run projects should be increased. The priority needs to be scaling lab diagnostics to the point where anyone with symptoms can get tested. The development of a more rapid point-of-care test that doesn't need to head to an overtaxed lab will aid containment efforts. It should be a well-funded priority alongside the development of possible treatments. 

These steps will be difficult and may contribute to further economic disruption. They're worth it to avert the human and financial costs of uncontrolled spread of this virus. 

To contact the editor responsible for this story: Beth Williams at bewilliams@bloomberg.net

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.

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