A report issued this week by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) describes a dystopian scenario of American hospitals reeling badly from the COVID-19 viral pandemic, igniting powerful reactions that contrast sharply with the President’s flat dismissal of the findings of the survey on which the report was based.
The 41-page report, titled Hospital Experiences Responding to the COVID-19 Pandemic, was based on surveys of hospital administrators from 323 hospitals across 46 states who were posed three open-ended questions from March 23-27, centering on a) the most difficult challenges experienced thus far in responding to COVID-19; b) what strategies hospitals are using to address or mitigate those challenges; and c) how government could best support hospitals responding to COVID-19.
Eight specific challenges cited in the report included the following:
- “Severe” shortages of testing supplies and extended waits of seven days or longer for testing results, which have “limited hospitals’ ability to monitor the health of patients and staff.”
- “Widespread” shortages of personal protective equipment (PPE) so serious that they “put staff and patients at risk,” along with “uncertainty about availability of PPE from federal state sources” and “sharp increases in prices for PPE” from some vendors.
- Shortages of other “critical” supplies and materials such as IV poles, medical gas, linens, toilet paper, food, thermometers, disinfectants, and cleaning supplies.
- Difficulty maintaining adequate staffing and support staff, in particular “a shortage of specialized providers needed to meet the anticipated patient surge,” along with “concern that fear and uncertainty were taking an emotional toll on staff, both professionally and personally.”
- Difficulty maintaining and expanding hospital capacity, with anticipation of being “overwhelmed” in the near future.
- Anticipated shortages of ventilators, with fears that they would ultimately “pose difficult decisions about ethical allocation and liability.”
- “Increasing costs and decreasing revenues” of a degree that could pose a “threat to (hospitals’) financial viability.”
- Changing and/or inconsistent guidance from federal, state, and local authorities, with “conflicting guidance from different governmental authorities, including criteria for testing, determining which elective procedures to delay, use of PPE, and getting supplies from the national stockpile.”
Newsweek reported this week that President Trump appeared to suggest that the report was in some way political in nature, asking “could politics be entered into that?” On Tuesday, the President reinforced that notion, tweeting that Grimm “spent eight years with the Obama administration” while calling the survey summary a “fake dossier.” The report’s architect, HHS Principal Deputy Inspector General Christi A. Grimm, was appointed to her post in January.
American Hospital Association (AHA) President and CEO Rick Pollack released a statement strongly defending the report, and pleading that government and healthcare entities learn from it. “This important and timely report by the HHS Office of the Inspector General accurately captures the crisis that hospitals and health systems, physicians, and nurses on the front lines face of not having enough personal protective equipment (PPE), medical supplies, and equipment in their fight against COVID-19,” Pollack’s statement read. “The AHA continues to urge that all possible levers be used by both the government and the private sector to ensure front-line heroic providers battling against COVID-19 have what they need for protection and to provide care for their patients and communities – countless lives are depending on it.”
The website FactCheck.org even weighed in, saying that it would “encourage readers to examine the report for themselves, adding that “we find it to be a straightforward report on the results of a survey.”
The report is available in its entirety online here: https://oig.hhs.gov/oei/reports/oei-06-20-00300.pdf