AMA letter to President Trump

March 30, 2020

The Honorable Donald Trump President The White House 1600 Pennsylvania Avenue, NW Washington, DC 20500

Dear Mr. President:

On behalf of the American Medical Association’s (AMA) Board of Trustees and our physician and medical student members, I am writing to commend your recent decision to extended physical distancing guidelines, but also to underscore our serious concerns about shortages of personal protective equipment (PPE). Physicians are on the front lines combatting this destructive and invisible enemy. They are working tirelessly to care for overwhelming numbers of critically ill patients, but they cannot do this alone. We need the help of everyone in the nation, including the federal government, to ensure we succeed.

The AMA was pleased to see your recent announcement regarding the extension of physical distancing guidelines through April 30. We agree with physicians, scientists, and public health experts that, given the lack of an available vaccine and widely available, rapid point-of-care testing, physical distancing is the most important tool we have to help stop the spread of COVID-19. We do not wish to underestimate the serious economic impacts of a nation staying at home. Our physicians, their practices, and their patients are feeling those impacts acutely. However, relaxing the physical distancing guidelines before we have sufficient evidence to demonstrate this is safe will seriously jeopardize the lives of all Americans, including the physicians and other health professionals working under exceptionally difficult circumstances to help curb the spread of this tremendously infectious disease. While the number of available tests has improved dramatically, testing is still insufficient to provide a complete picture of the scope of COVID-19 infections. As a result, we do not have adequate evidence to show that relaxing physical distancing guidelines is safe and appropriate in any area.

The AMA recognizes that prolonged physical distancing presents a number of significant challenges, but now is the time for strong leadership in the face of those challenges so as to ensure this pandemic ends as quickly as possible. What happens next week, next month, and next year will depend on the actions we take today. The AMA urges you to continue to follow the advice of your excellent team of science experts and to keep in place guidelines calling for physical distancing for so long as needed to flatten the curve. Should we prematurely relax these guidelines in any area, we can expect the devastating impacts of this pandemic to be prolonged, on our health care system, on our economy, and on the American public. Now is the time to give our physicians and health care workforce a fighting chance at stopping the spread, which we can do only by ensuring America stays at home.

Furthermore, as you are well aware, we are facing a severe shortage of PPE for our health care workers fighting COVID-19 on the frontlines. We are appreciative of corporate entities making efforts at increased production, businesses and others donating excess supply to hospitals and health care workers, and ordinary citizens helping to supply what they can. However, these efforts are unlikely to make a significant impact given the surge of COVID-19 cases that is imminently approaching.

Our physician members report that in many instances they are only days away from having exhausted supplies of PPE. Furthermore, state and local health departments, as well as health care facilities, have been left to fend for themselves in acquiring this critical protective equipment. We continue to hear that the lack of federal coordination of acquisition and distribution of PPE has created a situation where this equipment finds its way not to the areas where it is needed most, but to the highest bidder. In some cases, that bidder is the federal government, which wields bargaining power that states simply cannot match. This system of procurement not only leaves critical shortage areas without adequate supply, but has resulted in significant increases over normal prices and growth in the grey market as desperate buyers will do anything they can to ensure supply for their frontline workers.

We simply cannot stand by while our physicians, nurses, and other health care workers continually risk their own health and wellbeing to treat COVID-19 patients because their state or facility was outbid for critical protective equipment. We cannot ask overburdened state and local health departments and health care facilities to take on additional burdens of sourcing and bidding on basic PPE. Now is the time for the highest levels of collaboration and strong federal leadership to ensure our dedicated health care workforce can be kept safe and can keep working to fight the spread of COVID-19. We urge the Administration to take a stronger role to coordinate a national effort of acquisition and distribution of PPE, ensuring that critical PPE no longer goes to the highest bidder and areas in urgent need can protect essential health care workers. We also urge the Administration to do everything in its power to ensure that facilities capable of manufacturing PPE are doing so at the maximum possible capacity.

In the span of a few short months, COVID-19 has brought the world to a standstill, changing everything about life as we know it and forcing our health care system to tackle this overwhelming problem under the most challenging of circumstances. We are asking everything of our nation’s exceptional health care workforce, which has answered that call without hesitation. In return, we must ensure them adequate protection as they treat our most critical patients and we must ensure our nation stops the spread of this infectious disease threat by staying home for as long as we need. We owe it to our physicians and dedicated health care workers to give them every available chance to stem the tide of this horrible disease.

Sincerely, James L. Madara, MD Executive Vice President and CEO American Medical Association