The metaphor “flattening the curve” has succinctly captured the challenge of responding to the coronavirus pandemic in the United States. With no vaccine or effective treatment, the use of social distancing measures attempts to delay the spread of infection and keep the need for intensive, hospital-based health services within the capacity of our health care system. Unfortunately, too narrow a focus on flattening the curve may obscure larger gaps and deficiencies in our public health system that we have long ignored and must address.

Besides lowering the peak demand for health services, the “flattening” approach includes raising the baseline of available resources, such as coronavirus tests, hospital and ICU beds, ventilators, personal protective equipment, and trained health care workers. In short, we need greater surge capacity. Although a lack of funding for public health infrastructure and personnel is evident, another key reason for a lack of surge capacity is that excess capacity is inconsistent with the business models of for-profit hospitals, bottom-line sensitive nonprofit hospitals, and underfunded public hospitals. Most hospital administrators and executives traditionally have sought to increase utilization rates and eliminate excess capacity, such as empty beds and unused equipment and supplies.
.

The nationwide pandemic also highlights the fragmentation of our public health system. Unlike most countries, the U.S. has no national public health agency, with public health primarily the responsibility of state and local governments. Many jurisdictions lack the financial means or expertise to respond to a public health emergency, including the ability to manage quarantine or other mandatory social distancing measures. The authority of the Centers for Disease Control and Prevention is limited to controlling international and interstate health threats, as well as providing research, education, laboratory services, data collection and analysis, consultation, and policy recommendations for the states. A more centralized public health structure, regardless of the merits, would run counter to practices in place since colonial times and reflected in the Constitution’s separation of powers between the federal and state governments.
.

Read the rest of this discussion piece

Infographic about COVID-19

.

.
To access the full-size infographic, right-click this link and select save as
The above infographic is a modified version of a resource from Shutterstock.