As planning continues in Maryland for more cases of the coronavirus that has infected three people in the state and about 260 nationwide, gaps in public health systems are showing.
U.S. Sen. Ben Cardin, a Maryland Democrat, came Friday to the University of Maryland Medical Center for a roundtable discussion with doctors, nurses, hospital and local health department representatives and others to talk about needs still left unaddressed.
“We are not as well prepared as we could have been,” Cardin said. “We’ve shortchanged research, [didn’t] stockpile equipment or tend to public health infrastructure."
Cardin said President Donald Trump’s budgets have been “disastrous” leading to cuts to important infectious disease research and shortfalls in public health.
He said lawmakers are now seeking to address some of that with a just-passed $8.3 billion emergency spending bill that will funnel money to things such as masks and other personal protective equipment. It also will help pay for testing and loans to small businesses effected by the coronavirus.
Gov. Larry Hogan has asked separately for $10 million in supplemental funding to this year’s state budget and permission to tap the state’s rainy day fund for $50 million. The money will be used for a variety of response-related initiatives, including hiring additional staff, purchasing diagnosis equipment, supporting quarantine housing and other services.
Cardin said Congress is already at work on another funding measure to help pay for other equipment or measures that were missed by the first bill. Officials in the room Friday already had a list.
Dr. Letitia Dzirasa, Baltimore City Health Commissioner, and Ed Singer, the health officer for Carroll County, said their departments already were spread thin and would have trouble dedicating staff to monitoring the public for coronavirus if it becomes widespread.
“Our resources have declined and it’s difficult to respond to stuff like this,” Singer said. “But the public relies on us.”
Dr. Thomas Scalea, physician-in-chief of the University of Maryland Shock Trauma Center, and Dr. Brian Thomas Garibaldi, the medical director for the Johns Hopkins Biocontainment Unit, said hospitals have limited capacity to isolate and care for a surge of severely sick patients on top of the patients they routinely care for.
Scalea said he could open another intensive care unit at the medical center quickly with nurses and others but it would cost money.
“I can get up another ICU, but it’ll be expensive; we’ll need nurses, respiratory therapists, doctors,” he said. “I could stand up a unit in an hour if I had enough nurses.”
Cardin could make no funding guarantees but said that would be the type of thing the federal government would pay for, and “if needed, I want you to do it.”
Dr. Mohan Suntha, president and CEO of the University of Maryland Medical System, suggested the state’s unique system of state-controlled hospital rates would allow hospitals to recoup spending by raising costs for other services.
Others from emergency services agencies said they were concerned about shortages of masks and equipment. Those who care for vulnerable seniors were concerned about their welfare. Others who provide health care to the poor were fearful that some people without enough insurance or sick leave from work might not even agree to be tested if they were sick because of the potential costs.
Cardin said there was still a lot to work out, but public health and government officials were in constant contact and laying out plans if there are significantly more cases locally and nationally.
Salliann Alborn, CEO of Community Health Systems, a group of centers providing care for low-income people, made a plea for more, and consistent, public messaging campaigns “from trusted sources” to counter misinformation.
For now, the state has not been hard hit by coronavirus, but flu is widespread with 3,350 hospitalizations and 42 related adult deaths. Five children have died of the flu so far this season.
Cardin said the message that they all want to get out now is the same as it is for the flu: stay calm but be prepared. That means good hygiene habits, staying home when sick, maintaining extra supplies at home and reconsidering travel to heavily affected places
“I don’t want people to panic, but I want them to do the right thing,” he said. “Wash your hands.”
This story has been updated to describe how the state plans to use the supplemental funding requested by Hogan.