ASPS Shares Pandemic Preparedness Recommendations
On June 9, Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) released "Preparing for the Next Pandemic," a white paper with recommendations to address future pandemics based on lessons learned from the current crisis and historical pandemic planning under previous administrations. Alexander described the necessity of acting now, mid-crisis, to develop a foundation to avoid a repeat of the current catastrophe in a June 24 speech, saying, "Our minds go on to the next crisis if we don't get things done. So the time to look at the next pandemic is while we are in the middle of this one and say: What are we lacking? What could we do better? And let's fix it while the iron is hot, while our eye is on it."
Upon its release, Chairman Alexander encouraged public feedback on the paper, which explores (1) tests, treatments, and vaccines; (2) disease surveillance; (3) stockpiles, distribution, and surges; (4) public health capabilities; and (5) federal agency coordination. In its response, ASPS had two major objectives. The first was to stress those areas most central to continued operation of plastic surgery practices during an outbreak: the availability of personal protective equipment (PPE) and testing. While these are both well-known needs, ASPS took a novel approach in discussing domestic PPE production capacity based on what it has learned in talking with members of Congress and the White House over the last several months. Specifically, ASPS discussed how the United States has a profound deficit in our ability to make sewn goods, like masks, and that we need a flexible manufacturing base that allows us to redeploy domestic production capacity from a primary use in normal times (e.g., golf cart windshields) to a secondary, PPE-focused use during disease outbreaks (e.g., face shields).
The second objective of the ASPS recommendations was to introduce a new concept to help ease the burden on stressed and overwhelmed hospitals during infectious disease surges. The concept, which is under exploration in the ASPS Legislative Advocacy Committee, would create and perpetuate programs that make it easier for hospitals and health systems to temporarily contract with private specialty practices to take specific types of severe acute trauma cases when a hospital has exhausted its ICU capacity. ASPS received reports from members in various hard-hit areas who tried to work with local hospitals to make the plastic surgeons' accredited private practice ASCs available to take emergency cases, and the common barrier they faced was a lack of one or more facility accreditation types that would allow them to see specific types of patients under their states' laws.
States have varying requirements for their surgical facilities, with some requiring a state-based license, some requiring Medicare licensing, others requiring certification from one of the major private accreditation bodies, and yet others requiring a combination of certifications. ASPS's recommendation is for a federal program that allows, in extraordinary times, for any legitimate accreditation to satisfy reimbursement requirements for all patient-types. The hope is that some plastic surgeons will be able to keep their facilities and surgical skill in use, even during lockdowns, and the spread of the virus can be mitigated by keeping trauma victims out of disease-saturated facilities.