Guidance on Social Distancing and Partial Resumption of Economic/Health Care Activities During COVID

ACP Chapter Action Tool Kit
Prepared by ACP’s Division of Governmental Affairs and Public Policy
May 7, 2020

Summary

ACP policy on social distancing supports science-based recommendations for social distancing. With the Coronavirus (COVID-19) pandemic sweeping across the nation and the globe, we believe everyone should do their utmost to help curb the spread of this virus.  Social distancing based on the most up-to-date, evidence-based recommendations is currently our best weapon to stop the spread of COVID-19.

On May 7, 2020, ACP released a new clinical and public policy guidance on how to resume some economic, social and medical care activities in a phased and prioritized approach to help mitigate COVID-19 risk and allow for rapid expansion of health system capacity to conduct essential public health functions. ACP is concerned that it is unhelpful and misleading to frame the decision facing federal, state and local authorities as a binary choice of opening up the economy or keeping it closed, which creates unnecessary conflict, and hampers decision-making. Instead, ACP believes that the United States should chart a way forward to allow certain economic and social activities to be resumed in a phased and prioritized way, based on the best available evidence, in a manner that mitigates risk (slows and reduces the spread of COVID-19, and associated deaths and other harm to patients) and rapidly expands health system capacity to diagnose, test, treat, conduct contact tracing (with privacy protections), and conduct other essential public health functions.

The new guidance includes the following recommendations:

  • Communities need to have sufficient testing capacity. In the absence of an effective vaccine, ACP calls for testing to be prioritized, particularly for vulnerable populations, underserved communities, and populations at greatest risk; older adults and those with underlying medical conditions. Widespread contact tracing processes will need to be in place in order to successfully begin resumption of economic and social activities. 
  • Communities need to have appropriate health care system capacity. ACP recommends a national implementation strategy to ensure adequate capacity in hospitals, including equipment such as ventilators, sufficient Personal Protective Equipment (PPE) available for all physicians and health care workers, and trained personnel to assist with the potential for patient surges. 
  • Communities need to have the capability for effective contact tracing with privacy protections. ACP recommends traditional contact tracing methods and new technology development to supplement the effectiveness and capacity that provides appropriate level of privacy and informed consent by patients. 
  • Communities need to work with public health authorities to develop risk-based plans for a phased resumption of economic and social activities when cases and transmission are declining sufficiently. ACP’s recommendations include demonstration of a consistent and stable decline in COVID-19 cases for 14 days; that communities work with public health authorities, including physicians, hospitals and employers on decision making that includes an effective communication strategy.

ACP believes that the availability of a vaccine and treatments will be needed for complete resumption of normal activities. ACP’s recommendations also include specific criteria and instructions for resuming in-person medical care visits and other health care services. The recommendations include:

  • The ability of a community to have the capacity needed for COVID-19 mitigation, as recommended by ACP in the rest of the guidance, should also guide decisions on resuming in-person medical care visits and other health care services.
  • Public and private payers should provide direct financial support to practices to offset losses of revenue and increased costs, through at least the 2020 calendar year, even as they begin to resume in person visits.
  • Ambulatory internal medicine practices should start planning how they might safely and effectively begin to resume in-person visits that have been temporarily suspended or postpone

Action:

ACP chapters should advocate that their state follow ACP’s new public policy guidance in order for economic and social activities to begin to resume.

Resources