PITTSBURGH — U.S. Health and Human Services Secretary Alex Azar said a federal investigation is underway into the Brighton Rehab and Wellness Center in Beaver County as he was in western Pennsylvania on Friday to meet with the commissioners regarding their concerns.
“It is important that all of our states take this seriously,” Azar said of the need to protect nursing homes from the ravages of COVID-19.
To date, the Pennsylvania Department of Health data shows 368 residents at the Beaver County nursing home tested positive for coronavirus, and 76 have died. Thirty-one employees have also tested positive. Two weeks ago, the National Guard was called in to help.
Pennsylvania has reported 5,265 COVID-19 deaths, of which 3,469, or about two-thirds, occurred in nursing homes.
In neighboring New York state, the death toll in nursing homes and adult care facilities is now over 6,000.
Azar, a Johnstown native, was in western Pennsylvania to discuss the matter with Beaver County officials, as well as to meet with local business and hospital leaders at PPG Industries to listen to their concerns and desires for getting their employees safely back to work.
In the exclusive interview with the Washington Examiner, Azar discussed the plight of rural hospitals, the need to return to abbreviated normal at churches and schools, the return of college and university life, and how prepared the administration is if there is a second wave this fall.
A full transcript of the interview is below.
Washington Examiner: What brought you to western Pennsylvania today?
Sec. Azar: I came out here as part of our efforts to get America back up and running again, so I met with the Allegheny Conference and of all the CEOs and healthcare executives here to focus on getting our country back working again. We got to get people back to school. We’ve got to get back into our communities. What I’ve tried to talk about is how it’s not health versus the economy, it’s actually health versus health. This being locked up in our homes is not good for our health either because we’re not getting the needed preventative services. You know, millions of kids aren’t getting their pediatric vaccinations, hundreds of thousands of cancer screenings and treatment aren’t happening. With the economic dislocation, every point of unemployment, it leads to increase in suicide and mental illness. Those were all real, real healthcare costs and healthcare impacts on people that are just as real as the very real impacts from disease burden.
Washington Examiner: How do you strike the balance keeping the pandemic from spreading and the economic devastation and how do you people have to balance and there’s some families that have experienced both?
Sec. Azar: On the economic dislocation, that, of course, has been very severe, but if we can get back to work, we can have a quick rebound on that and get people back integrated into society again. And there are ways we can do that safely. We can do a face mask. We can do social distancing. Simple. We can be back at work and do that. You don’t have to just be in your house. And it’s also important that we understand what our own situation is. So each of us need to evaluate what our risk profile is and the profile of the people that household with us, a lot of the risks here really are our most fragile seniors who are in our nursing homes, so I’m going to be out in Beaver County today.
Washington Examiner: In Pennsylvania, there have been 5,265 deaths in the state; 3,400 of them were in nursing homes. And the same sort of situation in New York. What happened?
Sec. Azar: It is clear that the COVID has a disproportionate severity and mortality and pathology in our senior citizens, especially the most frail senior citizens who are in nursing homes. So you’re in a skilled nursing facility because you require a very high level of care. So you’re already very much at risk, and what this has shown is this COVID infections can really have a disproportionate impact there. And so that’s why very early on we asked our states to prioritize inspections of nursing homes, to take all of their inspections in nursing homes, to be focused on infection control. Everybody who’s in a nursing home, test all staff and nursing homes on a weekly basis. Essentially, can we try to ring-fence our nursing homes to keep visitors from coming into our nursing homes.
The Brighton facility has repeatedly been cited for safety violations. Repeatedly fined for safety violations and facilities like this where you’ve got … Our governors, our states have got to up their game on the regulation, the inspection of the quality of care in our nursing homes. We’ve got to ensure first testing … because there’s no reason even in a congregate living setting, there’s no reason that infectious disease should spread like this. If you practice proper infectious disease control, disease should not spread even in a nursing home. It’s not acceptable.
Washington Examiner: What about rural hospitals? They’ve lost the bulk of their business and have had to lay healthcare professionals off, like the Washington Healthcare System here in western Pennsylvania.
Sec. Azar: We’ve got to get these elective procedures back. You know, I’ve heard horror stories of, in some states, and some facilities like breast cancer treatments as being treated as elective. Well, I’m sorry that’s not elective. These procedures have to get started again. There was a temporary period where we asked for elective procedures to be stopped collectively … Dental, surgical, and medical procedures to be stopped mainly to conserve personal protective equipment for our healthcare workers in the hot zones.
We now need to get those elective procedures back up and running because there is a real health consequence from not having that hip replaced, from not getting that cancer screening, not getting that oncology treatment. That has to come back again. In addition, the economic impact to our healthcare sector is tremendous.
Our rural hospitals, our hospitals that aren’t in the COVID impact zones, they might have suffered 30, 40, 50% revenue loss because those elective procedures are what they depend on that, that margin of business that keeps our facilities going. I don’t like seeing layoffs of healthcare workers in the middle of a pandemic.
That’s why we really prioritize the Provider Relief funds that Congress passed … $175 million in relief funding. We’ve actually prioritized all healthcare facilities and healthcare providers across the country, not just those in hot zones, but because everybody in this country has borne a significant burden because they’ve stopped those procedures. So we’re working to compensate them and just as we’re compensating the hot zone hospitals who’ve taken the burden, of course, of caring for COVID patients correctly. And we’ve targeted money directly in rural hospitals, with $10 billion in payments directed at rural hospitals with an additional $500 million going to Indian health facilities because of course those are not just rural, but often very remote and dealing with very underserved individuals. And so, I’m very concerned about it.
Washington Examiner: What about people with addiction, opioids, meth. Have they fallen between the cracks? What has been your assessment of that situation during the virus?
Sec. Azar: We’re still very concerned obviously about the opioid crisis, and we’ve worked to ensure that opioid medication assisted treatment is still available to individuals, that we’ve tried to prioritize that. That, of course, is not elective medical care, so we’ve worked to try to make sure that those individuals are able to still get the treatment that they need. Now as they come out of the shutdown, we have to make sure that the drug gangs do not take advantage of the reopening of our economy to resupply the marketplace with opioids. So it’s been enforcement of our borders and our mail facilities is going to be very important to keep these illicit drugs out of the country. We’ve got to keep supporting all those who were addicted with medication assisted treatment and other therapies to help them stay off of the opioids. So that’s a really key priority. I also should mention on the nursing homes that in addition to asking for the states to require the nursing homes to test all of their patients and then weekly test all of their staff that are coming in work, we’re also shipping seven days of personal protective equipment to every nursing home in the United States to make sure that they’ve got a supply, in addition to what they ought to be procuring and buying on their own.
Washington Examiner: What is Operation Warp Speed?
Sec. Azar: So it’s obviously important for us to be able to develop therapeutics and vaccines and to do so historic time frames. And we’ve worked with drug companies on doing exactly that, but the timelines that drug companies work from, the president just found unacceptable and gave us permission to make them move faster. And, he said, this is the same country that could do the Apollo project or the ATLAS project. We ought to be able to march the entire power of the U.S. government and the private sector to do things that have never been thought of before.
What we’ve done is taken the power of the Defense Department and of HHS … Together, we’re working in partnership to bring vaccines here in historic time. Our goal is hundreds of millions of doses that are received by early next year pressing the development time of drug companies.
We’re going to produce those vaccines at commercial scale at the early stages so that if we get a successful drug vaccine, we’ll actually have vaccine made and ready to go at the time the FDA approved.
Washington Examiner: So opening America back up… you talked about schools, you talked about churches. Does opening up the country look different in every state?
Sec. Azar: It does look different. First, every state’s circumstances are different in terms of spread of disease but also culturally. Each state has different approaches. I was down in North Carolina where people seemed still to be a bit more restrained and then I went to Florida and went out to eat for the time in a restaurant in quite some time. That’s why it’s important. Each state has a different circumstance and we defer to our states’ governors to make these calls.
Washington Examiner: When you spoke to the manufacturing, energy, and healthcare CEO’s here this morning what was that conversation like?
Sec. Azar: They want to get back to work. They believe the conditions are here where we can and should get back to work. They said they need international travel to resume. They were talking about the critical need for a local economy and their workers need to be going to their factories abroad. So basically, work on maintenance and spinning up factories. There are foreign experts to be able to come in and say here, you’ve got to figure out ways to get international travel going again. Domestic travel. I flew commercial last week. I felt perfectly safe as did I think everyone who was with me.
Washington Examiner: What about higher education? Where do you see that this year?
Sec. Azar: There’s nothing magical about being in our house. What matters is when we go out in a workplace, school, or church setting is how do we behave? Do we take appropriate precautions? Under the circumstances we’re in, we’re in an area that has a community disease spreading … Are we practicing personal hygiene and social distancing? And as we go back to school, perhaps we don’t have student assemblies and perhaps they can just eat at their desks and perhaps the desks are separated a bit and they have fewer kids in each class. Well, so it goes back to the school. Are universities going to get back up and running? We want them to do that safely.
We see, for instance, right now, some of the areas that we are most focused on in the country, whether that is the D.C. metro area or Los Angeles or Chicago, those are actually metro areas that are very much closed. And areas that we’re not seeing issues in terms of case increase are cities that are very much open. And as I like to say, you can be in a closed city and practice bad personal hygiene and bad social distancing and you can be in an open city and practice good personal hygiene and good social distancing and that’s what’s going to drive a lot of the epidemiology of the disease here.
Washington Examiner: In that all of the unforeseen things that have happened, all the mistakes you’ve had to deal with, the miscalculations and the things you got right, are you, we, better prepared if we have a second wave? And in what way?
Sec. Azar: We absolutely have a game plan. We have a six-part game plan for how we’re going to deal with this. And it’s consistent with our long-term pandemic planning. First is surveillance. So we engage in influenza-like illness and other syndromic surveillance of individuals who present with any type of symptom that’s consistent with COVID. And we test those people. We have now historic levels of testing available in the United States. We have excess capacity available. Test anyone who is symptomatic. Then you test also asymptomatic people. So in settings particularly that are most vulnerable, nursing homes, prison populations, meatpacking facilities, congregate living, or congregate workplace settings, do surveillance testing to see if we have undisclosed outbreaks occurring. Third, contact tracing and containment. Where you find those cases, you isolate people, you test them, you contact trace them, you test them, you isolate, you treat. Build those circles. Fourth, healthcare system resilience. We built up the capacity in our healthcare system to make sure that we have the capacities locally to take care of individuals. That’s 110,000 ventilators added to our nation’s supply by July. That’s hundreds of millions of personal protective equipment distribution systems here in the United States to make sure our system is able to deal with any outbreaks that we have. Then fifth, therapeutics. Develop and bring to market a therapeutic to treat people. And sixth, vaccines. Bring hundreds of millions of doses of vaccine by early next year to individuals to be able to protect the American people. So, a six-part strategy.
You mentioned lessons learned and what are some of the things that are truly unprecedented in a pandemic? Unprecedented in a public health situation?
Where you have not just a novel pandemic flu but a novel coronavirus. We had to build, from the ground up, a complete testing system. That’s a real fallacy in peoples’ minds that somehow there was a testing system for coronavirus. So what happens is the CDC develops the lab tests that is very manual, very human-intensive, and they use that at the early stages. And they publish that and try to get that out to other public health labs. That’s part of the backbone of our testing in the United States.
Then you try to bring in the private sector companies, they are the ones that have brought us out of 450,000 tests being executed per day.
So, a key lesson learned is how do we facilitate this public private system and connect patients to the testing capacity we have in the United States? So that’s a key transformational action for future pandemics that we need to make sure is in place, because that did not exist. It did not exist at all. We built this within weeks, a system that’s delivering now over 15 million tests, and we’ll double that in the next couple of weeks alone.
The second thing that we have is the Strategic National Stockpile. So the stockpile was never conceived of to replace the $1 trillion private distribution system for medical, surgical, and pharmaceuticals in the United States. A next-generation strategic stockpile. We’re going to work with private distributors to maintain 90 days of critical supplies and have instead of what we had when we took over from the last administration.
