Weekly Review: COVID-19 Legal and Ethics Issues – August 24, 2020

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Weekly Review: COVID-19 Legal and Ethics Issues – August 24, 2020

Weekly Review: COVID-19 Legal and Ethics Issues – August 24, 2020

COVID-19 Policy Playbook Released

This new report from 50 leading experts on public health law, health care law, and global health law and policy analyzes developments in U.S. law and policy during the Covid-19 pandemic. The report, which was sponsored by the de Beaumont Foundation and the American Public Health Association, is divided into five sections and 36 chapters, offering recommendations to federal, state, and local leaders on ways to improve response efforts to better protect health, equity, and civil and human rights and to strengthen our response systems for future pandemics. The recommendations focus on the following key objectives:

  • Grounding legal measures in the best available science.

  • Collecting and assessing accurate data.

  • Improving and expanding access to health care, both now and post-pandemic.

  • Increasing and maintaining funding for public health emergency preparedness through a dedicated public health emergency fund.

  • Reforming the public health and health care systems to enable them to respond more effectively and equitably during a pandemic, and reduce disparities.

  • Addressing the affordability and availability of broadband service throughout the United States.

The summary of their findings can be found here. [Editorial note: I authored the report’s chapter on Contact Tracing, Quarantine and Isolation]

Equity Assessment Framework for Public Health Laws & Policies

The Network for Public Health Law has released a new framework to assist policymakers and practitioners with the assessment of new and existing laws and policies based on their impact on equity. From the Network’s press release:

What might an assessment using the Equity Assessment Framework look like in action?

  • A public health program manager might seek guidance from a team that includes the agency attorney on whether recommendations in the Community Guide can or should be implemented.
  • A neighborhood association might host a town hall on ballot initiatives that will impact the neighborhood, inviting in key speakers and community leaders and asking questions based on the framework.
  • A business might conduct and publicly share the results of an assessment of its workforce, management and leadership diversity. It can use the data along with the framework to inform changes in recruitment, hiring and retention.
  • Teachers, other school personnel and groups that advocate on their behalf might conduct an assessment of “pandemic clauses” that some school personnel are being asked to sign in order to return to the classroom during the COVID-19 outbreak, especially in light of existing laws regarding outbreaks of communicable disease in the school setting.
  • Health care delivery organizations might assess data reporting requirements and penalties, while also considering the impact of requiring the collection of more comprehensive demographic information (like sexual orientation and gender identity, broader race and ethnicity categories, occupation, and education level).

HHS Says Lab-Developed Tests No Longer Subject to FDA Review

In a surprise guidance issued earlier this week, the Department of Health and Human Services has stripped the Food and Drug Administration of its authority to review the safety and efficacy of tests that are developed by laboratories, including those testing for the coronavirus.  As described in the Washington Post, this announcement has been met with mixed reviews:

The new policy stunned many health experts and laboratories because of its timing, several months into a pandemic. Some public health experts warned the shift could result in unreliable coronavirus tests on the market, potentially worsening the testing crisis that has dogged the United States if more people get erroneous results. They argued the change is unlikely to solve current testing problems, which at this point are largely due to shortages of supplies such as swabs and chemical reagents.

But supporters cheered the change as long overdue, saying it could help get new and more innovative tests to market more quickly. They said that the FDA review process sharply slowed testing at the beginning of the pandemic and that the new policy could ensure such bottlenecks don’t recur.
Congressional hearings have been announced in response to this new policy.

Childhood Vaccination Policy Changes

The Department of Health and Human Services issued emergency rules allowing pharmacists to administer childhood immunizations during the Covid-19 pandemic. Childhood vaccination rates have been plummeting this spring and summer due to barriers to health care access created by the Covid-19 outbreak and response, and this change in policy should result in expanded access to required and recommended childhood immunizations. This JAMA Health Forum piece describes the impact Covid-19 has had on school immunization policies nationwide.

In addition, Massachusetts adopted a first-in-the-nation policy requiring that all students enrolled in child care, pre-school, K-12, and post-secondary institutions get annual flu shots before the end of 2020.

Telehealth Policy

A new poll found that 1 in 4 patients over 50 used telehealth services during the first three months of the pandemic. In 2019, only 1 in 25 respondents reported using such services.

Earlier in August, the President issued an executive order seeking make permanent many of the emergency policies that have expanded access to telehealth.

This past week, the American Hospital Association sent a letter to the Administration with more specific recommendations, including adopting policies to allow voice-only telehealth interactions, as well as “expanding the list of Medicare telehealth services to include those that were added during the pandemic; allowing virtual check-ins and e-visits to be used for new and established patients; allowing remote patient-monitoring to be used for new and established patients, and for acute and chronic conditions; and allowing direct supervision to be provided using real-time, interactive audio and visual technology.”

|2020-08-24T08:14:22-04:00August 24th, 2020|COVID-19 Literature|0 Comments

About the Author: Ross Silverman

Ross Silverman
Ross D. Silverman, JD, MPH, is Professor of Health Policy and Management at Indiana University Fairbanks School of Public Health and Professor of Public Health and Law at Indiana University McKinney School of Law in Indianapolis. He is a member of the IU Centers on Health Policy and Bioethics. His research focuses on public health and medical law, policy, and ethics, and law's impact on health outcomes and vulnerable populations. He also serves as Associate Editor on Legal Epidemiology for Public Health Reports, the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service. His most recent Covid-19 publications include: "Ensuring Uptake of Vaccines Against SARS-CoV-2" in the New England Journal of Medicine (with MM Mello & SB Omer), and "Covid-19: control measures must be equitable and inclusive" in BMJ (with ZD Berger, NG Evans & AL Phelan)

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