Scott Presses HHS To Ramp Up Testing in Long-Term Care Facilities

North Charleston, SC – As reports from around the nation and world continue to show the danger of COVID-19 spread in long-term care facilities such as nursing homes, U.S. Senator Tim Scott (R-SC) today wrote letters to both U.S. Department of Health and Human Services (HHS) Secretary Alex Azar and South Carolina Governor Henry McMaster regarding testing plans for these providers and their patients.

In writing to Secretary Azar, the Senator stated, “I ask that you prioritize, among other areas, rapid point-of-care testing capacity for long-term care facilities and other providers serving disproportionately older Americans, as well as expanded testing access for communities of color and populations with a high prevalence of underlying health conditions…According to data released last week, up to 50% of COVID-19-related fatalities in Europe were residents of long-term care facilities. In the U.S., the Kaiser Family Foundation recently reported that, among states that reported relevant data points, long-term care facility residents and staff accounted for roughly 27% of COVID- 19-related deaths and 11% of cases. In six states, fatalities in these facilities made up more than half of all deaths attributed to COVID-19. Fortunately, emerging research suggests that more proactive testing policies and enhanced access could meaningfully reduce these unnerving figures.”

To Governor McMaster, Scott wrote, “As you continue to develop and implement plans for reopening South Carolina’s economy in the coming weeks and months, scaling up our state’s testing capacity will undoubtedly play a crucial role in mapping out and navigating the road to recovery. While gaps remain, I applaud the work of your administration, the S.C. Public Health Laboratory, private labs, and healthcare providers throughout the state in substantially expanding testing initiatives thus far… As you strategize how best to allocate the testing-focused funding and supplies that you receive, I ask that you prioritize, among other areas, rapid point-of-care testing capacity for long-term care facilities and other providers serving disproportionately older South Carolinians, as well as expanded testing access for communities of color and populations with a high prevalence of underlying health conditions.”

The full text of the letters are below. A PDF of the letter to Secretary Azar is here, and to Governor McMaster is here.

April 29, 2020

The Honorable Alex M. Azar II
Secretary
Department of Health and Human Services
200 Independence Avenue, SW Washington, DC 20201

Dear Secretary Azar:

As states and localities across the nation develop plans to reopen their economies, the need for effective and scalable diagnostic testing capacity has become increasingly urgent. While significant gaps remain, Congress took a monumental step towards addressing these challenges last week through a historic $25 billion investment in our testing infrastructure. Moreover, by affording state and federal policymakers substantial discretion in how to allocate these funds, we have allowed for flexible and adaptive solutions that can respond to both existing hurdles and new ones that emerge in the coming weeks and months. As you work with state and local leaders, along with other federal officials, to allocate the testing-focused funding appropriated through the Paycheck Protection Program and Health Care Enhancement Act, I ask that you prioritize, among other areas, rapid point-of-care testing capacity for long-term care facilities and other providers serving disproportionately older Americans, as well as expanded testing access for communities of color and populations with a high prevalence of underlying health conditions.

Studies from across the globe continue to confirm that seniors who contract COVID-19 face a troublingly high risk of severe illness, making safety and surveillance initiatives at long-term care facilities and other providers serving our seniors all the more imperative. According to data released last week, up to 50% of COVID-19-related fatalities in Europe were residents of long-term care facilities. In the U.S., the Kaiser Family Foundation recently reported that, among states that reported relevant data points, long-term care facility residents and staff accounted for roughly 27% of COVID- 19-related deaths and 11% of cases. In six states, fatalities in these facilities made up more than half of all deaths attributed to COVID-19. Fortunately, emerging research suggests that more proactive testing policies and enhanced access could meaningfully reduce these unnerving figures. Recent modeling spearheaded by Imperial College London, for instance, found that using rapid point-of-care tests to screen nursing home and healthcare workers every week could reduce these individuals’ contribution to transmission by around 25%. While restrictions on visits and other infection control measures will play a valuable role in preventing further outbreaks at senior care facilities, providers that serve substantial shares of older Americans need consistent and sustainable access to high-quality rapid point-of-care tests in order to immediately identify and address potential COVID-19 cases.

In addition to prioritizing providers caring for older Americans, I ask that you allocate robust resources to building testing capacity among underserved communities, communities of color, and communities with a high prevalence of health conditions linked to severe COVID-19-related illness and death. As reported by CDC, data from the COVID-NET surveillance initiative showed that close to 90% of hospitalized COVID-19 patients in the catchment population had at least one underlying health condition. Among other common comorbidities, nearly half of hospitalized patients had hypertension, while more than one-quarter had diabetes, and close to one-fifth had asthma. Many of these conditions disproportionately affect people of color and lower-income Americans. While the majority of cases reported to CDC still appear to omit data on race and ethnicity, preliminary national data, supplementary surveillance efforts, and state- and county-level figures continue to indicate that African Americans are overrepresented among hospitalized patient populations and fatalities, as well as cases in general. With these disparities and heightened health risks in mind, I ask that you work to leverage safety-net providers like community health centers, along with drive-through testing sites and other appropriate models, to expand testing among communities of color and communities with a high prevalence of underlying health conditions linked to severe COVID-19-related illness and mortality.

Furthermore, the Department should target additional tests, as well as testing-related resources and equipment, to states currently experiencing capacity constraints. The “Testing Overview” published by the Administration this week included South Carolina among the eight states with the lowest monthly testing capacity per 1,000 people. Our state’s Department of Health and Environmental Control (DHEC) projected on Monday that there were likely 40,000 COVID-19 cases across the state, roughly 613% higher than the confirmed case total at that point. While private labs and innovative test development have spurred some improvement in recent weeks, access remains limited, and support from Congress’s recent appropriations could prove critical.

Allocating substantial portions of an unprecedented $25 billion federal investment will represent a challenging undertaking, and sustained engagement with relevant leaders, stakeholders, and experts at the local, state, and federal level will prove essential as you seek to balance diverse policy priorities. The Administration’s reported commitment to deliver the supplies needed to test at least two percent of every state’s population demonstrates a clear recognition of the type of bold action required to meet ongoing capacity needs. Our nation’s seniors, as well as vulnerable and underserved populations across the country, merit significant attention as these tests are distributed and as funding allocations move forward. I look forward to working with you and other federal leaders to ensure appropriate allocations for these and other priority areas.

Sincerely,

U.S. Senator Tim Scott

April 29, 2020

The Honorable Henry McMaster Governor
State House
1100 Gervais Street
Columbia, SC 29201

Dear Governor McMaster:

As you continue to develop and implement plans for reopening South Carolina’s economy in the coming weeks and months, scaling up our state’s testing capacity will undoubtedly play a crucial role in mapping out and navigating the road to recovery. While gaps remain, I applaud the work of your administration, the S.C. Public Health Laboratory, private labs, and healthcare providers throughout the state in substantially expanding testing initiatives thus far. Last week, Congress took a decisive step to bolster these efforts through an unprecedented $25 billion investment in the nation’s testing infrastructure. Moreover, in order to avoid one-size-fits all prescriptions, we allocated $11 billion of the funding appropriated explicitly for the states, facilitating flexible solutions tailored to particular needs. As you strategize how best to allocate the testing-focused funding and supplies that you receive, I ask that you prioritize, among other areas, rapid point-of-care testing capacity for long-term care facilities and other providers serving disproportionately older South Carolinians, as well as expanded testing access for communities of color and populations with a high prevalence of underlying health conditions.

Studies from across the globe continue to confirm that seniors who contract COVID-19 face a troublingly high risk of severe illness, making safety and surveillance initiatives at long-term care facilities and other providers serving our seniors all the more imperative. The Kaiser Family Foundation recently reported that, among states reporting relevant data points, long-term care facility residents and staff accounted for roughly 27% of COVID-19-related deaths and 11% of cases. In South Carolina, as of April 23, 435 COVID-19 cases had been identified across 56 nursing homes, rehabilitation facilities, and community residential facilities, with at least 28 coronavirus-related deaths reported in these centers. Fortunately, emerging research suggests that more proactive testing policies and enhanced access could meaningfully reduce these unnerving figures. Recent modeling spearheaded by Imperial College London, for instance, found that using rapid point-of-care tests to screen nursing home and healthcare workers every week could reduce theses individuals’ contribution to transmission by around 25%. While restrictions on visits and other infection control measures will play a valuable role in preventing further outbreaks at senior care facilities, providers that serve substantial shares of older Americans need consistent and sustainable access to high-quality rapid point-of-care tests in order to immediately identify and address potential COVID-19 cases.

In addition to prioritizing providers caring for older Americans, I ask that you allocate robust resources to building testing capacity among underserved communities, communities of color, and communities with a high prevalence of health conditions linked to severe COVID-19-related illness and death. As reported by CDC, data from the COVID-NET surveillance initiative showed that close to 90% of hospitalized COVID-19 patients in the catchment population had at least one underlying health condition. Among other common comorbidities, nearly half of hospitalized patients had hypertension, while more than one-quarter had diabetes, and close to one-fifth had asthma. Many of these conditions disproportionately affect people of color and lower-income Americans. Both national and state-specific data indicate that African Americans are overrepresented among hospitalized patient populations and fatalities, as well as cases in general. As of last week, Black South Carolinians accounted for 43% of COVID-19 cases and 56% of COVID-19-related deaths, despite comprising just 27% of the state’s population. With these disparities and heightened health risks in mind, I ask that you continue to leverage safety-net providers like community health centers, along with drive-through testing sites and other appropriate models, to expand testing among communities of color and communities with a high prevalence of underlying health conditions linked to severe COVID-19-related illness and mortality.

Securing, allocating, and distributing funding and supplies from the federal government’s $25 billion investment will present hurdles and challenges, and I commit to continuing my engagement with you and your administration, along with my colleagues in the South Carolina delegation and other federal officials, to ensure that our state receives the resources that it needs. Our seniors, as well as vulnerable and underserved populations across the state, merit significant attention as you work to effectively deploy the financial support and tests allocated to South Carolina.

Sincerely,

U.S. Senator Tim Scott

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