One-on-one with Surgeon General Jerome Adams: Latest plans to reopen the country

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WASHINGTON (Gray DC) -- As the country continues to fight coronavirus, President Donald Trump says we are making steady progress. The White House is working with states on plans to reopen the economy, but there are still a lot of questions.

As some states prepare to reopen the economy, Washington Bureau Chief Jacqueline Policastro is getting answers from our nation's top doctor. (Source: Gray DC)

Gray Television Washington Bureau Chief Jacqueline Policastro gets answers from the nation's head doctor, Surgeon General Jerome Adams.

Here is a transcript of their conversation:

JACQUELINE POLICASTRO:
Dr. Adams, the White House says more than a million Americans are being tested for coronavirus each week. How will the results help inform decisions about when and where to reopen the U.S. economy?

DR. JEROME ADAMS:
Well, one of the things that I'd like for people to know is that the task force guidelines for reopening America, one of the criteria that's in those guidelines is making sure we have adequate testing in communities. And when I say adequate testing, it's not just one test. It's making sure we have surveillance for influenza-like activity, like we do for the flu. It's making sure we have diagnostic testing for people who have symptoms. It's making sure we're testing people who are asymptomatic in certain areas, that we're doing sampling so that we know what the spread is like even amongst people who are not symptomatic, and it's antibody testing. So, there's going to be a package that communities need to look at based on their burden of disease to figure out a comfort level with reopening, and we stand ready to work with governors, to work with mayors, to work with hospitals to figure out what that package looks like, so that when we reopen, we can reopen safely.

JACQUELINE POLICASTRO:
The president says he wants to allow hospitals to get back to performing elective surgeries. What will it take for hospitals to do this, and is it safe for patients?

DR. JEROME ADAMS:
Well, that's going to be a question that again is decided on a case by case basis. If you're in New York City, you're going to have a very different approach to this than if you're somewhere that, one of our 24% of counties across the nation that have zero cases so far. But when we reopen elective cases, we want people to be thinking about things like, "Do we have enough personal protective equipment?" Not just to do the elective cases, but to deal with any potential flare-ups within that hospital system. We want them to be thinking about things like, "Okay, is it appropriate to have people who have other comorbidities in a recovery unit?" And if not, is that conversation occurring with the patient and the physician? So, when you look at the guidelines, it initially says in phase one, start with outpatient elective surgeries. Phase two, you go to inpatient, and each of those is designed to be graded so that we have increased capacity and an even greater assurance that people can be safe when they're getting these cases done. But I don't want people to feel like they can't get their basic healthcare. I actually am very concerned about a decrease in people actually going to get prenatal care, a decrease in people coming forward with cardiovascular symptoms. We don't want people to suffer from other negative health consequences because they're scared of COVID-19. And again, these guidelines and these phased processes help us get back to some sense of normal in regards to people getting access to healthcare.

JACQUELINE POLICASTRO:
There are new guidelines for nursing homes. They're now required to report COVID-19 cases to residents, their family members and the CDC. The administration says this is about transparency, but is there more oversight needed to protect nursing home residents?

DR. JEROME ADAMS:
Well, throughout this process, we're trying to make sure we have oversight to keep people safe, but that we're also removing unnecessary regulatory barriers that are inhibiting people to be able to respond to an acute crisis. So, I'll give you an example. CMS (Center for Medicare and Medicaid Services) put out new guidelines on tele-health. Originally, tele-health had several restrictions. It could only be done in rural areas, only certain providers got paid to administer tele-health. That's the case where lowering regulatory barriers actually created more opportunities for healthcare for people and made it safer because people didn't have to go in and have a face-to-face encounter.
From the nursing home standpoint, you're exactly right. The administration and the task force and I are very concerned about what has been not as much transparency as we would've liked when we see these outbreaks, and I speak as someone who had two grandmothers... Most of my grandmothers passed away while in nursing homes several years ago. I would want to know if my loved one was in a nursing home, and there was a COVID outbreak going on there.

JACQUELINE POLICASTRO:
We know this virus won't be gone anytime soon. Are we prepared for a resurgence?

DR. JEROME ADAMS:
Well, in some communities, we are, and other communities, we aren't yet. I want people to know that while testing has been a challenge, we've done 80,000 tests a month ago. We've now done four million tests. We're doing over a million a week and continuing to ramp up. And not every community is ready to reopen. Not every community is ready to deal with a resurgence, and that's what the phases are for. But we want people to be having these conversations right now to determine if they do have a resurgence, can we stop it at ten cases? Can we stop it at five cases? Can we stop it at one case and not let it flare up into 100 or 1,000 cases and ultimately overwhelm our healthcare systems? So again, we stand ready to work with local leaders to make sure they're making intelligent decisions, but this is going to be a locally orchestrated and federally supported response, and it's going to happen in different ways in different places across the country in terms of reopening.

JACQUELINE POLICASTRO:
Dr. Adams, thank you for your time.

DR. JEROME ADAMS:
Thank you. I appreciate it, and stay safe.

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