WE ARE UNITING TO DEMAND NATIONAL UNIVERSAL TESTING FOR ALL ESSENTIAL WORKERS AND VULNERABLE POPULATIONS.
WHY UNIVERSAL TESTING?
Updated June 15, 2020
Securing our nation starts with the front line. Right now, most Americans are practicing social distancing in order to stall the spread of the novel coronavirus. However, in order to perform the essential services that allow the rest of the country to survive at home, a wide cross-section of workers in our economy must go to work. They risk exposure to the virus daily in order to feed us, supply us, provide us with medical attention, and take care of our children. Further, we must provide testing for the cohabitants of essential workers, be them family members or roommates. Social distancing and total avoidance of physical contact between cohabitants is, for many, impossible.
We are approximately four months into the coronavirus outbreak in the United States, and still no federal plan exists to organize a comprehensive COVID-19 testing regimen for essential workers and vulnerable populations. The federal government has taken a block-grant approach, leaving states to determine who will receive tests, and how they will be made available.
The novel coronavirus has been improperly described as a "great equalizer." In reality, the outbreak is disproportionately killing black Americans, who are overrepresented in essential roles including food and hotel services. Increasing access to free testing is not only a matter of public health, but social justice. For those privileged enough to afford healthcare co-pays and hefty hospital bills, the cost may be just another annoying price tag. For the rest of us, the cost can be deadly.
Most of our essential workers have jobs outside of the healthcare system, and safeguards to protect them have been constructed on an ad hoc basis. As a result, a wide swath of the population is supplying food, stocking shelves, and delivering packages without all of the protections they need. Despite the danger, the Trump administration’s Occupational Safety and Health Administration (OSHA) has yet to design any form of longer-term workplace standard to insulate workers from the spread of COVID-19 during the time before a vaccine is available.
This lapse has serious consequences, and Americans are already in jeopardy. Amazon warehouses, for example, are running at full capacity: workers are in close proximity with one another while packing and shipping goods; they don’t have adequate time to wash their hands regularly, and they have access to woefully insufficient supplies of masks and hand sanitizer. While Amazon has deployed some measures, including forehead temperature checks and the use of thermal cameras in some facilities, these are not a feasible long-term solution. For example, not every COVID-19 carrier displays a fever. Regular diagnostic (PCR) testing is required to prevent the spread of infection. Serological (antibody) testing would be an additional benefit.
Plenty of experts have made it clear that the only way for us to move forward toward safely reopening the country is a robust testing regimen. Effective epidemiological testing consists of two main undertakings: testing large numbers of people at once, and engaging in sufficient contact tracing. This is the model that South Korea and Taiwan have followed successfully.
Among essential workers, their cohabitants, and vulnerable populations, testing must be universal—an individual’s ability to get a test must not rely on their income or immigration status. Aside from being morally deplorable, those biases sap the test of its efficacy for the population at large: the virus is still allowed to percolate within the untested population and can easily work its way back into the rest of society. Additionally, an unchecked spread within the population of essential workers could cripple supply chains. This is no small consideration—over 50% of farm workers, for example, are undocumented. Undocumented workers were already excluded from federal aid by the CARES Act; that pattern cannot continue if the United States is to adopt a successful testing regimen. California has recently made COVID-19 relief available to undocumented immigrants. Still, the Trump administration’s hostility toward immigration keeps many from seeking COVID care.
Similarly, test availability must not rely on employee classification. Full-time employees, part-time hires, and independent contractors alike need access to testing if they’re on the front line performing an essential function. The virus doesn’t care which kind of contract a worker might have signed.
A sufficient testing and tracing regimen requires two key federal resources: jurisdiction and funding. The current patchwork response from states does not meet those needs. For one, infected people can move between states' jurisdictions. While the creation of regional state-based coalitions has mitigated this problem for now, region-by-region supervision cannot be a long-term solution given the scope and variety of normal domestic travel between all fifty states.
States also do not have the authority to order manufacturing projects at the necessary national scale; that is, of course, a federal power. Regardless of how well a state deploys its funding to protect residents, states have a limited tax base and cannot take on a deficit. State budgets are not designed for the crisis at hand, and federal financial support is desperately needed. It is unacceptable for the federal government to be considering the prospect of the collapse of state budgets: it should note well that any one state’s collapse will bring severe nationwide consequences.
Experts estimate that our country needs to be running approximately 900,000 tests a day in order to safely begin the shift away from one-size-fits-all containment; we are currently conducting only 248,000 daily tests (this is up from 150,000 in April). Until there is a vaccine, consistent, large-scale testing is required to safely reopen the country.
As we begin to scale up testing, we must make tests easily available to essential workers, their cohabitants, and vulnerable populations. If we want to contain the community spread of COVID-19, we must increase access to testing for the people who have the highest rates of contact. Essential workers are the most at risk of contracting and spreading the virus. By mandating that all essential workers be tested for COVID-19 regularly, we can slow the infection rate of the virus, making reopening the country a safer possibility sooner.
In response to the crisis, Congress passed a $2 trillion economic stimulus (the CARES Act), the largest in history. Despite the price tag, the measure was little more than a stopgap. The federal government is spending immense sums on triaging the consequences of the pandemic while refusing to plan ahead to end the crisis through relatively cheap testing and tracing efforts.
In the immediate future, there are three steps the federal government needs to take:
Allocate sufficient federal funds for the specific purpose of testing essential workers and their cohabitants regularly for COVID-19—free of charge.
Label COVID-19 testing as treatment for an “emergency condition” under 42 U.S.C. 1396b(v) to ensure testing is available for all essential workers, regardless of immigration status.
We cannot safely begin the process of reopening the country if we don’t first establish a safe environment for our essential workers and those most vulnerable to the virus, including protesters. Evidence has shown that we need a strong testing mechanism, enforceable workplace precautions, increased production and distribution of PPE, and paid sick leave to ensure the health and well-being of the nation. If the federal government continues to hesitate, the results for Americans will be deadly, costly, and unnecessary.
Congress must act.
WHO ARE ESSENTIAL WORKERS?
Essential workers are those who have been determined to provide "life-sustaining and essential services." This criteria has been left intentionally vague and specific determinants vary by-state. In general, essential workers are employees who cannot provide "essential" services remotely, including: healthcare workers, laboratory personnel, law enforcement and public safety officers, first responders, food and agriculture workers, and many others in the industries including but not limited to financial services, manufacturing, delivery, and transportation.
For a more detailed list, click here.