As the country braces for an escalation in the spread of the COVID-19 outbreak and a growing number of people infected with SARS-CoV-2, the AAFP is actively working to assemble and distribute the most timely and relevant information for our members. It is becoming clear that this outbreak will place tremendous strain on our health care system and economy. In this post, I am providing an update on AAFP resources, along with a summary of our advocacy activities aimed at helping you and your practices prepare for this pandemic.

As of March 16, the number of confirmed COVID-19 cases in the United States had exceeded 3,400, and the worldwide count was well over 150,000. As a result of this growing case count, numerous states have declared states of emergency, which enables them to activate resources aimed at mitigating the spread of disease and treating those who fall ill. Many hospitals, health systems and medical schools have enacted travel bans for physicians and other clinicians, and several governors have issued directives prohibiting large gatherings.

The seriousness of the situation was made clear on March 11, when the World Health Organization characterized COVID-19 as a pandemic, noting that the organization was "deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction."

The WHO's declaration set in motion a series of closures and cancellations in the United States, ranging from public schools to professional sports. Many businesses are now encouraging their employees to work from home, and there is a national focus on social distancing. However, we all know that this is not an option for you. You are on the frontlines and a critical component of our nation's strategy to address this outbreak. Your commitment to patient care is commendable, and we want you to know that the AAFP is working around the clock to make sure you have access to information and supplies that will enable you to safely and effectively care for your patients and communities.

AAFP Resources

The AAFP is committed to informing, preparing and assisting you in caring for your patients and your communities. We have established a Prepare for Coronavirus (COVID-19) resource page, which provides the latest information on the outbreak and practice-based resources, including a Physician Office Preparedness Checklist. We also have patient-focused content on familydoctor.org.

I also encourage each of you to join and follow the AAFP's COVID-19 Rapid Response Member Exchange.

You may also find these resources helpful:

• CDC Coronavirus Disease 2019
• WHO Coronavirus topic page

AAFP Advocacy

On March 12, the AAFP issued a call to action via our Speak Out tool, urging you to contact your members of Congress and push for rapid improvements in the flow of information and coordination with frontline family physicians. Please take a few minutes to communicate your concerns to your elected officials.  

On March 11, the AAFP wrote a letter to the nation's largest commercial insurers urging them to collaborate with the Academy and family physicians across the country. In addition, we called on the companies to take immediate action to

• align telehealth coverage with the Coronavirus Preparedness and Response Supplemental Appropriations Act,
  
• eliminate out-of-pocket costs,
  
• establish pay parity for telehealth visits,
  
• facilitate expeditious care,
  
• increase medication access and
  
• communicate effectively with the physician community.

On March 11, the AAFP wrote a letter to House and Senate leaders that was copied to include all 535 members of Congress, urging legislators to keep pressure on the administration and its Coronavirus Task Force "to ensure that information, supplies and resources are flowing to physicians on the frontlines, not just hospitals and public health departments."

On March 10, the AAFP wrote a letter to Vice President Mike Pence, chair of the White House Coronavirus Task Force, raising concerns about four issues:

• the lack of an adequate supply of testing kits at the practice and community level;
  
• the lack of clearly stated protocol for when and how testing should be conducted and results reported;
  
• the scarcity of personal protective equipment for frontline physicians; and
  
• the lack of communication and information among federal agencies, health departments and frontline primary care physicians.

On March 2, the AAFP wrote a letter to HHS Secretary Alex Azar, opening a line of communication with the department regarding the outbreak and outlining a set of steps that need to be taken to "integrate family physician offices with federal agencies and public health efforts, including the distribution of information on evolving testing, vaccination and treatment."

Federal Legislation

The Coronavirus Preparedness and Response Supplemental Appropriations Act was approved by Congress on March 4 and enacted into law by President Trump on March 6. This legislation provides $8.3 billion in additional funding to the CDC, FDA, NIH and other federal agencies, such as the Small Business Administration and the Department of State -- all aimed at increasing readiness, preparedness and response activities.

The legislation has seven key provisions:

• Emergency telehealth waiver -- The law gives the HHS secretary the authority to waive or modify Medicare requirements associated with telehealth services when the president has declared a national emergency or the secretary has declared a public health emergency. These waivers allow Medicare providers to furnish telehealth services to Medicare beneficiaries in any emergency area. This provision also allows beneficiaries to receive virtual care in their homes from a physician or other clinician who has treated them in the past three years.
  
• FDA -- The agency will receive $61 million to facilitate the development and review of medical countermeasures, devices, therapies and vaccines to combat SARS-CoV-2. This funding will help the FDA maintain our national drug and device product inventory through extensive outreach to medical product manufacturers to identify and mitigate potential supply chain interruptions.
  
• Small business disaster loans -- The law allows $1 billion in loan subsidies to be made available to help small businesses with financial losses as a result of the COVID-19 outbreak.
  
• CDC -- HHS will receive $2.2 billion to support federal, state and local public health agencies to prevent, prepare for and respond to the outbreak.
  
• Vaccines and treatments -- The law authorizes more than $3 billion for research and development of vaccines, therapeutics and diagnostics to prevent or treat the effects of COVID-19.
  
• Community health centers – Nearly $1 billion is allotted to procure pharmaceuticals and medical supplies, support health care preparedness and community health centers, and improve medical surge capacity.
  
• Global health response -- The law allocates $435 million to support health systems overseas to prevent, prepare and respond to COVID-19, of which $200 million is for an emergency reserve fund.

AAFP Events

The AAFP has made the difficult but appropriate decision to cancel all in-person meetings scheduled through May 31. This includes the Annual Chapter Leadership Forum, the National Conference of Constituency Leaders and the Family Medicine Advocacy Summit. We are exploring virtual engagement opportunities and hope to have more information to share in the near future.

This will be a challenging period for each of you, your communities and the country. Please know that the AAFP is working hard on your behalf. Please stay connected and keep us informed of your needs. Most of all, thank you for what you do and your dedication to your patients. Be safe.

Shawn Martin is senior vice president of advocacy, practice advancement and policy.