In response to the recent resurgence of COVID-19, the ACGME has sent a letter signed by President and CEO Thomas J. Nasca, MD MACP to both presidential nominees, urging them to commit to accelerating the production of personal protective equipment (PPE) to protect frontline health care workers, who include many members of the GME community.
The following information was included in the letters to both candidates.
Now that our nation is confronting a resurgence of the COVID-19 pandemic, one of the highest priorities continues to be the health of frontline health care workers, including those receiving their education while caring for COVID-19 patients. Not only do they put their own health and personal safety at risk, but if experience from the global pandemic is any indicator, they are almost three times more likely than the general population to contract the disease. Particularly at risk, are our Black and Brown health care workers who staff our nation’s safety net hospitals, which serve those most vulnerable to infection and where data show that those health care workers are 21 times more likely to contract the disease. These workers can also become sources of transmission when they return to their communities and families.
The Accreditation Council for Graduate Medical Education (ACGME) is the nation’s principal accreditor for medical residency and fellowship education and has focused its efforts during this crisis to ensure there is adequate protection, supervision, education, and training of the US’s 140,500 resident and fellow physicians. Integral to the protection of these residents and fellows are the financial and logistic decisions to supply adequate personal protective equipment (PPE) to health care workers who require it so that the lack of it does not becomes a barrier to care delivery. We cannot ethically ask health care workers, no matter how altruistic their intent, to sacrifice their lives and those of their loved ones because all possible resources to protect them from infection were not marshaled by their institutions and their state and federal governments.
Failure to prioritize appropriate safety provisions for frontline health care workers undermines and marginalizes current and future generations of clinicians, further hampering an adequate supply of health care workers. This lack of regard for the lives of physicians and other health care professionals will contribute to their perception that they are viewed as expendable. This in turn will accelerate the demise of our physician workforce, which then will adversely impact our patients and our country, now and for the foreseeable future. Without adequate PPE and access to adequate viral testing, our physician faculty members and residents/fellows now risk becoming sources of this deadly virus, endangering their patients, fellow health care workers, and all those they contact. The pledge to “first do no harm” becomes meaningless under these circumstances. In order to preserve the integrity of our profession, we must ensure that adequate PPE, viral testing, and equipment required to serve our patients are provided to our nation’s health care facilities.
We appreciate your commitment to fully enact the Defense Production Act for coronavirus response in order to enjoin manufacturers to retrofit and mass fabricate the required PPE, viral testing kits, and other equipment (face shields, surgical and N95 masks, coveralls, powered respirator systems, gloves, and mechanical ventilators). The situation clearly warrants all the efforts that are currently underway, including shipping existing materials from the Strategic National Stockpile and replenishing them while encouraging the good will of industry to mass-produce materials required to provide protection to our frontline health care workers. However, in order to ensure the availability of PPE sufficient to meet Occupational Safety and Health Administration standard 29 CFR 1910 Subpart I levels of safe protection, this alone will not be sufficient. We urge you, Mr. Vice President, to commit now to using all existing executive powers if elected, including those described in the Defense Production Act, to accelerate the production and delivery of adequate PPE for our physicians in residencies/fellowships and all those who care for our nation’s patients. The ACGME is committed to working with you to accomplish these goals.