Essential Workers Need Federally-Funded Testing
COVID-19 diagnostic testing takes place in a public laboratory in Exton, Pennsylvania. Photo from the Office of Governor Tom Wolf.
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 to go to work instead. They risk exposure to the virus daily in order to feed us, supply us, give us medical attention, and take care of our children.
We are approximately three months into the coronavirus outbreak in the United States, and still no federal plan exists to organize a proper COVID-19 testing regimen for essential workers. In fact, state public health organizations have already warned of “widescale shortages” in remaining testing supplies.
Most of our essential workers work 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 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 testing is required to prevent the spread of infection. Serological testing for immunity 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, testing must be universal—a person’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.
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. Obviously, for one thing, infected people can move between states' jurisdictions. While the creation of regional state-based coalitions has mitigated that problem for now, region-by-region supervision cannot be a long-term solution given the scope and variety of normal domestic travel among 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. Instead, states are continuing to waste precious resources in bidding wars with one another. And regardless of how well a state even deploys its funding to protect residents, states have a limited tax base. Federal financial support is desperately needed.
Experts conservatively estimate that our country needs to be running approximately 500,000 tests a day in order to safely begin the shift away from one-size-fits-all containment; there is no other way to reopen the country. With insufficient federal support, we have instead plateaued at around 150,000 daily tests.
As we begin scaling up testing, we should increase protections for our essential workers first. Since they are most at risk of having recently contracted the virus, beginning testing with that group bears an exponential return on protections for the rest of the American people. There are other benefits, too: the standards set for the protection of our essential workers will also serve as guidance when we look to loosen restrictions down the line.
In response to the crisis, Congress recently passed a $2 trillion economic stimulus, the largest in history. Despite the price tag, the measure was little more than a stopgap: lawmakers have already suggested a second stimulus. The federal government is spending ever-larger sums on triaging the consequences of the pandemic while refusing to plan ahead to end the crisis more quickly. In fact, it actually cut support for state-run testing on April 10, under the reasoning that federal aid is intended merely as a “stopgap.”
In the immediate future, there are three steps the government needs to take:
Allocate sufficient federal funds for the specific purpose of testing essential workers for COVID-19.
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.
Direct OSHA to establish a set of workplace safety standards to protect essential workers from the spread of infectious disease.
We cannot safely begin the process of reopening the country if we don’t first establish a safe environment for our essential workers. The only way to do that is through a strong testing mechanism and enforceable workplace precautions. If the federal government continues to hesitate, the results for Americans will be deadly, costly, and unnecessary.
Congress and the White House must act.
This editorial is an adaptation of a petition circulating online; you can sign it here. Alex Siegal is the Editor-in-Chief of CPR and a junior at Columbia College studying Economics-Political Science. He can be contacted at a.siegal@columbia.edu.