Pleading with Gov. Tony Evers and leaders of the state Legislature to avert “a catastrophe” from the surge in COVID-19, the head of the Wisconsin Hospital Association (WHA) is calling on them to unite behind legislation to address the pandemic.
“With few tools available right now to curb spread other than increasingly urgent public appeals, our COVID numbers are growing rapidly and predict, quite accurately so far, a healthcare crisis in Wisconsin that without significant, swift, and unified action will become a catastrophe,” wrote Eric Borgerding, WHA president and CEO, in an open letter to Evers and the Legislature’s Republican and Democratic leaders. “This is hard to fathom for many across the state, but for those fighting this ever-growing battle in our hospitals, the data simply illustrate the human tragedy playing out in front of them every day.”
Among specific proposals, Borgerding’s letter endorses a measure that Evers offered this week for the state to provide $105 million to hire additional hospital workers.
The letter reviews the increasingly drastic ravages of the pandemic in Wisconsin. Hospitals held 2,274 COVID patients as of Monday — twice the number of a month ago and six times as many as eight weeks ago. There has been a string of record daily increases in hospitalizations. The state set an “awful new record” of 456 COVID patients in intensive care units and diminishing ICU capacity. Deaths doubled in two months, to 2,741 on Wednesday, with a record increase of 92 for one day alone.
“The undeniable cause of these clear and urgent trends is the community spread of COVID, which according to many experts is worse in Wisconsin than nearly anywhere else in the country,” Borgerding wrote, italicizing key passages for emphasis. “Indeed, on September 19, Wisconsin had a total of 101,227 confirmed COVID cases – it took us roughly seven months to reach that number. Just 36 days later, the number of cases had doubled to 201,046. Just 18 days after that, we hit 301,165 COVID positives in Wisconsin, triple the number we had just two months ago.”
Hospitals are reaching capacity and healthcare workers are “tired from working months of long hours behind masks, face shields and gowns, yet remain dedicated to their co-workers, patients and communities,” the letter states. “But their exhaustion, and increasingly their frustration, is compounded by the still-unmitigated spread of COVID.”
One consequence of the staff shortages — although not emphasized in the letter — is that some hospitals around the state have been deferring elective procedures, including healthcare networks in Milwaukee, La Crosse and elsewhere. The situation is still fluid, says Brian Potter, the hospital association’s senior vice president for finance and chief operating officer, with demand changing from day to day.
Particularly if they involved preventive procedures, such as a colonoscopy to screen for colon cancer, healthcare providers don’t want to delay them, he adds — but “sometimes it just becomes necessary.”
Appeal to unity
Even as Borgerding’s letter lays out the stark statistics of the current COVID-19 crisis, it avoids criticism of elected leaders. Instead, it is an appeal for unity and cooperation.
“We need you, the state’s top elected officials, to come together immediately with unified actions to slow demand for care by mitigating the spread of COVID-19 and to increase the capacity for care by making significant investments in our workforce and care sites and further streamlining regulatory policies,” the WHA executive wrote.
Borgerding calls for the lawmakers and the governor to agree to “a statewide COVID mitigation strategy” that could include a statewide mask policy, an affirmation that local governments have the authority “to adopt their own strategies,” and an updated version of a plan that the state’s largest business lobby proposed in the spring, setting guidelines for businesses to operate safely in the pandemic.
He made no mention of Republican lawmakers’ consistent opposition to the mask orders Evers has instituted, or of their support for lawsuits that seek to end those orders.
Not surprisingly, Borgerding embraces Evers’ proposal for $105 million to help hospitals hire more employees as they face “significant staff vacancies due to COVID-19 exposure in the community.” Hiring temporary workers, including those traveling from out of state, is two to three times as costly for hospitals, the letter states, and while additional workers may be available through the Federal Emergency Management Agency (FEMA), the government requires hospitals first to exhaust other staffing options.
Borgerding also calls on the state to expand community testing and contact tracing. Hospitals and clinics are currently conducting the majority of COVID-19 tests in Wisconsin and experiencing “increasing strain” as a result. Community testing should be expanded, he adds, and Evers, as well as legislative leaders, should ask the Trump administration to provide 100% of the cost of keeping the National Guard deployed for community testing for at least six more months.
Wisconsin needs “thousands more contact tracers to more effectively mitigate spread,” the letter states, although it does not include specific suggestions on how those might be funded.
The state’s one alternate care facility (ACF) in West Allis, for recovering COVID-19 patients who aren’t ready to go home but can finish recuperating in a lower-intensity setting, is “an important safety valve” for hospitals that are nearby, but it is too far from many of the state’s other hospitals, the letter states, and many patients are unwilling to be transferred there far from their homes.
“Wisconsin needs to open additional/regional ACFs in other parts of the state that are closer to surging patients,” the letter states, which would free up space in overwhelmed hospitals in those places for patients with COVID-19 as well as those hospitalized for other reasons.
The letter also calls for expanding the eligibility of hospitals to receive Medicaid payments for all outpatient services and for post-acute hospital services. And it advocates streamlining licensing procedures for out-of-state or recently lapsed healthcare workers, making permanent changes that the state has put in place during the pandemic.
In a statement, Assembly Speaker Robin Vos (R-Rochester) offered general agreement with the WHA letter, specifying his support for “more COVID testing, contact tracers and other solutions to help ease the strain on our healthcare facilities, decrease the rate of transmission and ultimately save lives.”
Vos indicated that he and Assembly Republicans have been hearing from WHA, healthcare providers and public health officials, so that the issues the letter raised “do not come as a surprise,” and urged the Senate leadership and Evers “to join me in putting aside partisan differences to find bipartisan answers.”
A spokeswoman for Evers referred to the governor’s call for unity in his address to the state last week.
Between the lines
In its call for unity in response to the state’s crisis, the WHA letter makes only oblique references to some of the sources of division that have contributed to Wisconsin’s current hot spot COVID-19 numbers.
When asking “for all our elected leaders to come together quickly” on a statewide strategy, the letter notes in passing that “previous efforts aimed at slowing the spread of COVID have been met by legal challenges and court battles.”
That is an implicit and compressed reference to a chain of legal cases:
- The lawsuit filed by Republican state legislative leaders, including Vos, against the Evers administration’s Safer at Home sheltering order. The state Supreme Court, which bypassed lower courts to take the case, threw out the order May 13.
- Two pending lawsuits to block the governor’s ability to declare new health emergencies, including the successive statewide mask orders that have been in place since Aug. 1. The Supreme Court is considering one of those cases; if it sides with the plaintiff, the effect would be to block the latest emergency and mask order, which Evers announced Wednesday to run into January.
Republican leaders in the Legislature have sided with the plaintiffs trying to throw out the mask orders and their associated health emergency declarations. Evers has several times urged the Republicans to end their support for those lawsuits.
- A lawsuit initiated by the Tavern League that halted the governor’s attempt in October to reduce the spread of the virus by limiting indoor gatherings to 25% of building capacity. The capacity order has been blocked by an appellate court, and the state Supreme Court won’t hear arguments on the administration’s appeal of that decision until mid-December.
The letter also doesn’t include the context for its suggestion that Evers and the Republican leaders of the Legislature cooperate “to affirm the authority of counties and municipalities to adopt their own strategies” for public health and safety.
In October and November, Wisconsin Manufacturers & Commerce sent letters to La Crosse, Winnebago and St. Croix counties, claiming that public health ordinances or advisories they were considering were unlawful or lacked “legal authority.”
This article has been updated to correct the information about the outcome of the St. Croix County proposed communicable disease ordinance.