Gragnolati: Coronavirus testing delays have far-reaching health care consequences

Atlantic Health CEO urges action to help hospitals fight pandemic in N.J., around nation

By Tom Bergeron
Morristown | Mar 13, 2020 at 2:45 am
Editor’s Desk

You can hear the frustration in Brian Gragnolati’s voice.

“We can do a flu screen and get a result back in 45 to 60 minutes, have that in the hands of our doctors and nurses who can develop a treatment plan for a patient based on what those tests say,” he told ROI-NJ. “Yet, with coronavirus, on average, it takes four or five days from the time that you have to seek permission to do the test and go through the government processes until you have a result. And, because of that, it creates an enormous logjam of people who could be discharged home just fine. It creates anxiety and it creates extra layers of work that we have to do to make sure that our staff members are safe in caring for these patients.”

Gragnolati is not only the CEO and president of Atlantic Health System, which runs Morristown Medical Center — the top hospital in the state. He also is the immediate past chairman of the board of trustees of the American Hospital Association — so he knows what hospitals around the country need.

And, right now, he said, they all desperately need faster test results.

“As I look at the highest priorities that we have right now, it is how can we get these tests to the bedside or to the exam table side or in the hands of the clinicians in a way that we can get these results back far quicker than we do today?” he said.

Gragnolati has seen some progress. Two commercial laboratories are now doing testing. And Hackensack Meridian Health and the Cleveland Clinic have both received approval from the U.S. Food & Drug Administration to use tests they’ve created during this time of emergency.

Gragnolati, however, said he would also like to see President Donald Trump do more. He signed a letter along with AHA colleagues urging the declaration of a national health emergency. More than that, he would like to see the president utilize the Stafford Act, a federal law designed to bring natural disaster assistance to state and local governments.

“The public health emergency releases some of the tools that the White House needs in order to break down the walls and make it simpler to do things that you need to do in an emergency situation, but it doesn’t go far enough,” he said. “The Stafford Act gives the president a lot of flexibility in meeting a lot of these needs. We’ve seen it used in other types of issues like natural disasters and in some health events.”

Trump, speaking to reporters Thursday afternoon, said he is considering the Stafford Act.

“We have very strong emergency powers under the Stafford Act,” Trump said. “I have it memorized, practically, as to the powers in that act. And, if I need to do something, I’ll do it.”

While it’s normally used for natural disasters, such as the recent wildfires in California, it has been used for pandemics before. In New Jersey, no less.

In 2000, former President Bill Clinton used the Stafford Act to pay for mosquito control efforts to address outbreaks of the West Nile virus in the state.

Gragnolati said there’s a great need to implement it again, as it will help on the other big problem looming with the health care providers on the front line of the coronavirus battle: a shortage of personal protection equipment.

“One of the big concerns that we have is the fact that the supply chain right now has been disrupted,” he said. “The availability of protective equipment for our team members, like N95 masks, gloves, gowns, etc., is challenged.

“If some of the modeling proves correct in terms of how this disease will spread, we may not meet the needs that we have in a very short order.”

Gragnolati and Atlantic are doing all they can to hold that off.

“We’re doing different modeling, we’re keeping track of these things, we’re redistributing them within the system,” he said. “But we’re also working hard on the supply chain to make sure that we’re getting our fair share of supplies.

“The other thing we need to do is to tap into the national stockpile in a way that makes sense. Now, that stockpile hasn’t been replenished since 2009. So, we’re pressing the government to make sure that all available equipment is there.”

Gragnolati couldn’t speculate when a tipping point would come.

“Do I have a particular date in mind?” he asked, and then answered. “No.”

He just knows the urgency.

“We’re working hard on this each and day,” he said. “The thing that I am absolutely focused on is to make sure that we get this to the right people who need this. Our team members need this to take care of the types of patients that need it — and we need to end the waste that’s occurring because we can’t get these tests done on a broad spectrum of people and get them done in a timely manner.”

For Gragnolati — someone who is in the middle of this storm — it all makes sense. And it all fits together. Hence his frustration.

“These issues are all interdependent, because the sooner we can get these tests and rule people out, the less protective equipment we have to use, which means that when we really need it, it’s going to be there,” he said.

It’s hard to argue with that logic.

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