As of August 5, 2020, COVID-19 has killed more than 700,000 people and has infected more than 18 million in 188 countries globally.  As we have seen with the COVID-19 pandemic, disease outbreaks have the ability to overwhelm entire health systems and, in addition to the loss of life, can cause worldwide economic disruptions. While COVID-19’s total global economic impact is still to be determined, we know the world economy as a whole lost an estimated $93-107 billion in productivity, in addition to substantial death and disability from the 2003 SARS and 2014-15 Ebola epidemics.  These effects highlight the need for every country to prioritize investments in health security and in building capacity to stop infectious disease threats at their source.

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As the U.S. has made demonstrable strides in expanding testing capacity and bringing testing innovations to market, it is critical to remember that testing does not replace personal responsibility. "Testing does not substitute for avoiding crowded indoor spaces, washing hands, or wearing a mask when you can't physically distance; further, a negative test today does not mean that you won't be positive tomorrow,"  said HHS Assistant Secretary for Health Admiral Brett Giroir, M.D. "Combining personal responsibility with smart testing is a key component of the Administration's national strategy for combatting COVID-19 – and the strategy is working."

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On Friday, President Trump signed an Executive Order directing the Department of Health and Human Services to ensure that American hospitals comply with their obligations under federal law to provide appropriate screening and medical treatment or transfer for infants, especially those born prematurely and/or with disabilities, and otherwise promote efforts to improve the survival of such infants

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As laid out in the Executive Order, the Emergency Medical Treatment and Labor Act (EMTALA) guarantees, in hospitals that have an emergency department, each individual’s right to an appropriate medical screening examination and to either stabilizing treatment or an appropriate transfer. The Rehabilitation Act of 1973 (Rehab Act) prohibits discrimination against individuals with disabilities in programs and activities receiving federal funding. The Born-Alive Infants Protection Act makes clear that all infants born alive at any stage of development are considered persons for purposes of these and other federal laws and are, therefore, afforded the same legal protections as any other person.

Under these laws, infants born alive who require emergency medical treatment, who are premature, or who are born with disabilities are entitled to meaningful and non-discriminatory access to medical examination and services when they present at hospitals receiving federal funds and have the right to be free from discrimination on the basis of disability. Infants with disabilities whose parents seek treatment should not be denied medical care on the basis of stereotypes, assessments of the quality of life, or judgments about the infant’s relative “worth” based on the presence or absence of disabilities.

Despite these laws, some hospitals fail to perform the required medical screening and, thus, do not provide potentially life-saving medical treatment to infants with disabilities or infants born before 24 weeks of gestation, even when parents plead for such treatment. For instance, in May 2020, HHS determined that an Ohio hospital had failed in 2017 to ensure medical screening examinations required by EMTALA were performed for twins born prematurely (at 22 weeks gestation) who were not sent to the hospital’s neonatal intensive care unit and died within several hours after delivery. In light of HHS’s determination, the HHS Office for Civil Rights will also be examining this matter to determine whether any additional civil rights violations occurred.