The case for death benefits and loan forgiveness for coronavirus front-line health care workers

Much has been written about the sacrifice that health care providers are making to care for patients suffering from COVID-19. Doctors updating their wills and sleeping away from their families to reduce risk of exposure. Nurses going to the bedside of patients, concerned about staffing levels, lack of adequate protective equipment, and exposure to the disease. Emergency medical works overwhelmed with cases in the field. Housekeeping staff keeping virus-laden rooms clean. Yet the question medical residents are asking cuts to the core of the heroism and tragedy the medical community is facing: Will there be death payments to their family and relief of their student debt if they die while fighting COVID-19?

Front-line COVID-19 health care workers are at increased risk of severe illness. They are pursuing their calling and jobs selflessly, yet are appropriately concerned not just about themselves but about not being there for their families. Many don’t have adequate insurance, and don’t solely have federal student loans: While federal loans are discharged after death, private student loans are not. Which is why Congress should pass legislation granting death benefits and educational debt relief for front-line health care workers.

This would not be done during normal periods of practice but only under these historic circumstances. There are precedents in other domains to which this pandemic response has been compared. The military has increased death gratuity payments for combat, and forms of debt relief. Police, firefighters, and other first responders have death and survivor benefits for those killed in the line of duty. A Public Safety Officer’s Benefits Program, administered by the Department of Justice, provides monetary compensation and educational benefits to survivors. A similar program should be considered for health workers who die fighting COVID-19. It could be administered by the Department of Health and Human Services.

After the Sept. 11 terrorist attacks, the World Trade Center Volunteer Fund was established to provide benefits to volunteers who incurred health-related illness from their work in the rescue, search, and recovery. In addition, the Victim Compensation Fund had provisions for rescuers and first responders. The fund was reactivated by the federal government in 2011, and the “Never Forget the Heroes” Permanent Authorization Act was signed into law last year to extend and ensure continued access for claimants. Mechanisms for professional fund oversight and identification for fraudulent claims are rigorous. In the current medical crisis, exposure information and claims could be verified through hospitals and health systems.

The Centers for Disease Control and Prevention estimates that more than 9,200 health care workers have been infected with COVID-19. Of this number, thought to be a substantial underestimate, 60 percent reported having contact with a COVID-19 patient in the health care setting within the prior two weeks. Among these, there were at least 184 intensive care admissions and 27 deaths. The Minnesota state health department reports up to 28 percent of COVID-19 cases are health care workers. In Ohio, early this week, 18 percent of health care workers were infected. In Massachusetts, more than 6,500 front-line health care workers have jobs that put them at increased risk of exposure, and over 1,600 hospital workers have tested positive for COVID-19. In Italy, over 130 doctors, nurses and nurses aides are dead so far. These numbers reflect limited testing and are rising by the day. While not all cases are necessarily acquired on the job, health care workers are at increased risk, with more severe cases, due to close, prolonged proximity to greater concentrations of the virus.

There is also a compelling case for forgiving remaining medical educational debt for those who die fighting this scourge, especially for those who had barely begun to practice. Legislation should be introduced to guarantee this. The average medical student debt exceeds $200,000; the average nursing school debt is approximately $20,000.

The total amount of funding would be justified, consonant with analogous funding for the fallen heroes of other national disasters, and would not be prohibitive, even with the present economic losses, alongside the government-allocated COVID-19 stimulus/support funds. (It should be noted that the other funds to be allocated for hospitals and medical systems are to mitigate tremendous operating losses for the hospitals and to allow them to survive and continue to battle the pandemic.)

It is the least we can do to honor, compensate, and remember fallen health care workers, and their families. It would bring at least some peace of mind to those who are bravely coming into the hospital for their shifts, being called on to possibly make the ultimate sacrifice on our behalf as this historic plague spreads across our nation.

Dr. David Silbersweig is chairman of the department of psychiatry and codirector of the Center for the Neurosciences at Brigham and Women’s Hospital and Stanly Cobb Professor of Psychiatry at Harvard Medical School.