U.S. Congress Steps Up Oversight of COVID-19 Response
Through a series of recent hearings, the United States Congress delved into the federal government’s response to the COVID-19 pandemic. This series of congressional hearings examined the current outbreak across several committee jurisdictions, asking important questions about preparation, response and what can be done to better prepare for future pandemics.
Senate HELP: COVID-19 Lessons Learned to Prepare for the Next Pandemic
Senate HELP Committee Chairman Sen. Lamar Alexander, R-TN, released a paper titled “Preparing for the Next Pandemic” — a white paper with five recommendations to address future pandemics based on lessons learned from COVID-19 and past pandemic planning. “In this internet age, attention spans are short. Even with an event as significant as COVID-19, memories fade and attention moves quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for the next pandemic.”
This white paper led to the formal Senate hearing discussing topics within the white paper and analysis of the federal response to the current pandemic. Alexander began the hearing by asking what manufacturing capacity the federal government should have on hand. Witnesses agreed that the U.S. did not adequately maintain manufacturing capabilities prior to the public health emergency and that annual appropriations, even mandatory appropriations, are needed to ensure swift action.
It was also agreed that public-private partnerships must be utilized to leverage federal funds with private sector innovation to meet the growing demand for vaccines. Currently, most vaccine manufacturing is targeted toward influenza with only a few large manufacturing plants holding the capacity to expand production. In response, the federal government must ensure emergency capacity build-up for an eventual COVID-19 vaccine. To do so, the federal government can encourage domestic manufacturing and other upstream developments such as procurement with targeted tax incentives or increased support of the Strategic National Stockpile (SNS). The federal government must also take a leadership role in developing a disbursement plan once a vaccine is developed.
The next hot-button topic of the discussion was the role of the federal government and current progress made by the Biomedical Advanced Research and Development Authority (BARDA). It was mutually agreed that the private sector is good at leveraging resources and creating efficient use of federal funds. Witness Dr. Julie Gerberding stated that public-private partnerships are needed but more coordination is needed between BARDA and innovators. Dr. Gerberding also stated that more transparency is needed to raise public confidence of eventual vaccines because of operation Warp Speed and that the National Academy of Medicine should monitor BARDA’s activities. A recent survey reported that a majority of people are cautious of an eventual COVID-19 vaccine given the expedited timeline and safety concerns. The mumps vaccine is considered the fastest-approved vaccine ever, taking approximately four years from collecting viral samples to licensing.
A number of senators also called for greater coordination of BARDA with the Coalition for Epidemic Preparedness Innovations (CEPI). CEPI was continually stated as a successful model of innovation, with both Dr. Gerberding and Sen. Murphy stating that the U.S. should partner with CEPI. Sen. Patty Murray, D-WA, believes that any reform within vaccine manufacturing capabilities should include more coordination with the CEPI model.
House Energy & Commerce Committee: Oversight of The Trump Administration’s Response to the COVID-19 Pandemic
Following controversial statements from President Donald Trump as the U.S. faces coronavirus increases in many states, on June 23, 2020, the House Energy and Commerce Committee hosted a marathon five-and-a-half-hour hearing on the "Oversight of the Trump Administration's Response to the COVID-19 Pandemic." This hearing featured testimony from Dr. Anthony Fauci (Director of the National Institute for Allergy and Infectious Diseases), Admiral Brett Giroir, M.D. (Assistant Secretary for Health), Dr. Stephen Hahn (FDA Commissioner) and Dr. Robert Redfield (Director of the CDC).
This was a politically fraught hearing, as states struggle with reopening their economies while attempting to keep cases down. Committee members on both sides acknowledged that COVID-19 has wreaked havoc on the nation and that mitigating a second wave of infections is critical. However, there was staunch disagreement between the parties on the Trump Administration’s response, as Democrats claimed a sluggish response and lack of administration leadership exacerbated the effects of COVID-19, while Republicans argued that the administration has done well in coordinating with other entities, using the president's authority to tighten borders, creating a COVID-19 task force, and protecting the country in the face of this emergency.
As the hearing went on, some major themes emerged from the discussion:
Testing — Witnesses were asked about the president’s comments regarding his asking staff to slow down testing. All stated that none of them have been asked to do so, emphasizing that testing has increased and that all are committed to increase access to testing.
Vaccines — Given the urgency of the COVID-19 pandemic, people are clamoring for an effective vaccine to be released quickly. Dr. Fauci noted that the creation of a vaccine will be a hallmark of the country’s containment of the coronavirus and that he is cautiously optimistic that a vaccine could be available by the end of 2020.
Reopening and Case Spikes — Dr. Fauci stated that the next few weeks will be critical in finding ways to address what he described as “a disturbing surge of infections.” He noted that the country is a mixed bag — some areas have done very well to follow guidelines and lower cases while other areas are seeing an increase. He commented that the best way to address these surges is to identify and contract trace cases to reduce community spread.
Second Wave — As states reopen, they have simultaneously begun to prepare for a potential deadly second wave of COVID-19 coming in the fall. Dr. Redfield urged Americans to get the flu shot in order to prevent the second wave hitting at the same time as a flu epidemic. All witnesses also mentioned the importance of consistent congressional funding to be able to properly prepare for these outbreaks.
Senate Homeland Security & Government Affairs Committee: The Role of The Strategic National Stockpile in Pandemic Response
U.S. Senate Chairman Ron Johnson, R-WI, and Ranking Member Gary Peters, D-MI, held a hearing focused on gaining clarity as to the role and intent of the SNS. The pandemic exposed the fragility of the nation’s preparedness and capacity to secure and stock crucial medical protective equipment, testing and vaccines. Though established nearly two decades ago in 2002, there continues to be confusion as to the intention, accountability, and role of SNS. The lead agency has shifted between HHS and DHS numerous times with varying levels of use from bioterrorism, to all hazards, to infectious disease.
Amid the COVID-19 pandemic, SNS supplies were depleted within weeks, leaving states scrambling to effectively respond to the public health emergency. As a result, Congress played catch-up by passing multiple supplemental emergency appropriation bills to rebuild the SNS and provide some stability. All panelists agreed that to move ahead, Congress must examine the stockpile constantly, develop a national strategic supply chain that is not dependent on foreign manufacturers, increase public health funding, develop a vaccine distribution system, and reestablish U.S. leadership in global preparedness.
One panelist emphasized that beyond funding the SNS, strategically mapping its operations and supply chain are keys to ensuring that it is adequately stocked with materials that have the cross-cutting ability to be utilized for a multitude of emergencies. There is an increasing need to stop relying on foreign manufacturers to provide medical supplies and to leverage the private sector to bring manufacturing back to the U.S., decreasing foreign dependency. Coordinating effectively between local and state jurisdictions and the federal government was a resounding need highlighted by both panelists and senators.
House Ways & Means: Health Subcommittee: Examining the COVID-19 Nursing Home Crisis
On Thursday, June 25, the Health Subcommittee of the House Committee on Ways and Means held a hearing titled “Examining the COVID-19 Nursing Home Crisis” led by Chairman Lloyd Doggett, D-TX, and Ranking Member Devin Nunes, R-CA.
The hearing was, at times, contentious. Democrats focused their attention on Trump Administration missteps and poor working conditions for nursing home staff, while subcommittee Republicans drew attention to the decision by some state governors to direct nursing homes to keep accepting patients even if they had been treated for COVID-19. There was some agreement, however, that nursing homes and other long-term care facilities need more personal protective equipment (PPE) and COVID-19 tests. The subcommittee also discussed what can be done to permit family members to visit relatives in nursing homes given the detrimental effects of social isolation.
House Committee on Education and Labor: Inequities Exposed — How COVID-19 Widened Racial Inequities in Education, Health and the Workforce
On Monday, June 22, the House Committee on Education and Labor held a hearing titled “Inequities Exposed — How COVID-19 Widened Racial Inequities in Education, Health and the Workforce,” led by Chairman Bobby Scott, D-VA, and Ranking Member Virginia Foxx, R-NC. This hearing was the latest in a series of House hearings on COVID-19 and racial inequities that have taken place in recent weeks.
Topics discussed in the hearing included racial disparities in the makeup of the essential workforce, the detrimental effects of segregated housing and schools, university admissions practices, and the negative economic and educational effects of the pandemic. Committee Democrats pushed for additional federal aid to states and local governments, including schools, while committee Republicans emphasized the need to restart the economy, pointing out that people of color have borne the brunt of economic shutdowns. Republicans also focused on the high infection and mortality rates in nursing homes and long-term care facilities.