Transcripts For CSPAN Hearing On Coronavirus Air Travel 20240713

About how the outbreak is affecting the Aviation Industry and travelers. This is two hours and 10 minutes. This hearing is called to order. On december 30th, 2019, dr. Lee wang young, a 34yearold ophthalmologist at wuhan central hospital, took to a group chat he was in with some friends from medical school to discuss a sarslike illness that had recently been sickening people around the city. He posted a snippet of a lab analysis that had found sars coronavirus, an extensive and extensive bacteria colonies, in a patients airways and says this new illness had even led his hospital to quarantine some patients in the emergency department. So frightening, a member of the group chat replied, is sars coming again . Suffice it to say the Chinese Communist government, which like all authoritarian regimes, is often more concerned about protecting its image than the life and safety of its citizens, was not pleased. And even as dedicated Public Health experts scrambled to warn each other, and collect more information on what was happening, chinas Security Services were busy trying to stop it. In probably the starkest example, on january 1st, the Wuhan Public Security bureau summoned eight doctors, including dr. Wengyoung, for posting and spreading rumors about wuhans hospital receiving sarslike cases. While dr. Wengyoung was eventually released two days later, that wasnt before he was forced by police to sign statements acknowledging that his warnings had been illegal behavior. Meanwhile, even as the city of wuhan and the nation of china were getting sicker and sicker, business as usual didnt stop. Community event, political parades, public gatherings, and global commerce, including most importantly, for this hearing on global aviation, continued. Allowing this virus to spread first within the city of wuha number, and then within, wuhan and then within the rest of china and then finally out to the rest of world. At 2 58 a. M. , on february 7th, in the city of wuhan doctor wengyoung died from the very virus he had tried to warn about. A virus which as of today has infected almost 95,000 men, women and children. Across the globe. Including right here in the United States. And has killed more than 3,200 people, including nine who are in senator campbells home state of washington. What we now know is that the virus dr. Wengyoung and others were warning about, and the virus that took his life, wasnt sars. But it was similar. Its the Novel Coronavirus now known as covid19. The spread of this virus across the globe has had and continues to have tremendous and farreaching impacts. Commerce has slowed. Faith in government has been shaken. And people are understandably scared. This virus was also called into real question, has also called into real question the efficacy of International Organizations like the World Health Organization, and the icao, both of which we reached out to participate in this hearing, but both of which either declined to participate or didnt respond. The icao, the International Civil aviation organization, for instance, excluded taiwan from its information sharing regarding the virus. This despite the fact that viruses like this as sars showed us, spread overwhelmingly by air travel, and taiwan has the 11th Busiest Airport in the world. The w. H. O. , for its part, has praised in every turn the response of the Chinese Communist government, despite the mountain of evidence showing that they played down the seriousness of the virus, and the extent of the spread for more than a month. These organizations arent going to look out for the broader global interests, and are going to instead praise authoritarian regimes, and it begs the question, if it is time to reevaluate our participation, or at the very least to make a concerted effort to push reforms. Covid19 is a real and serious challenge. And we need cool heads and factbased decisions. Not panic. Not hysteria. Unfortunately, some in the media, whether intentionally or not, seem to be inciting panic in americans over the virus. That is a large part of the reason why we convened these hearings. To give the American Public the opportunity to hear straight from officials on the front lines without spin or partisan bias. So heres what we know. This is a rapidlychanging situation. Every day, and on some days every hour, were learning more about the virus, where it has spread, and how the human body responds. So far, the mortality rate has been around 3 . And most of the deaths have been in the elderly. And those with Underlying Health conditions. The virus appears more transmissible than a typical seasonal flu, but so far, reports indicate the vast majority of cases are moderate to mild, requiring little to no medical attention. Early on, the administration acted, and acted swiftly, to limit travel to and from the affected regions. And to quarantine americans that had been to those regions. And to deny entry to foreign nationals, from those regions. This was the right thing to do. And those actions have proven critical for slowing the spread of the virus to the United States and its bought us additional time to prepare. But now the virus is here. And its spreading. And we must be ready for the fight ahead. There is more that can be done. There is more that should be done. Communication between agencies and municipalities is vital to containing the spread of the virus. In san antonio, communication was lacking. And a patient was released from Lackland Air Force base prior to testing positive. After testing positive, the patient was returned to quarantine, as and is currently under the supervision of the cdc. I urge the cdc to stay vigilant in keeping lines of Communications Open with all localities, to ensure the safety of the Public Health in texas, and all across the United States. We must do everything we can to marshal every resource necessary to protect the safety and lives of americans. So i look forward to hearing about the facts. I look forward to hearing about the message science. I look forward to hearing about what we know, what were doing, and what more we can and should be doing. And with that, i recognize senator sinema for her opening. Thank you, chairman cruz and thank you you to our witnesses for your efforts to protect americans from Infectious Diseases like the coronavirus. While not testifying today, i would like to acknowledge the efforts of our u. S. Air carriers and the transportation center, in the face of the Public Health crisis, we must Work Together, to share the burden of keeping americans safe both here and abroad, from a potential global pandemic. Todays hearing will focus on the current systems in place to collect contact data from travellers entering into the United States and to close gaps where they may exist. We need a timely and orderly way for travelers to input detailed Contact Information, based on criteria the cdc has outlined. I spoke with Vice President pence yesterday about an opportunity to quickly develop and implement a method to collect this information and sent him a followup letter this morning. Our Public Health officials need to ensure that we have a direct link to travelers, and to eliminate gaps that allow travelers to enter the United States without Public Health officials being able to reach them, in the case of the potential risk or exposure. I represent arizona. We have confirmed coronavirus cases. Its critical that Congress Pass a bicameral and bipartisan supplemental package that devotes necessary resources to developing vaccines and treatments, that reimburses states and local governments, and that ensures the safety of our front line workers, our seniors, and our vulnerable populations who are most at risk. Although we do not yet know the longterm impacts of coronavirus, theism impact weve seen thus far calls for action now, to protect and to reassure the public. As the situation continues to evolve, the government must continue to Work Together, we must coordinate with states and communicate with our industry partners. I look forward to hearing todays testimonies and mr. Chairman, i yield back. Thank you, senator sinnem averaged ayou recognize senator kcantwell, the ranching member of the, Ranking Member of the committee. Of the full committee. Thank you for holding one of the most i consider most important subcommittee meetings we could possibly ever. Have i want to take a moment to send my deepest sympathies to the people of Washington State to the families who lost lovd ones and the Health Care Workers who are working diligently in this epidemic. We are working hard in the state of washington but even the numbers continue to increase. We now have ten people who have died from the coronavirus. And we now have 239 confirmed cases. 231 people are being monitored by Public Health officials, and weve had schools and businesses, and even the federal facility that have been shut down temporarily as more people have been detected as possibly being exposed to the coronavirus. All the while, people are experiencing symptoms, and yet, not getting tested. This is the main focus i believe we need to communicate today. And we need to have a robust testing regime, all academic and commercial facilities, across the United States, participating in a testing process. This will give us better information and it will give us more information about the spread, the Community Spread of this disease. Until last friday, those suspected of covid19 in my state were required to have their test sent to the cdc to obtain results, and now since the update, the fdas actions on saturday, last saturday, we will be able to run more aggressive tests. But i still think were only at a few hundred tests per day in the state of washington. We need to be in the thousands, if not more. So i hope that we will get this right for the future of other states who are going to deal with this dilemma, and figure out how to have a clarion call to all labs to please, please develop these test kits, in compliance, but get the kits developed, and do the testing, because people are calling with what they think are symptoms, and they want to be able to be tested. I think that todays hearing today is a perfect example of why that is so important. We now have 14 states that have confirmed cases, and one of the persons is a woman, is a person from north carolina, who tested positive after visiting the nursing home in Washington State, that has been the subject of so much attention, and then traveled home to north carolina, on a plane. This underscores the importance of making sure the aviation sector is also prepared and how we mitigate the impacts of virus spread. After all, there are more than 44,000 flights, in this country, every day, and more than 2. 7 Million People fly in and out of our u. S. Airports. We have just sent a letter to the major airlines, and airports, asking them for their plans to meet this challenge. Further guidance, i think, hopefully, well hear today, on how we can keep the flying public safe. The airports, and the airlines, in the spirit of cooperation, need to understand measures that can be taken to help us in dealing with the coronavirus, and they should not be left wondering from the federal government what they should be doing, we should be very clear about what measures we can take, or what measures we should take, to help keep the flying public safe. So i hope the department of transportation and the cdc will shed some light on that here today, in this hearing. I look forward to hearing more about their answers, and mr. Chairman, and Ranking Member coordinating with you, how we can get this information out to the public in a timely fashion. The public wants to do everything they can do, too, but we have to get crisper on our answers about what we should be doing today. Thank you. Thank you, senator cantwell and please know that the people of america, across the country are lifting up in particular Washington State and the families who are grieving the loss of their loved ones. And i hope we will continue to see bipartisan cooperation to marshal all of the resources that are necessary to combat this virus, and to do Everything Possible to prevent any more loss of. Let me introduce the witnesses we have today. Mr. Joel sabot, the acting undersecretary of policy for the department of transportation. Serving extensively across the department of transportation since the early 2000s. In 2005, he oversaw the u. S. Governments reconstruction of iraqi airports. Ports and railroads. And served as the transportation counselor to the u. S. Embassy in baghdad. He also previously served as Deputy Assistant secretary for transportation policy, and Deputy Assistant secretary for management and budget, at d. O. T. From 2012 to 2018, mr. Sabot served as the executive director of the maritime administration. Most recently in january, mr. Sabot was named to represent the department of transportation in the president s Coronavirus Task force to help coordinate strategy to prevent the spread of the outbreak. He graduated from georgetown university, and Harvard Business school. Rear admiral steven red is the Deputy Director for Public Health science and implementation science at the centers for Disease Control and prevention. In this capacity, dr. Red is responsible for state and local readiness, emergency operations, select agents and toxin, and the nations cache of emergency medical counter measures. Prior to this role, he was the director of the influenza coordination unit and also the Incident Commander for the 2009 h1n1 pandemic response. Dr. Red received his bachelors degree his bachelors degree in history from my alma mater, princeton university, medical degree with honors at the Emery University school of medicine. He trained in medicine at Johns Hopkins hospital and completed the twoyear epidemic Services Training program at the cdc. Our third witness is mr. William bill farrar who is the executive assistant commission for Operations Support at u. S. Customs and Border Protection. Previously mr. Farrarerrara served as acting executive director in Field Support where he was responsible for managing an operating budget of 4. 1 billion as well as providing asset and Logistical Support and customer focused Human Resource solutions for nearly 28,000 employees. From june 2016 to june 2019, mr. Ferrara also served as the director of Field Operations for the boston field office. From november 18 to february 19 he also performed the duties of the department of Homeland Security attache to the united kingdom. He holds an associate of arts dre in business from the Community College of rhode island and is a graduate of the cbp institute and the university of Chicago Booth School of business. Well now recognize mr. Sabat for his testimony. Good afternoon chairman cruise, Ranking Member and distinguished members of the subcommittee. Thank you for inviting me to testify on behalf of the United States department of transportation and secretary chow on efforts to minimize the risk of the spread of covid19 in the United States. On february 26, President Trump appointed Vice President pence to combat the virus. Secretary aczar chairs the task force and i have represented the department of transportation on the task force since its inception on january 21st. The Governments Health professionals have the lead in determining the response to the coronavirus. D. O. T. In a supporting role has and will continue to coordinate daily with aviation stakeholders, foreign counterparts and other federal agencies to manage the risk in the United States. In this capacity, the department of transportation continues to ensure, first, an active air bridge remains in place for the safe return from infected areas for americans in addition to the thousands who have already safely traveled home from overseas. Second difficult, airlines funneling passenger flights to one of 11 designated airports equipped to help screen americans returning from the virusstricken areas. Third, continued air and sea cargo traffic between the United States and china and other countries such as South Carolina and it wli as the virus spread. Fourth, Health Protocols continuing to fly between the United States and foreign locations. Dissemination of Health Messages about the virus for airlines to use to inform their passengers. Our travel restrictions have been remarkably effective first layer of Health Screening of overseas travelers before they return home. These travel requirements delayed the spread of the virus from china to the United States giving the nation precious time to plan for proper mitigation. In the first 25 days since the president s proclamation, only 15 cases were detected within the United States. Our actions ensured that nearly 200,000 americans who were in or recently left china could return to the United States through an air bridge home. The number of passengers traveling from china to the United States has fallen from roughly 15,000 people each day before the Virus Outbreak to fewer than 1,000 each day now. To date over 53,000 incoming passengers have received Health Screening. This achievement took the cooperation of nearly 200 commercial airlines, a like number of overseas airports and the Civil Aviation authority of china. The department is also working closely with our sister federal agencies under the task force. Their expertise and authority were all necessary to accomplish the success. On january 31st, the administration declared that the virus presented a Public Health emergency in the United States. That same day, a president ial proclamation established the framework for our travel restrictions intended to protect the u. S. Public from this Communicable Disease while allowing american nationals to safely travel home. The restrictions first applied to china, subsequently extended to iran and Airport Passenger exit screening has been introduced in italy and south korea with the cooperation of their authorities. To focus the expertise of the medical professionals conducting screening, the secretary of the department of Homeland Security directed all flights inbound to the u. S. Carrying persons who have recently been in china to arrive at one of 11 u. S. Airports. Significant consideration, coordination and analysis among the federal agencies occurred to select those appropriate airports. Prior to and following the president ial proclamation, d. O. T. And interagency partners proactively communicated with air carriers and others in the Aviation Industry. D. O. T. Hosted multiple stakeholder calls with over 475 invited industry participants representing a range of u. S. And foreign carriers, domestic airports, trade associations, unions and other valued partners. As we plan for Community Transmission within the United States, d. O. T. Will coordinate similar efforts with transit stakeholders as part of the whole of government plan which includes the state and local Public Health agencies on the front line of mitigation efforts. One of the lessons we learned from czars sars, covid19 is having the same em pakt on aviation today. Industry analysts estimate the virus will reduce passenger numbers by some 4. 7 to 6 worldwide. The industry is resilient and snaps back quickly. At the peak of sars u. S. Travel halved. Within two months it was back to normal. The federal government and state and local governments are keeping their long prepared Emergency Response plans. The task force was constructed to coordinate the whole of government effort to work through the virus. We will work through it and come out on the other side. Thank you and i look forward to your questions. Mr. Szabat. Admiral redd. Good afternoon, distinguished members of the subcommittee. My name is steven redd, Deputy Director for Public Health service an implementation science, also serving as Senior Health response in the cdc noefl coronavirus response. Thank you for the invitation to testify today on behalf of the u. S. Centers for Disease Control and prevention on the efforts to protect the health and safety from this disease, coronavirus, covid19. This is a new virus and new disease. New information and science continue to accumulate and u. S. Government decisions to respond to this epidemic will continue to be based on that evolving science. Our overriding goal is to protect america from the effects of the virus. Were working to slow its spread into the u. S. And to minimize the impact. The u. S. Governments approach to covid19 is built on years and years of preparing and responding to Infectious Disease emergencies such as sars, mers, ebola an pandemic influenza. A key component of our work is to support state, local, tribal and territorial Public Health departments. This system is the backbone of Public Health and our responses to Public Health emergencies. Up to now more than 1 tho 5,500 cdc staff have been at headquarters and the field. Over the past two months, federal, state and local governments have mobilized to protect the american people. As weve heard globally, we have seen over 90,000 confirmed cases and those have occurred in 85 international jurisdictions. As weve discussed, several countries are currently reporting sustained Community Spread. Cdc with our federal and local partners have instituted multilayered aggressive containment and mitigation measures to slow introduction and spread of the virus into the United States. These Public Health interventions include early case recognition and isolation, identifying and tracking contacts and in some instances implementing Movement Restrictions or quarantine. Weve posted targeted travel warnings for several countries and even for cruise ship travel in asia. So americans can stay informed on proper precautions to take when and if they travel abroad. Measures the u. S. Government has taken include denying entry to the u. S. For certain travelers. This step has reduced the number of people coming into the United States from china by over 90 . Weve also funneled travelers from highly affected countries to 11 airports where weave instituted screening procedures and today weve screened more than 57,000 travelers. As of noon today, cdc reported cases of covid19 from 13 states. We expect the cases will be a mixture of travelrelated cases, cases related to contact and Community Spread cases. Its likely well see some communities more highly affected while others remain virusfree. I want to recognize that people are concerned about this situation as are we. As always, our number one priority is the health and safety of the american people. We appreciate that americans are taking this threat seriously and continuing to seek information about how to be prepared. While the immediate risk to the general American Public is low today, u. S. Government is doing everything we can to keep it low. Risk varies by exposure and some areas of the country are now experiencing Community Spread. I ask you as trusted leaders in your communities to help us with our mission to provide clear information to you and your constituents by urging people to get the facts from cdc about how to best protect themselves and their families. Thank you. Cruz thank you, dr. Redd. Mr. Ferrara. Good afternoon, chairman cruz, Ranking Member sinema, and members of the subcommittee. Thank you for the opportunity to testify on cbps response. U. S. Customs and Border Protection is an integral part of the u. S. Governments response to the virus as our men and women serve at the front line of defense, whether they be land, air or sea. Cbp has been working closely with the department of Homeland Security, centers for Disease Control and prevention and other interagency partners since casetion of the virus and china be gan ginn to increase. Cbp has taken decisive, proactive and preemptive actions to mitigate the threat, minimize risk and slow the spread of the virus. With limited exceptions, all foreign nationals who traveled to china or iran within 14 days are ineligible to enter the United States at this time. Dhs including cbp continues to work very closely with our partners at the cdc throughout all persons in main land chai nah or iran in the last 14 days through the designated ports of entry where the federal government has focused Public Health resources. All flights coming from Mainland China are funneled to one of the 11 it is nated poes. There are no flights from iran. However, all passengers coming from iran are also funneled to one of the 11 poes. Passengers traveling to the United States by air, we work in collaboration with the air carriers and foreign partners to deny the boarding of individuals that would be found inadmissible upon their arrival to the United States. Cbp continues to facilitate cdcs enhanced screening of travelers heading into the United States. Its critical of the u. S. Governments strategy to slow the spread of the virus and protect the american people. All travelers within Mainland China and iran within the last 14 days or exhibit symptoms consistent with covid19 are sent to cdc staff or dhs Contract Personnel for medical evaluation. Travel is identified by cbp officers ding their primary infection. I refer to a secondary screening area. In the secondary screening area dhs cwmd Contract Personnel take the following actions in support of cdc. They verify the screening is required, collect Contact Information for travelers requiring screening as travelers, if they have a fever, cough or difficulty breathing and take and record the travelers temperature. Cwmd is currently supporting enhanced screening with state or local ems, Public Health and First Responders in an overtime capacity. Cwmd established this capacity and response to the ebola virus threat. These actions ensure a trained, vetted and badged workforce was ready to rapidly deploy to support cdc. You dhs was able to use the established capability to quickly address the threat of covid19. At and between all ports of entry, cbp officers and agents continued to remain alert and notify cdc when encountering travelers committing signs of illness. Officers and agents are well trained and use a combination of travel history records, questioning observation and selfdeclarations to identify those requiring additional Health Screening. Cbp also closely works with the u. S. Coast guard to ensure that ships and crews with nexus to china or iran are appropriately identified and screened prior to coming to port. At cbp our employees are our greatest asset. We are taking every precaution to keep our workforce safe especially those that may regularly encounter disease carriers. All of the offices have a 30day supply of personal protective equipment or ppe including does. These are located across all field offices, sectors and air branches. We continue to work to monitor the Global Supply chain impacts and project critical needs for the cbp workforce. On february 5th cbp initiated an analysis that outlines the current comprehensive ppe guidance which includes guidance about wearing mass bs under the appropriate circumstances. Cbp continues to share information with our workforce on an ongoing basis. We are committed to doing all we can to keep our workforce safe as they work to ensure the safety of our nation. Thank you for the opportunity to appear today and i look forward to your questions. Thank you very much to each of the witnesses. Before i begin my questioning, i want to submit three letters for the record without objection. The first is a letter from commissioner john heller stat from the Texas Department of Health Services sent to secretary aczar at the u. S. Department of health and Human Services and others. The second is that letter requested that the cdc submit a written rationale for releasing patients from quarantine at Lackland Air Force base in texas. The second letter is a response from director redfield to commissioner heller stat outlining the procedures for discharging patients. The third letter is a letter i sent along with senators cornyn and mcsally to cbp regarding the possible spread of coronavirus across our border. I want to start my questions with that third letter. I mr. Ferrara, would you please explain how the screening process at the border currently works and how people coming through the 29 land ports of entry in texas are screened . Thank you, sir. At all of our ports of entry, our offices and agents are trained to look for folks that may exhibit signs of illness. Thats something that happens every day of the week in our operations. With particular note of coronavirus, covid19, we have issued guidance to our officers to ask certain questions about travel, particularly if folks are coming from china, now iran is included in that. We do we are questioned, check travel documentations and other information to try to see if, in fact, that person has traveled to those two areas. If they, in fact, have, the cdc is available at the area, we work directly with them. If not, we have our reachback and use our Public Health officials, local Public Health officials that we have relationships with to come to the proper conclusion. So does cbp plan to work with cdc medical staff in the future to heighten the level of screening performed at those points of entry . We currently work now with the cdc and follow the medical gietd dance that cdc provides. That interaction is continually happening, sir. Chairman cruz dr. Redd, let me ask some specifics about what we know of this virus. Right now what is the overall case fatality ratio for covid19 . Dr. Redd theres a number that i could give you, but i would like to say that, as more cases occur and we gain more experience, that number is likely to change. Theres been a lot of questions both about the detection of the numerator, the cases that have died and also whether all the cases that have infection with this disease have been identified. Thats particularly true in china where the case fatality rates have been in general a little higher than seen in the rest of the world. So i would encourage us to look to answer that question and look for cases that have been reported in other countries and theres spread and kind of a cleaner set of information. With the understanding that information is still growing and theres a great deal unknown, what is cdcs best estimate of the fatality rate . Its probably somewhere between today i would say between. 5 and 1 . And just to give you a frame of reference, seasonal influenza is about 1 in 1,000. So all of those estimates are higher than seasonal influenza today. Chairman cruz ok, that number differs from the estimate from the World Health Organization. What explains that . Dr. Redd i think that number probably includes information from china where the theres a question of whether all the less severe cases have been counted. I think this is something that, as more cases occur in china, were likely to see that percentage decline. I think its stay tuned. What we know now is its substantially more severe than seasonal influenza. How contagious is covid19 and in particular whats the predicted or not. If you would explain what that means as well. Sure. The way we assess transmissibility is how many cases occur from one case. How many additional cases can be the downstream cases. Seasonal influenza is usually somewhere between a little more than one and 1 1 2 new cases generated from a single case. For the information that we have right now for the Novel Coronavirus its probably between 2 and 3 or 2. 5 and 3. 5. That number is largely based on the experience in china. The elements of that what determines what it is, that number of new cases, has to do with the virus, has to do with susceptibility of people who might be exposed to the virus, and it has to do with the context. So situations where theres a lot of crowding, you might expect to see a higher r not than a place that had less crowding. This is a number, also, were going to be following, i would say theres been a little less variability in that particular number than there has been in the mortality. Now, reports are coming from china that indicated the incubation period can be up to 24 days. That differs from the 14day protocol releasing patients from quarantine. Can you speak to the accuracy of that report . Dr. Redd thats one report. I think thats a key question. I think its going to be important to monitor that. We have not seen secondary cases after people have gone through that 14day incubation period. I think our preliminary indication was that actually the incubation period for this virus was a little shorter on average that mers or sars, two other coronaviruses that can cause severe disease in humans. I think this is something that provides some margin of safety between the average. I think its something were going to have to continue to follow and well adjust as new information becomes available. Chairman cruz so, dr. Redd, are there common sense and reasonable precautions that americans at home should be taking now if youre concerned about your health and safety and your familys health and safety . Dr. Redd absolutely. And i think this is an opportunity as i include in my statement, if you can help us with this, that would be terrific. Theyre really things we do to prevent respiratory infections in general. Hand washing, covering coughs. If youre sick with respiratory illness, stay home. That can be a hard thing to do. I think in this circumstance its even more important than it is on a usual basis. Lastly, its really important for people to stay informed, that the information is changing so quickly that, if you know something at the beginning of the week, it could be different at the end of the week. I think particularly areas where the disease has been identified is something thats been changing quite rapidly. Chairman cruz thank you. Senator sinema . Supposed cinema supposed n. Sinema thank you, mr. Chairman. My first question is to mr. Ferrara and acting undersecretary szabat. Its my understanding it didi that passengers can choo choose to not provide complete data. Id like to ask unanimous consent to enter into the record a letter for airlines through america sent to the department of health and Human Services outlining suggestions to overcome this gap by having the federal agency set up a Single Online web forum for all Inbound International passengers. That would be by sea, land or air. Mr. Chairman, if theres no objection, id like to ask that that be entered into the record. A Single Online web form would allow the cdc to directly collect information from passengers and provide for a more complete, accurate and timely collection of data. My question to you two gentlemen is what discussions have there been between department of drpgs, u. S. Customs and Border Protection and cdc with the concerns these airlines have raised from a Public Health perspective, would compliance be improved if all travelers were directed to some single portal. If so, what funding or Additional Authority would be needed for congress to create such a system rapidly . Senator. Thank you for the question and your interest in this area. Like you, i want to tip my hat to those in the airline, the Aviation Industry and the association that have really stepped forward to offer Common Sense Solutions to the challenge that we have. As you mentioned, this is a real need that we have within the federal government as travelers are coming to the United States. Wet want to be able to Contact Trace them so that, if it turns out somebody who comes in is ill, we can reach back and find out who else theyve been in contact with. Previously, the information that has been gathered that we can collect directly from the industry only has about 20, 25 accuracy. Youve alluded to the fact that much of this information comes through travel agents which are not directly affected by the information thats provided by the air carriers themselves. So we have been working i would say multiple times daily, communications among the agencies and with the association trying to work through the technological difficulties of getting to the ultimate goal of this rule that has been put out which the carriers have said will take six to 12 months to comply with. So we dont want to wait six to 12 months to get that data. We have an interim system that the carrier has been kind enough to work with us right now, paperwork based on the travelers coming in. That works well given the small number of passengers we have arriving right now. Down to fewer than 1,000 a day, coming in mostly from china. With that, the system we have now coffers that, but its not scaleable with the concerns of adding more countries to the travel. We think the proposal the carriers put forward is definitely worth looking at. The challenge we have is a technical one of how well we work it within the various i. T. Databases of the federal and government agencies. We provide all the information we have in our systems to cdc via the airlines. As the undersecretary mentioned, its not complete for the cdc purposes. What weve done is a stopgap working with cwmd, the contractors. Were manually putting those into computers directly at those 11 airports. To the first part of your question, we have participated. Its an all of government effort to speak with the Airline Industry. This Data Exchange is a constant conversation, not just for this particular issue. So there are a lot of the right people working in getting through, but there are some challenges. Sen. Sinema if youd like to respond as well. Well, i think that at the moment were trying to make the system that we have work, but its clear that we need a better system, just as a small example of how were working together when customs and Border Protection people didnt have computers to enter the data, we were able to provide those from cdc so we could facilitate that entry. Yesterday i had an opportunity to speak with Vice President pence. As i mentioned in my Opening Statement, i followed up with a letter to him this morning. My understanding is theres a Web Developer who has the Technology Available to develop an app similar to the mobile passport app. It could be done as quickly as two to four weeks. Of course, the technical challenge is how do we get that across our institutions and deploy it . I believe that provides a real opportunity for us to address this Contact Tracing issue in a matter of several weeks rather than six to 12 months. Thats something i hope we can Work Together on and consider how to implement that quickly. Like the question i asked earlier, the collaboration between the Transportation Industry and the government is incredibly important, but pharmaceutical manufacturers are also currently leading the way in developing both a vaccine and developing a plasmabased treatment. Companies like johnson and john and developing a plasmabased treatment. Companies like johnson merck, many others, are collaborating through the research and Development Authority as well as other Public Health entities. Theres been conflicting information coming from different parts of the administration on the timeline for not just the development but the implementation of a vaccine for ordinary americans to access, and that is unacceptable. So my question for you, dr. Redd, is the cdc engaged with these biomedical and facial suit cal companies both in the development of a vaccine and in development of treatment of those experiencing illness when one has been approved for use for either vaccine or treatment, how will the cdc work with others to deploy it amongst our transportation, border and Health Personnel who, of course, are at increased risk for exposure because of the roles in keeping the broader public safe . Dr. Redd thank you, senator. I appreciate the last part of your question because i think thats where i can speak most directly. The nih and the Biomedical Advanced Research and Development Authority are the main parts of the department that are working on the both the basic development and the advanced development to get a product that could be approved. I think that the example of the work that we did in h1n1 influenza, that would be what i would foresee. Its going to be a while before we have a vaccine that meets a vaccine and probably a treatment as well. In h1n1 the government procured the vaccine, aid for the distribution and that was essentially a governmentrun program quite similar and actually built on the vaccines for childrens backbone for a product that wasnt licensed at the time. We didnt procure it, but we managed the distribution of a drug called peramavere used to treat influenza. I would envision that kind of a system. The first part of your system, the key was to get a product that is safe and effective. Thank you. Thank you, mr. Chairman. Chairman cruz thank you. Just to underscore senator sinemas first question, my understanding is the airlines have offered to contract with a Third Party Vendor and to cover the cost themselves to stand up, a website and or a secure mobile app they believe could be stood up within two weeks to gather the information that i understand cdc is requesting. Do each of the three of you think thats a good idea . Short answer, senator, yes, its a good idea. We welcome the fact they reached out and made this proposal. Our challenge this end and were working this as hard and fast as we can, is it technologically feasible. If we can, thats a great solution that gets us from the temporary solution were working with now and not having to wait six to 12 months for permanent solution. The way the system is devised right now, cdc receives the information from customs and Border Protection. However, that information, if its of high quality and complete, would be great. If its technologically possible and it meets all the different security standards, i think it would be a great opportunity to look into it. Thank you. Senator gardner. Thank you, mr. Chairman. Thank you all for your work on this. Obviously very critical. I want to thank our Public Health officials in colorado for the work theyve been doing and the governor of colorado for the work hes been doing to make sure we have a 50state approach that protects our people as i know youre fighting each and every day for. So thank you. What steps has the cdc taken to coordinate with foreign governments to verify their screenings and Public Health protocols abide by u. S. Standards specifically when traveling from hot spots like south korea and italy . Were in very close contact, particularly with the state department and department of defense in korea. My understanding is both korea and italy have instituted exit screening to identify persons who might deal with coronavirus. I think this is really an ongoing global effort. Were also working with the World Health Organization. Our work theres two parts to that. One is in places where we have staff, weve able to directly interface. Thats true in korea, not true in italy. Its true in china, not in iran. Does it make sense to provide to test everyone who comes in from countries of higher concern, 100 testing . I think the problem with that would be similar to the symptom screening, that a person could be incubating the disease and have a negative test and later they develop symptoms or maybe not develop symptoms and actually have the virus. When there are questions regarding how to abide by the cdc ifr and best protect passenger and employees health and prevent the spread of covid19, does the cdc have a person, a single individual prepared to serve as a point of contact for those questions . What weve done, and this is part of the rule making process. That rule is out for comment. There is a way to provide comments to that rule where examining we have no expedited procedure to appoint one person who can answer these questions . Theyre actually multiple people that are reviewing that. Reviewing the rule or reviewing whether or not we can appoint one person to answer questions. Reviewing the comments being submitted. So right now if United Airlines needed to call somebody, there is no one person point of contact . There is not. There would be theres a joint thats a problem. Email address. It gets better coverage than a Single Person would provide. In effect theres a place depends also on what the issue is. If its about the final rule how long does this interim final rule take . Dr. Redd it really i think there is that interim final rule will be it will be continued until the Public Health emergency is over or until theres thats in effect now or were waiting for Public Comment. Dr. Redd the rule is open for Public Comment now. Sen. Gardner when does it go into effect . Dr. Redd the interim final rule is the part that makes it interim has gone into effect already. Thats this process sen. Gardner so youre able to operate under this as it is. Thank you. Dr. Redd correct. Has the cdc provided updated sen. Gardner guidance to states on when to test for covid19 in light of Community Spread . Dr. Redd yes, sir. In fact, when i was when we were coming over here in the taxi, there was a news report that thats been released, essentially giving broader discretion to clinicians care caring for patients to get testing done rapidly. That was put into effect today. Sybil gardner sen. Gardner do you have a national or International Standards that govern airline precautions, disinfection protocols, should an Airline Employee test positive for covid19 . Dr. Redd we have guidance. I think the rules about that i might defer to my colleague about the standards. We do have guidance thats posted specificallyfor covid19 on aircraft equipment issues. But there are also International Regulations which i might turn to my colleague senator, are you asking about the standards that we have for how we disinfect the aircraft or about Health Standards, ppe for the crews . Sen. Gardner both. How we make sure the airplane itself is safe and how we make sure the crew is safe. Sec. Szabat several different measures. Because we made a conscious decision. We issued the 212f, travel restrictions with china, not to take down all flights. We still continue to have passenger flights taking passengers back from china. We want to put in place vigorous crew Health Protocols for passenger and cargo planes that are flying back. Those differ in terms of whether they can leave the aircraft or airport facility and their contact with other people and the amount of everything from washing their hands to the types of protective gear that they wear depending on whether or not theyre china based. In other words, living in china or flying out of china or coming, staying briefly in china, turning around and come back. Im out of time and i think it follows up on what senator sim sinema said. We have no way to contact a person on the plane with someone who may test positive for coronavirus . Half true. Before we put in those interim measures, our Contract Tracing was about 20, 25 . With the sber rim measures we have in place now at the f11 airports that mr. Ferrara was referring to, right now according to dhs, theyre at 94 to 96 accuracy with that Contact Tracing information. Chairman. Id like to amend my answer. The guidance for cleaning, were expecting to be cleared today or very shortly. We actually dont have guidance up today. I wanted to correct what i told you earlier. I hope that gets approved immediately. Thank you. Thank you, senator gardner. Ill note for the record that while after this hearing commenced, the news broke that we now have the 11th fatalityin the United States from california, so the first thats occurred outside Washington State. Senator cantwell. Thank you, mr. Chairman. Id like to cover a couple of things. Were trying to do a supplemental to get more funds out to the states for Public Health. Well hopefully vote on this before the end of this week, 7. 8 billion. I think theres 11. 5 million that would be a grant to Washington State for Public Health. Do you think some of that money could be used to Better Direct the public towards the testing regime . Right now, were being very broad. Were saying, if you suspect something, yes, call these various entities. And then people are calling their doctors saying we dont doctors, and they are saying we dont have that, and you have to go over here. And then they call them, and theyre like, no. Can we use some of the dollars youre going to get to be crisper about how to go about the testing . If you want a protocol that says you have to call your physician first, lets clearly state that. Lets be clear about how many tests a day that were able to do and how we create a system for that. Does that make sense . It does make sense. I think some of that money certainly will be used for communication activities. I think that clarifying that guidance on who should be tested and can be tested will be an important part of that. Its also likely to change over time, as has already occurred. Thats why i think if you create this site and create Accurate Information for people, then you wont have the anxieties of people saying, i feel sick, i have this going on, and i cant get a test. We want to alleviate that. I hope that some of those dollars can be used for that. Another thing i would hope you would advocate for is, so seattle flu study was a research institution, everybody working collaboratively to study and analyze flu results. Obviously, you had to consent to be in that. Thats how we caught the one student. Individual food and individual student thought they were sick with the flu, and three days later, four days later, when we finally changed the protocol for who could get tested, they tested positive. So now i think the university of washington has changed that, so that it also coffers covid19. Every city in america should be doing this. Everybody should have a flu covid19 irb, a research analysis, and the reason its important is so we can see this interplay between those who think they just have the flu, and so we can track the genetics of where this is going. Now we find its all related to the washington one case. This is finding out how Community Spread works. Can we also do that . Yes, maam. Actually, were i believe today there will be the collection specimens in several jurisdictions with additional jurisdictions through the week with a plan to build out a system that would be much broader really to all the reasons you said in addition. Mh broader really to all the reasons you said in addition. Every city in america could start this now. Theyd have it in place and they have to get the agreement and have to get the information. They can put flu information in this. Yes. This is really being built on flu surveillance to add Novel Coronavirus so that communities will know if the virus is in their community and would be able to have an estimate of the its not there, whats the certainty that it isnt there. I think it will help. Im glad the university of washington got this done. Now, for the airplane which our colleagues were just asking about, how long can virus material last on a surface . The virus can last hours to a day. Thats the estimate similar to other coronaviruses. Up to a whole day . Yes, maam. Up to a whole day. Ive not heard that before. Im glad youre clarifying that. Different surfaces have different weve heard the generalization before, and i think thats what is sometimes confusing. So up to a day. So now what do we need to do for our airplanes given that . Thats going to be in the guidance that we hope is released very shortly. Theres really the health side of that guidance which will be released and then the issue that we addressed in the earlier question. Mr. Szabat, do you want to comment on this . People are concerned about the obvious individuals and being able to contact them. People want to understand what is our plan, the department of transportations plan to communicate if the virus can be alive on a surface for a whole day, what kind of precautions do we need to take on our air surfaces . Thank you, senator, for the question. This is a whole of government effort. Department of transportation authority, its really safety of flight. We are in consultation with cdc, the other agencies and osha and niash which developed the standards for individuals on the airplanes. Our focus is to ensure that the mix of chemicals and other treatments do not actually harm the aircraft itself. Are you saying you dont have the authority to set the standard . Were saying that Health Standard is by design not our authority. Whose authority is it . Is it cdcs or is it the information wed have would be guidance. It wouldnt be wouldnt have Statutory Authority is my understanding. And my understanding again, im not the medical person on this panel, but much of the authority runs with osha which is not on the panel here, and we are in discussions with osha on developing these standards. Ok. Thank you for having the hearing, mr. Chairman. I think this is something we need to tackle right away. We need to understand what we are saying to the flying public about what the airline should be doing, what we should be doing to create the best and most positive environment for air transportation to continue. As you said, mr. Szabat, were going to want your transportation and we want it to be done. Lets get this protocol clearly established. Lets Work Together, get it established. Thank you, mr. Chairman. Chairman. Thank you. And to underscore senator canned wells point, if there are authorities needed to keep the flying public safe, let Congress Know immediately and we will create whatever authorities are needed because the priority needs to be public safety. Senator lee. Sen. Lee thank you, mr. Chairman. Thanks to all of you for being here and the insight youve provided. Congress is preparing to consider supplemental funding to several agencies to respond to the coronaVirus Outbreak. Two weeks ago the Trump Administration requested 1. 25 billion in new funding from congress for various response efforts. Id like to ask each of you to just respond briefly to share how your agency would plan to use supplemental funding and also to respond to a related question regarding assuming the administrations request reflected the needs of agencies that respond, if Congress Gives you substantially more than what the administration asked for or what you asked for, do you have a plan to responsibly spend all of it, and what would that look like . Well start with you mr. Ferrara. Thank you, sir. Currently based on the current threat and projected threat, cbp has what we need to do our job. Should things change working with the interagency and that threat vector change, we would certainly inform on our resource needs. You have what you need right now without a supplemental . Yes, sir. Yes, sir. Dr. Redd. Yes. We would use the funds, substantial amount of those funds would go to state and local Health Departments to do the work thats being done right now on identifying cases, testing those cases in their laboratories, identifying contacts. This is very labor intensive work. So Laboratory Testing would be an element of that at the state and local level. Communication, surveillance, some of the things we talked about with the effort to test specimens collected for other respiratory specimens. There would be a suite of activities that state and local governments would do. At the federal level we would be able to use those funds for many of the same things, laboratory support, surveillance work, communication, the things that we do in emergencies. So i think we would not have a problem spending all the money. And with regard to part of the question dealing with 1. 25 billion, i assume that included whatever supplemental sum you thought you might need. So if we were to authorize more than that, tell me how i think it might be better to see where we are with the bill thats going through. I think that there is a scaleability to the amount a smaller amount of money would last a shorter period of time. A larger amount would last a longer period. Mr. Szabat. Thank you, senator, for the question. Under the game plan, the Emergency Response planning, this whole of government effort is led by the health community, specifically the secretary of hhs. So the vast majority of the money requested, and i believe the money thats under discussion right now by congress is for the cdc and other health agencies. Some of that money would flow through them to address some of the needs such as senator canned well mentionedcant about what were trying to do with Health Guidance and protocols for airlines. That money is going through hhs. There is no money requested specifically for the department of transportation. Sen. Lee ok. Thank you. Dr. Redd, reports indicate that the south korean government has been trying to get a handle on who is coming into the country by having air carriers try to assess passengers as theyre boarding the planes going into korea to figure out whether they are suffering from the virus prior to boarding. Have you provided any guidance to air carriers in the United States dealing with how we would assess this issue with inbound passengers . Im not familiar with, if im understanding the question with south korea, we have provided guidance for screening that would be for passengers coming into the United States. If were working on that, im not familiar with it. I think that the value of that screening. A lot of that work is to figure out collect some of the information weve been talking about. Thats the way weve done it in the past, to collect Contact Information so that those individuals can be tracked. Its very laborious. Thats really the reason for this interim final rule is to do more to automate that system. To automate this system whereby you collect data on each passenger. Correct. With an eye toward hopefully excluding those who might bear symptoms or show some indication that they carry the virus . Largely we can screen for symptoms. If a person is incubating the disease, being able to track them through that incubation period is something that at least informing them that, if they have symptoms, here is what you should do. I think we wouldnt be able to identify people who are incubating disease from the Contact Information. But we could use that information to follow them. Ok. Thank you. Thank you mr. Chairman. Testank you to all the ifiers. Dr. Redd, im trying to get a handle on what our National Strategy is in terms of containment containment. It seems containment is something you do in the first phase of something thats a potential pandemic and were rapidly entering a phase of this during which theres sufficient Community Spread and. Where the containment strategy has sort of vanishing smaller and smaller returns. I want to make sure im getting that right and then ask a followup question. That is correct. A certain nuance to that is there are likely to be parts of the country where mitigation is the right posture. At the same time there could be other parts of the country where you can still use containment. Exactly. My next question is if were into a Mitigation Strategy phase, then what restrict air travel at all . If were talking about restricting air travel from korea, and it seems to me with the exception of the episode and that religious organization in the southern part of south korea that whats actually happened in south korea is they just tested more and got very aggressive about it, so their data is in. Our data is not in. Its not clear to me that their 6 or 7,000 cases, their numerator and denominator will end up any higher than ours by the time we do all the testing. Then it gets silly if were not allowing people to travel when one place is not any less or more safe than the other. I agree with your general point. I can give you the example of h1n1 influenza where for a short period of time we had a travel advisory to mexico. That didnt last very long, youd be more likely to get h1n1 in the United States than you would if you were returning from mexico. That would be a situation where we wouldnt that would basically be a scenario like that wouldnt be this intensive effort to track people entering the country. Ok. Just a new question. Your website right now says there are 80 total cases. Thats not true, is it . We update that on a daily basis. As cases are reported from states, they do that on their own schedule. Ours is a kind of a once a day. Sort of garbage in, garbage out. We just dont know yet. Its not that its 80. Its that youve confirmed 80. Thats correct. I would recommend you figure out a better way to reflect i understand the uncertainty here. Whats going to happen im afraid is that right now people are i think unreasonably reassured by this low total case count and unreasonably fearful of other places that are actually really whats happened is theyve deployed tests more efficiently and effectively than the United States. Whats going to happen well be calm until the tests get deployed. Those numbers will spike like crazy and well have a panic as a result of that. I think you have to figure out on the communications side how to reflect that uncertainty and prepare the public for the high likelihood that the number of cases that we have confirmed is going to skyrocket, not because epidemiologically anything changed but because we finally deployed the kits. I think well know the study that senator cantwell described to us, will help address that issue. If we do more testing and dont find that is possible. Im talking about in the next im talking about in the next couple of weeks. Exactly. Final question for you. This is so constructed and so bipartisan, i thank the chairman for convening this hearing and the Ranking Member. Can you ask the folks at the cdc if they would commit to a Daily Briefing on camera, no politicians involved. It doesnt have to be inflammatory. It doesnt have to be alarmist, but just a daily heres whats going on . Thats what happens in a Natural Disaster context. Thats what happens when you have a sort of a Civil Defense issue. We just need to hear from a singular authoritative informed voice and on a daily basis so were not all catch as catch can, trying to figure out where the data is and where this thing is going. Mr. Szabat, am i pronouncing your name correctly . Yes, senator. Yes, senator. My understanding is the faa has the authority to implement an emergency order so that those as you were talking to senator cantwell about this that right now their guidelines and i understand under normal circumstances youre talking about whether or not the airplane can fly safely. These are emergency circumstances, and i dont want to spend another two or three weeks figuring out Whose Authority is necessary to get a bunch of lawyers involved trying to figure out where you derive the authority. In an emergency situation you are certainly authorized to change those voluntary guidelines that the airlines some are abiding by and some not. And just change that into an emergency order. Id like you to look at that, please. Senator, we will. We will look at it as a whole of government effort. One of the reasons for the task force is to say, if there is something that needs to be done and it falls through the cracks of one agency, we borrow the authority of other agencies in order to get it done. Thank you. Dr. Redd, senator schatz asked about testing. From my conversation yesterday with Vice President pence and secretary azar, my understanding is that testing kits are going out, what was told to me, by the end of next week, the capability will be there for 1. 25 million tests. Is that accurate . Thats a combination of numbers from the Public Health test that cdc is deploying that are done in Public Health departments and what could be done by private Companies Applying through the fda process to use a test that would be a commercial test. That number is within the range ive heard as well. A small portion would be the Public Health test. The majority would be company developed. One of the great frustrations is a lack of testing. Youre telling the subcommittee the tests the kits are on their way and testing, that will be remedied shortly. Is that correct . For the Public Health testing well have the capacity to do 75,000 tests by the end of this week. Senator sullivan. Thank you, mr. Chairman. Thank you to the panelists for this very important briefing. Secretary szabat, i want to follow up on our earlier phone call, my discussion with you today and see if any more if there is anymore progress. You know the broader discussion from the other witnesses is weve closed down the passenger travel from china and other areas where theres been a risk, big risk on the issue of mitigation of the spread for air travel. However, there is a loophole, and i think everybody ive raised this ive been raising this issue now going on four weeks with Senior Administration officials. The loophole is cargo. Air travel. Cargo is very important for the whole country, for the whole world. We want to be able to have the supplies to address and be ready for, you know, what could be a significant challenge for our country, but the pilots on these cargo flights in some ways are a loophole. You have chinesebased crews that get off in the United States, big cargo hubs, whether anchorage or seattle or l. A. , memphis, and they spend the night, you know, in the population. Theres nobody ive spoken to, and ive spoken to everybody, including secretary chao and others, that doesnt recognize this loophole. But the Agency Agencies seem to be pingponging back and forth on how to address it. The one suggestion that i have made is to essentially do a turn and burn. You have cargo passenger airplanes come, say, to anchorage. They have two sets of pilots. They land. They get rid of their cargo. Then they get the other pilots to fly it back. There was some concern they might retaliate against our cargo airlines, however, some of the senior officials ive spoken to dont seem to think that would be a problem. So can you mr. Secretary, im hoping you can have a little more definitive answer than our discussion this morning. Can you tell this committee what were doing to address this issue . Because heres the real problem, if somehow theres a spread in another city, say anchorage, and its traced back to, you know, a pilot on a cargo crew, the likelihood of us then wanting to react to shut down the whole system is going to be strong. So were trying to preempt this with some good ideas. These are decent ideas. Theyre workable. Nobodys really complaining about them. But the authority seems to be pingponged back and forth. What are we doing to address this overseasbased crew loophole that everybody acknowledges we have . Senator, thank you for the question and thank you for the courtesy of flagging this for me earlier today. I regret, i do not have a more definitive answer for you now than i had this morning, except to say were working this hard. Well have a definite answer to you as quickly as possible this week. When will that be . Ive been literally raising this for almost a month. A month. So today is wednesday. Well have it to you by close of business friday, and hopefully before. Will that be cleared by everybody . No pingponging in terms of faa doesnt have authority . There is this issue that some people are viewing the crew rest doesnt count if youre sleeping on a plane. Again, were kind of dealing with an emergency here. Im sure the pilots who are resting on the plane as theyre sleeping to come over are rested enough to fly back, ok . Theyre all capable i mean, so, again, if thats a reg or an authority that you need help on, let us know, but dont use that as for four weeks now since ive been raising this with people, and so far, so good we havent had a spread from a cargo pilot, but i think were dodging bullets here, and we need to address it. Ill have a whole of government answer back to you by close of business friday, senator. Sen. Sullivan thank you. Admiral, i want to ask and highlight another issue thats a little bit more particular to my state, the great state of alaska, where one concern i have is our alaska native populations where, you know, theres over 200 communities in my state that are not connected by roads. So theyre very isolated and very, very remote parts of america, the most remote parts of the whole country. They dont have hospitals. They barely have clinics. Some of these communities dont even have flush toilets and clean water. Which is a tragedy for the whole nation, in my view. But as you likely know, the 1918 spanish influenza decimated these communities in alaska. Decimated them. So theyre vulnerable, and what im concerned about is if theres enough focus from cdc we do have a cdc office in anchorage, in part because of our high rates of Infectious Diseases. What is the cdc doing to make sure these extremely vulnerable populations if you ever get an outbreak in one of them where were ready to address the situation so we dont have a situation that happened 100 years ago, in some ways still an impact on my state . Yes, sir. I think this is an important issue. I know that you know that dr. Jay butler, who had served as the state Health Officer in alaska is now in atlanta at cdc. Yeah, hes outstanding. So i think we have that local knowledge of alaska now in atlanta, and i think that will help to make sure that we dont forget about remote population. I think its a real challenge, though. Can i get your commitment to have something a little more definitive that recognizes the vulnerabilities of certain communities like this, that are very remote, some ways you might not get the remoteness helps with the spread, but if it does get out there and theres really no very theres no hospitals. Theres very few doctors. Can i get your commitment to have a more definitive plan to help address these kind of let me commit to get back to you with what our proposal will be and we can have a dialogue about that. Great. You might want to work with the cdc office in anchorage. Which also has coordination with our native health system. Thank you. Thank you, mr. Chairman. Thank you. Senator tester . Sen. Tester really . I appreciate that, mr. Chairman. Now you beat me. Appreciate you all being here. I want to thank you for the work that youve already done on this critically important issue, and i think it is critically important, and i hope i hope it doesnt turn out anything like i have imagining potentially in my head. So i just want to give you my circumstantial, that is i fly four legs a week, i have town hall meetings, i meet with people all the time. Probably meet with 70, 80 people today alone. The question is, is that if anybodys going to get this, its going to be people serving in the United States senate because we all do that. Senator cruz flies home. He takes a Different Airline than i do. Flies a different leg. Exposed to a different population, and we come back and have a commerce hearing together. Ok . So the question i have for you, i got the washing the hands and getting the flu vaccine. Is there anything we can do to protect ourselves i dont care who answers it that you would recommend or do we just have to do what that is hope you dont have Something Else wrong with you so that you can get through it and survive it and move on . So, let me give a broad answer to that. I think hand washing is a critical element in protecting yourself, and for all of us protecting ourselves. There is kind of the other side of it, which is things that we want other people to do who might contract this disease and give it to us, and that would be covering coughs, really, really important to stay home when sick. And i think that is probably something that were going to have to just continue to stress. And that doesnt protect the person who is staying home, but it does protect everyone else. And so what i hear all those things, so what is the incubation on this test, do you know . Well, on average, five to six days with a range of shorter a couple of days to maybe up to two weeks, as weve heard. So, i, you know, got a few achy bones today. Does that mean i stay home . I think i would not stay home or use that as a reason for coronavirus. I think fever and respiratory symptoms would be where so by the time you stay home, youve already been youve already been affected for five or six days, is what youre saying. Well, youve been incubating. I think this is one of the issues. You can say no if we dont know. During that incubation period, can i spread it to the good senator from illinois . So i dont think that youre going to like my answer. I did wash my hands, ok . Its not possible to give a definitive answer on that. Id say that there is a much stronger suspicion that with very mild symptoms or right before you develop symptoms that there is there is in a lot of cases the chance of spreading the disease, which is different from the other coronaviruses, different from most viruses where the viral load increases the sicker that you get. This may be a case where viral load can be high even in that very early almost like the symptoms that you described. I wish it werent true. No, look, i got it. I just so how long do you think its going to take for this to run its course in our population . I i dont think that its possible to speculate. Anybody nobody knows . There are a lot of factors that could go into that. But so it really isnt possible to say. Sen. Tester ok. So, theres been a lot of talk the good senator jackie rosen just told me that italy shut down some of their schools. I think theres been talk about shutting this place down. There is talk about shutting all sorts of stuff down. Im going to tell you, i personally think thats a mistake because im not sure its going to matter, to be honest with you. A paralysis here is bad enough without really creating a paralysis. So what would be your recommendations on all that stuff . Because its like youve got a person with coronavirus in an airplane, so they come in and clean the airplane, and somebody else gets on with the coronavirus, you really havent done a damn thing. So, thats a very difficult question. I think its one of the reasons that the president has set up the system that he has with the Vice President in charge, that those different sectors are able to communicate more effectively so that we are we can talk about what the Health Benefits might be, but the other the adverse consequences, were not really expert in those, so i think this is something that will facilitate the appropriate decisions being made in a as quickly as theyre needed to be made. Good. This is a question for mr. Szabat. Do you believe there are going to be flight restrictions placed if this thing plays out its potential . Well, the easy answer to that, senator, is we already have flight restrictions in place. I know. Im talking about domestic flights. Its i dont know. Were outside the playbook, you know . The original playbook did not envision travel restrictions, you know you know Health Officials have historically said in the case of, you know, widespread flu or similar contiguous diseases we dont do travel restrictions. We went outside the playbook on this one and i would contend that the travel restrictions that we and some other countries did were very effective. In some cases they werent. Italy did more of a prohibition than we did, but they waited until after we did and it did not turn out to be effective. So theres going to be a lot of Lessons Learned from that. To your question, its now in the playbook something to think about, but i cant tell you under what circumstances we might consider pulling that trigger. Ok. Well, i just want to thank you all for your good work. I cant thank you enough. I have been frustrated with the president in his reaction to all this from the getgo. But you guys are pros and i want to thank you. Senator caputo . Thank you, mr. Chairman. I want to thank the three gentlemen here today. I want to just ask a just a general question of mr. Szabat. Are you you may not have these statistics, but as of now, do you see Domestic Travel on the decline because of this and people cancelling flights, less people traveling . What are you all seeing . Senator, thank you for the question, and youll youre better served asking that question from the industry and Industry Analysts who have, like, specific numbers, but certainly, you know, we are in daily contact with the industry, and they are looking at a decline in bookings going forward. Having said that, the so far the biggest hit for the Airline Industry has been on asian travel. For the u. S. Industry, thats the smallest part of both of their revenues, especially of their margins. This only becomes a major hit for the u. S. Flagged airline if the coronavirus spreads or concern of the virus spreads and passengers decide not to travel largely domestically, and second secondarily between the United States and europe. Thank you. Mr. Ferrera, thank you for your work at cbp. We had the tsa administrator in front of my subcommittee, which is Homeland Security appropriations, the other day talking about the protocols that have been put in place that you all are coordinating with. Let me just say when somebody comes in at the 11 airports, those are the citizens coming in into the 11 airports, you do a prescreening, you do that in coordination with cdc. What if somebody, like, exhibits the symptoms . Are they tested immediately . How is that rolling out . Thank you, maam. As you said, once they come into the one of the 11 airports, our officers identify them as potentially being ill or coming from iran or china. We refer them over to cdc or cwmd who is there. Thats a medical determination. They would determine if a test is required or not. Our Law Enforcement our priority is the Law Enforcement piece of it, making sure they get there. Get where they need to go . Yes, maam. It was brought to my attention there was an article in the wall street journal this morning, the title, hackers target companies with coronavirus scams. Its pretty shameful people would try to capitalize on growing fears and anxiety of whats going on. I dont know if this is a Homeland Security question. Absolutely you all have Cyber Security capabilities within your agencies. Is this something that you all are made aware of, that there are people that are impersonating the World Health Organization . Obviously this is a money making kind of scam. Dr. Redd, do you know anything about this . I was not familiar with that article. I think that the general issues of Cyber Security are ones that we need to take very seriously, and i think this would be an example of if those measures arent in place how they can lead to trouble. Well, you can imagine a scenario of a hacker contacting somebody and saying, you want to buy 25 masks or some preventive or a vaccine or expedited travel, or whatever you would be offering would really make you make a lot of the population very vulnerable to this kind of attack. So i would suggest that all of you in your respective departments take take this back with you as a red flag. Did you want to Say Something . Yes, maam. That is a department of Homeland Security that one of the functions that we do have. Right. So i will certainly bring that back and provide that information to the department. Let me ask you too again weve talked a lot about aviation. We obviously know about the cruise ship situation that occurred. We also have a lot of cargo going back and forth all around the world, but certainly to the to the far east and coming back in. I think initially there when i raised this question, people Homeland Security said, well, the incubation period is so so much so that if youre on a ship for 14 days getting back and forth, its really not going to be an issue, but see that it really is an issue because it could be passed from time to time to time. So are you working with the coast guard on this to make sure wherever those ships are coming in from that you have some kind of capabilities there . Yes, maam. In conjunction with the coast guard we, again, target people from china or iran who are traveling on those cargo ships, and we make sure working with our medical partners to keep those folks out of the port until we get the allclear from the medical folks. Just as a regular course of everyday living, today i kind of challenged myself to try to see how many things i could not touch that i know had been touched by numerous people before me. What a challenge. And so i think if everybody would try the exercise around the country, you would realize how not just susceptible you are, but how careful you need to be when you know youve been in some kind of contact or direct contact or you, yourself, maybe have a cold or are beginning to not feel well. So that was that was pretty staggering, starting with the elevator, the doors, the restroom. We could go on and on. Constituents coming to visit and all those things. Thank you very much, mr. Chairman. Thank you. Senator duckworth . Thank you, mr. Chairman. I want to thank you and the Ranking Member for having this hearing. As of yesterday, illinois, my home state, has had four individuals test positive. I wish them and everyone else who has been infected a speedy recovery. I want to credit the staff at the state and local levels for all the work theyve done, but i have to share my frustration here because i cant believe that were having some of the conversations were having now. After having faced other global outbreaks such as h1n1 and sars. Did we not learn anything about processes and procedures from those previous diseases . You know, americans have been flying commercially for more than a century, yet today on the cusp of a global pandemic, the inability of the federal agencies to collect and share Critical Data effectively with u. S. Airlines and state and local partners is really hindering our ability to stop the spread and to fight this disease, and so, you know, my last job in the army when i was finishing out my last tour was working at the pentagon in the defensive part of civilian authorities. And the last thing i did was give a briefing on global pandemics and what we would do in that particular office. Dr. Redd, you worked on h1n1, right . You alluded to it earlier. Yes, maam. Ok. That was in 2009. So how the heck has the cdc, the cbp and d. O. T. , how come we are still try how toing to figure out how to deal with these issues . How come they dont have computers . After weve seen ebola, h1n1, sars, and what are we going to do in this instance, but then also looking forward so that the next pandemic that hits there will be another one. That were ready for it and not caught flatfooted the way we are right now. I think that we have improved since really my own history is begins with the mid2000s. I think were far ahead of where we were at that point in time through a lot of hard work and attention from the members here, congress and the administration. I think that youre pointing out some things that need to change, and i think that there will be both in the very near term work to make sure that we are operating as effectively as we can now, and that there will be after action review items that will come out, many of which youre listing. So how long for yourself and mr. Ferrera, given the data sharing challenges with airlines, how long does it take for state Emergency Management agencies and Public Health departments to receive flight information about potentially infected travellers . How long does it take a state department . I have one of the Busiest Airports in the world in chicago. How long does it take idph, Illinois Department of Public Health or the local officials to receive information about a flight coming in that potentially has an infected patient onboard . Cbp transmits the information from these flights within an hour over to cdc. I dont know the process from cdc to the states. Ok. But we the information that we do have, we transmit within an hour. Ok. Dr. Redd, how long does my state does it take before my idph gets well, i think the problem is the information is often incomplete, and that is really what the interim final rule is trying to correct, is that if we had, you know, if we have a name, thats not very helpful. If we have a name and an address, thats somewhat helpful. If we have a name, address, phone number, email address, we can find people. That information at the Health Department would basically be the ability to do complete followup if those Data Elements are available. So you dont have a timeframe for me right now and we dont know when were going to have the capabilities to let rapidly let local Public Health people well, i think what we have is a very short period of time. The real question is getting complete information and doing that in a timely fashion. Senator, if i might add to that. This has been discussed at the task force level. The goal of cdc, the Health Officials, has been to collect the information so that cdc has it by the time the plane arrives and is already providing it to the local officials. The challenge that we have to the Public Health officials to where those passengers are actually going because, of course, they come to 1 of 11 airports for initial screening, but thats not where theyre ending up. Somebody flying into chicago going on to massachusetts, cdc wants to gather the information and extend it to the Public Health officials for wherever in massachusetts theyre going to. The and the system that we have right now is an interim system which is working very well, but it is it is paperwork and personnel intensive, and so it works for the passenger load we have coming in now from china. We could not scale it up to be more broad, and thats the challenge were talking about, about having a better nationwide system. Having said that, the system we have now is immeasurably better than anything weve had before, whether it was with h1n1 or sars. So each time we have one of these, we learn, and as dr. Redd said, well do a hot wash after this. We will learn from what weve done here and well do better next. Well, i think we need to do a lot more than better next time, and i would ask the chairman to maybe consider holding a hearing after the epidemic and see and learn about Lessons Learned and what they plan on doing next time. I do want to add one more loophole to what my good friend, the senator from alaska, mentioned with the cargo. Dr. Szabat and dr. Redd, are passengers from areas of concern receiving the same scrutiny aboard commercial flights . I think in addition to the cargo aircraft, private aircraft are another loophole that are in the system, and im out of time. Please answer that question. Its a good question. Ill answer the question. Senator, well get back to you with a full answer for the record, but i know i can speak personally, for example, for charter aircraft. We apply exactly the same rules to them as we do to any commercial aircraft. So if youre coming, for example, from china or now from iran, we dont have direct flights from iran, but if youre coming from china, you would have to land at one of the f111 airports. What about private . Ill get an answer on that. Ok. Thank you, mr. Chairman. Thank you. Senator rosen . Thank you, chairman, for having this very important hearing. Thank you for the work that youre doing. I know your staff, youre just working around the clock to try to figure out how to get ahead of this, be practice everyoactive, protect our nation, so i want to share my appreciation of that and all nevadaens with you, but since the coronavirus is changing so rapidly, it is critical that our Public Health officials doing the work on the ground, as senator duckworth says, have all the information they need to do Contact Tracing and the monitoring of travellers when warranted. So id just like to understand what the threshold metric being used to determine when air travellers must fill out that government Public Health locater form. Can you explain that to us . Are you people are not having to do that . What is the threshold . Just people from china . Just people from italy . Ok. Please explain that. Ok, so the way for the the current rule is travellers the interim final rule applies to travellers from china. Only . So were not doing it for anybody outside of china . So should we expand that . With your permission, senator, ill take that on. The we have two countries now that are covered by the socalled two12s process. We have no direct flights from iran. Very few americans coming back from iran in a 14day window, so for the most part, the ifr rules apply to those travellers. But were looking at a model thats going to that can be scaleable and expandible. For example, right now we just introduced new types of restrictions for travellers coming from italy and south korea where theyre getting exit screening coming out of those countries, but theyre not being required to do the same kind of Data Collection that were doing who is doing the exit screening . What kind of qualifications and training are you providing for that . So, its a careful answer to that question, senator. These screens are being done by the authorities in south korea and in italy. Before they come . Exactly. Exiting from there when they come here, thats correct. So youre thinking about expanding it and youll obviously keep us apprise of that and considerations for that. I also want to build upon that a little bit because obviously were talking about air travel, and we have all of our wonderful flight crew, pilots, the attendants, people who clean the cabins, but, really, the flight crew health, given the direct interaction and contact that the flight crew has with hundreds of passengers, id like to hear a little bit more about the recommendations for ensuring that their health is protected and what requirements does the d. O. T. Have for personal protective gear for flight staff such addss masks and gloves if those become recommended by Public Health officials . So im going to start answering this question, senator, and i put dr. Redd on notice it will get passed on to him. Department of transportation, we, of course, work closely with the industry and we hear from both representatives of the pilots and the flight attendants. But our role on the ppe side is that we pass on either the guidance or the requirements of and it can be osha or other health agencies. So we are in a sense from the department of transportation perspective, were a passthrough. Given my position on the task force, the role of the task force is to ensure that that guidance is put out. If i may put a plug in, because as you point out, you know, we give a lot of praise often for First Responders, but First Responders are responding to something. Our flight crews right now are on the cutting edge. They are the ones right now dealing with these risks every day and we do owe to them to make sure they have the very best equipment and the very best knowledge of how to perform selfsafety practices. Well, so you talked about youre the passthrough. So how are we going to compel the Airline Industry be sure that the health of these workers are protected, as they look, we all all of us fly every week multiple legs on many Different Airlines. For a living. So at the moment the requirements we have is the airlines agreed to meet these voluntary standards. Now, if they refuse to meet them or fail to meet them, we can consider other measures. Right now its clearly in the economic interests of the airlines and certainly in the personal interests of their pilots and crew to follow these measures. I just have a quick second, so im going to make this very short. Are we providing or are you helping the airlines to provide training, additional training to those flight crews for looking for signs of illness so that they may help when people are on the plane or when theyre getting off the ground and assisting in any of those reporting issues there . Theres theres a lot of interaction with the Airline Industry in that domain. Im not familiar if were actually doing something very specific to coronavirus, but theres been a longstanding collaboration in that kind of work. But let me let me follow up specifically on that question. We do have guidance for protecting crews. Again, its this question of voluntary guidance and kind of what you should do versus having the rule or the authority to do that which resides with osha. Its not just a question of the flight crews health, but then they become carriers in and of themselves. So thats the spread the public spread can be great. So, thank you. I appreciate it. My time is up. Thank you. Senator thune . Thank you, mr. Chairman. Thanks for this hearing and thank you to all of you for everything that youre doing, continue to do to address the crisis. Dr. Redd, first of all, i want to say i appreciate the cdcs work in containing the spread of the coronavirus and i want to thank you especially for being here today. I want to just follow up on some questions that i think have already been asked, but my understanding is cdc has issued guidance to air carriers to ensure theyre taking the precautions necessary to contain or respond to potential coronavirus cases on international flights. So the public is aware can you, again, perhaps talk about what some of those steps are what the airlines are following . I think the main thing is identifying patients who have respiratory illness and taking action to to really notify theres a system of communicating with ground if Something Like that were to occur. And its really, i think, the standard guidance, but just putting a little sharper edge on it because of the situation were in with the Novel Coronavirus. Do you are there ins stances of domestic Community Spread that youve soon so far . And does the cdc anticipate the need to provide similar guidance to air carriers for domestic flights, some of what youve done with your international . So, there are locations in the country which have cases that have been acquired within the United States, specifically in Washington State and in california, and i think it would not be surprising that other locations would see cases like that. The guidance for identifying people who are is is not limited to International Carriers, so it wouldnt be only International Carriers get that kind of guidance. Mr. Szabat, i understand and agree with the current focus on Major International airports and large cities in efforts to contain coronavirus, but it is important to ensure that smaller airports and Public Health authorities in rural areas are also prepared when confronted with a potential case. Has a department conducted outreach or provided guidance to smaller airports on containing the spread of the coronavirus . Senator, thank you for the question and for the concern. We share the concern for the health of the entire traveling public. And of which smaller airports are an important part of that web within the United States. So, we are working through, again, what i call the whole of government effort. When it comes to delivering health, preventive measures to these airports to any one of our private sector stakeholders within the playbook, the Emergency Response planning, that falls under health and Human Services and in Homeland Security. So our job is to ensure that those Communications Channels are open and are flowing. We have had just in the last two weeks two major conference calls, including aviation organizations and individual airports for exactly this reason, to connect them with their first line is their own Public Health authorities, and then through that is the cdc for Health Guidance. What resources is the cdc providing airports across the country, including smaller airports to ensure they can properly respond to a potential outbreak . I think in general the quickest line of of where to get help would be the local Health Department. We are certainly available to communicate, but our we would have guidance and we would work that through the local state and local Health Departments, so thats going to be kind of the first line of defense in the Public Health system, would be the local Health Department and the state Health Departments. Ok. Mr. Ferrera, its my understanding that cbp has enhanced screening measures at airports across the country to increase the chance that infected passengers are quarantined before entering the United States. Can you elaborate on and how that has changed for points of entry where screening has been enhanced . Thank you, sir. The information that were collecting for Contact Tracing comes through the traditional cbp Airline Systems and thats passed on to cdc. I think thats the only difference with the process, is that its passed on to cdc as a rule if these folks are coming in from those countries of iran and china. Mr. Szabat, does the department have an initial estimate for coronavirus effect on global air travel to and from the u. S. . The department does not, however, were closely following what the Industry Analysts are saying, and so currently the the current projection seems to be in the range of 4. 7 to 6 decline in Global Travel over the course of the year. And does that does the department believe that the reduction in International Travel will potentially lead to supply chain constraints for certain medical supplies . The department as the department does not have a position on that, but i can certainly say as a member of the task force, we see that there are disruptions in certain parts of the supply chain. You know, we will take as a Lesson Learned going forward, and this is both true for our private sector counterparts as well as ourselves, i think theres a lot of lessons to be drawn here about having overreliance on a Single Source of supplies. Thank you. Thank you, mr. Chairman. Thank you. Senator markey . Thank you, mr. Chairman. Admiral redd, good to see you, sir. Thank you for your service. My wife is a retired rear admiral in the Public Health service, so i know your core, your work and what youre dedicated to. So if you could perhaps discreetly just describe to us what it means when the president starts to call the coronavirus a hoax or puts out information which is medically inaccurate. What from your perspective is necessary in order for you to be able to do your job and for the public to be able to respond to the message which youre sending, which is medically accurate in terms of the disease itself and then what the response should be from the public. I think that the in the last several weeks theres been a focus on making sure that we are in alignment as a whole of government approach. I think that thats been very helpful with Vice President pence in charge. I think i think that that will help make sure that when a decision needs to be made that there will be communication across departments so that all of the really all of the experts are able to work more closely together, and i think that i think thats going to be very helpful as we move forward here. Ok. Well, thank you. But just know that we respect you and we respect science. We respect your conclusions and we really dont want this to be politicized at all. That will interfere with our ability to implement a plan that is effective, as soon as possible. I think weve already seen too much delay in not responding correctly and doing so soon. Id like to come to you, mr. Szabat . Szabat. Thats on the question of airline fees. We have a pandemic, which is going to hit the United States in much larger measure over the next weeks and months, according to the experts. We have airlines that actually have taken charge fees, change fees and theyve made a whole industry out of it, in terms of the amount of money they can, in fact, charge. The d. O. T. Is the only Consumer Protection agency overseeing air travel and you are statutory turley charged to stop unfair practices in aviation, allowing any airline to charge these excessive fees during the coronaVirus Outbreak is beyond unfair. I urge the department of transportation to take action immediately and prohibit all cancellation and charge fees during this emergency. Anything less is a failure to fulfill your duty, and thats why i plan to send a letter to secretary chao later this afternoon formally asking her to suspend these change and cancellation fees in the face of this Public Health crisis. The time for d. O. T. To act is now. We dont want citizenships deciding they have to fly because the cancellation fee would be too high, from their own perspective their own health or their family Members Health would be in danger if they came into contact with it. Would you commit to ensuring that d. O. T. , which is the Consumer Protection agency, ensures that change in cancellation fees are suspended during this crisis . Your concern and your request is noted, senator. You have my commitment that we will get on that right away. As you say, this is an Emergency Response situation. Were not looking to spend months or years developing a rule, so well get you an answer back very quickly. Yeah, i think thats not an incidental issue for many family. I can see more and more people have flown seven times in the last ten days, more and more people on each flight have a mask on. So for every one of those people, theres somebody else thats very concerned and didnt want to cancel the flight because they had to travel, but they might have if they didnt have the addition at fee. Youre not the only one who has noticed that. Ive noticed several of the carriers in the industry have already decided to say that theyre going to be cancel that they will withdraw some of those fees. I just recommend to you that it become an industrywide practice through your insistence upon it. If i may, admiral, the highest fatalities from the coronavirus have been in areas where the Health Care System has been overwhelmed. Cdc must take steps to prepare hospitals for surges of coronavirus cases that could stress Health Care Systems capacity to care for those patients, especially those who may need hospitalization and airborne infection isolation rooms. Cdcs current guidance, which hasnt been updated since february 11th, nearly a month ago, is for facilities lacking airborne infection isolation rooms to transfer patients to facilities with available rooms, but we know this option may not be available if there is a surge of cases in a particular region. Dr. Redd, can you commit to provide hospitals and other Health Care Providers clear and specific guidance on how to safely care for a surge of patients without airborne infection isolation rooms . Let me look into that and get back with you. I think that youre bringing up a very important point, and that if there are a number of patients exceeds the number of beds, there is going to have to be guidance for that situation. Yeah. So you will provide clear guidance to those hospitals . Yes, sir. Is that what youre saying . Let me get back to you with that, but, yes, we will do that. You will get back to me or you will provide the guidance . First get back to you and then provide the guidance. I think they need guidance. I think that many places in this country yes, sir. Need it right now. They need what they need to know what to do. So i would i would, honestly, ipad put a crash team together, try to figure it out tonight, put them in a room and send it out to these hospitals. Theyre out there waiting for you, youre the expert, to tell them what their plan should be. Yes, sir. So i honestly believe that it could hit a region within the next couple of days and theyd be without any real instruction, and i think that would be to those a disservice people, so thank you, mr. Chairman. Thank you, senator markey. I think it is important to correct the record, that i do not believe it is accurate that the president has said that the coronavirus is a hoax. And, in fact, i think thats quite contrary to what he has, in fact, said, and in fact, done. The president can obviously speak for himself, but my understanding is what the president referred to as a hoax was the partisan claim that some are advancing for partisan advantage that the administration is not treating this Public Health crisis seriously and is not marshalling the resources to keep americans safe. And i will say in my observation, having yesterday met with the Vice President of the United States, with the secretary of hhs, with the commissioner of the fda, that the resources with the head of the cdc. That the resources being marshalled are significant. And admiral redd, i want to ask you, in your opinion as a health professional, and as a lifelong expert in Communicable Diseases, how significant was the step the president , the administration took early on to halt air travel in and out of china and to quarantine americans returning to china, how significant was that . I think it was a very important decision to make, and i think that there was a prolonged period of time where we had a very small number of cases. So i think that was the right decision at the right time. I think that well i think well be in a better position to evaluate that more fully as time goes on, but at the present time, it was an important decision. In your medical judgement, had travel proceeded unimpeded, would we be facing in all likelihood a substantially worse outbreak in the United States . We would have more cases, i think we can say for sure, if those measures had not been put in place. And mr. Szabat, from the perspective of the department of transportation, how unusual is it for an administration to take the steps this administration took right at the outset of this outbreak . Senator, those steps were beyond unusual, they were unprecedented. I can tell you, i spoke personally with the president i think two days after air travel was halted to china, and the president asked me directly, he said, ted, what do you think . I told him, mr. President , you made exactly the right decision. I recognize there are real economic consequences to halting air travel, but at the end of the day the First Priority has to be protecting health and safety, has to be protecting lives until we understand the scope of this outbreak, until we understand what is happening with this virus, we need to do everything that is possible to prevent this outbreak from becoming a pandemic. And, and so i am grateful that the administration acted. That doesnt mean every step the administration has taken has been exactly right. Dealing with any crisis, there are going to be challenges, there are going to be mistakes, but i think we have seen a serious focus on this Public Health crisis, and thats the right thing, and i would note one of the mistakes was release an individual from lackland who subsequently tested positive. Thats a mistake that i addressed at the beginning of this hearing. I want to ask a couple of more questions and then were going to wrap up shortly. It has been reported, my understanding is that the cdc has asked commercial airlines in affected regions to take the temperature of passengers boarding planes. And that commercial airline gate agents are understandably feeling not prepared to do so, not trained to do so. Theyre not medical professionals. Is that understanding correct and is it right to be asking the gate agent to be taking someones temperature rather than a medical professional with the training to do that . I will have to check on that. Im not familiar with that process. I know that in korea and in italy, the governments are doing the exit screening, but let me get back to you on a confirming that my lack of knowing about that is that its not happening. Mr. Szabat . Just an update. Our information flow among agencies is good but it the not immediate. From the task force level, you know, weve learned while these measures have been put in place by the respective governments of italy and korea, in consultation with our agencies, theyve chosen how to implement it. So, for example, in korea there are three levels of screening, thermal temperature screening. Two of them are walkthrough. You walk through devices, one as you go into the airport and pass through security. The third is theyre asking all airlines, korean and the u. S. To use one of the handheld temperature devices to check the temperatures of people going into the United States. So, yes, that is a request that the governments have made of the u. S. Carriers as well as the foreign carriers to do that testing. So is it your testimony, just so i can understand, that its the government of korea that is asking them to do it, not the u. S. Government . So the u. S. Government is saying to the government of korea, if we want to continue to have flights from korea to the United States, you have to do Health Screening. Come back and tell us how do you intend to do it . This is how theyve come back and told us they intend to do it. Let me suggest, and, listen, i think Health Screening maybe an awful lot of sense from everything that ive heard, but the concern from airline gate agents that they are not trained and its they dont have the background to be doing that screening, that seems a very reasonable concern and it seems to me it ought to be Health Professionals that are doing Public Health screening. Let me shift to another issue on the cdc. Last month the cdc received reports that some of the testing kits were faulty and experienced inaccuracies in their testing. Were there cases in which the cdc released patients after they had been tested with faulty kits, and if so, in what circumstances . Let me go through the details of the lackland case. I think that is one instance where that occurred. It was not a faulty test. It was a process of communication, actually, the thing that you talked about in your Opening Statement is what happened. There was an individual who was ill who had recovered from that illness and the protocol at that point and still is the case is that two specimens that are negative more than 24 hours apart is a requirement to release an individual. This person had one test that was negative, had a second test that was indeterminate and then had a third specimen obtained that was negative. But that knowledge of that negative test didnt occur until after let me get the sequence right. There was a negative test. There was unknown to the people who did the third test, a fourth test was obtained by a different group. According to the protocol, there was the negative test, the indeterminate test and a negative test, so that met the criteria. Unfortunately, that fourth test that wasnt known by the people making the decision to release the person turned out to be a positive test. I think what that so i think the real issue was the communication there. No one should be released with a pending test. Thats one just obvious thing that is really about the internal communication. I think that the meaning of that test and whether there was some issue with the test or with person having a very low level of virus, i think thats something that we dont know right now. I dont think it was related to the other issue of the of the Quality Control work that was done on the original test. Is cdc examining why someone who tested positive had two negative tests . That certainly raises questions. Yes, sir. Yes, sir. I think one of the questions will be i mean, this is really its a new its a new infection, its a new virus, and, for example, in the ebola response, in west africa, the role of sexual transmission wasnt something that was recognized before an outbreak of that size occurred. During that outbreak it was learned that can be an important cause of outbreaks or infections. Im not suggesting that thats the case here, but just there more that the Scientific Community is going to learn about this disease. I think it may shed some light on how how an outcome like that could occur. Is the current protocol for releasing someone from quarantine three consecutive negative tests with no intervening tests . Its two negative tests separated by more than 24 hours. So that has not changed. I think that i think that your suggestion that this is something that really needs a hard examination is completely correct. I think the real issue here was that there was a test that was out there that wasnt the existence of that test pending should have been something that would have kept the person from being released in the first place. Then with the positive test, we wouldnt have had the it would still be the question of how do you get that kind of sequence, but we wouldnt have had the situation where a person with a positive test was released. So with respect, dr. Redd, i think its important to frame the problem. The problem wasnt the fourth test had happened. Were grateful that it did because it actually caught someone who was still positive. The concern is why, assuming someone who started out as positive and ended up as positive, why were were two tests in the middle that were negative and why was there an inconclusive test . Like, that raises right. Real questions about the accuracy of the testing, and i understand this is not not an easy thing to do, but i can give you some possibilities, but i think we i cant tell you for sure why that circumstance occurred. I would welcome those possibilities. One would be that there were a small amount of viral particles existing at that fourth test that were detected, it was a correct test, but the other negatives were also true, so right at the limit of detection, that there wasnt actually live virus available, just kind of the remnants of the nucleic acid existed even though the virus still existed. It was in low amounts. That would be one explanation. This is getting progressively less likely, but that there was some source of that virus that emerged similar to the aids or the ebola virus where a person can test negative over a long period of time but still have the virus in seemen. Semen. Semen. So maybe there is some protected site that we dont know about. I dont think thats very likely. I think its a question that demanding scientific scrutiny. Ted cruz let me also raise another question about the protocols. So in the letter from cdc director Robert Redfield to the director of the texas state Health Services. Director. Redfield stated the 11 individuals who had been passengers on board the diamond princess received voluntary testing for the coronavirus and were asymptomatic for the entirety of the 14day quarantine period. Is the reason the testing was only voluntary because they were asymptomatic . Does that maybe sense for make sense for lifting a quarantine if we know someone has been in an environment where theyve been exposed . I think this is a balance of individual liberty and protecting the health of the public and i think that the experience has been that staying asymptomatic for that period of time that those people would not have had a positive test, but i think it really is kind of the Civil Liberties versus protecting the public balance. So are the current protocols that someone will be released from quarantine if theyre asymptomatic for 14 days, whether or not theyve been tested . Thats correct. And those are the protocols even though we had this exchange in our first q a let me check back with you. Let me just let me verify that before i Say Something thats incorrect. I mean, there is that study from china indicating a 24day incubation period. That may not be accurate, but if our current protocol is to release someone after 14 days without testing them, if there is an incubation period longing than 14 days, that could presumably contribute to the spread of the virus, is that right . If those two circumstances were true, yes, it would. I want to thank all of the witnesses for your testimony. I want to echo youve heard senators from both sides of the aisle thank the professionals. I know you guys are not getting a lot of sleep right now. You are working hard. This is a serious challenge. This is not easy. There are a lot of unknowns. I believe we need to follow the science. We need to follow the medicine, we need to also be proactive protecting the American Public. So i thank each of you for doing so. I also want to understand score point that was made from multiple senators, which is if there are legal authorities that any of your agencies need right now to protect Public Health and safety and prevent the spread of this virus, tell us and tell us quickly. I think you will find a bipartisan eagerness to ensure we have the tools to prevent this outbreak from growing, to prevent further deaths, but we cannot address legal impediments if your agencies dont draw them specifically to our attention. I would note, we have a funding bill that is moving rapidly, and it is possible even as quickly as that funding bill attaching a provision to that if it proved necessary to addressing this challenge. With that, i want to thank all of the witnesses for their testimony, the hearing record will remain open for two weeks. During that time, senators are asked to submit any questions for the record and upon receipt, the witnesses are requested to submit their written answers to the committee as soon as possible. And with that, this hearing is now adjourned. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] [indistinct conversations] to fadel the federal response to the coronavirus, go to cspan. Org coronavirus. You can find our coverage including briefings and review the latest events anytime at cspan. Org coronavirus. Former Vice President joe biden holds a town hall today ahead of missouris president ial primary. That event is starting at 1 00 p. M. Eastern and you can watch online at cspan, cspan. Org, or listen live on the free cspan radio app. On sunday, Bernie Sanders held a rally in grand Rapids Michigan ahead of the president ial primary. Watch live at 12 30 p. M. Eastern cspan. Org,nline at or on the cspan radio app. We are back in joining me now is rosemary gibson, the author of china, exposing the risk of american independence on china for medicine. First of all, thank you for being with me again. Is great to see you again