Transcripts For CSPAN Former Ebola Czar Ron Klain Others Testify On Coronavirus Response 20240713

Recovery will come to order. The subcommittee is meeting today to receive testimony on Community Perspectives on coronavirus, preparedness and response. Without objection the chair may , declare the subcommittee in recess at any point. Without objection, members not sitting on the subcommittee will be permitted to participate in todays hearing. I now recognize myself for an Opening Statement. Good afternoon. We are here today to discuss the coronavirus, also known as covid19. We are at a critical point in responding to the Coronavirus Crisis that is facing our nation. Americans are concerned. Hundreds of americans are sick. Sadly, there are families mourning the loss of loved ones from the coronavirus and our hearts are with them. The nation is seeing cases on the rise and experts saying the outbreak is getting worse. In new jersey, we were just informed that we had our first death from coronavirus and at least two dozen schools are closing for coronavirus preparation. We have seen an increase in presumed cases. State and local governments are working tirelessly to limit the spread of the coronavirus in our communities. At the federal level we have seen our experts at the cdc and others other agencies working to address this issue. Unfortunately, we have also seen federal officials offer mixed messages on the seriousness of the coronavirus. We are not here today to point any fingers. But we must tell the truth. The American Public needs to be able to trust the information coming from all levels of government. It is now more important than ever for our leaders to trust science and speak with clarity and precision, so that americans can trust what they are hearing. As recently as last week that the virus is contained when we know that is not true because cases are on the rise. Another point of confusion with the Administration Lies in the test kits. While the experts at the cdc and even Vice President pence have expressed concern about potential testing shortages, the president on the other hand has dismissed these worries. There have been reports of the white house rejecting the advice of the cdc and even going as far as muzzling experts. These reports are troubling. Lets be clear. I want the federal response to the coronavirus to be robust. No one is rooting for failure , but i have seen what i have seen is leading me to believe to become very concerned. With that said, the goal of todays hearing is to understand what, as members of congress, we can do to minimize the coronavirus outbreak for the American Public. We need to hear today how congress can support state and locals in preventing the spread of this virus. I would like to thank the panel of Witnesses Today and look forward to hearing their remarks. Without objection, i now recognize the Ranking Member of the subcommittee, the gentleman from new york, mr. Kaine, mr. King for an Opening Statement. Thank you, mr. Chairman. I also want to welcome and thank all of our Witnesses Today for taking the time to be here. All of us have a lot to learn on this and i look forward to your testimony. The Novel Coronavirus or covid19 has already claimed thousands of lives across the globe, including over 20 here in the United States and i think as we realize those numbers could be changing by the hour and could be different by the end of this hearing for all we know. This is not the first time, though, our country has had to deal with an outbreak and likely wont be the last. Weve been preparing for situations such as this. Last year the department of health and Human Services conducted the contagion 2019 functional exercise, a multistate whole of government exercise to assess the nations ability to respond to a large scale outbreak. Last summer the president signed into law the pandemic and all hazards preparedness act. Since 2015 under republican and democratic leadership, funding for Infectious Disease response has increased by 70 . Thats 70 in five years. While the virus is here now in the United States, we didnt see the first cases until mid january, implementing travel restrictions bought us time, and mandatory quarantine helped to initially contain the spread of the virus. Unfortunately, through Community Spread, positive cases for covid 19 have now been reported in over 30 states. The new York State Department of health is reporting over 140 positive cases. Again, thats as of this morning. At the rate theyre going i think there are already several more just in my county today. And a state of emergency was declared this past weekend. Blind panic wont help us stop the virus from spreading. Cooperation, information sharing, and strong leadership are critical to successfully deal with a situation of this magnitude. We must ensure proper protocols are put in place and that the federal Government Works hand in hand with our state and local partners. As recommended, a National Blueprint for biodefense by the Bipartisan Commission on bio defense, i was pleased to hear last weeks panel of witnesses agree with the president s selection of the Vice President to lead the Coronavirus Task force. To achieve a whole of government coordinated response to this outbreak is important that the person in charge has visibility of the entire government and a direct line to the president. The Vice President is the right choice. While this has been a vigorous, international already been a vigorous, international, federal, state, and local response, as the situation continues to unfold, i encourage everyone to heed the advice from our medical professionals. Wash your hands. Stay home when sick. Visit the centers for Disease Control and prevention website for up to date information. I certainly commend the first responders, medical personnel and Public Health officials who have responded courageously for those who are sick. If i could just add, there are things we can criticize. Im sure things could have been done earlier at the start. There is no problem with constructive criticism but if we just criticize for the sake of criticizing it really adds nothing to it. If we can do it in a constructive way thats fine. Ill say in a bipartisan way, the state of new york have struck a cooperative balance and the counties i represent have done that also, saying this is real but we shouldnt panic and trying to provide the best Health Facilities possible. And i know that when this does hit a certain stage they may be overrun, but i think thats what we should be striving for. And at the federal level and i would disagree with the Ranking Member on this as far as muzzling, i think it is important to get a coordinated response out. And again, theres valid criticism that can be made. I think we should try to keep it in focus and try to find ways to go forward. Otherwise you have one side attacking the other and then it goes back and the American People get more confused than ever. Im not here to make excuses or explain away things but i think it is important that we try to treat this as a serious issue as it is, and again, the more briefings we get the more serious we realize it is and we should try to keep that focus in that way. With that, mr. Chairman i yield , back the balance of my time. Thank you. Did you mean did you mean the Ranking Member . Mr. King i was lost in the past, in the glorious past when i was chairman and you were Ranking Member. Glory days. Mr. Payne ok. Thank you. Mr. King i commend you as our chairman. Thank you, sir. I see yvette laughing over there. Mr. Payne other members of the subcommittee are reminded that under the Committee Rules Opening Statements may be submitted for the record. I want to welcome our panel of Witnesses Today. , who,rst is mr. Ron klain among many other positions in Public Service was the white , house Ebola Response coordinator during the Obama Administration and can provide Lessons Learned from his time battling a previous Public Health emergency. Thelso welcome today assistant commissioner of the division of Public Health infrastructure laboratories and Emergency Preparedness for the new Jersey Department of health. In his role, he provides strategic and operational leadership to coordinate new jerseys hospital and Public Health disaster resilience laboratory, services, and Emergency Preparedness and response. Welcome. Next we have dr. Nadine garcia, the executive Vice President and chief operating officer for trust for Americas Health, a nonprofit, Nonpartisan Organization that promotes Optimal Health for every person and community and advocates for an evidence based Public Health system that is ready to meet the challenges of the 21st century. Welcome, maam. And at this time id recognize the gentleman from mississippi , mr. Guest, to introduce our fourth witness. Mr. Guest thank you, mr. Chairman. It is an honor for me today to introduce a fellow mississippian dobbs iii. S e he is the state Health Officer at the Mississippi State department of health. Dr. Dobbs has served in this role since 2018. Dobbs has also held previous dr. Dobbs has also held previous positions as the health state officer and the state epidemiologist. He is Board Certified in Infectious Disease and internal medicine and practiced in mississippi before joining the department of health. He holds a doctorate of medicine and masters in Public Health from the university of alabama at birmingham. Dr. Dobbs, i personally want to thank you for providing your expertise on this panel today as an Infectious Disease physician and for sharing about the coronavirus preparation you are leading in mississippi. I am proud you have joined us today for this hearing and look forward to hearing your remarks. Thank you, mr. Chairman. I yield back. Mr. Payne i thank the gentleman. Without objection, the witnesses full statements will be inserted into the record. I ask each witness to summarize his or her statement for five minutes, and we are going to keep strict time today,. Eginning with mr. Klain thank you, mr. Chairman, Ranking Member king, thank you for having me here today. Before i begin id like to make two preliminary points. First, as frustrating as it may be, there is still a great deal we do not know about the coronavirus and the disease it causes. In fact, we know less about the coronavirus today than we did about ebola in 2014. Scientists are working at breakneck speed to improve our understanding, but as we learn more, our response to the virus will have to change. Secondly, while i am a political partisan, i come here today in the same way that i approached my tenure as white house Ebola Response coordinator, putting politics aside. There is no democratic or republican approach to fighting Infectious Disease, only sound and unsound measures. T doesnt mean the murine demurring on calling out failures where they occur. I have been critical of some steps of the administration and likewise commended some steps. With those two preliminary points made i want to move on , how to use the Lessons Learned in the Ebola Response and how to approach the present threat. The below response was not without problems and mistakes but ultimately president obama , mustered an all of government response to the challenge, authorized the first ever deployment of u. S. Troops to combat an epidemic and appointed me to lead a team of talented and dedicated professionals at the white house to coordinate the effort. In the end, the epidemic was tragic. 11,000 or more people died in west africa. But in september, 2014 there was a forecast that a million lives would be lost. Americas actions as part of a Global Response saved hundreds of thousands of lives. The ongoing legacy of this work is enormous. With congresss support, we implemented a National Four tier network of hospitals and medical facilities that remain prepared to this day to identify, isolate, and treat cases of dangerous Infectious Diseases. Nothing like that existed in 2014 before we started. Work on vaccines and therapeutics as well. The challenge we face from the coronavirus epidemic is different in many ways but contains some similarities. I think it is worth thinking about the lessons that can be applied in this case. First, in a complex, rapidly evolving scenario like we are seeing, there is no substitute for white house coordination and leadership. At the end of my tenure as Ebola Response coordinator, president obama accepted my recommendation to create a permanent pandemic preparedness operation inside the National Security council. That continued through the first year of the Trump Administration , but in july, 2018, that unit was disbanded. The administrations decision now to go through a series of different structures, first led first no task force then a Task Force Led by secretary azar and then a Task Force Led by provedesident pence has has produced uneven results and contributed to the largest fiasco in the u. S. Response, the failure to promptly enable widespread testing for the virus, which definitely is a result of some lack of coordination between the cdc and fda. There is simply no reason, none , why the United States lags behind nations like south korea and singapore in protecting its people. Second, we must ensure that science and expertise guide our actions, not fear, wishful thinking, or politics. As chairmanports, payne, indicated of senior officials in the government rejecting the advice of professionals of the centers for Disease Control and other aspects of sidelining or ignoring medical advice. There are many policy decisions to be made in the days and weeks ahead. Science and medical expertise must guide them, not politics. Third, the u. S. Has to lean forward in fighting this epidemic overseas, as that i think will become an increasing priority. Unlike what happened in west africa in 2014, the nations of china or italy or south korea do not need our help in responding. But this disease could easily spread to africa and other countries where we might have to step up and do the same kind of things we did in 2014. Fourth, the Administration Must move quickly to implement the emergency funding bill passed by Congress Last week. Congress deserves great credit for acting with unprecedented speed in funding this response. But passing a funding bill is only the first step, not the last step. Congress needs to make sure the administration is getting that money out and getting it out quickly and effectively. Too often bills get passed and they dont get implemented. That has to be a priority. The White House Task force should report regularly to the American People on the pace and deployment of the Funding Congress provided. Where is the money . When is it getting out . What is going to be done . Fifth, congress has to continue to do its own work on the coronavirus. That includes hearings like this and ultimately work on things fixed, both the executive and Congressional Branch into work on the longstanding issues of parrot nest that remain. It is not clear if this will be the big epidemic we see coming like the spanish flu was 100 years ago but sooner or later, it will come. There is a raft of bipartisan proposals sitting on shelves that congress has never acted on. Let this be a reminder of the need to act on that and i want to close by saying Public Officials of government need to take steps against discrimination. We are seeing discrimination against chinese americans, chinese american owned businesses that will spread as this virus spreads. This virus affects humans, not members of any race or ethnicitys. We need to make sure there are no discriminations against those communities. Ourhe chernow recognizes next speaker to summarize his statements for five minutes. Members of the subcommittee, on behalf of new jersey governor phil murphy, thank you for inviting the new Jersey Department of health to participate in this hearing. Im here before you as the assistant commissioner for the division of Public Health infrastructure laboratories and Emergency Preparedness. Im responsible for Public Health, Emergency Medicals Services and laboratories. Theoal is responding to Novel Coronavirus publicHealth Crisis. More so, i will share you with you experience working with our at the u. S. Ners department of health and services and the cdc. Im hopeful by sharing with you how new jersey has responded to the Novel Coronavirus Health Crisis that you will be able to strengthen and enhance the coordination between critical federal agencies and all states, including new jersey. January, the department of health actively monitored the Public Health situation arising from on city, china. Health experts readily identified a concerning novel pathogen that undoubtedly had the potential to escalate into a global pandemic. Of thehe leadership commissioner, on january 27, i established an internal crisis using National Incident Management System principles to coordinate preparedness and response activities from across the department. Shortly thereafter on february 3, governor murphy signed executive order 102, creating a statewide Coronavirus Task force led by the commissioner of health. Since their creation, the Crisis Management team and coronavirus ank force have provided infrastructure that has allowed departments to organize, responsee activities. Simply stated, new jersey continues to manage the Public Health crisis because of our strategic organization, expertise, and collection of institutional knowledge. I must draw your attention to aspectsmost important of nationwide Public Health response. Coordination and communication. On sunday, february 2, during the afternoon of super bowl sunday, the new Jersey Department of health was notified Newark International airport would be officially designated as the 11th funneling airport in the United States with the First Arriving flights arriving within 24 hours with more than 350 travelers onboard from china. Within moments of receiving this news, our Crisis Management team began working feverishly to secure housing, transportation, and Wraparound Services for these individuals potentially facing quarantine. Because we established a Crisis Management team that was well organized, highly disciplined, and remarkably proactive, we were able to effectively coordinate a measured response in a moments notice. More importantly, as new jersey begins facing its first cases of Novel Coronavirus just last week, the Crisis Management team and Coronavirus Task force continued to effectively coordinate all aspects of the states response to ensure that Communications Remain organized, timely, and in the publics best interest. Throughout the past eight weeks, my team has been in lock step with our friends and colleagues at the u. S. Department of health and Human Services and the cdc both at headquarters and within region 2. The daily interactions and near Real Time Communications during fastmoving situations has allowed the state of new jersey to effectively communicate and coordinate our activities between all stakeholders. As Novel Coronavirus continues to affect new jersey, the strong relationships we have with our federal counterparts ensures we can communicate candidly and resolve issues immediately as they arise. In a dynamic Health Crisis such as this, maintaining tight coordination through streamlined, Clear Communications greatly increases the effectiveness of our collective response. But despite our Great Partnership with our federal colleagues the state of new jersey expends more than 1. 8 million per month responding to Novel Coronavirus. While our cdc award of 1. 75 million is greatly appreciated it certainly will not cover the continued expenses incurred by the state or the health care and Public Health infrastructure including our care facilities, ems agencies, and local Health Departments. Recognizing that medical supplies are facing historic shortage and that Health Care Supply chain is nearly frozen for respirators, disinfectants and other personal protective equipment, we urge you to consider additional funding to new jersey and the distribution of items from the Strategic National stockpile. New jersey remains committed to fighting Novel Coronavirus and protecting the Public Health and safety of all People Living in and traveling through new jersey. As the country continues to respond to this Public Health crisis, we ask that you remain attentive to the evolving needs of each state, specifically new jersey and mobilize the information, resources, and funding needed to protect the nations Public Health and safety. Thank you. Thank you, sir. And our next witness, which i was told by my staff i butchered your name, so i will try to do better. Im sorry about that. I now recognize you to summarize your statement for five minutes. Thank you, chairman payne, Ranking Member king, and all the members of the subcommittee, good afternoon. I am the executive Vice President and chief operating officer at trust for Americas Health. Tfa is a nonpartisan Public Health organization and among our priorities has focused attention on a strong and effective Public Health Emergency Preparedness system. Over the past nearly two decades tfa has published an annual report called ready or not protecting the Publics Health from diseases, disasters, and bioterrorism. In our most recent report we identified areas of strength in Emergency Preparedness as well as areas that need attention at the federal and state levels. Discussion of our report findings including our state assessments can be found in my written testimony or on our website. I would like to highlight some of tfas policy recommendations to build our nations preparedness for Public Health emergencies and improve the National Response to the Novel Coronavirus disease or covid 19. First, we applaud congress for rapidly approving a robust, emergency federal funding package. Federal agencies should be preparing now to quickly distribute funds to states and other partners. Second, Congress Must prioritize ongoing investment in core Public Health and annual appropriations. The nations ability to respond to covid 19 is rooted in our level of Public Health investment in the last decade. The nation has been caught in a cycle of attention when an outbreak or emergency occurs followed by complacency and disinvestment in Public Health preparedness, infrastructure, and work force. The Public Health Emergency Preparedness line which supports front line state and local Public Health preparedness has been cut by over 20 since fiscal year 2010 adjusting for inflation and on top of steady cuts since 2004. In addition, we have long neglected our Public Health infrastructure. So many Health Departments are reliant on 20th century methods of tracking diseases such as via paper, fax, and telephone. Congress should prioritize funding for data modernization to help with emergencies as well as ongoing disease tracking. Third, we need to ready the Health Care System for outbreaks. Health systems across the nation are beginning to identify, isolate, and care for patients with covid 19. Health care must prioritize the protection of patients and Health Care Workers including appropriate training on Infection Control practices, personal protective equipment, and surge capacity. Unfortunately, funding for the Hospital Preparedness Program which helps prepare the Health Care System to respond to and recover from emergencies has been cut nearly in half since 2003. Fourth, congress should support the medical countermeasures enterprised including the Strategic National stockpile which build the pipeline of vaccines, treatment, medical equipment, and supplies for Health Security threats. Fifth, we must build the pipeline of the Public Health work force. Although supplemental funding may help with shortterm hiring, this temporary funding does not allow for recruitment and retention of workers. Emergency preparedness and response are personnel intensive endeavors that require training, exercise, and coordination across sectors. This experience just cannot be built overnight. Six, congress and employers should consider job protected paid sick leave to protect workers and customers from Infectious Disease outbreaks. One of the recommendations we have repeatedly heard is to stay home when sick. For millions of americans that is not a realistic option. They risk losing a paycheck and possibly their jobs if they stay home when sick or to care for a loved one. In fact, only 55 of the work force has access to paid time off. Congress should pass a federal law to require employers to offer paid sick days as soon as possible. Finally, science needs to govern the nations covid 19 response, led by federal Public Health experts who have years of experience in responding to Infectious Disease outbreaks. Keeping the public and partners informed will be critical. We encourage elected officials and Community Leaders at all levels to make policy and communications decisions based on the best available science, understanding that the situation is evolving rapidly and messages may change. Communities that are considering school or business closures should follow Public Health guidance but also consider unintended consequences. For example, nearly 100,000 schools serve free and reduced meals to 29. 7 Million Students each day. The u. S. Department of agriculture should be implementing flexibility for schools to make grabandgo meals and other options available if schools are to close. The full extent of this outbreak in terms of Public Health, health care, and economic and societal costs remains to be seen. We do know that taking immediate steps to mitigate the effects of this outbreak will save lives and prevent harm. Thank you for the invitation to participate today. I look forward to your questions. Thank you. I now recognize dr. Dobbs to summarize his statement for five minutes. Chairman payne, Ranking Member king, distinguished members of the committee, thank you all so much for having me. I really look forward to the opportunity to talk a little bit about why Public Health is important, why is it different from health care, why is it really relevant to what were talking about right now . When i was in medical school back in the 90s i thought id be a medical scientist. I spent the initial part of my career and much of what i was doing i was working on hiv control and tuberculosis control not only in the American South but also, too, in Southeast Asia and in russia. And i learned a lot not only about medical things but the value of Public Health. If you want to have an impact on what goes on in a community, you cant look simply at the individual. You have to look at the community and the environment that surrounds that person. Its this Public Health investment that allows us to do the work that we need to do to make sure that the pub, the community, and the individual is maximumally protected. Switching to the coronavirus conversation, coronavirus is a virus and though most people will get over it without a lot of issues it will be the mortality rate for older folks who are infected is really bad. We need to mold our responses to we need to make sure we tailor our responses to those most affected. We have tools in place that Public Health has been using for years to look at Different Things and in mississippi for instance we have these massive well, significant flu outbreaks in Nursing Homes every year and weve learned very quickly that if we implement those basic Public Health responses like rapid identification, immediate isolation, quarantine, restricting visitation, that we can actually severely limit the impact on our older folks. The things weve learned year after year from not only our sort of micro outbreak responses but also, too, from these major things like h1n1, ebola, zika, we build up expertise. We build up capacity. We build up tools. When we talk about ebola virus we scrambled, right . Because it was a new thing and what do you do . The community was really scared about what is going to happen with people in the community. We basically put together technology to do home monitoring using mobile devices. But building on that foundation we were then able to go on and use this for our folks coming over for coronavirus. These historical lessons help us work to the future. But one of the challenges we face is this funding up and down where sometimes we will get specific money to address a specific issue like zika or ebola but then as that crisis resolves or diminishes, then we have to contract back to a state of acceptable but not sufficient readiness. When we look at whats going on in mississippi right now, we have activated our Agency Emergency response functions and we are working closely with our state Emergency Management agencies. Within mississippi and other states we have a Pandemic Response plan thats tailored around influenza but we know the elements within that plan are well suited to the response for a pandemic coronavirus. And pulling together different experts within our state, especially under the governor reeves passed an executive order putting a new Planning Committee in, well leverage that information that we got from responding to h1n1 making sure were prepared for the next flu pandemic to move forward but we cant really make sure we advance those efforts unless we have some steady funding and dont go through this perpetual rollercoaster cycle of funding for one thing limited to that, dont have the flexibility to use it for the next thing. I really think we could almost use less money if given more stably over time and be more effective if we were able to be prepared for the next thing. Also, lets talk about innovation. I think innovation is very important. Making sure we innovate not only in technology for surveillance because the things we use for Public Health are high tech data rich environments. We just recently in mississippi invested in Artificial Intelligence Business Analytics trying to look at whats going on with outbreaks in our state. These are things that are not inexpensive but it is not only the software but the people. If you want the best people doing the most important job, we need to make sure that we build up our Public Health work force and have the people there that can do what they need. Then telehealth i would like to say i appreciate the creativity of expanding Telehealth Options as we look at this Covid Response because what is going to be better than making sure people can be taken care of in their home even if they are unable to get out or if theyre ill or theyre being monitored but also, too, the older folks who might need to come in for other nonmedical reasons besides a viral illness, they can stay home and be cared for and not come into the Health Environment where theyll be exposed to these potentially dangerous things. We are proud in mississippi to have a Telehealth Center of excellence where we are advancing telehealth capabilities to reach people in all sorts of areas and department of health has partnered with them. I would like to thank you for the funding coming down. We will put it to good use and make sure we do our best to cut off this epidemic. Thank you. Thank you. I now recognize myself for five minutes of questioning. Thank you. This question would be to all of the panelists. Many have criticized the administrations outbreak response for being too slow to realize the severity of the threat. How would you assess the u. S. Governments response and what aspects of the governments response could be improved upon . You know, mr. Chairman, i would say there are two things where were lagging quite badly. The first is this testing issue. Again, as i said in my statement, there is no reason why other countries, south korea, are so far ahead of us. 100,000 plus tests in south korea. Less than 5,000 in the United States. I think that is a product of bad decisions made at the cdc and a lack of real effort to accelerate testing around the country. The second thing i think is hospital preparedness. In various communities our hospitals are going to see an influx of cases and i dont think theyve been prepared for dealing with that whether that is working with fema to temporarily ramp up capacity in those hospitals or to do things like theyre doing in korea and germany with drive through testing. We need to be creative and flexible but really increasing the capacity of our system to deal with the influx of cases were going to see. Thank you. Mr. Neuwirth . To agree with mr. Klain in that the testing capabilities of each state are something that needs to be addressed. In new jersey weve only received two test kits to date, recognizing that, you know, our 9 million residents are actively dealing with sars, we would expect additional capacity in the state of new jersey to effectively and efficiently test everybody that needs to be tested. To date those two test kits, you know, are something that needs to be addressed. The second is that recognizing how fast moving the situation was even back in january its important that information be shared in a timely manner as effectively as possible and ensuring decisions made at the federal level are effectively communicated to the states to ensure the states are in a position and maintaining a posture to implement those policy decisions made at the federal level. The greater lead time that the states are given, the more effective and appropriate those implementationes are. Thank you. Ms. Gracia . Yes, i would emphasize the importance of the coordination and really coordination across agencies and having senior level coordination as we are seeing now through the white house with the Coronavirus Task force. Secondly, the importance of continuing to rely on the science and the evidence to make decisions whether its policy decisions, Public Health guidance that is being put out by the federal agencies, that we continue to rely upon the expertise and the experience of the scientists as well as the medical and Public Health experts. So we need to believe and trust the science as it is coming along. Thank you. Dr. Dobbs . Dr. Dobbs thank you. You know, its been a very complicated and rapidly evolving situation. I understand it is very challenging. By and large cdc has been very responsive to our needs. I can call the leadership pretty quickly. We in mississippi are a little behind in the sense we dont have much in the way of testing but we do have adequate testing capabilities at this time. I would say that early on if we were given more flexibility in who we test i think that would have been good. There were pretty strict guidelines at the beginning. The other thing is, and this is part of preparedness to begin with, i think the cdc coordination with Border Patrol was a little bit difficult at the very first when we were getting our travelers in. We had a little bit of hiccups with that. We had a little bit of hiccups with that. But theyve been very responsive and it is a difficult situation and i just really do appreciate the work of cdc and the assistance they gave us. Thank you. In the interests of time, the chair will recognize the gentleman from new york, Ranking Member mr. King. Thank you, mr. Chairman. Let me just i guess ask mr. Neuwirth and dr. Dobbs, again, you sort of touched on this already, but what improvements could be made in coordination with the federal government now . I mean, allowing for whatever has gone wrong in the past but as of today forward, the last several days going forward, how do you see the level of coordination and what improvements can be made . Well, i think the coordination even among federal agencies would be good because we have seen some miscommunications between those levels which then kind of trickles down to us that can be a little bit difficult. You know, Quick Communications are very important. By and large i think thats been very good. I think clear understanding of what funding is going to be available and what we can use it for. And also i cant say how much i support the Hospital Preparedness Program. I think thats been cut some over the years. Thats really a foundational element for these sorts of responses. We have pulled back from i think actually cashing up as many supplies and ppe as in years past because the priority has shifted a little bit. I think that would be very important. Mr. Neuwirth . Specifically referencing joint base maguire, dix lakehurst, this is a base used by our federal partners as a potential Housing Solution for quarantined individuals. New jersey has put forth a remarkable amount of support and resources to ensuring this Housing Solution remains intact and fully functional to meet the demands of the situation. You know, the base was operational for an initial twoweek period. And the state up until the absolute deadline of friday at 8 00 a. M. Was unaware whether or not that base would remain operational for the quarantine, as a quarantine Housing Solution. So ensuring that, you know, new jersey can appropriately support, you know, this Housing Solution moving forward, this is one example of where understanding where the federal government sits as far as continuing this operation and how we can best support it is important to us. Since new york and new jersey are so close, we have very parochial interests in this and probably tens of thousands of more commuters back and forth every day. What is the level of coordination between the states . And, also, i know Governor Cuomo has gotten approval from new york to do its own testing. Has new jersey applied for that approval . Yes. So were doing our own testing in the state right now as of today the states Public Health Environmental Laboratories is the one in new jersey performing the tests in state and assuring a rapid turnaround time as best we can. We are in lock step with our new york city and new york state partners. You know, we have historically had a phenomenal relationship with the city and the state just because of our proximity, the way we manage and deal with the risk together, how we conduct our preparedness and response activities are often in lock step. And so its the historical relationships weve been able to leverage for this event that have ensured the relationship has been maintained and leveraged so both sides of the river are fully aware of what the other side is doing so we remain in lock step. Mr. Klain let me thank you for your efforts in ebola. It was outstanding and i give you full credit for that. Governor cuomo announced today and i wonder if this was ever contemplated if the ebola virus had not been contained as it was, he has actually ordered the National Guard into Westchester County and new rochelle, a onemile containment zone, basically originates from a synagogue and i think now there must be 50 to 100 cases not actually diagnosed but certain people being tested from that area. Was that ever something contemplated by you . I support the governor doing it but i can see if it is carried to a larger level it is basically going to shut down almost any community center, house of worship, school. It will leave certain businesses open. Do you contemplate how that would actually be implemented . Congress, we did not. We never expected to have that many cases of ebola in the United States. We were focused on isolating people when they came here from west africa and getting them promptly to treatment. I do think this subcommittee should look at the issue raised by this kind of quasiquarantine of new rochelle and what other measures could be effective. I also think, thinking about the National Guard or fema to help increase hospital capacity, tent hospitals, rapid treatment centers, i think, you know, were going to need person power to help respond. At a time when our Health Care System well see doctors and nurses drop out because theyre sick. Theyre going to get the virus, too. I think creative thinking about who can help power this response is an important thing. My time is i yield back. Thank you very much. Thank you. The chair now recognizes the gentlelady from new york, miss clark. Miss clark thank you very much, mr. Chairman. I thank our Ranking Member and our expert panelists for coming in to share your expertise with us today. We know that America Needs a fully funded whole of government response to stay safe against the coronavirus. In my home state and city of new york, we are in the midst of an unprecedented Health Crisis. Leaders should not minimize or exaggerate the scale of the task before us. We can beat the coronavirus but the Administration Needs to set politics aside and put scientists in the drivers seat. Having said that, mr. Klain, after weeks of stating enough resources were available to fight the coronavirus the Trump Administration finally announced that it was seeking an emergency supplemental to make Additional Resources available. This request was made more than a month after the first recorded case of coronavirus was discovered in the United States. How would a timelier response or how would a timelier request excuse me have helped the u. S. Respond better . Congresswoman, i think that is a good question and i testified before the Foreign Affairs subcommittee about a month ago and said that the request should already be here and congress should be acting on it. I do think more funding might have accelerated the testing situation, might be helping states more quickly. I think it is important to know, again, Congress Deserves great credit for passing the funding quickly but the real question is how quickly does it go from washington out to the states . The gentleman and ladies to my left here, you know, theyll have to actually make this work on the ground and they cant unless the money moves from washington to them. I think thats really where we should be focused on now is once congress did this incredible thing of in two weeks writing and passing a bill, is the money really getting out there to ramp up testing, ramp up Health Care Systems, help the people who are going to need the help . Miss clark very well. So this question is for both you and dr. Gracia. I think many of us in congress were shocked and disappointed that the administrations initial proposed amount for the emergency supplemental was only 2. 5 billion. Luckily, Congress Passed an 8. 3 billion supplemental that was significantly more robust than the administrations request. What more can the government do to ensure that there is enough funding to support state and local outbreak Response Response efforts . I would add to that, leaving infrastructure in place so were not rebuilding the infrastructure time and time again as these outbreaks occur because certainly there will be others . Congresswoman, i agree with that so strongly and with what dr. Dobbs said earlier, issues sometimes the amount of money and the consistency of the funding. We are in the middle of an epidemic and thats what were focused on as we should be but were only three years away from the next one. And three years from the one after that and three years from the one after that. Its these boom and bust cycles in funding that undermine our preparedness. I think i hope what congress will take out of this is great job on the emergency supplemental but what are we doing to prepare for the big threat that is out there in the future . Thank you, congresswoman. You raise an important point and question and one is a recognition you have that Public Health departments at the state and local level are our first line of defense, where they are Public Health consequences. What we have seen, however, is that there really has been a longer term underfunding of Public Health and there have been cuts that have really impacted Public Health departments at the state, local, tribal, territorial levels. We look at, for example, the Public Health preparedness grant administered by the cdc that that has experienced cuts over the years, 20 , more than 20 over the past decade, where the Hospital Preparedness Program which has been cut in half since 2003. These are important funds to really be able to support Public Health over time, to be able to continue to have the type of Emergency Preparedness response infrastructure for surveillance for the workforce. Its very difficult to hire individuals for the short term and guarantee theyre going to be able to stay on board and build that training and capacity within the Public Health departments. There also is a need for more funding as it relates to the core capabilities in Public Health. Things like pandemic preparedness but also communication expertise, epidemiology and surveillance expertise, the ability to bring together coalitions, these types of areas are truly fundamental for core Public Health. The Trump Administration has repeatedly attempted to cut funding to Public Health. Could you describe how chronic underfunding of Public Health makes the United States more vulnerable to outbreaks . Dr. Gracia so, i think one is to recognize that we have made actually important progress, in particular over the past two decades as we look at Public Healths level of preparedness, in particular since the september 11th attacks, that there was recognition that Public Health really is part of the national Health Security enterprise and we needed to really bolster that infrastructure, which is inclusive of laboratory capacity, the workforce being able to have the Surveillance Systems in place and Communication Systems in place as well as looking at coalitions that can be built between Public Health and health care. As i noted earlier, what we need to do is really build on the expertise of Public Health threats. These are the individuals who have been through these types of outbreaks and other emergencies in the past and recognizing that the need to have stability in that funding so that it is not at risk, we have seen, for example, over the past decade the budget to the centers for Disease Control and prevention has declined by 10 and a large percentage of cdcs budget is closed to state and local Health Departments. Thank you, mr. Chairman. I yield back. Thank you. I recognize the gentleman from mississippi. Thank you, mr. Chairman. Dr. Dobbs, you and i had a chance to visit earlier before your testimony and you and i discussed about the fact that we currently in mississippi have both the ability and capacity to test for covid19 in our home state. Can you talk just a little bit about that, please. Dr. Dobbs dr. Dobbs dr. Dobbs part of it may be that the timing was advantageous, but we were able to bring up the covid19 testing pretty quickly. Our Public Health lab within a week of getting the guidance was able to get the testing activated. So far, we havent done a ton of tests. Weve done about 50 but theyre all negative. We have many coming in every day and we think we have sufficient capacity to meet demand for the near future but with private lab capacity coming online, like lab corps and others, that will help with the clinical environment. Im looking forward to the opportunity where Public Health can fulfill a different role, mostly surveillance so we can have a better understanding of whats going on in different communities and acute testing. We can run it in about four hours after we get a specimen. If something needs to happen right away we can execute that. Can you talk about your response that youve received so far from cdc . Dr. Dobbs in response to the testing, its been good. The information that theyve been giving us has been helpful. Their guidance has been good, their guidance for clinical scenarios. I will say the website is cumbersome. I need to talk to them about that. Et it doesnt come as fast as you want it. The quality of the work has been good from our perspective. Youve talked in your Opening Statement and questioning and written statement about the use of telehealth and say here telehealth will assist in Community Mitigation efforts by improving efficiencies, permitting patients to stay home and noncovid19 patients access to Health Care Without coming into physical contact with a clinical environment. Could you explain that briefly again. You bet. If you think about who is at risk for bad outcomes from covid19 its older folks primarily, people with chronicle medical conditions, people that will access the Health Care System frequently and a lot nonurgent, things that can be done through a telehealth platform. We have been pushing hard with our partners at umc and other health stills, blue cross, trying to help them set up systems where they will Fund Communications with people interest their home so that you dont have to right now, you know, or at least previously, you have to go to another clinic setting around a bunch of other people. Its so much more convenient, this is not only an opportunity for us to help with covid19 but maybe catapults the future of health care thinking what telehealth could look like. Is it conceivable telehealth could be used to help screen individuals as they are coming into the country in ports of entry . In a place like mississippi, especially where we dont have a lot of medical providers and rural geography if we could leverage telehealth for that function or any other function that requires medical intervention it does expand our reach remarkably. You talked about the importance of the Hospital Preparedness Program. Can you expand on that a little bit. If we think about the boots on the ground, who are the people who will respond locally when something goes awry, the locally community folks, the local Emergency Management folks, the hospital, the clinic, its going to be the people in that area and the hospital Preparedness Fund helps lets us organize these Health Care Coalitions so that we can have a reach into the communities and respond but also make sure that hospitals are ready not only in supplies but also planning because theyre going to be the at front line. The thing that worries me about this is utilization within our hospitals and intensive care units. If we have a bad flu year we run ot of beds. Having that infrastructure to make sure were ready is going to be important. That helps you in your department with the logistics as you are trying to find placement for individuals who are ill, whether it be with coronavirus or some other illness they be battling . Absolutely. And then also, even within the program, there are flexibilities that might help like, for instance, we have a warehouse of ppe that we keep, we have about 200,000 masks we can distribute immediately if we need to. Were ready to go. Based on some of the structure of the hpp program we only can use 10 of it for overhead administration but they count rent for the warehousesoverhead. We would welcome flexibility in funds for hpp as well. Dr. Dobbs, briefly for the people back in mississippi, can you talk about the emergency supplemental funding and how that will be used to fight coronavirus back home . We have got a laundry list of things we want to do. We want to expand surveillance, increase lab capacity, we want to expand and weve started doing some advanced analytics to figure out where cases are going to be. We want to make sure we have resource allocated for like ppe or other things to support hospitals. We want to ive brought on three doctors, i dont know how im going to pay for them, i guess this is how, and nurses, boots on the ground to get the work done and then advancing technology and equipment and other ppe needs. Thank you, dr. Dobbs. Mr. Chairman, i yield back. Thank you. The chair now recognizes the gentlewoman from illinois, miss underwood. Thank you, mr. Chairman and thank you to our witnesses for being here today. Its a pleasure to see my former colleagues from the Obama Administration here today as we chart a path for congress to lead a response to the coronavirus. Mr. Mr. Klain, what essential leadership functions must our federal government fill when it comes to helping the public, state and local Public Health department, employers and our Health Care System navigate this ploig Public Health crisis . I think on the competence side, the government has to provide the leadership and funding to deliver this response. This is going to be a giant project to manage these cases, to roll out testings, as the panel has discussed, to help our Health Care System get prepared for the influx of cases and to deal with all the other things, the contract tracing, state and local Public Health departments are going to do. So the government the federal government has to provide expertise in the form of the cdc and people at other agencies, has to provide funding and leadership and confidence. I think we these to see from washington clear direction and messaging so that the American People can panic less and can understand that there is a plan in place and a way of attacking it and so on and so forth. I think both those things, we just not hit the mark on that yet and we need to do better on both of those fronts. Thank you. You recently published a report evaluating states ability to respond to Public Health emergencies like the coronavirus. What did you learn from publishing that report about the actions the federal government must be taking to support state and local Public Health departmentness addition to providing supplemental funding . Thank you for that question. Indeed, we published this report which as i noted earlier demonstrates and documents the progress we have made overall with regard to our national Health Security and Public Health preparedness and there are areas for improvement. One being the issue with regards to funding for states and localities to respond in a way that meets these increasing number and frequency of Public Health threats. We also recognize, too, that this is an important area that not only involves the Public Health sector. Often we think about the Health Threats assize isolated to Public Health departments and yet they require a multisectoral approach in which we engage various sectors from the business sector to education sector, the Health Care Sectors and others that are really involved and have a seat at the table as well as the community and really driving preparedness and response. When we think about what the federal government can be doing, is really helping to support that capacity for state and local Health Departments, ensure that there is that stability of funding so that type of coordination, that expertise and that capacity can continue to be built in states and localities to do exactly, for example, as dr. Dobbs has spoken about, having the workforce that is trained, having the laboratory capacity, the surveillance thats needed. In your written testimony, you also touched on how the flu vaccination is a proxy measure for our ability to vaccinate a Large Population once the Coronavirus Vaccine becomes available. Can you expand on that . Dr. Gracia yes. You know, the flu and what we see, for example, with seasonal flu outbreaks demonstrates a couple points. One it shows how Public Health dreptsz often having to deal with multiple crises at the same time and how they can be stretched with regards to really being able to respond to the needs of the public. But secondly, because with the flu vaccine it is a vaccine that is recommended for almost a majority of the population, recommended by the cdc for individuals who are six months and older, it also demonstrates what our vaccine infrastructure looks like with regards to if we were in need of doing a Mass Vaccination Campaign for adults with children, children are seeing their physicians and other Health Care Providers for frequently, with adults that may be more difficult. In looking how were doing with seasonal flu, which as a nation the average National Average for seasonal flu vaccination is 49 , whereas the actual recommendation from the department of health and Human Services in the Healthy People 2020 is to reach 70 . We recognize that there are shortcomings and gaps with regards to that infrastructure, that entails Public Health departments, health care, commercial entities as well to ensure that population is vaccinated. And do you want to speak about why flu vaccination is so such an important part of our response to this threat . Dr. Gracia so in particular, we are currently in the midst of, you know, the flu season and we still have high activity across states. You know, its important that we know that the best way in particular to prevent the flu is through flu vaccination and many of the preventative measures we talk about with regards to hygiene and hand washing and staying home when sick, that those are similar types of preventative measures and guidance that were providing as it relates to covid19 and the Novel Coronavirus. As we think about what may be needed down the line with regards to the types of interventions, really building the capacity to respond to outbreaks such as the flu, is important as we think about outbreaks such as covid19. We saw one of the deadliest flu seasons in the 2017 2018 flu season in nearly four decades and that really lends to how we as a nation are prepared for these outbreaks. Thank you all so much for being here and your testimony today. I yield back. Thank you. The chair recognizes the gentleman from texas, the longhorn state. Mr. Censhaw. Thank you, mr. Chairman. Thank you all for being here on this important topic. This question goes to or the gentleman from new jersey and the gentleman from mississippi. I just want to get your take on the proper roles at the state level and federal level. We hear were unprepared, we hear were way unprepared or doing pretty well. Its all relative in the end how well prepared we are. I want to get an idea from you at the state level, what does preparedness look like at a reasonable reasonable standard and what is the different function of a local county Public Health Center Versus the state level versus the federal level . What is the best way to interact . First and foremost, preparedness looks like having the funding and resources feeded at all levels of government to adequately respond to what were seeing day to day. That requires our acute care facilities, hospitals, longterm care facilities, Health Departments, having whatever they need immediately to conduct their job, continue providing high quality care to those that are ill, allow the resources and staffing and information needed at the local Health Departments to ensure appropriate case management, Contact Tracing and overall management of the pathogen in the communities as needed. Coordination and communication to all levels of government is incredibly important to ensure that the states have a unified, coherent strategy on mobilizing all of the preparedness activities and resources that they have available to them. Without timely information from the top about important policy decisions that are being made can we get an example. I kind of want to dig into the preparedness. You said when everything is really perfect, thats prepared. But thats not reasonable. I asked for a reasonable standard. I mean, how much better can we be reasonably . I want to have reasonable conversations here. Of course we could quadruple your funding and you will be more prepared and come back and ask for more money. I know how this goes. Of course we want to keep getting better. Within a reasonable construct, what does prepared look like . How many masks and pieces of equipment are reasonable to ask for and should have had ready prior . What exactly are we not was the federal government not communicating to you effectively . What has been said moments ago that continued funding over, you know, the past several years to continue to maintain what weve built upon from previous outbreaks such as ebola, zika, the opioid crisis, theres been a lot of work thats been maintained, but the increases and decreases of funding year over year degrades the preparedness activities we have put into place. Ensuring that the resources are available to the states the the federal governments job to make sure the states have the resources but so what where is the states role in that and why cant you be ready to the standard youve set yourself . We are ready to the standard weve set for ourselves. Its a matter of maintaining that level of preparedness year over year. Because in between those years, the states are managing disasters, Public Health, Natural Disasters, technological the we use the resources and that we use the resources and preparedness activities to respond to. It requires tight coordination and support from the federal government to ensure that, you know, year over year as the states prepare for in response to various disasters, that capability is rebuilt and, you know, exercised and ready for the next disaster. Im just trying to get more details because im trying to get examples on exactly what where did we fall short and what exactly was it, and how can we do better the next time . I understand we always need to do more coordination and we can talk in vague terms and say more funding and coordination. Were really trying to get into some specifics here. Maybe the gentleman from mississippi can give us insight from mississippi . Thank you for your question. I think one of the things its important to think about from a state perspective, ive been doing this a long time, state budgets and county budgets especially are susceptible to the business cycle. When they contract, they just they cut indiscriminately. The stability that we see primarily is going to be for better or worse, theres a lot more stability from the federal funding sources. That can be the bedrock of Public Health. The other thing thats happened Prime Minister philosophically as we work to expand Insurance Coverage to people which is important and people need health care, theres been an assumption that Public Health and health care are the same thing and theyre not at all the same. I have about half the nurses i had four years ago. How do you respond to a crisis when i cant pull nurses to go to houses and check on people. I think this sort of communication about health care versus Public Health has distracted from some of our core needs. The other thing i think relationships is so important. Sometimes some places have great relationships with the local folks and the counties and stuff and when we have those relationships prebuilt, its not just a money thing, its a slow investment so when things do go bad we call joe and say we have this going on and we know what to do together. I think that gets to the stability and the steadiness of how much better it is to have a slow and steady approach than having a more reactive approach. Im out of time. Thank you, mr. Chairman. Thank you. The chair now recognizes the gentleman from louisiana, mr. Richmond. Thank you, mr. Chairman. I will pick up where my colleague left off talking about specific examples. Mr. Klain, i will ask you, not having enough tests is explain to me, was that necessary, incompetence, oversight . Tell me how it is that korea has more tests than the United States. Mr. Klain congressman, i think this is, as i said in my statement, singular failure of u. S. Policy and execution. The president imposed travel restrictions on people coming here from china. And those travel restrictions, though uneven and not complete, slowed the pace of the disease. It bought us time. Buying time works if you use the time productively. We knew in december, in early january, we were going itto need we were going to need millions of tests, i said we should test 30 Million People in the United States, seniors, people in Nursing Homes, doing surveillance, not just waiting for people to raise their hands and say test me. We needed that in january. We knew we needed that in january. The cdc pursued building its own test that turned out to be flawed and didnt adopt the w. H. O. Test, and we dont really know what significance there was in the messages that the president sent, that this wasnt a big deal. He said as recently as 15 days ago there was only 15 cases and its almost resolved. You had a series of management failures, bureaucratic failures, execution failures, that leave us so far behind other countries. This is a scientific problem. If they can test 150,000 people in south korea, america can test people too. They dont have any wisdom we dont have here. Thats a failure of execution in this country. Thank you. Dr. Dobbs, let me ask you, lead state Health Official in mississippi, i want to engage in a conversation about the collateral consequences and challenges that you face, so lets take gulfport, mississippi, and i am a casino worker that gets paid by the hour. Biloxi and gulfport survive a little bit on tourism. How if im feeling down, how do we get that person to take those days off thats necessary or selfquarantine for 14 days and still pay their bills at the end of the month . Thank you for the question. Thats an enormous challenge and weve been engaging with business communities, especially businesses that have a lot of hourly workers and not that we have a resolution to this at all but it is a big challenge because people who work hourly, and get paid and dont have sick leave, are not going to do it. At the state level, the State Government, you have to take a vacation day before you can take a sick day. People will not want to take a vacation day. We are looking at part of any Emergency Declaration to do away with that. With government, there are opportunities to address those inequities. In the business community, it is a challenge and i think we, as a country and as a state need to look at options to make sure people can have paid sick leave. The other thing to think about, and theres not an easy answer either, when people have to go without a jobut for two weeks who is going to pay the power bill. Were working with nonprofits but it could be a big issue and might cost a lot of money. Let me ask you another question, and im thinking out of the box, but in new orleans we are accustom to Natural Disasters, hurricanes, bp, levees, thats where fema steps in with either individual assistance or public assistance and start off with a certain amount and you have to prove your need and all of the other things. Is fema the agency that we could task with providing either individual assistance, public assistance if needed and prove somebody out there, if we want to be responsible with this, somebody will have to provide some assistance, so could fema do that under the individual Assistance Program . Technically speaking, im not sure its the best mechanism but conceptually, it sounds like a very good fit to me. If we align this with a disaster response. It seems like it makes a lot of sense. Congressman, it could. Five years ago, i wrote a piece where i said congress should amend the stafford act to add epidemics as a disaster for the purpose of the stafford act. Right now, fema could do what you suggested if you saw another hurricane in your state or an earthquake or a fire, but epidemics are not a Natural Disaster under the stafford act and to go back to the question congressman censhaw asked, thats a zero cost, but the kind of thing we should be doing to get prepared. Whether this one or another one, someday, we will face an epidemic that is a fema triggering disaster and the stafford act should catch up with that. Thank you. And to the former chairman when i got here, mr. King, from new york, one of the last recommendations that we still have not adopted from the 9 11 commission is to put all of the jurisdiction to responding to Natural Disasters and others and putting the stafford act back under homeland so weekend so we could coordinate and i think now may be the time for us to raise that issue in a bipartisan manner to get homeland the jurisdiction it should have. I agree. Its long overdue and i appreciate the gentleman raising that issue. Thank you. I yield back. Thank you. Mr. Neuwirth sorry. Ive done that once before. The chair recognizes the gentleman from texas, mr. Green. Thank you, mr. Chairman. I thank the Ranking Member, as well. I thank the witnesses for appearing. There are times when we are not as alert as we should be and i do confess that as i listened, i was not as alert as ishd should i should have been because i seem to believe that i heard dr. Dobbs indicate that in mississippi, you have to take a vacation day before you can take a sick day. Im confident that i was not as alert as i should be. I should be more alert. I should hear, i should listen. Dr. Dobbs, tell me that i did not hear you properly, that i misunderstood, please. No, sir. You are absolutely correct. Thats for State Government workers. Not for everybody. You know they eats the same way everybody else eats. He was telling them that in mississippi, if you are sick, before you can have a day of sick leave, you have to take a vacation day. Yes, sir. Do you know of any other state in the United States where this is prevalent . You know, i didnt know that that wasnt prevalent. I didnt know any better. So well, maybe i dont know better either. Staff, somebody, please help me. I want to know because i that shocks my conscience, to be honest. It does. Sickness and vacation are totally antithetical, theyre not the same, theyre not in the same class of time and leave. But you have given me reason to pause and think. Now back to why im here today, much of what we hear and learn when we experience these circumstances is counterintuitive, wearing some sort of gear on your face, the public believes thats beneficial. People go out and buy as much as they can for their faces because they assume it will protect them. The staff has provided meh some intelligence that i would like to share with you and i would like to find out what your thoughts are. It reads, many countries actually many others but i will say countries, many countries have implemented travel bans, restrictions and border closures against china and other affected nations. Notably, the world Health Organization, w. H. O. , opposes the use of travel bans and Public Health experts have expressed skepticism of the effectiveness of a travel ban. Now, im a lay person. I read this. I see travel bans in place. Would somebody kindly give me your thoughts an what the world Health Organization has indicated in terms of its opposition to the use of travel bans and the skepticism of the effectiveness . I will try to start, congressman. The issue is that almost theres been numerous studies of travel bans through the years and what they find is, that they can delay the introduction of a disease but not stop it. Were living through that right now. The Trump Administration imposed a ban on some travel from china and yet, coronavirus is here and spreading rapidly. It did delay i think the spread, but it didnt stop it. Now why. In part because by the time the ban was spread, 200 or 300,000 people from china had come here. The disease also is coming from italy, its coming from other countries around the world. We cant stop the spread of that. The travel bans never prevented americans interest traveling back home to our country as it should not but americans can bring this disease to our country as much as nonu. S. Nationals can. Even the trumps travel ban with regard to china exempted crews of planes and ships. Now why . Because our Health Care System needs imports from china. We cant have the kind of things these other people are talking about, ppe, drugs and Health Care System, unless theyre coming in our supply chain from china. Boats from china bring those here. Those boats are driven by men and women who are chinese. So that was exempted from the trump travel retricks. We live in an interconnected world. Travel restrictions will be incomplete and imperfect, too late, it doesnt mean an effort to slow the spread of the disease wasnt smart, i think it was smart in some respects. Were living the reality that it did not keep this virus out of this country. Thank you, mr. Chairman. I yield back. Thank you, sir. I ask for unanimous consent tore representative jacksonlee to sit on the panel and ask questions. The chair will recognize the gentlelady from texas, miss jacksonlee. I thank the chair for his courtesies and the Ranking Member as well and thank you for holding this important hearing. Im going to ask unanimous consent to submit into the record a coronavirus plan of action that i introduced about two months ago. I ask unanimous consent. Without objection. Thank you. Let me thank all of the witnesses that are here and its my intention to try to ask quick yes or no answers. I may focus not painfully, mr. Klain, on you, not painfully but because you have the federal experience and thats where we are now. To the Health Nonprofits and state agencies, i want to make sure that were being as helpful to you as we possibly can so we may have just the straight yes or no answers. I do want to say, is that with the leadership of the house, we passed an 8. 3 billion plan excuse me, funding that includes through emphasis of members on this committee and others, funding to state and local health agencies. We hope that you will see that money for purposes that you need to see them. My line of questioning will be along those lines and then i will spend some time with ron klain. So mr. Commissioner neuwirth, do you have test kits in your possession in the state of new jersey . I have two test kits in possession in new jersey. And is that entire state or do you think your local agencies have test kits as well . The state of new jersey has two test kits each with 500 tests in them. We can test a maximum of 432 individuals with two test kits. So even though you said 500 apiece or total . 500 apiece of which 432 total between the two. Even with me adding and saying you have 1,000, you can test 432. Each individual requires more than one test. This is only a news report, your Port Authority director, recent news reports are indicating that the port of new York New Jersey is now infected with the coronavirus . Is that something you can affirm . I, too, have seen any in thethat have seen that in the media. Dobbs, Mississippi State, thank you very much. How many test kits do you have, sir . We have the capacity to run about 700 tests. So in that can you say what how many test kits you have . I know you do several out of that . We just got a shipment of that additional kit, and each will run a bunch of tests obviously. So we have some left from the previous one and then a new one we just got in this week. So you wouldnt 700 tests does that mean on one individual two tests for each person, yes. Down to 350 per person that you could test. Im not familiar with im sorry the trust for Americas Health is this a congressman, we are a nonprofit nonpartisan Public Policy andcacy research organization. One is Emergency Preparedness and we produce a national report. Let me ask you theres a debate about the contagious nature of coronavirus. Would you say it has a high level of contagiousness, if you will . We are seeing that it is. Its a coronavirus that has easy transmissibility and so the way in which were talking about taking preventative measures and precautions is similar to what we would do for other does it have a high level of contagion factors . Were learning about the disease. I think one, we recognize enough, there is person to person transmission, were seeing Community Spread in certain parts of the country and so because of that, are taking these types of precautions. I think to a higher degree than others. People are comparing it to the flu and i dont pretend to be a professional but i would venture to say that the flu does not equate in its contagious factors to the coronavirus. Im going to i was almost going to call you, ron, dr. Klain, but let me move forward. My premise is we have not been as effective with the federal government starting with the administration. Ebola under the administration of president obama and biden and one of the strongest or one of the more difficult cases was in the state of texas where medical providers, nurses and others, someone took off for a wedding and vacation, but let me ask this, i think we had knowledge of this in december of 2019. What would have been the road map, been equipment for our preventative equipment for our health providers, storing up our test kits so they could be appropriately distributed, the appropriate documentation to inform people about washing hands, with an immediate statement after the first of the year, talking about preparedness and not panic. Can i yield to you on the response youve seen so far. Thank you. I would say there are three things that should have happened in january that didnt happen. First, a real focus on getting the test capacity Problem Solved by adopting the w. H. O. Testing approach or by some other solution. Were just way behind and as a result of being behind, we cant really have an effective containment strategy identifying where the disease is. Its in a lot of places in this country, we dont know where it is. Thats a problem. Thats a failure on testing. Secondly, i think getting our medical facilitys preparedness ready for a surge of cases, hospital, communities, Community Health centers are going to see an influx of cases and not have the capacity to deal with that. Thats really a problem. And the third is, i think crisper communications about warning people, this was coming. I understand, we dont want to panic people or be hyperbolic about it but weve known since january we would see a ramp of cases that would have effects across the country and what were going through is a little bit of public panic because its coming on suddenly, unexpectedly, we havent really prepared for that. I think those are the three things that we missed by a slow response here. Let me just thank you. Let me just thank you very much and the i will try to follow up with that. Mr. Klain, i will try to follow up. Thank you, mr. Chairman. Lets see. Now, unanimous consent request for the gentleman from louisiana. I ask unanimous consent to put in the record article by ron klain, success not to be repeated. Without objection. Mr. Chairman, may i add something to the record . Dated march 3rd, 2020, u. S. Has only a fraction of the medical supplies it needs to combat the coronavirus. Without objection. Thank you. Mr. Neuwirth, youve heard the that the federal government has been ineffectiveless ineffective in communicating and providing contradictory guidance to the local and State Governments during this outbreak. What has your experience been and how can communication with the state and locals be improved . So our experience has been one of there have been challenges to this point ensuring that were able to implement the policy decisions of the federal government in a timely and consistent manner. We are in lockstep with our regional representatives at u. S. Department of health and Human Services and the cdc, of course, but there are, you know, there have been since the beginning of this in january, instances where, you know, additional lead time on information coming from the feds would have provided the state of new jersey additional time to prepare and respond in even more efficient manner up until this point we have been very proactive in our implementation of the Crisis Management team and the Coronavirus Task force so weve been prepared to respond on a moments notice but additional lead time of information coming from the feds on important decisions such as screening at the airports, the joint base and the testing kits would be tremendously valuable. Oh. Yesterday, we learned that cdc has delayed presumptive coronavirus cases in new jersey, has this issue been resolved . This issue has not been resolved. To date, the cdc has not confirmed any presumptive positive case in new jersey. Thank you. And to mr. Klain and mr. Neuwirth, also the role of rollout of the test kits has been flawed, obviously we have to new jersey. What could the government have done better to ensure that local and state laboratories could test americans for coronavirus . Mr. Klain, do you want to start . You know, mr. Chairman, as i said a minute ago , i think we could have made a decision to adopt the testing protocols and kits used in other countries that allowed them to ramp up. We made a different decision here. We could have made it a high priority to focus on that. I think we lost time and were behind. I think the decision to bring in private labs is a positive decision. It certainly increases the capacity, but thats only going to deal with people in a diagnostic and clinical setting. Your doctor says go get a lab and we need to be doing surveillance and out in the community and finding the cases, finding the cases in Nursing Homes and Community Cents and where older people congregate. Centers and where older people congregate. I think thats really a weakness of relying on private labs as the Principle Solution for testing. I concur with mr. Klain, its important to recognize that state Public Health and Environmental Laboratories of which theres a network of them across the country, are primarily as surveillance laboratories not clinical diagnostic laboratories. We do not as state labs have the clinical through put that these three party commercial labs have. Its important to bring on board and bring online these thirdparty commercial laboratories for the clinical diagnostic piece that they can test tens of thousands of individuals in any given time and allow the states Public Health and Environmental Laboratories to conduct very progressive and very, you know, comprehensive surveillance activities across the state to ensure we remain ahead of where these cases are. Quicksand thank you. Thank you. And in the interest of time votes have been called and i , will recognize the gentleman from new york for questioning and a closing. Thank you, mr. Chairman. I request mr. Klain and let me just state for the record up front that obviously the test kits was wrong, it should have been out. Im asking this in a rhetorical way. Planning toward the future what we learned from the past. To me, the cdc, the fact that they did not accept the w. H. O. , was there a reason for that . Secondly, is there a partisan influence in the cdc or was this an honest mistake made by scientists in the cdc or doctors in the cdc when the test kits came out and they were obviouslily inadequate and flawed . Im getting at, there can be policy mistakes and just the luck of the draw they did their best and went wrong. Any thoughts you have based on your experience . Congressman, you know, i think we dont know the answers to that question. We dont know the answers to some of those questions. You have to ask cdc why they made the choices they made and the approach they took didnt work. I dont know the answer to that. I dont think this is a partisan thing. I dont think this is some conspiracy or political decision to go this way, but i do think and so i dont want to overstate my criticism of the administration puts also dont want to understate it. The signs were flashing yellow early on that the cdc approach was not going to work and i think stronger coordination and leadership from the top, to say weve got a mess here, no one chose to make this mess. It was an accident. We need to do something quickly to turn this around and get this fixed. I dont blame anyone for the initial mistakes and consequences but thats what leadership is. Leadership is saying this suspect working, we need to get on top of this and catch up. And i think thats i think where, you know, without being partisan or political thats where the policy decisions came. Once the lights were flashing yellow what did we do to accelerate a response to that. The only question i would add to that, i dont have the answers, im not trying to make this a partisan debate, would they have said this is politicians interfering with the scientists. If the cdc thought this was the right way to go and some member of Congress Said you have to speed this up and they did and it didnt work they would say its politicians interfering with the science. I think thats a people at the top congressman thats a look i think thats a fair question and what i would say is that the role of political leadership, whether that was president obama in the Ebola Response or President Trump and Vice President pence now is to ask the scientists how is it going, whats going on here . Why is it im waking up seeing korea tested 50,000 people and we tested 500. The same question like so i dont think theres anything politicizing about science to ask your scientists how come im seeing this on the news and not seeing this here. Ultimately the medical decision, scientific decisions should be made by them. The government should hold people accountable for results. Again, if i could make it semi again, if i could make it semi partisan point maybe thats important why it is to have you and the Vice President running these things. Maybe if mike pence had been there from the start they would have gotten a faster response. Chris congressman, i absolutely congressman, i absolutely agree with that. Some kind of white house coordinator was needed. It was one of my early criticisms of the administration. Im glad theyve done it. My only criticism of the current coordination someone needs to be on this fulltime. The Vice President has other responsibilities, its just a reality. I think they brought in ambassador birx, who i have a great deal of respect to work with the Vice President. Shes doing her other job as well running petfar. Whether her or someone this should be a fulltime job. This is a big problem for our country and leading the response shouldnt be your side gig. I hope when this is all over we have a good after action report. Thank you for your service. I thank the gentleman and i absolutely am a believer in the time of crisis, we should tend to lean on people that have had some experience in the past, the near past, such as yourself involved if these things. Thank you for your service. I would like to thank all the witnesses for their valuable testimony and the members for their questions. The members of the subcommittee may have additional questions for witnesses and we ask that you respond expeditiously in writing to those questions. Pursuant to Committee Rule 7d, the hearing record will be open for ten days. Without objection. Hearing no further business, the subcommittee stands adjourned. And we are 389 not voted. Thank you. [gavel banging] follow the federal response to the coronavirus at cspan. Org coronavirus. You can find white house briefings, hearings with key Public Health officials, and interviews with Public Health specialists. Any time at cspan. Org coronavirus. Unfiltered view of government, created by cable in 1979 and brought to you today by your television provider. On tuesday, joe biden extended his delegate lead over senator Bernie Sanders after winning primaries in mississippi, missouri, and michigan. As the results were coming in the former Vice President spoke to Campaign Staff in philadelphia after canceling a planned event in cleveland due to concerns over the coronavirus. Senator sanders also canceled a rally in ohio for the same reason