Transcripts For CSPAN Senate Hearing On Procurement Distribution Strategies In Response... 20240712

Good morning. This hearing will come to order. , want to thank eyewitnesses first of all for your service to this nation. On behalf of the committee, if you can thank the men and women who worked with you and apron pretty tremendous effort, trying to deal with an overwhelming situation, as a nation, we need to be grateful for your effort. Had thebly have not days off. I really do appreciate that. Toant to ask for consent have my statement entered into the record. Just a couple of facts. Just to lay out how extraordinary and overwhelming this effort has been. Not thatanuary 21, long ago, we had the first case reported of covid and eight days later on january 29, the administration established the task force. At that time, we only had five cases and zero deaths. Two days later, President Trump announced travel restrictions in china. That was not a popular decision, but it probably saved many lives and but as time to flatten what bought us time. Fema began assisting hhs. 12 cases and zero deaths. I would say that is pretty forwardlooking. Fema already recognizes this will be a real problem. About a month later, march 13, President Trump fema was put in charge of the effort. On march 19, the the president pence led response. 11 days later on march 30, fema announced the Stabilization Task force. Cases. 160,000 i point that out because it is easy to set up here. The easiest thing in the world is to be a monday morning quarterback or armchair quarterback. When i looked through the testimony and i see what has been pushed, in light of how overwhelming the situation was, how this is a brandnew virus it was never on earth. No human had ever experienced it. Have to say, well done. You do an extraordinary job. A bill in 2008. Far from perfect. We did the best we could do. 2, fema has spent money from the Disaster Relief fund. Probably closer to 100,000 employees. 100,000 people involved in this effort. Had a hard time force, assembled in a short period of time. We can talk about this later in terms of the data and charts. Make thatu need to information public. Publishing data that was not quite right, i get that. Types,look at the five it is really vital. Look at that and it is anywhere times the normal demand, as a result. It is pretty evenly matched. We had a requirement for double to triple that amount, overnight. I realized, that is not very easy. What we have been able to do, recognizing so much of the ,quipment is sourced overseas they are out grappling this as well. There was a Global Demand for these supplies. With theare able to do operation, pretty innovative, Rapid Response effort. I will just conclude by asking the questions that i think to be asked. The properk about effortof action is local first, supported by the state and federal government. This was so overwhelming that the government had to take a lead. The questions we need to be asking is about the National Stuff pile. Supply chain vulnerabilities when it comes to medical equipment, ppe and pharmaceutical will. This is going to be more targeted on your response, what we need to be doing to respond to a false surge or a future pandemic. We were not ready. We just were not ready. Blame us all, as a government and a nation, we were not ready for this. We need to be ready in the future. Be . Should those items who should hold them . Should it be at local, state, federal level . Commercial distributors . What should those inventory levels be of those items . Who should hold them . How do we take care of inventory . You cannot just buy in the n95 mass and walkway for 10 years. Maybe we use private sector warehouses. We maintain and in the way. If your standard inventory is one Million Masks, maybe we support 2 million inventory level. To whoys gets down should pay. Will always the case, i continue to the size that is at the local level and when the locals cannot handle it, the state steps in. The federal government has to be ready to support. I think you, the men and women who serve in your agencies. I turn it over to senator peters. You for your service to our country this urgent time of need. We have encountered few, if any challenges of the size and scope of the coronavirus pandemic. Mes we have encountered few if any challenges of the size and scope of the coronavirus pandemic. Addressing this pandemic is clearly a monumental task, and the federal governments failure to adequately prepare and quickly respond to this crisis has led to costly and tragic missteps. We have now lost more than 110,000 americans to this pandemic. Loved ones whose lives will never be replaced. As families across the country grieve these unimaginable losses we must make every effort to examine how we reached this heart breaking point and ensure we are better prepared to protect americans from the challenges of the future including a potential second wave. My home state of michigan has been hit especially hard. Among our states minority communities in particular in cities like detroit. This pandemic has highlighted longstanding disparities and inequities in health. When disasters strike minority communities often suffer the most severe impacts but are among the last to receive assistance. This crisis has served as a chilling reminder that we must do more to protect our most vulnerable in underserved communities going forward. A rigorous examination of the federal governments response will help ensure that successes can be replicated and any shortcomings can be addressed. These efforts are critical to containing this deadly virus and to continuing the safe reopening of our economy. In michigan and across the country americans are eager to get back to work, but Many Industries are still struggling to access the personal Protection Equipment that they need to reopen safely. Americans need these items so that they have the confidence that they are safe when visiting a restaurant or a store. I warned in a 2019 report that we face a Grave National Security Risk because of our overreliance on foreign manufacturers for medical supplies including those manufactured in china. The pandemic only intensified those vulnerabilities. I heard from those manufacturers in michigan who want to do their part to manufacture these critical supplies. Theres no doubt in my mind this hesitation slowed our response efforts, damaged our economy and cost american lives. I greatly machine the hard work so far to obtain and distribute supplies to those in great need. But as our economy continues to reopen we must double our efforts to secure resources to keep workers and customers safe. Effectively addressing this pandemic will also require widespread testing. But months into the most severe Public Health crisis of our lifetime we still have more questions than answers about our National Testing capability. Every state in the country has encountered challenges securing the resources to test people. Even michigan only has the resource tuesday conduct 15,000 tests per day. Without sufficient testing we cannot fully understand the extent of the catastrophe or take the necessary precautions to protect our communities. Moving forward we must adopt and implement a clear, effective and comprehensive National Testing strategy. These are just a few of the issues that i hope to discuss with you today. The loss and the heart break that we have experienced in this crisis are simply immeasurable and we must do everything in our power to prevent a rueturn to or most difficult days. The hearing is long overdue, but im eager to work with you on this vital mission. And senator peters, it is the tradition we swear in all witnesses so if youll stand and raise your right hand. You may be seated. Our first witness is admiral brett gerar. In his capacity he is the Principal Medical advisor. Prior to joining hhs he served as ceo of virus site, llc and executive Vice President of texas a ms center. Im honored to be here to update you on our nations progress. And to provide details during the pandemic response. On march 12th secretary azar requested i lead including oversight and coordination of the fda and cdc with regard to testing. Since then the nation has performed more than 20 million covid19 e. T. S now paced to perform more than 3 million per week. The nations capability will continue to increase so well have the capacity to perform 40 to 50 million tests per month by september. To meet the complex Health Challenges we implemented a phased approach that will allow the nation to meet the specific testing needs at each stage of the pandemic especially now during reopening when the need for testing is the greatest. In early march hhs and fema developed and implemented 41 Community Based drivethru testing sites in locations prioritized by the cdc in collaboration with state and local partners. These sites have tested over 245,000 high risk individuals and served as prototypes and we leveraged trusted pharmacies to further implement Community Based testing. This federal program is now providing testing at 437 locations in 49 states, and 70 of these locations are in communities with moderate to high social vulnerability by the cdc social Vulnerability Index. This has tested over 560,000 individuals. We authorized all license pharmacists to order and administer covid19 testing under the public readiness and Emergency Preparedness or prep act. Over 90 of americans live within 5 miles of a pharmacy. To meet the truly unprecedented demands as the chairman pointed out for reagents and platforms we secured the Global Supply chain through a military air bridge. We worked directly with manufactures to increase production. We collaborated with the private sector and the fda to validate multiple technologies that expanded existing Testing Capacity while minimizing the need for ppe. We secured the government secured and prioritized scarce point of care testing assets to supply state Public Health laboratories, the Health Service and other critical needs. Finally we used title 3 of the defense production act to manufacturing and invest in manufacturing. These and other efforts culminated in the current partnerships to support state reopens and provide any warning of any new outbreaks. Today we are working with states, territories and tribal communities to support their testing plans and goals that are evidence based and adaptable. Before this experience i only knew of fema as the agency that quite literally rescued my familys future after hurricanes and flooding in louisiana. Now i have even more respect for the agency and especially for the people who make it great. Hhs has integrated seamlessly into the fema process working closely with all our federal, state and local partners truly on a daily basis. The National Response Coordination Center has provided invaluable and unparalleled infrastructure, communications, process methodology and personnel of which to build an integrated response. The scale of which has been unequal in modern history. I am a member of the unified coordinating group, the ucg led by administrator gainer. It meet daily and ensures all levels of government Work Together in response to covid19. My primary role in the ucg is advise on and operationallize and help prioritize deployment of the u. S. Public Health Service dmicommission corp, the uniform service i lead. In this regard i will close in ri recognizing and expressing my heartfelt gratitude. 4,329 men and women were deployed to spore this response. To our Community Based testing sites and International Airports to fema and our task forces, to nursing facilities and to field hospitals in hard hit communities across our nation. I thank each and every one of these officers and their families, and on their behalf thank all of you in congress for supporting our Training Needs and the establishment of a Ready Reserve to supplement or ranks during inevitable future national emergencies. Thank you for the opportunity to provide these remarks. Thank you, admiral. Our next witness is mr. Pete gainer. He currently serves as the administrator of fema. In his capacity as administrator hes a principal advisor to the president , Homeland Security counsel and secretary of Homeland Security for all matters related to emergency management. He has over a decade of experience in emergency management. Prior to his experience as emergency manager he served 26 years in the United States marine corp. I am the fema administrator. Thank you for this opportunity. On behalf of the men and women of fema i would like to begin today by acknowledging and offering condolences to the loved ones of exactly 110,949 americans who have lost their lives to covid19. One life lost is one life too many and our hearts go out to all those who have been affected by the pandemic. This has been a trying time for our country and fema has been working around the clock to help our nation respond to his unprecedented global pandemic. As the fema administrator its been an hawn door work along side the dedicated men and women of fema. I want to acknowledge our many partners for their commitment to the nation. This response continues to be one locally executed, state managed and federally supported. When President Trump made the unprecedented decision to declare a nationwide emergency on march 13th the entire team has worked tear lassly. For the first time in American History we have a major disaster declaration in every state, territory, the District Of Columbia and one tribe concurrently. Today fema is responding to 104 active disasters. The magnitude of this pandemic has required us to reexamine our past practices, keep the risk to our staff as low as possible while refusing to fail in meeting our mission. Covid 189 has been a Global Crisis with most countries competing where for the exact same medical supplies. Every government across the nation has been competing for the same resources such as ppe. To complicate matters furthermost ppe is made in asia where the virus significantly slowed manufacturing. During Natural Disasters fema typically managed abundant disasters that are limited in Geographic Scope and impact. In response to covid19 fema has had a much different and difficult task in managing the lack of critical medical supplies and equipment. Rather than managing resources we are managing shortages. We have worked tirelessly to find medical supplies and equipment across the globe and rapidly move them to america. We quickly prioritize resources to ensure locations with the highest risk of covid19 and deaths will not be in danger of running out of supplies and lifesaving equipment. Using the hhs Strategic National stockpile early on it quickly became clear the scope and scale of this pandemic went far beyond what the stockpile was prepared for. To address these widespread shortages supply chain Stabilization Task force was swiftly created by fema and federal partners. And in less than ten days we created an air bridge with a goal of providing temporary relief and stabilizing supply chains. This air bridge cut International Shipments from 37 days on a ship to just one day by air. Since march 29th we have completed over 200 flights carrying lifesaving supply tuesday the american public. In addition to expediting supplies into the United States the federal response focuses on stabilizing the lives of americans in many impactful ways. Id like to provide you with a few pacts fat illustrate femas commitment and speed of delivery to the covid19 mission. Since march 13th we have provided 6. 8 billion in obligations to states for covid19 related activities with the first 1 billion obligated in just 11 days. 27 million in commodities including emergency food, 17 million in crisis counseling. Over 1 billion each to the states of new york and california. 1. 4 billion in support of the national guard, title 32. Medical professionals afloat and ashore providing critical medical support to numerous hospitals under stress and supporting the testing blueprint, the procurement and delivery of 13 million swabs and just one month. The procurement of 16,000 new ventilators with the goal of 110,000 ventilators through Mission Assignments through the u. S. Army corps of engineers deployed 31 federal medical stations. And finally conducted nearly 500 engagement with congress, governors, mayors and tribal leaders. While we continue to respond to covid19 we recognize the risk for future outbreaks exist and we want to ensure were all using available resources to address these critical shortfalls. To do so were utilizing the defense production act to ensure our nations future preparedness is not overly reliant on foreign producers. This will allow to pivot. At part of this pivot fema recently released planning guidelines for the 2020 Hurricane Season to help officials prepare for disasters in the context of a pandemic. We will do so with our core values of compassion, fairness, integrity and respect. This historic response and preparations for the future will continue to require a whole of america effort and fema looks forward to coordinate closely with congress. I would like to thank the committee for providing people waw the resources to meet these complex Mission Requirements and i look forward to any questions you may. Thank you, administrator gaynor. Rear admiral polechek he overseas supply, distribution and Health Services support. Hes served in the United States navy for more than 30 years largely focusing on managing logistics. Since march rear admiral has led the supply chain Stabilization Task force. Rear admiral. Put your mike on. Sorry, thought the light was on. Good morning, chairman johnson, Ranking Member peters and distinguished members of the committee. Thank you for the opportunity to discuss the federal response to the covid pandemic, strategies for future planning. Let me start by offering my condolence tuesday the family and friends who have lost loved ones to this pandemic. On a personal note let me share this pandemic is close to home as it did for many americans. I have two family members working on the front lines. My sister a nurse in westchester and my niece is a nurse in long island. To dilly Communications Im aware of the needs of Health Care Workers and if theyre being met. Specifically ventilators, personal protective equipment, and equipment for testing. It was clear the Global Demand for critical medical upon arrival quickly realized the Strategic National stockpile could not address the nations requirement as a bulk of the stockpile was around being allocated. We mobilized the supply Chain Task Force to address the widespread shortfalls in the midst of the competition for lifesaving equipment. It consisted of dozens of departments and agencies across the u. S. Government. I also want to add the support extended globally with the department of state helping track down viable manufacturers around the world. Our goal since the beginning has been to provide medical supplies where its needed when its needed. A strategy had to be developed and quickly executed to deliver the lifesaving supplies to covid outbreaks popping up around the country. We made a decision to leverage the strengths of both government and private sector for a whole of america approach. To execute this strategy we developed four lines of effort. The acceleration and preservation lines of effort were designed for outcomes measured in hours and days. With the shortages in ppe accelerati acceleration of the commercial market was required. Normal distribution methods using maritime shipping could not meet the speed to immediately get critical supplies to the point of care. Project air bridge is a major focus of this effort and expedited the movement of critical supplies from the Global Market to locations across the United States. On 29 march the first flight landed in new york with gloves, masks and respirators. By 30 april the 100th flight air bridge had delivered nearly 800,000 n95 respirators, 825 million gloves, 75 million surgical masks, more than 2 million thermometers, 6503in1 face shields. Using the air bridge we cut down the time it takes to transport supplies from asia to the u. S. From months to days. The supplies i just listed would still have been at sea on 30 april and not available to our Health Care Workers if normal shipping methods were used. At its core its a public, private partnership with 600 distributors. The federal government covers the cost of supplies purchased by the private sector in the u. S. As part of the agreement 50 of the distributor supplies in each chain have directed to points of care in gregraphic areas needed using cdc data along with inputs from dr. Birx. Based on cdc data prioritization was given to hospitals, health care facilities, Nursing Homes around the country to covid hot spots such as new york, new jersey, chicago and detroit. Beyond the air bridge our acceleration efforts continue to source supplies with flights carrying over 50 million procured masks and 2 million gowns into the u. S. Working with cdc we provided preservation guidance on how to extend the life of ppe and introduce options like deconnamination systems and allow for multiple use of n95 masks. You cant run a supply if you cant visualize it. Using data driven ensures the right quantities get to the right place at the right time. For the first time using a supply chain tool from dod were able to see the splay chain. We could now see inventory held by competing companies and how the distribution was filling those orders. We combined the supply chain data with cdc information ensuring commercial markets moved resources to the hot spots. Expansion is needed to align u. S. Manufacturing with current covid and future demands. Prior to covid the medical community procured from cheap overseas markets. We need to change that. American Business Leaders continue to respond. For example, with no financial incentive from the government walmart teamed with the medical supply chain and produced over 2 200 million hospitalization gowns. We increased to make Domestic Production equal to the surge of demand. And bring in 50 million n95s from 3ms overseas production. An example is contracts including contracts for thousands of venilatotilators delivered to the stockpile. Looking ahead were preparing america to be fully preprepared f for any future outbreaks. We now have more ventilators in the Strategic National stockpile than before the pandemic thanks to u. S. Production. Precovid the stockpile had less than 18 million n95 masks. There were no swabs. The stockpile will now include swabs for testing. A larger National Stockpile combined with more u. S. Production will enable toiped federal response. Naung for the opportunity to testify today. I look forward to answering any questions that you may have. Thank you rear admiral. I will defer my question to the end. Senator peters. Thank you, mr. Chairman. Admiral, first question for you. The coronavirus pandemic as we all know has disproportionately impacted the africanamerican community. Yet reports suggest its disproportionately located in areas with higher incomes and lower minority populations, so could you walk me through the steps the department has taken to evaluate access to coronavirus testing for minority communities including at the individual and even neighborhood level for these communities . Could we get a better understanding as to how you approach it . Yes, thank you, senator. In my job before covid this was a major part of my job as assistant secretary. The first thing we did and i mention this in my remarks is the federally sponsored pharmacy sites. There are 437 of those. We make sure this was by contract that the majority of which are located in sites of high social vulnerability. 70 of those 437 or the social Vulnerability Index takes into account race and ethnicity, income, languages, disability and other areas. So its the way that we can target those resources. Secondly, the federally qualified Health Centers we now Call Community Health Centers now take care 30 million primarily of the poor and underinsured in our nation. 92 of them are offering covid testing right now so almost all of them, and they are located in the neighborhoods of need. Last week we released guidance and this was a flaw in the system. There was no requirement of reporting of race, ethnicity, age, sex, or even zip code or location. With lab reports it was very difficult to understand what the data were, and we still dont have a good understanding of that. We released this was an authority the cares act gave to the secretary, and we enabled that last week. My office has a funding announcement that is available right now to create an entire National Infrastructure to focus on minority issues, primarily linkages to testing as well as linkages to Service Following testing. I think you said in your remarks something we are focusing on more and more is Health Disparities have plagued this country for decades. The underserved minorities sometimes it really is true. Your zip code matters more than your genetic code and this was really not something new, but it was a magnification of the Health Disparities we see, and i dont want to take up your time, sir, but we saw what had occurred for decades magnified by this pandemic. Theres no question and at a future time we can talk about that. A followup question you talked about how these resources are in these different areas and yet you also said we didnt really have data until recently. So how can you make that statement without data . So we what we do know is the social Vulnerability Index is a published index to understand what communities are really vulnerable. We so placed our Testing Centers in those communities. What i dont have is the nationalidate taw to say how many africanamericans have been tested, how many hispanics have been tested because that is not a requirement and the federal government does not get that. We have mandated that as part of the guideline last week but we have limited data. We just have limited data to understand the percentage of those tested. We know who suffers the consequences and were flying blind until this comes in, sir. And you agree this data is essential, we have to have it . Its absolutely essential. So, yes, were very anxious for that data and i wish we could present that but it was an authority that just gave to us in cares and it is a guideline now people will have to report. What steps are you taking to collaborate with other partners such as fema and others in these efforts . So, these are my brothers here. I mean literally since things moved to fema we are informally probably meet five times a day, but theres a formal meeting every single day where every task force reports to the unified coordinating group. We hear from every region so we really hear where the boots on the ground are because you cant hear in washington but we hear directly from the hhs, the fema regional administrators, and then we have almost every day we have a uniform coordinating group that provides direction in Decision Making and the admiral and i are not officially on the White House Task force but we are regular invitees. Again, were there with the administrator who is. Its been one of the great i think teams that have sort of selfassembled during this given the fema structure and really allowed us to do that. Administrator gaynor a dedicated office to develop a proactive plan that can assist that leadership, we have to ensure that aid in the system is always delivered equitably. I introduced achieving in Response Recovery and resilience act of 2020 which will basically establish an office of equal rights and Community Inclusion at fema that will refocus agencys efforts on those communities that have been left behind, and as we mentioned disparities with communities of color in particular. My question for you would you commit to working with me on this legislation and bring greater focus to fema to communities that are particularly vulnerable . Yes. And just for the record fema has an office of equal rights. I know you have that office and we appreciate the work that office does, but i think what we have seen transpire in the last few months we should probably redouble our efforts and focus more. We bring greater focus, for example the lack of data those are things we should have been doing from day one and we need have Lessons Learned from the past as we move forward to make sure we have more equitable responses in the future. So thats the spirit of the legislation. If i can share one thing totle you how early we were concerned about equal rights and civil rights. Early on in the process in may my office put a bulletin to all fema employees working on covid19. I spent 29 civil rights advisers across the country. They adjudicated 211 civil rights items before they became official. So we have been out there on the front line adjudicating civil rights, making sure that we stand up for whats right, what we believe in. Again, i love to work with you and your staff to moving that forward to an even greater effort. Thank you. Thanks, senator peters. Senator langford, buy, my wife had cspan on and she said you had to watch what senator langford had to say. I would recommend everyone go and look at the clip. Were trying to form a more perfect union. Gentlemen, thanks for your service, what youre doing. You do a lot of work behind the scenes americans dont have an opportunity to say thank you. So from the people of oklahoma let me pass on my thanks because youve done quite a bit to be able to serve the folks in my state and across the country. There was a lot of early engagement on expired n95 masks and expired prescriptions and such in the National Stockpile. Help me understand how we got to that point things were expired and how does it get better to deal with a rotation so we dont have expired materials in the future . Yes, sir, senator. Im going to refrain from talki talking previous to march 19th, right, so i cant speak to those practices, but i will talk to you about what were doing going forward. This National Stockpile shouldnt be thought about as i buy it, i put it on a shelf and im done. But working with colleagues at health and Human Services im trying to develop a National Stockpile index that uses practices that has used, a war Stopper Program where we buy inventory, we put it on a shelf with our commercial partners. And as the commercial partners make issues they replenish and they manage shelf life for us. Thats just one example. And so were looking to change from a stagnant mentality of buy it, put it on a shelf and then have to figure out how to rotate stock. You know, its not just n95 masks. Even simple things like needles and syringes sterilized and wrapped they all have a shelf life baseden the sterilization. So theres work to do going forward, and its going to take a bit. Do you need legislation to do that at this point, or do you have the authority to be able to do it right now . So i believe health and Human Services has the authorities, but it may take a difference in understanding of Funding Resources for them, and i wont be able to speak specifically for health and Human Services, but i think theyre going to need an annual appropriation that pays for a different Inventory Management practice than theyve had. You cant just put it on the shelf and then walk away from it. Well look forward because obviously if we buy a product and it sits on a shelf and starts to get near expiration itd be much better to be able to sell that and rotate it out and keep it moving. You talk about the dod process and storing it with commercial entities as well. Are we at a point right now if we had a vaccine lets say in november wed have enough syringes and distribution to be able to get it out . To answer that specifically were on a glide path to have approximately 400 million needles and syringes by ill say december. I dont have the numbers right in front of me, but its at least 400 million as we get into the winter and 700 some odd million as we get into next year. Administrator gaynor, let me ask you about this. Fema is all about mitigation, trying to prepare ahead of time and be able to get communities prepaired ahead of time. You started a list right now what we can do to be able to help hospitals, states, local entities how they can prepare for the pandemic. Because it wasnt just the federal government caught flatfooted on this. A lot of hospitals and local entities had ppe knowing they could reorder if they needed more but no one could reorder at that point. So everyone in the country was caught flatfooted. Have you prepared a process in what we need to do to prepare local entities and Administration Efforts . Its a great question, and im going to start with the way this whole system work and when it works the best everyone is involved. To include our citizens across the country. Were probably going to have readjust some grants. We put in about 2. 4 million in preparedness grants. Over the years we focused encyber and how were going to correct it so we dont fall into the same trap. Again, Everyone Needs to embrace preparedness for the local state and federal ellevel to include hospitals and everyone else. I think we need embrace preservation of ppe. There were moments over the past 90 days where it was dim when it came to having enough ppe. So we need to think about how we use pp erk in a new way. So i think were all very we like cheap 70 cent masks from china, disposable, throw away one time and keeps everybody happy. Maybe thats not the way we need to go forward. Again, a majority of ppe is not manufactured in the United States. I know we have a great effort to bring that back home, but really need a change of culture on whats important and, again, if youre a hospital or maybe you need to think about how youre going to manage your ppe and how youre going to manage surge and make sure it stays fresh over time. I think everyone owns a piece of the puzzle just not the federal government. Let me make a couple of comments if i can as well. One is weve got to relook again something this committee can continue to work on. Chong for the work on this area but dealing with domestic manufacturing. All the things we had to get with an air bridge to be able to ship over in a moment of pandemic i would suggest everyone of those supplies we should reexamine that we were in such a desperate moment we had to move via air bridge from asia, why arent we producing those domestically, and what can we do so we can continue ramping up nights and wksds rather than move them over from ags you a at point were exposed on this. Current va process for testing in particular hhs makes a decision on what the need is across the va, it gets to fema. Fema then gets those supplies onto the national va and gets down to hospitals. My numbers if they are correct on it about 300 testing units are given to hospitals or most entities across the country, somewhere around average on that per month. The hospitals in my state are looking for about 700 tests a week to be able to test more people coming in and to be able to help evaluate that. How do we bump up the numbers that are available to va as weve got a complicated process where hhs zeeds, fema distributes, it gets down to va and va distributes down to the individual hospitals and clinics . So thank you for that question and its good to shed some light on that. Dr. Stone who is the chief executive of the Veterans Health administration and i talk regularly. The va makes a request and we fulfill it. Thats just that clear. If they need 100,000 swabs, we give them 100,000 swabs. Weve had to tide them over with abbott i. D. Now, Rapid Testing machines, so quite simply for the va and dod if theyve asked anything weve supplied it to them. How the va distributes that to their system is kind of behind the curtain to me but weve supplied that nationally to the va, and weve made sure to take care of our veterans. I will look specifically into oklahoma, but at that level the va gets what they need. Go ahead. Just in addition to that the va has a dedicated Liaison Officer at fema full time, so if theres a requirement to request a problem we hear that directly all three of us and take immediate action. Theyre on the inside of this process, and again, we take immediate action on anything we see. Thank you. So let me answer the first part of your question. As a former manufacturer in order to guarantee manufacturing in the u. S. We have to guarantee orders at a reasonable price and guarantees a reasonable rate of return. Its that simply. How exactly we do it, but thats what we have to do. Just hold on because we cant hear you yet so there you go. Folks, can you hear me . Yes, we can hear you now. Okay, so i just wanted to add my thanks not only to the witnesses but to all the men and women who work in the field for your agencies during this extraordinary time. We do know that this has been an unprecedented amount of unprecedented amount of work and we are very, very grateful. Having said that, i want to add a caution. While the tame for an afteraction report, that was done well and what one, is for after the pandemic. I think there is general agreement that we needed to establish our goals earlier and that we still have some ways to go in terms of being transparent with what our goals are for things like ppe and testing are. Theres a difference between saying weve worked really hard and done all these things, and knowing that we have actually met our need. Theres a difference between saying lets see what we ask do and heres what we need to do. Thats what my questions are really focused on. Ill start with administrator gaynor. Again, i want to thank you and everybody at fema for all the hard work youve been putting in, but ive had a consistent frustration. Weve shared it with you, and i know its shared by the chairman and other members of the committee by the administrations inability or refusal to publicly lay out clear goals for the response. Ive been asking for months now for the administrations estimates on how many n95 masks and other pieces of personal Protection Equipment this country needs. It took over a month to even get verbal answers to these questions. Even now that i have this document which you have produced to my staff friday night, the Administration Still says we cant make it public. There are real questions about this documents, but i dont see the utility of asking about it if the public doesnt have access it at the same time so they can follow our discussion. The American People deserve answers to these basic quitses it. How much personal protective equipment we need and what our plan is to get there. So administrator gaynor, why is the administration refusing to make this document public . Public scrutiny is crucial. Whether they account for real needs, why cant i share this document with my constituents . I dont know of any prohibition. We provided those slides to you and the committee for your. Use if that includes sharing with your constituents, i dont see a prohibition against it. When it comes to, you know, understanding ppe and ill deferral to the admiral here, when it comes to ppe, scarcity, a demand for things that some sectors have never had a use for, it has taken time for us to understand that. Now that were into opening government, what do those numbers look like . Elective surgeries, dentists, all of these are new an additive to the problem. As we go, well update the slides, theyll be more comprehensive your staff explicitly told our staff that we could not share the documents. Im glad for your clarity today. I apologize for that. Thank you. Id like to move on to a question to the admiral, please. I think it would be better for forecast the needs are as you have discussions with different sectors so we can develop a plan to meet the need. Admiral, related to my question to the administrator, the fact that critical facilities still face shortages. Nursing homes around the country still do not have the personal protective equipment that they need to keep people safe. More than 500. Announcer ing and more th than 250 dont even have surgical masks. I appreciate this goes a challenging situation. About 40 of all u. S. Covid19 deaths are residents or workers at Nursing Homes the federal government has to do more. What are you doing to remedy the lack of personal protective equipment available to Nursing Homes and other longterm care facilities across the country . Thank you. Its a great question and i cant heared admiral. I appreciate your passion for the vulnerable. Were doing several things, the First Priority Nursing Homes is one of our top priorities, as we work to get items where theyre needed and when its needed. Secondly, weve instituted a project to bring personal protective equipment to every single registered nursing home in america. Thats 15,408 Nursing Homes delivered directly to their front doors. And whens that going to happen . We started that project building the supplies necessary in april. We started deliveries in may. That will run through weekly well be getting deliveries of several weeks worth of ppe as we go through august and into september, and were so, admiral, i realize that im over time, but admiral, what i am looking for is a plan that tells every nursing home in america where they are getting the equipment they need yes, maam. We gave every governor every monday when the Vice President has the governors call, i give them a state breakout with the nursing home and the address in each state and whether its been delivered. As you know, we dont have this equipment in many Nursing Homes. Maam, one of the things that the Health Care Ready network is now producing is an input of nursing home information working with seema verma, and ive seen regularly input from Nursing Homes where less than 2 of Nursing Homes that are reporting say that they dont have a weeks worth of personal protective equipment. I would really love to sit with your staff to go through that information and understand where youre saying that theres hundreds of Nursing Homes that dont have, because the Data Collected from the Health Care Ready network is showing a very small amount. Once we see those numbers we work with each one of those Nursing Homes to make sure they have ppe. I would appreciate following up with us on that. Mr. Chairman, if there is a second round of questions, i would appreciate being able to ask them. Okay. Senator rosen. Thank you, chairman johnson and Ranking Member peters, i thank all of our Witnesses Today for your hard work. In nevada were about to and weve had multiple earthquakes including a 6. 5 magnitude event that shook our entire state. Flooding and other disasters possible, so i would like to hear what fema and hhs are doing to respond to the covid19 pandemic while we are also responding to a dynamically to these Natural Disasters. Its absolutely critical, that we have our planning on right now. We have to be able to respond to these situations simultaneously. So for administrator gaynor and admiral giroir, how are we te testing and treat if power is impacted by a Natural Disaster . Are there additional mobile generators for refrigeration systems . Are these being acquired . What type of equipment might you need in a remote scenario . We have very rural remote areas that get the wild fires, have the earthquakes. What supply chains could be disrupted . What do you need from congress to start doing this . With my partners who are here and who are not here, early on, probably before the president declared a nationwide emergency in march, we knew that Hurricane Season was coming. We wanted to make sure that we were prepared for a Hurricane Season with the overlay of responding to covid19. Along that way, my team and my partners collected best practices, Lessons Learned, the best resources for covid19, and we built in 27 days im not sure if you can see it, but i brought a prop with me, the covid19 pandemic operations guide for the Hurricane Season. But you cant crash that out and put in wildfire or earthquake or flooding, because all the Lessons Learned in here apply to all hazard. Im going to take a look at that after this, but is there strong support in there for the state and local agencies, the First Responders . Is that in your document as well . Yes, maam, back to my a line of my opening statement, in it ill just give you an example about some of the challenges well face this year. It doesnt matter which emergency, but about sheltering. In it we want to stimulate conversation at the local, state, tribal territorial levels officials to say what does that evacuation look like . Do you have enough space . Can you screen people . If you have had somebody thats positive, what do you do with that . Are you going to do testing . Lots of prompting questions to have every emergency manager in the assassination look at their plans and make sure theyre up to date for whatever hazard they face. I have held conversations with every state emergency manager in the country about this. We have an exercise kit that we encourage all levels of government to use to exercise those plans with covid19. So pretty comprehensive. Ill make sure you and your staff have a copy. Ill be happy to answer any questions, and when it comes to testing, ill turn it over to admiral giroir about what testing may look like. On the testing side im so appreciative you brought this out its the reason why we are working directly with each state individually to make custom evidencebased plans for those states. My Multidisciplinary Team have met with teams from every state now three times to establish the initial state goals. We did this in late april. So for nevada, your teams goal was 120,000 tests. We concur, 120,000 tests were very good for your state. We provided all the supplies needed to do those 120,000 tests. Not only was it numerical, but there are specific issues, like your state is number eight in relying on the Public Health laborator laboratory. That being the case, we supplied more to the Public Health laboratory than other states not so reliant on it. We also focused on indigenous population. And in may your state did really good, just about met your state goals, certainly within a stones throw of it. We look forward to that, and now we are reviewing every state plan as required by the ppe legislation. We have the specific state plan were reviewing for may and june. On june 15th it will be the plan for the rest of the year. Again, this is a cooperative agreement between the cdc and the states, meaning were working together. Its not the states responsibility or the federal responsibility, its us working together to make sure the state plan is appropriate and can be executed. Admiral, i want to follow up on some that senator lankford asked about syringe s syringes enough the special glass that we need for those vials . If we dont have enough, are there alternative materials that we can consider using as we ramp up not just syringes being the vials that are needed as well . Agreed question, there is a bit of a dividing lining between my efforts and operation warp speed. Working closely with them, but they have a plan for vials and syringes. Theres also a secondary plan of a new technology to blister pack blown product where it will be prefilled. Youll get the dosage in a blister pack, be able to open it and inject it, squeeze it in one. Were actually using some investment money, defense production act on that item, but operation warp speed has all the details, but because it has something to do with the supply chain, i dived into needles and syringes just because i thought that was, you know, whats next but ill have to work with operation warp speed to get you a specific answer on the vials, maam. Thank you. I appreciate it. Senator portman. Were nor were not hearing you yet, rob. Hang on. Try it now. Rob, try again. No, were not hearing him. What does your audio mute button say . [ inaudible ] until we get this figured out, do you mind if we fine i heard it a bit. Can you hear some . Yes. Well reset your seven minutes. I apologize. Listen, first, i want to thank you today i want to youre going to have to talk louder, though. I want to thank you for your hard work on how to improve our supply chains in particular. Ive had this conversation in person, i know youre a sincere champion of american wry shoring by china rob. You want to put the microphone close to your mouth, and its fading in and out. Can you hear me . Yeah. We hear real good right now. Okay. You just testified, admiral we are ramping up production to meet the covid challenge, we are preparing america by increasing u. S. Production. As you know, and i know youre sincere about that, but this joint Acquisition Task force thats vetting contracts, which has now shifted over to dla, they are vetting contracts to supply ppe over the next 90 days. As chairman johnson said earl r earlier, you have to have the longterm contract to make the investment, to actually bring this ppe product back to america. I just havent seen an indication that this joint Acquisition Task force and dla are issuing these longterm contracts for ppe. These Companies Need the certainty to be able to make the investments, its the right thing to do. My question to you, i guess, would be about that. The company that has an exciting plan to bring textile production back to america. They are all ready to sheets and towels mitt romney is listening to us. We provided them to the marriott corporation, which they can do this, they have u. S. And towels and other linens. So they cant do it unless theyd like to make reusable gowns, but they cant do it unless they have longterm contracts. I want to know, one, what your view is on that. On the record, do you agree its in the National Interest to make the United States sir, im having a bit of a hard time hearing your question, but i get the genesis is about our plan to bring manufacturing back, and the requirements just do you support reshoring . Yes, sir. I dont think we could be ready for any future pandemic, and so a bit longer lens than just say for a second wave in the fall. You know, i talk about a vignette from unfortunately i bring a lot of dod with me, right . You cant about he resilient and ready if youre not managing your supply chains, and managing is the production of required resilient items. While the navy has full magazines of tomahawk cruise missiles, we still buy missiles and keep them on lowrate production. Thats so we can surge. That same mentality i believe has to happen in the health care area. We are working to aggregate demand, so the slides the committee got about demand, were working to aggregate that longterm demand and bring that to industry to say, hey, look, this is the repeatable longterm demand for health care items. Not just personal protective equipment admiral, let me ask a followup on that. Do you agree that the shortterm contracts, but do we need these longterm contracts in order to provide that demand signal so they do bring product back to these shores . Yes, sir. Im busily in the process of aggregating demand across dod, the National Stockpile, v. A. , and then in consultation with each state, through their regional administratorsadminist understand what the states would desire to stockpile, kind of three levels of inventory there, and bringing that National Demand forward. I would also say there will be work that the Administration Must do on the right ba backstopping to make sure items dont go back overseas, but theres a need for longterm demand for stable funding. Great, thank you. Can you tell us when dod is going to issue longterm contracts to companies who are looking to bring ppe back to our shores . Sir, we are continuing to do that right now. Weve asked the Defense Logistics Agency essential for a first wave of items. I think that was 450 million followed up by several billion. As you bring forward dods requirement, the vas requirements and states requirements, that number will be quite large. Well share that with industry as we go. We continue to work the backstream, the raw material pieces. We have pending defense production act investments to bring additional millions of square feet of the nonweaving fabric to make either gowns or surgical masks here with americanmade product. Thank you, admiral. I agree we need longterm contracts. I hope you will get dod to do that quickly. Admiral giroir, thank you for all your help with ohio. Right now we need more testing, 43rd in the country in testing per capita, even though the seventh most populous state. Theyre heavily reliant on people, staffing, we dont have enough Lab Technicians to run these tests, so weve been working with you all to get other tests in ohio, particularly tests that require less staffing. My understanding is youre working with ohio, but were still not there. You question is what can we do to get more testing into ohio. The logic test in particular is one that you have access to that we need in ohio. 70 of our states death looks like occurred in nursing home. We need more testing so in congregant settings like that, we need to make sure the virus is not spreading. Can you give us a sense of where we are in terms of getting those tests to ohio . Yes, thank you, senator. I really appreciated our calls weve had multiple times during the pandemic. Me too. In addition to working with the state in the plan that we outlined, we probably a week ago had a special session with all of your leadership in ohio, because the governor was concerned about the relative ly lower performance of ohio compared to other states. The good news is thats changed pretty dam tickly over the past couple weeks. When we a whole Multidisciplinary Team it looked like things were on track. You did well with your goals within a stones throw of achieving your may goals for testing. In terms of specific machines, just wanted to clarify this, is that is that like Everything Else theres not enough of any single material to go around. And therefore it really requires a couple of different approaches. T really requires a couple different approaches. For things like swabs and media, the market was so fragmented with multiple small producers that literally the federal government buys the supplies, and were committed to doing that through september at a rate of about 20 million each, distributing those to the states, at least through december and maybe further. For other markets that are more mature what we are doing is matching supplies market to the states, so were hoping to match the capability with what the states have. Thats where we will be. We did almost 12 million tests in may, which is an enormous milestone and very close to the states full goals. In terms of the specific tests, i do want to be clear that not everybody is going to be able to get the specific Newest Technology that they want the moment they want it. Well have to deal with the existing technologies. I call them the ford truck. I love my ford truck, it gets me places, but its not a sports car, right . So the sports cars in the Laboratory Environment like the hologonic panther, theyre new items, and ohio i think is getting two or three of those machines within the next couple weeks. Thats kind of where we are. Ohio has moved up the charts in the last couple weeks and your team seems satisfied and well continue to work with them. Theyre a highly skilled team and we enjoy working with them. Thank you, admiral. We appreciate your service and the is was of all the folks who work with you. Senator romney. Thank you, mr. Chairman. Can you hear me okay . Loud and clear, thanks. Good, thank you. Thank you, gentlemen, for your participation on this panel today. Thank you, mr. Chairman and Ranking Member for calling this panel. You know, some have hypothesized that asia was able to respond more quickly than the western nations, in part because they had the experience of sars, they learned from that experience. The old covid19 fool us once, shame on you, but fool us twice, shame on us. So i do want to look back at some of the things we did not do terribly well to try to understand why. Admiral you indicated you donald want to talk about things before march 19th, but given where you are, you probably have some perspective. We have what sounds like an ample and growing stockpile that can be well rotated. It sounds ideal, but why were we so, if you will, short prepared with regards to our stockpile . Was it the bureaucracy . Was it administrations . Im not looking for any names. Was it congress . Did we not provide sufficient funds to actually purchase a stockpile . Where was the problem and how do we avoid that in the future . Sir, again i now have a pretty good working knowledge of the National Stockpile. I will tell you that the health and Human Services team brought that up from centers from Disease Control in atlanta to the assistant secretary for preparedness about a yearplus ago. So, again, i was moved from the joint staff as the vice director for lo gistics in mid march, and had not worked with the health and Human Services staff. The National Stockpile has more in it than just pandemicrelated supplies. It also has chem bio focus. Admiral, i have such a short amount of time. If you dont have a good understanding of where the problem was, thats fine, but is that something you want to address or should i move on . Again, im not a health and Human Services employee. I was pulled to go forward and stabilize the supply chain. So i i have not spend a significant amount of time worrying about why they did or did not do things in the past. I would ask that maybe thats fine. I think it would be helpful if there is some effort to understand so we can avoid that in the future and be better prepared. Admiral giroir, you spoke momentarily ago that the fact youre coordinating the swabs and i think the moodium, which makes sense to me when something is in short supply, there needs to be coordination of how that gets distributed to our country, but i think theres the perception at the very beginn g beginnings of this crisis, the federal government said, governors, you have to get your own stuff. Im not sure which things were included in that, but i did talk to more than one governor who said they were scrambling on their own to find protective equipment or trying to find testing equipment, and they were competing against each other, and in some cases they had to ask for more than they needed in order to get what they need. Going forward, can you put together a model for what could be originated at the federal level and what should be originated at the state level . With the experience weve had now, i think it would be helpful if you could say they things needed to be done federally, these things had to be done at the state level. Is that appropriate . Yes, sir, and thank you for the question. I think youre exactly on target. Ill just make a comment, during the early parts of this from mid march to mid april, we had absolute shortages. I mean, there was no question we had shortages of everything. We were in a posture of trying to adjudication those tests as much as possible. Youre exactly right, at overall strategy and framework, particularly in diagnostics moving forward is exactly what we need. I think we have a working framework. It was built while we werefullying the airplane, but i think its a good time to look back and find out exactly what we need. Im going to open this to all three of you. Do any of you see any gaps, any things we are missing . Were asking questions based on our perceptions, but you are right there. Are there some things we should by focused on to prepare for the next pained, or for that matter, are there things to think about about . Is everything ready for the next time this happens . Or could you direct us to areas where we should be making a better effort . Ill just make a quick comment. When we see a gap, with he try to fill it. I think theres a lot of work on what were doing right now and theres a lot of futuristic work. These are really fantastic things, but i think we have to work on magnifying networking. Improving process flow i really want to foulke can on that, things like can we pell samples to i think we need to work with more private partners, universities, hbcus, other groups to make sure were reaching the population we need to reach, and its not that this isnt being done, but i think weve been a lot of do it now and the futuristic things, but theres a lot 1 2 middle, because thats where the advantages broadband reaped for september and okay. Thank you, admiral. I see my time is up. Mr. Chairman, thank you. Thank you, senator romney. Senator harris. Thank you, mr. Chairman. It is obviously impossible to conduct oversight when fema has not provided timely responses to critical questions on everything from Disaster Preparedness to addressing racial disparity. I would like unanimous consent to enter into report the four oversight letters i have send to fema for which i have not received a response. Without objection. Thank you. This is directed to the full panel. In the midst of this deadly epidemic the president has stated help from the federal government was a, quote, twoway street, indicating that states would only get assistance if their elected officials were nice to him. There have been multiple reports that while fema and other Administration Officials sought to prioritize resources to states and localities most in need, the president sought to mr. Gaynor, and admirals. Its admiral polo thank you for that, admiral. During the federal response to covid19 has the or any of the other panelists or anyone at the directed, suggested or implied that you direct or redirect resources to certain states or localities. Admiral, why dont you start . Yes, maam, thank you. I have soefd no direction from we have our prioritization cell at fema that takes cdc inputs and inputs from dr. Birx to provide covid communities most in need, and that so anything that was distributed or set was based on those priorities. Reports also suggest, as a followup to you, that the white house has intervened in the federal contracting process, which is designed, of course, to be devoid of political interference, has the president or anyone at the white house directed, suggested or applied that you should awashed or deny contracts to specific entities . Is thats a yes or no, please. Im not involved in the contracting process, so i have no knowledge of that. The fema organization has its own contracting staff. They do not work for me. Thank you. Mr. Gaynor . What question to start on. First one, which is during the federal response to covid19, has the president or anyone at the white house directed, suggested or implied that you direct or redirect resorb to certain states or localities for political reasons . Absolutely not. Has anyone at the white house or the president every suggested that you should award or deny contracts . Maam, when it comes to contracting, there is between a potentially lead that comes from multiple different places, so from governors to senators or congressmen, those leads are generated. They go into a validation system inside fema. Between that lead and a contract, that chasm is as wide as the grand canyon. Those things dont touch. I have the highest confidence in my Contracting Team that every contract was executed according to all the federal regulations, without influence from anyone in government, no matter where they sit. Thank you. Admiral giroir . The answer to the first question is, no, maam, ive not been directed to put any resources anywhere. Its always gone through the prioritization cell or other hhs mechanisms. For the second, i have no knowledge on that. Im not a contracting officer, either. Okay. Thank you. And the federal government has a very bleak history, frankly of failing to provide adequate resources like food, housing, Financial Support and others to specific communities that have experienced a disaster, and im referencing the administrations response to Hurricane Harvey in texas and Hurricane Maria in puerto rico. I led a letter in i believe this has come up earlier in the hearing. I finally received a response yesterday evening. Unfortunately it was inadequate, frankly and referred to data that hhs and cdc are collecting, but in the house hearing last week, cdc director redfield acknowledged that hhs has not fulfilled its responsibility to collect racial data, and as it relates to nongovernment at data, the ones we have do not indicate the mortalityd they do that the mortality rate for and other minority populations, particular are also disproportionately impacted. So i ask this question of admiral giroir, i know hhs is using a social Vulnerability Index, so i thank you for that. Mr. Gaynor, what specific action are you taking . Yes, maam, if i can just address the letters. Fema and my great partners are still responding to covid19 across the nation, so that is an ongoing responsible. I have received in excess of 300 letters from congress. These are numbers that we havent seen before. We try to get to each and every one of them as fast as we can. I think fema has a great relationship with congress about how fast and speed we respond to congress, so we will get to every one of those. I apologize for the delay, but my effort and focus has really been on response. To offset that, to include myself personally and my staff, over 500 engagements with congress, governors, mayors provide the uptostate data. I appreciate that. I only have a few minutes, but i would appreciate your attention to getting a response as soon as possible. Thank you for that. Yes, maam. My last question, i previously asked about how fema plans to address the wildfire season, and ive asked this a number of times to a number of different people at fema. We still have not received what is the Disaster Preparedness Response Plan for wildfires, which disproportionately impact my state in the midst of the pandemic. Can you tell me when well get that . Yes, maam, you actually have it. I want to step back, you know, this whole sim works locally executed, state supported, i was a local emergencily manager. I have a responsibility to my mayor, to my manager, my tribal chief. I appreciate the chain of command, we have a hurricane plan. Is that what youre referring to . That very different by nature than wildfire. Although it does say hurricane on the cover, in the first paragraph of the opening statement, it says that the lessons lenders in this can be applied to any disaster. Let me point out a distinct between hurricanes and wildfires. You can point my direction to where in that pamphlet this might be addressed wool fires hurricanes we get forecasts. Thankfully we have come to a point where we have science and technology that gives us warning time. Thats not the case with wildfires. Where in your report is that fact addressed . I have spent time with the families, the Fire Fighters in the midst of embers burning during the devastation of the wildfires and there was no warning for the family that live in those communities, much less for the firefighters and First Responders. Can you tell me in your report where the nature of that is assisted, including the fact that wildfires spread quickly. They are not regional. They will spread clearly. Where is that distinguished . Yes, maam. Its true that theres a difference in forecasting. You dont need a forecast to do planning. What this encouraging, every emergency manager across the country from the lowest to the highest level take their exists plans. If you have a evacuation is there a reason you dont have a plan for wildfires and only have a plan for hurricanes . Its not addressed specifically in your report. The lessons in this guide can be applied to any disaster. We are all hazards agency. Specifically for this season, its named the hurricane plan. You can apply all the Lessons Learned and best practices and resource to local and state planning. Im sorry. The firefighters in my state would disagree with what youre saying in terms of applying the same principles and standards in response to a hurricanes as to a wild fire. Thank you, mr. Chairman. Senator garver. Gentlemen, nice to see you again. Thank you for your extraordinary service, and thank you for your leadership during one of the most challenging chapter in the history of this country, at least in the years ive spend on this earth. I and my colleagues would tell you, you dont know me well, but my colleagues would tell you im a Glass Half Full guy. I take to my heart. Words in the bible, in all things give thanks, sometimes its hard to do. In the words of al better einstein, in adversity lies opportunity. Sometimes thats hard to realize. Theres got to be some opportunity here as well. I served in uniform, never made it to admirable, making it as far as captain, and but i was along with john mccain, was one of the last serving in the u. S. Senate. I like to run down to lincoln memorial. I usually go home at night, but i love the run down to lincoln memorial. I always run by the Vietnam Veterans memorial as well. Theres 58,000 names carved into that stone, and i think about them every time i run by them. Thats 58,000 names. We learned this week. I would say this to administrator gaynor, the number of deaths is 117,000 in this country. I just learned that this morning. Thats twice as many people died from this virus from the entire vietnam war from beginning to end. That war was predicated on an untruth, and we paid a severe price for that. We are in a different kind of war today. Were in a war that youre trying to help us turn the corner on, turn the tide. I just want to say the who, that you describe, the efforts that you have described from men and women in uniform, folks who are medical professionals, folks who are in the private sector who fly airplanes, you know, move goods from all across the world, heroic effort. We have somebody close to our family who is an anesthesiologist, and shes very special to us. She graduated from her training four years as a about to be an anesthesiologist, finished last week. For months she has worked in a hospital intubating people so they could be placed go into a coma and be placed on a ventilator and hopefully survived. Most didnt. Theres hundreds, thousands, tens of thousands of people across the country, and im inspired by them. Im inspired by the efforts you described here today. What im not inspired by are these numbers . Of in a world where we in the United States have less than 5 of the worlds population, we have recorded more than 25 of the worlds deaths from covid19. I have a friend you ask him how are you doing . And he says, compared to what . Were at 117,000 and counting. New zealand, 22. Singapore, 25. Taiwan, 7. Australia, 102. Canada, 7800. South korea, 274. Germany, 8800. Japan, 916. China i dont know that i believe these numbers, but theyre reporting less than 10,000 deaths. Even if you double that, its still only 20. And the thing that i have a hard time getting my head around and understanding is how, by comparison, so our deaths, how do they reach these staggering numbers by comparison so these other nations i just mentioned . Im not a real partisan guy, but im going to share with you what may sound partisan, but its the truth. I want to use these words from our president. February 28th, 2020, this is what he said its going to disappear. One day its like a miracle, it will disappear. That was february 28th, 2020. March 6th, the president s words anybody that wants a test can get a test. Thats what the bottom line is. Really . March 6th. Heres march 10th, the same president this was unexpected and were prepared and were doing a great job with it. And it will go away. U. S. St just stay calm. It would go away. March 24th we have never closed down a country for a flu, so you can say to yourself, what is this all about . May 20th, when you say we lead in cases, thats because we have more testing than anybody else. I dont look at that as a bad thing. I look at it as a badge of honor. That just flies in the face of the truth. Youve been asked and handed an incredibly difficult challenge. Truth be known, its because we were really late out of the starting gate. Realizing what we faced and addressing it right up front, right up front. Ed fellow used to be ahead of General Motors used to say leadership is staying out of step when everybody is marching to the wrong term. The people youve had to lead has had to march faster because of lack of leadership that we had in february and march into april. I just want to thank you for that herculean effort to get us out of this crisis finally, and were not there yet, because of your efforts, well be there someday. A question. When i was member of the house of representatives, i coauthored reauthorization of the defense production act. One of the things i was proud of, and i followed with interest the role this administration has played with respect to using the defense production act. What is the role of this white house this is for you, admiral and administrator gaynor. What is the role of the white house this steerings defense production act strategy . And specifically what is the role of 0lcu Peter Navarro in requests or shaping of policy . I would ask that of admiral polowczyk and administrator gaynor. Ill go first. Any use of i do my work that i figure out masks are currently in short supply rely on asia. The first action i put over to the joint Acquisition Task force was increase u. S. Production of n95 masks. That work came back from the acquisition professionals at dod, came back through fema, whose staff brought it to the unifieded command group, the ucg, where administrator gaynor, dr. Kadlec and admiral giroir approved that item and sent it to the white house, the nsc, to work through the staffing at the white house, and then it was again briefed to the White House Task force for approval. I would imagine that mr. Navarro is in that management process, but i had no first hind knowledge of mr. Navarros approval of something. It was all approved at the task force. Just a brief response, if you would, please. I wholly agree with the admirals recital of how that process works. Thats exactly how it works. Theres a function for that. We have used dpa, fema and my other partners, 15 times. Title i, title iii, title vii. And its pretty straightforward from my point of view. Thank you very much. Senator holy . Holley . Thank you. I appreciated your help in getting missouri, the home state ppe and other resources we need. Thank you for your response. I want to ask this question along these lines. We spoke to my governor today, and the governor tells me that the state really wants to continue to build up their supply of ppe because of the second line personnel, and in particularly law enforcement, First Responders, others, clinics, who are having trouble get ppe. The state wants to resource them. Of course, they dont have the ability to order directly themselves. They have to get resourced by the state, and the state feels they need to continue to built their supply. Would you be willing to work with me to make sure that missouri gets fully resourced and the respond ers responders get what they need . Yes, sir. And the dynamics were trying to understand, hospitals, Nursing Homes that have a precovid use for medicalgrade ppe. Now that covid is with us, there are other Critical Infrastructure that had no use for ppe, especially medical grade, so trying to understand exactly what some of these individuals or companies or, know are looking for, we would want to understand that. I would love to have a conversation about what exactly is the delta . Is it medical grade . Or cloth facial masks . Because you need less than six feet to get back to work. I think between the admiral and i, we can help solve that problem, i fid a need. Great. Good. I think make sure they get appropriately resourced is a priority that i would hope would be a high priority, and hope you can work with me on that. Ill hold you to that. Thank you. Admiral polowczyk, ive been following the work youve down, project air bridge, for instance, and my own view is were going to need to reshore these critical supply chains as soon as possible to make sure we dont find ourselves in the situation like the one weve in the last several months. But let me ask you, in your assessment, admiral, how severely have export controls by other nations impeded the flow of ppe or impeded our ability to acquire ppe . Senator, that is a great question. There is a bunch of unsung heroes. The cargo pilots, the fedex, the ups, the national air cargo. I could go on and on about those folks. China changed the rules multiple times. Subject our pilots to all sorts of tests, all sorts of other behavior, spraying them with disinfectant. So it is not just export controls which china has changed, along with other nations have changed, that slowed down or tried to interrupt. In my opening remarks i mentioned how fully involved the department of state was. I had great access to Senior Leaders within the department of state to bring up all of these issues to them and they continue to work, great efforts to loosen controls. Every time china changed a process, the department of state was able to work with the administrators there. Along with asking countries like malaysia to put workers back in glove factories. So unsung heroes, department of state, you may not be thinking about all of the partnerships, this is a Great Partnership between fema, department of state and others. Let me just ask you, a lot of Chinese Companies have no experience in producing medical equipment that retooled their factories to produce ppe during this crisis. Can you give us a sense of the quality of those chinese products. One of the things that we did, realizing that everybody said they had or could produce, i was very skeptical of those things. So very early on i realized there is nothing to buy that the Health Care Supply chain already wasnt working to bring to the points of care needed. So we used the department of state. They deployed members in country to go visit factories and go look at warehouses and then fema led a contract with underwriter laboratories to go do inspection for us. So we could not bring inferior product back to the United States. Very good. Broadly speaking, admiral, how would you address the state of ppe and the sort of devices weve been talking about. So internally, it is starting to ramp up. Let me just give you a slight metric. We essential make zero nitro gloves in the United States. And so we are working with one or two companies, the joint Acquisition Task force has identified several manufacturers that could ramp up to make nitro gloves so that is a further coming action. N95 masks, we had some u. S. Production going into middle march. We used the defense production act to ramp up that from 30 million to 40 Million Masks a month to 80 Million Masks a month which i think is sufficient. And other items such as ventilator drugs which are going to be significantly more difficult because of the advanced pharmaceuticals come from multiple places across the globe. And so were working to process to on shore those along with things like penicillin. That is more of a reostat than a light switch because it will take a little bit of a progress to work. It is going from very little to a lot more. Give us a sense of what you think the delta is now between our needs and our product capacity. N95 were ramp up to meeting our needs, Something Like disposable gowns, were in that process to start making more nonwoven fabric so weve turned to our textile industry to make textile gowns, nondisposable grounds, so that is 50 there. But on a ramp to be there by the fall. Very good. Thank you, mr. Chairman. Senator holly. Ive got a 12 15 commitment so i want to wrap this up before then. I just have a couple of quick questions. General gregoire, could you explain the testing and what is our current metric on that . Yes. Thank you. Senator, this gets to the question of how many tests are enough. And the number of tests that are needed in new jersey and North Carolina and massachusetts and detroit area is going to be different than montana and wyoming and other areas because of the overall disease. One reasonable metric that everybody can sort of get their hands on is what we call the percent positivity of tests. That means if you do 100 tests, how many of those 100 are positive. It is generally accepted that we should shoot for a rate of under 10 . For 10 that means youre testing ten people for every one positive. You could sort of understand if 80 of the people test are positive, you dont have enough tests out there. So that is a general metric. One of the World Health Organization said is subjected and it is not a magic number or written on stone tablets. Nationally were at 5. 8 positivity so were in a pretty good range. And i follow this every morning. Per state right now there is only one state in the District Of Columbia that is outside of the 10 change and theyre right on the margin. Again were not going to stop there but that is a metric that we could look at to give us an idea about how were doing. And you see when there is an outbreak in a certain state like in a Meat Processing facility, that percent positive goes up and we need to ramp up our testing more. One thing that really drilled a lot of the policy was the scary numbers coming out of china. 3. 4 case fatality rate. Ive been at the senor for evans based medicine and their estimate is between. 1 and. 41 infection fatality rate and the flu is 1. 3 , a bad near, 2010 and 2011 was i think. 18 . Currently do we have an estimate of what the infection mortality rate is going to be globally on covid19 . So, several months ago i came in and to the senate and the house and joint session and we made the estimate back then that the infection fatality rate was going to be about. 1 to. 5 . There was a lot of yelling and screaming that were underestimated it but it is in the. 1 ,. 2 . Whatever the rate is 117,000 there is no doubt about that. And it is that rate and it will vary from country to country. I expect our infection fatality rate to be lower than many countries. It is going to be higher than some. But it will be in that range. And i think in the spirit of this hearing, this could be considered one of the best of the worst cases. Because we could have had a virus where that fatality rate was much higher. So as god awful as this has been and how much suffering this has brought, i do consider us in onest best worst cases and we need to prepare for worst. We talked about not having a ppe for Long Term Care facilities. New york forced longterm care facilities to keep patients and florida said no you keep them. Because there is a higher fatality rate because if you are 75 and over, why wasnt there a game plan or should we have a game plan moving forward to transfer those that test positive for covid out of elderly care and into some kind of segregated hospitalization system where, by the way, the ppe could be used far more efficiently than a longterm care facility. So thank you for that. As was pointed out earlier, 40 or 45 of our deaths occur in elderly, primarily in longterm care facilities. In an ideal world, and we dont live in an ideal world and in the theoretical world you could put an elderly person back into the longterm care facility and do the appropriate isolation and that is very difficult to do given the amount and range of employees and all of the interactions. So we have put out, cms put out very specific guidelines of how we need to test and test weekly for workers in longterm care facilities and the cdc continues and will have more guidelines soon about how we really need to cohort. But i think in general it is a very dangerous practice to put actively positive patients back into an environment that you cant contain it. Particularly those of the highest vulnerability. It seems like we should move out of there into a different type of facility. Into a different type of facility or into a longterm care facility where everybody is positive so theyre cohorted. But cohorting by room or even by hallway is just a very difficult thing to do. It is something that hospitals can do. But the 15,000 longterm care facilities often with workers who have minimal training and low wages, it is just very difficult to make that happen. So i think you need to apply the extra precautions that you suggest and that were we will provide assistance to any tribe that needs help. If there is a specific tribe that needs a assistance or more, we will be happy to provide that to them. We will followup with you because we do have some tribes that do need this direct technical assistance. The Arizona Department of emergency and has expressed concerns with femas guidance that says the agency will be the arbiter of duplication decisions between fema category b and other federal funding available to the state. Littleere has been guidance to attract the many areas that overlap ineligibility that may exist. Could you explain how this process works . My second question would be, when can we expect to see complete written eligibility guidance to address those areas of potential overlap . Yes, maam. No matter covid19 or any other Natural Disaster, we are always worried about, especially if we are competing with another federal agency that may have like authority, we always want to make sure that we dont do a back becausecall we duplicate benefits. Covid19 has been more challenging because of all the different kinds of covid19 supplemental money, cares act money. We want to make sure that the appropriate agency owns that problem and those that are trying to use that money derive the greatest benefit from that money. Share. Cases, 7525 cost maybe if you use another agency like hhs, maybe it is 100 . We are working through all of those variables and we will be happy to work with you and your staff about trying to untangle jurisdiction can maximize the federal benefit when it comes to either the staff act or cares act. Thank you. I yield back. I have one final question, probably for the admiral or administrator. We talked about this earlier. There is going to be a fair amount of complexity of really honing in on how to handle the strategic stockpile moving forward. Who is going to be making those decisions . When will those decisions be made . I will start. Those decisions on the National Stockpile will work its way through the unified Coordination Group up to the White House Task force. Is, levels by that of inventory, i have personally briefed the Vice President on where i think the highend is. We are working with health and arman services to bring to be the resources that congress provided in the cares act to do that. Administration, the president has already agreed with, you know, more on the shelf, more items like swabs. Usingventory practices of the commercial marketplace potentially to rotate inventory. The decisions have already been made. But as we get down to the actual resources being applied, the numbers, i hold that up through health and Human Services to the White House Task force. Sir. S, lessons plenty of learned over the past 90 days when it comes to ppe and the National Stockpile. The admiral is on the next generation sns task force. We will take those Lessons Learned and make the best decisions to make sure we are ready in the short term over the summer and fall if there is a second wave. For longerterm, that is the greater challenge. How do we sustain these Lessons Learned over the long haul not to get put back in the position that we see ourselves today . This is an ongoing working effort. We will continue to be part of that process. Would love to have input from congress on how to make it better wed love to have input from congress on how to make it better. Input, but not only consultation from need not only input, you need consultation from congress. We set up about 10 members of our staff are really on oversight of covid19, National Stockpile, the supply chain vulnerability. This committee does not even get information on the National Stockpile. That goes to the health committee. Perfectly appropriate for that. This is a longterm process. We all need to take responsibility for this, which means we all need to be on a longterm basis involved in the process. It has got to be that collaborative effort. It cannot be just one administration, one time, or it sits on the shelf, gets forgotten. This has to be an annual hearing out of this committee to, where we take a look at that, where we sit. Can i add something . I didnt mean to interrupt you. Analogies of how we treat readiness in the department of defense. Of whether it be the stockpile, the health chair cares supply chain, or the readiness of health care in the nation. I think this has shown that there is a potentially different way that we should be thinking about it. I echo your concerns that it should not be a one under. I did one and done. I did not fully understand your question when you asked me. I think there is a ton of collaboration that needs to happen to help change mindsets of, i just put some stuff on the shelf and im going to go. How resilient are we . I think in things of great power competition. You can see where great power petition may have led us lead us in other areas of resiliency. I do think that there is a and im just suggesting that may be there is a, like you said, an annual hearing on the readiness of those things that we desire to be resilient. I think you are on the right track, sir. I absolutely agree with that. How do we have total system resiliency . One persons elective procedure is somebody elses lifesaving treatment or lifesaving diagnostic test. We cannot forget that. To goal of the shutdown was flatten the curve so we would not overwhelm our health care system. Fortunately, we did not. What we did is underwhelmed it in some in cases in so many cases, which resulted in layoffs. There are a lot of tough decisions being made with imperfect information. We have to look back. We have to analyze what we did, what we did not do right, what we did do right. We need to be better prepared in the future. I want to thank all three of you. I want to thank the men and women who work with you. I think it has been extraordinary effort. It has not been perfect. How could it possibly be . What is always so true in america, when we face these crisis, we see the best come out of our country, doctors and nurses, Grocery Store clerks. Throughout our country, people have stepped up to the plate to keep this country as together as possible during this process. Thank you all for your service. The hearing record will remain open for 15 days. This hearing is adjourned. Thank you very much. Thank you very much. Chatter]nible cspans washington journal. Every day, we are taking your calls live on air on the news of the day and we are discussing issues that impact you. They dunn leavy discusses prosecution of former National Security advisor michael flynn. The conversation continues with former u. S. Attorney jo Joseph Jennifer and paul rosen swine joseph to jennifer and paul rosen swine. Live washington journal at 7 00 eastern on wednesday morning and joined the discussion with your phone calls, facebook comments, and tweets. Live wednesday on the cspan networks, the House Judiciary Committee holds a hearing on policing practices and accountability. The committee will hear from George Floyds brother and family attorney. Other witnesses include Mark Morreale of the National Urban league and someone from the naacps Legal Defense fund. On cspan2, the Senate Returns at 10 00 a. M. To continue work on a bill to fund the National Parks and public lands. On cspan3, treasury secretary Steven Mnuchin joins the head of the small to testify about implementing the Small Business provisions in the cares act. Ises a look at what streaming live wednesday on cspan. Org. At 10 00 a. M. Eastern, the Senate Health committee looks at how the coronavirus will affect the new school year for k12 students. At noon eastern, a House Oversight hearing on the challenges that central essential workers are facing during the pandemic. At that time, the House Financial Services subcommittee hold a hearing on how the coronavirus impacts renters. You can follow those hearings live online at cspan. Org. Monday, nato secretarygeneral yen sultan berg took part in a conversation. Istalked about the role nato playing during the coronavirus pandemic and accused russia and china of spreading disinformation about the coronavirus. Held during a virtual conversation by the atlantic council, this is 30 minutes. His. It is wonderful to have this opportunity to discuss natos reflection process with secretarygeneral stoltenberg, at a time when the alliance is facing a wide array of challenges. Cyberussia and china, to attacks, climate change, and the pandemic. One of the changes we need to make today to ensure that nato will be relevant and effective over the coming decade and in 2030 . To answer these questions, we will begin with saving