Transcripts For CSPAN Hearing On Coronavirus Pandemic Response 20240712

Minutes of the hearing. Good afternoon and thank you for joining us today. Like to say my thoughts are with those who have lost a loved ones from the covid19 pandemic. Fay, with Tropical Storm making its way to the northeast, i hope everyone is staying safe. Ofare facing a crisis unprecedented proportion. The novel corona pandemic has already infected over 3 million and killed over 100,000 americans. The scale of the loss is staggering and efforts to produce a lifesaving axing continues, but not all americans have been impacted equally. Communities of color are not only more likely to be infected by the covid19, but they are also more likely to be killed by the virus. In my home state of new jersey, africanamericans disproportionately make up the covid19 fatalities. This disturbing trend is observed not only in new jersey, but across the nation. Data from the cdc shows africanamericans and hispanic populations are three times more likely to be infected and twice as likely to die from covid19 than white populations. This administrations response to the outbreak has been an utter failure on a multitude of levels. Nowhere is this more acute than its neglect of Minority Health. Since the onset of the outbreak, it has been clear that communities of color are disproportionately impacted. However, the impact on these communities have been obscured by Critical Data gaps. Even with this knowledge, the administration has been painfully slow in setting requirements for collection of racial and ethnic demographic information on covid19 infections. The example is just one of many that demonstrates the administrations lackluster outbreak response, especially when it comes to Minority Health. Even cdc director dr. Robert redfield admitted failure of the administration to collect Data Information issued an apology at made that apology at another congressional hearing last month. I would say dr. Redfield, the American People need more than that. Much of the focus of the administrations response to Minority Health during the pandemic is centered around the department of health and Human Services, the department of Homeland Security, federal Emergency Management agency, fema is playing a vital role as the lead federal agencies of response. Americans are counting on fema to get it right. Unfortunately, fema has had costly missteps in the past when it comes to not factoring in the needs of communities of color and researchers have continuously found that femas Recovery Program exacerbates existing disparities. While these disparities long proceed covid19, the effect they are having on minority communities in a national emergency, i worry about fema not doing enough to meet as we speak, lives are being lost in the country to longstanding Health Inequities and that is unacceptable. At todays hearing, i hope we can explore this problem and hear potential solutions from our panel of experts. The chairman now recognizes the Ranking Member of the subcommittee, the gentleman from new york, mr. King, for an Opening Statement. Chairman. Thank you, i appreciate the opportunity and i think this is a significant and important hearing. I will make my remarks brief. Let me just say new yorkers were hit particularly hard. We had over 400,000 confirmed cases. In my district alone, there is more than 20,000 confirmed cases. There is probably 1200 to 1300 deaths in the district. The particular focus of this hearing as far as how it impacted the minority community, thats particularly true in my district. The average community in the district, excluding the minority communities for the purposes of this debate, is between 15 and 20 cases per thousand. In the minority communities, it goes from 62 to 70 cases per thousand, 3, 4, five times higher in the minority communities. The immediate reason for that seems to be the front line workers, grocery workers, transit workers are minorities. So they are right on the front lines, frontline warriors, and they are getting impacted directly. Some of the longterm reasons are the Underlying Health conditions such as diabetes, and high blood pressure, Heart Disease are illnesses that for a long time go undetected and people may not know they have them and theres a lack of health care in minority communities. That is why i think it is important and i worked with a congressman on this. You have to have them, they are in the community where people in the committee feel safe going to them. They dont feel they are going to check their immigration status, they can just go. Having it nearby makes it more comfortable. These are people who very often have low incomes and may be dont want to be going to doctors. If they dont feel sick, they are not going to go looking for it. Thats why its important to get check ups and be tested and Community Health centers are extremely important. Now, we really began to realize this in early april, the extent of the pandemic in the minority communities. Working with suffolk county, they put a Testing Center on brentwood, two of the most impacted communities, especially brentwood. Also, i have to emphasize that whatever other partisanship is going on, fortunately on long island, congressman greg meeks and i have been working closely on this and ive been working with the state center who rep state senator who is a democrat, we have been trying to work as closely as we can. Sooner or later, we are going to come out of this pandemic. That is only the beginning. We have to realize this can certainly come again and what this has brought out is the underlying conditions as far as lack of Proper Health care in minority committees, so we are going to have to address that as we go forward. As far as the federal response, both of our county executives are democrat, i work with them, i have not heard there has been a lack of funding as far as one community against another. We did fight hard to get ventilators and the gloves, masks, but so far i dont see that being an issue, but i think the underlying, longterm issue is going to be the issue of Proper Health care and we have to take that into account, we have to find ways to rectify that going forward. With that, let me yield back and i look forward to the testimony. Thank you, mr. Chairman. I thank the Ranking Member for his candor and honesty, which is why i appreciate his service to this country so much. Thank you, sir. Thank you once again. I would like to work with you on the Community Health center issue. Thats something that has been very important to me and it is good to hear that youre interested in that and look forward to working with you. Members are reminded that the subcommittee will operate according to the guidelines laid out by the chairman and Ranking Member. With that, i ask consent to waive Committee Rule 882 for the subcommittee under the preceding for the period designated by the speaker under House Resolution 965 without objecting. The chairman now recognizes the chairman of the full committee, the gentleman from mississippi, mr. Thompson, for an Opening Statement. Chairman thompson thank you very much, mr. Chairman. Thank to my colleagues and witnesses. I would like to thank both of you and the Ranking Member for holding todays hearing on Health Disparities and covid19 pandemic. The covid19 pandemic did not create Health Disparities in this country. Instead, the pandemic is further exposing these disparities and their tragic effects on minority and disadvantaged communities. Todays hearing provides an opportunity to examine the federal response to the pandemic and what must be done to confront the disproportionate impacts of the pandemic in these communities. In march, fema was tasked with being the lead federal agency for covid19 response. I have been concerned about femas past Emergency Response efforts, where it failed to adequately address the needs of minority and economically disadvantaged communities. The complexities of a pandemic put this troubling history in starker view. In april 2020, fema published a new civil rights bulletin intended to ensure civil rights during the covid19 response. While the publication is an encouraging step, continued congressional oversight of the agencys efforts and operations is necessary to ensure response efforts to provide equitable assistance to minorities and economically disadvantaged communities. Of course, direction to fema and the entire federal government on Pandemic Response flows from the top. Unfortunately, president trumps response to the worsening pandemic has been a failure by any reasonable measure. Failure to address minority and economic Health Disparities is a significant part of the shortcoming. The administration has even struggled to provide policymakers with covid19 case and morbidity data outcomes by race and ethnicity. In fact, it took pressure from members of congress and the public for the centers for Disease Control and prevention to release its First Nationwide preliminary case and morbidity estimates by race and ethnicity on june 15, 2020, well into the pandemic. Our communities of color and the economically disadvantaged not only have to contend with a deadly virus and failed federal response, but also the systemic inequities that put these communities at greater risk for covid19related hospitalization and death. On april 29, 2020, every democratic member of this committee sent a letter to the department of health and Human Services office of Inspector General requesting they look at this issue and ways the federal government can better address Health Disparities in emergencies. Katrina taught us a lot. I thought we had learned a good bit about communities of color during emergencies but obviously we still have some work to do so i look forward to our witnesses testimony today and i yield back, mr. Chairman. We cant hear you, sir. Chairman payne thank the chairman for his Opening Statement and appreciate his leadership. Now, mr. Rodgers will now be joining us today so i move on to introducing the witnesses. Our first witness, dr. Georges benjamin. Dr. Benjamins experience includes having been secretary of the Maryland Department of health and Mental Hygiene and the former chief of emergency medicine at the Walter Reed Army medical center. He is also a member of the National Academy of medicine. Welcome. Our second witness is dr. Leana wen. Dr. Wen is a visiting professor of Health Policy and management at the George Washington University School of Public Health, where she is also a distinguished fellow at the mullen institute of Health Workforce equity. She also previously served as baltimores health commissioner. Thank you for being here. Our third and final witness is chauncia willis. Ms. Willis is the cofounder and ceo of the institute for diversity and inclusion in Emergency Management. She is a certified emergency manager, a master exercise practitioner and served as the immediate past president of the International Association of Emergency Managers. Welcome. Without objection, the witness full statements will be inserted into the record. I now ask each witness to summarize his or her statement for five minutes beginning with dr. Benjamin. Dr. Benjamin thank you very much for allowing me to spend some time with you this morning. You have my full testimony. Im going to focus on three areas. Some concerns i have about ongoing preparedness activity and the importance of rebuilding our Public Health infrastructure. As you know, this has devastated our nation. Over 3 million cases. Over 130,000 deaths. They are growing at 60,000 cases per day. If you look at the minority community, we have been devastated disproportionately as africanamericans. Over 13 of the population with 24 of deaths. Hospitalizations are five times for African Americans. They are four times for hispanics and nonhispanic whites. The native American Population is also devastated by this outbreak. I think that we ought to think about this epidemic as though we have three of them. Number one, we obviously have this big Infectious Disease epidemic. We also have an infodemic that i will talk about which is a lot of misinformation. Clearly fear plays a predominant role in our community. We do not know what is going on, it is a new disease, there are lots of issues. Quite frankly, we need National Leadership on this outbreak. Obviously, the impact has not just been on health, it has been on the economy and the social welfare, etc. There are three reasons for this. Higher exposure because of public facing jobs for minorities. Susceptibility because of a long history of chronic diseases and social determinants of health. 80 of what makes you healthy occurs outside of the doctors office. People are set up not to be able to have good health and that includes things such as coming to work multiple jobs because of pay inequality because of the lack of paid sick leave and housing, which prohibits you to be able to physically distanced if you get infected. These are all concerns that we have to address if we are going to go forward. Our response has been challenged in many ways. We have had inadequate testing. We have had inadequate data to target resources and responses. Contact tracing is behind where it needs to be. In terms of education, we have not done a great job of educating the public on what is going on and how to address this as we go forward. I remain concerned that should we get hit with something this summer like a severe storm or another hurricane, wildfires, an earthquake, that our ability to manage that will be severely stressed. Imagine being in a shelter where you cant really manage face coverings well, handwashing and physical distancing. We have not planned adequately for that. Finally, we need to fix our Public Health system. I was a Health Officer in maryland during 9 11. We had a good system. But congress and the administration at the time improved our Public Health system. But we as a nation have allowed that to erode away substantially over the last several years. It has impacted our response to covid. It stands to impact our response to natural disasters and i remain concerned that the coordination and leadership is not there for us to address these things as we go forward. With that, i will be kind enough to stop and take questions during the question and answer period. Chairman, i am not sure we heard you. Chairman payne thank you, dr. Benjamin, for your testimony. I now recognize dr. Wen to summarize her testimony. Thank you. Dr. Wen thank you very much. Thank you for addressing the intersection of Racial Disparities and the covid19 pandemic. I come to you from baltimore, where i am a practicing physician and have the honor as serving as health commissioner. Children born today can expect to live 20 years more or less depending on where they are born and the color of their skin. There are Racial Disparities across every metric of health as a result of racism and inequities. Covid19 is a disease that has unmasked these Health Disparities. The evidence is clear that African Americans, latinos, native americans and other minorities bear the brunt of this pandemic. My testimony outlines 10 actions that congress can take now to reduce the impact of the epidemic on people of color. I would like to highlight six of them that are relevant to the work of the Homeland Security committee. First, target testing to minority and underserved communities. Testing must be free, widespread and easily accessible. Yet, it is estimated that we need 10 times the amount of testing that we currently have. Congress must instruct fema to ramp up testing and set up facilities across the country. Existing hotspots should be the priority initially. The key is to have enough testing everywhere to prevent clusters from becoming outbreaks and outbreaks from becoming epidemics. Second, provide free facilities for isolation and quarantine. We know the key to reining in the virus is testing and tracing and isolation when someone tests positive, we tell them to selfisolate. What do you do when you live in multigenerational housing . Other countries have addressed this by setting up field hospitals and converting unused hotels into selfisolation facilities. Congress should request fema to do the same. Third, institute stronger worker protections. Minorities constitute a larger percentage of essential workers. The cdc has issued watereddown guidelines and osha has not met its mission to protect workers. Your committee can ensure that protections are followed for workers like tsa employees. This includes universal masking for all passengers in airports, as this will protect the employees and the public. You can institute stronger protections to limit the spread of covid19 in immigration detention facilities including access to ppe and protocols for isolation and quarantine. Fourth, suspend Immigration Enforcement for those seeking medical assistance for covid19. Public health hinges on public trust. Undocumented immigrants who fear deportation will be scared to seek help if they exhibit symptoms and pose a risk to themselves and their families. Congress should prohibit i. C. E. From accessing records and facilities of those seeking care for covid19. Congress should ask for temporary cessation of the Trump Administrations public charge rule. Fifth, prepare for the next surge. It is a National Shame that we ran out of ppe. There was no excuse in march and less of an excuse now. Ppe should not only be available to doctors and nurses. Cashiers, bus drivers, nursing home attendants and people of color should have protection. Congress must urge them to have a strategy to ensure that ppe, ventilators and other critical supplies are produced in sufficient quantity. Lack of action affects everyone but in particular, minority communities. Finally, support local Public Health. Funding for Public Health preparedness has been cut by half forcing local officials to make impossible tradeoffs between critical programs. I think we can agree that treating covid19 should not come at the expense of preventing cardiovascular disease and reducing overdose deaths. I urge that your Committee Also consider the Public Health safety net to be part of the backbone of Critical Infrastructure and National Security in the u. S. I would like to end my testimony by thanking all of you for focusing on tangible solutions. There are systemic problems that we must address that will take dedicated effort. But we are facing the biggest Public Health crisis of our time literally, a lifeanddeath threat facing committees of color. We cannot ignore problems. Now is the time to take action to reduce disparities in covid19 outcomes and improved health for all. Improve health for all. Thank you. Chairman payne thank you for your testimony. I now recognize ms. Willis to summarize her statement for five minutes. Chauncia chairman thompson, chairman payne and Ranking Members, thank you for the opportunity to testify. We are experiencing a paradigm shift across the United States as we respond to a pandemic, civil unrest and systemic racism with an uncertain outlook for recovery or an adequate recovery plan. The issues plaguing america, including the disparities associated with covid19, are a result of policies enacted that have historically lacked diversity and inclusion. Diversity, inclusion, and equity. Of all Emergency Management policies, only a few mention equity and none address using equitable strategies to produce Better Outcomes for vulnerable groups. Disasters do not discriminate, however, people do. Seenealth disparities during this pandemic can only be we understand and operationalize equities. They must be present in all practices within Emergency Management. Equity is different from equality. Equality is about giving everyone a shoe. Equity is giving everyone a shoe that fits. In Disaster Management, it can no longer be about doing the most for the most because when we do the most for the most, it leaves a gap [indiscernible] there are existing inequities within our countrys very fabric that lead to disproportionate deaths and negative impacts for the most vulnerable. These inequities are rooted in systemic racism and an antipoverty mindset. For example, the racist policy of redlining has led to lack of access to healthcare, exposure to environmental hazards and so forth. The field of Emergency Management lacks diversity and representation, which negatively impacts outcomes in disasters for underrepresented groups. Emergency management policies indicate that white male is the default setting. The field of Emergency Management is overwhelmingly white, made up of over 80 white males in leadership positions. However, the communities we serve as Emergency Managers are very diverse and the impacts of covid19 on diverse populations is significant. Current data shows that black and indigenous americans have experienced the highest rates of covid19 death in america. If they had died of covid19 at the same actual rates as whites, about 15,000 blacks, 2200 latinos and 400 native americans would still be alive. Americas disabled population is suffering because they lack access to testing. In addition, although people with disabilities are at high risk for covid19, there is a data gap in recording that prevents equitable strategy development. Also, the needs of rural areas are unique because they tend to have older populations with more chronic Health Conditions that raise the risk of developing more severe cases of covid19. They have fewer Healthcare Providers and more uninsured residents, meaning they must wait longer for treatment. The Emergency Management system must incorporate operationalized equity as a foundational principle for policies using social determinants of health to address the needs of diverse populations. Our organization recommends the following, a thorough review of current Emergency Management policies, including an assessment of the intended and unintended respects of these policies. Number two, intentional integration of equity into fema doctrine and contracts. Number three, ensure federal funding is tied to demonstrate diversity, inclusion, and equity. In addition, disaster plans to be evaluated and held accountable based on the performance of the equity strategy. Number four, integrate equity into Emergency Management curriculum and continuing education. Finally, inject preparedness mitigation funding in the most vulnerable communities, including communities of color. Emergency management must make Diversity Inclusion a priority so that lives will be saved and not sacrificed in disaster. Thank you for your time. Chairman payne thank you for your testimony. Id like to thank the witnesses for their testimony. I will remind the subcommittee that we will each have five minutes to question the panel. I will now recognize myself. But before i do that, i ask unanimous consent that congresswoman jackson lee be permitted to sit and question the witnesses. Objection. Ms. Willis, fema has a history of Emergency Responses plagued with racial and socioeconomic disparities. Despite this, the Trump Administration has made little to no effort to assure communities that the agency will respond to the pandemic in an equitable manner. With preexisting disparities in mind, what types of Emergency Response strategies should our country utilize to respond to the pandemic . Ms. Willis that is a great question. One of the most important strategies will be to ensure that we are training our Emergency Managers in equity to assist them in focusing policy creation and implementation on equity and vulnerable groups. Right now, within fema and Emergency Management as a whole, equity is not a priority and in fact, it is not seen as a priority in many areas of Disaster Management and that is a significant problem that must be addressed. We need an equity revolution. We must confront the intersection of race and poverty on biased Disaster Management policies as well. A thorough review of policies is needed and more funding must go into equity training and education. Thank you. Chairman payne am i correct in saying that we are not asking for special treatment in these communities, we are asking for equitable treatment in these communities. Communities . Is that correct . Chauncia that is absolutely correct. Surviving equity and disaster should not be an other, it should be priority. Thank you. Chairman payne dr. Wen and benjamin, when asked about Racial Disparities at a congressional hearing, dr. Fauci said institutional racism contributed to the disproportionate impacts of covid19 on African Americans and that they have suffered [indiscernible] somebody needs to mute, please. I am sorry. Dr. Fauci was saying that the community has suffered from racism for a long period of time. If the Trump Administration has known of these factors for a long time, why has the administration not done more to address these problems . Either one of you can start. Dr. Benjamin sure, i would be happy to start. If you think about the response, there are two areas where the administration can step up more. I know some has been done but there is more they can do. Number one is testing. Early on, there was not a lot of tests. But when we did have tests, they were not easy to get to. The drivethrough testing, if you did not have a car, you could not get there. We have to make sure testing is available to all parts of the community, to people that have shift work, to people who do not have paid sick leave so they can get testing. We need to make sure that testing is available. Issues we have seen in the last couple of weeks of people waiting hours to get tested is unacceptable for every citizen in our country, specifically for communities of people at higher risk. Sitting in a line three hours when you have symptoms and you dont feel well from a clinical perspective makes no sense. Secondly, we know that the issue of access to care remains a big issue. And i applaud Ranking Member king about Community Health centers and that is wonderful. But every citizen in this country should have access to quality, affordable healthcare. That is important. We need to stop fighting about that. Healthcare is a fundamental human right and we need to fix that. And i think the third thing is we have to deal with this issue of misinformation. One of the things we did in the aids epidemic is we did a lot of work educating faith leaders, barbers, beauticians, anyone who was an influencer in our community to get the communities of color, the communities that had languages other than english as their first language to make sure they understand the disease process and how to get help and how to protect themselves. Thank you, sir. Dr. Wen, my time has expired so im going to have to yield. Im sorry. I now recognize the Ranking Member of the subcommittee, mr. King, for questioning. Rep. King thank you, mr. Chairman. I would like to focus my question to dr. Wen. In new york and long island, we have a particular issue with transportation. The Long Island Railroad carries hundreds of thousands of people in and out of manhattan to brooklyn and back. We are talking about millions of people on the trains every day. Im trying to think of the next pandemic or the second wave of this one. What do you suggest we do to anticipate the problems we will get from transportation and as far as having testing sites, ways to detect it . Everyone traveling together in very close quarters, folks from low income communities and high income communities, from the suburbs and inner cities all coming together. Can you think of any way we can do to minimize the impacts of the second wave spreading or another pandemic . Dr. Wen yeah, thank you very much, Ranking Member. This is an excellent question. The most important thing that we can do in order to mitigate the spread on Public Transportation is the same as i would say if you had asked me what can we do to keep schools open. It is the same answer. We need to keep a level of covid19 in the community to be as low as possible. When you have communities in the south where one in 100 people have covid19, if one in 100 people have it and they dont know it and they are getting on a train or going to any public place, that is a lot of people they could be infecting. We really have to do our part in order to keep a level of infection as low as possible throughout the country. At this point, we know exactly what that would mean. This is a combination of distancing, Wearing Masks, good sanitation practices and cleaning. Ultimately, this is about keeping the level of infection as low as possible. Another is testing, to piggyback on what dr. Benjamin said earlier. We need free Testing Available to where people are and it needs to be rapid. It doesnt do any good when there is a test results that comes back in five to seven days or 10 days because what is that patient supposed to do in the meantime. In that time, they are spreading that disease to others, so that is important. Surveillance, we need to know where it is people are picking up illness, so we have to have surveillance in the community so that we can identify a cluster of outbreaks or cluster of infections before it becomes a large outbreak. Rep. King thank you, doctor. This question to anyone who wants to answer it. We have several hispanic american, low income communities with documented and undocumented People Living in those communities. You, dr. Wen, mentioned multigenerational, and they are more inclined to have multigenerational living in those communities. What is the best way to get testing into those communities . Im not advocating, but undocumented people are afraid to go to the doctor and testing. Can we aggressively go into those communities more, not for our good, but for their good, to get them tested . I guess you cant force them to be tested but to encourage them in those communities. Anyone who wants to answer. Dr. Benjamin sure, a van. All you need is a swab, a van, and a place to cool down. You can take mobile vans in those communities very effectively, park them on the corner, but you have to communicate with them. Or go to schools. You have a lot of empty buildings in the community that you can set up a Rapid Testing clinic in. Dr. Wen if i may add, you can go where people are, churches, community sites, it is really important to enlist trusted members in the community. Public Education Needs to be a part of that, including how everyone should receive health care. This is not a time to be asking about immigration status. Many people are going to be terrified to seek help because they fear they are going to be arrested by i. C. E. And be deported. Its important to assure them this is not going to happen at this time. Its about protecting them and everyone else around them. Rep. King my time is up. I yield back and thank the witnesses. Chairman payne the chair will now recognize other members for questioning. As previously outlined, i will recognize members in order of seniority, alternating between majority and minority. Members are reminded to unmute themselves when recognized for questioning. The chair now recognizes for five minutes the gentleman and chairman of the full committee, the gentleman and from mississippi, mr. Thompson. Mr. Thompson thank you very much, mr. Chairman and i thank the witnesses. One of the things we have tried to work with with fema is the issue of any national or natural disaster. They need to have a plan for the entire population, and that plan should include transportation, should include housing, facilities, all of that. Most of the plans we have come in contact with or have been presented try to look at communities as one entity and not, as peter was talking about, certain people stay in one area and certain people stay in another. I guess what im trying to say is, we get cookiecutter plans that many people assume will fit every situation. And what i have heard from the Witnesses Today is that you have to have a greater understanding of the communities in which you are working and your plans have to reflect it. The best example i can tell you, im speaking from my Congressional Office and we had a testing site that was five miles from my Congressional Office, and we dont have Public Transportation. So in the run of a day, they did 26 people because nobody could afford to get to the site. Well, if they had just talked with somebody and say where is the best place to come and do a site for testing, they said you need to come where the people are. That Comfort Level sometimes that our Emergency Responders go to. Can you give members of congress, how do we work with fema and other personnel in this venue to get them to understand you have to include entire communities in your planning and especially from an Emergency Preparedness standpoint because otherwise, they will get overlooked . I will throw that out to dr. Benjamin, dr. Wen and ms. Willis. Benjamin we have to understand their job they have to plan with communities and not to communities. That means they have to have community engagement, they have to be part of the planning process throughout every aspect of it and we need to make sure congress will require that governors and emergency planners show that they engage communities as part of the planning process. Remember the hivaids days when we were challenged to get good hivaids plans in place . Congress required Planning Communities be part of that planning process. I think you can link that to the funding in some way or other mechanisms to demonstrate communities are part of the planning process. As you know, there is enormous stress in communities not being used. Dr. Wen if i may add very quickly, that right now, we dont even have that cookiecutter approach. I agree we need to have a tailored approach but right now we dont even have a National Strategy of any kind. We need a National Strategy around testing, around quarantine and isolation facilities, around procuring supplies with the defense production act, we need to have that strategy in order to save lives. Ms. Willis i would say equity must become a core competence for Emergency Management, certainly in the Emergency Management leadership. I would also say we needed to tie funding to the investments in minority communities. Right now, that is not happening. We need to invest fema funding for preparedness rather than continuing to that is something that has been a problem and continues to be a problem the under investing in and divesting in communities of color. Chairman payne thank you. I now recognize the gentleman from louisiana, mr. Richman, for five minutes. Or maybe not. It doesnt seem like he is here, so we will go to the gentlelady from illinois, miss underwood, for five minutes. Rep. Underwood thank you mr. Chairman, and i am so grateful to our witnesses for appearing before our panel today. This is a topic that touches close to home. So much of the disparities related to covid19, this began with illinois as we were one of the first to release our data by race and ethnicity and that has certainly jumpstarted our national conversation. In the last week, my state of illinois surpassed 7000 lives lost, hundreds of thousands are out of work and every community has been impacted. But the harm done by this pandemic has not been reflected evenly. Committees of color are experiencing disproportionate loss of jobs and death. The cumulative grade for illinois of the positive rate for hispanics is more than five times the rate for white residents. In one county in my Northern Illinois district, the positive test rate for hispanic residents has been nearly eight times as high. Eight. Across the country, people of color, particularly black folks, are losing both their jobs and their lives at staggering rates. To tackle these inequities headon, we need to make culturally relevant investments in Public Health and economic opportunity, which is why i introduced with my house and Senate Colleagues the health force and Resilience Force act which would fund Public Health departments to hire locally for Contact Tracing. Dr. Benjamin, why is it so important to have local residents supporting Health Departments with initiatives like Contact Tracing and information sharing . Dr. Benjamin i dont speak spanish. I dont speak spanish. So it is language. Its trust. Its knowing where to go. I was once the d. C. Health officer and we were successful in many of our efforts there to reduce a whole range of Infectious Diseases because we had outreach workers that knew the community, and who to go to and when people didnt want to do something, they were able to convince them to follow medical advice. Thats essential in committees communities of color, especially where they are concerned about immigration, where english is not the first language, and frankly, right now, in these last years, we have stigmatized them. Rep. Underwood so we have invested billions of dollars in the search for a vaccine but actually developing a safe and effective vaccine is only the first step. We will then need to prepare to rapidly deploy it across the country. Unfortunately, we know that black and Latin Americans have lower immunization rates than their white counterparts. Dr. Benjamin, can you describe community specific efforts to increase vaccination rates for recommended immunizations for measles, smallpox and flu vaccines . What does the evidence of the deployment of those vaccines tell us about how we need to prepare to deploy and essential covid19 vaccine to ensure strong vaccination rates among communities of color . Dr. Benjamin when you start to recognize the uptake in communities of color, they do not get vaccinated as frequently. Secondly, we should recognize there is an enormous amount of mistrust that currently exists. With theoupled antivaccine community and others who are spreading a lot of disinformation. Weve already got people in social media space and passing out flyers telling communities of color dont get vaccinated. It will make you sterile. It will give you aids. It will give you the disease. It will kill you. So, there is already a lot of disinformation out there. More importantly, we need a national plan. We need the government to step up to the plate and put together a plan like we did with h1n1 to figure out how we are going to deploy this vaccine. Weve got lots of mechanisms to do that, but we have no plan. Rep. Underwood im glad you said that because last month, i introduced the disinformation act. This bill would help Public Health officials mitigate the impact of false information that can undermine efforts to keep our communities safe during this pandemic and beyond. Dr. Benjamin, in what ways could the spread of disinformation work in disparities, particularly with respect to vaccines but also Wearing Masks . Dr. Benjamin again, there is a group out there who is actually working to confuse us all around vaccines, around masks. I saw some flyers being passed out in new jersey that had the cdc and World Health Organization logo on them. It was obviously misinformation but there were flyers that said if you are infected, go to a synagogue. If you are infected, go to a low income committee. A low income community. If you are infected, ride Public Transportation. They are giving misinformation to hurt people. We have to push back against that kind of effort as aggressively as we can. Rep. Underwood in the same way you discussed targeting the strategies to mitigate spread like testing and treatment in the communities that are most impacted, we also need to target those same types of campaigns to spread Accurate Information and empower Public Health officials to do the same. In may, the house passed the heroes act, which included 7. 5 billion in direct funding for Public Health departments and 500 billion for states, 375 billion dollars for local governments. Unfortunately, the senate has yet to act to pass this bill. We know there are significant Public Health consequences to continue delays impacting the heroes act, so we are calling on our colleagues in the senate to rapidly take up this legislation and empower our state and local Health Departments. With that, mr. Chairman, i yield back. Thank you to our witnesses. Chairman payne i would like to thank the gentlelady for her questions. Always poignant. Please make sure my office has all of your pieces of legislation so i can sign on. Yes, mr. Chairman, thank you. Next, i believe we will recognize the gentle lady from texas, miss jackson lee for five minutes. I thought she was on. Staff is she available . , not at the moment. It is just you and ms. Underwood. Rep. Underwood if you would yield a couple more minutes, i do have a couple of more questions. I do yield. Underwood my next question is for dr. Wen. The cdc reported pregnant women could be at severe risk and the risks appear to be higher for black and hispanic pregnant women. As congress develops another covid19 relief package, which policies should we consider for pregnant and postpartum women . Dr. Wen thank you for that excellent question. I know you and i have worked closely on issues of Maternal Mortality and i thank you for your work on these important factors. I think there are two separate but related issues. One is about covid and disparities and the other is Maternal Mortality and now they are intersecting in this way because of severe effects among pregnant women during covid. We have to take them separately. For covid19, i think all the recommendations we have made thus far still stand. In this case, i would continue to emphasize the importance of a National Strategy. Right now we have seen what , happens when we have this piecemeal approach across the country. Unfortunately, elected officials not following the advice of Public Health experts and are in fact feeding into misinformation. Everything we can do, that all of you could be doing to ensure there is a National Strategy to the best of your ability would be extremely helpful and to spread that information to counter the misinformation that is rampant. When it comes to Maternal Mortality, we need to not only be looking at what happens during pregnancy, which is really critical, but how can we be improving health for women, womenticular for black and women of color throughout their lives . And i think that everything you have done, congresswoman underwood, to improve Maternal Mortality, but also not only address the Maternal Mortality issue but improve outcomes during covid19 as well. Rep. Underwood thank you for your leadership on this issue. And all other matters of Public Health. I want to return back to dr. Benjamin. I started to raise the heroes significant Financial Investment for states and local governments. With your background and leading the american Public Health association, can you describe the potential Health Consequences of inaction on this emergency funding for states, localities and Public Health departments . Dr. Benjamin we have 3 Million People with this disease and even though we dont have as many deaths today because of young people getting it who may not be as susceptible to dying, the death is a lagging indicator. We dont have a Public Health system that can adequately trace and do the Contact Tracing. This is going to get worse before it gets better. I can assure you that as we return to work. We are going to have to build that system and we need to do it as quickly as possible. Without those funds, frankly, we are up the creek. I was just talking yesterday to folks about going back to school. We dont go back to school until we get our hands around this disease. Rep. Underwood the thing i want to make sure that the committee and the American People understand is that for decades our state and local Public Health systems have been systematically seen their funding reduced, they have been working at the very top of their capacity across this country, and that was during a time of health and wellbeing, largely. We were not in a pandemic environment. So these types of resources are not going toward the state and local health apartments. Local Health Departments. They are to fill critical functions for the communities they serve. When we talk about the Resilience Force and hiring community members, training them and giving them a sustainable skill set to pour into this communities that they come from, it only serves to build the capacity of those local institutions. Would you care to comment . Dr. Benjamin absolutely. And my health department, when anthrax hit our nation, my Surge Capacity came from my aids program, etc. We continued to deal with hiv and stds and as dr. Wen pointed out come we still have people dying the leading cause of death is still cardiovascular disease and cancer. Those did not go away and we still have to address them and it is still much cheaper for our nation to prevent these diseases than to treat them when they occur. Rep. Underwood thank you again, and i yield back. Chairman payne thank you. The chair recognizes the gentlelady from texas, miss jackson lee. Rep. Jackson lee mr. Chairman, thank you for your kindness and thank you to the members. We are all doing double duty. Let me say, mr. Chairman, im delighted with your leadership and chairman thompsons leadership. I must publicly say congratulations on the recent success we had that we will be able to see you again in the year and months to come. Thank you very much. All the witnesses i have encountered in the past. And the members that are on. So let me just be very clear. Im now in the covid epicenter. I am in what will be politely haiti. Hades, not in an experience we never thought we would be in. We opened up on may 1, the cdc guidelines were not adhered to, which is a consistent decline in covid19 cases. I get personal calls from constituents of members who have died at home or who died of unknown causes or something called pneumonia, untested. The federal government is pulling out from testing. Weve only tested 2. 5 million in a state of close to 30 million persons. Im in the most populous county and populous city in the state of texas. The 18th congressional district, which is at the heart of these issues. I did give an opening and im going to ask for quick answers. Let me say to the witnesses that i am convinced of your position, dr. Benjamin, on building up the Public Health infrastructure. I can assure you that my Public Health Officials Say that. But let me just ask you when you said get your hands around it, if you find a pandemic of this nature in a community, what would it not add to the process of getting your hands around covid19, a reissuance of a stayathome order that allows medical professionals and others to understand where the hotspots are. We have a hundred firefighters in quarantine because of their exposure. We are in restaurants in various places. What about a stayathome order . You can answer it generically. Dr. Wen, i used to be able to focus on the fact that the latin x population, the african American Population are higher numbers but we have latin x persons who work every day who are scared with the posture of ice. What should be said . I have asked ice to stand down. Ive asked the White House Task force to ask ice to stand down. How dangerous is that when we have communities that are fearful of accepting health care and what should we do . Dr. Benjamin, would you answer the question about the viability of a stayathome order . Dr. Benjamin texas is in big trouble, and you folks should have tighter controls and mandatory mask wearing. Anytime anybody has to go out, it works. It absolutely works. Every nation in the world has demonstrated that it works. It worked in 1918. It is going to work again in 2020. But folks are playing too much politics with this. We cant get the economy back until we get our hands around it and we cant get our hands around it until we stop the transmission of the disease. You get this disease from other people. That means we have to stay away from each other as much as we can in an organized way. Then as we return, to try and engage one another, we need to do so in a cautious, measured, controlled manner, facial coverings, handwashing, and physical distancing. That is what we have right now. Rep. Jackson lee dr. Wen, would you comment on that . And i guess you might add i mentioned the testing sites. The federal government is pulling out of testing and transferring it to local vendors. I certainly welcome that, but how important is testing in addition to the question i gave you . Anyone else who wants to going in, likewise. Dr. Wen testing is absolutely essential. If you dont know who has the infection, how can you stop the spread . Especially since we know about a especially since we know about asymptomatic transmission. A new study shows up to 50 or even more occurs with people who dont even know they have it. So we absolutely need testing. State and local officials cannot do this alone. Theres no way to ramp up testing without federal support and that is why femas support in this and leadership is going to be so important. To the question about latin and other immigrant populations, we cannot have policies that will scare people. We cannot have individuals who are too terrified to take care because they think they or their loved ones will be deported. You absolutely cannot have ice have anything to do with testing, they cannot have anything to do with medical records or being in hospital facilities or any health care facilities. We also know Contact Tracing is critical to reining in the infections. When someone calls an individual and they are asking about their close contacts, they must be reassured that that information will never go to any immigration for officials of any kind. They are not going to be able to control the infection. This is a huge problem for exacerbating existing disparities, but its a huge problem for everyone in the country if there are people who are too scared to receive care. Rep. Jackson lee if you would indulge me, i dont know if ms. Willis wanted to answer the question. Chairman payne your time has expired but i will allow you another three minutes. Rep. Jackson lee you know we are in hurricane territory. I dont want to wish it on us, but we dont know what to expect. In the coming months of august, september, i would like for you to emphasize how important it would be, i think dr. Wen, in your testimony, you talked about different setaside sites that might be for people who are aysmptomatic or have certain conditions of covid19 that do not warrant hospitalization. But we are going to be in the middle of a hurricane, how do we deal with handling hurricane victims that need to be placed somewhere and take care of covid19 . But im going to go to ms. Willis first. Thank you. Ms. Willis i would just say we focus on communitycentered responses. We must incorporate those factors dealing with communities, especially those who might have a fear of deportation or general distrust of government. We must be sensitive and culturally competent. Rep. Jackson lee dr. Benjamin . Dr. Benjamin let me add that obviously shelters are clearly not ideal places when we just have people show up in a place. We saw this. We saw this with katrina and rita. We have got to rethink and reimagine how we are going to protect people until we get hit with another hurricane or tornado. Anything we have to evacuate people for even the coastal storms we have, weve got to figure out how we make sure they have access to handwashing, to potable water, how are you going to handle waste . Its going to be a big issue. We should have done the planning months ago. But if we dont do it now with a particular focus on communities that are most vulnerable, we are going to see huge outbreaks of disease. Trying to manage just a flu outbreak or any other infectious fire virus in a congregate setting is an absolute nightmare for managers. We know the science, we know how to make it happen but i dont think we are planning for it. Dr. Wen we keep on reacting to what has happened instead of anticipating whats ahead. In this case, we know exactly what is ahead and know what we need to do to control covid19 in the process. That is something the Trump Administration with the urging of congress can really do. You know what is going to be coming our way and now is the time to prepare. Rep. Jackson lee mr. Chairman, thank you for your indulgence. To put on the record the most important part of Congress Work is to pass the heroes act so we can get ppe out to hospitals and we need to get past the obstruction and blocking of the United States senate so we can pass that legislation and get it signed for the people of the United States who need it. Thank you, mr. Chairman and i yield back. Chairman payne absolutely. Our thoughts and prayers are with you in houston. We know you are really going through it right now. We had it in jersey, so i know how horrific it can be. Hang in there and i hope we can get people to safety. I have another question or two if i may. In reference to school openings, the cdc has released guidance for United States k12 schools and childrens programs to plan and prepare and respond to covid19. On tuesday, the president threatened to withhold funds from schools that did not reopen in the fall and tweeted on wednesday that he disagreed with the cdc guidance, calling it very tough and expensive. The white house is reportedly preparing its own School Reopening guidance and the cdc was reportedly considering modification to its own guidance for schools. The administration rushed to rush to reopen schools without following necessary guidance is troubling. Not just the policy but to parents as well. If schools do not reopen in a way, what are the possible impacts on communities disproportionately affected by the pandemic and we will start with ms. Willis. Ms. Willis thank you. Thats an excellent question. This entire policy the president is enforcing is to me very significantly traumatizing because im a parent. When i consider my son will be exposed to covid19 because i am a single mother, because i do have to work, im absolutely horrified. I know so many other americans are in the same position where you have to work and so now your kids must be sacrificed. To me, it is similar to the time when the president forced the meatpacking industry back to work when he knew they were going into dangerous circumstances and there is and there was nothing that could be done because they had to work. Its similar to slavery. If you think about what occurred with the yellow fever in this 1850s. Concept of sacrificing those who are most vulnerable and those who do not have a voice. Its absolutely astonishing and its an indictment against america. Thank you, sir. Dr. Benjamin we should never cut corners. Let us be real clear. Ive looked at the cdc guidance. It is not too tough. It is a good baseline and we should not weaken that guidance at all. Thats the first thing. The issue around costs you know its probably the least affordable of our options because if we have a bunch of kids that get sick, even if they dont get real sick, they cant go to school, their parents can go to work. Cant all you have to do is their parents cant go to work. All you have to do is have an outbreak in the second grade class. All those kids are out of school, their teacher is out of school, their parents are out of work. Where is the savings . The parent may get really sick, so then there is huge health both from a humanistic perspective as well as a cost perspective for their medical care. I dont get the economic analysis. By the way, he is not a doctor. Quite frankly we should listen , to the professionals who know what they are talking about and not someone whose motives i question. Im not making a political statement. Im a physician and i believe doctors and Health Care Providers know what we ought to do, and we ought to listen to us well. I dont tell lawyers what to do. I dont tell teachers what to do. Dr. Wen i agree completely with my colleagues. Im also the mother of two young kids and the daughter of a schoolteacher in los angeles. In this context, it is about students, but its also about teachers and staff. My mother had Breast Cancer and was on chemotherapy for eight years while she was teaching fulltime. I think Teachers Want to get back to in person instruction, but there are teachers who have chronic medical illnesses that we have to watch out for as well. You mentioned the cdc guidelines. If we are unable to meet the guidelines for a safe reopening, the answer is not lets change the guidelines. The answer is what is the hard work we are going to be doing in order to safely reopen . I agree with dr. Benjamin. We have already seen what happens when we cut corners. When we cut corners, we get an explosive spread of infection. When we do not listen to science, people die. The people who will suffer the most are those for whom it is not a choice to go to work and who are they . Africanamericans, latinx populations, native americans, people of color those who are suffering the greatest Health Disparities now. Chairman payne one last question. Reports continue to suggest the Trump Administration and fema are not adequately allocating medical resources, testing, and other supplies to communities disproportionately impacted by the virus. What are some of the ways fema can improve its efforts to make sure communities disproportionately impacted by the pandemic are receiving all the necessary medical resources . Let me just add to that, i have been on this committee since coming to congress in 2012. I have watched fema move through different administrations. A lot of femas issues are who is in the white house right now and their hands being tied. Though fema has some issues they need to overcome internally, a lot of their problems is with the person in the white house and the restraints he is putting on different entities of the federal government. With that, what do you think fema is not adequately allocating in those areas . Ms. Willis . Ms. Willis thank you. That is an excellent question and an accurate observation. Politics influences Emergency Management always too much. The response from fema has by theeatly influenced president , the administration, by a lack ofl science and informed decisionmaking. Policies and a lot of what Emergency Management will do in terms of response measures, including recovery and relief measures. Unfortunately, within Emergency Management, equity is not a priority. It is not a core function of femas mission. The focus on vulnerable groups determinantsial have never been a priority for fema. That needs to change. We need to begin focusing on equity and those groups who are most vulnerable. Once we do that, everyone will benefit. Studies show everyone benefits when we focus on those who are most vulnerable. Thank you, sir. Onmonday, a hearing oversight of ice detention facilities during the pandemic. A subcommittee hosts. Watch live coverage on cspan two, online at cspan. Org, or listen live on the free cspan radio app. Next, the Congressional Black Caucus leads a town hall on racism, violence, and police reform. Other members also shared their thoughts on new initiatives. What we saw with the tragic murder was the birth of a new movement that has been fighting to reenvision policing in the United States. Just a few weeks ago, the Congressional Black Caucus led