Peters, and delivering the opening statement, a minute to acknowledge the United States passed another milestone that we have lost 200,000 americans to covid19. Our hearts go out to their families, husbands and wives, mothers and fathers, children, grandchildren and grandparents. Americans everywhere must fight to stop the virus from spreading, to protect millions more from experiencing this loss. As members of congress we will go to republicans, all united to be our part. We turn to opening statement, unlike every hearing, in the u. S. Congress economic committee, simply explore economic issues. We will focus on Public Health. With the closing of coronavirus is in march causing unemployment in april, democrats reset some of those Public Health experts in the country. Two all two nobel prize laureates, 5 former chairs of the president s council of economic advisers and 3 were president of the National Economic association over 2 dozen in all. Every one of them have the same urgent message, the top priority for healing our crippled economy is to contain the coronavirus. Economists Austan Goolsbee said the number one rule of fire is economics, you have to stop the virus before you can do anything about the economics. Tragically we failed to control the virus, 200,000 americans are dead, more than we lost in world war i, the korean war and vietnam combined. The United States is only 4 of the World Population but approximately 21 of the worlds deaths. There have been 7 million confirmed cases of covid19 in the United States and this is likely a severe undercount. The number of cases continue to explode, 40,000 new positive test the day. The economy has suffered a severe blow, nearly 12 million fewer jobs today than we had in february, the official Unemployment Rate is 8. 4 , two times what was in february. Jerome powell said the rate could be 2 higher, miss classifying workers in differentiating those who left the labor force. Us workers permanently unemployed and that number continues to rise, 30 million depending on unemployment check to survive. Economic devastation contains out of control and tragically know one person or country is responsible, the person who should be leading the fight to contain the coronavirus, the president of the United States. Donald trumps record, coronavirus is a stunning studying incompetent and callous disregard for human life. He lied to the American People, he said it would magically disappear, he privately said to bob woodward the coronavirus was 5 times as deadly as serious strains of the flu, quote, deadly stuff. The president in the early weeks of the crisis, purchase ppe ventilators and educate the public, a step allamericans should take but it took 7 weeks after the first confirmed case for him to declare a national emergency. A week or two sooner to implement social distancing measures, could have, would have saved hundreds of thousands of lives or according to research by columbia university. The president ignored the advice of Health Experts, said that he knew are about Public Health and they did, he refused to wear a mask despite the fact that masks can play an Important Role in slowing the spread of the virus. Endangered peoples lives by preventing use promoting the use of hydroxy chloroquine which has no impact on covid19 and carries substantial risk. He recommended disinfectants to fight the virus and sadly some americans actually did it. He claimed children are almost immune. In every case the president was wrong, dead wrong. Public Health Officials argue reopening too early would lead to a second wave of infectious deaths and the president ignores them. He said you cannot cure the important problem itself. The Public Health measures, to, quote, liberate michigan, and state capitals. And steve i experts, and these, coronavirus cases spiked and people died. A number of new impacts on labor they were double what they were, 40,000 new cases the other day. Reopening the economy to make the economy look stronger in months leading to election day. In april, it was a big deal, you gamble with american lives and gamble with the us economy, it has resulted in more cases and more deaths, between may and august the economy regained half of the jobs lost. The Unemployment Rate dropped from 50 to 8. 4 , still two times higher than february and the next job when they were released next friday will continue to show marginal improvement but the cost of reopening too soon wont the obvious until after the election. We dont know what the numbers will be one thing for certain, the true impact of the presidency wont be evident until it is over. Donald trump holds the power of the us presidency but has refused to use it. If not contained, the coronavirus, as a result, many more lives will be lost and in the longterm the economy will suffer. The president failed to make the most meager effort to contain the coronavirus, his economic legacy. I look forward to testimony of witnesses and recognize the chairman of the full committee, senator mike lee. Thank you so much, mister vice chairman, for chairing todays hearing on this important topic. The Novel Coronavirus as it has swept across the nation and worked its way around the world this year, left a trail of devastation in its path. Not only serious physical disease, and economic ills as well. Jobs have been lost, businesses have been shattered, entire sectors have been disrupted. In response to this unique crisis, taking unprecedented Government Action but as the successful treatment of any illness, we have to make sure we are using proper remedies, as we take stock of current response to this pandemic we need to consider how policy has heard and helped so far and what we can do to improve what might be the right Solutions Moving forward. Whatever might come next, whatever might play in our path in the future. Some called for still more aggressive federal response to more stimulus, nationally coordinated response and widespread lockdowns. The benefit of policies like those have to be weighed against the costs they impose economically and otherwise, theres a host of possible unintended and in many cases unplanned consequences. And that we exacerbate, a whopping National Debt can have a tendency to crowd out private investment. The enhanced Unemployment Benefits included in the cares act provide a disincentive for those unemployed to return to work those inhibiting economic recovery. In addition to economic devastation the lockdowns had other negative affects by their very nature. Mandated isolation, Mental Health issues, stops countless others from getting routine Health Screenings and vaccinations, discouraged others for maintaining health in other ways in these respects, in and of itself, might not otherwise happen, might otherwise have been prevented. Rebounding across europe, the continents government are intent on avoiding any largescale losses and focusing on more tailored, localized measures to combat outbreaks, the knowledge they have day today, we got to make sure federal policy and federal policy adopted in washington and not inhibiting sound and effective solutions. Evidence shows it already had. In early days of this particular crisis, outdated certificate of needs rules prevented hospitals from acquiring new beds and equipment and the fda and the cdc rules against at home testing, the worst failure of all was something that involved sheer bureaucratic chaos that faithfully delay did effective testing for an entire month. Thankfully we already removed these barriers. Stopping aust from making progress, two important changes have been allowing doctors to cut this medicine across state lines. As well as allowing doctors to provide care through the use of telemedicine and technology. With regulatory flexibility we should consider moving forward so that we can quite quickly and freely administer to those whose needs, where the patient might be. As we respond to the coronavirus we need to acknowledge, sweeping centralized 1sizefitsall federal policies and ultimately worsen our attempts at recovery. If we are to have flexibility and resiliency in the face of this crisis and faced with what might come our way in the future, empowering states and localities which best understand, their own needs and communities can be addressed and devoted. The American People play a critical role, innovating the response in times of crisis, i look forward to hearing our panelist contributions today how best we can continue doing that. Thank you very much, really appreciate it. Our four distanced witnesses, the dean of Brown University school of Public Health and brown soninlaw, wonderful recognized expert on pandemic preparedness. A member of Harvard School of Public Health, directed the institute in 2014, and degrees in harvard, acknowledging from columbia university. Next, Austan Goolsbee, robert quinn special of Economics University of Chicago School of business. He served as chairman of the council of economic advisers in 201011 and Economic Affairs member from 20096 hes been a member of the Economic Advisory bill, in the bank of new york, he writes regularly on economic issues, earned a phd in economics from Massachusetts Institute of technology at yale university. Doctor jeffrey singer from the Cato Institute where he works into the permit of Health Policy studies. Doctor singers principle encounter of the largest oldest group in arizona. At the goldwater institute, and Brooklyn College in the new york medical we will hear from doctor adam michelle, Senior Analyst for the federal budget at the heritage foundation. Research focuses on how it impacts the opportunity of america. Doctor michelles National News outlets appears regularly on broadcast television for economic doctor michelle was a program manager, in george mason university. With that, i turn it over to you for opening comments. Members of the committee, i am a practicing physician, it is my honor to be here today. 200,000 americans died from covid19. This is a tragedy of immense magnitude and we have to ask how did we get here, how did we become the world epicenter, the nation with the most cases, the most suffering, the most deaths. When we take a step back and look at these outbreaks there are two strategies any nation should pursue, Public Health measures that patrol the buyer us virus and biomedical measures that keep people from becoming infected. The fundamentally we find ourselves where we are because we failed to put in place Public Health measures that could stop the virus. It didnt need to be this way. The first is testing tracing isolation, infected people identify and isolate, an old and well tried approach. We failed to set up a testing infrastructure through january and february having only rudimentary testing through march and april. We cant perform nearly the number of tests, the result was much of the early months of the operation the nation was blind to the spread of the disease finding ourselves in march with large outbreaks and several parts of the nation and because we had little Testing Capacity we were forced into a painful National Shutdown were good testing would have allowed us to be more selective in measures which gets us to the second leg of the 3legged stool, social distance, the most extreme version of which is lockdowns. When we locked down we did so unevenly. We slowed the spread in different areas of the country, largely open and the virus spread and we opened up the nation more fully after memorial day we did so with little regard to social distancing it over the summer and finally the third leg of the stool is Wearing Masks. By the end of march the data on masks was pretty clear. In early april the cdc represented large scale mask wearing, even today 17 states dont have a mandatory mask order and mask wearing across the nation is highly variable. Failure to implement these Public Health measures meant we have more cases and more deaths than any nation in the world. Economic costs of failing to control the virus as well, large decline of Economic Activity and loss of business. Are these economic losses the cost of controlling the virus . Quite the opposite. When we look across the world nations the did a better job controlling the virus of largely suffered less in the way of economic process and i want to highlight three nations, south korea has largely relied on testing and tracing, building up an infrastructure early, fewer than 400 deaths, less than california had last week. Not as much on testing, 1500 japanese have died and germany has mask wearing and Clear Communication about social distancing and their death rate is 80 less than hours. Of these countries stopped their economies to control the virus . In fact, we look at the countries with the smallest declines in gdp, another standout in virus control, south korea and germany suffered large economic declines. Most high income countries, not all but most managed to save lives and jobs, we struggled in both areas. Ultimately as we look ahead we need to focus on a path that allows us to stave save lives, the best way to do this is Public Health approach and while i have my own feelings on how to do this the best guide today was published by this white house in april of this year, the document entitled opening up america laid out a clear Public Health approach, in a set of metrics and guidelines the nation ignored. A robust economic recovery, that is what the American People want, not at the cost of losing their lives. Thankfully all the evidence says we have to choose. When we commit to controlling the virus. The conditions to help america economically drive. Thank you very much. Now i would like to introduce Austan Goolsbee. I applied you before having this hearing. There is nothing more important. I wanted to make 3 simple points. There is a piece i wrote in the new york times, there was only a handful of deaths in the United States, and this disease it was not going to spread around the country. I will this article saying if i had a Health Outbreak in this country of the magnitude of what they had in china given the structure of the us economy, the structure of all the rich countries, the Economic Impact would be worse here than it was in china which was devastating, when theres more focus in Service Industries and facetoface interaction, and and the first point, it was not a tradeoff in the economy, and we could reinforce eyes that, what killed what put it in as fast a drop is what happened in the country was not a policy lockdown. Thats not what killed the economy. The data is overwhelmingly clear the economic drop began before the lockdowns were in place, the drop in Economic Activity is very similar in places that have lockdowns in places that did not have lockdowns, the main thing that drove the economic decline is the same thing that drives decline in a crisis, when people are afraid, they withdraw. In this case they were afraid of catching the disease so they stayed home. The United States is particularly vulnerable on a hillside as you know because the factors that are correlated with the disease having a negative impact, obesity, previous heart conditions, diabetes, being over age 65. If you look at all the groups at risk, by some estimates it adds up to a majority of the American People so you can see why people would be afraid when they hear a disease that has those features is spreading around, theres not enough testing for them to feel comfortable going out without catching it. You need only look at his Airline Industry where there are no laws or bidding people from flying but the demand for air travel plunged anyway because people are nervous. I have done some research i will cite in written testimony where we have access to the phone location records for visitors to 2. 5 million visitors around the United States. We compared across metropolitan areas where on one side of the border they had a lockdown order and on the other side they did not. An example would be quad cities on the border of iowa and illinois. Moline, illinois, had a shutdown order, in north iowa they did not. The demand went down only 7 more in places with shutdown orders then not with shutdown orders. It wasnt the policy that did it. As i always say the virus is the boss. If we cannot stop the spread of the virus, we cannot bring the economy back to where we were much less grow what we needed to grow. It isnt a tradeoff and that is critical to see. A second point, just half a point, what the Us Government to individuals to the unemployed to large businesses, they are necessary to get us through this problem, they are not sufficient to restart the economy. To restart the economy, to stop the spread of the virus. There was a perfectly valid debate to have but what forms of relief was effective and what was the best way to enact those. They are in a serious position, to freeze to death for the furnaces out. They dont want to freeze to death but, to slow the spread of the virus. It is not too late. To slow the spread of a virus, and allow economies to turn around, they have taken different approaches. Whether there is more mask wearing, Public Health measures, even without a vaccine to sars, without a vaccine to murderers, for a long time there was no vaccine to ebola, we got control of the spread of the viruses. To stop the infection rate. And if they had addressed the virus at the same effectiveness as the average for the rich countries we would have 9 million more people at work and fewer people dead from this virus. To spread the virus in every weekend. Otherwise the economy will continue to suffer. And for every consumer and every day, are they afraid to go outside. We must keep that in mind. We will now hear from doctor singer, the floor is yours. I will appreciate being invited to testify. The food and drug administration, a delay in getting test kits, they should have authorized tests in use in similar countries, permitting states to the approved test for using their own borders. When the Public Health crisis ends the policy should not return to the status quo. As 3769, the right to test that would Grant Authority to states to approve tests within their borders, the secretary of health and Human Services that declared a Public Health emergency. Granting state authority to approve drugs and tests and other devices that may be marketed in their borders when theres not part of purchasing. Granting reciprocal approval with medical devices in similar countries. Proxy exists among the European Union states, iceland, liechtenstein and norway. That is 261 in july of 2019 called the result act would allow the marketing improved in certain countries but not yet approved by the fda if, quote, there is an unmet need. This is a step in the right direction. In the interests of promoting consumer choice, approval should not be contingent on an unmet need. In several states they suspended state licensing laws allowing practitioners to come to the aid a residents, these actions recognize a princeton problem, blocking access to care, in 2019 arizona became the first of several states to and ask laws recognizing outofstate occupational and professional licenses on those who establish permanent relations in their jurisdictions. Remaining states should do the same but requiring healthcare practitioners to establish locations makes the reform less effect even. They should remove this requirement and grant reciprocity to healthcare practitioners licensed in certain other countries that have reputations for quality medical education and develop provisional license programs to integrate practitioners from less advanced countries with the pool of healthcare providers, canada, australia, new zealand and most eu countries offer provisional licenses. State licensing laws in p the use of telemedicine, the only healthcare practitioners provide telemedicine to patients in states in which providers are licensed. To the extent consistent with its authority to tear down barriers of interstate commerce under article 1 section 8 of the Constitution Congress should define the locus of care all right, let me see what i can do. Located into that. The practice of medicine in their borders. Telemedicine are you in windows . Parts for a second. Can you mute mister dexter . Thank you. Where did you lose me . For a second done talking about provision licensing. State licensing, widespread use of telemedicine. Most states, provide telemedicine for patients in states the providers were licensed. To the extent consistent with its authority to tear down barriers to interstate commerce under article 1 section 8 of the constitution. They define the locus care, where it is located in which the consumer of the service resides, for residents in their borders crossing state lines to provide telemedicine or shortterm in person care can easily be classified as commerce. As interstate commerce. S 3993 in the u. S. Senate on june 17th, and the practitioners license required to this pandemic and limited to telemedicine. And permanent and part of the practitioners who provide in person care across state lines. And licensing laws are heavily influenced incumbent providers and render state Health Systems to meet changing demands for Public Health emergencies, for the relevant committees in the u. S. Senate and house of representatives should investigate whether state licensing laws constitute antitrust violations. Individual members of congress or congress as a whole for the federal trade commission of state laws, harmful effects of the pandemic, the Public Health consequences with policy tradeoffs might not be readily apparent but nonetheless extremely damaging, for tradeoff policy, for determinants of health. Policymakers should be sensitive to seen and unseen consequences of the policy. What is seen and not seen incentivizes government officials to be overly cautious and impose more restrictions for longer lengths of time then might be necessary. 1sizefitsall measures should be kept to a minimum. And Suitable Solutions using local knowledge. Thank you once again. Thank you very much. Thank you, doctor adam michel. Thank you for the opportunity to be here today. It has been 7 months into this crisis and no one has lost sight of the devastating cost to our health for the coronavirus. It is an equally unprecedented to begin with an overview of the current landscape, like the inability of economic recovery with more spending and briefly outline 3 areas where congress can help facilitate the recovery. Todays congress has authorized 4 trillion in aid, made another 7 trillion available. Due to the significant federal transfers the personal income and personal savings have increased during the height of the crisis and it remained elevated. Temporary programs represent a powerful 1time action but are not a sustainable solution, is very uncertain. The trillions of new programs have already been authorized also have future costs, they will discourage work, keep businesses from retooling for the new normal land add to the public debt for future tax increases. The federal government, the us economy on life support forever. Americans must return to work, return to communities and return to their schools. In february, februarys peak recovered half the jobs we lost in the spring. Other indicators trending in a possible direction was given the swift turnaround, not proof that the trillions of dollars spent over the last few months is responsible for the good news. Historical evidence, stimulus spending is not an effective way, things like a Paycheck Protection Program the cost of each job, shy of 300, 000. Instead, quicker than expected rebound is given by americans ready to reengage in communities and return to work. They will follow willingness and ability to return to work, return to school. States that allow businesses and schools to reopen with Safety Measures in place. Congress can facilitate the reopening by protecting workers and employers with liability measures to shield from frivolous lawsuits. Second congress can increase access to Business Capital for those who do reopen existing businesses to expand, entrepreneurs to take on risks of bringing new ideas to market for new need in the post crisis economy to scale up. Streamlined rules around that for facilitating equip as a quick recovery. Congress can increase worker flexibility, limited jobs available, people need option and with kids at home, people need additional flexibility. Last year 76 of people considered freelancing, if we were in a recession. They can make finding respectable Work Arrangements easier by streamlining the definition of what an employee is in providing safe harbors for nonwage benefits, traditional workplaces can be made more flexible by rolling back increases thresholds, the universal savings account for all americans can save more of their earnings regardless of their employment status. Largescale federalaid threatened to derail, new stimulus checks, temporarily, more federal spending, misguided attempts to support the economy. Additional stimulus spending will worsen americas budgeting balance without the benefit of across economic news. Thank you and look forward to your questions. We finished the presentation, begin around of questions as acting vice chair today, let me give Austan Goolsbee a i am fascinated by your research which shows the causes of lockdowns, people with money choosing not to spend on personal services, what does that tell us about the virus raging across the country with 30,000 new cases a day. This finding we have, shown in other data based on phone records, there are others who guard credit card records, what people spend money on and a highlight in the paper i would call your attention to is the prevalence of the disease in your local area, matter a lot to whether people go out to visit stores, go to the barber shop etc. If you do something that increases the infection rate you can easily undo even the economic potential you are hoping to accomplish by easing the lockdowns. We show in the paper in those places they get rid of the lockdown orders you see only a modest improvement to their economies of a little less than 7 , the lockdown was not something that was killing it and if repealing the lockdown lets the virus go up more, could easily over the median and longrun do more economic damage than you did improvement. The council of economic advisers, how stimulus, the unemployment for the patient programmer attending a stimulus or allow people to survive. It is an important distinction. I dont agree with the evidence that stimulus is always and everywhere, the impact of stimulus, these are relief, traditional stimulus, they spend this money to jumpstart the economy. This is literally so that people do not lose their homes, so that businesses do not permanently have to liquidate while waiting out this temporary storm. Thank you. As you laid out the testimony the response to covid19. I was fascinated by your comparison with south korea, japan, taiwan, australia, germany the cost of been enormous. If we had the response the germany has had. How Many American lives could have been saved. Germany is interesting because its not a tiny north american country, it is a pretty federal government were states have a lot of say so in many ways it reflects the structure of our nation and their mortality rate has been 80 lower than ours. If you do the math if our population was the same as germany we would have had 40,000 deaths, not 200,000 or 160,000 fewer americans would have died if we had the same death rate germany had. Thank you very much. The last few days have seen people say we may be Wearing Masks through all of 2021. If it is airborne the mask might be more effective at least in the short run than the vaccine. How does an american leader encourage people to wear a mask to get over this notion some masks are an assault on our rights as an american . Viruses create a lot what else do you care about . I have three children. I want them back in school. Their inability to get back to school is an assault on their freedom and ours was the inability of people to get back to work as an assault on their freedom. If everybody wore masks and we did the other Public Health, even if we focus on universal mask wearing we would have a lot more kids back in school and back at work. Those are real freedoms that come from basic Public Health measures. In a Public Health crisis, we never said individual freedom is paramount, and Public Health crises like in times of war we said there are national and social responsibilities that are just as important as individual decisionmaking. There are real tradeoffs and they cant just be about whether you want to wear a mask or not. It is what kind of society do we want to live in . Thank you very much. My time is up. I want to recognize senator lee. Thank you. I would like to start with doctor singer again. In your testimony you highlight the importance of considering other negative Health Impacts of the pandemic, other Health Implications including things like increased Mental Health problems, delayed vaccinations for children and decreased access to routine care. Can you suggest ideas or strategies to ensure these important kinds of healthcare are neglected . I concur with Austan Goolsbee, a lot of evidence has shown regardless whether there is a 1sizefitsall lockdown imposed people are not going to engage in Economic Activity until they feel unafraid. Even in the early days of this pandemic, in early march, there was a tremendous drop off in people making reservations at restaurants. Some of the tradeoffs are not a direct result of governing policy but a result of people on their own making decisions out of fear. I am a surgeon and we had a blanket moratorium on all nonemergency surgery. People mistake elect of for being unnecessary but it is necessary, just you can schedule it and there have been a lot we receive people show up in the Emergency Rooms with very advanced cases of surgical emergencies, the reason they were advanced was people let them go, people with appendicitis that ruptured days ago because they were afraid of catching covid19 and then people dealing with Substance Abuse disorder and a large part of treatment involves connection and when you are isolated at home not only are you in the rehab program, your cut off from connection to people and this makes people relapse. People hard deep rest, suicide rates in people neglect their health in general because they are afraid to come to the Doctors Office for maintenance visits dealing with maintaining medications dealing with their heart or lungs or blood pressure. Thank you. Related question i want to ask doctor singer, when we talk about disparities between the United States and other countries we consider to be pure nations, are there explanations for that other than people are getting sick at a higher rate here . Are there differences between the testing protocols adopted by the United States and testing protocols adopted by pure nations . There are so many multiple factors it is hard to make an apples to apples comparison but in many cases many of the other nations got testing going more quickly. In germany they were going testing in late january or private sector developed tests and we all know about koreas success which was built on their experience with the news outbreak in 2015 where they learned they need to allow the privatesector to test right away so they revised the process that we had here in the United States which slowed down the wheels of progress so they basically set up that private labs get tests out and keep their version of the fda in the loop and informed as things were going forward. They were and respond more quickly. I think that had a lot to do with it. That makes sense. I have another question for doctor michele and for you again, dr. Singer. A recent wall street journal article noted despite cases in europe rising, there are a lot of leaders rejecting lockdowns. One position coordinates and eu Scientific Advisory panel observed the Scientific Evidence that led to lockdowns failed broader social and economic repercussions. He is now advising policymakers to ask people to, quote, take personal responsibility to curb the disease by hearing to social distancing, Wearing Masks, avoiding crowded spaces and staying away for people at greater risk, close quote, rather than relying on government. Starting with you, doctor michelle, what a National Lockout of the United States starting in the spring had been misguided and should policymaked Health Experts update our messaging to emphasize personal responsibility . Yes, i think youre exactly right. The most economically costly publichealth measures are also those that are least effective at controlling the virus, namely lockdowns and stay at home orders. When you look across countries, cross states theres little evidence to show these legal restrictions on businesses in movement are what decrease the spread of the virus. Focusing on testing and isolating those who are sick, these are the things that we know work and i think that should do our Public Health response remains. Dr. Singer, whats your response to it . I agree. All you have to do is look to whats going on in the rest of the world. All of the countries that of lockdowns are experiencing surges in cases. The virus, everybody seems to think if we stay locked them long enough this virus will get bored and go to some of the planet. This virus is here. Its not going away. We have to learn to adopt Harm Reduction measures because even if we get a vaccine we dont know how effective vaccines going to be. Fortunately it must into this thing when it a lot more. We know what kind of behaviors we should adapt that we decrease risk. While i can understand lockdowns early on when we knew very little, we know much more that i dont think theres any excuse for it. In addition its important ive written about this, that when these decisions are made as decentralized and local as possible based on local knowledge come , different aread upon changes in circumstances can adjust. When all the decisionmaking authorities placed in one person, then no matter who the person is theres going to be incentive for the person to be overly cautious because the first thing youre going to see when regulations are relaxed his cases go up and thats on that person, or as what you dont see readily at the longterm tradeoffs and Public Health tradeoffs as well from delaying the relaxation of those decisions. We should try to handle them as much as possible by having an informed public with good information and consistent information, being told what to need to do to make the adjustment at the local level. Dr. Singer, you have just made what i think is one of the best arguments i have ever heard for the american form of government, for the twin structural protection of structuralism and separation of powers. Our tables built on the idea we dont want any one person or one group of people to accumulate excessive power. It applies not only in spite of but specifically in the midst of Something Like that covid pandemic. You dont want to put all of your decisionmaking power at the national level. Even when there are where the Arctic National decision to make you dont want to focus that in one person and you pointed out some reasons grounded in medical science why thats the case. I appreciate the perspective. My time has expired. Were going to turn next to senator klobuchar. Senator klobuchar, are you there . Very good. Thank you. Thank you all for this hearing, i dont want to start up with you, dr. Goolsbee. Thank you for your words about masks and about tracking and about being able to relate this to anthony. I think we all think of the pandemic and we dont want to get sick and many people personally lost loved ones. My husband was in hospital for a week, and came out of it here but i think sometimes we dont connect it with the economics which is also an important thing for people to see, that we need the mask, we need the tracking and its about keeping essays but its also about keeping our economy in a place where at least we can at some point go back to where it was. I guess my first question was, how long do you estimate it would take to make up the economic productivity and growth that we have lost . Thats a critical question clearly, and the answer depends totally on whether we can get control of this virus. If we could get the reproduction rate, the rvalue of the virus come down to less than one, and the spread of it was simply at the rate that it has been in other rich countries, i actually think in much of the economy to turn red could be pretty rapid. There are still going be some areas like cruise ships, until theres a vaccine its hard to see that, that sector going back to what it was before. But i think it could be turned around fairly quickly. Right. While the recent vaccine we could be in a much better place economically, if we had an administration was putting in place and apple just highlight in other countries, we talked about germany, australia, new zealand, cases where they handled the disease better. If you look at how much Unemployment Rates are higher or have changed now compared with before the vaccine was there, the u. S. Is by far an outlier. So our Unemployment Rate is more than double what it was when it arrived. I i have the list here. In germany the Unemployment Rate is up on a one percentage point. In korea its actually down. In france and new zealand it is down. Even in japan its up half a . In italy onetenth of a percent. Those are not our numbers to one area i want to ask a question here. You were mentioning how certain areas of economy, one of the things we know if its that one size fit all. Check for the most part is booming and then you have the Hospitality Industry with restaurants hurt and certain hotels, not all that certain hotels very much hurt and then your venues. Save our stages all over the country and you can exactly go stand in amash pit during a pandemic. There was some of the first to close and they will be some of the last open and that we have 40 cosponsors in the senate, the house has similar very by person that would with grants to these venues. Includes places like first avenue we would not have that prince but also includes the fargo theater, and small and midsized towns, often will have one cultural venues that is so important. Could you explain why thats important for the economys that surround these venues . Well look, economies around this venues very much reliant that, and that is one part that kind of Leisure Entertainment travel tourism, all of that space is particularly important in the u. S. Economy. I saw a recent survey from this past week in chicago that literally threequarters of the independent music venues and theaters in chicago believed that they were going to have to close down permanently because of this. Exactly. Thank you for your work. Thank you. Mr. Schweikert, you are up next. David schweikert, are you there . If not, it will be representative franco. Hello. I happily listening. I want to thank everybody for a very interesting discussion tonight, and i yield back. Great. Representative lahood, you are next. No response from lahood . Senator cotton. Senator cotton, if you are there let us know. If not we will go to we will go to ms. Herrera butler. Did you guys and meet me . Okay. Thank you. Sorry, i keep trying to change my name in this. I am not 9974. But because its a pretty name. Will go with it. This is the really insightful. Im standing up at the gallery because when the middle of a twoyear long meanwhile, i thought was wondering about exposing themselves more to come to think one of the things we learn from this is there are things at work in their things that are only for show and think what a number of us what im hearing is and what of interest in i want to does things that take the steps that work to protect vulnerable people, but we also need to move past the things that are just for show because the economic damage that is being brought in the country come like to get to it back on. I keep hearing people sat quickly can we start back up . Were losing business and southwest Washington State. They are dying on the find. They cant you start back up. That was someones life savings, its done. How do we limit that . The same is true in healthcare side. Dr. Singer, i got on when youre finishing her testimony and it was, you were highlighting the burdensome regulations take it away if healthcare including drug authorization and state licensure requirements. I meant certificate of needs. It was such a barrier to efficient effective telemedicine in this crisis. Is there something, so at least thats my opinion. Cms is thinking of making waivers permanent. Is this something you agree with . Are there other regulatory burdens during the rulemaking process . Well, representative, the cms plan is certainly a step in the right direction but that only deals with basically paying providers who engage in telemedicine. That only affects people who are on medicare and medicaid, but what makes it really not very effective is the state licensing law. So even as a provider, if i know that medicare will pay me for providing healthcare to summit in my neighboring state of new mexico, im in arizona, im not about to do it. It doesnt help. The problem is just like certificate as you make early, most state licensing laws and certificate need laws tend to be heavily influenced by the incumbents and keep out competition. And, in fact, in the mid80s when congress repealed the incentives that gave the states to establish a certificate of need laws, it recognized that, and so theyre still unfortunate about 38 states that still have been to one degree or another. Thats why i offered the proposal of Congress Actually passing a a law at a think its within congresses purview under section eight, the authority to regulate commerce among the states, would be to define the locus of care as a state in which the practitioner is licensed as opposed to which, in which state the recipient can happens to be residing and that would make it work. As far as certificate of need laws are concerned, its unfortunate as as a state issud its up to the states decide them. Im not a constitutional lawyer. Im not a lawyer, but my colleagues at the Cato Institute tell me that there is at least reason to look into whether or not certificate of need laws and state licensing laws might constitute a form of antitrust violation. At least asked the federal trade commission to look into that. Thats interesting. I cant see the clock. Do i have any time left . Well, somebody cut me off. Dr. Michael, in your testimony you say there should be no additional stimulus payment to individual companies out, we should face up the enhanced implement. Unfortunately so many of my constituents have received your check. Im Washington State right on the border and people cross over. Its been a bit of a mess and so the stimulus checks were the only thing that people actually, some of these people got in there and pretty dire situations. How would you suggest we reform the Unemployment Insurance system or some help the state do it so you dont end up in this problem again . Well, fantastic question, and i think the strength of our system is the unemployment system is handled at the state level and is able to be tailored to the populations across the country. I wouldnt want to federalize the system or make it a system that if the federal government failed to get the checks out, no one got them. Its unfortunate certain states have really struggled but other states have succeeded. I would hope that states learn from this crisis and are able to update and modernize their systems. Its ridiculous we are not able to provide unmatched benefit that allows a scaled match of somewhat prepandemic wages. Instead we had to do a lump sum payment. Thats a failure of state unemployment systems. I would point to state reforms and states need to make sure the systems are robust. A fine point on the fact we cant always rely on government for everything that we need. And like universal savings accounts to help people save for the own rainy day fund, to help people build their own savings rather than always waiting for the Government Systems that tend to not work when we need them most. Iq. Im sure amount of time. Yield back. Mr. Schweikert, you are up next. We can hear you, david. Unmute yourself. Are right. We were having some technology problems. Let me disclose, dr. Singer has been a friend for decades and decades, and assorted consider him my advisor on some weird technical issues. But dr. Singer, and also mr. Goolsbee, because you also touched on this when you are speaking. If i can do and said we are part of the joint economic committee, we want to have an understanding of the entire societal costs, just in the United States, but societal costs of the pandemic. The cost to my soontobe fiveyearold daughter who may have lost several months of education, the loss to society im hearing of a Young High School student who took her life any heartbreaking fashion in my community, all the way down to lost wages. Is there anyone out there, dr. Singer, ill ask you to go first, the you believe is building a model both two of us understand our entire societal costs and, therefore, helping us to sort of decision theory . Heres the cost directly related, heres the second degree, third degree type of cascade cost, as a good econoc model would produce. Not an economist and not sure anybody could really accurately answer the question because her silly things that we dont see and are not aware of come so much is subjective. I imagine there are some economists trying to come up with models that give an inkling of it but im not familiar with those models. Thank you, jeff. Dr. Goolsbee, i which is like its a fascinating kind of intellectual exercise that motivates our policy discussion. I dont think anybody has truly tried to put the whole burrito together in that way. You had to talk about a burrito when i missed lunch. I apologize. There have been a lot of work trying to isolate individual components so if you think of my own work and the work that i cited, thats about how to identify just whats the impact of lactone orders that that was about 7 on Economic Activity in those industries. The broader impacts on education, on Mental Wellness and the things you mentioned, its probably going to be sometime before we look back and were able to recognize that. A couple of economists i work with were trying to think this through. If any of you, other witnesses come across a paper, think of me, send it to us. Because it would help us build a decisionmaking model for the future, for ourselves and hopefully for the world. Dr. Goolsbee, as long as i have you, if i came to you and said we are not good to talk about the past, were not going to talk about decision made a week ago or three months ago, but as of today you want to my office and said heres policies of what you adapt to maximize economic expansion. Adam, im going to ask you the same one. What would you do today that helps keep our communities, society as healthy as a can also create as much economic velocity . What would you do today . Look, theres a critical area. I actually would put the focus of number one, of the Public Health measures which are not go for economists. Normally economist with the post economic policies and most of the economists are proposing Hotel Policies like you getting more mask wearing, more testing and tracing so the rather than having everyone shut down, we could just pull out of the conference people that are contagious. If you could wave a magic wand, that makes this recession very different from any previous recession. I would put the focus on the Public Health stuff. Adam, what would you do if i can do you right now today and said i need policy that we would do today . What would you do . I agree with dr. Goolsbee that we have to get testing and isolation of people that are sick right before people feel confident in returning to the precrisis activities, that people have to feel willing to go out and spend the money and go to work in order for anything else to matter. Then its about getting all of the other things we know, a lot of businesses and people to thrive, making sure taxes stay low. Its about fixing our debt trajectory so that taxes dont have to increase in the future. Its making sure entrepreneurs get access to capital for me. The whole host of progrowth policies that would then allow come once we get testing and tracing right, to allow the economy to accelerate back to where it was. With that, mr. Chairman, thank you for your patience and thank you for your patience with my technology. All, you bet. You are one of the more tech savvy members of the house or senate i know, so good to have you here. Ms. Beatty, you are next. Okay, i think i am unmuted now. Sorry, i some difficulties getting on as well here in the capital, but thank you and thank you to our witnesses. The first question i have is for you, dr. Goolsbee. Back in march of this year you said the number one rule of virus economics is at yet to stop the virus of course before we can do anything. Despite all these warnings this administration has refused to take him in my opinion, the virus seriously enough to combat it. Also in january the president said he had it under control. Then in february we had maybe about 15 cases, and he said that it would go away. But for one day it will maybe magically go away. Can you tell us when you look at other countries like korea, like germany who chose to attack the virus early on headon, can you compare longterm economic effects on choosing to Prioritize Health like these other countries did with the United States patchwork response, led to our states having more death cases . Is i continue to affect the economy . I think it did affect the economy and is continuing to affect the economy. As i mentioned when discussing with senator klobuchar, if you look at the employment performance in the countries where they made a clear National Strategy and prioritization to stop the spread of the disease, their job market destruction ds been far less than whats happened in the United States. Several of these countries the Unemployment Rate actually went down over the course of this rather than more than doubling like it did in the United States. I which is highlight the second component, which is hundreds of thousands of people have died in this country that did not need to die. Had we done this prioritization. I dont understand a National Strategy that is at best of mixed motivation. And by that i say, sometimes the federal governments response has been good, and then sometimes it comes with a playback, kind of a soundtrack that goes against the stated response. So making fun of people for Wearing Masks, saying we should liberate the country when they are trying to restrict access to restaurants and bars and places where the spread of the disease has been documented to be high. Those are things that go against other statements that you should take the disease seriously, and i think the numbers really speak for themselves. I think theyre pretty, pretty serious and pretty negative. Let me just applaud you and say thank you, because as an economist you are saying the exact same thing our expert for in the science area and in healthcare, many of them were also participating with this administration has told us the value of this. So i cannot thank you enough for that. To the second witness, let me ask you if you are aware of this. We recently heard that the white house had scrapped the plans for the United StatesPostal Service to send approximately 650 million worth of masks to americans through the mail. And then that got scrapped. So i think thats just another instance, but do you think that it wouldve made a difference, lets say, if we wouldve sent every citizen five masks so they couldve had them. What kind of health and Economic Impact do you think, if any, that wouldve made it every citizen wouldve been given one . As i understand the original plan was. Congresswoman, thank you for that question. Theres no doubt about in my mind that getting more people to wear masks which made a very big difference. If itd come from the government, the federal government, there is some skepticism in some corners. I think wouldve helped that skepticism if it came from the president or the white house seal of approval. But most importantly it would make it easier for people to wear masks and that wouldve made an enormous difference. Im sorry that was crap. Wouldve led to fewer cases, fewer deaths and i believe greater economic rebound. The fundamental point is where to get the fire under control and if we do that our economy can recover and masks wouldve been a really helpful part. I was in the Financial Services committee an hour ago and i pose the same question to secretary mnuchin because he had gotten involved with the Postal Service. He said he was not aware of it being scrapped. But at least he did say he would look into it because i dont think its too late. A month ago we were throwing around oversight when hundred 50,000 and now were over 200,000. This is going to be our new norm if are going to save lives. I yield back but thank both of you for the information, your honesty, and elyse giving us hope. Thank you. At least giving us hope. I i would now like to recogne senator cassidy it easier for his questions. Yes, yes, i him. Got me . Got you. Thank you all. Dr. Goolsbee, im struck because when people ask about the economy they always sit on as they come as somebodys mother because mothers ruled the world. Till theyre comfortable than a going to go to a vacation in new orleans and spend a night in hotel. Im glad your research actually kind of coincides with intuition ive had my whole life. Mothers ruled the world. It did seem like where to get that done. Dr. Jha, theres been some discussion as to the benefits of a federal response as opposed to the region one who can full disclosure you and i collaborated on something in which a region response collaborative, if you will, between states would be operative way of doing it. Would you like to comment on the relative advantage of a region response versus a federal . Absolutely, senator, thank you for that question. A couple of things. First of all we all understand and agree that the virus spread at any given moment is regional. What new york is experiencing today is different in what california is experiencing. Second, the long history and tradition of Public Health in america has always been one where states lead and the federal government is standing next to the state helping providing guidance, writing resources. Ive always believed states have fundamentally Important Role in this process. The problem here of course is that we have a global pandemic, and so, for instance, in psych testing can we think about pcr testing, testing with invoke sleep focused on the last six months have national and Global Supply chains. A strong federal health, engagement is and and and kobe helpful but i so agree what we have collaborated on, having groups of states come together is an alternative approach that can add and create the right market conditions, and set the right signals. I still think it would be very helpful to have a more engaged and more effective federal response helping the states, but ive always believed states had an Important Role. In miniport issues they they cant do it by themselves but a group of states come together is a good alternative. One example we had used continuously, and weve been up to take existing resource instead of using a kind of plug and play type approach. All those resources were available and when deborah birx came down to baton rouge and she was speak to that, listen, thermal facial supplies up there and we can use that instead of being in these systems. She had a point there was a lot of underutilized capacity that could be employed within each state prior to a federal government sort of kind of, this is how you do it. Indeed, you could argue us to have a better sense of where you should be independent and somebody in washington, d. C. I asked them not to challenge but to explore. There are two parts to that. I completely agree states to good sense of where the additional capacity is there issue is resources. A lot of states of feeling like they cant pay for things but if you look at the Broad Institute which is doing a great job, the tests are being paid for by private organizations and so private universities, harvard, brown, others are paying for testing there. The Public Schools and public universities are not. What it does is it does bring capacity in when your private purchasers or what we do is we create a very large divide between who is able to access or not. Its not clear every state can replicate road but part of the role of stroke of is to create an even is to not just a few small states can do a fabulous job but it needs a lot of other states that dont have that kind of capacity and also. I would argue the case package which put out when hundred 89 for testing attempted to do that, but that said, clearly we still need more testing and i wont argue with that. Dr. Goolsbee, email address is partly in the past but ive been very concerned about the opportunity clause. Children are extremely low risk of having competition from Covid Infection and yet they are paying an incredibly high price even the worldwide evidence shows they can set the go to school and as best we can tell theres no documented case of a child transmitting coronavirus to their teacher or to staff. Particularly for Primary School but apparently for secondary as well. Any comments on opportunity ony cost of locking down Elementary Schools which doesnt seem to benefit the Public Health by cost them tremendously . Well, i do think that we need to think about those opportunity costs, and if you think that not being able to open the schools has critical cost to the economy. I would rather see the schools open than the bars open. No offense to new orleans, but i do think thats more important. Ask speed is ive been particularly concern low income families with a Digital Divide and a parent that has to work is that a particular risk and do think theres evidence, empiric evidence that the children from lower income families even when given access to the net are less likely to use it. Those at academic risk are increased risk in a virtual environment. Any thoughts on that . I basically agree with that therefore time i was on the board of education for the city of chicago and in no that these issues of the Digital Divide make that shifting education to an online sphere, there is a risk that is going to hit lowerincome people harder than higher income people the same way that it is hit low income occupations harder than high end income occupations are going think i dont know and the doctors on our panel would have better sense, my read of the evidence is that definitely teachers can catch the disease so you have to think about how the teacher speedy but if i may, i think the best evidence is there catching in the community, not from the school. Im out of time. And kids can get sick. They have low mortality but in china for example, they did get very sick. I guess my point was in closing, the opportunity costs of a five and six you get from a low income family is much greater than the extremely rare severe competition from covid in a fight or secure all. Theres a lot of evidence of that. Im out of time. By the way, dr. Singer, youre a great fan somebody to give shout out and sorry i didnt work my question to you. I will use back just because im out of time. Thank you. Thank you, senator, very much. We will now start a second round and i will start. Dr. Jha, four recent examples come yesterday the cdc took that guidance a just put up stating the coronavirus could be spread by small particles such as those in aerosols and in the updated guidance theres no reference to airborne transmission. And then last week they change the testing types of people without symptoms who had contact with an infected person. Now we have the whole hhs what was talked about deep state scientists and scientists sedition, and then yesterday the baby for secretary azar decided take the role of the Agency Within hhs including the fda. Are you at all worried about the public distrust that comes in all the changing guidance and changing the sense of physical manipulation probably by the white house . Thank you for the question. There are two parts of the distrust that it would about. First, among doctors and nurses. We have a long tradition of short ending scdc or an fda recommendation as another way of saying this is the gold standard. When we we say the fda recommes this come youd have to spend what you mean. Use argument is this is where the best Scientific Evidence is. That is been a truism under republican and democratic administrations. We have never worked about the scientific credibility coming out of the cdc or the fda. That has changed in the last six months and that worries me immensely. Because great scientist of the fda and the cdc are still there. Thankfully they have not left. They are still doing great work and, unfortunately, what comes out increasingly from both of these agencies and certainly the cdc undulate out is increasingly muddled, contradictory and against all of the Scientific Evidence window. Either these great scientist no longer know how to decide, i doubt it, or something is modeling their ability to project and its link to the American People what the fundamental issues are around this virus. You should rent airborne is one of them. The others around testing. Its deeply distressing i think it leads American People on board because he no longer know where to turn, were to trust. It will take us a very long time to restore the trust in these agencies. Weve got to stop doing that. We have to let the scientists of these agencies speak directly to the American People. We pay their salaries through taxes. We deserve to hear from the. The white house chief of staff recently said the white house is aiming to 190 doses of vaccine ready by the end of october, which is now five weeks away. Is that safe or even realistic . So operation warp speed, which has been a program run by the white house, and i have been enormously supportive of it, i think in general has been a very good job of ramping up production, has done so at risk, meaning without even knowing whether the vaccines are safe or effective, has produced vaccines and i think thats right thing to do. Once we have clear evidence of safety and efficacy we will not want to wait as long, we would want to wait as little as possible. So until i think thats thats a good thing. The hundred million by the end of october is a much, much higher number than i have heard. I dont believe anybody knows when we will have or ought to know when we will have clear data on safety and effectiveness. My best projection is that it will come sometime in november. I best projection is we want tens of millions of doses by the end of this year. That number is really high and out of what i generally heard from most people in the industr industry. I want to thank you for making me feel better about paying that brown tuition come all the researcher able to do. To pick up on something dr. Cassidy said. No proven instance of children giving this disease to teachers or parents. Why then are the School Districts being so careful in closing down . This is complicated and is multifactor. First of all theres no doubt in my mind that younger kids are much less likely to spread this than older kids. Much of the evidence suggests older kids, high schools, essentially spread like adults. The issue of why we dont have a lot of evidence of it,. Is we havent had schools open independently. During the event of exclusive and close so of course we havent had a lot of instances of kids spreading it to pass. Were opening schools that were about to find out. This is incredibly frustrating because the cost of keeping schools close in virtual is massive. Its massive on kids, massive on parents. It disproportionally affects poor and minority kids and families and women in terms of the labor force. We can all talk about gender equality but we know the reality that women, they are what we know is we can lower the level of fibers in the community if we can speak with nuance to teachers instead of blustering that everybody has to open, and if we can understand the fears and address them through testing and through mask wearing and including improving ventilation schools, i believe we get a majority of schools open. We have to build trust. We cant bulletin back into school. What work and teachers wont tolerate. Parents wont tolerate the. Whatever level you level of nuance we dont have right now. Thank you very much. To quote the chairman of the house education and Labor Committee who says we want schools to open, which is want them to open safely. Now let me recognize the chairman of the joint economic committee, senator lee. If senator lee is still there. And if senator lee is not available at the moment im going to move to the next republican on the list, the Ranking Member from the house, mr. Schweikert, from arizona. David. We cant hear you yet but are up. Lets see, are we working now . I was going to teach you. I thought i was your favorite. Could we continue on that line of thought you were just having . One of the other weird little side projects in our office have been trying to get a thought, without day care, without schools opening. Is that almost like a wall, a barrier to sort of step up Economic Activity . I see what we have gone through with a kindergartner and homeschooling until she could now begin Public School this last week. Has anyone first given that some thought or seen some muddling and data that says we cannot grow and we can add a certain sort of gdp economic expansion entail actually have the ability for our to be in schools or day care . Anyone want to this is Austan Goolsbee. 100 that is a barrier a barrier for a lot of the workforce to come back to work, and has been, there been a few labor economists that a been trying to quantify that. I definitely think that you onto a critical element. This question of what would it take to be able to reopen the schools and what would it take to be able to reopen day care and other Childcare Options for, lets call it, the occupations at the Median Income and below, i think its critical. Thats a tremendously critical issue because such a high share of those occupations must physically be at their location at work to do the job. I think youre onto something and i can try to get you some of the evidence that they have accumulated. Would be helpful. This is one of my great frustrations, from those of us out in the phoenix, scottsdale area we can see School Districts where one School District next to a community, they are backing up to each other and they have different opening policies. I despise antidotes and are going to tell one having a little girl were started kindergarten, our first three weeks of sitting behind a laptop isolated, she was miserable, baking, daddy, daddy, please dont make me do this. This last week when she is now allowed to go to school in a classroom, mask wearing, its as if i have a different daughter. Im assuming many of us have experienced that. How do we actually sort of have a world where its not politics or lobbying by the actual mask thing heres the things we do to keep the teachers and her schools safe with an understanding of how important this is to get the economic expansion, economic survival of our country . Share with me. I see go ahead. Do you have a preference who goes first . Lets do jeffrey first and then the professor. I was just going to say, part of the problem is to get the teachers to overcome their fear. For example, taiwan what you talked about as a success story. To my knowledge the never close their school. Many schools in europe have had their schools at least k6, great school that has an open for months and there been no reported problems. Then here in the United States come for example, during the worst time of the outbreak in the new york metropolitan area both the City Department of education and i think just new york city had day care for their first responders, and there were no reported outbreaks with these children in day care centers, which that should cause of course, quell a lot of fears. Nevertheless, what we see happening is in many instances the teachers themselves are saying im not comfortable going back. Heart of it is having them, having their fear thank you, professor . I have spent more time on this subject that any other in the last three months, probably has spoken to 100 different teacher groups, school superintendents, mayors, governors on this. A couple of things. First of all, dr. Singh is absolute right that many european countries, taiwan, have been able to open up your the levels of virus in the canary was much, much lower than our american average. People live in arizona or texas or massachusetts we have to look at local committee spread. About a third of the country could go back to school quite safely given the level of spread. In another third we do need to bring capital. It down a little. You could open up k6 quite easily now but only to joint antivirus level a little bit lower. Anybody has to wear a mask. Some parts of the country the virus loads are so high that we really do need to work on bringing out and get i would close bars and close Indoor Dining for a close schools. Thats just a priority and values judgment i would make. If we did this and took this with nuance as opposed to bluster, i find myself in the mornings arguing ripped open schools in the afternoon trying to explain to people why cant open schools. People are like and which side are you on . The data. I think we can get most schooln it without the data try our decisionmaking. Mr. Chairman, thank you for your patience. I have become quite convinced that for those of us in Maricopa County we are seeing some very good numbers right now. There is a path to having our School Safety open and i think we [inaudible] and those on the left, those of us on the right could come up with a common language to mitigate fear and moved to facts, i think it would be very powerful to the economics of this country. With that i yield back, mr. Chairman. Thank you very much. I now recognize congresswoman joyce beatty from ohio. Joyce is still with us . Give her another couple of seconds here. Is senator lee with us . I will ask again. And let me move panelists, thank you for your patience. Both houses of voting this afternoon and so the go back and forth and back and forth. Is congressman lahood from illinois with this right now . Finally, im going to try another doctor. Doctor senator cassidy. Did you hang around for a second round . I sure did. Senator, the floor is yours. Thank you to see if i can get my video going, not that you care to sydney. Dr. Jha, we do need to distinguish, you say some schools should and some schools shouldnt vote what moving to distinguish between k6, for example, and high school. An 18yearold is is an adult effectively, at least in terms of Infectious Disease but it seems like Primary School is much less. I see that because again going back to the opportunity costs of a fiveyearold in the innercity or rural setting in which parents dont have access or if they do, lack of familiarity. The scene we say schools come to speak of new was, we should be nuanced, that it is k6 that we feel or k2 eight that we feel freer about. You mentioned and jeff mention, dr. Singh, like there been 1 million kids in quebec that come back to school and i think think. 03 1 event affected and all the children in other countries that we mentioned. Although the u. S. Doesnt have data there is data Worldwide Council going back my point being, would you agree when we say schools we must speak with nuance and not just say schools, but differentiate primary versus secular . Absolutely, absolutely. Let me say two things about this. We and our tracking that we do on global epidemics. Org, we split the country into green, yellow, orange and red. Everybody in green zones should be back in school. In yellow probably everybody can go back. Definitely k6. High school. In which we argued k6 can go back and back each avast which would of the country. There are some places can we can talk about europe, the never open up schools with the kind of case level that weve had in some parts of our country. That would be in my mind not based on what the evidence or expense of other places have been. I am much more based on the muddling data, much more hesitant in places with very Large Community transmission to say its totally fine for a fifth grader. This event goes back to dr. Singer, ill ask this. Then come back to the opportunity cost. Not be valid by the schools psychologist to look for abuse come not to get the meals, not of the in Person Instruction basically not getting instruction whatsoever, were still at extremely low risk of infection or serious infection, extremely low risk. It seems like we have a tradeoff. Dr. Goolsbee, it was interesting earlier you said its rare an economist advocates wearing a mask but i think we need more doctors advocating open up because of the opportunity cost of the children, particularly the younger children staying at home. Dr. Singer, you want to weigh in on that . Thats what we call the unseen, the costs that are not seen as opposed to what is seen. For example, as you know, dr. Cassidy, that are crucial periods of development come psychological development, cognitive skill development, social development that a lot of these very Young Children are missing out on some of this could be very difficult to make up. Then of course theres also the social determent of health. Some children come from households where theyre subject to child abuse or neglect, where the dont get proper nutrition and this is provided for them in the school system. These are all other costs that are not being taken into account. I personally, i saw just the other day the cdcs latest estimates of infection fatality rates, not case fatality rates. The estimates are if i remember correctly were. 0037 infection fatality rate for children under age 18. You need to put everything in perspective and balance what is the risk of them dying from a Covid Infection versus the risk of them dying of child abuse or neglect. Dr. Goolsbee, let me come again full disclosure, my wife is on the board of a school for children with dyslexia. Illiteracy is a major risk factor for incarceration, fute incarceration. If you look at the reading scores, children of color by grade three or four, 50 of them are reading below grade level. So again i go back to come i think were in agreement. I think im just pushing this point because dr. Jha, im going to disagree with you. If you have a five year old from an impoverished background and she or he is not in school, you are going to affect the future life. Possibly, in fact, indeed probably increasing the risk for future incarceration. For extremely low risk of infection or at least complications of infection. So i i keep feeling like we are being so careful about the spread of disease that we are being less careful, i dont want to put words in your mouth, dr. Jha, less careful about the longterm consequences of a child not being in school. I apologize because i was an unfair characterization, although i think you did say in the red zone you would still be nervous about Primary School children attending. Dr. Goolsbee, wider to speak and then i will give dr. Jha the last word . As i said at the beginning, i am quite sympathetic with the concerns about what youre calling the opportunity cost. We do still and we do still need, even if the kids themselves get sick but the vitali rate is low, we need to monitor whether they are coming home and getting their grandparents infected. If they are not, then that goes into the mask category of your other behaviors we can open up and allow without increasing the rate of spread of the virus. Santa like what dr. Jha was emphasizing was that in places that are in the red, and theres High Community transmission, there might be an elevated risk that the kids themselves wouldnt get sick, that they would come home and get mom and dad sick and maybe brother and sister sick, and that kind of goes back to our critical thing about whats the number one goal of virus economics . Youve got to slow the spread of a virus. In the countries where they have got low rates of infection, may have gone back to school. I do think thats vertically afford especially in these unequal times. Dr. Jha . Cant hear you. Sorry. You think i would know this by now. The last thing i would save two quick things. First of all, we have not seen any play open up schools and the red zone but when place it did try a few months ago was israel. They had pretty large outbreaks. I believe in katy tur we have a lot of evidence to drive this thing together parties schools are not just run, dont just have kids. They have adults and adults can transmit to each other and teachers can transmit to other teachers that i greet we do have a lot of evidence to show thats happened. What i do like to see is if were going to try those places, be very honest with people we dont have a lot of evidence, if everybody to wear masks and collect data very, very carefully. I also think lets get the red zones into orange and yellow zones by closing bars, by getting people to wear masks, by improving testing and we can stop disagreeing because we will all agree that getting especially younger kids but probably everybody back to school is clearly the right thing to do for kids, parents and everybody else. Thank you, mr. Chairman. Thank you for your indulgence. I yield back. Thank you, senator, very much. Now recognize my friend, the congressman from maryland. Thank you, mr. Chairman. I appreciate it. As a fellow businessman i am concerned about the grave impact the pandemic has had and will continue have on small business. In july i cosponsored the jobs and neighborhood investment act with senator warner on the senate side, to invest 18 billion in low income Minority Committee set up and hit the hardest to the bill provides fun and support to my door to finance institutions, to expand the flow of credit and prevent permanent damage to these communities. Dr. Goolsbee, do you see a connection between the devastating impact covid has had on black, latino, of the minority communities and the accelerated losses we have seen among minorityowned businesses . And then also secondarily, how do we craft responses, how should we craft responses, responsive policies and address these systemic inequities . On the second question of what do we do about that, thats a harder in the short run, as ive said, i think youve got to stop the sped of the virus, everything you can