Transcripts For CSPAN3 CDC 20240705

[inaudible conversations] i would ask her guess to take their seats. The subcommittee on oversight investigations will come to order. I recognize myself for an Opening Statement to todays hearing is the first opportunity for congress to hear testimony from doctors mandy cohen since she was appointed to the centers for days Disease Control director in july. Dr. Cohen congratulations on your point maybe we are taking the reins of the cdc at a critical time you have a heavy task ahead. As i have said editor jan oversight hearing to cope with 19 pandemic revealed he we did not have the cdc we thought we had. I look forward to hearing how you plan to change that. This is an opportunity to hear firsthand about how the cdc is responding to the ongoing respiratory virus. Im particular interest in hearing about how the cdc is helping to mitigate the shortage of respiratory essential virus or are city immunization for all infants. We have heard reports that are as the cases are sharply in certain areas of the country. With Unprecedented Demand for rsv immunization this year with the supply constraints i hope we hear what the cdc plans to do to ensure we have a sufficient supply of product for the season to comfort her to that the safe effective are cm initialization initialization immunization to protect her children but it does us little good if we dont do a better job at keeping supply. House the cdc planning to rebuild public trust in the agency, has the cdc learned from the mistakes it made during the cope with 19 pandemic and is the cdc committed to making deep reforms needed to avoid repeating the same mistakes. While im looking forward to hear your testimony on this point i cant believe i havent seen that evidence yet that the cdc is taking the failings of the cope with 19 pandemic to harp another area i have great concerns about as a detrimental effect of the School Closures have had on our kids learning. According to the report by the assessment of Education Progress for u. S. 13yearolds is at the lowest level in decades. According to a New York Times report from earlier this month School Closures led to 50 million children including my own being out the classroom causing the students to miss an extremely crucial time in their lives since they were forced to attempt to learn from home. Let me assure you learning from home for schoolage children is not as effective as being in a classroom. In that same report the times claims this may prove to be the most damaging instruction in the history of American Education but the damage brought by School Closures was enormous and our children will be living with the consequences for decades. If i said before cdc recommendations and guidance carry great weight. They justify not only School Closures. Preventing nursing home visitations of Vaccine Mandates that would result in millions of americans losing their jobs. In addition businesses Fitness Centers and of all churches and other places of worship were closed. Abiah left exposed mo problems for the cdc for the management of federal aging program has been such criticism for inadequate investigations in response to buy a security incidents including the investigations from this very subcommittee. Reading the china select racer porsche is how the cdcs approach to select Agent Program cdc initially refused to even investigate the lab and only did so once they were contacted by democratic representative jen costa california the cdc refuse to test the thousands of samples that may have contained, that could have contained unknown and dangerous pathogens. The agency also failed to take meaningful action regarding a refrigerator that was labeled ebola during the socalled investigation for the cdcs response was inadequate and failed to provide any support for the local government and put the public at risk through indifference. This is not acceptable and the cdc must do better. As we look to the future its clear that the cdc needs to do more than just a reset. There needs to be a Seismic Shift. They announced in april 2028 undergo a reform by starting to review their process the structures in place. Hence they have made a handful of changes but more is needed. I know that you have not been there like that to implement a Seismic Shift but i hope we can start to see the cdc guidance driven by the latest science and robust data. In closing i hope your tenure as director will start that process and reinvigorate this important agency. Thank you and i yield back myself and i now recognize the subcommittee Ranking Member ms. Castor for high for her fiveminute Opening Statement. I think you mr. Chairman and good morning everyone. Welcome dr. Cohen and thank you for your service as director of the centers for Disease Control and prevention for the timing of your appearance here today is very important as we want to ensure that all americans have all necessary information to protect themselves from respiratory disease as we head into the season of higher infections in illness driven by the flu, covid 19 and rsv. This subcommittee held a hearing in july and how the cdc can improve its effectiveness and performing its Core Public Health mission but they did so without having anyone from the cdc provide a substandard updates and thankfully we can hear directly from dr. Cohen today about her priorities to help americans stay healthy and to prevent and fight disease but one of the strength of the cdc is that it works in collaboration with states and local communities. Strong Public Health partnerships and infrastructure are our best line of defense. Families communities businesses and policymakers like us rely on uptodate information to understand the risks and devise Prevention Strategies but are working together we can improve the lives and health of the americans. Earlier this week the cdc released data showing Life Expectancy in america last year increased slightly after he decreased in 2020 and 2021 due to the heavy toll caused by covid19 where 1 million americans lost their lives. We are struggling compared to other wealthy countries. Nevertheless thanks to this historic emergency legislation passed by democrats in congress and extraordinary efforts of communities and Health Professionals across the country and the Biden Administration we put the days of the pandemic behind us. We can focus a new on ongoing Public Health risks like heart disease, cancer, maternal mortality, a weary prevention suicide and others. Poor country that is grappling with debts and deficits and for families looking to Lower Health Care costs is more important than ever that we make sure that all americans have access to Good Nutrition and lifesaving vaccines and that they dont start with. Unfortunately for years after the onset of the covid19 pandemic some of my republican colleagues continue to aggressively undergoing cost savings and maligned saint for lifesaving medical research. The republican majority actively opposed strengthening Public Health and failed to use the Lessons Learned to better position america to respond to the future. Republicans budgets in Congress Tell the story. Instead of working to keep our neighbors safe and avoid higher Health Care Costs republicans want to take us back to harmful cutbacks, shutdowns and a budget showdown. Meanwhile democrats are working to put people over politics, to keep our neighbors healthy and to prevent unnecessary hospitalizations and deaths and to be ready for the next ebola or zika or coronavirus. You never know whats going to happen. For sample earlier this summer serves the florida experienced a surprising outbreak of malaria with patients hospitalized to thank goodness the cdc experts jumped in to aid the community and brought up a containment and prevention strategy. There hasnt been an outbreak in 20 years and that is good because malaria is one of the worlds greatest Public Health problems and affects approximately 219 Million People each year with over 600,000 deaths. We are grateful for the response by the cdc but its also a great example of the importance of timely information for the public. Access to Timely Health information became entirely too political during covid with some officials in my state and other places altering information that the public needed. I hope you can all Work Together to improve the availability of accurate and Timely Health information for the public. Even in the best of circumstances the cdc has a very difficult job. While some politicians are intent on discrediting the cdc are actively spreading misinformation as former president trumpeted repeatedly in 2020 during the height of the coronavirus pandemic and as the governor and Surgeon General and my state of florida continue to do so today the job its so much harder. But we can do better. We can come together to improve Public Health and make sure that all americans stay healthy and well. I look forward to hearing from dr. Cohen today. Thank you and i yield back. I think the gentlelady and i now recognize the chair of the full committee mrs. Rodgers for her full statement. Id also like to welcome and congratulate director cohen for the center of Disease Control and prevention and they must have a transparent and honest conversation about the future of the cdc, an agency that is never and needs to be authorized by congress. Director cohen you might be the last appointed cdc director without a senate confirmation. Your actions and decisions can help return the cdc back to its fundamental mission or your actions could allow the cdc to drift further away. We want to hear from you today about the cdcs preparedness with the current wave of seasonal viruses such as the flu rsv and covid19 and at the same time we want to examine the cdcs past decisions and guidance to understand how you are taking Lessons Learned from covid 19 and other Public Health threats to improve our current and future Public Health strategies. This is a chance to restore transparency and build public trust in our Health Institutions and ensure that the d. C. Issued guidance is clear practical and consistently relevant and uptodate with the latest science. Sometimes this may include telling the American People with the cdc has done in doesnt doesnt know but to put it bluntly your predecessors took bad advice. They acted on bad advice and use political pressure and misled the American People. The institution you now run wanted schools remain closed by listening to nonscientific stakeholders namely the Teachers Union and because of their guidance to keep schools closed for an extended period our children the very future of our country now suffered generational learning loss and devastating Mental Health conditions. The gravity of the situation is clear, if we fail to restore trust in Public Health institutions and correct the past mistakes of the consequences for children and our country could be dire. It is in this context of urgency that we must consider the substantial investments made during the pandemic through congress provided schools with 190 billion to combat covid allocating the estimated 20 to mitigate learning loss and despite these efforts students in grades three through eight are lacking months if not years behind in breeding and math abilities. Nationwide or childrens academic performance has suffered a historic decline with reading and math scores plummeting to the lowest levels in 30 years. Further School Attendance is down and students are dealing with the crisis. These facts are not merely statistics, they are our children. Our nieces and nephews are neighbors children. They are the next generation of right now this is a stark indication of the broader fallout from actions taken during the covid 19 pandemic that we are only beginning to uncover. To reflect on events the events that led us to this point we must acknowledge the wave of responsible if it comes with being the director of the cdc. The agencys guidance has farreaching implications affecting not just Public Health but our daytoday lives and overall wellbeing of our children. It is imperative that we make a commitment to cooperate. To many of our inquiries the president an adequate answer to hold it nor do i think we all agree being transparent with us the americans that we represent is foundational to restoring trust. I know this is your first time testifying before congress is director of the cdc. Appearing is more than a perceived formality. Its a Pivotal Moment for accountability and reassessment. The insights to share today will only shed light on past decisions that will take a step toward rebuilding trust. This hearing is an opportunity to share how you will use Lessons Learned and apply them to the respiratory illness season as well as future decisions by the cdc. You have an opportunity to show the American People hiding a plan to lead as director and we look forward to your testimony and hearing about how youre going to to leave the cdc moving forward. Thank you for being here. I think the gentlelady for yielding back and i recognize the right member of the full committee for his statement for five minutes. Thinking mr. Chairman and thank you dr. Cohen. I look forward to your testimony working together on all the important decisions that the center for Disease Control attacking but its critical that we make every effort to extend access to vaccines against seasonal respiratory illnesses to all americans and new options and methods of vaccine delivery and take a coordinate effort between the cdc local Health Department those who were on the ground distributing and administering these vaccines. Right now covid 19 vaccines are being distributed commercially but not by the government for the First Time Since beginning the pandemic. We are now available for the first time for Older Americans and its critical that we communicate the message to americans about where and how to get vaccinated to protect themselves and their families from this respiratory illness for the cdc has the cdc is produced to compress a campaign to inform the American Public about the availability of covid 19 nrsc vaccines providing clear guidance on the best available ways and encouraging to see you contributing to this campaign dr. Cohen. Congress test do its part and must ensure the cdc has the resources and authority needed for the American People to protect her health and wellbeing for the covid 19 pandemic has systematic shortcomings in our Health Infrastructure preparedness that we must address instead of coming together to advance a bipartisan pandemic preparedness for authorization that applies to Lessons Learned in the pandemic of republican colleagues push an adequate in partisan this committee. I contain to be astonished and disappointed that we still can cant agree on the hard Lessons Learned throughout the pandemic. The very title of this hearing shows why a republican colleagues which was an important tool in reducing the spread of the deadly virus. Unfortunate a rejection of science seems to have taken a hold of House Republicans in its refusal to learn making it difficult to find a bipartisan path forward unnecessary important legislation to protect the American People as we go forward. Over and over again Public Health experts have told us having access to timely data during the pandemic is critical to an Effective Responses. Access to updated streamlined coordinated data is essential in order to the cdc to provide recommendations and guidance on information to the general public in a way thats useful and timely and better Health Information means better guidance for the country for the force and a republican colleagues refused to include such a provision in and extreme in partisan reauthorization bill. Democrats are committed to future preparedness and will continue to work toward that goal. We saw what happened during the early days of the pandemic and we should do whatever we can to avoid reliving those i hope you never productive discussion with dr. Cohen about her priorities for the cdc. We understand he a lot of time talking about covid such as maternal morbidity trends sexuallytransmitted diseases in office depends in Office Defense and good data in a sound public and Health Infrastructure that enables effective medication between the cdc and local governments across the country but we had to be able to spot it early in the value at the effectiveness and intervention so americans can receive the guidance that they deserve. Congress needs to ensure the cdc has adequate resources to do its work. You only need to look at the House Republicans can appropriations bill to see they are not serious about strengthening our Public Health. House republicans want to cut 1. 6 million from cdcs current funding level and this cut would seriously undermined undermine the cdcs ability to perform its Vital Mission that would endanger Public Health and safety. Once again shows how House Republicans continue to cave to the extreme elements of their party who have no adjusting government in my opinion. Its time for congress to make important necessary reforms to make our nation safer. I think you dr. Cohen im pleased mr. Chairman of having this hearing today and thank you can and i yield back. I think the gentlemen for yielding back. Members are reminded pursuant to the Committee Rules all members written statements will be made part of the record so provide those statements to the clerk promptly want to thank her witness for being here today in taking the time to testify to the subcommittee. You have the opportunity to give your Opening Statement followed by round of questions from members. Her witness today is dr. Mandy cohen. As you know if you testify and for this committee i cant recall a time we didnt, we pick our evidence under oath and if you have objection to testimony today . Seeing the gentlelady is not objective will proceed and you are entitled to be advised by council of rules including your testimony today. Saying she has not requested that council deserve would you please rise and raise your right hand . Do you promise to tell the whole truth the full truth and nothing but the truth so help you god . Seem to witness answering in the affirmative you are now sworn in and under oath set forth under title xviii, section 1001 of the United States code. With that we recognize dr. Cohen for your five minutes of testimony. Smith thank you chairman griffith Ranking Member and distinguished member of the subcommittee to an honor to appear before you today but the cdc is a Critical National security asset putting data and evidence into action to protect this countrys health and safety and im privileged to be here. I stepped in this role acknowledging the unprecedented challenges the agency and the country faced during kopech and the Health Threats are going to continue to impact the security and safety of americans. The cdc is trust and has the tools effectively and quickly respond to the next Public Health challenges in its foundational to combating disease. This years respiratory season provides an opportunity across three domains. First rapidly detecting and responding to Health Threats, second provide timely common sense evidencebased solutions to improve health and third bill turns are broader effective system that protects the Public Health. First, to be our National Security at our country needs rapidly detect and respond to Health Threats requiring faster and more transparent information. We are already putting Lessons Learned into action through our respiratory forecast and respiratory web site and for the first time we are keeping it combined view of covid flew nrcp the cdc is providing updates to help schools make informed decisions on how they were protect themselves and their families against respiratory viruses in our community. You can get your web site ran out and say that r. Is the season is in full swing. The flu season is just beginning across most of the country and accelerating fast and by receiving relatively low levels of covid, covid still the primary cause of new hospitalizations and deaths which is about 15,000 hospitalizations and 1000 deaths the cdc is leveraging innovative tools to more quickly detect disease transferred for example in collaboration with state and local jurisdictions the cdc is utilizing wastewater surveillance to rapidly detect spreading disease in communities but but this week the cdc launcd an updated beta for providing Public Health practitioners in the public early insights into the spread of Infectious Disease in the community. Its data that can be translated into action. Second are applying Lessons Learned by providing americans with clear and timely decisions to protect their help with the approval of new rsv immunization is for the first time we have immunizations available for all three major fall and winter respiratory diseases. They remain the safest and most effective protection for avoiding severe illness and death and i have been traveling with country talking about the importance of vaccinations answering questions and meeting with vaccinating partners on the front lines. As we build a stronger cdc its critical we build upon and strengthen the infrastructure and the system developed during the Pandemic Response for more integrated and effective Public Health system. The cdc must have the publics help help data system integrated with health care and our jurisdictional partners been fortunate at the end of the Public Health emergency the cdc is more limited in our ability to show information for covid and other in factious diseases like rsv. The cdc is working hard and fast to put in place agreement of the parties to improve access to data at the jurisdictional level and to enable a Robust National situational awareness. Even with these agreements in place and the important enhancements and capabilities absent new policy buffers and resources from congress they will continue to be a highly concerning bit of information at the cdc can use this protect health and security. For other they launched the projects is programmed to address gaps and vaccine access. The Program Provides vaccines to uninsured and underinsured adults. This is a tempore fix. A longstanding barrier to adult vaccination. The next time theres a vaccine preventable outbreak of the country will need to build a system to administer vaccines to adults who are underinsured and uninsured. It protects americans from marching Health Threats and we must provide verification collaborate across government and public and private partners. We need help from congress to support the cdc that has the resources and the policy levers to be the National Security asset when he put when he pitted look forward to working with you on these important goals. Thank you could. Thank you very much for your testimony. We will now begin the question and answer. Next up it and i will recognize myself for five minutes. In the Opening Statement with her was backandforth but even though we want the cdc and other Health Community to use the data and science that didnt appear to be the case during covid19 so that brings up my first question for diet concerns and the edges between the cdc and the Cdc Foundation in private financing with minimal reporting requirements or disclosures regarding how these funds are to be or whether their Strings Attached with this foundation. The results and the concern that private donors may be influencing Public Health policies through the foundation. What assurances can you provide us with their appropriate checks and balances between the cdc and the Cdc Foundation especially when it comes to transparency . Thank you chairman. Transparency is very important and im working hard to make sure that we can collaborate with many partners. They exist and they are doing work in alignment with the cdcs right to protect the health of the country so they have a board and an independent way of raising dollars in the community. We are trying to accomplish the mission. I think its fair to say that you can assure us that you will not allow any donations from individuals to the foundation to affect your sound decision as the head of the cdc, yes sir now. I will continue to making decisions on a half of the cdc according to the evidence. We have got to move on. Time is limited even for the chair. Dr. Cohen since youve become the cdc director level of cooperation from the cdc in response to this oversight has been to disappoint the cdc specifically is not respond to certain letters signed by hhs and assistant secretary for legislation but even these responses did not respond to our questions or provide a single document that recounted publicly available information. Under your leadership with getting your sea legs under you i hope the cdc will work with us to do our role as oversight. We have commit to working with us in having the cdc cooperate with our oversight for the betterment of the nation, yes or no . Mr. And i look forward to working with you on as i said my Opening Statement we work closely with congress on the forward to working with you personally. I build relationships across the aisle. Yes maam come thank you. With the current surge in respiratory disease in china we sent a letter tedious yesterday. Regarding this mysterious uptick in cases. Our hope is if you need is to help we will. We are hoping you could boost pressure and attempt to try to get china to not mislead the world as they did with covid19. What is the cdc steps to get complete and accurate data regarding this mysterious uptick in respiratory illness is in china quick thank you chairman. Obviously its really important the cdc continues to do the global work in scientific diplomacy. What we know as of today its happening in china they are seeing an increase in their respiratory illness in the northern part of the country and their pediatric population. What we do know again as of today we do not believe this is a new or novel pathogen and its existing beaning covid flew rsv microplasma but they are seeing in upsurges. The cdc has an office in china and officials have been in touch with our counterparts to make sure we understand the situation. They were sharing with us again not a novel pathogen. And youll keep us informed quick we will. The select committee on china the cdc refuse to take phonecalls from city and county officials about that bio lab. Does the cdc prayer tase a call on a serious issue . Mr. Chairman we take seriously working with our state and local partners and working collaboratively. In this case we did not lead the investigation but we were invited to join vesta gate to the asset leopard with onsite and completed that investigation. What can you tell me about the ebola refrigerator . C we two and a half days in the investigation took three and a close look at everything. Our team did not see anything that said the pole anywhere but when we heard afterthefact that someone said it was labeled the ebola we immediately followed up with pictures or evidence and we could not produce that. I think that was an erroneous conclusion and we did not believe there was any select agent on the premise. I back and i recognize ms. Castor for her five minutes of questions. So i think you mr. Chairman and thank you for your testimony in the important updates on what the cdc is doing to educate the public on covid19 are city this season but have been all three Vaccines Available represents great progress in the protection against viruses and provides an opportunity to check in with Health Providers at home. They are quite enthused about having all of these tools at their disposal especially the new vaccines for rsv for infants and pregnant mothers but i can agree more about the importance of ensuring cdc has exclusive access to timely Public Health that when a Public Health threat arises anywhere in the country communities cannot give an Effective Response if they dont know whats happening. We need quick action in the Health Emergency line. During the covid19 pandemic conference of copyright to the cdc work to efficiently collect data from states and localities that as we learned spending a lot of time on these during the pandemic was a distraction from the missions where we could have been preventing the spread in treating the sick. Thats a positive example of a quick and effective cdc response recently in sarasota on malaria. Can you walk us through how that worked and the importance of data gathering and what you were able to do on containment and prevention quick thank you Ranking Member cast her. It was working on the first domestically acquired malaria in 20 years. Our country was i think an example of how local, state and federal officials worked very well together. Its a good news story and that we identified after those first few cases that we hadnt seen in 20 years, local leaders were very much on top of it and to ask resistance. We were able to provide Technical Assistance related to how to control it and how to think about treatment for the individuals and we gave out guidance to the local community as well as Health Care Providers to make sure they were looking for additional cases. They provided backup laboratory capability for the area and we also made sure to look at all the mosquitoes in the area and making sure we were seeing further valerio and the mosquitoes so our Partnership Local state and federal together and the good news story is we did not see any continuation of malaria. Its important to stop it quickly and its important to have the data and evidencebased guidance very quickly and to take action and to spray for mosquitoes and make sure we are using protective measures. Thats Public Health at work. Public health can be often invisible. Ill bet most folks imported dont know the Public Health was working for them but we were and im proud of the team effort. Ill bet a lot of members here werent even aware of it. In a tourismbased economy important that a Public Health problem is solved. It really hurts the people. Talk a little bit about rsv. We talk about the flu and get your flu shot every year. Rsv, why is it more prevalent and why is it so important for pregnant women and infants to get the vaccination quick rsv is another respiratory viruses circulates in the season and it impacts their order builds, our seniors and our young babies. Babies by the age of two or three years have been exposed to rsv already. We now because of the pandemic we stayed at home so there was a cohort of kids that werent exposed to rsv and as we had lovely thanksgiving and christmas is we get a higher circulation and because children have not been exposed to that before they were newly infected with rsv. Young babies have little lungs and little bronchioles and get more sick from rsv. The good news is we have a vaccine for our older adults over 50 and an immunization for infants. Its a long acting monoclonal with antibodies directly to babies to protect them from rsv. We are in a different place but we know theres a limited supply of that immunization for babies. Its for parents to take precautions and are pregnant moms. We have a vaccine for pregnant moms between 30 and 36 weeks pregnant. They will get vaccinated so we are sure that the antibodies are passed along to dampen. I think the gentlelady and with regard to mosquitoes its not your jurisdiction but the nih and fda are working on that. I look forward to hearing your five minutes of questioning. Madam chair optimism about the fda for a separate discussion. Obviously its her first time before this committee is her role and cdc director but not your first time before this committee. Your role in previous congresses. We all share the goal of rebuilding the faith and the trust of the cdc. Most of us recognize we need a wellfunctioning and respected cdc in order to protect the American People. You shared some of your visions with us on how we travel that road but one thing missing is the degree that there has been selfreflection and decisions made as far as governance and how things work internally for the cdc. Are you free to speak on them quick what youve done internally to modify the culture and improve the culture. This is work i want to give credit that started before he i came on board a cdc director. They have changed the structure of the agency to make sure its more operationally focused and more to respond. We have created programs like the cdc program where we are training and keeping ready responders who are trained and ready to be deployed should we see an emergency. We are focusing on making sure we can turn data into action quickly and making sure that we are working as one team. At the cdc there are a lot of fantastic efforts. Often. Let me just ask you because we are working on the reauthorization act. Have you done an afteraction report to look at the cdc and what happened and what were right and what made an improvement and could you share that with those . Do you have such a document collects before my tenure there was an extensive review of how the cdc should be organized and that was put together as part of the moving forward plan and id be happy to share more details. Details of what could we have done better . Do we have access to that . I think they are been many ways in which we continue with Lessons Learned particularly when we think about the communication space or a quality space. Pierre already baking it into her work and i hope we are already seeing people communicate differently and more timely telling people what we know when we know it and what we dont know. I said that in my Opening Statement. We are both communicating differently and with many new procedures to make sure we dont make the mistakes on the lab site that we saw before and we are making sure our workforce is ready to respond. Plus i will say there is still ways in which we continue to work with congress to make sure the cdc is funded for that National Security asset we need for this country. And again we look forward to working with you. That always sound coming from a political figure arguing that someone should express humility talking about something that they are sure whats going to happen. We know whats important dangerous but we dont often know what happens next or were change her mind. Thats whats missing at the helm of the cdc during the top of the pandemic. Its a quality that we are not known for. Also on the biotech that the chairman asked about, have we develop Lessons Learned and how to prevent this from happening or is there going to be an effort for surveillance of labs . We know we are in unprecedented times and some of those threats come from a lab or an animal or a weapon and we need to be ready. That is why the cdc needs more resources to make sure we are detecting those threats and ready to deploy them. Its not the first time this has happened. We had this many years ago so its something that requires scrutiny. Let me just ask you as life inspect Life Expectancy increases by the center for Disease Control it talks about Life Expectancy would have been greater if not for the offsetting increase in mortality from the influence of pneumonia. Can you expand on the perinatal conditions quick sir id be happy to get back to you. If you would sure that what those thats important to me and id like to followup on that. Thanks mr. Chair. I think the gentlemen for yielding back and the gentlelady from colorado missed to get her questions. I always say we should have a hearing on flu preparedness. Like Everything Else in our lives do not become more complex because that now we have three things we are trying to prepare for. We are happy to have you where you are because we know you are taking it seriously. In february we had a hearing in the committee with Health Professionals from nih and fda about the governments covid 19 response which as you heard today we keep talking about it over and over again but we need to move forward to try to be prepared to respond better the next time instead of whining about it. At that hearing your predecessor dr. Walensky ursus committee to provide cdc with new Statutory Authority so it could fulfill its Public Mission and some of those priorities were priorities you discussed in your testimony. You need to turn off your mic, thanks. Some of these priorities are ones that you provided in your testimony today and we are talking about it nine months ago. Im kind of disappointed that we havent made more progress in giving the cdc more data because thats what were you really need to be able to identify the issue and then to alert the public. You cant respond to a crisis if you cant measure that crisis or if you are seeing it in the rearview mirror. The cdc doesnt have the authority to do that without congress. So you know theres an effort to transform the agency with the cdc moving forward and i know if you are trying to this forward and modernize the Data Infrastructure but can you give us an update as to your effort and let us know what you still need so we can work in a bipartisan way to give it to you quick thank you. Our Data Infrastructure is critical to making sure that the cdc is a National Security asset that we need and a lot of work has been done. I think youll hear a lot of success stories. The beginning the pandemic we transmitted information electronically and only about 200 hospitals are able to transmit that data electronically and that now purchase 30,000. We are making significant progress. As a state official from North Carolina that data was incredibly important to us and we want that information to be the state and the national level. I needed to know what was happening in South Carolina in order, because charlotte is on the border. So having information and disability is really important. We need to make sure we have the National Picture and thats the importance of the data authority. We are working closely with our states to see what we can do and make sure we have that infrastructure and the authority importantly the resources. What authority do you need . I want to touch on the resources because i will say in our current budget they zeroed out investments for infrastructure and thats not going to be compatible with the successful cdc but they are also authorities that allow for us to collect data and away from our Health Care Partners and state and local partners in a way that allows us to have that ability. We are happy to work with your team on how to structure that. We are always talking about data and we are focused on making sure we are protecting privacy would be collect this data but is really important. If you when your team can get back to a specifically with the legislative first of all i agree with you on resources. If we are going to sit here and collectively say we need to do a better job with the new pandemic we cant zero out the budget for data collection. Thats and i dont think that will happen in the end but in terms of the Legal Authority that you need if your team can work with us on specific legislative language we will try to work in a bipartisan way. I yield back. I think the gentlelady for yielding back and i recognize mr. Guthrie for his five minutes of questions. Thank you are hosting me in atlanta. Their a lot of hardworking americans in your building making sure we are protecting i appreciate that. As you know as we discussed and i wouldnt say im whining about covid. But we have Lessons Learned. A lot of institutions like wh owned others and i believe you are working to do that. Just instances that happened and in one of the letters from the leadership of dnc about the covid tracker data of belief 2000 removed from the covid tracker web site. It was at you personally but it was a glitch. Also the Vital Statistics system was previously reported. Which explain and i know those are two separate situations that explain those and what you have done . Your group show me what they want to do with the data and i believe people sitting in that room give good information to protect the American People. The question we have and we talked about it in other areas how can data remain private and when you see lack of transparency its hard to make that case. Would you talk about those specific instances . Think he representative guthrie. Making sure we have timely and Accurate Information is critically important. And when we look at our mortality data at the beginning of the pandemic when we were able to look at data it was quarterly. It wasnt in realtime but we know was moving so quickly we had report more quickly. We used a different mechanism through case surveillance data. Folks were collecting the data and would give it to the cdc and the caveat at the time the preliminary Gold Standard which was not as timely a times we were still reporting. Again it was slower. We made a lot of improvements and thank you congress for those resources. We can almost get realtime and that Gold Standard data. That is what we are using. We are able to sunset those datasets that you are preferring to so we are in a better place with timeliness and accuracy of the mortality. We are still looking at a million adults who lost their lives and 1700 kids who lost their lives to cope it. We had to keep those tools at our disposal. You talked earlier, i was going to ask you about whats going on in china now. Your assessment from what you know if its not a novel virus quick correct. We have been in close touch with their counterparts in china and that information has been collaborated with other counterparts across u. S. Government but also her European Union partners so we feel confident. Santa gets an institution with the World Health Organization. This is my assessment of it when coker broke out in china and sharing information so the rest of the world corrected and they have worse requested specific data from china and the recent transit circulation of known pathogens. Is china responding to the World Health Organization . I know you have people in china dealing with their chinese colleagues. Is the World Health Organization responding in a way that it should . I dont know firsthand about the china interactions. Our information is direct from our team who were in china with their counterparts. Mind standing from wh is that china has been sharing information related to this so again another way to cooperate. Do you know the World Health Organization is china for information in december of 2022. I know we have our own personnel in china with the cdc and are you confident that they have our inches. Diplomacy is incredibly important in that part of the world. Its a small office and we are trying to work on things that are mutually agreeable. Wed love to do more work and id be happy to talk more about it. If its coming straight from scientists. Thank you for your work and appreciate it and i yield back. The gentleman yields back and mr. Blunt is recognized for his five minutes of questions. Thanking mr. Chairman. Dr. Cohen thank you for being here to talk to us about the cdcs important work particularly at this time of year when the respiratory illnesses are on the top of their points mind and vaccines to work against seasonal calluses like covid teen and rsv. What the cdc is seeing its data about hospitalizations and deaths is cdcs seeing a sharper rise in rates of detection and hospitalizations in the wind compared to the others and what does the cdc project in terms of the winter and cases quick. For the first time you see a consolidated view of covids flu and r. Is the together under web site. You can see the relative impact. I would say we are in full swing of our flu season. We are seeing a lot particular in the southern part of the country where near peak is what i would say for rsv. With that we are also at the beginning of the flu season so we are not having early flu. We are having what i would call a typical flu season we expect to see a lot more flu cases of bird december and january so please make sure you are getting your updated flu shot and check with your communities. That being said even we are at the peak of rsv covids toga respiratory virus putting the most number of folks in the hospital and taking their lives. Its about 15,000 people in the hospital for cope it and that many people die per week across the country related to covid we are seeing an uptick in cope it. We had a late summer wave and we are going back up again which we expect after a lot of traveling gathering at thanksgiving. Its never too late to get that updated Covid Vaccine and making sure where youre getting out assisted testing and treatment. Its really important because we have treatment for these diseases, to get tested so you know it could have been that treatment can save your life. What about the monitoring of vaccine upticks for the flu and covid19 and rsv. Now that we are outside the official Public Health emergency this is one of the issues we were discussing related to lack of visibility with our data. We dont have the same level of data visibility that we have been the federal government was purchasing and distributing all the vaccines could what we have now is an imperfect tool to know how folks are arent getting vaccinated. Its a survey we have use for decades so its a validated survey but we ascend to ask folks did you get an update to the vaccine. We see about 16 of americans have gotten the updated Covid Vaccine and thats not enough ill say that right now. Ive been doing as much as i came to go around the country and meet and answer questions and explaining the importance of vaccinations but its not enough and i look forward to continuing to work with congress and other partners to make sure that we can help folks know what tools are out there and how they can protect themselves. I have two questions about that. But im outoftown. What kind of strategy is the cdc using to facilitate your recommendations to the public and Health Care Workers and how would a modernized Data Infrastructure increased authority to enhance your ability to make public communication more effective quick. First we are really concentrating our communitys effort with Health Care Providers. Doctors and nurses are some of the most trusted and most important folks who can talk to people about their vaccinations. One of the top reasons people dont get vaccinated this because their doctor or Health Care Provider didnt bring it up. We are focusing our efforts on the time when their limited funds on making sure that our Health Care Providers have all the information they need. As i said im going around the country to answer questions and working with providers but we have more work to do and would Realtime Data help us to direct our resources quickset salute we. When i went to the covid crisis in North Carolina we used daytoday today to decide should we deploy teams here should we increase media in a certain part of the state because we are seeing more . That Realtime Data is important to allow us to make sure we tailor our operational work. Thank you so much and thinking mr. Chair. Effect recognize the chairwoman of the energy and Commerce Committee ms. Morris rodgers for five minutes of questioning. The trifecta of respiratory diseases are city uncovered 19 and i hope we rebuild trust. Im growing increasingly concerned about what we are hearing from china with respiratory diseases and clusters of pneumonia reported among children, images of hospitals and schools being overwhelmed with Sick Children and that brings us back sadly to the early days of covid and reliable information is coming up at china. I along with her oversight chair and Health Subcommittee chair guthrie sent it led her to cdc asking what if any interaction we need to have with their chinese counterparts regarding this and i appreciate the email the cdc sent last night. I do want to urge you to respond to the letter completely and in a timely fashion. It was just sent yesterday. While i look forward to your response that like to note today whether the government of china has been transparent and forthcoming and have you spoken with your Public Health counterparts bayern do you have confidence in the accuracy and completeness of the information they are sharing in d of confidence in the independence of the World Health Organization and its ability to accurately share information . From the cdc in touch with chinese officials. They have been in direct communication. The chinese officials have shared with us again no novel pathogens of what they are seeing. To cooperate that across other sources from our Union Partners and others to make sure were getting a complete picture. Quickset is so important. I have been concerned about cdc depending too much on official announcements of the government of china or the World Health Organization that is proven to be ineffective. I also think it is safe to say the pandemic broke cdcs guidance drafting process collusion with the School Reopening guidance cdc still will not tell this committee what to consult with an drafting guidance concern documents. Throughout the pandemic cdc struggle to breathe timely accurate guidance had to regularly revise guidance within days of issuing them. The process is clearly broken. Do you believe doing something similar to what the fda does which is to say clear and transparent process theyre crafted, disseminated or applied should be implemented cdc . First i want to say it we want to make sure we are getting feedback. Make sure we are mirroring evidencebased solutions with what works on the ground. State official i want to make sure that guidance we are providing from the cdc works for our state. The core component of what we need to do. If guidance posted for Public Feedback for all to do. There are certain circumstances where we need to work quickly. Actually the example of malaria we responded to in florida required us to move very rapidly and put out guidance for communities in a rapid way. Thank you. I one more question i want to get to. I do believe this is fundamental we need good guidance practices. The fda did this over 25 years ago i have a bill that would require cdc to enact good guidance practices. It even includes a provision allowing the secretary to waive those practices in an emergency. Unfortunately cdc is opposing this bill. We see how cdc guidance have affected millions of americans everyday lives. The is a similar approach why should the cdc . I dont think theres a onesizefitsall for the kind of ride and cdc offers but sometimes like this example for malaria was not an emergency but we need to move quickly to prevent the emergency. Other times when we have the time like we have right now we have some guidance upon our website for feedback. I hear the intent of what you want is to make sure we are hearing feedback both from congress and from other stakeholders. Its very important to me as well. I dont think theres a onesizefitsall for this process. But here you on the intent of what we are facilitating. I want to work with you on this i believe good guidance is really important. We go a long way to helping trust that has been broken i yield back. And now i recognize for five minutes. Cook thank you madam chair. Seasonal rsv typically calls mild cold lexis symptoms but some can cause serious illness and hospitalization. If it isnt Young Children are at critically high risk of serious illness from rsv infection as we are here today. This is the first year theres rsv vaccine with the youngest children which is incredible advancement. What do parents need to know about the current season and what steps can they take to keep their kids healthy . First, we want parents to know that our youngest can be impacted by rsv. There is a new immunization if you are a pregnant mom to know if you are between 32 and 36 weeks there is a new vaccine for you that allows you to pass on your antibiotics to baby and protect your baby as well. New tools that are out there but remember you are in touch with your pediatrician about access. Thank you my district parents effort cdc message to get their children vaccinated. They are attempting to respond and there is high demand. Bushy parents having a hard time fighting this vaccine due to shortness which i know the cdc is aware pretty muslim for many constituents but access issue for covenants and vaccines for children under three years old. For example individuals from new york contacted me and showed up they should try to find a vaccine for 2yearold child but there were no such options available per the closest location that would offer the vaccine to children under three was nearly two hours away in hartford, connecticut im hearing about access issue for the immunization for children and pregnant individuals one from albany new york said her child has asthma it considered at a more severe risk for infection complications. Yet the immunization is not available local for her son. They shouted to up our colleagues here and congress are both pediatricians congressman schreier. They share concerns of health and wellbeing many of our youngest and most vulnerable constituents. We are joined together to send a letter to cdc pediatric vaccine access. Madam chair i ask that we enter this letter into the record. Thank you and i look forward to a complete response of this letter. In the meantime i have a few questions for you specifically to the rsv vaccine. Manufacturers to respond to the supposedly shortage up pediatric rsv vaccines . Thank you representative. We have been working very closely with manufacturers but i personally been on the phone amazing dozens of times to work to accelerate the supply. The good news is we were able to have about 70000 additional doses accelerated. We expect additional doses in the generate time from their manufacturing delays here. What cdc has done in addition to working with the manufacturers is to put out guidance to make sure we are using the supply that we do have. We have many hundreds of thousands of doses. But that we do use those doses goes under the age of six months or even at higher risk. And make sure they are getting prioritized for these doses it. I appreciate that. It is so important you are taking it so seriously. In addition to a just indicated is Anything Congress should be doing now to help alleviate current and future pediatric rsv vaccine shortages . I appreciate that question. I probably need to get back to you and what will be most helpful. Relook into that right now as i shared earlier the rsv immunization is a long acting monoclonal. Its a different production cycle than a traditional vaccine. It takes longer. There are decisions needed right now to make sure even next season we are in an adequate place for working with the manufacturers on. So let me take that back to the team and see if there are other things we need in play here. Curtsied to see this every year to educate americans and help for seasonal is indispensable. Its encouraging to see such Strong Demand for new vaccine and i look forward to working together to make certain you have the resources you need to continue cdc important work. We appreciate the Public Information effort that is incredibly important and without madam chair i think you healed back. Said now like to recognize the gentleman from South Carolina. Sorry. Representative duncan. Thank you madam chair. Todays hearing director cohen is fundamentally about understanding your priorities on how you going to lead cdc. Doctor cohens secretary of is f North Carolina department of health and Human Services during the covid 19 pandemic you mandated students in k8 grade wear a mask regardless of their vaccination status and threatened to sue School Districts that refuse to comply. Impose a school mask a mandate after governor cooper, Whose Administration you work for her, vetoed a bill that would have required inperson schooling. Youve also spoken publicly that you made decisions on whether to allow fans to attend Football Games or whether to lift mask mandates based on feelings about your friends and other state Public Health agencies were doing. None of this suggestion will push for the muchneeded changes in cdc. Or how they break from the culture. I would like to ask you if you have any regrets about the School Closures, the mask mandates or other restrictive measures imposed in North Carolina . Thank you representative. I am very proud of the work that we did in North Carolina. I feel that we did that in a way that was very inclusive. We listen, we had partners on both sides of the out in North Carolina. I barely had any test we had very little ppe. They certainly dont have any vaccine or treatment there very few tools that our disposal to protect folks. We are in a new place. I am looking forward to turning the new chapter for cdc as we look forward pretty want to make sure we are learning the lessons from the pandemic about transparency and about creating the infrastructures that we need to make sure we can detect and respond to diseases. I want to make sure we are in a place where we dont have to get into that place again. We trust the science and not the feelings a lot of those are subjective social distancing in all of this. Anyway, moving on we have a hearing it cdc on cdc reform back in june just after coveting Public Health Emergency Declaration was finally terminated parts of the major takeaways i had from that hearing is cdc is much too academic, too insular and does too much. To be fair to you in the cdc a lot of these feelings have the return congress. Cdc has never been authorized as a coherent agency. Congress is never told the cdc definitively what it is supposed to do and what it isnt supposed to do and cdc as an agency of all trades but master of none. That lack of underlying authorization is the root of a lot of cdc problems. We in Congress Need to revisit cdc authority and authorities to impose mask mandates. Some of the statutes date back decades were richly given to a Surgeon General who is now glorified spokesman for the nation. These authorities are totally out of date prior to covid 19 we are thankfully seldom utilized doctor cohen its a tragedy cdc push vaccine mask and distancing mandates on the constituents of self cohen and all across the nation that close Small Businesses schools and places of worship. It is worth noting the same restrictions were not applied to protests and riots that we saw all across the country but we owe it to the American People to provide coherent direction was cdc. Congress owes that the cdc as well. Set clear boundaries on your authority. And as i close out encourage my colleagues to read the report im going to request be entered into the record by the Heritage Foundation provides what i think is a realistic roadmap that can set us on a course to fix the failures. An overreach with soldering covid 19. Mr. Chairman, madam chairman out enter that into the record. Thank you for your leadership and holding this hearing. Director cohen i wish you luck it cdc as you face these challenges but we are not here to port your efforts went to define your mission and help you keep america safe and do it in a very pragmatic commonsense science based way. And with that i yield back. Without objection we will play set in the record. And now i call on mr. Ruiz for five minutes of questions. Thank you. Doctor cohen, for being here and for taking on the incredibly Important Role as the cdc director. I serve as an Ranking Member of the select subcommittee on the coronavirus pandemic and i believe the value of looking back at the governments response to the pandemic is to be more prepared going forward. Doctor cohen what are the most important lessons to take away for it cdc in the Public Health system from the pandemic . And how are you playing those lessons . I know you talked a lot about it let me ask about in a different way. One thing that can make the biggest difference what would be on top of that list . Thank you representative its always hard to choose just one. Thats a hard amount of work and i certainly bring a lot of Lessons Learned from North Carolina. Maybe i will focus on Operational Excellence. I think its really important to pair the science and the evidence and the data with execution. Meeting the ability for us to deliver a response effort for a Vaccine Distribution that is effective. Making sure we have systems that work. Certainly we talked a lot about data but having systems that coordinate between federal, state, local and we have the infrastructure to make sure we are delivering for the American People. I see cdc moving in that direction. What i mean by that were not putting out recommendations related to vaccines where putting programs in place to allow people to get vaccinated. For example the bridge program. Stood up first time very incredible heavy lift to stand up the program so quickly but is offering free vaccines for the underinsured. That is the kind of work we need to pair with the good data to say the vaccines are safe and effective. We have to break down barriers of cost and access of the same time. Quick as you begin your tenure as cdc what should our priorities be in congress to ensure the readiness . Thank you for that. A partnership with congress is so important that we talk a lot about meeting the resources and authority to beat the National Security asset that we need. I will also say its really important that we align to share good information about tools folks can used to protect themselves. We know folks want to leave covid in the rearview mere but it is still here with us is important to have a shared voice saying use these tools are safe and effective it. I am certainly going around the country doing that. I would love to have more voices join that chorus. But again the communication is important but we need those resources and authorities that allow us to do your job well. Quick some of our republican colleagues have raised concern about cdc federal select Agent Program and it cdc inspection of a facility in california break can you explain the role of the federal select Agent Program and file safety . And, is there anything you like to clear from the cdc response to reports about the facility . Thank you representative. Having numbers and accuracies at d. A. Fdi, cdc was brought into your point around select agents. Are asked to join onsite to investigate code to be select agents on site. Our team was there for two and half days and extensive review. We took hundreds of pictures per looked at the invoices, freezers, and what was actually very notable was the absence of equipment that you would normally see if there were select agents. Whether it was protective equipment or safety hoods or what have you, none of that existed at the slab. After the extensive review our team note selective agents on that property. And then again turn the investigation back to the fbi and others that were in charge. Thank you. We face challenges and rural and underserved communities and gettinga Public Health informato them. What are some the most persistent obstacles to cdc faces and getting Public Health information to hardtoreach communities . What strategies does the cdc employ to overcome these obstacles . Its very important we are reaching every community no matter what the niche of the opportunity for health. I think our most important tool here is partnership and trusted partners. There are trusted partners we work closely with that already know by their community trusted by their community and again we are focused a lot on making sure our Health Providers have the information and tools they are trusted doctors and nurses and those are folks to make sure we are partnering with. Thank you. Thank you and now i call on myself for five minutes of questions. Thank you director for coming to testify. Thank you for meeting with me in my office the other day. If addition to this committee i also serve on the select subcommittee on the coronavirus pandemic. Its obviously Important Health and safety of americans. The confusing and inconsistent recommendations coming from the cdc from the covid pandemic have really damaged Americans Trust in the cdc. And we want to rebuild that. Vaccine and mask mandate implemented by the Biden Administration and states have caused longlasting and distrust in the trust us the government knows best what is for you mentality. I have been told that while you served as the secretary of the North Carolina department of health and Human Services you were a staunch proponent of Vaccine Mandates. Extending School Closures and business lockdowns enclosures. Is what i have been told accurate . And if so how do we know you will not support government mandate at the federal level . Thank you representative. I appreciate we are looking forward we want to turn the new chapter there are a lot of Lessons Learned from the pandemic we have been talking about them today. And you have to remember different moments in time we needed different solutions. The goodness as we are in a different place and we can look forward to make sure we are building the National Security asset. And so we want to use tools upper tax folks health. Vaccines are important tools to protect health. Ive been trying to take those Lessons Learned and apply them. Hopefully you will take those lessons of another pandemic breaks out while you are still the director. Because i oppose a government mandates. I myself took the vaccinations but i dont think it should be forced on people. Then with that in mind, do you think the government mandating Vaccine Mandates actually did the opposite effect and made people more hesitant to take them . I think vaccines are a critical tool to keeping folks healthy and safe its not just the Covid Vaccine its the flu comments all the vaccines but it kept children and people safe for many, many decades. I think theyre continued to be really important tools and i look forward to working with congress to make sure that we can get good information to folks so they can make the choices for themselves. I can tell you from personal experience talking to many constituents, the mandates actually have the opposite effect on people. Less people want to take vaccines. I think its a better approach to encourage people to take vaccines not to force upon them from the government. Because then people will distrust a print not all people but a lot of people. My other question is, do you believe that wearing cloth masks or the surgical mask im not talking about the 95 mask. The surgical mask prevented people from getting covid . Thank you for that question. We dont masks work. They do work. The surgical masks work to make sure you are protecting the individual from circulating viruses. So they do work and again at different points in time they are some of our only tools that we had before we had reliable test or treatment for vaccine. They are still a tool that we can use. But do not forget washing hands, ventilation, we learned a lot during the pandemic and we need to use those tools for. You please have the cloth masks that people had for the openings in the cloth is bigger than the molecules of the Covid Vaccine preventative from getting covid . What surgical masks are certainly better. And 95 goes even better than that. But cloth masks still provided some barrier you folks but thats not when cdc makes its recommendation or what kind to where we sit where a well fitting appropriate mask yes. I hope the government balances the benefits for instance in schoolchildren having all schoolchildren mandated to wear masks when perhaps those masks benefits did not outweigh the negatives of children not being able to see lips smoothing or expressions and that type of thing. Thank you, go ahead. That is where we relied on the American Academy of pediatrics related to safety and masks for kids they continue to say that is a tool to make sure folks are protected. Thank you. [inaudible] no i call on representative for five minutes of questioning. For five minutes of questioning. I am so happy to welcome you doctor cohen at your first hearing right now. And i want to wish you the best of luck. I want to also say i am so grateful you have hit the ground running. Youve been all around the country encouraging people to get vaccinated we were in my city of chicago i have focused on Older Americans i am concerned what is happening right now in Nursing Homes and assisted living places where we see according to your agency that in fact the numbers of seniors who are right now being vaccinated is quite low. And in fact there was a study that found only 20 of the people in Nursing Homes right now have gotten the vaccines they need. Before i turn to you i just want to say we also rely on staff. Cdc does require staff to understand more about being vaccinated and to pass that on. But we are concerned some of the staff are not encouraging people to get flu vaccines. Could you reply to that . First thank you representative. We need to share your focus on his seniors and making sure they are vaccinating. We continue to see in our data those over 65 at the highest risk of hospitalization and death from covid, flu, and rsv. It is important folks get access to these tools. I want you to know we have been very focused on engaging a longterm care community. To understand barriers we continue to have weekly calls to folks how can we help and overcome any challenges . And i have spent my time as i traveled around the country to visit some Nursing Homes and particular view that have high rates of vaccinations to understand one of the best practices that we can share around the country . I was it a nursing home outside the philadelphia area statesmen nursing home where they really use their love of the football eagles to help them with their vaccination efforts. They made it a little fun. Because we understand folks are a bit fatigued from vaccines. Thinking about creative ways to get folks vaccinated and i appreciate you bringing up the staff because it is important for the staff themselves to get vaccinated. So we need to be working to get not just our vulnerable seniors but also those who are working closely with them so we have been working closely to make sure were thinking about folks in the communities. Thank you so much for that. In the remaining time i wondered if you could tell us looking forward what your priorities might be . I am not just talking about the issues but perhaps also the management of the cdc . Thank you for that opportunity to talk about the future. I shared we really need to make sure we are identifying and responding to Health Threats. That we are making sure were giving evidence basic Common Sense Solutions to protect themselves. I want to spend a little time on how we create a system that brings Health Delivery and Public Health closure together silos were not our friend during the pandemic. And i am working hard to make sure we are bringing cdc and public closer to her Health Delivery system. I want to make sure i do not lose the opportunity to talk about the importance of the Public Health workforce. And needing people to be experts and do this work as we go forward. Making sure we are training the next generation of experts in Public Health but does require a house to continue to work with congress to make sure we have the right authority to bring in the talent that we needed. To make sure we can carry out our mission. Thank you so much, and i yield back. Thank you. And, doctor, just so you know, our rules say that mr. Peters has to go first. [laughter] so i call on representative peters for phi minutes. [inaudible] [laughter] thank you, dr. Cohen. We had a really great conversation the other day, and i was excited about, you know, i think i was frustrated with a lot of people about cdcs communication, and im very indulgent because i know that, gosh, we didnt know anything. We didnt have any tools. And i thought that throughout the whole process looking back it would have been useful to share more of the uncertainty along with people as we went along. I think they would have appreciated that, and i think you just made a mistake in this testimony in that i wanted a clear answer to a question do cloth masks work. And you gave me an answer as a lawyer, but i had a hard time understanding it. And i think its a fair question. And i guess i wish that you had just said dont use cloth masks, use the surgical masks. Dont we have enough information to answer a question like that . Well, so i want to make sure that we are saying that cloth maxes masks are a barrier, meaning that they do work but do surgical maxes work better . Absolutely. Would i wear a cloth mask in no, i wouldnt. Its still pretty complicated. My district is, i think, the tenth best educated Congressional District in the country. My neighbor would say should i wear a cloth mask, i dont know from your answer what i should tell them. What i would say is, you know, i dont know what to tell them. So like i said, im a little bit frustrated with the still a little bit up clear response from you about a unclear response from you about a simple question. But let me ask about a complicated thing, which is data. What would you tell my neighbor about the importance of having good data the at the federal level to help us inform how to prevent Something Like this from happening again or how would yo . Sure. But i want to be clear, wear a surgical mask. [laughter] so, but on the data side, it is really important to have a National Picture of whats going on. I think weve made a ton of progress in that way. I mentioned, actually, a new digitalization around waste water data. That is going to give us a really interesting look at some early signal ifs about whats happening in communities all across the country. And the reason we need a National Picture, e mentioned, you know, i led the Covid Response in North Carolina. Charlotte, one of our biggest cities, is on the border with South Carolina. It was really important for me as a Public Health official to understand what was happening in South Carolina, to understand what would happen in charlotte. Back that up a couple steps. Why is that important . I think i agree with you. Why dont you explain, why is it important to have information and what information did you need to have to make yeah. So having that information allows us to demoye [inaudible] oh, depends on what were talking about, whether it was how many people are advantage vaccinated in an area, how many tests are we seeing people get access to. If i could see certain neighborhoods that werent getting as much its thing or vaccination, i could deploy different kinds of teams. We also had information at the height of the pandemic where ventilator use was and, you know, that was an important point related to South Carolina because there are multiple times where North Carolina had to share some of our ventilators with South Carolina. So knowing where ventilators were and how we could be sharing resources is really critical. So ive been long wondering what we could do in congress to support better data at the national level. I know the administration has taken on the data modernization initiative, i think thats great. It needs to be funded. What is left to be done in that initiative, and what do you need from congress in addition to funding . Thank you for that. The funding is critical, and we want to make sure were moving forward. But in terms of authorities, we have really scoped out manager that the i think allows us to do even a pilot is a step forward here. So we have some concrete language, and im happy to have our team share with you that weve been working on particularly with some of our Senate Partners about how we can think about an authority that allows for collection of data beyond covid to make sure that were getting the information we need to respond quickly, to your point, to deploy different kinds of tools based on what we see in the data. Do you have legislative ideas for us absolutely. Okay. Id love for you to share that the with us. I think we all want to make this work better. I want to say again, look, we started this, we were really vulnerable as a country. We didnt have even ppe. We didnt have a lot of science is. I think one of the ironies of this whole discussion is one of the great, great achievements of the Trump Administration was the warp speed creating a vaccine really fast. They dont want the talk about it now because theyre sort of antivaccine, but i would like to know what positive lessons we can learn from that so we can make sure that were ready next time. And i hope youll be forthcoming about the funding needs you have which will be smaller at the front end than they are in the middle. We spent a lot of resources dealing with. This i think that was i think that was the right thing to do, but lets make sure we dont have to do that again. I yield back. Now i recognize dr. Buschon for five minutes of questions. Thank you. And thank you, director cohen, for being here today, and thanks for recently coming to the gop doctors caucus. I very much appreciate i. Your job isnt an easy one. You knew that coming here though, right . Yeah, youve taken on the challenge, and i have a great deal of respect for that. I want to quickly follow up on what mr. Peters said about data. The key is making clear to the American People this is deidentified, nonpersonspecific data. Thats the challenge i have in rural america. People just dont trust the the feds on this. And we have to make sure that we do that. And i agree that we need better data. As ive discussed with your predecessor, dr. Walensky, as a physician myself, political influence must be removed from the Decision Making at the cdc. And ive mentioned that to you at doc caucus. This has happened recently under both republican and democrat administrations. Were all aware of the substantial percentage of the public has lost trust in the cdc, and we can agree or disagree on how exactly that happened or what the implications may be, but i believe all of us looking forward can agree that something needs to change if the agency is going to be effective at combating the spread of Communicable Diseases as was its original mission. Let me remind everyone, the cdc was established in 1946 at the as the Communicable Disease center, the cdc. The cdc has been the preeminent organization in the world on these issues for decades and still is, in my view, even with the challenges created by what i consider overbearing political influence. With that statement, i want to talk about specific communication and and how we communicate and convince the American People that were make progress here. On a communications side, do you have specific actions youve taken or do you plan to take to get to the American People what the cdc is doing and why . Thank you, dr. Buschon, for that. And, yes, i hope you are already seeing the cdc commune if candidate differently. First, weve overhauled our web site where people do come, and theres more to come with that as we continue to consolidate the information so its more usable, people can access it more quickly. But were also communicating in different mechanisms. So, for example, when there was a new variant that we saw in august, we needly saw something out to say heres what were seeing, heres what we know and heres what we dont know. I think that was brought up earlier. Were trying to rapidly communicate, and were trying to use different mechanisms to communicate. So were trying to make sure that the we are meeting folks where theyre getting their information. Theyre not coming to our web site necessarily for information. We have to go to where folks are whether thats using social media or others. Youre seeing me post a lot more videos, so we would recognize that some folks want to watch a short video to understand a complex topic. So i think theres a lot of ways in which were changing how were communicating. But were still going to make sure we are focused on bringing the best evidence and data to that but make sure that its simple and timely as well as work on the works on the ground for real people. Because you know as political people ourselves, communications is key. And that has changed dramatically over the last 101 years, right . And 10 years. And if were behind at an agency, you just dont reach most of the people. You have to be on social media, you have to do, to your point, go to where i have adult children. None of them watch the regular news, none of them they get alerts on their phone whether thats on snapchat, instagram, x, all of these, and im hopeful that we can do that. Who do you seek guidance on to help you do this . I mean, whos helping . Is it, you know, i mean, i would argue that maybe it should be madison avenue. [laughter] well, first, you can already follow me on insta a, but we have brought in additional folks to make sure that were modernizing how were thinking about communication, is so i think we still have work to do, but, yes do you have an internal, does the cdc have a Robust Internal Communications and Public Relations department specifically to address this . Yes, sir. We have a communications department. We have its under new leadership. I think theyre doing good work. But were not all the way there. We have more work to do. Okay, i appreciate that. And youre aware of the report on modern oh, e yes. This report . Yes, sir. Yeah. Theres a lot of good things in there. It was a bipartisan commission. I know that dr. Walensky and i talked about that. We actually had a meeting here in town, dr. Walensky was there. Theres a lot of good ideas in there, bipartisan. Of id just encourage you to use this as a resource along with your internal moving forward program. Thank you. Thank you. Now i recognize representative dingell for five minutes of questioning. Thank you, madam chair. Its food to see you here good to see you here, and thank you or for coming in and testifying on this porn topic. Important topic. As you know, the coronavirus pandemic did upend our nation. It strained our health care system, stunted our economy, disrupt ared children s learning, and no community was left untouched. It was the worst Public Health crisis weve experienced in a century, and youve come into the cdc at a time of turmoil, unrest, etc. Even as we continue emerging from the pandemic, covid 19 is still with us. I say to everybody, we may be done with covid19, but its not done with us. And we continue to see infections. It if fundamentally changed our nation, and were still dealing with many of the consequences. Today one of the problems we still have as we continue to witness significant distrust of our Public Health institutions like the cdc, unfortunately. So, and one of the questions i keep asking myself, how can we expect americans to make the best decisions to protect themselves and their loved ones if they dont have confidence in our leading Public Health institutions. So i was going to ask some of the questions my colleagues just did. On some of the communication issues. I know youre making this a priority, and im going to reinforce and maybe do a few more for the record, that that becomes really, really important. One of the things that im very concerned about, were hearing an uptick in respiratory cases. People arent getting any of their theres a distrust of all shots, of all not only the covid19 is vaccine, but the flu and the rsv. Why is it so important for people to get the latest covid19 vaccine and these other immunizations as well . Well, thank you, representative dingell. Ive been traveling around the country sharing with folks about why to get the updated Covid Vaccine. I really, its really three reasons. One with, the virus has changed. So so in the same way that the flu virus changes year over year, weve seen the covid virus change. You want to make sure that the protection you have is matched to the way the virus has changed. Second, whether youve had covid before or youve been vaccinated before, that protection decreases over time. And you want to make sure you are boosted up to the highest level of protection you can going into a time when we know we will see more covid circulating. And third, reducing the risk of long covid. We are still seeing 1 in 7 adults have extended symptoms even from a mild case of covid. No one wants to be sick for a short time, certainly not for a long time. And so for those reasons, we are encouraging folks to get the updated vaccine. It is why, you know, when we look at the data, there is not an age group that doesnt have some increased risk from the covid, from the cosid virus. Certainly our senior ises are at the highest risk. So those who are over 65 are to the at the highest risk of hospitalization and death. But our vaccines can prevent them. And i me weve been focused a lot on vaccines, but i just want to mention treatment again. We do have treatment for if covid and for flu, but you have to know you have it, which means you need to get tested. We are offering free covid tests at covid test. Gov. We want folks to make sure theyre ordering those tests so they can the get treatment. Let me ask you a quick question. Theres a lot of misinformation this up this, and a lot of people are still afraid to get all of these different immunizations, getting back to the communication issue. How are you combating misinformation . Yeah. So in order to combat misinformation, one, you just have to get a lot of the good information out there, and that means we have to partner with folks who are trusted. So whether thats doctors and nurses, and thats what weve been focusing a lot of our efforts to make sure our doctors and nurses and other Health Care Professionals have what they need, but also whether its the Faith Community or others to help get good information out. And i include congress in that as well to help us get good information out the communities to communities the make sure they hear the good information. The Accurate Information. Is so they can make choices for themselves. So im almost out of time. Im going to some questions for the record, but since we have less than a minute, or is there the anything else you want to add about the work youre doing . Just that i think the cdc is on the right past, but we have more work to do. And i recognize that. We do need help from congress to make sure that we are well resourced and have the authorities related to data and work force. We talked earlier about the importance of making sure that we have a vaccines for Adults Program as well. We have a vaccine for Childrens Program but do not have something similar for under or up insured adults. So all those things i look forward to working with congress on. Thank you. I yield back, madam chair. Thank you. Well, director, youre so popular that more people have showed up to ask you questions. So now i recognize representative palmer for five minutes of questioning. Thank the gentlelady. Director cohen, can you name three things that you would do duringly from the former director of director r finish differently from the former director . As i was sharing earlier, i led the Covid Response for North Carolina, and i think the lessons that the i bring from them are three of them. One, focus on transparency. I think transparencys really important to build trust. I think sharing what you know when you know it and also what you dont know. I hope you see that already under my tenure in how were communicating differently. So that is one. Second is a focus on Operational Excellence. We cant just recommend a vaccine, we have to make sure that were making access possible for folks. We need to marry the evidence with the operations. We are an operation ponce agency as well. So thats number two. And then the third is about relationships. Its really important that we are working as one team. We have to build relationships before a crisis hits so that when we get into those crisis, we can make sure to use those. Sometimes Public Health finds themselves siloed away from the Traditional Health care system. I think its really important that we Bring Health Care and Public Health closer together. Well, if the cdc had a sales department, that would all be fine. Im talking more about actual policy and specifically would you have shut down the schools, would you have closed the cools schools. Is that why you did in North Carolina . Well, sir, yes. Back in 2020 all the schools across the entire country were shut down including North Carolina. But i did work across the aisle would you shut them down had you been in charge, would you have shut down the schools if this were to happen again, if we had another major respiratory outbreak, would you shut down the schools . The good news is were in a different place than we were before. We have different tools and different mechanisms to respond, so i cant really address the hypothetical, but i to think weve learned a lot about how t did it harm our students by shutting town the schools . We always knew inperson instruction was incredibly beneficial youd be great in a sales d. Im trying to get to policy, and thats one of the key things that troubles us about the cdc. We have to address policy. You know . [laughter] theres a thing that if youre with explaining, you losing. So youre losing. So we need to get down to policy. We need to talk about the things that went wrong and what we need to do. Masking, you know . You keep the cdc insisted on masking kids as young as 2 years old and made the argument that there was no disagreement. I think the word is is equi poise. I have a study here that clearly shows there was widespread disagreement in europe, each here. Even here. Yet the cdc insisted on masking kids as young as 2 years old. What would be your position on that . Well, i would say its good that were in a different place and and were able to turn a chapter forward. We have a lot of different tools to protect to our children now, vaccines and treatment. Masks continue to be one tool amongst many that we can use to protect so you would continue to require masking for 2yearold kids . So again, we are in a very different place i know that. But im asking you, this is a policy question. There have been no randomized controlled trials on masking, and i cant help but think the cdc didnt want the randomized controlled trials because with it didnt put the narrative, didnt fit the position hay wanted to take. And they wanted to take. And theres a lot of people, i mean, a lot of people that felt like this was more ab power than it was medicine. And if youre going to continue to try to do a sales job, you want to continue to try to explain positions, its going to be the difficult. To get us onboard with the cdc. Because people dont trust you anymore. And theres been enormous damage done to science and medicine by the policies of the cdc and the National Institutes for health and others, dr. Fauci being the lead candidate for disinformation. So you can continue to come in and do a sales job, you can try to explain, but if there arent significant policy changes, i think its going to be very difficult going forward. I yield back. Thank you. And now i call on representative crenshaw for five minutes of questioning. Thank you, madam chairwoman. Thank you, dr. Cohen, for being here. I echo what my friend, mr. Palmer, said. If the cdc. Wants its credibility back, youve got to have a mea culpa moment youre in the perfect position to do it because you had nothing to do with their decisions at the time, so theres no reason to defend it. The data is the data. The data is very clear now. You can blame it on hindsight, you can blame it on, you know, we didnt know as much as we know now at the time. You can do all sorts of things, but you can tell the truth, and the public will start trusting the cdc again. Okay to say it didnt make sense to shut down the schools. Didnt make any sense to do major lockdowns. The data shows that now. Doesnt make sense to mask kids. Data says that now. Its okay say it. And the public will reward for you for it. Because its pretty dangerous thinking about the future when maybe even if we do have a disease that has a 50 president kill raid rate of 8yearolds rate of 8yearolds, but you know what in theyre not going to trust you because you refused to even say that you were wrong. And you werent even wrong, so you might as a well say others were wrong. Thats just some advice, unsolicited. You know, i have major questions with. I can read a long list of agencies that kind of seem to do the same thing. Barta, as possessor aspers, cdc, theres like a defense bio something, nih, theres a lot of overlap here. What is the difference between them and cdc . Thank you, representative crenshaw. Cdc does provide the Scientific Evidence and Technical Expertise particularly related to infebruary white house disease and other Health Threats. Aspers provides Emergency Response i would say to any kind of threat, a hurricane to an Infectious Disease threat. So they can bring in, bring in resources whether its people or stockpile resources, but its really cdc and that Technical Expertise that decides where do you deploy it, how, for what purpose. So its a partnership. You cant have one without the oh, and we do work very, very closely together to make sure that were coordinated. Seems like a lot of overlap and, you know, theres a ton of Academic Research that happens at cdc. And i think we have real questions. The cdcs never been authorized. Thats another fun fact. That Academic Research also happens at nih. Its very duplicative. How do we justify that . So i do think that they are separate types of portfolios, nih is doing evidence generation, the kind of work that cdcs doing is detection. Are we detecting threats and then responding to them understand anding what best practices work and understanding what best practices work. So that is the work that we are focused on in cdc and in Public Health. Again, nih, incredibly Important Research portfolio and i appreciate your intent to create a moreers toal cdc. A more operational cdc. Its not there right now. We have really no biodetection system. I know you want more of it. I know we talked about waste water in our previous conversations, and thats all good. I like that a lot, but with i do have more questions. I know mr. Griffith asked about this, but there was a hidden bio lab out in california. Local officials discovered a Chinese National was running ap illegal lab with 1,000 mice modifieded to be similar to humans, infected with nasty stuff like dengue, covid, tuberculosis. Wont get into a ton of details here. Think the main problem here is why did it take so long to actually respond to that lab and for the cdc to go test it . The American Public believes in their minds, like, this is exactly what the cdc is for. Locals cant deal with it, the state the human, the health and Human Services of california is asking cdc to do it. What was the timeline from that ask to actual response . Well, thank you so much. I was able to share some information earlier that there were a number of inaccuracies in the report that was put together from this. Again, state and local authorities are, as you were saying, are in charge as well as fbi, fda. Cdcs role was to come in and do an investigation related to select agents when we were invited and asked to do that, we did respond. We sent a team. They were there for two and a half days, did an extensive review. What we found was no evidence of select agents. And really what was compelling as i reviewed that information was it wasnt they didnt have any equipment that would is allowed folks to work with select agents. So not only did we see the freezers how long did it take from the request for the cdc to actually come . Because i thought it took a congressperson from california the get cdc doctor. My understanding is when we were asked, we deployed. O. K. Select agents, very specific. Im under the understanding if a vial of something is not labeled, that you dont test it. So we do have limited authority in some of this space. But what we did was go on premises, again, do a twoandahalf day investigation. We did not see any evidence of select agents at this lab. And worded very carefully and im out of time, but you need to tell us what law law that is. So if it says gatorade on it and youre, like, could be ebola, could be gatorade. It says gatorade, dont test it. The law says dont test it. I have a hard time believing the law says that. So im out of time, but if the chairwoman will let me keep going, im happy to. And i wish i could, but that would not be appropriate. [inaudible conversations] [laughter] the gentleman wants to, you know, bring up issues of the old false flag in naval combat just because it flew an American Flag didnt necessarily mean it was an american ship, and i understand that. Now recognize the gentleman in florida, mr. Dunn, for five minutes of questioning. Thank you very much, mr. Chairman. Dr. Cohen, i appreciate you being here today. In addition to being a member of the energy and Commerce Committee, i certain on serve on the select committee with china, and i have experience with [inaudible] im sure youre familiar with, the armys biological headquarters, a bs4 committee. The sect the select Committee Published a report, you said on the illegal buy bio lab that was located in the center of a maul town just across the street from an Elementary School and a block down from the city hall. The clandestine, theyre calling it a bio lab, its more like a warehouse, it was a disaster waiting to happen. Cdcs response, or rather, the lack of response, clearly enendangered millions of americans. There were a couple of things that really stood out to me. The first is that the cdcs select Agent Program completely failed the people of wheatley, california. The cdc literally refused. They did not respond when they were requested. They responded months later. And only when a congressman, costa, made that request. The come to the town and assess the situation. The discovery, i remind you, was made by a housing code inspector who was tracing a garden hose that went in a window. Thats how this was found. It took a phone call from costa to get there finally. Once the cdc arrived months after the first request, the investigation you conducted was completely unprofessional and inadequate. Completely unlicensed warehouse. Note licensing whatever paid 20 potential pathogens, humanized there was zero isolation facilities that will be necessary to legally or safely handle these agents. And perhaps most egregious and simpleminded the agency did not even bother to translate the chinese labels there are some vials of that did not even ask for a translation on this. Amazing. One local official started to dispose of these materials they asked cdc what to do with the ebola, again a federal select agent for the cdc branch chief i have the ima like to submit for the record. Without objection. Thank you. Cdc branch responded in sync we do not see an urgent need to test these samples at the moment. Most of the material we identified is not considered a serious threat to Public Health. Hiv, sarscov2, hepatitis, malaria and a bullet not considered a serious threat to Public Health. The conclusion made by the experts at cdc that a refrigerator ebola you look at the totality of the situation it reads like a nightmare or a horror story. What world is this okay . I refer to my colleagues remarks on trusted. How do you expect the American People to take a Public Health institution seriously when this is the reaction to a very real situation . The cdc should not ignore police and local Public Health. By the way that sample the stuff too. Too. The cdc should test substances requested by local government shirley that meets a threshold test. I would like you to explain ill give you a chance to answer some questions and that minimal time. Is the cdc supposed to be the first line of defense for human infection agents in the United States . Thank you for the opportunity to respond theres a number of inaccuracies in that report. I want to make sure you know that when we were asked and invited by the leader said that investigation, state and local officials we did deploy we did look at were there for two and half the investigation. We did not see any evidence of select agents. Not only did we look at the paperwork, the vials, the freezers. Is because of running out of time let me reclaim. They responded but they did not respond when their first requested. They responded months later. We had that examined by the fbi pretty came to our committee and told us that pray that is who we got the information from. If you have more information from the fbi would need to know for. Will be happy to share more about the timeline. When we deployed note select agents on site there. You know you did not test for anything for. Right this is where our experts of the two halfday review. I want to address we were talking about related to a bowl. We heard after the fact someone said something was labeled a bullet we took 300 pictures we did not see one. Is on the front of a refrigerator. We ask folks to stage of a picture of that . Can you validate that for someone else . Know we can validate that for us. We blow off the california Public Health department and say we dont believe . Obviously my time has expired mr. Chairman. I have to tell you in my professional career in biological warfare i have never seen anything like this. By the way the worst concern i have is this may not be the only one. This is what. Lets martial law the housing code in the country but turned them loose to find these things. I appreciate the battlements patients adjustments time is up. I recognize florida for tim its of questioning. Thank you, mr. Chairman. I appreciate you posting this today its so important thank you or appearing before the committee. Without a doubt Public Confidence in the cdc is tremendously damaged by the actions of multiple directives, directors and choices made within cdc leadership rate for example at one point in time cdc director said masks could offer more protection the vaccines. And of course would have Scientific Evidence that proves masks to very little to prevent transmission of covid19. Certainly we can dive into vaccine efficacy issues to justify lockdowns its clear the cdc has a very long road ahead to reestablish credibility regain the trust of the American People. I am hopeful your answers today will determine if you are in fact serious about taking on that challenge. Mr. Chairman for the record but asking i was content to submit the grammatical errors by the u. S. Disease control prevention during covid 19 pandemic. Accidental is requested document to be recorded into the record . Yes sir progress is there any objection to a document . I believe thats the one presented to 20 or 30 minutes ago but herrick no objection. Cypress shade thank you. Your predecessor the Scientific Advisory committee of recommendations. At times but she refused to convene the external Advisor Group at all. One of the most glaring examples of this was when the cdc director pushed for a third vaccine shot a booster for healthcare workers this recommendation was rejected by cdc Advisory Group and in response she overruled the Advisory Council move forward with their own recommendation for a third shot. My question to you is this, have you convened the external Advisory Committee since assuming this role . X yes, maam for. Perfect. But that being said, theres been two or 50 million on top of a. 75 billion spent in covid promotion marketing et cetera. From the cdc for this. Sometimes those external Advisory Council give recommendation that are contrary to the political agenda. Have you adopted external committees recommendations . Or have you got against those recommendations . Thank you so much. Under my tenure i believe you are referring to our external ac ip committee but yes, they have met a number of times we have new vaccines for the first time in history they had to meet for that. They had that meat for the updated Covid Vaccine, the rsv vaccine have all made recommendations for the vaccines we have adopted. Certainly there been troubling things coming out in recent years particular the height of the pandemic were members of the Advisory Committee were fired for presenting an opinion that was contrary to the political agenda of the white house. In a situation where one of your advisor members presents a divergent opinion, are you taking that into consideration . Or are you simply firing these people . I am not familiar with the situation where folks were fired. The way it works as a certain tenure and they surf without tenure. They do it roll off and we do choose additional members. We appreciate these independent Advisory Committees advise at cdc on this work. They are an important component of how we are reviewing vaccines in a recommendation. Is actually referencing doctor martin was let go this was very recent at the height of the pandemic. This should be a formal review of how it all transpired. That has a direct impact on the guidance of that then becomes issued in the public from cdc at this time it like you to take a look at the screen for me. As a screenshot. We have here a sampling of dozens of errors within the data the cdc was using to justify their positions during the pandemic. These errors excessively exaggerated covid address two children for example. One of the most damning errors in cdc repeated for over a month covid was a topfive cause of death for children. It took months for the cdc to correct this statistical error. Now it during the course of those months of millions of taxpayer dollars were spent to promote the vaccine for children just because a basic data point was incorrect. Now, how do you plan to rectify this question are quite frank with the cdc cannot do basic data points correct the credibility will never be restored within the institution. And also children there is no scientific justification for them receiving the vaccine could and we have document in cases where they have vaccine injuries as a result of that being pushed on them and their parents feeling pressure from the cdc. Can you speak to these errors and how you plan to address these basic errors that have been documented over the past three years . Congressman i appreciate this is the first time i am seeing so let me review and we can followup it what i could say 1700 kids of diet of covid. But let me tell you what i have done for my own daughters who are at nine and 11 i got them the original Covid Vaccine and a few weeks ago they got the updated Covid Vaccine because i have looked at the data and these are vaccines that safety profile is there in terms of a safety end and they are very effective at making sure our kids are protected. I do not want them to either get into the hospital nor do i want them to get long coveted. I got my own kids vaccinated. I am happy to look at this data but i want to at least share how i made a decision as a mom for my own kids regrets in my time is expired. But i would love to have in writing from you a detail of the threat that covid presents to children and young adults under the age of 18. You probably have it off your head if you could provide us that number very quickly to get ventures later appreciate the generally signed us up and ms. Miller meeks of iowa. For the opportunity to waive onto this important. Thank you for testifying today before the subcommittee but as you know i am a physician i was the director of the Iowa Department of Public Health before coming to congress. I not only served in this domain but i value it and believe a robust Public Health infrastructure at nationwide is crucial to the health and wellbeing of our country. That is why i release eight request for information earlier this year end how to strengthen her from the cdc to ensure our nations Public Health agency is performing as it should. Part of evaluating cdc in agencies in general is realizing when the state mistakes are made, one program should be eliminated or altered and when people need to be held accountable. During the pandemic and place of clear reasonable guidance backed by the best Scientific Evidence available at the time, americans are faced with confusing inconsistencies at best and clear bias at worst. Whether this bias entered democratic was politically motivated or not, it took Public Health backwards. Politics aside there is a near collective failed to execute its primary mission of protecting america from health, safety and security threats by conducting Critical Science in providing Health Information that protects our nation against expensive and dangerous Health Threats and responding when these arise. This includes numerous core operational failures as you mentioned. As well as total lapses and reliable communication. The cdc sprawling bureaucracy of silos and uncoordinated Administrative Research and academic programs, with disease condition or issue specific programs was also put on full display. Cdc was originally created in 1946 as a Communicable Disease center but with the Mission Apartment preventing the spread of malaria has since grown into it with 9 billiondollar budget that supports research and initiatives which are not within the Communicable Disease landscape additionally the inability to translate Research Researcher real world published data and evidence rapidly into Public Health recommendation during a pandemic was detrimental. As a result trust and Public Health and faith in our Public Health agencies and leaders has been decimated. I do not say this lightly or any satisfaction. Public mistrust of the cdc and Healthcare Professionals is not good. It presents a multitude of challenges for the health and wellbeing of our nation. Unfortunately however cdc has given people many reasons to not trust its recommendation and given some of the answers you have had just in this hearing specifically response to representative palmer it gives me pause this failure to acknowledge certain things for covid19s failure to communicate where the agency was getting information that was used to make decisions regarding masking, social distancing, School Closure guidance, went to get a booster, how to get a booster even the eight types of adverse events and adverse outcomes and denial of adverse events and outcomes i think to be clear i gave vaccines in all 24 counties in my district. But when the cdc insert itself between the patient and the doctor people rightfully became wary of the recommendations which we are seeing in this current respiratory illness sees in and out. Doctor you did not lead to the cdc during the pandemic but you did lead in North Carolina you are a supporter of Health Measures such as School Closures which proved to be detrimental not only to the students academic success but also to their Mental Health and social development. Do you acknowledge cdc has given americans good reason to question the agencys recommendations and can you please highlight how the agency is working to rebuild public trust and why we should review these efforts as genuine . Think it representative at miller meeks i do look for to this new chapter. I want to partner with you as we do that. There are a lot of Lessons Learned from the pandemic nothing is perfect in a crisis i learned a lot of those in North Carolina i was assuring earlier around transparency, operational effectiveness around partnerships. Those are all things i bring to the work at cdc. I think we do need to make sure we are learning those lessons there are mistakes related to our lab tests when it first came out we had to put processes in place to make sure that would never happen again we are communicating differently we are operating differently. But theres still more work to do here it is going to take a partnership of congress and others to make sure we are all moving in the same direction and offolks can feel confident vaccines and the treatments that can save their lives are look for to work with you on that. Thank you very much im just going to end with regardless of how transparent you may be or Operational Excellence we continue to put recommendations that dont show to the public the risk and the benefit in a transparent manner and we will continue to have a lack of trust in cdc per local Public Health nurses and doctors did not deny immunity as a cdc and Public Health professionals who testified before congress did. And it was embarrassing with that i yield potential it yields back recognize a gentleman from georgia, mr. Carter first five minutes of questions regrets thank you, mr. Chairman for allowing me too waive onto this committee and to this important hearing. Doctor cohen thank you for being here. It seems there has been a shift in the cdc for broader societal issues like Climate Change and social detriments of health and i am very concerned about that. You heard today the trust in cdc not only from congress but the general public and you know this. You have not been living in a shell but you understand the public trust is lacking right now. We want to help we are not here to pile on we are not here to beat you up. Im concerned your bite have more than you can chew has Short Mission changed all the sudden now you are going to bite off more than you can chew and talk about these issues . The mission beyond, has it expanded beyond Communicable Disease, outbreak control into areas such as nonCommunicable Diseases, injury prevention, Climate Change, social detriments of health . Well, thank you congressman and thank you obviously cdc being located in georgia. We appreciate your support of cdc in our work. We have a number of Health Threats that are at our doorstep. Many are Infectious Disease many are not. I look at too many suicides. Too many overdoses. I would call us Mental Health issues so i beg to differ on that. That is not what i am talking about. Im sorry then happy have you clarify. Which agency and the federal government do you think is more qualified or more prepared field of Climate Change the epd or the epa . The Environmental Protection or the cdc . Specifically related to health and heats. There are many Health Impacts of heat that we are understanding more and more. What cdc is great at is bringing data and evidence and best practices whether its suicide, how things heat or a wildfires are affecting peoples health. We need to have that data and evidence are Health Delivery system and others know how to react for quick student the cdc has too many emissions youre looking for more . We do need to make sure. The help of the committee and hope of congress your focus on what you need to be doing and you do it well. I mean obviously if we have another pandemic we do not want to see the same mistakes that we saw during this last one. Well, representative carter we agree on that prayer we need to learn the lesson from the pandemic i agree and focus and prioritization. We need to make sure we have a riskbased prioritization of what we are doing. Theres so many Health Threats out. We cannot tackle them all. As are infectious and noninfectious in those Health Threats. Week two down people in our country dying sooner or seeing early deaths. Im not trying to belabor this. What about deforestation . Thats affecting the environment how many forresters have you got it cdc . Rex i do not of the answer to that. You think you have any question. I dont know i dont think so for. I hope you dont. I hope you understand my points. We want you to focus pretty want you to get it right. We want to make sure youre fulfilling a mission and not expand beyond your mission. We obviously want you to do well. We want you to succeed. But at the same time youre not able to do that if you brought into these other things that are getting so much criticism. I appreciate one thing to Work Together on that Important Mission and again some things we been talking about to make sure we have the infrastructure needed workforce response, art lab capacity we are all talk about the same things. I do want to make sure we have the ability to address some of the Health Issues upstream. Articulate your clinical background. We spent a lot of time in different committees talk about the expense of chronic disease and how much money we spend it medicare and others on diseases we know can be prevented. We need to do the research and know the best practices so we can be preventing these diseases like diabetes. One last question before i let you go. Next to getting to move to the state of georgia were the cdcs with the greatest thing that happened your life . [laughter] thank you. I am grateful to be in the state of georgia. That will always have my heart it is been great to be at the cdc said thank you. Thank you neil back. A gentleman yields back we are hopeful mr. Armstrong is in another committee he wanted to ask questions you may have to do this questions for the record. But in the meantime want to make a few comments on make a closing comment. I have a few unanimous consent request one was to submit an article about malaria and forward it reminded my colleague mr. Carter rescinds a very important for the cdc to be focus on the change of climate is hotter in florida we have a longer wet seasons during the summer where it breeds and mosquitoes thats important to combat malaria, dengue, is eco. That is one article for the record. The other is the recent Los Angeles Times story that has the unfortunate statistic that more people died in the state of florida out of the most populous states in the country. We talk a lot today about misinformation. A lot of the deaths in florida it came after the vaccine was available. It is attributed to misinformation from our governor and Surgeon General that downplays the effect of the vaccine thats another for the record. And to others, one is a center for American Progress on the House Appropriations Committee Report should. Today i have heard a lot of concern about learning loss in children were its a concern for everyone. The concern that comes from a republican colleagues on this when they have proposed an appropriations bill that decimates investments in public education. They need good teachers and strong schools you would never pass these appropriation bills yes that is what i found the ofe table. Thank you. And thank you for your parents here today progress for the record that bill did not pass out of the house of representatives. I do not see mr. Armstrong that i will say couple closing things in regard to the vaccine hesitancy. It created a lot of mistrust from the current President Biden during the campaign of 2020. Dispersions on the vaccine before he became president and advocate. Also i would say if cdc is going to weigh in on climate lets make sure you take a look at all aspects and hopefully can put guardrails on because you are right. Heat and cold can be a serious problem and representing a district in takehome pay is 409th out of born and 351 of my big concerns is we make the cost of electricity. We make the cost of heating your home and cooling your home much higher with some of the policies of the administration. We are affecting health for the poorest of americans who cannot afford to heat their homes properly and as you know sometimes what they will do is bring inappropriate kerosene heater or some other heat source that is not suitable for their particular living structure we end up with a death from a health fire or Carbon Monoxide poisoning visit them to have to take into consideration. I see no it else here to ask questions im sorry mr. Armstrong is unavailable he has another committee he stuck on the chair, i get it. Sink there are no for their members wishing to ask questions i would like to thank our witnesses again for being here. Thank you. We have a document list that lists and your documents along with a couple others. Without objection theyll be the order pursuant to Committee Rules 10 Business Days to submit additional questions that witness respond to those questions within 10 Business Days upon receipt of the request. Without objection the committee is adjourned. Thank you. [background noises] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]