Transcripts For CSPAN Public Health Preparedness Response 2

To recognize the chairman of the committee for a statement. Thank you senator burr and casey and members of the committee. Fornt to thank senator burr chairing the hearing today, senator casey for serving as Ranking Member and senator at senator murrays request. Leaders oneen real this subject. Sen. Burr the original author of the first passage of the pandemic and all hazards preparedness act. I will call the all hazards preparedness act. In 2006. The law helps protect us from the full range of Public Health threats from natural disasters to bioterror attacks. Burr and caseyrs led the bipartisan authorization of the pandemic and all hazards act. Any members contributed at the time. Some of whom are still on the committee including bennett and isaacson, warring, hatch and others. Now the bill is to reauthorize for a second time. Todays hearing is the second we have had this year. Last week we heard from the administration on recommendations of advancing the reauthorization of the act including from the assistant secretary for preparedness and response, the food and drug administrator and the centers for Disease Control administration. In the middle of flu season, it is critical we reauthorize the act before many provisions expire in september. I hope we will do this in a bipartisan way and i expect this tradition with the law and the committee on this on almost all of our major bills. People are not as aware of the , iastation of the flu believe the figures are between 12000 and 50,000 americans die of flu every year. Dr. Collins has talked to us expediting of the universal flu vaccine which he sees soon. Tennessee has seen heartbreaking stories as the flu spread across the state and the country. Our state already in this season, a pregnant woman and three children have died of the flu. The act provides a Public Health preparedness framework that enables us to be prepared and able to respond to Public Health threats. By ensuring we have enough medicines to protect americans and to ensure our hospitals and state and local Health Departments are prepared to respond. Thanks to all our witnesses for coming here today, especially dr. Dries in her dr. Dreis ner. Sen. Burr we are holding a hearing entitled facing 21st century threats. Medical and Public Health profession fairness and response. Tomuld hear from dr. Nglesby. E i brent macgregor, Senior Vice President firm occurs commercial operations and cochair of the alliance for bio kruge,y and dr. Stephen head of Pediatric Medicine in chicago. Senator casey and i will have an Opening Statement and we will hear from the witnesses and then members will have up to five minutes for questions. I am pleased to chair the second hearing to inform our work on this. I would like to thank the chairman for us to bring senator casey and i to lead the discussion. We would hear from individuals were firsthand knowledge of the challenges we face combating Public Health threats and their ideas on how to move forward. ,ince the last reauthorization the framework has been tested by the emergence of pandemic flu, multiple natural disasters, and ebola breakout and a zika virus. The Lessons Learned in these events come from individuals like those sitting before us today in their efforts to protect and save lives. The last Hurricane Season resulted in three major storms devastating many communities raising new questions about our ability to manage and withstand of response. Ods the emergence of zika emphasized the need for improved Data Collection and surveillance to inform and protect as many mothers and babies as possible. Further, the ebola breakout in 2014 highlighted the need for a that brings the knowledge of the potential damage brought by these threats and a deep understanding of the efforts undertaken for research, development and procurement of medical countermeasures. I look forward to learning more about the opportunities and barriers each of you see to better leverage Innovative Technologies to solve these problems. Whether it is the challenge and developments of vaccines, the information crucial to a Public Health department in the midst of a crisis, the infrastructure a doctor needs to rapidly care for patients or improvements in the way policies complement one another. Your experiences reminds us we cannot let up on these efforts or lose sight of the urgency this mission demands. Get distracted by making changes to the laws that are outside of our focus of papa. Cting improving our programs to make the more effective in the future. I look forward to the insight each witness can provide and now i will turn to senator casey for any remarks he would like to make. Senator casey i would like to thank senator burr for his work on these issues. I would like to thank senator alexander chairman alexander and Ranking Member murray. Also i want to thank our witnesses for bringing their experiences to these issues and for joining us today. This is our second hearing on this topic. The focus of course is our nations preparedness to destinations preparedness to take on threats as we look reauthorize the act later this year. Now more than ever we must build our nations resiliency to help security threats, the threats that face our nation today are increasing in both frequency and intensity. It is critical to foster and advance innovation, drugs, devices. Ann we are considering emerging Infectious Disease or a bio weapon that has yet to be seen by man, or the response to a National Natural disaster, we do not and will not have a vaccine or countermeasure to protect us from these scenarios. In addition to supporting biomedical innovations, we must strengthen our hospitals and our Public Health professionals, our front line of defense against these Health Threats. We must ensure that we give our communities the necessary tools, they need to be ready when, not if, the next emergency strikes. By all accounts we have come a long way. I spoke at the last hearing about the success of the andital fairness program the Public Health Emergency Preparedness program. In the context of a Train Derailment in pennsylvania, one of many examples we could site. Grants or these programs also facilitate it helpsess activity, hospitals and Public Health systems with more regular occurrences. When subzero temperatures cause bursting pipes at st. Vincent ,ospital in erie, pennsylvania the hospital contacted the local Emergency Management agency and also the Regional Health care poalition created through hp funding who assisted in the response in that circumstance. The funding for these Preparedness Programs has withd from appropriations falling behind, authorized levels spiking only in response to ebola and zika. The impact of funding reductions means a decrease in the amount of time hospitals and megan medical staff have a have to plan and train for an emergency. The loss of thousands of Public Health jobs, the reduction in Emergency Managers and Public Health lab technicians. It is very dangerous to wait for a threat to emerge before passing emergency funding bills. We must be proactive, not reactive. How can we improve our Health Care System preparedness and our Public Health capacity and thereby improve our Situational Awareness in emergencies in an emergency . Can we work towards a per visit precision Public Health using better data and more efficiently guide responses to help emergencies to benefit our communities . I think we can. It was reported by publication nature when domestic transition of zika virus was confirmed in the United States, the entire country was not declared at risk. Surveillanceise defined two at risk areas of miamidade county. Neighborhoods measuring less than 2. 5 square miles. This allowed for targeting of resources to these regions. Building on that experience, we can expand surveillance through expensive valence, limited cause of disease and expand prevention. All last after last weeks hearing, we heard from assistant secretary catholic about the use of the empower program to identify and treat at risk individuals requiring electricity dependent assistant quitman. Identified a weakness. This only pulls in medicare data, not medicaid and not data. How do we ensure that we are acting on the data appropriately to protect these vulnerable individuals . The tragic death of 12 seniors at a nursing home during Hurricane Irma in september highlights this that more needs to be done to protect the most vulnerable citizens. Haveof our citizens additional characteristics that make them more vulnerable during a Public Health emergency. This includes our children, our ,arents, our Rural Communities individuals with limited english proficiency, individuals with disability and individuals with chronic illnesses and more. We must do better to help our communities prepare for potential Health Security trends. We must continue to invest in innovative biotechnologies and we must also improve our nonpharmaceutical preventions. Im looking forward to the hearing, for the witnesses testimony, and for how we can prepare hospitals and Health Systems to ensure equal consideration of all of our constituents. Thank you very much. We haver i am pleased four witnesses here today and i thank each of you for taking the time to beer. Introduce to be here. First i would like to introduce dr. Tom inglesby. He is internationally recognized for his work as a writer with numerous publications focusing and emerginge Infectious Disease as well the prevention of in response to biologic threats. Alexander to senator for an introduction. Senator alexander i would like john dreisner. A new didnt experience responding to state and local Health Emergencies including Infectious Diseases like zika and natural disasters such as wildfires the devastated eastern tennessee in 2016. Today, he will provide important insights into the preparedness and response capabilities of the state and local level where we can protect and save more lives. Sner is a physician with more than 25 years of service. Leadership inis tennessee and we welcome him to the committee. Younger, ae you were couple of tennessee basketball teams would probably recruit you tomorrow given their record this year. Next up like introduce mr. , brent macgregor, the Senior Vice President for for theal operations second Flu Vaccine Company in the world. The example of the success between public and private partnership to ensure we are better prepared for the crisis. Their facility in North Carolina is one of three advanced manufacturers in the country with the capability to rapidly respond in the event of a pandemic flu outbreak. Macgregor is the cochair of the alliance for bio security, it works to promote credible partnerships between the government, industry and other stakeholders to advance medical countermeasures. Kruge, the. Stephen head of pediatric emergency medicine at Childrens Hospital of chicago. He is also a professor of pediatrics at northwestern university. He serves as the chair of the american pediatric disaster bareness Advisory Council. Welcome. With that i will turn and you can lead with five minutes of testimony. Senator byrd, senator casey, members of the community, thank you for letting me speak about these issues. Im the director of the center for Health Security at Johns Hopkins Bloomberg School of health and professor of medicine at public and Public Health. Our mission is protect Peoples Health from disasters. Ill provide a brief overview of key areas that my colleagues and viable. Er the opinions expressed are are my own and dont necessarily reflect the views of Johns Hopkins university. The u. S. Faces a range of major Public Health risks, any of which could occur without much warning. They include natural disasters, Mass Shootings and bombings, chemical spills and potential use of chemical weapons. Radiation, Nuclear Threats and biological threats. Biological threats, whether accidental, or deliberate our particular concern and thus the big focus of my comments today. Biological threats can range from moderate size up to those capable opposing global catastrophic risk. What more can be done to prepare for these threats . We need to strengthen the Health Care System preparedness. That is the capacity to care for high numbers of sick or injured in emergencies. While there has been substantial for small disasters in the country, the nation is not ready to provide medical care for large catastrophes. Spyr program has helped fund these capabilities of the state and local level. A Significant Resource constraint limits what hpp can do. The trend should be reversed. New initiatives like establishing regional Disaster Resource hospitals could be a strong new additional component in improving medical preparedness. To strengthend the ability of our Public Health system to detect and response respond to threats. Since 2001 there have been serious to cdc and local levels to provide Early Warning provideutbreaks, diagnostics, investigate and contain outbreaks, communicate to the public, insure bio safety and security and more. There is been good forward movement, but not enough trained professionals to do the work. Public health relies on funding from cdc, Public Health emergency grants. That funding has been reduced by nearly 30 since 2002 even though Public Health crises have not declined. Believe a Public Health Emergency Contingency Fund should be established which would allow rapid Public Health response funding in emergencies. We need to move ahead in medical countermeasure development. There has been Good Progress with many priorities remaining. Including sustained funding and research development, manufacturing of countermeasures. Transition to new flu vaccine technologies, setting ambitious targets for Rapid Development of products. So that they are ready in the course of a given pandemic or epidemic. Fourth, the u. S. Needs to recognize threats that could inadvertently emerge from biological research. After the moratorium on potential panic, after Death Research was lifted after last month. Studying ways of making the most lethal viruses like bird flu respiratory transitional transmissible. This could lead to the accidental or deliberate release of a novel strain of the virus that could cause an epidemic or pandemic. I dont believe the benefits of this work are worth the risk, but if it goes ahead i advised there is high transparency in the program and serious dialogue among concerned governments. Fund the goalould of global Health Security agenda. The u. S. Helped launch with a billiondollar commitment to help countries prevent and respond to Infectious Disease threats. Since then, the cdc and usa have been working with 39 countries looking to stop increased increase resistance. At this point, u. S. Funding for ghsa is ending soon. If we pull away, others will soon. We should continue to support it. Its the most Effective Program we have to contain sources overseas. Improving our nations fairness and response capacity is a daunting endeavor. Im confident is an achievable goal. I appreciate the committees time and i welcome your questions. Morning. Thank you for this opportunity to appear before the committee and discussed the issue of significant importance to the defense of this country. Resilientagile and medical preparedness and response system. T is an honor to be here im a physician, commissioner of health in tennessee plus a local Health Director a decade