[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
CONFRONTING THE CORONAVIRUS:
THE FEDERAL RESPONSE
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HEARING
BEFORE THE
COMMITTEE ON HOMELAND SECURITY
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
SECOND SESSION
__________
MARCH 11, 2020
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Serial No. 116-69
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Printed for the use of the Committee on Homeland Security
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
42-346 PDF WASHINGTON : 2021
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COMMITTEE ON HOMELAND SECURITY
Bennie G. Thompson, Mississippi, Chairman
Sheila Jackson Lee, Texas Mike Rogers, Alabama
James R. Langevin, Rhode Island Peter T. King, New York
Cedric L. Richmond, Louisiana Michael T. McCaul, Texas
Donald M. Payne, Jr., New Jersey John Katko, New York
Kathleen M. Rice, New York Mark Walker, North Carolina
J. Luis Correa, California Clay Higgins, Louisiana
Xochitl Torres Small, New Mexico Debbie Lesko, Arizona
Max Rose, New York Mark Green, Tennessee
Lauren Underwood, Illinois John Joyce, Pennsylvania
Elissa Slotkin, Michigan Dan Crenshaw, Texas
Emanuel Cleaver, Missouri Michael Guest, Mississippi
Al Green, Texas Dan Bishop, North Carolina
Yvette D. Clarke, New York Jefferson Van Drew, New Jersey
Dina Titus, Nevada
Bonnie Watson Coleman, New Jersey
Nanette Diaz Barragan, California
Val Butler Demings, Florida
Hope Goins, Staff Director
Chris Vieson, Minority Staff Director
C O N T E N T S
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Page
Statements
The Honorable Bennie G. Thompson, a Representative in Congress
From the State of Mississippi, and Chairman, Committee on
Homeland Security:
Oral Statement................................................. 5
Prepared Statement............................................. 6
The Honorable Mike Rogers, a Representative in Congress From the
State of Alabama, and Ranking Member, Committee on Homeland
Security:
Oral Statement................................................. 3
Prepared Statement............................................. 4
The Honorable Sheila Jackson Lee, a Representative in Congress
From the State of Texas:
Prepared Statement............................................. 6
The Honorable Lauren Underwood, a Representative in Congress From
the State of Illinois:
Oral Statement................................................. 1
Prepared Statement............................................. 3
Witnesses
Mr. Ken Cuccinelli, II, Senior Official Performing the Duties of
the Deputy Secretary, U.S. Department of Homeland Security:
Oral Statement................................................. 10
Prepared Statement............................................. 12
Dr. Stephen C. Redd, Deputy Director of Public Health Service and
Implementation Science, Centers for Disease Control and
Prevention, U.S. Department of Health and Human Services:
Oral Statement................................................. 15
Prepared Statement............................................. 16
For the Record
The Honorable Sheila Jackson Lee, a Representative in Congress
From the State of Texas:
Letter, February 26, 2020...................................... 56
Letter, March 11, 2020......................................... 57
The Honorable Lauren Underwood, a Representative in Congress From
the State of Illinois:
Statement of the American Federation of Government Employees,
AFL-CIO...................................................... 71
Appendix
Questions From Honorable Michael T. McCaul for Ken Cuccinelli, II 73
Questions From Honorable Michael T. McCaul for Stephen C. Redd... 74
CONFRONTING THE CORONAVIRUS: THE FEDERAL RESPONSE
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Wednesday, March 11, 2020
U.S. House of Representatives,
Committee on Homeland Security,
Washington, DC.
The committee met, pursuant to notice, at 2:19 p.m., in
room 310, Cannon House Office Building, Hon. Lauren Underwood,
presiding.
Present: Representatives Thompson, Lee, Richmond, Rice,
Correa, Torres Small, Rose, Underwood, Slotkin, Cleaver, Green,
Clarke, Titus, Watson Coleman, Barragan, Demings; Rogers,
Katko, Walker, Higgins, Lesko, Joyce, Crenshaw, Guest, Bishop,
Van Drew.
Ms. Underwood. The Committee on Homeland Security will come
to order. The committee is meeting today to receive testimony
on the Federal response to the coronavirus.
Without objection, the Chair is authorized to declare the
committee in recess at any point.
Good afternoon. Today, the committee is meeting to examine
the Federal Government response to the novel coronavirus
pandemic.
As a nurse, I want to open by encouraging everyone to visit
coronavirus.gov for the most up-to-date information from the
Centers for Disease Control and Prevention--and take care to
practice habits that will keep us all safe. Wash your hands
often with soap and water or use hand sanitizer. Don't touch
your face. Cover your coughs and sneezes. Avoid close contact
with others if you or they are sick.
We know that the spread of coronavirus has likely not yet
reached its peak, and it is affecting all of our communities. I
don't think there is a person in this room who isn't worried
about an elderly or immunocompromised relative's health, a
friend's job, or a child's school closure.
Just yesterday the first 2 cases were diagnosed in the
counties that I represent in Illinois. Our jobs as Members of
Congress is to keep Americans safe by working with the
Executive branch to lead a strong Federal Government response,
including the House-led $8.3 billion supplemental funding
package that passed last week. A strong response must include
each of these 3 elements.
First, we must continue to support our local and State
public health departments, our health care system, our
emergency responders who are at the front lines of this
outbreak.
This starts with having reliable data to make decisions,
like how to prepare for a surge to our health system and how
much personal protective equipment is needed for health
workers.
It also means developing and disseminating clear, accurate
risk communication to the public. America's scientific and
public health expertise is unmatched throughout the world, and
it must be driving our decisions.
Second, we must protect people from health care costs
associated with the coronavirus. Testing and treatment must be
widely available at no cost to patients. Price gouging of
medical essentials and other supplies must be stopped.
If we do not take these crucial steps, the epidemic will
worsen because families will avoid seeking care for fear that
they can't afford it. Our communities will be less safe.
Third, we must soften the economic impact of this crisis on
American families and small businesses. This means paid sick
leave for every worker, unemployment insurance, and food
assistance if needed.
Given the committee's jurisdiction, today we will also
examine the Department of Homeland Security's role in the
coronavirus response effort. The Department plays a key role in
protecting workers on the front lines of this outbreak,
processing travelers entering the United States and referring
them for screening by health care workers as necessary.
We will have questions today about the efficacy of this
screening and how it is being performed at our air, land, and
seaports. We also want to learn more about the Department's
ability to protect its own workers, whether it has adequate
personal protective equipment for front-line personnel such as
Customs and Border Protection officers, Board Patrol agents,
and Transportation Security officers.
Finally, we want to hear about what plans the Department
has to ensure continuity of operation at certain essentially
facilities in case of outbreaks there such as ports of entry,
TSA checkpoint, and immigration detention facilities.
Today, we are joined by Mr. Ken Cuccinelli who is currently
serving as the senior official performing the duties of deputy
secretary of Homeland Security to respond to these important
questions. Mr. Cuccinelli is also the Department's
representative on the White House Coronavirus Task Force. I
hope to hear from him about the work of the task force this
afternoon.
He is joined by Doctor Stephen Redd, a medical doctor and
epidemiologist with decades of experience with the Centers for
Disease Control and Prevention. It is my understanding that
Doctor Redd was due to retire this month, but he has agreed to
stay on to assist with the coronavirus response.
We thank you, sir, for your dedication and service to our
country, and thank both of our witnesses for being here with us
today. I look forward to a productive dialog with my colleagues
and our witnesses today.
[The statement of Vice Chairwoman Underwood follows:]
Statement of Vice Chairwoman Lauren Underwood
March 11, 2020
Today, the committee is meeting to examine the Federal Government's
response to the novel coronavirus outbreak. We know that the spread of
coronavirus has likely not yet reached its peak, and is affecting all
of our communities. Just yesterday, the first 2 cases were diagnosed in
the counties I represent in northern Illinois.
Our job as Members of Congress is to keep Americans safe by working
with the Executive branch to lead a strong Federal Government response,
including the House-led $8.3 billion supplemental funding package that
passed last week. A strong response must include each of these 3
elements: First, we must continue support for our local and State
public health departments, our health care system, and our emergency
responders who are on the front lines of this outbreak. This starts
with having reliable data to make decisions, like how to prepare for a
surge to our health system, and how much personal protective equipment
is needed for health workers. It also means developing and
disseminating clear, accurate risk communication to the public.
America's scientific and public health expertise is unmatched across
the world, and it must be driving our decisions.
Second, we must protect people from health care costs associated
with coronavirus. Testing and treatment must be widely available at no
cost to patients, and price gouging of medical essentials and other
supplies must be stopped. If we do not take these crucial steps, the
epidemic will worsen, because families will avoid seeking care for fear
they can't afford it, and our communities will be less safe.
Third, we must soften the economic impact of this crisis on
American families and small businesses. This means paid sick leave for
every worker, unemployment insurance, and food assistance if needed.
Given the Committee's jurisdiction, today we will also examine the
Department of Homeland Security's role in the coronavirus response
effort. The Department plays a key role in protecting workers on the
front lines of this outbreak, processing travelers entering the United
States, and referring them for screening by health care workers as
necessary. We will have questions today about the efficacy of this
screening and how it is being performed at our air, land, and sea
ports. We also want to learn more about the Department's ability to
protect its workers, and whether it has adequate personal protective
equipment for front-line personnel such as Customs and Border
Protection officers, Border Patrol agents, and Transportation Security
officers.
Finally, we want to hear about what plans the Department has to
ensure continuity of operations at certain essential facilities in case
of outbreaks there, such as ports of entry, TSA checkpoints, and
immigration detention facilities.
Ms. Underwood. The Chair now recognizes the Ranking Member
of the full committee, the gentleman from Alabama, Mr. Rogers,
for an opening statement.
Mr. Rogers. Thank you, Madam, Chairman. I want to thank the
witnesses for their presence and for your preparation. I know
it takes a lot of time and effort to be here and prepare for
it. We appreciate that. It is very helpful to this committee.
As I said last week, our hearts go out to those who have
lost loved ones and to those who are currently undergoing
treatment. This is a global event and requires a global
response. Our country has faced outbreaks of serious disease in
the past. In each case, we have martialed our collective
resources and ingenuity to overcome these crises. I am
confident that will be the case with COVID-19.
Congress has worked closely with current and past
administrations to prepare for outbreaks just like this. Last
summer, the President signed into the law The Pandemic and All
Hazards Preparedness Act to enhance Government authorities and
authorize funding for emergency response and medical
countermeasures.
Since 2015 under Republican leadership, we have increased
funding for infectious disease response by 70 percent. Just
last week, we came together in a bipartisan fashion to provide
over $8 billion to help keep public officials able to respond
to this crisis and expediate the development of a vaccine.
I hope the spirit of bipartisanship will continue as we
look at ways to sure up the economy in the wake of this crisis.
But I am concerned about the petty political attacks on the
administration's response, such as the Majority's attack on the
Vice President.
The bipartisan commission on biodefense as well as the
panel of health experts that appeared before us last week
agreed that the Vice President should be the one leading the
response. The Vice President is the only one with a direct line
to the President and the authority to achieve a whole-of-
Government coordinated response to this outbreak.
Unlike the Ebola czar named under the Obama administration,
the Vice President is in the chain of command, and he didn't
lobby for the pharmaceutical industry. Last week we heard from
a panel of medical experts who all agreed that the Government
is doing the best they can under the circumstances.
Today, we had the CDC and the Department of Homeland
Security here to talk about their response efforts. I am
interested in hearing how the agencies are using the
supplemental funding Congress provided last week as well as
what additional authorities they need to effectively respond to
this crisis.
In the middle of a crisis like this, it is very important
for political leaders to avoid flaming the fire of hysteria.
Our job should be to support the response effort and to provide
the public with accurate and timely information to keep them
safe.
I encourage everyone to heed the advice of our medical
professionals and our Chairwoman. Wash your hands. Stay home
when sick. Visit the Center for Disease Control and
Prevention's website for updated information.
With that, I yield back the balance of my time.
[The statement of Ranking Member Rogers follows:]
Statement of Ranking Member Mike Rogers
March 11, 2020
As I said last week, our hearts go out to those who have lost their
loved ones and those who are currently undergoing treatment.
This is a global event that requires a global response.
Our country has faced outbreaks of serious disease in the past. In
each case, we've marshalled our collective resources and ingenuity to
overcome the crisis.
I'm confident that will be the case with COVID-19.
Congress has worked closely with current and past administrations
to prepare for outbreaks like this.
Last summer, the President signed into law the Pandemic and All-
Hazards Preparedness Act to enhance Government authorities and
authorize funding for emergency response and medical countermeasures.
Since 2015, under Republican leadership, we've increased funding
for infectious disease response by 70 percent.
And just last week, we came together to provide over $8 billion to
help public health officials respond to this crisis and expedite the
development of a vaccine.
I hope that spirit of bipartisanship will continue as we look at
ways to sure up the economy in the wake of this crisis.
But I'm concerned about petty political attacks on the
administration's response, such as the Majority's attack on the Vice
President.
The Bipartisan Commission on Biodefense, as well as the panel of
health experts that appeared before us last week agreed that the Vice
President should be the one leading the response.
The Vice President is the only one with a direct line to the
President and the authority to achieve a whole-of-Government,
coordinated response to this outbreak.
And unlike the Ebola czar named under the Obama administration, the
Vice President is in the chain of command and he didn't lobby for the
pharmaceutical industry.
Last week, we heard from a panel of medical experts who all agreed
that the Government is doing the best they can under the circumstances.
Today, we have the CDC and the Department of Homeland Security here
to talk about their response efforts.
I am interested in hearing how the agencies are using the
supplemental funding Congress provided last week, as well as what
additional authorities they need to effectively respond to the crisis.
In the middle of a crisis like this, it is very important for
political leaders to avoid fanning the flames of hysteria.
Our job should be to support the response effort and provide the
public with accurate and timely information to keep them safe.
I encourage everyone to heed the advice of our medical
professionals--wash your hands, stay home when sick, and visit the
Centers for Disease Control and Prevention's (CDC) website for up-to-
date information.
Ms. Underwood. The Chair now recognizes the gentleman from
Mississippi, Mr. Thompson, for an opening statement.
Chairman Thompson. Thank you very much. I appreciate the
Vice Chairwoman's handling of the meeting today. I have some
talking problems so I will be short. But let me say the
witnesses we had last week said absolutely we have to have
effective communication in a situation like this. People have
to tell the truth.
Well, I will just say some of the things that we have heard
in the past. The President called the Governor of the State of
Washington last week a snake. Well, that State has been the
most heavily hit State during this crisis. Our President just
can't call another Governor a snake.
Then in the same sense, the Vice President turned around
and said he is one of the best people doing the job addressing
it. So I think communication and how you outline this is very,
very important.
When this issue first came up, a lot of people said it was
a Democratic hoax. It was never a hoax. We have video where
people said it. It just should not be.
So in the interest of getting and addressing this problem,
taking a whole-Government approach, I would encourage us to
deal with the facts. But it starts at the top. If the top is
calling names, people have to respond. I think going forward if
we can agree that we will not call names, we will address the
issue.
A lot of communities are concerned from New Jersey to New
York to Texas all over. Everybody is being impacted. Most of us
who came to Washington this week, there were a lot of empty
plane seats on those planes coming to Washington because people
don't feel comfortable in terms of flying.
Some of the people on the planes have masks. We have been
told by professionals the masks really doesn't address the
problem. So I would hope, Madam Chair, that with our experts
here today we will hear the facts.
With that, I yield back.
[The statement of Chairman Thompson follows:]
Statement of Chairman Bennie G. Thompson
March 11, 2020
Last week, the committee held a hearing with non-government expert
witnesses to examine the Federal response to the coronavirus and assess
what more must be done to address this pandemic threat.
Today, the committee will hear from representatives from the
Department of Homeland Security and Centers for Disease Control on the
issue.
Since our last hearing, I have become increasingly concerned about
the threat posed by the coronavirus and the Trump administration's lack
of urgency necessary to mitigate the harm it poses to Americans.
Test kits have been slow to roll out, masks and personal protective
equipment for health care workers are in short supply, and even basics
like hand sanitizer are hard for consumers to find. We are clearly
behind the curve, and it will take a concerted whole-of-Government
effort to catch up. As President Trump's own former Homeland Security
Advisor Tom Bossert recently put it, ``it's now or never'' if we are to
get the coronavirus under control.
I hope to hear today from our witnesses about what those steps
might be, including whether limiting mass gatherings, temporarily
closing schools, or restricting certain travel may be necessary.
I also expect to hear from Mr. Cuccinelli about the work of the
White House Coronavirus Task Force and how he intends to make sure the
administration moves more quickly to help protect the American people
confront the coronavirus.
Finally, I want to know what the Department of Homeland Security is
doing in its role to protect the public and its own work force. The
coronavirus is here. We cannot change that. What we do in the coming
days and weeks will determine what comes next for our country.
Congress has already shown its willingness to support the response
with the recent emergency supplemental appropriations bill.
Our hearing today is another important part of our work, as we
fulfill our Constitutional oversight responsibilities.
I certainly hope the administration is up to the task. The American
people are counting on it.
Ms. Underwood. Other Members of the committee are reminded
that under committee rules opening statements may be submitted
for the record.
[The statement of Hon. Jackson Lee follows:]
Statement of Honorable Sheila Jackson Lee
March 11, 2020
Chairman Thompson and Ranking Member Rogers, thank you for this
opportunity for holding today's hearing on ``Confronting the
Coronavirus: The Federal Response.''
I thank today's witnesses and look forward to their testimony:
Ken Cuccinelli, senior official performing the duties of the
deputy secretary, Department of Homeland Security (DHS) and the
DHS representative on the White Coronavirus Task Force:
Stephen C. Redd, MD (RADM, USPHS), deputy director for
public health service and implementation science, Centers for
Disease Control and Prevention (CDC).
Today, the World Health Organization, declared that COVID-19 to be
a pandemic, which has reached at least 114 countries, sickening over
100,000 people, and killing more than 4,000.
My thoughts and prayers are with the families who have lost a loved
one to the coronavirus, and the many others who have contracted the
disease.
COVID-19's infectiousness ratio is 2.3, while the flu is 1.5,
making it much more infectious than the flu.
People can pass the illness along with few symptoms.
testing for covid-19
For these reasons, the Nation's testing for the virus must improve.
While the United States has produced 75,000 tests, South Korea has
tested over 200,000 persons and can perform 11,000 tests a day.
Testing is the only way to fully understand community spread of
COVID-19.
Currently tests, because there are so few available, are limited to
people who have traveled to areas where the virus is experiencing
community spread or if the person is symptomatic.
Limiting access to testing must end because communities, States,
and the Nation cannot plan a counter offensive to stop the spread of
COVID-19 without knowing who is and who is not infected.
houston area's first presumptive positive test of covid-19
The first presumptive positive COVID-19 case in Texas was reported
this week to have occurred in Montgomery County Texas, which borders
Harris County, the location of Houston, Texas.
Montgomery County, Texas officials confirmed that the man has not
traveled out of the State or country recently.
Currently, everyone he has been in close contact with is in self-
quarantine.
If the case is confirmed by the CDC, this could be the first
community-spread case in the Houston area.
The Houston area has other cases that are linked to travel outside
of the State, but this is the first case not linked to travel outside
of the State.
The Montgomery County Community has taken steps to protect children
by closing schools 2 days before spring break to do a deep clean, and
they are expecting to resume classes after the break.
The person is being treated at an undisclosed hospital and is
reported to be under observation and doing well.
We owe a special debt to First Responders who will be the lifeline
for many people who will need medical care to overcome novel
Coronavirus (COVID-19).
a vaccine
I have received reports that the Baylor's College of Medicine has a
vaccine for COVID-19.
We cannot delay in seeking confirmation on this report and, if
true, set into motion the processes necessary to produce enough vaccine
to inoculate the American people.
Even if Baylor has a cure it will take a year to grow enough
vaccine to treat people at risk of contracting COVID-19.
who
On March 3, the World Health Organization sought to differentiate
the spreading novel coronavirus from influenza, with the underlying
message that while seasonal flu cannot be stopped, countries still have
the chance to limit cases of COVID-19, the disease caused by the new
virus.
WHO said the Coronavirus is not SARS, MERS, or the flu.
COVID-19 is a unique virus with unique characteristics that
scientists, and virologists, and researchers around the world are
racing to understand.
We have a window to escape the worst of this disease's impact on
our world, but that window is closing.
A critical tool in the arsenal for stopping COVID-19 is the
Department of Homeland Security and, more specifically, the men and
women who are on the front line at our Nation's airports and borders.
The Department of Homeland Security has a vital mission: To secure
the Nation from the many threats we face.
This requires the dedication of more than 240,000 employees in jobs
that range from aviation and border security to emergency response,
from cybersecurity analyst to chemical facility inspector.
But we cannot forget that they too are vulnerable to the
Coronavirus.
We must protect DHS personnel and their families, while they
fulfill their vital mission of protecting the American people as we
fight the spread of COVID-19.
ebola lessons learned
In 2014, the world had a close call with the Ebola outbreak that
took the lives of so many, and reached U.S. soil, when Eric Duncan
arrived from Liberia for visit with his family not knowing he was
infected.
When Mr. Duncan went to an Dallas area hospital for treatment for
the symptoms of Ebola he was denied admission, but after returning a
few days later he was admitted and later died.
That battle with Ebola lasted from 2014 until 2016.
It took thousands of researchers, doctors, nurses, public health
professionals, and volunteers who worked for over 2 years to win that
war against Ebola.
To win that war we fought the disease close to its place of origin.
We could not afford to lose that fight because that would risk
Ebola becoming endemic, meaning that it could be contracted in many
Nation's around the world.
President Obama and bipartisan leadership in the House and Senate
made the difference.
President Obama created a Task Force and established a full-time
presence in the White House to ensure that the Nation would be ready
for when another pathogen threatened the American people.
covid-19 and public health
Today, COVID-19 is a new coronavirus threatens the world.
As of March 11, 2020, the global death toll is 4,382, while more
than 121,622 people have been infected in more than 80 countries.
In China, the COVID-19 outbreak has infected around 90,000
individuals, and killed 3,158 people.
More than 60,000 people in China have recovered from COVID-19.
Until China lifts the draconian quarantine measures put into place,
we will not know if they are past the worst consequences of COVID-19.
The number of deaths will surely rise in the coming weeks, but we
must not lose heart and be delayed in placing every tool needed in the
hands of physicians, researchers, medical professionals, public health
agencies, and Federal, State, and local emergency response agencies to
defeat COVID-19.
covid-19 in the united states
On Tuesday, March 11, Johns Hopkins reported that COVID-19 cases in
the United States have surpassed 1,000.
The Centers for Disease Control and Prevention (CDC) reported
COVID-19 is in 35 States.
Texas reported at least 8 new cases of Coronavirus in the State on
Tuesday.
They include the first known instances in Dallas, Gregg,
Montgomery, and Tarrant counties, while 2 new Collin County patients,
including a 3-year-old, contracted the virus from a family member.
There was also a new, seventh case in Montgomery County, which is
outside of Harris County late Tuesday.
In Dallas County, 2 people tested positive.
The first was a ``77-year-old out-of-State traveler with an
extensive travel history,'' according to a news release.
The second was a person in their 50's who ``is a close contact'' of
the 77-year-old. County officials said they expected the second
person's coronavirus test to come back positive, but that ``there is
not a cause for concern.''
This virus is a serious public health threat, but this does not
mean that we should have a public health panic.
fighting the spread of covid-19
The weapons for slowing the spread of COVID-19 are simple and they
work:
Washing hands;
Sanitizing surfaces; and
Quarantines.
These tools for controlling the spread of infectious diseases are
as old as civilization and are still used today because they work.
Some of the first records of the use of cleaning, washing, and
isolation of the sick is found in the Bible in the Book of Leviticus
Chapter 13.
Which provides detailed instructions to the community about
leprosy, a dreaded contagious disease.
The isolation or quarantine for leprosy was 14 days, the same
period that COVID quarantines may last.
Given the fluid nature of the events unfolding the time may be
longer based upon circumstances.
I believe that we are not doing enough to prepare the public for
what may be localized, household, or individual quarantines to address
spread of COVID-19.
My concerns about public education are informed by my work to
address the Zika Virus, a mosquito-borne illness, which emerged as a
domestic public health threat in Gulf Coast States in 2016.
zika virus
Zika Virus was the first illness known to cause severe brain
deformities in a developing fetus while in the womb.
I worked with infectious disease experts, policy makers, and worked
to raise awareness with my fellow Members of Congress.
Congresswoman Rosa DeLauro and I published an editorial in the
Houston Chronical on the importance of the Federal response to the Zika
Virus to help focus Congressional attention on the issue.
This year, when I saw news reports in early January on the novel
Coronavirus's rapid spread and the numbers of infected expanding so
quickly, I knew this was not something to be taken lightly and that
time was not on our side to mount an effective defense.
efforts to raise community awareness about covid-19
On February 10, 2020, I held the first press conference on the
issue of the novel Coronavirus at Houston Intercontinental Airport.
I was joined by public health officials, local unions, and
advocates to raise awareness regarding the virus and the implications
it might have for travel to the United States from China and to combat
early signs of discrimination targeting Asian businesses in the United
States.
On February 24, 2020, I held a second press conference on the
International Health Regulations Emergency Committee of the World
Health Organization declaration of a ``public health emergency from the
outbreak of the Coronavirus.''
At this media conference, I also released an Action Plan:
ENHANCED PRODUCTION OF N-95 MASKS
INFORMING STATE HEALTH AGENCIES AND ALL FEDERALLY-QUALIFIED
HEALTH CLINICS TO TEST ALL PATIENTS PRESENTING WITH FLU-LIKE
SYMPTOMS FOR THE CORONAVIRUS
INCREASE THE SUPPLY OF FLU VACCINE AND USE PUBLIC SERVICE
ANNOUCEMENTS TO PROMOTE GETTING A FLU SHOT TO REDUCE THE NUMBER
OF PERSONS WITH FLU-LIKE SYMPTOMS
TASK FORCE MUST NAME A SINGLE CORONAVIRUS AUTHORITATIVE
SOURCE FOR ALL FEDERAL INFORMATION ON THE VIRUS AND ESTABLISH
CLEAR COMMUNICATION LINKS TO K-12 AND POST-SECONDARY SCHOOLS,
THE MEDIA, AND THE PUBLIC
ESTABLISH A REQUIREMENT THAT THE NATION'S AIRPORTS, TRAINS,
AND MASS TRANSIT SYSTEMS, BOTH SMALL AND LARGE, NEED TO HAVE
RESPONSE TEAMS AS NECESSARY TO DEAL WITH AND TREAT THE
TRAVELING PUBLIC
MAKE SURE THE FEDERAL ADVISORY TASK FORCE MAKES PUBLIC
REPORTS ON THE STATUS OF THE SPREAD OF THE CORONAVIRUS
INCLUDING THROUGH THE DEVELOPMENT OF AN APP THAT PROVIDES UP-
TO-DATE TRAVEL ADVISORIES REGARDING CERTAIN COUNTRIES AND BASIC
INFORMATION ON THE VIRUS.
On February 26, 2020, I sent a letter to the Chair and Ranking
Member of the Committee on Homeland Security, seeking a meeting with
Acting Secretary of Homeland Security Chad Wolf to gain insight into
the preparedness of the agency to address a possible pandemic.
On February 28, 2020, I spoke on the floor of the House and
announced plans to form a Congressional Coronavirus Task Force.
On March 4, 2020, the House of Representatives is giving a full-
throated response to Coronavirus by introducing $8.3 billion in funding
to help State and local public health departments meet the challenge of
preparing communities for COVID-19.
On Monday, March 9, 2020, we sent the Dear Colleague invitation to
other Members of the House to signed by me, Congressmen Brian
Fitzpatrick, and Dr. Raul Ruiz, to join the Congressional Coronavirus
Task Force.
Our Nation can win this battle against COVID-19 because we have
knowledgeable and trained virologists, public health experts, and
physicians who are available to help people get the information they
need and provide care should they need it.
To win we must have the leadership, appropriate levels of funding,
and the guidance of State, Tribal, territorial, and local public health
officials.
I look forward to witness testimony on this important homeland
security threat.
Thank you.
Ms. Underwood. I welcome our witnesses. Mr. Ken Cuccinelli
currently serves as the senior official performing the duties
of the deputy secretary for the Department of Homeland
Security.
He is also the Department of Homeland Security's
representative to the White House Coronavirus Task Force.
Previously, he served as acting director of U.S. Citizenship
and Immigration Services. Mr. Cuccinelli was attorney general
in Virginia from 2010 to 2014.
Next, we have Doctor Stephen Redd, who is the deputy
director for public health service and implementation science
at the Centers for Disease Control and Prevention.
He previously directed CDC's Office of Health Preparedness
and Response where he was responsible for State and local
readiness and emergency operations. Doctor Redd is a medical
doctor, an epidemiologist with 30 years of experience at CDC.
Without objection, the witnesses' full statements will be
inserted in the record.
I now ask each witness to summarize their statement for 5
minutes beginning with Mr. Cuccinelli.
STATEMENT OF KEN CUCCINELLI, II, SENIOR OFFICIAL PERFORMING THE
DUTIES OF THE DEPUTY SECRETARY, U.S. DEPARTMENT OF HOMELAND
SECURITY
Mr. Cuccinelli. Thank you, Vice Chairman Underwood,
Chairman Thompson, Ranking Member Rogers, and distinguished
Members of the committee. It is my honor to appear before you
today to testify about the work of the Department of Homeland
Security, what we are doing to respond to the current outbreak
of the coronavirus.
I am very proud of the work the men and women of DHS and
our partners at the Department of Health and Human Services and
across the Government are doing. The Department's top priority
is the safety and security of the American people.
DHS is taking action at airports and land ports of entry to
support HHS in slowing the spread of the novel coronavirus to
say nothing of our maritime work.
DHS continues to work very closely with our partners at CDC
throughout all admissible persons who have been in mainland
China and Iran in the previous 14 days to one of 11 designated
airports of entry where the Federal Government has focused
public health resources.
At all ports of entry, CBP officers continue to remain
alert and notify CDC and other public health officials when
encountering passengers exhibiting signs of overt illness,
regardless of their travel history.
DHSCWMD is currently supporting CDC's enhanced entry
screening efforts through agreements with State, local, or
private-sector emergency medical services, public health, and
first responder personnel at all 11 designated airports of
entry for passengers who have been in China or Iran within the
previous 14 days.
CWMD supports the collection of passenger information for
CDC to provide direct information to State and local public
health officials to facilitate contact tracing efforts. CBP and
the Coast Guard continue their work to recognize, detect, and
assist individuals arriving through our land ports and
waterways.
In coordination with CDC and U.S. Coast Guard, CBP has
measures already in place at all ports of entry to identify
travelers with overt signs of illness to minimize the risk to
the public. U.S. Coast Guard reviews all advanced notice of
arrivals 96 hours in advance of a schedules arrival of a ship
in port.
The Coast Guard captain of the port communicates any
concerns stemming from sick or deceased crew or passengers to
their Coast Guard chain of command and the cognizant CDC
quarantine station who will coordinate with local health
authorities. This process has been working smoothly across the
country.
At and between land ports of entry, CBP is identifying
persons with recent travel to China or Iran and making
appropriate referrals to CDC or the local health system.
The DHS work force is our greatest asset, and every
precaution is being taken to keep our work force safe,
especially for our officers and agents on the front lines.
Ensuring that these individuals and all DHS personnel remain
safe and healthy is a critical--and immediately upon the onset
of COVID-19 as a global concern, the Department proactively
took action.
The DHS management directorate has established a work force
protection command center to ensure that protective procedures
are in place for the front-line work forces who may regularly
encounter potential disease carriers and is working with all
DHS components to assess their readiness.
CWMD continues to work with the U.S. Government
interagency, State Governors, State and local public health
agencies, non-governmental organizations, the Governments of
Mexico and Canada, and private industry partners and
stakeholders on medical and public health coordination and
information sharing.
The Cybersecurity and Infrastructure Security Agency, CISA,
has been assessing the National critical functions for
potential impacts to infrastructure and systems from COVID-19
and is working closely with private-sector owners and operators
to identify issues of concern and ensure continuity of these
critical assets.
FEMA is providing support to HHS as the lead Federal agency
in the areas of incident management, resource planning, and
Federal interagency coordination. Additionally, FEMA remains
postured to support HHS with consequence management to
anticipate any mitigation actions.
The American public can be assured that DHS and its
component agencies are taking decisive action to analyze a
threat, minimize risk, and slow the spread of the virus by
working closely with CDC health professionals and interagency
partners involved in this whole-of-Government effort.
I want to thank you, Vice Chairwoman Underwood, Ranking
Member Rogers, Chairman Thompson, and the Members and staff of
this committee for the support you have shown the Department
and the Government's effort to respond to COVID-19. I look
forward to your questions.
[The prepared statement of Mr. Cuccinelli follows:]
Prepared Statement of Ken Cuccinelli, II
March 11, 2020
introduction
Chairman Thompson, Ranking Member Rogers, and distinguished Members
of the committee. It is my honor to appear before you today along with
my CDC colleague RADM Redd to testify about the work the Department of
Homeland Security (DHS) is doing to respond to the current outbreak of
Coronavirus Disease 19, known as COVID-19.
Let me first say that I am very proud of the work that the men and
women of DHS and our partners at the Department of Health and Human
Services (HHS) and across the Government are doing to contain the
spread of the disease, slow the spread of the disease, and to prepare
and provide for a domestic response. The Department's top priority is
the safety and security of the American people, and we are committed to
an aggressive, proactive, and preemptive whole-of-Government response
in fulfillment of our mission. As required by Congress, in 2018,
President Trump signed the first-ever ``National Biodefense Strategy''
to build upon our ability to rapidly respond to and limit the impacts
of bioincidents like the one we are facing now. We are seeing that
strategy pay dividends as we implement a whole-of-Government response
to this disease.
Additionally, the operational coordination and cooperation between
HHS and DHS dates back to a 2005 Memorandum of Understanding (MOU)
enhancing preparedness against the introduction, transmission, and
spread of quarantinable and serious communicable disease into the
United States. Our combined experience and long-standing relationship,
continues to be beneficial today. Across the air, land, and maritime
domains, DHS has taken and continues to take proactive measures to
address COVID-19.
protecting americans through our efforts at air ports of entry
DHS is taking action at airports of entry to support HHS in slowing
the spread of the novel coronavirus. DHS is working to decrease the
workload of public health officials, expedite the processing of U.S.
citizens returning from China, and, above all, ensure that resources
are focused on the health and safety of the American people.
On January 31, 2020, the Secretary of Health and Human Services
declared COVID-19 a public health emergency in the United States, and
the President signed a Presidential Proclamation using his authority
pursuant to Section 212(f) of the Immigration and Nationality Act to
suspend the entry into the United States of foreign nationals who pose
a risk of transmitting the virus. As of 5 p.m. Eastern Standard Time on
February 2, 2020, foreign nationals, other than immediate family of
U.S. citizens and lawful permanent residents and other individuals
falling within narrow exceptions to the Proclamation, who were
physically present in the People's Republic of China, excluding Hong
Kong and Macau, within the previous 14 days has been denied entry into
the United States. On February 29, 2020, President Trump expanded this
Proclamation to also include most foreign nationals who have been in
Iran within the previous 14 days.
DHS, including U.S. Customs and Border Protection (CBP) and the
Transportation Security Administration (TSA), continues to work very
closely with our partners at the Centers for Disease Control and
Prevention (CDC) to route all admissible persons who have been in
mainland China and Iran in the previous 14 days to one of 11 designated
airports of entry where the Federal Government has focused public
health resources.
Any admissible person who has been in Hubei province, China in the
previous 14 days is subject to up to 14 days of mandatory quarantine
where CDC has made arrangement with State and local authorities to
ensure they are provided proper medical care and health screening. Any
admissible person who has been in the rest of mainland China or Iran
within the previous 14 days undergoes proactive entry health screening
at one of these airports and, if they are asymptomatic, up to 14 days
of self-monitoring to ensure they have not contracted the virus and do
not pose a public health risk.
DHS continues to closely monitor the spread of the virus and is
taking actions to ensure an appropriate response. We are working very
closely with airlines and our partners in South Korea and Italy to
implement exit screening procedures in those locations for travelers
coming to the United States.
DHS continues to facilitate enhanced health screening of travelers
entering the United States who have recently been in China or Iran.
Travelers identified by CBP officers during their primary inspection
are referred to a secondary screening area, where contractor personnel
(through agreements by the DHS Countering Weapons of Mass Destruction
Office (CWMD)) conduct enhanced entry screening. Travelers who have
been in Hubei province, China within the previous 14 days or who
exhibit symptoms consistent with COVID-19 are sent to CDC for tertiary
screening and consideration for quarantine. Between February 2 and
March 8, CBP referred 56,543 travelers for secondary screening by the
CWMD contract personnel at the 11 funneling airports. Of these, 91
individuals required referral to the CDC for medical evaluation. At all
ports of entry, CBP officers continue to remain alert and notify CDC
and other public health officials when encountering passengers
exhibiting signs of overt illness, regardless of their travel history.
We realize these actions could prolong travel times for some
individuals; however public health and security experts agree these
measures are necessary to contain the spread of the virus and protect
the American people. To minimize disruptions, CBP and the air carriers
are working to identify qualifying passengers before their scheduled
flights.
DHS CWMD is currently supporting CDC's enhanced entry screening
efforts through agreements with State, local, or private-sector
Emergency Medical Services, public health, and first responder
personnel at all 11 designated airports of entry for passengers who
have been in China or Iran within the previous 14 days. CWMD
established this capability in response to the Ebola virus threat that
was emerging in the Democratic Republic of the Congo last summer. These
actions ensured a trained, vetted, and badged workforce was ready to
rapidly deploy to support the CDC with airport screening operations.
DHS was able to adapt this capability to quickly address the threat of
COVID-19 and support CDC's enhanced health screenings in the National
interest.
CWMD support includes the collection of passenger information
allowing CDC to provide direct information to State and local public
health officials to facilitate contact tracing efforts. CWMD's efforts
have significantly increased the accuracy of the data collected.
protecting americans through our efforts at land and sea ports of entry
CBP and the United States Coast Guard (USCG) continue their work to
recognize, detect, and assist individuals arriving in the United States
through our land ports and waterways who may be carrying the virus. In
coordination with the CDC and USCG, CBP has measures already in place
at all ports of entry to identify travelers with overt signs of illness
who may be potentially infected with a communicable disease and to
minimize the risk to the traveling public.
USCG continues to review all ``Advance Notice of Arrivals'' 96
hours in advance of the scheduled arrival of a ship in port in
accordance with its current policies. The Captain of the Port will
communicate any concerns stemming from sick or deceased crew or
passengers to their Coast Guard chain of command and the cognizant CDC
quarantine station, who will coordinate with local health authorities.
This process has been working smoothly across the country.
To ensure continued facilitation of international trade, non-
passenger commercial vessels that have been to China (excluding Hong
Kong and Macau) or Iran or embarked crewmembers who have been in China
(excluding Hong Kong and Macau) or Iran within the previous 14 days,
with no sick crewmembers, may be permitted to enter the United States
and conduct normal operations, with restrictions. Crewmembers on these
vessels will be required under Captain of the Port authority to remain
aboard the vessel except to conduct specific activities directly
related to vessel cargo or provisioning operations.
At and between land ports of entry, CBP is identifying persons with
recent (within 14 days) travel to China or Iran and making appropriate
referrals to CDC or the local health system.
monitoring the disease
DHS and its components were well-prepared to take proactive and
preemptive action to mitigate the threat, minimize risk, and slow the
spread of the virus by working closely with CDC and other interagency
partners as cases of the virus in China began to increase. The National
Biosurveillance Integration Center (NBIC) within DHS CWMD began
tracking an outbreak of unidentified viral pneumonia in Wuhan, China on
January 2, providing early situational awareness on what we now know is
COVID-19. NBIC continues to generate and distribute daily updates to
thousands of Federal, State, and local partners to apprise them of the
situation. NBIC further supports CDC and CBP operations by analyzing
passenger travel data relevant to the movement of persons out of the
impacted area. These interagency analyses of flight data, in
conjunction with operational considerations, helped inform the
selection of U.S. airports for enhanced health screening for
coronavirus.
The Science & Technology Directorate's (S&T) National Biodefense
Analysis and Countermeasures Center has received an isolate of the
virus and is collaborating with CWMD to produce data on environmental
stability of the virus as well as decontamination strategies to inform
DHS component and interagency operations. Building on experience gained
during the response to the previous Ebola outbreak, S&T has also
developed and maintains a SARS-CoV-2 Master Question List (MQL), which
tracks current knowledge and research efforts on the virus across the
Government and academia, providing situational awareness on these
important efforts.
dhs workforce protection
The DHS workforce is our greatest asset, and every precaution is
being taken to keep our workforce safe, especially for our USCG, TSA,
CBP, and U.S. Immigration and Customs Enforcement officers and agents
on the front lines. Ensuring that these individuals, and all DHS
personnel remains safe and healthy is critical, and immediately upon
the on-set of COVID-19 as a global concern, the Department proactively
took action.
The DHS Management Directorate has established a workforce
protection command center to ensure that protective procedures are in
place for the front-line workforces who may regularly encounter
potential disease carriers and is working with all DHS components to
assess their readiness. Some current precautionary measures for these
officers include providing gloves, masks, and hand sanitizer.
Although the most recent CDC guidance does not recommend changes to
routine security screening operations or respiratory protection, TSA is
authorizing front-line personnel, whose security screening tasks
require routine, close contact with the traveling public, to wear
surgical masks if they choose to do so. CBP personnel have access to
personal protective equipment (PPE) as part of their normal operations
at all ports of entry and have been provided guidance in case of
exposure to a contagion. CBP issued an updated Job Hazard Analysis on
February 5, 2020, to all employees that outlines the current
comprehensive PPE guidance, which includes guidance about wearing masks
under the appropriate circumstances.
DHS continues to share information with the workforce on an on-
going basis. Our workforce protection command center is in close
coordination with Federal health partners and component health and
safety officials. Furthermore, the chief medical officer (CMO) in DHS
CWMD continues to advise DHS leadership on the on-going health threat
and its impact on workforce health.
supporting the interagency
As the lead Federal agency for coronavirus response, HHS leads
outreach to State, local, Tribal, and territorial public health and
safety officials on the outbreak status and the U.S. public health
response. In support of HHS, DHS provides information to ports of entry
on the risks of COVID-19, advising that front-line personnel be alert
for individuals who may have come from an infected region. TSA has been
working with select airlines to notify travelers on the risks of
potentially contracting the communicable disease. CBP has posted travel
notices at land border crossings informing passengers about the virus.
Finally, the USCG has issued a Marine Safety Information Bulletin to
maritime industry partners advising of required reporting of illnesses
or deaths on-board arriving commercial vessels and delineating
conditions whereby vessels may be denied entry into the United States.
CWMD, which includes the DHS CMO, continues to work with the USG
interagency, State/local public health agencies, non-governmental
organizations, the Governments of Mexico and Canada, and private
industry partners/stakeholders on medical and public health
coordination and information sharing.
Additionally, the Cybersecurity and Infrastructure Security Agency
(CISA) has been assessing the National Critical Functions for potential
impacts to infrastructure and systems from COVID-19 and is working
closely with private-sector owners and operators to identify issues of
concern and ensure continuity of these critical assets in the event
that COVID-19 reaches pandemic levels and the United States sees
significant community spread.
Since February 12, DHS has been augmenting the HHS Secretary's
Operations Center with personnel from FEMA, DHS HQ, USCG, CWMD, and
CISA, who are assisting the HHS-led interagency response through
increased support and coordination.
FEMA is providing support to HHS as the lead Federal agency in the
areas of incident management, resource planning, and Federal
interagency coordination. Additionally, FEMA remains postured to
support HHS with consequence management to anticipate any potentially
necessary mitigation actions. This on-going planning effort is similar
to the experience with past outbreaks of Severe Acute Respiratory
Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), caused by
similar viruses.
conclusion
The American public can be assured that DHS and its component
agencies are taking decisive action to analyze the threat, minimize
risk, and slow the spread of the virus by working closely with CDC
health professionals and interagency partners involved in this whole-
of-Government effort.
I want to thank you, Chairman Thompson, Ranking Member Rogers, and
the Members and staff of this committee for the support you have shown
the Department and the Government's effort to respond to COVID-19.
I look forward to your questions.
Ms. Underwood. Thank you for your testimony.
I now recognize Doctor Redd to summarize his statement for
5 minutes.
STATEMENT OF STEPHEN C. REDD, DEPUTY DIRECTOR OF PUBLIC HEALTH
SERVICE AND IMPLEMENTATION SCIENCE, CENTERS FOR DISEASE CONTROL
AND PREVENTION, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Dr. Redd. Good afternoon, Chairs Underwood and Thompson,
Ranking Member Rogers, and Members of the committee. Thank you
for the opportunity to talk with you about CDC.
Ms. Underwood. Turn on your mic, sir.
Dr. Redd. Is the mic not on. Maybe I need----
Ms. Underwood. OK.
Mr. Redd [continuing]. To get closer.
Ms. Underwood. Thank you.
Dr. Redd. Start over. Good afternoon, Chairwoman Underwood
and Chair--I am sorry--Chairs Underwood and Thompson, Ranking
Member Rogers, and Members of the committee. Thank you for the
opportunity to talk with you about CDC's role in the response
to the novel 2019 coronavirus or COVID-19.
Before I begin, it is important to recognize that this is a
new virus and a new disease. The science continues to
accumulate. We will continue to incorporate that new science
into our response decisions and response posture.
There are three overriding themes that have guided our
response. First, CDC's role in this interagency response is
built on decades of infectious disease experience and planning
for pandemic flu and other health emergencies. Second, our
response is dependent on support of a network of dedicated
front-line public health workers in our communities, the State
and local health departments.
Third, as we begin to see community spread of this virus,
it will be important for all of us to take action in preventing
its spread through common sense public health precautions like
handwashing, staying home if you are sick, and particularly for
high-risk and vulnerable populations avoiding crowds,
especially in poorly-ventilated spaces.
I encourage you to visit CDC's coronavirus website to learn
more about what you can do. Thank you for the second time we
have been able to talk about the website and all the
information that is there.
From the outset, CDC and our U.S. Government partners have
implemented an aggressive multi-layered strategy to slow the
introduction of this virus into the United States to buy time
so that our scientist could learn how this virus behaves, to
prepare our Nation's public health system and health care
system for the possibility of a global pandemic, which as you
have heard has been declared today, and to educate Americans
how best to prepare for disruptions to our daily lives and risk
to our families.
The administration's interagency containment strategy has
relied upon tried and true public health interventions. Early
diagnosis, isolation, and contact tracing, travel advisories,
and targeted travel restrictions, selective use of quarantine
for individuals returning from global transmission hot zones.
Without immunity or treatment, our Nation's public health
response has relied upon detection and contact tracing to slow
the emergence of this virus into the United States.
February 25 was an inflection point for the outbreak when
for the first time we saw new cases outside of China outpace
new cases within China. We have observed rapid, wide-spread
person-to-person transmission in South Korea, Iran, and Italy.
Before long we had detected our first case of community spread
in California.
So what have we learned? The virus spreads easily and
rapidly mostly through respiratory droplets from sneezing and
coughing. Going from 30 cases detected by Chinese scientists to
over 100,000 cases worldwide in a little less than 2 months.
Reports from China based on more than 70,000 cases of
COVID-19 indicate that about 80 percent of patients had mild
illness and recovered. Fifteen to 20 percent developed serious
illness, predominately in older persons and persons with
chronic underlying medical conditions.
For this reason, CDC has issued new guidance advising
seniors to avoid crowds, stay closer to home, and avoid cruise
ship travel and long plane trips.
As of today, CDC has received confirmation of more than 900
cases of COVID-19 in 38 States plus New York City and the
District of Columbia. It is with great sadness that I report
that there have been 31 deaths from this disease in the United
States.
As we experience growing community spread in the United
States, State and local health agencies on the front lines will
be making difficult decisions to reduce the spread with CDC
guidance and support. Thank you for your support for additional
resources to increase public health capacity on our
communities.
CDC has put more than 630 staff in the field and has--is
working side-by-side with other Federal partners--State and
local partners--and we have had over 1,500 people working on
the response within Atlanta and the field. CDC is committed to
this mission. We will continue to work 24/7 to protect the
American people from this global health threat.
Thank you, and I look forward to your questions.
[The prepared statement of Dr. Redd follows:]
Prepared Statement of Stephen C. Redd
Since President Trump took office, his work to protect the health
and safety of the American people has included a specific focus on
monitoring, preparing for, and responding to biological threats, such
as infectious disease outbreaks. As soon as the United States became
aware of a novel coronavirus at the end of 2019, the U.S. Government
was tracking its spread and began preparing necessary responses.
Within the first 2 weeks of China's initial report of the outbreak
in December 2019, China reported 45 pneumonia cases and 2 deaths. More
recently, there has been an increase in cases outside of China.
COVID-19 is a new disease, caused by a novel (or new) coronavirus
that has not previously been seen in humans. This new disease,
officially named Coronavirus Disease 2019 (COVID-19) by the World
Health Organization (WHO), is caused by the SARS-COV-2 virus, which is
in the same family of viruses as that cause the common cold. There are
many types of human coronaviruses including some that commonly cause
mild upper-respiratory tract illnesses. Coronaviruses are a large
family of viruses. Some cause illness in people, and others, such as
canine and feline coronaviruses, only infect animals. Rarely, animal
coronaviruses that infect animals have emerged to infect people and can
spread between people. This is suspected to have occurred for the virus
that causes COVID-19. Middle East Respiratory Syndrome (MERS) and
Severe Acute Respiratory Syndrome (SARS) are two other examples of
coronaviruses that originated from animals and then spread to people.
The potential global public health threat posed by this virus is high,
but right now, the immediate risk to most Americans is low. The greater
risk is for people who have recently traveled to an affected country or
been exposed to someone with COVID-19.
On January 29, 2020, President Trump announced the formation of the
President's Task Force on the Novel Coronavirus, which is chaired by
the Secretary for Health and Human Services and coordinated through the
National Security Council. The President's Task Force is composed of
subject-matter experts from the White House and several U.S. Government
agencies, and it includes some of the Nation's foremost experts on
infectious diseases. The Task Force is leading the administration's
efforts to monitor, contain, and mitigate the spread of COVID-19 while
ensuring that the American people have the most accurate and up-to-date
information to protect themselves and their families.
The President's top priority is the health and welfare of the
American people, and his administration has made it a priority to
prepare for infectious disease outbreaks that can cross borders. In
2018, President Trump launched the National Biodefense Strategy, which
lays out a framework for coordination among agencies, with the
Secretary of the U.S. Department of Health and Human Services (HHS) as
chair of the Biodefense Steering Committee, and helps identify gaps in
preparedness and response. As the situation around the new coronavirus
evolves, the administration will continue its coordinated response, in
collaboration with State and local governments and the private sector,
and adjust its positioning as needed.
Within HHS, the Centers for Disease Control and Prevention (CDC),
the Assistant Secretary for Preparedness and Response (ASPR), the
National Institute of Allergy and Infectious Diseases (NIAID), and the
Food and Drug Administration (FDA) play critical roles in responding to
COVID-19 by preventing and slowing the spread of the disease, assisting
repatriated Americans, protecting the supply of food, drugs, and
devices, and developing diagnostics, therapeutics, and vaccines.
centers for disease control and prevention
In late December 2019, Chinese authorities announced a cluster of
pneumonia cases of unknown etiology centered on a local seafood market
in Wuhan, China, with an estimated case onset in early December. CDC
immediately began monitoring the outbreak, and within days--by January
7, 2020--had established a Center-led Incident Management Structure. On
January 21, 2020, CDC transitioned to an agency-wide response based out
of its Emergency Operations Center. This allows CDC to provide
increased operational support to meet the outbreak's evolving
challenges and provides strengthened functional continuity to meet the
long-term commitment needed to curb the outbreak.
CDC is assisting ministries of health in countries in every region
of the globe with their most urgent and immediate needs to prevent,
detect, and respond to the COVID-19 outbreak.
CDC's most expert and practiced infectious disease and public
health experts are dedicated to this response 24/7 to protect the
American people. CDC is a disease preparedness and response agency, and
this work is fundamental to our mission both domestically and
internationally. The agency's approach to COVID-19 is built upon
decades of experience with prior infectious disease emergencies
including responses to SARS, MERS, and Ebola, and to pandemic
influenza.
To mitigate the impact of COVID-19 within the United States, CDC is
working alongside Federal, State, local, Tribal, and territorial
partners, as well as public health partners. This public health
response is multi-layered and includes aggressive containment and
mitigation activities with an objective to detect and minimize
introductions of this virus in the United States so as to reduce its
spread and impact. It is impossible to catch every single traveler
returning from an affected country with this virus--given the nature of
this virus and how it's spreading. Our goal continues to be slowing the
introduction of the virus into the United States as we work to prepare
our communities for more cases and possible sustained spread.
To accomplish this, CDC is also working with multiple countries, in
collaboration with U.S. Agency for International Development (USAID)
and other Federal agencies and WHO to support ministries of health
around the globe to prepare and respond to the outbreak. For example,
the U.S. Government is helping to support countries to implement
recommendations provided by WHO related to the identification of people
who might have this new infection, diagnosis, and care of patients, and
tracking of the outbreak. CDC staff are also starting to work together
with interagency colleagues in those countries to conduct
investigations that will help inform response efforts going forward.
The agency is using its existing epidemiologic, laboratory, and
clinical expertise to gain a more comprehensive understanding of COVID-
19. CDC is leveraging prior programmatic investments in domestic and
global public health capacity and preparedness to strengthen the
agency's response to COVID-19. Thus far, this response has been built
largely on the foundation of our seasonal and pandemic influenza
program's infrastructure. The on-going response to COVID-19 also
demonstrates CDC's continued commitment to strengthen global health
security. CDC has been engaged in global health security work for over
7 decades. Thanks to investments in Global Health Security, the U.S.
Government's work has helped partner countries build and improve their
public health system capacity. This global effort strengthens the
world's ability to prevent, detect, and respond to infectious diseases
like this new coronavirus.
This outbreak also underscores the need for the United States to
continue to play a leadership role on the global stage, and to
strengthen global capacity to stop disease threats at their sources,
before they spread. Furthermore, the outbreak demonstrates the
importance of continued investment in our Nation's public health
infrastructure. Despite years of progress in domestic disease
prevention and response, efforts to help modernize our Federal, State,
and local capability and health systems that are crucial to responding
to and understanding unprecedented threats continue.
The U.S. Government has taken unprecedented steps to prevent the
spread of this virus and to protect the American people and the global
community from this new threat and allow State, local, territorial, and
private partners time to prepare for any necessary response and
mitigation activities. Since February 2, 2020, pursuant to arrival
restrictions imposed by the Department of Homeland Security, flights
carrying persons who have recently traveled from or were otherwise
present within mainland China or other affected countries have been
funneled to designated U.S. airports with CDC quarantine stations. At
these airports, passengers are subject to enhanced illness screening
and self-monitoring with public health supervision up to 14 days from
the time the passenger departs the affected country. This enhanced
entry screening serves 2 critical purposes. The first is to detect
illness and rapidly respond to symptomatic people entering the country.
The second purpose is to educate travelers about the virus and what to
do if they develop symptoms.
These measures are part of a layered approach which includes our
other core public health efforts, including aggressively tracking
COVID-19 around the globe, building laboratory capacity, and preparing
the National health care system for community spread. These core
capabilities and expertise are essential to CDC's comprehensive
approach to addressing this outbreak.
While CDC believes that the immediate risk of this new virus to the
American public is low, CDC is preparing the Nation's health care
system to respond to identification of individual cases and potential
person-to-person transmission of COVID-19 in the community, at the same
time ensuring the safety of its patients and workers. CDC has developed
guidance on appropriate care and infection control for patients with
COVID-19 and is engaging regularly with clinical and hospital
associations to confirm that its guidance is helpful and responsive to
the needs of the health care system.
Furthermore, understanding the current constraints of the global
supply of personal protective equipment (PPE), CDC is working with
industry and the U.S. health system to comprehend possible effects on
facilities' abilities to procure the needed levels of PPE, and to
provide strategies to optimize the supply of PPE.
Effective disease surveillance enables countries to quickly detect
outbreaks and continuously monitor for new and reemerging health
threats. CDC continues to monitor the COVID-19 situation around the
world.
CDC has begun working with domestic public health laboratories that
conduct community-based influenza-like illness surveillance and
leveraging our existing influenza and viral respiratory surveillance
systems so that we may begin testing people with flu-like symptoms for
the SARS-COV-2 virus. HHS is developing plans to expand this effort.
This collaboration with domestic public health labs is another
layer of our response that will help us detect if this virus is
spreading in a community. All of our efforts now are to prevent the
sustained spread of this virus in our communities, but we need to be
prepared for the possibility that it will spread. Results from this
surveillance could necessitate changing our response strategy.
CDC has issued guidance for people at high risk of exposure to the
virus, including flight crews, recent travelers to China, and health
care workers. Through its extensive Health Alert Network, CDC shared
guidance for clinical care for health care professionals and State and
local health departments. Health departments, in consultation with
health care providers, can evaluate patients and determine whether
someone may have the illness and should be subjected to additional
diagnostic testing.
CDC has a demonstrated record of innovative science- and evidence-
based decision making, and an experienced and expert workforce that is
working 24/7 to combat this public health emergency. The COVID-19
outbreak is evolving rapidly, and the U.S. Government is constantly
making adjustments to respond to the changing nature of this public
health emergency. Our goal continues to be slowing the introduction of
the virus into the United States and preparing our communities for more
cases and possible sustained spread. While leaning forward aggressively
with the hope that we will be able to prevent community spread, CDC
remains vigilant in confronting the challenges presented by this new
coronavirus.
assistant secretary for preparedness and response
Currently, there are no vaccines or therapeutics approved by the
FDA to treat or prevent novel coronavirus infections. The Biomedical
Advanced Research and Development Authority (BARDA), part of ASPR, is
working with counterparts across the Government, including within HHS
and with the Department of Defense (DOD). The team is reviewing
potential vaccines, treatments, and diagnostics from across the public
and private sectors to identify promising candidates that could be
developed to detect, protect against, or treat people with coronavirus
infections. BARDA is working closely across the U.S. Government to
assess and identify potential partners and technologies suitable to
address the COVID-19 outbreak--both for prevention and treatment.
This has allowed BARDA to leverage existing partnerships,
accelerating the development of COVID-19 medical countermeasures,
including diagnostics, therapeutics, and vaccines. Established
partners, including Regeneron, Janssen, and Sanofi Pasteur, have shown
success in developing both prophylactic and therapeutic medical
countermeasures for emerging infectious diseases.
BARDA is collaborating with Regeneron to leverage their partnership
agreement to develop multiple monoclonal antibodies that, individually
or in combination, could be used to treat this emerging coronavirus.
Regeneron's monoclonal antibody discovery platform, called VelocImmune,
was used to develop a promising investigational three-antibody
therapeutic which was deployed to treat Ebola in the most recent
outbreak in the Democratic Republic of the Congo, and an
investigational two-antibody therapeutic to treat MERS. The technology
shortened multiple aspects of the product development time line for
therapeutics to treat MERS and Ebola from years to months. The
technology helped shorten certain stages of drug development, including
the process of antibody discovery and selection, preclinical-scale
manufacturing, and clinical-scale manufacturing. BARDA and Regeneron
are working to utilize these monoclonal antibodies, produced by a
single clone of cells or a cell line with identical antibody molecules,
which will bind to certain proteins of a virus, reducing the ability of
the COVID-19 virus to infect human cells.
BARDA is working with Janssen to leverage their Ebola, Zika, HIV
vaccine platform to expedite development of vaccines that protect
against the SARS-CoV-2 virus. Using existing resources, BARDA will
share research and development costs and expertise with Janssen to help
accelerate Janssen's investigational COVID-19 vaccine into clinical
evaluation. Janssen will also scale-up production and manufacturing
capacities required to manufacture the candidate vaccine. This same
approach was used to develop and manufacture Janssen's investigational
Ebola vaccine with BARDA support; that vaccine is being used in the
Democratic Republic of the Congo as part of the current Ebola outbreak
response. Additionally, BARDA and Janssen are working together to help
develop treatments for coronavirus infections. Janssen will conduct
high throughput screening on thousands of potential antiviral compounds
in order to identify medicines that could safely and effectively be
used to reduce the severity of illness and treat COVID-19 infections,
as well as identify compounds that have antiviral activity against
SARS-CoV-2 as an initial step in developing new treatments. These
products include those in development to treat and prevent MERS or
SARS, which are caused by coronaviruses also related to COVID-19.
Finally, in their work with Sanofi Pasteur, BARDA is able to
leverage a licensed recombinant influenza vaccine platform to produce a
recombinant SARS-CoV-2 vaccine candidate. The technology produces an
exact genetic match to proteins of the virus. DNA encoding the protein
will be combined with DNA from a virus harmless to humans, and used to
rapidly produce large quantities of antigen which stimulate the immune
system to protect against the virus. The antigens will be separated and
collected from these cells and purified to create working stocks of
vaccine for advanced development.
BARDA has initiated early steps of medical countermeasures
development with partners and will continue to work to accelerate this
process. Availability of these medical countermeasures is essential to
save lives and protect Americans against 21st Century public health
threats.
Our Nation's health care system is better prepared than it has ever
been. For example, all 50 States have Pandemic Plans, as a requirement
of CDC's Public Health Emergency Preparedness Program (PHEP) and ASPR's
Hospital Preparedness Program (HPP). HPP was established after the
September 11, 2001, terrorist attacks, with the goal of improving the
capacity of local hospitals across the country to deal with disasters
and a large influx of patients in an emergency. Using HPP funding,
State grantees initially purchased equipment and supplies needed for
emergency medical surge capacity. Over time, the program has
successfully evolved to support local, coordinated health care
coalitions, including hospitals, public health facilities, emergency
management agencies, and emergency medical services providers.
Investments administered through PHEP and HPP have improved individual
health care entities' preparedness and have built a system for
coordinated health care system readiness. HPP is the only source of
Federal funding to prepare the Nation's mostly private health care
system to respond to emergencies, including COVID-19.
Beginning in 2018, ASPR has been supporting Regional Disaster
Health Response Systems (RDHRS) pilot projects. The RDHRS concept aims
to provide funding directly to hospitals and health care systems to
establish multi-State regional partnerships to increase preparedness
and response capability and capacity for hospitals and health care
facilities in advance of, during, or immediately following incidents,
including emerging infectious diseases. Two sites were selected in
September 2018 to begin development of RDHRS pilots. In 2019, two
grants were awarded to support new centers of excellence pilots focused
on pediatric disaster care. The RDHRS and Pediatric Disaster Care
Center of Excellence cooperative agreement requirements are
intentionally aligned to ensure synergy between the programs and
collaboration between all sites and facilities. Ultimately, these
efforts inform best practices to help ready health care delivery
systems for disasters and emergencies and are critical in aiding
response and limiting the impact of disaster. As you all are aware, the
United States is in the middle of influenza season. Many emergency
departments are at 90 percent capacity. If influenza worsens, or if
COVID-19 intensifies domestically, emergency departments would be
severely strained, which is why supporting models such as the Hospital
Preparedness Program health care coalition network is so important.
The National Ebola Training and Education Center (NETEC) combines
the resources of health care institutions experienced in treating Ebola
to offer training, readiness consultations, and expertise to help
facilities prepare for Ebola and other special pathogens. The regional
Ebola and other special pathogen treatment centers, of which ASPR and
CDC funded 10 across the country, all have respiratory infectious
disease isolation capacity or negative pressure rooms for at least 10
patients, including pediatric patients. The NETEC and the regional
Ebola and other special pathogen treatment centers have been used to
support recent quarantine efforts. Should the coronavirus infections
increase domestically, these centers will become critical in isolating
infected persons and providing adequate treatment.
ASPR and CDC also work to enhance medical surge capacity by
organizing, training, equipping, and deploying Federal public health
and medical personnel, such as National Disaster Medical System (NDMS)
teams, and providing logistical support for Federal responses to public
health emergencies. NDMS was originally created during the cold war to
take care of military casualties from overseas in U.S. civilian
hospitals. Today, NDMS teams are deployed to strategic locations across
the country, caring for U.S. citizens who may have been exposed to
SARS-CoV-2, effectively providing medical care and limiting the
potential spread of the disease.
Recently, to assist in the repatriation effort, ASPR stood up a
National HHS Incident Management Team (IMT) located in Washington, DC.
The IMT serves as the National command-and-control element, deploying
Public Health Service Commission Corps Officers and NDMS personnel.
In addition, HHS provided cache equipment, (e.g., medical supplies
and resources) to Travis AFB, Marine Corps Air Station Miramar,
Lackland, Air Force Base, and Camp Ashland to support evacuees
quarantined at these facilities. HHS deployed one Disaster Medical
Assistance Team (DMAT) and one IMT on February 12, 2020, to support
American citizens in Japan on the Diamond Princess cruise ship, as well
as the Embassy, to provide medical care, prescriptions, and behavioral
health support.
Many active pharmaceutical ingredients and medical supplies,
including auxiliary supplies such as syringes and gloves, come from
China and India. This outbreak demonstrates why ASPR is seeking
innovative solutions and partnerships to better protect National
security. ASPR is working to increase access to personal protective
equipment (PPE) by:
Coordinating with CDC and other Federal agencies to share
information about optimization of PPE, to prevnt overbuying and
overuse of existing supplies.
Engaging private-sector partners who manufacture and
distribute PPE to share information and concerns, and to
explore options to anticipate and meet the needs of the U.S.
health care sector more effectively. During recent discussions,
for example, distributors informed us that they have
implemented allocations to help prevent stockpiling at health
care facilities. The allocation is a percentage of a customer's
previous orders and is designed to help protect the health care
supply chain and ensure the right supplies are available for
those who need it.
We are also partnering with other Federal agencies such as
DHS, DOD, and the U.S. Department of Veterans Affairs who are
large buyers of PPE, to develop acquisition strategies that
incentivize industry to expand PPE production while not
exacerbating supply challenges.
The Strategic National Stockpile (SNS) holds thousands of
deployable face masks, N95 respirators, gloves, and surgical gowns that
could be deployed if State and local supplies are diminished due to the
current COVID-19 response and commercial supplies are exhausted. The
SNS is working hand-in-hand with commercial supply chain partners and
other Federal agencies to continue monitoring supply levels and to
prepare for a potential deployment of SNS personal protective gear if
it is needed.
the national institutes of health
The National Institutes of Health (NIH) is the HHS agency leading
the research response to the global health emergency of COVID-19.
Within the NIH, the National Institute of Allergy and Infectious
Diseases (NIAID) is responsible for conducting and supporting research
on emerging and re-emerging infectious diseases, including COVID-19.
NIAID is well-positioned to respond rapidly to infectious disease
threats as they emerge by leveraging fundamental basic research
efforts; a domestic and international research infrastructure that can
be quickly mobilized; and collaborative and highly-productive
partnerships with industry. NIAID provides preclinical research
resources to scientists in academia and private industry throughout the
world to advance translational research for emerging and re-emerging
infectious diseases. These research resources are designed to bridge
gaps in the product development pipeline, thereby lowering the
scientific, technical, and financial risks incurred by industry and
incentivizing companies to partner in the development of effective
countermeasures including diagnostics, therapeutics, and vaccines.
NIAID also supports the Infectious Diseases Clinical Research
Consortium, which includes a network of Vaccine and Treatment
Evaluation Units (VTEUs). The VTEUs conduct clinical trials to
investigate promising therapeutic and vaccine candidates when public
health needs arise. NIAID collaborates with other Federal agencies,
including through the HHS Public Health Emergency Medical
Countermeasures Enterprise (PHEMCE), to help advance progress against
newly-emerging public health threats. In addition, partnerships with
academia, the biotechnology and pharmaceutical industries, domestic and
international researchers, and organizations such as the World Health
Organization (WHO) are integral to these efforts. NIAID has a long-
standing commitment to coronavirus research, including extensive
efforts to combat two other serious diseases caused by coronaviruses:
SARS and MERS. This research has improved our fundamental understanding
of coronaviruses and provides a strong foundation for our efforts to
address the challenge of SARS-CoV-2, the novel coronavirus that causes
COVID-19. NIAID has responded to the newly-emerging COVID-19 outbreak
by expanding our portfolio of basic research on coronaviruses. NIAID
scientists have rapidly identified the human receptor used by SARS-CoV-
2 to enter human cells. In addition, NIAID investigators and their
collaborators recently identified the atomic structure of the spike
protein, an important SARS-CoV-2 surface protein that is a key target
for the development of vaccines and therapeutics. NIAID scientists also
are evaluating the stability of SARS-CoV-2 on various ordinary surfaces
and in aerosols to better understand the potential for viral spread
throughout the community.
NIAID-supported researchers are assessing the risk of emergence of
bat coronaviruses in China, including the characterization of bat
viruses and surveys of people who live in high-risk communities for
evidence of bat coronavirus infection. Such research is necessary to
better understand this emerging infection and to investigate optimal
ways to diagnose, treat, and prevent COVID-19.
The NIAID Centers of Excellence for Influenza Research and
Surveillance (CEIRS), which conduct influenza risk assessments in
multiple sites throughout the world particularly in Asia, have
responded rapidly to the COVID-19 outbreak. CEIRS researchers at the
University of Hong Kong are evaluating the epidemiology, transmission
dynamics, and severity of COVID-19. These scientists also have
performed environmental sampling of the Wuhan market where the first
COVID-19 cases were reported.
NIAID is working with CEIRS collaborators and the CDC to obtain
additional virus and biological samples from patients to further
advance research efforts on COVID-19. Recently, the NIAID-funded BEI
Resources Repository made samples of SARS-CoV-2 available for
distribution to domestic and international researchers at Biosafety
Level 3 laboratories. In addition, CEIRS researchers and other NIAID-
supported scientists are developing reagents, assays, and animal models
that can be used to evaluate promising therapeutics and vaccines. These
research resources also will be shared with the domestic and
international scientific community as soon as they become available.
On February 6, 2020, NIAID issued a Notice of Special Interest
regarding the Availability of Urgent Competitive Revisions for Research
on the 2019 Novel Coronavirus. This notice encourages existing NIAID
grantees to apply for supplements for research project grants focused
on the natural history, pathogenicity, and transmission of the virus,
as well as projects to develop medical countermeasures and suitable
animal models for preclinical testing of COVID-19 vaccines and
therapeutics.
NIAID has responded to public health concerns about COVID-19 by
increasing on-going coronavirus research efforts to accelerate the
development of interventions that could help control current and future
outbreaks of COVID-19. These activities build on prior NIAID research
addressing other coronaviruses, such as those that cause SARS and MERS.
The CDC has developed a real-time Reverse Transcription-Polymerase
Chain Reaction (rRT-PCR) test that can detect COVID-19 using
respiratory samples from clinical specimens. NIAID is accelerating
efforts to develop additional diagnostic tests for COVID-19, and NIAID-
supported investigators are developing PCR-based assays for SARS-CoV-2
to facilitate preclinical studies and aid in the development of medical
countermeasures. NIAID scientists also are developing reagents for an
enzyme-linked immunosorbent assay for SARS-CoV-2. CEIRS researchers at
the University of Hong Kong have developed a separate RT-PCR test and
made their protocol publicly available through the WHO. These NIAID-
supported investigators also have distributed assay reagents to 12
countries to facilitate the diagnosis of COVID-19.
NIAID is pursuing the development of antivirals and monoclonal
antibodies for potential use against SARS-CoV-2. NIAID has launched a
multicenter, randomized controlled clinical trial to evaluate the
safety and efficacy of the antiviral drug remdesivir for the treatment
of COVID-19 in hospitalized adults with laboratory-confirmed SARS-CoV-2
illness. The adaptive design of this trial will enable the evaluation
of additional promising therapies. NIAID plans to assess other existing
antivirals for activity against SARS-CoV-2, and NIAID scientists are
working to identify monoclonal antibodies with therapeutic potential
from COVID-19 patient samples as well as historical SARS patient
samples. NIAID-funded scientists also aim to delineate new viral
targets to facilitate the development of novel therapeutics with broad
activity against coronaviruses. Finally, NIAID is expanding its suite
of preclinical services to add assays that investigators can use to
accelerate research and development of therapeutics for COVID-19.
A safe and effective vaccine for SARS-CoV-2 would be an extremely
valuable tool to stop the spread of infection and prevent future
outbreaks. Public and private entities across the globe have announced
plans to develop SARS-CoV-2 vaccine candidates following the release of
the SARS-CoV-2 genetic sequence. NIAID is supporting development of
several SARS-CoV-2 vaccine candidates, and is utilizing vaccine
platform technologies that have shown promise against the coronaviruses
that cause SARS and MERS.
The NIAID Vaccine Research Center (VRC) is collaborating with the
biotechnology company Moderna, Inc., on the development of a vaccine
candidate using a messenger RNA (mRNA) vaccine platform containing the
gene that expresses the VRC-designed spike protein of SARS-CoV-2. NIAID
anticipates the experimental vaccine will be ready for clinical testing
in the NIAID VTEUs within the next 2 months and will conduct
preclinical studies as well as a first-in-human study of this COVID-19
vaccine candidate. The Coalition for Epidemic Preparedness Innovations
(CEPI) will fund the manufacture of the first clinical production lot
of this mRNA-based vaccine candidate using the Moderna rapid
manufacturing facility.
NIAID Rocky Mountain Laboratories (RML) scientists are
collaborating with Oxford University investigators to develop a
chimpanzee adenovirus-vectored vaccine candidate against SARS-CoV-2; in
addition, they have partnered with CureVac on an mRNA vaccine
candidate. RML investigators also have launched a collaboration with
the University of Washington and have begun early stage testing of an
RNA vaccine candidate against SARS-CoV-2. In addition, NIAID-supported
scientists at Baylor College of Medicine and their collaborators are
evaluating an experimental SARS-CoV recombinant protein vaccine to
determine if it also provides protection against SARS-CoV-2. NIAID is
exploring additional collaborations with extramural research and
industry partners on other vaccine concepts. NIAID also is supporting
the development of standardized assays and animal models that will be
utilized to evaluate vaccine candidates.
With all these efforts, NIAID is coordinating closely with
colleagues at the CDC, BARDA, FDA, DOD, and other Federal and
international partners.
To achieve the ultimate goal of having a SARS-CoV-2 vaccine
available to the public, it is important that NIAID and the entire
biomedical research community pursue a range of vaccine strategies in
order to be better positioned to overcome the scientific or technical
challenges associated with any particular vaccine approach. In this
regard, NIAID has dedicated resources toward preclinical research to
advance a robust pipeline of vaccine candidates into Phase 1 clinical
evaluation. Further vaccine research, including Phase 2 clinical
trials, will then be required. Additional research also is needed to
better understand the fundamental biology of coronaviruses and to
facilitate the design of vaccines that elicit optimal immune responses
and protect against infection.
While on-going SARS-CoV-2 vaccine research efforts are promising,
it is important to realize that the development of investigational
vaccines and the clinical testing to establish their safety and
efficacy take time. Although we plan to begin early stage clinical
testing of an NIAID-supported vaccine candidate in the next few months,
a safe and effective, fully licensed SARS-CoV-2 vaccine will likely not
be available for some time. Currently, the COVID-19 outbreak response
in the United States remains focused on the proven public health
practices of containment--identifying cases, isolating patients, and
tracing contacts.
NIH is committed to continued collaboration with other HHS agencies
and additional partners across the U.S. Government and international
community to advance research to address COVID-19. As part of its
mission to respond rapidly to emerging and re-emerging infectious
diseases throughout the world, NIAID is expanding our efforts to
elucidate the biology of SARS-CoV-2 and employ this knowledge to
develop the tools needed to diagnose, treat, and prevent disease caused
by this virus. NIAID is particularly focused on developing safe and
effective COVID-19 vaccines. These efforts also help to expand our
knowledge base and improve our continued preparedness for the next
inevitable emerging disease outbreak.
food and drug administration
The FDA plays a critical role in overseeing our Nation's FDA-
regulated products as part of our vital mission to protect and promote
public health, including during public health emergencies. Our work
primarily focuses on four key areas: First, actively facilitating
efforts to diagnose, treat, and prevent the disease; second,
surveilling product supply chains for potential shortages or
disruptions and helping to mitigate such impacts, as necessary; third,
conducting inspections and monitoring compliance, including of
facilities that manufacture FDA-regulated products overseas; fourth,
helping to ensure the safety of consumer products.
A key focus area for the FDA is helping to expedite the development
and availability of medical products needed to diagnose, treat, and
prevent this disease. We're committed to helping foster the development
of critical medical countermeasures as quickly as possible to protect
public health. We provide regulatory advice, guidance, and technical
assistance to sponsors in order to advance the development and
availability of vaccines, therapies, and diagnostic tests for this
novel virus.
On February 4, 2020, the FDA issued an emergency use authorization
(EUA) to enable immediate use of a diagnostic test developed by the
CDC, facilitating the ability for this test to be used in CDC-qualified
laboratories.\1\ The FDA is dedicated to actively working with other
COVID-19 diagnostic developers to help accelerate development programs
and requests for EUAs. We have developed an EUA review template for
tests to detect the virus, which outlines the data requirements for a
Pre-EUA package that is available to developers upon request. To date,
we have shared the EUA review template with more than 100 developers
who have expressed interest in developing diagnostics for this virus.
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\1\ FDA. 2019 Novel Coronavirus Emergency Use Authorization.
February 4, 2020. https://www.fda.gov/medical-devices/emergency-
situations-medical-devices/emergency-use-
authorizations#coronavirus2019. FDA. FDA Takes Significant Step in
Coronavirus Response Efforts, Issues Emergency Use Authorization for
the First 2019 Novel Coronavirus Diagnostic: Critical Milestone Reached
in Response to this Outbreak. https://www.fda.gov/news-events/press-
announcements/fda-takes-significant-step-coronavirus-response-efforts-
issues-emergency-use-authorization-first.
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The medical product supply chain is always potentially vulnerable
to disruption, which makes our surveillance work and collaboration with
industry critical and why the agency takes a proactive stance on any
potential impact or disruption to the supply chain. An outbreak of this
global scale has an impact on the medical product supply chains,
including potential disruptions to supply or shortages of critical
medical products in the United States. We are in contact with
manufacturers; global regulators, like the European Medicines Agency;
health care delivery organizations; and other participants in the
medical product supply chains to quickly identify and address any
supply concerns that come from issues related to China and other
locations in Southeast Asia sourcing raw materials for manufacturing
drugs.
We are also tracking reports of increased ordering of some
essential medical devices through distributors, such as personal
protective equipment (PPE) (e.g., respirators and surgical gowns,
gloves and masks). FDA is working proactively to stay ahead of
potential shortages or disruptions of medical products. The agency will
use all available authorities to react swiftly and mitigate the impact
to U.S. patients and health care professionals as these threats arise.
Monitoring the safety of FDA-regulated product supply chains is one
of the FDA's highest priorities. The FDA utilizes risk-based models to
identify firms for inspection and prioritizes inspections based on
specific criteria. Because of travel restrictions to China, the agency
has postponed planned inspection activities in China. However, we are
currently continuing inspection and enforcement activities as normal
for the rest of our operations. Inspections of facilities in China
remain prioritized in our site selection model and, when travel
restrictions are lifted, inspections of facilities in China will
resume. Any travel to China that is deemed to be mission-critical is
being assessed on a case-by-case basis in close coordination with other
HHS components and with the Department of State. FDA is committed to
maintaining its scheduled inspections around the globe to the extent
possible, while maintaining the safety of the staff involved. We will
revisit this approach and adjust as necessary as this outbreak
continues to unfold. In the mean time, FDA is working with our partner
government agency, U.S. Customs and Border Protection (CBP), to
evaluate and adjust our risk-based targeting strategy to ensure FDA-
regulated products are safe when entering the United States.
While the outbreak is impacting our ability to conduct inspections
in China, it's important to underscore that the FDA's regular risk-
based process of surveillance testing of imported products, including
those from China, continues.
Inspections are one of many tools that the agency uses to inform
its risk strategy for imported FDA-regulated products and to help
prevent products that do not meet the FDA's standards from entering the
U.S. market. Other tools include: Import alerts, increased import
sampling, and screening. Inspections are also part of, among other
things, the new and generic drug approval process. While such pre-
approval inspections are on hold in China, we are working to mitigate
the impact on new and generic drug approval decisions by requesting
records that may be used in lieu of an inspection, depending on the
circumstances. Based on our evaluation of previous FDA inspection
history, a firm's previous compliance history and information from
foreign health authorities with which we have mutual recognition
agreements, we determine if the totality of the information would
suffice in lieu of such a pre-approval inspection.
All products offered for entry into the United States, including
items for personal use, are subject to the regulatory requirements of
CBP. Imported shipments of FDA-regulated products referred by CBP,
including those from China, are then reviewed by the FDA and must
comply with the same standards as domestic products. At this time, we
want to reassure the public that there is no evidence to support
transmission of COVID-19 associated with imported goods, including food
and drugs for people or pets, and there have not been any cases of
COVID-19 in the United States associated with imported goods.
We established a cross-agency task force to closely monitor for
fraudulent FDA-regulated products and false product claims related to
COVID-19 and we have already reached out to major retailers to ask for
their help in monitoring their on-line marketplaces for fraudulent
products with coronavirus and other pathogen claims.
FDA is utilizing all our existing authorities to address COVID-19
and we welcome the opportunity to work with Congress to strengthen our
response capabilities. There are 4 specific proposals included in the
President's budget that would better equip the agency to prevent or
mitigate medical product shortages.
(1) Lengthen Expiration Dates to Mitigate Critical Drug Shortages
Shortages of critical drugs can be exacerbated when drugs must be
discarded because they exceed a labeled shelf-life due to unnecessarily
short expiration dates. By expanding FDA's authority to require, when
likely to help prevent or mitigate a shortage, that an applicant
evaluate, submit studies to FDA, and label a product with the longest
possible expiration date that FDA agrees is scientifically justified,
there could be more supply available to alleviate the drug shortage or
the severity of a shortage.
(2) Improving Critical Infrastructure by Requiring Risk Management
Plans
Enabling FDA to require application holders of certain drugs to
conduct periodic risk assessments to identify the vulnerabilities in
their manufacturing supply chain (inclusive of contract manufacturing
facilities) and develop plans to mitigate the risks associated with the
identified vulnerabilities would enable the agency to strengthen the
supply chain by integrating contingencies for emergency situations.
Currently, many applicants lack plans to assess and address
vulnerabilities in their manufacturing supply chain, putting them, and
American patients, at risk for drug supply disruptions following
disasters (e.g., hurricanes) or in other circumstances.
(3) Improving Critical Infrastructure Through Improved Data Sharing:
Requiring More Accurate Supply Chain Information
Empowering FDA to require information to assess critical
infrastructure, as well as manufacturing quality and capacity, would
facilitate more accurate and timely supply chain monitoring and improve
our ability to recognize shortage signals.
(4) Device Shortages
FDA does not have the same authorities for medical device shortages
as it does for drugs and biological products. For instance, medical
device manufacturers are not required to notify FDA when they become
aware of a circumstance that could lead to a device shortage or
meaningful disruption in the supply of that device in the United
States, nor are they required to respond to inquiries from FDA about
the availability of devices. Enabling FDA to have timely and accurate
information about likely or confirmed national shortages of essential
devices would allow the agency to take steps to promote the continued
availability of devices of public health importance. Among other
things, FDA proposes to require that firms notify the agency of an
anticipated meaningful interruption in the supply of an essential
device; require all manufacturers of devices determined to be essential
to periodically provide FDA with information about the manufacturing
capacity of the essential device(s) they manufacture; and authorize the
temporary importation of certain devices where the benefits of the
device in mitigating a shortage outweigh the risks presented by the
device that could otherwise result in denial of importation of the
device into the United States.
Ms. Underwood. I thank all the witnesses for their
testimony. I will remind each Member that he or she will have 5
minutes to question the panel. I now recognize myself for 5
minutes.
Americans want to know what they should expect in the
coming weeks and months. Our State and local public health work
force and our health care system leaders need to know so they
can do everything that they can to be prepared. Dr. Redd, I am
looking for numbers here. What are the current upper and lower
estimates of total deaths due to the coronavirus that we should
expect in the United States?
Dr. Redd. So I don't have an exact answer to that question.
I think it is an important question. I think that there is a
lot that depends on how aggressive our public health
interventions are to really determine the ultimate course of
this epidemic.
Ms. Underwood. OK.
Dr. Redd. There are many unknowns.
Ms. Underwood. Yes, sir. What are the upper and lower
estimates for hospital and ICU admissions?
Dr. Redd. I would give the same answer I gave to the
previous question. The intensity of our public health
intervention measures will determine the ultimate impact of
this pandemic.
Ms. Underwood. OK. Then at current rate to detection
spread, when will California and Washington State run out of
ICU beds and then also hospital beds?
Dr. Redd. Again, the better and more intensive our
interventions are, the lower those numbers will ultimately be.
Ms. Underwood. Do you expect CDC to do modeling that will
be widely reported through like an MMWR or something like that?
Dr. Redd. A number of groups are doing that modeling. I am
not sure what our plans are. We are in communication with
modelers from the United Kingdom around the country on those
sort of things.
A lot of that has to do with estimating the value of
interventions that might be undertaken and where they would
have the greatest impact. So I am not--I don't know whether or
not those things from inside will be published, but there is a
lot of information out there already.
Ms. Underwood. OK. For our health system to prepare to
handle a surge in patients while protecting its work force,
providers need to be able to test every patient who meets the
criteria based on symptoms and exposure. But we know that right
now as the Governor of Illinois just said this morning, not
everyone who should be tested has been.
Dr. Redd, since December how many Americans who meet the
current criteria for being tested have actually been tested and
received their results?
Dr. Redd. I can give you the number of people who have been
tested. Let me, let me find that in my cards here.
Ms. Underwood. OK.
Dr. Redd. The guidance has changed as you know recently----
Ms. Underwood. I know.
Dr. Redd [continuing]. To allow----
Ms. Underwood. That is why we are asking about the current
criteria, sir.
Dr. Redd. Right. I think we are around a little bit more
than 1,700 people have been tested by CDC. There is a lot of
testing happening in State health department----
Ms. Underwood. I understand that.
Dr. Redd [continuing]. Labs now. Let me--if I might--take
the opportunity to talk about--and tell me if you want----
Ms. Underwood. Well, Dr. Redd, what we are really trying to
understand is the number of tests that have been completed, how
many tests need to be done to accurately depict community
levels that spread in the United States. Do you have that
figure?
Dr. Redd. I--what I would like to do is walk through how
the laboratory testing works in the United States.
Ms. Underwood. OK. Dr. Redd, we have heard that briefing
several times here in the Congress. We have some very specific
questions, sir. What is your plan to support States and
communities to get those tests done? When will that be done?
Dr. Redd. So we have taken aggressive action over the last
several weeks--CDC has sent materials sufficient to test 75,000
people through the public health system.
Ms. Underwood. Right.
Dr. Redd. There are over a million tests available through
the commercial system.
Ms. Underwood. Yes, sir.
Dr. Redd. Both of those numbers are increasing as we speak.
Ms. Underwood. Right. But my question, sir, was what is
your plan to support the States to get those tests done for
every single person who should be tested that meets the current
criteria? There is a big gap between 1,700 and 75,000 and a
million. Those are the 3 numbers you just outlined for us now.
Dr. Redd. That is true. The--I think that there are 2
different systems in play here. In the public health system--
and this is not just for this disease but in general, the role
of the public health laboratories are to detect cases early of
new diseases and then to be able to do--representative testing
to estimate the overall burden of disease.
Ms. Underwood. Right.
Dr. Redd. There is a separate system, the clinical system,
which is really for clinical care----
Ms. Underwood. Yes, sir.
Dr. Redd [continuing]. To make sure that a person gets
treated for the right disease that we don't assume that he has
COVID-19 when there is different treatable disease. That is the
much larger capacity that has actually being implemented
rapidly compared with previous efforts with new diseases.
Ms. Underwood. OK. I am going to stop you right there, sir.
Is every test result from both the public and the private labs
being fed into the Flu Surveillance System? Yes or no?
Dr. Redd. Right now the--we are working to include the
commercial laboratories in that system. The large commercial
systems are being included. The public health laboratories are
being included. There are others that are going to be kind of
outliers that we will work to include, but that would be the
ultimate aim.
Ms. Underwood. OK. While there is still a lot that we don't
know about the pathology of the coronavirus, we are seeing that
seniors are among those experiencing higher mortality rates.
So in addition to the coronavirus.gov that we both spoke
about, CDC has a coronavirus information hotline as I am sure
you are aware for those who don't have internet access or who
may not be as internet savvy, like some seniors.
When the committee staff called the hotline, they
consistently faced wait times of 30 to 60 minutes. How is CDC
working to improve its hotline?
Dr. Redd. Let me get back to you on that. I think that is a
very important thing that needs to be corrected----
Ms. Underwood. OK.
Dr. Redd [continuing]. And something to take action on
that.
Ms. Underwood. Just more broadly, sir, our job is to steer
the Federal Government toward the best possible outcome for
public health. Modeling estimates help us evaluate outcomes.
Surveillance informs modeling. Tests inform surveillance. We
need to get all 3 right, sir. We will be making some really
important decisions without a comprehensive view of what we are
facing.
So Dr. Redd, we are going to be sending over some follow-up
questions for you in writing. We would appreciate your help in
ensuring a prompt response. Thank you.
I now recognize the Ranking Member of the full committee,
the gentleman from Alabama, Mr. Rogers, for questions.
Mr. Rogers. I thank you. Mr. Cuccinelli, this morning the
CDC director said Europe is the new China in terms of outbreak.
Is CBP doing more screenings of international travel from
European countries to the United States?
Mr. Cuccinelli. So as each country or in this case region
becomes more and more problematic, it obviously gets reviewed
on a day-to-day basis. I would tell you that it isn't just CBP.
TSA is involved. CDC is involved. This is one of the things
that the task force has considered literally on a daily basis
as we have watched this pandemic move around the globe.
As you know, I am sure there is exit screening going on in
Italy in particular, but Europe presents a unique problem.
Because of the Schengen zone where their borders effectively
don't--they don't have borders for purposes of travel, there
are 29 countries that we have to confront here.
The question arises, does treating--we will take Italy. We
will continue with Italy. Italy in the fashion we would China
or even South Korea as a unitary entity even makes sense.
So what the task force came to with respect to Italy, is we
are testing--in fact, the Italian government is doing it on the
exiting side for direct flights to the United States. That is
about half of those flights--very close to half. They have
dropped from above 7,000 to just above 1,000 a day.
So the--there has been a substantial drop in that travel.
The reason that we chose not to expend the resources to capture
the indirect flights is by way of scale--don't hold me to these
exact numbers--to capture the last 2-, 3-, 4,000 travelers from
Italy depending on the day--and that was at full flight
capacity--would require screening approximately 100,000 people.
Those are resources that just--relative to the cost
benefit--were more appropriate to apply to public health
efforts other than that screening. So in Korea and Italy, we
have allies who we trust and who are transparent doing exit
screening.
We are of course doing entrance screening for those from
Iran and China or who have been through there. But the question
is a live question, Congressman, about how to treat Europe as a
whole. You have seen Department of State and CDC----
Mr. Rogers. Right.
Mr. Cuccinelli [continuing]. Warnings go up. That is not to
the level of using legal authorities to block travel yet, but
it is under consideration.
Mr. Rogers. Well, and it should be. That is the reason I
brought it up. Right now, we are just dealing with a handful of
those countries as you know.
Mr. Cuccinelli. Right.
Mr. Rogers. Given the freedom of travel throughout the
European Union, my view is we should be treating it as a region
as a unit and, and expecting them accordingly. Let me ask--you
know, we just passed in a bipartisan fashion an $8.3 billion
supplemental to help with this. I know a lot of that is going
toward vaccine development.
Mr. Cuccinelli. Right.
Mr. Rogers. But it went from $2.5 billion to $8.3 billion
real fast. Tell me how that money is broken out. What are you
going to do with it?
Mr. Cuccinelli. Well, as you probably know, the money that
DHS receives comes through HHS. So I will give you an example:
FEMA has been with ASPR since--for about a month now at their
request as the lead Federal agency in HHS and are--FEMA is
reimbursed for those services effectively through interagency
agreements.
So the dollars you are describing from the supplemental
that reached DHS come through HHS in exchange for services in
accordance with the law.
Mr. Rogers. Is it just FEMA or won't CBP to get some of
that money?
Mr. Cuccinelli. Right now, it is just FEMA. CBP, CWMD, the
Coast Guard, TSA are all operating out of their base budgets
for all the work they are doing----
Mr. Rogers. Do you expect----
Mr. Cuccinelli. As is the, you know, S&T as well.
Mr. Rogers. Do you expect that to be sufficient given the--
--
Mr. Cuccinelli. For the moment, we do. Yes. Some things
would have to change for that to not be sufficient but so far
none of those conditions have arisen.
Mr. Rogers. Doctor Redd, the Chinese government failed to
give us notice for 2 months from the time of the outbreak until
they did make the international community aware. What damage
did that do to our ability to deal with this in a better
fashion if any that you are aware of?
Dr. Redd. You know, I think there are some things that they
did well and others that they didn't. Reporting the outbreak
quickly, posting the sequence of the new virus--there did
appear to be a period of time when probably things were going
on that weren't getting out of China.
I think there were questions about whether there was human-
to-human transmission that initially it appeared it might be
just people exposed to animals. So I think that, that was a
period of time when we were--there is not really anything we
would have done differently. We were working on a diagnostic
test. We were sending materials that started the ball rolling
on vaccine production.
We--you know, as you know within weeks of identifying the
outbreak, it really--the restriction of travel from China
reduced travel by 90 percent. I think that was a very helpful
move to prevent more cases from China coming into the United
States.
Mr. Rogers. Thank you. Madam Vice Chair, I yield back.
Ms. Underwood. The Chair will now recognize Members for
questions that they may wish to ask the questions. In
accordance with our committee rules, I will recognize Members
who are present at the start of the hearing based on seniority
in the committee alternating between Majority and Minority.
Those Members coming in later will be recognized in the
order of their arrival. The Chair recognizes for 5 minutes the
gentleman from Mississippi, Mr. Thompson.
Chairman Thompson. Thank you very much, Madam Chair. In my
earlier comments, I talked about the importance of transparency
and communication. The public only gets what we tell them. If
we don't tell them accurately, then it is misinformation.
The best example I can share in my opening statement the
very first briefing we got we were told that there is a 800
number. The briefers--as Members of Congress--the briefers
didn't know the 800 number. They had to get the number and
bring it to us.
Now, I hear that the number is working, but if as a member
of the public who would call and be put on hold for 30 to 60
minutes. It just absolutely too big a problem. So I hope that
you--you look at it.
Two of the people we heard from last week--one was a former
head of CDC and the other was a respected researcher from John
Hopkins--they made it very clear to us that communication is--
and transparency in this kind of situation is absolutely
important.
So Dr. Redd, can you tell me if the coronavirus task force
is carrying out its meeting at a Classified level or are they
open?
Dr. Redd. I know that the meetings are being held in a
Classified facility. I don't think that they are Classified.
Chairman Thompson. Well, I want you to check because I
think there are some challenges in that arena because they are
in fact Classified. Part of the problem a lot of us are having
is an over classification of information to the point that the
public doesn't know. So look at that.
Dr. Redd. Actually, I would like to agree with your major
point, which is I agree that communication and information is a
critical took in combating the outbreak.
People need to know what is happening. They need to know
what kind of actions they can take to protect themselves. It is
really one of the most important tools that we have at this
point.
Chairman Thompson. So in line with the Chairperson's
question, how many test kits do we have as of today?
Dr. Redd. So on the public health side, 75,000. On the
commercial side, over a million--somewhere between 1- and 2
million right now. The numbers are increasing rapidly.
Chairman Thompson. So how would the test kits be dispersed?
Dr. Redd. So on the public side they go to State health
department laboratories and other laboratories that are a part
of our network for influenza surveillance. Actually, on the
commercial side it is however that system normally works. So it
depends on the company. Some of them have----
Chairman Thompson. Well----
Dr. Redd [continuing]. Facilities.
Chairman Thompson. Well, you know, we trying to help the
public--you are tell them we have a million test kits, but if
somebody from CDC in your position can't explain to me how the
public can access those kits that is not very helpful.
Dr. Redd. I agree with that. I think that what people need
to do if they feel that they are in need of a test is--the
first thing would be to call their doctor. The doctor would
then--depending on how they have access to the test--it could
either be through the commercial system or it could be through
the public health system----
Chairman Thompson. So----
Dr. Redd [continuing]. That person----
Chairman Thompson. Are those 75,000 test kits that you
talked about that are publicly available, does that address all
of the current needs here in the United States?
Dr. Redd. It doesn't. It doesn't. That is why the
commercial manufacturers are such an important part of this----
Chairman Thompson. Absolutely. But are they talking to each
other?
Dr. Redd. So I--I have----
Chairman Thompson. Well----
Dr. Redd. I mean----
Chairman Thompson. Get back to us.
Dr. Redd [continuing]. Basically yes. You know, I think the
answer is----
Chairman Thompson. Well, I mean----
Dr. Redd [continuing]. Yes.
Chairman Thompson. You know, we are trying to give the
public some comfort that if you say we have a million kits then
there is a process that is defined for those million kits to be
accessed.
We don't have that based on what you are telling me. I
think one of the reasons we are here today is to put some
clarity on how we address this situation.
Dr. Redd. Yes, sir. I think that people--I think that the
patient experience here is really critical. And that when they
need a test, they can get one quickly and get the results
quickly. That is the aim that we are----
Chairman Thompson. OK.
Dr. Redd [continuing]. Hoping to achieve.
Chairman Thompson. Thank you. If the Chairwoman will
indulge me just for--Mr. Cuccinelli, on March 1, 2020 a
District Court Judge ruled that you were not lawfully appointed
to serve as the acting director of USCIS and that accordingly
the reduced time to consult and prohibitions on extensions
directed must be set aside.
Are you still serving the senior--as a senior official
performing the duties of director of USCIS in opposition to
what the court ruled?
Mr. Cuccinelli. No, sir. The court ruled that in my
position as principle deputy at USCIS I was not properly
occupying the position of acting director of USCIS. That is
obviously something we are still analyzing and obeying the
court order with respect to the 5 plaintiffs.
My current position as senior official performing the
duties of the deputy secretary derives not from my previous
capacity as acting director of USCIS, but from my official
position as principle deputy of USCIS.
So my--as I perform the rules I am here doing today as a
senior official performing the duties of deputy secretary that
is not affected by the court's ruling. The court did not rule
that I am inappropriately occupying my current position. It was
the prior position.
Chairman Thompson. So that is your interpretation of the
court's order?
Mr. Cuccinelli. No, sir. That is the ruling.
Chairman Thompson. Well, I would--have you had the
counsel----
Mr. Cuccinelli. Yes.
Chairman Thompson [continuing]. From DHS look at that?
Mr. Cuccinelli. Yes, sir.
Chairman Thompson. Did they provide you something in
writing?
Mr. Cuccinelli. No, sir.
Chairman Thompson. So how did--what, they just told you?
Mr. Cuccinelli. Well, it is pretty simple and
straightforward Mr. Chairman. So it wasn't hard for them to
explain it to me.
Chairman Thompson. Well, I would--as Chair, we would like
to get it in writing because I think the court was fairly clear
that your present position was not consistent with the law. Any
way of trying to massage it just gets around it, but I--we will
look forward to getting that correction. I yield back.
Ms. Underwood. The Chair now recognizes the gentleman from
New York, Mr. Katko, for 5 minutes.
Mr. Katko. Thank you, Madam Chair. Mr. Cuccinelli, is there
anything else you want to add to the last line of inquiry
before we proceed----
Mr. Cuccinelli. Just----
Mr. Katko [continuing]. To other questions?
Mr. Cuccinelli. I would just point out the time line. It
might help understand the ruling. The case was filed last
summer when I was serving as the acting director of United
States Citizenship and Immigration Services as assuming that
vacant slot from my position as principle deputy.
The hierarchy if you will of the deputy secretary position
as it currently stands traces back to the principle deputy for
the United States Citizenship and Immigration Services. It does
not trace back to either the director or acting director
phrased in any way.
That is why I gave the answer to the Chairman that I did.
It was why I got the legal advice from counsel at DHS that I
did.
Mr. Katko. Thank you, sir. Doctor Redd, I want to drill
down a little farther on the previous line of our inquiry as
well. I am trying to get a handle.
So you have 75,000 tests in a Government--I mean in the
Government sector. You have a million tests in the private
domain. What happens--what is going to happen to those million
tests? Where do they go?
Dr. Redd. So those--the purpose of those tests would be
clinician, a doctor nurse practitioner, physician's assistant
could order a test and that would go just the way any test you
would get in a doctor's office would go.
It would be sent to a commercial laboratory either at the
hospital or one of the large companies. You would get a test
result. It would come back to your doctor. We are working on
making sure that, that information also is funneled into the
Government so we will be able to track those tests.
But it is essentially a way of providing a test that can be
used for clinical services where public health testing
generally is to detect the first cases and then to really to do
surveillance. You don't have to test every case to do
surveillance, but for clinical care you do need a test for each
person.
Mr. Katko. I just want to make sure I understand this. Is
it fair to say that you have the million tests that are already
available, plus you have 75,000 more tests? All of them are
getting in front line one way or another for testing of
patients?
Dr. Redd. Yes, sir.
Mr. Katko. OK. How much more--are going to be expected the
next few weeks that are going to be produced?
Dr. Redd. So the time line I am not so sure on, but it is
going to be additional millions of tests in the commercial
sector.
Mr. Katko. OK. Good. That is good to hear. Now, when we get
these tests out there, it is fair to say that these numbers are
going to go up, the number of positive tests are going to go up
and go up significantly; is that correct?
Dr. Redd. I think that is fair to say that we are going to
identify additional cases with more testing.
Mr. Katko. OK. As these numbers go up, you are going to
have to act according on what has been considered by the World
Health Organization now a pandemic.
I think we need to have the American people prepared for
the fact that we are going to have a very serious rise in the
number of cases. Has there been any estimates as to what they
think it is going to be, the numbers next month or so?
Dr. Redd. So I think the total numbers really depend on the
aggressiveness and intensity and effectiveness of our public
health measures. One of the things that is happening and just
in our strategy to respond, early on we wanted to identify
every case, identify the contacts of that case, recommend self-
monitoring to prevent further spread.
At this point, the individual measures in some parts of the
country where there is intense community transmission, those
measures are not appropriate. That there are more important
things to do.
That is really when we shift to a community measures such
as making sure nursing homes are especially protected,
canceling large gatherings, recommending as we have that people
that are at risks, seniors and people with chronic medical
conditions, take different steps to protect themselves from
becoming exposed.
So it is a shift from a kind-of an individual level case
tracking to something that is broader and applies to entire
communities.
Mr. Katko. As a matter of precaution, should we be doing
any of those things now and not waiting until they get all
these positive tests? What should we be doing now?
Dr. Redd. We should. In fact, we are in King County,
Washington; in Santa Clara County; in New York City. There
are--in fact today--I think maybe just as the hearing started,
there was guidance posted based on--a guidance document they
released a few days ago but tailored specifically for King
County and Santa Clara working with the health departments on,
you know, what does it mean to actually apply this guidance to
your community at--in the situation that you are in right now.
I think that the--in general these measures are more
effective the earlier they are implemented. We have seen that
in other parts of the country--or world in Singapore, Hong Kong
where they are taking very aggressive measures, and in those
cases had a really good success in preventing the kind of
transmission that we would like to prevent.
Mr. Katko. Last, the line--the lab testing. Could you just
briefly explain to us just so we are clear, how does the lab
testing actually work?
Dr. Redd. So a specimen is obtained from a person. We are
actually--the way that it has been--now is a nasal specimen. So
there is a device that is stuck in the person's nose to collect
a specimen, a throat swab that is put in transport medium, is
transported to a laboratory.
There is a process of denaturing that specimen that might
contain a virus. That denatured specimen is then put into a
machine that assays for specific parts of the nucleic acid, the
genetic material of the virus.
There are also a set of positive controls so to make sure
the test would find if it is there, and negative controls to
make sure if it is not there it wouldn't be detected. That then
yields a yes or a no result.
It also can tell you the concentration--something that is
called cycle threshold. That is basically the number of times
the machine has to go through this cycle. So a high number
means there is not that much virus there. A low number means
there is a lot.
Mr. Katko. All right. Thank you very much. I yield back,
Madam Chair.
Ms. Underwood. The Chair now recognizes the gentlelady from
New York, Miss Rice, for 5 minutes.
Miss Rice. Thank you, Madam Chairwoman. Mr. Cuccinelli,
during the past public health crisis like Ebola and H1N1, the
Department of Homeland Security played a pivotal role in a
clear and coordinated Federal Government response.
With the coronavirus, our State and local governments have
stepped up to fill this role. States like New York have had to
respond quickly to deploy emergency management and to work with
local partners to keep our citizens safe. They instead of your
agency are at the front lines of this outbreak.
So for some reason it appears--and maybe you can enlighten
me if I am wrong that DHS has not been on the front lines like
they have in prior epidemics? So could you clearly state what
DHS's role has been in responding to the coronavirus and what
you see as your role going forward?
Mr. Cuccinelli. Certainly. As we move further and further
away from containment which is where the Department of Homeland
Security has a significant role and into mitigation which we
have been doing for weeks now, as Doctor Redd has referenced
implicitly a number of times, the front lines folks in just
pure volume of numbers are your local and State public health
authorities.
This is--we are following the pandemic plan put in place 2
years ago which was the most recent iteration of that plan. It
in fact calls for extensive cooperation with the Federal
Government supporting local and State efforts.
The sheer number of medical and health care professional
personnel required to address a pandemic like this puts us in
the position of necessarily relying on State and local
officials to be front-line fighters in this effort.
I will give you an example. When we saw the Grand Princess
problem developing off the coast of California, we had a
unified command set up between the Coast Guard, CDC,
California.
But in practical terms, because those people were going to
land in California, were most likely to be impacting California
health care facilities and capacity, California very much had
the lead and did a great job with it. We are being very careful
not to step on States or to tell them what to do. We are
partnering with them as best we can, so----
Miss Rice. OK. Thank you. I am just going to stop you
there.
Mr. Cuccinelli. Sure.
Miss Rice. It is now being reported that my home State of
New York, we have almost 200 cases of the coronavirus which
makes it one of 3 States with the highest number----
Mr. Cuccinelli. Yes.
Miss Rice [continuing]. Of cases. Before this hearing, I
spoke with the head of the Department of Health in Nassau
County, which is on Long Island which my district is--fully
encompassed in.
I asked him--you know, I said that I was going to be at a
hearing with you. I said is there anything that you need that
you don't have that the Federal Government can provide?
He said what we really need--because now they are seeing
more significant cases of community spread; for instance, in my
district alone, the number of infected people has quadrupled
since Sunday.
Mr. Cuccinelli. Right.
Miss Rice. So I asked him what can the Federal Government
do? He said, you know, what we would love is some guidance as
to what public events should be canceled, what public events
should not be canceled.
Dr. Fauci testified today that large sporting events should
be banned. So what is your guidance? They are looking to the
Federal Government for some guidance on that issue so there can
be a--so we don't increase the panic. And----
Mr. Cuccinelli. Right.
Miss Rice [continuing]. That States are not doing different
things and getting people all riled up when they don't need to
be.
Mr. Cuccinelli. Well, we--in the Department of Homeland
Security, we essentially operationalize CDC guidance. We look
to the CDC's guidance as well, and because of the novelty of
this virus it has been changing. I know--I will turn it over to
Dr. Redd, but----
Miss Rice. Well, let me just stop right there. OK. So I
will follow up----
Mr. Cuccinelli. OK.
Miss Rice [continuing]. With my question. I just wanted to
ask you--Dr. Fauci also said ``We would recommend that there
not be large crowds.'' Would you consider a political rally in
an arena that is filled to capacity with between 8- and 12,000
people--would you consider that a large crowd?
Mr. Cuccinelli. We would consider probably anything over
1,000 people a large crowd.
Miss Rice. OK. Doctor, if you could--the questions that Mr.
Cuccinelli----
Dr. Redd. Yes, I think that the purpose of the gathering
wouldn't determine whether it would be, you know----
Mr. Cuccinelli. Right.
Miss Rice. Well, let me--do you agree with Dr. Fauci on
that, that there should not be--that he said we would recommend
that there not be large crowds? Would you recommend with him?
Dr. Redd. I would.
Miss Rice. Would you, Mr. Cuccinelli?
Mr. Cuccinelli. Again, we look to the medical professionals
for that----
Miss Rice. I am asking your opinion.
Mr. Cuccinelli. Guidance.
Miss Rice. You are in this for DHS.
Mr. Cuccinelli. I am sorry. I am not going to give you my
opinion. I will tell you the opinions I look to operationalize
when we do our jobs.
Miss Rice. But do you agree with what----
Mr. Cuccinelli. Dr. Redd.
Miss Rice [continuing]. Dr. Redd is saying?
Mr. Cuccinelli. Well, I certainly----
Miss Rice. Yes or no.
Mr. Cuccinelli [continuing]. Look to his employer for CDC
for where we----
Miss Rice. Why can't you answer this question?
Mr. Cuccinelli. Well, I am sorry. I don't know that it is a
can't----
Miss Rice. Is it because the President has said that he has
no plans to not have people--thousands of people gathered
together in large crowds? Is that why? Because Dr. Redd----
Mr. Cuccinelli. So when we had this----
Miss Rice [continuing]. Said it in 2 seconds----
Mr. Cuccinelli [continuing]. Decision to make----
Miss Rice [continuing]. That he agreed with Dr. Fauci. Can
you please give me a yes or no answer? Do you agree with Dr.
Fauci when he said we would recommend that there not be large
crowds?
Mr. Cuccinelli. I am not prepared to do that.
Miss Rice. OK. That is quite unbelievable. I think my time
is up. Thank you, Madam Chairwoman.
Ms. Underwood. The Chair now recognizes for 5 minutes the
gentleman from North Carolina, Mr. Walker.
Mr. Walker. Yes. Do you need another minute to kind-of go
into detail or are you satisfied with that answer?
Mr. Cuccinelli. Congressman, when we had this decision that
we had to make last week, it wasn't 1,000 people; it was about
200 at our Seattle office. We took into account what the local
authorities were doing. That was part of our decision-making
process.
We will adjust our decision making based on what is going
in the particular community at issue. Would I have less
reluctance in agreeing with Dr. Fauci if we were talking about
Seattle? Yes. Then if we were in the middle of, you know, an
area of a State that was not experiencing interruption.
Mr. Walker. Sure. So it is----
Mr. Cuccinelli. Absolutely.
Mr. Walker [continuing]. Is subjective. I know our
Democratic Governor just ruled that the NCAA tournament there
in North Carolina should move. So some of this could be
geographically influenced? Would you agree?
Mr. Cuccinelli. Absolutely. Again depending on what is
going on in that local area.
Mr. Walker. What procedures do have in place--specific
question here. I was recently in the Rio Grande Valley border.
Over 60 different countries--or migrants from 60 different
countries had been apprehended.
This year alone I believe several hundred Chinese
nationalists have been apprehended as well. The procedures in
place if you arrest a migrant that is showing size of
respiratory problems, how do you handle that? Do you separate
them or isolate them? What is the procedure in handling this?
Mr. Cuccinelli. So we have prior to the existence of this
virus in place standard operating procedures because we do
confront communicable disease on the Southwest Border with a
certain degree of regularity. Those folks are transferred to
ICE. They have quarantine procedures.
If that is not available, CBP is in a position of having to
rely on local health care systems to provide that support.
Those are the two avenues we have.
Mr. Walker. I appreciate that. Dr. Redd, thanks again for
your long-term service. I appreciate what you are doing. There
are reports that there are two strains of this virus. If the
virus continues to mutate, does this possibly slow efforts to
develop a vaccine or contain in other aspects?
Dr. Redd. Well, viruses that have the genetic material--
ribonucleic acid--when they--they naturally mutate. In fact,
the--when we do sequencing we actually get a bunch of different
viruses. There is a consensus sequence. So I think that they
just naturally mutate.
I don't think we can predict what will happen with the
virus. It would be unusual for there to be enough mutation that
a vaccine that we would produce against a strain now wouldn't
work because of that kind of drift.
Mr. Walker. We had a very strong presentation yesterday--
from Doctor Scott Gottleib who was pointing out the fact that
he believes in his opinion that this will slow down in the
summer or dissolve a good bit but have maybe a potentially a
small spike back in the fall. Is that what you guys are seeing
as well?
Dr. Redd. I think we hope that in the summer we will see a
drop in transmission. I don't think we can say that we know
that. That what you are describing is what happened with H1N1
where we had a fall--or a spring wave. Things went low in the
summer--still had more flu than usual in the summer. Then in
August and September, we saw a big increase.
I think that, that does--if that were to happen, it would
be a great thing because it would give us time to be more
prepared for that fall wave.
Mr. Walker. Right. Traditionally the flu follows that
pattern; is that correct?
Dr. Redd. That is true.
Mr. Walker. OK. We talked about it already. The World
Health Organization has now listed this as a pandemic. Does
that modify your guys' approach or change anything as far as
the way you are moving forward with it?
Dr. Redd. It really doesn't. I think what that declaration
was something that people working in this already knew that it
is around the world, and there is lots of community
transmission around the world.
Mr. Walker. OK. Thank you. Time for another question with
Mr. Cuccinelli. Do you have a plan for FEMA should an area that
is the center of outbreak--we were just talking about
geographic and maybe demographics as well--if there is an
outbreak that could be considered maybe a natural disaster? How
does those two connect and what is your role in this?
Mr. Cuccinelli. So you are probably familiar with our IMAT
teams that get deployed; for instance, Tennessee just had
devastating tornados. FEMA deployed its IMAT teams and them
followed up with support.
What we are designed around at FEMA is fairly large IMAT
teams to respond to a natural disaster as you describe. But
here we can and are seeing eruptions all around the country.
So what FEMA has done is they have broken their IMAT teams
down into smaller teams so there is at least one for every
single State and territory. They are smaller 4- or 5-person
teams. They have been trained specifically to support States
and local officials under these circumstances obviously
different from a natural disaster.
So we have adjusted our personnel--that is what we have
been doing with some of this time is changing our set up, our
structure, and our ability to reach out and more quickly
support States and local officials in that capacity.
If a local area is overwhelmed--if they have systems
overwhelmed, at that point, they might request FEMA assistance
on a more traditional basis that you are used to. I would note
the Stafford Act isn't really designed for this sort of
situation, but they are analyses of that going on right now.
Mr. Walker. Thank you. Madam Chair, I yield back.
Ms. Underwood. The Chair now recognizes for 5 minutes the
gentlewoman from New Mexico, Ms. Torres Small.
Ms. Torres Small. Thank you, Madam Chair. Thank you for
being here. I want to pick up on that string of coordination
with State and local governments because as you know State and
local governments are at the front lines of this crisis right
now.
Dr. Redd, it is my understanding that is the CDC's standard
to notify State officials if individuals from their State were
on-board a suspected coronavirus-infected ship. Can you confirm
that?
Dr. Redd. I think that, that depends on the setting. I
think that with the volume, we are working with the cruise
industry to identify who would actually do that notification.
Ms. Torres Small. In what setting would you not notify a
State if there was a----
Dr. Redd. State. Yes. Yes, we would--well----
Ms. Torres Small. Oh, perfect.
Dr. Redd. Yes.
Ms. Torres Small. OK. Wonderful. Wonderful.
Dr. Redd. I think contacting the individual is just a
different story.
Ms. Torres Small. Fantastic. OK. I----
Dr. Redd. Misunderstood you.
Ms. Torres Small. I appreciate that if the State--you will
notify the State if they are. Today, we learned that 2
individuals from my district who were on a cruise ship with
suspected cases tested positive for the coronavirus.
It is my understanding that the individuals returned to
their local community for over week before the CDC notified the
State of New Mexico. What are you doing to rectify this failure
of communication?
Dr. Redd. Oh, I have to look into that particular instance.
I am not familiar with that. We can get back with you on what
the specifics of that.
Ms. Torres Small. I appreciate that. I know things are
moving incredibly quickly, and so I--we are all working to just
move forward better together. So to that note, will the CDC
commit to sending a list of all individuals who have traveled
to New Mexico from areas of concern today?
Dr. Redd. I think that, that lists--I think this is one of
the problems that we are coming into is that there is
transmission from so many different places that it sort of
depends on what--what the--what locations coming from would
count as a place of concern.
So I think--you know, this is one of the things that we are
working with is many countries in Europe now have cases. It is
not just Northern Italy as it was a week or so ago. I think
this is one of the things that was referenced earlier that
there is daily discussion about what should be done about
travel from locations just as you described?
I think our current policy is, is problematic in that
people--there is a lot of cases and outbreaks being sparked
from travelers. You have heard from the testimony this morning
that Europe is the new China from the standpoint of coronavirus
and exporting of cases.
Ms. Torres Small. Thank you, Dr. Redd. Just to--I recognize
that this is a big problem you are trying to get your handle
around. So maybe we can identify some of the--the easier places
to start in terms of State notification. Can you notify the
State of all service members who are coming to New Mexico who
have traveled from areas of concern?
Dr. Redd. I believe that, that notification is occurring--
--
Ms. Torres Small. Let's confirm that.
Dr. Redd [continuing]. Particularly from--well, parts of
the world that service members have been identified in. But let
me--we will take that for action.
Ms. Torres Small. That is fantastic. The same with DoD
personnel?
Dr. Redd. Yes.
Ms. Torres Small. OK. What about public health service
corps members?
Dr. Redd. I think that, that is a reasonable suggestion.
Let me though--I think this is one of the instances where the
more places that have cases, we could essentially be
identifying any traveler returning to the United States.
There is a point at which that ceases to be as useful as--
particular as it was earlier when it was China or you could say
China, Iran, South Korea, Italy.
Ms. Torres Small. That is fair.
Dr. Redd. Because I think there is going to be a point
where that notification really--it is harder to take that for
public health action because there would be so many people
everywhere. You could almost take a plan coming from Europe.
Ms. Torres Small. Thank you, Dr. Redd. Just switching,
quickly in my last minute, to date how many people have been
tested for the coronavirus across the United States?
Mr. Cuccinelli. So I can't give you an exact answer on
that; 17,084 and have been tested at CDC. There are thousands
that have been tested in the last week at State health
department laboratories. We are working on setting up the
system to collect information from the commercial
manufacturers. So that----
Ms. Torres Small. OK.
Mr. Cuccinelli [continuing]. That what you are describing--
the question that you are asking is the one that we are seeking
to be able to answer.
Ms. Torres Small. So 17,084 confirmed plus other places
that you are working on seems lower than other countries where
they are testing--South Korea, for example, can test up to
10,000 a day. Germany has done a lot. Do you have a time line
for scaling up testing in the United States?
Mr. Cuccinelli. Well, we have scaled up in the past week
that there is 75,000 test kits for the--sorry--75,000 materials
sufficient to test 75,000 people on the public health side, a
million on the commercial side. I would like to say that we
cannot really test our way out of this epidemic. That that is a
part of the response, but there are many other----
Ms. Torres Small. And it is----
Mr. Cuccinelli [continuing]. Important elements.
Ms. Torres Small. Absolutely. But it is a part we need to
focus on. How many tests a day can we expect in the next few
weeks?
Mr. Cuccinelli. Yes, I think that--that is a hard question
because there is a lot--all the other things besides having the
materials are----
Ms. Torres Small. Do you have a goal?
Mr. Cuccinelli [continuing]. Appropriate? I think what we
want is what everybody here wants which is every person that
needs a test can get it the same day. That would be the
objective.
Ms. Torres Small. OK.
Mr. Cuccinelli. We are working toward that end.
Ms. Torres Small. Thank you. My time has expired.
Ms. Underwood. The Chair now recognizes for 5 minutes the
gentleman from Pennsylvania, Mr. Joyce.
Mr. Joyce. Thank you, Madam Chair. Thank you for holding
this hearing. I would also like to thank both of our witnesses
for appearing today and for keeping Congress informed as to
what President Trump's administration and the efforts to combat
and contain this novel coronavirus.
Secretary Cuccinelli, thank you for mentioning in your
testimony the work that DHS is doing to keep our front-line
employees safe, especially given that the nature of their work
leads actually to a higher risk of exposure. You mentioned in
your testimony that all CDP--all CBP personnel have access to
personal protective equipment.
Can you assure us that there is sufficient equipment for
all personnel at CBP? Do you believe additional funding is
necessary to ensure the on-going availability of this
protective equipment?
Mr. Cuccinelli. Congressman, tracking PPE for our employees
has been something we have done from Day 1, well back into
January. We are comfortably ahead of that curve. We keep a
stock of 30-plus days on hand. We would probably say we have
around 45 days available. That is standard for us.
We are not seeing a threat to that. We are not seeing a
draw-down at a pace that is cutting into our ability to
maintain protection and protective gear for our employed work
force.
Mr. Joyce. Thank you, Mr. Secretary. On another matter, the
lack of a full operational control of our Southern Border is
something of particularly concern to many of my constituents.
Since taking office, President Trump has repeatedly asked
for additional funding for the border security, including hard,
physical wall infrastructure. That has either gone unfunded or
ignored by Congress.
Briefly--Mr. Walker said this--but given the control that
comes in and out of our Nation is at the hands of CBP, it is
imperative that we seek to prevent this novel virus from coming
in through our borders. Do you agree that fully funding the
President's budget request for border security is necessary for
the protection of our country?
Mr. Cuccinelli. Well, certainly, we do, Congressman. The
way you phrased it, border security, speaks to the
comprehensive nature of the strategy we need to employ which
includes the whole wall system, but it also includes our
people, the folks in the Border Patrol and in ICE who back them
up at USCIS who do much of the processing. That entire system
is necessary to maintain security at our border.
One of the things--you know, every month you all see the
numbers of apprehensions and so forth. But what doesn't get
talked about as much is what we call the getaways. There are
plenty of people who are not caught.
When you think about that in terms of communicable disease
that takes on a whole new threat. It has existed with other
communicable diseases; measles to name one--TB. We do see them
in--across the United States at levels that many communities
haven't seen in some time because of the situation at the
border.
We are not yet having a coronavirus problem at the Southern
Border, but we are planning for such a problem as we see the
case numbers in South and Central America rise precipitously as
we are in other parts of the world.
Mr. Joyce. Secretary Cuccinelli, you talk about individuals
who are apprehended and those who get away. Have you
apprehended individuals from China or other nations where we
have known cases of the virus?
Mr. Cuccinelli. We have not yet apprehended anyone crossing
illegally--well, I will speak to legally in a second--who has
tested positive for the coronavirus. We have apprehended almost
400 Chinese nationals since January 1--no positive coronavirus
tests amongst those individuals or any others at this point.
We have also based on the 212(f) proclamation the President
implemented on January 29--I should say 31, effective February
2. We have turned away people from all--many countries of the
world because they had been in China or Iran in the previous 14
days.
The No. 1 category of foreign nationals we have turned away
are Canadians. Chinese are second at our land ports of entry
under the 212(f) authority. So we don't know who amongst those
folks had what medical condition because they were turned away.
Mr. Joyce. Thank you, Mr. Secretary for your attention to
this subject. I yield my remaining time.
Ms. Underwood. Mr. Cuccinelli, I just wanted to follow up
on that. Are you all testing every apprehended individual from
an affected country?
Mr. Cuccinelli. I am sorry. Are we--I am sorry, ma'am. I
didn't hear you.
Ms. Underwood. Are you testing every individual apprehended
from a coronavirus-affected country?
Mr. Cuccinelli. No, we are not. No, we are not.
Ms. Underwood. OK. So you said that--you just said that
there--out of the 400 Chinese nationals that there was no
coronavirus found. So how many of those 400 were you testing?
Mr. Cuccinelli. I don't know how many we have tested. We
don't test unless observe symptoms again using already existing
protocols. We are not creating yet new protocols to deal with
potential coronavirus sufferers. We deal with them as we would
any other immigrant that we encountered.
Of course setting this virus entirely aside--one of CBP's
roles, though not medically trained, is to observe those coming
into the country for symptoms of illness in general.
Ms. Underwood. Absolutely. Yes. We are very well aware of
the screening standards--passed a bill to that end out of this
committee. Would you be willing to submit to us in writing a
summary of those tests that you--that CBP has performed on
migrants apprehended at the Southern Border?
Mr. Cuccinelli. I would be happy to go determine how many
immigrants we have tested for coronavirus.
Ms. Underwood. And submit it to us in writing to this
committee----
Mr. Cuccinelli. Yes.
Ms. Underwood [continuing]. Promptly, please? Thank you,
sir. The Chair will now recognize, Mr. Rose, from New York, for
5 minutes.
Mr. Rose. Thank you, Madam Chairwoman. Dr. Redd, would you
agree that we will not be able to test nearly enough people
without automated, automatic or automated testing approved in
our State laboratories?
Dr. Redd. I think that, that kind of testing is being done
at the commercial scale. I am not sure it is necessary in the
public health scale side. That is where these different roles
that the two types of testing play is----
Mr. Rose. So maybe I am confused about something. My
understanding is, is that automated testing needs to be
approved by the CDC in conjunction with the FDA before it can
occur in any laboratory private or----
Dr. Redd. There is----
Mr. Rose [continuing]. Commercial or public.
Dr. Redd. There is a process of emergency use
authorization. That is an approval that the FDA grants to do a
test that is earlier in development.
Mr. Rose. You review it though?
Dr. Redd. Well, we develop it. We basically----
Mr. Rose. So has any--it exponentially increases the number
of tests that can be conducted in 1 day? It is significant. We
need for it----
Dr. Redd. Right.
Mr. Rose [continuing]. To happen as quickly as possible.
You would agree with that?
Dr. Redd. Right. I think that is right. I think whether we
do that on the commercial side or in the public health side
is----
Mr. Rose. I don't care what laboratory is doing it. It has
got to happen.
Dr. Redd. Exactly.
Mr. Rose. Has any laboratory in the country been approved
for automated testing yet?
Dr. Redd. I am--I can check on that. I can tell you that
the LabCorp and Quest use those kind of systems, and they have
been approved.
Mr. Rose. So is it happening anywhere in the country?
Dr. Redd. It is happening in those laboratories.
Mr. Rose. OK. Because it is not----
Dr. Redd. Let me--let me verify that.
Mr. Rose. That way--there is a difference between semi-
automated. There is manual, semi, and then full automated. We
have to get to fully automated, correct?
Dr. Redd. Let's check to--I will----
Mr. Rose. Because I can tell you not one laboratory in New
York has been approved. Can I have your word here publicly that
you will make this a top priority to get not just in New York,
but as many laboratories across the country approve for this as
quickly as possible?
Dr. Redd. I think we want the same end which is to have
really every person that needs to be tested be able to get that
test done----
Mr. Rose. Certainly.
Dr. Redd [continuing]. The day that they need it. To that
end, I think the exact means that you use to get there--I
wouldn't--I don't want to quibble about that.
Mr. Rose. But you do agree we can't get there without
automated testing?
Dr. Redd. Some level of automation, certainly.
Mr. Rose. Some level. OK. So thank you for that. I look
forward to working with you and your team----
Dr. Redd. Yes, sir.
Mr. Rose [continuing]. To get New York there as quickly----
Dr. Redd. I----
Mr. Rose [continuing]. As possible.
Dr. Redd. It is a high priority. I think what is going on
there is something that we are working very closely with the
health department on.
Mr. Rose. Do you have any sense of a time line for how
quickly we can get to these automated testings approved in New
York?
Dr. Redd. Well, I think--I guess again I think that this is
not a problem we can test our way out of. I think that, that is
part of the overall strategy. We need to be testing so that
our--we understand where we need to be intervening, and we
understand the effectiveness of those interventions. So I
actually----
Mr. Rose. Of course.
Dr. Redd. I don't think every--for public health purposes,
every single person doesn't need to be tested; for example, in
the influenza pandemic 10 years ago, we weren't able to test
everyone. We didn't need to test everyone. Our public health
interventions were guided by the ability to extrapolate from
the laboratory tests that we had.
Mr. Rose. Of course.
Dr. Redd. Different clinical purposes.
Mr. Rose. Absolutely. Those who have symptoms though. Those
who are symptomatic should be able to be tested same day? We
can't do that without these testings. It is necessary.
Dr. Redd. Especially----
Mr. Rose. It is not sufficient.
Dr. Redd. Right, and but especially for clinical purposes.
The public health--you know, doing a representative sample
doesn't help you if you are the patient----
Mr. Rose. Absolutely. So my apologies in advance that we
are going to be contacting your office every single day until
this happens in New York----
Dr. Redd. You don't need to apologize.
Mr. Rose [continuing]. And across the country. Mr.
Cuccinelli, thank you. Thank you for your service. I want to
talk to you about foreign travel. It is my understanding that
those foreign nationals traveling from China and Iran are now
tested upon reaching a domestic airport; is that correct?
Mr. Cuccinelli. No, that is not correct. They are barred
from entering the United States.
Mr. Rose. OK. So in terms of foreign screenings though,
where--which nations are we doing screening at----
Mr. Cuccinelli. So the way it works is the 212(f) only
covers foreign nationals. The President doesn't have the
authority----
Mr. Rose. Mm-hmm.
Mr. Cuccinelli [continuing]. Under 212(f) to do anything to
you and I as United States citizens. So U.S. citizens, legal
permanent residents, and their families come in. Those are the
people being screened at the airports.
So an American citizen flies from China--and there are
still some flights--to one of the 11 airports. They encounter a
CBP OFO officer, the blue uniform folks you see when you come
from another country. You show them your passport.
Now, they are going to see you came from China. They are
going to send you to secondary screening. That screening is run
by CWMD, our contract medical personnel. Unlike the traveling
questions that CBP asks you, they are going to ask you medical
questions. These are medically-trained personnel.
Mr. Rose. This is upon entry to the United States?
Mr. Cuccinelli. Correct. At the first point of----
Mr. Rose. Is there any consideration of expanding that to
other nations that are hard-hit by this; Italy, for example?
Mr. Cuccinelli. Yes. There is regular consideration of
that.
Mr. Rose. OK. Do you think that is a good idea at this--
knowing what we know right now to expand that to South Korea,
Italy?
Mr. Cuccinelli. Well, in the particular cases of South
Korea and Italy, those allied nations took very quick
affirmative steps to start performing exit screening. They are
essentially doing on exit what our medical screeners would do
on entry.
They did that in part to avoid being swept into a 212(f)
situation. That was acceptable to the President's task force.
He accepted it because of their transparency. These are allied
nations who are being very up-front with us about what they are
receiving.
Mr. Rose. From who?
Mr. Cuccinelli. They are also barring passengers who for
instance test over 37 and a half degrees centigrade for a
temperature, just to use an easy one.
Mr. Rose. Well, what I will ask is that please keep us
posted on your analysis going forward as to whether that should
be expanded.
Mr. Cuccinelli. Glad to do so.
Mr. Rose. Thank you.
Ms. Underwood. Oh, yes, I am going to wait for him to sit
down. OK. The Chair now recognizes Mr. Bishop for 5 minutes.
Mr. Bishop. Thank you, Madam Chairman. I have had to step
out for a bit so you all may have covered some of these items.
But Dr. Redd, do I still understand that it is the objective--
the Vice President said that he was--they were trying to make
it so--the administration is trying to make it so that any
doctor could order a test; is that correct?
Dr. Redd. Yes, sir.
Mr. Bishop. I heard you recite the numbers that I was
hearing last week that there would be a million test kits sent
out by the end of that week. Did that in fact occur?
Dr. Redd. It did. That is from the commercial side, not the
public health side; 75,000 was----
Mr. Bishop. Right.
Dr. Redd [continuing]. The number from the public health
side.
Mr. Bishop. Understood that. Do you get feedback to
indicate that there are uncertainties on the part of doctors at
this point in time whether or not they can order tests?
Dr. Redd. There are not uncertainties that I have heard.
Mr. Bishop. Word is that schools and universities are
closing. North Carolina has several. Is the CDC recommending
pulling classes until the virus is more contained or slows?
Dr. Redd. So that is a local decision. We have been working
with communities that have substantial human-to-human community
transmission. It is really a case-by-case basis depending on
the--you know, basically what the issue is, what set of
activities need to be changed from the normal way.
We have actually posted guidance today for King County and
Santa Clara County as examples of how to adapt our more general
recommendations to particular communities. But we are working--
I don't know the details of how we are working with the
communities in North Carolina, but we would be working minute-
to-minute with them on sort-of side trading these
recommendations to be the right intensity.
Mr. Bishop. In response to the Vice Chairman's questions
early on about how many persons you expect to be infected and
so forth, you said it depends on the intensity of the--of our
public health response.
How are you--I mean--so are there questions about how
intense to make it? I mean you all--you are part of the
organization that decides how intense of the response to have.
So are you holding back or have you decided what an ideal
is? Or is that changing day-to-day based on circumstances. If
it is changing based on circumstances, I would assume that
would be test results indicating how wide-spread this is?
Dr. Redd. So I think that the--as communities identify
cases in their community, there are a set of activities that--
there are questions, you know, should we cancel this event?
Should we cancel that? That--those aren't the kind of things we
can have a Federal guidance that would cover every eventuality.
So it is--you know, I think this is an instance where it is
a wide-spread event. The Federal Government can't cover every
location. So our role is to support State and local health
departments.
There are going to be some instances where we can provide
boots on the ground, but in general we are going to be
providing guidance and working with communities to make their
decisions based on their own circumstances.
Just for example, a large gathering--if it is people that
are at high risk, so older people or people with chronic
medical conditions, if that kind of thing is known it would--a
large gathering would be a smaller gathering than if it were
teenagers.
Mr. Bishop. Yes, sir. Thank you.
Mr. Cuccinelli. Congressman, could I add----
Mr. Bishop. Yes, sir.
Mr. Cuccinelli [continuing]. A little flavor to that as a
former State attorney general?
Mr. Bishop. Yes, sir.
Mr. Cuccinelli. For each of you, you all represent many
different States. Your States have in many cases vast
authority--legal authority in this arena. It is easy for us in
the Federal Government to overlook that, but your Governors and
your public health professionals have tremendous authority in
this area.
Many Governors, of course, have declared public health
emergencies and so forth. I have talked to a number of AGs--
many Governors--we have both talked to hundreds of local and
State officials. That is something that is--that allows for the
very specific surgical application of authority place to place,
State to State.
Mr. Bishop. Point well taken. Thank you, sir. Has your
question today covered the fact that we have a no-ban vote
tomorrow on the section 212(f) authority?
Mr. Cuccinelli. No, sir.
Mr. Bishop. Well, let me ask you quickly. Then we are
voting tomorrow on this political no-ban act to restrict the
President's use of 212(f) authority. Didn't the President use
212(f) authority here in order to have an early intervention to
stop Chinese folks--nationals--from coming in, in a way that
has helped the response to the----
Mr. Cuccinelli. That is exactly what he used. It was
available to use quickly at the advice of the task force. It
has been effective.
Mr. Bishop. Would it have been a problem if that authority
had been limited or restrained?
Mr. Cuccinelli. There is no question that the use of that
authority has bought us time. You have heard from both Dr. Redd
and I various ways that we have used that time in the Federal
Government. Our partners in local and State government have
used that time to be better prepared as this virus advances.
Mr. Bishop. Thank you, Mr. Cuccinelli. Thank you, Dr. Redd.
I yield back.
Ms. Underwood. The Chair now recognizes Ms. Slotkin for 5
minutes.
Ms. Slotkin. Thanks, gentlemen. I just want to say at the
outset that I am really invested in your success. I think that
we heard from the former head of the CDC who served, I think
under the George Bush administration, who talked about the
importance of trust and how critical that is in a public health
crisis or moment.
So I really want you to succeed. I want all of us succeed.
We are all on this boat together. So I really want to have
clarity for the people who are at home who are looking to you
all and to us for guidance. I guess I have the question on
preparedness.
I think we have heard a couple of times from you, Admiral
Redd, that the earlier we intervene the fewer number of cases
and the lesser the spread for lack of a better term.
I have seen other countries take much more aggressive
steps. You know, Italy is now--obviously, has a lot more cases,
but they have banned travel. People are staying in their homes.
There is no going to tourist destinations. There is no public
gatherings.
Should there be anything else and guidance that we give
beyond public health, washing your hands, staying--giving a
social distance? Should we be telling our businesses to go to
telework if at all possible?
Should we be getting people out of offices and schools, not
because this is such a terrible threat? I don't want to
incite--I am not--I am just saying preparedness helps us blunt,
you know, unnecessary panic.
Dr. Redd. Preparedness does help. I would point to
Singapore and Hong Kong as examples of aggressive early action
that has blunted the epidemic.
Ms. Slotkin. So----
Dr. Redd. I think in the case of Italy, it may be a lot too
late.
Ms. Slotkin. It got away from them. So what are the 2 or 3
other things that people should be doing besides the public
health guidance to minimize the spread of this illness, since
Michigan we just got our first 2 cases yesterday?
Dr. Redd. So I think that the--there are some individual
actions and there are community actions. I think that all of
these--protecting the elderly and medically vulnerable is the
highest priority because those are the people that are going to
have the worst outcomes.
So I think there is a lot of work around nursing homes in
particular that needs to be undertaken to prevent the virus
from getting into the nursing homes--things like reducing the
number of visitors.
Ms. Slotkin. Mm-hmm.
Dr. Redd. If anybody is sick--working there, being
absolutely certain that, that person doesn't--isn't allowed
back in. That people who work in one nursing home, don't work
in another nursing home.
Ms. Slotkin. Mm-hmm.
Dr. Redd. That when a patient is transferred from a nursing
home to a hospital, they are not sent to another nursing home.
Ms. Slotkin. OK.
Dr. Redd. These are the kind of things that are known to
spread other kinds of infections in that setting. I think that
the work that we do to protect people in nursing homes and the
elderly is critical----
Ms. Slotkin. So can I ask a quick question because again on
the public trust issue--the issue of testing. So I will tell
you that the sense in the public is that there is not enough
tests.
I am glad to hear the numbers that you all offered that
there is 75,000 public health tests and another million
available commercially. We are not getting those to our States
in a way that feels reassuring to people.
I guess I am confused on why we are playing catch-up on
this. My understanding is we have tested 8,500 people across
the country, but that South Korea is capable of testing 10,000
people a day. Can you help me understand why they are able to
do that?
Dr. Redd. They have implemented a different system then the
one that we are using. I am--I think that we probably should be
scoring ourselves on the ultimate impact of the epidemic and
how well we control it. Testing is a part of that. It is not
the only part.
So I am not sure--I mean we don't have really good
visibility on who is being tested. If you are just testing
people who are perfectly well, have not had any exposure, have
a negative test, I am not sure that really contributes to the
public health outcome.
Ms. Slotkin. OK.
Dr. Redd. I do think that--I agree with what you are saying
that there is a sense that we haven't done enough in testing.
We are doing everything we can to correct that. I also agree
with your statement about the importance of trust.
Ms. Slotkin. So I just--I am sorry. I just have one quick
second. So a lot of us really do respect the head of the NIAID,
Mr. Fauci--Dr. Fauci. He has gotten us through a lot of crises.
I guess I would ask that while you have devolved a lot of
things to the States--and I understand things are going to be
certainly a little bit different.
I guess I am just a prisoner to the fact that I was on--in
New York City on 9/11. Whatever people think of Rudy Giuliani,
he was clear. He was available. He was telling us what was good
and what was not good.
I am telling you that people are missing that. They are
feeling like they want clearer guidance. Just my strongest
recommendation is that Dr. Fauci be allowed to take that role
to reassure the country.
Ms. Underwood. The Chair now recognizes Mr. Crenshaw for 5
minutes.
Mr. Crenshaw. Thank you, Madam Chairwoman. Thank you both
for being here. I will actually continue along that line of
questioning because I have similar questions about, you know,
what is the standard we are trying to achieve with testing?
We do hear that South Koreans are testing huge amounts of
people, and it--it makes people feel like they should also have
a test whenever they want. Now, of course, you have to buttress
that against the reality that we come up against which is, you
know, are we then excluding people who actually need the test.
So I do want to get a more detailed sense from you of where
we should be. What is the right realistic standard that we
should be trying to achieve with respect to testing and
availability of testing? Should the threshold be lower than it
currently is because right now I believe you need doctor's
orders to get a test?
Dr. Redd. So I--this is a really important question. I
think right now there is this sense that you should just be
able to get it. You know, anybody should get a test everyday if
they want. I don't think that is really helpful to the
response.
I think that in communities that have transmission it is
very important to do enough testing to understand the
epidemiology of the disease. That is something that is a health
department role so that kind of testing is critical.
There is some questions about just the kinds of things
that, that kind of testing could help us understand whether
schools are an important place for virus transmission. Children
don't get as sick as older people.
Mr. Crenshaw. Right.
Dr. Redd. We are not really certain if school closure is
the right move. So we can't----
Mr. Crenshaw. And I----
Dr. Redd [continuing]. Understand that without testing.
Mr. Crenshaw. I agree with that general philosophy. So you
have laid out the philosophy of standardizing testing. So I
mean the next question is should we be reaching for a different
standard than we are currently implementing or should we keep
it about the same?
Dr. Redd. I think that a clinician saying this is a person
that needs a test--and that can be a pretty low threshold. I
think that is the right threshold action.
Mr. Crenshaw. So the right threshold. Admiral Redd, you
were also incident commander for the H1N1 pandemic response in
2009. Can you tell me what major differences there have been
between the current response to coronavirus and the H1N1 a
decade ago?
Dr. Redd. Yes. Well, I think the two biggest things are we
had a drug that worked against the virus, and we were able to
produce a vaccine within time to blunt the outbreak or at least
to have it available during the peak of transmission.
I think the other--we knew more about flu then we know
about this virus. Some of the issues that have come up about
when people can transmit the virus are--wouldn't have fit
conventional wisdom.
Mr. Crenshaw. Mm-hmm.
Dr. Redd. So I think there is more that the scientific
community has to learn about this coronavirus even though we--a
lot of uncertainty in H1N1----
Mr. Crenshaw. Sure.
Dr. Redd [continuing]. But less----
Mr. Crenshaw. That goes without saying. I mean--but the
actual response has it been dramatically different?
Dr. Redd. It is--it is a much larger response then we had
for H1N1. I think there are more sectors of Government
involved. We didn't do a lot of the things that we are doing
now because they weren't appropriate, the border issues. We had
cases here that the pandemic was first recognized in the United
States. So that----
Mr. Crenshaw. Right.
Dr. Redd [continuing]. That is a totally different
situation.
Mr. Crenshaw. Speaking of border issues, Mr. Cuccinelli, in
the face of a global pandemic should we have less security at
the border or more security at the border?
Mr. Cuccinelli. Under those circumstances, more of course.
I mean the greater your operational control of the border, A,
the less incentive there is to attempt to pass through that;
and B, this is just a numbers game--the less chance you then
have of people who may not even know----
Mr. Crenshaw. Right.
Mr. Cuccinelli [continuing]. That they are infected because
to Dr. Redd's comment about things that are different from
H1N1, one--the biggest one for this non-medical person is
asymptomatic transmission. That presents dangers that you can't
even understand when they are right in front of you.
Mr. Crenshaw. Do things like physical barriers, additional
technology, and more personnel increase our border security?
Mr. Cuccinelli. Absolutely.
Mr. Crenshaw. I want to ask you both about our medical
supply chain and how reliant we appear to be on China for some
very basic things, like generics, antibiotics, things like
that.
Could you both discuss the current state of our medical
supply chain, specifically how the Chinese shutdown has
affected it and how we can get better? How can we become more
self-reliant in the face of future pandemics?
Dr. Redd. It is an important question. That--unfortunately
for--to be able to answer your question directly and the
department that area is handled by the assistant secretary for
preparedness and response.
Mr. Cuccinelli. So I have been of course part of the
President's task force since January. This has been a focus for
us.
I would note, Congressman, that if you go back and look at
things like that first 212(f) proclamation, you will see--and
how we unrolled it--you will see that we made accounting--we
accounted for economic activity, not because of the money, but
because of the supply chains to which you are referring--and
not just medical.
We--at FEMA, for instance, and CISA, we keep track of 7
different sectors. Health care is just one of them--
transportation, energy, others. Because of the
interconnectedness of our economies and societies around the
world, we thought it very important to keep that cargo flowing
both by air and sea. We have made accommodations to do that.
I think that a lot of people's eyes, not just in Congress
but in the Federal--but in the Executive branch as well, have
been opened to some of the nuances of the supply chain
reliance. My understanding--and I am not the expert, but I am
here, and you want your questions answered.
My understanding is that we are not in danger on any
particular drugs with respect to interruptions from China at
the moment, not in any significant way--that there is
substantial--I will call them stockpiles, but they are working
capital equipment of drugs. There are substitutes that fill the
needs for where we do have gaps. That gets us out of months and
months----
Mr. Crenshaw. Mm-hmm.
Mr. Cuccinelli [continuing]. But it--when this is over and
we all step back and ask ourselves what did we learn here, this
is definitely going to be one of the subjects we are all going
to want to come back to and sit down together. As Congresswoman
Slotkin noted and as Vice President has said, we are all in
this together. Well, if history is any guide, we will be in it
together some time in the future so----
Mr. Crenshaw. Thank you, Madam Chairwoman.
Ms. Underwood. Thank you. The Chair now recognizes Mrs.
Watson Coleman for 5 minutes.
Mrs. Watson Coleman. Thank you very much. Dr. Redd, one of
the functions of the CDC is to collect information of what is
happening to our communities across the country.
I know that the CDC is no longer depending upon the State
test to come to you to be confirmed before they can move
forward with the decisions they have to make, but are you all
doing anything to collect all the information so that there is
essential place where the information can be held? Are you
disseminating it?
Dr. Redd. We are collecting information from the States.
The status of the tests that the States are doing, they are
performing the diagnostic tests. They are then actually sending
the clinical specimen to CDC for verification.
Mrs. Watson Coleman. That is not what I am asking you.
Because the CDC director said yesterday that you are not--we
are not depending upon their sending it to the CDC for
verification now. You are going to--I believe what found----
Dr. Redd. Well----
Mrs. Watson Coleman [continuing]. In the States or what I
am told.
Dr. Redd. There is this designation called presumptive
tests.
Mrs. Watson Coleman. Yes.
Dr. Redd. We are encouraging them to take action on those
results. Yes.
Mrs. Watson Coleman. What I am really wanting to know is
are you collecting the information--is there going to be
essential point of collecting the information? Because the one
thing--and Ms. Slotkin kind-of referred to it.
We don't know the extent of what is happening in our
communities. We experience an incident daily. So it becomes a
new phenomenon. So we would like to kind-of have greater
expectation then we have now. We don't have that sense of
confidence coming from the CDC or from the White House.
Dr. Redd. Let me describe it in a little more detail what
we are doing because we are collecting the results of test that
are being done at States. The other thing that we are doing is
working with our system for influenza where we are testing
specimens that are being collected with people that have
respiratory illness in Santa Clara County, San Francisco----
Mrs. Watson Coleman. Are you----
Dr. Redd [continuing]. San Diego----
Mrs. Watson Coleman. Are you also collecting the number of
presumptive cases? Are you collecting the data that the States
are finding that X number of cases--New Jersey has got what--I
don't--I don't even know today. It is more than it was
yesterday.
Dr. Redd. We are.
Mrs. Watson Coleman. Are you collecting that information?
Dr. Redd. We are.
Mrs. Watson Coleman. OK. Thank you. Thank you. This is a
question--the CDC has reported that more than 600 confirmed
presumptive cases. So we are all concerned that everyone is
given the kind of screening, testing, and whatever treatment
you can get irrespective of who you are.
So this question has to do the--a conversation that has
been developing around this immigration enforcement free zones.
So Mr. Cuccinelli, I guess for you more than anyone, I know
many health experts and legal experts are saying how important
it is for these people to be able to go in and be tested and
not fear being exposed to immigration enforcement. Have you all
had that discussion at all in your----
Mr. Cuccinelli. Yes.
Mrs. Watson Coleman [continuing]. Whatever it is you have.
Mr. Cuccinelli. Yes, we have. And----
Mrs. Watson Coleman. Where are you on that?
Mr. Cuccinelli. ICE has a pre-existing policy--and I mean
pre-existing the virus where they don't do enforcement in
health care facilities, doctor's offices, except under unique
single case circumstances. So that is not an issue with respect
to virus testing and anything of that nature.
Mrs. Watson Coleman. So those individuals don't have to
fear----
Mr. Cuccinelli. We repeated that publicly.
Mrs. Watson Coleman [continuing]. Going--those individuals
don't have to fear trying to get tested or treated or whatever?
Mr. Cuccinelli. Correct.
Mrs. Watson Coleman. OK. All righty. Mr. Cuccinelli, the
President has touted that measures the administration took to
try to prevent the infection from coming into the country by
screening certain passengers coming in.
We are told that there have been more than 40,000 people
who have been screened, but only 1 of those passengers has
actually been confirmed positive with the COVID-19. Meanwhile,
2 of the people conducting the screening--they work for you--
have tested positive in addition to 3 TSA--TSOs.
Can you tell me if you think these screenings are effective
and if you think that this is where we should be applying our
priority resources? If so----
Mr. Cuccinelli. So----
Mrs. Watson Coleman [continuing]. Why?
Mr. Cuccinelli. So obviously, this screening is at the 11
funneling airports that you are referencing. My most recent
data is consistent with your comment about 1 person being
quarantined; although, over 30,000--over 34,000 have been asked
to do self-isolation and then communicate with their local
public health authorities.
We don't know--we don't go back to those to find out how
many ultimately became positive. Again, this goes back to the
asymptomatic problem of people coming through screening. They
won't necessarily show symptoms.
Mrs. Watson Coleman. Well, you know, having information
come back, having information collected, having information in
a central location, and having information available is
something that is very important. There seems to be a big gap
in that in what we are experiencing right now. That is very
troubling and concerning.
My last question, today Governor Inslee just banned
gatherings of 250 or more in Washington State and Governor
Cuomo yesterday ordered a 1-mile containment around New
Rochelle.
As Federal leaders charged with responding to this virus,
can you tell the committee whether you had any direct
involvement in the decisions that these Governors have made to
try and contain the virus, either one of you? Is that yes or
no?
Mr. Cuccinelli. Yes, I certainly can't speak to having
personal involvement, but both States have been in deep
conversations with their Federal partners: DHS, CDC, and so
forth for some time now.
Mrs. Watson Coleman. OK. Thank you. I yield back.
Ms. Underwood. The Chair now recognizes the gentleman from
New Jersey, Mr. Van Drew, for 5 minutes.
Mr. Van Drew. Thank you. Thank you for not retiring. Thank
you both for being here. So I just want to clarify a few things
in my mind which I think maybe would help everybody and sort-of
almost a little bit rapid-fire. But we go back to border
security. I just want to make sure this is clear to people
because I think it is clear in common sense to me.
If we have open borders, if we have sanctuary cities,
sanctuary States, if we have people traveling around that just
got into the country not in the normal route, is it your
feeling, Mr. Cuccinelli that, that eventually could increase
the risk without question of these types of diseases?
Mr. Cuccinelli. Oh, well certainly. Absolutely. That is a
simple matter of math.
Mr. Van Drew. I mean there is nothing complicated about
this. If people for lack of a better term sneak into the
country and haven't gone through the normal legal immigration
route, we have a larger chance of the disease spreading more;
is that correct?
Mr. Cuccinelli. Yes. The legal route, we have an immediate
screening for illness that is part of the legal requirement for
entry.
Mr. Van Drew. OK. The second question that I have is about
the travel restriction that was originally criticized when the
President put the travel restriction on China and was seen as
something abhorrent and terrible.
If you were to look back now, would you say, Dr. Redd--both
of you that, that was obviously as much as we have issues and
problems now--the issues and problems and challenges would have
even been deeper and greater; is that correct?
Mr. Cuccinelli. Well, our understanding at the time when we
recommended it to the President and when we had that discussion
with him was that the academic models suggested not to do that.
So our advice was contrary to the then-existing models as
it was described in the task force. We made the recommendation
anyways. The President was well aware of that sort-of
contraindication. He adopted the recommendation. We universally
now believe we benefited tremendously.
Mr. Van Drew. Of adopting----
Mr. Cuccinelli. Obviously, it was fortunate from adopting
those measures.
Mr. Van Drew. OK. In canceling large events that we spoke
about, wouldn't it be dependent upon the State to--I mean just
thinking about how large the United States of America is
compared not to China obviously, but to a place like Italy or
some other areas?
Wouldn't it be on an individual case-by-case situation too
whereas for example I understand in Washington where you might
want to cancel any large gathering where in Nebraska perhaps
you would not? Is that accurate at this point? Is that----
Mr. Cuccinelli. It most----
Mr. Van Drew [continuing]. How we would deal with that?
Mr. Cuccinelli [continuing]. Certainly is. It is why it is
appropriate for Governor Inslee to make that decision. It is
why it is appropriate for Governor Cuomo to make those
decisions and not for us sitting here in Washington to impose
those decisions. That is part of the partnership.
The guidance you have heard Dr. Redd talk about has been
flowing freely. It has changed because this virus has literally
not been known in human beings for 3 months on the planet earth
yet.
So we are still learning, and we are going to be learning
for months to come. But that is why those local sensitivities
and letting local authorities have final say is so important.
Mr. Van Drew. Let me understand testing for a second. So,
you know, hypothetically I don't feel well. I feel that
possibly I have the coronavirus. I call my doctor, my nurse
practitioner, whoever the appropriate health professional is. I
say I really don't feel good. I have the symptoms. What should
I do?
They are--that person right now as of today is going to be
able to get that test if their doctor or health professional
thinks that is appropriate; is that correct?
Dr. Redd. It is. I think there is some work to be done to
make sure that they can get it as quickly and as easily as it
needs to be.
So I think that the test is available but making that
patient experience optimal, there is still work to be done so
that it gets done, same day. It gets a result back quickly.
There is work to be done there even though it is available.
Mr. Van Drew. Are we getting close to where it would be the
same day?
Dr. Redd. I think we are getting closer, but I wouldn't
want to give you a time line that by X date it is going to be
perfect.
Mr. Van Drew. OK. Another question too. We all understand
older people are at risk, immunocompromised are at risk. A
thought that came to me--and I think I know the answer, but
pregnant women and their unborn child that hasn't been born
yet.
Dr. Redd. Yes, I think right now the evidence isn't in.
There--the evidence that there is does not suggest that, that
is a group that is at particular risk, which is a little bit
surprising. But that is the state of science----
Mr. Van Drew. Thank God.
Dr. Redd [continuing]. Today.
Mr. Van Drew. Yes. Israeli researchers have been saying
that they are months away from developing a coronavirus
vaccine. Any thought on that?
Dr. Redd. I generally go with Dr. Fauci's talking points on
this. There will be a vaccine available pretty soon, but it
won't be tested yet. That is really the time-consuming thing.
So I don't--I am actually not sure what the Israelis are
promising, but having a vaccine available doesn't mean that it
has been shown to be safe and effective. That is what takes a
substantial amount of time. There are 2 cycles of test that
need to be done so it is going to be while before we have it--a
vaccine that is approved that we know is safe and effective.
Mr. Van Drew. OK.
Ms. Underwood. The gentleman's time----
Mr. Van Drew. It----
Ms. Underwood [continuing]. Has expired.
Mr. Van Drew. Did I go over? OK. I am sorry. Thank you.
Ms. Underwood. OK. Thank you. The Chair now recognizes the
gentlewoman from Texas, Ms. Jackson Lee.
Ms. Jackson Lee. I thank the Chair very much and the
Chairman and as well the Ranking Member. I ask unanimous
consent to place in the record the American Academy of Family
Physicians letter March 11 and a letter from me on February on
February 26. I ask unanimous consent.
Ms. Underwood. Without objection.
[The information referred to follows:]
Letter Submitted by Hon. Sheila Jackson Lee
February 26, 2020.
The Honorable Bennie Thompson,
Chair, Committee on Homeland Security, 176 Ford House Office Building
H-217, Washington, DC 20515.
The Honorable Mike Rogers,
Ranking Member, Committee on Homeland Security, Ford House Office
Building, Washington, DC 20515.
RE: Preparedness of the Department of Homeland Security for a
Coronavirus Pandemic arriving in the United States
Dear Chairman Thompson and Ranking Member Rogers: I write to
express my concern that the Department of Homeland Security (DHS) may
not be prepared for a major test of its preparedness for an eminent
biological threat in the form of a global pandemic caused by the new
coronavirus designated as COVID-19. For this reason, I request an
emergency briefing by the Acting Secretary of Homeland Security on our
Nation's preparedness for a pandemic. Due to the unprecedented number
of vacancies and acting positions in the agency as well as the high
turnover throughout the department, the ability of DHS to meet an
essential responsibility of protecting the Nation from a biological
threat should be assured.
Today, Europe announced it has begun to prepare for a pandemic. It
my belief that it is time for the United States to do the same. It is
better for our nation to prepare and not have a pandemic occur, than
not to prepare and it happens. Unfortunately, the disease is proving to
be highly contagious, mobile, and has a mortality rate that is much
higher than the flu, making it a significant threat to global health
and to our Nation.
The National Infrastructure Protection Plan is the foundational
document guiding the work of DHS in the event of a national emergency.
The National Infrastructure Protection Plan already defines public
health departments as critical infrastructure. This makes local and
State public health agencies eligible to receive homeland security
grant funds. The Federal Government's critical infrastructure
protection efforts, and related documentation can be found at (https://
www.cisa.gov/national-infrastructure-protection-plan.).
Thank you for accommodating this urgent request to convene a
meeting with the Acting Secretary and head of FEMA to discuss our
nation's preparedness for a pandemic and to determine what level of
Federal funding will be needed to carry out necessary work to prepare
the Nation for a possible pandemic. If you have questions, or need
additional information, do not hesitate to contact my Policy Director,
Lillie Coney at [email protected], [.]
Very truly yours,
Sheila Jackson Lee,
Member of Congress.
Letter Submitted by Hon. Sheila Jackson Lee
March 11, 2020.
The Honorable Mitch McConnell,
Majority Leader, U.S. Senate, Washington, DC 20510.
The Honorable Chuck Schumer,
Minority Leader, U.S. Senate, Washington, DC 20510.
The Honorable Nancy Pelosi,
Speaker, U.S. House of Representatives, Washington, DC 20510.
The Honorable Kevin McCarthy,
Minority Leader, U.S. House of Representatives, Washington, DC 20510.
Dear Majority Leader McConnell, Minority Leader Schumer, Speaker
Pelosi, & Minority Leader McCarthy: The American Academy of Family
Physicians, representing 134,600 family physicians across the country,
are working diligently to screen, diagnose, counsel, and treat patients
who have or believe they have COVID-19. Our members are fully committed
to helping their patients and their communities in this time of
national need, but we urgently need greater coordination.
We urge Congress to contact the White House Coronavirus Task Force
to ensure that information, supplies, and resources are flowing to
physicians on the front lines, not just hospitals and public health
departments.
Consistency and coordination will be the key to successfully
responding to this public health crisis. We are doing all we can to
assemble and disseminate information prepared by the Centers for
Disease Control and Prevention and the World Health Organization to our
members; however, we still lack critical information including:
the availability of testing kits
clearly stated protocols for when and how testing should be
conducted
how to address the scarcity of personal protective equipment
(PPE) for front-line clinicians
coordinated communication between Federal agencies, health
departments, and the medical community.
This lack of information and communication will have a devastating
impact on our efforts to treat our patients effectively.
If we are to be successful, it will be imperative that there is an
enhanced level of collaboration and cooperation with the Federal
Government and its agencies. We urge you to ask the White House
Coronavirus Task Force to partner with family physicians and other
primary care clinicians to ensure greater coordination and information
sharing. Please contact Stephanie Quinn, Director of Government
Relations for additional information.
John Cullen, MD
Board Chair, STRONG MEDICINE FOR AMERICA.
Ms. Jackson Lee. Let me thank both of the witnesses. Very
quickly, I have little time. Doctor Redd, let me thank you for
your years of services. Can I find out the first moment that
this country detected the coronavirus was coming in this
direction?
Dr. Redd. It was in late January, I believe. I can get the
date for you, but it was----
Ms. Jackson Lee. But wasn't cases arising in China in 2019?
Dr. Redd. We believe that there were. The report that they
produced was right at the end of December. We think that
probably the first cases were sometime in November, detected at
some point after that. We think actually the----
Ms. Jackson Lee. So let me respect what is being done. Let
me publicly say that I believe that this Nation was not
prepared equating to its greatness and the responsibility it
has not only to 300 million plus, but the world watches us. You
are with the CDC. We needed to be far better prepared.
So this first thing I want to have is as Members spread out
to their districts, we need an 800 number because we cannot use
coronavirus.gov and anything else. As Members, I have got
people calling me and asking, are we closing their schools?
So I am asking both the deputy secretary convey to this
task force, set up a number for Members of Congress, however,
you want to have a Classified or a cold--give us a number to
call. Can I have that conveyed and established, please?
Dr. Redd. I think we can commit to getting you a number
that you are going to get an answer to.
Ms. Jackson Lee. I appreciate----
Dr. Redd. I think----
Ms. Jackson Lee. Thank you, Doctor.
Dr. Redd. I think that the--the question of whether a
particular school is closing or not is not something----
Ms. Jackson Lee. No, no.
Dr. Redd [continuing]. We would be able to answer.
Ms. Jackson Lee. I am just saying these are the kind of
calls that are coming in. Let me move on. The level of
contagiousness of the coronavirus, would you explain that very
briefly how contagious it is?
Dr. Redd. Sure. The measure that is used to describe that
characteristic of a virus is the number of additional cases
that would arise from one case. It is called the R naught.
Ms. Jackson Lee. I am sorry. I am going to have to ask you
to move quickly on that.
Dr. Redd. OK.
Ms. Jackson Lee. Yes.
Dr. Redd. For influenza, it is 1.5. For this virus,
probably somewhere between 2 and 3. So it is more----
Ms. Jackson Lee. OK.
Dr. Redd [continuing]. Contagious than influenza.
Ms. Jackson Lee. It is more contagious--this is the kind of
information that really needs to be presented to the public,
not out of panic, but in terms of educating them. Let me go to
the test kits. You indicated that there was 75,000 to be
tested. Is that test kits or tests?
Dr. Redd. Those are tests.
Ms. Jackson Lee. Tests.
Dr. Redd. I agree that the----
Ms. Jackson Lee. Yes.
Dr. Redd. This nomenclature of kit has been confusing.
Ms. Jackson Lee. Right. So these are individual tests,
75,000?
Dr. Redd. Correct.
Ms. Jackson Lee. Is the 1 million individual tests as well
or kits?
Dr. Redd. That is people.
Ms. Jackson Lee. People. So 1 million people possibility,
but not yet?
Dr. Redd. It has been sent out. I think that availability
depends on other factors than the tests materials itself. That
is really the logistics of----
Ms. Jackson Lee. But they are going out to labs and local
governments? Are they going to physicians and hospitals?
Dr. Redd. They are--these are the laboratories companies
that do these tests so----
Ms. Jackson Lee. Right. So you have to access that?
Dr. Redd. Correct.
Ms. Jackson Lee. There is a process to be tested. People
need to be trained on how you use a test?
Dr. Redd. So there are people in the laboratory that are
trained. There is--it is mainly protecting yourself if you are
an individual collecting a specimen.
Ms. Jackson Lee. I have got to go quickly. I thank you. So
it is not standing out on the street and get tested or walk
into an urgent care and possibly get tested?
Dr. Redd. In the United States, no. In Korea, they have
drive-thru testing----
Ms. Jackson Lee. I----
Dr. Redd [continuing]. Where you get tested in your car.
Ms. Jackson Lee. That is coming to my next point which is I
hope to get in a phone call back if I could. Low-income people,
poor people do not have medical providers. They are walking
into urgent care, clinics, or hospitals. You have got to be
able to respond. I am not going to take the answer right now.
You have got to be able to respond to that.
I do need a one-on-one conversation. Baylor College of
Medicine, the infectious disease has a vaccine with 20,000
vials. They don't have the resources to do the clinical tests.
I want them to be connected to the task force to get those
clinical tests or to get them connected for resources.
They are ready to go right now. They are not Jackleg Joe or
somebody down the road in a lab that we can't find. I need that
to happen right now. So I don't--again--and can we--can I
dialog to find out how to work that out or who to connect them
to?
Dr. Redd. Yes.
Ms. Jackson Lee. I thank you. Let me ask my good friend
here in DHS--we have community spread in Texas, but I take
issue with the non--the connecting flights.
So our community spread came through a person who came from
Italy to Frankfurt to the United States. CBP is not prepared.
You need to implement some form of testing for CBP in terms of
asking the question of whether or not the person has come from
Italy, period.
The other point is, there are 3 TSO officers diagnosed in
San Jose. Can you just give me an answer of what you are doing
to ramp up preparation from those airports?
Ms. Underwood. The gentlelady's time----
Ms. Jackson Lee. If I can get that answer----
Ms. Underwood [continuing]. Has expired.
Ms. Jackson Lee [continuing]. I would appreciate it on the
record.
Ms. Underwood. Yes. So----
Ms. Jackson Lee. Thank you. If--and Deputy Secretary, thank
you.
Mr. Cuccinelli. The 3 TSOs are all at one airport, San Jose
International----
Ms. Jackson Lee. Right. But----
Mr. Cuccinelli [continuing]. So 46 other employees have
been sent home for self-quarantine.
Ms. Jackson Lee. I want to do TSO across the Nation. I
don't want to--I am just saying that they are susceptible.
Ms. Underwood. The gentlelady's time has expired. She posed
a number of questions. Perhaps you can submit the answer in
writing, sir. The Chair now recognizes Mr. Higgins for 5
minutes.
Mr. Higgins. Thank you, Madam Chairwoman. Mr. Cuccinelli.
Does your job description include advising and reporting the
Executive and the Department of Homeland Security based upon
your mission parameters and your background, your own personal
experience and knowledge?
Mr. Cuccinelli. Yes, sir.
Mr. Higgins. Dr. Redd, does your job description include
advising the CDC and HHS regarding your background as a doctor
and your specific mission requirements?
Dr. Redd. It does.
Mr. Higgins. Do you gentleman know Dr. Anthony Fauci?
Dr. Redd. Yes.
Mr. Higgins. Would you consider him to be a brilliant
scientist with an incredible medical background and an expert
on allergy and infectious diseases?
Dr. Redd. I would.
Mr. Higgins. Would you, Dr. Redd, concur with Dr. Fauci's
conclusions that based upon his scientific assessment and his
job description as an advisor and a counselor based up a
scientific data, would you concur with his conclusion that
large gatherings of Americans--it would be best to slow the
spread of this virus if there were not large gatherings?
Dr. Redd. Yes.
Mr. Higgins. Did that concurrence with his opinion that is
based upon science and medicine; is it now?
Dr. Redd. It is. There are elements to that, that we could
go into, but, yes.
Mr. Higgins. So in--on a clean slate, that is strictly
medical and scientific advice, correct? That is his job? Your
job and Mr. Cuccinelli's job is to advise the Executive?
Dr. Redd. Yes, sir.
Mr. Higgins. You swore an oath when you took office, did
you not, sir?
Dr. Redd. Did----
Mr. Higgins. Your oath was to the Constitution, was it not?
Dr. Redd. Yes, sir.
Mr. Higgins. It has been alarming to me to hear suggestions
in this committee and others that there seem to be suggestions
that there be some Federally-mandated overriding authority to
enforce restrictions of travel of free Americans and to
override the authority of sovereign States and the Governors
thereof to mandate the enforcement of restrictive gatherings of
free Americans.
We are not Italy. We are not South Korea. We are certainly
not Beijing. We are not Hong Kong. This is America. I have a
great deal of concern that this virus--and let's talk about
that for a second.
There has been a lot of talk about preparedness in this
committee and others. Does the CDC have stockpiles of millions
of test kits and vaccines for a virus that may surface next
year that we don't know what it is?
Dr. Redd. No, we do not. And----
Mr. Higgins. Of course not.
Dr. Redd. In fact, the--that----
Mr. Higgins. When was COVID-19 first discovered within an
American certified scientific lab and evaluated and said, yes,
this is COVID-19. This is a new virus?
Dr. Redd. It was in January 2020.
Mr. Higgins. Thank you very much. Did we have stockpiles of
prepared tests that--these tests must be virus-specific; am I
correct?
Dr. Redd. They are. We started producing them before we had
the virus. Actually, one the sequence was produced in early----
Mr. Higgins. But you had the scientific sequence?
Dr. Redd. We did.
Mr. Higgins. So there is no way for us now to know what
that sequence is for a virus that may be discovered next year,
is there?
Dr. Redd. Correct.
Mr. Higgins. So other than having infrastructure of our
massive Federal Government working in cooperation with
international organizations and our State and local governments
and--including private industry, did--well, how more prepared
could a nation be for a unknown virus then we are right now?
Now, surely, we will learn from this. Do you agree?
Dr. Redd. I do. We will----
Mr. Higgins. We will be better and stronger as we move
forward. Did we learn from SARS?
Dr. Redd. We did. We learned quite a bit over the last 20
years in emergency responses. If I could just go back to one of
your earlier points.
Mr. Higgins. Please do.
Dr. Redd. If I may, we work closely with State and local
governments. We don't make decisions for what they should do.
We are really at their service providing that kind of technical
and scientific guidance that you described. So we don't make
those decisions.
Mr. Higgins. I concur as we should as a Federal Government
and a Constitution that is represented to republic of sovereign
States.
Dr. Redd. Yes, sir.
Mr. Higgins. So the Governors of our sovereign States have
been instructed and advised and empowered to make decisions
within their States; is that correct?
Dr. Redd. Absolutely.
Mr. Higgins. Would you see the role of the Federal
Government in any other way?
Dr. Redd. I wouldn't--you know, I think there are places
where things like quarantine authority--there are State
authorities. There are Federal authorities. You know, those are
things we have to work out. But in general at CDC we work in
the service of the State governments.
Mr. Higgins. Well, thank you for service, gentleman. Both
of you, thank you for appearing before this committee today. It
has just been fascinating. Madam Chairwoman, thank you for
holding this hearing.
Ms. Underwood. The Chair now recognizes Mr. Thompson.
Chairman Thompson. Let me get something straight, Dr. Redd.
We just approved $8.3 billion last week to go to State
governments because they don't have the capacity to do exactly
what we are dealing with. So now are you agreeing that States
ought to do their own thing, and the Federal Government stay
out?
Dr. Redd. We guide--we provide advice to States. So it is--
we work at their service. We are providing a lot of funding
through your appropriation to do the things that we all agree
need to be done.
Chairman Thompson. But we giving them a heck of a lot of
money. So I don't think you can become a sovereign State and
not rely on your Federal Government to help in times of
pandemic.
Dr. Redd. Well, it--I think that we are certainly doing
everything we can to support the States, but they will be the
ones making these kinds of decisions. I am not following you--
--
Chairman Thompson. Dr. Redd----
Dr. Redd [continuing]. I think. I am----
Chairman Thompson. I think there are some health decisions
CDC makes independent of the States.
Dr. Redd. We really work--the way that CDC primarily
operates is by collecting information, analyzing it, and then
translating that into guidance or recommendations. We work very
closely with State health departments and State governments,
but at the end of the day for these kind of things we are
talking about close this event--it is going to be a State
decision.
Chairman Thompson. But States rely on CDC?
Dr. Redd. They do. We have----
Chairman Thompson. That is what I----
Dr. Redd. Yes, I think it is a partnership really.
Chairman Thompson. No State on its own can survive a
situation that we are dealing with right now without the help
of CDC.
Dr. Redd. Yes. That would be my opinion. I----
Chairman Thompson. That is what I am trying to get at.
Dr. Redd. Yes.
Chairman Thompson. Thank you. I yield back.
Ms. Underwood. OK. The Chair now recognizes Mr. Correa for
5 minutes.
Mr. Correa. Thank you, Madam Chair. I want to thank the
Chairman for holding this most important issue. I want to
welcome both of our witnesses, Dr. Redd and Mr. Cuccinelli for
being here today. I just want to say we are all in the same
team so to speak.
Mr. Cuccinelli, you said earlier you--I don't want to put
any words in your mouth that you didn't want to essentially get
in the way of local efforts--didn't want to interfere, didn't
want to step on any of those efforts; is that correct,
something to that effect?
Mr. Cuccinelli. Along the same lines that Dr. Redd was
just----
Mr. Correa. The reason I bring that up is I try to have a
town hall last Friday. My town hall in my district because
really to get information out--and I encountered very shy
county health officials who didn't want to get ahead of this
issue. There is a lot of confusion out there right now. This
issue is evolving on a daily basis.
Mr. Cuccinelli. It is.
Mr. Correa. World Health Organization just declared a world
pandemic. Who is in charge?
Mr. Cuccinelli. The way that the----
Mr. Correa. Is it----
Mr. Cuccinelli [continuing]. Leadership for this----
Mr. Correa. Is anybody in charge? Is anybody quarterbacking
this effort at the Federal level or is this left to 50 States?
Again just asking because my constituents want to know what is
going on. What really unnerves individuals is you have got
information, misinformation coming at you from all sectors.
So you got a Congressman, not a doctor, holding a town hall
trying to explain to people with a couple of other individuals
there who are doctors what is going on when my local county
health officials don't want to step into this issue. Who is in
charge?
Mr. Cuccinelli. So the answer to your question,
Congressman, is both which doesn't help with the confusion
side.
Mr. Correa. Both what?
Mr. Cuccinelli. Our authorities are limited and our
capacity.
Mr. Correa. But you do have a voice----
Mr. Cuccinelli. Absolutely.
Mr. Correa [continuing]. Of authority based on science we
hope----
Mr. Cuccinelli. Yes.
Mr. Correa [continuing]. To let people in this country know
what the state of this Nation is. It is not about State's
rights. It is not about Federal rights. It is about health
issues and science.
Mr. Cuccinelli. So among the things we have been doing,
Congressman--I don't even know how many calls I have been on
with literally hundreds and thousands of local health
officials, legal authorities, like----
Mr. Correa. But are we----
Mr. Cuccinelli [continuing]. Attorneys and so forth----
Mr. Correa. We need to continue----
Mr. Cuccinelli [continuing]. To talk them through this.
Mr. Correa [continuing]. To step up and really make that
voice clear and concise to folks as to what we need to do. Very
quickly, I am going to shift over.
Dr. Redd, I don't want to start any rumors here, but it is
my understanding that the World Health Organization created a
diagnostic test early on and offered it to the United States.
That the administration essentially decided to forgo using
this World Health Organization COVID-19 diagnostic test and
instead to have CDC develop its own; is that correct?
Dr. Redd. The tests were being developed at the same time
at CDC. It is actually in Germany where the test was actually
being developed. The WHO has kind-of a recipe for what the
test--kind-of the characteristics of the test.
Mr. Correa. So they weren't ahead of us? It was just almost
parallel in terms of our efforts?
Dr. Redd. Correct. It was----
Mr. Correa. Were those efforts coordinated?
Dr. Redd. We knew about their tests, but in terms of joint
development it was independently developed.
Mr. Correa. If I would ask, why we are not coordinating?
This is a world pandemic--easy to figure that it is coming our
way--China, Italy, Iran. Why would we not coordinate?
Dr. Redd. At that time, it was just China when we were
beginning development of the test. The issue--maybe this is a
later question that you would have. But when the issues with
our tests were identified, there was sort-of a decision to make
about how to proceed in correcting that issue.
If we had gone to the other tests, we would have kind-of
gone back to zero with the FDA in terms of the emergency use
authorization. So I am not----
Mr. Correa. Lessons learned, can we figure out how to
coordinate on a world-wide basis when we are looking at these
kinds of world pandemics coming at us: Zika--OK--Ebola, corona.
Something is going to come around the corner. I think our
constituents--our tax payers--deserve that we learn lessons and
react to this stuff on a world-wide basis immediately.
Mr. Cuccinelli. Congressman, can I comment?
Mr. Correa. Yes, sir.
Mr. Cuccinelli. So on January 6, CDC reached out to their
compatriots--the Chinese CDC taking its name from ours and
offered to cooperate and to help them.
Their scientists as I understand it were agreeable to that,
were enthusiastic about it, but their political leadership
wouldn't act on those communications for weeks and weeks and
weeks.
You heard Secretary Azar I am sure publicly complain
eventually of that--the Chinese were taking so long to let the
WHO team into China. That team included America
representatives.
Mr. Correa. Thank you.
Ms. Underwood. Colleagues, Members are reminded that votes
have now been called. We are going to try to finish up the line
of questioning, OK. So we are going to ask Members to be
thoughtful as they proceed. The Chair now recognizes Mr.
Richmond for 5 minutes.
Mr. Richmond. Let me just follow up where my colleague left
off. We are talking about lessons learned.
Mr. Cuccinelli, you mentioned that what China wouldn't do.
But isn't that what our leadership is supposed to do? I mean
people are not always going to just volunteer and follow, but
that is what we have our American leadership for, right?
Mr. Cuccinelli. Well, and our leadership reached out at
both the Secretary and Presidential level. By Secretary, I mean
two secretaries, Secretary Azar and Secretary Pompeo and the
President all reached out to their counterparts in China during
that time period.
Mr. Richmond. My suggestion would be sometimes you don't
take no for an answer. That would just--especially when you are
playing with something this important. But let me--I need to
just explain to my colleagues, how many tests does South Korea
do in a day?
Dr. Redd. They are doing a very large number of tests each
day. They have got 60 sites that are drive-thru, many more
tests than we are doing.
Mr. Richmond. So people in my district are not going to
understand how South Korea are ahead of us because we are the
United States of America. It is not the time to complain about
it, but we need to have that figured out.
Because let us take a community like New Orleans that is
high on tourism--the port is our biggest industry, tourism is
our second--when it comes we are in a world of trouble,
especially if we don't have the ability to test like we should.
So when do you think we would have that ability in New Orleans
to test as we would need.
Dr. Redd. So the ability to test is increasing day by day.
We have sent--we have got 2 systems to do tests in the United
States. We have the public health system. There are 75,000
tests out there in that system now. There are over a million
tests in the commercial sector with that number increasing
almost daily.
The place where we have work to do is making sure that when
a patient--a doctor decides a patient needs a test, they can
get it that day and can get results back quickly.
I think from the standpoint of being able to respond
effectively and to kind-of know where we are, a lot of the
things that we are doing now are going to clarify actually
where we are. For example, community surveillance to make sure
if there is a virus--not even having to go and say I think I
have coronavirus.
But if you have respiratory symptoms, there are systems
around the country that we are standing up to test people, not
just for influence which is what those systems were designed
for, but also for coronavirus. So we will be able to detect
transmission in a way that doesn't require that prompting.
Mr. Richmond. So the technical support that you all are
offering to local municipalities that would include tracing?
Dr. Redd. You know, it depends on where we are in the
epidemic. The contact tracing is--again is a really important
measure when you want to extinguish transmission. That was what
we have been doing in the early parts of the epidemic.
When you have community transmission, there is just--it is
just not feasible to do that. The effort is better directed
toward the kind of recommendations that you are seeing in King
County, in Santa Clara, in New York which is protect the
elderly and do things at a community level that can prevent
transmission.
Mr. Richmond. That would be--that would be my question
because I guess what I am hearing in New Orleans now--we have
put in a request for technical support from the CDC. It appears
that we have a case of an elderly person who lived either in
assisted living or a nursing home.
So we are going to need all the help we can get and we are
going to need it real quick. Are you all prepared to assist in
an event like that?
Dr. Redd. So I think that the--as there are more nursing--I
think what we need to do is to protect nursing homes.
Mr. Richmond. Let's----
Dr. Redd. I can't promise you that we are going to send a
team to New Orleans, but we are going to help the health
department in every way that we can.
Mr. Richmond. OK. So the answer is you don't know. Let me
also ask very quickly, do we think that--and this is about the
future, about putting pandemics under the Stafford Act so that
when it happens we can mobilize without having to come to
Congress.
We can do individual assistance. We can do all the things
we need if we put it under Stafford Act, include it with
natural disasters. Is that something we should do?
Dr. Redd. I think that one of the things that we have
learned from previous experience is very important work
Congress has done is to create the Infectious Disease Rapid
Response Reserve Fund.
That allowed us to respond immediately and not be delayed
waiting for an appropriation. I think the question of whether
the Stafford Act is the right mechanism or not or there is some
other mechanism is one that I think we need to have a dialog
about. But it is--it is essential that large emergency
responses like this not be hindered by the lack of funding.
Mr. Richmond. I yield back.
Ms. Underwood. Thank you. The Chair now recognizes Mr.
Green from Texas for 5 minutes. OK. If the gentleman yields to
Ms. Titus for 5 minutes.
Ms. Titus. Well, thank you, Mr. Green. I appreciate that
very much. I will just be brief. Mr. Cuccinelli, I think you
said earlier that you rejected the academic models that advised
against travel boundaries or travel restrictions and gave the
advice to the President to the contrary.
What would make you think you could reject an academic
model based on scientific study and evidence to advise the
President? Was that like bad politics as opposed to good
science?
Mr. Cuccinelli. Well, I am not quite sure how to answer
your last question.
Ms. Titus. Well, I think I know the answer.
Mr. Cuccinelli. It was our----
Ms. Titus. I think it probably was. And this----
Mr. Cuccinelli. It was our best judgment----
Ms. Titus [continuing]. Administration has very little----
Mr. Cuccinelli [continuing]. As a task force.
Ms. Titus [continuing]. Respect for----
Mr. Cuccinelli. And----
Ms. Titus [continuing]. Anything intellectual. And this is
yet another----
Mr. Cuccinelli. Do you actually want me to answer the
question?
Ms. Underwood. Gentleman will suspend.
Ms. Titus. No, that is fine.
Ms. Underwood. Gentleman will suspend.
Ms. Titus. If you can answer this question for me though,
Mr. Cuccinelli. As the acting director, you oversaw the roll
out of the very cruel public charge rule. Now, we heard
yesterday from the director of the CDC that the public charge
rule would discourage people from seeking the health care they
need amidst this outbreak.
Could you comment on this, Dr. Redd? Do you think the fact
that people don't have coverage or they are afraid to get
Medicaid because they are afraid they will lose their green
card, this could have some impact on the spread of this virus?
Dr. Redd. I am not familiar with that rule. I think we
should be doing everything we can to make sure that people that
need to get tested and need treatment have access to it.
Ms. Titus. Thank you, Dr. Redd. In light of that, Mr.
Cuccinelli, would you recommend that we take away that global--
I mean that public charge rule?
Mr. Cuccinelli. Do you want me to actually answer?
Ms. Titus. I would like an answer.
Mr. Cuccinelli. Oh, all right. Well----
Ms. Titus. It is a yes or no.
Mr. Cuccinelli. No.
Ms. Titus. Why not?
Mr. Cuccinelli. Oh, I thought it was just yes or no.
Ms. Titus. That is next question.
Mr. Cuccinelli. So the--because it is completely unrelated.
Anyone seeking help or testing or health care related to the
coronavirus does not affect a public charge analysis.
Ms. Titus. I guess the director of the CDC would disagree
with you. That is what he testified before House Appropriations
yesterday.
Mr. Cuccinelli. If he so testified, he was wrong.
Ms. Titus. OK. Thank you. I yield back.
Ms. Underwood. The Chair now recognizes Mr. Green from
Texas for 5 minutes.
Mr. Green of Texas. Thank you, Madam Chair. Dr. Redd, if I
may--and I will try to move expeditiously because my dear
friend Mr. Cleaver is here, and I would like for him to have
his turn. You have indicated that in South Korea they test
people in their cars as they drive-thru, true?
Dr. Redd. Yes, sir.
Mr. Green of Texas. You have indicated that they test some
60,000 people?
Dr. Redd. I didn't give a number, but that sounds right.
Mr. Green of Texas. Per day.
Dr. Redd. I am not sure if that--I can't verify that
number. We can check. I have got it in here, but I don't recall
the exact number.
Mr. Green of Texas. How many do we test per day in this
country?
Dr. Redd. It is not that high.
Mr. Green of Texas. Is it 40,000?
Dr. Redd. So we have--at CDC we have tested----
Mr. Green of Texas. Is it 30,000?
Dr. Redd [continuing]. One thousand seven hundred people--
1,784. State health departments----
Mr. Green of Texas. Is it----
Dr. Redd [continuing]. Have tested----
Mr. Green of Texas [continuing]. Twenty thousand?
Dr. Redd. I am sorry.
Mr. Green of Texas. Is it 20,000 per day?
Dr. Redd. It is not 20,000 a day.
Mr. Green of Texas. Is it 10,000----
Dr. Redd. It is on the border of----
Mr. Green of Texas [continuing]. Per day?
Dr. Redd. I really want to get back to you----
Mr. Green of Texas. Is it 5,000 per day?
Dr. Redd [continuing]. With numbers? I would like to get
back to you with the numbers.
Mr. Green of Texas. Is it a number that exceeds 10,000 per
day?
Dr. Redd. It is not a number that exceeds 10,000 a day.
Mr. Green of Texas. Is it a number that exceeds 5,000 per
day?
Dr. Redd. I would like to----
Mr. Green of Texas. Is it a number that exceeds 3,000 per
day?
Dr. Redd. I think it would be better for me to get back to
you----
Mr. Green of Texas. Does it exceed----
Dr. Redd [continuing]. With an exact number.
Mr. Green of Texas. Does it exceed 1,000 per day?
Dr. Redd. As I said before, it would be better if I got
back to you with the correct number.
Mr. Green of Texas. Is it true that there is a way to test
thousands of people per day?
Dr. Redd. I think that we are going to be seeing that----
Mr. Green of Texas. Is it true----
Dr. Redd [continuing]. In the commercial sector.
Mr. Green of Texas [continuing]. That the technology exists
such that thousands of people per day can be tested?
Dr. Redd. Yes.
Mr. Green of Texas. Is it true that if this technology
exists that the United States of America, greatest, richest
country in the world, can employ this technology?
Dr. Redd. I think that we will be doing that in the
commercial sector.
Mr. Green of Texas. Yes, is it true that the United States
of America regardless of setting can deploy this technology?
Dr. Redd. It certainly is possible.
Mr. Green of Texas. In the United States of America is it
not true that we can put a person on the moon?
Dr. Redd. We have.
Mr. Green of Texas. Yes, we have. So is it fair to say that
if they are doing it in South Korea that we can--maybe we can
ask them how to do it.
Dr. Redd. We are in discussions with them about their
response. One maybe 2 points to make, I think that at the end
of the day----
Mr. Green of Texas. Is it also true----
Dr. Redd [continuing]. Our----
Mr. Green of Texas [continuing]. That if we had 1 million
people tested that we would not be able to ascertain the
results within any reasonable amount of time because we don't
have the methodology, the means by which we can examine the
test and do it in an efficacious way such that we can give
results with some degree of immediacy? Is this true?
Dr. Redd. Well, it is one of the things that we are working
on----
Mr. Green of Texas. Is it true that----
Dr. Redd [continuing]. To do.
Mr. Green of Texas [continuing]. If we had a million people
tested, we would not be able to get the results back
immediately?
Dr. Redd. I think that the answer to your question----
Mr. Green of Texas. Is it true that it would take longer
than a week to do that, to get the results back?
Dr. Redd. I am sorry. I am trying to answer your question.
Mr. Green of Texas. I understand it. I am trying to ask a
question. Is it true that it would take longer than 2 weeks to
get the results back?
Dr. Redd. I think that there is----
Mr. Green of Texas. It is true that it would take longer
than 3 weeks?
Dr. Redd. I think the systems exist now to get results back
to patients more quickly, particularly----
Mr. Green of Texas. If we had a million people tested--we
are talking about a million--how long?
Dr. Redd. Well, people get blood tested every day, and
there are more than a million people. They get their results
back the same day.
Mr. Green of Texas. But I am asking you about current
circumstances--current circumstances. As we sit here waiting
for this answer so that we can vote, how long?
Dr. Redd. I think what we could get back to you with is for
the--the companies that are----
Mr. Green of Texas. The truth is there is----
Dr. Redd [continuing]. On a routine basis.
Mr. Green of Texas. There is a way to do this testing. It
appears to me that we don't have the will. We don't have the
will to move expeditiously to acquire the technology if we
don't have it. We can do this.
This country has the ability to get great things done in
short order. We for whatever reason don't have the will. Public
becomes highly suspect when we don't exercise the will where
you have few facts. You have much speculation. The speculation
is going to run rampant because we don't exhibit the will to do
that which can be done.
Dr. Redd. I respectfully disagree with you, sir.
Mr. Green of Texas. I will expect you to respectfully
disagree, but I respectfully disagree with your disagreement. I
yield back the balance of my time.
Ms. Underwood. The Chair now recognizes Mr. Cleaver for 5
minutes.
Mr. Cleaver. Thank you, Madam Chair. I won't use 5 minutes.
Admiral, thank you. I am--this is I guess a little personal,
but it probably has some applicability to the entire country.
My father is 97. He won't take the flu shot because he thinks
it will make him get the flu.
By the way, my grandmother said that messing around with
the moon messed up the weather and the flowers. So if we went
up there, we made some mistakes while we were on the moon.
But let me get back to my dad because he is healthy as far
as we know--97 years old. But he is already suspicious of
things. Then we are told that your shop wanted to advise
elderly Americans, you know, not to do certain things because
97 years old or whatever your immune system is vulnerable. That
it was overruled.
I am concerned about people out here who are--who may be
sick. They already--older people--already suspicious. Then they
can't get accurate information about their immune system and
the vulnerability to this galloping virus.
You know, we are probably going home tomorrow. We got to
deal with--I do--I am--in my real life I am a Methodist pastor.
I am going to deal with people this weekend wanting to know
what is going on.
You know, the White House says, you know, it is OK. You
don't need to worry about CDC said if you are older--an older
person, don't get on planes and so forth. What--Mr.
Cuccinelli--somebody--would you like to come to speak to the
church or call my father?
Dr. Redd. I think the question of distrust of authorities
and for example with the influenza vaccination is a really
difficult problem. I think it really gets back to the question
of trust that we have talked about----
Mr. Cleaver. Yes.
Dr. Redd [continuing]. To some extent today. And----
Mr. Cleaver. I am not blaming you. I am just--I just want
to know how did we get into this mess because it is--I think it
is going to--because it----
Dr. Redd. Well----
Mr. Cleaver. We could cause some people to----
Dr. Redd. I think your son is going to believe you more
than he is going to believe us. So I would recommend that you
give him the advice that is on the CDC website, and do your
best to encourage him to stay protected.
Mr. Cleaver. But what about flying? What about elderly
people flying?
Dr. Redd. I think that, that is for a 90-year-old person
today, I would not recommend flying.
Mr. Cleaver. Why would it be overruled? I mean I don't--
maybe I am not articulate enough, but----
Dr. Redd. Well, I actually--in the guidance that we have
that is--we do recommend that for----
Mr. Cleaver. Yes, but--I had to cut you off. But earlier we
were--the White House said don't make that information
available. That is all I want to know is why?
Mr. Cuccinelli. No, sir. There has not been a point where
we have said or anyone at the White House has said don't make X
information available.
Mr. Cleaver. OK. Well, these news reports are I guess----
Dr. Redd. I think maybe there is an interpretation of close
space with limited air circulation. That--you know, there are
ways to interpret that.
Mr. Cleaver. OK. I don't have time. The news reports that
is--I don't have the time to do this in here right now. But I
had news reports. I can get them--get it to you--which said
that CDC said they wanted to issue this warnings to the
elderly, and they were told not to do it by the White House,
you know.
Dr. Redd. Well, I think--you asked me for an interpretation
of our guidance. That was----
Mr. Cleaver. Yes.
Dr. Redd [continuing]. The interpretation I gave.
Mr. Cleaver. I appreciate that. I appreciate that.
Mr. Cuccinelli. Yes, and Congressman, I have participated
in the task force, and CDC has been a critical central member
of it from the beginning of course. As Dr. Fauci testified in
one of--he didn't testify.
It was a press conference. As he said when he was directly
asked, you know, have you been muzzled, he said, ``I have been
doing this for 30-plus years.'' I don't remember his whole
exact answer. He said----
Mr. Cleaver. I hear you.
Mr. Cuccinelli [continuing]. Nobody has told me to not say
anything.
Mr. Cleaver. I heard it.
Mr. Cuccinelli. That has been the case with the whole--with
the CDC as well.
Mr. Cleaver. Thank you.
Ms. Underwood. OK. The gentleman's time has expired. I ask
unanimous consent to enter into the record a statement from the
American Federation of Government Employees.
Without objection.
[The information referred to follows:]
Statement of the American Federation of Government Employees, AFL-CIO
March 11, 2020
Chairman Thompson, Ranking Member Rogers and Members of the
committee: On behalf of the American Federation of Government
Employees, AFL-CIO (AFGE), which represents more than 700,000 Federal
and District of Columbia employees who serve the American people in 70
different agencies, including approximately 100,000 employees at the
Department of Homeland Security (DHS), thank you for holding this
hearing entitled ``Federal Coronavirus Response.'' AFGE has serious
concerns involving the administration's efforts to prevent, detect, and
treat Coronavirus, or COVID-19, as it relates to the Federal workforce
and the American public. In addition to employees at DHS, our union
represents thousands of workers who are health care professionals at
the Department of Veterans Affairs (VA), the Department of Defense
(DoD) and the Bureau of Prisons (BoP) and the many Federal workers
whose jobs require regular contact with the public. Their health and
safety as they continue to provide services to the public is essential
to our homeland security.
Health care providers and emergency responders such as workers at
the Federal Emergency Management Agency (FEMA) are among those Federal
employees who have been or are likely to be called upon to provide
services to populations infected with COVID-19 or populations at risk
of infection. Workers who provide patient care and emergency responders
should be accorded the highest priority for disease prevention
measures. Additionally, Transportation Security Officers (TSOs),
employees at the U.S. Citizenship and Immigration Services (USCIS) and
Customs Enforcement (ICE) are in positions that require interaction
with the public and should be considered as at-risk for contracting the
virus.
AFGE is concerned that safety protocols have not been sufficiently
communicated to the front-line workforce, and adequate personal
protective equipment such as gloves, effective masks, and hand cleaner
have not been deployed to an adequate extent. Agencies are not
communicating with their workforces to a degree that will allow them to
protect themselves or the public adequately in order to contain the
spread of this virus. In most cases, employees have only been given a
link to the Centers for Disease Control website, told to monitor the
news and stay home if they do not feel well. The Office of Personnel
Management (OPM) has likewise provided only vague instructions in three
successive efforts to communicate the administration's plans for the
Federal workforce.
For many DHS employees, remote workstations or telework are not
options. However, we urge the committee to insist that the Acting
Secretary move immediately to allow all employees who are capable of
performing their duties via telework to begin doing so immediately. For
those who are not currently telework-ready, but whose jobs can be
performed in that capacity, this must include provision of necessary
equipment and remote work training to maximize employees' ability to
continue to perform their duties. Many of these employees provide
crucial support functions to the front-line workforce and are essential
to ensuring the continuity of homeland security and emergency
operations. The White House Coronavirus Task Force (Task Force)
directed OPM to include telework in its guidance to agencies, requiring
them to incorporate telework in their continuity of operations plans.
We urge the committee to insist that the Task Force provide regular
communications to agency leadership and the workforce regarding its
progress toward achieving this directive.
For those on the front lines such as first responders, law
enforcement officers, TSOs, and all those with substantial work-related
contact with the general public where telework is not practicable, we
urge the committee to insist that the acting director adopt a policy,
like the long-established precedent at the VA with Agent Orange, that
if they are exposed, there is a presumption that the virus was
contracted at work. As such, a front-line worker will have access
through the Federal Employees Compensation Act (FECA) to full coverage
of related medical treatment and for wage loss or disability related to
that condition or associated complications from the illness.
Further, all Federal employees who are in positions where they may
be exposed to COVID-19 should have rapid access to screening at no
cost. DHS should also direct TSA to immediately retract its recent
reductions of Federal Employee Health Benefit Program (FEHBP) coverage
for its large part-time workforce and provide for a temporary open
season to return to better health plans. These workers' share of
premiums doubled, and with their low pay, many changed to less
expensive policies with higher deductibles and less generous coverage.
We cannot afford to have such artificial barriers to employees seeking
the best possible medical treatment.
Workers who provide direct patient care and emergency services to
individuals who have contracted COVID-19 do not have clear, specific
guidance and effective preventive equipment and gear to protect
themselves from contracting the virus. In other cases where workers are
exposed to unusual hazards, current law provides for a pay
differential, or hazardous duty pay. Because these workers are in
immediate danger of exposure, and current protocols have no guarantees
of protection, employees required to work and interface with
individuals who have been quarantined or diagnosed with COVID-19 should
qualify for hazardous duty pay.
AFGE recognizes that COVID-19 is spreading rapidly and that
requirements of agencies and especially of the front-line workforce may
change. As it does, we thank the committee for its on-going and
diligent oversight as you work to protect the Federal workforce and the
American public.
Thank you for your consideration.
Ms. Underwood. I thank the witnesses for their valuable
testimony and the Members for their questions. The Members of
this committee may have additional questions for the witnesses,
and we ask that you respond expeditiously in writing to those
questions.
Without objection, the committee record shall be kept open
for 10 days.
Hearing no further business, the committee stands
adjourned.
[Whereupon, at 4:44 p.m., the committee was adjourned.]
A P P E N D I X
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Questions From Honorable Michael T. McCaul for Ken Cuccinelli, II
Question 1. For those who have traveled from areas of high exposure
to COVID-19, is traveler information being shared across the Government
between DHS, State, and the CDC? If so, how does this process work and
protecting those in the United States?
Answer. The multi-agency response entails information sharing
between pertinent Federal agencies. Through interoperability
agreements, traveler information is synthesized at U.S. Customs and
Border Protection's (CBP) National Targeting Center (NTC) and shared
with interagency liaisons from the Department of State (DOS) and the
Centers for Disease Control and Prevention (CDC). When travelers arrive
at the ports of entry, CBP and CDC personnel work together to identify
travelers who have COVID-19 or are potentially contagious. This
determination is made based on advanced information from the NTC and by
CBP officer observation.
Travel history for every traveler is assessed against CDC
guidelines, and travelers are referred for enhanced public health
screening as needed. Symptomatic travelers, both those displaying
symptoms of COVID-19 or symptoms of another potentially contagious
disease, are referred for public health assessment according to CBP and
CDC shared guidance, training, and policies.
On January 31, 2020, President Trump initially determined that the
potential for wide-spread transmission of the coronavirus by infected
individuals seeking to enter the United States threatens the security
of the homeland. Accordingly, the President issued Proclamations 9984,
9992, 9993, and 9996, which suspend entry to nearly all foreign
nationals who have been in China, Iran, or certain European countries
at any point during the 14 days before their scheduled travel to the
United States. American citizens, lawful permanent residents, their
immediate families, and other individuals not subject to the
Proclamations who arrive from impacted areas must travel through one of
13 airports where DHS has established enhanced entry screening
capabilities. All individuals not subject to the Proclamations who are
returning from an impacted area must self-quarantine for 14 days after
arrival.
Upon arrival in the United States, travelers proceed to standard
customs processing. They then continue to an enhanced entry screening
where the passenger is asked about his or her medical history and
current condition, and asked to provide for contact information for
local health authorities. Additionally, some passengers will have their
temperature taken. After the enhanced entry screening is complete,
passengers are given written guidance about COVID-19 and allowed to
proceed to their final destination. Once home, individuals must
immediately self-quarantine in their home and monitor their health in
accordance with CDC best practices. In order to ensure compliance,
local and State public health officials will contact individuals in the
days and weeks following their arrival.
Question 2. Does DHS need additional funds to combat the
coronavirus pandemic?
Answer. The Department greatly appreciates Congress' support for
COVID-19 funding provided in the CARES Act.
Among the needs we are encountering that is particularly acute are
for those agencies reliant to one degree or another on fees. As you are
aware, due to reduced travel, there is an impact to numerous fee
accounts; however, not all will have an operational impact. For the
accounts that will have an operational impact, the Department is
working to identify mitigation strategies, although each fee account is
different and potentially will have different mitigation options.
As the impact is better known and mitigation options have been
identified and vetted, we will provide the details to you and your
staff. The Department will continue to refine requirements as we
execute to current funding levels and monitor emerging needs.
Questions From Honorable Michael T. McCaul for Stephen C. Redd
Question 1. For those who have traveled from areas of high exposure
to COVID-19, is traveler information being shared across the Government
between DHS, State, and the CDC? If so, how does this process work and
protecting those in the United States?
Answer. The Centers for Disease Control and Prevention (CDC) and
Department of Homeland Security's (DHS) Countering Weapons of Mass
Destruction Office have worked closely in screening travelers for
COVID-19 illness and exposure at the 15 funneling U.S. airports;
collection and rapid sharing of data have been significant elements of
that partnership.
Prior to the COVID-19 pandemic, CDC has had a long-standing
partnership with DHS, via the National Targeting Center, related to
data sharing to facilitate contact investigations of travelers who may
have been exposed to an infectious disease during flights and to
implement Federal public health travel restrictions (i.e., ``Do Not
Board'' list and Public Health Border Lookout record). More information
about those restrictions is available here: https://www.cdc.gov/
quarantine/travel-restrictions.html.
Since early February, CDC has participated in a National Security
Council (NSC)-led collaboration with several agencies to look at
Government-held data to determine where additional integration and data
sharing could assist in public health follow-up programs on a larger
and more rapid scale than occurs routinely. CDC has agreements with the
Departments of State and Homeland Security that are either completed or
in progress to improve sharing of available data for contact
investigations and public health follow-up.
CDC is appreciative of the leadership of the NSC in this effort and
continues to collaborate with our partners to look at Government
holdings of traveler contact information and determining best practices
for sharing this data to help address unmet public health contact
tracing and traveler monitoring needs.
Question 2. Does DHS need additional funds to combat the
coronavirus pandemic?
Answer. CDC defers to DHS for this response.
[all]