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Saturday, May 21st, 2022

Public health experts urge lawmakers to focus on future pandemics

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A panel of public health experts called on Congress to focus on creating a mechanism that would help create vaccines for future pandemics, even as the world is working to cope with the ongoing COVID-19 crisis.

“This pandemic is a harbinger of things to come,” Julie Gerberding, former director of the Centers for Disease Control and Prevention and now executive vice president at pharma giant Merck & Co., told members of the U.S. Senate Committee on Health, Education, Labor, and Pensions, during a hearing Tuesday on “COVID-19: Lessons Learned to Prepare for the Next Pandemic.”

Gerberding told senators it is critical that the United States join the Coalition for Epidemic Preparedness Innovations (CEPI), an international organization working to develop COVID-19 vaccines without U.S. government participation. “It is pandemic malpractice for us not to be members,” Gerberding said. Of the 224 vaccine candidates in development around the world, 5 out of the 15 COVID-19 vaccine programs now in clinical trials have received funding from CEPI.

The Senate hearing was held simultaneously with a hearing before the U.S. House Energy and Commerce Committee where senior members of the Trump Administration were testifying about the administration’s response to the pandemic. Witnesses included Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health,
who said he was “cautiously optimistic” that a promising vaccine candidate could be made available to the Amerian public at the end of 2020 or the beginning of 2021.

Bill Frist, a former heart surgeon who served two terms in the U.S. Senate and predicted a COVID-like outbreak 15 years ago, stated to senators that “We need to plan for the next pandemic.”

Frist and the other experts said lessons learned from the ongoing crisis can be used to prepare for a potential second wave of the COVID-19 pandemic or the inevitable outbreak of future pandemics. He called for the clear delineations of the role of state and federal authorities in fighting pandemics; greater surveillance for tracing outbreaks; and the development of a “Manhattan Project-like program” for research and development of vaccines.

Several senators questioned why lawmakers were focused on planning for the next pandemic while the United States and world are still deep in fighting off the COVID-19 virus. “The next pandemic? The next pandemic? What about what is going on now?” asked U.S. Sen. Elizabeth Warren (D-MA).

Committee Chair Lamar Alexander (R-TN) said now is a good time for planning for the next pandemic while the world is focused on COVID-19. “We can’t take steps to deal with the next pandemic if we wait until the current one is over,” said Alexander, who said four presidents and countless congressional committees and private panels have set out plans and preparations for the next pandemic over the past 20 years but they all lacked the urgency created by the current crisis. “When do you think would be a better time to ask the U.S. Congress to build a manufacturing plant that may not be used for 10 to 15 years?”

“This isn’t new,” said U.S. Sen. Pat Roberts (R-KS). “It’s not as if the dogs hadn’t been barking about it back in the day.”

The experts agreed on several main points:

• U.S. funding for local and state public health programs has been inadequate for many years;
• There needs more delineation of authority between federal, state and local health authorities for administering public health services;
• Communities of color and economic disadvantage are being harmed unequally; and
• Public health officials and politicians need to have a further horizon when planning for pandemics.

“Public health, has been malnourished over the past 40 years,” said Michael Leavitt, a three-time Utah governor and the former head of the Department of Health and Human Services.

Leavitt said every pandemic has a local aspect that can be dealt with best at the local level, such as testing and tracing. He called for the ongoing federal funding of potential manufacturing plants so when a vaccine is developed for COVID-19 huge dosages can be made and distributed in a short time. He noted that the U.S. government created three manufacturing plants for an influenza vaccine but they were not maintained.

Joneigh Khaldun, chief medical executive and chief deputy director for health at the Michigan Department of Health and Human Services, spoke about the large discrepancy of infections and deaths between her state’s minority population and the white population. “The greatest tragedy of this pandemic is how it has ravaged communities of color. Racial and minorities are being unequally affected,” Khaldun said. She called for equitable access to testing and treatment for COVID-19 at no cost.

She also criticized what she called a lack of a national strategy for the procurement of materials. Michigan, she said, needed to create its own strategy and programs for procuring testing, tracing and treatment materials. “A national procurement and testing strategy would have prevented states from having to compete with each other,” she stated.

Gerberding criticized President Donald Trump’s Operation Warp Speed which seeks to speedily develop a vaccine for COVID-19, saying, “We must not sacrifice safety for speed.” Any vaccine, she said, must produce effective immunity to the virus, must be durable, so it lasts, robust if the virus changes and must be usable for both healthy and unhealthy people. But, she cautioned, “There’s a long way for us to be able to promise a delivery day or effectiveness (of a vaccine).”

U.S. Sen. Susan Collins (R-ME) wondered whether Congress should create financial incentives, such as tax credits, for private sector companies that are supplying the Strategic National Stockpile of medicines and medical supplies.

Each of the experts provided the panel with three priorities for long-term pandemic planning.

Frist prioritized establishing and investing in a long-term action plan, creating adequate funding, and expanding and encouraging the use of telehealth.

Khaldun said her priorities are to address the disparities in the treatment of people of color, improve testing and tracing, and to increase funding for state and local health departments.

For Gerberding it was developing a national vaccination plan, preparing for the potential merging of the COVID-19 epidemic with the annual fall surge in influenza cases, and sustaining financial investment for local and state health departments.

Leavitt said his priorities are to clarify the division of labor between state and federal health authorities, rejuvenate the public health infrastructure, modernize data collection at HHS and CDC. He added a fourth: an annual appropriation, as opposed to an episodic appropriation, on emergency health management.