Members of the Democrat-controlled U.S. House Energy and Commerce Committee argued Wednesday the Trump administration’s actions on COVID-19 were inadequate to bring the pandemic under control and only the massive expenditure being called for by President Joe Biden will be enough to defeat the virus.
The lawmakers were joined by two members of the Biden transition team’s COVID advisory panel and two public health experts, all of whom argued for major investments in vaccine distribution, development of therapeutics, data collection, education and coordination between the federal government and the states during a hearing before the Energy and Commerce Committee’s subcommittee on Health. The hearing came as the House is gearing up for a so-called budget reconciliation that would allow the Biden administration to pass its COVID bill without any support from Republican senators, all of whom oppose the $1.9 billion package.
“It’s important to understand the mess the Trump administration let behind,” said U.S. Rep. Frank Pallone (D-NJ), the chairman of the full committee, who criticized the former president for lack of organizing a distribution of the fledgling vaccines, for having each state undertake its own programs to acquire protective equipment and for testing, and for a state-by-state approach to masking, social distancing and education. “The states were given very few resources to carry out the distribution,” Pallone said.
“Without an effective federal coordination, we clearly are not going to make any progress (fighting the virus),” said Rep. Anna Eshoo (D-CA), the chair of the subcommittee.
“The previous administration failed in many ways, including not putting forward a clear plan for vaccine distribution,” said Rep. G.K. Butterfield (D-NC).
“Sadly, the chaotic roll-out of the vaccines has frustrated millions of Americans,” said Dr. Luciana Borio, vice president of In-Q-Tel who served on the Biden transition team.
“Vaccine distribution was initially left to states, which were inadequately prepared to handle the complex logistics,” said Borio, former acting chief scientist at the U.S. Food and Drug Administration (FDA), during her testimony. “The new administration has taken important steps to improve vaccine distribution within states. It is examining ways to maximize production of FDA-authorized vaccines to make more doses available sooner, provide direct assistance to states that need it, open up vaccination to more priority groups faster, establish more vaccination sites, increase use of pharmacies and mobile units for vaccinations, and make it easier for states to recruit vaccinators. These steps, done in conjunction with a campaign to counter misinformation and vaccine hesitancy, and a focus on improving vaccine access for ‘hard to reach’ populations, will enhance the nationwide vaccination program.”
“The fundamental behavioral interventions — masking, social distancing, and avoidance of indoor gatherings—remain the single best tools we possess in the fight against COVID-19, equal in importance to effective vaccines,” Borio said. “This requires careful public messaging, so Americans understand the value of both vaccines and behavioral modifications.”
“The last administration,” said Borio, “hurt the American public when it declared that FDA did not have the authority to regulate laboratory-developed tests. Once it became clear that developers of these types of tests wanted to have liability protections available under the EUA framework, HHS directed FDA to review these tests.”
In addition, she said, “The U.S. still lacks an interoperable data infrastructure to capture the results of diagnostic tests conducted by so many disparate entities in so many disparate settings. Our data systems are simply not connected despite the existence of technical standards to do so. Even within states, each county sometimes runs their own program. Federal coordination, and in some cases, mandatory provider participation will be required. I would argue that this should be one of the principal areas of attention if we are to build a 21st century public health system.”
Greg Burel, former director of the U.S. Strategic National Stockpile (SNS) and president of Hamilton Grace LLC, called for permanent funding for pandemic preparedness. “We must pivot from our long history of inconsistent, inadequate preparedness funding to long-term mandatory sustainable preparedness,” said Burel, who served Republican administrations. “We have witnessed the devastating effects of lack of preparedness on our nation’s health, our population’s mortality, our economic status and thus, our overall national security.”
Burel made the following recommendations:
- To clearly assign responsibilities to the appropriate entities, including the SNS. “The SNS has long been the lead to acquire, manage and deliver countermeasures to secure the civilian population’s health in emergency, but SNS appears sidelined during this response. Other federal departments have been assigned responsibilities SNS should lead effectively,” Burel said.
- To increase appropriations for SNS significantly. “Making these appropriations mandatory rather than discretionary would help to achieve better preparedness,” he said.
- To incentivize manufacturers who will boldly enter a domestic market to continue consistent production of medical materials. We must incentivize them to improve capability, plants and machinery to achieve better quality and higher output. Establishment of an aggressive government investment platform driven by clear needs for critical products would allow the us to develop and maintain this domestic base.
Several Republicans on the panel rebutted the criticism of the Trump response. Rep. Richard Hudson (R-NC), said the Trump administration was not given enough credit for Operation Warp Speed, which helped develop two vaccines in less than 10 months, an unheard of time for vaccine development. “Despite all the partisan sniping today President Biden inherited over 100 million doses of vaccine,” Hudson said.
“I hope our focus will not be on pointing fingers,” said Rep. Cathy McMorris Rodgers (R-WA), who said, “clearly some states were better prepared and used the advice of CDC scientists.”
“Each of us has a choice to make. We can fight the ideological battles and stay in our corners, or engage and fight the virus,” said Rep. Brett Guthrie (R-KY).
Michael Leavitt, the Republican former governor of Utah and former U.S. Secretary of Health, agreed that not enough was being done on the federal level to combat the virus but said focus should remain on preparation for future pandemics, while fighting the current virus. “We need to scout the next valley,” said Leavitt.
He urged Congress to work towards developing an open source, vendor-agnostic digital national testing and diagnostic system. Such a system would track test results, vaccinations and other key data, not only regarding COVID, but for other critical health conditions. Leavitt said when he was Secretary of Health they tried to organize a national health system but were frustrated when they encountered more than 200 different medical systems with no way to combine them. Such a system, he said, should provide ready and easy access to all consumers both digitally and by paper, to ensure that all vaccines are being recorded and not repeated. “Every state needs to participate,” said Leavitt, who urged that funding for such a system be included in the next COVID stimulus bill.
A major topic of discussion was the need for equity, among races and income levels, in determining access to treatments and the new vaccines.
“The CDC recommends that frontline and essential workers—predominantly people of color—be among those prioritized for vaccination due to high exposure risk,” said Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation, during her testimony. “But today the country is consumed with total allotments and weekly averages instead of whether shots are getting in the right arms. We must course correct quickly. Our Foundation believes an equitable response to the pandemic starts with collecting and reporting all COVID-19-related data by race, ethnicity, and socioeconomic factors.”
“Yet most states do not publish vaccine data that includes race and ethnicity. Among states that do, the share of vaccinations among Black people lags behind their share of cases and deaths,” she said.