Four policy and public health leaders testified before the Senate Health, Education, Labor, and Pensions (HELP) Committee on June 23 about lessons learned from COVID-19 and recommendations to enhance the country’s preparedness for future pandemics.
Committee Chairman Lamar Alexander (R-Tenn.) opened the hearing by stating, “Memories fade and attention moves quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for the next pandemic.”
Chairman Alexander previously released a white paper with five recommended areas for near-term congressional action to learn from the COVID-19 response and better prepare for future pandemics: accelerating research and development, enhancing disease surveillance, addressing stockpiles and distribution, improving state and local public health capabilities, and improving coordination between federal agencies [see Washington Highlights, June 12].
Ranking Member Patty Murray (D-Wash.) agreed with Chairman Alexander on the importance of future preparedness but added that “reflecting on how we prepare for the next crisis is no substitute for responding to the crisis at hand.”
In his opening statement, former Senate Majority Leader William Frist, MD, emphasized the importance of predictable, consistent base funding for public health programs. Frist described a recommendation to exempt several key “Health Defense Operations” programs — including those at the National Institutes of Health and the Centers for Disease Control and Prevention (CDC) — from yearly budget caps. Frist was joined by former CDC Director Tom Frieden, MD, in authoring this proposal, which Frieden shared at a May House Labor, Health and Human Services, Education Appropriations Subcommittee hearing [see Washington Highlights, May 8].
Frist also described a $4.5 billion mandatory funding stream proposal developed with former Sen. Tom Daschle and former Food and Drug Administration Commissioner Andrew von Eschenbach, MD, which would establish a public health infrastructure fund.
During questioning, Sen. Bill Cassidy, MD, (R-La.) pushed back on the CDC funding proposals, noting that some feel that the CDC has not been responsive to the COVID-19 challenge.
Former CDC Director Julie Gerberding, MD, MPH, defended the agency’s scientific experts and added that “the scale of this response would test any public health agency.” Former Health and Human Services Secretary Michael Leavitt added that “it's easy to be critical, in an emergency. The reality is, [the CDC] needs support.”
Several members discussed the role of systemic racism in driving the disproportionate impact of COVID-19 on communities of color. Sen. Maggie Hassan (D-N.H.) asked about dedicated federal investments to improve outcomes for the Black population, to which Joneigh Khaldun, MD, MPH, chief medical executive for the state of Michigan, pointed to upstream policies such as housing, Medicaid expansion, and addressing bias in the health care system.
Sen. Tina Smith (D-Minn.) shared a recent example of implicit bias in health care involving a Liberian immigrant seeking health care in Minnesota. Khaldun responded, “I believe that we should have mandatory implicit bias training for all health professional students. I think that our health professional schools should all work to expand diversity in their students.”
Sen. Murray also discussed the importance of addressing injustices in health care, including the need to ensure that both SARS-CoV-2 tests and the eventual vaccine are available to everyone. Khaldun highlighted her state’s difficulties with SARS-CoV-2 testing, notably the impact of a lack of federal coordination in delaying the delivery of necessary testing reagents and personal protective equipment. Responding to Sen. Chris Murphy’s (D-Conn.) question about current supply chain capacity, Khaldun testified that Michigan has “lab capacities to be able to do at least twice as many labs as we're doing now. But we are limited by the number of swabs and reagents. So, that is absolutely still a challenge.”
Regarding the development of a COVID-19 vaccine, Gerberding echoed the need for a national vaccine plan, adding that transparency into the vaccine development process could help build public confidence in the vaccine.
Sens. Elizbeth Warren (D-Mass.) and Lisa Murkowski (R-Alaska) asked about the need for a federal contact tracing program. Khaldun and Leavitt both supported a national plan to provide federal funding and establish national standards and a strategy to be implemented in individual localities.
Chairman Alexander closed the hearing by asking witnesses to list three actions Congress could take this year to prepare for the next pandemic. All witnesses recommended robust, sustained funding for public health agencies and local public health infrastructure. Other recommendations included upstream investments to address social determinants of health, creating a national vaccination plan, creating a clear roadmap of federal and state expectations in a pandemic, and making permanent the expansion of telehealth.
The Senate HELP Committee will next hear from administration health officials on June 30 when they provide an update on progress toward going back to work and school.
- Washington Highlights