Federal health and science agency officials provided updates on the federal government’s COVID-19 response on July 20 before the Senate Health, Education, Labor, and Pensions (HELP) Committee. The testimony followed a related May 11 HELP Committee hearing on the COVID-19 response [refer to Washington Highlights, May 14].
Committee members sought feedback on several issues including vaccination rates, booster shots and breakthrough cases, culturally appropriate outreach, viral variants, supply chains and stockpiles, public health infrastructure, and related public health concerns.
In their prepared remarks, both committee Chairwoman Patty Murray (D-Wash.) and Ranking Member Richard Burr (R-N.C.) noted their continued work on a bipartisan legislative proposal to better prepare for future public health emergencies, expected to be introduced this fall. The AAMC submitted pandemic preparedness recommendations on June 30 in response to a call for stakeholder input from Murray and Burr [refer to Washington Highlights, July 1].
“The stronger our health departments are at every level, the more effectively they can work to use sequencing technology and modern data systems to track the spread of diseases and monitor the success of vaccination efforts, stand up testing and contact tracing to stop disease outbreaks, develop science-based guidance to address local needs, build partnerships in hard-to-reach communities and build trust as communicators and fight misinformation,” Murray stated.
Burr shared recommendations for the federal agencies represented by the witnesses, including that the Assistant Secretary for Preparedness and Response (ASPR) “play a more prominent role [in] … commanding the public health and medical response during the emergencies, with better coordination among federal agencies, better availability of data and public health surveillance, stronger partnerships with innovators in the private sector, … and visibility into our supply chain for critical drugs.”
Burr added that the National Institutes of Health (NIH) also should continue to accelerate its basic research efforts, including increased leveraging of academic partnerships.
In his opening statement, NIH’s National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, MD, noted the accumulation of real-world evidence of the COVID-19 vaccines’ efficacy as an important update since his May testimony before the committee. He added that NIAID is engaged in research to understand whether booster shots will be needed to “increase the durability of protection” against SARS-CoV-2.
Acting Commissioner of the U.S. Food and Drug Administration (FDA) Janet Woodcock, MD, added that additional authorizations would be needed to allow for booster shots since the vaccines are currently approved under an emergency use authorization.
Several members sought information about breakthrough infections, in which individuals vaccinated against COVID-19 test positive for SARS-CoV-2. Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, shared that a recent study of COVID-19 deaths showed that 99.5% of those deaths were in unvaccinated individuals. She also noted the role of academic medical centers and hospitals in collecting data on breakthrough infections, by providing data on COVID-19 hospitalizations and vaccination status, as well as data on vaccination status in the community.
Sen. Ben Ray Lujan (D-N.M.) cited increased vaccination rates in Hispanic communities that received vaccine information in Spanish and asked how the CDC will build on the successes of culturally appropriate outreach to address COVID-19. Walensky responded that the CDC vaccination toolkit is available in over 20 languages, and the agency continues to partner with trusted community leaders to conduct outreach.
Regarding substance use disorder, Sen. Tim Kaine (D-Va.) asked how the CDC will address the dual opioid use and COVID-19 pandemics. Walensky cited that COVID-19 and substance misuse were the two largest factors in the recent declines in life expectancy in the U.S. To address this, she outlined the agency’s ongoing efforts including investigating the association between infectious diseases and injection drug use, supporting naloxone programs, and providing toolkits related to substance use disorders and mental health.
Sen. Maggie Hassan (D-N.H.) asked ASPR Dawn O’Connell about the agency’s efforts to improve the strategic national stockpile (SNS), citing the Strengthening America’s Strategic National Stockpile Act (S. 1974). The legislation, which Sen. Hassan recently introduced with Sen. Bill Cassidy (R-La.), is aimed at improving SNS maintenance, increasing domestic manufacturing of SNS products, providing additional funds for state stockpiles, and increasing transparency on SNS inventory.
O’Connell testified that the agency utilized the $10 billion provided as emergency supplemental funds by Congress to replenish the SNS, which has deployed more than 200 million items over the course of the pandemic and continues to develop partnerships with domestic manufacturers.
Regarding the SNS, Burr highlighted the challenges of developing a sustainable supply chain domestically with the federal government accounting for only 4% of personal protective equipment (PPE) purchases. He proposed exploring the feasibility of “creating an Americas trading block” to increase manufacturing of PPE in North and South America and promote competitive pricing against other global suppliers.
Sen. Jerry Moran (R-Kan.) urged agencies to make improvements in more quickly distributing funds from the Provider Relief Fund to support health care providers in the pandemic response, and to provide more detailed guidance for the use of the funds. The Department of Health and Human Services recently extended the deadline for providers to use the funds following requests from Congress and stakeholders, including the AAMC [refer to Washington Highlights, June 17].
Burr also questioned witnesses on federal agencies’ preparedness for this year’s flu season in the midst of an ongoing pandemic. O’Connell noted that agencies are actively working with vaccine manufacturers to ensure access to both flu and COVID-19 vaccines this fall.
The HELP Committee will hold the next hearing related to the COVID-19 response on July 27 as committee leaders continue their work on pandemic preparedness legislation.