[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
EXAMINING THE NATIONAL RESPONSE TO THE WORSENING CORONAVIRUS PANDEMIC
=======================================================================
HEARING
before the
COMMITTEE ON HOMELAND SECURITY
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
SECOND SESSION
__________
JULY 8, 2020
__________
Serial No. 116-73
__________
Printed for the use of the Committee on Homeland Security
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
43-190 PDF WASHINGTON : 2021
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................................................. 1
Prepared Statement............................................. 2
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............................................. 5
Witnesses
Honorable Jay Robert ``J.B.'' Pritzker, Governor, State of
Illinois:
Oral Statement................................................. 12
Prepared Statement............................................. 14
Mr. Jason L. Shelton, Mayor, City of Tupelo, State of
Mississippi:
Oral Statement................................................. 15
Prepared Statement............................................. 17
Dr. Umair A. Shah, Executive Director and Local Health Authority
of Harris County Public Health, Texas:
Oral Statement................................................. 22
Prepared Statement............................................. 25
Colonel Brian Hastings (Ret.), Director, Alabama Emergency
Management Agency:
Oral Statement................................................. 33
Prepared Statement............................................. 36
For the Record
The Honorable Sheila Jackson Lee, a Representative in Congress
From the State of Texas:
Data........................................................... 76
Article, July 7, 2020.......................................... 77
Article, July 4, 2020.......................................... 79
Article, May 17, 2020.......................................... 81
The Honorable Bennie G. Thompson, a Representative in Congress
From the State of Mississippi, and Chairman, Committee on
Homeland Security:
Statement of the Robert Wood Johnson Foundation................ 73
EXAMINING THE NATIONAL RESPONSE TO THE WORSENING CORONAVIRUS PANDEMIC
----------
Wednesday, July 8, 2020
U.S. House of Representatives,
Committee on Homeland Security,
Washington, DC.
The committee met, pursuant to notice, at 12:02 p.m., via
Webex, Hon. Bennie G. Thompson (Chairman of the committee)
presiding.
Present: Representatives Thompson, Jackson Lee, Langevin,
Richmond, Payne, Rice, Correa, Torres Small, Rose, Underwood,
Slotkin, Cleaver, Green of Texas, Clarke, Titus, Watson
Coleman, Barragan, Demings, Rogers, Katko, Higgins, Lesko,
Joyce, Crenshaw, Guest, Bishop, and Van Drew.
Chairman Thompson. The Committee on Homeland Security will
come to order.
The committee is meeting today to receive testimony on
examining the National response to the worsening of the
coronavirus pandemic.
Without objection, the Chair is authorized to declare the
committee in recess at any point.
Today the Committee on Homeland Security is meeting to
examine our National response to the worsening coronavirus
pandemic. This hearing comes at a critical moment. The number
of coronavirus cases is surging, topping 50,000 per day for the
first time on July 1, and setting alarming records for new
cases over the past week.
Dr. Anthony Fauci recently warned that U.S. cases could
double to 100,000 per day, if current outbreaks in the South
and West are not contained, putting the entire country at risk.
As infections threaten to spiral out of control, President
Trump has tried to downplay the impact of COVID-19, calling 99
percent of cases totally harmless, even as more than 130,000
Americans have died and many more have become seriously ill.
Just this week, he falsely claimed the U.S. coronavirus death
rate is the lowest in the world when, in fact, it is among the
highest. Unfortunately, the President's comments come as no
surprise.
His administration's response to the coronavirus has been
an abject failure by any reasonable measure. He ignored early
intelligence on the virus, continues to disregard the opinions
of doctors and scientists, including those in his own
administration, and perpetuates misinformation about COVID-19
rather than allowing the experts to speak directly to the
American people about the disease.
Just yesterday, Congress received notification that the
President has begun the process of withdrawing the United
States from the World Health Organization in the midst of a
pandemic, endangering global health against our own interests.
The President has shirked his administration's responsibility
to prepare and respond to the pandemic and his own obligation
to the Nation in a time of crisis, shifting the burden to State
and local governments and the people--and the American people.
The effect of American lives lost and damage to our economy
have been devastating.
The United States currently has 20 percent of the world's
coronavirus cases, despite having only 4 percent of the world's
population. As the countries are bringing their outbreaks under
control, U.S. cases are headed in the opposite direction.
Meanwhile, President Trump continues to deny the severity of
the problem and is instead focused on his own reelection
campaign.
Many State and local governments, public health officials,
hospitals, and medical workers are doing the best they can
under the circumstances, but we need real leadership at the
Federal level if our country is to overcome the COVID-19
pandemic.
Today we will hear from those who have taken action where
the administration has failed to do so: A Governor, a mayor, a
public health official, and an emergency manager. They are in
many ways on the front line of this worsening pandemic,
obtaining PPEs and testing supplies, requiring masks and social
distancing, and sounding the alarm about the devastating
effects of this disease on minority and economically-
disadvantaged communities.
I hope to hear that testimony about what needs to be done
to reverse the current trend of cases to protect our health and
our economy. The American people are counting on us.
I thank the witnesses and my colleagues for participating
today.
[The statement of Chairman Thompson follows:]
Statement of Chairman Bennie G. Thompson
July 8, 2020
This hearing comes at a critical moment. The number of U.S.
coronavirus cases is surging, topping 50,000 per day for the first time
on July 1 and setting alarming records for new cases over the past
week. Dr. Anthony Fauci recently warned that U.S. cases could double to
100,000 per day if current outbreaks in the South and West are not
contained, putting the entire country at risk.
As infections threaten to spiral out of control, President Trump
has tried to downplay the impact of COVID-19, calling 99 percent of
cases ``totally harmless'' even as more than 130,000 Americans have
died and many more have become seriously ill. Just this week he falsely
claimed the U.S. coronavirus death rate is the lowest in the world,
when in fact it is among the highest.
Unfortunately, the President's comments come as no surprise. His
administration's response to the coronavirus has been an abject failure
by any reasonable measure. He ignored early intelligence on the virus,
continues to disregard the opinions of doctors and scientists including
those in his own administration, and perpetuates misinformation about
COVID-19 rather than allowing the experts to speak directly to the
American public about the disease.
Just yesterday, Congress received notification that the President
has begun the process of withdrawing the U.S. from the World Health
Organization in the midst of a pandemic, endangering global health
against our own interest.
The President has shirked his administration's responsibility to
prepare and respond to the pandemic and his own obligation to lead the
Nation in a time of crisis, shifting the burden to State and local
governments and the American people. The effects on American lives lost
and damage to our economy have been devastating.
The United States currently has 20 percent of the world's
coronavirus cases despite having only 4 percent of the world's
population. As other countries are bringing their outbreaks under
control, U.S. cases are headed in the opposite direction. Meanwhile,
President Trump continues to deny the severity of the problem and is
instead focused on his own re-election campaign.
Many State and local governments, public health officials,
hospitals, and medical workers are doing the best they can under the
circumstances. But we need real leadership at the Federal level if our
country is to overcome the COVID-19 pandemic.
Today, we will hear from those who are taking action where the
administration has failed to do so--a Governor, a mayor, a public
health official, and an emergency manager. They are in many ways on the
front lines of this worsening pandemic--obtaining PPE and testing
supplies, requiring masks and social distancing, and sounding the alarm
about the devastating effects of this disease on minority and
economically-disadvantaged communities.
I hope to hear their testimony about what needs to be done to
reverse the current trend of cases to protect our health and our
economy. The American people are counting on us.
Chairman Thompson. 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, Mr. Chairman. I appreciate you
granting my request to allow Members to use the hearing room
today. As you know, I strongly disagree with the unilateral
decision to shut down the House of Representatives. We should
be conducting our important oversight and legislative business
here in Washington. We are much more productive when Members
are here in person doing our work together. We have always
proven we can do it safely. I hope we will return to regular
work as soon as possible.
As I said before, our hearts go out to those who have lost
their loved ones to COVID-19 and those who are currently
undergoing treatment. COVID-19 is an unprecedented global
pandemic that requires unprecedented response.
Unfortunately, we lost time early in the response when
China hid the disease from the world. For weeks, the Chinese
Communist Party refused entry of outside medical experts. The
Chinese suppressed journalists reporting. Worst of all, China
deliberately withheld evidence of the virus, the virus'
structure, and deadly spread. During this, the Chinese hoarded
life-saving medical supplies and encouraged foreign travel,
seeding the virus across the globe.
I want to commend Ranking Member McCaul's work on the
Foreign Affairs Committee to extensively document this deadly
cover-up in a recent report.
It is clear that China has pulled out all the stops to
manipulate everyone, from media outlets to the World Health
Organization. The WHO maintained for months that China had
promptly self-reported COVID-19. They did not. After months of
lying, the WHO has come clean. The WHO now says it found out
about COVID from media reports and whistleblowers from within
China.
The Chinese Communist Party, once again, has been caught
with blood on its hand.
Facing an extraordinary public health crisis, China's
deadly cover-up, the Trump administration has responded with a
whole-of-Government response. To date, the administration has
prohibited the entry of travelers from global hotspots; invoked
the Defense Production Act to increase supplies of critically-
needed medical equipment, such as ventilators; coordinated the
delivery of 176 million respirators, 682 million surgical
masks, and 17 billion gloves; sent over $125 billion to the
States to support medical response to COVID-19; distributed
over $500 billion in PPP loans to small businesses; helped
facilitate the testing of over 36 million tests. In fact, we
are now capable of conducting over 700,000 tests per day. That
is good news.
The bad news is the number of positive tests are rising in
many States. That is why it is important for all Americans to
continue to heed the advice of our Federal Government, State,
and local public health officials.
I am pleased to see a couple of public health emergency
response officials on the panel today. Colonel Hastings
currently serves as the director of Alabama's Emergency
Management Agency. He has a very distinguished career, 30-year
career in the Air Force. For the last 3 years, he has done a
tremendous job leading the EMA's response to several natural
disasters and now the COVID-19.
Colonel, thank you for joining us today.
I appreciate all the witnesses for appearing. I look
forward to hearing you all, hearing how you are using emergency
funding and support resources provided by Congress and the
administration to respond to this crisis. I am also interested
in knowing what more Congress can do effectively to help you
respond.
Our country has faced outbreaks of serious disease in the
past. In each case, we have marshalled our collective resources
and ingenuity to overcome the crisis. I am confident that will
be the case with COVID-19.
Thank you, Mr. Chairman. I yield back.
[The statement of Ranking Member Rogers follows:]
Statement of Ranking Member Mike Rogers
July 8, 2020
Thank you, Mr. Chairman.
I appreciate you granting my request to allow Members to use the
hearing room today.
As you know, I strongly disagree with the Speaker's unilateral
decision to shut down the House of Representatives. We should be
conducting our important oversight and legislative business here in
Washington.
We are much more productive when Members are here, in person, doing
our work together. We've already proven we can do it safely. I hope we
will return to regular order as soon as possible.
As I said before, our hearts go out to those who have lost their
loved ones to COVID-19 and those who are currently undergoing
treatment. COVID-19 is an unprecedented global pandemic that requires
an unprecedented response.
Unfortunately, we lost precious time early in the response when
China hid the disease from the world. For weeks the Chinese Communist
Party refused entry to outside medical experts. The Chinese suppressed
journalists from reporting. Worst of all, China deliberately withheld
evidence of the virus' structure and deadly spread.
During this, the Chinese hoarded life-saving medical supplies and
encouraged foreign travel, seeding the virus across the globe. I want
to commend Ranking Member McCaul's work on the Foreign Affairs
Committee to extensively document this deadly cover-up in a recent
report.
It's clear that China has pulled out all the stops to manipulate
everyone from media outlets to the World Health Organization. The WHO
maintained for months that China had promptly self-reported COVID-19.
They did not.
And after months of lying the WHO has come clean. The WHO now says
it found out about COVID from media reports and whistleblowers from
China. The Chinese Communist Party once again has been caught with
blood on its hands.
Facing an extraordinary public health crisis and China's deadly
cover-up, the Trump administration has responded with a whole-of-
Government response.
To date, the administration has----
Prohibited the entry of travelers from global hot spots;
Invoked the Defense Production Act to increase supplies of
critically-needed medical equipment, such as ventilators;
Coordinated the delivery of over 167 million respirators,
682 million surgical masks, and 17 billion gloves;
Sent over $125 billion to the States to support the medical
response to COVID-19;
Distributed over $500 billion in PPP loans to small
business; and
Helped facilitate the testing of over 36 million tests.
In fact, we are now capable of conducting over 700,000 tests per
day.
That's the good news. The bad news is that the number of positive
tests are rising in many areas. That's why it's so important for all
Americans to continue to heed the advice of our Federal, State, and
local public health officials.
I am pleased to see a couple of public health and emergency
response officials on the panel today.
Colonel Hastings currently serves as the director of Alabama's
Emergency Management Agency. He had a very distinguished 30-year career
in the Air Force. For the last 3 years, he has done a tremendous job
leading EMA's response to several natural disasters and now the COVID-
19 pandemic. Colonel, thank you for joining us today. I appreciate all
the witnesses for appearing.
I look forward to hearing how you all are using the emergency
funding and resources provided by Congress and the administration to
respond to this crisis.
I am also interested in knowing what more Congress can do to help
you effectively respond. 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.
Thank you, Mr. Chairman. I yield back.
Chairman Thompson. [Inaudible]
Mr. Rogers. Can you all hear the Chairman? I can't either.
Chairman Thompson. Can you hear me now?
Mr. Rogers. Yes, yes.
Chairman Thompson. All right. Other Members of the
committee are reminded that under the committee rules, opening
statements may be submitted for the record.
[The statement of Hon. Jackson Lee follows:]
Statement of Honorable Sheila Jackson Lee
July 8, 2020
Chairman Thompson and Ranking Member Rogers, thank you for holding
today's hearing on ``Confronting the Coronavirus: The Federal
Response.''
I thank today's witnesses and look forward to their testimony:
Jay Robert ``J.B.'' Pritzker, Governor of Illinois
Jason Shelton, Mayor, City of Tupelo, Mississippi
Umair A. Shah, MD, MPH, Executive Director and Local Health
Authority, Harris County (TX) Public Health
Col. Brian Hastings, USAF (ret.), Director, Alabama
Emergency Management Agency.
This hearing will allow Members to question State and local leaders
about the impact of the novel coronavirus (COVID-19) and the failures
of the Trump administration's response to the pandemic in their
communities.
Members will also have an opportunity to discuss how to improve
pandemic response and better support communities across the country
currently seeing sharp increases in COVID-19 cases.
We owe a special debt to First Responders who will be the lifeline
for many who will need medical care to overcome this coronavirus.
I introduced the ``FIRST COVID-19 Care Delivery Act'' to provide a
path to citizenship for doctors and nurses working in the United States
under the J or H visa designations or may be in the country under TPS
or DACA status.
My focus from the earliest news reports in early January on the
novel Coronavirus's rapid spread in China was what needed to be done to
minimize infections in the United States and find a cure.
I knew COVID-19 was not something to be taken lightly and that time
was not on our side to mount an effective defense based on my years of
service under several administrations.
There was a body of Federal work on the topic of a global flu-like
pandemic and what the United States needed to do to protect its people,
but I had concerns that the current administration would not fully
appreciate the gravity of the situation or be positioned to take the
right steps and push into action the key offices and programs needed.
History of U.S. Planning to Combat a Flu-Like Pandemic
Starting in 2005, the Bush administration released the ``National
Strategy for Pandemic Influenza,'' which called for greater
coordination of domestic production and stockpiling of medical supplies
in anticipation of a potential influenza outbreak.
Additionally, the Strategy included the following warning:
``A pandemic, or world-wide outbreak of a new influenza virus, could
dwarf this impact by overwhelming our health and medical capabilities,
potentially resulting in hundreds of thousands of deaths, millions of
hospitalizations, and hundreds of billions of dollars in direct and
indirect costs.''
In 2016, the Obama administration developed a strategic playbook on
pandemic preparedness.
The 69-page Pandemic guide, entitled, ``Playbook for Early Response
to High-Consequence Emerging Infectious Disease Threats and Biological
Incidents,'' includes, ``hundreds of tactics and key policy decisions
laid out by the National Security Council what should be done to fight
pandemics.''
Also in 2016, the Obama administration established the National
Security Council Directorate for Global Health Security and Biodefense,
also known as the White House's Pandemic Response Office, with the
mission of doing ``everything possible within the vast powers and
resources of the U.S. Government to prepare for the next disease
outbreak and prevent it from becoming an epidemic or pandemic.''
The Trump administration disbanded the office in 2018.
In January 2017, the U.S. Department of Defense finalized a report
on pandemic influenza and infectious disease response.
The report warned:
``A catastrophic biological incident could threaten the Nation's human,
animal, plant, environmental, and economic health, as well as America's
national security. Such an event would demand a rapid and effective
response in order to minimize loss of life and other adverse
consequences associated with the incident and to thwart ongoing threats
and follow-on attacks in the case of suspected criminal activity or
terrorism. The potential for a large biological incident to impact the
United States is real.''
Months before the spread of COVID-19, ``the Trump administration
eliminated a key American public health position in Beijing intended to
help detect disease outbreaks in China . . . [an] American disease
expert, a medical epidemiologist embedded in China's disease control
agency, left her post in July [2019].'' The expert, Dr. Linda Quick,
worked for the U.S. Centers for Disease Control and Prevention (CDC),
and according to one report, ``was in an ideal position to be the eyes
and ears on the ground for the United States and other countries on the
coronavirus outbreak, and might have alerted them to the growing threat
weeks earlier.''
A September 2019 report, published by the White House's Council of
Economic Advisers, ``warned a pandemic disease could kill a half
million Americans and devastate the economy.''
In November 2019, according to multiple public reports, ``U.S.
intelligence officials were warning that a contagion was sweeping
through China's Wuhan region, changing the patterns of life and
business and posing a threat to the population.''
The American people needed the Federal Government at its best to
protect them from a previously unknown, deadly, and highly infectious
respiratory threat as it developed into a global pandemic.
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 that time, I sent a letter to the President of the United States
requesting the immediate suspension of any health-related cuts that
impact efforts to contain and treat the coronavirus, including the $3.3
billion in cuts to the National Institutes of Health (NIH) and the
discretionary budget cuts for the Centers for Disease Control and
Prevention (CDC) of nearly 19 percent at $678 million, severely
threatening the CDC's ability to respond to this and other epidemics in
the future.
Additionally, I requested the President to suspend cuts in both the
Medicare and Medicaid programs.
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 Monday, March 9, 2020, we sent the Dear Colleague invitation to
other Members of the House, which was signed by me and the 2 co-chairs:
Congressmen Brian Fitzpatrick, and Dr. Raul Ruiz, as an invitation to
other Members to join the Congressional Coronavirus Task Force.
As you recall Chairman Thompson, on March 11, 2020, the World
Health Organization declared that COVID-19 was a pandemic, which had by
that date reached at least 114 countries, sickening over 100,000
people, and killing more than 4,000.
On January 29, 2020, the administration established a Federal
Coronavirus Task Force and began to close international travel,
eventually closing border crossings almost entirely.
After holding Task Force Briefings daily and first taking the lead
on the U.S. response, the administration then began shifting the
responsibility to Governors who have been left to shoulder the burden
of figuring out how to chart a path through a global pandemic.
The Task Force has resumed public activity and working with State
Governors to meet local and State needs.
The Nation has not left the first wave and we are predicted to have
a second more deadly wave in the fall.
The number of infections is on the rise and Governors and local
governments are the last line of defense for a COVID-19-exhausted
Nation.
On July 6, the CDC reported 2,932,596 cases of COVID-19 in the
United States, and 130,133 deaths.
july 2020
On July 7, 2020, the World Health Organization (WHO) reported
11,500,302 confirmed cases of COVID-19 globally.
On July 7, 2020, the Texas Department of State Health Services
(DSHS) reported 200,557 cases of COVID-19 in the State of Texas, which
included an estimated 94,120 active cases, 103,782 individuals who have
recovered from the virus and 2,655 confirmed COVID-19-related
fatalities.
On July 7, 2020, DSHS also reported that Texas had its deadliest
day from the coronavirus with 75 deaths and 10,400 new infections
State-wide, according to a data analysis and reporting by Hearst
Newspapers.
Across Texas, a total of 2,431,861 COVID-19 tests have been
completed, of which 2,163,729 were viral tests and 207,980 were
antibody tests.
On June 26, Harris County Judge Lina Hidalgo raised the Current
Level of Risk for Harris County from Level 2 to Level 1 or Code Red.
Level 1 signifies a severe and uncontrolled level of COVID-19 in
Harris County, meaning outbreaks are present and worsening and that
testing and contact tracing capacity is strained or exceeded.
As of July 7, 2020, Houston and Harris County Combined: cases
39,311, and deaths 407; Harris County: cases 13,915, deaths 163; and
Houston: cases 25,396, deaths 244.
At this level, residents must take action to minimize contacts with
others wherever possible and avoid leaving home except for the most
essential needs like going to the grocery store for food and medicine.
governor abbott
The Governor of Texas is taking action to pause or roll-back
measures intended to open the economy given the dire rise in COVID-19
infections in his State.
On July 2, Governor Abbott issued an Executive Order requiring all
Texans to wear a face covering over the nose and mouth in public spaces
in counties with 20 or more positive COVID-19 cases, with few
exceptions.
On June 3, 2020, the Governor issued an executive order stopping
local jurisdictions like Harris County and the city of Houston from
taking steps to mandate that all persons in public spaces must wear
face coverings or masks to reduce the spread of COVID-19.
On June 17, 2020, Governor Abbott issued a new executive order that
placed responsibility for all customers and employees wearing of face
mask or coverings on the business owner and in effect rescinded the
June 3 order.
The Governor also issued a proclamation giving mayors and county
judges the ability to impose restrictions on some outdoor gatherings of
over 10 people, and making it mandatory that, with certain exceptions,
people cannot be in groups larger than 10 and must maintain 6 feet of
social distancing from others.
On July 2, Governor Abbott announced that the Texas Health and
Human Services Commission (HHSC) will provide approximately $182
million in emergency Supplemental Nutrition Assistance Program (SNAP)
food benefits for the month of July.
On July 2, Governor Abbott and the Texas Health and Human Services
Commission (HHSC) announced that $2.67 billion in Federal funding has
been approved to support Texas hospitals that provide care for people
receiving Medicaid.
The glaring omission is the State of Texas refused to expand
Medicaid under the Affordable Care Act, which means millions of Texans
in need of health care due to COVID-19 may delay in seeking urgent
medical care unless steps are taken to inform them of their status
given the conditions created by the Pandemic.
june 2020
On June 30, Governor Abbott and the Texas Health and Human Services
Commission (HHSC) announced $9 million in Federal funding for nursing
facilities to implement infection control.
On June 30, Governor Abbott issued a proclamation suspending
elective surgeries at hospitals in Cameron, Hidalgo, Nueces, and Webb
counties to help ensure hospital bed availability for COVID-19 patients
in these communities.
This proclamation amends the Governor's previous Executive Order to
include these 4 counties in addition to Bexar, Dallas, Harris, and
Travis counties.
We are witnessing the State of Texas and community on what might be
the brink of its worst nightmare: Hospitals overrun with extremely ill
patients--not enough beds, doctors, nurses, equipment, or medicine.
It is my concern that Harris County and the city of Houston may be
on a glide path into what New York City experienced when the virus
spiked killing over 27,000 New Yorkers.
In March, estimates had COVID-19's infectiousness ratio as 2.3,
much higher than the flu, which is 1.5.
From the earliest arrival of the virus that causes COVID-19 we have
been struggling with the idea of asymptomatic and symptomatic persons
and the messaging around the two has not been clear.
testing for covid-19
Testing across the Nation and in my State of Texas has greatly
improved, but it is still short of where we need to be in order to
reopen safely.
I am troubled by plans to end the Federally-managed community-based
sites in the Harris County and the city of Houston without concrete
assurances that the sites will be maintained and fully staffed.
It is also troubling that contracts for testing and contact tracing
were left without consideration of cultural competence, diversity, and
inclusion to assure that the planning and execution of these essential
components for checking the spread of COVID-19 would be effective in
all communities and areas of the State.
According to the CDC 39,011,749 (over 39 million) tests have been
given resulting in 3,604,689 positive cases of COVID-19 being
identified, which is 9 percent of the total number of people tested.
The State of Texas has 29 million residents and only 2.4 million
test have been done.
There should and must be more robust and expansive community-based
testing.
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.
Chairman Thompson. I will yield to the Ranking Member for
the purposes of a colloquy.
Mr. Rogers. Thank you, Mr. Chairman. Could you please
explain our agreement on the committee procedures during these
remote proceedings?
Chairman Thompson. Thank you, Ranking Member. Let me begin
by saying that standing House and committee rules and practice
will continue to apply during this remote proceeding. Members
will be expected to continue to adhere to the rules of the
committee and the House. During the COVID period, as designated
by the Speaker, the committee will operate in accordance with
House Resolution 965 and the subsequent guidance from the Rules
Committee in a manner that respects the right of all Members to
participate.
The technology we are utilizing today requires us to make
some small modifications to ensure that the Members can fully
participate in these proceedings.
Mr. Rogers. Thank you, Mr. Chairman. Could you elaborate on
how Members may expect to be recognized during the remote
proceeding?
Chairman Thompson. Thank you. First, to simplify the order
of questioning, I will recognize Members for their 5 minutes
questioning based on a strict seniority basis as determined by
our committee roster, a departure from previous procedure.
Members must be visible to the Chair in order to be considered
as present for purposes of establishing a quorum or for voting.
Members should make every effort to remain visible on screen
throughout the proceedings. If a Member experiences issues with
their video stream, they may proceed with solely audio to
ensure connection, provided they have been identified
previously.
At the beginning of this hearing, Members are muted.
Members may unmute themselves in order to be recognized for
purposes of their 5 minutes of questioning of the witnesses. At
the conclusion of speaking, Members will be expected to then
mute themselves to prevent excess background noise. If a Member
does not mute themselves after speaking, the clerk has been
directed to mute Members to avoid inadvertent background noise.
Should a Member wish to be recognized to make a motion,
they must unmute themselves and seek recognition at the
appropriate time.
Mr. Rogers. Thank you, Mr. Chairman. What could a Member
expect should they encounter technical issues during this
remote event?
Chairman Thompson. In the event a Member encounters
technical issues that prevent them from being recognized for
their questioning, I will move to the next available Member of
the same party, and I will recognize that Member at the next
appropriate time slot, provided they have returned to the
proceeding. Should a Member's time be interrupted by a
technical issue, I will recognize that Member at the next
appropriate spot for the remainder of their time once their
issue has been resolved.
If I should encounter technical issues myself, the Vice
Chair of the committee, if available, or the next most senior
Member of the Majority shall assume the duties of the Chair
until I am able to return to the proceeding.
Mr. Rogers. Thank you, Mr. Chairman. What should Members
expect regarding decorum during the remote event?
Chairman Thompson. Thank you again. Members are reminded
that they are only allowed to attend one virtual event at a
time. Should they need to attend another committee proceeding,
please fully exit the hearing before entering another
proceeding.
Finally, all Members are reminded that they are expected to
observe standing rules of committee decorum for appropriate
attire and should have a professional and apolitical background
when they are participating in any remote event.
Mr. Rogers. Thank you, Mr. Chairman. What should Members
expect if a witness loses connectivity?
Chairman Thompson. In the event a witness loses
connectivity during testimony or questioning, I will preserve
that time as staff address the technical issue. I may need to
recess the proceeding to provide time for the witness to
reconnect.
Mr. Rogers. Thank you, Mr. Chairman. Finally, what should
Members expect if a vote is called during a remote event?
Chairman Thompson. H. Res. 965 requires Members to be
visibly present to have their vote recorded during a remote
event. Members who join the proceeding after a vote is called
and who are not called upon for their vote should seek
recognition from the Chair to ensure their vote is recorded.
Should a Member lose connectivity during a roll call vote, I
will hold the vote open for a period of time to address the
technical issue and provide Members with an opportunity to have
their vote recorded.
Mr. Rogers. Thank you, Mr. Chairman.
I yield back.
Chairman Thompson. With that, I ask unanimous consent to
waive committee rule VIII(A)(2) during committee remote
proceedings under the covered period designated by the Speaker
under House Resolution 965.
Without objection, so ordered.
I welcome our panel of witnesses.
I yield to the Vice Chair of the committee, Ms. Underwood
of Illinois, to introduce our first witness.
Ms. Underwood. Thank you, Mr. Chairman.
Our first witness is the Honorable J.B. Pritzker, the
Governor of the great State of Illinois. Before becoming
Governor, Mr. Pritzker was a National leader in early childhood
education for over 20 years and earned his law degree from
Northwestern University. We are so glad to have him on the
panel today to discuss his experience leading a State of nearly
13 million people through this challenging time, including one
of the largest cities in the country, as well as extensive
suburban and rural areas with very different needs.
Back in March, we heard testimony from Dr. Ngozi Ezike, the
director of Illinois Department of Public Health, and I am
looking forward to getting an update today from Governor
Pritzker.
Welcome, Governor.
I yield back.
Chairman Thompson. Thank you very much.
Our second witness is The Honorable Jason Shelton, the
mayor of Tupelo, Mississippi.
For those who are on here who might not know, Elvis Presley
was born in Tupelo, Mississippi.
After practicing law in Tupelo for more than a decade, Mr.
Shelton was first elected mayor in 2013. Under his leadership,
the city of Tupelo received a 2015 All-American City Award.
Welcome, Mr. Mayor.
Since we have two members of the panel who are from
Houston, Texas, I yield first to the gentlewoman from Houston,
Ms. Jackson Lee, to introduce our third witness, and after
that, I will yield to the gentleman from Houston, Texas, also
to finish that introduction.
Ms. Jackson Lee.
Ms. Jackson Lee. Mr. Chairman, thank you very much. To the
committee Members and the Ranking Member, to all of the
witnesses, thank you for your presence at this very important
hearing.
Dr. Shah, my pleasure.
My good friend, Dr. Umair Shah, is the executive director
and local health authority of Harris County Public Health since
2013. Under Dr. Shah's leadership, Harris County Public Health
is a Nationally-recognized, $100 million agency of 700 public
health professionals serving the Nation's third-largest county
with 4.5 million. He has been a strong, important, and
interesting but provocative messenger on the importance of the
health challenges throughout the Nation and really around the
world.
We worked together on the issues dealing with the Zika
virus, environmental health threats, creosote contamination,
and he has been a strong voice in the needs of the county as it
relates to the COVID-19 pandemic.
Today in Houston, the most important titles a person can
have is doctor or nurse, and he is that as he deals with COVID-
19 patients. He has been involved with the care of patients as
relates to the Harris County health. He previously worked as an
emergency department physician at Houston's VA Medical Center
and as chief medical officer of Galveston County Health
District. He earned his M.D. from the University of Toledo
Health Science Center.
We are very delighted to have Dr. Umair Shah, who is a
voice of leadership but also guidance during Houston's very,
very difficult time fighting COVID-19.
Thank you, Mr. Chairman. Delighted to be able to have the
privilege of introducing Dr. Shah.
Chairman Thompson. Thank you very much.
Now I yield to the gentleman from Houston, Texas, to
complete the introduction.
Mr. Green of Texas. [Inaudible]
Chairman Thompson. Unmute yourself. Will the gentleman from
Houston unmute himself?
Mr. Green of Texas. The gentleman believes he has done so,
Mr. Chairman. Thank you for the reminder. Greatly appreciate
it. Thank you to the staff for the outstanding job they have
done with this transmission, saving Al Green. I think we have
done an exceptionally fine job.
Mr. Chairman, one of the hallmarks of Dr. Shah's luminously
illustrious career is that he gets involved. He responds. He
responded to Tropical Storm Allison, Hurricanes Katrina
[inaudible] and Haiti. He responded to Ebola and Zika. He has
served as the medical branch co-director, and he did so at a
time when in my district we had some 27,000 persons to move
from Louisiana, my home State, to Houston, Texas, into my
Congressional district. He was there for the evacuees when they
were housed over at the Astrodome.
I am honored to have him as a dear friend, and we are
pleased to know that he serves our constituents not only in the
Ninth Congressional District, but across the length and breadth
of the State of Texas and indirectly across the country.
Thank you for being here, Mr. Shah--Dr. Shah, if you will--
and thank you for your involvement.
Chairman Thompson. Our final witness, as acknowledged by
the Ranking Member, is Colonel Brian Hastings, the director of
Alabama Emergency Management Agency since August 2017. Colonel
Hastings previously served in the United States Air Force over
30 years. During his military service, Colonel Hastings earned
2 Legion of Merit medals, the Bronze Star, and 3 Meritorious
Service Medals.
Welcome to the panel, Colonel.
Mr. Hastings. Thank you.
Chairman Thompson. Without objection, the witnesses' full
statements will be inserted in the record.
I now ask each witness to summarize his statement for 5
minutes, beginning with Governor Pritzker.
STATEMENT OF THE HONORABLE JAY ROBERT ``J.B.'' PRITZKER,
GOVERNOR, STATE OF ILLINOIS
Governor Pritzker. Thank you very much, Mr. Chairman.
Chairman Thompson, Ranking Member Rogers, and Members of
the committee, thank you for the invitation to testify about
our National response to the on-going COVID-19 pandemic.
Illinois is the sixth-most populous State with the fifth-
largest economy. We have some of the world's best hospitals,
like Northwestern Memorial and Rush, and we have renowned
researchers, modelers, and public health experts at world-class
institutions, like the University of Illinois and the
University of Chicago.
When it became clear that COVID-19 was not a phenomenon
limited to Asia or to Europe, we fully expected the Federal
Government, home of the Centers for Disease Control and the
U.S. Department of Health and Human Services, would arm the
States with information and equipment and testing capability
and personnel. After all, the Federal Government had the
experience fighting H1N1, SARS, and Ebola. A global pandemic
requires a National response, but that is not what happened.
First, though, I want to talk about what did happen. We
took action here early with Illinois' hospital leaders,
epidemiologists, modelers, public health officials, and
emergency management leaders quickly helping to put plans
together. We were among the first States to close nursing homes
to visitors and do wellness checks on the staff. In
consultation with local officials, I shut down St. Patrick's
Day celebrations and then closed bars and restaurants, and then
schools. We were the second State in the Nation to issue a
stay-at-home order.
The Federal Government wasn't leading. We were.
Illinois is home to the country's third-largest
metropolitan area and to major international transit and
tourism sectors. We had all the potential to become a major
early hotspot like New York, and like Florida and Texas have
now become. Early March projections showed that without
intervention, our health care system would be overrun, leading
to tens of thousands more deaths. Our curve peaked
approximately 6 weeks later.
Today, our COVID-related deaths per day are down 85 percent
from a high 8 weeks ago. Even as our testing continues to grow
to over 30,000 tests per day now, our COVID cases are down 71
percent from a high 9 weeks ago. The number of COVID-positive
hospitalizations, including in the ICU, has dropped by over 70
percent since early May. Our case positivity rate was over 23
percent at one point, and it is now at around 2.5 percent.
That isn't to say that the cascade of decisions that got
Illinois to this point were easy. In fact, every one of them
has been a choice between bad and worse, muddled further by the
White House's broken promises on testing supplies and PPE
deliveries.
I spoke with many of my fellow Governors, Democrats and
Republicans. They had the same problems. Because the Defense
Production Act was not broadly invoked early enough, we were in
a bidding war for life-saving supplies against each other and
against our international allies. We were paying $5 for masks
that should have cost 85 cents. There were States calling other
States to try and figure out if some international businessman
offering a warehouse of 2 million N95 masks was a scammer. Many
were.
In the midst of a global pandemic, States were forced to
play some sort of sick Hunger Games game show to save the lives
of our people. Let me be clear. This is not a reality TV show.
These are real things that are happening in the United States
of America in the year 2020.
If there is one job Government has, it is to respond to a
life-threatening emergency. But when the same emergency is
crashing down on every State at once, that is a National
emergency, and it requires a National response.
When medical professionals across the Nation are crying out
for supplies, it is the Federal Government's job to make sure
that a nurse being properly equipped in Peoria, Illinois,
doesn't come at the cost of a doctor being ready for work in
San Antonio, Texas.
There was no National plan to acquire PPE or testing
supplies, and as a result, people died.
I am so grateful to the incredible, experienced public
servants inside of FEMA, the CDC, HHS, VA, and the Army Corps
who worked so hard along the way to give us their expertise and
assistance. We will need more of that before we will have
vanquished COVID-19.
I want to offer my thoughts on what the Federal Government
can still do to step up and help us get through this pandemic.
First, we need to see a coordinated National strategy for
containment. That means more testing and more contact tracing,
and it may even mean National restrictions that will be
followed in every State.
Second, every State has suffered revenue loss because of
COVID-19, and without help, there will be massive layoffs of
public servants, teachers, and firefighters. A bipartisan
coalition of Governors thanks the House of Representatives for
taking swift action on State and local support in the HEROES
Act.
Third, the Federal administration also needs to provide
clarity on insurance coverage for COVID-19 testing. Testing is
not a one-off tactic. We need regular testing across our
population, and that means people need to know that their
insurance will cover their testing every time.
Fourth, we need to continue COVID response funding for the
National Guard through next year in the face of a possible,
maybe even likely, second wave.
Finally--and this might be the most important thing that we
can do to save lives--we need a National masking mandate. We
instituted ours in Illinois on May 1, one of the first in the
Nation, and it aligns with our most significant downward shifts
in our infection rate.
It is not too late for the Federal Government to make an
impact. In fact, it is more important than ever.
So I want to thank all of you, and I look forward to your
questions later on in this hearing.
[The prepared statement of Governor Pritzker follows:]
Prepared Statement of Hon. J.B. Pritzker
July 8, 2020
Chairman Thompson, Ranking Member Rogers, and Members of the
committee--thank you for the invitation to testify about our National
response to the on-going COVID-19 pandemic.
Illinois is the sixth-most populous State with the fifth-largest
economy. We have some of the world's best hospitals like Northwestern
Memorial and Rush, and we have renowned researchers, modelers, and
public health experts at world-class institutions like the University
of Illinois and the University of Chicago.
When it became clear that COVID-19 was not a phenomenon limited to
Asia or Europe, we fully expected the Federal Government, home of the
Centers for Disease Control and U.S. Department of Health and Human
Services, would arm the States with information, equipment, testing
capability, and personnel. After all, the Federal Government had the
experience fighting H1N1, SARS, and Ebola. A global pandemic requires a
National response. But that's not what happened.
First, though, I want to talk about what did happen. We took action
early, with Illinois' hospital leaders, epidemiologists, modelers,
public health officials and emergency management leaders quickly
helping to put plans together. We were among the first States to close
nursing homes to visitors and do wellness checks on the staff. In
consultation with local officials, I shut down St. Patrick's Day
celebrations, and then closed bars and restaurants, and then schools.
And we were the second State in the Nation to issue a stay-at-home
order.
The Federal Government wasn't leading. We were.
Illinois is home to the country's third-largest metropolitan area
and to major international transit and tourism sectors--we had all the
potential to become a major early hotspot like New York, and like
Florida and Texas have now become. Early March projections showed that
without intervention, our health care system would be overrun, leading
to tens of thousands more deaths.
Our curve peaked approximately 6 weeks later. Today, our COVID-
related deaths per day are down 85 percent from a high 8 weeks ago.
Even as our testing continues to grow to over 30,000 tests per day now,
our COVID cases are down 71 percent from a high 9 weeks ago. And the
number of COVID-positive hospitalizations, including in the ICU, has
dropped by over 70 percent since early May. Our case positivity rate
was over 23 percent, and it's now at 2.5 percent.
That isn't to say that the cascade of decisions that got Illinois
to this point were easy--in fact, every one of them has been a choice
between bad and worse, muddled further by the White House's broken
promises on testing supplies and PPE deliveries. I spoke with many of
my fellow Governors, Democrats and Republicans--they had the same
problems. Because the Defense Production Act was not broadly invoked,
we were in a bidding war for life-saving supplies against each other
and against international allies. We were paying $5 for masks that
should cost 85 cents. There were States calling other States to try and
figure out if some international businessman offering a warehouse of 2
million N95 masks was a scammer. Many were.
In the midst of a global pandemic, States were forced to play some
sort of sick Hunger Games game show to save the lives of our people.
Let me be clear. This is not a reality TV show. These are real things
that are happening in the United States of America in the year 2020.
If there's one job Government has, it's to respond to a life-
threatening emergency--but when the same emergency is crashing down on
every State at once, that's a National emergency, and it requires a
National response. When medical professionals across the Nation are
crying out for supplies, it's the Federal Government's job to make sure
that a nurse being properly equipped in Peoria doesn't come at the cost
of a doctor being ready for work in San Antonio.
There was no National plan to acquire PPE or testing supplies--and
as a result, people died.
I am so grateful to the incredible, experienced public servants
inside FEMA, the CDC, HHS, VA, and the Army Corps who worked so hard
along the way to give us their expertise and assistance--we will need
more before we have vanquished COVID-19.
I want to offer my thoughts on what the Federal Government can
still do to step up and help us get through this pandemic.
First, we need to see a coordinated National strategy for
containment--that means more testing and more contact tracing, and it
may even mean National restrictions that will be followed in every
State.
Second, every State has suffered revenue loss because of COVID-19,
and without help there will be massive layoffs of public servants,
teachers, and firefighters. A bipartisan coalition of Governors thanks
the House for taking swift action on State and local support in the
HEROES Act.
Third, the Federal administration also needs to provide clarity on
insurance coverage for COVID-19 testing. Testing is not a one-off
tactic: We need regular testing across our populations, and that means
people need to know their insurance will cover their testing every
time.
Fourth, we need to continue COVID response funding for the National
Guard through next year in the face of a possible, maybe likely, second
wave.
Finally, and this might be the most important thing we can do to
save lives: We need a National masking mandate. We instituted ours in
Illinois on May 1, one of the first in the Nation, and it aligns with
our most significant downward shifts in our infection rate.
It's not too late for the Federal Government to make an impact--in
fact, it's more important than ever. Thank you and I look forward to
your questions.
Chairman Thompson. Thank you, Governor. We look forward to
your responses to the questions.
I now recognize Mayor Shelton to summarize his statement
for 5 minutes.
STATEMENT OF JASON L. SHELTON, MAYOR, CITY OF TUPELO, STATE OF
MISSISSIPPI
Mr. Shelton. Thank you, Chairman Thompson, Ranking Member
Rogers, and distinguished Members of the Committee on Homeland
Security. Thank you for the honor and opportunity to be here
with you today to discuss the on-going devastating impact of
COVID-19 on our great Nation, and more specifically for me, to
discuss the impact on our local governments.
I did hear the Chairman mention that you can't have
political things in the background. I think I have complied
with that, but I also do have a not-so-subtle reminder that I
am from Tupelo behind me, and I hope that that is OK.
The adverse impact of the public health crisis and
corresponding economic crisis caused by COVID-19 has had a
direct negative impact on the ability of local governments all
across our Nation to provide the basic services that every
single American depends on in carrying out their normal day-to-
day activities, such as getting to work, providing for their
family, and having safety and security in their community.
As the Members of this committee are aware, nearly 3
million Americans have already been diagnosed with COVID-19,
and the number of deaths of Americans is in excess of 130,000
individuals.
While some loss of life from the pandemic is likely
unavoidable, in my opinion, many of these deaths could have
been prevented by a quicker and more uniform response from our
Nation's Commander-in-Chief and his administration. Rational,
stable, and consistent leadership, based upon medical and
scientific data, is desperately needed from our Nation's
highest office during this very real pandemic. Unfortunately,
that is missing at this moment.
In the last 6 months, we have seen leaders of nations all
over the globe respond to this deadly pandemic with rational,
science-based decision making and genuine concern for their
citizens and their economies. We have seen leaders from all
over the world step up and rise to the occasion. It is past
time to see that leadership here in the greatest country on
Earth.
As was mentioned in the Chairman's opening statements, our
Nation has 4 percent of the world's population but over 20
percent of the world's COVID cases. Similarly, we have over 20
percent of the world's deaths right here in the United States.
My purpose here to speak today is about the hardships
facing the local governments which are on the front line
responding to our Nation's health and economic crisis. Mayors,
county officials, parish officials, and others are on the front
lines and doing all that they can do to enact local policies
that are based on science and the recommendations of our
Nation's top agencies and experts. Their efforts, however, are
being hamstrung by the lack of rational, stable, and science-
based leadership in the White House.
Due to the continued political climate surrounding COVID-
19, our cities continue to have difficulty in getting
individuals and businesses to comply with the safety measures
to prevent COVID-19-related sickness and death in our city.
This will prolong both the health and economic crisis in our
community.
The city of Tupelo has been very proactive. We initiated
our emergency response February 24 of this year. Since that
time, I have issued 17 different executive orders, all ratified
by our bipartisan city council, to combat COVID-19. COVID-19
does not recognize city limits or even a county or State
border. That is why National mandatory policies are needed if
we are going to truly combat the health care and economic
crisis facing our Nation.
I want to take this opportunity as mayor of the city of
Tupelo, as a member of the small towns council of the National
League of Cities to thank the Members of this committee and
this collective body for passing the CARES Act legislation.
This is a great thing for our country. I also want to thank the
Members who have supported the HEROES Act and the SMART Act,
those legislations--pieces of legislation to get need--get
resources to local governments that are desperately needed.
That is the gist of my testimony today, to advocate that
direct Federal funding be delivered to local governments so
that we can offset the loss of revenue.
The National League of Cities anticipates about a $360
billion loss of revenue for local governments over the next 3
years. We need funding to be able to provide the very basics
that every American depends on to get to work every day;
garbage, trash collection, litter, you know, fixing potholes,
fixing a red light that is not working, fire protection, public
safety, EMTs, the things that every American depends on each
and every day. Those things, those functions of government
happen here at the local level.
The loss of revenue due to the economic crisis of COVID-19
is going to severely diminish our ability to provide those
basic services, and that is why direct funding from the Federal
Government to local governments is desperately needed.
Former Speaker Tip O'Neill famously said that ``all
politics is local.'' While the solutions will likely be debated
in Washington and our State capitols, they will be implemented
where literally the rubber meets the road, right here in our
local governments.
Thank you again for allowing me, Chairman Thompson, Ranking
Member Rogers, Members of this committee, thank you for
allowing me the opportunity to be here to advocate for local
governments. I appreciate the opportunity to speak to you, and
look forward to answering any questions that you may have for
me.
Thank you.
[The prepared statement of Mr. Shelton follows:]
Prepared Statement of Jason L. Shelton
July 8, 2020
Chairman Thompson, Ranking Member Rogers, and distinguished Members
of the Committee on Homeland Security, I would like to begin by
thanking you for the opportunity to be with you today remotely to
discuss the on-going devastating impact of COVID-19 to our great
Nation, and, more specifically, to our local governments. The adverse
impact of the public health crisis and the corresponding economic
crisis caused by COVID-19 has had a direct negative impact on the
ability of local governments all across our Nation to provide the basic
Government services that every American depends on in carrying out
their normal day-to-day activities such as getting to work, providing
for their family, and having safety and security in their own
community.
As you are aware, nearly 3 million Americans have already been
diagnosed with COVID-19 and the number of deaths from COVID-19 is in
excess of 130,000. While some loss of life due to the deadly global
pandemic is likely unavoidable, in my opinion many of these deaths
could have been prevented by a quicker and more uniform response by our
Nation's Commander-in-Chief and his administration. Rational, stable,
and consistent leadership, based upon medical and scientific data, is
desperately needed from our Nation's highest office during this very
real viral pandemic. Unfortunately, that is missing at the moment.
In the last 6 months, we have seen leaders of nations all over the
globe respond to this deadly pandemic with rational science-based
decision making and genuine concern for their citizens and their
economies. We have seen leaders from all over the world step up and
rise to the occasion. It is past time to see that type of leadership
here in the greatest country on earth.
We must, as a Nation, listen to our scientists and our health care
providers in responding to a medical crisis. If other nations have the
ability to flatten the curve and reduce the number of deaths, then we
also have that ability in the United States of America. Our Nation has
4.25 percent of the world's population, but over 20 percent of the
world's COVID-19 cases. Our Nation has 4.25 percent of the world's
population, but over 20 percent of the world's COVID-19 deaths. That is
a failure of leadership. This failure, in addition to the exacerbated
public health crisis, has caused a tremendous amount of harm to our
Nation's economy. The medical crisis and the economic crisis are
interrelated and one cannot be fixed without fixing the other, and
these two simultaneous crises are directly contributing to the
hardships being faced by American families, American businesses, and
local governments all across our Nation.
My purpose here today is to speak to the hardships facing local
governments which are on the front line of responding to our Nation's
health and economic crises. Mayors, municipal board members, county and
parish leaders, and countless other local officials are doing all that
they can to flatten the curve in their communities. Local officials are
making local policies based upon the recommendations of Dr. Anthony
Fauci and the National Institute of Allergy and Infectious Disease, the
Surgeon General, the Center for Disease Control, State agencies, and
their local medical communities. Their efforts, however, are being
hamstrung by the lack of rational, stable, and science-based leadership
from the White House.
In Tupelo, for example, by executive order, we recently instituted
a mandate to wear masks or face coverings at indoor businesses. The
request for our city to mandate this policy was made by the North
Mississippi Medical Center, our Nation's largest rural hospital, which
is based in Tupelo, Mississippi, and the Tupelo Economic Recovery Task
Force--a bi-partisan group of approximately 40 business and community
leaders in our city. While it appears that the majority of our citizens
support and are in voluntary compliance with the executive order, a
sizable number of people in our area are adamantly opposed to masks or
face coverings for a number of reasons, none of which are science-
based. The opposition is largely based upon conspiracy theories and
what appears to be unofficial right-wing political propaganda. Many
people appear to be of the belief that COVID-19 is simply a hoax
designed to hurt the President politically. The President has an
obligation as the leader of our Nation in both words and deeds to
dispel these rumors and encourage our citizens to take every precaution
to prevent the spread of COVID-19.
Because of these unchecked conspiracy theories and rumors, local
leaders have an increasingly difficult time enacting common-sense
measures to protect both the health of their citizens and their local
economies. That compounds the needs of local governments which I am
here to speak of today.
I have attached hereto as ``Exhibit A'' to my opening statement a
narrative of the efforts of Tupelo, Mississippi to combat COVID-19,
help our citizens, and re-boot our local economy.
A summary of those efforts are as follows: We instituted our
emergency protocol on February 24, 2020 and formed our administrative
team to respond to COVID-19 at that time; between February 24, 2020 and
April 30, 2020 I executed 17 separate Executive Orders to do my best to
combat the deadly virus and each of these orders were ratified and
adopted by our City Council.
Among the measures enacted by executive order and adopted by our
City Council was a mandate for our citizens and businesses to follow
``The President's Coronavirus Guidelines for America.'' The Tupelo
Economic Recovery Task Force also proposed and our city adopted the
``Tupelo Economic Recovery Guidelines'' which were formulated based
upon the President's ``Reopening of America'' guidelines.
Both the President's Coronavirus Guidelines and the President's
Reopening of America Guidelines were well-written and helpful in
combating COVID-19 and would likely have had a tremendously positive
impact had they been mandated nationally. Unfortunately, the President
issued no such mandates and was highly critical of Governors and other
leaders who actually mandated the very guidelines issued by the White
House in their respective State or community. While the written
documents called for a slow and measured approach based upon science
and data, the public mandate from the President and many Governors was
contrary to what was contained in those written documents. This has
greatly hampered the ability of local leaders to respond due to the
President's large and passionate following. This has had a direct
adverse impact on the economy and financial ability of local
governments all across the Nation to provide basic city services.
Due to the continued political climate surrounding COVID-19 our
city continues to have difficulty in getting individuals and businesses
to comply with safety measures to prevent COVID-19-related sickness and
death in our city. This will prolong both the health and economic
crises in our community.
Until we can slow the sickness and death in our community and
across the Nation, it is impossible to truly stop the adverse economic
impact to our local governments. That is why direct financial
assistance to local governments for revenue loss is desperately needed.
On behalf of the citizens of Tupelo, Mississippi and as a member of
the National League of Cities Small Towns Council, I would like to
thank the Members of this committee and the Congress for acting swiftly
to respond to the economic and medical crises caused by the deadly
global viral pandemic of COVID-19. I applaud this body's swift bi-
partisan effort to pass the various CARES ACT bills which provided
much-needed relief to individuals, hospitals, businesses, and State
governments across the country. In today's highly-politized climate it
is increasingly rare to see the leaders of both parties come together
so quickly to pass such historic legislation. The legislation helped
virtually every level of our society.
The purpose of me being here today, however, requires that I speak
candidly regarding to this issue to the honorable Members of this
committee as to what I believe to be a significant oversight in the
historic legislation.
Local governments under the acts were eligible for reimbursement
for actual unbudgeted expenses incurred as a result of COVID-19. For
many cities and local governments, however, the actual expenses
incurred paled in comparison to the most significant harm incurred by
local governments--the loss of revenue from the economic crisis caused
by COVID-19. While the CARES ACT bills did many great things, the
legislation unfortunately did not provide any means for local
governments to recover lost revenue and went further to directly
prohibit CARES ACT funds from being used to replace lost revenue by
local governments due to COVID-19. I have attached a summary of the
adverse financial impact to the city of Tupelo, Mississippi as
``Exhibit B'' to this statement.
By way of example, the State of Mississippi received over $1.2
billion of CARES ACT funds and not a single dollar of those funds could
be allocated to a local government to directly help the local
governments of our State recover from the substantial loss of revenue
due to COVID-19. Like in other States, municipal governments in
Mississippi receive a substantial portion of their revenue from local
sales tax. Tupelo, Mississippi receives approximately 50 percent of our
annual budget revenue from sales tax collections. Due to the economic
shut-downs and societal shift to even more on-line shopping, that
revenue, as indicated in Exhibit B, was greatly reduced for our city.
The same is likely true for every local government in the country that
depends on local sales tax revenue as a source of funding for their
annual budget.
As Americans, we rightfully are often passionate about the larger
issues that get debated in Washington, DC and in our respective State
capitols, but it is at the local level where the rubber literally meets
the road in American society.
The revenue loss in our city and in cities like us all across the
Nation may mean that streets do not get paved or repaired, that litter
pick-up and debris removal does not occur, that first responders and
other public safety workers are laid off or furloughed due to the
economic hardships faced by local governments, and that the opening of
new businesses are delayed because of backlogs in the permitting
offices or for a lack of building inspectors in the city. Virtually
every business in America has to interact with a local government and
the city services need to be available and timely available to keep our
local and our National economy moving forward.
While the Federal and State governments have a large-scale impact
on our Nation as a whole, the ability of every worker in America to
actually get to work on time by way of a decent road or local
transportation system depends on a capable and functioning local
government. Every mom-and-pop business in our Nation has to depend on a
local municipal or county (parish) government to make sure that the
infrastructure is sound and that the community is safe to operate their
business.
Fire fighters, first responders, police officers, code enforcement
workers, sanitary water and waste removal, garbage and debris pickup,
youth sports and adult recreation leagues, local parks, public works
departments, and a host of other functions that have a very real and
daily impact on the lives of every American are performed by the local
municipal or county government where that person and their family
lives. Those are the services being threatened by the loss of revenue
to local governments due to the economic crisis caused by the health
care crisis resulting from the global COVID-19 pandemic.
Former Speaker Tip O'Neill famously said that ``all politics is
local'' and it is certainly true at this moment that while our Nation's
response to COVID-19 may be debated in Washington, DC and in our
respective State capitols, it is being felt the hardest in our local
communities all across our great Nation.
As this honorable committee and this collective body continues to
debate and deliberate upon our Nation's response to COVID-19, on behalf
of all mayors and local officials and governments across our Nation, I
would respectfully request that you consider direct payments for local
governments to city and county (parish) governments for lost revenue.
Unlike our Federal Government and even our State governments, our
cities and counties (parishes), particularly in our small rural
communities, do not have the ability to absorb significant revenue
losses and also continue to provide the high level of services that our
citizens and businesses expect and deserve.
Thank you again Chairman Thompson, Ranking Member Rogers, and
distinguished Members of this honorable committee for allowing me the
honor and privilege of being here today under this unique remote format
to speak on behalf of our Nation's local governments.
ATTACHMENT A.--City of Tupelo COVID-19 Response
Closely watching the COVID-19 pandemic unfold, the city of Tupelo
responded early to be prepared with what was feared to be the largest
public health crisis for the United States and our city since the
Influenza Pandemic of 1917. On February 24, 2020, Mayor Jason Shelton
issued an executive order which appointed Tupelo Fire Chief Thomas
Walker to serve and administer the response to the Coronavirus threat
for the city of Tupelo. At that time, an internal COVID-19 Response
Team was formed. In the days following and with careful monitoring of
the statistics in Mississippi and Lee County, many difficult decisions
were made to prevent the spread of the virus. In total, there were 17
city of Tupelo executive orders through April 30, 2020 which addressed
the evolving nature of the pandemic. Each executive order outlined
restrictions based on COVID-19 local and State statistical data from
Mississippi State Department of Health, CDC, Johns Hopkins University,
and daily communication with health officials of North Mississippi
Medical Center. Due to the rampant spreading of the virus, the city of
Tupelo acted without waiting for the State of Mississippi's response,
and issued a shelter-in-place executive order on March 21, 2020. Once
the Governor's executive order was issued days later, the city ratified
its orders to comply. Various issues were addressed in executive
orders, including the discontinuing of water and light cutoffs as well
as evictions during the pandemic.
Government is essential and city services must continue to be
provided. Balancing the city government workforce to provide these
services balanced with their health was crucial. After Mayor Shelton
issued a declaration that Tupelo was in a State of Emergency, Tupelo
City Hall and all departments were scaled back as much as possible.
Those who could telework did so, and those jobs which required
physically being on-site were accomplished with smaller groups. Tupelo
City Hall remained open every day. Signage was placed on City Hall
doors and other department doors with CDC guidelines regarding health
symptoms, whether those entering had traveled, and other specifics.
Appointments were encouraged to the public for all city of Tupelo
business rather than in-person. Safety guidelines were put into place
for all departments, and city workers were provided masks and hand
sanitizer. Weekly department head meetings were conducted by
teleconference with Zoom. In addition, Zoom teleconferencing was used
for all Tupelo City Council meetings which were televised on Comcast
and Facebook Live. As another way to stay connected to the community,
the city of Tupelo produced a video ``We Will Be Back'' created to
inspire and give hope during this difficult time. The video premiered
on Facebook on April 24 and had almost 50,000 views.
Communication during the pandemic was and continues to be
imperative. Because it affected literally all aspects of our community,
there were many questions from our citizens. The first priority was
establishing an effective form of communication. The city of Tupelo
COVID-19 Team established an email where all questions and concerns
could be sent. Inquiries were answered swiftly by the team. This was
not only efficient, but also provided transparency and built trust with
our citizens. In keeping with the importance of communication, Mayor
Shelton was Facebook Live each day to update viewers with developments.
All social media was utilized to the fullest as well as the city of
Tupelo website, which had a complete section dedicated to COVID-19.
This section was easily visible and accessible on the home page, and
contained all Tupelo executive orders, State of Mississippi executive
orders, and a Q & A list. Communication with other entities was key in
staying informed. Administration participated in briefs from the White
House, Governor's office, and had frequent calls with Community
Development Foundation, Lee County Council of Governments, North
Mississippi Medical Center, various industry and business leaders, and
Tupelo Public School District. Staying in touch with all entities
provided valuable information to respond to the changing needs in the
community.
The huge economic impact was felt as most businesses and
restaurants closed. Options were explored to help them overcome the
challenges. Special accommodations were made to allow businesses to use
public parking spaces for curbside and take out service. Accommodations
were also made to allow for banners and signage without permits for
businesses. Also helpful was the extension of the downtown Tupelo
leisure and entertainment district to include the entire city limits of
Tupelo, which allowed restaurants to sell takeout alcohol with food
sales.
With businesses facing unprecedented challenges, Mayor Shelton
formed the Tupelo Economic Recovery Task Force, a cross-section of
business and community leaders who themselves were dealing with the
negative impacts of COVID-19, to advise him in creating meaningful
strategies for restarting the local economy and for pursuing State and
Federal assistance in supporting those efforts. The task force went to
work immediately to communicate with leaders at all levels of
government, working to ensure that the city of Tupelo comes out of this
crisis as successfully and safely as possible. The Tupelo Economic
Recovery Task Force has reviewed and approved plans laid out by Mayor
Shelton and his administration to safely reopen Tupelo's economy while
mitigating risk and protecting the most vulnerable. These plans, called
the ``Tupelo Economic Recovery Guidelines'' are formulated from
President Trump's ``Reopening of America'' as a foundational document
with input from the citizen-driven task force. The guidelines will
continue to comply with State and Federal orders.
The city of Tupelo has endured 2 devasting tornadoes in this
century, the first in 1936 which cost hundreds of lives and massive
infrastructure damage. In 2014 another tornado struck Tupelo, forcing
the city to again rebuild businesses and homes. Geographically, Tupelo
is located in ``Tornado Alley'', so being prepared is second nature to
the city. With the forecasting of modern meteorology, the city prepares
accordingly. On Sunday, April 12, tornadic weather was predicted for
Tupelo. With the COVID-19 pandemic, every precaution had to be made in
regard to public health. It was decided that all Tupelo storm shelters
would be open. City employees manned each shelter, and hand sanitizer
and face masks were given to everyone upon entering. There were cities
which did not open their shelters due to the pandemic. But with
Tupelo's unfortunate history of tornadoes, administration sided with
the welfare of its citizens to provide shelter to keep families safe.
Although the physical illness of COVID-19 has been first and
foremost in everyone's thoughts, the pandemic has also affected people
both emotionally and mentally. From health concerns to financial
burdens, everyone is dealing with some anxiety. Mayor Shelton
recognized that a fun diversion would help to take minds off the
pandemic for a while. He organized the ``Mayors Music Series'', which
lasted 30 days. Each day at 5:30 p.m., viewers could watch Facebook
Live for a free concert. Music was provided by local artists of various
genres, and even included the lively entertainment of Elvis Tribute
Artists from around the globe. The ``Mayors Music Series'' was a huge
success, and actually had 2 goals. The first was to provide something
fun to watch, especially to those sheltering at home. Second, it
provided income to musical artists who had no work during the pandemic.
Each artist was paid $500 each for their 30-minute show.
The collaboration of the city of Tupelo's outreach committee with
many community partners served a number of needs in the community in
response to the COVID-19 pandemic:
The Tupelo-Lee Hunger Coalition provided thousands of
lunches for students who receive free or reduced lunches. The
packing of food boxes continues today, as many families depend
on these weekly meals.
Tupelo City Schools also provided grab-and-go services and
meal delivery to homes with food insecurities. Mayor Shelton
signed a ``School Lunch Hero Day'' proclamation recognizing the
``men and women who prepare and serve school meals'' to help
nurture local children with their daily interaction and
support.
Project Search Students was organized to find job placement
for Tupelo High School graduates with special needs. The
students started their training with a rotation of job
positions at North Mississippi Medical Center. Students are
transported to and from their jobs by Tupelo Transit.
The Mayor's Homeless Task Force and MUTEH continued their
work during the pandemic. Welfare checks continued, homeless
encampments were cleaned up, and housing was arranged through
various organizations.
Queen's Reward Meadery switched from making mead brandy to
producing hand sanitizer. The city of Tupelo partnered with the
local company for a drive-through free hand sanitizer giveaway
on April 17 and April 24 at Tupelo City Hall. Each car received
2 bottles of the hand sanitizer.
Toyota Mississippi and Mid-South Food Bank set up a mobile
food pantry at the city of Tupelo's BancorpSouth Arena on April
20. Thirty thousand pounds of food was given away, with 500
slots available. This incredible donation served as many as
6,000 people.
Money left in the city of Tupelo Tornado Fund (2014)
established at the CREATE Foundation was used to assist needy
families with basic necessities including diapers, formula, and
toiletries.
Downtown Tupelo Main Street Association provided masks and
gloves for all merchants. They also provided on-line business
seminars, virtual shopping platforms, created a website
dedicated to relevant information for downtown restaurants and
merchants, and other creative ways to support the Main Street
Community during the economic challenges of the pandemic.
MEMA conducted a drive-thru COVID-19 testing facility at the
city of Tupelo's BancorpSouth Arena.
Steve Tabor and 8 Days of Hope, along with American Family
Radio delivered 20,000 meals for needy Tupelo families.
Blue Delta Jean Company switched from making their custom
blue jeans to making face masks for the community.
United Way of Northeast Mississippi established a fund at
the CREATE Foundation to assist families with needs and
financial hardship of the COVID-19 pandemic.
Saints Brew provided a grab and go take out breakfast for
the homeless.
Tupelo-Lee Humane Society offered drive-thru for those who
volunteered for short-term foster care for dogs and cats.
The COVID-19 pandemic has been a challenging time for the city of
Tupelo, as well as all municipalities. Using the information received
from medical professionals, the city's administration and Tupelo City
Council acted swiftly and thoughtfully to make decisions with public
safety the priority. Reaching beyond the city's scope of services and
collaborating with community partners, the city of Tupelo assisted
thousands of its citizens affected in various ways by the pandemic.
ATTACHMENT B.--COVID-19-Related Financial Impact on Tupelo, Mississippi
BancorpSouth Arena is closed due to COVID-19, which is
anticipated to cost tax payers almost 1 million due to the loss
of revenue; part-time employees have been eliminated.
Tupelo Convention and Visitors Bureau revenues were trending
up prior to COVID-19. Tupelo anticipates a drop of 20 percent
of the tourism tax revenue compared to last year's collections
without considering the growth we experienced prior to COVID-
19. The projected loss amount as of June 30 is $830,000. This
could change for better or worse as we approach the July 15.
Tupelo Parks & Recreation loss of revenue has cost the city
approximately $200,000. Indirect revenue from Parks &
Recreation events is much higher.
Tupelo Municipal Court revenue has dropped $100,000.
Tupelo Aquatic Center indirect revenue has dropped as
facility was closed (economic loss due to canceled events).
The General Fund has been slashed with a cut of more than
$500,000 to City Departments.
The city has incurred $250,000 in overtime pay pursuant to
the city of Tupelo's Emergency Policy.
PPE and protective measures cost the city over $35,000.
The city of Tupelo sales tax dropped $557,000 for March and
April combined. The true loss is $630,000 since our pre-COVID-
19 numbers were up 2 percent. Collections for the remaining
fiscal year are unknown at this point. Prior to COVID-19,
Tupelo had experienced 6 consecutive years of record-breaking
economic growth.
The city of Tupelo's Capital Plan decreased $1,000,000 for
the revitalization efforts due to budget cuts.
Total budget cuts of 2.5 million for the city of Tupelo.
The true impact of COVID-19 remains to be seen. The provided
numbers reflect the financial impact that can be determined at
this point.
Chairman Thompson. Thank you for your testimony.
I now recognize Dr. Shah to summarize his statement for 5
minutes.
STATEMENT OF UMAIR A. SHAH, EXECUTIVE DIRECTOR AND LOCAL HEALTH
AUTHORITY OF HARRIS COUNTY PUBLIC HEALTH, TEXAS
Dr. Shah. Thank you, Chairman Thompson, Ranking Member
Rogers, and Members of the committee and subcommittee. Members
of the Texas delegation, Representatives Sheila Jackson Lee, Al
Green, Dan Crenshaw, and Michael McCaul, I want to thank all of
you in particular.
My name is Dr. Umair Shah. I am the executive director and
local health authority for Harris County Public Health. I am
past president of NACCHO, that represents the nearly 3,000
local health departments across the country.
Harris County is the third most populous county in the
United States with 4.7 million people, including the city of
Houston as one of the most diverse and fastest-growing
metropolitan areas. The population in our community is larger
than 25 States.
We are no stranger, unfortunately, to emergencies such as
storms, hurricanes, fires, and infectious disease responses.
From a public health standpoint, there truly is never a dull
moment in our community.
Unfortunately, the present COVID-19 pandemic has had an
unprecedented impact on our community and our Nation well
beyond health, and has undoubtedly tested the resolve of the
American people.
Harris County Public Health has responded to H1N1 for 18
months back in 2009, 2010, but tomorrow marks only the 6-month
mark for COVID-19. It is truly a marathon not a sprint.
Today I am here to make 3 main points. One, we as a Nation
still have the opportunity to fight this pandemic but only by
working together. No. 2, all eyes are on Harris County in Texas
right now, and despite being successful previously, the
situation has now changed. No. 3, public health is key, and we
must support and invest in it.
Let me start by saying that the local response to COVID-19
led by Harris County Judge Lina Hidalgo has been strong,
decisive, and proactive, and has worked closely with other area
officials, including Houston Mayor Sylvester Turner.
Case in point, Harris County released its Four T's approach
for addressing COVID-19--test, trace, treat, and teamwork--from
March to May. This approach saw the Houston Harris County
community working together successfully to flatten the curve.
More recently, the story has changed. Our community has
seen an increase in cases, the percentage of tests that are
coming back positive and hospitalizations, including in our
county's safety net hospital system. Our threat level for
COVID-19 has been raised to red, its highest level. We now have
over 39,000 cases and 400 deaths in Harris County.
The changing picture in Harris County demonstrates what I
have called the layering effect of reopening in Texas on top of
events and holidays, such as Mother's Day, Memorial Day,
protests and marches, further layering exposure and risk to our
community.
Inconsistent messaging at the Federal, State, and local
levels have led to further confusion and complacency at the
individual community level. Case in point, CDC has not been
consistently visible as the Nation's voice of public health.
In Texas, while many local officials, elected and health
authorities alike, stated clearly that our State was reopening
too quickly, the process of reopening continued. Powers of
authority previously available at the local level were removed.
Fortunately, the State has now begun to dial back reopening.
Reopening responsibly means that decisions should be driven
primarily by health and medical, while balancing other
interests.
Public health often gets the short end of the stick. It has
been chronically underinvested in. I call this the
#InvisibilityCrisis.
While I have come to this committee before to share similar
points, enough is enough. We need to take this seriously if we
are ever to correct the course in time to protect our
communities. Yet when we need it the most, public health is
still largely invisible, underappreciated, and underfunded.
The COVID-19 public health work force has been working well
beyond 40 hours a week, available 24/7, months on end. The
public health front line is committed, but it is facing burnout
and stretched to its limit. In the span of 4 months, our
department has doubled its own work force. Our epidemiology
team has gone from 25 to 500. This massive scaling for COVID-19
has proven necessary, but without reliable and secure funding
outside reactionary and supplemental funds, it is simply not
sustainable.
Daily, our leadership juggles needs between the central
public health services and the COVID-19 response, and we are
not alone across the country. This is where the Federal
Government comes in, the primary financing mechanism to expand
capacities through CDC's ELC grant. For example, our department
is ineligible for direct funding, yet the same mechanism has
been used for the COVID-19 response.
The pandemic must be fought together. It is felt like every
health department has been left on its own trying to create new
systems response in real time. While Federal support is
appreciated, Federal testing sites were planning to cease
operations at the very time we were seeing increasing need.
Similar issues are likely to play out again when vaccinations
become available, meaning proactive planning for vaccine
distribution is needed soon.
Although scaling of testing has increased, results take too
long to reach health departments, especially at government-
supported sites. The data exchange is moving slower than the
disease. With this delay, public health measures become less
effective. This is especially true for those most vulnerable,
such as disproportionately-impacted communities and those in
congregate settings. We are equally concerned with the health
inequities seen in Hispanic and African American communities in
this response.
If the Federal Government expects there to be robust
systems of surveillance, better data informatics capacity is
needed at the local level. This includes CDC's support for
innovative study of disease patterns in Harris County,
utilizing state-of-the-art technologies, and genetic
sequencing.
As a workaround, our department has had to develop new data
systems, public-facing data dashboards, and on-line screening
tools for testing on its own. Those local efforts are necessary
to get the job done, but they are reactive as National efforts
to modernize such systems have failed.
Let me close by saying the pandemic is an unprecedented
time for our country. We are being tested like never before.
Smart, strategic, scalable, and sustainable investments are
needed now. All eyes are on Texas and Harris County. We should
be able to look to the Federal Government for leadership and
support.
On behalf of Harris County Public Health and our public
health colleagues across the Nation, the offensive line of the
football team, I appreciate again the opportunity to testify
today. Along with our local leadership, we join you in working
together in fighting COVID-19 to protect our National security,
our economic vitality, and the very health of our people.
Thank you.
[The prepared statement of Dr. Shah follows:]
Prepared Statement of Umair A. Shah
July 8, 2020
My name is Dr. Umair A. Shah, and I am the executive director for
Harris County Public Health (HCPH) and the Local Health Authority for
Harris County, Texas. I am a past president and former board member of
the National Association of County and City Health Officials (NACCHO).
NACCHO is the voice of the nearly 3,000 local health departments (LHDs)
across the country. I am also a past president and current board member
of the Texas Association of City and County Health Officials (TACCHO)
which represents approximately 45 LHDs across Texas.
Today, I particularly want to acknowledge Michael ``Mac'' McClendon
and Jennifer Kiger, 2 Nationally-recognized leaders in emergency
planning and response, who serve as our Department's deputy incident
commanders for COVID-19. They oversee an incredibly strong response
team who have all dedicated countless time and effort in protecting the
Harris County community.
never a dull moment
Harris County is the third most populous county in the United
States with 4.7 million people, including the city of Houston, and is
one of the most culturally diverse and fastest-growing metropolitan
areas in the United States. We are home to the world's largest medical
complex, the Texas Medical Center (TMC), one of the Nation's busiest
ports, the Port of Houston, and 2 of the Nation's busiest international
airports.
Harris County is no stranger to significant events, disasters, and
large-scale emergencies. These range from natural to infectious disease
in nature: Tropical Storm Alison (2001); Hurricane Katrina sheltering
(2005); Hurricane Ike (2008); Hurricane Harvey (2017); Tropical Storm
Imelda (2019); nH1N1 influenza pandemic response (2008); West Nile
virus (WNv) response (2012); Ebola readiness & ``response'' activities
(2014-2015); human rabies death and canine rabies, respectively (2008
and 2015); Zika virus (2016-2017); measles ``resurgence'' (2019); and 3
large-scale chemical fires (2019). From a public health response
standpoint, there truly is never a dull moment in Harris County.
Unfortunately, 2020 adds more to this list, with COVID-19 being the
summation of all of these emergencies both due to length of response
and more importantly its impact. As our department sent out its first
official health alert to regional health care partners on January 9,
tomorrow marks fully 6 months into the HCPH COVID-19 response and we
are nowhere near the end. It is truly a marathon and not a sprint when
it comes to our response activities and the toll it has taken on our
community.
The first cases of COVID-19 in Harris County were tied to an Egypt
cruise tour in late February and a number of milestone events and
phases have occurred since that time. Our department has been
responding continuously since then; yet we are reminded that during
nH1N1, HCPH was activated for 18 months and that was a mild pandemic in
comparison. Although we are months into the pandemic, responding to the
immediate and long-term impacts of COVID-19 will take years. The
pandemic will likely ebb and flow, and does not have the distinct start
and end of an emergency such as a hurricane. Preparedness, response,
and recovery phases will blur and need to be addressed in tandem.
covid-19 response
As you know, local health departments are the chief health
strategists for their communities. In January, HCPH in coordination
with the Houston Health Authority, Dr. David Persse, began hosting
coordination meetings and planning with partners well before the first
case of COVID-19 ever reached Harris County. We discussed then that it
was not a matter of ``if'' but rather ``when'' COVID-19 would impact
our community directly.
These partnerships have continued dynamically throughout the
response. Important twice-weekly calls are held with regional local
health authorities as well as separately with the health care community
through TMC. Key and timely communications and response efforts
directed by Harris County Judge Lina Hidalgo have been coordinated
through the Harris County Office of Emergency Management & Homeland
Security and with other county partners. These have been crucial to
real-time coordination and the elimination of barriers to response.
Earlier in March, HCPH partnered with Judge Hidalgo to release the
foundational ``Four T's'' approach for addressing COVID-19 (Test,
Trace, Treat, and Teamwork). More recently, the COVID-19 Threat Level
System was unveiled in June to help the community understand the
continued importance of COVID-19 prevention efforts for Harris County.
In addition to coordination with a multitude of partners, LHDs such
as HCPH play primary roles in disease surveillance and providing
guidance to the community that are unique from most of its partners.
Preventing spread without available medical countermeasures has been a
real issue in the COVID-19 response since there are no vaccines or
pharmaceuticals by and large that can address the myriad of issues that
COVID-19 presents. This means focus by LHDs on tried and true public
health measures such as communications coupled with specific activities
such as contact tracing, congregate setting assessments and testing,
and community testing are keys to a successful response. These further
the main goal of interrupting disease transmission and put a stop to
the pandemic.
harris county, texas . . . an increasing hotspot for covid-19
Harris County, led by County Judge Lina Hidalgo, and Houston, led
by Mayor Sylvester Turner, were rightfully proactive in recognizing the
pandemic's threat and proactively engaging the community. On March 11,
the Houston Rodeo, a pillar event for the community (it generated $300
million for the local economy in 2019), was canceled as soon as there
was evidence of the first case of community transmission in the Harris
County area. Shortly after, Harris County was one of the first in Texas
to issue a ``Stay Home, Work Safe'' Order to protect Harris County
residents.
While not easy, fortunately, the Harris County community listened,
and our community was successful in flattening the curve. In fact,
Harris County's case and death rate trailed far behind other major
communities such as LA, Chicago, and New York City through the earlier
stages of the response.
However, to the detriment of public health, those orders quickly
became political and the State took away all local authority to issue
any orders more restrictive than its own, including the requiring of
masks. Of note, the State's stance on masks, just last week, has now
changed which is a welcome step but time will tell if it is too late in
the response to have the necessary effect. Regardless of whatever level
of government it involves, decisions driving the response to the COVID-
19 pandemic should be driven by public health and medical experts
without the fear of retribution or political interference.
The spike in Harris County today demonstrates what I have called
the ``layering effect'' of reopening. Starting May 1, 2020, Texas began
reopening its businesses such as dine-in restaurants, retail, salons,
gyms, bars, and more. The layering effect occurred with these reopening
alongside holidays and milestone events such as Mother's Day, Memorial
Day, protests and marches, Father's Day, etc. that then ``layered''
exposure and risk to the community. The effects were even more
pronounced as inconsistent messaging at the Federal, State, and local
level meant that there was simply confusion and complacency at the
individual community member level. While local officials--elected
officials and health authorities alike--stated clearly that Texas was
reopening too quickly, the process of reopening continued and slowly
one began noting an increase in numbers of persons testing positive for
COVID-19 alongside hospitalizations in Harris County and in other parts
of Texas.
Much of the success during the prior phases of response has been
wiped out as these numbers have begun to climb. As of July 6, Harris
County has over 36,000 cases and 400 deaths with a steady increase of
late, necessitating the community's threat level being moved to its
highest level (red). Harris County now has the highest cumulative case
count in Texas, surpassing Dallas County. While Texas has now taken
steps to ``dial back'' reopening and require the wearing of masks, the
damage may already have been done as our local health care system is
very busy now and implementing necessary surge plans. It is not just
the cumulative numbers that are concerning but the fact that previously
1 in 8 tests in the community were coming back positive for COVID-19.
In the last few weeks, this positivity rate has now increased to 1 in 4
tests being positive, or about 25 percent of tests being conducted in
Harris County.
The impacts of COVID-19 are beyond just case counts unfortunately.
HCPH evaluated the health of Harris County in a milestone report Harris
Cares: A 2020 Vision for Health in Harris County released in late 2019
(prior to the COVID-19 pandemic) and found major health disparities.
More recently, the Harris County Commissioners Court Analyst's Office
released a report, Disproportionate Impact of COVID-19 on Low-Income
and Minority Households, stating that ``the fallout of the COVID-19
outbreak is exacerbating existing financial, health, food, and economic
challenges of low-income persons and communities of color.'' The impact
to the economy, the community's physical and mental health, and effects
of delayed care (e.g., addressing heart disease or diabetes, children's
immunizations, etc.) are on-going and will be felt well after the
pandemic stabilizes. Several recommendations from Harris Cares,
especially its focus on health equity and community voice, data sharing
capacity before emergencies, local governance, and sustainable
financing would have greatly enhanced HCPH's response to COVID-19.
#invisibilitycrisis
I spoke previously in Congress about the fact that public health is
often times invisible when it does its work. This so-called
``Invisibility Crisis'' (or #InvisibilityCrisis) means that we have a
real problem in our Nation when it comes to recognizing the importance
of the often behind-the-scenes work that public health is engaged in
each day. However, the invisibility crisis that has kept public health
an under-recognized workforce has put Local Health Departments (LHDs)
like HCPH undervalued and under-invested in over the decades. This is
the recipe for disaster when one is faced with a public health crisis
like COVID-19 where public health is expected to be front and center
leading the response.
The public often recognizes the vital role of other first
responders, such as EMS, Fire, or Police, but the substantial role of
public health and the public health workforce before, during, and after
a crisis often goes unacknowledged.
we've been here before
As Judge Hidalgo raised the threat assessment level to red, I
stated ``enough is enough'' to our community in addressing the
seriousness of the situation here in Harris County. To this committee,
today I stand before you to say also ``enough is enough''--we have let
the COVID-19 pandemic get out of hand in this Nation and must do
everything we can to correct the course before more people get infected
and more people die.
We need to take my recommendations given to the 2017 House Budget
Committee seriously:
Public health is underfunded and undervalued, yet is
absolutely critical to protecting our communities even when its
work is largely invisible.
Public health is like the ``offensive line'' of a football
team--rarely recognized for the success of the football team
but absolutely critical, nonetheless.
Public health and its capacity must be invested in a
sustainable and proactive way.
This #InvisibilityCrisis has unfortunately led to funding cuts for
public health and even more so, public health emergency preparedness at
every level of government over time. Despite the significant impact on
the community's overall health and well-being, public health is largely
invisible, under-appreciated, and as a result underfunded.
These issues are further exacerbated when public health agencies
are confused for health care. Yet even now it has been forgotten that
COVID-19 is a public health crisis with secondary impacts in health
care. Taking the offensive line metaphor further, the health care
system is perceived as the all-important ``quarterback'' and thus
receives the attention (and the funding) which makes our communities
less safe. It is important to note rising COVID-19 hospitalizations and
deaths are an indicator of failure to contain the pandemic through
prevention measures that should have happened at the community level.
Coming together to support the community while respecting the crucial
role that both public health and health care play in fighting the virus
is imperative to keeping communities and the Nation safe.
In 2019, I testified before this committee that strong public
health agencies at all levels of government are important because (just
as in medicine) there is a science and an ``art'' to public health
decision making. All levels of government, Federal, State, local, must
coordinate better with each other (and globally) in response activities
and planning for the next phases of the COVID-19 pandemic.
smart, strategic, scalable, and sustainable solutions
The best way forward is a path that allows all of us to work
smarter not harder. Solutions should be strategic and scalable actions
to ensure the COVID-19 response is meeting the needs of the community.
Solutions jump-started now must be sustainable beyond COVID-19 to
fix long-standing issues that have plagued public health and ensure we
are prepared for future threats. HCPH supports recommendations offered
by NACCHO, the Council of State and Territorial Epidemiologists (CSTE),
as well as recommendations offered to the Senate Health, Education,
Labor, & Pensions Committee on June 23, 2020, regarding ``COVID-19:
Lessons Learned to Prepare for the Next Pandemic.'' Further, HCPH
offers the following additional recommendations:
Public Health Workforce Crisis
1.1 LHDs needs sustainable and consistent financing to secure the
workforce and scale our response appropriately. LHDs depend on mixed
sources of funding that are either declining or unreliable.
1.2 LHDs need investment in workforce development to ensure
adequate recruiting, retention, and succession planning is available
throughout the response both for continuity of essential public health
services and dynamic COVID-19 response.
Inadequate Public Health Financing
2.1 Congress should require CDC to report on how much Federal
funding, especially for COVID-19 such as Epidemiology Laboratory
Capacity (ELC) funding, actually reaches LHDs via State health
departments. Congress should explore per capita funding formulas direct
to local health departments. Although existing ELC mechanisms may be
the fastest way to distribute to many local health departments today,
it is not equitable and leaves many populations (such as in the non-
Houston portion of Harris County) untouched.
2.2 Congress should increase funding for Public Health Emergency
Preparedness and review funding directed to LHDs as part of other
health care finance reform initiatives such as through Medicaid reform
as a sustainable mechanism for local health departments. Supplemental
and reactionary appropriations are necessary now, but do not allow for
planned scaling of response or preparation for future crises such as
pandemics.
2.3 Congress and States (in partnership with local authorities)
should coordinate to explore the services provided by LHDs and
clarification of jurisdictional lines by the Nation's web of LHDs and
authorities to inform public health system reform.
Federal Communications and Coordination
3.1 CDC should be made front and center as a leader in the current
pandemic and communicate clear honest, and consistent guidance with the
public on prevention messaging. Inconsistent policies and/or messaging
at the Federal, State, or local level creates undue confusion and
complacency at the individual community member level.
3.2 Scaling of testing (including through Federal sources such as
Federal Emergency Management Agency [FEMA]) should also include
coordination with LHDs and public health to expedite case investigation
and contact tracing. Testing support should be available when demand
and positivity rates have increased.
3.3 Proactive planning is needed now with Federal, State, and local
governments on vaccine distribution plans and communications. This is
especially important as many LHDs will continue to handle other
important response responsibilities at the time that vaccines become
available further exacerbating the issue. Operational roles and
responsibilities should be delineated before a vaccine is developed.
Disparate Disease Surveillance
4.1 Health and Human Services (HHS) and CDC should support
standardizing data platforms across State and Federal level for intake
of lab data before sharing back to locals. While there is funding to
support States in modernizing platforms, locals are not funded to
develop or maintain surveillance and reporting systems as they have
been forced to do for COVID-19.
4.2 If Congress expects efficient surveillance, the Federal
Government needs to encourage States to bolster local surveillance
capabilities for contact tracing and case investigation that are
interoperable across jurisdictions.
4.3 CDC and other Federal partners should coordinate through
coalitions such NACCHO, Council of State and Territorial
Epidemiologists (CSTE), etc. to provide technical assistance to local
health departments on policy and planning, data, epidemiology, and
other LHD needs. In fact, HCPH has had to reach out directly to many
local health departments across the county to share best practices and
feedback due to a lack of such sharing mechanisms in comparison to
previous emergencies.
4.4 Congress should invest in modern and responsive data systems,
such as the National notifiable disease surveillance system (NNDSS),
electronic case reporting (eCR), syndromic surveillance, electronical
vital records systems, and laboratory information systems. Technology
alone is not the solution, and data informatics workforce also needs
support at the local level.
local health department pain points during covid-19
public health workforce crisis
Local Health Department Perspective
Findings from NACCHO indicate State health departments and LHDs
have lost nearly a quarter of their workforce since 2008, shedding over
50,000 jobs across the country. The deficiency is compounded by the age
of the public health workforce--nearly 55 percent of public health
professionals are over the age of 45 and almost a quarter of health
department staff are eligible for retirement. Between those who plan to
retire and those who plan to pursue opportunities in the private sector
(often due to low wages), nearly half of the local/State health
department workforce might leave over the next several years. Further
worsening matters, several public health leaders across the country
have been threatened, fired, or pushed out of their job role leaving it
necessary to find qualified persons available to take over during a
pandemic.
Epidemiologists are the disease investigators and backbone of the
COVID-19 response. In order to support epidemiologists in investigating
cases and offering control measures, the workforce must also include
communications staff to push prevention messaging, data analysts to
explore trends and visualize outbreaks and case data, logistics and
clinical support for testing and operations, social services and
wraparound support for assisting with quarantine and isolation,
administrative and business support for massive scaling, policy
analysts, and more. Unfortunately, staff in public health across the
Nation--the invisible workforce--are mission-driven but unduly
stretched. The LHD workforce is diverse, facing burnout, and stretched
to its limit.
HCPH COVID-19 Response
By March 2020, the workload and strain on the HCPH staff to respond
to COVID-19 was so great, one of the first internal wellness
initiatives was to bring puppies and kittens from the HCPH Veterinary
Public Health Division to help our epidemiology staff destress. We
began instituting regular mental health sessions, which we have since
expanded. Eventually, it was not about mental health breaks, it was
having more work than the current workforce had the capacity to handle.
In the span of just 3-4 months (March-June), we have doubled the size
of HCPH.
Before COVID-19, HCPH was staffed with a workforce of approximately
650. Today, we have doubled to almost 1,300 employees and contractors.
The HCPH COVID-19 response has grown from 30 staff members under the
Incident Command System (ICS) to just under 900 while the HCPH
epidemiology group grew from about 25 to 500 staff with 300 contact
tracers alone on-boarded by May 22. COVID-19 has proved this scaling is
necessary, but without reliable and secure funding outside of
reactionary and supplemental funds, LHDs are not prepared for the next
pandemic or long-term planning.
Rapid scaling of HCPH has placed immense strain on our system, and
it has required an intense focus on quality control and continuous re-
alignment of skill sets. The response has pulled staff from across the
health department leaving many critical roles for continuity of
operations vacant. Dentists were needed to collect specimens at testing
sites. Food safety staff continue to provide data and administrative
support for our epidemiologists. Mosquito control staff coordinate
teams for mobile operations and contact tracing. Every week, our
command staff review workforce needs for public health essential
services and the COVID-19 response in order to shuffle staff,
accommodate conflicting needs, and ``right size'' the response.
Continuity of operations for non-COVID-19 public health services is
near impossible for a response that has no clear end in sight.
inadequate public health financing
A Local Health Department Perspective
LHDs work hard each day to meet the needs of the community and
often operate on a tight budget. To this immense work and tight budget,
public health added the COVID-19 response. Infrastructure investments
must be made now to further strengthen, enhance, and scale up the
ability of public health agencies and others to meet demands for future
COVID-19 vaccinations and for mitigating the long-term health impact of
COVID-19.
Health care finance reform has been the topic of discussion for
decades. Sweeping health care financing reform, although necessary,
does not translate to sustainable public and population health
capacity. Public health prevention infrastructure has never been funded
robustly enough to limit health care costs.
However, over the last decade public health has faced steep
declines and threats to financing. Public Health Emergency Preparedness
funding streams have steadily declined since initial allocation after
9/11. In Texas, instead of expanding Medicaid, the State submitted an
1115 Waiver that is set to expire in 2022. The direct participation of
LHDs accounted for 15 percent of the total DSRIP pool, or about $1.7
billion in Texas. 1115's were an unprecedented and novel pipeline to
LHDs for Medicaid dollars. No other mechanisms exist for LHDs in Texas
to secure Medicaid funding, despite being a critical component of the
safety net.
Public health financing reform is inhibited by the lack of
formalization and designation of LHDs in State and Federal regulation.
Not all LHDs are created the same and offer vastly different services
locality to locality. Without a massive effort to inventory provided
services, better understanding of jurisdictional lines and amount of
population served, and coded designations across State and Federal
Governments for LHDs it is difficult to jumpstart system reform and
revise funding formulas.
The primary financing mechanism for State and local governments to
expand their epidemiological capacity is through CDC's Epidemiology and
Laboratory Capacity (ELC) Cooperative Agreements. These dollars are
directed toward 50 States and 6 major cities. However, allocation from
States down to local governments has fluctuated and many LHDs are
unsure if the funding provided will be able to last throughout the
pandemic.
The ELC funding formula for cooperative agreements to the true
``boots on the ground'' LHDs is flawed and outdated. After distribution
to States, locals often do not receive a significant portion of these
dollars to expand their surveillance capacity even though they are
expected by their residents to provide surveillance, maintain
personalized dashboards, and conduct case investigations themselves.
This disparity for LHDs is compounded as CDC continues to use this
funding formula for supplementary funding throughout COVID-19 response,
continuing to leave many LHDs expected to perform out of the direct
funding loop. Accountability and oversight to States and CDC are needed
to ensure the Congressional intent of allocating funding to LHDs is
fulfilled.
HCPH COVID-19 Response
To scale the COVID-19 response and sync with closing of businesses,
several essential public health services have been impacted such as
restaurant inspections, mosquito abatement, clinic-based services,
Grant funded projects have been slowed, sometimes to a complete halt,
with requests for extensions being made across the board. For COVID-19
response, HCPH has had to divert limited resources from elsewhere in
order to scale some of the most important tools available to fight
COVID-19. HCPH's financial and grant portfolios are at risk alongside
many other LHDs across Texas and the Nation.
For fiscal year 2020-2021, HCPH had an operating budget of $121
million, comprised of 53 percent grant funding, 32 percent local
funding, and 15 percent special revenue funding. Making matters worse,
HCPH has spent approximately $25 million for COVID-19 over the course
of 6 months and has only received $4.4 million through discretionary
and supplementary Federal support to date (as pass-through dollars from
the State). The majority of costs for COVID-19 response will likely
have to leverage county disaster funds. These local disaster funds are
not a sustainable solution for public health response and planning.
When activating grant funded staff and resources for COVID-19 response,
LHDs face the threat of not being able to charge back grants for staff
time though the individual remains an LHD staff member. Had there been
more robust infrastructure and regular funding for public health before
COVID-19, LHDs would have been better poised to respond in more cost-
effective and timely manner.
CARES Act funding was passed to support counties and cities alike,
but without direct designation for LHDs, allocation is likely to be
limited for public health since funding constraints mean there is
competition for these precious dollars across local governmental
systems. However, one promising step related to the CARES Act funding
formulas is that it has clear guidelines on shared city and county
allocations based on population size. This is not the case for example
with ELC funding. For ELC and other Federal funding intended for local
health departments, funding formulas should be reviewed to ensure LHDs
such as HCPH receive their appropriate share (whether based on per
capita or another reasonable basis) in a manner similar to the CARES
Act funding for local governments as a whole.
federal communications and coordination
Local Health Department Perspective
From the outset of the COVID-19 crisis and continuing today, the
public has received mixed and contradictory messages on the severity of
the outbreak, the differing roles of Federal, State, and local
government, the availability of tests, potential treatments, the
appropriateness of masks, and time lines and approaches for shutting
down non-essential businesses and reopening. CDC has not been publicly
visible as the Nation's apolitical voice of public health. LHDs are
less effective to respond to early outbreaks when Federal, State, and
local health messaging and communications are not in sync.
HHS agencies (especially ASPR and CDC) have not coordinated with
States and LHDs on how best to access strategic National stockpiles at
the Federal, State, and local level. As a result, unnecessary confusion
has existed on Federal, State, and hospital-level responsibilities in
procuring PPE and testing supplies. Due to shortages, hoarding,
increased market prices, and competition between locals, States, and
even hospitals the supply chain was unduly compromised.
Inconsistent or unavailable guidance from the Food and Drug
Administration (FDA) on Emergency Use Authorizations (EUA), especially
for the reliability and availability of emerging testing technology,
has pushed LHDs to have to internally track unreliable vendors for
testing kits. This has been problematic throughout the response because
vendors have reached out directly to local health departments and local
elected officials.
Proactive planning is needed now with the Federal Government on
coordination for mass vaccinations.--The Federal Government should seek
input from local governments on how to best operationalize a COVID-19
mass vaccination. As was done during 2009 H1N1 response, Federal and
State governments should work with private partners to distribute the
vaccine while having a set priority criteria to ensure the vaccine is
available to those at most need first. Local public health departments
cannot be expected to run the mass vaccination operation while also
continuing other key response activities. Delineated roles and
responsibilities should be in place before a vaccine is developed so
wide-spread distribution plans among private and public partners is
clearly laid out.
HCPH COVID-19 Response
Since March, HCPH has been supported by 2 FEMA fixed-site testing
locations in Harris County (2 additional FEMA sites are within the city
of Houston jurisdiction). These sites were set to cease Federal support
by June 30--at the very time that Harris County was seeing increasing
demand for testing, increase in cases, and increase in positivity rates
for tests performed. To maintain Federal support for testing, HCPH
requested that FEMA remain for 2 months. After much advocacy at the
local, State, and Federal level, FEMA fortunately agreed to continue
its testing support for longer. However, it is still scheduled to cease
this support by July 14 even while testing remains more important than
ever.
In addition to the Federal testing support, in order to meet
additional testing demand throughout Harris County, HCPH has partnered
with private labs to provide testing at home, in mobile locations noted
as ``testing deserts'' (utilizing county-owned mobile units), and
through testing strike teams for congregate settings. In fact, HCPH has
spent $16 million (of its total $25 million expenditure) on testing
efforts in Harris County. Overall, to date, HCPH has tested 100,000
residents.
While things have become more coordinated now, earlier in the
pandemic, lack of coordination resulted in disjointed contracting and
securing of supplies and resources, many of which were largely
unavailable because they were also held by the Federal Government.
Local partnerships were needed to create local supply chains for PPE
and testing supplies. Without consistent or reliable testing options,
HCPH had to secure its own stockpile and build systems for local supply
chains and donations. When faced with shortages in viral transport
media that threatened operations, HCPH had to consider even
retrofitting its mosquito control lab to have capacity to produce 5,000
vials per week. At times, it felt every LHD was left on its own trying
to create a system for response in real-time due to these limitations
at hand.
Scaling of Government-supported testing sites has not resulted in
expedited contact tracing or scaled prevention because results are not
readily available to LHDs. In Harris County, FEMA community-based
testing centers instructed people being tested to contact their local
health department for their results when HCPH was not part of the
system and had no way to access the test results. Because Federal
testing sites utilized labs outside of the State, results were delayed
weeks before the LHD was ever able to access the result. This resulted
in wide-spread frustration with LHDs such as ours and the residents we
serve. Scaling of congregate and mobile testing through the State of
Texas done without full public health engagement has resulted in
similar issues for Texas.
In fact, HCPH has faced strong pushback from congregate settings to
investigate and test within facilities, in part due to overlapping
State and Federal jurisdictions of facilities. The Federal Government
should partner with States publicly to empower local health departments
to assess and test congregate facilities such as nursing homes,
assisted living, homeless shelters, detention centers, etc. due to the
concern about increased risk in these settings.
disparate disease surveillance
Local Health Department Perspective
Efforts to modernize public health surveillance and data systems
have been made over the years, but the categorical, disease-specific
approach to funding and implementing improvements has resulted in
uneven progress.
The Nation's public health infrastructure is so fragmented and
antiquated that health care providers who already have the data
collected and stored in electronic health records cannot rapidly share
these health data because LHDs cannot receive them electronically. The
data is moving slower than the disease. LHDs are responsible for
investigating cases and notifying potential contacts to break chains of
transmission, but that job becomes impossible when data shared to LHDs
is inconsistent, missing key information, or delayed. This issue area
is not new and has plagued public health response regularly.
Data Gaps for Timely Investigations
1. Labs have consistently reported incomplete results to State
health departments (which are in turn later shared to LHDs) through
multiple data pipelines, including facsimile (i.e., fax). LHDs must
perform background checks for basic contact information of known cases
when data is incomplete. Although HHS released guidance on data fields
that must be reported to States starting August 1, it is far too late
and limited mechanisms exist for enforcement.
2. Across the Nation, there are unclear jurisdictional lines of
LHDs and authorities. As mentioned above, without formal designations
and definitions of LHDs, States and the Federal Government often send
results outside of the LHD jurisdiction hoping that LHDs will work
together to share across the system. However, there is limited
interoperability, if any, to share efficiently case and contact
information across LHDs and no way to ensure cases are not falling
through cracks.
3. Disparate disease-specific surveillance systems exist for many
LHDs. Data collection requirements from the State and CDC during the
case investigation and monitoring of cases have consistently been
modified throughout the response. No system has proven robust enough to
meet local needs for reporting data requested in multiple formats,
including fillable PDFs and spreadsheets. Additionally, surveillance
systems lack the ability to measure key performance indicators which
are often needed to justify funding. Locally-created solutions to track
disease and performance of contact tracing have required real-time
development alongside an on-going pandemic.
4. LHD epidemiologists must manually call infection control
practitioners to track the status of hospitalized patients because
consistent access to electronic health records is not consistently
available to LHDs. Hospitals are required to send data directly to
Federal and State governments, but no interoperability exists for LHDs
to access and analyze health care data directly for surveillance,
decision making, or planning.
5. Technology solutions for disease surveillance are not feasible
without stronger investment into dedicated informatics workforce
support at the local level as well as hardware availability.
Disease Modeling and Planning for Local Officials
Additionally, LHDs are expected to provide disease trend analysis
and modeling projections to inform local decision making on non-
pharmaceutical interventions and planning. Although many Federal
modeling and projections are available at the State level, no
sufficient options exist for LHDs to maintain situational awareness.
Local models and dashboards from academic partners and others have been
ad-hoc and inconsistently maintained. Without accessible health care
data, aggregate data must be manually scraped from reporting health
care coalitions to inform health care utilization projections. LHDs
need disease modeling support, especially when the population of some
LHD jurisdictions is comparable to the size of small States (of note,
Harris County itself has a population larger than 25 States).
Data analysis support is also needed to determine local outbreak
trends and prevalence for granular, place-based decision making that
can inform local operations such as congregate setting outbreaks or
super-spreading events. Index case and social network analysis is
impossible without shared contact trace and case information across
jurisdictions. If Federal Governments expect efficient disease
surveillance, they need to encourage States to bolster local
surveillance capabilities. Knowing simply that a county or State has
increasing disease rates does not inform proactive prevention measures,
testing, or outbreak containment for LHDs. CDC should assist LHDs to
track genetic trends and seroprevalence.
HCPH COVID-19 Response
HCPH, for example, was forced to invest in ad-hoc and internally-
housed disease surveillance symptoms to catch up with the reporting
needs at the local, State, and Federal levels. While this may have been
true across other LHDs, HCPH created its own data reporting platform as
``off the shelf'' systems were simply not robust enough to capture the
data elements and needs of the local context.
Because lab results are often delayed when sent by the State
through multiple platforms, HCPH has had to secure direct partnerships
with labs to share data, in addition to their already-required State
reporting. To ease communications with infection control physicians,
HCPH has been able to request direct access to one hospital's Epic
electronic medical record system. These ``one off'' solutions are not
practical system-wide for data exchange and are an indicator of failed
public health and health care interoperability for LHDs to access
needed data for case investigations and data analysis.
HCPH was one of the first LHDs in Texas to develop a public-facing
dashboard using its own internally created surveillance platform that
it then incorporated public health data from its Houston Health
Department partner. When reporting cases out to the public, changing
guidance on CDC's probable case definitions led to delay and confusion
on how to classify cases using newer testing technologies and unknown
labs. This unclear guidance has resulted in complicated historical data
integrity and has limited any possibility of efficient data sharing
across jurisdictions. Additionally, third-party contact tracing apps
and surveillance solutions have continued to reach out to LHDs. HCPH
has spent much time in reaching out and following up on contact tracing
app solicitations without consistency from the State (or Federal)
government. Potential solutions from the public or private sector for
technology must be regional or State-wide to account for the mobility
of residents, especially in a community such as Harris County.
conclusion
On behalf of Harris County Public Health, and the nearly 3,000
local health departments across the country and those in Texas, I
appreciate again the opportunity to testify today. This behind-the-
scenes dedicated public health workforce, under continues to work
around the clock to protect our communities even as it is stretched to
its limits. Our work would be impossible without the leadership and
support of Judge Hidalgo and county leadership.
The pandemic is an unprecedented time for our country and our
Nation's public health preparedness is being tested like it never has
before. Smart, strategic, scalable, and sustainable investments are
needed now to prevent continually subjecting public health to trial by
fire.
We join you in working toward strengthening a public health system
that protects our economic vitality, National security, and the very
health of our people. Thank you for your support in building safe,
healthy, and protected communities across this great Nation of ours.
Chairman Thompson. Thank you very much, Doctor.
I now recognize Colonel Hastings to summarize his statement
for 5 minutes.
STATEMENT OF COLONEL BRIAN HASTINGS (RET.), DIRECTOR, ALABAMA
EMERGENCY MANAGEMENT AGENCY
Mr. Hastings. Good afternoon, Chairman Thompson, Ranking
Member Rogers, and Members of the committee. On behalf of
Alabama Governor Kay Ivey, thank you for inviting the Alabama
Emergency Management Agency to participate in today's hearing.
I am here before you as the director of the Alabama
Emergency Management Agency, and we are the State's lead agency
for the coordination of Alabama's all-hazards mitigation,
preparedness, response, and recovery activities. Thank you for
the opportunity to share with you Alabama's perspectives and
our experience in preparing for and responding to COVID-19.
Over the last 4 months, Alabama has transitioned from a
stay-at-home order issued on 20 March to a safer-at-home order
issued on 30 April. The latest order from Governor Ivey has
recently been amended and extended through 31 July.
When this pandemic began, Alabama was fortunate that ADPH,
our Department of Public Health, had on hand an existing
stockpile of PPE left over from the H1N1 response over a decade
ago. This stockpile of PPE was mostly expired but was able to
be distributed early in our response to COVID-19 with the help
of a waiver granted by the U.S. Food and Drug Administration.
The initial push of ADPH's existing PPE stockpile, combined
with the slow rise in COVID-19 cases and the release of Federal
Strategic National Stockpile, helped reduce the initial shock
of the global PPE supply-and-demand crisis. Today, the health
care supply chain is still struggling to provide medical-grade
respirators, some disinfectants, and other specific personal
protective equipment. This supply-and-demand mismatch continues
to plague Alabama, just as in many other States, as we continue
to provide PPE to the health care system, while simultaneously
working to replenish our State stockpile in preparation for the
fall surge of COVID-19.
As a State EMA director, I appreciated the more active role
FEMA played as the U.S. coronavirus response evolved. Even
though the dual reporting change of HHS and FEMA were sometimes
cumbersome, it was better than not receiving critical
coronavirus response information, and the relationship provided
much-needed visibility into the U.S. public health response at
a National level that we lacked, to some extent, during the
early days of the Federal Government's response.
The combination and collocation of FEMA and HHS leadership
was mirrored in Alabama's own Unified Command set up on 30
March. We found that this helped our communication information
flow across and within our State agencies. This combined
construct and the close coordination it enables between
emergency management and public health officials should be
purposefully encouraged in Federally-supported preparedness
programs. This would reduce duplication and streamline
coordination of preparedness outcomes driven by the separate
HHS and DHS/FEMA emergency preparedness funding programs, of
which FEMA's Emergency Management Performance Grants and HSS'
Public Health Emergency Preparedness programs are 2 prominent
examples.
As the United States develops future strategies and
policies for pandemics, all-hazards emergency management
activities and threats to National security, I offer a few
items for consideration to our Federal partners.
Assess public health vulnerabilities to National security
based on comprehensive supply chain analysis to include the
location of raw materials, availability of production
resources, transportation vulnerabilities, and location of
manufacturing.
No. 2, with regard to the CARES Act and the crucial
financial support it provides to State and local government,
there are lingering questions about eligibility that at this
time are causing some level of confusion at the State and local
levels. For example, it is unclear whether CARES funding may be
lawfully used to accommodate the extraordinary expenses of
emergency management agencies like AEMA that have been incurred
in responding to COVID-19, even though the vast majority of our
personnel expenses have been dedicated to that end, to date.
Increased clarity on the intended and allowable uses of CARES
funding would enable State and local officials to make better
decisions about the most effective and responsible uses of this
essential emergency funding mechanism as we work to maintain
Government operations during this crisis.
Requirements that are too restrictive or specific in our
emergency preparedness funding programs, whether in authorizing
legislation or implementing guidance passed down from Federal
agencies, often create very distinct functional cylinders of
excellence and siloed functional expertise in a way that is
inwardly focused, instead of enabling cooperation and sharing
of resources in a fully integrated National emergency
management and preparedness enterprise. Our focus should be on
fostering an outward sharing of resources and information that
is incentivized by Federal grants aimed toward developing
capabilities with commonality, interconnectedness, and
partnerships instead of driving duplication, competition, or
stovepipes. This is especially pertinent in terms of overlap
between sometimes competing objectives of the FEMA and HHS
emergency preparedness funding programs.
Last, in accordance with FEMA's framework of Federally-
supported, State-managed, and locally-executed disaster
activities, please give consideration to the role that
subdivisions of Government and private partners should play in
stockpiling resources for future pandemics or building local
capability. If the Federal Government focuses too much only on
Federal responsibilities, the United States may miss an
opportunity to create a whole-of-Government and whole-of-
society approach to preparing for future pandemics and complex
disasters. We all play a role in emergency preparedness, so the
Strategic National Stockpile should be a multi-tiered National
system comprised of integrated whole-of-Government, whole-of-
business, and whole-of-society partnerships to strengthen the
resiliency of the United States at all levels: State, local,
Tribal, territorial, and Federal.
In conclusion, I am proud to say that Alabama remains
committed to fighting the coronavirus, reducing loss of life,
and minimizing the suffering of our citizens. As our Nation
continues to respond to this public health crisis, we ask that
you remain attentive to the evolving needs of each State, in
particular, Alabama, and mobilize the information, resources,
and funding capabilities of the Federal Government that are
needed to protect our Nation's public health and safety.
Again, thank you for this opportunity to testify. Thank you
for your support of the CARES Act and to our Federal partners
who have partnered with us in the response, and I welcome your
questions.
Thank you.
[The prepared statement of Mr. Hastings follows:]
Prepared Statement of Brian Hastings
July 8, 2020
Good afternoon Chairman Thompson, Ranking Member Rogers, and
Members of the committee. On behalf of Alabama Governor Kay Ivey, thank
you for inviting the Alabama Emergency Management Agency (AEMA) to
participate in today's hearing.
I am here before you as the director of the Alabama Emergency
Management Agency, and we are the State's lead agency for the
coordination of Alabama's all-hazards mitigation, preparedness,
response, and recovery activities. My goal today is to share with you
Alabama's perspectives and our experiences preparing for and responding
to the novel coronavirus public health crisis. More so, I will share
with you our experience working with our State partners and our Federal
partners at the U.S. Public Health Service, U.S. Department of Health
and Human Services (HHS), the Centers for Disease Control and
Prevention (CDC), the Small Business Administration (SBA) and the
Federal Emergency Management Agency (FEMA). I am hopeful that by
sharing with you how Alabama has responded to the novel coronavirus
public heath National emergency, you will be able to strengthen and
enhance the coordination between critical Federal agencies and all
States, including Alabama. I will first give a little background on our
operations tempo this year and then give an update on Alabama's Unified
Command activities and the status of the phases of our State strategy
and conclude with a few observations.
Beginning in January, AEMA, along with the Alabama Department of
Public Health (ADPH), actively monitored the public health situation
arising from Wuhan City, China. Throughout the Winter and Spring,
Alabama was also managing the impacts from our record-breaking winter
rainfall and flooding, the fifth-worst tornado outbreak in Alabama
history on Easter Sunday, and the effects of a straight-line wind event
the following Sunday, all while responding to the coronavirus public
health crisis and complying with CDC guidelines and public health
orders. The significant impacts of these weather events resulted in
Governor Ivey requesting 3 of our 4 Presidential Major Disaster
Declarations in 2020, of which the declarations for flooding and
coronavirus have been approved, the 2 other weather-related requests
are currently pending approval. Already, 2020 has been another busy
disaster year in Alabama and COVID19 has added a level of complexity we
have not seen in our lifetimes.
Commensurate with President Trump declaring a National Emergency on
13 March in response to the global pandemic, Governor Ivey declared a
State of Emergency, Alabama received a Federal Emergency Declaration,
AEMA activated a hybrid virtual State emergency operations center and
deployed personnel for operations embedded with ADPH, and we started
State-level coordination group calls with our internal State emergency
management partners. Alabama began the groundwork for submitting a
Presidential Major Disaster Declaration request for Public Assistance
and the Crisis Counseling Program and worked with the Department of
Commerce to submit a Small Business Administration (SBA) Disaster
Declaration. Thanks to our close relationship with our Federal
partners, we promptly received approval of our SBA Declaration on 20
March easing the impacts on the small business community that makes up
70 percent of the Alabama economy. Our Major Disaster Declaration was
approved on 29 March for FEMA Public Assistance as well as the crucial
Crisis Counselling Program administered by the Alabama Department of
Mental Health in partnership with the Substance Abuse and Mental Health
Services Administration (SAMHSA) of HHS to ease the suffering of our
citizens most affected by the impacts of the coronavirus.
On 16 March, Governor Ivey stood up a Coronavirus Task Force to
leverage a whole-of-government approach in addressing the multitude of
complex and cascading effects of the coronavirus pandemic. Soon after,
Governor Ivey approved a coordinated State response under a unified
command with ADPH and AEMA as co-leads. Under this National Incident
Management System (NIMS)-compliant construct, ADPH provided the lead
and expertise on public health activities while AEMA provided wrap-
around services and support in the form of additional manning and
disaster funding mechanisms to bolster Alabama's whole-of-government
response. On 25 March, we held our first video conference call with key
leaders of State agencies in the unified command and then established a
fully integrated unified operations structure on 30 March along with
members of the Alabama Department of Public Health (ADPH), Alabama
Forestry Commission (AFC), Alabama National Guard (ANG), U.S. Public
Health Service (USPHS) and the Federal Emergency Management Agency
(FEMA). Recently, on 1 July, Alabama's Unified Command transitioned to
an ADPH-led incident command system postured for longer-term operations
with AEMA continuing to provide wrap-around services and coordinate
support from State partners and FEMA.
As we stood up the Unified Command in March, Governor Ivey approved
a grand strategy, strategy, and 4 phases of operations----
Grand Strategy.--Alabama demonstrates the capacity and resolve to
defeat Coronavirus, emerging more unified and capable. Alabama's
mobilization and community resilience are a model for America and help
lead the fight against the coronavirus.
Strategy.--Mobilize Alabama for a whole-of-society response to slow
the transmission of coronavirus to a level commensurate with our
medical system's capacity to care for our citizens in order to buy time
to find a vaccination or treatment to eliminate the health, economic,
and social impacts of the coronavirus on our people and economy.
Phases of our State Operations:
Reduce transmission of COVID19 (on-going)
Sustain & Expand health care capacity and capability (on-
going)
Inform and reassure the public (on-going)
Transition to a better Alabama (on-going).
Alabama has used a whole-of-government approach to reduce the
transmission of COVID19 and bolster the health care system by working
with subdivisions of government, associations, and organizations to
slow the spread of the coronavirus. At the height of our Unified
Command activities and leveraging crucial Federal support for National
Guard operations under Title 32 authorization, Governor Ivey had
activated 789 members of the Alabama National Guard to support
logistics and medical operations planning, commodity and PPE
transportation, warehouse management, nursing home decontamination, and
nursing home infectious disease training. The Unified Command,
leveraging the incredible support of the soldiers of the Alabama
National Guard (ALNG), assistance of the logistical experts from the
Alabama Forestry Commission (AFC), resources and staff of Alabama
Attorney General Steve Marshall, and many other State agencies, has
delivered 16,264,959 articles of personal protective equipment (PPE);
86,285 coronavirus test kits; and 10,974 vials of lifesaving
Remdesivir. The soldiers of ALNG Task Force 31 completed 185 nursing
home decontamination missions and provided 26 training missions to 821
civilians and nursing home staff to reduce the spread of COVID19. As
Alabama right-sizes our coronavirus response, there are currently 246
members of the National Guard activated. Additionally, at the request
of the Alabama Unified Command, the CDC deployed a team to Alabama to
help nursing homes obtain additional support with infectious disease
control.
Through Direct Federal Assistance (DFA) coordinated through FEMA,
the United States Army Corps of Engineers (USACE) deployed personnel to
Alabama who embedded in our Unified Command and completed more
alternate care site (ACS) assessments than any other State in FEMA
Region IV. These assessments provide Alabama's health care system with
a multitude of options to expand health care capacity in response to
COVID19 surges, if required. Our Alabama goal continues to be slow the
spread of COVID19 while supporting hospital surge capacity to keep
traditional hospital patients in traditional hospitals receiving
traditional hospital care, rather than to resort to ACS solutions
whenever possible.
Throughout the evolution of the COVID19 response, Alabama's Unified
Command has worked hard to message our activities, share the Alabama
story with our citizens, motivate Alabamians to adopt the beneficial
habits of non-pharmaceutical interventions, and align all our
communities toward a common goal of slowing the spread of the
coronavirus. Under the Unified Command construct, we created a Joint
Information Center (JIC) led by Governor Ivey's communications director
with support from ADPH and AEMA to support consistent and timely
messaging that has been aligned with CDC and other Federal COVID19
policy and guidance recommendations. Alabama has smoothly transitioned
from a ``Stay at Home'' order issued on 20 March to a ``Safer at Home''
order issued on 30 April; the latest order has recently been amended
and extended by Governor Ivey through 31 July.
Last, as we transition to a better Alabama, the Unified Command and
State partners continue to leverage FEMA Public Assistance and CARES
Act funds to mitigate short- and long-term negative effects of the
coronavirus on our communities, economy, and citizens. One example of
the incredible partnership between our Federal, State, and local
partners is the effort led by University of Alabama Birmingham (UAB)
Medicine with CARES Act funding allocated by Governor Ivey to develop a
State-wide coronavirus testing, tracing, and informatics program for
institutions of higher education to safely bring students back onto
campus this fall for in-residence education. The potential exists to
scale and scope this testing effort beyond 2- and 4-year colleges and
universities to mitigate the spread of the coronavirus throughout
Alabama.
Before I close my written statement, I would like to share a few
observations and recommendations. When this pandemic began, Alabama was
fortunate that ADPH had on-hand an existing stockpile of PPE leftover
from the H1N1 response over a decade ago. This stockpile of PPE was
mostly expired but was able to be distributed early in our response to
COVID19 with the help of a waiver granted by the U.S. Food and Drug
Administration (FDA). The initial push of ADPH's existing PPE
stockpile--combined with a slow rise in COVID19 cases and the rapid
release of the Federal Strategic National Stockpile (SNS)--helped
reduce the initial shock of the global PPE supply and demand crisis.
Today, the health care supply chain is still struggling to provide
medical-grade respirators, some disinfectants and other specific
personal protective equipment. This supply-and-demand mismatch
continues to plague Alabama, just as in many other States, as we
continue to provide PPE to the health care system while simultaneously
working to replenish our State stockpile in preparation for a possible
fall surge of COVID19 cases.
As a State EMA director, I appreciated the more active role FEMA
played as the U.S. coronavirus response evolved. Even though the dual
reporting chains of HHS and FEMA were sometimes cumbersome, it was
better than not receiving critical coronavirus response information and
the relationship provided much-needed visibility into the U.S. public
health response at a National level that we lacked, to some extent,
during the early days of the Federal Government's response. The
combination and co-location of FEMA and HHS leadership was mirrored in
Alabama's own Unified Command. We found that this helped with our
communication and information flow across and within State agencies.
This combined construct and the close coordination it enables between
emergency management and public health officials should be purposefully
encouraged in future Federally-supported preparedness programs. This
would reduce duplication and streamline coordination of preparedness
outcomes driven by the separate HHS and DHS/FEMA emergency preparedness
funding programs--FEMA's Emergency Management Performance Grant (EMPG)
and HHS's Public Health Emergency Preparedness (PHEP) programs being
two prominent examples.
As the United States develops future strategies and policies for
pandemics, all-hazards emergency management activities and threats to
National security, I offer a few items for consideration to our Federal
partners:
(1) Assess public health vulnerabilities to National security based
on comprehensive supply chain analysis to include the location
of raw materials, availability of production resources,
transportation vulnerabilities, and location of manufacturing.
(2) With regard to the CARES Act and the crucial financial support
it provides to State and local government, there are lingering
questions about eligibility that, at this time, are causing
some level of confusion at the State and local levels. For
example, it is unclear whether CARES funding may be lawfully
used to accommodate the extraordinary expenses of emergency
management agencies like AEMA that have been incurred in
responding to COVID19, even though the vast majority of our
personnel expenses have been dedicated to that end. Increased
clarity on the intended and allowable uses of CARES funding
would enable State and local officials to make better decisions
about the most effective and responsible uses of this essential
emergency funding mechanism as we work to maintain Government
operations during this crisis.
(3) Requirements that are too restrictive or specific--whether in
authorizing legislation or in the implementing guidance passed
down from Federal agencies--in our emergency preparedness
funding programs often create very distinct functional
cylinders of excellence and siloed functional expertise in a
way that is inwardly-focused, instead of enabling cooperation
and sharing of resources in a fully integrated National
emergency management and preparedness enterprise. Our focus
should be on fostering an outward sharing of resources and
information that is incentivized by Federal grants aimed toward
developing capabilities with commonality, interconnectedness,
and partnerships instead of driving duplication, competition or
stovepipes. This is especially pertinent in terms of the
overlap between--and sometimes competing objectives of--the
FEMA and HHS emergency preparedness funding programs.
(4) In accordance with FEMA's framework of Federally-supported,
State-managed, and locally-executed disaster activities, please
give consideration of the role that sub-divisions of Government
and private partners should play in ``stockpiling'' resources
for future pandemics. Emergency management and risk management
are everyone's responsibility. If the Federal Government
focuses too much only on Federal responsibilities, the United
States may miss an opportunity to create a whole-of-government
and whole-of-society approach to preparing for future pandemics
and complex disasters. We all play a role in emergency
preparedness, so the ``strategic National stockpile'' should be
a multi-tiered National system comprised of integrated whole-
of-Government, whole-of-business, and whole-of-society
partnerships to strengthen the resiliency of the United States
at all levels--State, local, Tribal, territorial, and Federal.
In conclusion, and I am proud to say that Alabama remains committed
to fighting the coronavirus, reducing loss of life, and minimizing the
suffering of our citizens. As our Nation continues to respond to this
public health crisis, we ask that you remain attentive to the evolving
needs of each State--and, in particular, Alabama--and mobilize the
information, resources, and funding capabilities of the Federal
Government that are needed to protect our Nation's public health and
safety.
Again, thank you for this opportunity to testify, and I welcome
your questions.
Chairman Thompson. I thank the witnesses for their
testimony.
I remind each Member that he or she will have 5 minutes to
question the panel.
I will now recognize myself for questions.
Governor, Johns Hopkins University has documented the
disproportionate number of deaths in the United States, the
disproportionate number of testing. How do you think we got to
this point in the United States that our people are dying more
disproportionately than others? After you say that, can you
give us what you think we ought to be doing that we didn't do?
Governor Pritzker. Well, you are talking about communities
of color, right? I just want to make sure. Because, from my
perspective, this is something that was so overlooked in the
very first weeks of the pandemic in the United States. Then as
the data was coming out, I think all of us, you know, that care
about this jumped on it and tried to figure out, you know, what
are the things that we can do to make up for, to try to, you
know, diminish the negative impact of coronavirus, particularly
on the African American community, the Latino community, the
Asian community.
Here, look, this is the conclusion that you have to reach,
which is this is a result of, frankly, hundreds of years of
failure to invest in basic health care, basic needs, you know,
investment in communities that has been lacking for so long.
The result is that, you know, you hear a lot about the
comorbidities that exist in the African American community.
Well, those don't just exist by accident. They exist because we
haven't invested in those communities. So people suffer from
the comorbidities more, guess what, in communities where there
is more poverty.
So, you know, from my perspective, to counter this, we put
a lot of testing capability into, at least here in Illinois,
into communities of color, particularly Black communities. We
have seen, of course, a disproportionate number of Black people
who get coronavirus dying from coronavirus. We also see a
disproportionate number of Latinos getting coronavirus relative
to their population size. So in both of those circumstances,
you know, we had to react. There are different challenges in
each of those communities that we had to react to.
But when you asked me what are the causes, I mean, the
causes are things that have existed for many, many years that
only now, I think, not just with coronavirus highlighting the
failures, but now on top of that, the recognition as a result
of the, you know, outpouring of protests and peaceful protests
in the wake of the murder of George Floyd that, you know, we
need to do so much more. We are not prepared in this pandemic
to deal with it. We need to make sure that we are doing
everything we can now, but we also need to make sure we put the
resources in so that, God forbid, if we have another pandemic,
this isn't [inaudible]----
Chairman Thompson. Thank you.
Dr. Shah, you talked about a few things that we could do
right now to try to minimize the increase in the numbers. Can
you kind-of repeat that for the Members again?
Dr. Shah. Sure. Thank you. Thank you, Mr. Chairman. To say
it very bluntly is that we have to make sure that we are
consistent in our policies and our messaging. I think that is
the No. 1 thing.
The second thing is that we also have to make sure that
health and medical and science and evidence, the best we can--
we know it is not always there because this is a new and novel
disease--that that is also driving those decisions. We are
particularly concerned about the CDC and the fact that the
visibility and the leadership that we have seen previously with
CDC that has not been noted, at least at the local levels, in
public health, and that is a significant concern.
Then I do think that there are some preventive measures
that are very much about the masks and really ensuring that we
have the policies in place from a prevention standpoint that
really can be very much a part of the solution forward.
We have to be smart about it, but we also have to be
thinking about how we can continue to move this process
forward. Because this phase, the phased approach that we are
having in our community is very different than the Governor is
having in Illinois right now or you are having in Mississippi.
Everybody is going through this at different times, and so we
all have to be working together.
Chairman Thompson. Thank you very much.
Mayor Shelton, you were one of the first municipalities in
Mississippi to require masks of your citizens, and your council
supported you. How did you reach that conclusion?
Mr. Shelton. [Inaudible]
Chairman Thompson. Unmute yourself.
Mr. Shelton. I apologize for that. Thank you, Chairman.
We began our emergency protocol February 24. You know, we
saw the pandemic coming toward us, so we made the decision then
that this is an emergency, so we have to treat it like an
emergency. So the 17 different executive orders we have done
since then have all been based on the recommendations of either
Dr. Fauci or the CDC, the Mississippi Department of Health. We
have tried to follow the science. We have the Nation's largest
rural hospital here in Tupelo, the North Mississippi Medical
Center. A lot of the requirements that we have mandated have
come from requests from the North Mississippi Medical Center.
I do want to--I appreciate getting credit for that, though
I want to make up for my friend, Mayor Robyn Tannehill in
Oxford, and some of the others. Tupelo is not the first on the
masks. We have been first on shelter-in-place and some of the
other things, but I want to give credit to my fellow mayors
where credit is due.
But we based those decisions on the science, the
recommendations, and, in our case, the requests of our medical
professionals here. You know, this is a health care crisis. We
have to listen to our health care professionals. We have to
make sound decisions based on the science.
Chairman Thompson. Thank you very much.
At the request of the Ranking Member, we are going to
recognize Mr. Higgins, who has a flight to catch. The gentleman
from Louisiana is recognized for 5 minutes.
Mr. Higgins. I thank the Chairman and the Ranking Member. I
thank the Chairman for holding this hearing.
As the Chairman and my colleagues are aware, I respectfully
object to House proxy voting and remote committee attendance.
The Senate is open and working in person, the White House is
open and working in person, yet the House is not. Walmart, Home
Depot, Lowe's, grocery stores, police departments, fire
departments, maritime ports, airports, all open and working in
person, but not the people's House. That is my position on
that. I respect that of my colleagues, but it is important that
we clarify our stance during this era of challenge.
I have a question for the Governor. If you would, good sir,
could you briefly summarize, what formula have you used to
deliver CARES Act relief funding into your local government
entities? This is a challenge across the country, and I am
interested to hear how you have handled that.
Governor Pritzker. Yes. Well, thank you very much,
Congressman, for the question. Let me start with, we began in
Illinois with a challenge. We didn't have a method, an entity
through which we could distribute those funds, so we had to go
to our legislature to have them pass a law to allow us to do
that. They did that. The legislature hadn't met during the
spring until mid-late May, and at that point, the legislature
created the opportunity for us to distribute those funds.
There is a direct amount of money that goes directly to the
counties and cities across the State, the ones that are outside
of the northeast metropolitan areas, which, you know, get those
funds through their counties that got funding directly.
Mr. Higgins. So, generally speaking, Governor, in the
interest of time, have you----
Governor Pritzker. Yes, sir.
Mr. Higgins. Would it be fair to say that as the executive
of your State, you have responded to a challenge that has never
been faced before, and you have navigated your way through it
within the parameters of the law, and you have done your best
to respond to the local and municipal governments within your
State? Is that a fair summary of your endeavor?
Governor Pritzker. Yes, sir.
Mr. Higgins. For the subsequent Governor--and I am sure you
are a fine gentleman and supported obviously by the majority of
the citizens of your State, but would it be fair to say that
for the subsequent Governor, you have now determined a path
forward for this particular type of challenge that was not
known until you navigated through it?
Governor Pritzker. Well, I wouldn't say that we have got
everything figured out, Congressman.
Mr. Higgins. But you are working on it?
Governor Pritzker. But we certainly have--there is an awful
lot of learning that has taken place from March until now. Yes,
I believe that we have created a path for someone in the future
to follow.
Mr. Higgins. Thank you.
May I respectfully state that that is exactly what our
President has done in response to this incredible challenge
that we have never faced before as a Nation.
Now, I would like to ask the mayor, Mr. Mayor, what is your
perspective, sir, for your municipality? Very briefly, have you
had problems receiving funds, CARES Act relief funding from
your executive, yes or no?
Mr. Shelton. Well, Congressman, as you know, the CARES Act
specifically prohibits loss of revenue funds----
Mr. Higgins. I understand, and yet every State executive
had received massive amounts of the people's treasure, intended
to be distributed by the State executive, into local and
municipal governments. So as a mayor, you sound like a smart
and compassionate man. We thank you for that. Have you had
problems receiving that funding?
Mr. Shelton. Congressman, again, the lost-revenue funding
is not available. My understanding is that the State is going
to send for the PPE funds----
Mr. Higgins. So you haven't received funding yet from your
executive?
Mr. Shelton. I would have to double-check that but not that
I have been made aware.
Mr. Higgins. All right. Thank you, sir. I don't know how
much time we have remaining. We are absent a clock from what I
can see, but--17 seconds?
Mr. Hastings, I will leave you with this question: Do you
believe that a public health crisis is best addressed at the
local and State level or by Federal mandate? I yield.
Mr. Hastings. I think it depends on your perspective.
Growing up in the emergency management community, our strategy
for handling all hazards is Federally-supported, State-managed,
locally-executed. So we try to adhere to that as we partner
with the Federal Government, with our State agencies, and our
counties and municipalities, which are the pointy edge of the
spear.
A caveat to that might be, is that as the sixth-poorest
State in the union, and heavily rural populated State, there
are some counties and municipalities that need extra support.
So we are sensitive to that in identifying gaps and then trying
to plug in both Federal and State capabilities and resources in
those areas as we can.
Mr. Higgins. Given that response, I thank the Chairman and
the Ranking Member, my colleagues across the country right now,
and here in the District of Columbia. Mr. Chairman, I yield.
Chairman Thompson. Thank you very much. We now yield 5
minutes to the gentlelady from Texas, Ms. Jackson Lee.
Ms. Jackson Lee. Thank you very much, Mr. Chairman, and I
appreciate it very much to have the opportunity. Thank you to
the witnesses. In 2016, the Obama administration developed a
strategic playbook on pandemic preparedness, the playbook
entitled ``Playbook for Early Response to High-Consequence
Emerging Infectious Disease Threats and Biological
Incidences.''
I am reminded of the Ebola pandemic or episode, and it
started, or it was certainly focused in Dallas, Texas. Had it
not been for the focus of the Obama administration on
infectious disease and cooperating relationships with the
Federal Government, there is no way of knowing how disastrous
Ebola would have been in the United States.
The playbook was in the Trump administration, left behind,
and it reportedly did not heed its guidance. The mortality rate
was cited by the administration as the lowest in the world as
it relates to COVID-19. Johns Hopkins indicated that it is the
sixth worst in the world. We also heard the words that COVID-19
would go away like magic.
Governor Pritzker, thank you for your leadership. Would you
focus in on the disaster that is created on top of the disaster
when there is no National effort, there is no National
strategic plan to be able to deal with COVID-19?
Governor Pritzker. Well, thank you very much,
Congresswoman. Let me just begin by saying that we had--
immediately, you know, we knew we needed supplies. So, PPE was
something, you know, certainly a term that I don't think I had
ever used before in my life. All of a sudden, we were out in
the marketplace competing for the most basic things, like N95
masks, gowns and such, to make sure that our hospitals were
supplied, and then our first responders and so on.
We are competing against every other State in the United
States, States that have more resources than we do, countries
that have more resources than we do, with no help from the
Federal Government, no invocation of the Defense Production Act
to help us out.
So that was just the very first manifestation of the
problem that, you know, people were going to work--our HEROES,
our nurses, our doctors--going to work unable to use PPE that
was so necessary to keep them healthy, so they could keep other
people healthy.
Ms. Jackson Lee. Well, Governor, we thank you for yielding.
Governor Pritzker. So, that was just one example, but I
will just add, the testing supplies, you know, were impossible
to get, and the Federal Government was, you know, nowhere to be
found for too long on that topic.
Ms. Jackson Lee. For those of us who have interacted with
the military, we know the saddest terminology is MIA, missing
in action, very sad terminology. We mourn and continue to look
for our soldiers, but when you are MIA, lives can be lost. Do
you think lives have been lost throughout the United States
because of that ineffective National strategy?
Governor Pritzker. There is no doubt about it. Thousands
and thousands of lives have been lost, tens of thousands,
across the Nation, as a result of the inaction, the late action
taken by the administration.
Ms. Jackson Lee. Thank you.
Dr. Shah, thank you for your leadership. Let me just cite
right now into the record, Harris County has confirmed cases
today, 39,311. There have been 395 deaths. This is as of 7
a.m., July 8, this morning. Houston, 55,000 cases confirmed,
581 deaths, this is in fatality. I have a document in my hand
that I ask unanimous consent to put in the record, Texas
Coronavirus Timeline * that was done by a number of individuals
reported in the Houston Chronicle, that indicates May 1 was
when our orders--our stay-at-home lift--orders were lifted
rather, and then we proceeded to open everything up and we are
now where we are today.
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* The information is provided at the conclusion of this document.
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Would you please respond to the idea of the ineffectiveness
of saving lives when there is no National strategy, or when
there is the early and too-early opening up of States in
particular. Then, finally, when there is no cooperation, is it
important to have cooperation between county and city
governments? I want to thank Judge Hidalgo and thank Mayor
Turner for their leadership. Also, if you would comment on what
happens when 5,000 persons are coming to a community that has
asked them not to come to, and all of the resources will have
to be used as these people congregate for a convention?
Dr. Shah. Thank you, Congresswoman, and thank you again for
your support. Let me unpack that as quickly as I can in the
interest of time. First and foremost, that in any time you have
inconsistencies that are occurring across that chain of
Federal, State, local, I don't really care where it is at, that
is where you have the problems in the community, and that is
where my biggest concern is.
When it comes to what we have really looked at from why
people are coming together, it does not matter, from a public
health standpoint, whether it is a red or blue issue, whether
it is a left or right issue. When people are coming together,
that layers risk on top of each other, and that is the biggest
concern, especially if it is an indoor--there is some
difference between indoor and outdoor--but definitely an
indoor.
The other aspect of this that is I think is absolutely
critical is that as we have played this out, the State and
local dynamics are absolutely critical. But when you have the
Federal Government not having a National strategy, what that
does is that everybody is fending for themselves, everybody is
doing things differently. While we believe in really State and
local nuances, we also believe there should be a path forward
that the Federal Government provides as we have seen in
previous emergencies.
Ms. Jackson Lee. You know, I have worked on testing sites.
I would just like to have you emphasize how important it is to
have testing sites, how important it is to continue to have the
Federal Government maintain its testing sites, and how eager
Harris Countyians and Houstonians are desperately in need of
tests.
Dr. Shah. That is absolutely right. Testing is the
foundation of this response. Folks have focused on contact
tracing and all these other, you know, terms in public health
as if these are new terms. These are things that we have been
doing for decades, but the foundation remains testing. Testing
gives you then the cases. Cases then allow you to determine,
after investigating who are the contacts, and that is when
contact tracers come into mind, come into play, and then they
turn around and reach out to individuals to get them tested,
and you start that whole cycle over again. That is why testing
is absolutely critical.
Congresswoman, I have said, you cannot trace without a
case, and, so, testing is the foundation, and we do need to
have that testing support from the Federal Government.
Chairman Thompson. The gentlelady's time has expired. I
would now recognize the Ranking Member from Alabama for 5
minutes.
Mr. Rogers. Thank you, Mr. Chairman.
Mr. Hastings, unfortunately, Alabama has had several
natural disasters over the last 3 years that we have had to
manage. How are you and your fellow EMA directors adjusting
your plans to this health crisis created by COVID-19, and are
you getting adequate support from FEMA in this planning
process?
Mr. Hastings. Ranking Member Rogers, thanks for that
question. In my written testimony, it talks about, this has
been a banner disaster year again for Alabama as the seventh-
worst major-disaster-declaration State in the Union. We have
been complying with all the CDC and public health guidelines
through the transition of stay-at-home and safer-at-home. Since
we have been essential personnel, we haven't stopped a beat
since the beginning.
So at the beginning of March, we went into remote and
dispersed operations. We deployed our people away from the EOC,
and stayed connected via IT, and we did not accept--since we
are--I declared everyone essential personnel, no one received
unemployment and we kept working.
So what we did is we just made sure that we wore masks when
we were close to people. We socially distanced as we went out
into the communities and working with our counties, because the
locals is where the disasters happen, just like politics. So,
we have changed the way we have done business.
Now, there are some people who did not like that we went so
early into remote and dispersed operations. But we were just
executing the pandemic annex of our emergency operation plan,
and we are fortunate to have our own IT division and a separate
network that allows us to do those things.
In preparation for the hurricane, which has had a lot of
attention recently, we are working with the CDC guideline,
public health guidelines, FEMA preparedness plans, the Red
Cross, and local communities, both Baldwin and Mobile County,
to reexamine the preferred method of non-congregate sheltering.
But it is very challenging, because as well as you know,
between the coast and middle Alabama, there is not a whole lot.
It is the rural south. So, to find opportunities for non-
congregate sheltering to house people in a disaster is very
challenging. So we are going to have to find a blend of
congregate sheltering, complying with public health orders, and
then also, soon as we can, get our survivors, our evacuees, the
folks looking for a shelter, back into some type of non-
congregate shelter in a hotel, a larger amphitheater, or some
of those larger coliseums that we have in Montgomery, Alabama,
and a few places in the coastal counties.
But it has entirely changed everything that we do, and it
has made us question whether we can even go to the State
Emergency Operation Center, because you only have 2 feet, 3
feet, between 125 people, 100 feet below ground.
So we have also looked at other opportunities, like the RSA
Towers in Montgomery, of where maybe we, on a floor or Joint
Forces Headquarters of the National Guard, we would stand up a
Joint Force office and administer and partner with our Federal,
State, and local communities, to manage and navigate a disaster
in the upcoming season. Hope that answers your question, sir.
Mr. Rogers. Well, both the Chairman and I care very much
about hurricane preparedness, so I appreciate that. But back to
COVID-19, you heard Governor Pritzker talk about the demand for
PPE. How has Alabama managed demand for PPE outside the health
care sector?
Mr. Hastings. It has been challenging. As it has evolved,
there are portions of the PPE that are now available to us. So
we just got 2\1/2\ million cloth masks. We helped the Alabama
Superintendent of Education procure 2\1/2\ million masks,
partly youth masks and adult masks, for the upcoming education
season.
But where we are having problems, and it is hard to get
visibility of the health of the supply chain, and also to
actually get our hands on these medical-grade masks, are the
N95s. So we still have a shortage. As soon as we get any of
those in, whether it is from the Federal Government or a
stockpile, it goes right out to the hospitals. The hospitals
are receiving those, both from the task force of the White
House, through normal supply chains, but it is not ``normal''
yet. It is not to the levels that it was pre-COVID-19.
Then we are working through the Big Six supply chain, and
we have a call with the Federal Government, the Supply Chain
Task Force, on Friday, to see how Alabama, a small State, can
maybe partner with the Federal Government, other regions, to
get higher prioritization for these critical, medical masks,
both for our hospitals now and to build a stockpile for the
upcoming fall COVID surge.
Mr. Rogers. OK.
Mr. Chairman, my time is expired. I yield back.
Chairman Thompson. Thank you very much. The Chair
recognizes the gentleman from Rhode Island, Mr. Langevin, for 5
minutes.
Mr. Langevin. Thank you, Mr. Chairman. I want to thank all
of our witnesses for their testimony today.
Governor Pritzker, if I could start with you, thank you for
being here today. I just want to go back to the discussion
about PPE, and really, the dire challenges you had in acquiring
PPE for your State to begin with. You described it as a Hunger
Games competition, so to speak.
So I think you, and I would clearly agree that it would
have been much more effective for the President to truly invoke
and use the Defense Production Act, where it could have been
both used for acquisition and distribution of PPE. We would
have gotten a bulk price, the taxpayer would have got a lower
price, and we would have been distributing more effectively.
It was the position of the administration--and I have had
the opportunity to speak directly with the director of FEMA--
that they would acquire the equipment and then they put it into
the pipeline, so to speak, but not using the Defense Production
Act. Can you tell us where we are today? Did that strategy ever
work in terms of putting into the commercial pipeline? How are
you and other States doing today in terms of being able to
access PPE now?
Governor Pritzker. Two different answers. First of all, the
air bridge, as you are, you know, talking about, the air bridge
was designed to bring supplies, you know, and give them to
distributors in the United States who already had a list of
customers, not based upon where the need was for dealing with
COVID-19, but simply customers that were preexisting, that they
needed to provide supplies to, because that is what you do for
your customer list, and prioritize them based upon your
business dealings.
Those supplies, sure, they worked their way through the
United States but not prioritized for COVID-19. So I think the
air bridge was an utter and complete failure in the sense that
most of the supplies need to go to areas where there is a great
need, and not necessarily to where some private, for-profit
distributor thinks they need to feed a preexisting customer. So
that is one thing.
Where do we stand now? We have been constantly, I mean,
from Day 1, we have been out in the marketplace, competing to
get PPE, and you know, the State of Illinois, as a buyer, we--I
had many conversations directly with manufacturers, and I can
remember one in particular who basically said to me, Look, you
know, I will allow you to acquire this amount of these PPE
items, or this equipment, if you will up your order by X amount
so that you are greater than this other customer who is
promising to acquire, you know, a certain amount. So,
essentially, pitting me against another customer.
In an environment in which we have a pandemic--people are
dying, you know--I am having to make decisions, you know, based
on some business person's desire for greater profit. So that
was very troubling.
Today we have acquired a lot of PPE. We have made sure that
we have got a constant supply, and we have orders that are on-
going on a regular basis. I would say prices have come down.
The environment is a little bit better. It is not back to
normal. Someone else on the panel said, you know, this is not
pre-COVID pricing, but we are paying a lot less today than we
were at the very beginning, and we are able to acquire PPE here
in Illinois.
Mr. Langevin. All right, thank you, and, hopefully, that is
the case with other Governors in other States, but clearly, not
the most efficient system. It would have been better to have
the PPE be directed to where it is needed most based on need.
Let me ask this on preexisting conditions and health
insurance. You know, on June 27, President Trump had tweeted
the following statement, where he said, ``I will always protect
people with preexisting conditions, always, always, always.''
Now, The Washington Post fact checker has stated that this
claim is untrue. So, the President's claim that he would
protect preexisting conditions received this rating, in part,
because--and I quote--in the middle of a pandemic, against the
advice of many Republicans, the President is trying to ask the
Supreme Court to strike down the entire Affordable Care Act,
including coverage guaranteed for people with preexisting
conditions.
So Governor, I want to ask, you know, how does the lack of
health insurance, especially in vulnerable populations,
exacerbate the current public health crisis? And Governor, as
we approach the 30th anniversary of the Americans With
Disabilities Act--and I am someone who lives with a
disability--how important is the Affordable Care Act's
guaranteed coverage of preexisting conditions particularly for
people with disabilities?
Governor Pritzker. Well, the guarantee of coverage for
preexisting conditions is vital. It is probably the most
important aspect of ObamaCare and the expansion of Medicaid.
The idea that we would do away with this, particularly at this
moment in history, seems just unimaginable to me.
Look, first we have got to make sure--and I mentioned it in
my remarks--we have got to make sure that everybody knows they
can get a test for free, that they shouldn't be dissuaded from
getting a test thinking this is going to cost them, you know, a
lot of money. Hopefully, you have got private coverage, but if
you don't, let's make sure everybody can get a test, because
that is the most important thing, along with contact tracing,
that we can do going forward--masking being another one--so
that we can identify--you know, testing allows us, and contact
tracing allows us to identify where the outbreaks are and
minimize them. So we want people to get tested.
Then, of course, when people get sick--I mean, this is a
National emergency. People should be able to get health care.
They should be able to get treated. We should be keeping
everybody alive and not having people think about whether or
not they should go to the hospital in the first place when they
are contagious and when they are symptomatic.
So I am very concerned about where we are, and all I can
say is that we have got to make sure that we maintain our
Medicaid coverage and make sure that, particularly people who
are having difficulty getting testing, know that it is
absolutely free to them.
Mr. Langevin. Very good. Governor, thank you very much. I
know my time is expired.
Chairman, I yield back, but I thank all of our witnesses.
Chairman Thompson. Thank you very much. We now recognize
the gentleman from New York for 5 minutes, Mr. Katko.
Mr. Katko. Thank you, Mr. Chairman, and thank you all for
being here.
Governor Pritzker, just a very quick, succinct question.
Via the average, did the State of Illinois get stockpiles of
PPE that were being brought in and then you decide where to
disperse them throughout the State? Because I know that is what
happened in New York.
Governor Pritzker. Not through the air bridge. The air
bridge was bringing in equipment, PPE, that was being given to
distributors. To the extent there were Government entities that
happened to be on the customer list of the distributors that
received those supplies, they may have received them.
But in terms of what we got as a State, we were asked at
the very beginning, Congressman, what do we need, which is a
terrific question for the Federal Government to ask. So we put
forward a list of all the items--gowns and gloves and N95 masks
and so on--that we needed. We have, in total, from the very
beginning to now, we have received about 12 percent of
everything that we asked for. So at some point, the Federal
Government just gave up on delivering----
Mr. Katko. I understand what you are saying, but I just
want to question, did you receive anything from the air bridge,
and the answer is no. Did you receive stockpiles from FEMA at
all, then you decided where they would go?
Governor Pritzker. We did receive--that is what I am
talking about. The 12 percent of what we asked for, we received
12 percent, and we were able to direct that where we thought it
should go.
Mr. Katko. You were aware, were you not, that the biggest
problem with the PPE shortage at the beginning of the crisis--
and it got exacerbated as the crisis spread--was the fact that
our National stockpile was not where it should have been,
correct?
Governor Pritzker. That is true, yes.
Mr. Katko. That has been a systemic problem that spans
several administrations, not just this one?
Governor Pritzker. I am not sure. All I know is the Federal
Government didn't have what it needed.
Mr. Katko. Right. OK. That is what I thought. OK. Tell me,
I got a quick one, switching gears basically, Governor, did you
ever institute a policy in Illinois whereby individuals that
came from nursing homes that had been infected with the
coronavirus were sent back to the nursing homes after being
diagnosed?
Governor Pritzker. We did not institute a policy like that,
no.
Mr. Katko. Why not?
Governor Pritzker. We wanted--well, No. 1, we were making
sure that the hospitals were releasing, if they were releasing
nursing home residents, that they were COVID-free.
Mr. Katko. Right.
Governor Pritzker. So when they went back to their nursing
homes, they were COVID-free. That was something that we had.
Also in our nursing homes, we had a policy of making sure that
the nursing homes--or we provided for the nursing homes, a
policy that they should separate, of course, COVID-positive
from COVID-negative residents.
Many of them did. I will say some of them didn't do it
right, and, you know, we are holding them accountable.
Mr. Katko. OK. Thank you very much.
Mayor Shelton, I love Elvis, so I am going to ask you some
questions. When I left as a Federal organized crime prosecutor
in El Paso, my parting gift was a velvet Elvis picture, so--and
I still have it in my office today. That was 20-some-odd years
ago. I am curious, you are a city of less than 500,000, and
homes in my area, in my district, I have the city of Syracuse,
which is less than 500,000, and the county it is in, including
the city, is less than 500,000. So under the CARES Act, they
have received no direct funding, and I presume you have not
either?
Mr. Shelton. That is correct, Congressman.
Mr. Katko. Have you received any funding from the State
that was sent by the Federal Government?
Mr. Shelton. No. My understanding is we have not. Now, we
have been told that we have been approved for some funding for
different things, but as far as actually receiving those funds,
I just asked my communications director to double-check, and
she said we have not. But my understanding is we have not
actually received any of those funds of the $1.2 billion that
was sent to the State of Mississippi.
Mr. Katko. Yes. Here is the oddity with our--just to the
right, Syracuse in the city--in the county of Onondaga received
no money, similar to you. Just to the west of me is the city of
Rochester in the county of Monroe, and because there were just
over 500,000, they received over $120 million in the last
package. So the disparity in support for the 2 cities is
stunning.
So tell me, as a small city, what you would do if you got
that money, and what it would help you prevent doing?
Mr. Shelton. Well, thank you, Congressman, and that is the
crux of the matter. So the things that we would do are basic
city services. So every business in the city of Tupelo has to
make sure that literally the lights are on on the streets, you
have first responders, that you have firefighters, that you
have police officers, that you have the ability of public works
to respond if there is a water--you know, a water break, you
know, some sort of, you know, the incidents that happen in
cities every single day, fixing potholes, cleaning up,
beautifying the city, those basics, that is what is in
jeopardy. The city is collectively losing $360 billion.
So, you know, we have the big-picture issues in Washington
and our State capitals, but the nuts and bolts of American
society happens in our small cities and in our counties all
across the country. Those basic city services of literally
being able to drive down a decent street and have functioning
red lights, have your garbage picked up at your curb, have
litter, debris picked up, those basic services.
Then you get beyond that when you talk about economy--the
permitting office, building inspections, code enforcement--all
of those local offices that are necessary to make sure that
businesses are open and running, that a new business can get an
occupancy permit, that a new construction project can be
inspected. All of those type things are jeopardized by the loss
of revenue to cities and counties across the country, where we
don't have the money, you know, we have to do cutbacks or
furloughs, and those basic city services don't get performed.
That directly--that has a direct adverse impact on mom-and-pop
businesses and individual families all across the Nation.
Mr. Katko. All right. Appreciate that. It is very helpful.
Last, I want to thank you, Governor Pritzker, for acknowledging
that. You have done an awful lot of learning during this
crisis. I think we all have, and I think that starts at the top
of government, all the way down to the States and locals as
well.
We all have a lot to learn from this, and I have submitted
a bill to Congress along, with my colleague and good friend,
Stephanie Murphy, from the Democratic side of the aisle, to
form a 9/11-type commission after this is all over to look back
and see what we can do better next time.
It is easy to criticize, but now, I think as you
acknowledge, the lot of learning that you did on the job and I
think everyone has from the top down.
With that, I yield back. Thank you.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentleman from Louisiana, Mr.
Richmond, for 5 minutes.
Mr. Richmond. Thank you, Mr. Chairman, and I guess
following the gentleman from New York, I will, in a minute,
call BS when I think I hear BS. Let me start with thanking you
for your holding this hearing and your patience.
I mean, my colleague from Louisiana, Mr. Higgins, talked
about how important it was for people to actually be in the
room and be there so that we could have this hearing as he
asked to skip the order so that he could go catch a flight and
leave the hearing.
So I just want to make sure that, while we are having this
call, that we are honest. This issue is far too important to
the American people to simply politicize it or play defense.
Mr. Katko mentioned that learning is important in this
role, and I agree with him 100 percent, but I also would say
that accurate information to the American people is very
important. With that, let me just ask one basic question to all
of the witnesses: Do you all agree that wearing a mask is a
basic tool to containing and beating the coronavirus? Could you
answer with a yes or no, please?
Governor Pritzker. Yes.
Mr. Shelton. Yes.
Dr. Shah. Yes.
Mr. Hastings. Yes.
Mr. Richmond. Hearing that we are in unanimous agreement, I
think that it is, unfortunately--if we are going to talk about
learning, I want to make sure that all my colleagues understand
how important it is. My colleague who left the hearing early,
in his area, said, what you are wearing is a bacteria trap. It
is not helping your health or anybody else's. That is not
learning. That is not accurate information. That is Mr.
Higgins' quote.
His next quote was, wearing a mask was dehumanization of
God's children. I just want to say that the biggest rise right
now in Louisiana, in terms of coronavirus spreading, is in Mr.
Higgins' district. I use that not to pick on Mr. Higgins, but
to highlight that accurate information to people in this
country, and leading by example, is one of the ways that we are
going to defeat COVID-19 and save lives, not Republican lives,
not Democratic lives, not Black lives, not White lives, but
that is how we are going to save the lives of people, and I
think that that is very important.
Mr. Shelton, let me ask you a question. You mentioned the
essential workers, and I want to talk about that. Let's take
your public transit bus drivers, or any of your essential
workers, are any of them getting hazard pay?
Mr. Shelton. Well, we have a--Congressman, thank you. We
have an emergency plan here for workers that we get time-and-a-
half, everybody that was with the city. Our State enacted a
policy to allow us to put people on administrative leave. So in
Tupelo, we utilized those policies so that every city worker in
the city of Tupelo received their salary, and then those that
worked during the emergency got time-and-a-half.
More specific toward transportation, though, that is
actually something that is in very real danger of getting cut
altogether from the budget cuts. We have already cut over $2.5
million from our budget.
We have got budget time coming up. Our municipal budgets
have to be finished by September 15, and our municipal
transportation system very well could not survive this year's
round of budgets due to lack of funding.
Mr. Richmond. What about those city services that you may
contract out? I mean, in some places they contract out their
labor or staffing, their bus drivers or their sanitation or
their hoppers. How are you providing hazard pay for bus drivers
or others that may be privatized?
Mr. Shelton. Well, our transportation system is contracted
out, so that is private. Our waste collection is private
through waste management. So those, you know, other than city
of Tupelo maintaining our payments, those companies are
responsible for making sure the employees get paid.
Now, some of them, my understanding, have taken advantage
of some of the unemployment benefits through the CARES Act.
There are a lot of great benefits that have helped a lot of
people, and I, again, want to thank this body for passing that.
But it has been a challenge.
Mr. Richmond. Since I am about to be out of time, but the
HEROES Act would allow us to send you a substantial sum so that
you could provide hazard pay for your city employees, but also
make sure that those who are providing city services would have
the ability to receive some sort of hazard pay also and protect
them?
Mr. Shelton. That is absolutely correct, Congressman. Thank
you. The HEROES Act would be a huge help to local governments
all across the United States of America.
Mr. Richmond. Thank you, and with that, Mr. Chairman, I
yield back.
Chairman Thompson. Thank you very much. The Chair
recognizes the gentlelady from Arizona, Mrs. Lesko, for 5
minutes.
Mrs. Lesko. Thank you, Mr. Chairman, and it is good to see
the other Members, if not in person, virtually.
Governor Pritzker, I have a question for you. You had said
somewhere along this testimony that you wanted to thank all of
the Congress Members that voted for the HEROES Act. In the
HEROES Act, there is a provision that released Federal
prisoners 50 years old and older, no matter what type of crime
they had committed, and it also financially incentivized States
to do the same.
In a letter that our office received against a bill that
was included in the HEROES Act, it says, we are incredibly
concerned--and this came from an organization called Rights for
Girls, which is an organization that protects girls and women
from sexual trafficking--sex trafficking and violence, and it
says, ``We have been contacted by survivors from several States
that are extremely distressed about the wide-spread release of
people from prisons, including those with histories of sexual
violence, sex trafficking, and child-sex offenses.'' Do you
support that provision of the HEROES Act as well?
Governor Pritzker. Well, I haven't read that provision, but
I can tell you that here in Illinois, you know, we have been
very careful looking at our prisons to make sure that any
releases that have been done--and there have been some--have
been people who have committed nonviolent offenses, people that
were near the end of their term, their sentence, and, indeed,
making sure that we are doing the best that we can to keep
COVID-19 away from the staff, you know, the officials that work
at our prisons, as well as the prisoners themselves.
You know as well as I do that the congregate settings, in
every circumstance--and it is certainly true in prisons--are,
you know, are just, you know, petri dishes, potentially, for
COVID-19. So we have done as much as we could, but----
Mrs. Lesko. Thank you, Mr. Governor. I have to ask the next
question, just because I have a limited period of time if I
didn't. But at least it sounds like you are making some common-
sense decisions about not releasing just anybody and everybody.
The next question I have is in the HEROES Act, it actually
would allow--or have the IRS pay illegal aliens $1,200 in those
relief payments. Do you support that provision of the HEROES
Act as well?
Governor Pritzker. Well, look, we have undocumented
residents in the State of Illinois, and it is important for us
to make sure that they are supported in some fashion, that they
are not starving, that they are people who can survive. So, you
know, we are supporting them at the State level, and we
certainly would appreciate support from the Federal level.
Mrs. Lesko. All right. Thank you, Mr. Governor. Also, Mr.
Governor, you had said in your testimony today that we need a
National masking mandate. I don't know about Illinois--and I am
going to ask you about Illinois--but in Arizona, there are some
portions of the State of Arizona, some rural areas, that don't
have any cases. So in Illinois, I assume it is the same. Do you
think that even if a--like an area that has no cases at all,
that you should mandate people wearing masks if there is
nothing happening in that area?
Governor Pritzker. I do, and here is why. This disease,
this infection, knows no boundaries. The fact is that people in
our rural areas, in southern Illinois, for example, we have an
infection rate, a positivity rate, that is now roughly the same
as the positivity rate in the city of Chicago----
Mrs. Lesko. All right. Thank you.
Governor Pritzker [continuing]. So this can go anywhere.
Mrs. Lesko. Thank you, Mr. Governor. So then, since you
want this top-down mandate on masks, would you also agree that
we should have a top-down National mandate on the violence that
is--gun violence, the shootings of residents against residents
in Chicago, should the National government come in and do
something about that as well, instead of the local and the
State?
Governor Pritzker. Actually, the Federal Government does
provide some funding to help us fight violence, and we use that
appropriately.
Mrs. Lesko. But should it be a mandate, as with the masks,
from the National level down?
Governor Pritzker. Well, I do think the Federal Government
should provide violence prevention funding and helping us to
deal with the violence that exists in cities all across the
Nation, yes.
Mrs. Lesko. Thank you, Mr. Governor. I wasn't asking about
funding. I was asking about a mandate, like the mandate that
you want on mask-wearing.
So with that, I will yield back. Thank you.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentlelady from New York, Miss
Rice, for 5 minutes.
Miss Rice. Thank you, Mr. Chairman. I would just like to
throw out to all of the witnesses. We are--in my district,
school districts work independently, and they are each coming
up with a plan as to how they are going to reopen schools. The
mayor of New York city just said that New York city school kids
will be coming back very likely 2 or 3 days a week with a
severely-reduced class size.
We have already seen how difficult it is for kids to get a
quality education when they are learning from home, for a whole
host of reasons. I would just start with the Governor, and then
go through everyone else. How are you looking at reopening the
schools? Has that decision been made yet in your State, and are
you following the CDC? You know, the President came out today
and basically said that, don't listen to the CDC, because their
guidelines are ridiculously restrictive, whatever that means,
and he has said now that we should all wait for guidance to
come directly from the White House. I don't know what he has
based that guidance on, but if it is not on the CDC, I really
don't know what value it is going to have.
So, Governor, if I could start with you and then just go
through everyone else, that would be great.
Governor Pritzker. Sure. Well, I think if the President
really wanted schools to be open, he wouldn't have just said
it, he would have put forward a plan. But here in Illinois, we
are--you know, our Board of Education, in fact, did put forward
a plan. It is a plan that takes into account that there are
differences between the more rural areas of our State, the
suburban, and the urban areas, and allows the local school
districts to adjust how they would reopen.
There are areas where it will be difficult to bus everybody
in a rural area to the school, because there are only so many
school buses. We can't have the school buses packed with kids
in the morning going into school and packed with kids going
home. So, you know, we have got to make sure that we have got
shifts, let's say, or that kids are perhaps coming in on
alternate days.
Remember, we are also trying to save the lives of and the
health of the people who work at the schools--our teachers, our
paraprofessionals. So, you know, this is a challenge, there is
no doubt about it, and we are watching our metrics very
closely, so that we can make adjustments, and we will be making
decisions along the way here. But as for now, we have provided
at least guidance for school districts about how they should
open.
Miss Rice. Anyone else have any thoughts on that?
Mr. Shelton. Yes. Thank you, Congresswoman. You know, we
have known since this pandemic started in March--you know,
before March, got to the country in January--we have known that
we have got--that we are going to have to open schools in the
fall. The President, you know, contradicting CDC today is part
of what I said--you know, what I was alluding to in my opening
statement and my submitted documents, that that exacerbates the
problems that local officials are having.
You know, when I issue an executive order here, and then
the President--you know, my executive order is based on CDC
recommendations--and then the President gets on Twitter and
says, don't believe that, well, the President's passionate
supporters are going to listen to the President and not the
CDC. That complicates the ability of government at every single
level to be able to respond to COVID-19.
As far as our school district here in Tupelo, it is, like
you mentioned, a separate school district. They have a plan to
reopen in August, but they are kind of going day-to-day, seeing
how the situation [inaudible] if the cases continue to rise
here.
Dr. Shah. Congresswoman, here in Texas, from a public
health perspective, Texas Education Association has, just
yesterday, put out some guidelines related to how schools will
reopen here in Texas. We have been working with some of our
school districts prior to this, and I think the concerns that
individuals have is what you have just heard from the Governor
and the mayor, which is really about not just protecting the
students, but also protecting the staff and any visitors that
are coming in. It is the entire group of individuals that need
to be protected. So, there are concerns that schools have
related to that safety piece.
Obviously, we have an increase in cases, and we have
increase in concern and worry in our community as well as
[inaudible]. So I don't believe it has been worked out, but I
will tell you that those guidelines are being looked at very
closely, not just at the State level, but at the local level,
not just in the education system, but also in the public health
system.
The concern is to make sure that we have an approach that,
again, is common-sense driven, that we want to make sure it is
also based on evidence and science, but it also assures the
safety and health of everyone involved, and that also may mean
that a hybrid approach of in-person, in addition to obviously
virtual, that some of those approaches need to be part of it.
Miss Rice. Colonel Hastings.
Mr. Hastings. Thank you, ma'am. In Alabama, I am not the
superintendent of schools, but I know that Dr. Eric Mackie has
been in close coordination with Dr. Scott Harris, our public
health officer, and they put forth a road map to open schools
that I thought was very reasonable, followed CDC guidelines and
public health orders.
But ultimately, like in your State, ma'am, here in Alabama,
it will be a local decision of how the schools open. Because we
are a diverse tapestry of 67 counties and a tribe of a
multitude of personalities, cultures, and a way of living. You
can't mandate from a central point down and have it work.
So I feel like there is enough information out there for
our local superintendents and principals to find that happy
medium to make parents feel safe, children feel safe, faculty
feel safe, and to make sure that children coming together in
close quarters, you really need to be careful, because they may
be the perfect vector of this disease, and then they bring it
back to Alabama. In Alabama, especially in rural Alabama, we
have multigenerational homes.
So that is all going into this, and how we use the CARES
Act money, the CARES Act money given to the school districts,
and then allowing the counties to partner to operate in a way
that is good for them.
Miss Rice. Thank you all very much, and thank you, Mr.
Chairman. I yield back.
Mr. Rogers. Mr. Chairman, this is Mike, Mike Rogers. Can
you hear me?
Chairman Thompson. Ranking Member, go ahead.
Mr. Rogers. Yes, sir. I just wanted to make sure that you
were aware that we are having a problem with the public feed.
None of Mrs. Lesko's and most of Miss Rice's testimony was not
seen. They were looping Cedric Richmond's questioning
repeatedly, but it is back up now, but just wanted you to be
aware there is a problem.
Chairman Thompson. Thank you. We were about to recess to
create the ability to go on-line again. Our YouTube channel is
down. So thank you, Mr. Ranking Member, and we will recess
shortly and reconvene subject to the call of the Chair.
Mrs. Lesko. Mr. Chair, this is Congresswoman Lesko. I have
a question. Mr. Chair? I just want to know if--because I have
another appointment I need to go to, if I have to reask my
questions, or are the questions recorded and the answers that
the Governor gave, so you can rebroadcast them later?
Chairman Thompson. Well, I can't give you that question
yet. I will talk to the technical people. If we can, we will do
that. Other than that, if you can submit it in writing, I am
sure we can get it. But the technicians are working on the
problem right now. We will recess subject to the call of the
Chair.
[Recess.]
Chairman Thompson. Well, we would like to reconvene our
hearing, and, Mr. Bishop, we will go to you for questioning
since Mr. Crenshaw is not available. If he comes, according to
the rules, we will just go back. So the gentleman will be
recognized for 5 minutes for questioning.
Mr. Bishop. Thank you, Mr. Chairman. Can you hear me?
Chairman Thompson. Yes.
Mr. Bishop. Thank you, sir.
Governor Pritzker, I was struck by the certitude of your
criticism of the administration's efforts. I was just looking
on the Worldometers website, and it appears to me that in terms
of the experience measured by deaths per million during the
pandemic, a number of nations have had worse experience than
the United States. Of the larger ones, the United Kingdom,
Spain, Italy, Sweden, and France have all suffered worse
results. Do you believe that those nations also have had a
failed response--national response?
Governor Pritzker. Look, what I can tell you is that we
were--a lot of promises were made to the States, including to
us, that were not delivered upon. That is what I was really
referring to. I am not comparing us to other nations
specifically. I am just saying the Federal Government, the
White House in particular, had made promises about the delivery
of PPE, about testing supplies, had the capability to allow the
CDC to give us more guidance, and really, you know, very little
of that was delivered.
Mr. Bishop. One of the things that has gained a lot of
currency, and the President refers to it a lot, is that his
early decision to cut off entries from China other than U.S.
nationals, do you concur--a lot of Democrats criticized that--
do you concur that the President made the right decision in
that regard?
Governor Pritzker. Well, I think we all are seeing now
that, you know, travel by people who may be infected is
something that everybody's paying attention to, and that, you
know, limiting that by people who, again, come from areas that
are--have significant infection rates is important. So I--
again, I have not been somebody who has talked about that.
What I have talked about, though, is the way in which that
was done. You know, we had a problem on the days in which the
President just decided and announced it, really nothing was
done to help airports deal with the problems of all the
incoming, international passengers from those places. Many
people were desperate to get back to the United States who may
have been U.S. citizens living in places like China or in
Europe----
Mr. Bishop. Thank you, Governor.
Governor Pritzker. Yes. So--let me just say, we had an
overrun of people--it was a real problem--packed into a----
Mr. Bishop. Let me change subjects just a bit. You were
particularly critical on the PPE thing, and you made reference
to that again. I guess Illinois maintains a stockpile of PPE.
Is that correct?
Governor Pritzker. That's right. We had a stockpile to
begin with.
Mr. Bishop. Why didn't you have bigger stockpile?
Governor Pritzker. Well, look, I can't answer that
question, because those stockpiles were put in place before I
became Governor, but what I can say is--and I think I heard one
of the other panelists talk about--that there were leftovers
stockpiles from H1N1 that had expired, that had to be, you
know, reupped and allowed--yes.
Mr. Bishop. Suffice to say that if you had larger
stockpiles or any State had larger stockpiles of its own public
health supplies, they might be less inclined to cast blame or
find blame with the Federal Government for the amount of its
stockpile. Fair to say?
Governor Pritzker. Well, I would say this is certainly an
unprecedented pandemic, but I would also say that the Defense
Production Act, it wasn't really a criticism that we didn't
have the stockpile at the Federal level. It was that we could
immediately have invoked the Defense Production Act in order to
help us rebuild those stockpiles.
Mr. Bishop. Let me ask you about that. So, I mean, what
that would assume is that by taking command, control, of the
economy for producing PPE, we would produce more and faster and
get them distributed to the right place and leave the existing
economic actors in place. Is that what you believe? Do you have
any evidence to support that that would have been better?
Governor Pritzker. Well, the existing economic actors were
not prioritizing PPE to the places that were needed in this
pandemic. It was the States and local governments and emergency
management personnel and health officials that----
Mr. Bishop. And hospitals, right?
Governor Pritzker. And hospitals too. My point is that we
weren't getting that PPE from the Federal Government, and what
we needed was to--yes, we needed the Federal Government to
organize the market, to direct those resources so that we could
use them to save lives.
Mr. Bishop. What is to say that in the context of a 2-month
period of time, or 3-month period of time, the Federal
Government taking over that market with a command-and-control
structure would have produced more, and in the right place,
than allowing the market to function with augmentation of
efforts from the Federal Government, such as FEMA directing
resources, as it did? [Inaudible] confidence to that effect.
Governor Pritzker. Right. Well, look at what happened with
the air bridge. You know, the distributors who received the
items through the air bridge distributed them, again, not based
upon where the need was, but based upon where their customers
were, you know, who they had as historic customers, not where
the need was right at that moment. That is precisely what
Defense Production Act invocation would have allowed the
Federal Government to do, to direct the resources where they
were needed.
Remember, New York, California, other States that had an
immediate rise in cases, PPE could have gone directly to those
places immediately, to Chicago and to Illinois, where we needed
it. Of course, we knew where the hotspots were. So, again,
having some direction from the Federal Government would really
have helped.
Mr. Bishop. Thank you, Mr. Chairman. My time is expired,
and I yield.
Chairman Thompson. Thank you very much. The Chair
recognizes the gentleman from New Jersey, Mr. Payne, for 5
minutes.
Mr. Payne. Thank you, Mr. Chairman, and I would like to
thank the witnesses for being here.
Governor Pritzker, Illinois, like my home State of New
Jersey, has made serious progress in combating the spread of
coronavirus. Although, you know, we still both have a long way
to go. At a time when much of the actual attention is focused
on new hotspots, such as Florida, Texas, and Arizona, are you
getting everything you need from FEMA to continue the fight
against the COVID-19, and ensure that the recent gains are not
short-lived?
Governor Pritzker. Well, thank you, Congressman Payne, and
let me first congratulate you on your victory yesterday. I
happen to have spoken with your Governor last night to get his
advice on a matter or two. Let me just say that, look, we need
more help. There is no doubt about it. You know, we are trying
to expand--desperately trying to expand our testing in the
State of Illinois. We think that is a hugely important thing.
We have done--we have made a lot of progress on it, but the
Federal Government, once again, can be more help to us in that
process. They were, by the way, along the way. Not at the
beginning, but by May, the Federal Government was, in fact,
sending us swabs, which was something that we needed
desperately, I think were needed around the country.
There is so much more that is needed, though. Let me just,
you know, go back to something I said in my remarks, which is,
remember that our State and local governments, because there is
a failure of revenues as a result of COVID-19, are going to be
faced with massive layoffs for first responders, for the basic
services that people need across our State and across our
Nation.
Without those resources, I mean, what we have seen as a
health care crisis, where we have had to put a lot of dollars
into public health, is, of course, now also become a financial
and economic crisis. We don't want it to be exacerbated by
having State and local governments make massive cuts to the
very services that, at this critical moment, people really
need.
So I would just say that if I had to name, you know, among
the things that I have talked about, one of the most important
things is making sure that our State and local governments can
do what they need to do during this terrible crisis, because it
is not over, and it is not ending in the next couple of months.
We need to see a very effective treatment or a vaccine before
we can get beyond this.
Mr. Payne. Absolutely. You know, to the point about the
Federal Government, you know, in the HEROES Act, we tried to
address that with the aid to State and local governments, but
it is sitting over there in the Senate with the other 600 bills
that we have passed over this Congress.
So, you know, maybe one day they will decide to pick them
up and take a look at them while the American people languish
with this dreaded disease.
I tend to agree with you, this administration has been less
than desirable in their attitude in reference to this. FEMA has
done the best they can, but they are at the behest of the
President and the Vice President. You know, it is unfortunate
that they aren't allowed to do what they need--they know what
to do. It is being allowed to do it, and going in and helping
different locales fight this disease.
Now, we see what is happening in Florida and Texas and
Arizona, but there was no problem, it was going away. You know,
if we are not careful, we will see the same situation back in
our States. So, you know, and the President of the Senate's
attitude is, you know, well, pull yourself up by your
bootstraps, you know, except in Kentucky where he is making
sure they have everything. So it is just unfortunate that the
administration has taken that attitude.
Dr. Shah, you know, I am pleased to see you here today. I
appreciate you gave excellent testimony back in October last
year at my subcommittee hearing on bioterrorism preparedness. I
see the massive resurgence of COVID-19 this summer as a
disturbing trend.
Dr. Shah, what do you think will happen in the winter when
the flu season will return? What do we need to be doing to
prepare?
Dr. Shah. Thank you, Congressman, and good to see you
again, and thank you for reminding of the pre-COVID hearing
last year, which seems, you know, ages ago.
Mr. Payne. Yes.
Dr. Shah. On your previous question, I did want to make a
comment that public health has seen over 56,000 jobs that have
been lost over the decade, and that is really concerning to me.
From a public health standpoint, across the Nation, we have
taxed the public health system so much that very well we are
going to see markedly more diversions and folks leaving the
public health work force, which is a real concern of ours.
In the fall, to your question, the real concern that we
have is that we are still not through, as Dr. Fauci said, this
first wave, and now in just a couple of months, we are going to
very much be in the midst of flu season. While we are in the
midst of a summer, if you will, a usual respite from flu, now
flu is going to come back in the midst of fall season. We also
have concerns about people not taking flu vaccine because of
concerns, misguided though they are, around anti-vaccination,
that there is really a concern that people are not going to be
vaccinated and, No. 2, that you are going to have a vengeance
when you have both flu and COVID that are intermixed together
in the fall, and that is a concern of all of ours in public
health.
Mr. Payne. Thank you.
I don't know if my time is----
Chairman Thompson. The gentleman's time has expired.
Mr. Payne. Thank you, Mr. Chair.
Chairman Thompson. I know you are celebrating yesterday,
but we have some other Members.
Mr. Payne. I yield back. I am sorry.
Chairman Thompson. That is all right.
We now recognize the gentleman from Texas for 5 minutes,
Mr. Crenshaw.
Mr. Crenshaw. Thank you, Mr. Chairman.
Thank you Dr. Shah. It is good to see you as always. You
mentioned Harris County's history of responding to crisis and
disasters. You have a lot of history being on the front lines
doing so, and we appreciate that. How does this Federal
response to COVID relate to the past disasters that you have
seen?
Dr. Shah. First of all, Congressman, great to see you, and
thank you for your continued support, really appreciate it.
You know, I think there are a couple things I would say.
One is about the disaster itself. This is not a hurricane in
one spot. This is throughout the country, throughout the globe.
All communities across the world are going through this
differentially. So there is this massive nature of this. But
the piece that is of concern to me is that, in the past when we
have had these disasters, these emergencies, we have actually
seen CDC oftentimes be that leading voice and actually
convening behind the scenes, a lot of discussions with State
and local health officials that allows us to learn from each
other. That has not happened as much as I have seen in the
past.
I have got a lot more to say, but I think let me pause
there because I know you have more questions.
Mr. Crenshaw. Yes, and I do. That is a reasonable concern
to have, and I appreciate your candid and honest response.
Because what I have heard from [inaudible] hearing, the tone of
this hearing, you know, you would think we live in a totally
different world than what actually happened. I won't dwell on
the dishonesty that I have heard from others, but I appreciate
your honesty on this. I think we are on the same page.
When we met in my office in early March, we focused on the
fact that we had public health issues other than COVID and that
COVID could negatively affect those on-going issues too. There
are other public policy goals, as it turns out: Education,
jobs, other health issues. What was the result of the lockdown
on these other public health issues?
Dr. Shah. Well, thank you again for that. As you know that
it is not just health and medical impacts from COVID. It is
this real socioeconomic, sociodemographic impact across the
communities. So it has--obviously, it is too early for us to
have specific numbers to say what was the impact on education
or the economy all throughout.
I will say this: That we know that there have been
secondary impacts, and while they have not been quantifiable,
we also know that education, jobs, et cetera, also have
secondary impact on health, and vice versa. They all work
together. So, you know, I do want to make sure that we
recognize that we have to really make sure this is not an
either/or, that we are only looking at health. We should be
looking at all of those aspects together. It is an ``and'' as
we continue to fight this pandemic.
Mr. Crenshaw. As you state, I mean, dealing with this, it
is a science and an art. Some people say, well, let's listen to
the science. Well, science disagrees on a lot of things, and
there are judgments that have to occur, weighing costs and
benefits and weighing other issues, like we just mentioned.
There has also been a lot of debate over reopening the
economy. Now, Texas reopened in early May. Places like
California, which is seeing spikes just as bad as Texas, even
though nobody likes to mention that--I wonder why--they opened
up a lot slower and they were locked down much more severely,
but both saw spikes.
So can you expand on what you talked about with the
layering effects that you mentioned that may have caused the
spike that we are seeing across the country?
Dr. Shah. Yes. You know, this virus is an equal opportunity
virus. It does not respect seasons. It does not respect who you
are, how you are, what you are trying to do in life. At the end
of the day, if you are exposed, there is this real concern that
the exposure can lead to infectivity, and I think that is the
critical piece.
The layering effect, in my mind, is very important. It is
not just reopening. I can't quantify exactly how much, because
no one can. It is not just reopening restaurants at 25 percent,
then 50, then 75, or bars or gyms, and back and forth. But what
it is is that you have layering effect in addition to these
milestone events like, as I mentioned, Mother's Day and
holidays and protests, and now we have had Father's Day, and
now you have graduations in between. Now we have had 4th of
July. All of that layers upon each other.
When you dial something up or you have an event, it
generally takes a few weeks for you to see the impact. Just
conversely, when you dial down, it takes a few weeks for you to
see the impact. It is not immediate.
But the concern we have in our community, as you know, is
that what is happening in our health care system is that we
cannot wait for this runway, because there is limited runway in
that health care system, and that is why we are concerned about
making public policy decisions that can really interrupt this
transmission now.
Mr. Crenshaw. Thank you.
I am out of time. I have a lot more to say, but thank you,
Mr. Chairman. I yield back.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentlelady from Illinois, Ms.
Underwood, for 5 minutes.
Ms. Underwood. Well, thank you, Mr. Chairman.
What a treat it is to have our Governor with us on the line
today. He certainly has made us quite proud throughout this
response, and I have a series of questions for him.
I would like to begin, Governor, your background is in
education, and I am sure you would agree that returning to
school is integral to the well-being and development of our
children, as well as to working parents, and to the long-term
health of our economy. But it is essential to make sure that
reopening schools does not place students, teachers, and their
families in danger. States and schools should be able to count
on the Federal Government for guidance during a crisis of this
scale.
So as you prepare to safely reopen Illinois schools, what
information, expertise, and resources do you need from the
Federal Government?
Governor Pritzker. Well, thank you, Congresswoman. I want
to just begin by saying thank you for your very strong advocacy
for the State of Illinois in Washington, and especially for
your advocacy in helping us get through this pandemic with
everything that we may need. I know you are fighting for us
there, and I really appreciate that.
In answer to your question, you know, this is a very
complex challenge, getting our kids back to school and doing it
safely. You know, we didn't do this starting out with the idea
that we have to get everybody back to school. We started with
the idea, you know, does the science and the data allow us to
send kids back to school? If so, in what manner and how would
that work? Especially when we know that we need to watch our
distance, we need to make sure people are wearing masks or face
coverings, and all the challenges of people with preconditions
that the adults and the children who are going to be in that
school, not to mention--and people don't really mention this
much--the parents who interact with the school.
So, you know, that has been the challenge. What we did to
begin with was we got our health professionals--and this is how
we have done all of the facets of reopening and restoration
that we have done. We got the public health officials together
with the people who know our schools best, all across the
State. Again, we have very different school districts in rural
Illinois than we do in suburban and, you know, in the city of
Chicago, for example.
But we got them together and made sure that the ideas that
were being put forward were, No. 1, going to keep our kids and
everybody at the school healthy and safe and, No. 2, were
feasible and, No. 3, what investments do we need to make----
Ms. Underwood. Yes.
Governor Pritzker [continuing]. To make sure that we can
get those accomplished. So long story short is the Federal
Government's guidance is so vitally important, from the CDC. I
hate to say that I have often found the CDC as being muzzled
along the way here. I think the CDC is what we should be
relying upon. There are a lot of terrific epidemiologists and
expertise that exists at the CDC, but often, what we have found
is either they put out guidance and then the White House tells
them, no, we are pulling it back----
Ms. Underwood. That is right.
Governor Pritzker [continuing]. Or they are beginning to
put out guidance and someone says, you are not allowed to talk.
So we are very concerned about that fact.
So I feel very fortunate that I come from a State where we
have got some terrific, world-renowned scientists,
epidemiologists, researchers, and so on. So we have been able
to rely a lot on our local capability that really is world-
class. But I wish that we could have a Federal Government that
was our partner in this endeavor. That is why I was so
frustrated to see the President just sort-of pronounce that,
well, everybody should open their schools. Well, great. Please,
please provide us the kind of guidance that will help us do
that.
Ms. Underwood. Yes. I am certainly concerned about their
announcements today from the Department of Education, for
example.
We have a minute left, sir, so I know that the State
budgets across the country have been devastated by the
pandemic, and nearly 2 months ago, the House passed a bill, the
HEROES Act, that would provide nearly--not nearly--$500 billion
in relief funds to State government, including almost $18
billion for the State of Illinois. Unfortunately, the Senate
hasn't acted on the bill.
So for the benefit of our colleagues in the Senate, what
impact would this funding have on our State of Illinois?
Governor Pritzker. Well, before I say that, I just want to
say that I talk to Republican and Democratic Governors all the
time, all across the Nation. So when I answer your question, I
am partly answering what I think Republican and Democratic
Governors across the country are saying, which is, without that
funding, imagine how difficult it will be to reopen schools----
Ms. Underwood. Right.
Governor Pritzker [continuing]. To provide, you know, the
resources that we need for schools, not to mention our public
health infrastructure, which is funded by State government. Our
city, county governments provide our firefighters and our
police officers and public safety. They are already making
layoffs, significant layoffs. We can't afford to have that
happen across the country in the middle of a pandemic.
If you can spend, you know, trillions of dollars helping
large corporations survive, $500 million to support State and
local governments, which provide such vital resources for our
residents, you know, I would say is a small price to pay for
what is absolutely necessary here.
Ms. Underwood. Well, Governor Pritzker, thank you for your
leadership. Thank you for being with us today.
Mr. Chairman, I yield back.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentleman from Pennsylvania for 5
minutes, Mr. Joyce.
Mr. Joyce. [Inaudible] Let's start again. Thank you.
Chairman, thank you for yielding and thank you for
convening this hearing, although I am disappointed that we are
not all here together to conduct this important committee
business in person.
I would like to thank my colleague, Ranking Member Rogers,
for his leadership in gathering us here today. I would also
like to thank our panel of witnesses for appearing today.
The COVID-19 pandemic started a crisis unlike anything we
have seen in our lifetimes and certainly unlike anything I have
seen in practicing medicine for over 25 years. As we have seen
this virus progress, it has disproportionately impacted elderly
patients, especially those living in nursing homes or other
long-term care facilities.
In my home State of Pennsylvania, this problem was
tragically increased by a misguided order from our Governor to
readmit COVID-19-positive residents back into nursing homes.
This order flew in the face of common sense and guidance from
the Center for Medicare and Medicaid Services issued just days
before.
I would strongly urge this committee and the entire House
of Representatives as a body to look into this order and
similar orders given in New York, Michigan, California, to take
full account of these deadly mistakes.
As we continue to face this virus, we cannot forget where
it originated. Chinese obstruction and outright lies to the
media and to international investigators are at the root cause
of this virus and allowed it to spread onto a global scale. It
remains critical that we are vigilant to the threat from China
and act together as a committee to respond to any increased
cyber attacks or other threats to our homeland while we
continue to fight this coronavirus.
Director Hastings, thank you for appearing today. In your
testimony, you mentioned how quickly you were able to receive
major disaster declarations from the Trump administration. I am
pleased to report we had similar success in my home State of
Pennsylvania, and our delegation was able to support the
request from our Governor in a bipartisan manner. It is also my
understanding that the Trump administration was able to approve
similar declarations very quickly for States all across the
country.
Director Hastings, could you please elaborate on any
additional resources that Congress might need to make available
to help States like Alabama be successful in their continued
fight against COVID-19?
Mr. Hastings. Thank you, Congressman. I think in my written
testimony, I talked a little bit about the CARES Act. One of
the things that we are concerned about--and I was going to get
ready to poll the Region 4 State directors--is the
interpretation of whether the CARES Act funding can be used for
both the activities that any emergency management agency does,
because we are not considered public safety agents. So that is
one.
No. 2, we also got really quick approval through the
Alabama Department of Commerce through the Small Business
Administration to get an SBA disaster declaration. The blessing
and the curse of being in Region 4 is that we are disaster-
prone, so I enjoy a great relationship with our sister States
and also with FEMA Region 4.
But I think the biggest thing is that the National
emergency right now ends on 31 December, and I am not a public
health officer, epidemiologist, or a pathologist, but I just
don't see COVID-19 going away at the new year. So I think we
need to batten down the hatches for a long fight and really
start to look at the habits we have today, the things we need
to do, kind-of reinvent the way we do things, to deliver
services to our people in inventive, agile, and innovative
manners, because I don't believe we are going to go back to
normal. I think we need to go forward to better, and I don't
know what forward to better is yet.
I agree with the Governor of Illinois that we are
exploring, deciding, making mistakes, learning from them along
the way. If we can continue to share those things with the
Federal Government, our States, in a more collaborative,
cooperative manner, I think we will be better as a Nation, as
regions, and things like that. But I just don't think the need
and the assistance from the Federal Government will end on the
3lst of December. So that is one thing I am a little bit
concerned about.
Mr. Joyce. Thank you for your hard work. Thank you for your
dedication to Alabama and to our country. Thank you for your
insight.
Mr. Chairman, I yield the remainder of my time.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentleman from Texas, Mr. Green,
for 5 minutes.
Mr. Green of Texas. Thank you, Mr. Chairman. I thank the
witnesses for appearing. I am also very grateful to the Ranking
Member for his role that he has played in the process.
If I may, I would like to refer to some empirical evidence
and then ask a question.
This is intelligence that relates to new cases as of 7/7/
2020, new cases of coronavirus, I might add. In Texas, on 7/7/
2020, a State with 29 million people, we had 10,028 cases. I
would like to juxtapose Texas to Canada. Canada, population of
37 million, decidedly more than Texas, had 172 cases. Texas,
10,000; Canada, 172. This makes it intuitively obvious that we
can do better, and I can't believe that the Canadians know more
about the virus than we do. I can't believe that they have
better medical facilities than we have. So there must be other
things that are giving them the opportunity to have 172 cases
on yesterday and Texas 10,028.
Dr. Shah, my dear friend, I would like for you to comment
on this, if you would, the rationale for Canada being so
successful as opposed to my State that I love dearly, and I
assume you love dearly as well as a resident.
Dr. Shah. Well, thank you Congressman. Always good to see
you and your support, leadership. Yes, I came to Texas because
I do, too, love this State.
I will tell you that this is the concern that we have. When
you say that there are 10,000 new cases that are being, you
know, deemed positive on a single day and then you compare it
to our neighbors to the north and it is markedly less than
that, then that means that we as a Nation have to do markedly
better. It is not about the politics; it is about the policies.
It is not about the red or the blue; it is about all of us
working together.
We just had 4th of July, and that means that we should be
coming together as a Nation, because we are well beyond and
behind the 8-ball when it comes to fighting this pandemic, and
that concerns us across the country. That concerns us in Texas.
That certainly should concern us here locally. So I agree with
you, and that is a concern that we have.
I do think it is about that inconsistent messaging, and it
is also about having the strategy that really allows us to
continue to assure that everyone understands their role and
everybody is working together. That is what we are not seeing.
Mr. Green of Texas. Thank you.
Colonel, if I may, I have had the opportunity to look at
your record. You have served your country well, and I
compliment you.
I have to ask you a question. I am a member of several
fraternities. If my fraternity wanted to come to your State,
say 6,000 strong, and we wanted to have a convention within a
facility, not without, would you recommend that we have this
in-person convention indoors, 6,000 strong?
Mr. Hastings. Congressman, my recommendation would be based
upon our current safer-at-home guideline and campaign that the
Governor has and the public health orders that are currently
applicable in Alabama. So it does recommend that large
gatherings, where you can't have social distancing, are not
recommended. So if someone was asking for my recommendation, I
would not recommend that, as part of the Unified Command, as
the director of Alabama Emergency Management, and as a
supporting partner with Alabama Department of Public Health on
behalf of the strategy that Governor Ivey has in place right
now.
Mr. Green of Texas. Dr. Shah, if you would, would you
kindly respond to the example that I have accorded?
Dr. Shah. I would agree that, just as you just heard from
Mr. Hastings, we are very concerned about anytime you bring
people together for any reason, regardless of why people may be
passionate about it, that concern, from a public health
standpoint, increases risk. You certainly don't want to do it
in any community where you have increasing numbers of cases or
tests that are coming back positive or hospitalizations; for
example, in ours.
Mr. Green of Texas. Would it make a difference if all of us
were of a given political persuasion, we are all a part of one
political group, if you will, a party perhaps, would that make
a difference?
Dr. Shah. From a public health standpoint, no.
Mr. Green of Texas. Thank you, Mr. Chairman. I yield back.
Chairman Thompson. Thank you very much.
Governor, I got your message that you are going to have to
depart. Let me thank you very much for the time you have given
us. I know you will stay as long as you can, but thank you very
much, on behalf of the Ranking Member and myself, for being a
witness for our committee.
Governor Pritzker. Thank you very much, Mr. Chairman and
Congressman Rogers.
Chairman Thompson. Thank you.
The Chair recognizes the gentleman from California, Mr.
Correa, for 5 minutes.
Mr. Correa. Thank you, Mr. Chairman, for holding this most
important hearing, and our Ranking Member as well, thank you
very much. I want to thank our guests today for being here. I
wish the Governor would have stayed on for 3 more minutes, I
did have a question for all of you, and I still do.
I represent Central Orange County here in California.
Ninety percent of our industry here, of our jobs are dependent
on tourism. Our biggest employer here is Disneyland. Ninety-
five percent of my constituents that work in the entertainment,
hotels, restaurant business have been out of jobs for months
now. As we have these economic stimulus packages that we in
Washington have rolled out, as those come to an end, you are
going to see people begin to hurt in a very serious manner.
Every weekend I am out giving food baskets, food to my
constituents, folks driving in with nice cars that have not had
a paycheck in weeks.
As I am listening to your testimony, and all of you--some
of you mentioned it this morning or last night, the President
came out and contradicted the CDC. I am also trying to figure
out, as Americans, where do we turn to? What do we do to get a
unified message to unify us and say, we have got to move
student body left or student body right, pick a play and
execute, as opposed to being contradictory as to what we are
supposed to do?
So I am going to ask Mayor Shelton, Dr. Shah, and Colonel
Hastings, what is the message out there for my constituents? We
are a Democratic district, but you know what, we have a lot of
my constituents that also follow the President's message very
carefully.
What do we say to our constituents? In the context of
getting our country back in order, making sure that folks are
able to go back to work, but we have got to get this COVID-19
under control, what do we tell our constituents?
Dr. Shah.
Dr. Shah. Well, this is--thank you, Congressman. This is
exactly what I said about the inconsistent messaging. It
creates confusion and even complacency and, unfortunately, it
actually means that people take risks. They don't know exactly
who is right or wrong, and they may make a decision to take a
risk. From a health standpoint, that is a terrible way to make
decisions, terrible. Because what it does is, at the end of the
day, we now increase transmission and exposure, and that cooks
upon each other, and the next thing you know you have increases
in cases. So----
Mr. Correa. Colonel Hastings, I have got 2 minutes. Go
ahead and answer the question.
Mr. Hastings. Sure. Well, you know, we have an Alabama
strategy and a grand strategy in phases of our State
operations, and we want to make sure that everyone is behind
that. But I think to what the doctor was saying is that it is
not--in a digital world, this is not a binary answer; it is
very analog. You can open the economy, but you have to comply
with public health orders and CDC guidelines. You can open the
economy, but when you close down your schools, you have got to
figure out how do you deliver school to the children if the
children can't come to you, like we did. Or if we close down
businesses or services, instead of people coming and
congregating, how do those people deliver those services to the
people?
So where, yes, people are going to be suffering, and on
July 3l, I am concerned about maybe a looming humanitarian
crisis. You know, this time that we have right now, we need to
take a step back, take a deep breath and go, how do we reinvent
the way we do business, how do we reinvent how we connect with
people, and we can do----
Mr. Correa. How do we get that unified message? How do we
get that unified message?
Mr. Hastings. Well, in Alabama, our strategy is mobilize
Alabama for a whole-of-society response to slow the
transmission of coronavirus to a level commensurate with our
medical system's capacity to care for our citizens in order to
buy time to find a vaccination----
Mr. Correa. Thank you, Colonel Hastings.
In my last 30 seconds, Mayor Shelton, tell me.
Mr. Shelton. The President of the United States needs to
get on TV and have a call to unity, that he needs to dispel the
conspiracy theories and the rumors that are hampering the
efforts of government at all levels to respond. We need both
parties in the House and Senate to continue to work on
legislation that is going to get help where help is needed.
Mr. Correa. Thank you very much, gentlemen.
Mr. Chairman, I yield.
Chairman Thompson. [Inaudible]
Mr. Correa. You are muted, sir.
Chairman Thompson. The Chair recognizes the gentleman from
Kansas City, Mr. Cleaver.
Mr. Cleaver. Thank you, Mr. Chairman.
One of my big concerns is we politicize everything and, you
know, we have things like, you know, your seatbelts, which is
required to be in your automobiles and, I guess, motorcycle
helmets to a lesser degree, they may be regulated [inaudible].
But it has become a--you know, if you support the President,
you don't do this. I am so concerned about it because I think
we are probably going to lose some lives over that, and may
have already done so.
But, Dr. Shah, one of the things that I am talking about is
in my birth State of Texas, you know, we have this contagion
running rampant in Texas. Can we say to people in Texas--I have
about a hundred, maybe probably more that I just don't know
about, but at least a hundred of my family members live in
Texas now. If I were to talk to them, can I tell them, with any
degree of accuracy, that everybody in Texas who wants to take
the test can take the test?
Dr. Shah. You know, that is--thank you, Congressman, and
great to hear from somebody who is a Texan at heart.
What I would say is two things. I have been saying this is
a tale of two cities. We've gotten better with testing, but we
are not where we need to be as a Nation and certainly here in
Texas. The key message that I have been saying--and people have
asked me this question--if somebody wanted to get tested, could
they get tested? The answer is, yes, likely, should be. But if
the answer is--we have 5 million residents in Harris County
alone, if today they said, I want to get tested today, the
answer is absolutely no.
So the answer is really very much about we are better than
where we were, but testing is a key foundation, and we need to
really spend a lot of our efforts as a Nation on making sure
testing capacity is even better than where it has been.
Mr. Cleaver. Well, I am also concerned--thank you. Thank
you, Doctor.
I am also concerned, though, however, that the
politicalization has gone so wildly that I was at a meeting
with some Members of Congress, and I was told that even if a
vaccine is created, this particular Member--this is a Member of
Congress who said, I am not going to take it, my family is not
going to take it, and the people I know will not take it. Why
would I take a vaccine--this is a Member of Congress--why would
I take a vaccine that could very likely kill me?
So my question is--you deal with this stuff on an everyday
basis--is that even if--I mean, you know, even if everybody can
get tested, and even if we get a vaccine, we have intelligent
human beings out saying openly that they are not going to take
a test and that they are going to prevent their family from
taking it and all the people they know.
So if a couple of Members say that, we are talking millions
of people. I mean, each Member of Congress represents 800,000--
roughly 800,000 people. If somebody even higher says, roll with
me--I know you can't solve that problem, but with the vaccine,
I mean, how many people do you think, Doctor, die each day from
taking the polio vaccine or the flu vaccine?
Dr. Shah. Well, Congressman, I think that is the concern.
That is the mixed messaging. That is the issue. That is why
there are other countries that are doing better, because they
have come across, come around to the fact that we are all in
this together, and we have become divided. That is the issue.
The other piece that you said earlier about the testing, I
will say that it is not just the quantity of tests; it is also
the quality of the test, the turnaround time, the lag of the
testing. It is all that together, which means that this is a
very critical time for us as a Nation. Unless we can get all of
our efforts centered on fighting this pandemic, we are going to
be in this longer and we are going to have more unfortunate or
adverse outcomes.
Mr. Cleaver. Thank you.
I took the [inaudible] yesterday. That is why I have a
Band-Aid here. Every time I get a chance to take a test, I am
going to take one, and I am trying to say that to everybody
else.
So thanks, Doctor. This is somewhat frustrating, but thank
you very much for what you do every day.
Dr. Shah. Thank you. Thank you, Congressman.
Mr. Cleaver. Thank you, Mr. Chairman.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentlelady from New York for 5
minutes, Ms. Clarke.
Ms. Clarke. Thank you very much, Mr. Chairman. I want to
thank all of our witnesses for their expert testimony today.
As a New Yorker, we went through the eye of the storm,
being the epicenter of this pandemic. We are going through a
painstaking phase in an introduction to our economy once again.
But nothing is more troubling to me as a Member of this
committee than to see the type of spiking that we are seeing in
the southern, midwestern parts of our country, particularly in
the southwestern part of the country, particularly because it
would seem to me that we would have learned observing what New
York State went through.
My question is, you know, are States actually coordinating
and having conversations with one another about the experiences
that each State has gone through? Because it seems to me that
we are stuck in Groundhog Day here, and this is costing lives
across this Nation.
It would seem to me, Mr. Chairman, that there would be a
coordinated effort to get a National platform, a National
standard for making sure that there are PPEs for each and every
State across this Nation, that the stockpiles that everyone is
talking about is facilitated by the Federal Government and that
that demand would be something that we could also rally behind
as Members of Congress.
So my question, then, is to the general from Alabama. What
conversations are you having with similar colleagues in other
States that have experience, say, New Jersey, Connecticut, New
York, that have gone through sort of the eye of the storm, if
any?
Mr. Hastings. Personally, I like to catch up on the
National news every evening at the end of the day, and ours is
kind of regionally specific, I have to admit. We have calls
with HHS/ASPR and FEMA Region 4. So among the Region 4 States
we share, and we are sensitive to what is going on in other
States, because as you guys are going through the eye of the
storm, we were having trouble getting PPE and some resources
because the Nation had prioritized some of those resources
toward those hotspots that initially happened.
So because Alabama was kind-of a slow burn with the COVID-
19 rise, we were having trouble getting some of those
resources, and rightfully so. They were going to places like
Chicago, Detroit, Pennsylvania in the Philadelphia area, New
York City, and Georgia, and the hotspots in Region 4. But we
have not had conversations with those northern tier States,
other than through the National Emergency Management Agency
giving out some documents that I go through once a week showing
what all the different States are doing, and then it is up to
me as an emergency manager to kind-of take a look at how the
Nation is doing, how the region is doing, and especially how
Alabama is doing, ma'am.
Ms. Clarke. Well, let me follow-up this question very
quickly with, do you think that there are lessons to be learned
as you now face this that perhaps have already been learned by
other jurisdictions in other parts of the country? If this is a
National pandemic, you know, is there something that prohibits
the type of conversation that would put you in a better footing
to deal with the outbreak that you are experiencing in Alabama?
Mr. Hastings. No, I think there is. I think behind the
scenes--and I can't speak specifically to it, but being in the
conversations with Dr. Harris, our public health officer, and
University of Alabama Birmingham Medicine, you can hear that
both hospitals and the health care coalitions are sharing with
their partners, and they are sharing lessons learned daily with
whether it is PPE uses, how you flow patients in and out of
health care hospitals and facilities. So that is going on
behind the scenes.
Ms. Clarke. All right. Very well.
My time is running down, but I would like to get your take
on it, Dr. Shah.
Dr. Shah. Congresswoman, thank you for that question. You
know, I know that your State, unfortunately, has gone through a
tremendous amount.
I think this is exactly what I was saying earlier where I
see a role for the CDC to play across the system. I am
absolutely convinced that we have to learn from each other.
That is how you learn best. Unfortunately, in this emergency,
we have not seen that sharing across the system, except on an
ad hoc basis. Not that it doesn't happen, Congresswoman; it is
happening in a public health world, but it is not happening as
systematically as it should happen. Unfortunately, that is also
a significant driver and sometimes repeating some of those
issues that we could have learned from other communities.
Now, I will say that our county elected official, Judge
Hidalgo, has been in touch with elected officials across the
country, and I have also been in touch with health officials
across the country. But I will tell you it is not systematic on
the health side as it should be and as we have seen previously.
Thank you for that question.
Ms. Clarke. I yield back, Mr. Chairman, and thank you for
this very important hearing.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentlelady from Nevada, Ms. Titus.
Ms. Titus. Thank you very much, Mr. Chairman. It is good to
see you.
As I have sat here most of the morning, I am from----
Chairman Thompson. Good to see you.
Ms. Titus. Thank you.
As I have sat here, I have heard a number of my Republican
colleagues, some of whom are from some of the hottest spots in
the country, grill the panel, especially the Governor, in a
not-so-subtle attempt to defend the President's actions. The
witnesses have responded with answers that are informed. They
are straightforward. They are based in fact, not in partisan
politics. I really want to commend them for that and thank
them.
I would note, though, that in the Republicans' defense of
the President, I haven't heard any of them mention, defend, or
ask about the President's rallies in Tulsa, at Mt. Rushmore,
and his future planned ones and how they put an extra burden on
first responders, hospitals, and FEMA folks. I wonder if they
believe the President when he says 99 percent of the cases are
totally harmless and have that misinformation placed into the
mixed message that the public is getting that stymies our
attempts to get over this.
I am also just kind-of curious how many of these Members
are going to attend their political convention next month,
given all that is still going on and what is really happening
in Florida. But I guess we will wait and see about that.
The question I really want to ask, though, first, is to Dr.
Shah. My district is a lot like Harris County. We have a very
large Hispanic population, and the numbers show that the virus
is disproportionately affecting the members of that community.
It is kind-of easy to understand why. You know, they work a lot
of front-line jobs. They can't take off. They are essential
workers. Many of them are uninsured. Many members of the
community are afraid to come forward to be tested or get
information or be treated because of immigration concerns.
Also, they live in densely-populated neighborhoods. And even in
one family, you may have extended family members or, you know,
neighbors or something all living in one house. So it is fairly
easily to figure out why.
But I am wondering what we can do to better serve that
community, how we can better count those numbers, use that
data, how local government can supplement what the Federal
Government is having such a problem collecting. Can you tell us
what you all are doing or maybe give us some suggestions?
Dr. Shah. Sure. Congresswoman, thank you for that question.
Thank you for your earlier comment about our answers as a
collective.
Some of the things that we are doing, as you know, we have
a large Hispanic population here in Harris County, and we have
to match the diversity of our community with our own work
force. So I think it starts there, and we have done that, not
just in advance of COVID-19, but also during COVID-19 with the
hiring of our contact tracers. We hired 300 contact tracers by
May 22, and the diversity in that room, I will tell you, was
incredible, including different languages.
The other piece is that we have to really be making sure
that as our outreach engagement efforts are in the community,
that they are also Spanish-speaking or bilingual, not just
Spanish, but obviously in the case of Vietnamese or Mandarin
Chinese, whatever that looks like, we have to be very much
synced in with that.
Then we are also looking at and working with partners in
media with that specific ethnicity in mind, so Spanish-speaking
media or leaders that are in the Hispanic community, in
particular, but also the African American community and beyond,
to really make sure we have partnerships because, ultimately,
they don't always think about the health department as being,
you know, that partner. But when there is someone in between as
being a trusted source, that also helps, especially in the
faith community.
There are many other strategies that I could put out there,
including putting our mobile testing in those areas and also
making sure that, you know, we are doing our case investigation
appropriately and, obviously, ensuring that we have resources
in those communities.
But I think that is an excellent question, and that is
something that every day we are very mindful of and responding
to.
Ms. Titus. Thank you. Thank you very much.
I will yield back, Mr. Chairman.
Chairman Thompson. [Inaudible]
Mr. Hastings. You are muted, Mr. Chairman.
Chairman Thompson. Thank you very much.
The Chair recognizes the gentlelady from California, Ms.
Barragan, for 5 minutes.
Seeing as she is not with us, let me, in the interest of
time, thank the witnesses for their valuable testimony and the
Members for their questions.
Before adjourning, I ask unanimous consent to submit a
statement for the record from the Robert Wood Johnson
Foundation.
[The information follows:]
Statement of the Robert Wood Johnson Foundation
health equity principles for state and local leaders in responding to,
reopening, and recovering from covid-19
overview
COVID-19 has unleashed a dual threat to health equity in the United
States: A pandemic that has sickened millions and killed tens of
thousands and counting, and an economic downturn that has resulted in
tens of millions of people losing jobs--the highest numbers since the
Great Depression. The COVID pandemic underscores that:
Our health is inextricably linked to that of our neighbors,
family members, child- and adult-care providers, co-workers,
school teachers, delivery service people, grocery store clerks,
factory workers, and first responders, among others;
Our current health care, public health, and economic systems
do not adequately or equitably protect our well-being as a
Nation; and
Every community is experiencing harm, though certain groups
are suffering disproportionately, including people of color,
workers with low incomes, and people living in places that were
already struggling financially before the economic downturn.
For communities and their residents to recover fully and fairly,
State and local leaders should consider the following health equity
principles in designing and implementing their responses. These
principles are not a detailed public health guide for responding to the
pandemic or reopening the economy, but rather a compass that
continually points leaders toward an equitable and lasting recovery.
``Health equity means that everyone has a fair and just
opportunity to be as healthy as possible. This
requires removing obstacles to health such as
poverty, discrimination, and their consequences,
including powerlessness and lack of access to good
jobs with fair pay, quality education and housing,
safe environments, and health care.''
What Is Health Equity? And What Difference Does a
Definition Make?
Robert Wood Johnson Foundation, 2017
1.--Collect, analyze, and report data disaggregated by age, race,
ethnicity, gender, disability, neighborhood, and other
sociodemographic characteristics.
Pandemics and economic recessions exacerbate disparities that
ultimately hurt us all. Therefore, State and local leaders cannot
design equitable response and recovery strategies without monitoring
COVID's impacts among socially and economically marginalized groups.\1\
Data disaggregation should follow best practices and extend not only to
public health data on COVID cases, hospitalizations, and fatalities,
but also to: Measures of access to testing, treatment, personal
protective equipment (PPE), and safe places to isolate when sick;
receipt of social and economic supports; and the downstream
consequences of COVID on well-being, ranging from housing instability
to food insecurity. Geographic identifiers would allow leaders and the
public to understand the interplay between place and social factors, as
counties with large black populations account for more than half of all
COVID deaths, and rural communities and post-industrial cities
generally fare worse in economic downturns. Legal mandates for data
disaggregation are proliferating, but 11 States are still not reporting
COVID deaths by race; 16 are not reporting by gender; and 26 are not
reporting based on congregate living status (e.g., nursing homes,
jails). Only 3 are reporting testing data by race and ethnicity. While
States and cities can do more, the Federal Government should also
support data disaggregation through funding and National standards.
---------------------------------------------------------------------------
\1\ People of color (African-Americans, Latinos, Asian Americans,
American Indians, Alaska Natives, and Native Hawaiians and other
Pacific Islanders), women, people living in congregate settings such as
nursing homes and jails, people with physical and intellectual
disabilities, LGBTQ people, immigrants, and people with limited English
proficiency.
---------------------------------------------------------------------------
Health Equity Principles
1. Collect, analyze and report disaggregated data.
2. Include those who are most affected in decisions, and benchmark
progress based on their outcomes.
3. Establish and empower teams dedicated to racial equity.
4. Proactively fill policy gaps while advocating for more Federal
support.
5. Invest in public health, health care, and social infrastructure.
2.--Include in decision making the people most affected by health and
economic challenges, and benchmark progress based on their
outcomes.
Our communities are stronger, more stable, and more prosperous when
every person, including the most disadvantaged residents, is healthy
and financially secure. Throughout the response and recovery, State and
local leaders should ask: Are we making sure that people facing the
greatest risks have access to PPE, testing and treatment, stable
housing, and a way to support their families? And, are we creating ways
for residents--particularly those hardest hit--to meaningfully
participate in and shape the Government's recovery strategy?
Accordingly, policy makers should create space for leaders from
these communities to be at decision-making tables and should regularly
consult with community-based organizations that can identify barriers
to accessing health and social services, lift up grassroots solutions,
and disseminate public health guidance in culturally and linguistically
appropriate ways. For example, they could recommend trusted, accessible
locations for new testing sites and advise on how to diversify the pool
of contact tracers, who will be crucial to tamping down the spread of
infection in reopened communities. They could also collaborate with
Government leaders to ensure that all people who are infected with
coronavirus (or exposed to someone infected) have a safe, secure, and
acceptable place to isolate or quarantine for 14 days. Key partners
could include community health centers, small business associations,
community organizing groups, and workers' rights organizations, among
others. Ultimately, State and local leaders should measure the success
of their response based not only on total death counts and aggregate
economic impacts but also on the health and social outcomes of the most
marginalized.
Are we making sure that people facing the greatest risks
have access to PPE, testing and treatment, stable
housing, and a way to support their families?
3.--Establish and empower teams dedicated to promoting racial equity in
response and recovery efforts.
Race or ethnicity should not determine anyone's opportunity for
good health or social well-being, but, as COVID has shown, we are far
from this goal. People of color are more likely to be front-line
workers, to live in dense or overcrowded housing, to lack health
insurance, and to experience chronic diseases linked to unhealthy
environments and structural racism. Therefore, State and local leaders
should empower dedicated teams to address COVID-related racial
disparities, as several leaders, Republican and Democrat, have already
done. To be effective, these entities should: Include leaders of color
from community, corporate, academic, and philanthropic sectors; be
integrated as key members of the broader public health and economic
recovery efforts; and be accountable to the public. These teams should
foster collaboration between State, local, and Tribal governments to
assist Native communities; anticipate and mitigate negative
consequences of current response strategies, such as bias in
enforcement of public health guidelines; address racial discrimination
within the health care system; and ensure access to tailored mental
health services for people of color and immigrants who are experiencing
added trauma, stigma, and fear. Ultimately, resources matter. State and
local leaders must ensure that critical health and social supports are
distributed fairly, proportionate to need, and free of undue
restrictions to meet the needs of all groups, including black, Latino,
Asian, and Indigenous communities.
State and local leaders must ensure that critical health
and social supports are distributed fairly,
proportionate to need, and free of undue
restrictions to meet the needs of all groups,
including black, Latino, Asian, and Indigenous
communities.
4.--Proactively identify and address existing policy gaps while
advocating for further Federal support.
The Congressional response to COVID has been historic in its scope
and speed, but significant gaps remain. Additional Federal resources
are needed for a broad range of health and social services, along with
fiscal relief for States and communities facing historically large
budget deficits due to COVID. Despite these challenges, State and local
leaders must still find ways to take targeted policy actions. The
following questions can help guide their response.
Who is left out?
Inclusion of all populations will strengthen the public health
response and lessen the pandemic's economic fallout for all of society,
but Federal actions to date have not included all who have been
severely harmed by the pandemic. As a result, many States and
communities have sought to fill gaps in eviction protections and paid
sick and caregiving leave. Others are extending support to undocumented
immigrants and mixed-status families through public-private
partnerships, faith-based charities, and community-led mutual aid
systems. Vital health care providers, including safety net hospitals
and Indian Health Service facilities, have also been disadvantaged and
need targeted support.
Will protections last long enough?
Many programs, such as expanded Medicaid funding, are tied to the
Federal declaration of a public health emergency, which will likely end
before the economic crisis does. Other policies, like enhanced
unemployment insurance and mortgage relief, are set to expire on
arbitrary dates. And still others, such as stimulus checks, were one-
time payments. Instead, policy extensions should be tied to the extent
of COVID infection in a State or community (or its anticipated spread)
and/or to broader economic measures such as unemployment. This is
particularly important as communities will likely experience reopenings
and closings over the next 6 to 12 months as COVID reemerges.
Have programs that meet urgent needs been fully and fairly
implemented?
All existing Federal resources should be used in a time of great
need. For example, additional States should adopt provisions that would
allow families with school-age children to receive added Supplemental
Nutrition Assistance Program (SNAP) benefits, and more communities need
innovative solutions to provide meals to young children who relied on
schools or child care providers for breakfast and lunch. States should
also revise eligibility, enrollment, and recertification processes that
deter Medicaid use by children, pregnant women, and lawfully-residing
immigrants.
5.--Invest in strengthening public health, health care, and social
infrastructure to foster resilience.
Health, public health, and social infrastructure are critical for
recovery and for our survival of the next pandemic, severe weather
event, or economic downturn. A comprehensive public health system is
the first line of defense for rural, Tribal, and urban communities.
While a sizable Federal reinvestment in public health is needed, States
and communities must also reverse steady cuts to the public health
workforce and laboratory and data systems. Everyone in this country
should have paid sick and family leave to care for themselves and loved
ones; comprehensive health insurance to ensure access to care when sick
and to protect against medical debt; and jobs and social supports that
enable families to meet their basic needs and invest in the future. As
millions are projected to lose employer-sponsored health insurance,
Medicaid expansion becomes increasingly vital for its proven ability to
boost health, reduce disparities, and provide a strong return on
investment. In the longer term, policies such as earned income tax
credits and wage increases for low-wage workers can help secure
economic opportunity and health for all. Finally, States and
communities should invest in affordable, accessible high-speed
internet, which is crucial to ensuring that everyone--not just the most
privileged among us--is informed, connected to schools and jobs, and
engaged civically.
Everyone in this country should have paid sick and family
leave . . . comprehensive health insurance . . .
and jobs and social supports that enable families
to meet their basic needs and invest in the future.
conclusion
These principles can guide our Nation toward an equitable response
and recovery and help sow the seeds of long-term, transformative
change. States and cities have begun imagining and, in some cases,
advancing toward this vision, putting a down payment on a fair and just
future in which health equity is a reality. Returning to the ways
things were is not an option.
Chairman Thompson. I understand Ms. Jackson Lee has a
unanimous consent.
Ms. Jackson Lee. Yes, Mr. Chairman. Can you hear me? Can
you hear me?
Chairman Thompson. Yes, Ms. Jackson Lee.
Ms. Jackson Lee. Thank you so very much.
I ask unanimous consent to place into the record current
COVID-19 statistics in Houston, Texas, as of 7 a.m. at 7/8/20.
Texas Coronavirus Timeline, Houston Chronicle, July 7, 2020,
which captures the demise of our success story and also where
we are today. Houston Chronicle, Evidence growing that
Houston's main coronavirus strain is more contagious than the
original, dated July 4, 2020. A pandemic plan was in place--by
Stat News--Trump abandoned it, and science, in the face of
COVID-19, dated May 17, 2020.
Ask unanimous consent to place these items into the record.
Chairman Thompson. Without objection.
[The information follows:]
Data Submitted by Honorable Sheila Jackson Lee
Current COVID-19 Statistics as of 7 am 7/8/20:
US
CONFIRMED CASES: 3.05M
DEATHS: 133k
TEXAS
CONFIRMED CASES: 216,167
DEATHS: 2,758
HARRIS COUN1Y
CONFIRMED CASES: 39,311
DEATHS: 395
HOUSTON
CONFIRMED CASES: 55,122
DEATHS: 581
______
Texas Coronavirus Timeline
By Stephanie Lamm, Zach Despart, Jeremy Blackman, Jasper Scherer and
Taylor Goldenstein, July 7, 2020 10 o'clock a.m. https://
www.houstonchronicle.com/projects/2020/texas-coronavirus-
timeline/
A State once lauded as a model for COVID-19 containment
came to ``the verge of a nightmarish catastrophe''
on the Fourth of July. Here's how it happened.
March 4, 2020
Dr. Jacquelyn Minter, director of Fort Bend County Health and Human
Services, announces that a Fort Bend man in his 70's is the Houston
area's first ``presumptive positive'' case of COVID-19.
March 11, 2020
The Houston Livestock Show and Rodeo is canceled after a Montgomery
County man in his 40's becomes the first person in Texas to contract
COVID-19 from community spread.
March 16, 2020
Harris County orders all bars closed and restaurants limited to
takeout and delivery for 15 days. HISD schools close through at least
April 10.
March 19, 2020
Gov. Greg Abbott issues an executive order that limits social
gatherings to no more than 10 people, closes all schools, shuts down
bars and restricts restaurants. Texas declares a public health disaster
for the first time in more than 100 years.
March 24, 2020
Harris County Judge Lina Hidalgo and Houston Mayor Sylvester Turner
announce a stay-home order for the county and city through April 3.
March 31, 2020
Gov. Abbott issues an order that reopens churches with limitations.
Many congregations say they will continue to hold services on-line and
abide by recommendations to prevent the spread of COVID-19.
April 17, 2020
Gov. Abbott announces he will reopen State parks, allow retailers
to offer to-go sales and let physicians and nurses perform diagnostic
tests and surgeries that had been put on hold to ensure hospital
capacity for COVID-19 patients. ``We have demonstrated that we can
corral the coronavirus,'' Abbott says.
April 21, 2020
Harris County Judge Lina Hidalgo orders residents to cover their
faces in public starting April 27. ``If we get cocky, we get sloppy, we
get right back to where we started, and all of the sacrifices people
have been making have been in vain,'' Hidalgo says while wearing a
homemade mask. ``Let's not get complacent. Let's remember that we still
have work to do.''
April 26, 2020
White House coronavirus task force coordinator Dr. Deborah Birx
holds out Houston as one of the places that give her ``great hope''
that the American economy can get rolling again.
April 27, 2020
The State is testing 14,000 people a day, less than half of Gov.
Abbott's goal of 30,000 as he announces he will lift his stay-home
order on May 1. Some health experts warn that testing and contact
tracing in Texas are insufficient for this move. ``Without robust
testing, we remain in the dark,'' says U.S. Rep. Veronica Escobar, D-El
Paso.
May 1, 2020
Gov. Abbott lifts his stay-at-home order as the State reports a
record 50 deaths in a day from the virus.
May 4, 2020
Harris County officials extend their stay-home order through May
20, encouraging residents to report violations. ``We need to remain
vigilant for a phased reopening to work,'' County Judge Hidalgo writes
on Twitter.
May 7, 2020
Gov. Abbott amends his coronavirus executive order, removing jail
time as a possible punishment for those who break it. Abbott makes the
revision as he heads to Washington, DC, to meet with President Donald
Trump, who praises him.
May 8, 2020
Gov. Abbott slams Houston on National television over coronavirus
restrictions and overstates the city's enforcement efforts. ``In
Houston, they were issuing fines and potential jail time for anybody
who refused to wear a mask,'' he says. No arrests or fines had been
issued.
May 18, 2020
Gov. Abbott presses ahead with the State's reopening, allowing
nearly all businesses and activities to resume at a limited capacity.
The State reports a record 58 deaths in a single day, though Abbott
notes that the rate of people testing positive for the disease is
falling.
May 25, 2020
More than 250 social distancing complaints are lodged with the city
of Houston over Memorial Day weekend, including concerns regarding a
packed pool party at a Midtown club. ``I started getting pictures from
City Council members and others saying, `This is crazy,' '' Mayor
Sylvester Turner says.
May 21, 2020
Gov. Abbott says the Panhandle is turning a corner after having
been hit especially hard by infections at meatpacking plants. Abbott
says the infusion of State and Federal resources into the region are a
model for how to contain hotspots in Texas going foiward.
June 3, 2020
All businesses operating at 25 percent capacity are permitted to
expand occupancy to 50 percent--including bars--with certain
exceptions. Amusement parks and carnivals in counties with less than
1,000 confirmed positive cases may open at 50 percent capacity. (Staff
photo by Melissa Phillip)
June 5, 2020
Houston officials point to a 2-week rise in cases and
hospitalizations, saying they suspect Memorial Day and the latest
reopenings may be the cause. ``If the numbers keep up in this
direction, we could be headed to a place where we run out of hospital
space,'' Harris County Judge Lina Hidalgo says.
June 12, 2020
Restaurants begin operating at 75 percent as the State records its
highest number of COVID hospitalizations in a single day, 2,166. Bexar
County Judge Nelson Wolff writes to Abbott asking that he be allowed to
mandate masks. Gov. Abbott declines, saying: ``Judge Wolff and I have a
philosophical difference. He believes in government mandates. I believe
in personal responsibility.''
June 16, 2020
Texas reports 2,518 hospitalizations, nearly a 66-percent increase
since Memorial Day. ``It does raise concerns but as shown today there
is no reason to be alarmed,'' Gov. Abbott says as he rejects requests
from municipal leaders in Houston, San Antonio, Austin, Dallas, and
Fort Worth for the ability to mandate masks.
June 17, 2020
Bexar County Judge Nelson Wolff in Bexar County tries again with a
new mandate that businesses require masks at all times. Abbott says go
ahead. ``Government cannot require individuals to wear masks,'' Gov.
Abbott tells WKTX in Waco. ``However . . . local governments can
require stores and businesses to require masks.'' Leaders in Harris and
other counties prepare similar rules.
June 19, 2020
Amusement parks and carnivals in counties with more than 1,000
confirmed positive cases of COVID-19 are allowed to open at 50 percent
capacity.
June 22, 2020
The positive test rate hits 9.76 percent, just shy of the number
Gov. Abbott indicated would cause him to pause the State's reopening.
Abbott pleads with Texans to practice social distancing and wear masks
as he acknowledges that the virus is now ``spreading at an unacceptable
rate.'' Health experts warn Houston could be the next epicenter of the
National pandemic.
June 24, 2020
Officials in Bexar and Harris counties say they are in crisis and
Gov. Abbott signals that the reopening is in jeopardy as COVID
infections and hospitalizations surge in the State. ``The numbers have
completely spiked,'' Abbott says. The positive rate hits 11.76 percent.
June 25, 2020
Gov. Abbott delays further reopenings and orders hospitals in the 4
hardest-hit counties to postpone elective surgeries to make way for
COVID patients. That night, Lt. Gov. Dan Patrick appears on National
television to assure viewers that the State is not reversing course or
running out of intensive care hospital beds. ``We have seen a spike in
cases. We expected that,'' Patrick says, pointing falsely to increased
testing.
June 26, 2020
Gov. Abbott orders bars to close again and rolls back restaurant
capacity to respond to increasing COVID hospitalizations. Infectious
disease expert Peter Hotez tells CNN that deaths are a lagging
indicator and will inevitably rise in the coming weeks: ``This is a
tragedy.''
July 2, 2020
Gov. Abbott orders nearly all Texans to begin wearing face masks in
public as the State enters the Fourth of July weekend amid a dire
stretch of new infections, surging hospitalizations and with deaths
beginning to mount.
``We have the ability to keep businesses open and move our economy
forward--but it requires each of us to do our part to protect one
another,'' he says.
July 4, 2020
``We're on the verge of a nightmarish catastrophe,'' says Vivian
Ho, a health economist at Rice University and the Baylor College of
Medicine, as the State logs 7,890 hospital beds occupied by COVID-19
patients, a 43 percent increase from the week before. ``On May 1, I
thought we actually had a chance to get this virus under control and
get the economy opened up safely. I'm not sure we can get it under
control anymore.''
______
Article Submitted by Honorable Sheila Jackson Lee
evidence growing that houston's main coronavirus strain is more
contagious than original
Todd Ackerman, July 4, 2020, Houston Chronicle, Updated: July 8, 2020
1:48 p.m.
https://www.houstonchronicle.com/news/houston-texas/houston/article/
coronavirus-evidence-growing-houston-strain-mutant-15386157.php
Evidence is growing that a mutated coronavirus strain, the main one
circulating in the Houston area, is more contagious than the original
virus in China.
Two new research papers show that the newer strain is more
transmissible, a possibility first suggested by a team of scientists in
May. At the time, that suggestion was considered highly speculative by
many scientists, including some in Houston.
``A summary of the data thus far suggests that this strain has
gained a fitness advantage over the original and is more transmissible
as a result,'' said Joseph Petrosino, Baylor College of Medicine chair
of molecular virology and microbiology. ``It is safe to say this
version is more infectious.''
Evidence is growing that a mutated coronavirus strain, the main one
circulating in the Houston area, is more contagious than the original
virus in China.
Two new research papers show that the newer strain is more
transmissible, a possibility first suggested by a team of scientists in
May. At the time, that suggestion was considered highly speculative by
many scientists, including some in Houston.
``A summary of the data thus far suggests that this strain has
gained a fitness advantage over the original and is more transmissible
as a result,'' said Joseph Petrosino, Baylor College of Medicine chair
of molecular virology and microbiology. ``It is safe to say this
version is more infectious.''
Petrosino said that although Baylor hasn't yet conducted a
surveillance study, the area rate of positive tests and increase in
hospitalizations point to a significantly higher prevalence of the
virus strain now. He said Baylor is finding the mutated strain in as
many as 80 percent of viruses it analyzes.
Houston Methodist researchers reported the strain was prevalent in
the Houston area in a paper in mid-May. The paper said 70 percent of
the specimens examined, taken from COVID-19 patients treated at
Methodist from early March to March 30, showed a mutation to the spike
proteins the coronavirus uses to attach to and enter human respiratory
cells.
The week before, researchers at Los Alamos National Laboratory
reported on the mutation. They said it doesn't make people sicker, but
appears to facilitate the spread of the virus.
The Los Alamos team expanded on the findings in a peer-reviewed
paper published in the journal Cell Thursday.
The Methodist researchers were among scientists skeptical of that
conclusion. Dr. James Musser, the hospital's chairman of pathology and
genomic medicine and a study author, said Friday he would like the
science to play out a bit more as studies reviewed by scientists are
published. He gave no update on the percentage of mutated strains
analyzed at Methodist.
The mutation is thought to have occurred in Europe, then was
introduced by travelers to the east coast of the U.S., particularly New
York. It has since become the world's most dominant strain, accounting
for about 65 percent of cases submitted to a major data base from
around the world, according to one team of scientists.
Except for the new Cell publication, all of the papers are examples
of what is known as ``pre-prints,'' preliminary reports made public
ahead of their peer-reviewed publication because of the discoveries'
time-sensitive nature.
One of the papers, by a Scripps Research Institute team, showed
that significantly increasing the number of functional spikes on the
viral surface in laboratory experiments allowed the virus to bind to
and infect cells. It said that the mutation provides greater
flexibility to the spike's ``backbone,'' which makes viral particles
better able to navigate the process fully intact.
``Over time, it has figured out how to hold on better and not fall
apart until it needs to,'' Michael Farzan, a paper author and co-
chairman of the Scripps department of immunology and microbiology, said
in a news release.
Another paper, by the New York Genome Center, found a huge increase
in viral transmission when researchers switched from the original virus
sequence to the mutated one, a change they interpret as an indication
the new strain is more efficient at invading the human cell and taking
over its reproductive machinery.
At least three other lab experiments suggest that the mutation
makes the virus more infectious, the Washington Post reported Thursday.
Those findings also appeared in pre-prints.
The mutation, known as D614G, involves one of roughly 1,300 amino
acids that act as building blocks for the spike protein. Not much
different from the original virus, it switched genetic instructions for
the amino acid 614 from an aspartic acid (D) to a glycine (G).
In the Cell paper, the Los Alamos researchers wrote that patients
with the D614G mutation have more virus in their bodies. Their
laboratory experiments found the mutation is three to six times more
capable of infecting human cells.
Strains of the virus circulating in the Houston also include the
original one from China and one from South America, according to
Methodist's study. The area's multiple-continent seeding contrasts with
relatively single-continent seeding in New York and Seattle. Seattle's
came mostly from Asia.
Many scientists, noting one paper found no evidence of increased
transmissibility, say the evidence for D614G's greater contagiousness
is still far from definitive. ``This is an extraordinarily challenging
problem, the evolution and demography are complex, so there's much more
work to be done,'' Marc Suchard, a biostatistician at the UCLA School
of Medicine, told the New York Times.
Though Baylor's Petrosino suggests the mutated strain is more
prevalent, he adds that the recent spike is mostly a result of people's
wanting to gather and being willing to take risks to do so.
``The bulk of it is from people not social distancing properly, not
masking appropriately and a reluctance to participate in contact
tracing,'' said Petrosino. ``I think people have been getting tired of
the safety measures and have started becoming more lax in their
practices.''
______
Article Submitted by Honorable Sheila Jackson Lee
a pandemic plan was in place. trump abandoned it--and science--in the
face of covid-19
By Jason Karlawish, May 17, 2020, STATNEWS, First Opinion
https://www.statnews.com/2020/05/17/the-art-of-the-pandemic-how-donald-
trump-walked-the-u-s-into-the-covid-19-era/
President Obama was bothered. It was the summer of 2009 and he was
in a meeting at the White House to talk about preparations for an
expected autumn outbreak of swine flu. Elbows on the table, he thumbed
through the pages of a report on preparations for it.
``So,'' he asked no one in particular, ``if you guys are so smart,
how come you're still making this in eggs?'' he asked, referring to the
nearly century-old process for making vaccines in chicken eggs.
Those around the table erupted into laughter. The president's quip
was a moment of levity at an otherwise serious meeting.
The ``smart guys'' the president was jesting with were the members
of the President's Council of Advisors on Science and Technology, or
PCAST. Founded in 1990 by President George H.W. Bush, the council,
administered by the White House Office of Science and Technology Policy
(OSTP), is an advisory group of scientists and engineers appointed by
the president to augment the science advice he receives from other
White House advisors, departments, and agencies.
In June 2009, the recently inaugurated Obama had given his PCAST
advisors their first assignment: What does the president need to do to
prepare for an influenza pandemic? Five weeks later, on Aug. 7, they
gave him their answers at a meeting in the White House's State Dining
Room.
The story of this meeting and the ensuing 8 years of science-
informed policymaking, which I have drawn from interviews with members
of PCAST and internet archives of documents, show a president
comfortable with having back-and-forth discussions with an assembly of
the some of the nation's top scientific minds. The president was
committed to integrating science into his day-to-day decisions. One of
those decisions was how to plan for and respond to the outbreak of a
pandemic illness.
Over the course of the Obama presidency, a pandemic infrastructure
was put in place. It included recommendations for a top-level White
House official devoted to planning and responding to emerging
infectious threats and, to guide that person's work, the ``Playbook for
early response to high-consequence emerging infectious disease threats
and biological incidents.''
And then on Jan. 21, 2017, Donald Trump became president.
Beginning the morning after his inauguration, a spectacular
science-related tragedy has unfolded. The Trump administration has
systematically dismantled the executive branch's science infrastructure
and rejected the role of science to inform policy, essentially
reversing both Republican and Democrat Presidential administrations
since World War II, when Vannevar Bush, an engineer, advised Presidents
Franklin D. Roosevelt and Harry S. Truman.
President Trump's pursuit of anti-science policy has been so
effective that as the first cases of COVID-19 were breaking out in
Wuhan, China, no meaningful science policy infrastructure was in place
to advise him. As a consequence, America is suffering from a pandemic
without a plan. Our responses are ineffectual and inconsistent. We are
increasingly divided by misinformation and invidious messaging. And
it's not even over.
To understand how Trump walked America into this mess, and that his
recent claim he ``inherited practically nothing'' in pandemic
preparedness from the previous administration is plainly wrong, it
helps to have a picture of the infrastructure he neglected and ignored.
On April 27, 2009, on the eve of his 100th day in office, Obama
made a five-block trip from the White House to 2101 Constitution Ave.
There, in the Great Hall of the National Academy of Sciences, he spoke
about his administration's commitment to science.
``Science is more essential for our prosperity, our security, our
health, our environment, and our quality of life than it has ever been
before,'' he announced. He introduced the members of PCAST and
explained how his administration would engage the scientific community
directly in the work of public policy.
``I want to be sure that facts are driving scientific decisions--
and not the other way around,'' the president said. The audience broke
into laughter.
Obama explained that his science advisers were already briefing him
daily on the emerging threat of swine flu, which some were projecting
could kill thousands of Americans.
The day before this speech, which came just 12 days after the first
case of swine flu had been reported in the U.S., Obama had declared a
public health emergency. Three days after the speech he asked Congress
for $1.5 billion to address this emergency.
In the weeks that followed, the White House science policy
infrastructure he had introduced at the National Academy of Sciences
set to work.
Although every president since Franklin Roosevelt has had some
engagement with science policymaking, the degree of the contact between
the president and his science advisers has varied.
George H.W. Bush met frequently with his head of OSTP, Allan
Bromley, a physicist and former Yale classmate of the president. George
W. Bush, in contrast, met just seven times with the head of his Office
of Science Technology and Policy, John H. Marburger III, and eliminated
two associate directors from the office. Obama's engagement with his
science policy apparatus was singular. He met with his OSTP director,
John Holdren, as often as seven times a week.
Holdren, a plasma physicist whose scientific career included 23
years co-directing the Energy and Resources Group at the University of
California, Berkeley, had this regular and close contact with Obama
because, in addition to leading the OSTP and acting as co-director of
the President's Council of Advisors on Science and Technology, he was
the assistant to the president for science and technology.
The title of assistant to the president grants its holder great
privilege and power. Assistants to the president have direct access to
the president. An assistant can schedule a meeting with the president
or send a memo directly to the president. Even cabinet secretaries
aren't afforded such direct and easy access. To send a memo or meet
with the president, they must work through the assistant to the
president for cabinet affairs.
There are, of course, many Federal agencies and departments engaged
in science policy, such as the Centers for Disease Control and
Prevention, the Food and Drug Administration, the National Aeronautics
and Space Administration, the Departments of Agriculture and Energy,
and more. Each has its own mission and focus. The PCAST provides the
president with immediate daily access to science information and advice
that are independent of the agendas of these various agencies and
departments.
Easy and continuous access to science was of notable value to the
administration's early, rapid, and sustained efforts to plan for a
viral pandemic.
PCAST's ``Preparations for 2009-H1N1 Influenza'' identified
multiple on-going efforts across the government to plan for a viral
pandemic. It also made recommendations. One stands out.
During a pandemic, important decisions must be made rapidly and
based on limited data. PCAST recommended designating one individual,
preferably the homeland security adviser, to coordinate all policy
development and report directly to the president.
Obama took that advice and asked John Brennan, a career CIA
employee and assistant to the president for homeland security, to take
on the task. Like Holdren, Brennan reported directly to the president.
The two assistants worked closely together.
The initial flare of swine flu tapered off in the summer of 2009,
but came back again in the fall as expected. The resurgence was managed
well. Surveillance was in place, a vaccine was developed, and messaging
had been implemented to quell unfounded fears of its risks.
What was clear, however, was that the next viral infection might
not be so easily managed. Vaccines were not readily available for
viruses such as Ebola and coronaviruses. The question wasn't whether a
pandemic would occur, but when.
More work and reports followed.
A 2010 PCAST report answered the president's egg question. It
recommended reengineering the influenza vaccine production enterprise.
Recombinant DNA technology and other methods are now used to make
vaccines in addition to the egg-based method.
By 2016, the final year of the Obama Administration, much had been
learned from swine flu about managing a pandemic, and more knowledge
had been added from the responses to the 2014 Ebola outbreak in West
Africa. From October 2014 through February 2015, Ron Klain, a former
chief of staff to Vice President Joe Biden, was the White House Ebola
response coordinator.
From this experience, Klain concluded that a director with singular
focus was needed for a pandemic. ``The next president should put a
coordinating unit together before an outbreak begins,'' he argued in
his essay ``Confronting the Pandemic Threat'' in the spring 2016
Democracy Journal.
Klain called for a pandemic prevention directorate to make sure
preparation and response are a priority from day one in a new
administration and to oversee the government's response to a pandemic.
PCAST endorsed Klain's recommendation. In a November 2016 report,
the council recommended that an assistant to the president for pandemic
prevention and response should be part of the National Security Council
staff. The council gave the incoming Trump administration what it
called an important overarching observation: ``There is significant
overlap between some of the steps needed to protect the Nation from
intentional biological attack and those needed to protect against
natural outbreaks of new and emerging infectious diseases.''
Another important event in 2016 was a Federal effort that engaged
the work of PCAST, OSTP, and other agencies and departments to create
the ``Playbook for early response to high-consequence emerging
infectious disease threats and biological incidents.'' This 69-page
document was written to coordinate a response to an emerging disease
threat anywhere in the world. It detailed decisionmaking rubrics with
key decisions and questions such as these: ``Determine whether to
implement screening and monitoring measures, or other travel measures
within the U.S. or press for measures globally'' and ``What are the key
services and critical infrastructure that need to come back on line for
society to return to normal?''
Together, the November 2016 PCAST report and the playbook were
messages to the incoming president to pick up where the Obama
Administration had left off, since more work was needed to prepare for
and respond to a future pandemic.
None of that happened.
On the morning of Jan. 22, 2017, the day after Trump's
inauguration, the PCAST website was taken down and all of its reports
vanished from the White House website (though they can be found in the
Obama White House archives).
For 2 years, the directorship of OSTP was vacant, the longest in
its history. The staff was reduced by two-thirds. The current director,
Kelvin Droegemeier, a professor of meteorology at the University of
Oklahoma whose appointment was confirmed by the Senate on Jan. 2, 2019,
isn't an assistant to the president and is unable to directly
communicate with the president.
PCAST lay dormant until November 2019, when Trump appointed members
to it. Unlike its predecessor, which included a diversity of scientists
from academia and industry, the current version includes members drawn
primarily from industry. Their charge has been narrowed. The council is
to advise the president on ``how does America win in the Industries of
the Future and how do we prepare the workforce of the future to take
advantage of this opportunity?'' They're not to produce any reports
(the prior PCAST produced 39 reports).
The minutes of the council's meeting on Feb. 3 and 4, 2020, include
no discussion of the COVID-19 pandemic.
The sum of the work done by Trump's Council of Advisors on Science
and Technology? Zero.
The follow-up on the 2016 recommendation for an assistant to the
president dedicated to pandemic prevention and response also fell on
deaf ears.
As Ebola was once again breaking out in West Africa, Rear Admiral
Timothy Ziemer, who had been charged with creating a national
biodefense strategy, resigned from Trump's National Security Council on
May 11, 2018. At the time of his departure, that strategy hadn't yet
been created.
The remaining staff members were faced with managing a portfolio
that bundled together epidemics, biological threats, and weapons of
mass destruction. Dividing their time among many responsibilities whose
day-to-day urgencies can seem to be greater than preparing for a future
pandemic is precisely what Ron Klain and PCAST had warned about in
2016. The Pandemic Playbook was neglected, and its existence has even
been denied.
By the end of December 2019, as the COVID-19 epidemic began
breaking out in China, Trump was largely without any coherent
scientific input into his policymaking. Given that none of the
president's assistants, the people with direct access to him via memo
or meeting, have any scientific expertise, his nonresponse, even
complacency, in the face of the emerging epidemic in China is sadly
understandable.
On March 10, after a meeting with U.S. senators about COVID-19, the
president remarked to the press that America was prepared and doing a
great job. ``And it will go away. Just stay calm. It will go away,'' he
insisted.
The next day, the World Health Organization said that the global
outbreak was a pandemic. And in the U.S. alone, as I write this nearly
1.5 million Americans have developed COVID-19 and nearly 90,000 have
died from it.
Remarks such as ``it will go away'' cannot be excused as occasional
gaffes or verbal missteps. They're the words of someone who simply
doesn't understand science--and doesn't want to.
The COVID-19 pandemic is a problem that must be understood and
addressed using sciences such as virology, epidemiology, public health,
and biomedicine. Yet in the face of a crisis that needs science,
America is led by an administration that not only isn't scientific but
is actively anti-science.
Trump's remarks, from long before he was elected president and
throughout his presidency, on a variety of topics including vaccines
and autism, climate change, and wind farms, show he rejects scientific
conclusions and methods.
From the stage of the White House briefing room, Trump has likened
the COVID-19 virus to a bacterium that is resistant to antibiotics,
insisted that the virus could not cause a pandemic, that warm weather,
as well as sunlight, will kill it, and has repeatedly touted untested
pharmaceuticals such as hydroxychloroquine and noxious household
detergents as interventions to either prevent or treat infection.
Too little and too late Trump let scientists such as Anthony Fauci
and Deborah Birx share the stage. But even then he has undercut their
messages and spread confusion.
Trump, for example, asserted that Fauci was ``playing both sides''
(sides he did not name) in decisions about whether and how to reopen
schools. Fauci, in fact, had called for an approach to reopen schools
that was informed by evidence to respect regional differences. ``We
have a very large country and the dynamics of the outbreak on
different, in different regions of the country. So I would imagine that
situations regarding school will be very different in one region versus
another, so it's not going to be universally, or homogeneous.''
I'm a scientist. I don't believe in science--I reserve belief for
religion. I trust in science to help me diagnose and treat my patients,
to understand how Alzheimer's disease robs them of their memories and
ability to function, and to find new treatments for it and other
diseases. And now, during this awful pandemic, I desperately want my
president to trust it too. And yet he won't even wear a mask.
Jason Karlawish is a physician, co-director of the Penn Memory Center,
and author of the forthcoming book, ``The Problem of Alzheimer's: How
science, culture and politics turned a rare disease into a crisis and
what we can do about it'' (Macmillan/St. Martin's Press, November
2020).
Ms. Jackson Lee. Thank you, Mr. Chairman.
Chairman Thompson. [Inaudible] Thank you very much, Ms.
Jackson Lee.
We now have Ms. Barragan from California for 5 minutes.
Ms. Barragan. Thank you, Chairman Thompson, for convening
this hearing today.
The Trump administration's response to the coronavirus
pandemic has been inadequate. We have seen the pandemic raging
through our country. We are seeing spikes. We have heard from
public health officials that they tried early on, Dr. Bright in
particular, to warn this administration, to request that they
immediately start getting PPE, and that advice was not
followed. We are still in the first wave of the pandemic, and
public health experts warn of a disastrous second wave if we do
not reduce the spread of the virus.
So it is crucial to ensure the Federal Government leads by
both example and do direct assistance and that any and all
reduction measures implemented or revised by the Government are
backed by science and our public health officials.
I want to start my first question, Dr. Shah and Mayor
Shelton, as part of the response to homelessness during COVID-
19, FEMA has committed to reimburse 50 to 75 percent of
expenses for shelter and temporary housing through their Public
Assistance Program, Category B. Having a range this large makes
it difficult for a continuum of care and other jurisdictions to
project funding plans as this range is large. Along the same
lines, we have been told that it could take 4 to 5 years for
localities to receive FEMA reimbursements.
Dr. Shah and Mayor Shelton, can you comment on what effect
this has on the uncertainty of the ability to respond to the
pandemic and recover from the crisis?
Dr. Shah. Congresswoman, I will go first only because you
said doctor first, so I will just go first and then turn it
over.
You know, there are two inherent questions that you are
asking. One is about homeless individuals and those, you know,
that we are absolutely concerned about in our communities,
obviously the concern about the inability potentially to
isolate and/or potentially to spread infection if they test
positive. On the flip side, the other question is really about
the longer-term impact of uncertainty in reimbursement. I think
both are critical. We have to do what we have to do to protect
our communities now, and we oftentimes are thinking,
unfortunately, of doing what we have to do today and then
hoping that there is not this delay in the reimbursement side,
because that then obviously gives--that uncertainty gives pause
because there is only a limited number of dollars that you have
to be able to do what you need to do to protect the community.
With that, I will yield to the mayor.
Mr. Shelton. [Inaudible]
Ms. Barragan. Mr. Mayor, I think you are on mute.
Mr. Shelton. Sorry about that.
Thank you, Doctor.
Thank you, Congresswoman, for the question and opportunity.
During the COVID crisis, we have continued our homelessness
outreach here in the city of Tupelo. We contract with an
organization, Mississippi United To End Homelessness, here in
Tupelo. So we have continued those and just tried to do the
best we can as far as, you know, safety precautions, masking,
you know, that type thing. But we have continued our efforts
there.
I can speak first-hand to the FEMA issue, though. We had a
tornado, F3 tornado, hit the city of Tupelo in 2014, caused
wide-spread damage throughout the city. President Obama quickly
declared a National disaster, and, you know, we got Federal aid
that was desperately needed and greatly appreciated. But we are
still, you know, 6 years later, we are still dealing with the
red tape for reimbursements and that type thing. So, you know,
6 years later, even though the help, we requested it, the
President was gracious enough to send that help, but, you know,
we are still dealing with that now, and we are in a new
National disaster with this and other things along the way.
Ms. Barragan. Thank you.
Dr. Shah, you in your written testimony, talked about the
public health department in Harris County faced strong pushback
from congregate settings to investigate and test within
facilities due to overlapping State and Federal jurisdictions
of facilities.
I happen to represent Terminal Island Federal prison where
there was almost a 70 percent outbreak of COVID-19. What
specifically should the Federal Government be doing to help
local public health departments combat the spread of
coronavirus in congregate facilities?
Dr. Shah. Thank you, Congresswoman. First, it is that
support with resources, tools, what has worked in other
settings, that technical assistance. The second is really a
markedly more nuanced look at what are the authorities that are
available, whether it is through the Federal Government or
working with State governments, to allow for public health
departments to be able to assess and test in these congregate
settings.
In nursing homes, obviously, that is the highest level of
concern in many ways, and I will say that our State was able to
work with local health authorities to allow us to be able to go
in and assess. But when we get past nursing homes into other
tiers, it becomes more of a knocking on a door, sending
correspondence, and not being able to have the authority to go
in unless you have a bona-fide proven case, and that is the
limitation that we have.
So this is where the Federal Government can really help
with strategies and technical assistance and, if necessary,
changing some of those authorities that would really allow,
especially in a crisis like this, to be able to have public
health departments or health authorities like myself to be able
to do more so we can protect the most vulnerable in our
communities.
Ms. Barragan. Thank you.
With that, I yield back.
Chairman Thompson. Thank you very much.
The Chair now recognizes the gentlelady from New Jersey,
Mrs. Watson Coleman.
Mrs. Watson Coleman. Thank you, Mr. Chairman. Thank you for
holding this hearing. Thank you to each of the witnesses for
sharing very important information with us.
I would like to just sort-of establish a chronology that I
think is relevant to our discussion here, because everyone is
talking about, at least my colleagues on the other side of the
aisle, about having never been here before and experiencing
this virus and this pandemic and not ever having had this
experience.
I want to harken us back to 2005 when the Bush
administration released its National strategy for pandemic
influenza, recognizing the prospects of a pandemic and saying
that there needed to be greater coordination, domestic
production, and stockpiling of medical supplies, et cetera.
Then in 2016, the Obama administration developed a
strategic playbook on pandemic preparedness, a 69-page guidance
on fighting pandemics. The incoming administration, the Trump
administration, was indeed briefed on this playbook's existence
but reportedly didn't heed the advice.
Also in 2016, the Obama administration, recognizing that
you had to elevate these issues to the highest level, created
the National Security Council Directive for Global Health
Security and Biodefense in the White House, something that this
President disbanded in the office in 2018.
In 2017, the Department of Defense finalized a report of a
pandemic influenza saying that a catastrophic biological
incident could threaten the Nation's human, animal, plant, and
environment and health, et cetera.
Months before that, the Trump administration eliminated a
position of a medical epidemiologist which was embedded in
China's disease control center, and leaving that post left us
without on-the-ground knowledge when things were heating up
immediately.
I say all that to say--and there is even more than that. I
say all that to say that there was forewarning, forearming, and
guidances on how to deal with something of this nature.
The one thing that was prominent in all of these
discussions and these guidances were that you needed strategic,
coordinated leadership at the very, very top. Instead of
talking about this virus being a hoax, talking about it having
a limited severity, talking about it being something that was
just going away, the opposite has absolutely happened, and this
administration has been an abysmal failure in keeping us
Americans safe from the ravages of this pandemic.
I also wanted to just say for the record that we have been
criticized for not being in Washington face-to-face doing
business because the Senate is face-to-face doing business and
the White House is face-to-face doing business, but we know
with the Senate's failure to pass the HEROES Act and the White
House failing to deal with these issues of coronavirus and
trying to shut down any kind of medical information that is
coming out and guidance, that neither of those entities is
doing a job even though they are face-to-face.
But having said all that, I have got one question. Why am I
still seeing lanes and lanes and hours and hours of cars in
line waiting to be tested at this stage in this pandemic in any
State? Why, oh why, oh why, is it taking more than 24 hours to
have the results of the tests that were taken so that the
contact tracing that would take place would be relevant and
helpful?
So I want to ask that question of Dr. Shah and of Colonel
Hastings.
Dr. Shah. Thank you, Congresswoman. First is that the lines
obviously are because we are seeing--at least in our
communities, we are seeing increased demands, increased demand
with limited supply, and there you go, there you get the
results.
On the lab side, which I think is a really critical piece
that I mentioned just quickly earlier, that is an on-going
issue. Even on our FEMA Federal sites, the turnaround time in
lab results is a problem, and sometimes it is a couple of weeks
before we get those results back. It has gotten better, but it
is not where it needs to be.
So the individual may not get their lab, and you know how
it is, if any of us don't get a laboratory result, and what it
means for us as a person and what it means for the physician or
the health care provider and, absolutely, the public health, it
is a problem. Because as you said, very appropriately, it
delays the entire system.
Here is the final answer. We don't have a system,
especially electronically. We should have a system so this
should not be happening in our country today.
Mrs. Watson Coleman. Is this not something that is
attributed to the fact that we haven't had a rigorous,
rational, and consistent Federal leadership and coordination
around these issues?
Dr. Shah. I think there is--there are a lot of things that
play into this. I do think it starts with the Federal
Government, but it is not limited to the Federal Government. I
think there is something about how commercial labs are doing
things, the recording, the requirements. We are getting
incomplete, inaccurate. Sometimes we are just being told,
``Umair Shah, no contact information.'' Before we can even
trace the context, we have to go trace the case and figure out
who that individual is, and then 4 or 5 days later, from a
different line list from the State, we get that same individual
as a duplicate, and now we have to go back and match. Then we
are getting it by fax, and we are getting it by email. We are
not getting it in the format that should be required. Again, we
don't have a system.
Mrs. Watson Coleman. Thank you, Dr. Shah. I submit to you
that that still has to do with the lack of leadership,
guidance, regulations and accountability, suggestions and
helpfulness on the part of this failed administration, and with
that, I yield back. Thank you, Mr. Chairman.
Chairman Thompson. Thank you. The gentlelady yields back.
The Chair recognizes the gentlelady from Orlando, Mrs. Val
Demings.
Mrs. Demings. Well, thank you so much, Mr. Chairman, and
thank you so much to our witnesses who are with us today.
Dr. Shah, with regard to the vendors for testing kits,
could you explain in more detail what challenges you have had
with unreliable vendors, particularly regarding their efforts
to sell you emerging testing technology?
Dr. Shah. Well, Congresswoman, this is an on-going issue
for us, and I will tell you that being the third-largest county
in the United States, that when vendors and others see
something in the news, whether it is contact tracing or
laboratory or something else happening, they make contact. I
have put my email information, I am active on social media, so
people try to contact me directly, or our team members. I will
tell you, this has really been a problem, because there has
been no--there hasn't been a great way to have a clearinghouse,
if you will, of the minimum of what you are looking for.
This is where, you know, I know the FDA has made strides.
It has been overwhelming, because there are so many vendors,
but that is a role that can also be at a Federal level, to
really help give that technical assistance across the system.
The other piece of this, which I think is critical, is that
everybody has become an expert in all of these, right? So
contact tracing, now everyone says, I can do contact tracing
for you, and the moment they see an increase in activity, some
are doing it out of the goodness of their heart because they
want to help, and others unfortunately are doing it because
they want to make a buck, and it is really hard to decipher in
between, and that has been a real challenge.
Mrs. Demings. Doctor, you talked about how the Federal
Government could, perhaps, help in this area, so local health
departments and others don't have to try to figure out what is
reliable or what is not. Could you give me some examples of how
you feel the Federal Government could be a greater help to you?
Dr. Shah. Sure. I have said this in both my oral testimony,
and also my written testimony, so, please, if your staff can
look at that more closely, there may be some additional ideas
here. But I think, in general, what it is, is that we are left
fending for ourselves. It feels that we are learning every day
something new. As the Congresswoman from New York had mentioned
just earlier, instead of being able to learn from those other
entities across the system, and/or getting the Federal guidance
that says, here is the minimum standard that you should be
looking at, you should be utilizing, or, here are the kinds of
things you should be looking at--I get that we have to be
careful in the private sector, we can't say, not this one, not
that one--but at least give us those minimum standards that
allow us to make informed decisions. That really would help us,
rather than for us to be trying to do this on our own, and that
is a challenge for us, and it remains--and I suspect it will
remain for the next several months as we continue in different
phases, including in the vaccine world.
As soon as we get to vaccines, it is also going to be this
whole piece about how do we get supplies to you, how do we get
other, you know, materials to you, who can do it better, who is
going to--and again, we are going to have this avalanche of
people reaching out, and we are not going to be able to handle
all those requests.
Mrs. Demings. Then finally, I know we have been talking
about the lack of PPE equipment since the very beginning, but
as we approach the fall and, you know, the stories of, are we
going to see a resurgence, we aren't really sure what the
landscape is going to look like, what particularly concerns you
about supply chains moving into the fall?
Dr. Shah. Well, you know, Colonel Hastings said it really
nicely, which is that all of it concerns us, you know, and
really, it is obviously what is happening in the health care
system. We want to make sure we protect our health care
providers, our first responders, the ones who are repetitively
being, obviously, in contact with a COVID-positive patient.
In addition to that, we really are very concerned about
making sure that the supply chain constraints are alleviated as
we continue to have more demand, as you get into the fall
season again, with flu and other infectious diseases. They do
not miraculously go away. They have not miraculously made room
for COVID-19. They are still there, or they will be there, and
we have to make sure that whether it is gloves, or masks or
gowns, or lab materials, that all of these are really there and
the constraints are not, again, left to locals or States trying
to figure out what is the best way to procure for their
communities.
Mrs. Demings. Dr. Shah, thank you so much.
Mr. Chairman, thank you, and I yield back.
Chairman Thompson. Thank you very much, Madam
Congresswoman. Let me thank all of the witnesses again for
bearing with us through some technology challenges, but the
information you provided us has been very, very helpful. We are
trying to get it right, not only because as Americans we have a
responsibility to do that, but it is so, so very important that
in getting it right, we can also save lives. So your testimony
has been very, very helpful.
The Members of this committee, however, may have additional
questions for you, and we ask that you respond expeditiously,
in writing, to those questions. Without objections, the
committee record shall be kept open for 10 days. Hearing no
further business, the committee stands adjourned.
[Whereupon, at 3:21 p.m., the committee was adjourned.]