Senator Lamar! Alexander continued his series of hearings on the COVID-19 pandemic response today. It was generally rhetoric free although Democrats' talking point that COVID-19 outbreak is far from over - as if we didn't know - was used liberally. Democrats also took the opportunity to assert an agenda to address issues of inequality something we highlighted recently with a guest speaker.
The focus today was on vaccine development, supply chain and public health funding. Witness included:
William Frist, MD, Former Senate Majority Leader, Nashville, TN
Joneigh S. Khaldun, MD, MPH, FACEP Chief Medical Executive And Chief Deputy Director For Health Michigan Department of Health and Human Services
Julie L. Gerberding, MD, MPH Executive Vice President And Chief Patient Officer, Merck & Co., Inc., Co-Chair CSIS Commission on Strengthening America’s Health Security
Governor Michael O. Leavitt Former U.S. Secretary Of Health And Human Services
Vaccine
- While there is promising work underway we don't know if a vaccine will work; needs to be produced at scale; ideally successful with a single dose; needs to be safe and effective
- Vaccine needs to produce effective immunity that is durable; able to neutralize the virus; and hopefully robust enough to handle a virus that changes over time
- Cautiously optimistic but long way from promising a delivery date for what they suspect will be several vaccines with different effectiveness in different populations
- Vaccine is only beginning, will need fill, finish and distribution chains and there has been less work done there,
- Federal government built three manufacturing facilities for seasonal influenza but failed to sustain funding and did not keep facilities warm so they could be stood up quickly.
- Federally supported manufacturing was targeting influenza and needs to be augmented by emergency capacity
- Cannot invest at scale for 130 vaccine candidates. Need federal planning in partnership with industry
- To address Americans with concerns there will need to be transparency around safety, monitored by the National Academy of Medicine
- Need to consider use of platform technology to pivot, especially if vaccines for different populations
Disease Surveillance
- Testing system failed because testing was never part of pandemic training; assumption was clinicians would already identified the disease through usual process
- Need to modernize domestic and international surveillance and threat detection system; pandemic laid bare our inability to tests and report across the country
- Studies say 180k contract tracers needed; states cannot do that but federal government has provided funding
- National surveillance strategy and standards with local execution is needed
- CDC needs to modernize surveillance and data collection standards so data can be collected and reported in near real time (instead of one week lag)
Supply Chain
- Any state that failed to plan was going to be disappointed. Federal response is designed for localized disasters
- Lack of continued funding over time meant that there are a lack of incentives for manufacturers to supply system
- Need to consider financial incentives; either an artificial market or tax incentives
- Need to solve the problem of keeping supplies relevant to changing circumstances
- Going to generally need more PPE for businesses, nursing homes, schools
- Federal government will need to guarantee market for 10-15 years, not one year.
Call with questions. Sometimes these hearings are worth the time and this was one of them.
Emily Evans
Managing Director – Health Policy
Twitter
LinkedIn
