Transcripts For CSPAN2 Hearing On Coronavirus Pandemic Response 20240712

Staying safe. A crisis of unprecedented proportion the novel corona pandemic already infected 3 million and killed over 100,000 americans. The scale is staggering, efforts to produce a lifesaving vaccine, not all americans have been impacted equally. Communities of color are not only more likely to be infected by the covid19 but more likely to be killed by the virus. In my home state of new jersey africanamericans face up to covid19 fatalities. This trend was observed not only in new jersey, data from the cdc shows that africanamericans, 3 times more likely to be infected and twice as likely to die from covid19 than white populations. The administrations response to the outbreak has been an utter failure on a multitude of levels. Nowhere is this more acute than in its neglect of Minority Health. Since the onset of the outbreak it has been clear that communities of color are disproportionately impacted. However the impact has been up secured by critical data. Even with this knowledge the administration has been painfully slow in setting requirements for the collection of racial and ethnic demographic information of covid19 infections. The example is one of many to demonstrate the lack of outbreak response especially when it comes to Minority Health. Cdc director doctor robert redfield, the failures of the administration to collect demographic information on infections and deaths is at another hearing. I would say doctor redfield, the American People need more than that. Much of the focus of Administration Response to Minority Health during the pandemic is centered around the department of health and Human Services, the department of Homeland Security federal Emergency Management agency fema playing a vital role as the lead federal agency for response. Americans are counting on fema to get it right. Fema has had a misstep in the past when it comes to not factoring in the needs of communities of color and the researchers have continually found femas Recovery Program exacerbates existing disparities and while these disparities precede covid19, the effect they are having on minority communities in National Emergency in itself, i worry about fema not doing enough to meet lives are being lost in the country to wealth inequities and that is unacceptable. At todays hearing i hope we can explore this problem and hear potential solutions from our panel of experts. The chairman recognizes the Ranking Member of the subcommittee mister king for an Opening Statement. Appreciate the opportunity and this is a significant hearing. I will make my remarks brief. I asked my staff to submit for the record, new york has been hit hard with 300,000 confirmed cases, my district, 120,000 confirmed cases, in particular in this area, that is particularly true in my district. The average community excluding the Minority Community for the purpose of this is between 50, 20 cases per thousand and going through 6270 cases per thousand, that is four or five times higher than minority communities. The immediate reason seems to be the frontline workers, transit workers are minorities. They are on the front lines and they are getting impacted directly in the longterm reasons are the Underlying Health conditions like diabetes and high blood pressure, Heart Disease are a long time going. People might not know they have them. There is a lack of healthcare in minority communities. It is important and i work on this to increase use of Community Health centers, they are in the community where People Living in that community feel safe and secure, dont feel they will check immigration status or anything. Having it nearby makes it more comfortable, going to doctors as they dont feel sick they are not going to know what they are looking for. Its important to get checkups and Community Health centers are extremely important. We need to realize in early april the extent of the pandemic in the minority communities so they put support county, testing center, the most impacted communities especially brentwood. I want to emphasize when partisanship is going on on long island, congressman greg meeks and i work extremely closely on this. The state senator who is a democrat working as closely as we can sooner or later we will come out of this pandemic, this could occur again and as you point out what this is brought out is the underlying conditions, lack of healthcare for people in the Minority Community. As far as federal response to the initial bulk of county executives are democrat, i worked with them on lack of funding, one community against another and ventilators and gloves and so far i dont see that being an issue but the underlying longterm issue is proper healthcare and we have to take that into account and rectify that going forward. Thank you, mister chairman. I think the Ranking Member. For his candor and honesty which is one of the reasons i appreciate his service, thank you. I want to work with you on the Health Center that has been important to me and good to hear that you are interested in that and look forward to working with you on that. Members are reminded the subcommittee will operate according to guidelines laid out by the chairman and Ranking Member in their july 8th, to waive the Committee Rule 8 a to the subcommittee, the remote proceeding under the cover period made by the speaker under House Resolution 965. The chairman recognizes the chairman of the full committee, the gentleman from mississippi for an Opening Statement. Good afternoon to my colleague, i like to thank you in the Ranking Member on Health Disparities on the pandemic. The pandemic did not create the Health Disparities in this country but short of exposing these disparities and their tragic effect on minority and disadvantaged communities, this provides an opportunity to examine the federal response to the pandemic and what must be done for a disproportionate impact of the pandemic in these communities. In march, in the agency for covid19, the response after adequately addressing the needs of minorities for economically disadvantaged communities. The complexity over the pandemic with troubling history, and intended to assure the response. The publication, continued congressional oversight for operations that are necessary to assure response efforts for equitable assistance, direction to fema and the federal government goes from that. Unfortunately Donald Trumps response to the worsening pandemic has been a failure by any reasonable measure, failure to address minority and economic Health Disparities is a significant part of the shortcoming. The administration struggled to provide policymakers with morbidity data outcomes by race and ethnicity. The fact is it took pressure from members of congress and the public for the centers for Disease Control and prevention to release its First Nationwide preliminary case on morbidity estimates by race and ethnicity on june 15th, 2020, until the pandemic. Communities of color and economically disadvantaged have to contend with a deadly virus had failed federal response but systematic inequities that push these communities at greater risk of covid19 related hospitalization this and death. On april 20 ninth 2020, every democratic member of this committee sent a letter to the department of health and Human Services office of Inspector General requesting they look at this issue in ways the federal government can better address disparities in emergency. Katrina taught us a lot. I thought we had learned a good bit about communities of color during emergencies but obviously we still have some work to do. I look forward to our witnesses testimony today and i yield back, mister chairman. Cant hear you, sir. Thank you, mister chairman for the Opening Statement and appreciate his leadership. Mister rogers will be joining us today. I move on to introducing the witnesses. Our first witness, executive director of the American Public Health Association, doctor benjamins experiences include. And the former chief of emergency medicine at the Walter Reed Army medical center. Also a member of Nassau Academy of medicine. Welcome. Doctor lena win is an emergency physician and visiting professor of policy and management at the George Washington University School of Public Health. And distinguished fellow at the mullen institute of health, workforce equity. She also previously served as baltimores health commissioner, thank you for being here. Our third and final witness, ms. Willis is the cofounder and ceo of the institute for diversity and Emergency Management. A certified emergency manager, master exercise practitioner, served as immediate past president of the International Association of Emergency Managers region number 4. Welcome. Without objection the witnesses. It will be inserted into the record. I now ask each witness to summarize his or her statement for five minutes beginning with doctor benjamin. Chairman rep pain and Ranking Member kim, thanks for spending time with us this morning. Im going to focus on three areas, disparate impact and cause of it. There are concerns about the preparedness activity and rebuilding the Public Health infrastructure. As you know this has devastating effect, 3 million cases, 130,000 deaths, they are growing, 60,000 cases a day. If you look at the Minority Community we have been devastated disproportionately with 24 of deaths. Hospitalizations, 5 times, nonhispanic whites and four times hispanic to nonhispanic whites and also substantially being devastated by this. We ought to think about this epidemic as well as three of them. We have a big Infectious Disease epidemic. And plays a predominant role in our community. We dont know what is going on, lots of issues. Quite frankly we need to strengthen the National Leadership we have on this outbreak. It is on social welfare etc. There is higher exposure, public facing jobs, minority accessibility because of long steel chronic diseases and social determinants of health. 80 of what makes you healthy occurs outside of Doctors Office so people are fed up not to be able to have their health and that includes such things as having to work multiple jobs because of pay inequalities and lack of paid sick leave, housing which prohibits you from being able to distance even if you get infected in the home. These are all concerns if we are going to go forward. Our response has been challenged in many ways. We had inadequate testing. Iple jobs because of pay inequality because of the lack of paid sick leave and housing, which prohibits you to be able to physically distanced if you get infected. These are all concerns that we have to address if we are going to go forward. Our response has been challenged in many ways. We have had inadequate testing. We have had inadequate data to target resources and responses. Contact tracing is behind where it needs to be. In terms of education, we have not done a great job of educating the public on what is going on and how to address this as we go forward. I remain concerned that should we get hit with something this summer like a severe storm or another hurricane, wildfires, an earthquake, that our ability to manage that will be severely stressed. Imagine being in a shelter where imagine being in the shelter when you cant really manage coverage very welcome handwashing and physicallan distancing and have plan adequately for that. And finally we need to fix our Public Health system. I was a Health Officer in maryland on 9 11. We had a pretty good Public Health system but you in congress and administration at the time improved our. Public healthhe system. But we as a nation have allowed that to erode away substantially over the last several years. It is impacted our response to covid. It stands to impact our response todi natural disasters and i remain concerned that the coordination and the leadership isnt there for us to address these things as we go forward. With that i would be kind enough to stop and take questions in the questions and answer. Mech. Thank you, mr. Chairman and members of the committee. Chairman, i am not sure we heard you. Chairman payne thank you, dr. Benjamin, for your testimony. I now recognize dr. Wen to summarize her testimony. Thank you. Dr. Wen thank you very much. Thank you for addressing the intersection of Racial Disparities and the covid19 pandemic. I come to you from baltimore, where i am a practicing physician and have the honor as serving as health commissioner. Children born today can expect to live 20 years more or less depending on where they are born and the color of their skin. There are Racial Disparities across every metric of health as a result of racism and inequities. Covid19 is a disease that has unmasked these Health Disparities. The evidence is clear that African Americans, latinos, native americans and other minorities bear the brunt of this pandemic. My testimony outlines 10 actions that congress can take now to reduce the impact of the epidemic on people of color. I would like to highlight six of them that are relevant to the work of the Homeland Security committee. First, target testing to minority and underserved communities. Testing must be free, widespread and easily accessible. Yet, it is estimated that we need 10 times the amount of testing that we currently have. Congress must instruct fema to ramp up testing and set up facilities across the country. Existing hotspots should be the priority initially. The key is to have enough testing everywhere to prevent clusters from becoming outbreaks and outbreaks from becoming epidemics. Second, provide free facilities for isolation and quarantine. We know the key to reining in the virus is testing and tracing and isolation when someone tests positive, we tell them to selfisolate. What do you do when you live in multigenerational housing . Other countries have addressed this by setting up field hospitals and converting unused hotels into selfisolation facilities. Congress should request fema to do the same. Third, institute stronger worker protections. Minorities constitute a larger percentage of essential workers. The cdc has issued watereddown guidelines and osha has not met its mission to protect workers. Your committee can ensure that protections are followed for workers like tsa employees. This includes universal masking for all passengers in airports, as this will protect the employees and the public. You can institute stronger protections to limit the spread of covid19 in immigration detention facilities including access to ppe and protocols for isolation and quarantine. Fourth, suspend Immigration Enforcement for those seeking medical assistance for covid19. Public health hinges on public trust. Undocumented immigrants who fear deportation will be scared to seek help if they exhibit symptoms and pose a risk to themselves and their families. Congress should prohibit i. C. E. From accessing records and facilities of those seeking care for covid19. Congress should ask for temporary cessation of the Trump Administrations public charge rule. Fifth, prepare for the next surge. It is a National Shame that we ran out of ppe. There was no excuse in march and less of an excuse now. Ppe should not only be available to doctors and nurses. Cashiers, bus drivers, nursing home attendants and people of color should have protection. Congress must urge them to have a strategy to ensure that ppe, ventilators and other critical supplies are produced in sufficient quantity. Lack of action affects everyone but in particular, minority communities. Finally, support local Public Health. Funding for Public Health preparedness has been cut by half forcing local officials to make impossible tradeoffs between critical programs. I think we can agree that treating covid19 should not come at the expense of preventing cardiovascular disease and reducing overdose deaths. I urge that your Committee Also consider the Public Health safety net to be part of the backbone of Critical Infrastructure and National Security in the u. S. I would like to end my testimony by thanking all of you for focusing on tangible solutions. There are systemic problems that we must address that will take dedicated effort. But we are facing the biggest Public Health crisis of our time literally, a lifeanddeath threat facing committees of color. We cannot ignore problems. Now is the time to take action to reduce disparities in covid19 outcomes and improved health for all. Improve health for all. Thank you. Chairman payne thank you for your testimony. I now recognize ms. Willis to summarize her statement for five minutes. Chauncia chairman thompson, chairman payne and Ranking Members, thank you for the opportunity to testify. We are experiencing a paradigm shift across the United States as we respond to a pandemic, civil unrest and systemic racism with an uncertain outlook for recovery or an adequate recovery plan. The issues plaguing america, including the disparities associated with covid19, are a result of policies enacted that have historically lacked diversity and inclusion. Diversity, inclusion, and equity. Of all Emergency Management policies, only a few mention equity and none address using equitable strategies to produce Better Outcomes for vulnerable groups. Disasters do not discriminate, however, people do. Seenealth disparities during this pandemic can only be we understand and operationalize equities. They must be present in all practices within Emergency Management. Equity is different from equality. Equality is about giving everyone a shoe. Equity is giving everyone a shoe that fits. In Disaster Management, it can no longer be about doing the most for the most because when we do the most for the most, it leaves a gap [indiscernible] there are existing inequities within our countrys very fabric that lead to disproportionate deaths and negative impacts for the most vulnerable. These inequities are rooted in systemic racism and an antipoverty mindset. For example, the racist policy of redlining has led to lack of access to healthcare, exposure to environmental hazards and so forth. The field of Emergency Management lacks diversity and representation, which negatively impacts outcomes in disasters for underrepresented groups. Emergency management policies indicate that white male is the default setting. The field of Emergency Management is overwhelmingly white, made up of over 80 white males in leadership positions. However, the communities we serve as Emergency Managers are very diverse and the impacts of covid19 on diverse populations is significant. Current data shows that black and indigenous americans have experienced the highest rates of covid19 death in america. If they had died of covid19 at the same actual rates as whites, about 15,000 blacks, 2200 latinos and 400 native americans would still be alive. Americas disabled population is suffering because they lack access to testing. In addition, although people with disabilities are at high risk for covid19, there is a data gap in recording that prevents equitable strategy development. Also, the needs of rural areas are unique because they tend to have older populations with more chronic Health Conditions that raise the risk of developing more severe cases of covid19. They have fewer Healthcare Providers and more uninsured residents, meaning they must wait longer for treatment. The Emergency Management system must incorporate operationalized equity as a foundational principle for policies using social determinants of health to address the needs of diverse populations. Our organization recommends the following, a thorough review of current Emergency Management policies, including an assessment of the intended and unintended respects of these policies. Number two, intentional integration of equity into fema doctrine and contracts. Number three, ensure federal funding is tied to demonstrate diversity, inclusion, and equity. In addition, disaster plans to be evaluated and held accountable based on the performance of the equity strategy. Number four, integrate equity into Emergency Management curriculum and continuing education. Finally, inject preparedness mitigation funding in the most vulnerable communities, including communities of color. Emergency management must make Diversity Inclusion a priority so that lives will be saved and not sacrificed in disaster. Thank you for your time. Chairman payne thank you for your testimony. Id like to thank the witnesses for their testimony. I will remind the subcommittee that we will each have five minutes to question the panel. I will now recognize myself. But before i do that, i ask unanimous consent that congresswoman jackson lee be permitted to sit and question the witnesses. Objection. Ms. Willis, fema has a history of Emergency Responses plagued with racial and socioeconomic disparities. Despite this, the Trump Administration has made little to no effort to assure communities that the agency will respond to the pandemic in an equitable manner. With preexisting disparities in mind, what types of Emergency Response strategies should our country utilize to respond to the pandemic . Ms. Willis that is a great question. One of the most important strategies will be to ensure that we are training our Emergency Managers in equity to assist them in focusing policy creation and implementation on equity and vulnerable groups. Right now, within fema and Emergency Management as a whole, equity is not a priority and in fact, it is not seen as a priority in many areas of Disaster Management and that is a significant problem that must be addressed. We need an equity revolution. We must confront the intersection of race and poverty on biased Disaster Management policies as well. A thorough review of policies is needed and more funding must go into equity training and education. Thank you. Chairman payne am i correct in saying that we are not asking for special treatment in these communities, we are asking for equitable treatment in these communities. Communities . Is that correct . Chauncia that is absolutely correct. Surviving equity and disaster should not be an other, it should be priority. Thank you. Chairman payne dr. Wen and benjamin, when asked about Racial Disparities at a congressional hearing, dr. Fauci said institutional racism contributed to the disproportionate impacts of covid19 on African Americans and that they have suffered [indiscernible] somebody needs to mute, please. I am sorry. Dr. Fauci was saying that the community has suffered from racism for a long period of time. If the Trump Administration has known of these factors for a long time, why has the administration not done more to address these problems . Either one of you can start. Dr. Benjamin sure, i would be happy to start. If you think about the response, there are two areas where the administration can step up more. I know some has been done but there is more they can do. Number one is testing. Early on, there was not a lot of tests. But when we did have tests, they were not easy to get to. The drivethrough testing, if you did not have a car, you could not get there. We have to make sure testing is available to all parts of the community, to people that have shift work, to people who do not have paid sick leave so they can get testing. We need to make sure that testing is available. Issues we have seen in the last couple of weeks of people waiting hours to get tested is unacceptable for every citizen in our country, specifically for communities of people at higher risk. Sitting in a line three hours when you have symptoms and you dont feel well from a clinical perspective makes no sense. Secondly, we know that the issue of access to care remains a big issue. And i applaud Ranking Member king about Community Health centers and that is wonderful. But every citizen in this country should have access to quality, affordable healthcare. That is important. We need to stop fighting about that. Healthcare is a fundamental human right and we need to fix that. And i think the third thing is we have to deal with this issue of misinformation. One of the things we did in the aids epidemic is we did a lot of work educating faith leaders, barbers, beauticians, anyone who was an influencer in our community to get the communities of color, the communities that had languages other than english as their first language to make sure they understand the disease process and how to get help and how to protect themselves. Thank you, sir. Dr. Wen, my time has expired so im going to have to yield. Im sorry. I now recognize the Ranking Member of the subcommittee, mr. King, for questioning. Rep. King thank you, mr. Chairman. I would like to focus my question to dr. Wen. In new york and long island, we have a particular issue with transportation. The Long Island Railroad carries hundreds of thousands of people in and out of manhattan to brooklyn and back. We are talking about millions of people on the trains every day. Im trying to think of the next pandemic or the second wave of this one. What do you suggest we do to anticipate the problems we will get from transportation and as far as having testing sites, ways to detect it . Everyone traveling together in very close quarters, folks from low income communities and high income communities, from the suburbs and inner cities all coming together. Can you think of any way we can do to minimize the impacts of the second wave spreading or another pandemic . Dr. Wen yeah, thank you very much, Ranking Member. This is an excellent question. The most important thing that we can do in order to mitigate the spread on Public Transportation is the same as i would say if you had asked me what can we do to keep schools open. It is the same answer. We need to keep a level of covid19 in the community to be as low as possible. When you have communities in the south where one in 100 people have covid19, if one in 100 people have it and they dont know it and they are getting on a train or going to any public place, that is a lot of people they could be infecting. We really have to do our part in order to keep a level of infection as low as possible throughout the country. At this point, we know exactly what that would mean. This is a combination of distancing, Wearing Masks, good sanitation practices and cleaning. Ultimately, this is about keeping the level of infection as low as possible. Another is testing, to piggyback on what dr. Benjamin said earlier. We need free Testing Available to where people are and it needs to be rapid. It doesnt do any good when there is a test results that comes back in five to seven days or 10 days because what is that patient supposed to do in the meantime. In that time, they are spreading that disease to others, so that is important. Surveillance, we need to know where it is people are picking up illness, so we have to have surveillance in the community so that we can identify a cluster of outbreaks or cluster of infections before it becomes a large outbreak. Rep. King thank you, doctor. This question to anyone who wants to answer it. We have several hispanic american, low income communities with documented and undocumented People Living in those communities. You, dr. Wen, mentioned multigenerational, and they are more inclined to have multigenerational living in those communities. What is the best way to get testing into those communities . Im not advocating, but undocumented people are afraid to go to the doctor and testing. Can we aggressively go into those communities more, not for our good, but for their good, to get them tested . I guess you cant force them to be tested but to encourage them in those communities. Anyone who wants to answer. Dr. Benjamin sure, a van. All you need is a swab, a van, and a place to cool down. You can take mobile vans in those communities very effectively, park them on the corner, but you have to communicate with them. Or go to schools. You have a lot of empty buildings in the community that you can set up a Rapid Testing clinic in. Dr. Wen if i may add, you can go where people are, churches, community sites, it is really important to enlist trusted members in the community. Public Education Needs to be a part of that, including how everyone should receive health care. This is not a time to be asking about immigration status. Many people are going to be terrified to seek help because they fear they are going to be arrested by i. C. E. And be deported. Its important to assure them this is not going to happen at this time. Its about protecting them and everyone else around them. Rep. King my time is up. I yield back and thank the witnesses. Chairman payne the chair will now recognize other members for questioning. As previously outlined, i will recognize members in order of seniority, alternating between majority and minority. Members are reminded to unmute themselves when recognized for questioning. The chair now recognizes for five minutes the gentleman and chairman of the full committee, the gentleman and from mississippi, mr. Thompson. Mr. Thompson thank you very much, mr. Chairman and i thank the witnesses. One of the things we have tried to work with with fema is the issue of any national or natural disaster. They need to have a plan for the entire population, and that plan should include transportation, should include housing, facilities, all of that. Most of the plans we have come in contact with or have been presented try to look at communities as one entity and not, as peter was talking about, certain people stay in one area and certain people stay in another. I guess what im trying to say is, we get cookiecutter plans that many people assume will fit every situation. And what i have heard from the Witnesses Today is that you have to have a greater understanding of the communities in which you are working and your plans have to reflect it. The best example i can tell you, im speaking from my Congressional Office and we had a testing site that was five miles from my Congressional Office, and we dont have Public Transportation. So in the run of a day, they did 26 people because nobody could afford to get to the site. Well, if they had just talked with somebody and say where is the best place to come and do a site for testing, they said you need to come where the people are. That Comfort Level sometimes that our Emergency Responders go to. Can you give members of congress, how do we work with fema and other personnel in this venue to get them to understand you have to include entire communities in your planning and especially from an Emergency Preparedness standpoint because otherwise, they will get overlooked . I will throw that out to dr. Benjamin, dr. Wen and ms. Willis. Benjamin we have to understand their job they have to plan with communities and not to communities. That means they have to have community engagement, they have to be part of the planning process throughout every aspect of it and we need to make sure congress will require that governors and emergency planners show that they engage communities as part of the planning process. Remember the hivaids days when we were challenged to get good hivaids plans in place . Congress required Planning Communities be part of that planning process. I think you can link that to the funding in some way or other mechanisms to demonstrate communities are part of the planning process. As you know, there is enormous stress in communities not being used. Dr. Wen if i may add very quickly, that right now, we dont even have that cookiecutter approach. I agree we need to have a tailored approach but right now we dont even have a National Strategy of any kind. We need a National Strategy around testing, around quarantine and isolation facilities, around procuring supplies with the defense production act, we need to have that strategy in order to save lives. Ms. Willis i would say equity must become a core competence for Emergency Management, certainly in the Emergency Management leadership. I would also say we needed to tie funding to the investments in minority communities. Right now, that is not happening. We need to invest fema funding for preparedness rather than continuing to that is something that has been a problem and continues to be a problem the under investing in and divesting in communities of color. Chairman payne thank you. I now recognize the gentleman from louisiana, mr. Richman, for five minutes. Or maybe not. It doesnt seem like he is here, so we will go to the gentlelady from illinois, miss underwood, for five minutes. Rep. Underwood thank you mr. Chairman, and i am so grateful to our witnesses for appearing before our panel today. This is a topic that touches close to home. So much of the disparities related to covid19, this began with illinois as we were one of the first to release our data by race and ethnicity and that has certainly jumpstarted our national conversation. In the last week, my state of illinois surpassed 7000 lives lost, hundreds of thousands are out of work and every community has been impacted. But the harm done by this pandemic has not been reflected evenly. Committees of color are experiencing disproportionate loss of jobs and death. The cumulative grade for illinois of the positive rate for hispanics is more than five times the rate for white residents. In one county in my Northern Illinois district, the positive test rate for hispanic residents has been nearly eight times as high. Eight. Across the country, people of color, particularly black folks, are losing both their jobs and their lives at staggering rates. To tackle these inequities headon, we need to make culturally relevant investments in Public Health and economic opportunity, which is why i introduced with my house and Senate Colleagues the health force and Resilience Force act which would fund Public Health departments to hire locally for Contact Tracing. Dr. Benjamin, why is it so important to have local residents supporting Health Departments with initiatives like Contact Tracing and information sharing . Dr. Benjamin i dont speak spanish. I dont speak spanish. So it is language. Its trust. Its knowing where to go. I was once the d. C. Health officer and we were successful in many of our efforts there to reduce a whole range of Infectious Diseases because we had outreach workers that knew the community, and who to go to and when people didnt want to do something, they were able to convince them to follow medical advice. Thats essential in committees communities of color, especially where they are concerned about immigration, where english is not the first language, and frankly, right now, in these last years, we have stigmatized them. Rep. Underwood so we have invested billions of dollars in the search for a vaccine but actually developing a safe and effective vaccine is only the first step. We will then need to prepare to rapidly deploy it across the country. Unfortunately, we know that black and Latin Americans have lower immunization rates than their white counterparts. Dr. Benjamin, can you describe community specific efforts to increase vaccination rates for recommended immunizations for measles, smallpox and flu vaccines . What does the evidence of the deployment of those vaccines tell us about how we need to prepare to deploy and essential covid19 vaccine to ensure strong vaccination rates among communities of color . Dr. Benjamin when you start to recognize the uptake in communities of color, they do not get vaccinated as frequently. Secondly, we should recognize there is an enormous amount of mistrust that currently exists. With theoupled antivaccine community and others who are spreading a lot of disinformation. Weve already got people in social media space and passing out flyers telling communities of color dont get vaccinated. It will make you sterile. It will give you aids. It will give you the disease. It will kill you. So, there is already a lot of disinformation out there. More importantly, we need a national plan. We need the government to step up to the plate and put together a plan like we did with h1n1 to figure out how we are going to deploy this vaccine. Weve got lots of mechanisms to do that, but we have no plan. Rep. Underwood im glad you said that because last month, i introduced the disinformation act. This bill would help Public Health officials mitigate the impact of false information that can undermine efforts to keep our communities safe during this pandemic and beyond. Dr. Benjamin, in what ways could the spread of disinformation work in disparities, particularly with respect to vaccines but also Wearing Masks . Dr. Benjamin again, there is a group out there who is actually working to confuse us all around vaccines, around masks. I saw some flyers being passed out in new jersey that had the cdc and World Health Organization logo on them. It was obviously misinformation but there were flyers that said if you are infected, go to a synagogue. If you are infected, go to a low income committee. A low income community. If you are infected, ride Public Transportation. They are giving misinformation to hurt people. We have to push back against that kind of effort as aggressively as we can. Rep. Underwood in the same way you discussed targeting the strategies to mitigate spread like testing and treatment in the communities that are most impacted, we also need to target those same types of campaigns to spread Accurate Information and empower Public Health officials to do the same. In may, the house passed the heroes act, which included 7. 5 billion in direct funding for Public Health departments and 500 billion for states, 375 billion dollars for local governments. Unfortunately, the senate has yet to act to pass this bill. We know there are significant Public Health consequences to continue delays impacting the heroes act, so we are calling on our colleagues in the senate to rapidly take up this legislation and empower our state and local Health Departments. With that, mr. Chairman, i yield back. Thank you to our witnesses. Chairman payne i would like to thank the gentlelady for her questions. Always poignant. Please make sure my office has all of your pieces of legislation so i can sign on. Yes, mr. Chairman, thank you. Next, i believe we will recognize the gentle lady from texas, miss jackson lee for five minutes. I thought she was on. Staff is she available . , not at the moment. It is just you and ms. Underwood. Rep. Underwood if you would if you would yield a couple more minutes i do have a couple more questions for our witnesses. I will yield. Thank you so much. My next question is for dr. Wen. The cdc reported pregnant women might be at increased risk with severe covid i think the list and the risk appear to be even higher for black and hispanic pregnant women. As congress develops another covid19 relief package, which policies should be considered to protect and postpartum women during this pandemic . Thank you for the excellent question. I know you and and i have workd closely on issues of Maternal Mortality. I thank you for your leadership on these important factors. I think there are two separate but related issues. One is about covid and disparities, and the others but Maternal Mortality and now theyre intersecting. Because of the increased likelihood of severe effects among pregnant women during covid. I think where to take them separately. For covid19 i do think all the recommendations we have made thus far still stand. Ins he this case i would contino emphasize the importance of a National Strategy. Right now we have seen what happens when we have this piecemeal approach across the country when we have unfortunately elected officials who are not following the advice of Public Health expert and, in fact, are feeding into misinformation. Everything we can do, that all of you could be doing to ensure there is a National Strategy, to the best of your ability, would be extremely helpful, and to spread that information to counter the misinformation that is also rampant. When it comes to Maternal Mortality, we need to not only be looking at what happens during pregnancy, which is really critical, but also how can we be improving health for women and in particular for black women and women of color throughout their life . I think everything you have done, congresswoman underwood, to improve Maternal Mortality, but also there for not only address the Maternal Mortality issue but also improveve outcoms during covid19 as well. Thank you for your leadership on this issue and all of the matters of Public Health. I want to return back to dr. Benjamin. I started to race the heroes act and the significant Financial Investment that would be made for states and local governments. With your background leading American Public Health Association can you describe the potential Public Health consequences of inaction on this emergency funding for states, localities and Public Health department . . Heres the challenge we have. We have 3 Million People with this disease and even though we dont have as many deaths today because of young people getting it who may not be as susceptible to dine, the death is a lagging indicator. We do not have Public Health system that can adequately trace and toca the Contact Tracing. This is going to get worse before it gets better. I can assure you of that as we return to work. We are going to have to build the system. We need to do as quickly as possible. Without those funds frankly were up the creek. I was just talking yesterday to some folks about going back to school. We dont go back to school unless we get our hands around this process is dr. Wen pointed out. The thing i want to make sure the committee in American People understand is for decades our state and local Public Health systems have said systematically seen the funding reduced. Theyve been working at the very top of the capacity across this country, and that was during a time ofg, health and wellbeing, largely. We were not independent environment. These types of resources are not going towards the state and local Health Departments. They are to build critical functions to protect the communities they serve. When we talk about bills like the health forceir and resiliene force and hiring community members, training them and giving them a sustainable skill set to further for pour into te communities that they come from, it only serves to build the capacity of the folk cetaceans. Would you care to comment, dr. Benjamin . Absolutely. In my Health Department when anthrax hit our nation come my Surge Capacity come from a hiv aids program, crying disease program, et cetera. We continued to deal with hiv and stds. As dr. Wen pointed at we still than covidg other growing very quickly the leading cause of death is still part of vascular disease and cancer. Those did not go away and was left her dress pin. It is still much cheaper for our nation to prevent these diseases than to treat them when they occur. Thats right. Thank thank you again, and i yid back, chairman payne. Thank you. The chair now recognizes gentlelady from texas, ms. Jackson lee. Mr. Chairman, thank you so very much for your kindness, and thank you to the members. We are all doing double duty. Let me also say, mr. , mr. Chai, im delighted with your. Leadership, chairman thompson leadership, but i must again publicly say congratulations on the recent success that we had that well be able to see you again in the year and months to come, so thanks very much. All the witnesses i have encountered in the past, and the numbers that are on. So let me just be very clear. I am now in the covid epicenter. I am in what would be politely called hades, not haiti, but in an experience we never thought we would be in. We opened up on may 1. The cdc guidelines were not adhere to come which is a consistent decline in covid19 cases. I get personal calls fromm constituents of members whotu he died at home or who died in quotes unknown causes or something called pneumonia and tested. The federal government is pulling out frome testing. We have only tested 2. 5 million in a state of close to 30 million persons. Im in the most populous county, the most populous city in the state of texas and im at the 18th Congressional District which is a at the heart of thee issues. I did give an opening and im going to ask for quick answers so that i can ask all the let me say to the witnesses that im convinced of your position, dr. Benjamin, on building up the Public Health infrastructure. I can assure you my Public Health Officials Say that. But let me just ask you when you said get your hands around it. If you find a pandemic of this nature in a community, would it not add to the process of getting your hands around covid19, a reissuance of a stayathome order that then allows the medical professionals and others to understand where the hotspots are . Now we have 105 bodies firefighters in court to because of their exposure. We are in restaurants come in various places. What about a stayathome order . You can answer it generally. Dr. Wen, i used to be able to focus on the fact that the latin latinx population, the africanamerican population are the higher numbers, but we have latinx persons who work every day, children who go to school that undocumented, scared with the posture of ice. What should be said . Ive asked iced to stand down. Ive asked the White House Task force to ask icet standin. Dangerous is that when we had communities that are fearful of accessing healthcare in which we do . Dr. Benjamin, which answer that question about the viability of a stayathome. Order . Texas is in big trouble and you folks ought to have a much tighter stayathome order a mandatory mask wearing. Anytime anyone has to go out. Look, it works. It absolutely works. Every nation in the world has works. Rated that it it worked in 1918. Its going to work again in 2020, but folks are playing too much politics with this. The economy back into we get our hands around it. We cant get our hands around until you stop the transmission of the disease. You get this disease from other people. That means where to stay away from each other as much as we can in an organized way, then as we return to try and engage one another. We need to do so in a cautious, measured, controlled manner. Facial coverings, handwashing, and physical distancing, thats what we have right now. Thank you doctor. Dr. Wen, would you comment on that . Allegation might add, i mentioned the testing points. The federal government is pulling out a testing in transferring into local vendors. I welcome that but were not at that point. How important is testing in addition to the question i gave you . Thank you. Anyone who wants to join in, ms. Dr. Wen, thank you for your service. Thank you. It is, testing is absolute essential. If you dont know who has the infection, how can you stop the spread . Especially since we know that 80 transmission, a new study shows 50 more of all the spread with people dont even know they have. We m need testing. States and local officials cannot do this alone. Theres no wayay for them to rap up testing without federal support and thats what femas support in this and leadership in this is going to be so forth. To the question that about latinx and other immigrant populations. Look, we cannot have policies that will scare people. We cannot have individuals who are too terrified to take care because they think they or their loved ones are going to be deported. You absolutely cannot have ice have anything to do with testing. They cannot have anything to dov with having medical records or being in hospitals hospital far any healthcare facilities. We also know Contact Tracing in addition to testing is critical to rein in the infection. When somebody calls an individual and their asking better close contacts, they must be reassured that information would never go to immigration officials of any kind. If we do not have those policies in place then we will not be able to control the infection. This is a huge problem for exacerbating existing disparities but its also a a problem for everyone in the country if there are some people who are too scared in order to receive care. Mr. Chairman, if you would and told nick i dont know ms. Willis wanted to answer the question your time has expired i will allow you another three minutes. Thank you, mr. Chairman. Ms. Willis, before you answer i would like to throw back after you answer, dr. Benjamin and dre territory. I do want to wish it on us but we dont know what to expect in the coming months of august, september. Id like you to emphasize how w important it would be, i think dr. Wen in your testimony talked about different setaside sites that might be for people who are asymptomatic or maybe who have certain conditions of covid19 that dont work hospitalization be in the middle of a hurricane. How do we deal with handling hurricane victims and youd be placed somewhere and take care of covid19 . But im going to go to ms. Willis first and ask you all to answer it after that. Thank you, ms. Willis. I would just say that we focus on Community Centered responses. We are more flexible and we have the desire to listen. As Emergency Managers we must incorporate those factors impeding with communities, especially those who might have fear of deportation or a general distrust of government. We must be sensitive and culturally competent. Thank thank you, maam. Thank you for the answer. Dr. Benjamin . Let me add that obviously shelters are clearly not ideal places when we just have people show up in a place. We saw this with katrina and rita. We have got to rethink and reimagine how we are going to protect people into we get hit with another hurricane or tornado. Anything that we have to back with quick people and move them, even the coastal storms that we have. Hes got to figure out how we make sure they have access to handwashing, have access to potable water, how are you gog to handle waste . Is a going to be a big issue in light of the outbreak. We need toho use that planning we shouldve done it months ago. But if we dont do it now with a particular focus on communities that are most vulnerable, we are going to see huge outbreaks of disease. Trying to manage just a flu outbreak or any other infectious virus in in a conjugate settins an absolute nightmare for managers. But we know the signs. We know how to not make that happen and it dont think we are doing that. I dont think were planning for. I have a few seconds, dr. Wen. Thank you, dr. Benjamin. We keep on reacting to whats happened instead of h anticipatg whats ahead. And in this case we know exactly whats ahead and we know exactly what we need to do to control covid19 in the process. Thats something the Trump Administration with congress is urging can really do. You know whats going to be coming our way and now is the time to prepare. Thank you so much, mr. Chairman. Thank you for indulging me and i know just put on the record the most important part of congresses work is to pass the heroes act so we can get resources out for ppe, testing, hospitals and others and we really need to get past the obstruction and the blocking by the United States senate so we can pass the legislation and get outside for the people of the United States who needed. Thank you, mr. Chairman. I yield back. Absolutely. You know, our thoughts and prayers are with you in houston. We know youre really going now. Gh it right in jersey so i know how horrific it can be so hang in there so we can get people to stay safe. Thank you for your kind words. Thank you. Absolutely. I have another question that you that i want to, if i may, for all of you. Its in reference to school opening. The cdc has released guidance for United States k12 schools and childrens programs to plan and prepare and respond to covid19. On tuesday the president threatened to withhold funds from schools that did not reopen in the fall and tweeted on wednesday that he disagreed with the cdcs guidance, calling it very tough and expensive. The white house is reportedly preparing its own School Reopening guidance, and the cdc was reportedly considering modification to its own guidance for schools. The administrations rush to reopen schools without following all of the necessary caution is troubling, not just to policymakers but also to parents as well. If schools do not reopen in a responsible way, what are the possible impacts on communities disproportionally affected by the pandemic wax and we will start with ms. Willis. Thank you. Thats an actual question. This entire policy that the president is enforcing is actually to me very significantly traumatizing because im a parent. When i consider that my son will be exposed to covid19, because i am a single mother, because i do have to work, im absolutely horrified i know so many other americans are in the same position, where you have to work and so now your kids must be sacrificed. To mede its similar to the time in the president force the meatpacking industry backhe to workrc knowing that they were going into dangerous circumstances and there was nothing that could be done because they had to work. Its similar to slavery when we think about the essential about what you think occurred in the 1850s with the yellow fever. This concept of sacrificing those who are mostt vulnerable and those who doe not have a voice, its absolutely astonishing and its an indictment against america. Thank you, sir. We should never cut corners. Let me be real clear. Ive looked at the cdc guidance. It is not too tough. It is a good baseline and we should not we can that guidance at all not weaken that guidance at all. Secondly, the issue around costs, you know, its probably the least affordable of options. Because if we have a bunch of kids that get sick, even if they dont get real sick, they cant go to school. Their parents cant go to work. Have to do is have an outbreak in the second grade class, all those kids are out of school. Their teacher is out of school. Their parents areas out of work. So where is the savings . Their parent may get really sick and so then theres a huge health, and both from a humanistic perspective as well as a cost perspective for their medical care. I dont get the economic analysis. And by the way, hes not a doctor so quite frankly we should listen to the professionals who know what they are talking about and not someone whos motives that i questioned if im not making a politicall statement. Im a physician and i believe doctors and Healthcare Providers know what we ought to do, we ought to listen to us very well. I dont tell lawyers what to do. I dont tell teachers what to do. Thank you. Dr. Wen. With myr complete colleagues. Im also the mother of two young kids. I am the daughter of a schoolteacher in los angeles who passed away. She was alone time schoolteacher. Its about students, and teachers and staff to my mother had breast cancer. She was on chemotherapy for eight years while she was teaching full time. I think Teachers Want to get back to inperson instruction that there are many teachers who have chronic medical illnesses s that we have to watch out for as well. In this case you mention about the cdc guidelines. If were unable unable to meet the guidelines for safe reopening, the answer isnt lets change the guidelines. The answer is what is the hard work we are going to be doing in order to safely reopen . I agree with dr. Benjamin. Weve already seen what happens when we cut corners. When we cut corners we get rises, surges, explosive spread of infection. We should have already learned lesson, when we do not listen to science, people die. People who will suffer the most of those for whom it is not a choice to go to work and who are they . Its africanamericans, latinx population, native americans, people of color, those who are suffering the greatest Health Disparities now. Thank you. And one last question. Reports continue to suggest the topat administration and fema ae not adequately allocating medical resources, testing and other supplies to communities disproportionally impacted by the virus. What are some of the ways fema can approve its effort to ensure communities disproportionally impacted by the pandemic are receiving all the necessary medical resources . Let me just add to that. I have been on this committee since Comedy Congress in 2012. I have watched fema move through different administrations. A lot of femas issue is who is in the white house right now and their hands being tied. So though fema hasnt issues hes they need over, internally, a lot of the problem is with the person in the white house and the restraints he is putting on different entities of the federal government. With that, what do you think fema is not adequately allocating in those areas . Ms. Willis . The response from fema has been greatly influenced. Guest . The response from fema has been influenced by the president , by the administration and in general by a lack of science and informed Decision Making and unfortunately, politics drives a lot of what Emergency Management will do in terms of response measures, including recovery and relief measures. And unfortunately, within Emergency Management, equity is not a priority, its not a core function of femas mission. So the focus on vulnerable groups and using social determinant determinants, we need to begin focusing on equity, and focusing on those groups who are most vulnerable. Once we do that, everyone will benefit. Studies have shown, everyone benefits when we focus on those who are most vulnerable. Thank you, sir. Were going live to capitol hill where the House Appropriations are planning to vote on 20211 spending op Homeland Security, Financial Services and other government programs. Live coverage on cspan2. 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