Transcripts For CSPAN3 CDC Director Dr. Redfield Other Federal Officials Testify On Coronavirus... 20240713

Member for his longtime friend ship and partnership in this issue. Also want to thank the members of the cdc and Senior State Department officials for taking the time to come up here. Obviously, this is a very timely subject. This is our second hearing. A couple weeks ago we had the first hearing in congress on coronavirus, and this will be my second hearing. I think about this issue based on my background as a physician, but more importantly, as the former chief medical officer for Sacramento County who is in charge of the Public Health Delivery System there. And as a faculty member, my last Home Institution was the university of california davis, school of medicine. The reason why i give that background is last night it became personal for me because its hitting close to home. The first Novel Coronavirus case potentially person to person, nontransmission is in Sacramento County as we speak. That patient is housed at uc davis. I have been in communication with my former colleagues that are over there. There are a couple of concerning issues that, you know, as we go through the hearing i am going to want to ask questions about. If i think about this particular case, initially it arose in sewano county, which is close to Travis Air Force base, one of the points of entry where were quarantining patients as we evacuate them from overseas. Thus far, we dont know if this patient did not have any travel history, and were not aware of any Contact Tracing. That work continues. The patient arrived at uc davis last wednesday or thursday, was intubated at the time on a ventilator. At that juncture the doctors at uc davis and medical staff did not have a concrete diagnosis and had requested testing for coronavirus. It was determined that this patient did not fit the criteria for testing of coronavirus. This past sunday the doctors and the medical staff insisted on the test. A test was performed last night. We got the results back and the news that all of you have heard. This is the first patient testing positive where we dont have confident Contact Tracing. One thing that i will want to talk about, and perhaps dr. Redfield, when we do our questioning, is the testing criteria. Also, the rapidity of getting testing capabilities quickly to every state and the distribution of test kits. Chatting with the ambassador from korea earlier today, koreas testing 15,000 people a day right now. So, you know, whatever we can do to assist, you know, our scientists to get testing capabilities up and running as quickly as possible. There is a couple of areas i would like to focus on in this hearing as well. I do applaud President Trump, although i think it was delayed, in announcing and identifying someone as the head he didnt use the term czar, but ill use that term, the focus point to work across the interagency and who has direct a access to the president and vice president. I want to applaud the announcement. Very well qualified and i think, you know, has our support. I also appreciate the administrations funding flexibility. I did think the initial amount of 2. 5 billion was not going to be sufficient. I know the senate suggested 8. 5 billion. That may not be enough. And i think for this body in a bipartisan way we should just be ready to make sure our scientists and the folks that are on the front line, particularly the folks that are in Public Health systems in hospitals on the front line, have the resources and support. Our number one job is protecting Domestic National security, and at this juncture, while we dont know this rapidly evolving Public Health threat, weve got to be ready to make sure that our communities, our Public Health infrastructure and our Global Health leadership has the funds and the ability to do their job. In addition, as we are thinking about the dollar amount to appropriate, we have to do a quick assessment of Public Health infrastructure and assess the needs as well as the gaps. Having been in charge of the Public Health system in a large county, i know we run on shoestrings. And our infrastructure in a bad flu season would overwhelm the hospitals and emergency room capabilities. Slap on potentially we dont know how bad coronavirus will get, we just have to be prepared for the worst and hope for the best here. I also want to make sure, and, you know, we talked about this with some of my colleagues on both sides of the aisle earlier this morning, we need to keep politics out of this. This has to be a nonpartisan effort. This has to be a about looking at the science following the facts and doing what we have to do to keep the American Public safe, but then also to focus in on the international community. Thats going to be extremely important. In addition, we have to make sure in this era where its easy to put out false information, we do have a very concerned public. We are all leaders as members of congress, and have the ability to communicate effectively. The more we can coordinate with the cdc and others to get Accurate Information out there to make sure the public is accurately informed and that we can quickly dispel any misinformation will allow us to do our jobs and allow you to do your jobs and our scientists to do their jobs better. Lastly, this is the Foreign Affairs committee. Global Health Security is something that we look very closely at. In this sense, American Leadership has to be central to how we approach this in a global aspect. Dr. Redfield, i will be curious to get an update on how our scientists are doing, our cdc workers are doing in china in the hot zone, if they have accommodated our workers, and we have got to have an international response. Everyone working together in a transparent way sharing information so we can get ahead of this. So, again, i appreciate the witnesses for taking their time to come down here to inform us as members of congress, but also to inform the general public on what is rapidly evolving here. Again, appreciate the members that are here. With that, let me turn it over to the Ranking Member for your opening statement. Appreciate those words. This is like yesterday. Deja vu all over again, right . We had the opportunity to meet with the chief of missions yesterday. Chairman era opened up with pretty much the same thing. We are all on one team. This is team america. We have to be like a virus or a bacteria. We know no borders. We dont care what your political affiliation is. We need to come together and make sure we have the right response for america. We had this meeting, this hearing three weeks ago, and you look around about the concern because i think that speaks loudly for people to wait as long as they did. We need to be prepared and we want to make sure that were in that. I am a veterinarian by trade. We dealt with herd situations. Thats not to mean we should treat people like animals, but we should put in the proper safeguards so we protect our population. We have a bill that we have sponsored. Its called the one health bill which coordinates animal diseases with human diseases. This is why. Seven out of ten human diseases originate with animals. We have dealt with coronavirus for the last 30, 40 years in horses, cattle, dogs, cats, and other species. So we know what viruses do. I think the important thing that comes out of this, we lived through the zika virus and we saw the misinformation that was going out, the panic, the media, politics got put into that, and it was a disaster. What i have seen in this response is there is a level kind of a calm i dont want to say a calm, but there is more of a rational approach. I hope we can do that in this hearing. It will help this and help inform the American People. Other things that were doing is this appropriations season and we are putting in appropriations for nih, nsf, for the research and development, but also for organizations like gavi that does vaccines around the world and sepi, the coalition for epidemic preparedness. They are looking at the upcoming diseases to have vaccine models already ready for when Something Like this happens because we can all rest assured this is not going to be the last time we are faced with Something Like this. And then i think the collaboration that we have with other countries. We brought up the epidemiology last meeting that we had here. We had two epidemiologists. We looked at the origin of where this supposed to have come from in that province in wuhan, and it was the fish market or fresh market. We asked the epidemiologist if enough research was done, and they felt, no, it hadnt, but yet the Chinese Government came and removed that market. And so that starts raising questions. Then you look at the amount of response, the severity of the response of the quarantines and people isolated. It sometimes doesnt match what were looking at, as a disease, or what were told, its not that severe, we can control it. But yet when you have that province that was under quarantine, its about 20 of the United States of america under quarantine, and then we have heard its over 100 Million People under quarantine. What we want to make sure is we have a measured accurate response and that we have a readiness that were ready to respond to this in the appropriate ways. I think so far what we have seen, im kind of proud of what our country has done, and i said our country, not an administration, but it was the country. A lot of that comes from you guys here in this audience. So we appreciate that. As i was talking about collaboration with other countries, we want to make sure no countries are excluded. Countries like taiwan that was so instrumental in the sars epidemic for a country like china to put pressure on other countries to exclude them from this process and the w. H. A. , world healed assembly, or w. H. O. , i think thats a wrong move. This is, again, viruses dont care what your political affiliation is. We need all hands on deck to deal with this. So with that, mr. Chairman, i am going to yield back, and thank you. Thank you to the Ranking Member. I am very pleased to welcome our witnesses to todays hearing. We are joined by four excellent public servants. Jonathan fritz serves as Deputy Assistant secretary for the bureau of east asian and pacific affairs. Followed by principal Deputy Assistant secretary for the bureau of cloonsular affairs. The final is dr. William waters, executive director, manager director for operational medicine at the bureau of medical services. Finally, we are honored to be joined by dr. Robert redfield, the director of the centers for disease and prevention. Please summarize your written statements to five minutes and without objection your prepared written statements will be made a part of the record. Mr. Fritz, if youd like to begin. Thank you, chairman bera and Ranking Member yoho. Thank you for the opportunity to testify today regarding the outbreak of the criminal Investigation Division coindividual virus. Throughout this emergency the department has worked around the clock on Mission Number one for us. Ensuring the safety and security of u. S. Citizens abroad. Secretary and Senior Leadership team have been personally engaged in directing and supporting the u. S. Response to this outbreak. In close consultation with colleagues at the donepartment health and Human Services, including cdc colleagues, the department of Homeland Security, the department of defense and others. Utilizing their expertise, our diplomats and staff serving in the region executed evacuation plans provided Consular Services, engaged foreign governments, and reported on Economic Issues arise interesting this outbreak. We simply could not have done so much to care for u. S. Citizens and our personnel in china without a department widest. U. S. Diplomats in china, seoul, tokyo, pan pen and elsewhere contributed to the evacuation efforts, including those at our consulate general in wuhan. Throughout it all we regularly engaged peoples republic of china at the most senior levels, including President Trumps february 7th conversation with president xi. Secretary pomp secretary pompeo stressed protecting u. S. Citizens in types of crisis is our number one priority. Our ambassador to china worked with the ministry of Foreign Affairs of china to facilitate evacuation flights. Our team in china was on the ground helping obtain permissions for our flights and processing passengers operating in often difficult conditions. This work was instrumental in evacuating u. S. Citizens and even some allies to safety. We faced challenges in evacuating u. S. Citizens from the Quarantine Zone in china and additionaling complexities supporting u. S. Citizens on cruise ships. Ensuring the health and safety of u. S. Citizens on board the diamond princess cruise ship docked in yokohama. The u. S. Embassy tokyo coordinated closely with the japanese government, with carnival corporation, and cdc and other components of the department of health and Human Services to assist u. S. Citizens on the ship. After high number of coindividual cases were identifi made an assessment from the u. S. Citizens were at risk of high exposure and should be repate trade. In cambodia whoa organized Response Teams to assist u. S. Citizens on the cruise ship westerdam working with holland america, cambodian authorities and embassies with other countries with citizens on board the thip. It included consular, medical and logistics experts for health screening, lodging and travel needs for 600 u. S. Citizen passengers. Our eshz utilized the consular messaging platform and soechl accounts to provide timely updates to passengers. In coordination with these efforts usaid provided fund fog are affected and at risk countries to address critical gaps in covid19 country readiness including Risk Communication and engagement. Laboratory detection, enhanced surveillance and Infection Prevention and control. In addition, u. S. Aid is arranging shipments of personal protective equipment to selected countries in coordination with the World Health Organization. Our efforts continue apace. We are continually engaging with host governments in the asiapacific region to ensure they are informed of our policies and we can share information and best practices to address this outbreak. We successfully encouraged beijing to accept u. S. Experts in the w. H. O. Mission to china. On february 7, 2020, the United States government announced that it is prepared to provide up to 100 million in existing funds to assist countries, including china, impacted by and at risk from the virus. Assistance to contain and combat covid19 will be provided bilaterally and with existing organizations. This demonstrates strong u. S. Leadership and response to the outbreak. Thank you, mr. Chairman. I look forward to answering your questions and those of other members of the subcommittee. Thank you, mr. Fritz. Mr. Brownlee. Chairman bettra, thank you f the opportunity to testify today. The Consular Mission has always been the safety and security of u. S. Citizens at home and abroad. We have worked in recent weeks hand in hand with our colleagues from the cdc, hhs as per, nih, dhs and others to provide critical information and travel alerts for u. S. Citizens overseas, arrange repatriations from citizens from two countries and provide in person Consular Services to u. S. Citizens impacted by the outbreak in many other countries. In china, u. S. Embassy and consulate staff made thousands of phone calls and corresponded tirelessly via email and various Online Platforms to reach u. S. Citizens in hubei province. We worked with the Chinese Government to help chinese grandmothers accompany their u. S. Citizen grandchildren on evacuation flights. As the Chinese Government locked down wuhan, our team in china coordinated with local authorities to allow u. S. Citizens to travel to the airport to be evacuated. Using state department chartered evacuation flights and working with our interagency partners such as hhs, cdc, and dod, we brought approximately 800 u. S. Citizens from wuhan back to the United States. In japan, u. S. Embassy staff created a dedicated web page for u. S. Citizens quarantined on the diamond princess and reached out to them individually by email and phone. As some u. S. Citizens developed health problems, not all reindicated to covid19, consular officers worked with japanese hospitals to ensure u. S. Patients received appropriate medical care. In collaboration with our interagency partners the department transported over 300 u. S. Citizens back to the United States on february 16th. We remain in close communication with japanese authorities and the cruise lin e to assist zpii kblens who remained in japan after the evacuation. In cambodia, u. S. Embassy staff met the cruise ship westerdam in the port city of our staff coordinated ksh excu coordinated we provided roles in ensuring u. S. Citizens were connected with the appropriate cruise ship authorities and Cambodian Health care professionals. We sent a team to the airport in pan on pen. Consular services in coolworked into the night to help those u. S. Citizens get home last week. We are supporting u. S. Public Health Authorities efforts to contain the virus outside the United States. Visa officers have implemented president ial proclamation 9984 which suspends entry not United States of any aliens present in china except hong kong and macau during the days before attempted entry into the United States. The bureau of Consular Affairs is entirely fee funded. And most of those fees come from visa applicants. Under our current authorities, we use these fees to cover most of the costs of providing services for u. S. Citizens abroad such as those i described. However, based on what we now know, we anticipate a loss of approximately 98 million. A loss of 98 million in visa revenues this year as a result of covid19. To ensure we can help u. S. Citizens in distress despite falling visa revenues, i would ask that you grant the department greater flexibility in spending existing fees. We remain committed to protecting the health and welfare of u. S. Citizens overseas and working actively with the governments and International Partners to achieve this goal in this crisis. Thank you, mr. Chairman. I look forward to answering your questions and those of the other members of the subcommittee. Thank you, mr. Brownlee. Dr. Walters. Chairman bera, distinguished members of the subcommittee. Thank you for the opportunity to testify today. The department of state is committed to taking all necessary steps to protect the health of our overseas work force and promote the well being of u. S. Citizens around the world. Between january 28th, 2020, and february 16th, 2020, the department executed the most complex nonmilitary evacuation of u. S. Citizens in its history. The safe and efficient rescue of 1,174 people from wuhan, china, and the diamond princess cruise ship in japan is a testament to the agility, pro fishty and dedication of our work force, our interagency partnerships and others to accomplish our core mission advancing the interests of the American People. Following the sars outbreak of 2004, the u. S. Government Accountability Office recommended that the Department Work with interagency partners and the private sector to develop capabilities to support the medical evacuation and transportation of u. S. Citizens from areas impact bid tmed by t outbreak of infebruary issues disease. In the 2014 ebola disease outbreak it served as a remind their the Department Must have a standing Crisis Response aviation capability to protect the u. S. Employees and citizens when emergency situations arise. Such a prompt repatriation of u. S. Citizens from quarantined conditions could not have been possible had it not been for the bureau of medical Services Existing aviation contract and solid corporate partners. Its the departments only standing response aviation support and critical caramel evacuation capability and the u. S. Governments only standing biocontainment transport capability. Upon reset of the mission directives, we managed to configure and simultaneously coordinate five aircraft and flight clearances, overflights and other requirlogistics. Personnel were trained and equipped to manage these operations. The department successfully directed and executed a total of seven flights over four missions with evacuees transported to five different locations within the United States equipped to safely receive, evaluate, and house persons exposed to the virus. This operation involved close coordination with our interagency partners, including the federal Aviation Administration and the departments of defense, health and Human Services, Homeland Security, and others. We also coordinated with International Partners, including the governments of the peoples republic of china, japan, the republic of korea, and canada. I was the lead medical Service Officer overseeing these missions and led the second and Third Mission on the ground in wuhan. Some 41 countries and territories have reported cases of covid19 infection, hoistipl the health of our employees and citizens in these countries and territories at risk. In these unprecedented times the departments medical professionals are committed to doing everything we can for the health and safety of our work force and the u. S. Citizens overseas. In summary, id like to thank each of you for your continued support as we keep pace with this International Emergency. We know that your support to the department, the bureau of medical services in particular, has made this all possible and that your continued support will be critical in the months and years to come. Thank you. Thank you, dr. Walters. Director redfield. Thank you, chairman bera and Ranking Member yoho and members of the committee for the opportunity to speak to you today. Cdc, the department of health and Human Services, the state department and other u. S. Government partners are fully committed to confront the serious o serious Global Health threat. Cdcs Public Health approach to covid19 is built on decades of expertise and prior Public Health energies such as sars, mers, ebola and pandemic influenza. Our goal is to keep america safe and to slow the introduction of this new virus into the United States. Our response involves multilayered aggressive containment and potential mitigation measures as needed. These Proven Health proven effective Public Health interventions include early diagnosis, isolation and Contact Tracing. It also includes targeted travel restrictions as well as the use of quarantine for individuals returning from Transmission Hot zones such as hubei province, china, and the diamond princess cruise ship docked in japan. Internationally, cdc is working with the World Health Organization and ministries of Health Across the globe to continue to combat this outbreak. The cdc has deployed over 600 staff to the response, including staff supporting japan, south korea, and our Country Office in china. This outbreak underscores our National Leadership role on the global scale and the necessity of strengthening our global capacity to stop diseases at their source before they spread. When this outbreak was first reported in december 2019 china reported 27 cases of pneumonia linked to a seafood market. Today there is more than 78,000 cases and over 2,700 deaths. Over the past two months, we have seep confirmed cases reported in 46 international locations, including the United States, and several of these countries now are supporting are reporting sustained Community Spread. In the United States, 15 cases have been confirmed by our nations Public Health and medical Community Based on clinical guidance provided them by cdc. On february 26th, the cdc confirmed an infection with the virus caused by covid19 in a person who did not have any relevant travel history or exposure to other covid patients. Its possible this could be an instance of Community Spread of covid which would be the first time this has happened in the United States. Three cases have been detected among the americans repatriated from wuhan and another 43 cases were confirmed i dont think the Cruise Ship Passengers that were repatriated from japan. We commend the efforts of the government of japan to institute a quarantine measure on board the ship and we appreciate japans cooperation with the United States government to vault and care and evacuate american citizens. Cdc works in partnership with the state department to assist in this repatriation effort of american citizens both from china and japan. All of the individuals repatriated from wuhan by the state department charters have now been released from their mandatory quarantine. These individuals are not at risk of spreading the virus to others and should return to their normal lives. Passengers from the diamond princess are in the process of completing their quarantine at several locations across the United States. We are grateful to all of the americans who have and still are undergoing quarantine for the patience and cooperation as well as willingness to ensure they, fair families, the community, and nation remains safe. We this the department of defense, the military personnel, their families on a the installations where the evacuees have been quarantined. Efforts to direct flights from the Mainland China to 11 u. S. Airports continue. The cdc is working with custom and borer protection to screen arriving passengers from Mainland China for illness and identify people at high risk of exposure and make sure they are referred for the appropriate Public Health followup. To inform future travelers of the virus and where its spreading, the cdc continues to post travel advisories and alerts, specifically china and south korea are now level three warnings that advise travelers against nonessential travel. Finally, cdc is currently Current Assessment in the United States is the risk of this infection remains low. However, we do anticipate new community cases. We have implemented a successful containment strategy, but we must be prepared to move to a blended containment mitigation approach. We also need to make sure we continue to strengthen our Public Health infrastructure as allowed to by the chairman and be ready for broader Community Spread. Cdc and hhs will continue to keep members of congress informed of new developments. We recognize that you are trusted leaders in your community and communication with the public is essential during this emergency. Thank you and i look forward to your questions. Thank you, director. I will turn to my opening questions, and then ill recognize the Ranking Member and other members for five minutes for the purpose of questioning the witness. Director, in my opening statement, as well as you alluded to it in your opening statement, this potential first patient, Community Spread, and it is in my home county, Sacramento County, at and the patient is housed at the hospital i used to attend and have taught lots of medical students in. You know, in talking to my colleagues earlier today and getting a sense of the timeline of this patient, one thing is a bit concerning. I have taken care of patients like this who get transferred, who are intubated, you dont have a sense of what the respir other diagnosis is. Cultures are coming back negative, et cetera. In this case, it seems like last wednesday the medical staff asked for a test of coronavirus and were told this patient didnt meet the criteria and this was not a coronavirus patient. As the patient worsened, it sounds like this past sunday there was an insistence and strong push and ult wli the patient was tested and we know the results came back 72 hours later as a positive test. A question that i have, and maybe its twofold, number one, what current criteria are we using to determine who is going to get a test and who is not going to get a test . When a doctor caring for this patient, and they are looking at a patient, they request its a nobrainer. We ought to do that test based on the medical expertise. At a minimum with this new case, we ought to rethink what the criteria are. I would be curious to hear what criteria we are using today and if the cdc is updating that criteria. The second component is it is our testing capabilities seem a bit too slow at this juncture. I would be curious to hear what we are doing to increase the rapidity and availability of tests if we are getting testing kits out to all 50 states as well as more broadly to cities and others. And then it did take 72 hours from testing to get the results. If we could get those Testing Facilities a bit closer, i would be curious to see how the cdc is thinking about that. Im also told one of my sister institutions, ucsf, they have produced a more rapid test, need the ability to get some samples to confirm the sensitivity of that test and there are some private Sector Companies that are also working on rapid diagnostic tools as well. So dr. Redfield. Mr. Chairman, thank you for the questions. First, i think you know when this outbreak started, for better or worse, even in china, it was linked to whether you were exposed to sea market, food market. Every confirmed case was from the market. And then in discussions i had with the chinese cdc director i suggested they look at other people with flu like illnesses. When the United States began in pui, we had the epidemiological advantage of a link to hubei initially where most of the cases came from. Clearly, whats been demonstrated by the recent case is thats no longer operational. I will tell you as soon as that case was recognized we met and we revised our Case Definition for persons under investigation, and i am today that has been posted along with a new Health Advisory that the recommendation should be when a clinician or Public Health individual suspects coronavirus, we should be able to get a test for coronavirus. So thats the current guidance that went out today. This is a fluid situation. And your second question is also critical. How do we expand the availability of testing. We think it was an accomplishment to, within a week, to develop a test to get eyes on this. I think the cdc scientists were able to do that. But that was not the take away, the broader responsibility for the prieftd sector to come in and be able to provide broader testing for the nonPublic Health community. We have had aggressive discussions about how to expand that. And we are continuing. We have shipped our kits, as you know, initially out to many, many jurisdictions. We had trouble with one of the controls. That has now been corrected and there are now 40 jurisdictions that have the ability to do the test modified with the fda approval. Today, tomorrow, we anticipate more kits from the private sector that have been contracted by cdc to get out, and hopefully our real goal is lab core and m mayo kr mayo clinic and others. You get at the root of it, why is there a different . I use to run a diagnosisist lab. To develop a Laboratory Test and to deploy it, in our country, we develop a Laboratory Test and we need to go through a regulatory process in order to get it deployed. And again im not criticizing the regulatory process. Im just saying thats the difference. And many labs in this country, many hospitals could stand up, as you mentioned, San Francisco and others, your own davis could stand up a test within several days because we have published the sequences and methods and how do this. Thats how that one company, idt, is now ready to sell it to us, which is basically a copy of the cdc test. I think we have to look at that. This is an example where we were slowed, in a sense, because of the way we want to assure accuracy of these diagnostic tests. I know you all are wrestling with that. But we are having more kits out later today, they are going to be sent to the states. The state of california, i talked to your secretary of health just today because they were down to 200 tests. We are sending more out there. There are three laboratories now i am told in california that have the ability to do the tests. But both of your points are very, very important. We take them very seriously. One at least we are not going to let happen again because we corrected it after the first case and the other wrere workig hard to get the tests out and hoping the private senatctor co in for the clinical use. Director, i appreciate the change in the criteria and applaud that. I do think this is a unique situation where we need all hands on deck. We do need to take a look at speeding up the rowiegulatory process. We need to allow the academics and those that have the ability to develop their own testing capabilities to quickly move through the process to make sure these are sensitive and specific and accurate diagnostic tests. Then if the private sector can augment our ability, especially now that there may be Community Spread, we have got to stop the bottleneck and get these tests out to all parts of the country. So, we can take that up here. But i do, you know, looking at the administration, whatever we can do to speed up that regulatory process to make testing readily available to the practitioners out there. With that, let me recognize the Ranking Member. I appreciate it. I appreciate yalls testimony. I think what you were bringing up is a lot of the questions i had. I assume its a pcr test. Okay. I think along that lines there should be provisional approvals quickly. If you guys are in a bottleneck w where you cant get that, let us know so we can help relief that and do the testing and verification down the road. But you need a place to start. When we are to the point where we have private manufacturing of these we need to make sure we are on the same page, its the same test, so we dont have a variation in sensitivity or specificity and we need to make sure that the other countries are doing the same. My concern is, you know, with so much of the apis being created in china, about 80, 85 plus is what i have heard, you know, i look at it from a National Security standpoint. A National Health standpoint. Not just our country, but other countries, you know, if somebody needs advil and you have a population of 1. 3 billion people, you know, are they going to service their customers first before over here . I think this is a wakeup call for american manufacturers and Pharmaceuticals Companies not to be dependent on a country. What are your thoughts about that . Whoever wants to tackle that. Mr. Fritz, youre the one. Thank you. There is clearly going to be Economic Impacts as the outbreak continues to develop. We are paying very, very close attention to not just the general macroEconomic Impacts that are going to occur with regard to the United States economy and other economies around the world, but also to the impacts on supply chains, and particularly as you mentioned supply chains important to our ability to react to future instances, future outbreaks. I dont have anything that i can share with you right now, Ranking Member, in terms of what those responses will look like. It is something we are looking at very carefully. We have people across the interagency process who are actively considering ways to make sure that we are able to make sure that we do have access to the necessary supply chains. All right. Let me ask about the cooperation. Do you guys feel that the cooperation is adequate with the Chinese Government as far as transparency . Just working side by side. Or do you feel like heres the information well give you and kind of guarded . Sir, why dont i take a shot at that on certainly with regards to the evacuation of our personnel of american citizens, very diplomatically and logistically challenging. I would is have to say we achieved a lie hehigh level of coordination with the chinese authorities with the five flights in and out of wuhan. They werent easy, but we did, in fact, we were able to rely on our chinese counterparts in working with us to make sure that those succeeded. Do you feel like they are treating all the countries that way . We heard reports they werent litting the taiwanese out. I wouldnt be able to characterize the way they have been treating everyone the way they have been treating us. They worked well with other partners. I heard similar reports about our friends from taiwan being treated differently with regard to their evacuation plans. I would say in general, however, i think the prc authorities have generally made goodfaith efforts to help evacuate folks from wuhan, other nationalities. Does anybody have reports about this being in north korea, which i assume it is . Do we have definitive proof . We dont have any confirmed reports. Okay. Lets see. I think with that, mr. Chairman, i am going to dwreeld back. I look forward to the questions and i am going to gather more information. Thank you all. I know working together, as you are, we will be prepared for this in the United States, and hopefully we can be the ones that help the other countries the most. Thank you. The gentleman from michigan, mr. Levens is recognized to question the witness for five minutes. Thank you, mr. Chairman. On tuesday, nancy mesonia, the director of the National Center for immunization, respiratory diseases at the cdc said this of coronavirus. Ultimately, we expect we will see Community Spread in the United States. Its not a question of if this will happen, but when this will happen. And how many people in this country will have severe illnesses. But National Economic Council Director larry kudlow then said, we have contained this. I wont say its airtight, but its pretty close to airtight. End quote. And also, this is all on tuesday, President Trump of the coronavirus in the United States, quote, that its under control and, quote, a problem thats going to go away. So that was all on the same day. Americans are scared of this situation, and they want to know whats being done to keep them safe. And hearing mixed messages like this within the span of hours isnt reassuring. Dr. Redfield, how can the virus be both a problem thats going away and also not a question of if, but when . What should we be telling our constituents about what to expect . Thank you very much. I think very, very important question. Right now at this stage, and i have said this and i continue to say it, the risk to the American Public is low. We have an aggressive containment strategy that really has worked up to this time. 15 cases in the United States until the case we just had in sacramento, we hadnt had hada case in two weeks. We believe we will see new cases and we believe now there may be the initial cluster occurrence of a community acquisition. Some countries, this has moved very quickly, like we saw in korea. There were more cases there than we had in all china. We have seen it in italy. Its moving fast. Iran, its moving fast. But other countries have really used containment and a blended Mitigation Strategy like singapore and hong kong, and they have really limited the spread after the initial introduction from china. We are of the point of view that we are still in aggressive containment mode, which is dependent on early case recognition, isolation, and Contact Tracing that now is going to be looking to a identify these Community Introductions and practice Public Health to minimize them. But at the same time weve done this to give us time, and i think what the doctor was trying to say, i think it was maybe could have been done much more articulately from what the American Public heard, she was trying to say its a good time for us to prepare if we have to go to more mitigation. We are still committed aggressively to get aggressive containment, and i think i want the American Public to know at this point that the risk is low. I want them to know that we are going to start identifying more cases like we did the other day. I am going to ask them to, obviously, accelerate their own view of the standard things that we do for flu, hand washing, cough in your sleeve, dont go to work or school if youre sick. And we are we have launched a larger for our next level of our multilayered Public Health response is to now institute broad surveillance. And we have initiated it. We are planning over the hopefully the new the next four, eight weeks. Obviously, linked to the supplemental to actually make our Surveillance System for coronavirus the same as flu nationwide. So we can be, you know, very quigley picking up when there is an introduction in the commun y community, go in and try to stop it. Let me quickly ask you another question in my limited time. I want you to speak about the danger of xenophobia in a situation like this. Cnn reported on disturbing example from the sars outbreak when, and quoting them, people of asian descent were treated like pariahs in the west. There were reports of white people covering their faces in the presence of asian coworkers and Real Estate Agents who were told not to serve asian clients, end quote. We saw similar incidents during the h1n1 swine flu outbreak in 2009 and the 2014 Ebola Outbreak. Sadly, i have heard reports of incidents like this around coronavirus. So, id like you to talk about why its so important to avoid stereotyping people as carriers of the coronavirus and how incidents like these can be avoided and how they are dangerous really for Public Health. I couldnt agree with you more. Those who heard me talk before, i said that stigma is the enemy of Public Health in all its forms. Whether its in dealing with hiv, dealing with drug use disorder, whether its dealing with obesity, dealing with a response to the coronavirus at this time, stigma has no role. No place in Public Health. Its counterproductive. I think we will have to proactively get that message out to the American People so that we dont harm our own Public Health with stereotypes motion might have. Dont you agree . I will continue to echo it. I think you make an important point because we have, you know, we have seen those reports. And i think we need to reecho t stma h stig th stigma has no role. Thank you. Mr. Redfield, i want to start with you and you spoke specifically about early diagnosis being part of the positive thats going on here. Can you discuss with me what are early symptoms which lead to early diagnosis . You know, i think the first thing i want to say is there is a lot we dont ne. And were learning more each day. Thats what concerns those of us that are confronting this. If it was flu, we understand flu. But there is a lot we dont know. What we have learned in the last eight weeks is that this virus can actually cause asymptomatic infection. No symptoms. Now, thats complicated when you are dealing with a Public Health threat if you can have it and on the princess ship, over 50 of the individuals that were diagnosed in the process in japan lacked symptoms. Now, there may be an ascertain. Issue because they thought if they had symptoms they would be treated different. Clearly, there are a percentage of people that lack symptoms. There is clear evidence those individuals can transmit the virus. As the chairman knows, that makes this more complicated. The other side of it, if symptoms can be as negligible as a strachechy throat, a dry cough, and you can see thats why initially we had pui definitions that were narrow because if all of a sudden everybody with a scratchy throat or dry cough during flu season came, we had some perplexities. At the severe end it can cause a severe pneumonia, respiratory compromise requiring critical care. Overall, it looks like five to 5 of individuals in the china situation are critical, 15 need critical care. Other countries are showing similar. But on the other spectrum, there could be asymptomatic illness. We are still learning. Its complicated. Obviously, in the individual case we talked about here where severe pneumonia in an otherwise healthy individual in light of what we know can prompt the medical community to consider the coronavirus in a differential diagnosis. But a lot of individuals may just present with a sore throat and a dry cough. Let me go to the other side of the table. 80 plus thousand cases diagnosed, and the number that i have read is 33,000 recovered in Mainland China. Recovered from having the diagnosis. Can you say what has been a chief factor that has led to those that have recovered through it . Is that something that we know . I think there is probably two major factors. One or maybe three. One is age. And one is comorbidities. Individuals that have diabetes or hypertension or chronic effective lung disease and happen to be elderly, these individuals have a much higher mortality. But the other issue that needs to be stressed is the effectiveness of the Health Care System. So in wuhan the mortality right now is somewhere over 4 . Their Health System is beyond strained. Before this outbreak they had 132, i think, isolation beds for Infectious Disease. Today they have over 20,000. Now, you can go from 132 beds to 20,000. You can build the structures. But as the chairman knows, where are the doctors . Where are the nurse sns where are the ventilators . Where are the Trained Health care professionals . We see a mortality and we believe its the integrity of the Health System that is a major factor. If you go to the rest of china, the mortality is probably about a half a percent, okay . So i think the major factors i would say with comorbidities, age, and the resilience of the Health System you are in when you get sick. If you dont have access to oxygen, mortality will be higher. We are worried about the countries on board recently, many dont have health stystems that can sustain life. This is something you have a lot more faith in our Health System, obviously, than wuhan or pick any of the other countries that you just listed off . Yeah, i think we have we are in a strong position. We have Effective Health care system. You know, i think, you know, at this stage if we can continue to do what were trying, early identification, find these earl identification, find these community cases, get our ams around them, i think we can continue to respond. Obviously, if the numbers get to the point that we cant control then thats a different totally different issue, but right now ill pause you there because my time is about to end, just to say, i think you mentioned something that is important to realize asht about this, that our Health System has a different starting point than that Health System of wuhan and many other places. Certainly doesnt make us impervious to this, but its a better starting place to be at. Thank you for your comments. Thank you, mr. Mast. The gentlelady from pennsylvania is recognized for five minutes to question the witness. Thank you. Im actually going to start, i know that its my obligation in some ways to ask complicated questions about policy, but dr. Redfield, id actually like to start and lead off of mr. Levins conversation for the human beings who are at home, my kids, my family members, my community, and ask the doctor who you are the 18th director of the center for Disease Control and prevention and administrator of the agency for toxic substances and disease registry. And in your capacity, could you help me to answer a few questions that i frequently get asked. The first one can be any answer, i dont know the answers. Im just asking on behalf of my community. Should people be afraid . Thank you. Could you turn on your microfen . No. Should people engage in regular handwashing and coughing into their sleeves . Absolutely. Should people be stocking up on cleaning supplies . No. Should people be stocking up on Prescription Medications that they have . Not at this time. Should people be stocking up on food supply . Not at this time. Should you wear a mask if youre healthy . No. And is there a website, and you can answer this later if you dont know it by heart, where people can go to access good information about these questions . Absolutely. The cdc. Cdc. Gov. We have all of the information on that website. And a sub can take you to coronavirus, where we are, any preparedness, and all of recommendations. And, sir, is there anything else that i should have asked you thats a regular everyday person kind of question . The one comment i would make because i do see people feeling a need to go buy mask. And i would ask them, and some people scoff at me when i say this, we need to make sure those n95 masks are available for the doctors and nurses that are going to be taking care of individuals that have this illness. And it really does displease me to find people going out. Theres no role for these masks in the community. These masks need to be privatized or Health Care Professional s as part of their job taking care of individuals and or individuals who have this virus and are in home isolation, home quarantine, for these family members. Prioritize the uses we recommend and get people to realize thats what the masks need to be preserved for. Thank you. I appreciate that. With the last couple minutes of my questioning, for mr. Fritz or dr. Redfield. Im going to followup on the line of questioning that has to do with prescription and pharmaceutical supply chains and the integrity of the supply chain. Is there a place, a way that we have historically been tracking various supply chains . In my old business, we would make sure we had at least two or three suppliers of the same material just in case. Is there something that we have a database or other system that tracks those kinds of suppliers and where they are geographically . Thank you, congresswoman, for the question. As i mentioned, there is a very intense interagency process under way. I think hhs, in particular, the food and drug administration, and other relevant agencies, are all looking very carefully at this exact question and making sure that the answer to that question Going Forward is that we do have access to whatever we need to sustain ourselves in the current outbreak and to make sure that were ready for future ones. So, i understand that the fda largely is, you know, sort of lead on this, but is there a role that the state department can play on this . Is there something that we at this body can do to be helpful in that . The state department is doing, were looking very closely at the impact of the outbreak on our Global Supply chains s and, of course, were working with some of our other Foreign Affairs and traderelated agencies to map that out then, again, together with hhs and others looking how that impacts our ability to access what we need in time of crisis here in the country. Yeah. Im just looking for this to be sort of a sad lessons learned, how can we take this experience and make sure it doesnt happen to us again, how can we make sure we know where our suppliers are and how to make sure were safe from this exposure. This is teaching us wie need to pay close attention. Were bound and determined to ensure whatever lessons are learned from this are applied Going Forward. Thank you. With my last minute of conversation, i want to take off on something, we were happy that our Health Care System was better than wuhan. Thats awe . Awesome. Can you comment more, how we need to work with other nations to make sure all our Health Care Systems are working together in tandem on this . Thank you for that question, nap. Id like to point out that u. S. Foreign assistance has helped countries around the world to build public systems that are able to be resilient in the sorts of these crises. Of course, thats being put to the test in many instances. I think what we can say is things probably would be much worse if it had not been for our efforts over a number of years to share best practices and actually make Resources Available to build capacity around the world in this aspect. And, of course, we have announced up to 100 million of assistance for partners around the world to respond to the covid19 crisis. Thank you. Ive run out of time. I yield back. Thank you. The gentleman from ohio, recognized to question the witness for five minutes. Thank you very much, mr. Chairman. Mr. Fritz, ill direct my question at you, if i can. I was one of the original founding cochairs of the congressional taiwan caucus and im now one of the cochairs of that caucus. And as you know, as we all know, the prc, china, considers taiwan a breakaway province. Taiwan, for all intents and purposes, conducts itself as an independent nation, not necessarily recognized by the world as such, but it is, and the people there are free. They ought to be a model to other kcountries around the globe. Theyve been bullied by the prc for many years now. My question is this they have sought to be recognized on observer status, basically, at the w. H. O. , for many years. In my view, they ought to be essentially a fully recognized participant in the w. H. O. Its kind of a gap in our world Health System in not recognizing them, not letting them fully participate, but at this point, china has still blocked them from so participating. With something as serious as the coronavir coronavirus and, obviously, its origins in the prc, in china, and taiwan being right next door and taiwan having some of the top medical institutions and doctors, medical personnel, in the world there, you know, it seems to make no sense that china continues in this effort. Taiwan could be helpful. Even many helpful to china. So, so what gap does this create in the worlds response to this various serious medical and the situation we have with the coronavirus, what whats the problem with what chinas doing relative to taiwan . Thank you very much for the question, congressman. As you said, taiwan is a robust democracy. Its a mod until that respecel. A reliable partner in Public Health and a number of other concerns that we share and its a force for good in the world. Couldnt agree more. I think this covid19 outbreak only further underlines the unacceptability of taiwan being excluded from the World Health Organization, the world health assembly, because the peoples republic of china blocks every attempt for it to do so. As you mentioned, not only has the covid19 outbreak affected taiwan, they have 30some cases there, and to the extent theyre unable to get timely information from the w. H. O. , that impacts Public Health on taiwan. On the other hand, as you pointed out, taiwan has a lot of expertise and have some experience, in fact, they have their own epidemiological track record now dealing with covid19 and too the the extent that is being shared in a complete and timely fashion with other w. H. O. Members, clearly that doesnt do anything for the Public Health of the rest of the international community, which is, of course, why the United States has and continues to push very hard for taiwan to have meaningful participation in the w. H. O. And be granted on server status at the world health assembly. China, its worth pointing out that the peoples republic of china was okay with taiwan being an observer when a Different Party was in charge in taiwan. Its only when the democratic the ddp party came into power in 2016 that china began blocking across the board taiwan participation, and we continue to push back very, very hard against that with as many of our likeminded partners as possible. And i think our argument is only bolstered now by the covid19 outbreak. I would point out this push by the usg is fully consistent with our u. S. Onechina policy and, of course, with the taiwan relations act which governs unofficial relations between the United States and taiwan. Thank you very much. My times almost expired, so let me just reiterate what you said. I agree with all the points that you made. Thank you for that. I want to thank the administration for continuing to be a friend to taiwan and we would encourage it to continue to do so, even step that up, and its a shame that the prc, china, allows its intransigents with respect to taiwan to put not only the people of taiwan and its own people but the rest of the world more at risk than we ought to be, so they ought to do the right thing here and allow taiwan not just to be observer status but to be a full member of the World Health Organization, the w. H. O. Thank you very much. Thank you, mr. Chabot. The gentleman from rhode island, mr. Cicilline, is recognized to question the witness for five minutes. Thank you, and mr. Chairman, i want to thank you for the courtesy in allowing me to participate in this hearing. Thank you to our witnesses for their testimony. Dr. Redfield, i want to ask you kind of to follow up a little bit on ms. Houlihans question about the supply chain. As you described this potential pandemic becoming really a global challenge, i guess it already is by most estimates, what are we doing to assure that theres a sufficient supply of medical supplies, you mentioned oxygen, do we have a coordinating body thats figuring out if this pandemic proceeds in a serious way, this country, that well have thing a set to the access to the resources we need to the kind of containment youve spoken about in treatment, is there someone doing that sort of planning . Thats not what i do within cdc, but the assistant secretary for preparedness and response has done exten tentens tent work. Theres an Interagency Group going through this in quite detail with the fda and asper in terms of many of the medical issues but theres a broad ee e intragovernment group doing it in the broader issues. I can tell you thats ongoing. I know asper and fda have done it on the broader side and a broader Intergovernmental Working Group to get down to all of these issues. Right. You also made reference to the china cdc or counterpart, can you speak a little bit about the relationship between the cdc in the u. S. And the chinese, particularly as it relates im particularly interested in this Health Care Working transmission. Two weeks ago china reported 1,700 Health Care Workers had been infected by coronavirus, and just wondering what were learning about that transmission and whether or not thats informing protocols here in this country to protect our Health Care Workers. Yes, thank you. The cdc has had now over a 30year working relationship with chinas cdc. Theres a reason they call it china cdc. And i actually have a u. S. Cdc component thats affiliated with the embassy but is attached to the china cdc. The chair the head of cdc china and i have been in regular discussions since the very beginning when this happened on new years eve. And had very open scientific discussions about what he knew at the time, what he was learning, so we could use that information. And that continues bidirectionally, as i say. From the at the beginning, there was not a thought that there was humantohuman transmission. They saw that in the first week they didnt see any, in the second week. Remember, they were using, you know, a definition of whether people were severely ill, the n werent realizing this could be mildly symptomatic. Since then, theres obviously been an extensive hospitalbased transmission. One series that was published in one of our journals, jama, recel recently, showed 40 of cases were infected because they were Health Care Workers or went into the hospital, infected once they go there. Health care transmission is really a high, high risk particularly in areas that really arent vigilant in the importance of infection control. Were happy to say to date we havent had a Health Care Worker obviously, the new case as was mentioned by the chairman raises concern because people were intubated. Thank you. Were obviously evaluating the Health Care Setting . Doctor, can you give us a quick update on the Vaccine Development status. Whether or not Additional Resources are needed. What the timetable looks like that. I think lots of people are interested in that. The nih, dr. Fouchi, has the lead on this. I can tell you what hes told us and others is that they do have a candidate product that they are planning to move into a phaseone trial hopefully in the next six weeks, which will evaluate immunicity and safety. They partnered with a private sector company. Assuming that goes well, they would move into an expanded phasetwo trial, and, but in reality, if everything goes really well and they get the Strategic Partners that they need, hes saying he looks at a year to 18 months before we could have it. We do believe scientifically that this is a virus that should be able to have a successful vaccine based on the coronavirus, as opposed if we were trying to do this, say, for hiv, you know, we would say, well, we dont know because were not sure how thats going to work or not, but for this virus, theres a lot of scientific reasons to think that it will be successful and the nih is really moving forward very aggressively to try to make that happen. Thank you, m. Thank you, mr. Chairman, i yield back. The gentlelady from virginia, ms. Spanberger, is recognized for five minutes. Thank you. Thank you to the witnesses for being here. And as you might imagine, i am very concerned about this the issue of this virus and constituents across central have var virginia, the district i represent, are deeply kconcerne. I want to start by sayinging thank you, dr. Redfield, for what you said too my colleague representative houlihan, they shouldnt be afraid. I appreciate you being here today to talk about this important issue and how to recognize that. So much of how were handling this disease, outbreak, will also be determined by how were communicating, what the temperament and feeling on the ground is. I want to talk about some local preparedness. Dr. Redfield, ill start with you. The coronavirus is expected to put additional strain on our Health Care System and noted our Health Care Providers are already at near max capacity due to a bad flu season. How is the federal government ensuring medical proviters across the country have what they need and the resources that they need and what else could we be doing . Very important question and i want to say my Partnership Agency in the health and Human Services, asper, has been working and continues to work, to see that hospitals begin to get prepared. That is one of their central missions, the assistant secretary for response and preparedness. Asper. Theyre going through that in great detail. They had dialogues with different hospital corporations. Hospital leaders. To begin to see that. For us, theres not a lot of flex in our Health System right now. Most hospitals because of influenza, if youre looking at them, they may be at 95 , 96 , 97 capacity. This is why i stress our current response, multilayered resporngs response is con tanment, containment, containment, containment , to try buy us tim for the fruits of labor by nih, dr. Fouchi and the public sector. Hopefully in the not too distant future, well have a vaccine. I can tell you, aspr is very aggressively working and evaluating this. The term they use is resilience to try to make sure they can build resilience into the system. Following up on that notion of containment, if your written testimony you noted the importance of using illiness Surveillance Systems. Can you tell us more how were applying assisting systems to this virus and are u. S. Public Health Agencies developing new illness Surveillance Systems specific to coronavirus . Yeah, this is really important. This is really one of the most important components from cdcs perspective in the recently requested supplemental. We have an kplebt excellent Surveillance System in this nation for flu. We have multiple Surveillance System, as you just mentioned. We have multiple. Rather than recreate the wlehee we proposed weve actually begun this to at least initiate it is, is were really adapting our entire respiratory disease Surveillance Systems and now interfacing coronavirus 19. And, you know, im very hopeful in the next 8, 12, weeks well be in a position that well have your flu Surveillance System, if you follow that, and youre going to have your National Coronavirus system. Im more interested in this as im hoping is the canary in the minefield, in the mine, that i can see when and if were getting community, i dont have to wait until an individual gets hospitalized and is on a ventilator. You know,vy to vi have to be h with you, we dont know what were going to find when we start this, but were very anxious to get this broad coronavirus Surveillance System using all the systems that we have right now for respiratory disease and get that operational as soon as possible. And to be able to see the trends that we may be seeing that, in fact, demonstrate that were looking at potentially an outbreak in a locality or in a state. Absolutely. And then be able to put the full power of the Public Health approach of case recognition, isolation, Contact Tracing, to make sure that cluster is contained. Do you have the Financial Resources and the employee capacity for this Surveillance System and what you need into the future . Well, i will say thats one of our major components of the supplemental that was put forward. The was to be able for us to roll this out nationally. Great. Thank you so much. To the other witnesses, i know i concentrated my question on dr. Redfield, but i do appreciate your time and your presence here today. Thank you. I yield back. Thank you, ms. Spanberger. The gentleman from california, mr. Lou, is recognized to question the witness for five minutes. Thank you, chairman, for calling this important hearing. Thank you, dr. Redfield, for your Public Service including your service to u. S. Military. The Washington Post published an article, headline is a faulty cdc coronavirus test delays monitoring of diseases spread. My first question to you is does the cdcs activity for coronavirus work . Yes. Okay. What the error rate on that test . So we created a test very rapidly based on the sequence of the virus, within really the week of the sequence being published. Its a prcbased test. And the way it was developed designed at cdc was it actually measures three different, if you will, components. I just need to know the error rate. Well if you know it. Yeah. The problem was when the test was sent to the states, one of the components had a contaminant in it. The test at cdc works fine. When it was given to a manufacturer to scale up for the has the cdc fixed it . It has been corrected, and there are tests that are being shipped out as we speak. Okay. So, in fact, the first test didnt work. First test works because it was developed at cdc and it works fine. We test every one in the country. When the manufacturer scaled to send to the states, when the states got it, it could tell positives, it could tell negatives, but because of one of the contaminants in the control, there was another group that was we dont know if its positive or negative. It was inconclusive. And at that time, the fda requested that we not use that test and have people send it to cdc where the initial lots that we made were quite functional and there was no contaminant. Thats the test we continue to use today. There are now over i just need so current test works. Current test works. Okay. Great. So its very important now that 48 countries have coronavirus cases. In italy, its skyrocketed now to 650 cases. South korea has now 1,700 cases. As you, yourself, stated, there are more new cases in south korea than in china. Why is that were only testing people who have travelled to chi china . That seems to make not a lot of sense to me. Well, when this outbreak originally occurred im talking about rite nght not when it occurred. Why arent we testing those who traveled to south korea, italy, traveled to the 11 countries where there are now coronavirus cases . Were continuing the travel restrictions no, no, talking about testing people. Why dont you expand the test as a person in Northern California that doctors recommended get the test and cdc said no because the person hadnt traveled to china. Thats really stupid. We know this expanded way beyond china, 48 countries, every continent except antarctica has the cases. Can you commit to expanding the tests to beyond those who just traveled to china . Congressman, i mentioned before you were here, just so you know, we initially had a geographic restriction. We have changed that. Weve posted theres no geographic restriction. If a clinician or Health Department official considers coronavirus and a differential diagnosis, that now makes our criteria. When did you make that change . Wed we did it and posted it today. Thank you for making that change. Okay. So in terms of transmission, earlier you said people shouldnt be afraid. My understanding based on the articles, reuters reported coronavirus contagion rate makes it hard to control. There are two scientific studies that show essentially each person affected with the coronavirus is passing disease on to between two and three other people. Got this long incubation period, potentially 14 days or more. You could have an exponential explosion of cases rather quickly such as in italy, isnt that correct . I think weve seen that, obviously, in italy, creekorea, iran. And, yet all right. So this person in Northern California who didnt travel to china, where we dont know where he got the coronavirus, he could have passed on to two more people who pass it on to two more people who pass it on to two more people, so there could be a whole cluster of cases, but until as of yesterday, we dont know because we werent testing anyone who didnt travel to china. Am i understanding this correctly . The current Public Health evaluation of the case in the chairmans district is being led by the state Public Health system of california. Were supporting it. We have a large number of contacts that have been evaluated that are being isolated, that are being tested to really look at the full extent of the potential transmission around that case. Thank you. Im going to conclude by saying donald trump has attempted to minimize the coronavirus outbreak. Theres an article in daily beast titled coronavirus may explode in the u. S. Overnight just like in italy. I request that when the data and science contradicts what donald trump says that you follow the data and the science. I yield back. Yeah, i can say cdc is sciencedriven Service Organization and thats one of the prides that i have to be the director now, to be in a sciencebased, datadriven, but most importantly Service Organization. Thank you. Let me recognize the gentleman from california, mr. Sherman. Thank you. China failed to, actually, hid this disease at the beginning. China continues to they try to exclude taiwan from the w. H. O. There are a number of things china could be doing. We need chinese cooperation to start Clinical Trials. Dr. Redfield, are we getting it . There is a drug called redesovere thats now in Clinical Trials in china and japan and has been expanded actually to the United States to the repatriated individuals. There are similarities, vague similarities, to the flu. Flu is often seasonal. Is this disease our president has said, oh, its going to be gone by april. How confident are we that transmission will be substantially less when the winters over . Its unknown. There are various treatments that are used for flu such as theraflu. Is there any reason to think that theres some chance that that would be helpful in redu reducing the effect of the disease . Not for the coronavirus19. And likewise the sars vaccine, would that provide any protection . Its unlikely that the crossreactive but the methods they used to develop that vaccine is the reason dr. Fouchi has been able to accelerate the vaccine hes developing. Good. And whats the earliest we could have a vaccine . Well, dr. Fouchi has said one year to 18 months if everything goes well. Gotcha. Lets see, how well are we cooperating with china today . Are they providing the information we need and are people on the ground . Mr. Fritz. Thank you, congressman. I pointed out a bit earlier that we did get a very we got goodfaith cooperation from chinese officials as we worked to send in and get out our five planeloads of evacuees. Im not talking about yeah, but sir we have people on the ground at the epicenter of this epidemic getting information thats helping dr. Redfield do his job. Ill defer to my cdc colleague on the actual are you getting what you need from china . I have regular discussions with my counterpart and the head of cdc. We do have a cdc a u. S. Cdc thats embedded into the china cdc, so we are having daily interactions. I have a team of respiratory experts that are there working there. At a scientific level, were having good dialogue. Congressman, if i could, i would point out that, you know, secretary pompeo and others have also, of course, made it clear that chinas allergy to freedom of speech, freedom of expression, et cetera, et cetera well, yes. Have been, obviously, had a very negative impact on the the initial response of local officials was to try to keep it under wraps and the failure to be a free society, thats why this thing got going and were now in a position that, perhaps, could have been avoided if china had a different policy toward Free Expression versus hide things and hope they that you can keep them under wraps. Lets see. Why does the administration request for additional funding rely overwhelming on transferring funds from other diseasefighting accounts . Dr. Redfield, do we need to spend me money on ebola . Can we just grab that money . No problem . Obviously, we have an ongoing Ebola Outbreak right now in the congo. I really cant you think its wise, then, to take all the money that we had appropriated for ebola and not spend any money on ebola . I really cant comment on the budgetary decisions that were made. Are you doing useful work that will save lives or may save lives with regard to ebola . Are you if we leave the money in the budget, will you spend it effectively in ways that help save lives . We currently have an ongoing Ebola Outbreak in the drc where we have a number of cdc people deployed. I say this, knock on wood, were finally close to winning. Okay . Were down to really in the last week, we didnt have a single case. So we now we now project based on our models that we might actually end this outbreak by the end of june, but, obviously, when instability happens again, we could be right back where we were two months ago. So and if this Ebola Outbreak expands in the eastern congo, it could be a threat to the United States just as a chinese epicenter problem has been a threat to the United States and even to california . Well, weve been fortunate with ebola in that theres very Little Movement from the ebola eastern congo where this outbreak is and the United States, but we obviously have had to invest significantly in what we call exit screening from the congo as weve dealt this. As you know, weve been in this outbreak now, were almost about to start the third year. If we dont fight ebola in africa, does that mean americans are safe and everythings fine and youre assuring me that we can just not worry about ebola and everybody and were not going to have a problem this year, next year . I think one of the most important things our nation can do is build a robust Global Health security capacity, all right, so we can detect, prev t prevent, and respond to these outbreaks at their source. Thats exactly what were doing with ebola. The more we can expand that capacity and i believe strongly its a core mission of cdc, were the stipof the spear to identify these infectionful disease thre Infectious Disease threats. What were seeing with the coronavirus, why its so important we have Global Leadership in the ability to i would comment the outbreak of this coronavirus demonstrates the importance of your work and absolute folly of pulling the plug on some of your work because of an unwillingness to fund the additional work that we need to do for the coronavirus. With that, ill yield back. Thank you. Im going to use the chairmans prerogative to ask a couple questions. I feel bad mr. Brownlee, dr. Walters, i appreciate your coming down and i dont know if im doing a favor asking you questions or if the goal as witnesses is to slide out of here with no questions. I appreciate your coming down. You know, mr. Brownlee, i hear your concerns and well continue an ongoing conversation about flexibility and consular functions. Ive been honest in my concerns with the administration in announcing travel restrictions for individuals coming from china. I understand the rationale and reasoning behind it but also have some concerns about whether its going to do what we hope it does with regards to containment. Mr. Brownlee, Going Forward, are we considering similar measures against other nations, and if we are, under what specific circumstances . And then the last question would be, as the cdc and the state department issued travel advisories for countries who have been impacted by coronavirus, what specific objective, criteria, are we using to make these determinations . Maybe, dr. Redfield, thats a question for you. Thank you very much for your question, chairman. With regard to further proclamations, this remains the prerogative of the white house. They are gathering information from all available sources as to whether further restrictions might be necessary to help contain the virus. As dr. Redfield has noted now several times, were still in the containment phase. Whether cdc and other Health Care Providers Public Health authorities will recommend that is beyond my scope. With regard to travel advisories, this, too, is something we we revisit constantly in the bureau of Consular Affairs. We are looking at a variety of different ires with regard to any single country. Health is one. Crime is another. Risk of terrorism another. Natural disaster, et cetera. We look at information that we draw from a variety of sources. The u. N. Provides some information on health issues. We talk to the bureau of Diplomatic Security with regard to the crime and terrorism risks. We pull information from the intelligence community. In other words, from a variety of different sources. We talk to our friends that the five likeminded countries, uk, australia, et cetera. We gather all this information. We use a factbased metric matrix to try to decide what were going to rank a country one, two, three, or four. Great. I hope that answers your question. Dr. Redfield. The purpose of the cdc levels is really a different purpose. Its really for Public Health purposes only. And we actually have three levels, you know, makes it confusing. We have the first which is just an alert to let the American Public know that there is an ongoing Infectious Disease issue. And so right now, for the alert, singapore, taiwan, thailand, vietnam. Once we see that there is significant humantohuman transmission, so its not just, hey, theres something going on there, we go to what we call a level one. Right now, thats hong kong. When theres actually multiple clusters of haultohuman transmission, then we go to a level two. And that really tells people, particularly if you have yo youre older or have any to mct comorbidities, you ought to consider travel. This changes every day as you said. Level three, were telling people this is when we have broad Community Based transmission. We tell the American People we recommend they dont travel. Those are our levels. We reevaluate them every day based on the data we see of whats happening . T in the time around humantohuman transmission, how isolated it is, how broad it. Right now, obviously, in korea, we have very broad transmission throughout the country. It its moved to a level three. China, very broad transmission. You should anticipate these are going to continue to change. They can go up or down. I wouldnt be surprised if we have changes in the next 24, 48 hours based on whats happening in these countries. Thank you, dr. Redfield. Mr. Fritz, i know youre on a tight timeline. We appreciate you being here if you have to leave the panel. Thank you. If i can ask dr. Walters a question, because, again, i appreciate you coming down here and making yourself available to us. In thinking through the evacuation of some of the americans on the diamond princess and so forth, you know, there were reports that positive testing patients and, again, it may be that those results werent communicated or id be curious, but some of the positive testing patients were comingled with negative testing patients and just curious how that might have happened and then how we avoid that happening in the future. Thank you. Mr. Chairman, thank you for the question. The timeline matters. So the diamond the decision to evacuate american citizens from the diamond princess was not based on, you know, theres an outbreak of covid19 on the ship. The decision was based on there was evidence of ongoing persontoperson transmission, this was a problem that was not getting better, it was getting worse. And despite the best efforts of the government of japan. Once the decision was made that it was safer to move these american citizens, many only wh of whom were in an age range that puts them at the greatest risk, we follow a protocol. This was the sixth flight wed done in, like, two weeks. Each of those individuals, each of the 329 individuals that we took off that ship were evaluated by a medical officer from either the state department or health and Human Services aspr. Within that 24hour period. The embassy in tokyo had reached out to the ministry of health, welfare and labor and asked all lab results be reported by 4 30 that afternoon. The evaluations were done, the evacuees then were handed from the government of japan over to the care of the United States government. They were disembarked from the ship. They were loaded onto buses. And this was to be one Single Movement of 15 buses from the ship to the airport. It was only once those evacuees were 329 people on 15 buses and the minutes after midnight on the docks at yokohama that an official from the government of japan approached the Embassy Personnel with a list. On that list were 16 names, and of the 16 names, 14 people were manifested and some were on 15 different buses and the buses were already in movement. And the movement from the docks at yokohama to the airport, there was some discussion, hey, weve got this problem, were working through it. Thats only a 40 or 45minute movement. Once they arrived at the airport, the 14 were identified in a way that was efficient but protected their privacy. And its important to remember, none of these individuals had symptoms. They were not coughing, sneezing, you know, they didnt have fevers. That had all been confirmed. They were removed from the bus. They were taken to the only place now, imagine, morning is breaking at that airport. Its raining. These are 60 to 80yearold american citizens that are helped off the buses and put into an isolation area aboard the aircraft. The way the aircraft is set up, the airflow moves from the nose to the tail. So the sort of most atrisk area is near the tail of the aircraft. We had already partitioned off as we had in previous flights an area to protect other passengers from any contagion that might be with those folks. They were placed there then there was a robust interagency discussion. Much has been made about the discussion, but at the end of the day, we reached consensus and there was consensus between our partners that we rely on from health and Human Services, state department, and others, that, yes, these are evacuees, yes, theyve been placed into the care of the u. S. Government, yes, they are contained and they pose no further threat and with that, we brought them back to the finest quarantine facility in the world to receive the best care available. Great. Thank you for that explanation. I know the Ranking Member had additional questions. Yeah, thats for state department because we heard over in china how the i think it was 1,600 Health Workers came down and they were sick. We had talked to our ambassador from cambodia. We had a discussion with him today. He was saying what a stellar response our state department did of working 24 7 at 6 different locations moving people out. What kind of protections do we have for our state Department Personnel because i know when we go on codels, you guys work your tails off. We appreciate it. We want to make sure you have the coverage and health care you need. You feel adequate . Yes, sir. Thank you for the comments and the question. Heres what i would say. This this is an International Emergency with right. Significant domestic risk. But in 220 locations around the world, we have a workforce of 75,000 people. Some of whom are in countries that have active cases, others are in countries that may tomorrow find themselves with active cases. Right. We learned our lessons in 2004. We learned our lessons again in 14, 15. And were thankful to congress for the support weve had in the preparedness side of this. There is ppe at every embassy. Our Health Care Workers, workforce of almost 700 in all these locations are well educated, theyre well prepared. We continue to look at our Resource Requirements and we continue to look a the our authorities. Not just to take care of american citizens, chief of Mission Personnel, but really in that global picture to protect americans. We feel confident that if, you know, an embassy were to come down and the workers get exposed that we can get the supplies needed in there if its in an area thats more remote where we dont normally have Good Health Care maybe that we can get it in there in a sufficient number, we feel like were protected there, right . So, we have theres two parts to that answer. The first part is the same aviation contract that made these evacuations possible is the Safe Aviation contract that makes delivery of critical supplies possible. The second part to that is actually a greater risk. And the greater risk here is when you look at the way we do medical evacuations, chief of Mission Personnel around the world, they dont typically come back to the United States. They go to medevac centers with established relationships in south africa or uk. Okay. Those countries are now making it more and more difficult in a way that you can understand to bring nonuk citizens or nonsouth African Citizens in if theres any risk that they have covid19. So we continue to work with our International Partners to keep those diplomatic platforms open so that dr. Redfields teams have a place to work and the resources and relationships to do it but still be able to medevac our chief of Mission People home when the time comes. Okay. Thank you. Dr. Redfield, again, theres this cloud of lack of transparency that we keep getting from china. What signals can we see from china to see what the real extent of damage is behind the containment . You know, the National Peoples Congress Meeting has recently been canceled. I mean, thats a pretty strong signal to show that that threat is really theyre really that concerned about it, as they should be, but then with the people over there not getting, you know, an open press where they can get reliable information, do we feel like theyre being forthright with you . I mean, youre working with them on more of a scientific platform. Do you feel comfortable with the information youre getting . My colleagues, the scientific interaction were having with our cdc colleagues and the china cdc, im very comfortable with it. As i said, i have my own director of the american cdc in china. Theyre regularly interacting. So at the scientific level, were having collaboration. I really cant really comment beyond that. I will say its worth noting that they probably introduced some of the most aggressive containment mitigation strategies that weve ever seen. Ever seen on the planet. In the history of the world. You know, but, and i and i would like to say just, though, people are feeling better that theres a reduced number of cases in china. Just last night if thats accurately reported. Accurately reported, but even then it was 434 people and somewhere between 25 and 30 deaths last night, so they still have a major problem despite everything theyve done in mitigation. I want to throw one thing out. I dont really expect an answer on this. Being a veterinarian, weve seen the poor sign viral diarrhea syndrome broke out several years ago. Within a year it was in america. Lost about 300,000 sows in america. African swine fever broke out may of 2018. Weve not seen that here. We do know this. Its a very hearty virus that can be transmitted in different fomites, resist freezing, resist heat and make the transshipping from china to the United States in containers in different materials whether its feed, packaging. This is something we need to be alert through afis, usda, through cdc, that were monitoring these things better than we ever have before because thats a port of entry we might not even be looking about. Were looking at people but also need to look at containers and fomites coming in that way. The only comment i would make thr th for this virus, just so you know, were aggressively evaluating how long this virus can survive and be infectious. Where on copper and steel its pretty typical, its really pretty much about two hours. I will say on other surfaces, cardboard or plastic, its longer. So we are looking at this because we dont know the role of fomite transmission. Now, its i dont think its going to impact cargo, okay, unlike maybe some of the other viruses that youve talked about, but i do think that it may have contributed to the huge outbreak we saw in that diamond princess. It may not have all been aerestolized. It could have been fomite. Were aggressively evaluating that to see how long the virus survives in different conditions. Wed appreciate you keeping us informed on that. Thank you. I understand ms. Spanberger has an additional question. Yes, thank you, mr. Chairman. Since we have been in this hearing, theres a breaking story with the Washington Post. I dont expect that you all have seen it yet, but it is theres a whistleblower report that a senior hhs official who oversees workers at the administration for children and families has now filed a whistleblower report that hhs employees were sent to an airplane hangar to meet evacuated americans at the march air force base in riverside and they were not given any ppe or protective equipment while they were interacting directly with those who were potentially impacted. I raise this recognizing that were dealing with different agencies here present today, but i think this speaks to a general concern, its a little bit of a followup to congressman beras question related to whether or not state doe apartment officep have what they need to stay safe and i would ill pose that question but then also wanted to make sure to make the point that this is deeply concerning because as were dealing with significant outbreak, something that is personally causing great fear in our communities, among individuals, we need to ensure that our constituents have faith that the administration of the u. S. Government is doing Everything Possible and theres already some concerns about whether or not thats the case and what how people can keep themselves safe and so finding out that the u. S. Government might have put its own personnel in harms way is deeply concerning to me. So if you could comment both whether or not your agencies are ensuring that their personnel are safe and then comment on, you know, what we can do in light of this when were back in our districts and people are saying, how can we trust the government to keep us safe if this is happening to its own people . Id love your comments on that. You know, thank you for the question and the concern. I can speak having been on those missions and certainly the first trip out of wuhan, the second, the third, the diamond princess and based on a relationship that ive had with hhs, aspr, and cdc, dating back to 2014, every precaution has been taken. So was it your experience that you did not witness any individuals who were not wearing ppe . No. I can tell unequivocally that everyone involved with those evacuations was appropriately equipped and trained. Okay. Well, and i dont seek i dont seek be argumentative with you, sir, im reading whats breaking news in the Washington Post. But that is good to hear. And then specifically with state Department Officials and the availability of protective gear and the attention to detail there. We take every precaution. We have the equipment and the training that we need to do this safely. Thank you. And would you care to comment as well, mr. Brownlee . Yes, please. My consular colleagues in china, japan, and elsewhere, have been working on an ongoing basis with people. So, for example, in japan there are still 100plus u. S. Citizens from the diamond princess in the country. A number of those are hospitalized. We are regularly engaging with those people, but were doing so in a safe fashion. Taking professional advice. So whereas initially some of the visits were taking place in person, that became cumbersome because they were having to suit up. Now these visits are taking place in a telephonic basis. I have here a photograph. I gave the chairman a copy of it. That shows my colleagues standing on the key side as they were processing people coming off the diamond princess. They were properly taken care of. I can see the photo from here that they ill leave you a copy. That they are equipped. And then the general concern about, again, this is just report that is breaking news, the voracity of it will be determined later, but it is in the news and people are reading it. Its adding to this story. Are there other comments you all would like to make related to ensuring that our constituents and people we represent have faith that were handling this, all involved agencies are handling this virus and concerns, you know, in the way that it should be handled . And just in light of what might otherwise be some concerning news. What i would say is the psychology in dealing with highly Infectious Disease is often worse than the pathology. That we have the best medical care in the world, whether its ebola or coronavirus, the american Health Care System is ready to receive and ready to take care of our Health Care Workers and our public. From the state departments perspective, you know, we have a workforce that is at the front line. We are happy to be there to facilitate the relationships that are going to be critical for containing this overseas, whether its a delivery of foreign assistance or the exchange of technical information. What i tell my family is that you live in the best country in the world and that that people who know how to do this are in positions where they can advise state, local, and interNational Health care workers. Thank you. I thank you for the indulgence of the second question, mr. Chairman, and to the witnesses, thank you so much for all of the work i know that you are putting in on this. Thank you for your continued service to our country and to keep us all safe and healthy. I truly appreciate it. I yield back. Thank you. Let me recognize the gentleman from california, mr. Sherman. Doctor, whats your best estimate as to the mortality rate of this disease among those who are healthy and under age 65 . Again, i think the most important thing in that scenario, under 65 and healthy, is whether your Health Systems functional or not. So, as weve seen with the wuhan Health System ill healthy, Health System, healthy human, under aingeage 56. Yeah. My constituents. I think, again, we dont have the data, i suspect if y, if yok at the mortality rate outside of china, were probably looking at somewhere around a half a per sevent percent. Again, we have to see more data to really be clear on that. Seasonal flu has a mortality rate of . About. 1 per thousand. 1 per thousand, or. 1 . 1 , im sorry, yeah. 1 . The chinese are telling us that theres a decline. Should we believe them . Doctor . I think that there probably is a decline. Again, i do think some of the mitigation strategies are starting to have impact, particularly out of wubei. Most of the cases now are in the hubei area. I want to ask you about masks. Its funny, i went on to amazon, buy 50 masks, its 50 bucks. Not very heavy. Less than a challenge. Amazon wants to charge an additional 400 for shipping and handling. Needless to say, well be in touch with amazon on this. But the i dont think that amazon has ever charged 400 to ship a box of not on a rush basis, actually a delay for two weeks from now, less than a pound, 400 shipping and handling seemed an extraordinary charge, but, you know, given mr. Bezos need for food and the necessities of life, i can understand. We see pictures from all over the world, people wearing these masks. Who should wear the machk maskse United States . Yeah. As i mentioned earlier, the masks, the n95 masks, really need to be reserved for Health Care Providers that are taking care of these patients in the hospital as well as confirmed individuals that are in home isolation to minimize the spread while theyre in home isolation. We would not recommend the American Public go out and get these masks and does the mask protect the person wearing it or protect others from the person wearing it . Well, theres really the issue here is to protect the individual whos been exposed to someone who has the pathogen, and then and we believe that thats where the mask the mask should be. A lot of people you see wearing these masks, theyre really not going to have a functional impact whatsoever in terms of transmission. These surgical masks that you see everybody wears on the even when i, you know, was traveling today here in the city, i saw people again, even in our own city wearing masks. Some of them do it that has a cold or an illness that it think it might minimize them. I would tell those people to stay home. That would be more effective than trying to feel that you have to go to work and wear a mask. I think the cdc has on its website really good guidance on the appropriate use of masks and i encourage people to go look at it. Looks like the chinese have had a decline. Theyve dealt with extraordinary lockdowns of entire areas. Should we be locking down any neighborhood where we find that someone what level of lockdowns do we need, if any . Yeah, the backbone of our response right now and really the most important part of our multilayered response, even though sometimes people dont recognize it because its not like travel restrictions or screening at airports. The backbone is the American Medical Community and Public Health community. As i mentioned, of our 15 cases that we diagnosed in this country, 14 of them were diagnosed by our medical Public Health community. So, im going to maintain confidence on early diagnosis, isolation, and contact as our major mechanism. To test for this, is it sufficient to just take peoples temperature as they were doing, or is it contagious before its symptomatic . And do we need to give a lot of people blood tests . Yeah, so the issue of how infix, this disease is at different times is we dont know. We know you can contribute before symptoms. Does it contribute meaningfully, we dont know and thats what were trying to learn. Clearly the cdc is working on another test which the chairman would understand. Were trying to develop serological tests. In china theyre measuring the active virus, and thats what were doing. But that doesnt really tell us what the denominator is of whos really been infected. You need a serological test to do that. I know the chairman understands what youre saying. Youre saying we want to test to see which people have been exposed, have the antibodies, and may have been asymptomatic throughout the whole process, just didnt know they had the disease. Yes. See, youre not the only member up here who understands it. Thank you. Once again, i just want to recognize and say i appreciate the service to our country. And obviously this is a very fluid situation. Just want to make reference to the breaking story. Im fully confident that we do everything we can to protect our personnel and our workers. As we were evacuating folks from china, putting them on airplanes, bringing our citizens back home. It does sound like there was someone who did see some personnel that did not have protective gear and were released i hate to use the term whistleblower because its gotten politicized. But it is important that if there are folks that are raising issues, and i do feel that its very important for this body to say publicly we want to encourage folks who see things for the sake of bettering ourselves, those whistleblowers or those individuals that are raising issues. We are fully committed to protecting them, and we fully want folks that are seeing things to feel comfortable and protected from coming up, not commenting on whether the story is accurate or inaccurate. But i am commenting on the fact that it is important for folks that see things to identify them and not fear retribution for coming forward. That is our law. That is the way this process works. Dr. Redfield, i appreciate youre coming up to the hill and keeping us informed. Again, in conversations with my colleagues at u. C. Davis, we look forward to looking closely with the cdc. As one doctor to another, you know, as we work through the regulatory process to speed up our testing capabilities and the availability of diagnostic tests throughout this country, we look forward to working with well, youre not the one holding it up necessarily. But we do look forward to speeding up that regulatory process to make sure we get these tests out and are able to do it. Again, i appreciate updating folks that we are testing. I do think that is going to be helpful in trusting our doctors that are on the front line if they do suspect coronavirus, being able to get that test in. I just want to make one comment for the record that we have been working very closely with the fda. They have been very supportive. I just want to make sure of that. But theyre operating within the Regulatory Framework that we have. And i think the point that i wanted to make is that the loss of Laboratory Development tests to be used when were developing new tests and responding to new emergencies i think is something that should be relooked at. I appreciate that. Again, thank you and thank all three of you as well as your colleagues at hhs, usad, Homeland Security for regularly coming up to the hill to brief eastbound manies of congress. Again, this is fluid so lets maintain close contact and dialogue. With that, this hearing is adjourned. Cspan, your unfeltered view of government. Created by cable in 1979 and brought to you today by your television provider. Secretary of defense has indicated that protection of the force is his number one priority regarding the coronavirus. So, u. S. Northern command is the lead for the department, working very closely in support. Were connecting with them on a daily basis frequent number of times a day. Were watching for implications on global mobility. And what specific actions are you taking . Inside the transportation enterprise, locations like Travis Air Force base has become a receiver for a potential folks coming out of the theater in the indopacific. So were not taking particular Health Protection measures inside the command other than to protect the force, but in a more broad sense were in support of health and Human Services. And thats done through the lead of u. S. North comp. General waters, do you feel youve been given the necessary resources and other tools to american servicemen and women and their families in europe . Yes, senator. And weve also been given the appropriate authorities as we week in europe we have over 300 cases in the nation that is most concerned in italy with six reported deaths. Weve restricted travel to several zones and required flights to be screened for the virus. Are you taking any adishditil steps to constrain travel by servicemen and women or their families on their on leave and so forth . We have in what we feel are the infected areas, in particular two states inside of italy. And do you have plans to restrict travel in any other states . We anticipate the need may arise in germany, but that is still to be determined. Top military officials testified about precautions being taken abroad to protect u. S. Forces and their families as the coronavirus continues to spread. The comments came during a Senate Armed Services Committee Hearing regarding the european and transportation commands fiscal year 2021 Defense Authorization request. Watch tonight beginning at 8 00 p. M. Eastern on cspan3. Earlier today, republican representatives jim jordan and mark meadows spoke at the annual conservative Political Action conference with American Conservative Union chair mat sclap about the upcoming election and the impeachment process against President Trump. C papac is waking up. We started earlier this year. You know why . Because theyve been torturing us for three and a half years