Transcripts For CSPAN Public Health Preparedness Response 2

This is just over two hours. I would like to call the hearing to order. First off, i would like to recognize the chairman of the committee for a segment. Thank you. I want to thank the senator for chairing the hearing today. Sen. Casey serving as Ranking Member at senator murrays request. They have both been real leaders on this subject. Senator burr was the original i will call it the all hazards preparedness act. In 2006. The law helps protect us from the full range of Public Health threats. In 2013, senators berger and senator burr and senator casey led the committee. Many members of the committee contributed, some are still on the committee. In the middle of the flu season, it is critical we reauthorize the act before many of its provisions expire and set number. I hope we will do this in a bipartisan way and i expect that. It has been the tradition with the law and with this committee on almost all of our major bills. Thele are not as aware of devastation of, for example, loop. I mentioned flu season. I believe the figures are between 12,00050,000 americans die of flu every year. Dr. Collins has talked to us flut expediting a universal vaccine which he sees soon. Tennessee has seen heartbreaking stories already this winter as the flu spread across the state and country. In our state already this season, a pregnant woman and three children have died and tennessee of the flu. Preparednessdes a framework that enables us to be prepared and respond to Public Health threats by ensuring we have enough medicine to ensure americans and to ensure our Health Services can respond to emergencies. Thank youf our thank you to all of our experts who are here today. Thank you. This morning we are holding a hearing entitled facing the. Reats we will hear from the director of the center at John Hopkins School for Public Health. Tennesseeor from the department of Public Health. The Senior Vice President for seekers and and head of pediatric emergency medicine at the Childrens Hospital in chicago. Senator casey and i will have an Opening Statement and then we will hear from witnesses. Members will have up to five minutes for questions. I am pleased to chair the second hearing to inform our work. Chairmanto thank the for giving the opportunity to senator casey and i to lead that discussion. Today we will hear from individuals with firsthand knowledge. Since the last authorization, the Emergency Response framework has been tested by the emergence of pandemic flu, multiple Natural Disasters, and ebola breakout and the zika virus. The lessons comes from those like those sitting before stood a and their efforts to protect and save lives. The last Hurricane Season resulted in three major storms, devastating many communities and raising questions about our ability to withstand multiple times of response. The instances of zika showed us the need for more protections for as many mothers and babies as possible. Ebola outbreak in 2014 highlighted the need for knowledge of the potential damage that can be brought by these threats and a deep understanding of the effort undertaken for research, procurement ofd medical countermeasures. I look forward to learning more about the opportunity send barriers each of you see to better leverage innovative Tech Knowledge he to solve these problems. Technology to solve these problems. Whether it is information crucial to the Public Health department and myths of a crisis, the infrastructure of dr. Needs to rapidly care for patients are improvements in the way these policies complement one another, your experiences reminds us we cannot let up on these efforts or lose sight of the urgency this mission demands. We must not get distracted by making changes to the laws that are outside of our focus of public, improving and strengthening our policies and programs to make them more effective now and in the future. I look forward to the insight each witness can provide. Now i returned to senator casey for any remarks he would like to make. Several casey i would like to thank n. Casey thank you for joining us today. This is our second hearing on this topic. Is as we look forward to amending the act later this year. Now more than ever we must rebuild our nations resiliency to help security threats. The threats that face our nation today are increasing in both frequency and intensity. It is critical to foster in advance innovation and drugs devices. Yet, when we are considering any merging Infectious Disease or in engineered bio weapon that is yet to be seen by man or the response to a Natural Disaster like a hurricane, we do not and will not have a vaccine or countermeasure to protect us from these scenarios. So in addition to supporting biomedical innovations, we must also strengthen our hospitals and our Public Health professionals, our front line of defense we must ensure that we give our communities the necessary tools, they need to be ready when, not if, the next emergency strikes. By all accounts we have come a long way. I spoke at the last hearing about the success of the hospital fairness program and the Public Health Emergency Preparedness program. In the context of a Train Derailment in pennsylvania, one of many examples we could cite. The these grants or these programs also facilitate preparedness activity, it helps hospitals and Public Health systems with more regular occurrences. When subzero temperatures cause bursting pipes at st. Vincent hospital in erie, pennsylvania, the hospital contacted the local Emergency Management agency and also the Regional Health Care Coalition created through hpp funding who assisted in the response in that circumstance. The funding for these Preparedness Programs has decreased from with appropriations falling behind, authorized levels spiking only in response to ebola and zika. The impact of funding reductions means a decrease in the amount of time hospitals and megan medical staff have a have to plan and train for an emergency. The loss of thousands of Public Health jobs, the reduction in Emergency Managers and Public Health lab technicians. It is very dangerous to wait for a threat to emerge before passing emergency funding bills. We must be proactive, not reactive. How can we improve our Health Care System preparedness and our Public Health capacity and thereby improve our Situational Awareness in emergencies in an emergency . Can we work towards a per visit precision Public Health using better data and more efficiently guide responses to help emergencies to benefit our communities . I think we can. It was reported by publication nature when domestic transition of zika virus was confirmed in the United States, the entire country was not declared at risk. Instead, precise surveillance defined two at risk areas of miamidade county. Neighborhoods measuring less than 2. 5 square miles. This allowed for targeting of resources to these regions. Building on that experience, we can expand surveillance through expensive valence, limited cause of disease and expand prevention. All last after last weeks hearing, we heard from assistant secretary catholic about the use of the empower program to identify and treat at risk individuals requiring electricity dependent assistant quitman. Yet he also identified a weakness. This only pulls in medicare data, not medicaid and not data. How do we ensure that we are acting on the data appropriately to protect these vulnerable individuals . The tragic death of 12 seniors at a nursing home during Hurricane Irma in september highlights this that more needs to be done to protect the most vulnerable citizens. Most of our citizens have additional characteristics that make them more vulnerable during a Public Health emergency. This includes our children, our parents, our rural communities, individuals with limited english proficiency, individuals with disability and individuals with chronic illnesses and more. We must do better to help our communities prepare for potential Health Security trends. We must continue to invest in innovative biotechnologies and we must also improve our nonpharmaceutical preventions. Im looking forward to the hearing, for the witnesses testimony, and for how we can prepare hospitals and Health Systems to ensure equal consideration of all of our constituents. Thank you very much. Sen. Burr i am pleased we have four witnesses here today and i thank each of you for taking the time to beer. Public introduce to be here. First i would like to introduce dr. Tom inglesby. He is internationally recognized for his work as a writer with numerous publications focusing on public care and emerging Infectious Disease as well the prevention of in response to biologic threats. I now turn to senator alexander for an introduction. Senator alexander i would like to welcome dr. John dreisner. He has a new didnt experience responding to state and local Health Emergencies including Infectious Diseases like zika and Natural Disasters such as wildfires the devastated eastern tennessee in 2016. Today, he will provide important insights into the preparedness and response capabilities of the state and local level where we can protect and save more lives. Dr. Dreisner is a physician with more than 25 years of service. I appreciate his leadership in tennessee and we welcome him to the committee. I am sure you were younger, a couple of tennessee basketball teams would probably recruit you tomorrow given their record this year. Next up like introduce mr. Macgregor, brent macgregor, the Senior Vice President for commercial operations for the second Flu Vaccine Company in the world. The example of the success between public and private partnership to ensure we are better prepared for the crisis. Their facility in North Carolina is one of three advanced manufacturers in the country with the capability to rapidly respond in the event of a pandemic flu outbreak. Macgregor is the cochair of the alliance for bio security, it works to promote credible partnerships between the government, industry and other stakeholders to advance medical countermeasures. Finally, dr. Stephen kruge, the head of pediatric emergency medicine at Childrens Hospital of chicago. He is also a professor of pediatrics at northwestern university. He serves as the chair of the american pediatric disaster bareness Advisory Council. Welcome. With that i will turn and you can lead with five minutes of testimony. Senator byrd, senator casey, members of the community, thank you for letting me speak about these issues. Im the director of the center for Health Security at Johns Hopkins Bloomberg School of health and professor of medicine at public and Public Health. Our mission is protect Peoples Health from disasters. Ill provide a brief overview of key areas that my colleagues and welcome. I consider viable. The opinions expressed are are my own and dont necessarily reflect the views of Johns Hopkins university. The u. S. Faces a range of major Public Health risks, any of which could occur without much warning. They include Natural Disasters, Mass Shootings and bombings, chemical spills and potential use of chemical weapons. Radiation, Nuclear Threats and biological threats. Biological threats, whether natural or accidental, or deliberate our particular concern and thus the big focus of my comments today. Biological threats can range from moderate size up to those capable opposing global catastrophic risk. What more can be done to prepare for these threats . We need to strengthen the Health Care System preparedness. That is the capacity to care for high numbers of sick or injured in emergencies. While there has been substantial for small disasters in the country, the nation is not ready to provide medical care for large catastrophes. The aspyr program has helped fund these capabilities of the state and local level. A Significant Resource constraint limits what hpp can do. The trend should be reversed. New initiatives like establishing regional Disaster Resource hospitals could be a strong new additional component in improving medical preparedness. Second, we need to strengthen the ability of our Public Health system to detect and response respond to threats. Since 2001 there have been serious to cdc and local levels to provide Early Warning of new outbreaks, provide diagnostics, investigate and contain outbreaks, communicate to the public, insure bio safety and security and more. There is been good forward movement, but not enough trained professionals to do the work. Public health relies on funding from cdc, Public Health emergency grants. That funding has been reduced by nearly 30 since 2002 even though Public Health crises have not declined. In addition i believe a Public Health Emergency Contingency Fund should be established which would allow rapid Public Health response funding in emergencies. We need to move ahead in medical countermeasure development. There has been Good Progress with many priorities remaining. Including sustained funding and research development, manufacturing of countermeasures. Transition to new flu vaccine technologies, setting ambitious targets for Rapid Development of products. So that they are ready in the course of a given pandemic or epidemic. Fourth, the u. S. Needs to recognize threats that could inadvertently emerge from biological research. After the moratorium on potential panic, after Death Research was lifted after last month. Studying ways of making the most lethal viruses like bird flu respiratory transitional transmissible. This could lead to the accidental or deliberate release of a novel strain of the virus that could cause an epidemic or pandemic. I dont believe the benefits of this work are worth the risk, but if it goes ahead i advised there is high transparency in the program and serious dialogue among concerned governments. Finally, we should fund the goal of global Health Security agenda. In 2014 the u. S. Helped launch with a billiondollar commitment to help countries prevent and respond to Infectious Disease threats. Since then, the cdc and usa have been working with 39 countries looking to stop increased increase resistance. At this point, u. S. Funding for ghsa is ending soon. If we pull away, others will soon. We should continue to support it. Its the most Effective Program we have to contain sources overseas. Improving our nations fairness and response capacity is a daunting endeavor. Im confident is an achievable goal. I appreciate the committees time and i welcome your questions. Good morning. Thank you for this opportunity to appear before the committee and discussed the issue of significant importance to the defense of this country. A strong, agile and resilient medical preparedness and response system. It is an honor to be here. Im a physician, commissioner of health in tennessee plus a local Health Director a decade before for a decade before that. The vaulted will be sharing are my own, but im confident they are shared by my Public Health colleagues from across the country who strive to repair and respond to threats of all kinds. Infectious disease outbreaks like measles, foodborne illness and are annual epidemic of influenza can test our capacity. Also largescale National Events like ebola, zika or act of terrorism. Public health mobilizes during Natural Disasters like storms, hurricanes, tornadoes, floods, wildfires. Terrorism. And other extreme weather events and fortunately does a Public Health jurisdiction go more th