You 19 started in would has wuhan, china. Atients have become sick with covid19 have cough, fever, and he more serious cases underlying viral few monia. In china approximately 80 of had mild the illness symptoms. 15 required hospitalization. 5 developed critical illness. T has a one to 14day inc. A bigs period and spread by respiratory droplets with people in close contact. And elderly and those with at rlying conditions are risk. The u. S. Had confirmed 118 cases including eight deaths. The majority of those cases are travelers or repatriated travelers from china but there is no connection etween any known case of covid19 which suggests that in those places there is some level transmission of on. D covid going an emergency supplemental going on between congress and the 2014, tration, in congress appropriated 5. 4 billion for the ebola response. View, covid19 will require perhaps as much or more respiratory transmission and the likelihood that it is going to be widespread around the country so all jurisdictions will need to prepare and respond. Ealth care systems should be planning to provide care for large numbers of critically ill as weve seen has been required in china and south korea and italy. Also need very strong Infection Control strategies, ncluding access to personal protective equipment as well as other kinds of engineering and administrative controls and hospitals. The federal government should be engaging at the highest level of regarding p. P. E. Manufacturing and maximizing critical medical material. Steps should be taken to make care hat routine medical is not disrupted, as it has been clinics where we saw unrelated to covid19 were cancer d, including clinics, dialysis clinics, and ther important medical facilities. Were trying to help ensure contacts. If cases increase significantly, it may no longer be possible to cases and contacts and there may need to be a shift, probably will need to be strategy, and at that point Public Health, agencies will need to focus on surveying overall ation for the level of covid19, advising how tested, and n be how it needs to be isolated when sick and working with political and local the state level to consider social distancing policies that will do good than harm. C. D. C. Has been doing all lab week, but il this testing is going getting in Public Health labs around the country. I believe we will see cases rably more diagnosed around the u. S. In the coming days as weve seen in the week. Largescale testing at clinical sites around the country will die re clinical nothingists diagnostic c. D. C. And cause Public Health labs were not esigned for the kind of high clinical testing that will ultimately need to take place. Vaccine development is likely to 12 to 18 months. One of the worlds experts is to youll hear more about that. As we develop an effective need to have the means to mass manufacture it, normal. Not ideally that should be occurring in multiple sites around the world. Even if the u. S. Is the country vaccine, there will be a huge demand for the world. Around the ntiviral or antibody base medicines should be under way should those be successful. One of the themes of our reparedness in this country needs to be Close Partnership between government and industry the place ustry is where diagnostics on a large medicines,. , vaccines, hospital equipment are being manufactured so there is o way around having a very close Effective Partnership and making sure that those industries are well aware of the will receive from the government to do that work. Finally, id say its very from this point forward for the federal government to be speaking in a consistent voice. As we did in the 2009 h1n1 known, whats unknown, how were learning to learning to fill the gaps and information should come out government on a daily basis. And i do think that should come officials here because theyc. D. C. Are close to the people around the agencies. For the opportunity to testify. Mr. Thompson thank you. To dr. Ezike to summarize her statements. R. Ezike chairman thompson, vice chair underwood, Ranking Member rogers, and distinguished members of the committee. Name is dr. Ezike. Thank you for inviting me to speak about the Novel Coronavirus and the preparedness and response efforts of the llinois department of Public Health. Even before our first illinois case was identified in chan, a federal, state, county, and local coordinated effort was enacted. Enabled our state to be a leader rapidly sing this developing outbreak. The c. D. C. Quickly deployed a team to illinois after our first was announced and was essential in partnering with us the response. They have been equally responsive with our recently nnounced third and fourth cases. The illinois congressional supported our request for immediate approval of an mergency use authorization for the covid19 test, which has been invaluable in the effort to illness. G illinois was the first state in the United States to validate and to begin testing inhouse, a capability we had or the last three to four weeks. We began surveillance testing enabling illinois to bett better determine how much circulating within our community. Our success in testing raises a concern, however. Will we have enough to maintain testing . Ase our we are requesting that c. D. C. Provide an uninterrupted supply testing materials. The ability of states like test samples lessens the burden on the c. D. C. To expedite c. D. C. Additional reagent shipments to states. And other illinois has utilized and proven ts capabilities in the past when responding to the domestic h1n1, zika and ebola. Participated in crimson contagion. This is a National Tabletop xercised that used a covid19like outbreak that was set to have originated in china the u. S. However, Surge Capacity remains not able to beis sustained for extended periods of time. Emergency supplemental funding is necessary. Congress to urages appropriate funds enough to reimburse illinois and other for the costs associated with this aggressive response. Health infrastructure such as data management, nformation sharing, and Operations Management are essential just for daytoday in tion, but theyre vital the settings of Public Health emergencies. This ample, during response, the state Health Department is closely monitoring of airborne ity infection isolation rooms. Rooms are tion providing are proving critical in the treatment of hese patients by controlling the spread of the virus to the public and Health Care Workers. Inventory these beds daily as an indicator of disease rates capacity ust surge estimates. An important support for this from aspers me hospital preparedness program. The transmissibility of covid19, isolation sites are effective house persons. Its challenging to find establishments willing to take isolation or quarantine patients. When covid19 began in illinois, of chicago was given very little time to set up screening operations at ohare establish a requisite quarantine site. Hicago has continued to maintain both its screening operation and quarantine site at enormous cost. Without reimbursement and ngoing money for future expenses, governments will likely struggle to maintain hese critical Public Health interventions. Must be aattention given to mitigation strategies for the state. We are working closely with longterm facilities to mplement strategies aimed at protecting what will be our most vulnerable citizens. N addition to these Community Mitigation approaches, we encourage the public to employ heir own strategies to keep themselves healthy. We said it over and over. The frequent hand washing, ill, g home when anitizing frequently touched surfaces. Individuals should take care to rely on trusted sources of c. D. C. Tion such as the Public Health security is Homeland Security. Country is nothing without the health of its people, and we can all Work Together to ensure support thisnue to response and decrease the potential negative effect and the people of this country. N closing, i wish to again thank the committee for its invitation and the attentiveness illinoiss success illinois successes and responding to in covid19. Want to yield to dr. Gerberding to sum advise her statement. Dr. Gerberding i want to thank testify llowing me to with such distinguished colleagues. The key patient officer at merc where i served as the president of the vaccine years s for a number of and more recently as the chief patient officer contributed to he development and deployment of the ebola vaccine in the democratic republic of the now licensed, even though it was created on the fastest possible track and able to ve been contribute to about 300,000 doses of the vaccine. This week, the director general w. H. O. Indicated his optimism that that outbreak has control. Ome under im also witnessing as the Csis Commission on global Health Security which ubmitted this report to the record, the commission is the bipartisan includes bipartisan members of the senate house and has the stated purpose to advise the congress taken to hat can be improve our global Health Security. Written before coronavirus was recognized, but i think many of the recommendations, which are in my written really apply to the situation that we are experiencing today. I would be remiss if i didnt ention that im also on the executive committee of bio, the iotechnology innovation organization. Today, many of the c. E. O. s of washington toe in brief members of congress. About 40 of these companies have innovations and molecules and and are stepping up to try to contribute to the of thison and treatment coronavirus outbreak. So were lucky we live in a a vital hat has such biotechnology organization. Former lly, i am the c. D. C. Director in the past life where we were dealing with nthrax and sars and many other outbreaks. The first coronavirus outbreak, sars, challenged the United States and challenged the world, we learned many lessons, which are relevant to where we are today. Dont have time to give the full picture of the u. S. Public situation. I think my colleague has expressed it from a state view say eloquently, but i would its important to remember where we are in the outbreak right now. Perspective. There are really three main phases of outbreak response. Is detection, and that happened in china and was eported fairly early in the process, but we dont have full detection because we havent had and we still dont know whether the cases were de were detecting represent of the iceberg and how much of the iceberg is undetected yet because we because many or patient are asymptomatic which i suspect. The second phase is the phase of trying to contain the outbreak where it starts, and i dont any had the ifrt world we have seen history of the more we have seen a dramatic demonstration what has occurred in china and what has occurred in countries around the keep the attempted to virus out of the country. It was the heroic effort. But it t perfect, probably did buy us some time. For that i think we should all be grateful. Now is in the phase of slowing the spread of the virus. Here. Were doing everything we can on the front lines of Public Health identify and isolate cases, o quarantine people who may be incubating and limiting the social spread. We need toness have a the effort down by hings recognizing we also need to sustain our essential services, our usinesses need to run, medical supply chain needs to and te, and our security safety needs to also be part of capability. Response so were going to be seeing a lot of local decisionmaking. F youre looking at it from a highlevel view, whats going on in chicago might look different in some s going on other part of the country. But you know that each to make l location has decisions in the best interest given the state of the outbreak their particular community. One of the most important lessons that i wanted to my Opening Statement is something weve learned in every outbreak and do with the importance of trust. We must have credible leadership every level federal, state, and local. E must have clear and consistent communication from trusted individuals who are about Public Health, health care, and the cience and evidence of Public Health interventions. E must have a spirit of collaboration, combat. A spirit of Health Protection politics. Thank you. R. Thompson thank you very much. I must add, we hear from a lot this witnesses on committee and what youve told sobering, to ite say the least, but quite informative. Compliment you at questions. Ng of the but one of the things that each was the u talked about need in a situation like this to effective communication. Mixed re seems to be messages to the public from the administration at this point the severity of this outbreak. Any of my constituents have repeatedly called asking for citing on many issues inconsistencies made by the ighlevel administrative officials. How would you assess the u. S. Governments communication with regarding the risks presented by this outbreak . Federal can the better . Nt do dr. Inglesby, well start with you. Dr. Inglesby i think the state of the outbreak has changed a in the last month, and we have a very big federal government with many different working on this. And so there have been days when within the government there have different messages issued. I dont think that was intentional. I think its partly people kind of catching up to where we are in the outbreak. Do think it will be very valuable for the government to with as much of a single and consistent voice as possible in a big government. Its on the one hand, i think its important to say what the risk is at this moment. Main of the risk statements have been said from he government, today the risk is very low for any particular american. That may be accurate for today, ut i think it will be helpful for americans to understand risk Going Forward. BelieveHealth Officials will likely happen in their communities . Not in an alarmist way, but so informed, begin to take measures, as we heard my colleagues talk about, to try to their own risks, to make sure theyre staying home when sick, to make sure theyre their hands properly, isinfecting after they touch public surfaces. So i think consistent messages that empower the public will be even though we dont know what exactly will happen next, we expect this disease to continue to spread in the point. At this it will be useful for people to know that. Ezike. Mpson dr. Dr. Ezike in illinois, our intersection with the federal overnment has been primarily with the c. D. C. , and we have had and se communication collaboration. We are on hours of calls days ar every day, seven week. Had federal c. D. C. Staff come on site to help us directly investigations. And with the f. D. A. , they were the ones that gave us the to be able to test. That ability to test and being to dorst state being able that has been very instrumental in being able to quickly versus ourr positive negative cases. O we have seen how good communication, collaboration, and coordination between the and our local Health Departments, how that been successful in giving us a pretty good illinois. N mr. Thompson dr. Gerberding, through this in another life. Talk about the same issue as it relates to the public n and consistent voi voice . Dr. Gerberding i will share a i learned gs i think along the way. The one hardest for me, you enough. Mmunicate in an it really does that it really does take, like you said, daily, regular. What did we know what do we know oday that we didnt yesterday . What are we doing . What can you expect Going Forward . Hardest things being in the early phases of an outbreak like this is we dont expect. Now what to this is new and were learning as we go. O preparing people for change, for decisions that we make today might be different from decisions that we make next week. These are very important things. And to just acknowledge them. Theyre nt panic if given straightforward information. They panic when they hear and conflicting information and they dont know who to trust or who to believe. The other important lesson that i learned was the the tance of governors in communication. We tend to think that everything is washington and federal and if we do our job right it will just automatically flow through the system. Know, governors have a great deal of authority in heir states, and they need to be brought into the communication and information flow, because they influence a number of important decisio decisions at the state and local level. That they are connected to the federal response is critical. All ofmpson and i thank ou for saying that, because yesterday, the administrations oronavirus task force held a press briefing that was closed recordings. Nd audio and thats troubling in a time because information is very important. So if you hold briefings, i they should be public. Should be made because its the consistency of provides the at confidence thats so important times. These troubling so my theme to the is,nistration Going Forward please allow at the briefings to ave the press there, have the cameras rolling, have the recordings being made because adds to strengthening of communication required in a situation that now. In so i wanted to make sure that Administration Hears Us so will be ess briefings a transparency standpoint to the public and i think all three of you have kind in aid thats so important situations like this. I yield to the Ranking Member. Thank you, mr. Chairman. Gerberding, you talked about Lessons Learned in your previous life. Most learnedave we from this outbreak given that stages that wely need to take heed of . In you think of one particular that stands out . Dr. Gerberding i will say the less