Coronavirus without objection. The chair is authorized to declare the committee in recess at any point. Good morning. Today, the committee is meeting to hear from medical experts about how our country can best confront the coronavirus. Americans are justifiably concerned about the virus which has spread around the world and claimed the lives of thousands. Understandably, they have questions about how it may affect them, their loved ones and their communities. How concerned do we need to be about the virus . Who is most at risk . What can communities do to compare prepare . What can americans do to protect themselves and their families . What is the federal government doing . What more should it be doing . My constituents are looking to the federal government for leadership, guidance and expertise. I shea i am sure my colleagues constituents are as well. I am concerned that the Trump Administration has downplayed the threat and overstated how close scientists are to developing a vaccine and silenced experts who disagree with him. Instead, we have to acknowledge the threat and allow doctors and scientists to offer candid assessments of the situation and direct the federal response. We are fortunate to have a distinguished panel of physicians to offer their expert opinion. Government must do to support state and local protect the lives of americans. Input like there is will absolutely be essential to confronting this threat. I appreciate their willingness to join us today. When the Ranking Member comes, we will allow him to read his statement into the record. Erfurt our first witness is center. Ctor of the his work is internationally recognized in the field of Public Health and emerging Infectious Disease and tovention and response biological threats. I now recognize the gentlelady from illinois, is underwood to introduce our next witness. Inc. You. I want to look on the director of the Illinois Department of Public Health. He is a pediatrician and internist. She has dedicated her career to helping the people of illinois. She has served in Public Health goals for the past 15 years. She received her undergraduate degree from harvard and her middle double medical degree from the university of san diego. Assistant professor of pediatrics. I want to thank her and her team for working aroundtheclock to serve to respond to the recent coronavirus outbreak in illinois. Herincerely appreciate taking the time to share her expertise today. Finally, we have she serves as the director for the centers of Disease Control from 20022008. She currently serves as executive Vice President and chief patent officer for strategic communication, Global Public policy and population health. Is also the cochair on strengthening America Health security. The witnesses for statement will be inserted in the record. At this point, i would like to defer to the Ranking Member for an Opening Statement. This is a great panel. I look forward to testimony. Our hearts go out to those who have lost their loved ones and those who are currently undergoing treatment. This is a global event that requires a global response. Many of our International Partners are working diligently as united effort to address covid19. Actions from other countries may have hindered a copy as a response. I remain concerned that chinese officials knowingly withheld information from public and the International Health community in the most critical stages of this outbreak. Im sure the early days of this outbreak will be under intense scrutiny once this process is over. I deepest concern for the moment is the level of preparedness at the state and local level. I have heard from medical professionals and Emergency Managers that are dealing with an increasingly concerned public. We have a distant wish panel of medical officials here today. I am interested to hear what they need from the federal government to effectively deal with crisis. That thispleased doctor is here. She led a very Effective Response to the outbreak of sars this. Naged finally, i am interested in the honest assessment. Your expert medical opinion is invaluable. It was important for political leaders to avoid fanning the flames of hysteria. I would jump should be to support the medical community and provide them the resources they need to handle this and future outbreaks. Hopefully this funding will help speed along this important diagnostic treatment and vaccination resources that will alleviate this crisis. Have one request that we enter this into record. Without objection. Sherman thompson, Ranking Members of the committee, thank to for the chance to react covid19. I am the center i work at the center for Health Security. Between 90,000 cases worldwide and code over 3100 people across 55 countries. Patients have become sick with covid19 and have a cough, fever and an underlying pneumonia. In china, 80 of those with this illness had mild symptoms. Andrequired hospitalization 5 developed critical illness. An emergency supplemental appropriation is being between congress and administration. Covid19 will require twice as much or more given its respiratory transmission and the likelihood that it will be widespread around the country. Need tosdictions will prepare and respond. Lth care systems this has been required in china and in south korea and italy. They will need strong Infection Control strategies including access to personal protective equipment as well as other kinds of engineering and administrative controls. The federal government should be engaging at the highest level of industry regarding p. P. E. Manufacturing and maximizing supply of this critical medical material. Steps should be taken to make sure that routine medical care is not disrupted, as it has been in china, where we saw clinics unrelated to covid19 were disrupted, including cancer clinics, dialysis clinics, and other important medical facilities. Were trying to help ensure highrisk contacts. If cases increase significantly, it may no longer be possible to isolate all cases and contacts and there may need to be a shift, probably will need to be a shift in strategy, and at that point Public Health, agencies will need to focus on surveying the population for the overall level of covid19, advising how the public can be tested, and how it needs to be isolated when sick and working with political leaders at the state and local level to consider social distancing policies that will do more good than harm. C. D. C. Has been doing all lab testing until this week, but testing is going getting in Public Health labs around the country. I believe we will see considerably more cases diagnosed around the u. S. In the coming days as weve seen in the last week. Largescale testing at clinical sites around the country will require clinical diagnostic companies because c. D. C. And Public Health labs were not designed for the kind of high clinical testing that will ultimately need to take place. Vaccine development is likely to take 12 to 18 months. One of the worlds experts is to my left so youll hear more about that. As we develop an effective vaccine, we need to have the means to mass manufacture it, which is not normal. Ideally that should be occurring in multiple sites around the world. Even if the u. S. Is the country to develop the vaccine, there will be a huge demand for the vaccine around the world. Antiviral or antibody base medicines should be under way should those be successful. One of the themes of our preparedness in this country needs to be Close Partnership between government and industry because industry is the place where diagnostics on a large scale, p. P. E. , medicines, vaccines, hospital equipment are being manufactured so there is no way around having a very close Effective Partnership and making sure that those industries are well aware of the sport they will receive from the government to do that work. Finally, id say its very important from this point forward for the federal government to be speaking in a single, consistent voice. As we did in the 2009 h1n1 about whats known, whats unknown, how were learning to learning to fill the gaps and information should come out of the government on a daily basis. And i do think that should come from our Health Officials here at h. H. S. Or c. D. C. Because they are close to the people around the agencies. Thank you for the opportunity to testify. Mr. Thompson thank you. Now to dr. Ezike to summarize her statements. Dr. Ezike chairman thompson, vice chair underwood, Ranking Member rogers, and distinguished members of the committee. My name is dr. Ngozi ezike. I thank you for inviting me to speak about the Novel Coronavirus and the preparedness and response efforts of the Illinois Department of Public Health. Even before our first illinois case was identified in china, a strong federal, state, county, and local coordinated effort was enacted. Enabled our state to be a leader in addressing this rapidly developing outbreak. The c. D. C. Quickly deployed a team to illinois after our first case was announced and was essential in partnering with us through the response. They have been equally responsive with our recently announced third and fourth cases. The illinois congressional delegation supported our request for immediate approval of an emergency use authorization for the covid19 test, which has been invaluable in the effort to containing illness. Illinois was the first state in the United States to validate this test and to begin testing we began surveillance testing this week, enabling illinois to better determine how much covid19 is circulating within our community. Our success in testing raises a new concern, however. Will we have enough to maintain and increase our testing . We are requesting that c. D. C. Provide an uninterrupted supply of testing materials. The ability of states like illinois to test samples lessens the burden on the c. D. C. We encourage c. D. C. To expedite additional reagent shipments to illinois and other states. Illinois has utilized and proven its capabilities in the past when responding to the domestic cases of sars, h1n1, zika and ebola. Idph participated in crimson contagion. This is a National Tabletop exercise that used a covid19like outbreak that was set to have originated in china in the u. S. However, Surge Capacity remains something that is not able to be sustained for extended periods of time. Therefore, emergency supplemental funding is necessary. Illinois encourages congress to appropriate funds enough to reimburse illinois and other states for the costs associated with this aggressive response. Public Health Infrastructure such as data management, information sharing, and Operations Management are essential just for daytoday function, but theyre vital in the settings of Public Health emergencies. For example, during this response, the state Health Department is closely monitoring the availability of airborne infection isolation rooms. These isolation rooms are providing are proving criticl in the treatment of these patients by controlling the spread of the virus to the public and Health Care Workers. We inventory these beds daily as an indicator of disease rates and to adjust Surge Capacity estimates. An important support for this capability came from aspers hospital preparedness program. Given the transmissibility of covid19, isolation sites are required to house effective affected persons. Its challenging to find establishments willing to take on isolation or quarantine patients. When covid19 began in illinois, the city of chicago was given very little time to set up screening operations at ohare and establish a requisite quarantine site. Chicago has continued to maintain both its screening operation and quarantine site at an enormous cost. Without reimbursement and ongoing money for future expenses, governments will likely struggle to maintain these critical Public Health interventions. Additional attention must be given to mitigation strategies for the state. We are working closely with longterm care facilities to implement strategies aimed at protecting what will be our most vulnerable citizens. In addition to these Community Mitigation approaches, we encourage the public to employ their own strategies to keep themselves healthy. We said it over and over. The frequent hand washing, staying home when ill, sanitizing frequently touched surfaces. Individuals should take care to rely on trusted sources of information such as the c. D. C. Public Health Security is Homeland Security. Our country is nothing without the health of its people, and we can all Work Together to ensure that we continue to support this response and decrease the potential negative effect and impact on the people of this country. In closing, i wish to again thank the committee for its invitation and the attentiveness to illinois successes and opportunities in responding to covid19. Mr. Thompson i want to yield to dr. Gerberding to summarize her statement. Dr. Gerberding i want to thank you for allowing me to testify with such distinguished experts. I am here wearing several hats. I am currently the chief patient officer at merc where i served as the president of the vaccine business for a number of years and more recently as the chief patient officer contributed to the development and deployment of the ebola vaccine in the democratic republic of the congo, which is now licensed, even though it was created on the fastest possible track and so far weve been able to contribute to about 300,000 doses of the vaccine. This week, the director general of the w. H. O. Indicated his optimism that that outbreak has finally come under control. Im also witnessing as the cochair of the Csis Commission on global Health Security which submitted this report to the record. The commission includes bipartisan members of the senate and the house and has the stated purpose to advise the congress on steps that can be taken to improve our global Health Security. The report was written before coronavirus was recognized, but i think many of the recommendations, which are summarized in my written testimony, are prescient and really apply to the situation that we are experiencing today. I would be remiss if i didnt mention that im also on the executive committee of bio, the biotechnology innovation organization. Today, many of the c. E. O. s of b. I. O. Are here in washington to brief members of congress. About 40 of these companies have innovations and molecules and platforms and are stepping up to try to contribute to the prevention and treatment of this coronavirus outbreak. So were lucky we live in a country that has such a vital biotechnology organization. And finally, i am the former c. D. C. Director in the past life where we were dealing with anthrax and sars and many other outbreaks. The first coronavirus outbreak, sars, challenged the United States and challenged the world, and i think we learned many lessons, which are relevant to where we are today. I dont have time to give the full picture of the u. S. Public health situation. I think my colleague has expressed it from a state view very eloquently, but i would say its important to remember where we are in the outbreak right now. From the u. S. Perspective. There are really three main phases of outbreak response. The first is detection, and that happened in china and was reported fairly early in the process, but we dont have full detection because we havent had full testing and we still dont know whether the cases were we are detecting represent the tip of the iceberg and how much of the iceberg is undetected yet because we havent tested or because many patients are asymptomatic which i in fact suspect. The second phase is the phase of trying to contain the outbreak where it starts, and i dont think in the history of the world we have seen a more dramatic demonstration what has occurred in china and what has occurred in countries around the world who attempted to keep the virus out of the country. It was the heroic effort. It wasnt perfect, but it probably did buy us some time. For that i think we should all be grateful. Where we are now is in the phase of slowing the spread of the virus. Its here. Were doing everything we can on the front lines of Public Health to identify and isolate cases, to quarantine people who may be exposed or incubating and managing the social system that promotes spread. But we need to advance the effort to slow things down by recognizing we also need to sustain our essential services, our businesses need to run, our medical supply chain needs to operate, and our security and safety needs to also be part of our overall response capability. So were going to be seeing a lot of local decisionmaking. If youre looking at it from a highlevel view, whats going on in chicago might look different from whats going on in some other part of the country. But you know that each individual location has to make decisions in the best interest given the state of the outbreak in their particular community. One of the most important lessons that i wanted to emphasiz