Covid19 is not the first pandemic we will ever deal with and certainly will not be the last one, but it is incredibly important that we come together as a nation and as a planet to get ahead of this, address it, ad, you know, come up with remedy for it. If we think about the basis of Global Health security, it is a threepronged approach containment, mitigation, and then treatment. This is the third hearing that i am chairing on this subject. The first focused on the containment strategy. That was the first hearing that congress held. The conclusion of that was the initial strategy of trying to contain this disease with travel bands, etc. , was likely not going to be successful. Very difficult, and i think what china did was ambitious. About us some time that most of us in the Public Health world recognize that we would likely see in community cases, it would be difficult to stop the spread of this disease. The second hearing we had was on mitigation, largely looking at testing, this was last thursday after the First Community spread case hit my hometown of a patient wasre hospitalized at university of california Davis Health System where i used to practice. What we discovered was the testing criteria were probably too rigid, that we were missing a lot of community test, and we also started to discover the ability to test, the availability of test kits, etc. , was largely not there. The viceed to hear president yesterday savings are ramping up, but we probably did lose quite a bit of time and we are likely going to see many more community cases, probably in all of our congressional districts. There is a lot to be learned bureaucratic down that prevented us from rapidly getting this test out there. Todays hearing is focused on treatment based on science and what we can learn from how this virus initially developed, what we can learn from looking at the chinese response, we now have a big data set, how did they manage . China is a communist country so they were able to do things we cannot do as a democratic nation. We respect individual rights and individual freedoms here, but there is still a lot we can learn from how they did surveillance, etc. , especially given the breadth of Contact Tracing we will likely have to do. We will not have enough epidemiologists, the cdc will not have enough personnel, so what can we learn and how china and korea, and if youre looking at the data coming out of korea now, their aggressive approach and communitybased testing, they were doing 15,000 test a day may have mitigated the responseow bad could have been, so i think that will be incredibly important. We will also look at the science spread,fficiently it is , solong the virus can live i think this is an incredibly timely hearing. Sos is a science committee, im glad we are looking at the science of this and the Science Basis of the treatment and i appreciate the witnesses that are here that are bringing their scientific expertise that help us understand. With that, the chair recognizes mr. Lucas. According to the centers for Disease Control at this time, most people in the United States have little immediate risk of exposure to the virus. However, Public Health experts also advise us a pandemic is likely, so we must gather the facts and be prepared. Today, i hope our expert witnesses can provide Important Information we can share with our constituents. I also hope we can learn what tools are needed to detect and prevent the next pandemic. Inid19 was first identified wuhan, china, in december 20 19. Since then, the World Health Organization has reported over 90,000 cases in over 3000 deaths spread throughout 76 countries. In the United States, the cdc has reported at least 100 52 confirmed cases and 11 deaths. We know that for most individuals, the illness is not serious. Were still getting information on the death rate. The impact on vulnerable populations is particularly concerning, though, and my thoughts are with the individuals and families that have been affected. This is not the first Global Pandemic in modern times, and im quite certain it will not be the last. Just over 100 years ago, the world faced one of the deadliest 1918 avian flu pandemic, also known as the spanish flu. Since 1980, outbreaks of emerging Infectious Diseases have been occurring with greater frequency and have been causing higher numbers of human infections than in the past. The vast majority of these infections are initially caused by the spread of the disease from animals to humans. The sars outbreak in 2003 and an avian flu outbreak in 2006 were wake up calls for the american Public Health system, and congress made considerable investments in improving our nations capacity to detect and respond to pandemics. We would be in a much worse position without those investments. Im confident the u. S. Government has the tools necessary to deal with this. Their work has yielded insiderable Investments Technology and pretty to modeling as well as medicine, growth, and Vaccine Development. Integration of Technology LikeArtificial Intelligence and greater availability of data, researchers are able to identify and track outbreaks faster. Last congress, we also modernize the pandemic all hazards preparedness act to set up a framework to deal with precisely this type of outbreak. While significant progress has been made, gaps remain and a pandemic could be devastating to the global population. Population has grown, so has the livestock, swine, and poultry population needed to suite us, needed to feed us, providing opportunities for viruses to spread, evolve, and infect people. To better understand how diseases like avian flu, swine fluke, ebola, zika, sars, and now Coronavirus Spread and operate, we must investigate we must invest in basic research to learn about the interconnection between people, animals, and plants and shared environments. Yesterday, the house passed a supplemental appropriation bill to address the response and development of a vaccine. I supported the bipartisan bill, and i hope my colleagues and i can Work Together on the longterm strategy to prepare for any Global Pandemic we may face in the future. Our top priority is the health and welfare of the American People. Im pleased the president has created the corona task force. This Interagency Group is working to monitor, contain, and mitigate the spread of coronavirus while ensuring the American People have access to accurate and uptodate information. The best thing americans can do right now is follow the guidance of cdc. Many of the recommendations are simple things you learn from your mother. Wash your hands, do it thoroughly and frick only. Cover your mouth if you cough or sneeze, avoid touching your face, stay home if you are sick. I want to take thank witnesses for taking their time to share their expertise and insights with us during this crucial time to help keep americans safe, healthy, and secure. With that, i yield back the balance of my time, mr. Chairman. Thank you, mr. Lucas. Gentleman was who wish to submit additional opening statements, your statements will be added to the record at this point. At this time, i would like to introduce our witnesses. First we have dr. Susan murray come the Program Director for the Global Health program at the Smithsonian National disease and conservation biology. Next is dr. John brownstein, the chief innovation officer at lost in Childrens Hospital and professor at harvard medical school. The doctor whoe will be introduced by the chair of the subcommittee of intelligence. Thank you very much, mr. Chairman. A is a privilege to introduce leading scientist in Global Health who is also my neighbor and a true leader and our community. He is professor and dean at Baylor College of medicine and codirector of texas childrens centerenter ford for Vaccine Development. He leads a team of Product Development partnerships for for diseasesccines that affect hundreds of and adults worldwide. Welcome. We are glad to have you here today. , dr. Cell, a senior scholar at Johns Hopkins centers for Health Security and an assistant professor at John Hopkins Bloomberg school of Public Health. You will each have five minutes for your spoken testimony. Your written testimony will be included in the record for your hearing. When you have completed your spoken testimony, we will begin questions. Each member will have five minutes for questioning. Dr. Murray, you may proceed. Thank you very much. Of the esteemed committee, thank you for calling this hearing and inviting me to participate. My name is dr. Suzanne murray, and im the director of smithsonians Global Health program. Our program utilizes experts in wildlife medicine, human medicine, Public Health, conservation, biology, and epidemiology to study and respond to Health Issues at the human animal interface. We utilize a multidisciplinary approach to investigate emerging Infectious Diseases that threaten both human and animal life and we build in Country Capacity to train the next generation of health specialists. In short, this is the reason our program was created. Wildlife, and Environmental Health are inextricably linked and depend upon each other. In order to safeguard the future of all species, it is critical we have research and decisions firmly rooted in scientific knowledge, understanding the current viral threats, the patterns of drivers and disease emergence in the Human Behaviors that contribute to such emergence will best allow us to not only respond to this outbreak but the next one and the one after that because we do know they are coming. Already we have identified many of the drivers of disease emergence and spread including land use change, increase human wildlife interaction, and the globalization of travel and markets. Time and history have repeatedly shown us it is much more humane, efficient, and economical to prevent disease rather than to diagnose,respond, treat, and attempt to contain an outbreak, so increased understanding of as yet undiagnosed viruses, the drivers of emergence and the risk factors associated with various behaviors, we can develop Early Warning systems, prepare Rapid Response teams, and provide Critical Data and information to the vaccine industry to better prepare for the next outbreak. Just as critical, we must educate local medical professionals and the People Living in the communities at the greatest risk of outbreaks. By preventing the spread of pathogens at the source, we can avoid global consequences that we are experiencing now. For example, over the last 10 years and working with partner agencies, our team has collectively identified over. 200 novel mammalian viruses 12 hundred is a lotto viruses. It is only a small amount of the ones out there. 160 one belong to the same 161 belongovid19 to the same family as covid19. We have also trained over 6000 people in more than 30 countries at the front line of defense against imaging diseases. At this moment, the world is focused on the novel coronavirus, covid19, as it should be. While it is essential we do everything we can to respond to this global crisis, it is also a time we need to be thinking of emerging viruses. The next Global Pandemic is not a matter of if but when and where. To quickly identify and contain such infections, health and disease must be evaluated across species and on a global scale. It inwe might not imagine this context, ben franklin was right when he said an ounce of prevention is worth a pound of cure. When it comes to outbreaks, the cost of responding to a crisis can dwarf investment in research and education. Beyond the obligation to protect human life, there are financial benefits from focusing on preventative measures. For example, the human and economic toll from the west african Ebola Outbreak was massive. More than 11,000 people lost their lives, and well over 4 billion was spent globally. In the case of the sars epidemic of 2004, the estimated Global Financial impact was between 30 billion and 50 u. S. Billion and the Current Situation is expected to be on orders of magnitude higher. Advancements in the detection of novel pathogens show the most efficient way to respond to and contain an outbreak is through the coordinated wildlife and human surveillance. While we estimate there are 1. 7 as yet unknown viruses, about half of which can affect human people and some lead to new pandemics. As of now, there are no coordinated programs to work in highrisk regions to identify these viruses, get their genetic sequences into labs, and identify ways to reduce risk of them emerging. Our best defense against spreading diseases that make their way into the human population is through research and education. While we cannot stop every disease outbreak, we can reduce their frequency and build the capacity for a rapid Global Response when they do occur. Thank you once again for this hearing and your interest in this pressing and important topic. I look forward to answering any questions you might have. Congressman bera, Ranking Member lucas, and distinguished members [no audio] dr. Brownstein, could you turn your mic on . Dr. Brownstein that would help. Congressman bera, Ranking Member lucas, and distinguished members of the house of Representatives Committee on sciencebased technology, thank you for inviting me today to speak with you. Today i will describe ways the novel technologies like Artificial Intelligence can help detect monitor and predict emerging Infectious Diseases. I will also discuss how nontraditional sources can supplement technological techniques. But as i described the good news, i do not want to sugarcoat the bad. We urgently need federal and local investment of new technologies for Public Health surveillance and response. Such investments will augment the capacity and publical to implement new ways to monitor the healthy population. It will deepen our understanding of communitybased mortality. It will also save lives. This is the goal in boston Childrens Hospital where we develop technology and use freely online information to provide insights to agencies and the general public. We did this for the h1n1 influenza pandemic, avian influenza, ebola in west africa, and covid19. These platforms ultimately played a Critical Role in the Innovative Surveillance technology to help detect monitor and mitigate these diseases. Our project which is available to the public brings together sources from a variety of places to help provide a unified view of the world of Infectious Diseases. To dues that we use ai Machine Learning, natural leg which processing to organize the information to make it available. Heres an example. On december 30, 22019 platforms ordered system unknown viral outbreak. Using ai is one of years of research into the potential disease and word spreads. Machine learning models can predict where viruses may arrive next. That helps us inform Public Health how to respond. Predictive modeling can be used with data like prior disease history whether Laboratory Data symptom surveillance altogether through ai help us Exchange Information and conduct surveillance and measure public response to the events and response. It is also critical to support sentinel surveillance which allows publichealth information impacting the community. One example is the cloud serving platform. It identifies an individual who may need medical attention in realtime. Our team has augmented this tool to improve covid19 surveillance. To date, there is no evidence supporting widespread transmission of covid19 u. S. But it suggests the same transition at the Community Level will be occurring. Current global situations make sure this outbreak will become a pandemic. It threatens the health of the people of the United States and globally. The covid19 outbreak also demonstrates some reason for optimism. It demonstrates what we can accomplish when scientific disciplines unite around