Officials are asked about the federal governments response to the spread of coronavirus. We will hear from the director at this security meeting. The committee will come to order. The committee is meeting to receive testimony about confronting the coronavirus. Without objection, the chair is authorized to declare the committee in recess at any point. Good morning. Today the committees 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 might affect them, their loved ones and communities. How concerned do we need to be about the virus . Who is most at risk . What can communities do to prepare . What can americans do to protect themselves and their families . What is the federal government doing . What more should it be doing . When might we have a vaccine or other treatment . My constituents are looking to the federal government for leadership, guidance and i amtise and i share my sure my constituents are two. I am concerned the Trump Administration has downplayed the threat, overstated how close scientists are to developing a vaccine and silenced experts who disagree with them. We must acknowledge the threat and allow doctors and scientists to offer candid assessments of the situation and direct a federal response. We are fortunate to have a distinguished panel of physicians to offer their Expert Opinion today. I look forward to hearing from them about what the federal government must do to stop support state and local efforts and protect the lives of americans. Input like theres will absolutely be essential to confronting this threat and i appreciate their willingness to join us today. Comes,e Ranking Member we will allow him an opportunity to read his statement into the record. I welcome forward our panel of witnesses. Dr. Tom inglesby is the director of the center for Health Security of the Johns HopkinsBloomberg School of Public Health. His work is internationally recognized in the fields of preparedness, pandemic and emerging Infectious Disease, and response to biological threats. I now recognize the gentlelady from illinois to introduce our next witness. Dr. Ezike. O welcome she is a pediatrician who has dedicated her career for Health Care Access to the people of illinois. She has served in Public Health roles for the last 15 years in my home state in illinois. She received her undergraduate degree from harvard. She completed her internship at rush medical center, where she is a professor of pediatrics. I want to thank her and her team for working aroundtheclock to deal with the coronavirus outbreaks in illinois and to take the time to share her expertise with us. Have dr. Julie g erberding. Serves astly executive Vice President and chief patent officer for a Strategic CommunicationsGlobal Public policy. She is cochair for the center of strategic and International Studies commission on strengthening americas Health Security. Witnesssjection, the full statement will be inserted in the record. I would like to defer to the Ranking Member for an Opening Statement. I apologize for being late. I have two hearings going on simultaneously. This is a great panel. Our hearts go out to those who have lost loved ones and those currently undergoing treatment. This is a global event that requires global response. Many of our National Partners are working diligently as part of a united effort to understand and address the spread of covid19. Some actions taken by other countries might have hindered a comprehensive response to this virus. I remain concerned chinese officials withheld information from the International Community in the most critical stages of this outbreak. My deepest concern at the moment is the level of preparedness at the state and local level. I have heard from responders and medical profession ares that are dealing with an increasingly concerned public. We have a distinguished panel of medical professionals. I am interesting im interested to hear what we need from the federal government to deal with this crisis. Director of the cdc for most of the Bush Administration is here. She has led an effective response. She has managed more than other 40 Emergency Responses. I am interested in hearing about her experiences. Finally, i am interested in the panels assessment of the risk of the virus. Invaluable ors reassuring the public in times like this. It is important for political leaders to avoid fanning the flames of hysteria. Our job is to support the medical community. That is why i am pleased we will be considering his supplemental appropriations bill today. Hopefully this will help speed along important treatment resources that will alleviate this crisis. I have one request that we enter this into the record. Without objection. Each witness to summarize his or her statement in five minutes beginning with dr. Inglesby. Thank you for the chance to testify today about cobit 19. Covid19. Dr. Inglesby im director for the Johns Hopkins university. Covid19 started in wuhan, china. As of yesterday, it has infected between 85,000 and 90,000 cases worldwide. Patients have become sick with covid19 have cough, fever, and the more serious cases underlying viral pneumonia. In a china, approximately 80 of those with the illness had mild symptoms. 15 required hospitalization. And 5 developed critical illness. The virus has a one to 14day incubation period and spread by respiratory droplets with people in close contact. And elderly and those with underlying conditions are at highest risk. As of yesterday, the u. S. Had confirmed 118 cases of covid19 including eight deaths. The majority of those cases are returning travelers or repatriated persons from china but there is no connection between any known case of covid19 which suggests that in those places there is some level of Community Transmission of covid going on. An emergency supplemental going on between congress and the administration. 20142015, congress appropriated 5. 4 billion for the ebola response. In my view, covid19 will require twice as much or more given its respiratory transmission and the likelihood that it is going to be widespread around the country and so all jurisdictions will need to prepare and respond. Health care systems should be planning to provide care for large numbers of critically ill patients, as weve seen has been required in china and south korea and italy. They will also need very strong Infection Control strategies, including 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 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 entirely unrelated to covid19 were disrupted, including cancer clinics, dialysis clinics, and other important medical facilities. Public Health Agencies are working to isolate suspected cases around the country and 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 to create tests 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 necessarily the normal process for vaccine manufacturing. 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, affective partnership and making sure that those industries are well aware of the support 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 about what is happening. I think a Daily Briefing as we did in the 2009 h1n1 about whats known, whats unknown, how we are 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 around the country. Thank you for the opportunity to testify. Mr. Thompson thank you. Now to dr. Ezike to summarize her statement for five minutes. 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 january,identified in a strong federal, state, county, and local coordinated effort was enacted. It 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 inhouse, a capability we had for the last three to four weeks. 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. We 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 critical 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 house infected 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 also working closely with longterm 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 responsibility in responding to covid19. Thank you. Dr. Now recognize gerberding to summarize her statement. Dr. Gerberding i want to thank you for allowing me to testify with such distinguished colleagues. I am the key 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 is the bipartisan 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 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 f