Transcripts For CSPAN2 Public Health Preparedness Response

I like to call the hearing to order. And id like to recognize the chairman of the committee for a statement. Thank you senator burns. Senator casey members of the committee. How to think senator burr for chairing the hearing today and senator casey for serving as Ranking Member at senator murrays request. Theyre both been leaders. Senator per was the original author of the first passage of the pandemic. He helps protect us from the full range of Public Health threats. Natural disasters and outbreaks of net the disease. Then in 2013, senators bring caseys led the bipartisan authorization of the pandemic and all hazards act. Many can be contributed to that time including senators and see in bennett, war, hatch, roberts, and others. Now it needs to be reauthorized for second time. Todays hearing is the second weve have the sheer. Last week we heard from the administration on recommendations of advance including from the assistant secretary of preparedness and response the senators for the prevention. The flu season its critical that we reauthorize the act. I hope will do this in a bipartisan way and i expect that it has been the tradition of the lawn this committee on all of our major bills. People are not as aware of the devastation the flu season. The figures are between 12 and 50000 americans die of flu every year. Doctor collins has talked to us about expediting the universal flu vaccine which she sees you. Tennessee has seen heartbreaking things already. Already a pregnant woman and three children in tennessee have died of the flu. The act provides a Public Health framework that enables us to be prepared and able to respond to Public Health threats by ensuring we have enough medicines to protect americans and ensure we are prepared to respond to emergencies. Thanks for witnesses especially doctor dreiser who has come from tennessee. Thank you. This morning were holding a hearing of facing threats i will hear from doctor tom inglesby, director of the center for Health Security, doctor john, commissioner of the Tennessee Department of Public Health, brett mcgregor, and cochair of the alliance for bio security, head of pediatric emergency medicine at lurie Childrens Hospital in chicago. Well have an Opening Statement in the will hear from the witnesses. Im sheet please to chair the searing to a former work. I want to thank the chairman for giving the opportunity to senator casey and i to lead the discussion. Today will hear from individuals with knowledge of the challenges we face combating Public Health threats from their idea on how to move forward. Since the last reauthorization has been tested by pandemic flu, multiple master disasters, and ebola breakout and seeker virus. The Lessons Learned come from individuals like those sitting before us today. In their efforts to protect and saves lives. Blessed Hurricane Season had three major storms devastating communities raising questions about managing i was standing multiple periods of response. Besides the need for improved Data Collection and surveillance to inform and protect as many mothers and babies as possible. Further it highlighted the need that shows the knowledge that can be brought by this threat the deep undertaking for procurement and other measures. I look forward to learning about the leverages and Innovative Technologies to solve these problems. Whether the challenge of a vaccine, information crucial to a Public Health department, infrastructure of doctor needs to care for patients or improvements to the way the policies complement one another, your experiences remind us you cannot let up on these efforts early side of the urgency. We must not get distracted, improving and strengthening our policies and programs to make them more effective, known in the future. I look forward to it eat should witness can provide. Thank you. I think you for your years of work on these issues. As a think senator alexander and breaking member murray for this opportunity. Also i think our witnesses for bringing their experience and work to these issues and for joining us today. This is her second hearing on the topic. The focus is our nations preparedness to combat the Health Threats as we look towards reauthorizing the pandemic later this year. Now, we must rebuild our nations resiliency to help security threats. The threats that face our nation today are an increasing in frequency and intensity. Its critical to faster drugs, devices and diagnostics. Yet when were considering things that have yet to be seen by my response to it Natural Disaster like a hurricane, we do not and will not have a vaccine or countermeasure to purge tech tests. So in addition to supporting biomedical innovations we must strengthen hospitals and Public Health professionals, a front line of defense against these Health Threats. We must assure to give communities the tool and support they need to be ready, when, not if the next emergency strikes. Weve come a long way. I spoke at the last hearing about the Preparedness Program in the context of a trained realm in pennsylvania. One of many examples we could site. The grants for these programs facilitate preparedness activities that help hospitals and Health Systems with more regular occurrences. When subzero temperatures cause bursting types, they contacted a local Emergency Management and Healthcare Coalition created through hpp funding who assisted in the response from that circumstance. And yet funding has decreased with appropriations falling behind authorized levels spiking only in the response to ebola and zika. The impact means a decrease in the amount of time hospitals and medical staff can plan and train for an emergency. The loss of thousands of Public Health jobs, the reduction of Emergency Managers and lab technicians. Its dangerous to wait for threat to emerge to pass bills. We must be proactive, not reactive. How can we improve the Health Care System preparedness and thereby improve our Situational Awareness in an emergency . Can we work toward a precision Public Health using better data to guide responses to benefit our communities . I think we can. As reported by the publication, nature, when the seeker virus was confirmed in the united states, the entire country was not declared at risk. Instead surveillance defines two areas of miamidade county. The measure less than two and half square miles. This allowed for targeting of resources. Building on that we can expand to eliminate disease and spark opportunities for prevention. Last weeks hearing we heard from assistant secretary about the use of the empower program to identify and treat at risk individuals requiring electricity dependent medical assisted equipment. The system only pulls in medicare the tragic death of 12 seniors were needs to be done to protect our vulnerable citizens. The dr. Is also a professor of pediatric Northwestern University school of medicine and serves as the chair of the American Academy of pediatric Disaster Preparedness Advisory Council. Welcome. With that i will turn to you doctor and lets begin. You can laid off. Thank you. Senator, members of the committee, thank you for the chance to speak today about these important issues. I am the director of the center for Health Security at Johns Hopkins Bloomberg School of Public Health where i am a professor of medicine and Public Health. Dissenters mission is to protect Peoples Health from epidemics and disasters and build resilient communities. I provide a brief overview of key areas my center, colleagues and i consider vital to the nation preparedness and response capabilities. The opinions expressed are my own and do not necessarily reflect the views of Johns Hopkins university. Health threats could occur without much warning. These include Natural Disasters, ecological accidents, Mass Shootings and bombings, chemical spills and potential use of chemical weapons. Radiation and Nuclear Threats and biological threats. Biological threats whether Natural Light aged seven and nine in china were accidental such as an epidemic release from the land were deliberate like smallpox or anthrax. A particular concern and a big focus of my comments today. Biological threats can range from modest in size, up to those capable of opposing global catastrophic risks. What more can be done to prepare for these threats . First, we need to strengthen Healthcare System preparedness. That is the capacity to care for high numbers of sick or injured in an emergency. There has been substantial progress in prepare for disasters but the nation is not ready to prepare radical care in north contest of your big epidemics of contagious disease. The hospital Preparedness Program has been helping fund and build the capability is at the state and local level. Significant resource constraints limit what they can do. It has more than 50 percent since it started in 2002. The command should be reversed. New initiatives like establishing regional Disaster Resource hospitals can be a strong new additional components in improving medical preparedness. Second, we need to strengthen the ability of the Public Health system to detect and respond to threats. Since 2001, there been serious efforts at the cdc, state and local efforts or local level to provide early warning, lab diagnostics, investigate and contain outbreaks, communicates the public and ensure safety and security. There has been good Forward Movement but theres too much to do and not enough trained professionals to do the work. The Public Health relies on funding from cdc, Public Health Emergency Preparedness grants. The funding has been reduced by nearly 30 percent since 2002. Even the Public Health crises have not declined. This should be strongly supported and in addition i believe that a Public Health Emergency Contingency Fund should be established which would allow rapid Public Health response funding and emergencies. Third, we need to move ahead in medical countermeasure development. It has been Good Progress but many parties remain anthony sustained funding and Research Development manufacturing and acquisition of countermeasures. Technologies and setting more ambitious technologies for products and emergencies so they are ready in the course of a given pandemic or epidemic. Fourth, the us needs to recognize stress that could inadvertently emerge from biological research. After the moratorium on Pathogen Research was lifted last month, researchers can now get apply for funding to study for example, ways of making the worlds most lethal viruses like h5n1 bird flu like seasonal flu. This can lead to accidental or deliberate release of the strain of virus that can cause an epidemic or pandemic. I do not believe the benefits of the worker worth the risks. If it will go ahead i advised that there be high transparency in the program and serious dialogue among concerned governments internationally and how to proceed. Finally, we should fund the global Health Security agenda for g hsa. In 2014 they launched ghsa with a billiondollar commitment to help prevent, detect and respond to Infectious Disease threats. Since then, the cdc and usad have been working to increase lab and surveillance to abilities, strengthen public workforces and much more. At this point, us funding for ghsa is ending soon. We pull away from the ghsa, other countries will likely do the same. We should continue to support it. It is the most effective that we have to do this overseas. Improving nations preparedness and response capacity is a daunting complex endeavor. But i am confident it is achievable. I appreciate the committees time and i welcome your questions. Thank you doctor. Good morning. Chairman and senators. Distinguished committee members. Thank you for this opportunity to appear before the committee and discuss an issue of significant importance to the common defense of the country. A strong agile and resilient Public Health and medical preparedness and response system. It is an honor to be here senator. I am the commission of health in tennessee is a local Health Director for a decade before that and many years before that as well. I will be sharing with you today my own thoughts but im confident they are shared by my Public Health colleagues across the country. We strive every day to prepare and respond to threats of all kinds. These debts may be Infectious Disease outbreaks like the measles, foreignborn illness and annual epidemic of seasonal influenza. Not like this you can unpredictably test our responsiveness and capacity. These can also be largescale, national or global events like a influenza pandemic or acts of terrorism. Public health also globalize is as you know during Natural Disasters like storms, hurricanes, tornadoes, floods, wildfires, etc. And other extreme weather events that unfortunately, seldom does a Public Health jurisdiction of any size go more than a few years without experiencing. As well through mechanisms like Emergency Management assistance compact, even uninfected jurisdictions are frequently called upon to assist neighbors. Public health and Emergency Preparedness response and recovery is a responsibility, discipline and service that we have to get right. Lies physical health depend on if it is something we do every day. In the matter of local resiliency. All disasters play out locally. It is also a matter of National Security. In a few moments i will share my perspective of you being directly involved in certain roles at all levels with military and civil capacity. What is healthy and medical Emergency Preparedness response and recovery . It is not stuff for equipment for plans. It is people. Shelters do not staff themselves. A firetruck cannot put out a fire without firefighters. And people like Public Health nurses or firefighters cannot be hired and trained after the alarm sounds. They need to be there ready to go before the threat ever emerges. If they are to be effective in responding to it. Preparedness is about the people involved and the interconnected networks. To be truly prepared we need three key things. One is to train people with knowledge and all connected by relationships built on trust. Number two, expertise in leadership at all levels. Local, state and federal. And three, communication and shared Situational Awareness among responding leaders, people on the ground and experts. Try to create these three things after an event begins, takes the one commodity that is most precious in an emergency, time. We do not have time to create this network after the event starts. Anyway the Public Health and Emergency Response and Recovery Network is like a safety net for a performer. It has to be in place before the show starts anchored and inspected and in good shape to do the job. Many people think equipment or supplies are the net. But, if you remember nothing else from my testimony today, i would like you to remember this. People, people, not things are. Net. People are in that. Anchors matter but people run the response. The relationships, knowledge and trust over time is what strengthens the chords, holds it together and keeps them adaptable and resilient. The more chords, the more capable we are. Things like durable medical equipment, medical countermeasures and Communications Infrastructure are essential anchors for that net. Without that the network of people cannot be as effective. But the people are the net. Our accomplishments and successes over the last 15 years illustrated in my written remarks can be directly attrib