Transcripts For CSPAN2 Public Health Preparedness Response

The hearing today. Senator casey for serving as Ranking Member. They have both been leaders on the subject. Senator burr was the author of the pandemic and all hazards preparedness act. Ill collect all hazards preparedness act. The law helps protect us from the full range of Public Health threats from National Disasters to terror attacks. In 2013, senators burn casey by the bipartisan authorization of the pandemic and all hazards act. Many contributed including senators and sam bennett. Warren, hatch, roberts, and others. Now its to be reauthorized for a second time. Todays hearing is the second for this year. Last week we heard from the administration including from the assistant secretary, the fda and the centers for disease control. In the middle of the flu season is critical we reauthorized the act before many of the provisions expire in september. I hope will do that in a bipartisan way. People are not as aware of the devastation of the flu, and i mentioned. The figures are between 12 and 50000 americans die of the flu every year. They have talked about expediting the universal flu vaccine what she sees soon. Tennessee has seen these earlier is that is spread across the state and country. Already a pregnant woman and three children in tennessee have died at the flu. This provides a framework that enables us to be prepared and able to respond to health threats. To ensure we have enough medicine to protect americans into sure hospitals are prepared to respond. Thanks for witnesses for coming here to today. Thank you. This morning were holding a hearing entitled facing 21st century threats. We will hear from doctor tom inglesby, tractor for the center john hopkins, doctor john dreiser, commissioner of Tennessee Department of Public Health. Brett mcgregor, Senior Vice President of operations, and cochair of the alliance for bias security. In doctor stephen, head of Pediatric Medicine in chicago. Senator casey and i will have an Opening Statement in the will hear from witnesses and witnesses will have up to five minutes for questions. Im pleased to today, will hear from individuals with firsthand knowledge of what we face including Public Health threats and their ideas on how to move forward. This framework has been tested by the emergence of pandemic flu, Natural Disasters and ebola breaker and ezekiel virus. The Lessons Learned come from individuals like those sitting before us today in their efforts to protect and save lives. Last Hurricane Season resulted in major storms raising news questions to manage and withstand these times of response. Emphasize the needs of improved Data Collection to inform and protect as many mothers and babies as possible. It highlighted the need for a that brings the knowledge to the potential damage that can be brought by the stats in a deep understanding for research and development. I look forward to learning more about the barrier cc to leverage technology. Whether the challenge in the development of a vaccine, the information crucial of the health department. Improvements to the way these complement one another, your experience reminds us we cannot let up on these efforts really set on the search and see. We must not get distracted by making changes to the law outside of our focus. Improving and strengthening our programs to make them more effective now and in the future. I look forward to what each witness can provide. I want to thank you for your years of work on these issues. I think the chairman and Ranking Member for this opportunity. The thinker witnesses for bringing experience and work to these issues and joining us today. This is her second hearing on this topic. The focus is our nations preparedness to combat Public Health threats as we look towards reauthorizing this pandemic. Whether never we must continue to build our nations resiliency. To help security threats, the threats that face our nation today are increasing in frequency and intensity. Its critical to foster and advance you, when we consider the emerging Infectious Disease or an engineer by a weapon yet to be seen by man, for the response to Natural Disaster like a hurricane, we dont have a countermeasure to protect us. In addition to supporting these we must also strengthen our hospitals and Public Health professionals. Our front line of defense against the self threats. We must ensure we give our communities the necessary support necessary when the next emergency strikes. I spoke at the last hearing about the success of the hospital Preparedness Program. Another Public Health Emergency Preparedness program in the context of restraint or ailment. One of many examples we could say. These grants also facilitate preparedness activity that help hospitals and Public Health system with more regular occurrences. The reachable Health Care Coalition created through the funding who assisted in the response of that circumstance and get the funding for these Preparedness Programs has decreased from appropriations falling beyond levels only with the response to ebola. The impact funding reductions means a decrease in the amount of time the hospitals and medical staff have to plan and train for an emergency. The loss of thousands of public jobs, the eduction and Emergency Managers and Public Health Lab Technicians is very dangerous to wait for threats to emerge to try to pass emergency funding bills. We must be proactive, not reactive. So how can we improve our Health Care System preparedness in our publichealth capacities and thereby improve our Situational Awareness in an emergency . Can we work towards a precision publichealth using better data to more efficiently guide responses to help emergencies to benefit our communities . I think we can. For example as reported by the publication, when domestic transmission was confirmed in the United States, the entire country was not declared at risk. Instead, precise surveillance to find the atrisk areas of Miamidade County of neighborhoods measuring less than 2. 5 square miles. This allowed for the targeting of resources to these regions. Building on that experience, we can expand surveillance to eliminate the causes of disease and spark opportunities for prevention. All last week where h or i shouy after last weeks hearing we also heard from the assistant secretary about the use of the Empowerment Program to identify and treat atrisk individuals requiring electricity dependent medical and assistive equipment. He also identified a weakness. The system only pulls in medicare data, not medicaid or try care so how do we ensure that we are acting on the data appropriately to protect these vulnerable individuals. The tragic death of 12 seniors at a nursing home during the hurricane in september highlights that more needs to be done to protect the more formidable citizens and most of the citizens have additional characteristics that make them more vulnerable to any Public Health emergency and this includes our children, our parents, our Rural Communities and individuals with limited English Proficiency from individuals with disabilities and of course individuals with chronic illnesses and more. We must do better to help communities prepare for potential Health Security threats. We must continue to invest in innovative biotechnologies and we must also improve our non pharmaceutical interventions. Im looking forward to the hearing for the witnesss testimony and for how we can continue to prepare our hospitals and Health Systems to ensure equal consideration of all of our constituents. I am pleased we have our four witnesses here today and i think each of you for taking the time to be here. I would like to introduce first the director of the center for Health Security at Johns Hopkins school of Public Health and he is internationally recognized for his work as a writer with numerous publications focusing on Public Health preparedness pandemic and emerging Infectious Disease as well as the prevention of and response to biological threats in taiwa ande now turn to senator alexander. I would like to welcome surely the tallest commissioner of health an in history may be n the country. He served as becoming a sure Tennessee Department of health since 2011. He has significant experience responding to Public Health emergencies including Infectious Diseases like Natural Disasters such as the wildfires that devastated eastern tennessee in 2016. Today he will provide important insights into the nations preparedness response capabilities and states whats working and where we can improve and where we can protect and save more lives. A physician with more than 25 years of service and commissioner coffee helps to protect from publichealth threats. We appreciate his leadership and we welcome him to the committee. Im sure if you were a little younger this a couple of tennessee basketball teams that would probably recruit you tomorrow. [inaudible] next i would like to introduce the Senior Vice President for commercial operations the secondlargest Flu Vaccine Company in the world. Its an example of the success that can be achieved through publicprivate partnerships to ensure that we are better prepared for the threats that face us. Holly springs North Carolina is one of the three in the country with the capable body to rapidly respond in the event of a pandemic flu outbreak. Hes also the cochair of the alliance for bio security, the Alliance Works to promote the critical partnerships between the government industry and other stakeholders to advance and encourage the development of medical countermeasures. Welcome. And finally, doctor stephen, the head of pediatric emergency medicine at the Childrens Hospital of chicago, also a professor of pediatrics at Northwestern University, school of medicine and serves as the chair of the American Academy of pediatric Disaster Preparedness Advisory Council. With that i will turn to you and you can leave for up to ten minutes. Thank you for the chance to speak today about these important issues. Im the director of the center of the Johns Hopkins school of Public Health foPublic Health fe or of medicine and Public Health. The centers mission is to protect Peoples Health from epidemics and disasters and build resilient communities. I will provide a brief overview of areas of my colleagues and i consider vital to the nations preparedness and response capabilities. The opinions expressed are my own and dont necessarily reflect the views of Johns Hopkins university. Theres a range of major Public Health threat any of which could occur without much warning. These include Natural Disasters, technological accidents, nasa shootings and bombings, chemical spills, radiation and Nuclear Threats and biological threats. Biological threats whether natural lake in china or accidental such as an epidemic or deliberate like smallpox or anthrax are a particular concern and big focus of my comments today. Biological threats could range from modest and size that is capable of posing global catastrophic risks. Risks. What more can be done to prepare for these threats . First, we need to strengthen the Health Care System prepared us. That is the capacity to care for high numbers of sick or injured in an emergency. While theres been substantial progress preparing for small disasters in the country, the nation isnt ready to provide medical care in large catastrophes were big epidemics continuous disease. The hospital Preparedness Program is helping fund and build the capabilities of the state and local level, but Significant Resource constraints limit what we can do. The budget has decreased more than 50 since the start in the 2002. That trend should be reversed. New initiatives like establishing regional Disaster Resource hospitals could be a strong new additional component in improving medical prepared. Second, we need to strengthen the ability of the publichealth system tPublic Healthsystem to o the threats to it since 2001, thereve been serious efforts at the cdc, state and local levels to provide early warnings of outbreaks, provide diagnostics, investigate and contain outbreaks, communicate to the public and ensure greater safety and security and much more. Theres been Good Movement but theres too much to do and not enough professionals to do the work. Public health relies on funding from cdc Public Health Emergency Preparedness grants. That funding has been introduced by nearly 30 since 2002. Even th though publichealth crs have declined. It should be strongly supported and in addition i believe a Public Health emergency continuance initiative while rapid publichealth response funding and emergencies. Third, we need to move ahead on the medical countermeasure development. Theres been Good Progress but many priority is remain including sustained funding and Research Development manufacturing and acquisition of countermeasures, transitioning to the new flu vaccine technologies and setting morgan bushs targets for the products and emergencies so that they are ready in the course of a given pandemic were epidemic. Fourth, the u. S. Needs to recognize threats that could emerge from biological research. After the u. S. Moratorium of the Pandemic Pathogen Research was lifted last month, researchers can now again applie apply for g to study for example ways of making the worlds most lethal viruses respiratory transmissible like the seasonal flu. This could lead to the novel strain of the virus that could cause an epidemic or even a pandemic. I dont believe the benefits are worth the risk but if its going to go ahead i would advise to be transparency in the program and serious dialogue among the concerned government internationally on how to proceed. Finally, we should fund a Global Security agenda. In 2014 the u. S. Health launched with a billiondollar commitment to help countries prevent, detect and respond to Infectious Disease threats. Since then the cpc and usaid have been working in 39 countries with programs to stop and improve resistance from increased Lab Surveillance capabilities, strengthe, strengd publichealth workforces and much more. But at this point, u. S. Funding is in said. If we pull away from it, other countries will likely do the same. We should continue to support it. Itits Cost Effective program e have to contain International Outbreaks of the sources overseas. Improving the nations preparedness and response capacities is a daunting and complex endeavor but im confident it is an achievable goal if we focus our efforts on these initiatives. I appreciate the time and welcome your questions. Good morning, chairman alexander, senator burr, senator casey and distinguished committee members. Thank you for the opportunity to appear before the committee and to discuss an issue of significant in that instant the common defense of this country, the strong, agile and recently and Public Health and medical prepared this response system it is an honor to be here, senator alexander said in a positio imn of the commissioner of health and was a vocal Health Director for a decade before that. The thoughts i will be sharing with you today are