Transcripts For CSPAN2 Hearing On Coronavirus Air Travel 20

On december 30th, 2019, doctor lee, 34yearold ophthalmologist at wuhan hospital, took to a group chat to discuss the stars like illness that had recently been sickening people around the city. He posted a snippet of a lab analysis that found stars coronavirus, extensive bacterial colony in a patients airways and said this new illness even led his hospital to quarantines and patients in the emergency department. So frightening, a member of the group chat replied. Is sars coming again . The Chinese Communist government which like all authoritarian regimes is often more concerned about protecting its image than the life and safety of its citizens, is not pleased. Even as dedicated Public Health experts scramble toward each other, collect more information on what was happening chinas Security Services were busy trying to stop them. Probably the starkest example, on january 1st, wuhan Security Bureau some in eight doctors for posting and spreading, quote, rumors about wuhan hospitals receiving sars like cases. The doctor was released two days later, not before he was forced by police to sign statements acknowledging that his warnings had been, quote, illegal behavior. Meanwhile even as the city of wuhan and the nation of china were getting sicker and sicker business as usual didnt stop. Community events, political parades, public gathering, Global Commerce including most importantly for this hearing on global aviation continued. Allowing this virus to spread first within the city of wuhan and the rest of china and finally to the rest of the world. It to 508 am on february 7th, the city of wuhan, doctor we n wenung died of the virus he tried to warn about. A virus that has infected almost 95,000 men, women and children across the globe including right here in the United States. And has killed more than 3200 people including nine in senator cantwells home state of washington. What we now know, the virus they were warning about and the virus that took his life wasnt sars but it was similar. It is the Novel Coronavirus now known as covid 19. It has tremendous farreaching impacts. Commerce has slowed, faith in government has been shaken and people are understandably prepared. This virus was also called into real question the efficacy of International Organizations like the World Health Organization, the icao, both of which reached out to participate in this hearing but both of which either declined to participate or didnt respond. The icao, International Civil Aviation Organization for instance excluded taiwan from its information sharing regarding the virus. This despite the fact that the virus like this as sars showed us spread overwhelmingly by her travel, taiwan has the eleventh Busiest Airport in the world. Who has praised at every turn the response of the Chinese Communist government despite a mountain of evidence showing they play down the seriousness of the virus and the extent of the spread for more than a month. These organizations are not going to look out for broader global interests but instead praise authoritarian regimes. It begs the question if it is time to reevaluate our participation or at the very least make a concerted effort to push reforms. Covid19 is a real and serious challenge and we need factbased decisions, not panic, not hysteria. Unfortunately some in the media, intentionally or not, seem to be inciting panic and americans over the virus, that is a large part of the reason we convened this hearing. To give the American Public the opportunity here straight from officials on the front lines without spin or partisan bias. Here is what we know. This is a rapidly changing situation. Every day, some days every hour we are learning more about the virus. Where it has spread and how the human body responds. So far, the mortality rate has been around 3 and most of the deaths have been in the elderly and those with Underlying Health conditions. The virus appears more transmissible than a typical seasonal flu. So far reports indicate the vast majority of cases are moderate to mild requiring little to no medical attention. Early on the administration acted and acted swiftly to limit travel to and from the affected regions and to quarantine americans that had been to those regions and to deny entry to foreign nationals from those regions. This was the right thing to do. Those actions have proven critical for slowing the spread of the virus to the United States and brought us additional time to prepare. Now the virus is here and it is spreading. We must be ready for the fight ahead. There is more that can be done, more that should be done. Communication between agencies and municipalities is vital to containing the spread of the virus. In san antonio communication was lacking. A patient was released from Lackland Air Force base prior to testing positive. After testing positive the patient was returned to quarantine, currently under the supervision of the cdc. I urge the cdc to stay vigilant in keeping lines open with localities. And across the United States. We must do everything we can to marshal resources to protect the safety and lives of americans. I look forward to medical science. I turned it over to senator sinema. Your efforts to protect against diseases like coronavirus. They are not i would like to acknowledge the efforts of carriers and Transportation Industry in the face of a Public Health crisis. To share the burden of keeping americans safe here and abroad from a potential global pandemic. The system to contact data from travelers entering into the United States to close gaps where they exist. We need a timely way for travelers, Contact Information based on criteria the cdc has outlined i spoke with mike pence yesterday about an opportunity to quickly develop and implement a method to collect inflammation and followup this morning. Public Health Officials need to ensure we have a direct link to travelers and illuminate gaps that allow travelers to enter the United States without Public Health officials to reach them in the case of potential risk or exposure. I represent arizona. We have confirmed it is critical that Congress Passed a bicameral package to developing vaccine and treatment. It ensures the safety of our frontline workers, seniors and other vulnerable populations that are most at risk as we dont know the longterm impact of coronavirus, the impact they have seen alter action now to protect and reassure the public. The situation continues to evolve the government must Work Together to coordinate state and communicate with industry partners. I recognize senator cantwell, the Ranking Member. Thank you, mister chairman, for holding what i consider one of the most important subcommittee hearings we could ever have. I want to send my deepest sympathies to the people of Washington State and families who lost loved ones to healthcare workers who are working diligently to respond to this epidemic. In the state of washington, the numbers continue to increase. We have ten people who died from the coronavirus, 39 confirmed cases, 231 people are being monitored by Public Health officials and we have schools and businesses in federal facility that has been shut down as they are exposed to the coronavirus. All the while, people have been experiencing symptoms and not getting tested. This is the main focus we need to communicate today, to have a robust testing regime across the United States. Participating in a testing process. This can give us better information and more information about the Community Spread of this disease. Those suspected of covid19 in my state were required to be tested for the cdc to obtain results, updating the fdas actions last saturday, we will run an aggressive test. We are only a few hundred tests per day in the state of washington. We need to be in the thousands, not more. I hope we will get this right for the future of interstates who are going to deal with this and figure out how to have a clarion call, please develop these in compliance but do the testing because people are calling with what they think are symptoms and they want to be able to be tested. Todays hearing is a perfect example why that is so important. We have 14 states of confirmed cases and one of the persons is a person from North Carolina who tested positive after visiting the nursing home in Washington State that was the subject of so much attention and travel home to North Carolina on a plane. This underscores the importance of making sure the aviation sector has also prepared for how we mitigate the impact of virus spread. 44,000 flights in this country every day and 2. 7 Million People fly in and out of us airports. We have sent a letter to the Major Airlines and airports asking them for their plans to meet this challenge. Further guidance hopefully will here today on keeping the public safe. The airports and the airlines in the spirit of cooperation need to understand measures, in dealing with the coronavirus and they should not be left wondering from the federal government, what we should be doing, we should be very clear about what measures we can take or what measures we should take to keep the flying public safe. I hope the department of transportation and cdc will shed some light on that today in this hearing. I look forward to hearing about their answers and coordinating with you how to get this information to the public in a timely fashion. The public wants to do what they can but we have to get crisper on our answers about what we should be doing today. Thank you. The people of america across the country and particularly Washington State and families grieving the loss of their loved ones. I hope we continue to see bipartisan cooperation to marshal all the resources that are necessary to combat this virus and do Everything Possible to prevent any more losses. Let me introduce the witnesses we have today. Mister joel thune he szabat who has served in the department of transportation sincerely 2000s. He oversaw the Us Governments reconstruction of iraqi airports and railroads and served as transportation counselor to the us embassy in baghdad and also previously served as secretary of transportation policy and Deputy Assistant secretary for management and budget at dot. From 20122018 he served as executive director of the maritime association. Most recently in january mister thune he szabat was in the Coronavirus Task force to coordinate strategy to present the outbreak. He graduated from georgetown university. Rear admiral stephen redd, responsible for state and local readiness, emergency operations, select agents and toxins in the nations cash of emergency medical countermeasures. Prior to this role he was the director of the influenza coordination unit. He directed the h1 and one Pandemic Response and received his bachelors degree in history from Princeton University and medical degree with honors, and the University School of medicine. He trained in medicine at Johns Hopkins hospital and completed the to your Epidemic Intelligence Service Training Program at the cdc. Third witness is Mister William ferrara of operation support at u. S. Customs and Border Protection, served in numerous roles at cvp. Previously served as acting executive of Mission Support in the office of Field Operations where he was responsible for managing and operating budget of 4. 1 billion in providing asset and Logistical Support and customer focused Human Resource solutions for 28,000 employees. From june of 2016 to june of 2019 he served as director of Field Operations for the boston field office. November 18thfebruary 19th he performed the duties of the department of Homeland Security attache in the united kingdom. He holds an associate of arts degree in business in the Community College of rhode island and a graduate of the cvp Leadership Institute and university of Chicago School of business. I recognize mister szabat for his testimony. Good afternoon, chairman cruz, Ranking Member sinema, thank you for inviting me to testify through the efforts to minimize the risk of the spread of covid19 in the United States. February 26th, donald trump appointed mike pence to lead the Us Government ever to combat the virus. Secretary azar shares the White House Task force and i represented the department of the task force and its inception on january 30 first. The Health Professionals determine the response to coronavirus, dot in a supporting role will continue to coordinate daily with aviation stakeholders, foreign counterparts and other federal agencies managing the risk of the United States. The department of transportation, and act a bridge remains in place for safe return from affected areas for americans in addition to the thousands who safely traveled home from overseas. Secondly, airlines funneling passenger flights to 11 designated airports to speed americans returning from virus stricken areas. Third, continued air and sea cargo traffic between the United States and china and other countries, south korea and italy as the virus spreads. And Health Protocols established to protect the crews a craft continuing to fly between the United States and foreign locations. Dissemination of Health Messages about the virus to inform their passengers. Remarkably effective the first layer of Health Screening of overseas travelers before they return home. They delayed the spread of the virus, precious time to prepare for their measures and plan for proper mitigation, the first 25 days since the president s proclamation only 15 cases were detected within the United States. Our actions ensure the 200,000 americans who were in a recently left china could return to the United States. 15,000 people before the virus outbreak, fewer than 1000, 53,000 incoming passengers that receive Health Screening. This achievement of 200 commercial airlines, a like number of overseas airports and Civil Aviation authority of china the devout is working closely with our sister federal agencies under the task force, their expertise and authorities were necessary to accomplish this success. January 30 first the ministration declared it was a Public Health emergency in the United States. That same day the president ial proclamation establish the framework for travel restrictions intended to protect the us public from this Communicable Disease while allowing american nationalists travel safely home. Travel restrictions first applied to china. It has subsequently been extended to iran and Airport Passenger exit screening has been introduced in italy and south korea with the cooperation of their authorities. Focus the expertise of the medical professionals conducting screening, the secretary of the department of Homeland Security directed all flight inbound to the us carrying persons who had recently been inside his arrive at one of 11 us airport significant consideration, coordination and analysis on the federal agencies occurred to select those appropriate airports. Prior to the proclamation, dot and interagency partners proactively communicated their carriers and others in the Aviation Industry, dot hosted multiple stakeholder calls, 475 invited industry participants representing a range of us and foreign carriers, domestic airports, trade associations, unions and other value partners, the plan for Chinese Communist<\/a> government which like all authoritarian regimes is often more concerned about protecting its image than the life and safety of its citizens, is not pleased. Even as dedicated Public Health<\/a> experts scramble toward each other, collect more information on what was happening chinas Security Services<\/a> were busy trying to stop them. Probably the starkest example, on january 1st, wuhan Security Bureau<\/a> some in eight doctors for posting and spreading, quote, rumors about wuhan hospitals receiving sars like cases. The doctor was released two days later, not before he was forced by police to sign statements acknowledging that his warnings had been, quote, illegal behavior. Meanwhile even as the city of wuhan and the nation of china were getting sicker and sicker business as usual didnt stop. Community events, political parades, public gathering, Global Commerce<\/a> including most importantly for this hearing on global aviation continued. Allowing this virus to spread first within the city of wuhan and the rest of china and finally to the rest of the world. It to 508 am on february 7th, the city of wuhan, doctor we n wenung died of the virus he tried to warn about. A virus that has infected almost 95,000 men, women and children across the globe including right here in the United States<\/a>. And has killed more than 3200 people including nine in senator cantwells home state of washington. What we now know, the virus they were warning about and the virus that took his life wasnt sars but it was similar. It is the Novel Coronavirus<\/a> now known as covid 19. It has tremendous farreaching impacts. Commerce has slowed, faith in government has been shaken and people are understandably prepared. This virus was also called into real question the efficacy of International Organizations<\/a> like the World Health Organization<\/a>, the icao, both of which reached out to participate in this hearing but both of which either declined to participate or didnt respond. The icao, International Civil<\/a> Aviation Organization<\/a> for instance excluded taiwan from its information sharing regarding the virus. This despite the fact that the virus like this as sars showed us spread overwhelmingly by her travel, taiwan has the eleventh Busiest Airport<\/a> in the world. Who has praised at every turn the response of the Chinese Communist<\/a> government despite a mountain of evidence showing they play down the seriousness of the virus and the extent of the spread for more than a month. These organizations are not going to look out for broader global interests but instead praise authoritarian regimes. It begs the question if it is time to reevaluate our participation or at the very least make a concerted effort to push reforms. Covid19 is a real and serious challenge and we need factbased decisions, not panic, not hysteria. Unfortunately some in the media, intentionally or not, seem to be inciting panic and americans over the virus, that is a large part of the reason we convened this hearing. To give the American Public<\/a> the opportunity here straight from officials on the front lines without spin or partisan bias. Here is what we know. This is a rapidly changing situation. Every day, some days every hour we are learning more about the virus. Where it has spread and how the human body responds. So far, the mortality rate has been around 3 and most of the deaths have been in the elderly and those with Underlying Health<\/a> conditions. The virus appears more transmissible than a typical seasonal flu. So far reports indicate the vast majority of cases are moderate to mild requiring little to no medical attention. Early on the administration acted and acted swiftly to limit travel to and from the affected regions and to quarantine americans that had been to those regions and to deny entry to foreign nationals from those regions. This was the right thing to do. Those actions have proven critical for slowing the spread of the virus to the United States<\/a> and brought us additional time to prepare. Now the virus is here and it is spreading. We must be ready for the fight ahead. There is more that can be done, more that should be done. Communication between agencies and municipalities is vital to containing the spread of the virus. In san antonio communication was lacking. A patient was released from Lackland Air Force<\/a> base prior to testing positive. After testing positive the patient was returned to quarantine, currently under the supervision of the cdc. I urge the cdc to stay vigilant in keeping lines open with localities. And across the United States<\/a>. We must do everything we can to marshal resources to protect the safety and lives of americans. I look forward to medical science. I turned it over to senator sinema. Your efforts to protect against diseases like coronavirus. They are not i would like to acknowledge the efforts of carriers and Transportation Industry<\/a> in the face of a Public Health<\/a> crisis. To share the burden of keeping americans safe here and abroad from a potential global pandemic. The system to contact data from travelers entering into the United States<\/a> to close gaps where they exist. We need a timely way for travelers, Contact Information<\/a> based on criteria the cdc has outlined i spoke with mike pence yesterday about an opportunity to quickly develop and implement a method to collect inflammation and followup this morning. Public Health Officials<\/a> need to ensure we have a direct link to travelers and illuminate gaps that allow travelers to enter the United States<\/a> without Public Health<\/a> officials to reach them in the case of potential risk or exposure. I represent arizona. We have confirmed it is critical that Congress Passed<\/a> a bicameral package to developing vaccine and treatment. It ensures the safety of our frontline workers, seniors and other vulnerable populations that are most at risk as we dont know the longterm impact of coronavirus, the impact they have seen alter action now to protect and reassure the public. The situation continues to evolve the government must Work Together<\/a> to coordinate state and communicate with industry partners. I recognize senator cantwell, the Ranking Member<\/a>. Thank you, mister chairman, for holding what i consider one of the most important subcommittee hearings we could ever have. I want to send my deepest sympathies to the people of Washington State<\/a> and families who lost loved ones to healthcare workers who are working diligently to respond to this epidemic. In the state of washington, the numbers continue to increase. We have ten people who died from the coronavirus, 39 confirmed cases, 231 people are being monitored by Public Health<\/a> officials and we have schools and businesses in federal facility that has been shut down as they are exposed to the coronavirus. All the while, people have been experiencing symptoms and not getting tested. This is the main focus we need to communicate today, to have a robust testing regime across the United States<\/a>. Participating in a testing process. This can give us better information and more information about the Community Spread<\/a> of this disease. Those suspected of covid19 in my state were required to be tested for the cdc to obtain results, updating the fdas actions last saturday, we will run an aggressive test. We are only a few hundred tests per day in the state of washington. We need to be in the thousands, not more. I hope we will get this right for the future of interstates who are going to deal with this and figure out how to have a clarion call, please develop these in compliance but do the testing because people are calling with what they think are symptoms and they want to be able to be tested. Todays hearing is a perfect example why that is so important. We have 14 states of confirmed cases and one of the persons is a person from North Carolina<\/a> who tested positive after visiting the nursing home in Washington State<\/a> that was the subject of so much attention and travel home to North Carolina<\/a> on a plane. This underscores the importance of making sure the aviation sector has also prepared for how we mitigate the impact of virus spread. 44,000 flights in this country every day and 2. 7 Million People<\/a> fly in and out of us airports. We have sent a letter to the Major Airlines<\/a> and airports asking them for their plans to meet this challenge. Further guidance hopefully will here today on keeping the public safe. The airports and the airlines in the spirit of cooperation need to understand measures, in dealing with the coronavirus and they should not be left wondering from the federal government, what we should be doing, we should be very clear about what measures we can take or what measures we should take to keep the flying public safe. I hope the department of transportation and cdc will shed some light on that today in this hearing. I look forward to hearing about their answers and coordinating with you how to get this information to the public in a timely fashion. The public wants to do what they can but we have to get crisper on our answers about what we should be doing today. Thank you. The people of america across the country and particularly Washington State<\/a> and families grieving the loss of their loved ones. I hope we continue to see bipartisan cooperation to marshal all the resources that are necessary to combat this virus and do Everything Possible<\/a> to prevent any more losses. Let me introduce the witnesses we have today. Mister joel thune he szabat who has served in the department of transportation sincerely 2000s. He oversaw the Us Government<\/a>s reconstruction of iraqi airports and railroads and served as transportation counselor to the us embassy in baghdad and also previously served as secretary of transportation policy and Deputy Assistant<\/a> secretary for management and budget at dot. From 20122018 he served as executive director of the maritime association. Most recently in january mister thune he szabat was in the Coronavirus Task<\/a> force to coordinate strategy to present the outbreak. He graduated from georgetown university. Rear admiral stephen redd, responsible for state and local readiness, emergency operations, select agents and toxins in the nations cash of emergency medical countermeasures. Prior to this role he was the director of the influenza coordination unit. He directed the h1 and one Pandemic Response<\/a> and received his bachelors degree in history from Princeton University<\/a> and medical degree with honors, and the University School<\/a> of medicine. He trained in medicine at Johns Hopkins<\/a> hospital and completed the to your Epidemic Intelligence Service<\/a> Training Program<\/a> at the cdc. Third witness is Mister William<\/a> ferrara of operation support at u. S. Customs and Border Protection<\/a>, served in numerous roles at cvp. Previously served as acting executive of Mission Support<\/a> in the office of Field Operations<\/a> where he was responsible for managing and operating budget of 4. 1 billion in providing asset and Logistical Support<\/a> and customer focused Human Resource<\/a> solutions for 28,000 employees. From june of 2016 to june of 2019 he served as director of Field Operations<\/a> for the boston field office. November 18thfebruary 19th he performed the duties of the department of Homeland Security<\/a> attache in the united kingdom. He holds an associate of arts degree in business in the Community College<\/a> of rhode island and a graduate of the cvp Leadership Institute<\/a> and university of Chicago School<\/a> of business. I recognize mister szabat for his testimony. Good afternoon, chairman cruz, Ranking Member<\/a> sinema, thank you for inviting me to testify through the efforts to minimize the risk of the spread of covid19 in the United States<\/a>. February 26th, donald trump appointed mike pence to lead the Us Government<\/a> ever to combat the virus. Secretary azar shares the White House Task<\/a> force and i represented the department of the task force and its inception on january 30 first. The Health Professionals<\/a> determine the response to coronavirus, dot in a supporting role will continue to coordinate daily with aviation stakeholders, foreign counterparts and other federal agencies managing the risk of the United States<\/a>. The department of transportation, and act a bridge remains in place for safe return from affected areas for americans in addition to the thousands who safely traveled home from overseas. Secondly, airlines funneling passenger flights to 11 designated airports to speed americans returning from virus stricken areas. Third, continued air and sea cargo traffic between the United States<\/a> and china and other countries, south korea and italy as the virus spreads. And Health Protocols<\/a> established to protect the crews a craft continuing to fly between the United States<\/a> and foreign locations. Dissemination of Health Messages<\/a> about the virus to inform their passengers. Remarkably effective the first layer of Health Screening<\/a> of overseas travelers before they return home. They delayed the spread of the virus, precious time to prepare for their measures and plan for proper mitigation, the first 25 days since the president s proclamation only 15 cases were detected within the United States<\/a>. Our actions ensure the 200,000 americans who were in a recently left china could return to the United States<\/a>. 15,000 people before the virus outbreak, fewer than 1000, 53,000 incoming passengers that receive Health Screening<\/a>. This achievement of 200 commercial airlines, a like number of overseas airports and Civil Aviation<\/a> authority of china the devout is working closely with our sister federal agencies under the task force, their expertise and authorities were necessary to accomplish this success. January 30 first the ministration declared it was a Public Health<\/a> emergency in the United States<\/a>. That same day the president ial proclamation establish the framework for travel restrictions intended to protect the us public from this Communicable Disease<\/a> while allowing american nationalists travel safely home. Travel restrictions first applied to china. It has subsequently been extended to iran and Airport Passenger<\/a> exit screening has been introduced in italy and south korea with the cooperation of their authorities. Focus the expertise of the medical professionals conducting screening, the secretary of the department of Homeland Security<\/a> directed all flight inbound to the us carrying persons who had recently been inside his arrive at one of 11 us airport significant consideration, coordination and analysis on the federal agencies occurred to select those appropriate airports. Prior to the proclamation, dot and interagency partners proactively communicated their carriers and others in the Aviation Industry<\/a>, dot hosted multiple stakeholder calls, 475 invited industry participants representing a range of us and foreign carriers, domestic airports, trade associations, unions and other value partners, the plan for Community Transmission<\/a> in the United States<\/a> dot will be coordinating with stakeholders as part of the whole government plan which includes state and local Public Health<\/a> agencies on the front line of mitigation efforts. One of the lessons we learned from sars is the public reconsiders travel in the face of a new Communicable Disease<\/a>, covid19 is having that impact on aviation today. Industrialist estimate they reduce passenger numbers by 4. 76 worldwide. The industry snaps back quickly at the peak of sars us travel had in two month it was back to normal. The federal government, state and local governments, touting long prepared emergency plans, the Coronavirus Task<\/a> force is instructed coordinate the government ever to work through the virus. We will work through it and we will find the other side. Thank you and i look forward to your questions. Thank you, mister szabat. Admiral redd. Thank you, distinguished members of the somebody. My name is stephen redd, Deputy Director<\/a> of Public Health<\/a> service and implementation science and im also serving as senior response official in cdcs Novel Coronavirus<\/a> response. Thank you for the invitation to testify on behalf of the centers for Disease Control<\/a> and prevention, on efforts to protect the health and safety of americans from this disease, covid19. Let me begin by acknowledging this is a new virus, a new disease, new information in science continue to accumulate and Us Government<\/a> decisions to respond to this epidemic will continue to be based on that evolving science. Our overriding goal is to protect america from the effects of the virus. We are working to slow its spread into the us and minimize the impact. Us governments approach to covid19 was built on years and years of preparing and responding to Infectious Disease<\/a> emergencies such as sars, ebola and pandemic influenza. A key component of our work is to support state, local, tribal and territorial Public Health<\/a> departments. This system is the backbone of Public Health<\/a> and also our responses to Public Health<\/a> emergencies. Up to now, 1500 cdc staff are involved in the response at headquarters in atlanta and in the field. Over the past two month, federal, state, local government have mobilized to protect the American People<\/a>. As we heard globally we have seen 90,000 confirmed cases that occurred in 85 jurisdictions. As we have discussed, several countries are currently reporting sustained Community Spread<\/a>. Cdc with federal and local partners have instituted multilayered aggressive containment and mitigation measures to slow the spread of the virus into the United States<\/a>. Public Health Interventions<\/a> include early case recognition and isolation, identifying and tracking contacts and implement a Movement Restrictions<\/a> or quarantined do we posted targeted travel warnings for several countries and even for cruise ship travel in asia so americans can stay informed on proper precautions to take when and if they travel abroad. Measures the Us Government<\/a> has taken include denying entry to the us for certain travelers, this produced the number of people coming into the United States<\/a> in china by 90 . We also funneled travelers from highly affected countries to 11 airports where he screened 50,000 travelers. As of noon today cdc reported 120 cases of covid19 from 13 states. We expect to continue to find more cases and we expect these cases will be a mixture of travel related cases, cases related to contact and Community Spread<\/a> cases. And highly effective while others remain virus free. I want to recognize people are concerned about this situation as are we. As always our number one priority is the health and safety of the American People<\/a>. We appreciate americans are taking this threat seriously and continuing to seek information about how to be prepared. The immediate risk to the general American Public<\/a> is low today, Us Government<\/a> is doing everything we can to keep it low. Risk varies by exposure, some areas of the country are experiencing Community Spread<\/a>. I ask us trusted leaders to help us with our mission to provide clear information to you and your constituents by urging people from cdc how to best protect themselves and their families. Good afternoon, chairman cruz, Ranking Member<\/a> sinema and members to the subcommittee. The response to the committee, u. S. Customs and Border Protection<\/a> is part of the government response to the virus as men and women serve on the front line of between us ports of entry whether they the land, air, or see. They are working with the department of Homeland Security<\/a>, centers for Disease Control<\/a> and prevention and other interagency partners and cases of the virus in china began to increase. Cvp and special partners have taken decisive proactive and preemptive actions to mitigate the threat, minimize risk and slow the spread of the virus. All foreign nationals who travel to china or iran in 14 days are eligible to enter the United States<\/a> at this time. Dhs including cvp continues to work closely with partners at the cdc for all persons in Mainland China<\/a> or iran in the last 14 days for 11 designated ports of entry where the federal government has focused Public Health<\/a> resources. All flights from Mainland China<\/a> are funneled to 11 there are no flights from iran, all passengers are final. We also work in collaboration with air carriers and partners to deny boarding of individuals that would be found in admissible on the arrival to the United States<\/a>. Nd foreign partners to deny the boarding of individuals that would be found inadmissible upon their arrival to the United States<\/a>. Cbp continues to facilitate cdcs enhanced screening of travelers heading into the United States<\/a>. Its critical of the u. S. Or dhs weapons of mass destruction, Contract Personnel<\/a> and medical evaluation. Travel is a dignified by cbp officers during the primary inspection. I refer to a rescreening area in the second rescreening every dhs cwmd Contract Personnel<\/a> take the following actions to support cdc. They verify if the screen is it required, as drivers about Health Status<\/a> can for example, if the fever, cough or difficulty breathing and take and record the travelers temperature. Cwmd is call this morning the enhanced Health Screening<\/a> efforts to agreement with state or local cms, Public Health<\/a> and First Responders<\/a> in an overtime capacity. Cwmd established this capacity in response to the ebola virus through. These actions ensured a train headed workforce of it to rapidly deployed to support the cdc. Dhs was able to use established capability to quickly address the threat of covid19. Fever, cough or difficulty breathing and take and record the travelers temperature. Cwmd is currently supporting enhanced screening with state or local ems, Public Health<\/a> and First Responders<\/a> in an overtime capacity. Cwmd established this capacity and response to the ebola virus threat. These actions ensure a trained, vetted and badged workforce was ready to rapidly deploy to support cdc. Dhs was able to use the established capability to quickly address the threat of covid19. At and between all ports of entry, cbp officers and agents continued to remain alert and notify cdc when encountering travelers committing signs of illness. Officers and agents are well trained and use a combination of travel history records, questioning observation and selfdeclarations to identify those requiring additional Health Screening<\/a>. Cbp also closely works with the u. S. Coast guard to ensure that ships and crews with nexus to china or iran are appropriately identified and screened prior to coming to port. At cbp our employees are our greatest asset. We are taking every precaution to keep our workforce safe especially those that may regularly encounter disease carriers. All of the offices have a 30day supply of personal protective equipment or ppe including does. These are located across all field offices, sectors and air branches. We continue to work to monitor the Global Supply<\/a> chain impacts and project critical needs for the cbp workforce. On february 5th cbp initiated an analysis that outlines the current comprehensive ppe guidance which includes guidance about wearing mass bs under the appropriate circumstances. Cbp continues to share information with our workforce on an ongoing basis. We are committed to doing all we can to keep our workforce safe as they work to ensure the safety of our nation. Thank you for the opportunity to appear today and i look forward to your questions. Thank you very much to each of the witnesses. Before i begin my questioning, i want to submit three letters for the record without objection. The first is a letter from commissioner john heller stat from the Texas Department<\/a> of Health Services<\/a> sent to secretary aczar at the u. S. Department of health and Human Services<\/a> and others. The second is that letter requested that the cdc submit a written rationale for releasing patients from quarantine at Lackland Air Force<\/a> base in texas. The second letter is a response from director redfield to commissioner heller stat outlining the procedures for discharging patients. The third letter is a letter i sent along with senators cornyn and mcsally to cbp regarding the possible spread of coronavirus across our border. I want to start my questions with that third letter. Mr. Ferrara, would you please explain how the screening process at the border currently works and how people coming through the 29 land ports of entry in texas are screened . Thank you, sir. At all of our ports of entry, our offices and agents are trained to look for folks that may exhibit signs of illness. Thats something that happens every day of the week in our operations. With particular note of coronavirus, covid19, we have issued guidance to our officers to ask certain questions about travel, particularly if folks are coming from china, now iran is included in that. We do we are questioned, check travel documentations and other information to try to see if, in fact, that person has traveled to those two areas. If they, in fact, have, the cdc is available at the area, we work directly with them. If not, we have our reachback and use our Public Health<\/a> officials, local Public Health<\/a> officials that we have relationships with to come to the proper conclusion. So does cbp plan to work with cdc medical staff in the future to heighten the level of screening performed at those points of entry . We currently work now with the cdc and follow the medical gietd dance that cdc provides. That interaction is continually happening, sir. Dr. Redd, let me ask some specifics about what we know of this virus. Right now, what is the overall case fatality ratio for covid19 . Theres a number that i could give you, but i would like to say that, as more cases occur and we gain more experience, that number is likely to change. Theres been a lot of questions both about the detection of the numerator, the cases that have died and also whether all the cases that have infection with this disease have been identified. Thats particularly true in china where the case fatality rates have been in general a little higher than seen in the rest of the world. So i would encourage us to look to answer that question and look for cases that have been reported in other countries and theres spread and kind of a cleaner set of information. With the understanding that information is still growing and theres a great deal unknown, what is cdcs best estimate of the fatality rate . Its probably somewhere between today i would say between. 5 and 1 . And just to give you a frame of reference, seasonal influenza is about 1 in 1,000. So all of those estimates are higher than seasonal influenza today. That numbers differs from the estimate from the World Health Organization<\/a>. What explains that . Ted cruz i think that number probably includes information from china where the theres a question of whether all the less severe cases have been counted. I think this is something that, as more cases occur in china, were likely to see that percentage decline. I think its stay tuned. What we know now is its substantially more severe than seasonal influenza. How contagious is covid19 and in particular whats the predicted or not. If you would explain what that means as well. Sure. The way we assess transmissibility is how many cases occur from one case. How many additional cases can be the downstream cases. Seasonal influenza is usually somewhere between a little more than one and 1 1 2 new cases generated from a single case. For the information that we have right now for the Novel Coronavirus<\/a> its probably between 2 and 3 or 2. 5 and 3. 5. That number is largely based on the experience in china. The elements of that what determines what it is, that number of new cases, has to do with the virus, has to do with susceptibility of people who might be exposed to the virus, and it has to do with the context. So situations where theres a lot of crowding, you might expect to see a higher number not than a place that had less crowding. This is a number, also, were going to be following, i would say theres been a little less variability in that particular number than there has been in the mortality. Now, reports are coming from china that indicated the incubation period can be up to 24 days. That differs from the 14day protocol releasing patients from quarantine. Can you speak to the accuracy of that report . Thats one report. I think thats a key question. I think its going to be important to monitor that. We have not seen secondary cases after people have gone through that 14day incubation period. I think our preliminary indication was that actually the incubation period for this virus was a little shorter on average that mers or sars, two other coronaviruses that can cause severe disease in humans. I think this is something that provides some margin of safety between the average. I think its something were going to have to continue to follow and well adjust as new information becomes available. Dr. Redd, are there common sense and reasonable precautions that americans at home should be taking now if youre concerned about your health and safety and your familys health and safety . Absolutely. And i think this is an opportunity as i include in my statement, if you can help us with this, that would be terrific. Theyre really things we do to prevent respiratory infections in general. Hand washing, covering coughs. If youre sick with respiratory illness, stay home. That can be a hard thing to do. I think in this circumstance its even more important than it is on a usual basis. Lastly, its really important for people to stay informed, that the information is changing so quickly that, if you know something at the beginning of the week, it could be different at the end of the week. I think particularly areas where the disease has been identified is something thats been changing quite rapidly. Thank you. Senator cinema . Thank you, mr. Chairman. My first question is to mr. Ferrara and acting undersecretary szabat. Its my understanding it didi that passengers can choo choose to not provide complete data. Id like to ask unanimous consent to enter into the record a letter for airlines through america sent to the department of health and Human Services<\/a> outlining suggestions to overcome this gap by having the federal agency set up a Single Online<\/a> web forum for all Inbound International<\/a> passengers. That would be by sea, land or air. Mr. Chairman, if theres no objection, id like to ask that that be entered into the record. A Single Online<\/a> web form would allow the cdc to directly collect information from passengers and provide for a more complete, accurate and timely collection of data. My question to you two gentlemen is what discussions have there been between department of drpgs, u. S. Customs and Border Protection<\/a> and cdc with the concerns these airlines have raised. From a Public Health<\/a> perspective, would compliance be improved if all travelers were directed to some single portal. If so, what funding or Additional Authority<\/a> would be needed for congress to create such a system rapidly . Senator, thank you for the question and your interest in this area. Like you, i want to tip my hat to those in the airline, the Aviation Industry<\/a> and the association that have really stepped forward to offer Common Sense Solutions<\/a> to the challenge that we have. As you mentioned, this is a real need that we have within the federal government as travelers are coming to the United States<\/a>. Wet want to be able to Contact Trace<\/a> them so that, if it turns out somebody who comes in is ill, we can reach back and find out who else theyve been in contact with. Previously, the information that has been gathered that we can collect directly from the industry only has about 20, 25 accuracy. Youve alluded to the fact that much of this information comes through travel agents which are not directly affected by the information thats provided by the air carriers themselves. So we have been working i would say multiple times daily, communications among the agencies and with the association trying to work through the technological difficulties of getting to the ultimate goal of this rule that has been put out which the carriers have said will take six to 12 months to comply with. So we dont want to wait six to 12 months to get that data. We have an interim system that the carrier has been kind enough to work with us right now, paperwork based on the travelers coming in. That works well given the small number of passengers we have arriving right now. Down to fewer than 1,000 a day, coming in mostly from china. With that, the system we have now coffers that, but its not scaleable with the concerns of adding more countries to the travel. We think the proposal the carriers put forward is definitely worth looking at. The challenge we have is a technical one of how well we work it within the various i. T. Databases of the federal and government agencies. We provide all the information we have in our systems to cdc via the airlines. As the undersecretary mentioned, its not complete for the cdc purposes. What weve done is a stopgap working with cwmd, the contractors. Were manually putting those into computers directly at those 11 airports. To the first part of your question, we have participated. Its an all of government effort to speak with the Airline Industry<\/a>. This Data Exchange<\/a> is a constant conversation, not just for this particular issue. So there are a lot of the right people working in getting through, but there are some challenges. If youd like to respond as well. Well, i think that at the moment were trying to make the system that we have work, but its clear that we need a better system, just as a small example of how were working together when customs and Border Protection<\/a> people didnt have computers to enter the data, we were able to provide those from cdc so we could facilitate that entry. Yesterday i had an opportunity to speak with Vice President<\/a> pence. As i mentioned in my Opening Statement<\/a> i followed up with a letter to him this morning. My understanding is theres a Web Developer<\/a> who has the Technology Available<\/a> to develop an app similar to the mobile passport app. It could be done as quickly as two to four weeks. Of course, the technical challenge is how do we get that across our institutions and deploy it. I believe that provides a real opportunity for us to address this Contact Tracing<\/a> issue in a matter of several weeks rather than six to 12 months. Thats something i hope we can Work Together<\/a> on and consider how to implement that quickly. Like the question i asked earlier, the collaboration between the Transportation Industry<\/a> and the government is incredibly important, but pharmaceutical manufacturers are also currently leading the way in developing both a vaccine and developing a plasmabased treatment. Companies like johnson and john johnson and merck are collaborating through the research and Development Authority<\/a> as well as other Public Health<\/a> entities. Theres been conflicting information coming from different parts of the administration on the timeline for not just the development but the implementation of a vaccine for ordinary americans to access, and that is unacceptable. So my question for you, dr. Redd, is the cdc engaged with these biomedical and facial suit cal companies both in the development of a vaccine and in development of treatment of those experiencing illness when one has been approved for use for either vaccine or treatment, how will the cdc work with others to deploy it amongst our transportation, border and Health Personnel<\/a> who, of course, are at increased risk for exposure because of the roles in keeping the broader public safe . Thank you, senator. I appreciate the last part of your question because i think thats where i can speak most directly. The nih and the Biomedical Advanced Research<\/a> and Development Authority<\/a> are the main parts of the department that are working on the both the basic development and the advanced development to get a product that could be approved. I think that the example of the work that we did in h1n1 influenza, that would be what i would foresee. Its going to be a while before we have a vaccine that meets a vaccine and probably a treatment as well. In h1n1 the government procured the vaccine, aid for the distribution and that was essentially a governmentrun program quite similar and actually built on the vaccines for childrens backbone for a product that wasnt licensed at the time. We didnt procure it, but we managed the distribution of a drug called peramavere used to treat influenza. I would envision that kind of a system. The first part of your system, the key was to get a product that is safe and effective. Thank you. Thank you mr. Chairman. Thank you. Just to underscore senator sinemas first question, my understanding is the airlines have offered to contract with a Third Party Vendor<\/a> and to cover the cost themselves to stand up, a website and or a secure mobile app they believe could be stood up within two weeks to gather the information that i understand cdc is requesting. Do each of the three of you think thats a good idea . Short answer, senator, yes, its a good idea. We welcome the fact they reached out and made this proposal. Our challenge this end and were working this as hard and fast as we can, is it technologically feasible. If we can, thats a great solution that gets us from the temporary solution were working with now and not having to wait six to 12 months for permanent solution. The way the system is devised right now, cdc receives the information from customs and Border Protection<\/a>. However, that information, if its of high quality and complete, would be great. If its technologically possible and it meets all the different security standards, i think it would be a great opportunity to look into it. Thank you. Senator gardner . Thank you, mr. Chairman. Thank you all for your work on this. Obviously very critical. I want to thank our Public Health<\/a> officials in colorado for the work theyve been doing and the governor of colorado for the work hes been doing to make sure we have a 50state approach that protects our people as i know youre fighting each and every day for. So thank you. What steps has the cdc taken to coordinate with foreign governments to verify their screenings and Public Health<\/a> protocols abide by u. S. Standards specifically when traveling from hot spots like south korea and italy . Were in very close contact, particularly with the state department and department of defense in korea. My understanding is both korea and italy have instituted exit screening to identify persons who might deal with coronavirus. I think this is really an ongoing global effort. Were also working with the World Health Organization<\/a>. Our work theres two parts to that. One is in places where we have staff, weve able to directly interface. Thats true in korea, not true in italy. Its true in china, not in iran. Does it make sense to provide to test everyone who comes in from countries of higher concern, 100 testing . I think the problem with that would be similar to the symptom screening, that a person could be incubating the disease and have a negative test and later they develop symptoms or maybe not develop symptoms and actually have the virus. When there are questions regarding how to abide by the cdc ifr and best protect passenger and employees health and prevent the spread of covid19, does the cdc have a person, a single individual prepared to serve as a point of contact for those questions . What weve done, and this is what weve done, and this is part of the rule making process. That rule is out for comment. There is a way to provide comments to that rule where examining we have no expedited procedure to appoint one person who can answer these questions . Theyre actually multiple people that are reviewing that. Reviewing the rule or reviewing whether or not we can appoint one person to answer questions. Reviewing the comments being submitted. So right now if United Airlines<\/a> needed to call somebody, there is no one person point of contact . There is not. There would be theres a joint thats a problem. Email address. It gets better coverage than a Single Person<\/a> would provide. In effect theres a place depends also on what the issue is. If its about how long does this interim final rule take . It really i think there is that interim final rule will be it will be continued until the Public Health<\/a> emergency is over or until theres thats in or until theres thats effect now or were waiting for Public Comment<\/a> . The rule is open for Public Comment<\/a> now. When does it go into effect . The interim final rule is the part that makes it interim has gone into effect already. Thats this process so youre able to operate under this as it is. Thank you. Correct. Has the cdc provided updated guidance to states on when to test for covid19 in light of Community Spread<\/a> . Yes, sir. In fact, when i was when we were coming over here in the taxi, there was a news report that thats been released, essentially giving broader discretion to clinicians care caring for patients to get testing done rapidly. That was put into effect today. Do you have a national or International Standards<\/a> that govern airline precautions, disinfection protocols, should an Airline Employee<\/a> test positive for covid19 . We have guidance. I think the rules about that i might defer to my colleague about the standards. We do have guidance thats posted specifically for covid19 on aircraft equipment issues. But there are also International Regulations<\/a> which i might turn to my colleague senator, are senator, are you asking about the standards that we have for how we disinfect the aircraft or about Health Standard<\/a>s, ppe for the crews . Both. How we make sure the airplane itself is safe and how we make sure the crew is safe. Several different measures. Because we made a conscious decision. We issued the 212f, travel restrictions with china, not to take down all flights. We still continue to have passenger flights taking passengers back from china. We want to put in place vigorous crew Health Protocols<\/a> for passenger and cargo planes that are flying back. Those differ in terms of whether they can leave the aircraft or airport facility and their contact with other people and the amount of everything from washing their hands to the types of protective gear that they wear depending on whether or not theyre china based. In other words, living in china or flying out of china or coming, staying briefly in china, turning around and come back. Im out of time and i think it follows up on what senator sim sinema said. We have no way to contact a person on the plane with someone who may test positive for coronavirus . Half true. Before we put in those interim measures, our Contract Tracing<\/a> was about 20, 25 . With the sber rim measures we have in place now at the f11 airports that mr. Ferrara was referring to, right now according to dhs, theyre at 94 to 96 accuracy with that Contact Tracing<\/a> information. If i may, mr. Chairman. Id like to amend my answer. The guidance for cleaning, were expecting to be cleared today or very shortly. We actually dont have guidance up today. I wanted to correct what i told you earlier. I hope that gets approved immediately. Thank you. Thank you, senator gardner. Ill note for the record that after this hearing commenced the news broke that we now have the 11th fatality in the United States<\/a> from california, so the first thats occurred outside Washington State<\/a>. Senator cantwell . Thank you, mr. Chairman. Id like to cover a couple of things. Were trying to do a supplemental to get more funds out to the states for Public Health<\/a>. Well hopefully vote on this before the end of this week, 7. 8 billion. I think theres 11. 5 million that would be a grant to Washington State<\/a> for Public Health<\/a>. Do you think some of that money could be used to Better Direct<\/a> the public towards the testing regime . Right now were being very broad. Were saying, if you suspect something, yes, call these various entities. And then people are calling their doctors saying we dont have that and you have to go over here. And then they call them and theyre like, no. Can we use some of the dollars youre going to get to be crisper about how to go about the testing . If you want a protocol that says you have to call your physician first, lets clearly state that. And then lets be clear about how many tests a day that were able to do and how we create a system for that. Does that make sense . Does that make sense . It does make sense. I think some of that money certainly will be used for communication activities. I think clarifying that guidance on who should be tested and can be tested will be an important part of that. Its also likely to change over time as has already occurred. Thats why i think if you create this site and create Accurate Information<\/a> for people, you wont have the anxieties of people saying, i feel sick, i have this going on and i cant get a test. We want to alleviate that. I hope that some of those dollars can be used for that. Another thing i would hope you would advocate for is so seattle flu study was a research institution, everybody working collaboratively to study and analyze flu results. Obviously you had to consent to be in that. Thats how we caught the one student student. The individual student thought they were sick with the flu and three days, four days later when we finally changed the protocol for who could get tested, they tested positive. So now i think the university of washington has changed that so that it also coffers covid19. Every city in america should be doing this. Everybody should have a flu covid19 irb, a research analysis. And the reason why its important is so we can see this interplay between those who think they just have the flu and so we can track the genetics of where this is going. Now we find its all related to the washington one case. This is finding out how Community Spread<\/a> works. Can we also do that . Yes, maam. Actually were i believe today there will be the collection specimens in several jurisdictions with additional jurisdictions through the week with a plan to build out a system that would be much broader really to all the reasons you said in addition. Every city in america could start this now. Theyd have it in place and they have to get the agreement and have to get the information. They can put flu information in this. Yes. This is really being built on flu surveillance to add Novel Coronavirus<\/a> so that communities will know if the virus is in their community and would be able to have an estimate of the its not there, whats the certainty that it isnt there. I think it will help. Im glad the university of washington got this done. Now, for the airplane which our colleagues were just asking about, how long can virus material last on a surface . The virus can last hours to a day. Thats the estimate similar to other coronaviruses. Up to a whole day . Yes, maam. Up to a whole day. Ive not heard that before. Im glad youre clarifying that. Different surfaces have different weve heard the generalization before, and i think thats what is sometimes confusing. So up to a day. So now what do we need to do for our airplanes given that . Thats going to be in the guidance that we hope is released very shortly. Theres really the health side of that guidance which will be released and then the issue that we addressed in the earlier question. Mr. Szabat, do you want to comment on this . People are concerned about the obvious individuals and being able to contact them. People want to understand what is our plan, the department of transportations plan to communicate if the virus can be alive on a surface for a whole day, what kind of precautions do we need to take on our air surfaces . Thank you, senator, for the question. This is a whole of government effort. Department of transportation authority, its really safety of flight. We are in consultation with cdc, the other agencies and osha and niash which developed the standards for individuals on the airplanes. Our focus is to ensure that the mix of chemicals and other treatments do not actually harm the aircraft itself. Are you saying you dont have the authority to set the standard . Were saying that Health Standard<\/a> is by design not our authority. Whose authority is it . Is it cdcs or is it the information wed have would be guidance. It wouldnt be wouldnt have Statutory Authority<\/a> is my understanding. And my understanding again, im not the medical person on this panel, but much of the authority runs with osha which is not on the panel here, and we are in discussions with osha on developing these standards. Ok. Thank you for having the hearing, mr. Chairman. I think this is something we need to tackle right away. We need to understand what we are saying to the flying public about what the airline should be doing, what we should be doing to create the best and most positive environment for air transportation to continue. As you said, mr. Szabat, were going to want your transportation and we want it to be done. Lets get this protocol clearly established. Lets Work Together<\/a>, get it established. Thank you, mr. Chairman. Chairman. Thank you. And to underscore senator canned wells point, if there are authorities needed to keep the flying public safe, let Congress Know<\/a> immediately and we will create whatever authorities are needed because the priority needs to be public safety. Senator lee. Sen. Lee thank you, mr. Chairman. Thanks to all of you for being here and the insight youve provided. Congress is preparing to consider supplemental funding to several agencies to respond to the coronavirus outbreak. Two weeks ago the Trump Administration<\/a> requested 1. 25 billion in new funding from congress for various response efforts. Id like to ask each of you to just respond briefly to share how your agency would plan to use supplemental funding and also to respond to a related question regarding assuming the administrations request reflected the needs of agencies that respond, if Congress Gives<\/a> you substantially more than what the administration asked for or what you asked for, do you have a plan to responsibly spend all of it, and what would that look like . Well start with you mr. Ferrara. Thank you, sir. Currently based on the current threat and projected threat, cbp has what we need to do our job. Should things change working with the interagency and that threat vector change, we would certainly inform on our resource needs. You have what you need right now without a supplemental . Yes, sir. Yes, sir. Dr. Redd. Yes. We would use the funds, substantial amount of those funds would go to state and local Health Departments<\/a> to do the work thats being done right now on identifying cases, testing those cases in their laboratories, identifying contacts. This is very labor intensive work. So Laboratory Testing<\/a> would be an element of that at the state and local level. Communication, surveillance, some of the things we talked about with the effort to test specimens collected for other respiratory specimens. There would be a suite of activities that state and local governments would do. At the federal level we would be able to use those funds for many of the same things, laboratory support, surveillance work, communication, the things that we do in emergencies. So i think we would not have a problem spending all the money. And with regard to part of the question dealing with 1. 25 billion, i assume that included whatever supplemental sum you thought you might need. So if we were to authorize more than that, tell me how i think it might be better to see where we are with the bill thats going through. I think that there is a scaleability to the amount a smaller amount of money would last a shorter period of time. A larger amount would last a longer period. Mr. Szabat. Thank you, senator, for the question. Under the game plan, the Emergency Response<\/a> planning, this whole of government effort is led by the health community, specifically the secretary of hhs. So the vast majority of the money requested, and i believe the money thats under discussion right now by congress is for the cdc and other health agencies. Some of that money would flow through them to address some of the needs such as senator canned well mentionedcant about what were trying to do with Health Guidance<\/a> and protocols for airlines. That money is going through hhs. There is no money requested specifically for the department of transportation. Sen. Lee ok. Thank you. Dr. Redd, reports indicate that the south korean government has been trying to get a handle on who is coming into the country by having air carriers try to assess passengers as theyre boarding the planes going into korea to figure out whether they are suffering from the virus prior to boarding. Have you provided any guidance to air carriers in the United States<\/a> dealing with how we would assess this issue with inbound passengers . Im not familiar with, if im understanding the question with south korea, we have provided guidance for screening that would be for passengers coming into the United States<\/a>. If were working on that, im not familiar with it. I think that the value of that screening. A lot of that work is to figure out collect some of the information weve been talking about. Thats the way weve done it in the past, to collect Contact Information<\/a> so that those individuals can be tracked. Its very laborious. Thats really the reason for this interim final rule is to do more to automate that system. To automate this system whereby you collect data on each passenger. Correct. With an eye toward hopefully excluding those who might bear symptoms or show some indication that they carry the virus . Largely we can screen for symptoms. If a person is incubating the disease, being able to track them through that incubation period is something that at least informing them that, if they have symptoms, here is what you should do. I think we wouldnt be able to identify people who are incubating disease from the Contact Information<\/a>. But we could use that information to follow them. Ok. Thank you. Thank you mr. Chairman. Testank you to all the ifiers. Dr. Redd, im trying to get a handle on what our National Strategy<\/a> is in terms of containment containment. It seems containment is something you do in the first phase of something thats a potential pandemic and were rapidly entering a phase of this during which theres sufficient Community Spread<\/a> and. Where the containment strategy has sort of vanishing smaller and smaller returns. I want to make sure im getting that right and then ask a followup question. That is correct. A certain nuance to that is there are likely to be parts of the country where mitigation is the right posture. At the same time there could be other parts of the country where you can still use containment. Exactly. My next question is if were into a Mitigation Strategy<\/a> phase, then what restrict air travel at all . If were talking about restricting air travel from korea, and it seems to me with the exception of the episode and that religious organization in the southern part of south korea that whats actually happened in south korea is they just tested more and got very aggressive about it, so their data is in. Our data is not in. Its not clear to me that their 6 or 7,000 cases, their numerator and denominator will end up any higher than ours by the time we do all the testing. Then it gets silly if were not allowing people to travel when one place is not any less or more safe than the other. I agree with your general point. I can give you the example of h1n1 influenza where for a short period of time we had a travel advisory to mexico. That didnt last very long, youd be more likely to get h1n1 in the United States<\/a> than you would if you were returning from mexico. That would be a situation where we wouldnt that would basically be a scenario like that wouldnt be this intensive effort to track people entering the country. Ok. Just a new question. Your website right now says there are 80 total cases. Thats not true, is it . We update that on a daily basis. As cases are reported from states, they do that on their own schedule. Ours is a kind of a once a day. Sort of garbage in, garbage out. We just dont know yet. Its not that its 80. Its that youve confirmed 80. Thats correct. I would recommend you figure out a better way to reflect i understand the uncertainty here. Whats going to happen im afraid is that right now people are i think unreasonably reassured by this low total case count and unreasonably fearful of other places that are actually really whats happened is theyve deployed tests more efficiently and effectively than the United States<\/a>. Whats going to happen well be calm until the tests get deployed. Those numbers will spike like crazy and well have a panic as a result of that. I think you have to figure out on the communications side how to reflect that uncertainty and prepare the public for the high likelihood that the number of cases that we have confirmed is going to skyrocket, not because epidemiologically anything changed but because we finally deployed the kits. I think well know the study that senator cantwell described to us, will help address that issue. If we do more testing and dont find that is possible. Im talking about in the next im talking about in the next couple of weeks. Exactly. Final question for you. This is so constructed and so bipartisan, i thank the chairman for convening this hearing and the Ranking Member<\/a>. Can you ask the folks at the cdc if they would commit to a Daily Briefing<\/a> on camera, no politicians involved. It doesnt have to be inflammatory. It doesnt have to be alarmist, but just a daily heres whats going on . Thats what happens in a Natural Disaster<\/a> context. Thats what happens when you have a sort of a Civil Defense<\/a> issue. We just need to hear from a singular authoritative informed voice and on a daily basis so were not all catch as catch can, trying to figure out where the data is and where this thing is going. Mr. Szabat, am i pronouncing your name correctly . Yes, senator. Yes, senator. My understanding is the faa has the authority to implement an emergency order so that those as you were talking to senator cantwell about this that right now their guidelines and i understand under normal circumstances youre talking about whether or not the airplane can fly safely. These are emergency circumstances, and i dont want to spend another two or three weeks figuring out Whose Authority<\/a> is necessary to get a bunch of lawyers involved trying to figure out where you derive the authority. In an emergency situation you are certainly authorized to change those voluntary guidelines that the airlines some are abiding by and some not. And just change that into an emergency order. Id like you to look at that, please. Senator, we will. We will look at it as a whole of government effort. One of the reasons for the task force is to say, if there is something that needs to be done and it falls through the cracks of one agency, we borrow the authority of other agencies in order to get it done. Thank you. Dr. Redd, senator schatz asked about testing. From my conversation yesterday with Vice President<\/a> pence and secretary azar, my understanding is that testing kits are going out, what was told to me, by the end of next week, the capability will be there for 1. 25 million tests. Is that accurate . Thats a combination of numbers from the Public Health<\/a> test that cdc is deploying that are done in Public Health<\/a> departments and what could be done by private Companies Applying<\/a> through the fda process to use a test that would be a commercial test. That number is within the range ive heard as well. A small portion would be the Public Health<\/a> test. The majority would be company developed. One of the great frustrations is a lack of testing. Youre telling the subcommittee the tests the kits are on their way and testing, that will be remedied shortly. Is that correct . For the Public Health<\/a> testing well have the capacity to do 75,000 tests by the end of this week. Senator sullivan. Thank you, mr. Chairman. Thank you to the panelists for this very important briefing. Secretary szabat, i want to follow up on our earlier phone call, my discussion with you today and see if any more if there is anymore progress. You know the broader discussion from the other witnesses is weve closed down the passenger travel from china and other areas where theres been a risk, big risk on the issue of mitigation of the spread for air travel. However, there is a loophole, and i think everybody ive raised this ive been raising this issue now going on four weeks with Senior Administration<\/a> officials. The loophole is cargo. Air travel. Cargo is very important for the whole country, for the whole world. We want to be able to have the supplies to address and be ready for, you know, what could be a significant challenge for our country, but the pilots on these cargo flights in some ways are a loophole. You have chinesebased crews that get off in the United States<\/a>, big cargo hubs, whether anchorage or seattle or l. A. , memphis, and they spend the night, you know, in the population. Theres nobody ive spoken to, and ive spoken to everybody, including secretary chao and others, that doesnt recognize this loophole. But the Agency Agencies<\/a> seem but the agency,pi agencies seemo be pingpong back and forth on how to address it. One suggestion i have made is to essentially do a turn and burn. You have cargo passenger airplanes, to anchorage. They have two sets of pilots. They land, geten rid of the caro and then to get the other pilots to fly back. There were some concerns they might retaliate against our cargo airlines. However, some of the senior officials ive spoken to dont seem to think that would be a problem. Can you, mr. Secretary, im hoping you can have more definitive answer than our discussion this morning. Can you tell this committee what we are doing to address this issue . This is a real problem. It somehow theres a spread in another city, say anchorage, and itsac trace back to a pilot on a cargo crew, the likelihood of us then wanting to react to shut down the whole system is going to be strong. We are trying to preempt this with some good ideas. These are decent ideas. They are workable. Nobody has complained about them but the authorities seems to be pingpong back and forth. What we doing to address this overseas base crew loophole that everybody acknowledges we have . Senator, thank you for the question and thank you for the courtesy of flagging this for me earlier today. I regret i didnt have more definitive answer for you now and had thisfi morning except a second working and i will have an entity as quickly as possible. When will that be . Ive been raisingng this for almost a month. So today isto wednesday. I will have it to you by close of business friday and hopefully before. Will that be clear by everybody, no pingpong in intrinsic faa doesnt have authority . Does is issue some people arguing the crew rest doesnt count if youre sleeping on the plane. Were dealing with an emergency hip and should the pilots who are resting on a plate as her sleeping to come over our rest enough to fly back. They are all capable again, if thats a regulation or an authority you need upon, let us know but dont use that as four weeks since of embracing thisle with people and so far so good we havent had the spread from a cargo pilot, but i think were dodging bullets and we need to address it. I5 whole of government govd to back too you by close of business friday. Thank you. Admiral, i want to ask and highlight another issue thats a little bit more particular to my state, the great state of alaska, where one concern i have is our alaskan native populationss where, you know, theres over 200 communities in my state that are cannot that are not connected by road. They are very isolated in very, very remote parts of the whole country. Itll have hospitals. They barely have clinics. Some of these communities dont even have flushsh toilets and clean water, which is a tragedy to the whole nation, in my view. But as you likely know, the 1918 spanish influenza decimated these communities and alaska, decimated them. They are formidable and what im concerned about is theres enough focus from cdc, we have cdc office in anchorage in part because of our high rates of Infectious Disease<\/a>s. What is the cdc doing to make sure that these extremely vulnerable populations, if you ever get an outbreak in one of them, where were ready to the situation so we dont have a situation that happened when hundred years ago which to let an impact on my state . Yes, sir. Is think this is important iss. I know that you know that doctor j butler, who serves as a state Health Officer<\/a> in alaska, is now in atlanta. Is outstanding. We have that and that will help to make sure we dont forget about remote population i think its a real challenge of those. Can like it or commitment of somethinghe a little bit more definitive that recognizes the vulnerabilities of certain communities like this that are very remote, in some ways you might not get the remoteness helps spread but if it does get out there and is really no hospitals, very few doctors. Canna get your commitment to the more definitive plan to help address these kind of speedy that they commit to get back to you with what our proposal would be an we could have a dialogue about that. Great. You might want tolo work with te cdc office in anchorage. Yes, sir. Which also escort nation with our native health system. Thank you. Thank you, mr. Chairman. Thank. You. Senator tester. Really . Doggone it, i appreciate that, mr. Chairman. I appreciate you all being here, and i want to thank you for the work youve already done. This critically important issue. It is critically important and i hope it doesnt turn out anything like i have imagined potential in my head. So i i just want to give you my circumstantial, that is i fly forelegs the week. I have town hall meetings. I meet with people all the time, probably meet with 70, 80 people today alone. The question is, is if anybodys going to get this is going to people serving in the United States<\/a> senate because we all do that. Senator cruz fly solo, he a Different Airline<\/a> i do. Exposed to different population and we come back and have Commerce Committee<\/a> together, okay . The question i have for you is i got to washington hands and getting the flu vaccine is or anything wein can do to protect ourselves i dont care who answers it that you would recommend, or do we just have to do what, that is, hope you did Something Else<\/a> wrong with you and so you can get through it and survive it and move on . So let me get the right answer to that. I think and washing is a critical element in protecting yourself, and for all of us protecting ourselves. There is kind of the other side of it, which is things we want other people to do that my contract this disease and give it to us, and that would be coveringng coughs, really, realy important to stay home when sick. I think that is probably something we will have to just continue to stress. That doesnt protect a person who is staying home but it does protect everyone else. And so what i hear almost things, so what is the incubation period on the stuff, do you know . On average, five to six days with a range of short of a couple of days to make it up to two weeks as we have heard. You know, ive got a few achy bones today. Does that mean i still . I think i would not stay home or useth it as a reason for coronavirus. I think fever and respiratory symptoms would be where so by the time you stamp youve already been affected for five or six days is what youre saying. You have been incubating. This is one of the issues. You can say no, we dont know if we dont know, i drink the incubation period can i spread it to the good senator from illinois . I dont think you will like my answer. I did wash my hands, okay . [laughing] its not possible to give a definitive answer on that. I would say there is a much stronger suspicion that with very mild symptoms or right before you develop m symptoms tt there is, there is a lot of cases the chance of spreading the disease which is different from other the other coronavir. Given for most viruses where the viral load increases the sickerh they get. This may be a case where viral load can be high even in that very early almost like the symptoms you describe. I wish it were not true. Look, i got it. So how long do you think its going to take this to run its course in our population . I dont think thats possible to speculate. Nobody knows . There are a lot of factors that could go into that. It really is impossible to say. Okay. Theres been a lot of talk, the good senator jacky rosen just told me that italy just shut down some of their schools. Theres talk of shutting down all sorts of stuff down. I personally think thats not a mistake because on not sure when the matter to be honest with you i think it contributes to a paralyses are is bad enough without [inaudible] yourwould be recommendations on all that stuff . Its like youre the person with coronavirus and it point so they cleaned airplane. You really havent done a damn thing. Thats a very difficult question. Its one of the reasons that the president has set up the system that he has with the Vice President<\/a> in charge, that those different sectors are able to communicate more effectively so that we can talk about what the Health Benefits<\/a> might be, but the adverse consequences, when im an expert in those. In the spirit i think this is something that will facilitate the appropriate decisions being made in as quickly as there needed to be made. Good. This is a question for mr. Szabat. Do you believe are going to be flight restrictions placed if this thing plays out as potential . The easy answer to that is what it would have flight restrictions of the. I i know what im talk about domestic flights. I dont know. We are outside the playbook. The original playbook did not envision travel restrictions, Health Officials<\/a> have historically have said in the case of widespread flu or similar contagious diseases we dont do travel restrictions. We went outside the playbook on this one and i would contend that the travel restrictions that we and some of the countries did were very effective. In some cases they weredi o not. Italy didnt even more of a prohibition than we did but there waited until after we did and it didid not turn out to be effective. Theres going to be a lot of Lessons Learned<\/a> from that. But to your question, its now in the playbook something to think about, but i cant chile under what circumstances we might consider pulling the trigger. I just want to thank you all for your good work. I cant thank you enough. I have been frustrated with the president in his reaction to all of this from the getgo. You guys are pros and you want to thank you. Senator senator capito. I want to just ask just a general question of mr. Szabat. You may not have statistics but as of now do you see Domestic Travel<\/a> on the decline because of this and people canceling flights, less people traveling . Senator, thank you for the question, and your better served asking that question from industry and industry and others who have like specific numbers. Certainly we are in daily contact with the industry and they are looking at a decline in bookings going forward. Having said that, so far the biggest hit for the Airline Industry<\/a> has been on asian travel. Ci for the u. S. Industry thats the smallest part of both of the revenues andco especially of thr margins. This only becomes a major hit for the u. S. Flag airlines if the coronavirus spreads or concern of the virus spreads and passengers decide not to travel largely domestically. Secondarily between the United States<\/a> and europe. Iq. Mr. Ferrara, thank you for your work at cbp. We had the tsa administrator in front of our subcommittee which appropriationsy the of the day was talk about protocols that up and put in place that youee all are correlating with. Let me just say when somebody comes in at the 11 airports, those are the citizens come in into the 11 11 airports, you do a prescreening. You do that in coordination with cdc. What if somebody, like, exhibits the symptoms . Are they tested immediately or how is that rolling out . Thank you, maam. As you said once they come into one of the 11 airports are officers identify them as potential of being ill or at least coming from either iran or china. We refer the over to cdc are cwmd who was there. Thats a medical determination so they would determine if a test is required or not. Our Law Enforcement<\/a>, our priority is Law Enforcement<\/a> piece of it, making sure they get there. Get for the nee to go. And was broughtwa to my attentin that was an article in the wall street journal this morning the title of which is packers target companies with coronavirus scams. Its pretty shameful people try to capitalize on o what we see s some growing fears and anxieties about whats going on. I dont know if its a Homeland Security<\/a> question. I know absolutely you all have cybersecurity capabilities within your agencys. Is this something that you all are made aware of, that this people that are impersonating World Health Organization<\/a> . Obviously this is a moneymaking kind of skin. Dr. Redd, do you know anything about the . I was not familiar with that article. I think the general issues of cybersecurity are ones when you to take very seriously at a think this would be an example of, if this measure are not in place how they could lead to trouble. You can imagine a scenario of a hacker contacting somebody and saying you wanto to buy 25 mas, or some preventive or a vaccine or expedited travel, or whatever you would be offering would really w make you, make a lot of the population very vulnerable to this kind of attack. So i would suggest all of you in your perspective departments take this back with you as a red flag. Did you want to Say Something<\/a> . Yes, maam. That is a department of Homeland Security<\/a>, one of the functions we do have so i will bring that back and provide that information to the department. Let me ask you again, we talked a lot about aviation. We see its an issue because it can be passed from time to time to time. Are you working with the coast guard on this to make sure wherever the ships are coming in from that you have some kind of capabilities there . Yes, maam, in conjunction with the coast guard we target people from either china or iran who are travelling on gar cargo ships and work with our medical partners to keep these people out of the port until we get the all clear from the medical folks. As a course of everyday living. Today i challenged myself to try to see how many things i could not touch that i know have been touched by numerous people before me. What a challenge. And so i think, if everybody would try to exercise around the country, you would realize how not just susceptible you are, but how careful you need to be when you know youve been in some kind of contact or direct contact or you yourself maybe have a cold or not beginning to feel well. So, that was pretty starting with the i elevators, doors, restrooms and constituents coming to visit. Thank you, mr. Chairman. Thank you, senator duckworth. Thank you, mr. Chairman. I want to thank you and the Ranking Member<\/a> for having this hearing. As of yesterday, from my home state of illinois, four people have been positive, and want to wish them a speedy recovery and for all the work theyve done. I have to share my frustration here. I cant believe were having the conversations were having now after other global outbreaks like h1n1, and sars. Americans have been flying more than a century and on the global pandemic, on the cusp, failing to share with u. S. Airlines and partners, is hindering our ability to stop the spread and to fight this disease. And so you know, my last job in the army whi i was finishing out my last tour was working at the pentagon in the defensive port of civilian authorities and the last thing i did was give a briefing on global pandemics and what we would do in our particular office. Doctor, you worked on h1n1, you alluded to it. Yes, maam. That was in 2009. How the heck does the cdc, cbp, and dot and they dont have computers, how come we dont have a way that were talking to airlines . How did we get here after weve seen ebola, h1n1 and sars and what are we going to do in this instance and looking forward to the next pandemic that hits because there will be an another one that were ready for it and were not caught flatfooted the way we are right now . I think that we have improved since, really my own history begins with the mid 2000s and i think were far ahead of where we were at that point in time through a lot of of hard work and attention from the members here, congress and the administration. I think that youre pointing out some things that need to change and i think that there will be both in the near term, work so were operating as effectively as we are now and there will be, after action review items that will come out, many of which youre listing. So how long, for yourself and mr. Ferrara, given the data sharing challenge with airlines, how long does it take for state emergency and Health Departments<\/a> to receive flight information about potentially infected travelers . How long does it take a state department . I have one of the busiest in the world in chicago, how long does it take. Illinois department of Public Health<\/a> or local officials to receive information about a flight thats coming that has a potentially infected patient on board. Within an hour over to c. D. C. I dont know the process from cdc to the states, but the information that we do have, we transmit within an hour. Okay. How long does my state, does it take before my i think the problem is that the information is often incomplete and that is really what the interim rule is trying to correct. If we had if we have a name, thats not very helpful. If we have a name and an address, thats somewhat helpful. If we have a name, address, phone number, email address, we can find people and that information at the Health Department<\/a>, basically would be the ability to do complete follow up that those Data Elements<\/a> are available. You dont have to time frame for me right now and we dont know when we will have the capability to rapidly let Public Health<\/a> people know . I think for what we have, its a very short period of time, but the real question is getting complete information and doing that in a timely fashion. And senate, if i might add to that. This has been discussed the at Task Force Level<\/a>. The goal to c. D. C. And Health Officials<\/a> is to collect the information so that c. D. C. Has it by the time the plane arrives and is already providing it to the local officials. The challenge that we have to the Public Health<\/a> officials to where those passengers are actually going, because of course, they come to one of 11 airports for initial screening, but thats not where theyre ending up. If someone is flying to chicago and going on to massachusetts, c. D. C. Wants to gather information and extend it to the Public Health<\/a> officials wherever in massachusetts theyre going to. And the system that we have right now is an interim system which is working very well, but it is paper work and personnel intensive so it works for the passenger that we have coming in now from china. We could not scale it up to be more broad and thats the challenge that we are talking about, having a better nationwide system. The system that we have now is immeasurab immeasurablebly better. Each time we have one we learn and as the doctor said well do a hot wash after this and learn from what we do here and better next time. I think we need to do better than next time. And i ask the chairman to consider holding a hearing after the epidemic and see, and learn about Lessons Learned<\/a> and what they planned on doing next time. I do want to add one more loophole to what my good friend the senator from alaska mentioned with the cargo. Are passengers aboard charter and private flights from areas of concerned receiving the same scrutiny as passengers aboard commercial flights . In addition to the of cargo aircraft, private aircraft in the system. Please answer that question. Its a good questionments ill answer the question. Senator, well get back to you with a full answer for the record, but i know i can speak personally, for example, for charter aircraft, we apply exactly the same rules to them as we do to any commercial aircraft. So if youre coming, for example, from china or now from iran, we dont have direct flights from iran, but coming from china you would have to land at one of the f111 airports. What about private . Ill get you an answer for the record on that. Thank you. Senator . Thank you, chairman for having this very important hearing. Thank you for the work that youre doing. I know your staff. Youre just working around the clock to try to figure out how to get ahead of this, object proactive, protect our nation so i just want to share my appreciation and that of all nevadans with you. Since the coronavirus is changing so rapidly, it is critical that our Public Health<\/a> officials doing the work on the ground, as senator duckworth says have all the information they need to do Contact Tracing<\/a> and the monitoring of travelers when warranted. So, id just like to understand what the threshold metrics being used to determine when air travelers must fill out that government Public Health<\/a> locator form. Can you explain that to us . People are not having to do that . What is the threshold . Just people from china . Just people from italy . Please explain that. So, the way, for the current rule, is travelers interim final rule applies to travelers from china. Only . So were not doing it for anybody outside of china, so should we expand that . Well, with your permission, senator, ill take that on. We have two countries now that are covered by the socalled 212f process which have this, travelers from china, travel,from iran. We have no direct flights from iran and very few americans will come back from iran within a 14day window. The ifr rules apply to those travelers, but were looking at a model that can be scaleable and expandible. For example, now we introduced new types of restrictions from travelers from italy and south korea, getting exit screening out of the countries, but theyre not being required to do the same kind of data collection. Who is doing the exit screening . What callcations and training are you providing for that . So its a careful answer to that question, senator. These are being done by the authorities in south korea and in italy. So we dont before they come here. Exactly, exiting from there when they come here, thats correct. So youre thinking of expanding it and youll obviously keep us apprised of that and considerations on that. I want to build on that because able were talking air travel and we have all of our wonderful flight crew, the pilots, the attendants, and people who clean the cabin. The contact that the flight crew have with hundreds of passengers, id like to hear a little more about the recommendations for ensuring that their health is protected and what requirements does the d. O. T. Have for personal protective gear for flight staff, such as masks and gloves, until those become recommended by Public Health<\/a> officials . Im going to start by answering this question, senator and put the doctor on notice it will get passed on to him. Department of transportation, we of course work closely with the industry and we hear from both the representatives and the pilots and the flight attendants, but our role on ppe side is that we pass on either the guidance or the requirements of and it can be osha, niosh or other health agencies. So we are in a sense, from the department of transportation perspective were a passthrough, given by position on the task force, the role of the task force is to assure that that guidance is put out and if i may put a plug in, because as you point out. We give a lot of praise often for First Responders<\/a>. First responders are responding to something. Our flight crews right now are on the theyre on the cutting edge. Theyre the ones dealing with risks every day and we do owe it to them to make sure that they have the very best equipment and best knowledge of how to perform selfsafety practices. So you talked about youre the passthrough, how are we going to compel the Airline Industry<\/a> to be sure that the health of these workers are protected as they look, we all, all of us fly every week, multiple legs on many Different Airline<\/a>s. Right, so at the moment. The requirements that we have are the airlines agree to meet these voluntary standards, now, if they refuse to meet them or fail to meet them. We can consider other measures. But right now its clearly in the economic interest of the airlines and personal interests of their pilots and crew to follow these measures. And i just have a quick second so im going to make this very short. Are we providing or are you helping the airlines to provide training, additional training to those flight crews for looking for signs of illness so that they may help when people are on the plane or when theyre getting off the ground and assisting in any of those reporting issues there . Theres a lot of interaction with the Airline Industry<\/a> and that domain. Im not familiar with were actually doing something very specific to coronavirus, but theres been a longstanding collaboration in that kind of work. Let me follow up specifically on that question. We do have guidance for protecting crews. Again, its this question of voluntary guidance and kind of what you should do versus having the rule or the authority to do that which resides with osha. Its not just a question of the flight crews health, but then they become carriers in and of themselves. And so thats the spread, public spread can be great. So, thank you, i appreciate it. My time is up. Thank you. Senator thune. Thank you, mr. Chairman, thank you for this hearing and thank you to all of you for everything that youre doing, continue to do to address the crisis and, dr. , first of all, i want to i say i appreciate the cdc work this containing the spread of the coronavirus and thank you especially for being here today and i want to just follow up and questions i think have already been asked, but my understanding is that c. D. C. Has issued guidance to air carriers to ensh your that theyre taking precautions necessary to contain and respond to a potential coronavirus on a flight. And the public is aware, can you talk about some of the steps are, that the airlines are following . I think the main thing is, identifying patients who have respiratory illness and taking action to really notify. Theres a system of communicating with ground, if Something Like<\/a> that were to occur and its really, i think, the standard guidance, but putting a sharper edge on it because of the situation that were in with the Novel Coronavirus<\/a>. Do you are there instances of domestic Community Spread<\/a> that youve seen so far and the c. D. C. Anticipates the need to provide similar guidance for domestic air carriers as what youve done with your international . So, there are locations in the country which have cases that have been acquired within the United States<\/a> specifically in Washington State<\/a> and in california and i think it would not be surprising that the locations would see cases like that. The guidance for identifying people who are ill is not limited to International Carriers<\/a>, so it wouldnt be only International Carriers<\/a> get that kind of guidance. I understand and agree with the current focus on Major International<\/a> airports and efforts to contain coronavirus, but its important to ensure that smaller airports and Public Health<\/a> authorities in rural areas are also prepared when confronted with a potential case. Has the department conducted outreach or provided guidance to smaller airports on containing the spread of the coronavirus . Senator, thank you for the question and for the concern. We share the concern for the health of the entire travelling public and at which smaller airports are an important part of that web within the United States<\/a>. So were working through, again, the whole of government efforts when it comes to delivering Health Preventive<\/a> measures to these airports to any one of our private sector stake holders, within the play book, the Emergency Response<\/a> planning, that falls under health and Human Services<\/a> and in Homeland Security<\/a>. So, our job is to ensure that those communications, channels are open and are flowing. We have had just in the last two weeks two major conference calls, including Aviation Organization<\/a>s in airports for exact this reason to connect them with the first line is their own Public Health<\/a> authorities and through that is the c. D. C. For Health Guidance<\/a>. Dr. Redd, what resources does the c. D. C. Provide airports across the country. Including smaller airports so they can be sure to respond to potential outbreak. I think in general, the quickest line of where to get help would be the local Health Department<\/a>. We are certainly available to communicate, but we would have guidance and we would work that through the state and local Health Department<\/a>. So thats kind of the first line of defense is the local Health Department<\/a> and the state Health Departments<\/a>. Mr. Ferrara, its my understanding that cbp is enhancing across the country to the chances for them to be quarantined entering the United States<\/a>. And can you talk about normal operations and changed in points of entry where screening has been enhanced . Thank you, sir. The information that were collecting for Contact Tracing<\/a>, it comes through the traditional cbp Airline Systems<\/a> and thats posed passed on to c. D. C. Thats the only difference. Its passed on to c. D. C. That these folks are coming from these countries of iran and china. Mr. Szabat, does the department has an initial information on to and from the u. S. . The center does not, but we follow closely what the Industry Analysts<\/a> are are saying. The current projection, 4. 7 to 6 decline in Global Travel<\/a> over the course of the year. And in part the reduction of International Travel<\/a> will potentially lead to supply chain constraints for certain medical supplies . The department, the department does not have a position on that, but i can certainly say as a member of the task force, we see that there are disruptions in earn is parts of the supply chain. You know, we would take as a Lesson Learned<\/a> going forward, and this is both for our private sector counterparts as well as ourselves, i think theres a lot of lessons to be drawn here about having everreliance on a Single Source<\/a> of supplies. Thank you. Thank you, mr. Chairman. Thank you. Senator markey. Thank you, mr. Chairman. Admiral redd, good to see you, sir. Thank you for your service. My wife is a retired rear admiral in the Public Health<\/a> service so i know your core, your work and what youre dedicated to. So if you could perhaps discretely just describe to us what it means when the president starts to call the coronavirus a hoax or puts out information which is medically inaccurate . What from your perspective is necessary in order for you to be able to do your job and for the public to be an i believe to respond to the message which youre sending, which is medically accurate in terms of the disease itself and what the response should be for the public. I think that in the last several weeks theres been a focus on making sure that we are in alignment as a whole of government approach. I think that thats been very helpful with vicepresident pence in charge. I think that that will help make sure that when a decision needs to be made that there will be communication across departments so that all of the really all the experts are able to work more closely together. I think thats going to be very helpful as we move forward here. Okay. Well, thank you, but just know that we respect you and we respect science. We respect your conclusions and we really dont want this to be politicized at all, that will interfere with our ability to implement the plan thats effective as soon as possible. I think weve already seen too much delay in not responding correctly and doing so soon. Id like to come to you, mr mr. Szabat. Not from the question of airline fees, we have a pandemic which is going to hit the United States<\/a> in much larger measure over the next weeks and months according to the experts. We have airlines that actually have taken charge fees, change fees and made a whole industry out of it in terms of the amount of money which they can, in fact, charge. The d. O. T. Is the only Consumer Protection<\/a> agency overseeing air travel and you are statutorily charged to stop unfair practices in aviation, allowing any airline to charge the excessive fees during the coronavirus outbreak is beyond unfair. So i urge the department of transportation to take action immediately and prohibit all cancellation and charge fees during this emergency, anything less is a failure to fulfill your duty and thats why i plan to send a letter to secretary chou later this afternoon in the face of this Public Health<\/a> crisis and the time for the d. O. T. To act is now. We dont want citizens deciding they have to fly just because the cancellation fee would be too large. In fact, from their perspective given their own health, their other family members health. It might be a danger to them if they could many in convict. Would you comm and that the fees are suspended during this crisis. Your commitment is noted. Well get on that right away. As you say, this is an Emergency Response<\/a> situation, were not looking to spend months or years developing a rule so well get you an answer back quickly. I think thats not an incidental issue for many families. I can see more and more people have flown seven times in the last 10 days. More and more people on each flight have a mask on. For every one of those people there theres somebody else thats concerned and dont want to cancel and they might have if they didnt have additional fee. Youre not the only one that noticed it. Several of the carriers in the industry have decided to say theyll withdraw some of those fees. I just recommend to you that it become an industrywide practice through your insistence, but i think youll be great. If i may, admiral, the highest fatalities from the coronavirus have been in areas where the Health Care System<\/a> has been overwhelmed and cdc must take steps to prepare hospitals for surges of coronavirus cases. And stress Health Care System<\/a>s capacity to care for those patients, especially those who may need hospitalization and airborne infection isolation rooms. Cdcs current guidance which hasnt been updated since february 11th, nearly a month ago, is for facilities lacking airborne infection isolation rooms to transfer patients to facilities with available rooms, but we know this option may not be available if there is a surge of cases in a particular region. Can you commit to provide hospitals and other Health Care Providers<\/a> clear and specific guidance on how to safely care for a surge of patients without airborne infection, isolation rooms . Let me look into that and get back with you. I think youre bringing up a very important point and that if there are a number of patients exceeds the number of beds, theres going to have to be guidance for that situation. Yeah. So you will provide clear guidance to those hospitals . Let me get back to you, yes, we will do that. You will get back to me or you will provide the guidance. First get back to you and then with and then provide the guidance. I think they need guidance. I think that many places in this country need it right now. They need what they need to know what to do. So i would honestly, id put a crash Team Together<\/a> and try to figure it out tonight and put them in a room and send it out to the hospitals. Theyre out there waiting for you. Youre the expert. Tell them what their plan should be. So i honestly believe it could hit a region within the next couple of days and theyd be without any real instruction and i think that that would be providing a disservice. Thank you, mr. Chairman. Thank you, senator markey. I think it is important to correct the record that i do not believe it is accurate that the president has said that the coronavirus is a hoax. And in fact, i think thats quite contrary to what he has in fact said and in fact done. The president can obviously speak for himself, but my understanding is what the president referred to as a hoax was the partisan claim that some are advancing for partisan advantage, that the administration is not treating this Public Health<\/a> crisis seriously and is not marshalling the resources to keep americans safe. And i will say in my observation, having yesterday met with the vicepresident of the United States<\/a> with the secretary of hhs, with the commissioner of the fda, that the resources with the head of the cdc, that the resources being marshalled are significant and admiral redd i want to ask you in your opinion as a Health Professional<\/a> and as a lifelong expert in Communicable Disease<\/a>s, how significant was the step that the president , the administration took early on to halt air travel in and out of china and to quarantine americans returning to china, how significant was that . I think it was very important decision to make and i think that there was prolonged period of time when we had a very small number of cases. So i think that was the right decision at the right time. I think that well i think well be in a better position to evaluate that fully as time goes on. At the present time thats an important decision. In your medical judgment had travel proceeded unimpeded would we be facing in all la likelihood a more substantial outbreak. We had be if the measures had not been in place. And from the perspective. Department of transportation, how unusual is it for an administration to take the steps this administration took right at the outset of this outbreak . Senator, the steps were beyond unusual, they were unprecedented. I can tell you, i spoke personally with the president i think two days after air travel was halted to china and the president asked me directly, he said, ted, what do you think . I told him, mr. President , you made exactly the right decision. I recognize real consequences to halting air travel, but at the end of the day, the First Priority<\/a> has to be protecting health and safety, protecting lives until we understand the scope of this outbreak, until we understand what is happening with this virus we need to do everything thats possible to prevent that outbreak from becoming a pandemic. And so i am greatful that the administration acted. That doesnt mean every step the administration has taken has been exactly right. Dealing with any crisis, there are going to be challenges, going to be mistakes. But i think we have seen a serious focus on this, this Public Health<\/a> crisis and thats the right thing and i would note one of the mistakes was releasing an individual from lackland who subsequently tested positive and thats a mistake that i addressed at the beginning of this hearing. I want to ask a couple more questions and then were going to wrap up shortly. It has been reported, my understanding is cdc has asked commercial airlines in affected regions to take the temperature of passengers boarding planes. And that commercial airline gate agents are understandably feeling not prepared to do so, not trained to do so. Theyre not medical professionals. Is that understanding correct and is it right to be asking the gate agent to be taking someones temperature rather than a medical professional with the training to do that . I will have to check on that. Im not familiar with that process. I know that in korea and in italy the governments are doing the exit screening, but let me get back to you on a confirming that my lack of knowing about that is that its not happening. And just an update because, you know, our information flow among the agencies here is good, but its not immediate so from the Task Force Level<\/a> weve learned while she is measures have been put in place by the respective governments in italy and korea in consultation with our agencies theyve chosen how to implement it. For example in korea there are three levels of thermal temperature screening, two are walk through and one as you enter the airport and go through security. The third theyre asking all airlines, korea and flying to the u. S. , hand held temperature devices to check temperatures of people going to the United States<\/a>. Yes, thats a request that the governments have made of the u. S. Carriers as well as the foreign carriers to do that testing. So is it your testimony just so i can understand, that its the government of korea that is asking them to do it, not the u. S. Government . So the u. S. Government is saying that the government of korea, if you want to have continue to have flights from korea to the United States<\/a>, you have to have Health Screening<\/a>s, tell us how you intend to do it and this is how theyve come back and told how they would do it. Listen, screening makes sense from everything ive heard, but the concern from airline gate agents that they are not trained and they dont have the background to be doing that screening, that seems a very reasonable concern and it seems to me a ought to be Health Professionals<\/a> that are doing Public Health<\/a> screening. Let me shift to another issue on the cdc. Last month the cdc received reports that some of the testing kits were faulty and experienced inaccuracies in their testing. Were there cases in which the cdc released patients after they had been tested with faulty kits and if so, under what circumstances . Let me go through the details of the lackland case and i think thats one instance where that occurred. And that was not it was not a faulty test, it was a process of communication, actually the thing that you talked about in your Opening Statement<\/a> is what happened. Theres an individual who was ill, who had recovered from that illness and the protocol at that point and still is the case, is that two specimens that are negative, more than 24 hours apart, is a requirement to release an individual. This person had one test that was negative, had a second test that was indeterminate and then had a third specimen obtained that was negative, but that knowledge of that negative test didnt occur until after let me get the sequence right. So theres a negative test, there was unknown to the people that did the third test, a fourth test was obtained by a different group. According to the protocol, there was the negative test, the indeterminate test and a negative test, that met the criteria. Unfortunately, that fourth test that wasnt known by the people making the decision to release the person, turned out to be a positive test. I think what that is i think the real issue was the communication there. No one should be released with a pending test. Thats one just obvious thing that is really about internal communication. I think that the meaning of that test and whether there was some issue with the test or with the person having a very low level of virus, i think thats something that we dont know right now. I dont think it was related to the other issue of the Quality Control<\/a> work that was done on the original test. Is cdc examining why someone who tested positive had two negative tests . That certainly raises questions. Yes, sir, i think that one of the questions will be i mean, this is really, its a new infection, its a new virus, and, for example, in the Ebola Response<\/a> in west africa, the role of sexual transmission wasnt something recognized before an outbreak of that size was concerned. During the outbreak it was learned can be a cause, and really outbreaks or infections. Im not suggesting that thats the case here, but theres more that the Scientific Community<\/a> is going to learn about this disease. I think it may shed some light on how an outcome like that could occur. Is the current protocol releasing someone from quarantine three consecutive negative tests with no intervening tests . Its two negative tests separated by more than 24 hours, so that has not changed. I think that your suggestion that this is something that really needs a hard examination is completely correct. And i think the real issue here was that there was a test that was out there that wasnt that the existence of that test pending should have been something that kept the person from being released. And given the positive test there would be the question of how do you get that kind of sequence, but we wouldnt have had the situation where the person with a positive test was released. With respect, dr. Redd, i think its important to frame the problem. The problem wasnt the fourth test that happened, were grateful that it did because it actually caught someone who was still positive. The concern is why, assuming someone who started out as positive and ended up as positive, why were there two tests in the middle that were negative and why was there an inconclusive test . That raises. Right. Real questions about the accuracy of testing and i understand this is not an easy thing to do, but i can give you some possibilities, but i cant tell you to are sure why that serving occurred. Welcome those possibilities. One would be that there were a small amount of viral particles existing at that fourth test that were detected, it was a correct test, but the other negatives are true so youre right at the limit of detection, that there wasnt actually live virus available, just kind of the remnants of that neucletic acid there in small amounts and i think this is getting progressively less likely, but that there was some source of that virus that emerged, similar to the aids or the ebola virus where a person can test negative over a long period of time, but still have virus in semen, so maybe theres some protected site that we dont know about. I dont think thats very likely, but you know, i do think its a question that really demand scientific scrutiny. Let me ask raise another question about the protocols. So in the letter from cdc director Robert Redfield<\/a> to the department of texas state services. The director stated that the 11 individuals who had been passenger aboard the diamond princess, that 11 individuals had been offered voluntary testing for the coronavirus and were asymptomatic for the entirety of the 14day quarantine period. Is the reason the testing was only voluntary because they were asymptomatic and does that make sense for lifting a quarantine if we know someone has been in an environment where theyve been exposed . I think this is a balance of individual liberty and protecting the health of the public. And i think that the experience has been that staying asymptomatic for that period of time that those people would not have had a positive test, but i think it really is kind of the Civil Liberties<\/a> versus protecting the public balance. So are the current protocols that someone will be released from quarantine if theyve been asymptomatic for 14 days whether or not theyve been tested . Thats correct. And even the protocols, even we had the exchange in the first q a let me check back with you and verify that before i Say Something<\/a> incorrect. Theres that study from china indicating a 24day incubation period. That may not be accurate, but if our current protocol is to release someone after 14 days without testing them, if there is an incubation period longer than 14 days, that could presumably contribute to the spread of the virus, is that right . If those two circumstances were true, yes, it would. I want to thank all of the witnesses for your testimony and i want to echo, youve heard senators from both sides of the aisle thank the professionals. I know you guys are not getting a lot of sleep right now. Youre working hard and this is a serious challenge. This is not easy. There are a lot of unknowns and i believe we need to follow the science. We need to follow the medicine, but we need to also be proactive protecting the American People<\/a> and so i thank each of you for doing so. I also want to underscore a point that was made from multiple senators, which is if there are legal authorities that any of your agencies need right now to perspective Public Health<\/a> and safety and to prevent the spread of this virus, tell us and tell us quickly. I think you will find a bipartisan eagerness to ensure we have the tools to prevent this outbreak from growing, to prevent further deaths, but we cannot address legal i am impediments if your agency do not draw them to our attention. I note we have a funding bill thats moving rapidly, its possible even as quickly as that funding bill attaching a provision to that if it proved necessary to addressing this challenge. With that, i want to thank all of the witnesses for their testimony. The hearing record will remain open for two weeks. During that time, senators are asked to submit any questions for the record and upon receipt, the witnesses are requested to submit their written answers to the committee as soon as possible. With that, this hearing is now adjourned. [inaudible conversation [inaudible conversations] [inaudible conversations] our cspan campaign 2020 bus team is travelling across the country asking voters what issues should president ial candidates address. The issue most important to me in campaign 2020 is foreign policy. I know that candidates have addressed it already, but i think its important for the candidates to focus on issues that they constitutionally have a lot of control over. I think its just important because compared to other people in the government its one area they have a lot of direct control over. The issues that are most important to me for this election cycle is actually three of them. When im looking at candidates im looking at their stance on the second amendment, their stance on immigration and their stance on abortion. The most important issue for me in this 2020 campaign is health care. So many of my family and friends have struggled to make ends meet with their medical bill and medical debt. So being able to get medicare for all would be really beneficial to pretty much everyone i know so thats the main issue i have for this election. My Biggest Issue<\/a> is probably Climate Change<\/a> and how we can address it while also addressing economic disparities and like kind of rebuild our economy to be more sustainable. The issue i would like the candidates to address are the american right and what their stands on in preserving these rights. Im currently here in utah and i am from arizona, so i would like the candidates to dive deeper in what their stances are. Voices from the road on cspan. Cspan. The senate is expected to vote on the coronavirus emergency funding bill later today. After the house approved the legislation yesterday 8. 3 billion dollar package supports the federal response, allows medicare providers to offer teleHealth Services<\/a> to patients that are at their homes. Includes money to help prevent the spread of the virus and offers assistance to state and local agencies. Several senators talked about the impact that the coronavirus is having on the economy and the federal response to the outbreak. Mr. President , the American People<\/a> are apprehensive about the spread of the coronavirus in the u. S. And abroad as we can always remember. 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