The committee will come to order. The company is leaving today to receive testimony on confronting the coronavirus, without objection, the chair is authorized to declare the committee and recess at any point. Today the committee is meeting to hear from medical experts about how our country can best confront the coronavirus. Americans are justifiably concerned about the virus. It is spread around the world and claimed lives of thousands. Understandably, there questions about how how it may affect them, their loved ones in their communities. Our concern how concerned we need to be about the virus. It is most at risk. What can communities do to prepare. What can americans do to protect themselves and their families. What is the fellow government doing. What more should be doing. When might we have a vaccine or other treatment. My constituents are looking to the federal government for leadership, guidance and expertise and i share my colleagues constituents two. I am concerned that the Trump Administration has downplayed the threat, overstated how close scientists are developing a vaccine and experts who disagree with him. Any silence them. Instead we must acknowledge the threat and allow the doctors and scientists to offer candid assessments of the situation. And direct the federal response. We are fortunate to have a distinguished panel of physicians to offer their Expert Opinions today. I look forward to hearing from them about with the federal government must do to support state and local efforts, help hospitals and Healthcare Providers and protect the lives of americans. Like theirs, will absolutely be essential to confronting the threat. And i appreciate their willingness to join us today. When the Ranking Member comes, we will allow him an opportunity to read and statement into the record. It will go forward, i will come are panelist witnesses, and first witness, the director of the center for is the director of the center for Health Security of the john hopkins cool Johns Hopkins dr. Tom inglesby. His work is in the field of Public Health pandemic and emerging Infectious Diseases. And prevention and response to biological threats. And now the general id from illinois, to introduce our next witness. It. Unwelcome the director of the Illinois Department of Public Health. Illinois Public Health director dr. Ngozi ezike. Dedicated her career to improving Health Outcomes and access to the people of illinois. Shes served in the past 15 years my home state of illinois. She received her undergraduate degree from harvard, her medical degree from the university of california san diego. She completed her internship at Rush Medical Center where she is assistant professor of pediatrics. I want to thank her and her team for working around the clock. And sincerely, appreciate her taking the time to share her expertise with us today. Thank you. Finally we have cdc director julie gerberding. She served as the director for cdc. And prevention from 2002, 22008. She currently serves as executive Vice President and chief patent officer for strategic, Communications GlobalPublic Policy and Population Health and merit. She is also cochair of the center for strategic and International Studies commission on americas Health Security. Without objection, the witnesses. My will be inserted in the record. At this point i would like to defer to ricky members on Opening Statements. Thank you. This is a great panel and i look forward to the testimonies. Our hearts go out to those who have lost their loved ones and those who are currently under treatment. This is a event that requires global response. And no many of our International Partners are working diligently as a part of an effort to understand and address covid19 spread pretty and some of the actions taken by the countries may have hindered a comprehensive response. Our main concern for county officials knowingly withheld information from public and International Health communities in the most critical stages of this outbreak. Im sure that the early days, will be under intense scrutinys. My deepest concerns for the moment of level of preparedness at the state and local levels. Ive heard information from medical them or managers dealing with an increasingly concerned public. We have a very distinguished panelist of medical people. And what they need from the federal government im also pleased that the doctor is here today. Cdc director julie gerberding. The outbreak of sars and managed more than other Emergency Responses im very interested in hearing about her experience and how lesson source for managing those Health Emergencies can be applied to the covid19 outbreak. And finally the risk from the virus. Your expert medical opinions is valuable and reassuring the public. Its also very important for political leaders to avoid blaming hit and distorted. Our jobs to be supporting the medical community and providing them with things that they need to handle this in future outbreaks. I am very pleased that we will be presenting a bill today, hopefully the funding will help speed along this vaccination resources that will help us out. I have a request enter this into the record. Without objection. I now ask each witness to summarize his or her statement for five minutes. Beginning with Johns Hopkins dr. Tom inglesby. Given the chance to testify today about covid19. Im the director of the john hopkins Health Security. Covid19 was first recognized in wuhan china and as of yesterday, has affected somewhere between 90000 cases worldwide and 3100 people have been killed. Across 65 countries british patients become sick with covid19 often have constant even more serious cases, under nine no money. In china, roughly 80 percent of those this illness, and mild symptoms, 15 percent required hospitalization, and 5 percent developed critical illness. The mars has a one 15 incubation. And primarily be a respiratory droplets between persons at close contact. In the elderly and those of underlying medical conditions are at highest risk. As of yesterday, the u. S. Had confirmed, hundred 19 cases of the 19 including death in the of this case the returning travelers are people from china. About 20 cases, there are no connections between any known case of covid19 which suggested that in this place, there is some level of transmissions going on. Emergency supplemental appreciation and between congress and the administrative rate in 2014, 2015, congress appropriated money for the bullet response and my view covid19 will need twice as much more. Given his respiratory transmission and the likelihood is going to be widespread rather country and so all jurisdictions we need to compare and respond. Healthcare system should be planning to provide care for large numbers of critically ill patients as we have seen has been required in china. An insult. And italy. It will very strong Infection Control strategies including access to person personal protective equipment as well as other kinds of engineering and administrative controls in the hospital. The federal government should be engaging at the highest level of industry regarding ppe manufacturing, maximizing supply of this critical medical materials. Steps should be taken to make sure that routine medical care is not destructed as a husband and try to what we saw the next entirely unrelated to covid19 to Cancer Clinic dialysis another important facilities. Public Health Agencies are working to isolate the infected cases around the country. And help ensure isolation of highrisk contacts. If cases increase significantly, and may not no longer be possible to isolate all cases and contacts and may need to be in ships. Probably will need to be a shift in strategy. At that point, Public Health agencies will need to focus on surveilling the oblations, the over all level of covid19 and how the public should be tested and how it needs to be isolated with sick and working with political leaders at state and local levels. The consider social distance these policies that will do more good than harm. In the cdc has been doing lab testing into the sweeper it is now getting going and Public Health labs across the country. I believe we will see considerably more cases diagnosed throughout the u. S. In the coming days. As we have seen in the last week. Large scale testing at clinical sites around the country will require Clinical Diagnostics Companies to create high clinical test because cdc Public Health labs were not designed for the kind of high clinical testing that will ultimately need to take place. Exiting developments will take 12 to 18 months. One of the worlds experts, you will hear more about that. We should be developing as we develop an effective solution, we should also be developing the mass manufacturing it. Its not necessarily the proce process. Ideally that should be occurring in multiple sites around the world. Even if u. S. Is a country to develop the vaccine, there will be a huge demand for the vaccine run the world. Antiviral or intelbased medication can be developed or sooner. And plans should also be underway for that prediction those be successful. One of the themes of our preparedness this country to be in Close Partnership in government and industry because industry is a place where diagnostics and largescale, ppe, medicines and vaccines in hospital equipment are being manufactured so theres no way around having a very close Effective Partnership in making sure that those industries are well aware and score they will receive from the governments to do that work. And finally i would say, that is very important from this point forward for the federal government to be speaking with a single consistent voice about what is happening. A Daily Briefing would be good. About what is known and unknown and how we are learning to fill the gaps of information to come out of the government on a daily basis. They do think that should come from a Health Officials either hhs or cdc. As they are closest to the science and local Public Health agencies around the country. Thank you for the chance to testify today and i look forward to your questions. Cement thank you for your testimony. I now recognize derek kan to summarize her statements. Chairman, vice chair, Ranking Member, and distinguished members of the committee, and the director of the Illinois Department of Public Health and i thank you for inviting me to speak about the Novel Coronavirus in the preparedness and response efforts of the Illinois Department of Public Health. Even before our first illinois case was identified in january. Strong federal state county and local coordinated effort was enacted. Enabler state to be a leader in addressing this rapidly developing outbreak. The cdc quickly deployed a team to illinois after our first case was announced. And was essential in partnering with us through the response. They have been equally responsive with the recently announced turn and forth cases. The only congressional delegation, supported our request for immediate approval of the emergency youth authorizations for the covid19 test. It has been invaluable in the effort to contain the illness. Illinois was the first state in the United States to validate this test and begin testing and how the capability that weve had for the last three to four weeks. We began surveillance testing this week. Enabling illinois to better determine how much, 19 is circulating with our communities. Our success in testing raises a new concern however. This is with the covid19. Willie have enough ages to retain this testing. We are requesting of and then interrupted supply of testing materials. The ability to test samples, lessons the burdens on the cdc. We encourage the cdc to expedite additional shipments to illinois and to other states. Illinois has utilized and proven its capabilities in the past when responding to the domestic cases of stars, h1 and one, and ebola, recently participated in contagions, this is a National Tabletop exercise that used the covid19 like outbreak was sectioned that originated in china. However, Surge Capacity remains something that is not able to be sustained for extended periods of time. Therefore emergencies supplemental funding is necessary. Illinois encourages congress to appropriate funds enough to reimburse illinois and other states. For the cost associated with his aggressive response. Public Health Infrastructure such as data management, information sharing, and Operations Management are essential just for daytoday functions but they are vital in the settings of Public Health emergencies. During this response, the state Health Department is closely monitoring the availability of airborne inspection isolation rooms. These isolation rooms are providing approving critical treatment of these patients by controlling the spread of the virus to the public and health court. Mandatory these daily as an indicator of disease rate into the just capacity estimates an important support for this capability, came from hospital preparedness program. Given the transmissibility of covid19, isolation sites are required to house affected persons. And challenging to find establishments to willing to take on isolation 14 patients. When covid19 gannon illinois, that shouldnt city of chicago was given very little time to set up screening operations in ohare, and establish a requisite hoarding site. Chicago is continued to maintain both the screening authorization and quarantine sites, and in normas cost. Without reimbursement and ongoing monies. For future expenses, governments will likely struggle to maintain these critical Public Health interventions. Additional intention, needs to be given to mitigation strategies of the states. We are also working closely with longterm facilities to implement mitigation strategies aimed at protecting would be our most vulnerable citizens. In addition to these communities litigation, we encourage the public to employ their own strategies to keep themselves set healthy. The frequent handwashing, stay home, sanitizing frequently touched surfaces. Individuals should take care to rely on trusted sources of information such as the cdc. Public Health Security as Homeland Security. Our country is nothing without the help of its people and we can all Work Together to ensure that we continue to support this response and decrease the potential negative effect pretty and impacts on the people of this country. In closing, wish to again thank the committee for this invitation and the attempt of illinois successes, and opportunities in response to to the covid19. Thank you. I now recognize cdc director julie gerberding. I am here wearing several hats. Currently serving and more recently, as his chief officer that contributed to the development and deployment of the ebola vaccine in the democratic republic of congo. It is now licensed, even those created on the hospital track, so far ive been able to contribute 300,000 doses of the vaccine this week. The director, indicated his optimism that operate as finally come under control. Im also witnessing, as a cochair commission on global Health Security which submitted this report to the record of the commission, bipartisan members of the senate and the house and hasnt stated purpose to advise the congress positives that can be taken to improve our global Health Security. If the report was written before coronavirus was recognized but i think many of the recommendations which are summarized in my written testimony of questions and really apply to the situation that we are experiencing today. And finally, i am the former cep director in a past life where we were dealing with anthrax aside from many other outbreaks. The first coronavirus outbreak, sars challenged the United States and the world and i think we learned many lessons which are relevant to where we are today. I dont have time to give the full picture ofthe us Public Health situation and i think my colleague has expressed it from the state view very eloquently but i would say its important to remember where we are in the outbreak right now from a us perspective. There were three main phases of outbreak response. The first is detection and that happened in china and was reported fairly early in the process we dont have all detection because we havent had testing and we still dont know whether the cases we are detecting represent the tip of the iceberg and how much of the iceberg is undetected yet because we havent tested or because