The committee on health education, labor and pensions will please come to order. First, the usual administrative matters like the theater announcements we use to receive, we are getting used to those, we follow the advice of the attending physician and sergeantatarms consulted with all the right people, we are seated 6 feet apart, that means no room for public or the media here but the media is participating and we hope the public is as well. And the videoconference is a real change for the United States senate and a very welcome one because it makes it possible to attract witnesses who have busy schedules on the same day such as today, by video conference, you may remove your masks since were 6 feet apart. The sergeant at arms, press gallery, architect of the capital, capital police, committee staff, Evan Griffiths for their hard work to keep us safe. We will each have an Opening Statement and we turn to our witnesses we thank for being with us today, each witness we ask you summarize remarks in five minutes which will allow more time for the large number of senators we expect to participate to present their testimony. We have one round of questions for a 5minute round. Less than four months ago on march 1st, coronavirus situation was about this. At the end of february there were 75,000 cases around the world, only 14 in the United States except 39 who had been brought home from overseas with the virus. By march 2nd, there were two deaths in the United States by march 3rd when we had a hearing, there were six deaths. On march 1st, sunday at the New York Times on the front page it said this. That most experts were far from certain that this virus would carry to all parts of the United States and with topnotch scientists, modern hospitals and sprawling Public Health infrastructure most experts agree the United States is among the countrys best prepared to prevent or manage such an epidemic. Even six weeks after the first virus was found in the United States, even experts underestimated the ease of transmission and the ability of this coronavirus to spread without symptoms. These qualities made the virus in the words of doctor fauci my worst nightmare, it has devastated the world, this committee is holding this hearing, with an event as significant as covid19 memories fade and attention moves to the next crisis when the nation is in the midst of responding to covid19. The United States congress should take stock now. At what parts of the local, state, federal response to this crisis worked what could work better. To be better prepared for the next pandemic which will surely come. I released a white paper outlining five recommendations to prepare for the next pandemic, they were these. Tests, treatments and vaccines accelerate research and development, disease surveillance, expand our ability to protect, identify, model and track emerging Infectious Diseases, stockpiles and surges, federal and state stockpiles and medical supplies Surge Capacity and distribution, improve state and local Public Health capabilities, who is on the flagpole, who is in charge, improve agencies with a Public Health emergency. With health education, in this feedback, my colleagues on the democratic and republican side. For any of the witnesses we have today, 15 years ago, the majority leader of the United States senate, in the press club. It a question of if or when. A Public Health prescription to minimize the below, with antivirals and vaccines, research, stockpile Surge Capacity. Senator first is one of the witnesses today, and im including a record two of his. The chief medical executive and chief Deputy Director for health at the michigan the permit of health and Human Services, Julie Gerberding coordinating response to cardin. Third witnesses Julie Gerberding who served as director for Disease Control and prevention under george w. Bush, she helped lead the preparedness efforts in response to stars, was not oil virus, h1n1 avian influence and the rise of multidrugresistant bacteria like mercer. Michael leavitt, governor of utah, secretary of health and Human Services and administrator of the epa, with the avian flu, increased efforts on pandemic preparedness, the secretary in 200713 years ago, everything you do when you give a pandemic is alarmist. After a pandemic, that is the dilemma we face, and not stop us from doing what you need to prepare. Congress passed legislation to prepare for pandemics before. Clinton, bush, obama, trump and several congresses enacted nine significant laws to state and local governments and hospitals and Healthcare Providers to prepare for Public Health emergency including a pandemic. States and Hospital Systems over the last 15 years to help them prepare as well. In writing those Laws Congress considered linear reports from president ial commissions, offices and inspectors general, Government Accountability office and outside experts, reports contain all sorts of warnings that the United States needed to address the following familiar issues familiar by now, better methods to quickly develop test treatments and vaccines and scale manufacturing capacity to identify emerging Infectious Diseases, more training for the Public Health workforces, better distribution of medical supplies, better systems to share information within and among states, many reports warned that while states play the lead role in the Public Health response, many states didnt have enough trained doctors, nurses and healthcare professionals, had adequate stockpiles and struggle with funding challenges. In some systems overreliance on inflexible federal funding contributed to these problems. Looking at Lessons Learned from the covid19 crisis many of the challenges congress has worked to address in the last 20 years still remain. Additionally Courtney Kube covid19 exposed gaps that were not previously identified including unanticipated shortages of testing supplies and sedative drugs which were necessary to use ventilators for covid19 patients. Memories fade, attention moves to the next crisis. Five months ago we were in the midst of an impeachment of the president , today that seems like ancient roman history, makes it imperative congress act on needed changes this year to better prepare for the next pandemic. I look forward to hearing from more witnesses and appreciate the feedback we are receiving on the white paper which to draft and pass legislation this year. Senator murray. Thank you, mister chairman. I want to thank our witnesses for joining us today and thank our staff or wrangling the technology to make this possible. I said before we need to understand fully and exactly everything that has gone wrong in our response to covid19, why and how we work to make sure we are never in this situation again. Reflecting on there is no substitute to respond to the crisis at hand, killed over 120,000 which continues to spread. Pretending the pandemic is over, donald trump said it is fading, the record case increases, mike pence wrote an oped saying we are winning and there isnt a second wave. Experts like doctor fauci warner we are not even through the first wave yet. Admiral gerard stepped down from his role leading testing efforts without being replaced, donald trump is calling for less testing even though we dont have anything close to the testing and tracing capacity we need to safely reopen our community. It is not just officials in the white house sticking their heads in the sand. Leader mcconnell and some republicans suggested there is less urgency to take further actions gaining 2 and a half million jobs after losing 20 million jobs. I can tell you younger students that math doesnt add up. I hope we dont just spend our time talking about how to avoid mistakes in the next pandemic but instead address the mistake this administration is still making during this one and the ones they are at risk of repeating as the response to covid19 continues. One what lesson weve learned is this crisis is no great equalizer but a course that perpetuates and deepens the injustices that black communities, tribal communities, people with disabilities and so many other states. Weve known for decades the Healthcare System treats some communities much worse than others especially communities of color, those disparities are caused by a long history of systemic racism and underfunding and those in charge have a responsibility to acknowledge the problem and do everything they can to close that gap. This administration has not taken that responsibility seriously, they turn a blind eye to the problem. They are determined to make it worse as we have seen in the administrations your responsible rule to allow discrimination in healthcare. Weve seen once again how desperately we need a National Sick leave policies, they do what is best for Public Health without fear of losing their jobs or paychecks and we learn how important it is the Occupational Safety and Health Administration, they stop dragging their feet and it isnt optional by immediately operating, a temporary standard but there are several lessons we need for allowing vaccines. We can file the Trump Administration, that they have so much of, this pandemic will not end until we have a vaccine that is safe, effective, that we can widely produce, and equitably moved to everyone. When it comes to developing a vaccine, we need a thorough, transparent and science driven one. We need to know the process is free especially actor the hydroxy chloroquine debacle in the final vaccine or vaccines truly meet the Gold Standard families have relied on for so long which is why the Administration Needs to commit to being fully transparent about the Development Review process and about the data that is ultimately used to evaluate safety and effectiveness. We also need the administration to detail how it will produce and distribute vaccines everywhere to everyone. Even the incomplete data we currently have shows black, latino and tribal communities are disproportionately impacted and have significantly less access to testing than white communities. This is something we cannot repeat when it comes to vaccine nor can we afford to repeat delays like those the Trump Administration caused by resolving coordination problems in the National Supply chain, must work now to draft and release a comprehensive covid19 vaccine plan, we still havent gotten on that. With other barriers, how do we fight misinformation and vaccine hesitancy. To ensure it is ready to meet the unprecedented challenge from how do we build global partnerships instead of turning our backs on the world it betrays our American Values but puts people at home in harms way. These are not questions we need to ask before the next pandemic starts. I look forward to hearing witnesses perspectives on all the urgent issues, this committee will get the perspectives, what they have not heard from yet, secretary aczar, secretary scalia, it is clear we have a lot more work to do to respond to this pandemic. I urge a republican colleagues get back to the table to work on this together, the challenges the nation, the Public Health crisis, the economic crisis the pandemic has set in motion and the persistent systemic inequities driven by racism has only exasperated our urgees. Thank you, mister chairman. To summarize your statement in 5 minutes, more time for questions. Look forward to hearing from each of you, my privilege to introduce the first one. Senator bill frist, he represented tennessee for two terms in the senate. In the United States and he served on this committee. Heart and Lung Transplant surgeon by training, practicing physician serving in the senate since 1928, serves on several boards, a senior fellow at the bipartisan fellow, and in 2005, gave many speeches on the inevitability of a Global Pandemic and importance of preparedness isolated two of those to the record. After doctor frist we will hear from doctor Joneigh Khladun who served as chief executive and chief Deputy Director for help in the Michigan Department health and Human Services in this position, aging and Adult Services in behavior, health and development of Disabilities Administration for the state of michigan. Joneigh khladun has extensive experience in state and local governments, prior to recurrent role she served as director and Health Officer for the Detroit Health department, a practicing emergency medicine physician. A third witness is doctor Julie Gerberding, chief patient officer at merck and company, strengthening American Health security, the center for strategic and international studies. Doctor Julie Gerberding was with the center for Disease Control from 20022009 under her leadership cdc coordinated preparedness efforts in response to several Public Health threats including sars, west nile virus and avian flu, played a key role in the response to anthrax attacks in 2001. Senator romney, introducing the final witness. I am happy to introduce my friend mike Michael Leavitt, most resourceful for freeing me from the golden chains of a privatesector, got me to leave my position to run in 2002 in salt lake city, at the state of utah, where he became since then a dear friend, also kind enough when, the transition team, had a great administration, put together extraordinary themes of layout a pathway to help the country and numerous ways. Mike leavitt was 3 term governor of utah, served as administrator of the epa and secretary of health and Human Services, one of his priorities was to focus on pandemic preparation, secured 7 billion in funding with the administration and congress to prepare for pandemics, he has found that a firm, Michael Leavitt partners, the premier firm in the country with hundreds of employees under his management with private equity firm that he has built, an extraordinary record that contributes to our country. Thank you, senator romney. We begin with senator frist, back to your old committee. Members of the committee, if only remotely, to see so many old friends and colleagues, placing the focus on preparing for Infectious Diseases that will come. In 2005, in the same speech, 15 years ago, about the pandemic is no longer a question of if but when, i even said it would come from china. In china the Senate Delegation in 2003, treating hivaids patients, it was Crystal Clear then, what was inevitably to come. This proposed a specific 6 point plan, manhattan project, during my time in the senate we laid the foundation with the bioterrorism act in 2005, subsequently as outlined, this was not enough nor will it be enough, what i recommended in 2005 remains undone, the same 6 categories i use that. Communication, we need to clarify who is in charge in any merging pandemic, to be coordinated. The federal response must be led at the National SecurityCouncil Level to facilitate the whole of government approach, the experienced expert, the apolitical voice, surveillance, we must modernize realtime domestic and International Threat detection system. This pandemic is laid bare our inability of the federal level to track outbreaks with testing and reporting across the country. We must engage globally, diplomatically and economically, an outbreak anywhere in the world is at risk everywhere, the ability of developing nations to detect tracking the normal virus will be inexorably tied to the capacity of a Public Health infrastructure which is vitally dependent on us support. Antiviral agents and vaccines in 2005, we have a dangerously inadequate vaccine Manufacturing Base in the United States. We must establish pub