The Strategic National Stockpile is intended to serve as the nation’s supply of life-saving pharmaceuticals and medical supplies, and was managed by the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR). In response to the COVID-19 pandemic, HHS ASPR integrated with the Federal Emergency Management Agency’s (FEMA) National Response Coordination Center.

Why was responsibility for the Strategic National Stockpile transferred from HHS ASPR to FEMA in the middle of the pandemic? Was the transfer part of a pre-existing plan for pandemic response? Please explain any advantages or disadvantages in regard to responding to COVID-19 that have become apparent during or after the transfer of responsibility.

Despite improvements in some regions, the country as a whole is still averaging more than 20,000 new confirmed cases of COVID-19 per day.

In preparation for surges of COVID-19 infections, what mechanisms are in place to establish better, more accurate demand requirements for personal protective equipment and other critical medical supplies needed by US frontline health systems from the Strategic National Stockpile?

Last month, former presidential science advisors released a report “warning that the US has just three months to rebuild its national stockpile of emergency medical supplies or risk further drastic shortages of testing kits and protective gear should coronavirus strike again in the fall.”

Are you familiar with this report, and if so, what is your response?

Admiral Giroir, by the end of May, there were around 400,000 COVID-19 tests done per day in the US. Some public health experts believe that in order to safely reopen, as many as 900,000 daily tests may be needed.

The Administration is demobilizing you from your position as head of COVID-19 testing efforts in mid-June, and there are no plans for a successor to be assigned to the position.

Given that the COVID-19 testing supply chain still isn’t fully operational and US testing capacity still needs to be ramped up, what assurances can you and the Administration give that the critical testing needs facing the country will be met without a “testing czar?”

The Administration put the Federal Emergency Management Agency (FEMA) in charge of coordinating the response of the US supply chain to COVID-19. What was the decision-making process behind FEMA taking on such a role? Is FEMA the federal agency best suited for this role? Please explain why or why not.

In May, the Federal Emergency Management Agency turned over the coordination of longer-term purchasing of COVID-19 supplies, including personal protective equipment, to the Defense Logistics Agency.

The Defense Logistics Agency, or DLA, is the supply chain manager for all Department of Defense entities with requisite demand management and ordering systems, global supply networks, and distribution assets in almost every state.

Could the DLA have been mobilized sooner, such as when federal procurement deficiencies forced states to bid against one another for scarce essential medical supplies, such as masks and ventilators, on world markets? Why or why not? What impact could an earlier DLA mobilization have had? Please explain.

The HHS Protect system was established as a data aggregation and analysis resource for CDC, FEMA, and others working to respond to COVID-19. However, the current system does not leverage predictive capabilities, and would also benefit from the integration of additional data generated throughout more federal government agencies, academia, and the private sector.

Will the HHS Protect system be upgraded along these lines? How do your agencies plan to continue to leverage data and innovative ways to improve response and preparedness to this and future outbreaks, as well as other health security threats? Please explain.

Clearly this pandemic has highlighted the issue of the dependability of supply chains for critical medical supplies – not only physical protective equipment for medical workers and responders, but a whole range of other essential items such as pharmaceuticals, pharmaceutical ingredients, glass for vaccine vials, and even saline solution.

We need assured access to these items – which might mean domestic manufacture, but doesn’t have to. Have your agencies, or will your agencies, be conducting analysis of health and medical supply chains to assess how the United States can assure access to those critical items it needs to have? If so, what have you found? What are the major areas for improvement?

Dr. Giroir, there are two main types of coronavirus tests. Viral tests are used to determine whether a person is currently infected with the coronavirus. Antibody tests are used to determine if a person had been infected with the coronavirus in the past.

The FDA has granted emergency use authorizations for nearly 70 COVID-19 tests. While no test is perfect, some tests used to diagnose COVID-19 may be missing up to 20 percent of positive cases.

What is being done to ensure reliable COVID-19 case reporting and protect the American people from the consequences of unreliable test results?

Follow-up: Was there any pressure put on HHS officials in regard to the Abbot Labs ID NOW point-of-care test? If so, please describe.

Experts like Dr. Anthony Fauci have predicted a likely resurgence of COVID-19 in the fall. What testing supplies, personal protective equipment, medicines, and so on, need to be invested in right now in order for the US to be prepared? How should these supplies be staged? Please explain.

Follow-up: What are the metrics for tracking this effort, and what benchmarks need to be met?

One of the main functions of the federal government is to provide for the security of its citizens. In the face of the coronavirus pandemic, the Administration has not performed well. For example, public health often had to compete with economic and political considerations in internal debates, which slowed the path toward belated decisions to seek more money from Congress, obtain necessary supplies, and address shortfalls in testing.

As some of the White House’s efforts have been counterproductive, what ground is most important for your agencies to make up in the near-term, and in the long-term? What can Congress do to support the work of your agencies?

Public health experts and researchers have consistently recommended that the US dedicate more resources to infectious disease preparedness and response.

Had we known that COVID-19 was coming, what should have we done 3 years ago to prepare for it? How does that inform what we should be doing going forward to protect not only against this health crisis, but also against potentially catastrophic biological events that we may encounter in the future?

Your evidence-based question could be here!