US response to the COVID-19 novel coronavirus outbreak

Source: US Senate HELP Committee

Source: Johns Hopkins University’s Center for Systems Science and Engineering

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Send in your ideas and questions about the US response to the COVID-19 novel coronavirus outbreak for the Senate

The outbreak of COVID-19 novel coronavirus has the world on edge. The virus is spread person-to-person, and transmission may occur even before an individual is exhibiting symptoms.

In the US, experts recommend preparing for more people to become infected, and in order to minimize spread, a coordinated and effective public health response is necessary both in the US and around the world.

The Senate Committee on Health, Education, Labor, and Pensions has called a hearing to scrutinize the US response to the COVID-19 outbreak and the benefits or costs of recent changes to US preparedness for biological threats. Leaders from the Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, Office of the Assistant Secretary For Preparedness And Response, and Food and Drug Administration will appear to testify.

The Committee wants to hear your thoughts on diagnostic tests, public health infrastructure, vaccine development, potential antivirals, or medical supply stockpiles, among other issues. 

This website gives you an opportunity to tell Congress what issues should be discussed during this critical hearing. You can submit questions that lawmakers should ask witnesses (sample questions below), personal stories about your experiences related to infectious diseases, or your general thoughts on how Congress can help keep Americans safe from the spread of the COVID-19 virus.

Hearing details

An Emerging Disease Threat: How the US Is Responding to the COVID-19 Novel Coronavirus

What: Senate Committee on Health, Education, Labor, and Pensions hearing

Who: The witnesses who will testify during this hearing are:

  • Dr. Anne Schuchat, Principal Deputy Director, Centers for Disease Control and Prevention, Atlanta, GA
  • Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
  • Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response, Washington, DC
  • Dr. Stephen Hahn, Commissioner, US Food and Drug Administration, Silver Spring, MD

When: Tuesday, March 3, 2020 at 10:00am ET

Where: 430 Dirksen Senate Office Building, Washington, DC / Webcast

Nonpartisan analysis and research

Sample questions for lawmakers to ask witnesses. Please share yours for lawmakers.

More sample questions will be added as objective contributions are received from the expert community. Submit via the form below, or email us at [email protected]! Last updated Monday 3/2/2020.

Thousands of healthcare workers, most of them in China, have become infected with the coronavirus while taking care of infectious patients. Aside from ensuring stockpiles of personal protective equipment and that supply chains are up to par, what else will be done to keep US healthcare workers safe? 

Follow-up: What is our plan to deal with potential temporary shortages of healthcare workers if illnesses among healthcare workers here in the US occur at a high rate, similar to China?

Hospitals in the US are bracing for large numbers of patients in the event of a coronavirus outbreak but there is a chance they could become overwhelmed like hospitals in China. In addition, considering the incidence of severe COVID-19 cases (about 15%) and the risk factors for people (age, pre-existing conditions), what is the plan to ensure that US hospitals and clinical sites are not overwhelmed by frightened patients?

Follow-up: What’s our plan B if hospitals become overwhelmed? Do we have capacity to establish distributed care at home for large numbers of individuals?

The CDC and FDA last week developed a new coronavirus test protocol that cuts out one of the test kit’s components that was giving state labs trouble. The protocol still uses other components from the original CDC test kit that were consistently performing well in a number of labs, and more state health labs are now capable of starting coronavirus testing.

However, it was also reported that labs in New York are experiencing issues with yet another component of the CDC test kit, and that New York will pursue the creation of its own test.

Why did it take two weeks from the first signs that the test kit had issues for the protocol to be adjusted, and how do the issues in New York’s lab, which are not accounted for by the adjustment, factor in to this? What specifically was wrong with the initial CDC test kit? How is this impacting testing, disease surveillance, and response?

Follow-up: What exactly was problematic with mix N3 that shipped with CDC’s original test kit? Was it the N3 forward primer, the N3 reverse primer, the N3 probe, or something else in mix N3?

Follow-up: It sounds like mix N1, where primer N1 forward doesn’t look optimal, could also be problematic. Is it known what part of the N1 mix is performing inconsistently in New York’s labs?

Follow-up: Please explain the decision to have CDC develop its own diagnostic test rather than follow the WHO guidelines. Please explain why academic scientists who had submitted their tests, identical to the CDC design, were required to meet high FDA standards only suitable for mass commercial products (e.g,, prove no false positives for SARS1 or MERS). These decisions appear to have delayed testing for weeks at a critical point in the spread of the illness.

Even though pharmaceutical companies like Moderna and Gilead are working around the clock, a deployable coronavirus vaccine is estimated to be ready in 12 to 18 months. In the meantime, what non-pharmaceutical measures, for instance, patient isolation, large-scale quarantine of a major city, or travel restrictions, is the CDC prepared to deploy in order to slow the spread of the coronavirus among the population?

CDC’s Dr. Nancy Messonnier announced at a press conference on February 25 that we should expect “severe disruptions” to daily life. What types of disruptions was she referencing? What scenarios are being considered? Are citywide quarantines on the table? How will the US amend travel restrictions if there are a large number of cases in the US?

Follow-up: Given the issues with the CDC COVID-19 virus test kit that shipped, and how that has impacted testing or disease surveillance, what other evidence is being used for scenario planning?

The outbreak of novel coronavirus has brought with it an outbreak of conspiracy theories and other misinformation about the epidemic.

In your opinion, how damaging has misinformation been to the response to novel coronavirus, and how are your respective organizations fighting dis/mis-information? Who are your strategic partners in these efforts?

The US is about 12 to 18 months away from a vaccine that could be used to help with the COVID-19 epidemic. Then, the vaccine needs to be given to Americans.

Once a successful COVID-19 vaccine is developed, what is the plan for mass production and distribution among the population? How will distribution of the vaccine be prioritized?

Vice President Pence will now oversee the US government effort to minimize the spread of the COVID-19 virus. The State Department’s Dr. Debbie Birx, an expert on HIV and AIDS, has been named White House coronavirus coordinator, and will report to him. HHS Secretary Alex Azar is chair of the coronavirus task force.

How often are you coordinating via the interagency task force? Within this leadership structure, who do you specifically contact in order to report up the chain to the Vice President? What specific role is your agency filling in the overall plan for responding to the coronavirus outbreak, and are there any gaps?

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?

Viruses spread independent of ethnicity or nationality. In addition to China, Italy, South Korea, as well as many other countries, are experiencing COVID-19 outbreaks.

Was the implementation of a travel ban on non-US citizens traveling from China to America based on national origin or likelihood of exposure to SARS-CoV-2? Will travel from Italy or South Korea be banned? Are these travel restrictions effective in responding to the outbreak?

Dr. Fauci, your agency’s collaboration with Moderna has led to a candidate vaccine and clinical trials were recently announced. How will patients be selected for trial enrollment? What is the timeline for phase II/III trials and manufacturing at scale?

To fully understand the scale and scope of the COVID-19 outbreak, the open sharing of all scientific data is critical.

What is your assessment of China’s, Iran’s, and other countries’ transparency, and how it is impacting response to the outbreak? What are you doing to encourage transparency?

Follow-up: One issue that needs more clarification is whether people who are infected by the virus, but who do not show symptoms like coughing or fever, can spread the virus to others. Is it known how common asymptomatic spread is, and how much it contributes to the epidemic?

Some hospitals and doctors in the UK are starting to test patients with flu-like symptoms for the coronavirus, instead of only testing symptomatic patients that have traveled to places with coronavirus outbreaks. What efforts are being made to increase the number of labs that can test for COVID-19 virus in the US? How long will it take to make testing widespread?

Follow-up: Currently, the CDC recommends testing those with symptoms – coughing, fever, shortness of breath – in addition to travel to disease-afflicted countries, or exposure to someone with confirmed infection. Will the CDC change their case definition of who should be tested, given that many more countries are reporting sustained transmission? In addition, would CDC consider a strategy of testing random patients to get a sense of undetected spread?

There have been news reports of potential shortages of key medicines due to supply chain disruptions related to the coronavirus. The FDA is also tracking several different supply chains for potential shortages. Dr. Kadlec, in addition to the impact of COVID-19 itself, what other secondary or tertiary effects should we be prepared for? What is our plan to mitigate the potential impacts?

Follow-up: When considering the supply chain of active pharmaceutical ingredients and other critical, life-saving medications, as well as various forms of personal protective equipment, what is the plan to enable production of these materials in the United States should we lose access to these materials from international suppliers?

There have been inconsistencies in statements regarding the COVID-19 outbreak from the White House and US health officials. The American people deserve clear, accurate information from our government.

What information has your organization provided to senior-level leadership at the White House on COVID-19, and how do you intend to maintain public trust as we move forward?

The dollar amount of emergency supplemental funding that Congress will approve for minimizing the spread of the COVID-19 novel coronavirus is still being decided on. 

How have your respective organizations been involved in advocating for the resources that you need to respond to COVID-19, and what are the funds that your agency needs from the proposed emergency supplemental?

Leveraging public-private partnerships will be critical to minimizing the spread and impacts of the COVID-19 virus outbreak. For example, NIH is partnering with Moderna to advance development of a vaccine for the coronavirus and BARDA is teaming up with numerous other pharmaceutical companies.

How have you strategically engaged with strong private-sector partners to support targeted investments for COVID-19 response? Have there been any challenges in forming these partnerships? What could be done to improve the process?

COVID-19 outbreaks in the US would stress our health system, and some Americans have very limited financial resources, or are with minimal or no healthcare. 

How do you plan on offering equitable and affordable access to resources during a potential COVID-19 outbreak in the United States?

Dr. Fauci, what are the key bottlenecks for developing a COVID-19 vaccine that is ready for wide-scale distribution? Once the initial research has identified candidates, is there a way to expedite the vaccine development process and quickly conduct clinical trials to test candidate vaccines for safety and efficacy? And how quickly can we manufacture enough doses to protect the American people and our friends and allies?

During your discussions with the interagency, are there plans to support those who are more vulnerable to this outbreak than others? For example, is there going to be any financial relief available to hourly employees who don’t have sick days? Will there be any protections in place to keep them from losing their jobs if they are quarantined? If not, what incentive will they have to report their illness and not to break the quarantine? Will people have to choose between losing their job and not being able to pay their bills and keeping quiet and spreading the virus?

Follow-up: Will there be any protections in place for undocumented immigrants, or will their choice be to spread the virus or be deported / incarcerated?

The risk of a pandemic should never be under-estimated, but some types of over-reaction can cause more damage than the virus itself. Unfortunately, there are already widespread reports of hate and hostility towards not just Chinese Americans but also all Asian Americans.  From physical assaults, bullying in schools to empty restaurants and grocery stores, these stories have surfaced across the nation, from New York City to Los Angeles and from Montana to Texas.

How can Congress and the US respond to coronavirus without also causing panic about and fueling racism against Chinese and Asian people in the US?

Your evidence-based question could be here!

Quick reads

Novel Coronavirus 2019: Global Implications and Responses – Congressional Research Service In Focus

Additional Efforts Would Enhance Likelihood of Effective Implementation of US National Biodefense Strategy – Government Accountability Office Highlights

US faces long-standing challenges related to defending against biological threats – GAO Highlights

Capabilities and challenges of technologies to enable rapid diagnoses of infectious diseases – GAO Highlights

Primer on the World Health Organization – CRS In Focus

Deep dives

Overview of US Domestic Response to the COVID-19 Novel Coronavirus – CRS Report

Additional Efforts Would Enhance Likelihood of Effective Implementation of US National Biodefense Strategy – GAO Report

US faces long-standing challenges related to defending against biological threats – GAO Report

Capabilities and challenges of technologies to enable rapid diagnoses of infectious diseases – GAO Report

Exploring Lessons Learned from a Century of Outbreaks: Readiness for 2030 – National Academies of Sciences, Engineering, and Medicine Report

Global Health Risk Framework: Resilient and Sustainable Health Systems to Respond to Global Infectious Disease Outbreaks – NASEM Report

Resources

Press clips

Looking at the COVID-19 novel coronavirus outbreak as everyone’s problem – The Atlantic piece

Visualization of modeling COVID-19 spread – Washington Post piece

The new coronavirus is a mirror that reflects how a society works, and where it fails – The Atlantic piece

The coronavirus outbreak is a huge wakeup call, interview with NTI’s Dr. Beth Cameron – Vox piece

The next plague is coming. Is America ready? – The Atlantic piece

Coronavirus outbreak a major test of China’s system – Wall Street Journal piece

How to prepare for a coronavirus pandemic – Foreign Affairs piece

Washington Post Coronavirus Live Updates

Wall Street Journal Coronavirus Live Updates

Congressional correspondence

Letter from a bipartisan group of Members of Congress to the Centers for Disease Control about the dissemination of novel coronavirus diagnostic tools to state and local jurisdictions

Letter from Senator Cotton (R, AK) to Department of Health and Human Services regarding information sharing with China

Letter from 31 Democratic Senators to Department of Health and Human Services regarding the US response to the novel coronavirus outbreak

Letter from Senator Hawley (R, MO) asking the Trump Administration about US-China travel restrictions

Letter from Senator Markey (D, MA) to the National Institute of Allergy and Infectious Diseases about novel coronavirus vaccine development efforts

Related hearings

Are We Prepared? Protecting the US from Global Pandemics – Senate Committee on Homeland Security & Governmental Affairs hearing

The Wuhan Coronavirus: Assessing the Outbreak, the Response, and Regional Implications – House Foreign Affairs Subcommittee on Asia, the Pacific, and Nonproliferation hearing

Biological Threats to US National Security – Senate Armed Services Subcommittee on Emerging Threats and Capabilities hearing

Bipartisan bills

Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, S.1379

Health Care Workforce Protection Act of 2019, H.R.4982

National Strategy for Pandemic Influenza Update Act, H.R.5730

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Contribute your nonpartisan, objective statements and questions. We will collate your submissions and post them here – anonymously – as part of this resource for policymakers. Submit via the form above, or to [email protected]!