In his second day of testimony before the House Oversight and Reform Committee, a key expert on the White House coronavirus task force told lawmakers that a lack of testing is reflective of a system “not really geared to what we need right now,” and “that is a failing.”
With 1,663 reported cases of coronavirus in the United States and 41 deaths — the latest reported this evening in Kansas — Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said of the test, “The idea of anybody getting it easily, the way people in other countries are doing it — we are not set up for that. Do I think we should be? Yes, but we are not.”
National Nurses United told committee staff of multiple incidents in which healthcare workers have been exposed to the coronavirus and tried to receive testing but were refused. CDC Director Robert Redfield told the committee that he would “look into that in detail.”
“There are countless more examples of problems of people getting access to tests all across the country, including in my home state of Florida. We need to have someone in charge of making sure that as many people as possible across this country have access to getting tested as soon as possible. Who is that person?” asked Rep. Debbie Wasserman Schultz (D-Fla.). “Is it you? Is it the vice president? Can you give us the name of who can guarantee that anyone, but especially healthcare workers, who need to be tested can be?”
“The responsibility that I have at CDC is make sure all of the public health labs have it and they can make the judgment on how they want to use it,” Redfield replied.
Redfield told lawmakers that “obviously we want to see the test used for broader public health surveillance” but “when the test turns positive after you actually are infected …is still a scientific question.”
Fauci said that with broader testing “you will start to get a feel for what the penetrance is and that is a different process.”
“Unfortunately, our system from the beginning was not set up to do that and that is the reason why we are not able to answer the broader questions of how many people in the country are infected right now,” he added. “We hope to get there reasonably soon, but we are not there now.”
Redfield testified that since March 2 “there has been, I’ve been told, over 4 million tests now to have entered the market — but what I want to say, the test isn’t the whole answer.”
“You need people to do the tests, laboratory equipment to do the tests. You need some of the reagents that actually now are in short supply to prepare the tests. You need the swabs to take the test. So we’re working very hard with the FDA to make sure all these different pieces — you know, right now the actual test to do this coronavirus test I think we have the test in the marketplace,” the CDC director continued. “The question is how to actually operationalize them, and I think that’s what Tony and I are saying is the big challenge right now.”
Redfield said the government is “trying to stand up a national reporting mechanism that is going to put not just the CDC test, not just a public health lab test but the LabCorp test, the lab Quest test and the individual hospital lab so that we can have a single site where people can see how many tests have been done, how many test are positive.”
Asked whether the CDC would ensure that every American would get access to free coronavirus testing regardless of their insurance status, Redfield replied, “I can say that we are going to do everything to make sure everybody can get the care they need… CDC is working with HHS now to see how we operationalize that.”
“You need to make a commitment to the American people so they come in to get tested,” said Rep. Katie Porter (D-Calif.). “You can operationalize the payment structure tomorrow.”
“I think you are an excellent questioner so my answer is yes,” Redfield responded.
Rep. Ralph Norman (R-S.C.) noted that there were about 80 people in the hearing room. “Walk me through the likelihood of any one of us in this room getting the virus, assuming somebody here has the symptoms,” he said.
Fauci said that “in the spirit of staying ahead of the game, right now, we should be doing things that separate us as best as possible from people who might be infected.”
He called Congress’ move to limit Capitol access to staff and lawmakers “a really, really good idea.”
“I know you like to meet and press the flesh with your constituencies; I think you need to really cool it for a while because we should be practicing mitigation even in areas that don’t have a dramatic increase,” Fauci said, emphasizing the importance of social distancing. “I mean, everyone looks to Washington state, they look to California, they’re having an obvious, serious problem. But their problem now may be our problem tomorrow.”
Health and Human Services Assistant Secretary for Preparedness and Response Robert Kadlec warned that there’s a limited supply of personal protective equipment in the strategic national stockpile to meet the mounting demand. “Annually, about 350 million respirators are used. Only a small percentage of that is used by the healthcare industry, about 35 million, and we believe that the demand for that could be several hundred million to up to 1 billion in a six-month period,” he said. “…CDC has provided guidance on reuse, how can we use them longer. We’ve gone to the manufacturers and how they could surge more, and many of them are doing that. And domestically, even though some of their sources for product, finished product is from overseas like China.”
Kadlec added that non-medical N95 respirators used in manufacturing, mining, and construction may have to be used in healthcare, though manufacturers of those masks fear a lack of liability protections.
“There is the Public Readiness Emergency Preparedness Act that was passed in 2005 that basically indemnifies manufacturers, distributors and users of products that are defined as a device or as a covered countermeasure,” he said. “I happened to be on the staff that did that legislation in 2005. We did not consider a situation like this today. We thought about vaccines. We thought about therapeutics. We never thought about respirators of being our first and only line of defense for healthcare workers.”