HHS Congressional Hearing Transcript on COVID-19 July 10

Chairman Payne: (00:00) This administration's response to the outbreak has been an utter failure on a multitude of levels. Nowhere is this more acute than in its neglect of minority health. Since the onset of the outbreak, it has been clear that communities of color are disproportionately impacted. However, the impacts on these communities have been obscured by critical data gaps. Even with this knowledge, the administration has been painfully slow in setting requirements for a collection of racial and ethnic demographic information on COVID-19 infection. The example is just one of many that demonstrate the administration's lackluster outbreak response, especially when it comes to minority health. Even CDC director, Dr. Robert Redfield, admitted the failures of the administration to collect demographic information on COVID-19 infections and deaths and made that apology and another congressional hearing last month. I would say, Dr. Redfield, that the American people need more than that. Chairman Payne: (01:29) While much of the focus of the administration's response to minority health during the pandemic is centered around the Department of Health and Human Services, the Department of Homeland Security's Federal Emergency Management Agency, FEMA, is playing a vital role as the lead federal agency for response. Americans are counting on FEMA to get it right. Unfortunately, FEMA has had costly missteps in the past when it comes to not factoring in the needs of communities of color. And researchers have continuously found that FEMA's recovery programs exacerbate existing disparities. Chairman Payne: (02:19) And, while these disparities long proceed COVID-19, the effect they're having on minority communities in a national emergency in itself, one, I worry about FEMA is not doing enough to meet. As we speak, lives are being lost in the country to long standing health inequities. And that is unacceptable. At today's hearing, I hope we can explore this problem and hear potential solutions from our panel of experts. Chairman now recognizes the ranking member of the sub committee, the gentleman from New York, Mr. King, for an opening statement. Mr. King: (03:04) Thank you, Chairman Payne. I appreciate the opportunity. And I think this is a very significant hearing, an important hearing. I will make my remarks brief. I prepared a statement. I asked my staff if they could submit it for the record. Let me just say that New Yorkers were hit particularly hard. We have over 400,000 confirmed cases in my district alone. There's more than 20,000 confirmed cases. There's probably 12 to 1,300 deaths in the district. Now, in particular, the focus of this hearing, as far as how it's impacted the minority community, that's particularly true in my district. The average community in the district, excluding the minority communities for the purpose of this discussion, is between 15 and 20 cases per thousand. In the minority communities or Brentwood, Central Islip, and Wyandanch, it goes from 62 to 70 cases per thousand. So, that's three, four, five times higher in the minority communities. Mr. King: (04:01) Now, the immediate reason for that seems to be that many of the frontline workers, the grocery workers, transit workers, are minorities. So, they are right on the front lines. They are frontline warriors. And they're getting impacted directly. I think some of the longterm reasons, though, are that the underlying health conditions, such as diabetes and high blood pressure, heart disease, are illnesses that, for a long time, go undetected and people may not know they have them. And there is a lack of healthcare in the minority communities. That's why I think it's important and I work with Congresswoman Yvette Clarke on this too, we have to increase the use of community health centers. To me, you have to have them there in the community where the people living in that community feel safe and secure going to them. They don't feel they're going to be checked for immigration status or anything else. They can just go. Mr. King: (04:51) And also, having it nearby just makes it more comfortable. And also, these are people very often have low incomes and really don't want to be going to doctors. They can't afford it. And, if they don't feel sick, they're not going to go looking for it. And that's why it's important that you have checkups, be tested. And I think community health centers are extremely important. Mr. King: (05:10) Now, we really began to realize this in early April, the extent of the pandemic in the minority communities. So, they did put, working with the local Suffolk County, they put a testing center in Wyandanch and also in Brentwood, which again, are two of the most impacted communities, especially Brentwood. Also, I have to emphasize that whatever other partisanship is going on, fortunately on Long Island, Congressman Suozzi, Congresswoman Rice, Congressman Zeldin, Congressman Greg Meeks, and I have been working extremely closely on this. And also, I've been working with the state Senator who represents Central Islip and Brentwood, Senator Monica Martinez, who is a Democrat. We've been trying to work as closely as we can. Mr. King: (05:55) But again, sooner or later we are going to come out of this pandemic. But the fact is that's only the beginning because we have to realize this can certainly occur again. And, as you pointed out, what this has brought out is the underlying conditions, as far as a lack of proper healthcare for people in the minority community. So, we're going to have to address that as we go forward. Mr. King: (06:15) As far as the federal response, I haven't seen that be an issue on Long Island. Again, both of our county executives Democrat. I've worked with them. I have not heard that there has been a lack of funding from the federal government, as far as one community against another. I know we did fight hard to get the ventilators, and the gloves, and masks. But that, so far, I don't see that being an issue. But again, I'm not ruling it out. But I do think the underlying, longterm issue is going to be the issue proper healthcare. And we have to take that into account, strongly into account. We have to find ways to rectify that going forward. So, with that, let me be yield back. And I look forward to the testimony. Thank you, Mr. Chairman. Chairman Payne: (07:04) I thank the ranking member for his candor and honesty, which is one of the reasons I appreciate his service to this country so, so much. Thank you, sir. Mr. King: (07:17) Thank you, chairman. Chairman Payne: (07:17) Once again. And I'd like to work with you on the community health center issues. That's something that's been very important to me. And it's good to hear that you're interested in that. And look forward to working with you on that position. Mr. King: (07:31) Thank you. Chairman Payne: (07:38) Okay. So, members are reminded that the subcommittee will operate according to the guidelines laid out by the chairman and ranking member in their July 8th [inaudible 00:07:48]. With that, I ask unanimous consent to waive committee rule 8A2 for the subcommittee during the remote proceedings under the covered period designated by the speaker under house resolution 965. Without objection, so ordered. The chairman now recognizes the chairman of the full committee, the gentleman from Mississippi, Mr. Thompson, for an opening statement. Mr. Thompson: (08:20) Thank you very much, Mr. Chairman. Good afternoon to my colleagues, as well as our witnesses. I'd like to thank both of you and the ranking member for holding today's hearing on health disparities in COVID-19 pandemic. The COVID-19 pandemic did not create health disparities in this country. Instead, the pandemic is further exposing these disparities and their tragic effects on minority and disadvantaged communities. Today's hearing provides an opportunity to examine the federal response to the pandemic and what must be done to confront the disproportionate impacts of the pandemic in these communities. Mr. Thompson: (09:05) In March, FEMA was tasked with being the lead federal agency for COVID-19 response. I've been concerned about FEMA's past the response efforts where it failed to adequately address the needs of minority and economically disadvantaged communities. The complexities of a pandemic put this troubling history in stark reveal. In April 2020, FEMA published a new civil rights bulletin intended to ensure civil rights during the COVID-19 response. While the publication is an encouraging step, continued congressional oversight of the agency's efforts and operations is necessary to ensure responsive efforts provide equal, equitable assistance to minority and economically disadvantaged communities. Mr. Thompson: (10:01) Of course, direction to FEMA and the entire federal government on pandemic response flows from the top. Unfortunately, President Trump's response to the worsening pandemic has been a failure by any reasonable measure. Failure to address minority and economic health disparities is a significant part of the shortcomings. The administration has even struggled to provide policy maintenance with the COVID-19 case and morbidity data outcomes by race and ethnicity. In fact, it took pressure from members of Congress and the public for the Centers for Disease Control and Prevention to release its first nationwide preliminary case on morbidity estimates by race and ethnicity, on June 15, 2020, well into the pandemic. Mr. Thompson: (10:56) Communities of color and economically disadvantaged have to contend, not only with a deadly virus and failed federal response, but also systematic inequities that put these communities at greater risk of COVID-19 related hospitalizations and death. On April 29, 2020, every democratic member of this committee sent a letter to the Department of Health and Human Services Office of Inspector General requesting they look at this issue and ways the federal government can better address health disparities in emergencies. Mr. Thompson: (11:37) Katrina taught us a lot. I thought we had learned a good bit about communities of color during emergencies. But, obviously, we still have some work to do. So, I look forward to our witnesses testimony today. And I yield back, Mr. Chairman. Dr. Georges Benjamin: (12:13) We can't hear you, sir. Chairman Payne: (12:34) I thank the chairman for his opening statements and appreciate his leadership. Now, Mr. Rogers will not be joining us today. So, I'll move on to introducing the witnesses. Chairman Payne: (12:50) Our first witness is Dr. Georges Benjamin, who serves as executive director of the American Public Health Association. Dr. Benjamin's experience includes having been secretary of the Maryland Department of Health and Mental Hygiene and the former chief of emergency medicine at the Walter Reed Army Medical Center. He is also a member of the National Academy of Medicine. Welcome. Chairman Payne: (13:21) Our second witness is Dr. Leana Wen. Dr. Wen is an emergency position and visiting professor of health policy and management at the George Washington University's Milken School of Public Health, where she is also a distinguished fellow at the Fitzhugh Mullan Institute of Health Workforce Equity. She also previously served as Baltimore's health commissioner. Thank you for being here. Chairman Payne: (13:57) Our third and final witness is Chauncia Willis. Ms. Willis is the co-founder and CEO of the Institute for Diversity and Inclusion in Emergency Management. She's a certified emergency manager, a master exercise practitioner, and serves as the immediate passed president of the International Association of Emergency Managers, region four. Welcome. Chairman Payne: (14:28) Without objection, the witnesses full statements will be inserted into the record. I now ask each witness to summarize his or her statement for five minutes, beginning with Dr. Benjamin. Dr. Georges Benjamin: (14:44) Chairman Thompson, Chairman Payne, and ranking member King, listen, just thank you very much for allowing me to spend some time with you this morning. You have my full testimony. I'm going to focus on three areas, disparate impact, and the cause of it, some concerns I have about ongoing co-occurring preparedness activity. And then, of course, the importance of rebuilding our public health infrastructure. Dr. Georges Benjamin: (15:07) As you know, this has devastated our nation. Over three million cases, over 130,000 deaths. And they're growing at 60,000 cases a day. If you look at the minority community, we have been devastated disproportionately. For African-Americans, we're 13% of the population but 24% of the deaths. Hospitalizations are five times for African Americans and non Hispanic whites, and four times for Hispanics than non Hispanic whites. And the Native American population is also substantially being devastated by this outbreak. Dr. Georges Benjamin: (15:44) I think that we ought to think about this epidemic as though we have three of them. Number one, we obviously have this big infectious disease epidemic. We also have an infodemic, which I'm going to come back and talk about, which is a lot of misinformation and disinformation. And clearly fear plays a predominant role in our community, a lot of it because we don't know what's going on, it's a new disease, there's lots of issues. And, quite frankly, we need to strengthen the national leadership that we've had on this outbreak. And, obviously, the impact has not just been on health, but it's also been on the economy. It's been on the social welfare, et cetera. Dr. Georges Benjamin: (16:27) There are three main reasons for this, higher exposure because of public facing jobs for minorities, susceptibility because of a long history of chronic diseases, and social determinants of health. 80% of what makes you healthy occurs outside the doctor's office. And so, people are set up not to be able to have good health. And that includes things such as having to work multiple jobs because of pay inequalities, because of the lack of paid sick, the housing, which prohibits you from being able to really physically distance, even if you get infected in your home. These are all concerns that we have to address if we're going to go forward. Dr. Georges Benjamin: (17:08) Our response has been challenged in many ways. We've had inadequate testing. We've had absolutely inadequate data, so we can target our resources and target our responses. Contact tracing is well behind where it needs to be. And, in terms of education, we've not really done a great job of educating the public on what's going on and how to address this as we go forward. Dr. Georges Benjamin: (17:34) I remain concerned that, should we get hit with something this summer, like a severe storm, or another hurricane, wildfires, or an earthquake that our ability simply to manage that will be severely stressed. Imagine being in a shelter where you can't really manage face coverings very well, hand washing, and physical distancing. And we really haven't planned adequately for that. Dr. Georges Benjamin: (17:59) And finally, we need to fix our broken public health system. I was the health officer in Maryland on 9/11. We had a pretty good public health system. But you in Congress and the administration at the time buffered and improved our public health system. But we as a nation have allowed that to erode away substantially over the last several years. It has impacted our response to COVID. It stands to impact our response to natural disasters. And I remain concerned that the coordination and the leadership isn't there for us to address these things as we go forward. With that, I'll be kind enough to stop and take questions during the question and answer period. Thank you, chairman and members of the committee. Dr. Leana Wen: (18:57) Chairman, I'm not sure we heard you. Chairman Payne: (19:02) Thank you, Dr. Benjamin, for your testimony. I now recognize Dr. Wen to summarize her testimony. Thank you. Dr. Leana Wen: (19:12) Thank you very much. Chairman Payne, ranking member King, and distinguished subcommittee members. Thank you for addressing the intersection of racial disparities and the COVID-19 pandemic. Dr. Leana Wen: (19:22) So, I come to you from the city of Baltimore, where I am a practicing physician and had the honor of serving as its health commissioner. In my city, children born today can expect to live 20 years more or less, depending on where they are born and the color of their skin. There are racial disparities across every metric of health that's a result of structural racism and inequities. COVID-19 is a new disease that has unmasked these long standing health disparities. And the evidence is clear that African Americans, Latinos, Native Americans, and other minorities bear the greatest brunt of this pandemic. My written testimony outlines ten actions that Congress can take now to reduce the disproportionate impact of the epidemic on people of color. I'd like to highlight six of them that are directly relevant to the work of the Homeland Security Committee. Dr. Leana Wen: (20:12) First, target testing to minority and underserved communities. Testing must be free, widespread, and easily accessible. Yet, it's estimated that we need ten times the amount of testing that we currently have. Congress must instruct FEMA to ramp up testing and to set up testing facilities all across the country. Existing hotspots should be the priority initially, but the key is to have enough testing everywhere to prevent clusters from becoming outbreaks and outbreaks from becoming epidemics. Dr. Leana Wen: (20:44) Second, provide free facilities for isolation and quarantine. We know the key to reigning in the virus is testing, tracing, and isolation. Well, if someone tests positive, we tell them to self-isolate. What do you do if you live in crowded multi-generational housing, as minorities disproportionately do? Other countries have addressed this by setting up field hospitals and converting unused hotels into voluntary self-isolation facilities. Congress would request FEMA to do the same. Dr. Leana Wen: (21:14) Third, institute stronger worker protections. Minorities constitute a larger percentage of essential workers. The CDC has issued watered down guidelines and OSHA has not met it's mission to protect workers. Your committee can ensure that workplace protections are followed for federal workers like TSA employees. This includes universal masking for all passengers in airports, as this will protect the employees as well as the public. You can also institute stronger protections to limit the spread of COVID-19 in DHS run immigration detention facilities. That includes access to PPE and appropriate protocols for isolation and quarantine. Dr. Leana Wen: (21:55) Forth, suspend immigration enforcement for those seeking medical assistance for COVID-19. Public health hinges on public trust. Undocumented immigrants who fear deportation of will be scared to seek help if they exhibit COVID-19 symptoms and pose a risk, not only to themselves, but to their families and communities. Congress should prohibit ICE from accessing records in facilities of those seeking care for COVID-19. Congress should also ask for temporary cessation of the Trump administration's public charge rule. Dr. Leana Wen: (22:26) Fifth, prepare for the next surge. It's a national shame that we ran out of masks and other PPE to protect our healthcare workers. There was no excuse in March and even less of an excuse now. And PPE should not only be available to doctors and nurses. Why shouldn't grocery cashiers, bus drivers, nursing home attendants, who are disproportionately people of color, have protection too? Congress must urge the Trump administration to have a national strategy. This includes activating the Defense Production Act to ensure that PPE, ventilators, and other critical supplies are produced in sufficient quantity. Lack of action affects everyone, but in particular, minority communities. Dr. Leana Wen: (23:08) Sixth and finally, support local public health. Funding for public health preparedness has been cut by half over the last decade, forcing local officials to make impossible trade offs between critical programs. I think we can all agree that treating COVID-19 should not come at the expense of preventing cardiovascular disease and reducing overdose deaths. I urge that your committee also consider the public health safety net to be part of the backbone of critical infrastructure and national security in the U.S. Dr. Leana Wen: (23:40) I'd like to end my testimony by thanking all of you for focusing on tangible solutions. There are systemic problems that we must address that will take sustained commitment and dedicated effort. But we are facing the biggest public health crisis of our time, literally a life and death threat facing our communities of color now. We cannot just ignore problems. Now is the time to take action to reduce disparities in COVID-19 outcomes and, in so doing, improve health for all. Thank you. Chairman Payne: (24:09) Thank you for your testimony. I now recognize Ms. Willis to summarize her statement for five minutes. Chauncia Willis: (24:21) Chairman Thompson, Chairman Payne, ranking member King, and members of the Emergency Preparedness Response and Recovery Subcommittee, thank you for the opportunity to testify on this important topic. We are experiencing a paradigm shift across the United States as we respond to a pandemic, civil unrest, and systemic racism with an uncertain outlook for recovery or an adequate recovery plan. The issues plaguing America, including the disparities associated with COVID-19, are a result of policies enacted that have historically lacked diversity, inclusion, and equity. Of all emergency management- Miss Willis: (25:03) ... lacked diversity, inclusion and equity. Of all emergency management policies, only a few mentioned the word equity and none address using equitable strategies to produce better outcomes for vulnerable groups. Disasters do not discriminate. However, people do. The health disparity seen during this pandemic can only be improved if we understand and operationalize equity. Equity must be present in all plans, policies, programs, and practices within the field of emergency management. Equity in all things. Equity is different from equality. For example, equality is about giving everyone a shoe. Equity is giving everyone a shoe that fits. In disaster management it can no longer be about doing the most for the most, because when we do the most for the most, it leaves a gap. And [inaudible 00:25:51] those who have the least. Miss Willis: (25:55) There are existing inequities within our country's very fabric that lead to disproportionate death and negative impacts for the most vulnerable groups among us. These inequities are rooted in systemic racism and an antipoverty mindset that exist- Miss Willis: (26:16) For example, the racist policy of red lining has led to a lack of access to healthcare, exposure to environmental hazards and so forth. The field of emergency management lacks diversity and representation, which influences the way policies and programs are crafted and negatively impacts outcomes and disaster or underrepresented groups. Currently, emergency management policies indicate that white male is the default setting and baseline standard for disaster response and recovery. In fact, the field of emergency management is overwhelmingly white, made up of over 80% white males in leadership positions. However, the communities we serve as emergency managers are very diverse, and the impacts of COVID-19 on diverse populations is significant. Miss Willis: (27:02) Current data shows that black and indigenous Americans have experienced the highest rate of COVID-19 deaths in America. If they had died of COVID-19 at the same actual rate as whites, about 16,000 blacks, 2,200 Latinos and 400 native Americans would still be alive. America's disabled population is also suffering because they lack access to testing and non-urgent healthcare. In addition, although people with disabilities are at high risk for COVID-19, there is a data gap in reporting that prevents equitable strategy development. Miss Willis: (27:39) Also, the needs of rural areas are unique because they tend to have older populations with more chronic health conditions that raise the risk of developing more severe cases of COVID-19. They have fewer healthcare providers and more uninsured residents, meaning they must wait longer for treatment. The emergency management system must incorporate operationalized equity as a foundational principle for policies using social determinants of health to address the needs of diverse population. Miss Willis: (28:11) Our organization, [IDEAM 00:03:13], recommends the following. A thorough review of current emergency management policies, including an assessment of the intended and unintended effects of these policies. Number two, intentional, measurable integration of equity into FEMA doctrine, programs, grants, and contract awards. Number three, ensure federal funding is tied to demonstrated diversity inclusion and equity in all things, especially grants and contract awards. In addition, disaster plans and programs should be evaluated and held accountable, based on the performance of their equity strategy. Number four, integrate equity and culturally competent thinking into emergency management curriculum and continuing education. And finally, invest a majority of preparedness mitigation and recovery funding in the most vulnerable communities, including communities of color. Emergency management must make diversity inclusion and equity a priority so that lives will be saved and not sacrificed in disaster. Thank you for your time. Mr. Chairman: (29:17) ... for your testimony. I'd like to thank all the witnesses for their testimony. I'll remind the subcommittee that we each have five minutes to question the panel. I will now recognize myself, but before I do that, I announce unanimous consent that Congresswoman Jackson Lee be permitted to sit and question the witnesses without objection. Mr. Chairman: (29:46) Miss Willis. FEMA has a history of emergency responses plagued with racial and socio economic disparities. Despite this history, the Trump Administration has made little to no effort to assure communities that the agency will respond to the pandemic in an equitable manner. With preexisting disparities in mind, what types of emergency response strategies should our country utilize to respond to the COVID-19 pandemic? Miss Willis: (30:26) Thank you, sir. That's a great question. One of the most important strategies will be to ensure that we are training our emergency managers in equity to assist them in focusing policy creation and implementation on equity and vulnerable groups. Right now, within FEMA and emergency management as a whole, equity is not a priority. And in fact, it is not seen as a priority in many areas of disaster management. And that's a significant problem that must be addressed. We need an equity revolution. We must confront the intersection of raising poverty on biased disaster management policies as well. A thorough review of policies is needed and more funding must go into equity, training and education. Thank you. Mr. Chairman: (31:18) And am I correct in saying that we're not asking for special treatment in these communities, we're asking for equitable treatment in these communities? Is that correct? Miss Willis: (31:29) That's absolutely correct. Mr. Chairman: (31:31) Thank you. Miss Willis: (31:32) Providing equity in disaster should not be an "other". It should be a priority. Thank you. Mr. Chairman: (31:38) Thank you, very much. Dr. Wynn and Benjamin, when asked about racial disparities at a congressional hearing in June, Dr. Fauci said that institutional racism contributed to the disproportionate impact of COVID-19 on African Americans, and that they have suffered from racism- Speaker 1: (32:03) [inaudible 00:07:03], they want to test video. Speaker 2: (32:12) How do I take this off sound? Mr. Chairman: (32:12) Excuse me. Somebody needs to mute please. I'm sorry. Mr. Chairman: (32:19) Dr. Fauci was saying that the community had suffered from racism for a very, very long period of time. If the Trump Administration has known of these factors for a long time, why has the administration not done more to address these problems? Either one of you can start. Dr. Benjamin: (32:39) Sure. I'll be happy to start. If you think about the response there, they're really three areas where the administration can step up a bit more. I know some of it they've done, but there's still more things that they can do. Number one, testing. Early on, as you know, there wasn't a lot of tests, but when we did have tests, they weren't in the hood, quite frankly. They weren't easy to get to. The drive through testing. If you didn't have a car, you couldn't get there. We've got to make sure that testing is available to all parts of the community., To people that have shift work, to people that don't have paid sick leave so they can ask to get to the testing. Dr. Benjamin: (33:15) And then we need to make sure that that testing is available. Television pictures that we're seeing the last couple of weeks have long lines of people waiting hours to get tested, are frankly unacceptable for every citizen in our country. And then specifically for communities that are people that are at higher risk. Sitting in a line three hours when you have symptoms and you don't feel well, and from a clinical perspective, just makes no sense of course. Dr. Benjamin: (33:43) Secondly, we know that the whole issue of access to care remains a big issue. And I applaud recommend ranking member King and you and all that about community health centers. Mr. Chairman: (33:59) Recognized. Dr. Benjamin: (33:59) And that's wonderful. But every citizen in this country ought to have access to quality, affordable health care. That's important. We have to get Medicaid coverage to all of our low income citizens, and we need to stop fighting about that. Healthcare is a fundamental human right and we need to fix that right now. Dr. Benjamin: (34:15) And I think the third thing is we've got to really deal with this issue of misinformation, disinformation. One of the things we did during the AIDS epidemic is we did a lot of work educating faith leaders, barbers, beauticians, anyone who was an influencer in our community, to get to communities of color, to get to communities that had languages other than English as their first language, to make sure they understand the disease process and how they can get help and what they can do to protect themselves. We have not done that. Mr. Chairman: (34:50) Thank you, sir. And Dr. [Wynn 00:09:55], my time has expired so I'm going to have to yield. I'm sorry. I now recognize the ranking member of the subcommittee, the gentleman from New York, Mr. King, for questions. Mr. King: (35:19) Thank you, Mr. Chairman. I'd like to focus my questions to Dr. Wynn just to start. New York and on Long Island we have a particular issue with the fact of transportation. New York City subway system carries millions of people every day. The Long Island railroad carries hundreds of thousands of people in and out of Manhattan and Brooklyn and back. And there's tremendous transportation back and forth. We're talk about millions and millions of people who are on the trains every day. I'm trying to dig down to the next pandemic or the second wave of this one, what can you suggest that we do try to anticipate the problems you're going to get from transportation, having so many people packed together on these trains and as far as having testing sites and ways to detect it? Because again, that's where you have people of all economic strata, races, religions, everyone traveling together in very close quarters, both from low end communities, low income communities, high income communities, from the suburbs, the inner cities, all coming together. Can you think of any way we can do it to minimize the impact of the second wave spreading or another pandemic, God forbid. Dr. Wynn: (36:34) Thank you very much ranking member. This is an excellent question. The most important thing that we can do in order to mitigate the spread on public transportation actually is the same as I would say, if you had asked me about what can we do to keep schools open. It's the same answer, which is that we need to keep the level of COVID-19 in the community to be as low as possible. Because you can imagine when you have communities in parts of the south, where one in a hundred people have COVID-19, if one in a hundred people have it and don't know it and they're getting on trains or they're going to schools or really any public place, that's a lot of potential people that they could be infecting. Dr. Wynn: (37:11) So we really have to do our part in order to keep the level of infection as low as possible throughout the country. And at this point, we know exactly what that would mean. We know that this is a combination of physical distancing, wearing masks, also good sanitation practices and cleaning, but ultimately this is about keeping that level of infection down as low as possible. Two more things quickly. Another is testing, to piggyback on what Dr. Benjamin had said earlier. We absolutely need widespread, free testing available to where people are and it needs to be rapid. Dr. Wynn: (37:45) It doesn't do any good when there's a test result that comes back in five to seven days, or even 10 days in some cases, because what does that patient supposed to do in the meantime? And in that time they're also spreading the disease to many others. And so that rapid testing is critical. The final point is surveillance. To your point about transportation, as well. We need to know where it is that people are picking up illness. We also have to have surveillance in the community so that we can identify a cluster of outbreaks or a cluster of infections before it becomes a large outbreak. Mr. King: (38:19) Thank you, doctor. And I'll adjust this question to anyone who wants you to answer it. In my district in particular, we have several large Hispanic American, low income communities with both documented and undocumented people living in those communities. And I think it was you, Dr. Wynn, that mentioned about multi-generational, and they're more inclined to have multi-generations living in those communities. How is the best way to get testing into those communities to alert the people to get the testing? And again, I'm not advocating open immigration at all, but again, undocumented people are afraid to go to doctors. They're afraid to go for testing. Rightly or wrongly. How do we overcome that and can we aggressively go into those communities more? Not for our good but for their good, to get them tested. I don't know. I guess you can't force people to be tested, but really encourage it in those communities. Mr. King: (39:12) Anyone who wants to answer. Dr. Benjamin: (39:17) Sure. A van. Mr. King: (39:19) Thank you, Doctor. Dr. Benjamin: (39:21) Sir, I'm sorry sir. All you need is a swab, a van and testing, and a place to cool the sample down. So you can take mobile vans in those communities very effectively, park them on the corner and ask people to come in. But you've got to obviously communicate with them so they don't feel threatened. Or go to schools. You got lots of empty buildings in your community, you can set a rapid testing clinic in. Mr. King: (39:50) I'm sorry, go ahead. Dr. Wynn: (39:52) If I may add too, I completely agree with Dr. Benjamin. You need to go to where people are. Churches, community sites, public housing. Also, it's really critical to enlist trusted members, trusted messengers, in the community to the point that you raised congressmen, that you need individuals who have the community trust. And public education needs to be a part of that, including public education about how everyone should receive healthcare. This is not a time to be asking about immigration status. Many people are going to be terrified to seek help because they think that they're going to be arrested by ICE and deported. And so it is really important to reassure them that this is not going to happen at this time. That this is about protecting, not only them, but everybody else around them too. Mr. King: (40:34) My time is up. I yield back Mr. Chairman. Thank you. And thank you witnesses. Mr. Chairman: (40:41) I'd like to thank the gentleman from New York. The Chair will now recognize other members requesting questions that they may wish to ask witnesses. As previously outlined, I will recognize members in the order of seniority, alternating between majority and minority. Members are reminded to unmute themselves when recognized for questioning. The Chair now recognized for five minutes, the gentlemen and the chairman of the full committee, the gentlemen from Mississippi, Mr. Thompson. Mr. Thompson: (41:15) Thank you very much, Mr. Chairman. And I think the witnesses. One of the things we have tried to work with with FEMA, is an issue any national or natural disaster, they need to have a plan for the entire population. And that plan should include transportation, should include housing, health facilities, all of that. Most of the plans we've come in contact with, or have been presented, try to look at communities as one entity and not, as Peter was talking about, certain people stay in one area, certain people stay in another. Mr. Thompson: (42:14) I guess what I'm saying is, we get cookie cutter plans that many people assume will fit every situation. And what I've heard from the witnesses today is that you really have to have a greater understanding of the communities in which you're working, and your plans have to reflect it. Best example I can tell you, I'm speaking from my congressional office and we had a testing site that was five miles from my congressional office, and we don't have public transportation. So in the run of a day they did 26 people, because nobody could afford to get to the site. Well, if they had just talked to somebody and said, "Where is the best ways to come to do a site testing?" They'd say, "Well, you need to come where the people are." And so if that comfort level sometime that our emergency responders go to. So can you give members of Congress, how do we work with FEMA and other personnel in this venue to get them to understand that you have to include the entire communicate in your planning, especially from an emergency preparedness standpoint, because otherwise they'll get overlooked. And I'll just throw that out to Dr. Benjamin, Dr. Wynn and then to Miss Willis. Dr. Benjamin: (44:06) I think we have to make sure that FEMA understands that their real job is to build resilience and preparedness for communities. And that means that they can't do cookie cutters. They have to plan with communities and not to communities. And that means they got to have community engagement. They've got to be part of the planning process throughout every aspect of it. And we need to make sure that Congress can require that the governors and emergency planners show that they've engaged communities as part of the planning process. You remember the HIV AIDS days when we were challenged to get good HIV AIDS plans in place? Congress required planning communities be part of that planning process. And so I think you can link that to their funding in some way or some other mechanisms to demonstrate that those communities are part of the planning process, because as you know, there's enormous strength in communities that are not being used. Mr. Thompson: (45:06) Absolutely. Dr. Wynn? Dr. Wynn: (45:11) If I may add very quickly, that right now we don't even have that cookie cutter approach. I agree, we need to have a tailor approach, but right now we don't even have a national strategy, really, of any kind. We need a national strategy around testing. We did a national strategy around quarantine isolation facilities, around procuring supplies, the Defense Production Act. We need to have that strategy in order for us to save lives. Mr. Thompson: (45:34) Thank you. Miss Willis? Miss Willis: (45:38) Thank you, sir. And I would say that equity must become a core competence for emergency managers, certainly, and the emergency management leadership. And I would also say that we need to begin tying funding to the investments of minority communities. And right now that's not happening. We need you to invest a majority of FEMA funding for preparedness mitigation and recovery in our most vulnerable communities, rather than continuing to overfund communities that will bring in revenues, such as tourism areas. And so that's something that has been a problem and continues to be a problem. There's an underinvestment and divestment in communities of color. Thank you, sir. Mr. Thompson: (46:32) Thank you very much. I yield back. Mr. Chairman: (46:35) Thank you, the gentlemen from Mississippi. I now recognize the gentlemen from Louisiana, Mr. Richmond, for five minutes. Mr. Chairman: (46:52) Or maybe not. Mr. Chairman: (46:53) Okay. Well, it doesn't seem like he's here. So now we will go to the gentle lady from Illinois, Miss underwood for five minutes. Miss Underwood: (47:10) Well, thank you, Mr. Chairman. And I am so grateful to our witnesses for appearing before the panel today. This certainly is a topic that touches close to home. As you know, so much of the disparities conversation related to COVID-19 did begin with Illinois, as we were one of the first to release our data by race and ethnicity. And that has certainly jumped started our national conversation. In the last week my State of Illinois surpassed 7,000 lives lost from COVID-19. Hundreds of thousands more are out of work, and every single community has been impacted. But the harm done by this pandemic has not been inflicted evenly. Communities of color are experiencing disproportionate rates of illness, hospitalization, financial loss, and death. In Illinois the cumulative rate of positive coronavirus tests for Hispanic residents is more than five times the rate for white residents. In one County in my northern Illinois district, the positive test rate for Hispanic residents has been nearly eight times as high. Eight. Miss Underwood: (48:13) Across the country people of color, and particularly black folks, are losing both their jobs and their lives at staggering rates. To tackle these inequities head on we need to make culturally relevant investments in public health and economic opportunity, which is why I introduced, with my House and Senate colleagues the Health Force and Resilience Force Act, which would fund public health departments to hire locally for testing and contact tracing. Miss Underwood: (48:42) Dr. Benjamin, for Latinx communities and other underserved populations, why is it so important to have local residents supporting health departments with initiatives like contact tracing and information sharing? Dr. Benjamin: (48:57) I don't speak Spanish. I don't speak Spanish, so it's language, it's trust, it's knowing where to go. And I was watching a Washington D.C. health officer and I got to tell you that we were successful in many of our efforts there to reduce a whole range of infectious diseases because I had outreach workers that knew the community. Knew who to go to. And when people didn't want to do something, were able to convince them to follow medical advice. That's essential in communities of color, and particularly communities where they're concerned about immigration, where English isn't the first language. And frankly, right now, in these last few years, we've stigmatized. Miss Underwood: (49:39) Yep. And so we've invested billions of dollars in the search for a vaccine, but actually developing a safe and effective vaccine is only the first step. We will then need to prepare to rapidly deploy it across the country. And unfortunately we know that black and Latinx Americans have lower immunization rates than their white counterpart. Dr. Benjamin, can you describe the importance of community specific efforts to increase- Ms. Underwood: (50:03) And can you describe the importance of community-specific efforts to increase vaccination rates in black and Latin X communities for recommended immunizations like measles and smallpox and flu vaccines? And also what does the evidence from deployment of those vaccines tell us about how we need to prepare to deploy an eventual COVID-19 vaccine to ensure strong vaccination rates among communities of color? Dr. Benjamin: (50:23) Well, we should start recognizing that there's a disparity in vaccine uptake in communities of color. In other words, communities of color don't get vaccinated as frequently as whites in this country. Secondly, we should recognize there is an enormous amount of mistrust that currently exists and that's coupled with primarily the anti-vaccine community and others though who are sending a lot of disinformation. Look, we've already got people in social media space and passing out flyers telling the community of color, "Don't get vaccinated. It will make you sterile. It will give you AIDS. It will give you the disease. It will kill you." So there are already a lot of disinformation out there and we need a national effort to do that. But more importantly, we need a national plan. The federal government needs to step up to the plate and put together a plan just like we did with H1N1 to figure out how we're going to deploy this vaccine. We've got lots of mechanisms to do that but we have no plans. Ms. Underwood: (51:23) Well, I'm so glad you said that because last month I introduced the Protecting Against Public Safety Disinformation Act. This bill would help public health officials mitigate the impact of false information that can undermine efforts to keep our community safe during this pandemic and beyond. Dr. Benjamin, in what way could the spread of disinformation worsen disparities in the impact of COVID-19 particularly with respect to vaccines but also wearing masks? Dr. Benjamin: (51:51) Well again, there's a group out there who's actively working to confuse us all, around vaccines, around masks. But there are flyers, I saw some flyers that were being passed out in New Jersey which had the CDC and the World Health Organization logo on them. They were obviously misinformation. But they were flyers that basically said, "If you're infected go to a synagogue. If you're infected go to a low-income community. If you're infected ride public transportation." In other words, they're trying to spread the virus. So they're giving misinformation to hurt people. And so, I think we've got to push back against that kind of effort as aggressively as we can. Ms. Underwood: (52:32) And in the same way that you all discussed targeting the strategies to mitigate spread, testing, and treatment in the communities that are most impacted, we also need to target those same types of campaigns to spread accurate information and empower those public health officials to do the same. Dr. Benjamin: (52:51) Absolutely. Ms. Underwood: (52:52) Thank you. In May, the House passed the Heroes Act which included nearly $7.5 billion in direct funding for public health departments, in addition to $500 billion in relief for states, and $375 billion for local government. Unfortunately, the Senate has yet to act to pass this bill. We know that there are significant public health consequences to continued delays in passing the Heroes Act. And so, we are calling on our colleagues in the Senate to rapidly take up this legislation and empower our state and local public health departments to do this much-needed work. And with that, Mr. Chairman, I yield back. Thank you to our witnesses. Mr. Chairman: (53:27) I'd like to thank the gentlelady from Illinois for her questions, always poignant. And please make sure my office has all of your pieces of legislation so I can sign on. Ms. Underwood: (53:41) Yes, Mr. Chairman. Thank you. Mr. Chairman: (53:44) Next, I believe we will recognize the gentlelady from Texas, Ms. Jackson Lee, for five minutes. I thought she was on. Staff, is she available? Speaker 3: (54:18) Not at the moment, sir. It's just you and Ms. Underwood. Ms. Underwood: (54:22) Well, Mr. Hayes, if you would yield a couple more minutes, I do have a couple more questions for our witnesses. Mr. Chairman: (54:27) I will yield. Ms. Underwood: (54:28) Thank you so much, sir. My next question is for Dr. Wen. In June, the CDC reported that pregnant women might be at increased risk for severe COVID-19 illness and the risks appear to be even higher for black and Hispanic pregnant women. Dr. Wen, as Congress develops another COVID-19 relief package, which policies should be considered to protect pregnant and postpartum women during this pandemic? Dr. Wen: (54:54) Thank you for that excellent question. And, I know that you and I have worked closely on issues of maternal mortality. I thank you for your leadership on these really important factors. I think there are two separate but related issues. One is about COVID and disparities, and then the other is about maternal mortality. And now, they're intersecting in this way because of the increased likelihood of severe effects among pregnant women during COVID. So I think we have to take them separately. Dr. Wen: (55:28) For COVID-19, I do think that all the recommendations rest of the things that we have made thus far still stand, and in this case, I would just continue to emphasize the importance of a national strategy, because right now we have seen what happens when we have this piecemeal approach across the country, when we have unfortunately elected officials for not following the advice of public health experts, and in fact, as Dr. Benjamin said, are feeding into misinformation. And so everything that we can do, that all of you can be doing to ensure that there is a national strategy to the best of your ability would be extremely helpful and to spread that information too, to counter the misinformation, that's also rampant. Dr. Wen: (56:08) Then I would say when it comes to maternal mortality, we need to be not only looking at what happens during pregnancy, which is really critical, but also how can we be improving health for women and in particular for black women and women of color throughout their lives. And I think that everything that you have done, Congressmen Underwood to support and improve maternal mortality, what also, therefore not only address the maternal mortality issue but specifically also improve outcomes during COVID-19 as well. Ms. Underwood: (56:40) Well, thank you for your leadership on this issue and all other matters of public health. I want to return back to Dr. Benjamin. I started to raise the Heroes Act and the significant financial investment that would be made for states and local government. With your background and leading the American Public Health Association, can you describe the potential public health consequences of the Senate's inaction on this emergency funding for states, localities, and public health department? Dr. Benjamin: (57:05) Here's the challenge we have, we've got three million people with this disease. And even though we don't have as many deaths today because of the number of young people that are getting it who may not be as susceptible to dying, death is a lagging indicator as you know, and we do not have a public health system that can adequately chase and do the content tracing. This is going to get worse before it gets better. I can assure you of that as we return to work. And so we're going to have to build that system and we need to do that as quickly as possible. Without those funds, frankly, we're up the creek. And I was just talking yesterday to some folks about going back to school, we don't go back to school unless we get our hands around this disease process, as Dr. Wen pointed out. Ms. Underwood: (57:56) Yep. So the thing that I want to make sure that the committee and the American people understand is, for decades, our state and local public health systems have been systematically seeing their funding sources reduced. They have been working at the very top of their capacity across this country. And that was during a time of health and wellbeing, largely, right? We were not in a pandemic environment. And so these types of resources are not going towards the state and local health departments as sort of excess, right? They are to fill critical functions to protect the communities that they serve. And so when we talk about bills like the health force and the resilience force and hiring community members, training them and giving them a sustainable skillset to further pour into those communities that they come from, it only serves to build the capacity of those local institutions. Would you care to comment, Dr. Benjamin? Dr. Benjamin: (58:50) Oh, absolutely. In my health department, when the anthrax letters hit our nation, my surge capacity came from my HIV-AIDS programs, and my chronic disease programs, et cetera. I pulled epidemiologists and outreach workers throughout all of my programs. [inaudible 00:59:06] And then we had to continue to deal with HIV and STDs. As Dr. Wen pointed out, we still have people dying. Other than COVID growing very quickly, the leading cause of death is still cardiovascular disease and cancer. Those did not go away and we still have to address them. And it is still much cheaper for our nation to prevent these diseases than to treat them when they occur. Ms. Underwood: (59:32) That's right. Thank you again, and I yield back. Mr. Chairman: (59:35) Thank you. The Chair now recognizes and can see her, the gentlelady from Texas, Ms. Jackson Lee. Ms. Jackson Lee: (59:46) Mr. Chairman, thank you so very much for your kindness and thank you to the members. We're all doing double duty. Let me also say, Mr. Chairman, I am delighted with your leadership, Chairman Thompson leadership, but I must again publicly say congratulations on the recent success that we had, that we will be able to see you again in the year and months to come. So thank you so very much. All the witnesses that I have encountered in the past and the members that are on, so let me just be very clear, I'm now in the COVID epicenter. I am in what would be politely called Hades, not Haiti, but in an experience that we never thought we'd be in. We opened up on May 1st. The CDC guidelines were not adhered to, which is a consistent decline in COVID-19 cases. I get personal calls from constituents of members who have died at home or who died with, quote, unknown causes or something called pneumonia untested. Ms. Jackson Lee: (01:00:49) The federal government is pulling out from testing. We've only tested 2.5 million in a state of close to 30 million persons. I'm in the most populous county, the most populous city in the state of Texas. And I'm in the 18th Congressional District, which is the heart of these issues. So let me, I did give an opening and I'm going to ask for quick answers so that I can ask all of you. Let me say to the witnesses, that I am convinced of your position, Dr. Benjamin, on building up the public health infrastructure. I can assure you my public health officials say that. Ms. Jackson Lee: (01:01:32) But let me just ask you, when you said "get your hands around it" if you find a pandemic of this nature in a community, would it not add to a process of getting around COVID-19 or getting your hands around not COVID-19 for a reissuance of a stay-at-home order that then allows the medical professionals and others to understand where the hotspots are? Now, we've got a hundred firefighters in quarantine because of their exposure. We're in restaurants, we're in various places. Ms. Jackson Lee: (01:02:10) Let me just yield to you. What about a stay-at-home order, and you can answer it generically, I'm just giving you some facts. Dr. Wen, I'd like you to be able to focus on the fact that a Latin X population, the African American population are the higher numbers, but we have Latin X persons who work every day, children go to school that are undocumented scared with the posture of ICE, what should be said? I've asked for ICE to stand down. I've asked for the federal government. I've asked the White House task force to ask ICE to stand down. How dangerous is that when we have communities that are fearful of accessing healthcare and what should we do? Dr. Daniels would, excuse me. I'm so sorry, Dr. Benjamin, would you answer that question about the viability of stay-at-home order? Dr. Benjamin: (01:03:02) Yeah. Yeah. Yeah. Texas is in big trouble and you folks ought to have a much tighter stay-at-home order and mandatory mask-wearing anytime anyone has to go out. Look, it works. It absolutely works. Every nation in the world has demonstrated that it works. It worked in 1918. It's going to work again in 2020. But folks are playing too much politics with this. We cannot get the economy back until we get our hands around it. You can't get your hands around it until you stop the transmission of this disease. You get this disease from other people. That means we have to stay away from each other as much as we can in an organized way and then as we return, to try not to engage one another. We need to do so in a cautious, measured, controlled manner, facial coverings, hand washing, and physical distancing because that's what we have right now. Ms. Jackson Lee: (01:04:04) Thank you, Doctor. Dr. Wen, would you comment on that? And I guess you might add, I mentioned the testing point, the federal government is pulling out of testing here, transferring it to local vendors. I certainly welcome that, but we're not at that point. How important is testing, in addition to the question I gave you? Thank you. Dr. Wen: (01:04:21) The testing is- Ms. Jackson Lee: (01:04:22) The witness wants to answer that. I'm sorry. Wants to join in. Ms. Willis, please. Likewise, Dr. Wen, thank you for your service. Dr. Wen: (01:04:30) Congresswoman, thank you. Testing is absolutely essential. If you don't know who has the infection, how can you stop the spread, especially given that we know about asymptomatic transmission? A new study showed that up to 50% or even more of all the spread occurs with people who don't even know that they have it. So we absolutely need testing. States and local officials cannot do this alone. There's no way for them to ramp up testing without federal support and that's why FEMA support in this and leadership in this is going to be so important. Dr. Wen: (01:04:59) To the question that you raised, Congresswoman about Latin X and other immigrant populations, look, we cannot have policies that will scare people. We cannot have individuals for too terrified to seek care because they think that they or their loved ones are going to be deported. So you absolutely cannot have ICE have anything to do with testing. They cannot have anything to do with having medical records or being in hospital facilities or any healthcare facilities. And we also know that contact tracing in addition to testing is critical to reigning in the infection. So when somebody calls an individual and they're asking about their close contacts, they must be reassured that that information will never go to immigration officials of any kind. If we do not have those policies in place, then we're not going to be able to control the infection. Of course, this is a huge problem for exacerbating existing disparities, but it's also a problem for everyone in the country if there are some people who are too scared in order to receive care. Ms. Jackson Lee: (01:05:58) Mr. Chairman, if you would indulge me, I don't know if Ms. Willis wanted to answer the question. Mr. Chairman: (01:06:04) Your time has expired, but I will allow you another three minutes. Ms. Jackson Lee: (01:06:08) Oh, thank you, Mr. Chairman. Ms. Willis, just before you answer, I'd like to throw back after you answer. Dr. Benjamin and Dr. Wen, well, you know we're in hurricane territory. I don't want to wish it on us, but we don't know what to expect in the coming month, August, September. I'd like you to emphasize how important it would be, I think Dr. Wen in your testimony you talked about the different set-aside sites that might be for people who are asymptomatic or maybe who have certain conditions of COVID-19 that don't warrant hospitalization, but we're going to be in the middle of a hurricane. How do we deal with handling hurricane victims that need to be placed somewhere and take care of COVID-19? But I'm going to go to Ms. Willis first. If you all would answer that and after my three minutes. Thank you, Ms. Willis, if you want it to answer. Ms. Willis: (01:07:03) Yes, Ma'am. Very quickly, I would do say that when we focus on community-centered responses, we are more flexible, COVID-sensitive, and we have to have a desire to listen. So as emergency managers, we must incorporate those factors in dealing with communities, especially those who might have a fear of deportation or a general distrust of government. We must be sensitive and culturally competent. Thank you, Ma'am. Ms. Jackson Lee: (01:07:32) Thank you for the answer. Dr. Daniels, Benjamin. Daniels. Dr. Benjamin. Dr. Benjamin: (01:07:41) Yeah. Let me just add that obviously, shelters are clearly not ideal places when we have to ask people to shelter-in-place. And of course, we saw this with both Katrina and Rita. We've got to rethink and reimagine how we're going to protect people should we get hit with another hurricane or tornado, or anything that we have to evacuate people and move them, even the coastal storms that we have. We've got to figure out how we're going to make sure that they have access to hand-washing, how they're going to have access to potable water. How are they just going to handle waste? Is it going to be a big issue in light of the outbreak? Dr. Benjamin: (01:08:26) And we need to do that planning, we should've done it months ago. But if we don't do it now with a particular focus on communities that are most vulnerable, we're going to see huge outbreaks of disease. Trying to manage just a flu outbreak or any other infections virus in a conjugate setting is an absolute nightmare for managers. But we know the science. We know how to not make that happen. And I don't think we're doing that. I don't think we're planning for it. Ms. Jackson Lee: (01:09:02) Thank you. You have a few seconds, Dr. Wen. Thank you, Dr. Benjamin. Dr. Wen: (01:09:05) We keep on reacting to what's happened instead of anticipating what's ahead. And in this case, we know exactly what's ahead and we know exactly what we need to do to control COVID-19 in the process. And so I think that's something that the Trump administration with Congress's urging can really do. You know what's going to be coming our way and now is a time to prepare. Ms. Jackson Lee: (01:09:28) Thank you so very much. Mr. Chairman, thank you for indulgence. And I know that just to put on the record, the most important part of Congress's work is to pass the Heroes Act so that we can get resources out for PPEs, testing, hospitals, and others. And we really need to get past the obstruction and the blocking by the United States Senate so that we can pass that legislation and get signed for the people of the United States who need it. Thank you, Mr. Chairman. I yield. Mr. Chairman: (01:09:59) Absolutely. And our thoughts and prayers are with you in Houston. We know that you're really going through it right now. We had an in Jersey, so I know how horrific it can be. So hang in there and just hope we can get people to stay safe. Thank you. Ms. Jackson Lee: (01:10:15) Thank you for your kind words. Thank you. Mr. Chairman: (01:10:18) Absolutely. I have another question or two that I want to, if I may, and for all of you, it's in reference to school openings. The CDC has released guidance for United States K through 12 schools and children's programs to plan to prepare in response to COVID-19. On Tuesday, the President threatened to withhold funds from schools that did not reopen in the fall, and tweeted on Wednesday that he disagreed with the CDC guidance calling it "very tough and expensive." The White House is reportedly preparing its own school reopening guidance. And the CDC was reportedly considering modifications to its own guidance for schools. The administration's rush to reopen schools without following all of the necessary precautions is troubling, not just to policymakers, but also to parents as well. If schools do not reopen in a responsible way, what are the possible impacts on communities disproportionately affected by the pandemic? And we will start with Ms. Willis. Ms. Willis: (01:11:46) Thank you, Sir. That's an excellent question. This entire policy that the President is enforcing is actually, to me, very significantly traumatizing because I'm a parent. When I consider that my son will be exposed to COVID-19 because I am a single mother, because I do have to work, I am absolutely horrified. And I know that so many other Americans are in the same position, where you have to work, and so now your kids must be sacrificed. To me, it's similar to the time when the President forced the meatpacking industry back to work, knowing that they were going into dangerous circumstances, and there was nothing that could be done because they had to work. It's similar to slavery. When we think about the essential workers, and we think about what occurred in 1850 with the yellow fever. This concept of sacrificing those who are most vulnerable and those who do not have a voice, it's absolutely astonishing and it's an indictment against America. Thank you, Sir. Speaker 3: (01:13:01) Benjamin. Dr. Benjamin: (01:13:02) Yeah. Let me just add, we should never cut corners. Let's be real clear. I've looked at the CDC guidance, it is not too tough. It's a good baseline and they should not weaken their guidance at all. That's the first thing. Secondly, the issue around costs, it's probably the least affordable of our options because if we have a bunch of kids that get sick, even if they don't get real sick, they can't go to school. Their parents can't go to work. So all you have to do is have an outbreak in a second-grade class, all those kids are out of school, their teachers are out of school, their parents are out of work. So where's the savings? And their parent may get really sick. And so then there's a huge health, and both from a humanistic perspective, as well as a cost perspective for their medical care. Dr. Benjamin: (01:14:07) So I don't get the economic analysis. And by the way, he's not a doc. So quite frankly, we should listen to the professionals that know what they're talking about and not someone whose motives that I questioned. And I'm not making a political statement. I'm a physician and I believe that doctors and healthcare providers know what we ought to do. And then we ought to listen to us very well. I don't tell lawyers what to do. I don't tell teachers what to do. Speaker 3: (01:14:35) Thank you, Dr. Wen. Dr. Wen: (01:14:37) I agree completely with my colleagues. I'm also the mother of two young kids. I'm the daughter of a school teacher in Los Angeles, who has passed away, but she was a long time school teacher. And I just want to mention this in this context, it's about students, it's also about teachers and staff too. My mother had breast cancer. She was on chemotherapy for eight years while she was teaching full time. And I think teachers want to get back to in-person instruction, but there are many teachers will also have- Speaker 4: (01:15:03) ... want to get back to in-person instruction, but there are many teachers who also have chronic medical illnesses that we had to watch out for as well. And in this case, you mentioned, Chairman, about the CDC guidelines. If we're unable to meet the guidelines for safe reopening, the answer isn't, "Let's change the guidelines." The answer is, "What is the hard work that we're going to be doing in order to safely reopen?" Speaker 4: (01:15:22) I agree with Dr. Benjamin. We have already seen what happens when we cut corners. When we cut corners, we get rises, surges, explosive spread of infections. We should have already learned our lesson. When we muzzle scientists, when we do not listen to public health, people die. And to Miss Willis' point, the people who will suffer the most are those for whom it is not a choice to go to work. And who are they? It's African-Americans, Latinx populations, Native Americans, people of color, the ones who bear the brunt of the greatest health disparities and who unfortunately are suffering the greatest health disparities now, too. Speaker 5: (01:15:56) Thank you. And one last question. Reports continue to suggest that the Trump administration and FEMA are not adequately allocating medical resources, testing and other supplies to communities disproportionally impacted by the virus. What are some of the ways FEMA can improve its efforts to ensure communities disproportionately impacted by the pandemic are receiving all the necessary medical resources? Speaker 5: (01:16:29) And let me just add to that. I've been on this committee since coming to Congress in 2012 and I have watched FEMA move through different administrations. And a lot of FEMA's issue is who is in the White House right now and their hands being tied. So though FEMA has some issues they need to overcome internally, a lot of their problem is with the person in the White House and the restraints that he is putting on different entities of the federal government. But with that, what do you think FEMA is not adequately allocating in those areas? Miss Willis? Miss Willis: (01:17:27) Thank you, sir. That's an excellent question and an accurate observation. Politics influences emergency management way too much. The response from FEMA has been greatly influenced by the president, by the administration and in general by a lack of science in informed decision making. And unfortunately, politics drives a lot of what emergency management will do in terms of response measures, including recovery and relief measures. Miss Willis: (01:18:01) And unfortunately, within emergency management, equity is not a priority, it's not a core function of FEMA's mission. So the focus on vulnerable groups and using social determinants of health has never been a priority for FEMA. That needs to change. We need to begin focusing on equity and focusing on those groups who are most vulnerable. Once we do that, everyone will benefit. Studies have shown everyone benefits when we focused on those who are most vulnerable. Thank you, sir. Speaker 5: (01:18:36) Thank you. Dr. Benjamin? Dr. Benjamin: (01:18:39) Yeah. I'm always not in the room when they're making those decisions, but I do know for one thing is that FEMA really has to beef up its situational awareness. It doesn't work very well. They really have to improve their situational awareness and their supply chain management and their ability to make decisions very quickly. And when you have a really good emergency medicine function, it works extraordinarily well. But when you have one that is politicized, when you have one that is not simply doing things because it's in the right mode to help the public, when you think your job at FEMA is only to coordinate activities and not to understand that they're really an emergency response health agency, then they're going to fail. I used to run the EMS system for the District of Columbia when it was working. And the good news is, it's working now. And we believed that it was important to help people, to save lives.