Testing High on the Agenda at House COVID-19 Hearing

WASHINGTON — “Testing” was the word of the day at Tuesday’s House Energy & Commerce Committee hearing on the federal government’s COVID-19 response, with committee members on both sides of the aisle agreeing that the current level of testing was not good enough.

“Testing has been a problem since the beginning, and while it’s improved, we are still falling far short of the 900,000 daily tests public health experts believe we need,” committee chairman Frank Pallone (D-N.J.) said in his opening remarks. “We are also hampered by the administration’s refusal to develop and implement a national testing and contact tracing strategy. This cannot continue — we need federal public health experts to take more of a leadership role, and this administration is failing to allow that.”

“COVID-19 has laid bare how vulnerable we are and how much more work we need to do as a government,” said Rep. Greg Walden (R-Ore.), the committee’s ranking member. “Six months ago, we’d barely heard of this virus … We quickly went from knowing little about this virus to creating a test for it, and testing more than 25 million samples, with recent averages of more than 500,000 tests a day, but we all know there’s more to be done.”

No One Told to “Slow Down” Testing

The witnesses — including former White House COVID-19 testing czar Adm. Brett Giroir, MD, were also on board. “My purpose is to increase the number of tests; the only way we’ll be able to understand who has the disease, who is infected and can pass it, and to do appropriate contract tracing, is to test appropriately, smartly, and as many people as we can,” Giroir said in response to a question from Rep. Diana DeGette (D-Colo.).

DeGette also asked the witnesses about a remark by President Trump on Saturday that he told his administration to “slow the testing down.” “Neither the president nor anyone in the administration has instructed or suggested we should do less testing; we are proceeding just the opposite,” responded Giroir, who is the assistant secretary for health at the Department of Health and Human Services. “We want to do more testing, and higher quality.”

DeGette asked witness Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), about the suggestion by some that although there have been some recent spikes in new COVID-19 cases, there’s less to worry about because deaths are decreasing due to the fact that many of the new cases are in younger people. “I think it’s too early to make that kind of link,” Fauci said. “Deaths always lag considerably behind cases … You’re seeing more cases now, while deaths are going down. The concern is, if those cases then infect people who wind up sick and go to the hospital, it is conceivable you may see the deaths going up.”

Rep. Ben Ray Luján (D-N.M.) wanted to know how testing was going to increase. “We’ve been hearing bold proclamations of promises of increased testing for months now, and every time they’ve come up short,” he said to Giroir, who had earlier stated he expected the U.S. to be testing 40 to 50-million people a month by the fall. “What’s going to be different moving forward, and how does the U.S. get to the 50-million-test promise?”

“I disagree with your question; I don’t believe we’ve come up short every time we’ve said something,” said Giroir. “Right now we’re doing about 15 million tests per month…. When I tell you 40 to 50-million tests, that’s because I know every single lab, producer, what they’re doing, when they’re providing it, how they’re going to distribute it…. The capacity will be there for 40 to 50 million tests at least in the fall. Hopefully it will be much greater than that.”

Withdrawal from WHO Raises Concerns

But while testing was a major subject in the hearing, it was far from the only one. Rep. Jerry McNerney (D-Calif.) asked about the White House announcement that the U.S. would be withdrawing from the WHO. “I was not specifically consulted about the withdrawal or attempt to withdraw,” Fauci said. “We have a longstanding relationships with the WHO. The NIAID is a collaborating center…. [CDC Director Robert Redfield, MD] and I are on a weekly call supervised by the WHO where we get the opportunity to speak to medical leaders in various countries.”

Redfield said he wasn’t consulted directly either. “CDC has a long history of working with WHO; we continue that collaboration” in areas such as polio eradication and influenza surveillance across the world, he said. “We continue working at the scientist-to-scientist level.”

Fauci responded in the affirmative when asked if he had concerns about the withdrawal. “Yes I do; despite any policy issues that come from higher up at the White House, we at the operational level continue to interact with the WHO in a very meaningful way, literally on a day-by-day basis,” he said.

Rep. David Loebsack (D-Iowa) asked Giroir whether he thought healthcare providers now had the personal protective equipment (PPE) that they needed. “Today at this particular moment, I do believe they have the supplies they need,” said Giroir. However, in case the current COVID-19 wave gets worse, or a second wave comes, the administration is increasing the Strategic National Stockpile to make sure there is 90 days’ worth of supplies available, including PPE, he added.

Many More Cases Are Coming

On the subject of a second wave, the witnesses generally agreed more cases were coming, although they didn’t use the word “wave.” “We are going to experience significant coronavirus infection in the fall and winter of 2020 and 2021,” said Redfield. Fauci said that “there will be coronavirus infection in the fall and winter because the virus is not going to disappear.”

Rep. Bill Flores (R-Texas) didn’t shy away from partisan finger-pointing, noting the top seven states that account for 60% of COVID-19 deaths are all governed by Democrats. “It’s obvious that some governors made big mistakes, but we’re not hearing much about that today,” he said. “While those governors were complaining about President Trump, they were ignoring their own populations.”

He tried to get Fauci to comment on which state had the better approach: New York — which has a Democratic governor — where the Health Department ordered nursing homes to accept COVID-19 patients that had been discharged from hospitals; or Florida — which has a Republican governor — where the state set up isolation centers for COVID-19 patients. “I don’t think I’m in a position to evaluate that,” Fauci said.

Rep. Kurt Schrader (D-Ore.) said a lot of people were hanging onto the hope that a vaccine would take care of everything. “I’m very worried that many, many Americans are waiting until there’s a vaccine” — which they think will take a year or year and a half — “and that’s going to be a panacea, that it’s all going to be OK. I’m not blaming anybody here, but that’s a terrible miscalculation on the part of many Americans.” Instead, a vaccine could take longer than that, and it will just be one tool in the toolbox, he said.