alt=Lois M. CollinsSALT LAKE CITY — Medical supply shortages and production capability are on the mind of Utah’s junior senator as Congress considers how best to help public health experts deal with what’s expected to be a major outbreak of coronavirus within the United States.
Sen. Mitt Romney, R-Utah, wondered how Congress could best appropriate funds to be sure that both health care providers and the general public have access to tools to fight the novel coronavirus and COVID-19, its resulting disease. And those were the questions he asked Tuesday of public health officials during a hearing of the U.S. Senate Committee on Health, Education, Labor and Pensions. The hearing included experts from the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration and others.
Preparedness is not a partisan issue, Romney said, but rather one for Congress as a whole, because it provides funding.
In a major pandemic, the United States would need 3.5 billion N95 respirator masks and has about 35 million, Dr. Robert Kadlec, assistant secretary for preparedness and response, said in answer to Romney’s question.
“I’ve been concerned,” Romney replied. “It strikes me that we should have substantially more than 10% of what would be needed for a substantial pandemic. We should have that in stock.”
He laid the blame for any lack of resources on inadequate congressional funding, emphasizing that it’s not an administration issue. And he noted the problem of inadequate preparedness resources goes back to previous administrations, too.
Lawmakers are finalizing a $7.5 billion emergency bill to fund the government’s response to the coronavirus outbreak, which is sending shockwaves through the economy as it disrupts everyday life, The Associated Press reported.
Masks and their proper use came up several times in the hearing.
How much they help depends on the mask and how it’s used, according to Dr. Anthony Fauci, longtime director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
“If you look at the N95 masks, they’re much better than those sort of floppy masks,” Fauci responded to Romney’s question of whether the public would be protected by masks. But he emphasized that the main purpose of those masks is to prevent someone who is sick from infecting others — and to protect health care providers taking care of those who are ill.
They could also prevent “gross droplets” when someone coughs and sneezes on you, “but it doesn’t provide the kind of protection people think it does.” And there’s a downside because people fuss with and misuse masks, he said.
The senator also wondered about exposure to illness on airplanes. Dr. Anne Schuchat, CDC principal deputy director, said experts believe the coronavirus would only reach people in a couple of rows each way, while other infections could spread further.
The panelists predicted that production of a vaccine that successfully made it through phase 1 and phase 2 clinical trials could take a year or more to ramp up. When Romney asked who had the capability for mass production, Fauci said it would fall to major pharmaceutical companies.
“The federal government is not going to be able to make hundreds of millions of doses. It’s going to have to be a partnership with the private sector,” Fauci said.
“Do we have that capacity?” Romney asked. “Is that capacity outside the U.S.? I am looking for whether legislatively or from an appropriations standpoint we should provide funding to make large numbers of vaccines in the U.S. and have it ready to go in case. If this isn’t the pandemic we’re worried about — if another one comes down the road — is this something we should have ready to go?”
“Yes, sir,” Kadlec agreed. He said America’s mass capacity right now is limited to egg production, which is used in some vaccinations, but not in the potential vaccines being tested against this novel coronavirus. Because of that, “we have a longer-than-six-month wait to produce vaccines on scale.”
Questions from other committee members ranged from how testing is managed — and restricted — by the CDC to whether money allocated for surveillance is also being used for other purposes. Several expressed concern that testing is not yet “up to scale,” and whether cases might be missed as a result, increasing the possibility others will be infected.
Fauci said confusion exists about treatments and vaccines in the pipeline. He told the committee that about 80% of those infected have recovered on their own without special help. But between 15% and 20% need “supportive care,” ranging from oxygen to intubation and other medical interventions.
“So we want desperately to have a therapy for these individuals,” he said, noting “candidate therapies” being tested in randomized trials, including remdesivir, developed by Gilead. The drug is being tested in China in a large trial, as well as in a National Institutes of Health trial in the United States.
Fauci said it would be several months before it’s known whether it works against coronavirus in humans and whether it’s safe. If the answer to both is yes, it could be fast-tracked to quick availability. Other drugs are also being tested against the virus and COVID-19.
The timeline is different for a vaccine, but development, he said, will be “the fastest that we’ve ever done.” He said a vaccine is likely to be in a Phase 1 clinical trial within about two months. But it will still take time to prove safety and efficacy and ramp up to being available to the public.
Experts have said a vaccine is likely a year or more away.
Sen. Patty Murray, D-Washington, told the public health experts that she was frustrated about the lack of testing for coronavirus in her state, the hardest-hit so far, with seven deaths.
“It’s unacceptable that people in my state and nationwide can’t even get an answer to whether or not they are infected,” she said.
FDA Commissioner Stephen Hahn told the senators that testing capability would be scaled up greatly this week, with ability to perform a million coronavirus tests by the weekend.