i am a public health data. unlike senator hickenlooper, who was a mayor, or if the chair who was a mayor, we have the experience of seeing silos and state health systems or federal health systems that do not share well with each other. and you have providers too. that created huge challenges for us early in covid. just to run back the tape. at the beginning of covid, it was hard to even get racial information of those getting covid into dying from it. it took a wild to realize and some jerry rigging to realize it was affecting african-americans and latinos more than others. but we did not know that right away. with a better health data system, we would have. often minorities are low income and have had less health care and access -- health care access, which has given them more comorbidities and make them susceptible to covid. they often worked jobs where they cannot just go virtual all so they were more susceptible. it took us a while to figure that out. but we did figure that out, and began vaccinating beginn

let's use our words carefully and let's so trust in public health measures. let's go back to understanding that this virus spreads from airborne or aerosols to the public and that any covering blocks that aerosol from leaving your mouth. some coverings are better than others, others aren't as good but by reducing those molecules you reduce the risk of transmission so yes, masks help to reduce the risk of transmission. just like if there are, if these molecules are transmitted by your mouth when you speak, you cough, you scream or sing and the further you are the less likely you are i being infected with adroplet . ngthat will either breathe in through your mouth, your eyes . so yes, in these circumstances social distancing is a preventative measure. so vaccines do work. vaccines are safe. i do not wish anybody regardless of whether i natural infection can cause a more robust immune response to go and get infected or two want to get infected or to disregard the importance of a vaccine. i don't want a republican or a democrat for anybody to get the symptoms, to

. >> up next to us when it from top public health officials on preparing for future public health emergencies. cdc director dr. rochelle walensky warned about the implications of the current public health emergency ending on may 11. the senate h.e.l.p. committee also hear some fda commissioner robert caleb about lessons learned from the covid-19 pandemic. this is just over two hours and ten minutes. [inaudible conversations] [inaudible conversations] [inaudible conversations] >> okay, thank you. the senate committee on health, education, labor and pensions will come to order. this afternoon we're going to chear from two panels. we're going to hear from on a first panel dawn o'connell the assistant secretary for preparedness and response. rochelle walensky the director of the centers for disease control, and dr. robert califf the commissioner of the fda. our second panel we will hear from doctor -- and will hear from robert wiseman and martin kerry. so we have two very, very important panels. let me begin by thanking all of the folks who were on the first panel. all oft us know that the last t

>> we need an apology from public health officials. we need to have scientific debate not using censorship, but instead using scientific evidence and i think we need some humility to public officials. neither vaccinated immunity or natural immunity are perfect, let's not try to suggest the other side is evil. but it's not an either. we can be honest with the public about the data and still recommend safe practices today. ... end safe practices today. >> i thank you for being here today and mr. chairman, i yelled. >> we now recognize dr. jackson from texas. >> as discussed in this hearing, the science he had at the time when vaccine mandates were put in place, supported and not only provided protections but looks like you provided superior protections compared to immunity were -- required by the vaccine. this is also something that we probably knew was true based on many other studies of other coronaviruses such as sars and mers. the natural immunity was >> was not used -- was not disregarded in the healthcare system. i want to point out

for the sake of public health. for the sake of our neighbors regardless of the political affiliation, i am poor everyone here today to remain focused on the facts and come together to identify real solutions to put people over politics, to prevent future harm, to save lives and ensure america is stronger and bader -- better prepared in the future. thank you. >> thank you dr. release. our witnesses today are dr. marty mcgarry. he served in leadership in the world health organization safety program, elected to the national academy of medicine and published more than 250 peer-reviewed scientific articles. dr. marjorie's mogensen. express these and infectious disease -- expertise and infectious disease. completed her postdoctoral fellowship at the university of california san diego. dr. tina tan. she is a board-certified certified pediatrician as well as current professor pediatric and infectious diseases in chicago. pursuant to committee on oversight, the witnesses will please stand and raise their right hand. do you

buck up next test my top public health officials are preparing for future public health emergencies. did you see director warned about the implications of the current public health emergency depending on 11th but sent health committee also hears from commissioner about lessons learned from the covid-19 pandemic. this is just over two hours 10 minutes. rusmac hey, thank you. the senate committee on health education and pagers will come to order. this afternoon we are going to hear from two panels. we are going to hear from our first panel the assistant secretary for preparedness and response. the shot will instigate the director centers for disease control and doctor robert the commissioner for food and drug administration. our second panel we will be hearingat from them will hear fm robert wiseman and martin carey we have two very, very important panels. let me begin by thanking all of the folks who were on the first panel. all of us know the last three years have been unprecedented in our lifetimes where we with the worst public health crisis 100 years at the thank all of you under

y graduate school of public health and health policy. he is also a full, i'm a senior technical officer, so communicable diseases for the world health organization. i will welcome uh, 2 or 3 of you. thank you very much for being here on inside storage. if i can. uh, begin with. you place being a full uh w, i, cio, employee. do you think that this is a confusing or conflicting message from the w? i chart, i mean, saying on one hand it's no longer a public health emergency, but also trying to convince people and governments around the world to still consider this a very real threat. it's a very confusing message for most people, some governments, but certainly for the general public. we have to remember that w h o declared the public health emergency of international concern in the context of the international health regulations. when there's a health threat that okay, that it's such a big risk to other countries in terms of spread of infection and mortality that it calls on countries to collaborate internationally. so we're, we're already

witnesses to help us better understand the serious threat that antimicrobial resistance causes to public health. it is not a new phenomena, it has been vexing scientists in congress for years, however, it has been increasing across the board and imposes health risks to the public. according to the center for disease control and prevention, more than two point eight americans have an infection in 2019 and one and 35,000 americans died from the infection in these numbers are expected to grow as more and more dangerous organisms develop resistance to the treatments available today. and that is deeply concerning tower public health. there is not seem to be one obvious solution to the issue and it cuts across the board to how we identify resistant threats to how we administer available drugs while also fostering the developments of new treatments. the challenging balance between withholding certain antibiotics for patients in order to avoid unintentionally promoting more resistant strains of bacteria and providing the patients the best treatment available. in terms of developing new treatments, the

public health from harvard school public health or from the harvard medical school.perhaps one of the suggestions would be to entertain the career options for public health and physicians and medical scientists to join the intelligence communities in doing the research ezell. >> i think that would be a good day. also know recruit when i i goy degree from harvard history department. we have to rethink how we recruit so going to medical schools, public health policy schools would be a very good idea. >> thank you. i yield back. >> i now recognize the chairman of the full committee mr. comer from kentucky for five and is a question. >> thank you, mr. chairman. what you think each of the witnesses for being here today. as i said from the beginning discovering the origins of covid-19 is vital to both the public health and national security of the united states. former cdc director redfield testified last month this is not simply a scientific question but also one of intelligence and i agree with that. we need to ensure the intelligence is accurate and truthful. on march 1

firearm injury is a major public health crisis, and just like all other public health crises, we have to invest money into research to figure out how to bend that curve, how to reduce lives lost. i have to emphasize this is not a political issue at all. this is a public health crisis in the same way that we would invest in cancer, the same way we would invest more in clean water, or seatbelts to reduce deaths from motor vehicle crashes. it we are focusing -- host: we will go to some questions we are receiving for you. their first one is via twitter. "how do physician quality reports impact us? our surgeries being denied for riskier patients for fear of impacting physicians' quality scores?' guest: that is a great question. one thing that is different about the american college of surgeons database is we do something called risk adjustment. we did not give numbers of complications or deaths after a certain procedure. we include patient factors. did that person have diabetes? how old were they? we fold into that the complexity

private procurement of another vaccine that of influenza these initial vaccine prices following the public health emergency period will likely be the floor for the price hikes in the future so what must congress include to protect the american public and their investment? first should empower federal government to exercise necessary leverage withouter getting funds for the countermeasures and negotiating procurement contracts. through the purchasing agreements the government could mitigate thenm substantial price increases during negotiated lower price as they did during the covid pandemic. the two prevent the prices from continually rising year after with othery have vaccines, the government should call for the price to be upheld. additionally what they've been able to negotiate and a few contracts the government could also ensure manufacturersnt give them the best price compared to that ofo other countries. besides the pricing provisions the federal government must also conveys access and compliance safeguards within the contracts under the flexibility and speed. the use of contracting mechanis

markary focuses research and public health and healthcare derivative issues range from contra costa covid-19. covid-19. he proves it worked the world health organization or help develop surgeons checklist which is help reduce surgery related deaths around the world. he completed his medical training at georgetown johns hopkins and is the author and co-author of over 250 250 peer-reviewed papers. dedicate that right? pretty impressive. look for hearing from you today. thank you for joining us. thank you. thank you, senator sanders, thank you ranking member cassidy and thank you, senator markey that it's a privilege to present. i speak him have a soft and not johns hopkins university for the national academy of medicine of which i am a member. congress should avoid the false narrative that insufficient federal findings were to blame for our pathetic covid response. take for example, one johns hopkins student created a cobra tracker that the world used, and it was not created by the 21,000 employees at the cdc. as a bad effect when hhs met with the cdc, they said it would take months to crea

every single day i appreciate his work and at this time, i want to introduce the director of the public health doctor. >> well, good morning everybody and thank you, mayor. broebd and senator haney the health agency across california statewide from the devastating opioid crises and we're talking to assembly member haney i have a clinic across the street and an hiv clinic and for years with hiv we which somebody turned positive became infected with hiv we waited for years or months or years before we starting medication and recently a person find out they were perfect positive and gave them a package explained how to do it and literally no barriers on demand we realize that model for hiv in san francisco this is a major step and that model for the treatment of substance abuse disorder and that is why we really need to think all the tools to reach people where they are and every door is truly the right door to make sure the treatment an demand a right and an incredible importance last year 6 hundred and 47 people died from this within our city and 70 percent two quarters involved finally and yet

standards are needed now because the science is clear, this pollution poses serious threats to public health. the tragic outcomes include premature death, respiratory illnesses like childhood asthma, cardiovascular problems, and other detrimental health impacts. the trucking industry is leading source of this dangerous air pollution. and is especially dangerous for the 72 million americans who live near truck freight routes across the united states. the e.p.a. rule will cut knox -- nox pollution from these vehicles by half by 2045. that will make a huge difference because one in three american lives in counties with unhealthy air and the 100,000 americans die every year from premature deaths associated with air pollution. this harmful air pollution has negative repercussions for all americans, but especially dangerous for our most vulnerable communities, children, the elderly, low-income communities, and communities of color. now the e.p.a. rule is a critical tool to protect these americans, improve public health outcomes, and secure the right to clean air for everyone. this rule is expected

work and other global health challenges, i spoke to dr tom frieden, the former head of the us public healthn, thank you so much for taking the time to speak with us today. i want to start off by asking you about this announcement from the world health organization that it will be launching an international pathogen surveillance network. can you just begin by helping us understand exactly what that is and how that might help us prepare for a potential pandemic in the future? carl, we're seeing some encouraging developments, really a commitment to collaborate globally, to share information, to share resources, and even more importantly, to build capacity in countries around the world, because even the strongest network in the world will only be as strong as its weakest link. that's why it's so crucial that we build capacity in country. this particular network is looking at things such as genomic surveillance, tracking the genomes of different microbes, seeing, as we've all learned, the different variants of covid, looking at waste water surveillance, looking at surveillance for pathogens that

eastern time the title 42 public health order will terminate. at that point we want to get him process at our southern border using our immigration enforcement authorities under title eight of the united states code. our overall approach is to build lawful pathways for people to come to the united states and to impose tougher consequences on those who choose not to use those pathways. we are taking this approach within the constraints of a broken immigration system that congress has not fixed for more than two decades. without the resources we need, personnel, facilities, transportation and others, that we requested of congress and that we were not given. we have seen the effectiveness of our approach. more than 100,000 people from cuba, haiti, nicaragua and venezuela have arrived lawfully through the pathway we have made available to them and we reduce border encounters from these groups by 90% between december of last year and march of this year. our president has led the largest expansion of lawful pathways ever. at the same time we are clear

so i'm a public health nurse and. i was with the university health system when the started to make a tremendous. so thank you for mentioning it. but my question is over over my lifetime social movements have happened. you know, the civil rights movement many in i think it was 2017 when there was a movement to replace obamacare and there was seemed to be a movement where people did not want that. so wondering is going to take a social movement for us to really rethink and restructure health care, health and health that's a that's a really good that i i'm one of these people that hopes that it doesn't that we can like we just pound the pavement people like let people know that there's unity to large extent. you know, in people knowing that the health care system is broken, people knowing that they're paying too much for it people, recognizing that interests are above patient interests and that spreads across both parties. you know, now going to be like what's going to catalyze that? that's a great i hope that at the gras

>> it is a big week for public health.l public health emergency ending is basically administrative and financial. it is a key mechanism within global health security. officially it means ending the mobilization of international coordination. funding, advancing vaccines, etc.. unofficially, it is one of the strongest signs the who sees covid-19 as a threat in our repertoire of things trying to kill us every day. it is really quite a monumental moment. it is important to recognize what it does not mean. you touched on this a little. it does not mean covid-19 is gone. sars-cov-2 is mutating about twice as fast as the flu. it means we are going to get future waves. we may get a big tsunami also from another variant of concern, which would be pie. like you said, we cannot ignore the fact covid-19 is a leading cause of death for americans and people around the world. to me as an epidemiologist, our work is not done. but this is a monumental moment. some time for reflection, as well >> there is confusion about what to do. how to

so, they can have more success tomorrow. ♪ one thing leads to another ♪ >>> the covid-19 public health thursday without f fanfare, but because of the changes in public policy that go along with it, we will feel it. you'll feel it in your wallet. covid tests won't be free anymore. people covered by medicare or private insurance are no longer guaranteed free the at home toast tests and could be charged for lab testing. you may have to pay for treatments. treatments bought by the federal government will be available at no charge as long as supplies last. that also goes covid-19 v vaccines. once the supply runs out, the affordable care act and other laws will keep them free for most people. now other changes can prevent public health officials from keeping the country safe from the next pandemic. labs across the country no longer require to report coronavirus test results to the cdc. hospitals and state agencies won't have to provide the federal government with comprehensive data needed to detect and respond to public health threats. joining me to talk about what all this means for public

do you think it has _ public health as well. do you think it has become - public health as well. health as well. do you i think it has become more, our awareness of loneliness is more acute because of the pandemic? i think we are perhaps more aware of it because we all had aware of it because we all had a personal experience we we have either ourselves suffered or someone we know that is close to but these trends were beginning many indicators of social increasing and so, a problem is will.— social increasing and so, a problem is will. does there need to be _ problem is will. does there need to be public— problem is will. does there need to be public policy - problem is will. does there need to be public policy inl need to be public policy in place to encourage community and encourage people to connect?— and encourage people to connect? ~ ~ , ., connect? we think the small ste -s connect? we think the small steps there _ connect? we think the small steps there are _ connect? we think the small steps there are other - connect? we think the small steps there are other people can ta

preparedness, disaster response, and other major threats to our public health. population health provides a limited number of our city and countywide direct clinical services, like our adult immunization and travel clinic, city clinic, tv clinic, and the public health lab. the san francisco health network comprises of bulk of direct health services provided by the department of public health. each year the network serves more than 120,000 san franciscans throughout our clinics and hospitals and our other clinical programs, which i'll discuss today. i also want to note in acknowledgement in the request to look back on dph investments in omi, lakeview/omi in district 11, over the past ten years, we did have challenges gathering information. we really rely on our electronic health record, which we began to implement in 2019 and so, it's hard to look before 2019 and after 2019 and compare data to come up with things like unr -- like un-duplicated patients. health services is next to come, so we use different health records, which created some challenges in looking ov

the boards of illumina and pfizer doctor, good to have you back in a practical sense fo of the public health >> probably not a lot of the practical impact for most americans. the administration has takeno es that i think had the most immediate impact upon people's lives.ility around health care through telehealth the dea issued a rule that they will also extend provisions that will allow controlled substances to be prescribed through telehealth services. i think the most immediate impact is going to be a decline in medicaid enrollment because the public health emergency allowed states to continue to enroll people into medicaid. that continuous enroll cement going to now end as a result of the lifting of the public health emergency and you'll start to see people get taken off of the medicare rolls there's some estimates by the keiser foundation and also by the department of health and human services that upwards of 15 million people could lose medicaid coverage over the course of the next 15 years. that will put some pressure on hospitals and providers not to mention individuals that could lo

work, and other global health challenges, i spoke to d tom frieden — the former head of the us public healthe to speak to us today. i want to ask you about this announcement from the world health organization that it will be launching an international pathogen surveillance network. can you begin by helping us begin to understand what that might mean? ~ . , understand what that might mean? ~ ., , mean? we are seeing some encouraging — mean? we are seeing some encouraging developments. j encouraging developments. really, a commitment to collaborate globally, to share information, to share resources, and even more importantly to build capacity in countries around the world. because even the strongest network in the world will only be as strong as its weakest link. that is why it is so crucial that we build capacity in countries. this particular network looks at things such as genomic networks, tracking the genome of different microbes, looking at waste water surveillance, looking at surveillance, looking at surveillance for pathogens that could cause death and devastation, and it can be prevent

because i -- would expect this future behavior past mayor and public health and limited rolls royce planning resources lead mow to believe not with standing my strong sdoir to have a laguna handa worth of mental health facilities rolling out in the next 5 years. my sense we have a huge night for it. yea, i think it it is entirely possible that even with supervisors pushing for it and the administration buying into it, this there will in the be the ability for the department of public health and whoever needs to figure out operating costs and the design and the mix of facility and not locked facilities and where they go and how that would work. i can imagine we would roach a point we are like, we have the housing needs we know we have them and should put this money in to actual housing projects this will get builteen he the critical kroiing ned in san francisco now and in california. and my view is for longer term if sill isfor mental health and a need we continue not to meet. things get worse and san francisco's biggest problem. this being said witness the machine sein the housing boinld con

increased frequency of outbreaks means we should not be asking if we will face another serious public healthen and how many? covid-19 is not gone even with the health emergency over, according to the cdc. still, 1000 americans are dying from the virus every week in washington, lauren blanchard, fox news. and from more now we are joined by dr peter chunhong , infectious disease specialist at ucsf, doctor. always good to see you. we appreciate the time certainly the end of the public health order. the public health emergency in this country feels like a symbolic and to the pandemic for a lot of people. i'm curious to get your perspective here. how do you view it? is this the end of covid? it's certainly not the end of covid. alex is that last reporter said it's still a public health threat. it's just not front and center in our minds and consciousness anymore . i think we need to be vigilant and open minded doesn't mean we have to be afraid or change our ways. but i think you know in the winter we might get another surge. as the reporter said, we may get and it's very likely we're going to get

preparedness, disaster response, and other major threats to our public health. population health provides a limited number of our city and countywide direct clinical services, like our adult immunization and travel clinic, city clinic, tv clinic, and the public health lab. the san francisco health network comprises of bulk of direct health services provided by the department of public health. each year the network serves more than 120,000 san franciscans throughout our clinics and hospitals and our other clinical programs, which i'll discuss today. i also want to note in acknowledgement in the request to look back on dph investments in omi, lakeview/omi in district 11, over the past ten years, we did have challenges gathering information. we really rely on our electronic health record, which we began to implement in 2019 and so, it's hard to look before 2019 and after 2019 and compare data to come up with things like unr -- like un-duplicated patients. health services is next to come, so we use different health records, which created some challenges in looking ov

it's a little different for public health foundation, in both cases they adhere to administration fees and public foundation adheres to a sliding scales as the donations gets bigger and admin gets low are because they felt more comfortable and doesn't need as much flexibility to wrap up fundraising effort in particular, but jennifer will speak more to that. lastly, i apologize. i think that was the last thing. but happy to take any other questions. >> all right. thank you. before we go into public comment or commissioners comments, do we have a motion to approve the mou. >> i move to approve the mou. >> is there a second? >> second. >> any public comment. >> i don't see hands. we're on item seven, press star three if you would like to make public comment. no hands, commissioners. >> commissioners, any questions or comments? >> i wanted a follow up. the san francisco general foundation puts out these letters that ask for donations into their fund. so, your template looks very daunting, you know, normally you would put in $100 and sign your name, do they have to check off boxes they they

. . ., , comes to building better public health. ., , ., . , comes to building better public healthis pretty simple — health. the always on concept is pretty simple and _ health. the always on concept is pretty simple and that _ health. the always on concept is pretty simple and that is - health. the always on concept is pretty simple and that is it - health. the always on concept is pretty simple and that is it is - health. the always on concept is| pretty simple and that is it is not efficient to wait for the next pandemic to come and be spread around the world, that's start to build up the capabilities to respond to it which is what we did the last time. it is far better to have activities which are running in peace time to deliver really good public health interventions, for example a system whereby we are looking for a wide range of different infectious diseases on a routine basis, using genetics, and then that can pivot to identify new pathogens if they appear in intensive care units. that could be running all the time in the background i could allow us a real head start in id

>> we know from public health research that being denied a wanted abortion threatens women's health. there is a study called the turn away study that found that women who are unable to access a wanted abortion experience long-lasting health harms from being forced to carry the pregnancy to term. two women in the study who were denied abortion care died following childbirth. that study was pre-dobbs. what we know from the most recent data on the impact of abortion bans post dobbs is there has been a significant reduction in the number of abortions happening. more women and pregnant people are being denied a wanted abortion and suffering these health harms. society of family planning, resource organization, conducted a study called the "recount" study. it said that in six months following the dobbs decision, 5000 400 fewer abortions happened each month in the u.s. that is a huge public health impact on people seeking abortion care and not able to access it. what we are also seeing post dobbs are public health harms that reach even more broadly. abortion bans are obstructing access to h