Experts testifying Tuesday at a hearing highlighted several steps, like sustained funding and improving vaccine development and distribution, that must be addressed to prepare for the next wave of COVID-19 or another pandemic.

Witnesses addressing the Senate Health, Education, Labor and Pensions Committee largely agreed about what needs to be done by the government and private sector to prepare for what could come next.

“Memories fade and attention moves quickly to the next crisis,” Senate HELP Chairman Lamar Alexander, R-Tenn., said in opening remarks. “That makes it imperative that Congress act on needed changes this year in order to better prepare for the next pandemic.”

The witnesses — former Senate Majority Leader William Frist; Joneigh S. Khaldun, Michigan Department of Health and Human Services chief medical executive and chief deputy director for health; Julie L. Gerberding, executive vice president and chief patient officer at Merck; and Michael O. Leavitt, a former Health and Human Services secretary and Utah governor — all called for more sustained public health funding.

“Our second pandemic might come in about three months, so that’s why it’s important to do what we’re doing,” said Frist, who is also a physician.

He suggested a mandatory yearly appropriation for public health of about $4.5 billion.

“We need to make sure that we find a budget mechanism that allows the sustained funding to not be subject to budget caps and not be something that gets involved in horse-trading when the budget process rolls around every year,” said Gerberding, who is also a former Centers for Disease Control and Prevention director.

Action needed on vaccines

Public health officials and scientists have said a COVID-19 vaccine is critical for a return to normalcy, and the experts at Tuesday’s hearing explained multiple steps that need to occur to make a vaccine deployment successful.

“If we want to end a pandemic, we are going to need a vaccine that’s feasible and produced at large scale. We need a vaccine that’s ideally successful in a single dose,” said Gerberding.

She said a COVID-19 vaccine must be durable so that the protection lasts beyond a few weeks or months and stands up to any possible mutations.

“We must not sacrifice safety for the sake of speed. I think that is going to be a very important component about the communication of the safety of the vaccine,” Gerberding said.

She recommended building up emergency capacity to produce vaccines through private-public partnerships.

Senate HELP ranking member Patty Murray, D-Wash., asked her about growing concern that the public may be hesitant to receive a vaccine because of the accelerated schedule of Operation Warp Speed, the Trump administration’s vaccine development initiative.

“What specific commitments should the administration make right now to build confidence in a vaccine?” Murray asked.

Gerberding suggested that the safety of the vaccine could be monitored by the National Academy of Medicine.

“Involving the scientific community, credible experts apolitical in orientation, is really going to be an important part of building this trust,” she said.

Other recommendations

The witnesses’ other suggestions were also largely aligned and similar to a white paper that Alexander released earlier this month.

Khaldun said Michigan has had issues receiving necessary supplies and that equitable access is necessary in preparing for any future pandemic. She recommends building out the national testing structure and infrastructure. 

“We still struggle with the limited number and types of supplies we receive from HHS and FEMA,” Khaldun said. “A national procurement and testing strategy would have prevented state and local governments from competing with each other and avoided one of the most outrageous realities of this pandemic — turning people away who should have been tested.”

Frist called for several actions, including clarifying who’s in charge of communication. He and Gerberding said the federal response should be led by the National Security Council. CDC should remain apolitical, he said.

He also said surveillance must be improved so the federal level can better track outbreaks, and he recommended public-private partnerships with industry, building out the supply chain, improving research and development, and ensuring that telemedicine remains accessible.

Leavitt emphasized that everyone must have a pandemic plan, not just the federal government. Since pandemics are intensely local, he said, business, local governments, churches, and other entities also need to prepare in advance.

He also said the roles of state and federal governments in mitigating a pandemic need to be clarified in advance to prevent confusion and the information-gathering capabilities of the federal government need to be fully funded and modernized.