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WASHINGTON — Congress, in a rare show of bipartisanship, is gearing up to try to prevent the next pandemic.

Already, a duo of powerful senators has pledged, publicly, to work together on legislation that will “make sure nothing like [Covid-19] ever happens again,” as the influential Democratic Sen. Patty Murray (Wash.) put it. They will work, too, to diagnose the problems and important lessons to be learned from Covid-19. There are several potential ways they could seek to pass a future bill, including attaching it to a major infrastructure package President Biden is planning to push this year.

Murray’s Republican counterpart atop the Senate’s health panel, Sen. Richard Burr (N.C.), even hired a top Trump administration pandemic preparedness official to help with the work. Robert Kadlec, who had a front-row seat to the pandemic as Trump’s HHS assistant secretary for preparedness and response, will soon advise the Senate health committee, a committee aide confirmed to STAT.

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The lawmakers’ public commitment is the clearest indication yet that the coronavirus pandemic may, as public health advocates hope, snap lawmakers out of a longstanding pattern of funding public health programs in a panic, then letting dollars lag over time.

“While Covid response funding has been extremely important, it is not a substitute for sustained funding. You lose people, and you lose expertise. You don’t need to update your technology once, you need to do it over time,” said Dara Lieberman, the director of government relations for the public health policy group Trust for America’s Health.

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Bankrolling preparedness efforts for short periods after devastating events is like “getting smoke detectors when your house is on fire,” said Dante Disparte, a member of the Federal Emergency Management Agency’s national advisory council.

Congress has passed pandemic preparedness legislation before, and America was still woefully underprepared when Covid-19 actually tested those systems. That’s why it’s also important to invest in transformational changes instead of just buying more N95 masks or giving more funding to public health agencies, according to Michael Osterholm, a prominent epidemiologist at the University of Minnesota and former Covid-19 adviser to Biden.

Murray, a no-nonsense operator who doesn’t actively seek the spotlight, will be leading the charge for Democrats. She has a unique position as a power broker this Congress, as she holds both the helm of the Senate panel that controls public health policy and also the chairmanship of the subcommittee that controls the purse strings of health care spending.

She will find a willing negotiating partner in Burr, the architect of laws that created the federal government’s pandemic response framework. He has an eye toward his legacy, as he’s announced he isn’t running for reelection to North Carolina’s Senate seat in 2022.

“There’s a lot to learn from what went right and why, and what went wrong because of the law and policy, what went wrong because of individuals, and what to do to fix the law and how to protect from future failures of personnel. Kadlec knows a lot about all of that and will bring us good insights,” the Senate health committee aide said.

Kadlec, in addition to his role as ASPR under Trump, helped author Burr’s marquee 2006 law, the Pandemic and All-Hazards Preparedness Act, during a former stint on Capitol Hill.

Murray and Burr plan to have a series of hearings, but they won’t have the sort of comprehensive after-action report that has accompanied policymaking after other major crises. As yet, there’s little appetite in Congress for a 9/11 style commission to uncover the fatal structural weaknesses in America’s preparedness that the pandemic exposed.

Though hospitals’ and doctors’ groups support one, the only bipartisan legislation to create such a commission, from Sens. Bob Menendez (D-N.J.) and Susan Collins (R-Maine), hasn’t picked up momentum so far. A spokesperson for House Speaker Nancy Pelosi (D-Calif.) pointed to an oversight subcommittee the House created that is designed to favor Democrats.

But there’s no reason for lawmakers to delay action until the Covid-19 pandemic entirely subsides, said Asha George, executive director of the Bipartisan Commission on Biodefense.

“There’s a number of lessons learned that we already know. They don’t have to wait to go forward,” George said.

But finding bipartisan agreement on a pandemic preparedness philosophy will be difficult, even after the Covid-19 pandemic. The disparate approaches favored by Democrats and Republicans exemplify the most fundamental differences between the parties on the role of federal and state governments.

One issue that is already proving divisive is states’ role in pandemic response. Democrats see state public health departments’ systemic underpreparedness, laid bare by the coronavirus, as an opportunity for Congress to address a failure in the Covid-19 response.

“The federalism system works for all sorts of things. Not necessarily as well when you are in a pandemic,” said former Clinton HHS Secretary Donna Shalala.

Murray has already offered legislation that would gradually build up to $4.5 billion in sustained annual funding for the Centers for Disease Control and Prevention and state and local public health departments, targeted toward helping them build out eight primary competencies including disease surveillance, communications, extra workforce and supplies, and community partnerships. She also hopes to address racial disparities in health care.

“There is no question that systemic racism is an urgent public health crisis,” Murray said in a written statement. “Public health departments must be able to prioritize equity throughout their work and funding in this bill would help them do that.”

A Murray aide said the senator is open to attaching the bill to whatever legislative vehicle will get across the finish line.

Murray’s bill has already garnered support from public health advocates such as the National Association of County and City Health Officials, which has argued that federal funding is necessary to bolster state health departments because the federal government can’t implement nationwide public health policy without a baseline readiness. A weak response in one area jeopardizes progress in another.

“Public health experts say a response is only as strong as its weakest link. Creating strong, uniform, systematic federal guidance and funding for strong infrastructure is literally a no-brainer,” said Lawrence Gostin, a university professor at Georgetown Law School.

But Murray’s bill doesn’t have any Republican co-sponsors yet, and a senior GOP aide said there are concerns around how much responsibility the federal government should bear for states’ chronic underfunding of public health departments.

Instead, Republicans’ preferred solutions focus more on building on Operation Warp Speed’s facilitation of vaccine development, a bright spot in the U.S. pandemic response.

Burr’s predecessor, retired Sen. Lamar Alexander (R-Tenn.), laid a groundwork for the GOP approach to pandemic preparedness in a white paper released last year with input from more than 300 stakeholders. A senior GOP aide said Burr was looped in early in the policy development process, as Alexander knew he was likely to take over.

Republicans want to facilitate innovation through public-private partnerships, reform the CDC, modernize public health data systems, and diversify the supply chain for medical supplies to reduce foreign dependence. Kadlec said there’s also an opportunity to more clearly delineate the roles of FEMA, the Food and Drug Administration, the ASPR, CDC, the Centers for Medicare and Medicaid Services, and the Health Resources and Services Administration.

The next biological threat facing the United States may not be a respiratory contagion like Covid-19, Kadlec said, so lawmakers should think broadly about preparing for other threats including cyberattacks and bioterrorism as well.

“I would caution that we can’t fight the last war. We have to look more broadly to the future,” Kadlec said.

  • I’m all for many of these proposals; however, I would hasten to point out that Trump, or someone like him, could once again ignore, gut, and destroy many if not most of these preparations if it suited his political ends. Last year’s completely unnecessary debacle could most certainly be repeated.

  • Maybe making “challenge diseases” by GoF experiments for the then needed vaccine needs to be given more oversight. Right now anyone with a BSL-3 can and will continue doing research that should only be in level 4. The chance that this virus was a research accident will never be known as a political impossible question at this point. So,let’s make sure funding & regulations are tightened, particularly GoF or gain of function viral research applications and anything goes lab work.
    Although big pharma may like the way things are now we could do a lot better by making chemical intermediates here as well as supporting domestic manufactured PPE. Our national security and the job market would both be served. Lowering inequality and increasing our national security would help everyone and make “public health” actually work.

  • This story is incomplete. Congresswoman Marcy Kaptur from OHio’s 9th district introduced a resolution for a new NIH institute the National Institute of Viral Diseases. Congresswoman Kaptur rationalized scientists missed corona-19 virus big time. whatever we have didn’t work. We need give viral diseases a lot more attention in the future. DCNeckers, Perrysburg Ohio

  • If the intent of these bills is to do things like ensure plenty of medical supplies on hand at hospitals and the like, then I’m all for it. What I am implacably opposed to is restrictions on private life activities. This needs a cold stop, NOW. The other issue is the wide spread embrace of politics by public health last June has completely and utterly discredited public health in the eyes of myself and many others. Public health needs to be completely gutted and rebuilt before it can have any credibility whatsoever. The problem, of course, with any kind of legislation is that we have seen the utter cravenness of the political class when they decided to use COVID-19 as excuse to push political agendas having nothing to do with COVID-19. For this reason alone, many of us are very skeptical of any efforts of any kind by Congress, and government in general, for “preparedness” for any future pandemic.

  • Several states are trying to pass laws that prevent public health officials and/or the governor from enacting mandatory public health measures like mask wearing. Instead they want it to be up to the legislature to approve. So, when the next pandemic happens we will be screwed again if these laws are passed.

  • Sustained funding as rider to Biden’s infrastructure plan. The recently passed covid bill, (ironically entitled the Save America bill) could easily have included such legislation; and could do so now by reprogramming non-covid related schemes to covid relief.

  • I suspect that the National Association of County and City Health Officials spoke to the need to bolster annual and consistent funding for local health departments nationwide. While state health departments will also benefit from federal appropriations directed to them, without specific appropriations language requiring useful portions of that funding to flow seamlessly and quickly to local health departments along with annual reporting by state health departments and federal agencies on whether, what proportions, for what purposes, and in what timeframes Congressional appropriations were received by local health departments, experience teaches that what was meant by Congress to be meaningfully helpful to build capacity in local health departments becomes instead a mere trickle, along with a flood of false expectations for capacity.

  • While some steps may help it is not possible to be prepared nationwide. The cost alone of stockpiling AND THEN MAINTAINING national stockpiles capable of covering the entire nation would be enormous. We would also need to be willing to do what needs to be done at the first sign of worldwide spread…CLOSE THE BORDERS. As we saw with Covid that will never happen due to public and political angst over such actions. We cannot even keep illegal immigrants out of our country. Look at what is happening at our southern border today. We are being told to continue mitigation efforts while Covid carrying illegal immigrants are allowed across our borders, and then released AND SHIPPED to cities across our nation. Does ANY of that make any sense? The best preparedness steps are those we as families take for ourselves. Buy PPE once it becomes available at a reasonable price once again. Have enough supplies in your home to shelter in place and get by for at least three weeks and for at least 6 months if possible. That means food, water, sanitation needs, medical needs, etc… Most people can afford to gradually build up such stockpiles if they choose to and make an effort to do so. Stop expecting “the government” to come and help you when bad things happen because when bad things happen on a regional or national scale….There will not be enough resources to get to everyone. If you community as Community Emergency Response Team training take it. It is a free 2-3 days of training to help train civilians to prepare for and care for themselves and their neighbors when emergency resources are overwhelmed.

  • maybe they could work together at the same time to lower both health care and drug costs now almost 18% of GDP ; it was 3.65 TRILLION with a T in year 2018 now higher than the Federal Budget

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