[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]
A GLOBAL CRISIS NEEDS A
GLOBAL SOLUTION: THE URGENT NEED
TO ACCELERATE VACCINATIONS
AROUND THE WORLD
=======================================================================
HEARING
BEFORE THE
SELECT SUBCOMMITTEE ON THE CORONAVIRUS CRISIS
OF THE
COMMITTEE ON OVERSIGHT AND REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTEENTH CONGRESS
FIRST SESSION
__________
DECEMBER 14, 2021
__________
Serial No. 117-58
__________
Printed for the use of the Committee on Oversight and Reform
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Available on: govinfo.gov,
oversight.house.gov or
docs.house.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
46-490 PDF WASHINGTON : 2022
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COMMITTEE ON OVERSIGHT AND REFORM
CAROLYN B. MALONEY, New York, Chairwoman
Eleanor Holmes Norton, District of James Comer, Kentucky, Ranking
Columbia Minority Member
Stephen F. Lynch, Massachusetts Jim Jordan, Ohio
Jim Cooper, Tennessee Virginia Foxx, North Carolina
Gerald E. Connolly, Virginia Jody B. Hice, Georgia
Raja Krishnamoorthi, Illinois Glenn Grothman, Wisconsin
Jamie Raskin, Maryland Michael Cloud, Texas
Ro Khanna, California Bob Gibbs, Ohio
Kweisi Mfume, Maryland Clay Higgins, Louisiana
Alexandria Ocasio-Cortez, New York Ralph Norman, South Carolina
Rashida Tlaib, Michigan Pete Sessions, Texas
Katie Porter, California Fred Keller, Pennsylvania
Cori Bush, Missouri Andy Biggs, Arizona
Shontel M. Brown, Ohio Andrew Clyde, Georgia
Danny K. Davis, Illinois Nancy Mace, South Carolina
Debbie Wasserman Schultz, Florida Scott Franklin, Florida
Peter Welch, Vermont Jake LaTurner, Kansas
Henry C. ``Hank'' Johnson, Jr., Pat Fallon, Texas
Georgia Yvette Herrell, New Mexico
John P. Sarbanes, Maryland Byron Donalds, Florida
Jackie Speier, California Vacancy
Robin L. Kelly, Illinois
Brenda L. Lawrence, Michigan
Mark DeSaulnier, California
Jimmy Gomez, California
Ayanna Pressley, Massachusetts
Jenifer Gaspar, Deputy Staff Director & Chief Counsel
Beth Mueller, Counsel
Yusra Abdelmeguid, Clerk
Contact Number: 202-225-5051
Mark Marin, Minority Staff Director
Select Subcommittee On The Coronavirus Crisis
James E. Clyburn, South Carolina, Chairman
Maxine Waters, California Steve Scalise, Louisiana, Ranking
Carolyn B. Maloney, New York Minority Member
Nydia M. Velazquez, New York Jim Jordan, Ohio
Bill Foster, Illinois Mark E. Green, Tennessee
Jamie Raskin, Maryland Nicole Malliotakis, New York
Raja Krishnamoorthi, Illinois Mariannette Miller-Meeks, Iowa
C O N T E N T S
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Page
Hearing held on December 14, 2021................................ 1
Witnesses
Dr. Ali Khan, Dean, College of Public Health, Professor,
Department of Epidemiology, University of Nebraska Medical
Center
Oral Statement................................................... 6
Katheryn Russ, Ph.D., Professor, Department of Economics,
University of California, Davis
Oral Statement................................................... 8
Dr. Martin Makary, M.D., M.P.H., Professor of Surgery, Johns
Hopkins School of Medicine
Oral Statement................................................... 9
Dr. Krishna Udayakumar, Associate Director for Innovation, Duke
Global Health Institute, Associate Professor of Global Health
and Medicine, Duke University School of Medicine, Director,
Duke Global Health Innovation Center
Oral Statement................................................... 12
Sebnem Kalemli-Ozcan, Ph.D., Professor of Economics, University
of Maryland
Oral Statement................................................... 13
Written opening statements and the written statements of the
witnesses are available on the U.S. House of Representatives
Document Repository at: docs.house.gov.
Index of Documents
----------
No additional documents were entered into the record for this
hearing.
A GLOBAL CRISIS NEEDS A
GLOBAL SOLUTION: THE URGENT NEED
TO ACCELERATE VACCINATIONS
AROUND THE WORLD
----------
Tuesday, December 14, 2021
House of Representatives
Committee on Oversight and Reform
Select Subcommittee on the Coronavirus Crisis
Washington, D.C.
The subcommittee met, pursuant to notice, at 2:10 p.m., via
Zoom; Hon. James E. Clyburn (chairman of the subcommittee)
presiding.
Present: Representatives Clyburn, Waters, Maloney,
Velazquez, Foster, Krishnamoorthi, Scalise, Jordan,
Malliotakis, and Miller-Meeks.
Chairman Clyburn. Good afternoon. The committee will come
to order. Without objection, the chair is authorized to declare
a recess of the committee at any time. I now recognize myself
for an opening statement.
Tragically, in the two years since the coronavirus emerged,
there have been more than 270 million infections and over 5.3
million deaths worldwide.
Even more tragically, more than a third of these deaths
have occurred since life-saving vaccines became widely
available to those of us in the United States and most other
highly developed nations.
Nearly 40 percent of people around the world have not yet
received even a single dose of a coronavirus vaccine. That's
three billion people who remain at far higher risk than they
should be.
Some of these three billion are those who have been
unwilling to get the vaccine. The Select Subcommittee held a
hearing of vaccine hesitancy earlier this year, and we continue
to examine its causes and seek solutions to increase vaccine
uptake.
Many others, who remain unvaccinated, however, have been
among those who have been unable to get the vaccine because it
is unavailable in the countries where they live.
Many poor countries around the world have received only a
fraction of those in the United States and elsewhere in the
Western half.
Fifty-six countries, largely in Africa and the Middle East,
have not been able to vaccinate even 10 percent of their
populations. In some of the world's poorest countries, such as
Haiti, that figure is below one percent.
This inequitable access to coronavirus vaccines is causing
unnecessary death and suffering, and we have a moral obligation
to save lives by expanding vaccine access.
But ensuring that vaccines are available around the world
is not just the right thing to do, it is necessary to protect
our own health and our economy.
Experts say that variants are 6 to 8 times more likely to
emerge from less developed countries where a lag in vaccination
rates create opportunities for the virus to mutate.
The more that new virus develop, the greater the risk that
there will be more infections, more deadly, and that they will
be resistant to the current life-saving vaccines.
We have learned from this pandemic just how difficult it is
to prevent new variants from reaching our shores once they
emerge.
The best protection is, therefore, to make sure they do not
develop in the first place. By increasing access to vaccines
around the globe, we can save lives and protect public health
at home.
Helping other countries vaccinate their citizens is also
the right thing to do for our economy. The American economy,
like the economies of all nations in the 21st century, relies
on international trade to reach its full potential.
Many goods we manufacture here depend on materials sourced
elsewhere. Other goods made in the United States are exported
and sold to other countries. Outbreaks in these countries hurt
American businesses and workers.
Coronavirus surges in southeast Asia this summer illustrate
how connected our economy is to global public health. In
Malaysia semiconductor plants shut down because of coronavirus
outbreaks, American car companies like Ford and General Motors
could not produce new cars.
They were, therefore, forced to suspend work in factories
here at home. American workers and American consumers feel
these consequences. As a result of the shutdowns in Malaysia,
General Motors was forced to cut production by an estimated
100,000 fewer vehicles in the second half of this year.
Outbreaks in Vietnam have similarly hurt the supply of
clothing, footwear, and cell phones manufactured by American
companies. Global vaccination will help us avoid empty shelves
and higher prices here at home.
A fully vaccinated world is critical to the American
recovery. In fact, a report commissioned by the Gates
Foundation found that high-income countries like the United
States could reap economic benefits from global vaccination
that are more than 12 times the cost of funding those mass
vaccination efforts.
For all these reasons, I applaud the Biden administration
for its leadership and ensuring vaccines are available around
the world. As reflected in this chart, the United States has
donated nearly 300 million vaccine doses and has committed to
donate over 800 million more, more than every other country
combined.
President Biden recently reaffirmed his commitment to help
vaccinate the globe, pledging an additional $400 million to
help low-income countries administer vaccines on top of the
$1.2 billion previous dedicated to global vaccination efforts.
As we face another new coronavirus variant, we call on
other countries around the world to step up and follow
America's example.
I would like to thank today's witnesses for being with us
today. I look forward to hearing more about the importance of
increasing global vaccinations for both public health and
economic strength.
I now recognize the ranking member for his opening
statement.
Mr. Scalise. Thank you, Mr. Chairman, and appreciate you
having this hearing. Appreciate our witnesses who are before us
today.
It is a true testament to President Trump's Operation Warp
Speed that anyone in America who wants the COVID vaccine can
get that vaccine and its fully paid for. I've been proud to
support President Trump's Operation Warp Speed, an amazing
public-private partnership that led to the development of three
different vaccines, which, by the way, only took less than a
year to produce when many were saying it would be years to
produce that.
But in addition to that, produced, manufactured and
distributed enough vaccines to give shots to every single
American who wants one.
America has also donated millions of doses to countries
around the world, as the chairman just showed. I believe there
is bipartisan agreement on this subcommittee, the vaccines have
helped us reopen our economy, helped people get back to work,
and helped people to live their lives again. There's no doubt
about it, they have saved millions of lives.
But they have been around for about a year now, and widely
available for more than six months. Yet about 1,300 people are
still dying each day in the United States. Sadly, there have
been more COVID deaths this year than last year.
Though there's still plenty left to learn about COVID, one
thing we know for sure at this point is that vaccinations are
not a panacea against preventing the spread of the virus.
Despite these facts, after nearly a year in office,
President Biden still has no real strategy to protect American
families from COVID.
The same administration that promised to shut down the
virus still does not have an FDA commissioner. It took
President Biden almost a year to finally get a nominee to lead
the FDA, and he's just having his confirmation hearing in the
Senate today.
There's been no hearing or investigation into the origins
of COVID, which we, in the minority, have continued to push
for.
The only strategy they seem wedded to is one that increases
government control over people's lives with more illegal
mandates.
The Biden administration ignores naturally acquired
immunity and won't dedicate much attention to therapeutics, but
they want to mandate vaccines in any setting they can think of.
They want to bully and shame Americans into thinking like they
do or else face termination from their jobs.
The Biden administration has tried to apply unlawful
vaccine mandates to private companies with over 100 employees,
to healthcare workers, to Federal contractors, and even Federal
employees.
President Biden has dedicated more time trying to get
healthcare workers fired if they don't get vaccinated than he
has spent on alternatives like therapeutics to keep families
safe.
Fortunately, for Americans, the Biden administration is
losing big time in the courts. The Federal courts have struck
down, halted, or delayed most of President Biden's unlawful
mandates.
This slide actually shows all of the different mandates
that have been blocked. The OSHA mandate, for example, that
President Biden issued for Federal--for private employers was
blocked by the Fifth Circuit Court of Appeals last month.
The CMS mandate that healthcare workers had to be at least
partially vaccinated by December 6 of this year or face
termination, that after a preliminary injunction issued by a
Federal district court in Missouri, which applied to ten
states, the healthcare workers mandate was finally blocked
nationally just two weeks ago.
The unlawful mandates for Federal contractors and
subcontractors was blocked last week as well after a Federal
district court in Georgia found it exceeded executive
authority.
Finally, under executive order 14043, virtually all Federal
employees had to get vaccinated or risk losing their job. Sound
familiar?
On November 29 of this year, leadership in the Office of
Management and Budget and the Office of Personnel Management
encouraged Federal agencies to delay enforcement of yet another
Federal mandate.
This is a dismal record of failure and rejection of
President Biden's unlawful mandates.
With healthcare systems still treating COVID patients and
facing staffing shortages, I warned months ago that the Biden
administration's proposed vaccine mandate on healthcare workers
would exasperate the shortage and could harm patient care.
But the Biden administration pushed for it anyway. They
continued to offer nonsensical solutions that don't solve the
purported problem but rather create serious problems of their
own.
What is this twisted infatuation President Biden has with
firing millions of hardworking families right before Christmas
and especially at a time when most employers can't find
workers?
It seems like all President Biden wants to do is threaten
people, bully people, and try to get them fired from their jobs
when the courts are saying it's illegal for the President to do
this.
They want to do the same thing on global vaccinations. To
increase the vaccine supply worldwide, the Biden administration
wants to force the American developers of COVID-19 vaccines to
give away their intellectual property, to give away those
rights.
That's right, for years we all spoke out against China
trying to steal America's intellectual property. Now we have
the American President trying to give our intellectual property
away to China and other countries for free.
If President Biden gets his way, imagine the chilling
effect this would have on the ability to develop more life-
saving drugs in the future.
On a bipartisan basis for more than 25 years, the U.S.
trade representative made protection of U.S. intellectual
property a cornerstone of our trade agreements. When America's
ingenuity is protected and able to flourish, America can
compete and win.
American pharmaceutical companies have led the world in
both research and development and introduced more life-saving
drugs. The COVID vaccines are a great example of this. We're
the world's leader because we have strong IP protections, and
because we prohibit the U.S. Government from setting prices,
like the socialized healthcare systems abroad.
Now President Biden wants to take a sledge hammer to
innovation by removing protections for U.S. intellectual
property. Stripping innovators of their constitutionally
protected patents will undermine innovation, weaken our
international competitiveness, and only help communist China,
the country that spread the pandemic in the first place.
Even if the U.S. Government was successful in forcing the
companies to give away their vaccine recipe, it would take the
manufacturing process years to build those facilities, to
source the materials that are needed to safely produce these
complex vaccines.
This would not yield more safe and effective shots in arms
across the world. It's yet another illegal attempt to undermine
American competitiveness. As I've said before, we should
protect IP. We should contract with U.S. manufacturers and help
distribute the vaccine to countries who need it.
It is a quicker and smarter and safer strategy. There would
be more shots administered, and we wouldn't have to knee-cap
future innovations to do that.
It seems like some people just want to use COVID as an
excuse to exert control over Americans and expand the powers of
big government socialists even when it makes no sense.
Americans are sick of this.
Thankfully, and finally Mr. Chairman, people are coming
around to the idea that these shutdowns and mandates must end.
Quote, the emergency is over. That was a quote from Democrat
Governor and former colleague of ours from Colorado, Jared
Polis.
The New York Times editorial page had an article just this
Sunday titled, COVID isn't going anywhere, it's time we started
acting like it. We need to stop living in a state of emergency.
It's time to figure out a way to both protect people and their
freedoms while doing a better job of handling COVID. The Biden
administration must finally lead on this. First, they need to
clean up their mixed messaging on public health that has left
Americans confused and frustrated, and then they need to start
following the science on schools, masks, and vaccines.
Americans have had enough.
Thank you, Mr. Chairman. I yield back.
Chairman Clyburn [continuing]. Mr. Scalise. I am pleased to
welcome today's witnesses. I would first like to welcome Dr.
Ali Khan, a practicing physician and dean of the College of
Public Health at the University of Nebraska Medical Center. Dr.
Khan previously served as the director of Office the Public
Health, Preparedness, and Response at the Centers for Disease
Control and Prevention, where he led our responses to numerous
domestic and international public health emergencies.
I would next like to welcome Dr. Katheryn Russ, a professor
of economics at UC Davis. Dr. Russ is an expert in open
economy, microeconomics, and international trade policy, a
research associate at the National Bureau of Economic Research,
and a senior fellow at the Peterson Institute for International
Economics.
She previously served as senior economist for international
trade and finance for the White House Council of Economic
Advisers.
Next, I would like to welcome Dr. Martin Makary, a
professor of surgery at Johns Hopkins School of Medicine.
I would like also to welcome Dr. Krishna Udayakumar--I'm
going to have problems with a few of these names, but I hope I
get them OK--the founding director of the Duke Global Health
Innovation Center and associate professor of medicine and an
associate professor of the practice of global health at Duke
University.
Finally, I would like to welcome Dr. Sebnem Kalemli-Ozcan--
is that Ookan? Whatever it is, I'm going to let you tell us
when you speak--she's a Neil Moskowitz professor of economics
at the University of Maryland, a research associate at the
National Bureau of Economic Research and a research fellow at
the Center for Economic Policy Research.
She co-authored a leading study commissioned by the
International Chamber of Commerce Research Foundation that
analyzed the economic value of global coronavirus vaccinations.
Will the witnesses please raise their right hands? Do you
swear or affirm that the testimony you're about to give is the
truth, the whole truth, and nothing but the truth so help you
God?
Let the record show that the witnesses answered in the
affirmative.
Without objection, your written statements will be made
part of the record.
Dr. Khan, you are recognized for five minutes for your
opening statement.
STATEMENT OF DR. ALI KHAN, DEAN, COLLEGE OF PUBLIC HEALTH,
PROFESSOR, DEPARTMENT OF EPIDEMIOLOGY, UNIVERSITY OF NEBRASKA
MEDICAL CENTER
Dr. Khan. Good afternoon, and thank you, Chairman Clyburn
and Ranking Member Scalise and distinguished members of the
Select Subcommittee on the Coronavirus Crisis. As you just
heard, I'm Ali Khan, a physician, scientist, former assistant
Surgeon General, former director of preparedness at CDC, and
currently the dean of the College of Public Health at the
University of Nebraska Medical Center.
With the emergence of the Omicron variant, I'm pleased to
be here today to offer testimony to support an improved
strategy that will allow us to defeat COVID and end this
pandemic.
In September of this year, COVID-19 surpassed the 1918
Spanish influenza pandemic death toll and is now the deadliest
disease event in our Nation's history. This is despite the
scientific advancements we have made since the early 1900's.
And yet 800,000 Americans have lost their lives from a
preventable disease with 5.3 million deaths globally.
Over the years, many have claimed the mantle of the great
pandemic or Black Death, including plague, smallpox, influenza,
HIV, SARS, and now COVID.
And we have repeatedly addressed these pandemics with
better and better tools, technologies, and transformational
public health solutions.
Now, undoubtedly, we are in a much better position than we
were a year ago. So, two years later, why do we still say we're
in a pandemic? Well, because COVID is still disrupting critical
healthcare, social, and economic functions in our communities.
In the U.S., we still see almost 65,000 hospitalizations a
day and healthcare rationing going on in America, in addition
to supply chain disruptions and outbreaks closing schools,
businesses and sports.
And the emergence of a new variant like Omicron has sent
capital markets into a tailspin, but the rise of the Omicron
variant may or may not draw out this pandemic. We are at risk
of more infections and deadly variants until we fully address
this pandemic globally.
Now thanks to American ingenuity, I'm happy to tell you
that we already have all the tools we need to beat COVID and
transition to a post-COVID world that still has some ongoing
cases.
We have vaccines that are safe and effective, developed by
President Trump, we have quarantine, self-isolation, masks,
proven effective control methods, and we're seeing new and
cutting-edge antivirals emerge, free COVID testing across the
Nation and increasingly in our homes.
But the end of the pandemic no longer depends just on good
public health science. It depends on action, and it depends on
rebuilding citizen trust in their government that has been
eroded by the politization of this response and rampant
misinformation.
So how do we balance our right to freedom, personal
autonomy, and responsibilities with the right of everyone to be
protected from infection and death? How do we remember that
sacrificing for the common good is how communities are built.
And it's how wars are won, including wars on microbes.
It all starts, I think, with the admission that we're
stalled and need a new and different strategy to end this
pandemic. In the U.S., we need new public health officials and
voices, and we need new national and local political leaders to
help restore trust to those who are skeptical about the vaccine
and even skeptical about the disease itself.
We need to increase vaccine confidence. The 60 percent
vaccination rate nationally is clearly not enough to return our
lives to something resembling normal even with those who have
natural immunity.
We need better solutions to increase coverage to at least
85 percent or more through vaccine mandates, incentives, or
non-mandate approaches that are people-centered and community-
based.
And for the skeptical, we do need standardized tests to
recognize the duration of natural and acquired immunity. We
also desperately need public-private partnerships to support
collection of realtime COVID data in the U.S., so we stop
relying on foreign countries for our data, to decide what to do
with vaccines, et cetera.
And to fully protect us from new variants, we need to
increase global vaccination supply, access, and confidence. So,
globally as you said, Mr. Chairman, only 7.1 percent of
residents of low-income countries have had a single dose yet.
And remember, individuals may require two, potentially three
doses to be protected.
So, immediate actions include the U.S. must share its
Moderna patent with the global community and announce temporary
waivers on other intellectual property and licenses, actively
share technology and know-how, remove export controls for
critical materials, and continue to fulfill our 1.2 billion
vaccine donation.
We learned this lesson with the HIV pandemic, that in the
time of deadly pandemics, profits will never outweigh lives
anywhere in this world. We need to solicit more partners in the
U.S. vax logistic efforts to make vaccines become--to have
vaccines become vaccinations. Can't have vaccines sitting on
tarmacs as we see happening.
And finally, we need global standardization for strategies
and triggers to help fight misinformation and help fight the
global anxiety, as people know what's going to happen and when
and why. And we saw this recently with the trigger for travel
bans again.
So, as somebody with 30 years of experience responding to
outbreaks all over the world, I want to assure the American
people that there's hope and there's a light at the end of the
pandemic tunnel. And so I will leave you with a simple
message--get vaccinated, get tested, and mask on, America.
Chairman Clyburn. Thank you, Dr. Khan.
Dr. Khan. Thank you, sir.
Chairman Clyburn. We will now hear from Dr. Russ. Dr. Russ,
you are recognized for five minutes.
STATEMENT OF DR. KATHERYN RUSS, PROFESSOR, DEPARTMENT OF
ECONOMICS, UNIVERSITY OF CALIFORNIA, DAVIS
Dr. Russ. Good afternoon, honorable Chair Clyburn and
members of the Select Subcommittee. Thank you for the
opportunity to testify that, in addition to the humanitarian
urgency, ensuring vaccination against COVID-19 globally and
with the most effective vaccines available is critical to the
U.S. economy. I'll tell you four reasons why.
First, leaving large pools of people unvaccinated overseas
increases the risk that new variants will sweep through the
U.S. work force. As we saw this fall, each new wave has a
direct and serious impact throughout our economy, including the
services sector.
Second, failing to vaccinate the world as a whole creates a
host of supply chain problems. The lack of availability of
effective vaccines overseas has worsened some of the biggest
hang-ups that American businesses and consumers are
experiencing now.
Perhaps the most visible example is the one the chair
mentioned--the plight of the U.S. auto industry in the third
quarter of this year. A COVID-19 outbreak in Malaysia triggered
public health restrictions that curtailed the already short
supply of semiconductors for U.S. auto makers.
The acute shortage forced massive shutdowns at U.S. auto
plants. Monthly domestic auto production dropped below a
hundred thousand units by September, the only time on record
this has happened in the last 28 years, other than our
lockdowns in spring 2020.
These shutdowns helped keep prices elevated in domestic car
markets which is a key driver of the overall inflation facing
American consumers over the last few months.
Malaysia's vaccination rate has reached 80 percent, but the
first 15 million shots they got were a vaccine that is much
less effective at preventing infection than the ones you and I
have received.
Countries across southeast Asia and throughout the world
have had to use vaccines from China and Russia, which are much
less effective than our mRNA vaccines. This increases the
chance of outbreaks that can cause supply chain disruptions.
Other examples are the COVID-related shutdowns affecting
two major ports in China over the summer--Yantian and Ningbo.
China is quick to resort to lockdowns to prevent the spread of
the virus, partly because the vaccines there are not as
effective as vaccines in the U.S.
These two ports are so large that the closures generated
prolonged shipping delays for a wide array of products headed
for the U.S. and other countries. The closures were also a
reminder that shutdowns could suddenly interrupt the supply of
many of the products that the U.S. sources from China.
Third, failing to ensure global delivery of vaccines can
lead to labor market shortages, causing additional supply
problems for the U.S. economy. Because there are large pools of
people who have not been vaccinated, some countries have
resorted to restrictions on workers' movement to reduce spread.
Resulting labor shortages are affecting production in a
broad array of agricultural and manufacturing industries
worldwide, like footwear and textiles in Vietnam, wine and
other agricultural products in Europe.
These restrictive measures might be mitigated or avoided
were all workers properly vaccinated and tested.
Finally, due partly to lack of access to vaccines, emerging
markets in low-income countries are unlikely to return to the
growth path that they were on pre-pandemic for some time.
This lower growth abroad threatens jobs and U.S. export
industries. More than ten million American jobs depend on
exports of goods and services to the rest of the world.
Close to half of these exports are purchased by developing
countries, where the most effective COVID-19 vaccines are
harder to come by than they are here.
Risks of lockdown-induced slowdowns also loom in many high-
income, U.S. trading partners where vaccination is incomplete,
including Australia, Austria, and Germany.
We must wage a global war on COVID-19, due foremost to the
immense humanitarian need but also to reduce economic
volatility and uncertainty for American businesses and
consumers.
Whether it is $50 billion or double that, it would be a
bargain compared to the cumulative injury to the U.S. economy
and our influence abroad were we to delay any longer. Thank
you.
Chairman Clyburn. Thank you, Dr. Russ.
We will now hear from Dr. Makary. Dr. Makary, you are
recognized for five minutes.
STATEMENT OF DR. MARTIN MAKARY, PROFESSOR OF SURGERY, JOHNS
HOPKINS SCHOOL OF MEDICINE
Dr. Makary. Chairman Clyburn, thank you, Ranking Member
Scalise, members of the committee, thank you for the
opportunity to testify. My name is Marty Makary. I'm a public
health researcher at Johns Hopkins.
By way of background, I studied epidemiology at the Harvard
School of Public Health where I received a master's in public
health and have served on the faculty of the Johns Hopkins
School of Public Health for the past 16 years.
I also take care of surgical patients, including
immunocompromised patients.
I would like to personally ask you to consider new
scientific data that tells us that some COVID policies have
become too extreme, too rigid, and are no longer driven by
clinical data.
Take for example, boosters in children who already had
COVID. When pharma announced on Wednesday that they did a lab
experiment that shows that boosters raise antibody levels
against Omicron, without releasing the underlying scientific
data, the CDC immediately urged everyone 16 and 17 years old to
get a booster.
Is this what we've come to? Pharma tells people what to do
in a press release and the CDC just falls in line?
Meanwhile, Germany just reported that no healthy child, 5
through 17, has ever died of COVID in the first 15 months of
their pandemic, with nearly all of those children unvaccinated.
The CDC has never told us if any U.S. COVID deaths in
children have been in healthy children.
And Germany, France, and other countries now restrict the
Moderna vaccine from people under age 30 because of concerns of
heart complications.
Now, I'm very pro vaccine, I've been vaccinated, but we
have a modern-day McCarthyism, if somebody asks a question
about boosters in young people. Remember, just 12 weeks ago,
the FDA external experts voted against boosters for everybody
by a 16-2 vote, and for good reasons.
But weeks after that vote, the FDA made another internal
push to ream through boosters for all. But this time they
inexplicably did not convene their experts, their external
experts. The CDC did the same.
As a result, they got their broad booster recommendation by
circumventing their external experts who opposed it. Public
health officials justified it, pointing to declining antibody
titers, but they ignore, and continue to ignore, the powerful
T-cell immunity, which a study just last week, done by the NIH
itself, found to be highly effective against Omicron.
Vaccine doses are now being used to boost young people
without any supporting clinical data. Those vaccinated--those
vaccine doses to boost young people should be going to the 93
percent of the population of the world in low-income countries
who have received no vaccine.
Let me be clear, there is nothing that represents American
waste, excess, and global arrogance more than requiring a
young, healthy, low-risk student, who had the infection in the
past and already has natural immunity, to get a booster.
Yet dozens of colleges and universities have already
announced this as a requirement.
I believe in mammograms, and I believe they save lives, but
I don't recommend them universally for men or children. We need
precise medical guidance, not blanket medical guidance that's
good for marketing departments.
If the U.S. wants to help struggling countries ration their
limited vaccine supply in the midst of an epidemic, tell them
to recognize natural immunity and have those who had COVID step
aside of the vaccine line to protect those who are vulnerable
faster with the live-saving vaccine. That's what we should have
done.
Over 20 scientifically sound studies have demonstrated that
natural immunity is as good or better than vaccinated immunity.
Yet our public health officials continue to ignore it. In fact,
they never talk about it.
Why don't they just do their own study of people who had
the COVID infection 20 months ago in New York, test their
bloods and interview them? Why have they never done that study
with their gigantic budgets? Instead they say it's unknown.
Well, my research team is doing that study because the
government has failed to do it.
Teachers, nurses, soldiers, they have circulating
antibodies from prior COVID infection, they have antibodies
that neutralize the COVID virus, but they are antibodies that
the government does not recognize. As a result, careers have
been destroyed and medical privacy is essentially dead.
The U.S. can also show leadership with medications.
Fluvoxamine and inhaled budesonide, a steroid inhaler, both
have been around for years, both are inexpensive, both have
impressive, randomized control trial data that show they
dramatically reduce COVID deaths.
Why do we never hear our public health leaders talk about
them? These are not medications with the controversies of
hydroxy and ivermectin. These are solid, randomized,
controlled, trial-supported interventions.
Paxlovid cut COVID deaths and hospitalizations by 91
percent. The application has been sitting at the FDA for four
weeks as Americans die every day.
Molnupiravir had its up vote by the external experts two
weeks ago. What is the FDA doing two weeks after the experts
vote to authorize the medication?
Finally, anyone in the world getting vaccinated today with
an mRNA vaccine should space it out to at least three months.
That data is in.
Many of us begged U.S. policymakers to do this. The U.K.
actually did it as a broad policy. Makes sense. Why would you
give two life preservers to people in an ocean when some are
drowning with none?
The data are now in. The experiment is over. The U.K. did
it right. We did it wrong.
Yet Uganda has had approximately one percent of its
population vaccinated when the President announced that they
will use a new shipment of almost 700,000 vaccines for second
doses, following U.S. guidance.
As the world rations a scarce vaccine supply, they should
learn from our mistakes, not repeat them. Thank you, Mr.
Chairman.
Chairman Clyburn. Thank you, Dr. Makary. We will now hear
from Dr. Udayakumar.
STATEMENT OF DR. KRISHNA UDAYAKUMAR, ASSOCIATE DIRECTOR FOR
INNOVATION, DUKE GLOBAL HEALTH INSTITUTE, ASSOCIATE PROFESSOR
OF GLOBAL HEALTH AND MEDICINE, DUKE UNIVERSITY SCHOOL OF
MEDICINE, DIRECTOR, DUKE GLOBAL HEALTH INNOVATION CENTER
Dr. Udayakumar. Chairman Clyburn, Ranking Member Scalise,
and members of the House Select Subcommittee on the Coronavirus
Crisis, it's an honor to be with you today. My name is Krishna
Udayakumar, and I'm an internal medicine physician and global
health and policy researcher at Duke University.
Through the nonpartisan COVID Global Accountability
Platform, led by Duke and COVID collaborative, we're generating
actionable insights to accelerate an effective, equitable,
global-pandemic response.
We know that the COVID-19 pandemic continues to evolve in a
highly dynamic manner around the world. We are in a global war
against a virus that doesn't respect borders and rapidly
advances across continents.
But global leaders have yet to use the full arsenal of
tools available to fight this war. Unprecedented scientific
achievements, begun under the Trump administration and
continued under President Biden, have led to the development of
highly effective and safe vaccines, promising therapies, and
other critical interventions, including diagnostics.
But the world has been unable to marshal a coordinated,
effective, and equitable response. The widening gap between
vaccine haves and have-nots around the world has prolonged the
pandemic, worsened inequity, and increased the risk of the
emergence of additional variants that could pierce vaccine
immunity.
Indeed, we are witnessing the consequences of a failed
global response with Delta variant-driven surges in many parts
of the world, including the U.S., while the Omicron variant
spreads rapidly with worrying signs of increased
transmissibility and immune evasion.
Based on current vaccination rates, nearly all low-income
countries, including most African countries, are not on track
to reach the globally agreed upon 40 percent vaccination target
for the end of this month.
Our recent analysis identified three urgent actions to
accelerate global vaccination. First, improve transparency of
vaccine production, supply, and allocation, to drive stronger
accountability and more effective vaccination planning and
implementation.
Second, allocate a rapidly increasing supply of vaccines
much more equitably and urgently.
And third, strengthen country-level capabilities and
capacity to ensure effective and efficient vaccination.
As overall global vaccine supply continues to increase
significantly, now with over a billion doses produced each
month, challenges in allocation, distribution, and delivery in
low-and middle-income countries are becoming more urgent.
Strong, bipartisan, American leadership has been critical
to address major global health crises over decades. From the
eradication of smallpox, to increasing global access to
treatments for HIV and AIDS, to managing recent Ebola
outbreaks, such American leadership is needed again to
effectively address the COVID-19 pandemic.
The best way to prevent further domestic and global
catastrophe is to dramatically decrease cases and slow
transmission of the virus through widespread global
vaccination, combined with other public health measures.
Thankfully, there is significant progress and U.S.
leadership from which to build. The U.S. and G7 allies have
taken important but still modest steps to close the global
vaccination gap, including accelerating large-scale production
and delivery of high-quality vaccines, increasing financial
supports to COVAX and other entities, and supporting the share
of over 1.6 billion doses.
The U.S. has now donated over 317 million vaccine doses, as
you noted, Mr. Chairman, more than every other country
combined.
President Biden also hosted a global COVID-19 Summit in
September to further galvanize global coordination and
response. The recently announced initiative for global vaccine
access, or GlobalVax, is also a step in the right direction.
While commendable, these actions still fall far short of
the true scale and urgency required. Much more needs to be done
to provide high quality vaccines more quickly and to build
countries' vaccine distribution and delivery and capacity which
is rapidly becoming the key constraint in the race between
vaccines and variants.
The $315 million allocated to support global vaccine
delivery in GlobalVax is substantially inadequate in the
context of the billions of dollars that will be needed to
support successful vaccinations around the world.
In fact, we have proposed, with the endorsement by a
bipartisan group of experts, a bold U.S. emergency plan for
global COVID-19 relief.
Mr. Chairman and members of the subcommittee, the global
COVID-19 pandemic is both an international, humanitarian crisis
and also a threat to our own Nation's security, health, and
economic interests.
We can impose travel restrictions, promote vaccines and
boosters, recommend masking and distancing, but those steps
will not keep Americans completely safe because we cannot stay
isolated from the rest of the world.
Building from significant efforts to date, we must further
unleash unparalleled American resources and capabilities and
provide bold American leadership to address the global
pandemic. Such an effort will reflect both our ideals as a
people and our interest as a Nation.
By galvanizing global efforts to vaccinate the populations
of the world's poorest, most afflicted countries, we can
accelerate the end of the pandemic here and everywhere. Thank
you for the opportunity to testify.
Chairman Clyburn. Thank you very much, Dr. Udayakumar.
The chair will now hear from Dr. Kalemli-Ozcan--or is that
Ozcan? Dr. Ozcan, you're recognized for five minutes.
STATEMENT OF DR. SEBNEM KALEMLI-OZCAN, PROFESSOR OF ECONOMICS,
UNIVERSITY OF MARYLAND
Dr. Kalemli-Ozcan. Good afternoon, Chairman Clyburn,
Ranking Member Scalise, and other members of the Select
Subcommittee. Thank you for the opportunity to appear before
you to discuss the economic case for global vaccinations.
My name is Sebnem Kalemli-Ozcan, a professor of economics
and finance at the University of Maryland College Park, with
specialty in international macroeconomics, finance, and
globalization.
Rolling out a vaccine to stop the spread of a global
pandemic doesn't come cheap. Already billions of dollars have
been spent developing drugs and putting place in programs to
get those drugs into people's arms.
However, given the uneven distribution of vaccine, with
poorer countries lagging far behind richer nations, the
question is simply, what is the economic cost of not
vaccinating everyone?
My work, joint with my colleagues, calculates these
economic costs of uneven global vaccinations and how much of
these costs will be borne out by which countries such as the
United States.
Back in January 2021, with the projected progression of the
pandemic at that time, we have estimated $4 trillion global
cost at the end of 2021 under the scenario of rich countries
vaccinating all of their citizens while poor countries only
inoculating half of their populations.
Forty-nine percent of this $4 trillion global cost is going
to be borne out by the rich countries composed of United
States, Canada, Japan, and Europe. For United States, the cost
is three percent of its 2019 gross domestic product, $671
billion.
As of now, the reality of the vaccinations turn out to be
much worse than our initial assumption as rich countries were
not able to vaccinate all their citizens and poor countries are
nowhere near vaccinating half of their population as we just
heard.
With the ongoing pandemic, if we do not achieve global
vaccination, the economic costs that we have estimated will
only grow exponentially in 2022 and 2023.
To arrive at our economic estimates, we analyzed 35
industries, such as services and manufacturing in 65 countries
and studied how these sectors linked economically in 2019
before the pandemic.
For example, construction sector in the U.S. relies on
steel imported from Brazil, American auto manufacturer need
glass and tires that come from countries in Asia and so forth.
Then we used data on COVID infections in each country to
demonstrate how coronavirus crisis can disrupt supply chains,
curbing and delaying shipments, providing a very early and
inevitable possible global supply chain disruption.
In our economic epidemiological model, the more a sector
relies on people working in close proximity to produce goods,
the more disruptions we're going to be because of high
infections. As sectors link globally, domestic supply chain
disruptions become global.
With that model, how vaccinations can solve this problem by
smoothing the disruptions as healthy and immune work force is
able to produce and deliver parts in time, increasing output.
Widespread vaccination in rich countries will certainly
help domestic businesses such as restaurant and services, but
industries such as auto, construction, wholesale, and retail
that depend on other countries for labor, materials, parts and
supplies, will continue to suffer if vaccines are not made
available worldwide.
In addition, people in other countries, if they remain out
of work because of repeated lockdowns required to control the
spread of the virus, then they will have less money to spend on
the sales of exports in North America and Europe.
Our work estimates the economic costs arising from supply
chain disruptions, where a key reason for this disruption is
the ongoing pandemic. How can we predict the economic costs of
supply chain disruptions that we are living through today 10
months ago before they became evident that they are widespread
and now known as the container crisis and the great disruption?
This is because our economic estimates take into full
account of the full complexity of the entire global trade and
production network data.
Our research shows that vaccinating the other nations is
not an act of charity but an act of economic rationality with a
high return on investing in global vaccinations. We have
calculated a return to such investments 166 times.
The number is calculated by deriving the cost of not
vaccinating the rest of the world, on rich countries, by cost
of vaccinating as put out by----
If United States alone wants to close this gap, it implies
a return to investment to United States of 24 times in
investing in global vaccinations.
As Chairman Powell has stated to this committee recently,
economic activity remains low pre-pandemic level in United
States, according to our model, in the absence of global
vaccinations, 2021 United States gross domestic product will be
3.1 percent lower than what could have been, showing the heavy
economic toll of not vaccinating the world for the United
States.
As shown by the new Omicron variant, we know that no one is
safe until everyone is safe, because if we wait longer on
global vaccinations, new variants are going to emerge.
Our work is an economic counterpart to this because no
economy is an island and rogue economies are interdependent to
each other. So, full economic global recovery will come only
when every economy recovers from the pandemic. Thank you.
Chairman Clyburn. Thank you, Dr. Ozcan.
Now, I do not see the ranking member at this point. We are
to go into questions. I see the ranking member has returned.
Mr. Scalise. Hey, Mr. Chairman. Yes, I'm voting on this one
too, so I'm not sure if you voted on the----
Chairman Clyburn. I have not. I have not. I'm going to
yield to you for five minutes of questions while I go vote, and
I'll take my five minutes when I get back.
Mr. Scalise. OK. Well, thank you, Mr. Chairman. And
obviously when you look at what we opened with, the mandates
have been thrown out by courts over and over again. We've had
three different court cases on mandates.
All three have said that the President doesn't have the
legal authority to fire people, whether it's Federal workers,
subcontractors, or healthcare workers. Yet it seems like that's
the administration's main focus.
I think if you go to Mr. Makary's opening statement, I
think you touched on some things that a lot of us would like to
see explored more. I've talked to a lot of medical
professionals that have said it seems like the Biden
administration is really underplaying the importance of things
like natural immunity, of some of the other therapeutics that
are out there.
And we've had, you know, obviously we mourn the lives of
the hundreds of thousands of Americans who have died, but we
also know that we've had millions of Americans who have
contracted COVID and then came through it and lived.
Some had really, really tough experiences, some had very
mild symptoms. That fact, by the way, is before and after the
vaccine. Vaccinated and unvaccinated people have gotten COVID,
who have experienced different degrees of difficulty going
through it, and again, some that have had no problems, but
they've tested positive and now they have immunities.
And it seems like there is a missing gap in the science on
what these immunities do, how it protects people going forward.
And I think you touched on it with children, but if you could,
Dr. Makary, talk about what Congress should be looking at more,
what should the scientific community in Washington be doing
that it's not doing to study more about what natural immunity
really means?
If you could unmute.
Dr. Makary. Thank you, Ranking Member Scalise. You raise a
really important point because the original sin of this
pandemic was that when this virus hit the United States we had
a complete paralysis of research at the NIH.
With over $42 billion, they could not pivot any of those
dollars quickly to answer the most basic questions that the
American people were asking, all of us in healthcare--how does
it spread, do masks work, how long do I need to quarantine for,
when is the peak day of viral shedding in the course of
illness.
We could not answer those questions with any solid evidence
because the NIH was unable to pivot their funding. We just did
a study of NIH funding last year, the year of the pandemic.
They spent five percent of their budget last year on COVID
research. They spent twice as much on aging research.
The average time for them to give research dollars to a
group of researchers, like my team, was five months in a health
emergency.
They had 278 research grants on social determinants of
health, an important topic, but about four on how the virus
spreads. And so you had this very popular group think, led by
our top public health officials that it was surface
transmission--wash your hands for 20 seconds, pour a gallon of
alcohol gel on your grocery bag.
We had a vacuum of scientific data and what filled that
vacuum is political opinions. That is the original sin of this
politicalization. It was the inability of the bureaucracy of
the NIH to pivot their funding to answer the practical,
clinical questions that we needed answered.
And today, we can't do this--we seem unable to do any
followup on the therapeutics--fluvoxamine, budesonide,
hypertonic saline spray. I mean, none of these things have
gotten the research dollars to this day. We've basically been
unifocused on vaccines, an important intervention, but it's
come at a heavy exclusion.
So, when we talk about helping the world, we are not doing
them a service if we're only telling them about one of several
important ways to reduce death and mortality.
Mr. Scalise. Well, I appreciate that, and clearly as we
continue to promote the vaccine and its safety and
effectiveness--again, the President only talking about
mandating vaccines or else somebody is going to get fired. The
courts aren't even allowing that. So, at some point you would
think the President would move on and come up with other
alternatives including natural immunity, which many medical
professionals are starting to look into and recognizing that
there's a dearth of studies being done to show how that helps
keep people safe.
All this focus should be on helping keeping people safe,
not only one-size-fits-all approach.
Let me finally ask you about schools. We've seen a lot of
studies that have shown kids ought to be in school, and it
actually hurts them not to be. Have you seen any research on
that as well?
Dr. Makary. Brown University has a good study showing that
kids who have been in school during the pandemic, compared to
kids who have been in school before the pandemic, have more
cognitive, motor, and learning deficits. This is a tragedy.
It's uncharted territory.
We're going to appreciate the down side of this far into
the future. Young women have had a 51 percent increase in
emergency room visits for self-inflicted harm, and so the list
goes on and on, substance abuse. Opioid deaths are up 300--
30,000 this year. So, anyway that is the American tragedy that
will be----
Mr. Scalise. I know I'm out of time, but we'll try to get
that Brown study to all the members. I appreciate that
feedback. With that, Mr. Chairman, yield back.
Chairman Clyburn. Thank you very much, Mr. Ranking Member.
Dr. Khan, I'm going to ask you, under the Biden administration,
the United States has led the global coronavirus vaccination
campaign to combat the pandemic with more than $1.6 billion
committed, nearly 300 million vaccine doses donated, and more
than 800 million additional doses pledged.
Our country leads all others by a significant margin in all
of these metrics, and we have called on our international
partners to do more to address vaccine inequity.
Dr. Khan, what would you say are the benefit of America's
leading contributions to global vaccination efforts?
Dr. Khan. Mr. Chairman, as we heard very eloquently from
our economic speakers also, there's no doubt that in the United
States, because of the failure to get this pandemic under
control, we still have healthcare rationing going on, we have
schools, businesses, et cetera, disrupted supply chain, but
that-plays out globally also.
And until--if we want to protect people, we have to protect
everyone. Otherwise, we will continue to have new variants
emerge and make their ways onto our shores and force us into
another cycle of aggressive prevention strategies.
So yes, the U.S. is taking the global role, which is
necessary because then that allows us to work with other
partners to say other countries need to step up also and
continue these efforts to increase both vaccine supply, vaccine
access, and to address the misinformation that's rampant in the
United States.
We see it all the time here in the U.S., unfortunately, and
it's now made its way worldwide, with increasing vaccine
hesitancy.
So, we need to address all three of those issues, and as I
said during my testimony, we answered this question with the
HIV pandemic when we said profit will not trump lives. And
those were the decisions we made then to make sure that HIV
treatment was available to everybody worldwide.
It's a simple decision for us to make now. The U.S. owns
the Moderna patent, and it can clearly make it available to the
global community. The global--WHO has set up an mRNA technology
hub that's ready to make this happen. So, it's not a matter as
if countries could not scale up if they were not issued these
license and assistance with know-how.
They clearly can scale up. We can have national hubs that
are producing vaccine, get us closer to getting a global
community vaccinated and get to a post-pandemic phase.
Chairman Clyburn. Thank you very much for that.
I know that we are going to be a bit convoluted as we go
through this today.
So, is Mr. Jordan--I don't see him.
I want to go to Ms. Malliotakis. Is she with us?
Ms. Malliotakis. I'm here, Mr. Chairman. Would you like me
to go next?
Chairman Clyburn. Yes, please.
Ms. Malliotakis. OK. Thank you.
I want to thank you all for your testimony and thank you to
the chairman for having this hearing today.
I'm actually a member also of the Foreign Affairs Committee
and we definitely talk about vaccine diplomacy, the importance
of it, particularly as it impacts our supply chains.
So, my first question would be, I guess, be for our
economics professors here. Just if you could touch on the
impact that vaccine diplomacy has on alleviating the supply
chain issues we are experiencing today. Some of it is on
vaccine mandates as well right here in the United States, and
that's impacting the supply chain.
So, can you just talk a little bit about both of those
dynamics?
Dr. Russ. Sebnem, would you like to go first?
Dr. Kalemli-Ozcan. Sure. I mean, basically the United
States is doing the right thing here because we do have to
increase the supply of global vaccines.
I just want to be very clear here. This is not about, you
know, allocating. So, this is not about let's just not, you
know, give all the available vaccines in my country but, you
know, like ration. Beyond that, as we heard from Dr. Khan, to
increase the vaccine production and the vaccine supply to other
countries, and the United States leadership so far has been
very good, and it is definitely helping, but it is not enough.
The supply chain issues are going to be sorted out when we
do this globally. If you look at the very complex spider web
looking figure of the global supply chains in my written
testimony, you will understand that this is not just about some
chips or some lumber issue. So, all of these sectors are
intrinsically linked to each other with different countries
having different exposures. I mean, without really doing it at
the global scale, you wouldn't be able to solve all supply
chain issues. But the stimulus, the fiscal stimulus now that
skyrocketed the demand is making the supply chains work.
So, in that respect, it is very urgent that we need to do a
lot with the vaccine----
Ms. Malliotakis. Thank you.
Dr. Makary, if you could comment, though, because, on one
hand, what the prior individual said is somewhat true, but also
the vaccine mandates are having a tremendous impact on our
economy.
New York City was--the New York Times today has slowest
recovery rate than the rest of the Nation. Unemployment is
double the national average. I believe a lot of that is due to
a lot of the mandates, the vaccine passports, and other
restrictions that have been put in place.
If Dr. Makary can please comment on the concerns that you
have regarding some of the mandates, I would appreciate that as
well.
Dr. Makary. Representative Malliotakis, we can't get
Abraxane chemotherapy in parts of the United States because of
our supply chain prices, bleomycin to treat Hodgkin's lymphoma.
There are downstream effects, not to mention the many
careers destroyed and up to one in five people leaving
healthcare. The real story in New York that we are not hearing
about is that they are having significant staffing issues, and
they are asking for a partial halt or a plan to halt elective
surgery to so-called get ahead of Omicron. But the real story
is they are having significant staffing issues.
Now, all of these problems, our massive chemotherapy supply
chain problems, halting elective surgery, they could have all
been avoided with a flexible immunity mandate; in other words,
recognizing natural immunity, allowing for more medical
exemptions, not require immunization for healthcare workers
that are not on the frontlines, that is, patient facing, we
would have avoided so many of these problems.
Ms. Malliotakis. One last question to followup. Regarding
the mandates, how much should we be focusing on these mandates
as opposed to looking for, you know, treatments and
therapeutics? You mentioned natural immunity, but what about
treatment and therapeutics, making that more of a priority?
Dr. Makary. Representative, no one should be dying of COVID
right now, with rare exceptions. With best practices of
budesonide, Fluvoxamine, the hypertonic saline spray,
immunization, two drugs sitting at the FDA, their applications
are sitting on someone's desk as we wait for these two drugs
that have cut COVID deaths to zero or near zero in both of
their phase III trials, no one should be dying of COVID right
now. We never hear about therapeutics from our public health
leaders, only this intense focus on vaccinations. We can do
both.
Ms. Malliotakis. I appreciate that. I think it's a balance
that is required here, and I appreciate all of your testimony
today.
And thank you, Mr. Chairman. I yield back.
Dr. Kalemli-Ozcan. Mr. Chairman, can I clarify a point
here? Because I think it's very important in terms of the
immunity from getting sick and not----
Chairman Clyburn. Yes.
Dr. Kalemli-Ozcan. OK. The economic cost estimates are
short term. So, the costs are going to come from every single
threat. In our model, we have an economy epidemiological model,
nobody dies. But the minute you get sick, there are going to be
an economic cost of it. Natural immunity is going to take time.
So, this is very important. And with the price pressure,
that cost is going to get bigger. So, in that sense the costs
are really becoming from being sick and not able to be
productive two weeks, wait until we have this setup out there,
as long as you are sick a week or two weeks, you can go back to
work force later with your natural immunity. But that two weeks
is going to add to the economic cost with the price pressure.
That's all.
Chairman Clyburn. Thank you very much.
The chair now recognizes Ms. Waters for five minutes.
Ms. Waters. Thank you very much, Chair Clyburn.
This is a very, very needed hearing that you are doing
today because there's so much information out there, a lot of
it sometimes conflicting, and so I have a few questions that I
really want to ask.
First of all, let me thank Dr. Khan for his caution about
CDC accepting information that they get from press releases. I
have often wondered why they could adopt certain things so
quickly and wondered whether or not the testing and the
research had been done before they start to advise about five-
year olds, et cetera, et cetera, et cetera. So, I want to learn
a lot more about that, but I thank him for opening up that
discussion.
Second, I want to get to the global problem that we have,
and I want to ask Mr. Udayakumar whether or not we are
assisting in any way to help other nations to develop their own
vaccines. As I understand it, there is something in terms of
international law that may be stopping them from being able to
do it. Some of them want to do it.
What do you know about that?
Dr. Udayakumar. Sure. Representative Waters, thank you for
that question.
The U.S. is assisting several organizations around the
world in trying to stand up vaccine manufacturing capacity. The
format that has been used to date has included U.S. public
sector investment from the International Development Finance
Corporation, as well as working with U.S. manufacturers.
So, examples of that would include what was announced at
the Quad Vaccine Partnership. So, Johnson & Johnson partnered
with Biological E. in India with investment from the DFC and
others to enable the production of a billion doses of vaccine
over the coming year.
We have also seen vaccines, in terms of licensing,
especially for fill/finish capacity. We've seen announcements
of Pfizer BioNTech enter into such a partnership in South
Africa. We have heard that Johnson & Johnson may allow
manufacturing in its entirety.
So, the work that's happened to date has included voluntary
licensing from our private sector manufacturers in partnership
with the public sector being able to help support everything
beyond intellectual property, the know-how, the access to
supply chains, the regulatory advice, and oversight access to
financial capital. And it's really that type of model that we
need to continue to see.
We most definitely need to increase the vaccine
manufacturing capacity across low-and middle-income countries.
And we have seen significant progress, including through a
partnership for African vaccine manufacturing, that's also
underway. This is a space that is going to take some time,
months to years, to stand up, given the complexity; but there's
significant progress that's already being made.
Ms. Waters. Well, thank you so very much.
And I would like to know--well, at one point the Caribbean
was begging the United States to help with the vaccines. Now,
that was early on. Do we have that problem anymore? Because
they had the money to purchase, but they did not have access,
despite the fact that the United States had a memorandum of
understanding with both Canada and Mexico.
Now, are we in a position now where we can help others
really and not do what--allow to happen what happened with the
Caribbean?
Dr. Udayakumar. Yes. Thank you, ma'am.
We are in a much better position than we have been in the
past and the best position we've ever been in. As I mentioned,
we see global output of more than a billion doses of high-
quality vaccines each month that will allow us in the U.S. to
make sure that we are following the science in terms of primary
vaccination and boosters. We are not in a position of having to
sacrifice any of that.
But, in addition to boosters as warranted, the U.S., as
well as primary vaccination, we do have enough. We continue to
send tens to hundreds of millions of doses internationally, and
we need to continue to do that.
Recent analysis shows that if you look at the G7 and
European countries, by the end of this year, in addition to
everything that they might need for domestic needs, they will
likely have more than 500 million doses of excess vaccines. And
those are the ones that absolutely have to reach low-and
middle-income countries as soon as possible.
Ms. Waters. Thank you so much.
We have another problem I want to mention just quickly, and
that is in Haiti we got vaccines to them and they could not
distribute them. And so we had to make sure that we retrieved
them before they expire. And we just need to come up with some
ways of helping countries like Haiti.
With that, I have used up all of my time. And I thank you
very much.
Chairman Clyburn. Thank you very much, Ms. Waters.
The chair now recognizes Mr. Jordan if he is with us? I
don't see him.
Mr. Jordan?
How about Dr. Miller-Meeks?
The chair now recognizes Ms. Velazquez for five minutes.
Ms. Velazquez. Thank you, Mr. Chairman. Thank you for the
timing of this important hearing.
Dr. Kalemli-Ozcan, you called for a study to model the cost
of incomplete global vaccination. What did your study conclude
about the costs of failing to achieve global vaccination to
advanced economies like the United States?
Dr. Kalemli-Ozcan. Yes. So, the study shows that the
overall cost to the United States, Canada, Japan, and Europe
will be $4 trillion. For the United States, it will be $671
billion, which is two percent of the United States 2019 gross
domestic product.
And this is assuming, by the way, that the United States
and other rich nations vaccinate everyone in their own country
and the rest of the world at least reaches the 40 to 50 percent
of vaccination in their countries. So, our estimates are lower
than that.
So, since the vaccinations were way worse than what we
assume, the cost, the true costs are much higher than that, and
it's going to get higher in the next year and year after if we
really don't take the global vaccinations seriously.
Ms. Velazquez. Thank you.
And so, Doctor, what does your research show about the
potential economic benefits of donating vaccines to developing
and less wealthy nations?
Dr. Kalemli-Ozcan. Huge. We calculate the return of
investment over the Unites States of 24 times. The richest
countries overall is going to get a return of investment over a
hundred times. The return of investment for countries like
France, Germany is going to be 20 times.
So, there's no question of just, you know, sending these
vaccines. And now we hear from Dr. Udayakumar and Dr. Khan
that, you know, we can easily do this. We are in a position of
producing billions, so it is a no-brainer. I mean, this is a
rounding error compared to the money we spend in fiscal
spending domestically in rich countries.
Thank you.
Ms. Velazquez. Thank you.
And Dr.--Professor Russ, COVID outbreaks in Malaysia and
Vietnam have contributed to supply chain issues, such as the
slowing of the production of component parts for American car
manufacturers, unfinished goods sold in the U.S.
Dr. Russ, can you tell us about how the outbreaks in
Southeast Asia earlier this year affected the U.S. economy?
Dr. Russ. Sure. So, if we take just the example of the
semiconductors causing the auto plant shutdowns, so car prices
have been rising the last few months. So, the White House
Council of Economic Advisors just stated that about 1.4
percentage points of the 6.8 overall inflation that consumers
faced in November compared to the last year was due to auto-
related items.
So, those shutdowns helped keep those prices for autos
high, and that means that it contributes to the overall
increase in prices that consumers are facing.
And it's not just autos. I mean, that's a really visible,
you know, big, big shock, but also--and the chair mentioned----
I was muted. Sorry.
So, not just autos, but also clothing, textiles, so many
different products.
And if we want to think about active pharmaceutical
ingredients, important for diabetes or chemotherapy, many of
these come from China. And so China is really quick to move to
lockdowns because their vaccines are not super effective. We
saw the port lockdowns that caused major shipping disruptions
globally, but including for the United States.
So, the normal time for shipments to get to the United
States from China is 40 days by sea, and in the fall it peaked
at 73 days. So, that's an extra 33 days that we have to wait
for, say, medical supplies to come when we are sourcing those
active pharmaceutical ingredients.
So, it's really widespread this impact that it can have on
the U.S. economy.
Ms. Velazquez. So, we can say that vaccinated people around
the globe will help mitigate economic disruption in the United
States?
Dr. Russ. Yes, absolutely, including inflation.
Ms. Velazquez. Thank you.
I yield back, Mr. Chairman.
Chairman Clyburn. I thank the gentlelady for yielding back.
The chair now recognizes Mr. Jordan for five minutes.
Mr. Jordan. Thank you, Mr. Chairman.
Dr. Makary, how many--well, let me start with this.
What's the budget at CDC? Do you happen to know that?
Dr. Makary. CDC, it's about $9 billion, sir.
Mr. Jordan. How about at NIAID, what's the budget there?
Dr. Makary. $6 billion.
Mr. Jordan. $6 billion. $9 billion CDC, $6 billion NIAID.
What about NIH? What's the budget there?
Dr. Makary. Between $42 and $43 billion.
Mr. Jordan. Forty-two and 43, so if I do the quick math,
that's like $57, $58 billion. That's annual, right?
Dr. Makary. Annual.
Mr. Jordan. And do you know how many people work at CDC?
Dr. Makary. CDC and NIH together, about 30,000 people.
Mr. Jordan. Thirty-thousand. What about if you add in
NIAID? Do you know how many that is? Or they are part of NIH as
well? Right? So 30--what was that number?
Dr. Makary. That's right. That's right. Thirty-one people
between CDC and NIH.
Mr. Jordan. Thirty-one thousand people spending $58 billion
a year. Why hasn't our government done a study on natural
immunity?
Dr. Makary. If I can be honest, Representative Jordan, I
don't think they want to know the answer. It would undermine
the indiscriminate vaccine--vaccination policy for every single
human being, including extremely low-risk people.
Mr. Jordan. So, how many Americans have got COVID since
we've had this virus, do you know?
Dr. Makary. North of half of Americans based on the
Columbia University study that showed one in three had COVID at
the end of last year, a year ago.
Mr. Jordan. So, there's certainly a sufficient sample size
to do a study. And there's $57 to $58 billion somewhere--I
mean, you could use some of that money to do a study. And then,
of course, you know, you've got 30-some thousand people who
could conceivably do a study on a pretty fundamental question.
Now, I think I saw in your opening statement that you are
actually doing a study on natural immunity. Is that right?
Dr. Makary. That's right. With private funding, Johns
Hopkins, my research team, is doing a study.
Mr. Jordan. OK. So, there's no grant money coming from CDC,
NIH, nothing like that?
Dr. Makary. No, sir.
Mr. Jordan. And are any of these 30-some thousand employees
helping you with your study?
Dr. Makary. No, sir.
Mr. Jordan. Now, other countries, if I understand--I think
this was in your opening statement as well. Other countries
have done this study. Is that correct?
Dr. Makary. Most of our learning has come from Israel and
other countries, yes, sir.
Mr. Jordan. And what have they found? Let's start with the
Israel study, if you could just refresh my memory. What did
Israel find?
Dr. Makary. The Israel study is the largest study done
worldwide, and it found that natural immunity, adjusted for age
and comorbidity, is 27 times more effective than vaccinated
immunity. And they just put out December 5 another study, a
followup study, again, affirming similar results, that natural
immunity is stronger than vaccinated immunity.
Mr. Jordan. But are--the scientists in our government at
the CDC and NIH, they don't account for that? They don't talk
about that? What do they say about that study, or do they say
anything?
Dr. Makary. They never talk about it unless asked. But I
would say that they are doing worse than being absent on the
topic. They are undermining natural immunity through two
studies that the CDC did that are so flawed, that are so poorly
put together, honestly, they would not qualify for a seventh
grade science fair. The results cannot be derived from the
data, and it's a disgrace that those two studies were put out
because it undermines the larger body of science.
Mr. Jordan. So, they won't talk about international studies
that conclude natural immunity is 27 times better than the
vaccine, but they will do some bogus, in your word, some
seventh grade science studies using some of those 30,000
employees and using some of that $58 billion of American
taxpayer money, they will do that? Is that fair?
Dr. Makary. That's fair. I will say that the intention is
noble, but just very paternalistic. That is, they believe in
private conversations that if they acknowledge natural
immunity, some people may avoid vaccination and think I'll just
get the infection. We don't want people to do that, but we can
be honest with the data and encourage vaccination at the same
time.
Mr. Jordan. Well, I think the American people, particularly
the ones paying--this is their money, they expect honesty and
transparency from our government. They don't expect to be
deceived.
So, I mean, this is what gets me. We can spend money, some
of that $58 billion, and some of the resources at NIH and CDC
can be used to fund gain of function research and give a grant
to EcoHealth, who then sends some of that money to a lab in
Wuhan China, that's just fine. But we can't find any resources
to deal with a fundamental question about natural immunity, and
so much so that you have to go out and get private funding to
do it yourself?
Dr. Makary. That's right. The NIH spent twice as much money
on aging research last year, the year of COVID, more than they
spent on COVID researcher.
Mr. Jordan. This would be laughable if it wasn't so
serious. And the implications, when you think about these
mandates and everything else that's happening, what it's doing
to our economy, not to mention just being honest with the
American people who, after all, it's their money. But we have
the head guy, Mr. Fauci, Dr. Fauci saying, I represent science,
but he is afraid to actually do the science and do the studies
that need to be done to answer this question. And we have to
rely on international studies and your private study to get the
truth to the American people.
Dr. Makary. We've subjected 72 million children to intense
restrictions for two years, yet we don't have the most basic
research. We've never had an NIH-funded study on masks on kids,
and we've never had any information revealed by the CDC on
whether or not any healthy child has died of COVID.
Mr. Jordan. So, doctor, it's either they know the answer
and don't want the American people--they know the answer and
don't want the American people to know, or they do know the
answer and are trying to hide it. I mean, it's like they know
the answer or they are not sure of the answer--Mr. Clyburn. The
gentleman's time is----
Mr. Jordan [continuing]. I should say, or they know the
answer and are trying to hide it from the American people. It's
one of those two.
Chairman Clyburn. Thank you. Your time has expired.
Mr. Jordan. Thank you, Mr. Chairman.
Chairman Clyburn. Thank you.
The chair now recognizes Mrs. Maloney for five minutes or
Mr. Foster.
Mrs. Maloney. I'm here.
Chairman Clyburn. Mrs. Maloney is there.
Mrs. Maloney. Thank you.
Well, thank you, Mr. Chairman, on this important hearing.
Even as we are working to keep and increase vaccination
rates in the United States, we don't have to--we have to really
focus also on the fact that we need to vaccinate the rest of
the world, and helping vaccinate people in lower income
countries is not only the right thing to do, from a
humanitarian and diplomatic standpoint, but it also helps
protect the health and safety of Americans.
And as long as the coronavirus continues to circulate
widely across the globe, new variants will arise and Americans
are going to be at risk. We are already on another new variant.
So, I would like to ask, Dr. Udayakumar, how does a failure
to bring the coronavirus under control around the world put
Americans at risk?
Dr. Udayakumar. Thank you, Representative Maloney.
I think we continue to put Americans at significant risk so
long as we don't have a global plan of attack against the
pandemic that leads to a global recovery. First and foremost,
we put the health and lives of Americans at risk as we saw with
the Delta variant, as we are seeing with the Omicron variant
that have both emerged in other parts of the world where
infections were raging and vaccine were underutilized and
underavailable.
We can't isolate ourselves from the rest of the world, so
we are prone to anything that happens elsewhere. So,
fundamentally, to protect Americans, we need to make sure
there's a global response.
Second, our economy, as we've heard from colleagues today,
is intertwined with the rest of the world. We will not see as
strong a global economic growth and recovery or global trade or
global travel so long as the pandemic continues.
Third, as you started off rightly by saying, it's also the
right thing to do. It is a way for the American people to
express our values as a people to the rest of the world and
lead in a way that brings strong American values in helping
those that are most in need. And, of course, it's also the
ability to influence the future decades of diplomatic relations
in the world.
So, I think we have every incentive that could be possibly
aligned to do the right thing and do it quickly.
Mrs. Maloney. Thank you.
The new variants have been devastating. We've seen the
problems brought on by the Delta variant now which happens to
be even more contagious. It's really going through New York
very--infecting a lot of people. It's very, very contagious,
twice as likely to result in hospitalization in our city than
other strands.
And so I would like to ask, Dr. Khan, what does our
experience with the Delta variant tell us about the potential
threat posed by not only Delta but other new variants that seem
to be arriving?
Dr. Khan?
Dr. Khan. Thank you for that question, Representative
Maloney.
Correct. Our 1,300 deaths a day and 65,000 hospitalizations
are due to the failure to adequately respond to this pandemic
with vaccinations. And each of these variants have arrived
overseas, and until we have a global response--a global
vaccination campaign, layered with other public health
measures--you know, there's masks, there's testing,
quarantining, isolation, treatment--you layer them altogether,
we need to do this globally, otherwise we will be at risk for
yet another variant. It may not be Omicron. Obviously, between
Delta and Omicron, there were a lot of numbers that went
through there that didn't turn out to be a big issue for us,
but it could be whatever the next variant is.
So, we must make sure that we have a global response to
this pandemic if we want to protect Americans and go into this
post-pandemic phase.
Mrs. Maloney. Dr. Khan, how would temporarily waiving
patent rights on certain vaccines help accelerate global
vaccination efforts, given the fact that we have to be as
concerned about other countries as our own?
Dr. Khan. It would allow many of these hubs that are being
stood up to use those patents immediately, including, as I
said, the U.S. owns the Moderna, critical Moderna patent on the
spike protein formulation. So, having--and the WHO has already
set up a facility that's ready to do that work. The companies
don't want to work with them, unfortunately, because profit for
them outweighs lives. But the U.S. has the ability to be paid
for these vaccines. The American people paid for these
vaccines, and they can demand that these companies work with
these other countries and make sure that we get everybody
vaccinated.
That's the solution. We need to get more sites that are
vaccinating, in addition to, as I said, access issues, the
logistics issues and to address the vaccine hesitancy that we
also seem to be exporting.
Mrs. Maloney. You mentioned the Moderna vaccine. Scientists
at the National Institute of Health played a critical role in
developing these vaccines, and the Federal Government, I
believe, should have a say in how it's licensed this vaccine
abroad.
Dr. Khan, can you put this into the context of the global
vaccination effort? Why is it important for the Federal
Government to be involved in making these decisions abroad?
Chairman Clyburn. The gentlelady's time has expired.
Mrs. Maloney. My time has expired.
Dr. Khan. Can I answer? No?
Chairman Clyburn. Quickly.
Dr. Khan. We need to get everybody vaccinated as fast as
possible, and everything we do to increase that speed will
increase our transition to post-pandemic and move us back to a
better new normal and take care of these trade issues and all
of these social and political and economic disruptions, and
healthcare disruptions.
Chairman Clyburn. Thank you, Dr. Khan.
The chair now recognizes Mrs. Miller-Meeks for five
minutes.
Mrs. Miller-Meeks. Thank you, Mr. Chair.
And, you know, it's interesting listening to the panel, and
I agree that this is a global pandemic. So, all of our
panelists would agree this is a global pandemic? They can just
voice yes.
All of them agree that we need to have immunity, and we
know that we can acquire immunity through two different
sources; one through vaccination, and the second way that they
can acquire immunity is through infection-acquired immunity,
which we have heard discussed already.
It's frustrating to me to hear that the response from some
of our panelists is that if the United States forces U.S.
companies to give up intellectual property rights and patent
protections to allow more dosages to be developed, one is that,
are there facilities that can develop vaccines immediately and
with the safety requirements? And then, two, is there a public
health infrastructure in order to deliver vaccines? And, three,
while we are waiting for this, individuals are developing
COVID-19 and developing immunity. So, perhaps talking about
immunity would be extraordinarily helpful.
And one of the greatest problems today that we see and I
see, I have been told for over a year to listen to the science,
and I listened to the science, but I see that there's a lack of
evidence-based decisionmaking from the Biden administration.
And one example of this is what's happening in schools.
President Biden promised to support a return to the safe
learning as quickly as possible. Yet, even as the teachers were
prioritized for vaccines, they refused to turn to in-person
instruction. Students' learning loss due to remote or hybrid
learning is astronomical, and we just had another publication
about that this week. Failing grades are rising, and child
suicide rates are surging, and yet some schools remain remote
or hybrid despite no scientific basis for this decision. And we
heard again this week that schools in certain states are going
back to hybrid learning because of the Omicron variant, which
to this point has had very little fatalities.
In addition to which, when I was touring in some areas of
my district yesterday, I learned that one of the school systems
in a rural area closed down for a week for mental health
reasons for the faculty, not for the students. And that put a
burden then on those individual childcare providers and parents
who were in that school system.
So, for even those schools that are in person, many are
forcing children to wear masks, even though there is no study
that shows masks on their own provide any additional protection
for children.
Dr. Makary, do you have any studies which show the efficacy
of masking children in school?
Dr. Makary. No. The topic of masking children has not been
studied with any formal randomized control trial. The data that
we are relying on are really from adults, and that's--the
largest custom randomized control trial was conducted by
researchers at Stanford University, and they found that
basically a cloth mask had almost a negligible benefit. A
surgical mask had a roughly 11 percent reduction in
transmission, and higher quality masks were higher.
Now, I don't love that study design, but it's all we have
to work on. And basically we've imposed the covering of faces
of 52 million school aged children with very weak data.
Mrs. Miller-Meeks. And are there some evidence-based
consequences of masking children in schools?
Dr. Makary. Certainly if you talk to those who are speech
pathologists, guidance counselors, if you look at mental health
disorders in kids, it's got to play a factor.
And the Brown University study that showed that
developmental aspects of childhood are being significantlly
hindered in those who have gone to school during the era of
masks being worn in school. That was very validating to many
frontline people who have had concerns.
Some kids do great with masks. Some kids struggle. A
quarter of kids wear glasses, and it fogs up the glasses many
times. So, it's easy to say my kid does well with the mask and,
therefore, everyone should wear it. Come to inner city
Baltimore and take a look at the kids who are not in school or
in school wearing a mask and trying to learn on an iPad with
glasses on. It's an entirely different situation than somebody
who has got private tutors for their kids in the Hamptons with
a $10,000 Zoom suite.
Mrs. Miller-Meeks. And, you know, Dr. Makary, like you and
like our other panelists, I'm fully vaccinated. I've given
vaccines in all 24 of the counties in my congressional
district. But I think we've brought up a very important point
in this hearing is that I have asked Dr. Fauci and Dr. Walensky
on hearings of this subcommittee, we had five public health
experts just recently in this hearing ask them about infection-
acquired immunity, asked them about the Israeli study, and all
of them were less than supportive of evidence-based data that
has come out about infection-acquired immunity.
I put forward a bill to mandate all insurance, both private
and Federal, cover for serology testing for human antibodies
and also T-cell antibodies because we know the T-cell immunity
is stronger and lasts longer. But, yet, as you are indicating,
when we are talking about trying to globally vaccinating
countries, we are vaccinating now children 16 to 17 and
recommending boosters for individuals who may already have
immunity rather than recommending testing for that.
We don't know in children because the CDC--and I've asked
this of Dr. Walensky, you know, for those children who have
died of COVID 19, what were their risk factors? What were their
vulnerabilities? That's information we should know before
recommending that every child be vaccinated from the ages of 5
to 12 or 5 to 11 and then recommending boosters. Because, as I
think you indicated, would you agree those boosters could be
doses that could go overseas to other countries in order to
increase the rates of immunization?
Chairman Clyburn. The gentlelady's time has expired.
The chair now recognizes Mr. Foster for five minutes.
Mr. Foster. Thank you.
Am I audible and visible here, Mr. Chair?
Chairman Clyburn. Yes.
Mr. Foster. Thank you.
So, Dr. Khan, we've heard a lot of speculations about how
maybe we would be better off with a national response that
focused on natural immunity rather than vaccination.
And so if we had adopted that sort of approach, which is
pretty much what Third World countries are forced to do because
they don't have access to vaccine, if we had adopted that
approach, what would it have meant in terms of patient overflow
in emergency rooms and ICUs? What would it have meant in terms
of the burnout of medical personnel?
Dr. Khan. Thank you, Representative Foster.
We did adopt this strategy. This is the Great Barrington
Death Declaration, Scott Atlas Strategy of Natural Immunity.
There's a reason in the English language we say, ``Avoid it
like the plague,'' because in no other plague have we ever
said, Let's go out and get infected. Yes. So, the trouble with
natural immunity is you have to get infected to get natural
immunity, which makes you either dead or have long COVID or
other complications, causing orphans causes often, et cetera,
overwhelms healthcare systems.
But let me step back, Representative. I'm big fan of
immunity, innate immunity, natural immunity, acquired immunity.
Love all of them; love B cells, T cells, probably have some
love for dendritic cells too. But what really beats all of
those is hybrid immunity, and the data is unequivocal with
hybrid immunity. Right? Nice. CDC study in Kentucky, May and
June of last--of this year. Two-point-three percent less likely
to get infected if you were previously infected and vaccinated
versus just previously infected.
And even Israel that we like to talk about, I think they
only give you 3 to 6 months before they say, sorry, you have to
get vaccinated. With the Omicron variant, we are seeing the
data has clearly coming out with the Omicron variant. Natural
immunity is not as good with the Omicron variant and overcomes
very easily. So, that 3 to 6 months will probably go away also.
So, what's better is hybrid immunity. So if you have been
naturally infected, get infected. I may also add--and I want to
thank Dr. Makary for the data. So, over half of Americans have
already probably been infected in some way, shape, or form. You
add in 200 million people who have at least been fully
vaccinated, so essentially everybody in America has some
version of fully vaccinated or natural immunity, In which case
why do we have any cases anymore? We should have zero disease
in America if you have combination of vaccinated and natural
immunity.
So, this continued misinformation and false god of natural
immunity is one of the reasons why we have the military
deployed to hospitals across America to say, Please help us.
It's why we have healthcare burnout. And institutions are in
trouble not because of the interventions of vaccination,
masking, social distancing, isolation, and quarantine.
Institutions are in trouble because of the disease which we
respond to with good better public health measures.
Mr. Foster. Yes. Thank you. And----
Dr. Khan. So, we need to get people vaccinated.
Mr. Foster. Thank you.
Now, we've also heard that masking may be as small as 11
percent effective. OK. Now, that sounds like maybe a small
number, but that means that this virus, first off, has to find
a new victim or die every week or two. OK.
So, now that means if it's 11 percent effective, then you
have only 89 percent of the virus that will be transmitted in
the next generation. One generation it will be 89 percent
squared, the next one cubed, and on and on and on. After ten
generations, 10 weeks afterwards, you will find that 70 percent
of the virus has been wiped out by masking, which is why you
see at the country comparison level masking is so effective and
as a general public health precaution.
So, 11 percent, even if the number is that low, is nothing
to be sneezed at in terms of the public health impact.
Now, also we've heard the claim made that somehow the
administration is not interested in natural immunity, and I can
tell you they are very focused on it, particularly in terms of
the Omicron and what that will mean.
Now, the multiplication factor seems to be about every
three days, the doubling time, every three days. That means
that if it's every three days, after one month, it's a factor
of a thousand. So, one case will turn into a thousand cases;
after two months, a million cases; after three months, a
billion cases. The likelihood is that within the next three
months, most of humanity will be expected by this. And it is a
matter of crucial concern that I can tell you from the very--
from the top of the administration and understanding why
whether that will provide some level of cost immunity to the
Delta variant, which is apparently the lethal version of it.
And so I just want to put that out there, that there is no
shortage of interest in the implications of cross-immunity to
the Omicron virus in the administration. It is going to be a
crucial issue and officials at the highest level are working on
it.
I guess my time is up at this point, and I yield back.
Chairman Clyburn. Thank you.
Mr. Foster. OK.
Chairman Clyburn. Thank you for yielding back.
The chair now recognizes Mr. Krishnamoorthi for five
minutes.
Mr. Krishnamoorthi. Can you hear me now?
Chairman Clyburn. Yes, I hear you now.
Mr. Krishnamoorthi. OK. Great. Thank you, Mr. Chair.
I'm the cochair of the Global Vaccination Caucus in
Congress, so this is a very important hearing.
Let me first ask Professor Russ, Dr. Russ, it's correct
that vaccinations abroad could relieve supply chain
disruptions? Correct?
Dr. Russ. Yes; in two ways.
Mr. Krishnamoorthi. Let me--I want to just build on this
question.
And reducing supply side disruptions will in part tamp down
price inflation? Correct?
Dr. Russ. Yes.
Mr. Krishnamoorthi. And, therefore, global vaccinations
would help fight inflation? Right?
Dr. Russ. Yes.
Mr. Krishnamoorthi. Do you have an estimate of how much
inflation would go down because of global vaccinations?
Dr. Russ. No.
Mr. Krishnamoorthi. Would it be a substantial portion of
the inflation that we see?
Dr. Russ. It's hard to tell. The relationship between the
price of imports and the impact on our domestic inflation is
not linear. So, if you think about the contribution of the
shortage in semiconductors, it generated these shutdowns in
U.S. auto production that contributed to keeping prices high on
autos in the United States.
Right now autos contribute to one-fifth of the inflation
that we are seeing. That's not all because of the vaccine-
related supply disruptions.
Mr. Krishnamoorthi. I understand, I understand.
Dr. Udayakumar, a new study came out from South Africa
today suggesting that the Omicron variant may cause less severe
disease, and they found a 29 percent lower risk of
hospitalization. However, they also found that in the U.K.
members of the same household were three times more likely to
pass on Omicron than Delta.
So, if we have 29 percent fewer hospitalizations but three
times more people infected, that would produce more
hospitalizations overall and would potentially overwhelm
hospitals in this country, would it not?
Dr. Udayakumar. Yes, Representative Krishnamoorthi, it's
exactly right. We like to think about transmissibility, immune
evasion, and severity as different variables that impact, and
certainly the significant increase in transmissibility is quite
worrisome.
Mr. Krishnamoorthi. So, since the Delta variant became the
dominant variant in the U.S. in July, almost 200,000 people
have died from COVID-19 in this country. Given that the two-
dose vaccine regimen is less effective against Omicron and
natural immunity is less protective against reinfection with
Omicron and it's significantly more transmissible--yes or no
question--are we likely to see tens of thousands of deaths in
the U.S. alone because of Omicron?
Dr. Udayakumar. I would say it's probably too early to tell
because we don't really know the questions around severity, but
it is likely that we will see that level of deaths in the U.S.
over the coming months.
Mr. Krishnamoorthi. So, one of the things that I'm pushing,
along with my co chairs of the Global Vaccination Caucus, is
$17 billion more in Fiscal Year 2022 appropriations for the
scaling up of manufacturing capacity of vaccines.
And what I wanted to ask you is, would you agree that this
additional $17 billion for the purchase of vaccines, as well as
the scaling up of vaccine capacity, is needed right now to
combat the lack of vaccinations globally?
Dr. Udayakumar. Yes, Representative Krishnamoorthi, we are
still tens of billions of dollars short in the global response.
I would just note, in addition to vaccine manufacturing and
purchases, the additional bottleneck going into 2022 is really
going to be on the delivery side. So, country level readiness
is also something we need to invest significantly in, in the
billions of dollars.
Mr. Krishnamoorthi. I'm glad you brought that up. So, I
have introduced legislation called NOVID. It's a play on words;
no more COVID. One-hundred of my colleagues and I urge that
this be adopted as part of our legislative process going
forward to help make sure that we combat the problem of a lack
of vaccines abroad.
Let me--Dr. Ali Khan, you know, I read in a recent piece by
Dr. Makary that back in the spring of last year natural
immunity apparently had reached a very high level. And he said,
quote, I expect COVID will be mostly gone by April 2021.
That wasn't the case, was it?
Dr. Khan. No, it wasn't. And anybody who was a field
epidemiologist, public health expert would have known that.
Mr. Krishnamoorthi. Thank you.
I yield back.
Chairman Clyburn. I thank the gentleman for yielding back.
I do not see any others here. Am I missing somebody?
It is now time for me to yield to the ranking member for
whatever closing statement he may want to make. Is the ranking
member available for his closing statement?
Mr. Scalise. Like on queue, Mr. Chairman. I appreciate
that.
Between votes we were able to pull this hearing off too.
So, I appreciate all of the witnesses for bearing with us and
for bringing your different viewpoints to mind; you as well,
Mr. Chairman.
And, obviously, when we look at where we are on COVID with
yet another variant that's come, we've seen different
approaches by different states, and I think some states have
shown the way for how you can confront the virus while also
maintaining people's own rights and freedoms and the ability
for people to live their lives, to keep their businesses open,
to keep their jobs.
And, unfortunately, I think one of the things that we've
been very frustrated by is that it seems, coming out of the
Biden administration, it has been more of a one-size-fits-all
approach and more of a top down kind of bullying, shaming
approach just on vaccine mandates.
And, again, to show the President, has tried and been
blocked by courts all across this country on these mandates.
The courts have said you can't fire people in the healthcare
industry, for example, if they don't get a vaccine. You can't
fire people that work for a company with over 100 employees if
they don't get the vaccine
You can't fire someone who's a government contractor.
But it's just alarming that President Biden's main focus
seems to be trying to get people fired from their jobs as
opposed to putting more time and effort into some of these
alternatives. And I'm glad we've started to discuss them. You
know, what do immunities really provide you? For how long do
those immunities really last? And for someone who says they
don't want to get a vaccine, I'm vaccinated. I think most of
our members are vaccinated and have encouraged other people to
get vaccinated.
But we also see that there are segments of our country that
don't want to get vaccinated, and it's not all Trump
supporters. It's people in every community, in African-American
communities, in Hispanic communities, across the political
spectrum. It's not a political issue. It's a personal choice.
And people are making that personal choice with the facts.
You know, let's first get them the facts and let's trust
the science. But it seems like science is getting thrown out
the window when it doesn't meet a narrative. And we really
should be putting more time into looking into those questions.
You know, what are alternative therapies that aren't being
researched right now that could help protect and keep people
safer while also maintaining their freedoms, the ability for
people to go about their lives again?
You know, this idea that some states just want to shut
everything down is not--it's not realistic, and it ignores
where many people are in their lives. Like, let's look at the
models of places where it's worked well. Many states have done
it much better than other states.
Those are the kind of discussions we ought to be having.
Bring in scientists that have different viewpoints so that we
can hear how we can put more ideas on the table. I don't see
enough of that happening. And, once again, I will say we ought
to have a hearing to investigate the origin of COVID-19 to see
what really happened, why the world wasn't told the truth, how
many lives could have been saved, and how we can prevent
something like this from happening again.
So, I appreciate the testimony we've had.
Mr. Chairman, I'll see you on the floor in a little while.
With that, I yield back the balance of my time.
Chairman Clyburn. I thank the ranking member for yielding
back. Thank you so much.
Let me thank all of you for being with us today, all of the
witnesses today. In closing, I want to say that we appreciate
your insight, your expertise, and your advice on the urgent
need to accelerate vaccinations around the world.
I often quote Dr. Martin Luther King, Jr.'s letter from the
Birmingham City Jail for various reasons. Today I wish to quote
his statement that ``Injustice anywhere is a threat to justice
everywhere. We are caught in an inescapable network of
neutrality, tied in a single garment of destiny. Whatever
affects one directly, affects all indirectly.''
On no subject is that statement more clearly true than the
subject of vaccinating the world against the coronavirus. The
injustice facing those who still lack access to a vaccine is a
threat to justice everywhere in the world, including here in
the United States. It's a threat to health justice, and it's a
threat to economic justice.
As we have heard from today's witnesses, the only way to
end this crisis once and for all, for all everywhere, is to
make sure that the United States continues to support global
vaccination efforts so the virus cannot spread unchecked
anywhere.
We have the tools to end this pandemic. Vaccines and
boosters are highly effective at preventing hospitalization and
death and curbing the spread of the virus. But it will only
work if people can have access to them. As we continue urging
fellow Americans to take advantage of these lifesaving
vaccines, we must dedicate the necessary resources to allow
everybody in the world to access them. Their lives and
livelihoods depend on our efforts. The American lives and
livelihoods depend on our efforts.
To protect the lives and livelihoods of all of us caught in
the escapable network of neutrality, tied in a single garment
of desolate, we must achieve a global solution to this global
problem by accelerating vaccinations across the world.
With that, without, objection, all members will have five
legislative days within which to submit additional written
questions for the witnesses to the chair, which will be
forwarded to the witnesses for their response.
This hearing is adjourned.
[Whereupon, at 4:04 p.m., the committee was adjourned.]
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