[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                      LOOKING AHEAD SERIES: OFFICE OF THE 
                                ATTENDING PHYSICIAN

=======================================================================

                                HEARING

                               BEFORE THE

                       SUBCOMMITTEE ON OVERSIGHT

                                 OF THE

                   COMMITTEE ON HOUSE ADMINISTRATION

                       HOUSE OF REPRESERNTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                               __________

                             MARCH 23, 2023

                               __________

      Printed for the use of the Committee on House Administration
      
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]      


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                   COMMITTEE ON HOUSE ADMINISTRATION

                    BRYAN STEIL, WISCONSIN, Chairman

BARRY LOUDERMILK, Georgia            JOSEPH MORELLE, New York,
MORGAN GRIFFITH, Virginia                 Ranking Member
GREG MURPHY, North Carolina          TERRI A. SEWELL, Alabama
STEPHANIE BICE, Oklahoma             DEREK KILMER, Washington
MIKE CAREY, Ohio                     NORMA TORRES, California
ANTHONY D'ESPOSITO, New York
LAUREL LEE, Florida

                      Tim Monahan, Staff Director
                  Jamie Fleet, Minority Staff Director

                                 ------                                

                       SUBCOMMITTEE ON OVERSIGHT

                    BARRY LOUDERMILK, GEORGIA, Chair

MORGAN GRIFFITH, Virginia            NORMA TORRES, California
GREG MURPHY, North Carolina               Ranking Member
ANTHONY D'ESPOSITO, New York         DEREK KILMER, Washington

                Caleb Hays, Subcommittee Staff Director
                         
                         
                         C  O  N  T  E  N  T  S

                              ----------                              
                                                                   Page

                           Opening Statments

The Honorable Barry Loudermilk, Representative from the state of 
  Georgia........................................................     1
The Honorable Norma Torres, Representative from the state of 
  California.....................................................     2
The Honorable Bryan Steil, Representative from the state of 
  Wisconsin......................................................     4
The Honorable Joseph Morelle, Representative from the state of 
  New York.......................................................     5

                           Witness Statements

Brian Monahan....................................................    10

                       Submissions for the Record

June 2020 Considerations for Events and Gatherings...............    30
July 2021 Science Brief: COVID-19 Vaccines and Vaccination.......    40
February 2022 Transcript of the CDC media telebriefing on COVID-
  19.............................................................    69

                                  QFRs

Brian Monahan....................................................    82

 
        Looking Ahead Series: Office Of The Attending Physician

                              ----------                              


                        Thursday, March 23, 2023

                  House of Representatives,
                         Subcommittee on Oversight,
                         Committee on House Administration,
                                                    Washington, DC.

    The subcommittee met, pursuant to notice, at 3 p.m., in 
room 1310, Longworth House Office Building, Hon. Barry 
Loudermilk [chair of the subcommittee] presiding.
    Present: Representatives Loudermilk, Steil, Griffith, 
Murphy, D'Esposito, Morelle, Torres, and Kilmer.
    Staff present: Tim Monahan, Staff Director; Aubrey Wilson, 
Deputy Staff Director and Director of Oversight; Elliott 
Tomlinson, Deputy General Counsel and Deputy Parliamentarian; 
Hillary Lassiter, Clerk; Jordan Wilson, Director of Member 
Services; Jamie Fleet, Minority Staff Director; Khalil Abboud, 
Minority Deputy Staff Director and Chief Counsel; Matthew 
Schlesinger, Minority Oversight Counsel; Eddie Flaherty, 
Minority Chief Clerk; Andrew Garcia, Minority Special 
Assistant; and Enumale Agada, Minority Oversight Counsel.
    Chairman Loudermilk. The Subcommittee on Oversight will 
come to order.
    I note that a quorum is present.
    Without objection, the chair may declare a recess at any 
time.
    Also, without objection, the meeting record will remain 
open for 5 legislative days. So members may submit any 
materials they wish to be included therein.
    I thank Ranking Member Torres, a classmate of mine and came 
in Congress together, and members of the subcommittee for 
participating in what I may emphasize is the inaugural hearing 
of the House Administration Oversight Committee, not just the 
first of this Congress but the first ever. So I think that's 
something that we're looking forward to having, more of these.
    I look forward to working together to bring robust 
oversight to the legislative branch, including many entities 
that we oversee. Unfortunately, many of these offices have not 
been called before our committee in years, resulting in a lack 
of accountability to both Congress and the American people.
    We're very honored to have Dr. Monahan with us today. In 
fact, Dr. Monahan has not appeared before a congressional 
committee ever, which is a testament to why we're having 
hearings now. But this is not unique to him. No Attending 
Physician has ever been called to testify and that's changing 
in this Congress.
    For nearly 100 years, the Office of the Attending 
Physician, or OAP as most of us know it, has served both 
chambers, offering healthcare and guidance to senators, 
representatives, Supreme Court Justices, and even staff and 
visitors during emergencies.
    Prior to the 116th and 117th Congress, the OAP operated 
largely behind the scenes. Then COVID-19 pandemic hit us, and 
subsequent strains reached our nation, resulting in the OAP 
becoming a substantial voice with an increased sense of 
authority, enabled by the office of former Speaker Nancy 
Pelosi.
    In a time when we needed true health guidance based on 
facts, the OAP issued what appeared to be inconsistent health 
and safety guidance across the two Chambers of Congress due to 
political pressures. Greater restrictions were placed on the 
House of Representatives than the Senate, even though the 
chambers not only operate on the same campus but physically 
gather on two sides of the same building.
    I look forward to hearing from Dr. Monahan about how such 
guidance was decided upon, the pressures he faced, and what 
this Committee can do to insulate the Office of Attending 
Physician from political manipulation in the future.
    Taking a step back from the polarization of health 
guidance, the pandemic also brought to light another issue 
within the office. The Attending Physician played a key role in 
advising House personnel on protective--personal protective 
equipment, or PPE as we all have come to know that term, the 
usage and testing requirements of PPE. However, the OAP did not 
hold the contracting authority to oversee the procurement and 
purchase of PPE or contract procurement for the COVID testing 
contractors.
    My hope is that, as a result of this hearing, we'll be able 
to identify OAP authorities that need to be better defined to 
ensure adequate accountability and responsibility in responding 
to a health crisis.
    Finally, with the full opening of the campus, it's time to 
ensure that the House's support services are back in full 
operations.
    I look forward to receiving an update on whether all OAP 
offices across the House have returned to regular business 
hours and what the timeline is for OAP returning to offer its 
full medical and health support services to those on campus.
    Ultimately, we must establish accountability for this 
office, transparency of its operations and decisionmaking, and 
explore reauthorization of its overall authorities.
    The OAP plays an important role for congress, not only for 
critical health and safety support but also for continuity long 
term.
    I'm thankful that Dr. Monahan is here to have a 
conversation with us about what we can do to ensure the OAP 
returns to being a trusted office that is strong and 
independent.
    Thank you for being here. Let me also say, as a fellow 
veteran, thank you for your service to our Nation in the United 
States Navy.
    I now recognize the Ranking Member, Mrs. Torres, for 5 
minutes for the purpose of providing an opening statement.
    Mrs. Torres. Thank you, Chairman.
    Welcome, Dr. Monahan.
    It is a privilege to be here for the Subcommittee on 
Oversight's first hearing in the 118th Congress.
    Oversight of our government should be a bipartisan 
objective, and while there is a lot of political theater 
happening in other committees, I am hopeful that we will lead 
by example in doing the important work in a bipartisan way.
    Our constituents sent us to congress to work on behalf of 
the American people and ensure that taxpayer dollars are spent 
appropriately and effectively. Holding our institutions 
accountable when they fall short should be a bipartisan 
objective. With that said, I look forward to collaborating with 
my colleagues and the chairman on this very important work.
    For today's hearing, we turn our attention to the Office of 
the Attending Physician, which is led by Dr. Brian Monahan. It 
is really good to see you again, doctor.
    Dr. Monahan has occupied this role since January 2009, 
serving admirably under both Democratic and Republican 
majorities. He is certified by the American Board of Internal 
Medicine in internal medicine, hematology, and medical 
oncology, and holds the rank of rear admiral in the United 
States Navy.
    He has served as a surgeon general specialty leader and as 
training program director of hematology and medical oncology at 
the National Naval Medical Center, National Capital Consortium.
    Dr. Monahan has also served as chairman and professor of 
medicine and pathology at the Uniform Services University of 
the Health Sciences in Maryland.
    Dr. Monahan is also notable for the dedicated and 
compassionate care that he provides to members of the House and 
the Senate.
    Dr. Monahan, in my opinion, you are not some paper pusher 
hiding behind a fancy title. You are hands-on, accessible, and 
personable. Knowing each member and their spouses by their 
first name, traveling with us, visiting us when we are sick, 
and making yourself available at any time to discuss even a 
minor issue is very appreciative.
    Dr. Monahan spent this past weekend, as a matter of fact, 
in Florida providing care and services to my republican 
colleagues during their annual retreat. In such a small 
minority, you know, it is really important to keep you healthy 
during this time.
    In addition to the enormous responsibility of caring for 
every member of the House, Dr. Monahan and his team are also 
charged with the care of each senator, Supreme Court Justice, 
congressional staff, and the millions of visitors that come to 
our campus every year.
    Over the past 3 years, Dr. Monahan has had the challenging 
task of guiding the House and other institutions at the heart 
of our democracy through a dangerous, unprecedented, and 
rapidly changing public health crisis.
    It is important to overstate the critical role Dr. Monahan 
and his staff played in keeping those of us who work in the 
House safe, not just members but the bill clerks, maintenance 
workers, and staff that are the true lifeblood of this 
institution. Healthy and able to continue to do our work on 
behalf of the American people was his primary duty.
    Unlike the Senate, the House was able to continue 
proposing, debating, and voting on legislation during the early 
days of the pandemic, thanks in part to the use of proxy 
voting, the eHopper, and remote proceedings. These were very 
challenging times, and with Dr. Monahan's guidance and 
direction, the House was able to continue to legislate on 
behalf of the American people.
    Dr. Monahan, please extend my sincere gratitude to your 
team for a job well done. Still, as members, we should never 
miss an opportunity to examine our responses to crisis and 
identify lessons learned. As a former 911 dispatcher, I know 
how important it is for our leaders to look at a path forward, 
learning from past experiences, especially when it comes to 
public health and safety. Today's hearing provides a forum in 
which we can do just that.
    It is my expectation that, through Dr. Monahan's testimony 
and answers to today's questions, we can identify ways to 
better support you.
    Additionally, given that is a new subcommittee, today's 
hearing offers us a chance to learn about the office structure 
and operations while also laying the foundation for a 
collaborative and communicative oversight relationship.
    Finally, the Office of the Attending Physician has 
proactively recommended ways that the office can be updated and 
better prepared for challenges ahead. I look forward, Mr. 
Chairman, to learning about these recommendations and the ideas 
that are brought forward.
    With that, I yield back to the chair.
    Chairman Loudermilk. I now recognize the chairman of the 
full committee, Mr. Bryan Steil, for the purpose of providing 
an opening statement.
    The Chairman. Thank you very much, Chairman Loudermilk. 
It's exciting to be here on the first meeting of the 
Subcommittee on Oversight in House Administration. I'm excited 
in your role and the expertise you bring to this hearing. I 
think it's really important as we reflect about how we get this 
institution back to normal following a tumultuous few years. I 
think your leadership is spectacular in that regard.
    Ranking Member Torres, I appreciate your comments in 
particular about the opportunity to have a real bipartisan 
approach to this as we really work to depoliticize a lot of the 
institutions here at the House to the benefit not only of the 
members, of the staff, but really of the American people to get 
this place up and working.
    Dr. Monahan, I appreciate you being here. I know you're a 
rear admiral in the Navy, and we thank you for your service 
over your career to our country and also to your service in 
this part of your career to the institution of the Nation's 
Capitol. It's greatly appreciated.
    While the Office of the Attending Physician, or OAP, has 
historically operated often behind the scenes, the office plays 
an important role, as we've noted, in the House, the Senate, 
and the Supreme Court as well. I would like to specifically 
thank you but also all of the members of your staff at the OAP 
for their 24-hour support for the broader congressional 
community.
    More recently, the OAP played a very prominent role in the 
House's response to the COVID-19 pandemic. Unfortunately, I'm 
pretty concerned that the office may have been manipulated or 
polarized by former Speaker Pelosi and her team during the 
pandemic. I think that's why, in one way, it's so important we 
hear directly from you today, Dr. Monahan.
    Why am I concerned? So, despite being in the same Capitol 
Building, the House and the Senate had different and, in my 
opinion, inconsistent health guidance. For example, someone on 
the House side of the Capitol would have to wear a mask under 
the rules, but once you got halfway through the rotunda, you 
could take it off and cross into the Senate side and be in 
compliance with the Senate rules. I think we would all agree 
that that doesn't make a lot of sense.
    So the lack of transparency and kind of the politicization 
of the guidance was really highly concerning to a lot of 
Members, and this Committee's work is to really look at what 
led to that and to prevent any abuse of health guidance in the 
future.
    So, through our hearing today, I hope we can reestablish 
the accountability for this office, increase transparency of 
its operations and decision makings, and review its overall 
authorities with the goal of making the office stronger and 
more independent.
    I look forward to working together to ensure your office 
meets the needs of Congress as an independent nonpolitical 
entity that's rooted solely in scientific fact. I appreciate 
your being here.
    Mr. Chairman, I yield back.
    Chairman Loudermilk. I now recognize the full committee 
Ranking Member, Mr. Morelle, for the purpose of providing an 
opening statement.
    Mr. Morelle. Thank you, Mr. Chairman. I want to thank you 
and the Ranking Member for this hearing today.
    I do appreciate very much, Admiral, what you do and what 
your team does. I think for all members who may need your 
services appreciate the professionalism, the expertise, the 
amount of care and attention that members get in a place where 
it's very stressful. You're away from home. Whether or not 
you're the primary care provider for them or you play a 
secondary role to those who have a healthcare provision back in 
their home community, I think you just do an excellent job.
    I do want to point out--and I'm appreciative of the fact 
that you're here. I think all of us here on both sides of the 
aisle always want to be looking at the things that we do, and 
this committee, particularly, has responsibility for the 
administrative tasks of the House, and I think we should always 
be open to suggestions about how to improve, how to make sure 
that we're having transparency, that we're asking the right 
questions about what you do and what your very talented team 
does.
    I also think that--and we'll get into this on questions, 
and I appreciate the time, and I won't take up much time here, 
but the fact that you provide services for both Houses, as well 
as the Supreme Court, and that the two Houses and the 
leadership of the two Houses may look differently at your 
recommendations, when I think the question here for all of us 
to answer is: Are you providing the same guidance to both 
leaders and then allow them, particularly as my colleague and 
good friend, the Chairman of the standing committee has 
mentioned, why there were differences in the implementation of 
different procedures during the pandemic?
    Was that decisions that you made? Were the recommendations 
you made to the two Houses different, or did they simply make 
different decisions with the recommendations that you gave? I 
think that's really an important question for us to answer, and 
some may have abided by the science and some may not have.
    That's not a decision for you to make, as I understand it, 
but, obviously, one would have questions about what 
recommendations you made, particularly during the pandemic, and 
how did you come to make those recommendations? Were you 
following the science? Kind of what was your strategy in making 
those recommendations to the two different Houses?
    I think that will be important, probably as well as 
whatever recommendations you made to the chief justice and the 
administrative team in the Supreme Court. So I think those are 
important questions. I'm looking forward to your answer.
    Again, I just appreciate your service to the country and 
certainly appreciate your service to those of us here in 
Congress.
    So, with that, I yield back, sir.
    Chairman Loudermilk. Thank you.
    Now, without objection, all other members' opening 
statements will be made part of the hearing record if they are 
submitted to the committee clerk by 5 p.m. today.
    Pursuant to paragraph (b) of Committee Rule 6, we'll now 
move to swearing in of the witness.
    If, Dr. Monahan, you'll please stand and raise your right 
hand.
    [Witness sworn.]
    Chairman Loudermilk. Thank you.
    Let the record show that the witness answered in the 
affirmative.
    I will now proceed to introduce the Honorable Dr. Monahan.
    Rear Admiral Dr. Brian Monahan, who was appointed in 2009, 
is the seventh Attending Physician of the U.S. Congress and the 
U.S. Supreme Court.
    Following his service with the U.S. Marine Corps 3d 
Battalion, 6th Marine infantry regiment, Rear Admiral Brian 
Monahan completed his internal medicine residency at the 
National Naval Medical Center where he was selected as chief of 
residents.
    Dr. Monahan completed his training in hematology and 
medical oncology at the National Cancer Institute and National 
Naval Medical Center in 1996, and serves as a professor of 
medicine and pathology at the Uniform Services University of 
Health Sciences in Bethesda, Maryland.
    His public health leadership--in his public health 
leadership capacity, Dr. Monahan is the physician responsible 
for the medical welfare of members of Congress, Justices of the 
Supreme Court, and directed to the coronavirus pandemic 
response protocols for the legislative branch of the U.S. 
Government.
    The Attending Physician is instrumental in security 
planning with the Architect of the Capitol, Senate Sergeant at 
Arms, House Sergeant at Arms, United States Capitol Police, and 
other congressional officials to ensure medical support during 
contingency operations and natural and manmade disasters.
    Dr. Monahan, we appreciate you being here today and look 
forward to your testimony.
    As a reminder, we have read your written statement, and it 
will appear in the full hearing record. Under Committee Rule 9, 
you are to limit your oral presentation to a brief summary of 
your written statement, unless I extend this time period in 
consultation with Ranking Member Torres.
    Please remember to press the button on the microphone in 
front of you so that it is on and the members can hear you, 
which is important, and we all tend to forget that sometimes.
    When you begin to speak, the light in front of you will 
turn green. After 4 minutes, the light will turn yellow. When 
the red light comes on, your 5 minutes has expired. We would 
ask you to then just--if you need to wrap up at that point, 
we'll give some leeway there.
    I might remind my colleagues there are 41 House hearings 
going on today. So we do plan on having two rounds of 
questions. So, if you can, keep your questions within the 5 
minutes. We'll have a little leeway, but being on time is 
important for those who have to move back and forth between the 
different committee hearings.
    At this point, I recognize Dr. Monahan for 5 minutes.
    Dr. Monahan.

        STATEMENT OF BRIAN MONAHAN, ATTENDING PHYSICIAN

    Dr. Monahan. Mr. Chairman, Ranking Member, thank you for 
the opportunity to address the subcommittee.
    The Office of Attending Physicians, or the OAP, was 
established in 1928, following the unexpected deaths of several 
members and in recognition of the need for medical care in 
Congress by Speaker Longworth. Since my appointment in 2009, it 
has been my honor to serve as the seventh attending physician.
    The OAP is a small office of fewer than 50 people with many 
responsibilities for health, safety, and medical care here on 
the Capitol complex. I would like to speak briefly about those 
services, other than the classified programs.
    The OAP provides comprehensive medical care to Members of 
Congress and the Supreme Court. Staff are accessible 24 hours a 
day, 365 days a year. The OAP is voluntarily accredited by the 
Joint Commission, achieving the gold seal of approval 
continuously since 2014.
    We provide preventative care, vaccinations, first aid, and 
nursing services to members and staff through our health units 
located throughout the Capitol complex. We supervise and equip 
all of the lactation suites and provide first aid, CPR, and 
naloxone rescue training classes.
    OAP personnel supervise air quality, water quality, food 
safety, pest control, and overall workplace comfort and safety 
issues. For example, our staff conducts health inspections of 
all food service establishments and virtually every meal served 
on Capitol Hill.
    We also work with the Capitol Police and Architect to 
ensure individuals are compliant with environmental health 
education and medical surveillance programs.
    We provide medical expertise for congressional travel and 
contingency support planning, such as medical threat 
assessments for staff delegation travel and congressional 
delegation travel.
    The OAP provides medical care for large special events, 
such as the State of the Union Address, the Presidential 
Inauguration, joint sessions of the congress, large scale 
ceremoneys, member retreats, and party national nominating 
conventions.
    The OAP is also tasked with providing medical emergency 
care to staff, visitors, and other members of the public. We 
triage and stabilize individual patients and manage mass 
casualty situations. For example, the OAP provided care for 
numerous heat injuries during the outdoor memorial service for 
Senator John McCain and managed the response to the 2001 
anthrax attack, and the April 2013 ricin episode.
    We are often the first on scene for serious and violent 
events. For example, we mobilized to provide emergency care in 
2013, when a driver was shot and critically wounded outside the 
Hart Office Building and the OAP recovered the infant in their 
car, and in 2016, for a shooting in the Capitol Visitors 
Center.
    We were the first responders in the 2018 Crozet, Virginia, 
Amtrak collision derailment with dozens of injured members and 
staff, as well as a fatality and life-threatening injuries on 
the ground.
    In 2021, we responded and provided critical support to 
Capitol Police officers rammed by a vehicle. One Capitol Police 
officer sadly died in that incident. We also responded to 
numerous serious injuries to police officers and members of the 
public on January 6, 2021, in support of the Congress' return 
to normal operations.
    In March 2020, healthcare systems and providers across the 
nation, including the OAP, were faced with the largest 
international public health crisis in a century: the SARS-CoV-2 
coronavirus pandemic. Many members and staff have been exposed 
to or contracted COVID-19. Sadly, I am aware of at least 5 
deaths in the congressional community among our 3,361 COVID-19 
cases.
    Other members and staff have had serious ongoing health 
challenges. At times, the staff at the OAP has been available 
24 hours a day to provide both remote and in-person care and 
advice to Members with COVID, their staff, and their families.
    In March 2020, the OAP was tasked with an advisory 
participation in the Joint congressional Continuity Board, 
known as the JCCB, that established a bicameral response plan 
for the early weeks of the pandemic and the operational posture 
of the entire Congress organization.
    The Committee on House Administration also required the OAP 
to create a physician-and nurse-staffed COVID response center 
which responded to queries 24 hours a day and delivered contact 
tracing services to all the contacts, both the quarantined and 
the cases.
    As an organization that principally provides primary care, 
the OAP staff does not include any pandemic-related scientific 
staff, such as epidemiologists, et cetera. We do not have the 
expertise or resources to develop ad hoc public health 
recommendations.
    Rather, the OAP sought the advice of national and regional 
experts at the Centers for Disease Control and Prevention, the 
National Institutes of Health, and other agencies. Ongoing 
dialog with these experts ensured the OAP was knowledgeable of 
current Federal COVID response guidelines.
    The OAP also coordinated with local government partners who 
were essential for sustainment of congressional activities. The 
OAP sought to maximize congressional operations while reducing 
the spread of disease and death.
    The OAP made recommendations to reduce spread at large 
gatherings, including voting procedures, procedures for caucus 
meetings, and solemn ceremoneys, such as those of Congressman 
John Lewis, Senator Robert Dole, Harry Reid, and Justice 
Ginsburg.
    The OAP sought at all times to enable the business of the 
Congress without excess COVID cases or deaths. At a time when 
COVID testing resources were scarce or unavailable, the OAP 
successfully made them possible with a rapidly scalable 
capability. This enabled Members to obtain PCR test results 
very rapidly and provided insight to limit disease spread.
    Currently, the Capitol COVID testing center provides the 
gold standard PCR results within minutes. The present test 
positivity rate is less than 1 percent. Since March 2020, the 
OAP has performed over 159,000 PCR tests.
    The development of COVID vaccines through Operation Warp 
Speed represents an astonishing medical success. The OAP was 
instrumental in ensuring Congress was prioritized in the 
national security-based program for continuity of government 
vaccine access and delivered immediate large-scale 
distribution. This required acquisition, installation of ultra 
cold storage chain, developments for a protocol for operating 
COVID immunization clinics, and handling thousands of calls per 
day with the invaluable assistance of many Library of Congress 
personnel.
    The OAP has administered over 32,400 coronavirus 
vaccinations. As COVID treatments were developed, mechanisms 
were put in place to immediately prescribe medications locally 
and in home districts. Non-COVID health needs, including both 
mental and physical health conditions, were continuously 
addressed.
    The OAP was also tasked with COVID-related communications. 
We endorsed interventions recommended by the CDC and, thus, was 
not immune to changes or reversals in COVID-19 guidance.
    The OAP recommendations were the same to both Chambers of 
Congress. Leadership of each Chamber operationalized these 
recommendations with respect to their independent and unique 
bodies. This result was communicated in my Dear E-Colleague 
letters.
    In conclusion, I would like to thank my 48 OAP staff for 
their remarkable, uncommon dedication and altruism in support 
of individual good health and the congressional mission while 
placing themselves at direct increased health risk. I am 
appreciative of each and every one of them.
    Thank you, Mr. Chairman.
    [The prepared statement of Dr. Monahan follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Chairman Loudermilk. Thank you, Dr. Monahan.
    I will begin our questioning today, followed by the Ranking 
Member, and then we'll alternate between parties.
    I now recognize myself for the purpose of asking questions 
of our witness.
    Dr. Monahan, thank you again for your service here. I know 
I have used, on occasion, the Office of Attending Physician, 
which is something for me because there's three professions 
that I have never really cared to do business with. The first 
is a funeral director. The second is doctors, and the third are 
lawyers. However, the first one is inevitable, but I will only 
ever use it one time. The second will actually delay the time 
that I go to the funeral director, and the third usually drives 
you closer.
    So, with that, I do have an appreciation for the work that 
you and others in the medical profession do for those of us.
    Now, Dr. Monahan, during the pandemic, the House Sergeant 
at Arms, in consultation with your office, issued health 
guidance and restrictions for the House Office Buildings and 
the House floor. Because, as you heard, there is appearance of 
political influence there, that's really what we're trying to 
get at, is to find out how things actually work.
    Can you explain to us how the guidance was determined and 
the approval process that the guidance went through prior to 
being pushed out to the House community?
    So, when you're working with the Sergeant at Arms, what was 
the process to come up with the guidance?
    Dr. Monahan. The initial episode, going back to March 2020, 
specifically between March 8th and March 11th, was a very hairy 
time in the Congress of all the first responders and 
communities in the House and the Senate to rapidly position the 
organization to respond to a growing and frightening situation 
with, you know, hundreds or thousands of deaths in Europe 
coming--and with a fear they would come toward us with the 
growing concerns.
    In the Congress, we have limited forums to have a 
campuswide response to an event. One such forum is the Capitol 
Police Board. The other forum we have is the Joint 
congressional Continuity Board. They often operate in a 
classified fashion.
    They came together with all the stakeholders on the campus 
community, and that involves the House Sergeant at Arms, Senate 
Sergeant at Arms, and about probably 30 people in a large room, 
and we began to look at the Federal guidance for COVID-19, 
Department of Defense related instructions with regard to 
concerns, and other national experiences for COVID-19 issues.
    From that, we created a posture as to how the organization 
would respond that all the joint leadership then reviewed and 
embraced, and we created a circumstance of sentinel events that 
we were watching for. These were defined by key metrics that 
would occur.
    From that, we would derive one of three operating 
conditions for the Congress. Condition one was enhanced social 
distancing. Simple things like no handshaking, 6-foot 
separations, limitation of gatherings at that sort of thing at 
regular business.
    No. 2, condition two would be reduced operating capacity.
    No. 3 would be the essential operating capacity for the 
legislative branch to perform their functions. So that was how 
it first started. That was the first guidance that started.
    As the pandemic arose, we participated in the executive 
branch led initiatives to crush the curve, diminish physical 
activities, and shut down to a very low level of activities 
everywhere.
    Right around March 17th or so, the Congress had its last 
big session, a late night session, and then the members 
returned to their home districts. Then we went into like a 
pause or like a legislative recess.
    During that time, each chamber wanted to come back into 
session as quickly as possible to address these needs, the 
House and the Senate. The Senate wanted to come back first. So 
the Senate leadership came to me to say: Dr. Monahan, we need 
to have operating practices that will allow us to come back 
into session and operate as safely as possible and do our work 
for the American people.
    The House echoed the same sentiment with, you know, a 
strong instruction that we're not going away. We're going to be 
here and get the work done.
    So, from that, I began a process to create the first 
edition of the pandemic social guidelines. These guidelines 
are, essentially, the CDC guidelines. They have some 
operational elements that are unique to our organization and 
the work that the Congress does. So that's why they are 
shaped--they are essentially the same by way of: What is 
isolation? What is quarantine? How many days if you're sick, et 
cetera? Six foot separations, hand washing, maintenance of a 
daily health inventory before coming to work, sick people stay 
home, et cetera.
    From that, then I went through a process back and forth of 
both the majority and minority on the Senate side, and 
immediately the majority, minority on the House side to come to 
a consensus.
    The first edition reflects broad consensus involving the 
U.S. Capitol Police, all the agencies within the Congress, such 
as the Architect of the Capitol, Office of the Clerk, and many, 
many talented people. So it took a long time for me and 
thousands of phone calls to come up with this, you know, 10, 12 
pages how we're going to operate.
    So that went out first. Then the Senate came back into 
session. The House came back into session. My guidance to each 
Body, both House and the Senate was the same. However, as a 
student of the Congress for the past 15 years, just kind of 
watching them, there is a profound difference between the House 
and the Senate. It's not a simple matter of terms of election 
and terms of office service, but, rather, their policies, their 
Chamber operations are very unique.
    Each leadership group would take my same advice and 
operationalize it, and that's how you see some variations from 
the House and the Senate.
    Things went along pretty well, and you saw the additions of 
my guidelines go on with further things, and one thing I would 
stress throughout this is the coronavirus was novel, meaning 
previously not seen, with unknown features. There were many 
judgments made at the start of coronavirus that turned out to 
be not fully accurate as to how it would spread, what the risks 
were, some of its response to various seasons, how much it 
would strike the American people.
    So it's constantly changing. So you'll notice in the 
guidelines, as the CDC updates their response for new and 
emerging science, my guidelines would update also.
    Then, I would say, moving along--if I could have a few more 
minutes, Mr. Chairman, I will tell you moving along to some 
critical events into 2020, when we get to the summer of 2020, 
there starts to be, like, more issues, more deaths, more 
sickness, more issues, prolonged shutdowns, suffering of the 
American people, deaths, hospitalizations, National Guard 
mobilized to keep our hospitals open, intensive care units 
built in parking garages, et cetera.
    In the middle of that, each Chamber was meeting in session, 
having their votes, et cetera, and trying to do the best they 
could to minimize the spread of disease.
    On the House side, there were significant other--there were 
significant differences also in the Chambers. The House having 
four times more members, more travel, more reaches out to every 
corner of the United States to gather back again and have this 
large gathering of people and inside spaces.
    The Centers for Disease Control would often characterize 
risk levels, and the House floor turned out to be the highest 
risk scenario: Members of varying stages of health traveling 
throughout the United States from varying high risk/low risk 
areas, et cetera, coming together in an enclosed space. So they 
required quite a bit of suggestions with regard to best 
practices. Again, the leadership had their roles of enforcing 
those things.
    So there is a difference, between guidelines I provide the 
same to both Chambers, operational aspects about how they 
function as unique bodies, and, last, enforcement was different 
between the House and the Senate, how the members chose to 
enforce these practices.
    Chairman Loudermilk. So you provided the same guidance, 
both to the House and the Senate. Was the leadership of the 
House and the Senate and the House Sergeant at Arms consulted 
by your office at the same time?
    Dr. Monahan. Yes, sequentially. So there were within--I 
can't talk to people on these conference calls all at once, but 
I would talk to them sequentially, go back and forth, share 
documents, ask for input, synthesize, go back another round, 
and it finally would come to a thing we could all agree upon.
    Chairman Loudermilk. You--same guidance of the House, same 
guidance went to the Senate----
    Dr. Monahan. Yes.
    Chairman Loudermilk [continuing]. at the same time?
    Okay.
    Dr. Monahan. There's a slightly different forum--Mr. 
Chairman, one last thing I would say. We don't have 
communication tools to the entire organization. The Senate 
doesn't have a Dear E-Colleague letter or any kind of broadcast 
tool to communicate instruction. So I used a joint Senate 
leader letter written to both leaders.
    The House has a tool called the Dear E-Colleague electronic 
distribution system, for which we don't have access. So you'll 
notice my first remarks in this regard come through the 
Sergeant at Arms because we didn't have access to the system 
initially, but CHA subsequently changed that.
    Chairman Loudermilk. Okay.
    Well, my time has expired. Thank you for the very detailed 
answer. I think that was helpful.
    I now recognize the ranking member, Mrs. Torres, for 5 
minutes.
    Mrs. Torres. Thank you, Chairman.
    Dr. Monahan, I think you've answered part of my first 
question, which is the House of Representatives has 441 Members 
who meet with scores of constituents every week, travel from 
every part of the country. We congregate on the House floor, in 
committee rooms. During votes, the entire House membership, 
along with some staff members, can be on the floor at the same 
time.
    So how, if at all, did all of these characteristics impact 
the COVID-19 risk associated with in-person coverings?
    Dr. Monahan. They would constitute the CDC predefined 
category as the very highest risk: the inside meeting of people 
at close proximity from different areas of the United States, 
some experiencing very high rates of COVID disease, others 
lower rates, but together, all at once, the highest risk.
    Our members also have quite a few of the defined risk 
factors for predictive of bad outcomes, such as death or 
hospitalization, predominantly ailing to average age and other 
factors, such as their general health and some serious 
underlying health conditions, immunosuppression, et cetera.
    Mrs. Torres. The average age of our members of Congress in 
the 117th Congress was 58 years old. Many of our members are on 
some type of medication, high blood pressure, low blood 
pressure, whatnot. So all of these health risks was something 
that you looked into as you provided information and advice to 
the leadership of both Houses?
    Dr. Monahan. That's correct. The Congress looks just like 
the American people, since that's where they're derived from, 
and they reflect variations of age, health, whether that's some 
are athletes. Some are suffering from metastatic cancer. Some 
are on chemotherapy. Some are immune suppressed. All of those 
together raise the risk.
    My goal was to make the assemblage of people at the lowest 
possible risk. So I have to pay a lot of attention to those at 
the highest risk, that the organization keeps the entire group 
at the safest, like, status.
    Mrs. Torres. Thank you, Dr. Monahan.
    I'm going to yield back.
    Chairman Loudermilk. I thank the ranking member for 
returning the amount of time that I went over.
    So, at this point, we're going to take a quick 5-minute 
hospitality break before our next round of questions. I ask 
members to please return promptly, as we need to continue 
going.
    So this committee stands in recess, subject to the call of 
the chair, which will be about 5 minutes.
    [Recess.]
    Chairman Loudermilk. Thank you all. The Oversight Committee 
Subcommittee will come to order.
    I now recognize Mr. Griffith for 5 minutes for the purpose 
of questioning our witness.
    Mr. Griffith. Dr. Monahan, thank you for being here. I 
greatly respect you as my physician and appreciate the Office 
of the Attending Physician serving the members of Congress and 
staff.
    I understand your office is relatively autonomous, and I 
like that, and, in fact, I asked you about it one time when I 
was in visiting because I was concerned how could you give a 
good advice to the House and the Senate, the legislative 
branch, when you were, as a naval officer, subject to the 
orders of the Commander in Chief.
    You explained to me that there was a different chain of 
command, that you weren't in the chain of command, and that the 
president couldn't give you orders, that it was the Senate and 
the House that gave you orders.
    Can you give me some more information on that? The reason I 
ask is, in discussing that, as I joined this committee, several 
members said: That's not our understanding because we've been 
told several times on other issues--I don't remember what they 
were--that you were bound by naval guidelines, naval rules and 
regulations.
    So can you help me explain that?
    Dr. Monahan. Yes. It's a very unique situation. I'm an 
Active Duty naval officer. I follow all regulations and 
customs. I don't appear in uniform for you today, as I run a 
hybrid office of both military and civilian personnel and 
appear as the head of a congressional office or agency.
    Mr. Griffith. So, on medical issues related to the House 
and the Senate, are you subject to any naval regulations or to 
commands by the Commander in Chief?
    Dr. Monahan. No. I work directly for the four joint leaders 
of the bicameral leadership of the legislative branch.
    Mr. Griffith. Alright. Let's talk about that.
    You testified earlier that you spoke with about the COVID 
regulations--as time moved on, you spoke with both the majority 
leader in the--excuse me--the Speaker of the House and the 
minority leader of the House. Is that accurate?
    Dr. Monahan. Yes.
    Mr. Griffith. About all the changes and what was going on 
with the guidelines, you spoke with them and took their advice?
    Dr. Monahan. Yes. Many times in person with them and many 
times with their staffs.
    Mr. Griffith. Alright.
    So, you know, you talked a little bit earlier about your 
process on all that, but there was a lot of consternation 
because of the two different decisions. Was that a decision 
that Kevin McCarthy participated in? Or was he just consulted 
or told what was happening? Is that something that, basically, 
then Speaker Nancy Pelosi dictated the difference that we have 
in the House and the Senate?
    Dr. Monahan. I spoke with all parties. I listened intently 
to both the majority leader--I'm sorry, the Speaker of the 
House and the minority leader. It was impressed upon me that 
the House operates in a way that has a majority and minority, 
and when it comes to the operational based decision making, the 
majority interest prevailed.
    Mr. Griffith. I'm not fussing at you. I'm just trying to 
get the facts.
    So this was Nancy Pelosi's decision to do all of that stuff 
based on your advice?
    Dr. Monahan. I gave her advice, and then the execution came 
through the leadership of the House----
    Mr. Griffith. That would be Nancy Pelosi?
    Dr. Monahan [continuing]. that----
    Mr. Griffith. That would be Nancy Pelosi.
    Okay. So that brings up the question of swearing in 2021. 
We had a special goofy box up in the gallery.
    Dr. Monahan. Oh, there's a Plexiglass----
    Mr. Griffith. The Plexiglass. It looked like one of those 
soundproof boxes on a game show.
    So I'm asking you, was that your advice to do that?
    Dr. Monahan. No. I was consulted before the start of the 
Congress----
    Mr. Griffith. You advised against it, didn't you?
    Dr. Monahan. I saw it the first time you saw it. So I 
walked in, in the morning when the floor began, and there it 
was, the plexiglass assembly at the corner of the gallery.
    Mr. Griffith. That's not something you cooked up, and you 
never certified that as being safe, did you?
    Dr. Monahan. Well, I was consulted on a range of things as 
to how could members come to the House floor, in a quarantine 
state, if that were necessary. At that time, the guidelines for 
quarantine were just as severe as isolation. So Members could 
be pulled out into isolation just by being within 6 feet for 
more than 15 minutes of a known positive case.
    That changed later in the coronavirus to make things 
better, but at that time, at the start of the Congress, there 
was that issue.
    So I was asked by the leadership office to say, is there a 
way someone in a quarantine position, if necessary, could 
fulfill their constitutional duties and cast their vote on the 
House floor? The constitutional duty thing held very strongly 
with the members, and on the first day of the Congress, I was 
told there was not a proxy kind of system; you had to be there 
in person to exercise your duties.
    So, at that point, we said, is there a contingency way that 
we could have a way for a person who was COVID test negative at 
possible risk of disease but not, in fact, ill to be present in 
the House Chamber to cast their vote?
    I replied: There may be a way to do that if we took 
advantage of a corner of the room with high-flow ventilation, 
if we took special precaution as to how the person entered the 
building, from the east front plaza through a surveyed route. I 
gave advice like that, but I didn't specify----
    Mr. Griffith. You may or may not be aware of this--and my 
time is running out, but isn't it true that there were some 
members who had been exposed and would later have the disease 
who came into the Capitol without going through any special 
thing? Now, they might have gone up to the booth, to the goofy 
booth, but they came into the Capitol and exposed everybody to 
COVID. And isn't it true that several members of Congress came 
down with COVID shortly thereafter?
    Dr. Monahan. Well, people could develop exposure through 
any route, through travel and meeting with their family----
    Mr. Griffith. I understand that. But yes or no, were there 
a lot of people who traveled through who probably should have 
been excluded or had special means to get in who just came in? 
Isn't that true?
    Dr. Monahan. You could say that about any of the members, 
sir.
    Mr. Griffith. Alright.
    Isn't it true that there was a small majority, and so the 
speaker did that because she wanted to make sure she had every 
vote on the floor?
    Dr. Monahan. No one told me anything like that, sir.
    Mr. Griffith. Okay.
    Dr. Monahan. This was a general discussion as to how----
    Mr. Griffith. Would you have recommended, if they had asked 
you about the special booth, that maybe you would have two or 
three special booths in the gallery so that you didn't have 
people exposed to other people who were in the booth?
    Dr. Monahan. Only one person was allowed to be in the booth 
at one time. I wasn't given any contingencies as to the numbers 
that would be required.
    Mr. Griffith. Did they wipe the booth down in between a 
person going into the booth?
    Dr. Monahan. Yes, the booth was cleansed between people 
there, and people in the booth had to wear a mask, and they had 
to be COVID test negative before they came.
    Mr. Griffith. Mr. Chairman, if you'll give me just--because 
I'm not going to be able to stay for the second round. If 
you'll give me just another minute.
    So, when voting was taking place later, just a few days 
later, we were told we had to go up in the gallery. We couldn't 
stay on the floor in order to make objections if we wanted to 
make an objection to a parliamentary procedure--I was told 
this--because of the COVID regulations, and yet, on the day of 
the swearing in of the Speaker and the vote on the Speaker, 
none of that pertained. Isn't that correct?
    Dr. Monahan. I don't know precisely that answer, sir. I 
know there's a difference between day one----
    Mr. Griffith. The answer is yes, but I understand you may 
not know it. I have to yield back because my time is up.
    Thank you so much for being here today.
    I yield back, Mr. Chairman.
    Chairman Loudermilk. The gentleman yields back.
    I now recognize Mr. Morelle for 5 minutes.
    Mr. Morelle. Thank you, Mr. Chairman.
    Again, thank you, Admiral, for being here. I do want to--
I'll admit I'm perplexed. I don't think I even understand the 
last set of questions. But I do know this, that on the day when 
there is a Speaker vote--and I think we experienced this, this 
year, several days of Speaker votes, there are no rules in the 
House. So you can't set up the procedures that we had already 
adopted for the previous Congress on the day that there is a 
Speaker vote. I think we all understand that because we 
experienced it in a lengthier situation here today.
    But and, just to be clear, I think--let me look at my 
numbers. But, in January 2021, the month in question, there 
were 7.1 million Americans who had reported that they had 
COVID. So the number of cases in the United States was 7.1 
million, much higher than the previous month, much higher than 
the next month. 105,000 Americans died in the month of January.
    So I'll just note that as a context for whatever decision 
was being made relative to trying to do the greatest, in my 
view, the greatest physical safety situation that you could 
have while you're compelling Members.
    Obviously, in the previous Congress, we were--you know, 
there was an ability to vote remotely, and there were different 
ways of addressing. I think we were voting remotely even then.
    But then, when we come back on January 4, the organizing of 
the House, that's when the problem was because you couldn't 
continue the existing rules until you adopted the rules package 
again. So I just make that point. I don't need--unless you want 
to comment on it, but I think that's what was happening at that 
moment.
    Dr. Monahan. That's correct, sir. There was this technical 
issue of the first day of the Congress, you need to have the 
members to vote on a rule package.
    Mr. Morelle. Alright.
    Just out of curiosity, do you know, did anybody keep track 
of whether more Democrats or Republicans utilized the 
plexiglass structure?
    Dr. Monahan. Several of each did, sir.
    Mr. Morelle. I beg your pardon?
    Dr. Monahan. I would say about equal numbers did.
    Mr. Morelle. Equal numbers?
    Mr. Morelle. Republicans and Democrats.
    Mr. Morelle. Okay. So it's not as though only Democrats 
availed themselves of it?
    Dr. Monahan. I looked at it as a way for people to exercise 
their constitutional duty on the first day of the Congress, as 
a way to--how can we accommodate that? I thought it was a 
reasonable and safe thing for the members and did not increase 
the risk to the larger collective.
    Mr. Morelle. Yes, I guess I look at it the same way, 
Admiral, and I appreciate your comments. I don't think there is 
anything insidious about it. I think to your point, we're 
trying to make sure that people were safe who had been exposed 
and trying to make sure that people could and should, because 
they are representing 700,000 constituents each, that those 
constituents have their voices represented by folks before the 
House could pass rules, which, as we learned this year, you 
can't pass rules if you're not even really a sworn member until 
the Speaker's vote has been successfully concluded.
    Just a couple--and I only have a couple minutes, so I'll do 
these quickly.
    In June 2020, your office issued guidance that included a 
requirement that face coverings be used during meetings in an 
enclosed space for more than 15 minutes. Do you know was that 
guidance in line with the guidance established by the CDC?
    Dr. Monahan. Yes, sir. It was the exact guidance.
    Mr. Morelle. The CDC, I just note parenthetically, in June 
2020, would have been an appointee of at the time President 
Trump.
    Dr. Monahan. Yes, sir.
    Mr. Morelle. The following month, in July, the House 
implemented a requirement that all individuals entering House 
Office Buildings or the House Chamber wear a face covering. Was 
that consistent with CDC guidelines?
    Dr. Monahan. Yes, it was, sir.
    Mr. Morelle. The next major change to House policy on 
masking was in May 2021. At that time, guidance changed to 
eliminate the requirement that fully vaccinated individuals 
wear face coverings in the House and after the floor staff was 
fully vaccinated in the House Chamber. Was this change 
consistent with CDC guidance?
    Dr. Monahan. Yes, sir, it was.
    Mr. Morelle. In July 2021, the Delta variant became 
widespread. I understand that variant was more contagious than 
prior strains. Is that true, sir?
    Dr. Monahan. That's correct.
    Mr. Morelle. Was the face covering requirement reinstated 
at that time?
    Dr. Monahan. Yes. The Director of the CDC issued like an 
urgent declaration on or about the 27th of July to make--to 
reinstitute mask wear for the vaccinated, a dramatic reversal 
of that practice from the preceding 2 months.
    Mr. Morelle. Again, I would note that at that time, the 
then ranking Republican member of this committee wrote an op-ed 
in The Washington Examiner demanding the Capitol be reopened. 
He also sent a Dear Colleague letter to the Republican 
Conference stating that the reinstitution of the mask in the 
House was not grounded in science and accused Speaker Pelosi of 
being authoritarian.
    Can you just describe, was reinstituting the face covering 
justified in your mind and in line with the CDC guideline?
    Dr. Monahan. It was, sir. You could look back at the time 
that I think about the crisis in coronavirus communications; 
the worse possible days were beginning on the 27th of July 
through the 30th of July based upon the CDC's growing concern 
for the American people of risk of reinfection if vaccinated 
with the new emerging Delta variant virus.
    They had evidence about that for the preceding weeks, and a 
case cluster began developing in the city of Provincetown, 
Massachusetts. That scared them that that was actually 
happening, that people who were vaccinated could acquire the 
virus. It would grow in their nostrils and nose up to a high 
level and spread to other people. They had evidence of that. 
They moved forward with that.
    There were some drafting errors in the guidance and some 
misstatements that a reasonable person could look at very 
intently and suddenly wonder, was science being arbitrary, or 
was this really some other process taking place that wasn't 
scientific?
    So I would have to say that I don't know anything about 
authoritarianism. I never experienced that from my talking with 
any of the leadership, but I have to say that a reasonable 
person would take a lot of issue with the way science showed 
itself through these communications from 27 July through the 
30th of July of that year.
    Mr. Morelle. I thank the chair for allowing the admiral to 
answer that question.
    I yield back.
    Chairman Loudermilk. The gentleman yields.
    The chair now recognizes Mr. D'Esposito for 5 minutes.
    Mr. D'Esposito. Thank you. Thank you, Chairman.
    Admiral, thank you for your service to this nation.
    On July 27th, 2021, your office issued guidance that 
mandated mask usage for the House, clearly stating, in quotes, 
to be clear, for meetings in an enclosed U.S. House of 
Representatives' controlled space, masks are required, end 
quote, but only recommended that masks should be worn in the 
Senate. Why?
    Dr. Monahan. The House choose to enforce the 
recommendation--I gave the same guidance to both Chambers. The 
Senate would not consider requirements. The House leadership, 
through the majority mechanism, made it a requirement that they 
would. I agreed with that.
    My goal was that it was necessary for people to wear a mask 
in inside spaces. The House had a requirement because they had 
a enforcement mechanism for that purpose.
    Mr. D'Esposito. Okay.
    So you've been the attending physician for over a decade, 
correct?
    Dr. Monahan. Yes, sir.
    Mr. D'Esposito. Now has it ever been normal in the past 
where the House and the Senate would take your guidance and 
decide on it on an individual basis?
    Dr. Monahan. That's their operating posture. People 
commonly--each Chamber preserves their prerogatives to act, and 
sometimes there's variations every day, but in most--in serious 
health guidance, there generally is not.
    Mr. D'Esposito. Alright.
    What does the current state of COVID testing and treatment 
look like on campus? Do you think it's currently running 
effectively and efficiently?
    Dr. Monahan. Yes. We have the most efficient, high-quality 
testing system in the nation. It's running very efficiently. 
But the need is diminishing. Like, as in the most recent couple 
of days, we've had zero positive cases.
    Mr. D'Esposito. That's a good thing.
    Dr. Monahan. Eventually our testing program will sunset as 
we head into May of this year.
    Mr. D'Esposito. What makes it the most effective testing 
procedure in the nation?
    Dr. Monahan. Its accuracy, its speed, and its return of 
results to the individual in a timely enough basis to make a 
change in their behavior, to limit spread in their families and 
limit spread in their colleagues.
    Mr. D'Esposito. Alright. Thank you.
    Thank you, Chairman. I yield back.
    Chairman Loudermilk. The gentleman yields.
    The chair now recognizes Mr. Kilmer for 5 minutes.
    Mr. Kilmer. Thank you, Chairman.
    Thanks, Admiral, for being with us. I appreciate the work 
you and your team do.
    I'm actually just curious what sort of lessons were 
learned. You know, God willing, we don't have another pandemic, 
but we sure might. Any key lessons that----
    Dr. Monahan. I'd say the No. 1 lesson is humility in the 
face of uncertainty, and this virus changed, its variant 
viruses and its threat to people, its response to our vaccines, 
the development of vaccines. So constant change, humility, and 
I think communications are the single greatest lessons about 
this issue.
    You can't have better--you can't have good enough 
communications with this. That's a really powerful thing that 
led to a lot of our issues. My suggestions were based primarily 
upon having a communications mechanism to get the word out to 
people in a way that was nonpartisan and equally distributed.
    Mr. Kilmer. I'm just curious if you feel like, as an 
institution, we're adequately prepared, just from a continuity 
of operations standpoint, should something like this happen 
again? Obviously, this was unprecedented and felt a little 
like--I think in part because we were--sort of making it up on 
the fly. Anything the institution should do just from a 
continuity of operations standpoint?
    Dr. Monahan. Well, there are several things that would be 
helpful such as, No. 1, prepositioning of supplies; developing 
supply chains that don't depend on a single vendor in a foreign 
country, for instance, that would help. Also, communication 
with executive branch agencies, legislative efforts that 
Congress can undertake that would help my office forge those 
crucial links early in the course of the pandemic, rather than 
have to negotiate them on an ad hoc basis through great labor 
every single time.
    Mr. Kilmer. The only other thing I wanted to ask--and I 
really appreciated that, even in the midst of the pandemic, you 
and your team sent a letter to the Select Committee on the 
Modernization of Congress saying: Here are some areas where we 
could modernize the operations of the OAP and how Congress can 
better engage when we have a pandemic like this. I'm just 
curious if there's any update on OAP's modernization efforts 
and anything this committee can do to help?
    Dr. Monahan. Yes, sir. I think in my written comments I'll 
give you several suggestions along those lines. We currently 
have incorporated many of our lessons as far as how we lean 
forward for testing selection, how we've come to work very 
closely with very great professionals here in the Congress, the 
Office of the Chief Administrative Officer, the Clerk of the 
House, the Architect of the Capitol's Office. I had the 
privilege to work with many, both skilled and gracious people 
and staffs throughout the House and Senate in this work.
    Mr. Kilmer. Super. Chairman, I yield back. Thank you again, 
Admiral.
    Chairman Loudermilk. The gentleman yields.
    I now recognize the chairman of the full Committee, Mr. 
Steil for 5 minutes.
    The Chairman. Thank you very much, Mr. Chairman.
    Thank you very much for being here, Dr. Monahan. Again, 
please express to your broader team our appreciation for how 
hard they often work on our behalf, in particular during a 
really difficult period of time throughout the COVID pandemic. 
I know a lot of members on your team really stepped up, and so, 
if you would, share my appreciation for the work that they do 
day in and day out for this institution.
    I want to go back to, kind of, COVID guidance. There's a 
lot of frustration--some lingering frustration amongst folks 
and see if I got this correct. I was going to ask you if there 
was inconsistencies in your guidance, but I think what you have 
actually told us is that your guidance to both Chambers was 
consistent, but the implementation of your consistent guidance 
was inconsistent. Not trying to make a joke there, but your 
guidance was consistent to the Chambers. They implemented it 
differently; is that right?
    Dr. Monahan. That's correct, sir.
    The Chairman. Did you ever feel political pressure in the 
drafting and preparation of your guidance?
    Dr. Monahan. I was subject to the full diversity of views 
that I appreciated, and incorporated those. Some would call it 
pressure; I would just call it opportunities to listen more 
closely.
    The Chairman. So you were engaged in dialog--people--folks 
from both sides of the aisle, both sides of the Capitol, in the 
process while you were developing that guidance. Is that a fair 
assessment?
    Dr. Monahan. That's correct, sir. Yes.
    The Chairman. Okay. At any point, did you get into 
discussions of potential quarantine of members?
    Dr. Monahan. Yes, sir, I did. There were CDC guidelines 
that affected quarantine recommendations to general Americans, 
and that would apply to members of congress and our staff, et 
cetera, and we had those discussions.
    The Chairman. Did the Speaker's Office advise you ever not 
to use the term ``quarantine''?
    Dr. Monahan. Never. They never altered my language or made 
language suggestions.
    The Chairman. Say that again. I apologize.
    Dr. Monahan. They did not alter my language or make 
language suggestions.
    The Chairman. So you were in dialog with the speaker's 
office, probably with the Senate side as well regarding the 
guidance, but they did not alter any of the text or language?
    Dr. Monahan. No. We had a lot of debates, and it's, you 
know, trying to always draft a better document, more clear, et 
cetera.
    The Chairman. Okay. So, at the end of the day, your 
guidance issued during COVID across the House was your 
guidance, but the Speaker's Office put forward the guidelines 
with which were the rules of the House?
    Dr. Monahan. That's correct, sir, how they enforced at 
various times.
    The Chairman. Okay. If I can go back--I know Mr. Griffith 
was asking you a question particularly as it relates to January 
3d of 2021. So I'm going to take us back just over 2 years. As 
you may recall, that day we were in the middle of the pandemic. 
My colleagues on the other side of the aisle had a close 
Speaker's vote. We can now relate on our side of the aisle on 
the broader challenges to get folks across the line, but in 
that is we arrived into the Capitol Chamber, there's what I 
call the penalty box, for lack of a better term, kind of a 
Plexiglass area in the House Chamber. As you're standing at the 
dais looking out, it would be to your upper right.
    Were you involved in recommendations that would be 
medically advised to have people behind plexiglass?
    Dr. Monahan. Yes. I discussed the general concept of how 
could a person in a quarantine status who was diseased negative 
come to the floor and a cast their vote. I said: Well, there's 
a way we could devise such a thing.
    But I didn't specify dimensions, materials, and the 
fabrication, et cetera.
    The Chairman. You gave general, kind of, guidance and ideas 
of how something may be implemented, which is probably within 
your medical realm?
    Dr. Monahan. Yes, sir.
    The Chairman. But the actual decision making implementation 
was that of the Speaker's Office?
    Dr. Monahan. Yes, sir.
    The Chairman. So the first time you saw it, you came in, 
like maybe we all did, on January 3d, 2021?
    Dr. Monahan. I was impressed of the quality of the 
workmanship. I said, wow, I couldn't have done that as good.
    The Chairman. That location was for members that tested 
negative but were in a quarantine. Was that your 
recommendation?
    Dr. Monahan. That was for members who were in a quarantine 
status due to exposure who felt well, who would test negative, 
and I specified they had to enter the Capitol through a 
surveyed route, free of contact with other people, exit the 
same route and maintain that just with appearance in that 
gallery and then leave.
    The Chairman. Did you offer any advice for any member that 
potentially tested positive?
    Dr. Monahan. Yes. I told them not to--I told them they 
should follow the CDC guidelines and remain in isolation in 
their homes and not report to the Congress.
    The Chairman. Do you know if people followed that advice?
    Dr. Monahan. Yes, sir. I believe every time it came to 
that, I would have extensive dialogs with the members, and each 
time, the member of Congress would generally follow my advice. 
I was very impressed with their dedication to support the CDC 
guidelines.
    The Chairman. Thank you very much. I don't have further 
questions, just again, really appreciate you taking the time 
here. I know how much work and effort goes into your broader 
office, and appreciate your testimony. I yield back.
    Chairman Loudermilk. Thank you, Mr. Chair. I now recognize 
the other physician in the room, Dr. Murphy for 5 minutes--ish.
    Mr. Murphy. Ish, give or take.
    Thank you, Mr. Chairman. Thank you, Dr. Monahan. Nice to 
see you again. I appreciated our discussion the other day. I 
hope that calmed your fears about what this interrogation and 
meeting was going to be about. We're not here to scare anybody.
    I do think it's important that we ask hard questions. The 
status and the trust in the American medical system has been 
decimated, absolutely decimated, because of the partisanship 
that we saw during the pandemic. It was--it's terrible, and 
sadly enough, I'm just going to say the perception was that, 
either by coercion or participation, there was thought to be 
some partisanship seen in the House Physician's Office by some 
of these actions.
    I'm just going to drill down a little bit on this 
Plexiglass thing because I was absolutely blown away by it. Do 
you think that was appropriate to bring someone in on an 
airplane? At that time, we didn't know about transmissibility, 
whether if you were COVID positive, COVID negative, whether you 
were infectious, not infectious or what. Do you as a physician 
talking to another physician think that was an appropriate 
action?
    Dr. Monahan. For people in quarantine, they should not 
travel on airplanes and commercial transport. I wouldn't----
    Mr. Murphy. So the answer's no?
    Dr. Monahan. Could you repeat the question again, sir?
    Mr. Murphy. Do you think the actions taken by the Speaker 
at that point in time to have someone who had just had COVID, 
whether they tested positive or not--I have a little bit of 
question as to whether that was--do you think it was 
appropriate, given your medical opinion and the standard of 
care that that person--transporter went on an airport, went 
through an airport, came through the House Chamber, and went up 
into that Plexiglass room; do you think that was an appropriate 
action?
    Dr. Monahan. Theoretically, sir, I would say no. I was not 
aware of that scenario that you describe occurring.
    Mr. Murphy. Yes. I would say no in my medical opinion, and 
I would do that in a court of law. I thought it was absolutely 
inappropriate. This, again, shows to the partisanship that we 
saw, bending the rules in COVID that was seen in so many 
different areas.
    You said you relied on the CDC a lot. Did you ever speak 
personally with Dr. Fauci about any of this?
    Dr. Monahan. I talked to him perhaps three times over the 3 
years, sir.
    Mr. Murphy. His recommendations at certain points were 
what? Do you recall?
    Dr. Monahan. Well, mostly just to reinforce existing CDC 
guidelines. He didn't share with me any insight more than was 
in the guidelines.
    Mr. Murphy. Okay. He is a quite polarizing figure, and I 
think personally--and I'll say this from a physician 
standpoint--done more to undermine distrust in our medical 
system than any other person in medical history, but that's a 
different aside.
    In your office, can you tell us a little bit about how you 
are able to access specialty care for individuals, patients who 
need it?
    Dr. Monahan. Yes, sir. Members of Congress have multiple 
options here in the Washington, DC, region. We have a large 
number of specialists, university medical centers, military 
medical centers, civilian practices. I try to find the best 
possible consulting available for the member based on my 
understanding of this community and what the members' needs 
are. Members can avail themselves through their health 
insurance fee-for-service deductibles with any specialist in 
this area that I arrange. They also have the option to seek 
medical care at one of our local military centers without 
charge.
    Mr. Murphy. Alright. Well, thank you. I don't want to beat 
a dead horse because I think a lot of the questions 
previously--it's obvious that the House Physician's Office is 
deeply appreciated, hopefully never needed as far as in a 
time--emergency. I was quite--I don't want to say alarmed--but 
just surprised that you guys have such a large carriage area 
for anything that would happen in a large area.
    Do you have folks that are trauma trained?
    Dr. Monahan. Yes, sir. I have an emergency medicine 
physician who's trained for all kinds of trauma responses. I 
have emergency medicine technicians who are trained in trauma 
response, patient transport, et cetera.
    Mr. Murphy. They're here just when the House is in session 
or the Senate's in session?
    Dr. Monahan. No, sir. They're here throughout business 
hours and when the House and Senate are in session.
    Mr. Murphy. Okay. I'll ask one last question. This is 
somewhat of a personal one. I'm a board certified, still 
practicing, urologist. I had a conversation with you a couple 
months ago about being able to maybe just use a room because I 
had a congressional colleague ask me for an expert opinion 
about something. You were reluctant to allow that at that point 
in time. I hope we can get individually to a point where the 
answer would be yes. We have 19 medical professionals in this 
building, and sometimes expertise, since you don't have 
specialty care and it would be referred out, would be of 
interest and in the best interest of members of Congress. So I 
hope you and I offline can come to some type of agreement where 
that expertise could be given to our fellow Members.
    Dr. Monahan. I'd like to get to yes, sir.
    Mr. Murphy. Alright.
    Thank you, Mr. Chairman. I have no further questions.
    Chairman Loudermilk. Thank you, doctor.
    Thank you, Dr. Monahan.
    At this point, we'll proceed into the second round of 
questions, and I'm going to defer to the Ranking Member, Mrs. 
Torres, for 5 minutes.
    Mrs. Torres. Thank you, Chairman.
    I would like to start by, Mr. Chairman, I ask unanimous 
consent to enter into the record the following documents; June 
20th--I'm sorry--June 2020 guidance from the CDC entitled 
``Considerations for Events and Gatherings''; July 2021 
guidance from the CDC entitled ``Science Brief: COVID-19 
Vaccines and Vaccination,'' which informed the Office of 
Attending Physician's guidance to the congressional community; 
and February 2022 transcript of the CDC media telebriefing on 
COVID-19.
    Chairman Loudermilk. Alright. Without objection.
    [The information referred to follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Mrs. Torres. Thank you.
    I have to agree with some of my colleagues on the other 
side of the aisle. I have pushed back on some advice that you 
have given me in the past: yellow fever, vaccination, getting 
my COVID vaccine here versus in California. But we have always 
been respectful to each other back and forth, and, ultimately, 
you have led me to do the right thing for myself. So thank you, 
once again, for being the mature person in the room when 
dealing health issues for members.
    The day after the issuance of the mask guidance related to 
the Delta variant, Dr. Monahan, there were 80,701 new cases in 
the U.S. Is that correct?
    Dr. Monahan. That sounds right to me, ma'am.
    Mrs. Torres. Which Chamber's COVID mitigation procedures 
tracked more closely with CDC guidelines?
    Dr. Monahan. The enforcement clearly in the House was more 
close to that. The spirit of the guidelines was in the Senate 
also, just the enforcement was slightly different.
    Mrs. Torres. That could be that, you know, we have four and 
a half times more members gathering than they do?
    Dr. Monahan. That's correct. You also had approximately 
four and a half times more cases of active disease.
    Mrs. Torres. Okay. Can you also walk us through that--I 
don't know, what did we call it, that specialized area that was 
created for Members to show up and vote in the gallery, which 
was one of my demise issues during January 6th. We couldn't 
lock that door.
    But could you walk us through that again? Members of 
Congress could have been--could have come into contact with 
somebody that was COVID positive while they were here in D.C., 
not necessarily traveling from California to Congress?
    Dr. Monahan. Yes. That's correct.
    Mrs. Torres. Okay. That is the extent of my questions, so 
thank you, again.
    I yield back to the chair.
    Chairman Loudermilk. The gentlelady yields.
    I'll now recognize myself for the purposes of asking what 
will be the final questions of the day, Dr. Monahan, unless 
other members come back. This is what happens when you usually 
do two rounds of questions, especially when there's 41 
committee hearings going on on Capitol Hill. So it's no 
reflection on you. It's just how busy things are, as you are 
aware.
    I'd like to shift--just for a moment--I may come back to 
the--and to the ranking member, on our side of the aisle, we 
referred to it as the penalty box because it resembled a 
penalty box in hockey--and as I was advised, they did too.
    Actually, before I shift over to some other parts, let me 
just make sure--I want to close out this issue of the penalty 
box and all that, of all the discussions we talked about, 
whether you're positive or negative, but was the decision to 
allow Representative Gwen Moore to be on the House floor for 
the Speaker vote only days after testing positive for COVID in 
contradiction to the guidance at the time, your decision or the 
Speaker's Office decision?
    Dr. Monahan. Sir, I couldn't answer that question in a 
forthright way because I could not get into speaking about a 
specific member's health status. If you could rephrase it 
without the reference to the person, I could----
    Chairman Loudermilk. If there was someone who had tested 
positive for COVID only days before, would it have been within 
the guidance to allow them to come in and be in the penalty 
box?
    Dr. Monahan. I'm not aware of that case occurring, but if 
someone were to ask me that question, I would say it would not 
be within the guidance. I would not recommend a recently 
positive person to enter the Congress.
    Chairman Loudermilk. Okay. I thank you for not only for the 
answer but also protecting the privacy of others. Privacy is 
something that's very important to me.
    Now, I'll shift over to kind of more the operations. So, as 
we've seen throughout the Federal Government, we've had 
agencies that were very slow to get back to operations, and 
that's something that we've been focused on is getting some of 
the different agencies back to work, back in the office. This 
has been bipartisan as the mayor of D.C. has also been 
supportive of our efforts to do that.
    So, have--of all the health units across House office 
buildings and the Capitol and the Congressional Visitors 
Center, I know that you have personnel throughout. I've 
experienced it even in the Rayburn office building in times 
past when I needed help: Have all these health units returned 
to regular hours of operation since the COVID-19 pandemic?
    Dr. Monahan. Yes, sir.
    Chairman Loudermilk. Okay. Do you have any staff that are 
currently teleworking?
    Dr. Monahan. No, I do not.
    Chairman Loudermilk. That's good to hear as well. Have 
health units returned to offering the full suite of specialty 
services to patients, particularly those paying the monthly or 
annual fee?
    Dr. Monahan. That's in progress now, sir. Some of our 
consultants kind of fell out because of the highly personalized 
care. Their access to individual one on one care in a small 
office, say for instance, chiropractic care, for instance, that 
was suspended. I'm working on resuming that now. I have to 
setup a contract, establish a provider, et cetera.
    Chairman Loudermilk. What about physical therapy, was that 
resumed?
    Dr. Monahan. Yes, sir, it has. That was never interrupted.
    Chairman Loudermilk. Okay. I'm glad to know about the 
chiropractic coming back too. This place causes me to need one 
now and then.
    One last question: Is there anything that your office can 
provide that we're not currently providing as far as what 
you've seen maybe a change in the needs of certain specialties, 
or is there anything that you would--if you were able to make a 
change in the services you provide, or the way you operate, 
what change would you recommend?
    Dr. Monahan. Well, sir, I'd like to be certain that our 
services are aligned to what the needs are of the population. 
As you know, as Americans notice, the representation of men 
versus women who are serving the Congress has changed in the 
recent decade. So I'd like to have a greater focus on women's 
healthcare and more specialty interest in that from buy in from 
the group that would most benefit from it.
    Chairman Loudermilk. Well, thank you.
    With that, I appreciate you being here today. Members of 
the subcommittee may have some additional questions for you, 
and we ask you please respond to those questions in writing.
    Without objection, each member will have 5 legislative days 
to insert additional material into the record or to revise and 
extend their remarks. If there is no further business, I thank 
the members for their participation.
    Without objection, the committee stands adjourned.
    [Whereupon, at 4:21 p.m., the subcommittee was adjourned.]
  

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