Transcript: Senate Committee Hearing on Coronavirus Affecting Small Businesses

Marco Rubio: (00:00) ... so businesses' ability to continue to function, and I think that's of immediate concern. That's the one thing we've got to deal with if we're triaging this problem right away, but I think we're beginning to see the outlines of the second problem, and that is what it means when your supply chain is disrupted, and we all just left a meeting of the entire Senate with leaders in our country and healthcare, and what's becoming evident and apparent is that one of the impediments to the widespread availability of testing is a supply chain unpredictability. It isn't just the tests. If you don't have cotton swabs, if you don't have protective gear for the lab technicians or the basic ingredients needed for the test, you're going to have a problem in conducting those tests. And from our perspective is the role that small business can play structurally now and for years to come in ensuring that these sorts of supply chain disruptions don't become a national threat to the country. Marco Rubio: (00:57) A lot of it will be focused on China because that is where a lot of this activity has gone, but it's not just China. If you're India, if you're South Korea, if you're a country that also makes these things, and you're facing this threat, you're going to hoard it. You're going to act in the best interest of your nation, and that's understandable. We need to start acting in the best interest of our nation in these regards. And so, that's an important ... Later today, if we can bring it here, because I believe we can, we have been engaged before last night in conversations with the White House with ranking member Cardin and his team, with individual members of this committee, with our counterparts in the House Small Business Committee on what relief to small businesses should look like and how we can help them. Marco Rubio: (01:48) And so, hopefully, later today, we're going to have an opportunity to present it. And the crux of it, as I've already outlined to some, is taking the commitments the president made last night and funneling it through our 7(a) program and our community banks. Because they are in the community, they have, through Community Advantage and other related programs as well, have the ability to process the paper on this. We're going to have to give them a little flexibility. We're going to have to allow small businesses to use the funds they have borrowed to make payroll, to provide paid sick leave for employees that are hurt or employees that are sick or employees that frankly can't come to work. We're going to have to give them the flexibility to do that. We want to make sure that the money that's being lent is real and going to be paid back, but by the same token, and that's where the community bank process can help, but we also have to make it quick. Marco Rubio: (02:43) These guys can't wait 90 days to get these funds, and workers can't wait 90 days for the paid sick leave that this will give these small businesses an opportunity. I'm not claiming this solves all the problems. It does help. If we're going to make that kind of commitment to small business, I believe that it should be in a way that's most effective and responsible with the taxpayer money but also most helpful to those small businesses. Marco Rubio: (03:04) On the supply chain issue, I think the backdrop to our general economy, even before, and this committee issued a report a year ago that warned about it, even before all of this, is that we are dangerously reliant, in particular on China, for the production of critical goods, and that includes goods, as I've already outlined, that are needed to fight the coronavirus. And I think we rely on far more goods than we know, and part of the economic pain that's going to be inflicted on the country as a result of these disruptions will be directly related to disruptions in the supply chain because of an outbreak that shut down factories that end up impacting the availability of important consumer goods. Marco Rubio: (03:44) Just a brief review that our staff put together for this hearing last year ... This is according to the Census Bureau. China accounted for 88% of electric hand drill and saw imports, 87% of air conditioning machinery imports, 83% of hydraulic jacks and hoists, 72% for cell phones and its parts, 58% of forklifts, 51% of lithium ion batteries. The list goes on and on. Disruptions in these supply chains tell you that, even after the virus is contained and starts coming under control, we could have shortages, and you know the industries that are relying upon this. This is where the spread of this becomes much more serious. Marco Rubio: (04:24) So, the focus is on three things that we really wanted to talk about. And first is there are the immediate consequence of not having the capacity to produce these essentials here at home, and small businesses are going to experience a great deal of economic pain as a result of supply chain disruptions. But there's also going to be increased demand, increased demand for medical supplies and surgical masks and pharmaceutical drugs. And our small businesses can be a part of the answer to that, to filling in those gaps in the supply chain for critical sectors that have been exposed as weakened because of offshoring of our productive capacity to China and elsewhere. The absence of having these domestic businesses that can ramp up production to meet demand for these critical goods limits our ability to mitigate the worst effects of this virus beyond its broader economic impact, and the result is that the virus could end up being more damaging than it needed to be and the economic impact, as a result, greater than it needed to be. As I pointed out earlier, we're already seeing this. Marco Rubio: (05:29) One of the reasons why we've struggled to produce the testing kits is because we rely on foreign producers for the chemicals that are needed to make them. And there's a growing shortage because more people are testing, and as I said earlier, the countries that have it are going to be less willing to provide it. So, I truly believe that one of the things we should look at, after we provide the initial set, is what can we do through the SBA, through the work of this committee, and it has to be bipartisan ... There's no other way to do it ... to help small business be a growth sector in our economy to meet some of this increased demand. Marco Rubio: (06:01) Second, obviously, that we will discuss and I'm sure you will point to, is the longterm consequences of the vulnerability, particularly when it comes to China. This wasn't the accidental byproduct of globalization. It's an outcome of a deliberate strategy on their part, which made biomedicine and high-end medical equipment a priority in their Made in China 2025 plan. They put it in writing. It's long been practiced. It encourages domestic companies and their predatory practices and provides a short-term bargain for foreign companies but big time costs for our nation and the world. For years, China's been able to entice American multinational corporations with access to its markets, in exchange for offshoring and sharing intellectual property. And we've watched this. Beijing captured critical portions of the global supply chain. Today, 80% of the active pharmaceutical ingredients in the United States and the drugs that are here are sourced somewhere else, and a lot of that is China. And now, in the face of the pandemic, as I said, the absence of this capacity in the medical sector is endangering our healthcare system, and that is something we have to figure out in the short term and forever. So, it's hopefully something that we are able to act on, to find out what role can small business play in growth and in taking back the ability to make these critical goods in the United States right now and in the future. Marco Rubio: (07:22) So, I hope that we can come up with a second wave of proposals that will empower small businesses to bring their production of critical goods all in-house and getting American multinationals to buy domestically from them, not as a matter of economic protectionism, but as a matter of national security and national economic stability. This is good for our public health. It's good for our economy. It's good for, as I said, our national security, and it's good for our people. So, I look forward to hearing from our witnesses who are experts on these topics about what we can do to help small business be a part of solving this challenge. And now, I turn it to the ranking member. Ben Cardin: (08:00) Well, Mr. Chairman, thank you very much for convening this hearing. As you pointed out, we came from an all-Senate members' briefing on the COVID-19 virus and its consequences. We learned from that briefing. We heard last night that it has struck our family. Senator Cantwell's staff person has the virus, Senator Cantwell, former chair and ranking member of this committee and senior member of this committee, and that there are members of her staff that are now in quarantine as a result, and of course, one getting, needing treatment. So, we know this impacts all of us. I want to just underscore the last point that you made. Our first priority is to triage, to deal with the circumstances that we're confronting today, whether they're the medical circumstances or the economic circumstances. But I hope that we will follow your advice and recognize this will not be the last crisis that we're going to have, and in regards to the supply chain, we need to take a look at making sure that we are better prepared for the next crisis that comes down than we were for this one. So, I agree, and I look forward to working with you in regards to those issues. Ben Cardin: (09:14) Clearly, our first priority is to deal with the medical challenges. That's our first priority. We still are not where we should have been or need to be in regards to testing. We are developing the vaccines and drugs that will hopefully be available. The drugs, the therapeutic drugs, that may be available to help us in this crisis is possible. The vaccines will not, but I am proud of our leadership in regards to those developments at institutions located in the state of Maryland, including the National Institutes of Health and Johns Hopkins University and University of Maryland Medical Center. We need to deal with local responses, make sure they have the capacity, the hospital capacity, mitigate the spread. And the Emergency Supplemental dealt with many of those needs, and as the chairman pointed out, that's the first installment. It's not going to be the last installment. Ben Cardin: (10:06) And we also have to deal with the economic impact, including the disruption of the supply chain to American small businesses. I was pleased to see that it was recognized in the Supplemental. There was a recognition of the problems that small businesses are confronting. We recognize that small businesses are very much impacted by the facts that Americans are self-quarantining and not using the business community as much as they would, the avoidance of gatherings, the cancellation of events, the school closures, the trip cancellations. Ben Cardin: (10:48) All that has an impact on American small businesses. I could give you specific examples in Maryland. Johns Hopkins has just announced that they're closing their campus, from the point of view of students and faculty. I can tell you Charles Village in Baltimore city, a lot of small businesses are located in Charles Village. They depend upon the students and faculty. They're not going to be there, and it's going to impact those small businesses. We could give you many, many more examples. Chanel Wallace, who owns a hair salon in [inaudible 00:11:19], Maryland, shared that order for hair extensions placed in January has yet to be filled with her vendor in China because of the coronavirus. Jerry Chang, who owns a noodle restaurant in Gaithersburg, reported in the middle of February that his restaurant has already experienced a 30% decline in sales, and the spread of the coronavirus is only going to make that situation worse. Sterling Forever, a jewelry company based in Towson, reported that, not only were some of the factories in their supply chain closed, their distributors were requesting advance payment to help with the crisis. And the list goes on and on and on. Ben Cardin: (11:58) So, we know that we're just starting to see this. It's getting worse by the ... I would say by the day, but it seems like it's getting worse by the hour. So, we know we have an immediate crisis. Capital is the lifeblood of small businesses. We need to deal with that issue. The Emergency Supplemental allowed small businesses to qualify for economic injury, disaster loans, idle, and provided some resources to the Small Business Administration in order to administer that. We need to build on that Supplemental. Ben Cardin: (12:31) Let me point out, Mr. Chairman, that I've already heard from some small businesses. They need to get the information on how they qualify, so we need to get that help out to small businesses, so that they can take advantage of what was in the first Supplemental dealing with the coronavirus. Our resource partners need to be better empowered. They're the ones in which small businesses will go to for help, our women business centers, our minority business development centers, and the other resource partners. We need to make sure that they have the resources. We all heard last night as President Trump mentioned the number for small businesses that I thought was one that we could work with, $50 billion. Let's work with that in the most effective way. Chairman, I agree. We all need to come together with a bipartisan solution. I would hope that the disaster loans will provide help and will deal with resiliency, the issues that you talked about, paid leave for the workers of small business, dealing with telecommuting. That's going to cost some resources. Do we have the resources to provide that? Ben Cardin: (13:36) Let's take a look at the SBA loan packages. Let's make them easier, more generous, and less costly for small businesses to be able to take advantage of those, including looking at the costs of taking out a small business loan. And Mr. Chairman, I would hope we would also look at one additional factor. If you've seen a 30% decline in your revenues, will you qualify for a loan? The disaster loans are direct loans. That's good, from the SBA, but they have to be repaid. If you don't have the revenues, how are you expected to repay, and will the SBA structure allow those loans to take place? We need to take a look at a targeted grant program to keep small businesses afloat. Why? Because that's where job growth, innovation, and our economy depends upon it. This is an extraordinary crisis that requires us to respond in kind. Let us act in that regard to triage the current situation, be prepared for the future. I think we can work together and get this done. We need to do that for the sake of American businesses. As Congress begins to address this economic impact of the coronavirus, we must ensure that we focus on being prepared to withstand the economic disruption that is occurring in our economy. I look forward to hearing from our very distinguished witness panel and look forward to all of their testimony. Marco Rubio: (15:04) And just along those lines, before I turn it over to our witnesses, items we've discussed with your staff, as you're aware, on the 7(a) loan part, is allowing the loans to be used for payroll support. That would include paid sick leave, so the employers could use that. We'd waive the fees on both the borrower and the lender to lower the costs. On the, particularly, the SBA Express loans, ensuring that, increasing the loan limit for those ... Those turnaround in about 36 hours. And on the EIDL loans, which have already been approved for coronavirus impact in 20 states, have already applied. The SBA will be able to determine repayment solely on the applicant's credit score. They're not going to have to go and get tax returns or transcripts, and they don't have to prove that they couldn't get credit from somewhere else. Marco Rubio: (15:56) So, some of those are ideas to address some of the issues you raised. It won't solve every problem, obviously, but certainly we are trying to move as quickly as we can on these topics, and, but it'll have to be done, because of the nature of this place, not to mention the nature of the crisis, in a bipartisan way. And I think we can get to a point where we can put something forward that would achieve the president's purpose of getting $50 billion available to small business, but do it in a way that works, is responsible, and works for the borrowers. So, with that, Marco Rubio: (16:27) I appreciate everyone who has come here. We're going to try to move on this now, and we're going to begin with all of our witnesses. I'll begin that with, Ms. Gibson is a senior advisor at The Hastings Center. She led the national healthcare quality and safety initiatives at the Robert Wood Johnson Foundation, is the author of China Rx: Exposing the Risks of America's Dependence on China for Medicine. So, Ms. Gibson, thank you for being here. Rosemary Gibson: (16:55) Good morning. Thank you Chairman Rubio and members of the committee for the opportunity to be here today. I'm here to talk about small businesses that are prepared to start production of critical medicines that are in short supply that are needed to care for people who are hospitalized with coronavirus. The medicines I'm talking about today are generic drugs, and generics are 90% of the medicines that we take. Members of Congress take them, occupants of the White House. The focus is generic drugs, and right now, we are rationing in the United States of America. The term is "on allocation," essential medicines, including critical antibiotics that are necessary to treat hospitalized patients with coronavirus. I visited a hospital last week, and there's an antibiotic that they can no longer get. There are other antibiotics that are in short supply. There was a volunteer EMS worker who goes out on ambulances in her community, and she said they don't have epinephrine on their ambulance, which is used to revive people. I said, "So, what do you do?" And she said, "We just drive faster to the hospital." Rosemary Gibson: (18:11) The $8.3 billion emergency package for coronavirus was an important step forward. There was support for research for vaccines, for coronavirus therapies, to actually cure people with coronavirus, but there was nothing in that supplemental package to make, here in the United States, the essential generic drugs that are necessary to treat critically ill people with coronavirus, as well as critically ill people under normal circumstances, in our nation's hospitals. Rosemary Gibson: (18:45) China is the dominant global producer of the core chemicals to make thousands of our generic drugs. There was mentioned of the active ingredients coming from China and other countries. We have to look beyond the active ingredients. That's the data the FDA has, but what's missing is the core chemicals to make those active ingredients for essential medicines to treat coronavirus patients, sedatives, pressors to raise their blood pressure, antibiotics. 90% of those core chemicals are sourced in China. There's talk that we should let the free market fix this. The reality is that there is no free market. Generic manufacturing has collapsed in the United States. There are only two Western companies left that are making generic drugs, and they announced last year they're dropping half their products because they can no longer make them, so they are on the FDA shortage list. Rosemary Gibson: (19:55) And how does this happen? It's because patterns of China forming cartels, which has driven out production of so many of our core medicines. We can't make penicillin anymore because of what I wrote about in China Rx, the penicillin cartel. We can't make vitamin C. we can't even make aspirin and thousands and thousands of other medicines. And India put out its export ban because it's giant generic industry which supplies us with 25% of our generics depends on China for those core chemicals. So, what can we do? In doing this work on China Rx, small companies have approached me, and these are brilliant people, wanting to prepared tomorrow, to start using advanced manufacturing technology to make medicines fully made here in the United States that are in short supply. Rosemary Gibson: (20:47) There is a precedent for the U.S. government to fund medicinal manufacturing, namely flu vaccines through HHS and BARDA. BARDA knows how to do this. We could use that same model to make critical, essential generic drugs through BARDA, through public-private partnerships. They'd need investment for capital and for equipment, but the production cost of using new technology would make our drugs much less expensive. Rosemary Gibson: (21:16) I'd like to close by saying there's another thing we have to address, and this has nothing to do with coronavirus, but there are thousands of children who've died in recent years because we can no longer make the old staple generic drugs that are necessary to sustain them. These are children with rare diseases. There are small companies that approach me. They want to make them, and together we can make a difference, not only for coronavirus patients, but for these children. I look forward to working with the committee and the staff on how we together can do a lot of good to ensure that every patient has the medicines that they need, when they need them. Thank you very much. Ben Cardin: (21:54) Thank you, Mrs. Gibson, for your testimony. Now, I'll call on Dr. Gerard Anderson, who's the professor of health policy and management and professor of international health at the Johns Hopkins University, Bloomberg School of Public Health, and a professor of medicine at the Johns Hopkins University School of Medicine. He's also director of the Johns Hopkins Center for Hospital Finance and Management. Dr. Anderson. Dr. Gerard Anderson: (22:16) Well, thank you, Senator Cardin, Senator Rubio, and members of the committee. So, I've been a professor at Johns Hopkins School of Public Health for the last 37 years, and let me tell you about my greatest fear about coronavirus. Yesterday, I went to the local grocery store. Tonight, I'll go to the dry cleaners and maybe go out to dinner with my wife. My greatest concern is these people in these small businesses will go to work with coronavirus. The shopkeeper will want to keep this business open because they don't have the funds to keep the office closed for 14 days. The worker will not report that she has coronavirus because she probably doesn't have sick leave. The uninsured worker will not have the $200 or so that is necessary for the coronavirus test. Remember, 10% of Americans are uninsured, and they are most likely to be working in small businesses. Dr. Gerard Anderson: (23:13) So, what can Congress do to alleviate my fears? Pay the shopkeeper to close the business for 14 days if they do have an employee with coronavirus, alone, probably won't do the trick because most of them have huge [inaudible 00:23:30] debts anyway. As Senator Cardin said, grants may be necessary. At least for the next 90 days, make sure the person has at least 14 days of paid sick leave, and for the next 90 days, pay the provider giving the test to the uninsured person at Medicare rates. While larger companies allow the people to work from home, and Johns Hopkins is doing that for me, many small businesses don't have the option because they have to work with their clients face-to-face. Helping the cruise line is under discussion. From a public health perspective, small businesses are so much more important than the cruise lines. We can get along without vacations. We can't get along without the small businesses that feed us. Dr. Gerard Anderson: (24:20) Let me change the subject for a minute. The good news in my testimony is that small business is going to develop the vaccine to coronavirus. A significant portion of the world's new drugs come from uniquely American public-private partnership that involves the NIH, our universities and medical centers, small biotech companies, and finally, large pharmaceutical companies. Most of the initial drug development occurs in universities and small biotech companies, not the big pharmaceutical industries. Dr. Gerard Anderson: (24:54) For example, this is how the first drug that was effective in treating hepatitis C was developed. It began in a lab at Emory University with funding by the National Institutes for Health. With promising results, they started a small business and attracted venture capital. After the clinical trials showed positive results, a big company, Gilead, in this case, purchased this small company [inaudible 00:25:20]. One year after that, we had hepatitis C drugs with FDA approval, and it was brought to market. Dr. Gerard Anderson: (25:27) One of the companies with a promising coronavirus right now is a small business. It's name is Moderna. It began operations in 2011. The first clinical grade batch of this drug was shipped to the NIH for a phase 1 clinical trial in late 2019, and the clinical trials have already begun. In my written testimony, I list three other small companies that are developing coronavirus, and there are 40 other ones developing vaccines. So, how can the Congress help these small biotech companies develop the vaccine? The key is knowing that the small business will get paid for developing the vaccine. Congress can guarantee the purchase of a certain volume of vaccine at a price or giving them advance market commitments to purchase safe and effective products. Dr. Gerard Anderson: (26:20) In my written testimony, I also discussed some other ways that Congress could help the small businesses provide services to address the coronavirus epidemic. Small business can provide telehealth services to people in quarantine in rural communities. People in quarantine need to discuss their health condition with medical professionals without subjecting the clinician or the public to the disease. Medicare now pays for telehealth, but most private insurers do not. Congress could ensure that more generic drugs are made in America. Dr. Gerard Anderson: (26:56) In my written testimony, I explained how we helped create a small nonprofit company that's going to manufacture drugs that are overpriced and in short supply, working with Intermountain Healthcare. And we created Civica Rx. It's gotten up and running, and it's now manufacturing 20 drugs with 20 more in the pipeline. BlueCross just gave them $55 million to expand into the outpatient market. Dr. Gerard Anderson: (27:27) Finally, small business can assist in worker training. Many small businesses are not prepared. Many hospitals are not prepared to train their employees, and small business can do that. I'm happy to answer any questions. Marco Rubio: (27:41) Thank you, Dr. Anderson. Tim Morrison is a senior fellow at the Hudson Institute, where he specializes in Asia-Pacific security missile defense, nuclear deterrent modernization and arms control, but he was previously deputy assistant to the president for national security, and has written and spoken extensively about the national security aspects of supply chain issues. Thank you for being here. Tim Morrison: (28:04) Thank you Chairman Rubio, Ranking Member Cardin, and members of the Senate Small Business Committee. Thank you for the invitation to be here today. I would like to start with the cold reality and the simple fact. According to the World Health Organization, the National Health Commission of the People's Republic of China initially knew of the Wuhan virus as early as December 8th of 2019, yet initial substantive disclosures to the WHO did not take place until approximately January 11th, 2020. I don't think it's too much to ask how many people in the United States and elsewhere have been infected, gotten sick, or worse, as a consequence of the Chinese Communist Party's decision to sit on the fact of this epidemic. In fact, I think you, as our elected officials, must demand the answer to this question and determine how to respond. Tim Morrison: (28:48) In 2004, as Ms. Gibson has explained, the United States stopped making penicillin domestically. This happened without a vote in this body. It happened without decision in the executive branch. It was a decision prompted by China's Made in China 2025 plan to dominate what the Chinese Communist Party determined were strategic sectors which Chinese industries should control globally. Tim Morrison: (29:10) And so, we are here today to ask, on a good day, what does it mean to rely on the People's Republic of China for our basic healthcare commodities? Larry Wortzel, a member of the U.S.-China Commission, will tell you about his blood pressure medicine making him sick because it was contaminated with rocket fuel in a Chinese manufacturing facility. Rocket fuel. Surgeons around this country may tell you about the hundreds, if not thousands, of surgeries that were canceled because millions of surgical gowns had to be recalled because they may not have been sterile when they were packaged up in the People's Republic of China and sent to the United States. This was in January of this year. Tim Morrison: (29:48) Now, what if there was a malign intent? For example, what if this body passes a resolution demanding a high-level visit of an American official to Taiwan in furtherance of the Taiwan Travel Act of 2018? What if the United States chooses to sanction Huawei or another ... Tim Morrison: (30:03) What if the United States chooses to sanction Huawei or another Chinese state proxy for the Uighur suppression? What if the Chinese Communist Party decides to retaliate to these sovereign decisions by cutting off the shipment of medicines to the United States? Do you think it can't happen? Ask the Japanese who lost access to rare earth elements from the People's Republic of China in 2010 over a territorial dispute. Tim Morrison: (30:25) The People's Republic of China's state owned Jinhua, a communist party propaganda outlet recently noted that the PRC could and I quote, "Plunge the US into the mighty sea of coronavirus," if it wanted to do so. I asked you to think about all of the tools of economic statecraft that you can use to support American producers, including small businesses and strategic industries. For example, I know several of you were involved in the passage of the Build Act in 2018. This was an effort to leverage private sector investment in international development to counter China Inc. What other tools are available to do the same at the Small Business Administration or the Export Import Bank? I urge you do not allow America's job creators and innovators to be unilaterally disarmed. Their government can and should defend them from foreign aggression. Chairman Rubio, your amendment to last year's National Defense Authorization Act concerning reliance on the PRC for pharmaceuticals was a key step. You sounded the alarm on this risk. Lastly, I know several of you serve on the Senate Foreign Relations Committee and related National Security Committees. I urge you to investigate the influence of the People's Republic of China in international organizations like the World Health Organization. Ask yourselves why, despite meeting all of its established criteria, the World Health Organization waited more than three months to label COVID-19 a pandemic. Why is the World Health Organization choosing now to adopt the Chinese Communist Party's playbook by removing Taiwan from its country list? I want to thank you for the opportunity to testify here today and I stand ready to answer your questions. Senator Rubio: (32:05) Thank you and our final witnesses is Ms. Wynne Briscoe is the acting director of the Small Business Development Center in the Southern Maryland region. Thank you for being with us. Wynne Briscoe: (32:14) Good morning. Thank you all for having me this morning. Again, Wynne Briscoe, the acting director for the Small Business Development Center. In that capacity, I consult with manufacturers throughout the state of Maryland. Based on those experiences, I wish to offer some recommendations to your committee. I see the coronavirus pandemic and the supply chain disruptions that it's caused for some companies offering an opportunity to address the supply chain concern with a longer term question. What opportunities does the current crisis offer US businesses to fulfill newly emerging supply chain vulnerabilities within other companies? And how can these supply chain assist American small businesses long after the current health crisis has come and gone? Wynne Briscoe: (33:05) In other words, I believe that we should act and think about the supply chain disruption and the current crisis in a way that will take us beyond the current crisis and set our economy on a level plane. Wynne Briscoe: (33:20) When I consult with Maryland manufacturing companies, I insist that they have at least three alternative sources for the products that they produce. This is something that is going to be long beyond the current health crisis and something that the SBA can help make happen. And my idea I've created based on my experience with manufacturing companies that I'm recommending that you direct the Small Business Administration produce a nationwide list of companies. Let them self identify of their supply chain concerns, those that have current supply chain concerns and those that forecast in the future of having supply chain concerns. From there it would be a self identified list of Made-in-America products and services. For those, SBA would be monitoring and these would be an opt-in list for those businesses that wish to participate. Wynne Briscoe: (34:13) This would be businesses that the SBA has worked with throughout the country currently as well as over the last 10 years. This list would be compiled and it would be monitored by the Small Business Administration. For example, if they find when they're doing their outreach efforts, hypothetically a company in Miami that might be producing paper. And its largest manufacturer might be China. Can we find an American company to replace that source? Again, another example might be a Maryland-based company that'd may be looking to replace its suppliers of key ingredients for his bakery supply products of a specialty product that it sells locally. Wynne Briscoe: (34:54) The SBA does not have to do this process alone. It can work together with other federal agencies such as the Department of Commerce, Minority Business Department Development Administration to identify additional smaller companies that may be having concerns. With SBA compiling this Made-in-America master list, it could be sorted through NEGs codes and have descriptions that would describe such as paper products or sweeteners so that it would be easy to sort and address. Wynne Briscoe: (35:24) These companies would receive this information on a regular basis and it would be distributed throughout our network of small business development centers, as well as the agencies that the SBA regularly communicates with. This process and something similar to it, using the SBA to identify companies looking to expand their American supply chain suppliers as well as the companies looking to bolster their supplies domestically is essential to our nation's economy. Wynne Briscoe: (35:55) May we learn from this time and learn from this crisis, using this to strengthen our nation's supply chains well into the future. Developing alternative suppliers of key products and services well in advance is how we like to prepare our businesses with the Maryland Small Business Development Center and how I suggest that we move the nation forward and proceed. We should look at this situation as a way to strengthen America's supply chains and ways to benefit America's smaller businesses. Wynne Briscoe: (36:27) So I appreciate you listening to my suggestion of creating a voluntary opt-in nationwide list of supply chain opportunities of made-in-America products and services and for recognizing the insights of America's Small Business Development Center consultants and what we bring into solving this national problem by inviting me to this panel today. Thank you for your time. Senator Rubio: (36:51) Thank you. The ranking member. Ready for questions? Senator Cardin: (36:56) Let me thank all four of our witnesses, Ms. Briscoe, let me just ask the question where you laid off. I think your suggestion is an excellent suggestion. But it does point out to the fact that we need to be better prepared for the next crisis. And I say that at my opening statement. We need to have better supply chains locally. And there's real opportunity for small businesses and helping us in that regard. The challenge will be to connect the opportunities with the businesses that are there. And there's where our resource partners can be of tremendous help. I appreciate what you do in the state of Maryland, our Minority Business Development Centers, our Women Business Centers. All those are places of contact where this type of a list could connect to the companies that are out there with investors to really provide new opportunities for small businesses. Senator Cardin: (37:53) So I just really wanted to underscore and get from you your capacity today to reach out. We've already modified the disaster relief programs so that small businesses can qualify. I know that they're going to be knocking on your door saying, "Can we get help under this program?" The state of Maryland will help, but it's going to be your offices are going to be called upon to do this. Do you have the capacity to expand your reach? To take care of, for example, the suggestion you made on developing a list? Wynne Briscoe: (38:31) Well it would initially start with compiling the data from the businesses. So the SBA is what I'm recommending, start from the top down, utilizing the Small Business Development centers, utilizing all of the agencies that work along with the SBA and find the businesses that currently do produce the products here in this country that can be of assistance to other businesses, that they not be aware of. Wynne Briscoe: (38:56) So the first short term would be identifying what is made here in this country. And from there, SBA would then follow up with that with sort of an opt-in matching if there's a company that's looking for that product or service and they're now being matched with a product and service that's made here, with that business in exchange. So that's how we foresee this rolling out from the top down through SBA, through the resource partners such as the Small Business Development Center and SCORE and the minority business centers and the women business centers and our veteran business centers and connecting with the key stakeholders throughout the state. And then not just doing it alone. Throughout the country, working along with the commerce department and all of the other federal agencies that work with businesses so that we can, from an higher level, identify what's being made here currently and how that can be a gap in the supply chain for the businesses that need them here nationally. Senator Cardin: (39:52) No, I think it's an excellent suggestion. I'm just trying to figure out how we encourage that to be done and where the resources need to be placed in order to make that a reality. And I think you've given us a good blueprint, so I thank you for that. Wynne Briscoe: (40:05) You're welcome. Senator Cardin: (40:06) Dr. Anderson, you gave a pretty chilling account. You're a small business owner. You're running a cleaning establishment, depends upon you and perhaps one or two other workers. You contract ... you don't feel well. The advice is for you to go home and stay home and perhaps someone in your operation in fact did get the virus. Now you're going to be treated and be isolated for a period of time. That's what we want you to do. We don't want you to spread that disease to people coming into your establishment because you need to keep your business open. Senator Cardin: (40:42) So how do we provide the financial help to that type of a small business owner, which is in our interest to stop the spread of the virus, but also to keep that business open because of the impact it has on the local community? The chairman talked about, and we're working on a program that's going to make it easier for SBA loans, including how we determine whether they're credit worthy. That's important steps. But if you're talking about closing a business, it's hard to understand how you can deal with another loan on top of that. And that's why I appreciate your response in regards to perhaps looking at grant programs. It's a little more complicated because we haven't done that in the past. But I take it your comment means that in our tool box, we really are interested in dealing with this crisis. We're going to have to look beyond the traditional loans. Dr. Gerard Anderson: (41:38) Yeah. I mean, my local person that does my dry cleaning, there's two people that work in that place. I'm sure there's somebody in the back office. But there are two people in the front office. And if one of them has Coronavirus, that place has to close because they're essentially out ... they just can't work with just one person. And they're not going to be able necessarily to take out a loan. I mean, it's going to be a lot of work. They're going to need help to open again 14 days later. And I think a grant is what they're going to actually need. Senator Cardin: (42:12) I thank you. I think we just have to have, we've got to be flexible. This is a crisis that no one could anticipate how it's impacting. As I said, every hour it's becoming more and more devastating to our economy. So we're going to need to develop in Congress, flexible toolkit in order to keep businesses going in our community, particularly small businesses. Again, I thank you all for your testimony. Senator Rubio: (42:41) Thank you. Senator Hawley. Senator Hawley: (42:44) Thank you Mr. Chairman. And thank you for holding this hearing today and for focusing our attention on what is obviously a very hugely significant topic. I think it's been clear for a while now that we are far too reliant on China for our domestic production, especially for essential products that we rely on, and of course our medical supply chain is at the very top of that list as we're sadly finding out. Senator Hawley: (43:04) This is one of the reasons that I introduced legislation two weeks ago that would give the FDA more authority to require that our medical product manufacturers report all the details of their supply chain report, where they are facing potential shortages, and then give the FDA new authority to speed potential replacements, including of course replacements ideally that are made in this country. Senator Hawley: (43:25) Ms. Gibson, can I just start with you? You stated in your testimony that we know China produces about 9% of our generic drugs, which is a lot. But do you have any sense of how many of our drugs involve Chinese production? In other words, maybe they're not made wholly there, but Chinese production is involved. Rosemary Gibson: (43:44) Thousands. Thousands of our generic drugs and even some of the brand name products and perhaps even new therapies for coronavirus may depend on the chemicals that are sourced primarily in China. And if you're hospitalized with Coronavirus, if you have a severe case, which thankfully is very small numbers of people, small percentage, you might be on a ventilator. So you'll need sedatives like fentanyl and propofol. Your blood pressure may get dangerously low, so you'll need pressers like dopamine or epinephrin. You might get a secondary infection, bacterial in nature, and you'll need antibiotics. You might become septic, which is life threatening. Rosemary Gibson: (44:32) I was sitting in a room with the people that actually make medicines. These are the men and women in pharmaceutical engineering, pharmaceutical chemistry. And I said, "So tell me if you have to make these tomorrow, where do the core chemicals come from to make it? How much are we dependent on China?" And they said 90% of the chemicals to make those basic generic drugs depend on China. Rosemary Gibson: (44:58) The good news is that there is advanced manufacturing technology and really brilliant chemists right here in the United States that want to make it, are capable of starting production tomorrow. And Civica RX, they've committed to all their APIs being made outside of China. But they want to take the next step and make sure all the chemical components were not dependent on China. Advanced manufacturing technology, and we have brilliant people in this country and they want to do it. So we can make a lot of these medicines here. They just need the investment to get started. Senator Hawley: (45:37) It just strikes me that based on your testimony, which I think is really eye opening, that we probably do not appreciate or have not appreciated until now the extent of our reliance, the true scale of the vulnerability in our medical supply chain. Senator Hawley: (45:50) Dr. Anderson, let me ask you, in your view, what is the most helpful thing the federal government can do to support these small biotech companies that you've spoken about and that you write about? What are the right incentives that we ought to be proposing or adopting? Dr. Gerard Anderson: (46:05) Essentially that they have a guaranteed place to sell their products. So right now they are coming up with these great new ideas and they don't always have a place to sell their products. And it's true mostly in, not in cancer, where there's a lot of profit in there, but in an anti-infective, in antibiotics and things like that. You develop something new in that area and the current system doesn't work. So that's why we have to create Civica RX, which is this thing that's run out of Intermountain Healthcare in Utah and other places. We just did not see that the marketplace was producing certain areas because the profitability was not high enough. Senator Hawley: (46:51) Let me ask you something else I found interesting. You wrote in your testimony that while small biotech companies often make the initial discoveries during a vaccine or drug development process, it's the large pharma companies that then often buy them up and gain ownership over the IP. I'm wondering if that trend accelerates the offshoring of our capacity to China. Are those things related? Dr. Gerard Anderson: (47:12) Well, I think what we've seen now is in fact that's happening. So all of a sudden, Pfizer has their major manufacturing plant in China. So the big companies are looking where they can produce it the least expensively and are going there, especially in the generic because it's all price driven. Senator Hawley: (47:33) Just Mr. Morrison, before I run out of time, I was reading your testimony. I was astounded to learn and you reiterated this factor. So Ms. Gibson, you mentioned it too, we stopped making penicillin domestically in this country in 2004, right? Yet the CDC says 62 million penicillin prescriptions were filled in the United States in 2015. I've got two little boys at home. I think the Hawley household accounted for a number of those prescriptions. Just to make it clear here, is it correct to characterize the decision to move the production of penicillin overseas as an economic decision? It was economically driven? It was a profit driven decision. Is that your understanding? Tim Morrison: (48:13) Yes sir. I think that the point I've made in China 2025 is essentially to destroy the free market and create incentives to offshore production in China. And originally this seemed like a good thing. We'll save prices. We'll move value where value can be moved. We'll continue to do the innovation. But China is scooping that up as well. And so without any decision by any government authority, this happened and now we're going to deal with the consequences. And of course an antibiotic isn't instrumental to treat a virus, but the respiratory infection, it is. Senator Hawley: (48:44) Right. It just strikes me as my last comment, Mr. Chairman, that our current drug policy seems to privilege economic considerations of maybe a few companies over public health considerations. Is that fair to say, Mr. Morrison? Tim Morrison: (48:56) I would largely agree sir. Senator Hawley: (48:57) Thank you Mr. Chairman. Senator Rubio: (48:59) Senator Booker. Senator Booker: (49:00) Mr. Chairman, thank you very much. I've got sort of three areas that I want to try to get to in a very short five minutes. And Dr. Anderson, maybe I can just get you because I'm uncomfortable right now. Senate's about to go out on a recess. We see this curve, the bell curve that we're in right now, with the increasing levels of infections is going to continue to go up. Any modeling would say that our control actions to try to bend this curve are not doing that well. Having been an executive during a number of crises, including Super Storm Sandy, it's the first order keeping people safe. But it's a second order consequences when something like that happens. Senator Booker: (49:33) We're about to face, nationwide, second-order consequences of what it means to have schools closed, what it means to be told to go home and stay home. And so could you just take 30 seconds for me to sound the alarm a little more dramatically than you did? Just saying going out tonight to your store, what does it mean if we have a large scale orders for social isolation as well as basically people sheltering in place, in terms of the local economies that depend upon small businesses. Can you just paint this picture for me? Because I think that we need to be taking a lot more dramatic action to try to stabilize a lot of the small businesses and help people who are going through this crisis. Dr. Gerard Anderson: (50:19) So I just walked through my neighborhood and I see basically restaurants basically empty. I see dry cleaners, no one going. I see, in the last week or so, a fundamental change in how the economy is working and I think the stock market is telling you that's what's happening. And I think what we're seeing it in the real world, in our neighborhoods every day is just [crosstalk 00:50:47]. Senator Booker: (50:46) So something as basic as schools closing, childcare crises. I live in a community at the poverty line where people, if they miss one paycheck, they can't make a rent paycheck, they can't make a car payment. Their lives spiral out of control. So telling a food service worker for example, to stay home for two weeks is just not going to happen, right? Dr. Gerard Anderson: (51:04) Unless they get paid. Senator Booker: (51:06) Right. Dr. Gerard Anderson: (51:06) And you've got to make sure that they're willing to stay home because they're going to [crosstalk 00:51:11] get paid. Senator Booker: (51:10) 80% of our food service workers do not have paid family leave. Every year, we see the spread of flu and like that because they're handling our food. Right now in this crisis, we cannot bend the curve, unless we find a way to make it so people can stay home without putting themselves in impending doom. Senator Booker: (51:25) I want to stop there, pivot real quick. The testimony of Morrison and Gibson, I wish every Senator could read that, because clearly this is a national security issue. It's not just pharmaceuticals. It is rare earth metals. I mean I can go through the things that should something more major in terms of a conflict between us and China breaks out, that it would cripple our economy and our health and wellbeing and safety. And so this idea that it's a free market, when I know this from New Jersey that people are luring companies to manufacture over in China. And so again, knowing here we are in a time of crisis, it's too late. Shouldn't we as a federal government be doing more on these issues to make sure we are building manufacturing capacity here? Ms. Gibson? Rosemary Gibson: (52:16) Yes. What we can do and what small businesses want to do to prevent a future situation with drug shortages, they want to make the active ingredients, which is what makes the medicine medicine. They can make it fully here in the United States using advanced manufacturing technology. Stockpile that, because it lasts longer than the finished drugs. And if we have another Coronavirus outbreak, have a standup facility ready to go, which we have with ... companies have these as backup, redundant capability. Take that API out and make those medicines that are in critical shortages. This is what small business, the innovative thinking and the technology and the brilliance- Senator Booker: (52:58) But this takes conscious longterm planning. You cannot just flip a switch and have the manufacturing capacity here. I have a bill that tries just talking about seeding critical startup capacity here so that we build it correct. Rosemary Gibson: (53:13) There are small businesses that can start production of active ingredients made here in the United States. They could start within weeks. It would take maybe nine months to start making small quantities of these key ingredients fully made in the United States, not dependent on China for chemicals. They could do that in about nine months. Senator Booker: (53:32) Mr. Morrison- Rosemary Gibson: (53:33) And they could start for the stockpile DOD and VA, use our government purchasing power to stimulate that market. Tim Morrison: (53:38) That's effectively where I was going to sir. You have tremendous purchasing power through Medicare, Medicaid, Tri-Care, the Department of Veterans Affairs. These are some of the largest healthcare consumers in the world. You can control their procurement regulations. Tim Morrison: (53:51) And if I could just make one more pitch. Right now, the federal government may be allowed maybe about to allow the TSP I fund to invest in the MSEI Index. We are going to be investing in Chinese enterprises. I've worked 19 years for the federal government. Please don't put my pension in nontransparent Chinese companies. Senator Booker: (54:09) And so I just want to just make a massive appeal to my Chairman right now that this should be a committee urgency. We can address this. It's actually not that hard. We just don't have the collective well. This is a national security crisis that one of our serious adversaries is doing things strategically to undermine our health and economic wellbeing, which at any point they could cripple our economy. And actually this has a win win. It corrects for a national security crisis and it actually helps our overall economy. And the fact that they're doing it and we're not. So I just appeal to the chairman and the ranking. Let's work on this as a project. This is an obvious area where we should have bipartisan commitment to fill these vulnerabilities and actually build more American economic manufacturing. Senator Rubio: (54:54) Absolutely. And that that is the goal of the second tranche of work we're going to have to do on this. So we're trying to figure out what can we do to help assist small business quickly, right now, but we're going to have to come back and do more on a host of issues. This hearing has actually been scheduled for over a month and a half before this really ... so we already identified this in our report last year. And I agree with you. There are still a couple people that debate whether we have a supply chain issue. I'm not sure they'll be able to make that argument here any longer, in any advent. Senator Cardin: (55:24) Let me just underscore what the chairman is saying. We're going to try see whether we can get something done as early as today, if at all possible. We recognize that within the next couple of weeks we really need to put together a package that is going to make a broader appeal to some of the issues that are here. We're not talking about months, we're talking about we need to respond while there's an interest. So we're going to try to work with everyone and try to see what we can get done. Senator Rubio: (55:49) Yeah, and one last point before I turn to Senator Hirono is we want to do it in a way that obviously respects the jurisdiction of this committee, which is small businesses who have supply chain disruption vulnerability, but also small businesses as the answer to the supply chain vulnerability. And that will require access to capital and the ability to invest to ramp up. So we've got some work to do. But I'm glad we had a head start on some of this. So, all right, Senator Hirono. Senator Hirono: (56:19) So Ms. Gibson, did I hear you say that we can reduce or totally eliminate the overdependence we have on China? That we in our country have the capacity to create or manufacture these chemicals that are so necessary? Rosemary Gibson: (56:34) For a lot of medicines, brilliant chemists and pharmaceutical engineers can make these chemicals here. Senator Hirono: (56:43) So is that not happening? Rosemary Gibson: (56:45) Well on the generic side, the margins are so slim that companies would not invest in new plant and equipment to do it. And also, our last large generic company, Mylan in Morgantown, West Virginia merged with Pfizer. And Pfizer last year announced the opening of its global generic headquarters in Shanghai. So we don't have these companies. In five years, there's two more Western companies, they'll be gone. So we have a so-called free marketplace where companies can make those kinds of relocation decisions. Senator Hirono: (57:18) So are you suggesting that there be some kind of legislation that will prevent or effect a cost on these companies that will take their manufacturing to places like China? Rosemary Gibson: (57:28) Well I think sort of the horse is out of the barn on that. But how can we grow and incent small businesses that are eager to fill this very large vacuum that we have. They want to do it. Civica I'm sure would want to purchase essential medicines and all their ingredients made here in the United States. The DOD could purchase it, the VA, we could start a whole new market with manufacturing here in the United States. Senator Hirono: (57:54) I think we are going to need to figure out though, because if a small business creates these chemicals et cetera and they get bought up by a larger company that is interested in the bottom line, they go off to China. That's not resolving the situation. So we're obviously going to need to come up with some, really in my view, tightly drafted legislation that will get us to where we need to go. Rosemary Gibson: (58:17) There are some provisions that can be done that you can't sell your plant for national security reasons. [crosstalk 00:58:22] if we made any investment- Senator Hirono: (58:23) But those are the kind of ideas we need to put in place, I'd say. Dr. Anderson, here we are in the midst of a pandemic. I mean it's a here and now. And I know of any state that is dependent, so dependent on tourism as a major part of the economy. And I'd say most states, tourism is there number one or number two driving factor. So we're already seeing thousands of people losing their jobs. Most of them probably do not have paid leave sick leave or anything else. So here and now, I agree with you that we really need to figure out how to ease the impact on workers and their families in the here and now, because if we expect people, 20% who are not even insured to go to the doctor, that's not likely to happen. Senator Hirono: (59:14) I think this crisis has really illuminated and illustrated the huge gaps in healthcare coverage in our country and how it is creating a risk for all of us. So we can have that conversation later. But for the here and now, I'm wondering whether you think Dr. Anderson, that we obviously need to have a lot more testing in our country so that we can get a sense of how far this ... how much of this virus is already in our country. We do not know that. So testing. And then obviously we're going to see this continue if we don't develop a vaccine. Would you agree that testing and developing a vaccine are critical to our ability to get a handle on the spread of coronavirus in our country? Dr. Gerard Anderson: (01:00:02) First of all, the vaccine is- Mazie Hirono: (01:00:03) ... Coronavirus in our country? Dr. Gerald Anderson: (01:00:03) First of all, the vaccine is absolutely critical, but it's going to take a year or whatever. Mazie Hirono: (01:00:08) And in the fall this virus can come back. Dr. Gerald Anderson: (01:00:10) Hopefully it won't happen again, but it may resurge in the fall. Mazie Hirono: (01:00:14) Count on that. Dr. Gerald Anderson: (01:00:14) Let me go back to the question though, about what we can do besides for generic drugs. Because we're now working with the state of California and they have said that they want to essentially manufacture or produce drugs for the 13 million people that they insure. And they are trying now to do that based upon plants in California. And so they have the power of 13 million people that could manufacture drugs and they're trying to do with Civica and other places based in the United States. So, the government has this huge purchasing power and can use it to do things that are manufactured or produced in the United States. Mazie Hirono: (01:00:59) I'm all for government using its purchase purchasing power. But note that we can't even, under Medicare, have a discussion about drug purchasing. We can't even negotiate those things. So, I'm all for our government using his power to create the kind of situation where drugs that we need are being produced for our people and we apparently aren't there yet. But whatever you can do to raise your voices to head us in the right direction along these lines, I am grateful. Thank you, Mr. Chairman. Dr. Gerald Anderson: (01:01:30) Medicare can't, but Medicaid can. Mazie Hirono: (01:01:32) Yes. Dr. Gerald Anderson: (01:01:33) DOD can, VA can. So there's a number of very important buyers in the public system that can. Mazie Hirono: (01:01:41) Yes. Medicare though is the huge gap. So, I know. Dr. Gerald Anderson: (01:01:44) I understand. Mazie Hirono: (01:01:46) Thank you. Marco Rubio: (01:01:46) Senator Shaheen. Jeanne Shaheen: (01:01:51) Thank you all very much for being here and for your testimony. The president last night talked about one of the actions that he was taking would be to invoke a travel ban on passengers coming from the EU and initially it sounded like he was also saying cargo, although that got corrected later. Jeanne Shaheen: (01:02:13) But given what Senator Hirono said and what I know to be true in New Hampshire about the importance of the tourism industry and the impact on so many small businesses of our European travelers. Can you speak to what the impact of that might be on the small businesses that you're working with? Jeanne Shaheen: (01:02:31) And I had some questions, as did other senators, earlier at a briefing on the coronavirus about why the UK was exempt from that travel ban and what we were told is because they're, because of Brexit, no longer part of the Schengen zone, which is where people can travel across borders without screening. But they are a part of that zone until December of 2020. So, they are still very much in the Schengen zone. So, I'm just saying that, I guess, is a point. I'm not necessarily asking you to comment on that, but if you could comment on what the impact you think will be on small business, of the travel ban from European customers. Dr. Gerald Anderson: (01:03:23) So, I think it's going to be huge for the people. If you're just in the Washington DC area, we get so many visitors, you get them for skiing and other things. So, these are huge industries that are going to lose 20, 30% of their business literally overnight. They don't have contingency plans for a 20 or 30% reduction in their business and it's not just, "Oh, take out a loan." You're going to need some real cash immediately that you know you don't have to pay back because you're going to be in the hole for awhile. Jeanne Shaheen: (01:04:02) Ms. Briscoe, have you heard from any folks through the SBDCs in Maryland about the potential impact or is it too soon to know? Wynne S. Briscoe: (01:04:10) We have not had at this current time any businesses that have reached out to us specifically about the supply chain impact at this moment, but we will be sending out a correspondence to our caseload to ask them have they had an impact or how do they feel about a future impact? They may have supplies that can sustain them currently, but is it something for the long run that they can maintain. So, we will be in communications with them. Jeanne Shaheen: (01:04:34) Great. Thank you. On February 27th, the FDA pointed out that it had received its first notification from a drug manufacturer about a drug shortage. And I'm sorry I didn't hear all of the testimony earlier from Ms. Gibson and Dr. Anderson. So, you may have referenced this, but the question that I have is how do we balance the public's need to know on an issue like that without it creating a run on those drugs and a real panic about how to respond to that kind of situation? Rosemary Gibson: (01:05:16) I think the FDA did the right thing in not naming the medicine because that would have contributed to hoarding and precluded the opportunity to allocate it to those people who need it the most. But I also think we've had drug shortages in this country for more than 20 years and we haven't been honest about the impact that it's had on patients. So, at some point, maybe when we get through this, we have to have an honest conversation about the shortages of medicines in this country. The terrible impact it has, what the real root causes are, and address those. Jeanne Shaheen: (01:05:54) Dr. Anderson? Dr. Gerald Anderson: (01:05:54) So, the FDA says there's about a hundred drugs. In places like Johns Hopkins, we know there are 250, 300 drugs that are in fact on shortage and we sort it borrow it from the university of Pennsylvania and then pay it back to the Mayo Clinic and do all sorts of bartering on this when there is in fact a shortage. But this is not a new thing. It's just going to get worse with the travel bands because so many of the drugs are manufactured overseas. Jeanne Shaheen: (01:06:24) And of course that that doesn't address the cost of so many drugs, which while they may be available, if you can't afford to use them because you don't have insurance and can't cover the cost, you're in the same position. Dr. Gerald Anderson: (01:06:38) Well, that's particularly true in this case for the uninsured because if you go to the doctor it's going to cost you $200 just to get a simple test and if you need to get some kind of x-ray or something, it's going to be now $1,000 and if I'm uninsured I probably don't have $200 or $1,000. Jeanne Shaheen: (01:06:56) Right. Well, as you all point out, this is an opportunity for us to look at some of those issues and hopefully respond in a more positive way going forward. Jeanne Shaheen: (01:07:04) Mr. Morrison, I would just like to share your concern about investment of the thrift savings plan in the MSCI index. Using that as the index for how to make those investments. Senator Rubio and I have been beating that drum for a while without much support from the administration. Tim Morrison: (01:07:24) Time is running out. Jeanne Shaheen: (01:07:25) Thank you. Marco Rubio: (01:07:27) Just on that point, we have reason to believe that they've actually expedited moving in that direction. It's just crazy. It's crazy. I don't know. I know that's not a term that you normally used like to describe public policy, but this is nuts. Taking the retirement funds of federal employees in the military to be invested in companies in China that are actively working to undermine our national security, our healthcare security, and our economic security. It just can't happen. If it weren't so serious, you would laugh at it and say that can't be true. That's something from the Inquirer, or whatever. But it's real and hopefully we can see action taken on this promptly among other things. Senator Rosen, are you ready? Jacky Rosen: (01:08:15) Yes, thank you Mr. Chairman. Thank you to the ranking member. Thank you for all being here today. Needless to say, it has been quite the roller coaster since the coronavirus has reared its ugly head and it's going to probably get worse before it gets better. Jacky Rosen: (01:08:36) And so practically speaking, I can tell you that people think of Nevada and Las Vegas as these giant casinos, and we are those, but in fact, 99% of businesses in Nevada are small businesses in support of, especially in the Southern Nevada area, in support those large businesses. They provide over 40% of the private jobs in our state. They really are the backbone of our economy. Some of them, you think about all the weddings we have, they're the vendors who bring the flowers and the candles. All of those people that make that happen, make the magic happen in Las Vegas, of course, in Reno, and all across of our state. And we have nearly 50 million of those visitors a year. Jacky Rosen: (01:09:26) So, as far as small businesses go, what suggestions do you have for those businesses to be able to adapt in some way to the current environment? Maybe specifically if you could speak to people in the travel and tourism industry, do you suggest working through the Small Business Development Center? Are they a good cooperative partner, the SBA? Can you just talk about how some of these supportive businesses for our tourism industry, if you can? Anyone at all or just in general? Dr. Gerald Anderson: (01:09:58) Let me try. I think the key thing is to make sure that they're going to be around in three months or two months. And I think with the challenges, if you just give them a loan, they're going to be in trouble because they're now going to have to pay for it and not get any money for the last two months or so for the flowers and all those things, because nobody's going to be having weddings and using all those flowers because they can bring all their friends and relatives to the wedding. Dr. Gerald Anderson: (01:10:26) And so, you're going to have to essentially, if you want them to survive after two months, is to give them a grant to survive. You're going to have to give the worker who might have coronavirus, 14 days of paid sick leave so that they can quarantine at home, and you're going to have to give the uninsured person who's got it, who needs to go to the doctor but doesn't have the $200 to go to the doctor, some money. And pay them on the basis of Medicare rates. You won't make them a Medicare beneficiary, but pay them on the basis of Medicare rates so they actually do get tested and so when they're working in one of these small businesses, we know that you're safe to go to a small business because as soon as we feel like it's not safe to go a small business, we're going to stay at home. Jacky Rosen: (01:11:15) So, we have to just remove the obstacles for doing that, specifically getting testing and being quarantined. I think that's the best thing and then financial support that may not need to be repaid back is really the way to do it. Because it's going to take a while for everything to recover when we do hopefully all go into recovery. Jacky Rosen: (01:11:37) This is happening, I know, across the country and not specific to tourism, but we have a lot of wonderful things about our entire nation. A lot of it is its diversity and I've heard stories about people in businesses that they're not buying frozen Chinese food in the grocery store, they're not going to the ... Because they think the virus is going to be at the Chinese restaurant or they think that, "Oh, now that it's been in Italy, so I shouldn't do this or that." Jacky Rosen: (01:12:10) So, how do you think the mechanism for some of our small businesses, I guess they can put up signs, but how do we try to dispel these myths that you shopping or going to an Italian restaurant in Henderson, Nevada, it's not getting a coronavirus from Italy because we're living there. Rosemary Gibson: (01:12:33) Well, I'll take a stab at ... To the extent that food service companies import food from China, we do have a lot of food imports from China. We should be mindful that the FDA withdrew its inspectors from there to protect them from what was going on. So, the big question is who's going to be inspecting the places that are making our food in China or elsewhere to ensure that it is safe? And the same is true for our medicines. Ben Cardin: (01:13:00) ... Sure drugs are available in this country and it's not just supply chain, it is the economics of how the pharmaceutical industry is organized here in the United States. Dr. Gerald Anderson: (01:13:11) That's why when we created- Marco Rubio: (01:13:13) Before we conclude, I had a number of observations and then wanted to elicit points from you. Let's start with the first and that is ... So, let me begin by saying I'm a big believer in capitalism. I'm a big believer in free markets and one of the reasons I am is because I believe it provides for the most efficient allocation of capital to the most productive place. Marco Rubio: (01:13:36) However, there are times in which the most efficient allocation of capital does not align with our national interest. And in those times in which it doesn't align with our national interests, it is incumbent upon public policymakers to make adjustments. So, we are now facing that and for many months and years we've been talking about this in conversation with people and the answer always was either A, denial that a problem existed or accusing this of being some sort of a rejection of the market. It was theoretical, now it is no longer theoretical. Marco Rubio: (01:14:15) We have before us, just in the healthcare- Dr. Gerald Anderson: (01:14:17) For 13 million Californians, the state is going to buy on those, and that allows a company to get started in California because they have a guaranteed market. Civica has a guaranteed market for 1,200 hospitals. They are willing to get started. Otherwise they wouldn't get started. So, guaranteed purchase is the critical thing for me. Marco Rubio: (01:14:40) And so in that realm, let me say that there is a court decision that undermined the ability to do that. There's a DOD and VA requirement to buy American on key components and drugs and the court ruled against it, and so this requires a legislative fix. Dr. Gerald Anderson: (01:14:58) Correct. Marco Rubio: (01:14:58) And there is hopefully, any moment now or any day now, an executive order issued by the white house that will strengthen these by American requirements. Because now the federal government, in addition to driving the investment, one things that will drive investment is that there's a customer that's going to buy it and we can be a big customer in some sectors. Again, that's not government ownership of the means of production. That's what socialism is. But it is government saying it's in our national interest to do these things. This is not even protectionism. This is security. So, I hope we can fix that, but there's more to do. Rosemary Gibson: (01:15:31) If I may add, Senator Rubio, and thank you for your leadership on this. We wouldn't have our aircraft carriers or military equipment fully made in China. If we wanted to do a free market, we could do that and just outsource all of that. But we realize that there's a point which we don't want to cross. I will say that if we want to have manufacturing here in the United States for our essential drugs as a national security issue, if we look at how we've been making medicines, it's the same way we've been doing it 100 years ago. We have the opportunity to bring manufacturing home to make it more efficient, less costly, and that will take some initial investment. So the DOD and the VA can have all of their components made here in the US, otherwise we just buy and Civica has found this. Civica is still finding it, still has to get the core ingredients from China. New types of manufacturing, we can bring all of it back to the United States. Marco Rubio: (01:16:24) And this is something that I hope that we'll be able to do together, and part of these hearings and the report we did is to create awareness about these challenges. I wanted to ask you about that in a second, Mr. Morrison. But I wanted to ask you, Ms. Briscoe, from the small businesses perspective. Marco Rubio: (01:16:39) So, we view the small business sector as a place that we can see some of this stuff happen. It's easy to focus on the guys on the cover of the magazines, on the stock market on a daily basis. But there's a lot of potential capacity out there now and you've done a good job of addressing small businesses through your idea, small businesses vulnerable to supply chain disruption, but also small businesses who could fill supply chain disruptions. Wynne S. Briscoe: (01:17:04) Correct, correct. Marco Rubio: (01:17:05) But finding the way small businesses could fill that is a key thing. So, right now we're focused on just keeping people in business. There are a substantial number of small businesses that cannot afford to go seven to 10 days without operating. They don't have that kind of cash reserve and things of this nature. Wynne S. Briscoe: (01:17:21) They basically would be the problem and the solution at the same time and that's what we're looking to do. Marco Rubio: (01:17:26) So, what can we do as we move forward on this first traunch of work, which is just making available in the most appropriate way, through Seven A and Community Advantage and leveraging the community banking industry, which is there and on the ground, providing increase in the percentage of guarantees to make the loans easier to issue, what would be the best thing we can do for small businesses to be able to it quickly and stay afloat. Obviously we've got to make them aware of it from a paperwork standpoint and so forth. Do you have any practical advice as to how to make that? Because one thing is to pass a bill that allows it and the other thing is utilization, knowing it's there, and some for some businesses, frankly, it may not be the solution. But what can we do on the ground level to actually make the program more accessible? Wynne S. Briscoe: (01:18:12) It should be a step by step process that's going to be easily and readily assessable for business owners to understand what they make and how it can benefit, as they've stated, a guaranteed buyer. If they have a matchmaking process, if I know I'm making something and I know you're interested in purchasing, it should be just as simple as that. They will need an infusion in capital if they're going to scale up their production. So, that's something that we're going to have to address as far as cashflow and also workforce. Those are two major things. Marco Rubio: (01:18:39) And that second point about the infusion of capital ties right into one of the things that we've been talking about as far as the second step, and that is not only do you want to make more capital available for companies to stay afloat, but to the extent possible, we want to try to focus, as much of that as possible, not just to small business writ large, but specific critical industries that could help fill these gaps and that are tied to all this. Marco Rubio: (01:19:05) Which leads me to the question for you, Mr. Morrison, and that is isn't one of the challenges we face now that the definition of a critical industry for the country has to be broader than it's historically been? Everyone will agree aircraft carriers and airplanes are things we need to make. It takes a little while to convince people that making forklifts or pharmaceutical ingredients that at an individual level may not mean anything to most people around this country, but in the cumulative have enormous impact, part of the challenge we have is identifying a much broader scope of what qualifies for a critical industry or critical supply need for the country and the 21st century, which either we took for granted in the past or never had to address. Tim Morrison: (01:19:48) Mr. Chairman. I think that's exactly right. There's a reason that we've effectively lost the race for 5G. It's because we've relied on the market and now there are no American companies left that do this work. The Chinese had a plan. They're on the cusp of their 14th five year plan, they have Made in China 2025 and Made in China 2035 is about to come out. They have determined the strategic sectors that they want to dominate in the future economy and what they do in the domestic market is they boost up the price, they restrict the ability for outside companies, American companies and other companies, to compete and then they provide all manner of trade promotion tools, zero interest loans, to dominate export markets. Tim Morrison: (01:20:32) And so our small businesses, our medium sized businesses and other American ventures, are playing by one set of rules and the Chinese companies are playing by another set of rules and in another realm of national security we would call that unilateral disarmament. Tim Morrison: (01:20:46) And so that's the question to investigate. That's why I talked about the Build Act. That's why I talked about your amendment to the Defense Authorization Act last year. Using our market power, determine what industries are critical and then taking steps to level the playing field. Do not put our businesses on a different playing field and tie them to different rules than the Chinese holds its businesses. Marco Rubio: (01:21:09) Well, I appreciate all of you being here today and your patience on the hearing, and we sent it as voting now, so we'll have to head to that. But I want to thank you because your expertise and your ideas are aligned with a lot of the work we're already doing, come up with some good new ideas as well. The hearing record will stay open for two weeks and any statements or questions for the record should be submitted by Thursday, March 26th at 5:00 PM and with that, the hearing's adjourned. Marco Rubio: (01:21:38) Thank you, [inaudible 01:21:38] [crosstalk 01:22:38] Governor Brown: (01:21:38) (silence) Governor Brown: (01:33:12) I'll turn it over to Chair Kafoury. She's been a fantastic partner in this work and I appreciate her close collaboration. Chair Kafoury: (01:33:26) Thank you, Governor. Good morning. Yesterday the World Health Organization declared COVID-19 a pandemic, but as all of us know, disasters are local, so I need you to know that even before this new coronavirus was named or barely in the United States, Multnomah County stood up our emergency operations response. We knew that we had to test track, report and support the people who will be touched by this virus, because we know our community. We're beside them as they look for work, celebrate recovery, start a family or get their first library card. And we're there when the crisis hits. Chair Kafoury: (01:34:15) We know that the Metro area is particularly vulnerable to a virus that feeds on people coming together, because people come together here. We have the restaurants, the clubs, the concert halls, and we have the largest and the most popular venues. We have the largest airport and the port of Portland. We also have the largest number of unsheltered people in the state, the largest number of shelters in the state. And we know that these neighbors are particularly at risk, because they are older and sicker than the rest of the population. So we've been running hard to respond. Chair Kafoury: (01:34:56) When called upon by OHA, we launched a drive through testing clinic, like they did in South Korea, to quickly and safely test those who are prospective cases. We have tracked dozens of contacts, advised hundreds of callers and met with community partners to develop reams of guidance. Over the past month, more than 100 Multnomah County employees and subject matter experts have taken shifts in our emergency operation center. And that was all before we had a single case. Chair Kafoury: (01:35:29) On Tuesday, we had our first presumed positive test result in Multnomah County, and on Wednesday I declared a state of emergency. Multnomah County's declaration of emergency gives us the flexibility to sustain what we're doing now and face what may come in this unprecedented outbreak. Chair Kafoury: (01:35:50) What we're doing now is regularly convening and advising providers and residents of every manner of shelter. Outreach workers are fanning out, getting necessary supplies to our neighbors on the street, blankets, tarps, hygiene supplies and information cards with guidance. And we're keeping our winter shelter beds open and increasing motel vouchers to limit overcrowding. Together Mayor Ted Wheeler and I have committed additional resources to keep as many people as healthy as possible for as long as possible, but we can't protect our community without the partnership of our stakeholders. Chair Kafoury: (01:36:31) I want to specifically thank the more than 150 school superintendents, directors of nonprofits, businesses, the arts, hospitality, and many more who joined community listening sessions with myself and Dr. Jennifer Vines yesterday. Hard to believe that that was only yesterday. That input and engagement is incredibly valuable. Chair Kafoury: (01:36:55) We also cannot be successful without our partnership with Washington and Clackamas Counties and the state of Oregon. The actions that the governor described today are our best chance to do what Dr. Vines calls flattening the curve, slowing the rate at which people are exposed and potentially become ill, because we know that a surge of cases could quickly overwhelm even our extremely capable health partners. Governor Brown has given us a roadmap to navigate this unknown landscape and help us know how in the weeks ahead we can connect in different ways. Chair Kafoury: (01:37:36) And like leaders in many organizations, I'll be trying to figure out how to get vital work done to keep our clinics open, to keep serving veterans and older adults and to still be Multnomah County in the face of such a threat. Thank you. And now I'd like to welcome... oh first I would like to call out some of our partners that are here today. We have Dr. Sharon Myron, Susheela Jayapal, Senator Lew Frederick, Commissioner Jessica Vega Pederson, Commissioner Lori Stegmann, Gresham Mayor Shane Bemis, the Superintendent Guadalupe Guerroro and Governor. Thank you. Mayor Wheeler: (01:38:16) Thank you. And I want to thank Governor Brown and Chair Kafoury for their leadership during this time. After much thought and consideration and discussions with our county and state partners this morning, I declared a state of emergency on behalf of the city of Portland. This is a decision I don't take likely given the broad implications, but due to COVID-19's progression on the West Coast, I believe that it's in the best interest of public health to declare a state of emergency at this time. It gives the city additional authority to properly address the threat of infection and harm. It also gives us the tools that we need to support the county, the state, and our own city employees. Mayor Wheeler: (01:39:04) I know you have a lot of questions on how we plan on exercising these emergency powers. We'll keep you posted on that, but for now we begin with the activation of the state of emergency to give us flexibility to act on those emergency powers if and when it's necessary. Mayor Wheeler: (01:39:21) Here's what else the city of Portland is doing so far. The Water Bureau and our Bureau of Environmental Services have suspended service disconnections during the state of emergency. That means they will not shut off water due to the nonpayment of bills related to sewer, storm water or water bills. The city has decided to do this to ensure that everyone has access to the utilities they need to stay healthy and not worry for the time being if they're going through a financial hardship. We've also expanded community hygiene stations and portable toilets with hand washing stations across the city and those efforts will be expanded. We're assisting shelter providers to keep winter shelters open on an extended basis, in addition to getting outreach providers more assistance and equipment, as well as increased motel vouchers for those who need it. Mayor Wheeler: (01:40:17) On the economic front, we're working to help our small and large employers alike recoup losses from canceled events and loss of business and find additional financial support. I've also directed a team at the city to generate ideas for a stimulus package and we'll work with Prosper Portland to convene a COVID-19 economic impact task force to analyze other ways that we can be of help. Mayor Wheeler: (01:40:44) We're also aggressively protecting the thousands of city employees and our visitors by postponing or canceling nonessential work gatherings, encouraging teleconferencing instead stopping non-essential travel for meetings or conferences and encouraging vulnerable employees to stay home for as long as they need to. Mayor Wheeler: (01:41:06) To wrap this up, COVID-19 has been jarring for every one of us, globally, nationally and locally. The negative health, economic and social impacts are and will continue to be significant. Nonprofits have already had to cancel their yearly fundraisers and therefore are struggling. Arts and cultural institutions in our community will be severely impacted. Small and large employers are already developing contingency plans. People are at risk of being laid off. Mayor Wheeler: (01:41:40) I share this to tell you that we see, we hear and we understand the anxiety and fears that people are expressing. But at a time when it is tempting to act out in a state of panic or fear, I want to say this loud and clear all of us here, from the state to the region, to the county, to the city. We're working around the clock to make sure that your health and your safety are protected. That is our number one priority. We're making every decision without priority in mind. Mayor Wheeler: (01:42:14) Thousands of public services... thousands of public servants are working tirelessly on this one purpose. You know this well. This is a rapidly changing pandemic. We will be frequently updating you as information becomes available. Portlanders have always looked out for each other, but now I'm asking you particularly at this time to help your neighbors who might need help. Thank you. Dr. Sidelinger: (01:42:47) Thank you very much, Mayor Wheeler. As we've seen as this global pandemic has evolved across the world, this virus does not discriminate. While we have 19 people who've tested positive in Oregon, we know that is just the tip of the iceberg and there are likely hundreds more throughout our state. I think we have to remember our thoughts need to go out to those individuals, their families and friends and communities as they recover. They need our support. They don't need stigma or misinformation to help them get better. Dr. Sidelinger: (01:43:19) So while we only have 19 people in Oregon who tested positive for the virus that causes COVID-19 and looking at estimates from Washington and where Oregon is in our epidemic compared to our neighbors to the north, we estimate there could be 150 to 250 cases right now in Oregon. If we take projections from Washington infectious disease researchers and estimate a doubling of cases every week, which may be conservative, this could mean over 75,000 cases by mid-May in the state of Oregon without taking action. And so that's why our state and local officials are taking aggressive action today on social distancing. Dr. Sidelinger: (01:43:59) With the evolution of this outbreak new guidance, looking at the estimates of what could happen here in Oregon, these measures are being taken so that we can build upon the individual measures we've asked people to take, including washing their hands, covering their coughs and sneezes and staying home other ill, to put in measures that are more aggressive, that mandate the canceling of large events of 250 or more, look at those events that draw vulnerable populations, our older adults and those with underlying conditions of 10 or more and canceling... working with our business communities, work sites so that they can separate their employees and their customers to offer safety to everyone around them. Dr. Sidelinger: (01:44:38) Working with schools to do what we can to assure that our students and school communities are safe while we try to keep schools open because we know that education is incredibly important for students and the social connections at school. Certainly there's a tool for canceling schools as we look at the evolution of this epidemic, but we want to ensure that students and their families have access to is there this education, that parents can still go to school if they have essential jobs and healthcare and law enforcement and others, and so we don't take these steps lightly. Dr. Sidelinger: (01:45:08) We continue to look at the research and the effects of what we're doing every day so that we can see what do we need to do to help slow the spread of this disease in Oregon, protect Oregonians and make sure that everyone has access to the high quality care that we offer here throughout the state. I'd now like to turn it over to one of my colleagues who's been arm in arm with us here working on this outbreak, Dr. Jennifer Vines. Dr. Jennifer Vines: (01:45:34) Good morning everyone. I'm Dr. Jennifer vines. I'm the Multnomah County Health Officer and I'm also the Lead Health Officer for Clackamas, Multnomah and Washington counties. I want to acknowledge that this situation has moved at warp speed and public health has been keeping up as best we can, understanding that lives are on the line and so our livelihoods. Dr. Jennifer Vines: (01:45:53) As we think about a virus coming through our community, it's already here. There is nobody immune to this virus. There is no vaccine, there is no treatment. The majority of us will suffer a mild illness. For those people, we ask you to stay home and not seek healthcare if you wouldn't otherwise. But some of us, in particular our elderly, people with underlying medical conditions, are the ones we know are at risk of severe illness and potentially needing lifesaving intervention at the hospital level. Dr. Jennifer Vines: (01:46:24) To the best of our knowledge and with the toolkit that we have in public health the strategy of social distancing is one tool that we have and I have no illusions about the bitter pill this is to swallow for our communities. You hear public health saying education is important, business opportunities are important, social connections are important. And unfortunately, we have to look ahead at what's happening in Washington and Italy and we have to use the public health tool of social distancing as the best way, in our opinion, to try to slow the spread of this virus through our community, spread out those severe and critical cases so they can get the healthcare they need when they need it. Dr. Jennifer Vines: (01:47:05) You will see your local public health authorities shifting in strategy from focusing on individual cases and detailed contact investigations and follow up. You will see us shifting now to supporting our health systems to supporting our communities on what does these social distancing measures mean for them. And you'll see us trying to do high level health systems coordination to keep those services running. Dr. Jennifer Vines: (01:47:28) So again, I would call on all of us. Let's tap into the creative energy and the spirit of community that I know is in our region. Please be creative with alternative ways of coming together. Please look at our guidance, take it to heart. And by all means keep in touch with your elected officials who care deeply about this situation and about the impacts in our community. Thank you. Speaker 1: (01:47:55) So now we'd be happy to take questions. Just a quick reminder, we have hundreds of people who are viewing this through live stream. So in addition to your colleagues in the media, there are many concerned Oregon residents who are also viewing this. What I'd like to ask you to do is to please introduce yourself, identify the outlet you're with and direct a question to one of our local officials or health experts. And then I would like to ask the individual who's going to respond to the question to repeat the questions to the people who are viewing this through live stream can hear the question. With that, who has first question? Amber: (01:48:34) I'm Amber with KPTV. And regarding any large gathering ban, there's oftentimes private events, maybe a wedding, a large wedding in our area. Speaker 1: (01:48:42) So the question is regarding the ban on large gatherings, would that apply to private functions like a wedding? Who'd you like to direct that question to? Amber: (01:48:49) Governor would be best. Governor Brown: (01:48:53) The answer is yes. The ban would include weddings. We're certainly asking people to take personal responsibility. If the wedding is 240 people, I would encourage you to make sure that the elderly and those with underlying conditions stay home, but obviously we want our weddings and marriages to go forward. Elise Haas: (01:49:28) And Governor while you're still up there... I'm Elise Haas. I'm with KOIN 6 News. In regards to social distancing, what does this mean for public transit? I know you're trying to [inaudible 01:49:26]. Governor Brown: (01:49:28) Do you want to talk Pat? Do you want to talk? Dr. Sidelinger will answer that question. Speaker 1: (01:49:32) Make sure you repeat the question Dr. Sidelinger. Governor Brown: (01:49:35) Sure. Dr. Sidelinger: (01:49:37) The question was what does large gatherings mean for public transportation? The focus of the order on large gatherings is these organized events, but we know that we have workplaces and public transit where people come together. So we've been working with TriMet and other public transportation partners that they can increase their environmental cleaning, wiping down commonly touched surfaces, and if possible, implementing measures that would separate people in public transportation, so they try and maintain at least three feet apart while they're riding to school or work or wherever they need to go. Rosemary: (01:50:07) Quick question for you, Governor. If things improve... I'm Rosemary from KXL radio, if things improve the two weeks, will you lift the ban or are you going to keep it in a for that full month? Speaker 1: (01:50:19) So for our feral livestream audience, the question is will we lift the ban in two weeks if things improve? Rosemary: (01:50:28) Yes. Governor Brown: (01:50:28) We'll be making decisions moving forward based on recommendations from the CDC and public health professionals and medical experts. At this point in time we are committed to the ban. Obviously, if things change in two weeks we'll examine it. But any change in decision will be based on from local medical experts and public health professionals. Hillary: (01:50:53) Hi, this is Hillary from the Oregonian. A question perhaps for Dr. Sidelinger or someone else who could address when you might expand the testing rules for people who want to get tested to be able to get tested with your tests. Governor Brown: (01:51:07) Thank you Hillary. I will let Dr. Sidelinger and Director Alan answer respond to that question. Dr. Sidelinger: (01:51:15) The question is about testing and when will limits on testing be lifted at the state level? Currently testing is becoming much more widely available for COVID-19 not just in Oregon, but across the country. The Oregon State Public Health Laboratories is committed to prioritizing those tests for those who are most seriously ill, so our hospitalized patients with viral pneumonia, for supporting our public health partners as we identify cases, particularly cases that may have some high risk exposures or are at higher risk for complications. And as you heard yesterday, as we announced two cases in a congregate care facility for helping to assist testing rapid testing in those facilities. Dr. Sidelinger: (01:51:56) For other individuals who have mild illness, we encourage them to stay home while they recover, as the vast majority of people will recover without needing any interventions. For those who do seek care, if they, with their doctor, agree that a test is needed that will inform the next decision making, commercial laboratory testing is available and many of our local hospital systems are also stepping up their efforts to test and we anticipate those additional resources will come online soon. Dr. Sidelinger: (01:52:23) We updated our testing guidance from the OHA to clarify some of these things and did another push out to all of our providers, so they have the latest information on testing here in Oregon. Speaker 2: (01:52:32) Where did that 250 number come from? Dr. Sidelinger: (01:52:38) I think there was some followup on testing first and then we can- Elise Haas: (01:52:41) Yes, follow-up on testing. I'm Elise Haas, with KOIN 6 News. Will be doing something similar to Washington? I know that they're like, universities are helping step in and processing those tests at U-Dub. Are we going to be doing something similar? Dr. Sidelinger: (01:52:52) Again, we have many of our local hospital systems, including our academic partners who are looking to step up this testing and the Oregon State Public Health Lab is committed to assisting them to bring that testing up as quickly and efficiently as possible and we know that our commercial lab partners have already stepped up and offered testing, so we're working on multiple fronts to try and increase the availability of testing for those who need it. Speaker 3: (01:53:15) Additionally following up on testing, which are the five hospital systems where it's now okay to conduct your testing? Can you tell us when they began testing and what their capacity is? Dr. Sidelinger: (01:53:24) We don't have any hospitals systems locally who are up and testing. They're currently setting those tests up. They need to be validated. It's a long process, but the Public Health Lab has committed to assisting them and as soon as they come on board, we'll let you know. Connor: (01:53:37) Connor [inaudible 01:53:37] from WD. What is the testing capacity roughly? Dr. Sidelinger: (01:53:39) Currently in our Oregon State Public Health Laboratory we can perform about 80 tests per day. If needed to support the high risk populations and our public health investigations, we can step that number up as the situation changes. The capacity in the commercial setting varies and they're supporting our clinicians out in the community right now to offer testing. And we anticipate these additional hospital systems should be up and running in the next week and that'll provide even more flexibility and opportunities to test here in Oregon. Pat Dooris: (01:54:07) One more question on testing. Pat Dooris, from KGW. Just to clarify for everybody who's watching and for our audiences, people don't need the state's approval to get a test, right? Only if they're going to try and get a test to the state lab? Dr. Sidelinger: (01:54:21) Correct. Our testing guidance, we're really prioritizing testing at the Public Health Laboratory. Physicians who have hospitalized patients with viral pneumonia can submit that test online and don't need any approval from public health. Submitting that form and answering the questions is enough. Our local public health, tribal, public health and state public health partners are working with providers, if there's a potential outbreak or a question about a case and can approve those cases for the Oregon State Public Health Lab. For clinicians ordering tests in their office based on their clinical judgment, they do not need to contact public health. We do not need to give them approval. They can order that test. That test will be submitted. The provider will get the results to give to the patient and state public health will receive those results as well so we can assist in investigations. Governor Brown: (01:55:10) There was a question earlier about the number 250, in terms of large gatherings. I made that decision based on the CDC guidelines after talking to medical experts in local public health professionals. Dan McCarthy: (01:55:24) I have a question for you, Governor Kate Brown, Dan McCarthy with KATU News. You had mentioned that school closures are considered a last resort. Is there a reason why they're considered a last resort rather than a preemptive move? Governor Brown: (01:55:36) Yes. We're taking all appropriate steps necessary in terms of our schools. I know this is extremely difficult for Oregon families, but the reality is it's critically important for our children to remain in school, to get the education they need. Several schools provide both breakfast and lunch and there are also in many of our schools, we have local health professionals on campus, so we think it's critically important that our children stay in school as long as it's possible and safely available. Pat Dooris: (01:56:13) Okay. But in the Seattle area, they canceled a lot of churches, church gatherings, masses. Would you recommend that for say the Portland Archdiocese? Governor Brown: (01:56:20) We're using that same number of 250. I understand that this is a hardship for many, many families. We would certainly encourage Oregonians to comply with the spirit of these recommendations and there are other ways I believe through telephone, through more individual gatherings and obviously through the internet for Oregonians to get the spiritual guidance that they need. Speaker 4: (01:56:47) I'm going to follow up on the gathering. So she mentioned weddings, right? If they were to be somebody that I guess ignores that and still have a private event or more, is there a penalty for that? Governor Brown: (01:57:00) There's certainly is a criminal penalty, but the harsh reality is we need our public safety and our public health personnel to be focused on containing the virus and making sure that we have the capacity we need to address the needs of the virus. Connor: (01:57:20) Does this include outdoor gatherings too, like Portland Saturday Market or some [inaudible 00:27:25]? Governor Brown: (01:57:26) I'll let Director Allen speak to that. Patrick Allen: (01:57:30) I'm Patrick Allen, Director of the Oregon Health Authority. The guidance in outdoor events is really around the ability to achieve social distancing, separation of people. If an outdoor event is able to maintain that social distancing, then it would not fall under the under this guidance. If they can't, then it would. Connor: (01:57:47) So what about the example of the Portland Saturday Market? Patrick Allen: (01:57:51) That's one that we're going to have to see how it plays out in practice. I can imagine circumstances where it can be very difficult and I can also imagine working where it can be managed and we'll work with them to see how that develops. Hillary: (01:58:02) Patrick Allen, Hillary, from the Oregonian. At the Veterans Home has everyone been tested at this point for COVID? Patrick Allen: (01:58:08) Yeah, thanks. The question was, has everyone at the Oregon Veterans Home been tested? We deployed an infection control and testing strike team last night to the site. No, everyone has not yet been tested. It's a fair number of people and so we're working through a priority process of patients, close contact staff, those kinds of things, and we will test all of the patients and staff in the facility. It will take us a little bit of time to accomplish that. Connor: (01:58:32) How many people is that? Patrick Allen: (01:58:36) One second, and I can tell you that. That's 151 residents, 225 staff and others. Hillary: (01:58:54) Dr. Allen, Hillary again, from the Oregonian. What new information triggered this change in response? What, I guess, made you realize that the previous approach of telling people to cover their cough, et cetera, wasn't working? Patrick Allen: (01:59:08) Well, of course, we're continuing to tell people to cover their cough and sneeze and stay home when they're, when they're sick because that continues to be the very best thing people can do to protect themselves and others from the disease. Yesterday was a confluence of a variety of events. We completed the analysis that Dr. Sidelinger talked about in terms of estimated future cases by May 15th, something on the order of potentially as high or higher than 75,000. The World Health Organization made its pandemic decision. We also became aware of a variety of individual decisions that were being made across the state about cancellations and those kinds of things. And really only the governor has the ability to establish and enforce an order, and we thought that was a far better than a whole bunch of individual decisions kind of scattershot across the economy. Hillary: (01:59:54) Director just going, circling back on the Veterans Home, can you say how long it's expected to take to complete the testing there? And perhaps for you or Dr. Sidelinger, why. Hillary: (02:00:02) ... to complete the testing there? And perhaps for you or Dr. [Seidlinger 00:02:00:02], why are you not expanding the testing that you're doing with the CDC tests at the state lab? Patrick Allen: (02:00:11) Yes, I'll try to take both, and then Dr. Seidlinger can correct me if I get it wrong. I don't have a specific estimate. I would expect that we can gather the samples over the next couple of days down there, but I'll verify that and make sure that's the case. Patrick Allen: (02:00:24) The reason we're not expanding the criteria at the state lab, actually, is to preserve the capability to do exactly what we're doing at the veteran's home. We want to have that capacity to be able to do those critical kinds of incidents and be able to go in and provide a surge capacity to be able to accomplish that testing. We think that the everyday testing that can go on through the commercial labs and, ultimately, through the hospital systems, should be the production level of testing. That's the way most tests for most diseases in the state work, is that regular labs do that work, and the public health lab is really intended as a special purpose safety net testing facility, and we want to preserve that capacity. Speaker 5: (02:01:01) Beyond testing, what's happening at the [inaudible 02:01:03] the situation at the home in Lebanon. What's happening there? What's happening with the residents [inaudible 00:01:08]? Patrick Allen: (02:01:09) Sure. The question is, what else is happening at Lebanon? The team that went down there, in addition to collecting samples for testing, is also focusing on assessing the infection control capabilities and practices at the facility, and then providing other assistance that that facility identifies that it needs to manage the circumstance. I've not been down there myself, but what I've been given to understand is, this really is a state-of-the-art facility that has already been practicing state-of-the-art practices around infection control. They have individual rooms for each person, they've got the ability to create negative airflow in the room so that the air is not circulating from one room to another. They're establishing what we call staff cohorts, where staff who are tending to those who are sick are not the same people as staff who are attending to those who are well, so that that minimizes infection they have, and are doing absolutely everything we could have asked them to do in a circumstance like this. Pat: (02:02:05) Governor, a political question, will this postpone your special session? Governor Brown: (02:02:11) Pat's question was, will this postpone a special session? I know that legislative leadership are talking, I spoke with both Democrats and Republicans yesterday. I actually think that legislative leadership on both sides of the aisle wants to make sure that we have the adequate resources that we need. And should a special session be needed to ensure that OHA and local public health authorities have adequate funding, I'm sure that they will come together around that. Hillary: (02:02:38) Governor, earlier this year, you guys had been looking at, at the state level, spending as much as half a billion, that you were getting these good revenue forecasts. With the economic outlook changing, does that still seem like a good idea? Governor Brown: (02:02:52) Hillary's question is, we have roughly a billion dollars in reserves right now. I don't know what the total of expenditures would have been should the budget bills have passed, probably roughly in the neighborhood of 400 to 500 million. I would just say, I think there are some still dire needs out in our communities around Oregon. We were able to get the $11 million funding package for the Umatilla Basin recovery package done. I would certainly argue that fuel reduction still needs to be a priority. Much of the state is in drought, and there was $21 million on the table that would've been boots on the ground in rural Oregon for fuel reduction, thinning, and proscriptive burning. I would argue that that is still a priority. Obviously, we are watching the economic forecast and the economic situation very carefully. We have a large number of resources in reserve in our stability funds, and we will be very prudent fiscally moving forward. Speaker 6: (02:04:05) My name is [inaudible 02:04:03]. I'm wondering, Governor, why has it taken the state two weeks to implement commercial testing and testing in hospitals? Governor Brown: (02:04:11) I'm going to let Dr. Seidlinger respond to your question. Dr. Seidlinger: (02:04:16) The question was, why is it taking two weeks to set up testing in commercial laboratories? Let me say that our federal partners have been working very hard to try and expand the capacity for testing. Initially, the Center for Disease Control and Prevention with the Food and Drug Administration developed the test that tested the initial cases in the CDC laboratory. They quickly pushed out a test to state public health laboratories and large local public health laboratories to expand that capacity. There were some quality issues with those initial tests, so they were put on hold while those were worked out and assured that they were performing as they should. Currently, I believe all 50 states have their state public health laboratories up, with many of the large local public health labs continuing to do testing. That testing in most places is really focused on getting the people who are most at risk and the people most at risk for complications tested. Dr. Seidlinger: (02:05:05) The federal government also worked very quickly in a system that often takes a long time to set up testing in the commercial settings. That can often take a lot longer than these public health labs stepping it up, and they put out emergency use authorizations as they did with state public health lab studies commercial testers, and it depends on their ability to do those tests. Dr. Seidlinger: (02:05:26) There's many things that are involved in doing that test. People focus on the CDC test kit, and that's one aspect of it, but there's other things that the labs need to do those tests, many of which are in short supply. So, all commercial labs are working to ensure that they have the supplies they need, from collecting the swab, to issuing the test results to get those out, and I think they're working very hard to get those up. And they're working directly with the federal government. At the state, where we have the control and the power to be able to help, we're doing that, and that's where four healthcare systems will be coming up. Because we want to work with our partners to ensure that testing capability is available to support all those who need it and to support our healthcare partners in offering that test to those who need it. Hillary: (02:06:09) I have a followup question, Governor. Are you satisfied with [inaudible 02:06:13] test the state is able to send out currently? Governor Brown: (02:06:16) Certainly, I would appreciate the capacity to have more testing, but my understanding, at least according to public health professionals, is that we have an adequate amount. Hillary: (02:06:30) And I have follow up questions either for Mayor [inaudible 02:06:31] or [inaudible 02:06:31] reopen public council meetings at this time? Speaker 7: (02:06:38) That is under consideration. We're taking into account the distancing requirements that have been suggested by public health authorities, and that's currently under evaluation. We have not yet made a final decision on that. Hillary: (02:06:49) [inaudible 00:06:50]. Speaker 7: (02:06:51) Oh, I'm sorry. Thank you. The question was, are we going to cancel city council meetings or restrict public access to council meetings or implement social distancing requirements? At a minimum, we will implement social distancing requirements, but everything's on the table. Speaker 8: (02:07:07) I have a question for one of the doctors, Rosemary [inaudible 00:07:10]. At what point would you say we have to reach before you would make a decision that people need to stay calm, children shouldn't go to school? Dr. Seidlinger: (02:07:27) I think we've been talking about schools. We plan around schools for potential pandemic influenza outbreaks and other things because we know schools are an important place that can help spread that disease. So, even before our first case here in Oregon, we talked about that. With our first case having some contact in schools, we put that into action and worked with our school district partners. Local public health and school districts work together all the time on investigating outbreaks and keeping people healthy, so we will continue to look as cases come up, see what contacts there were at school, see what actions needed to be taken at that school to make sure that people are healthy and safe. Dr. Seidlinger: (02:08:04) Strong messaging about excluding people who are sick and updating our rules so that those students, those faculty, those teachers, can be excluded from school and stay home so they don't make others sick. And this will continue to evolve. We'll look situation by situation, but weighing everything that's going on right now, weighing the impact on kids, weighing the impact that school closures could have on the broader health of Oregon, we are making the decision to keep those schools open. And we will continue to evaluate that. I can't give you a hard number or hard percentage, but we look at all these cases and we take our exposures in schools very seriously. And I don't know if Dr. Vines wants to add. Dr. Vines: (02:08:42) Thank you to the question of how will we know if we've reached a point around broadening the social distancing recommendations, in particular closing schools? I would just add to what Dr. Seidlinger said, that the difficult decision making for our elected officials and for those of us in public health is that if we start seeing crowded emergency departments and full intensive care units, by then it's too late for these social distancing measures to have much impact. So, that is the very difficult decision making that everyone in the room, and a lot of great people are working on right now, to try to understand the implications, what would it mean for our healthcare workforce? What would it mean for families? How would people eat? How would people still go to work and pay their rent and buy groceries? So, these are, as you are clearly understanding, these are incredibly complex questions, and we are grappling with this actively. And again, everything is changing so quickly. I agree with everything Dr. Seidlinger said with the caveat that, again, I can't predict where we'll be in the next few days. Hillary: (02:09:49) Dr. [inaudible 02:09:46]. Patrick Allen: (02:09:50) I'm not one of the doctors, but if I could add a little bit. You asked about advising people to stay home. I just want to emphasize the CDC has said, and we have already said, if you are in the at risk population, older Oregonians, people with underlying health conditions, you should stay home as much as possible. That's absolutely our guidance today to people. You should stay home as much as possible. We can't emphasize enough how dangerous this is for people who are at risk. Speaker 9: (02:10:18) So, I was just circling back on testing. Can anyone here tell me today what the private test capacity is, numerically, just at this moment? I know it's probably changing quickly. Dr. Seidlinger: (02:10:29) I cannot talk about the commercial testing that's available within our Oregon Public Health Laboratory. Again, we can test about 80 a day with the capacity to surge up. For the commercial capacity that would have to come from them. Speaker 9: (02:10:41) Can you clarify what you mean by commercial capacity? Is this like [inaudible 02:10:44]? Dr. Seidlinger: (02:10:45) So, currently, LabCorp, Quest, and many other national providers that support a lot of health systems, a lot of outpatient clinics and doctor's offices, have offered this test, and they're working rapidly to expand it. So, those numbers would have to come from them and their capacity. Speaker 9: (02:10:58) Is that not an important piece of information for Oregon's response to this situation? Like who would be the person where I could get that information from? Dr. Seidlinger: (02:11:07) Again, if you want to talk to what is LabCorp's capacity, I would suggest talking to LabCorp. Right now, what I can say is that we have adequate capacity in the Oregon State Public Health Laboratory to support our public health infrastructure and identifying those cases who are most at risk for complications, those cases are most at risk for disease, and it's situations that, as Director Allen said, to investigate potential cases in a congregate care setting where we need to act fast. So, we have that capacity. We will continue to expand that capacity as needed, and the commercial capacity is coming up. And if you want to know the exact numbers, you'd need to talk to them. Pat: (02:11:43) [inaudible 02:11:43] did I hear you right that you said there's drive-through testing in Multnomah County? Speaker 10: (02:11:48) No, sorry. Thanks Pat, asking about the drive-through testing at Multnomah County. We did, in conjunction with the Oregon State Lab, we did a emergency testing last weekend with the drive- through capacity, but it was in the same number of tests that are available through the state. Speaker 11: (02:12:06) I had a quick question [inaudible 02:12:09] a lot of people, I think their personal hygiene to the point where hand sanitizer supplies are sold out in stores. Is the state working with manufacturers about restocking things like that or is that something that you guys, don't do? I'm not sure who that would be. Patrick Allen: (02:12:27) Yeah. I'll take a shot at that and invite others to bail me out if needed. There are shortages of lots of things like hand sanitizer and those kinds of things, and they're not just shortages in Oregon, they're not just shortages in the United States, they're global shortages. This circumstance has been compounded by the fact that its epicenter is in China, which means the demand in China has been huge. Much of these materials are manufactured in China, and so they're tending to divert that manufacturing to their own use. And then, the manufacturers themselves in China have been significantly disrupted, and so it's a huge demand issue as well as a supply chain issue. And it applies not to just hand sanitizer, but all kinds of other things that we will need in this circumstance. We have a stockpile that we're able to distribute to healthcare providers and other critical pieces of the healthcare infrastructure. There's a national stockpile that we have the ability to access and we are accessing, but these shortages will continue and may become significant, despite the efforts of the federal government to have private companies ramp up production. Speaker 12: (02:13:36) I have a question about incarcerated [inaudible 02:13:33]. Patrick Allen: (02:13:36) Sure. Speaker 12: (02:13:36) [inaudible 02:13:36] saying maybe very difficult or saying [inaudible 00:13:40]. Patrick Allen: (02:13:42) So, the question is, what about people who are in custody? And yes, we are working with corrections to tailor some of these recommendations to their environment. They do already have protocols that they implement around influenza and other infectious disease, and so the protocols themselves are not necessarily dramatically different than that. We're working with them on a visitation protocol similar to what we've done with congregate care. And so, there's some tailoring that needs to be done, and they're challenging in a corrections environment because some of these things that need to be trimmed back or done differently are themselves part of how corrections work smoothly. But we're working actively with them on that. Speaker 12: (02:14:26) They said they're sort of waiting for [inaudible 02:14:27] a matter of if, it's a matter of when. Patrick Allen: (02:14:29) Oh yeah, no, I talk regularly with the Director of Corrections, and I can assure you they're not waiting for a case. They're working with us right now on the steps they need to take. Governor Brown: (02:14:39) I just want to add two things. Number one, I know that there was a recipe floating around for making your own hand sanitizer, but Dr. Vines reminded me that soap and water, as long as you are using it properly, are extremely effective and the best tool that we have. I also wanted to add, we are concerned, frankly, about our testing capacity, and we are working with our federal partners and HSS. However, the federal government is the only one who can expand our testing capacity, and we are calling on them to do that. Pat: (02:15:26) Governor, we heard from Dr. Vines about how fast things are changing- Speaker 13: (02:15:27) Sorry, excuse me. Why don't we taking two more questions. Pat: (02:15:30) ... and you certainly hear that from the public, people saying, "I can't believe how fast things are going." I wonder what it's been like for you and how difficult was the decision to make this historic change? Governor Brown: (02:15:39) Well, Pat, that's exactly right. We all know, we have not seen anything like this in our lifetimes, and all we need to do is look around at what is happening around the entire world. For me, my heart goes out to the families impacted by this disease. Speaker 14: (02:19:00) Is that buzz still here? Is the buzz gone? You guys all okay? Buzz? [inaudible 00:19:05]. Speaker 15: (02:19:05) I need [inaudible 02:19:05]. Speaker 14: (02:19:05) Okay. Speaker 15: (02:19:06) Thanks. Who's still getting the buzz? Speaker 16: (02:19:10) It's a hiss. Speaker 15: (02:19:11) It's a hiss. Where's my audio guy? Speaker 17: (02:19:13) There we are [inaudible 02:20:27]. Speaker 18: (02:22:13) Mic check. Mic check. [inaudible 02:22:13] good to go. How we sound? Good? Good? Good? [inaudible 02:22:17] go back to the [inaudible 02:22:24]. Speaker 19: (02:22:31) Check, check, check, check, check, check, check, check, check, check, check, check, check, check. One, two. Check, check, check, check... One, two, three... One, two, three, four. Testing. One, two, three. Testing. One, two, three. Check. Check, check... Here's the thing. You have a clamp, right? Speaker 20: (02:23:05) I got one in my car. Speaker 15: (02:23:05) [inaudible 02:23:33]. Speaker 19: (02:23:06) Can we hear it in the PA? Is that possible? [inaudible 02:24:00]. Speaker 21: (02:23:41) I don't know what's going on. Speaker 19: (02:23:42) Can you turn [inaudible 02:24:04] to see how it sounds? Speaker 21: (02:24:07) I tested three of the boxes before you come. We had plenty of time [inaudible 00:24:10]. Speaker 19: (02:24:10) [inaudible 02:24:10] stop just for a second. How does this sound [inaudible 02:24:12]? [crosstalk 02:24:14]. Speaker 15: (02:24:12) Can we have a mic check? Can [inaudible 02:24:17] in the room? Speaker 19: (02:24:31) Look. Check this out. Look. Check it out. Let's put a mic at the speaker and feed the boxes for everybody. It's not [inaudible 00:24:37]. Speaker 22: (02:24:37) Voice is still low. Speaker 15: (02:25:12) Check, check. They can hear me [inaudible 02:24:44]. Speaker 22: (02:25:12) [inaudible 02:25:12] very little. Speaker 23: (02:25:12) He said we were [inaudible 02:24:49]. Speaker 19: (02:28:56) Jim? Jim, do you have a light stand?... Yeah, yeah, you have the [inaudible 02:25:11]? Where we were? Oh. Excuse me. Sorry. Speaker 15: (02:28:57) Okay, now it's back to buzzing. Speaker 19: (02:28:57) Excuse me. [inaudible 02:26:55] to something? Thank you. Speaker 19: (02:28:57) (silence). Speaker 19: (02:28:59) Excuse me. Pardon me. Pardon me. Excuse me. Pardon me. Thank you. [inaudible 02:29:16] sorry guys. Thank you so much. Speaker 24: (02:29:40) Thank you so much. Speaker 25: (02:33:02) Are we still hearing the hissing? Speaker 26: (02:33:03) Yeah. Speaker 27: (02:33:03) Yeah. Speaker 25: (02:33:03) Okay. Speaker 25: (02:33:03) We're going to do another mic check, see what we're hearing now. Everyone still has hissing. Can you hear me at all over the hissing? Speaker 26: (02:33:35) No, I can't hear you at all. Speaker 25: (02:33:38) You can't hear me. Copy. One, two, three, four, five, six. We're going to do the last, final mic check. Sorry for the hiss. One, two, three, four, five, six, seven, eight, nine, 10. Can we turn the house down, please? Speaker 27: (02:38:22) No, I'd rather have it up. Speaker 25: (02:38:24) Oh, you'd rather have the house up. One, two, three, four, five, six, seven, eight. Speaker 28: (02:38:40) Can we make it louder in the house? Speaker 26: (02:38:41) We have to bring the house back up. Speaker 28: (02:38:42) House loud. Speaker 25: (02:38:43) House loud. Speaker 28: (02:38:44) Have some music, please. Speaker 25: (02:40:07) No, you can put that on top of the speaker. Speaker 29: (02:40:51) I got it. Let me just do it. You tape that one down. Speaker 25: (02:40:52) It's not long enough. That's what I'm saying. Speaker 30: (02:40:55) No, I think it's going to be really low and distracting, hissy fit. Speaker 25: (02:41:00) Last call for mics. Speaker 30: (02:41:00) Last call for mics. Speaker 31: (02:41:29) Last call for mic a hall. Speaker 29: (02:41:37) That's it. This is crazy. It's all going to fall down. Speaker 25: (02:41:43) Tape it down. Speaker 29: (02:41:44) No, this isn't going to work. This is not going to work. Speaker 25: (02:41:44) Okay, you need to calm down [inaudible 02:41:54]. All right? Speaker 25: (02:41:44) Where's the actual mic? Where's the actual mic? Speaker 32: (02:41:44) Thank you. Speaker 25: (02:41:44) Okay, thank you. Speaker 25: (02:41:44) What do you have? Speaker 33: (02:42:31) Go low so you can't see it. Speaker 25: (02:42:35) No, that's not coming here. You can put those on the speaker. Yeah. Thank you. Speaker 34: (02:42:40) That's not coming here. Speaker 25: (02:42:40) Give me a minute. Hand that to me. What is this? Speaker 35: (02:43:13) You can tape it anyway. You want me to do some tape? Speaker 36: (02:43:26) Thank you. Thank you for that. Speaker 37: (02:43:26) I'm sorry. Sorry about that. Speaker 25: (02:43:54) Step back there. Step back. Step back. Speaker 38: (02:43:55) I got that. You have tape still? Underneath? There we go. Beautiful. Speaker 38: (02:46:22) Let's put one piece right over the top there and come down. Yeah, perfect. That's great. Okay. Nestle that down. Okay, our podium sign still straight? Okay, great. Everyone, please welcome Vice President Joe Biden. Joe Biden: (02:46:51) Good afternoon. My fellow Americans, today across the nation many of us are feeling anxious about the spread of the COVID-19, known as the coronavirus, and the threat it poses to our health, our loved ones, our livelihoods. Joe Biden: (02:47:13) I know people are worried. My thoughts are with those who are directly fighting this virus, those infected, families that have suffered a loss, first responders and health care providers who are putting themselves on the line, as I speak, for others. I'd like to thank those who are already making sacrifices to protect us, whether that's self-quarantining themselves or canceling events or closing campuses, because whether or not you are infected, or know someone who is infected, or have been in contact with an infected person, this is going to require a national response, not just from our elected leaders or our public health officials, but from all of us. We must, all of us, follow the guidelines of the health officials and take appropriate protections to protect ourselves, and critically, to protect others, especially those who are most at-risk from this disease. Joe Biden: (02:48:14) It's going to mean making some radical changes in our personal behaviors, more frequent and more through handwashing, staying home from work if you're ill, but also altering the deeply ingrained habits in our country, like handshakes and hugs, avoiding large public gatherings. That's why earlier this week, on the recommendation of officials, my campaign canceled election night rallies that we had planned to hold in Cleveland, Ohio. We're also reimagining the format for large crowd events we had planned in Chicago and Miami in the coming days, and we'll continue to assess and adjust how we conduct our campaign as we move forward, and find new ways to share our message with the public... people first above of everything else . Joe Biden: (02:49:05) Yesterday, we announced a Public Health Advisory Committee of experts who will continue to counsel my campaign and me, help guide our decisions on the steps to minimize further risks. We will be lead by science... officially declared COVID-19 a pandemic. Downplaying it, being overly dismissive... is only going to hurt us and further advantage the spread of the disease. But neither should we panic or fall back on xenophobia. Labeling COVID-19 a foreign virus does not displace accountability for the misjudgments that have been taken thus far by the Trump administration. . Joe Biden: (02:49:56) Let me be crystal clear. The coronavirus does not have a political affiliation. It will infect Republicans, Independents, and Democrats alike. It will not discriminate based on national origin, race, gender, or ZIP code. It will touch people in positions of power as well as the most vulnerable in our society, and it will not stop. Banning all travel from Europe or any other part of the world may slow it, but as we've seen, it will not stop it. And travel restrictions based on favoritism and politics, rather than risk, will be counterproductive. Joe Biden: (02:50:36) This disease could impact every nation and any person on the planet. We need a plan about how we're going to aggressively manage here at home. You all do know the American people have the capacity to meet this moment. We're going to face this with the same spirit that has guided us through previous crises, and we'll come together as a nation. We'll look out for one another and do our part as citizens. We have to harness the ingenuity of our scientists and the resourcefulness of our people. And we have to help the world to drive coordinated global strategy, not shut ourselves off from the world. Joe Biden: (02:51:20) Protecting the health and safety of the American people is the most important job of any president, and unfortunately, this virus laid bare the severe shortcomings of the current administration. Public fears are being compounded by a pervasive lack of trust in this president, fueled by adversarial relationship with the truth that he continues to have. Joe Biden: (02:51:43) Our government's ability to respond effectively has been undermined by hollowing out our agencies and disparagement of science. And our ability to drive a global response is dramatically, dramatically undercut by the damage Trump has done to our credibility and our relationships around the world. Joe Biden: (02:52:04) We have to get to work immediately to dig ourselves out of this hole. That's why, today... combat and overcome the coronavirus. The full details of the plan, if you want to see them, go to joebiden.com, where I lay out the immediate steps we have to take to deliver, one, decisive public health response to curb the spread of the disease and to provide treatment to those who need it, and a decisive economic response that delivers real relief to American workers, families, and small businesses, and protects the economy as a whole. . Joe Biden: (02:52:42) I offer it as a roadmap, not for what I will do as president 10 months from now, but for the leadership that I believe is needed and required at this very moment. President Trump is welcome to adopt all of it today. . Joe Biden: (02:52:56) The core principle is simple. Public health professionals must be the ones making our public health decisions and communicating with the American people, public health professionals. It would be a step toward reclaiming public trust and confidence in the United States government, as well, towards stopping the fear and chaos that can overtake communities faster than this pandemic can overtake them. It's critical to mounting an effective national response that will save lives, protect our frontline health workers, slow the spread of the virus. . Joe Biden: (02:53:33) First, anyone who needs to be tested based on medical guidance should be tested at no charge. The administration's failure on testing is colossal, and it's a failure of planning, leadership, and execution. The White House should measure and report each day, each and every day, how many tests have been ordered, how many tests have been completed, and how many have tested positive. By next week, the number of tests should be in the millions, not the thousands. We should make every person in a nursing home available for testing. Every senior center or vulnerable population has to have easy access to the test. And we should establish hundreds of mobile testing sites, at least 10 per state, and drive-thru testing centers to speed testing and protect the health of our workers. Joe Biden: (02:54:31) The CDC, private labs, universities, and manufacturers should be working lockstep to get this done, and get it done correctly. No effort should be spared, none. No excuses should be made. Tests should be available to all who need them, and the government should stop at nothing to make that happen. Joe Biden: (02:54:54) We must know the true extent of this outbreak so we can map it, trace it, and contain it. Nor should we hide the true number of infections in hope of protecting political interests or the stock market. The markets will respond to strong, steady, and capable leadership that addresses the root of the problem, not efforts to cover it up. Joe Biden: (02:55:17) Secondly, we need to surge our capacity to both prevent and treat the coronavirus, and prepare our hospitals to deal with an influx of those needing care, as I've been saying for weeks. This means not just getting out testing kits and processing them quickly, but making sure communities have the hospital beds available, the staff, the medical supplies, the personal protective equipment necessary to treat the patients. Joe Biden: (02:55:47) The president should order FEMA to prepare the capacity with local authorities to establish temporary hospitals with hundreds of beds on short notice. The Department of Defense should be planning now, should have been planning, to prepare for the potential deployment of the resources provided medical facility capacity and logistic support that only they can do. A week from now, a month from now, we could need an instant 500-bed hospital to isolate and treat patients in any city in this country. We can do that, but we are not ready yet, and the clock is ticking. Joe Biden: (02:56:27) As we take these steps, state, federal, and local authorities need to ensure that there is accurate, up-to-date information available to every American citizen, to everyone, so everyone can make an informed decision about when to get tested, when to self-quarantine, when to seek medical treatment. And the federal government should provide states and municipalities with clear guidance about when to trigger more aggressive mitigation policies, such as closing schools. Joe Biden: (02:56:57) Thirdly, we need to accelerate the development and treatment of a vaccine. Science takes time, and it will still be many months before we have a vaccine that can be proven safe for public use and produced in sufficient quantities to make a difference. But therapeutics can and should come sooner. This will save lives. When I put together and we passed the Cures Act of 2016 to accelerate work at the National Institutes of Health, but now it has to make available resources to speed that process along. We have to fast-track clinical trials within NIH, while closely coordinating with the FDA, the Food and Drug Administration, on trial approvals, so that science is not hindered by the bureaucracy.