Coronavirus Crisis Update: Sen. Chris Van Hollen on Covid-19 and How to Move Forward

Andrew Schwartz: You're listening to the COVID-19 Update, a podcast from the CSIS Global Health Policy Center, focused on the science and policy implications of the outbreak. I'm Andrew Schwartz of the Center for Strategic International Studies. And I'm joined by my colleague, Steve Morrison to discuss the latest on COVID-19.

Andrew Schwartz: My colleague, Dr. Steve Morrison, and I are joined today by a very special guest Senator Chris Van Hollen of the great state of Maryland. We're very, very happy to have you here, Senator, thank you so much for joining us.

Senator Van Hollen: Well, it's great to be with you this morning.

Andrew Schwartz: Senator, here in the United States, we now have 1.4 million cases of COVID and deaths are approaching 90,000. 33 million are unemployed. How do you think our country reached such a profound crisis?

Senator Van Hollen: Well, we would have faced a difficult time, no matter what, but I believe that the administration took a bad situation and made it even worse through their failure to prepare and their failure to respond. They dismantled some of the early warning systems that we had in place, both in China, with respect to CDC personnel on the front lines, and they eliminated an office at the White House that was designed to coordinate national strategy in response to a pandemic like this, and then we're very late in the game in terms of a response. And so this virus got a six to eight week head start in the United States, and that is why we're seeing the highest death toll in the world. We're having to play catch up, and again, the response even today is very, very uneven. You see states trying to move ahead, but the federal response from the Trump Administration has unfortunately been undermined by more politics than health policy.

Andrew Schwartz: I want to bring my colleague Steve Morrison in in just a minute, but Steve and I did a podcast with the eminent historian, John Barry, who wrote The Great Influenza, studying the 1918 pandemic in our last podcast, last Friday. And the first thing we asked Professor Barry, what did he think was the most important lesson learned from 1918? And he said, without hesitation, that's easy. It's the government needs to tell the people the truth about what's going on. And what do you think about that? And what's going on with our administration right now?

Senator Van Hollen: Well, if you think about a situation like this, you realize how important public confidence is. And public confidence depends on being able to rely on the government, providing them the best healthcare information. And what we've seen from this administration is mixed messages. You do have some of the healthcare officials who work their hardest to and provide good, reliable healthcare information to the public, like a Dr. Fauci. And then you have administration officials, including the president himself, undermining those messages, now publicly rebuking people like Dr. Fauci. Removing the person who was the head of BARDA, which helps develop vaccines. And so you see this constant back and forth between public health officials trying to bring the truth to the American people and the President and political officials undermining them. And that of course undermines public confidence and leads to a much riskier situation because if people choose to believe that it's just fine to go out before it's safe because the President says so, that obviously puts everybody at greater risk. And so we've got to get back to a place where when you have public health crisis, we put the public health officials first.

Steve Morrison: Thank you Senator for joining us this morning. Just to follow up on your last remark, science in public health has definitely come under an unprecedented level of attack. You mentioned Rick Bright, who's lodged a whistleblower charge against his dismissal over the weekend, the White House aide Navarro attack the CDC. We've never seen the CDC systematically discredited in this manner. What is it that we can do? What is it that you can do in the Senate with your colleagues to counter this trend? Because it is contributing to mass confusion around what people should do in this particular moment in time where we're telling people to be very vigilant, be socially distanced, but we're also telling people that the economy needs to reopen. It's a difficult transition moment right now. We need strong public health guidance.

Senator Van Hollen: Well, you're right. This is a critical moment for exactly the reasons you say, which is that we want to reopen our economy and our society, but we want to do it in a safe way. And we know that's not like throwing a switch from off to on right away. It's going to be more like a dimmer where you slowly try to open, consistent with direction on the health issues from public health officials. There's not really a great answer to your question when you have the person who has the greatest bully pulpit in the country, the President of United States, putting out misinformation. That said, what the Congress can do is what we're trying to do, which is number one, hold hearings, and we did see Dr. Fauci and other healthcare officials appear in the Senate. Now, of course, the administration blocked them from testifying in the House of Representatives because they don't want the House to have that forum, which would be important to the public.

Senator Van Hollen: Then each of us needs to do our own jobs with respect to our constituents. So for example, I've now held three telephone town halls in the state of Maryland with the healthcare expert on the phone each time, trying to provide unbiased healthcare information to our constituents. And it's important that Governors be doing that, but also that Senators and Members of the House be doing that because when you've got the person with the megaphone, the President of United States, putting out bad information, we just have to work extra hard to get the truth out.

Steve Morrison: Thank you. I'd like to ask you a question about Remdesivir, which the therapy that's been granted emergency use authorization. That's the first such a pretreatment for COVID-19. Gilead Science has moved with remarkable speed through the trials to reach this point with significant financial and other forms of support coming from US agencies. And it raises questions around what are the obligations in terms of access and pricing and guaranteeing people they'll have affordable access. Obviously these same issues are going to be coming into force with any discussion around vaccines. We now have the warp speed operation launched by the white house to try and accelerate this. We had statements made at the end of last week by the president about access and these issues tell us what you think.

Senator Van Hollen: Well, this is a huge issue, as you say, both for the so-called therapeutics like Remdesivir, that's designed to treat COVID-19 as well as an eventual vaccine. And this question was first raised when it came to testing for the coronavirus and in the early legislation that we passed out of the Congress, we made it clear that testing had to be provided universally for free or at an affordable cost to everybody. After all, we don't want people not getting tested because they can't afford it. That's bad for them, and it's of course, dangerous to everybody else as well. And the same will hold true with respect to any kind of vaccine. We need to make sure that the entire population can get vaccinated. And that again goes to access and affordability and price. So we're going to have to insist that whatever vaccine is developed is made universally available.

Senator Van Hollen: This raises other questions about our healthcare system and our prescription drug system. I actually have introduced a bill sometime back, a bipartisan bill with Senator Rick Scott in Florida called, the We PAID Act, which says that when the taxpayer has invested the money to do the research, that leads to the development of a drug, that we have to have a process, and we establish it in the legislation, for fair pricing of that drug. After all, we spend about $40 billion a year doing research at NIH and taxpayers who made that investment should not face price gouging at the other end. So interestingly, at least in the United States, the vaccine that's being developed and there are a number of them, but the one under NIH is sort of oversight would be covered by that legislation as an example of where NIH and the United States government has to ensure pricing at a place that it's available to everybody. So we're going to push for that with respect to the vaccine here, but it's also an important issue more broadly.

Steve Morrison: Thank you, Andrew?

Andrew Schwartz: Thank you, Steve. Senator, in Congress, you all passed three separate funding packages. There's a fourth one now, though, that seems to be stuck. What's going on with that and how could it be moved forward?

Senator Van Hollen: Well, that's right. We've passed three and a half, we say, if you include the upgrade to the PPP program, which also included additional funds for testing. And now the House of Representatives, last Friday, passed the Heroes Act, which is badly needed in terms of dealing with the economic pain that's been caused by the social distancing that we've had to take to prevent the spread of the virus and to stop the cycle. Right now you have people like Mitch McConnell, the Republican leader in the Senate saying, "Well, there's nothing urgent about moving on this legislation." At the same time, I can tell you, I hear every day from folks throughout the State of Maryland, that they need additional support right now.

Senator Van Hollen: And I'm talking about both continuing some of the programs that are in place for unemployment insurance enhancement, but the most immediate thing right now is state and local governments that are talking about cutting their budgets for police, firefighters, emergency responders, because they of course have seen dramatic reductions in their ability to pay for those services. So the house bill, at least a third of that bill is devoted to help at that grassroots local level. And so when Mitch McConnell said, "Ah, just let them all go bankrupt," right, that sent a very bad signal. Now he's had to walk it back a little bit. I hope that Mitch McConnell will begin negotiations on this house bill, but right now he's not in any hurry to take this up. I think the American people want to get something more done now.

Andrew Schwartz: What are you all doing to push him to reopen negotiations?

Senator Van Hollen: Well, we're urging folks from throughout the country, on a bipartisan basis to reach out. So, for example, the National Governor's Association, bipartisan organization, has written to the Congress asking for $500 billion for the states, and that's exactly what the Heroes Act has in it. It has $500 billion for the states for this year. Then it has additional monies for the states the next year, actually it's $250 billion this year, $250 billion next year, for $500 billion. And also as funds going directly to cities and counties and towns, you know, my guess is at this point, we're going to have to see more pressure from some of these States like Kentucky on these members. And I can tell you when they start seeing budget cuts to their emergency responders, they may be in a little more of a hurry to get something done.

Andrew Schwartz: One thing that you have personally championed is national service. And this is something that you've been pressing the creation of a national service army drawing from AmeriCorps, FEMA and other agencies, Peace Corps. Seems to me that there's awful lot of young people out there right now who are thinking about gap years, who are having a hard time getting jobs who may find the cost of education to be unaffordable right now. Can you tell us about national service and how this fits into plans for recovery?

Senator Van Hollen: Yes. I'm glad you asked about this because together with Senator Markey and Senator Coons and others in the house, we proposed a large expansion of AmeriCorps and other national service programs to meet the moment and really then to be there to take on other national challenges. But of course, right now we're facing a huge one and all the healthcare experts are telling us that we have to ramp up testing and contact tracing, as well as provide other necessary services in response to the pandemic.

Senator Van Hollen: And so, what better way to both do that and address the fact that so many people have lost their jobs right now, or can't get one, then create a mobilization through public service. And so AmeriCorps is a great foundation, but our legislation would essentially increase it by 500,000 people per year, over a three year period, and get them to focus on the public health needs and other national priorities of the moment. We're going to keep pushing for it. I think it's way overdue and this crisis highlights the need to have that kind of civilian volunteer force that you can mobilize for national purposes.

Steve Morrison: Thank you for doing that. We have at CSIS the last two years, we've had a commission on strengthening America's health security co-chaired by former Senator Kelly Ayotte and former CDC director, Julie Gerberding. And one of the things that we've been pushing is this COVID crisis response corp. Congressman Ami Bera, California, Democrat of California, and Congresswoman Susan Brooks, Republican of Indiana, have been pushing this particularly hard. And so we're really heartened to see that you've taken this step and anything we can do to help support that, we would welcome that. Can we shift just to some of the issues close to home in Maryland that you've been very active on, particularly around protection issues around the federal workforce, around prisoners and those who work with prisoners, in places of detention, and those that work in the meat processing plants. These are populations have very high vulnerability. Tell us what you've been doing to try to enhance the protection for these vulnerable populations.

Senator Van Hollen: Well, I'll take each of those in order starting with federal employees. We had the push the administration very hard early in this pandemic to put in place a real telework policy. They were very slow in creating any kind of direction to agencies with respect to putting that policy in place. And of course that's really important because we didn't want thousands and thousands of federal employees congregating in offices and spreading the disease or having to travel on the Metro to get to work and spreading the virus further that way. So we've been pushing very hard on that front, as well as trying to make sure that the employee voices are heard within the federal government.

Senator Van Hollen: And I organized a bipartisan letter that included Senator Collins and Senator Murkowski laying out a number of steps. We think the administration still needs to take to put in place the policies that protect federal employees. As you indicated, there are other places where you have large concentrations of people where we've seen the coronavirus catch fire prisons has been one of them. And so I wrote to our Governor, Governor Hogan, urging him to take steps to release those who did not pose a risk to the community, put people in home detention as alternatives. And I'm pleased that he moved in that direction at the federal level, we've been pushing the attorney general to do the same and on the Eastern shore of Maryland, we've also seen an outbreak as part of some of the poultry operations, same as you've seen with meat processing plants and other parts of the country. So we're trying to surge testing in those areas.

Senator Van Hollen: The last thing I will mention is we're also pushing hard for a strategy for testing and PPE in the most other hard hit communities, especially communities of color, where we've seen a disproportionate impact and any testing plan as we ramp it up needs to make sure that we provide adequate testing in places where we've seen the most of outbreaks. And so we're pushing very hard for strategy there as well.

Steve Morrison: Thank you, Andrew?

Andrew Schwartz: Senator, I want to ask you, since we're talking about Maryland, what are you hearing about the University of Maryland? The University of Maryland, I believe, is the largest employer in the State of Maryland. What are you hearing about classes for the fall and plans for the University of Maryland open up?

Senator Van Hollen: Well, my understanding is University of Maryland is struggling to make the same sort of decisions that other universities are trying to make in this period of great uncertainty. What exactly will classes at the university look like in fall? To what extent will people come back to campus or to what extent will they essentially continue the kind of distance learning that they did at the end of the current semester there? And I think all universities are struggling with this, I don't think any final decisions have been made. I think everybody recognizes you're not going to get back to full normal. So the question is whether or not there is some set of policies you can put in place that allows people to come back for certain purposes. Do you have classes that are more spread out where people can tune in remotely, but if you want to be there six feet apart, is that an alternative? So I think that they're really trying to work through all those issues right now.

Andrew Schwartz: And the same with our sports, right?

Senator Van Hollen: That's right. So sports you're saying?

Andrew Schwartz: Yeah. Same with professional sports like the Ravens, the Orioles, even that team that's based in Washington, DC, the baseball team,

Senator Van Hollen: There we go,

Andrew Schwartz: Some people have heard of them. The Nationals.

Senator Van Hollen: Well, I've got my Orioles face mask and I just ordered my Nats face mask, so we make sure that that rivalry is equally represented.

Andrew Schwartz: Bipartisan.

Senator Van Hollen: But look, when it comes to baseball, I think they are moving ahead with their plan to begin games without fans in the stands, certainly to begin with, but televised games. So I think different sports are putting together different plans. Baseball obviously the game itself is very different in terms of contact in a sport like football. So all of that will involve a lot of testing. And the testing piece is something that all the healthcare experts say is absolutely necessary. We have to dramatically ramp up real time testing so that we're able to quickly identify and detect any outbreaks so that we can contain it, right, through the contact tracing.

Senator Van Hollen: And we are woefully behind when it comes to testing, which is why many of us have been pushing the president to adequately use the defense production act. We point out that we made over 300 aircraft per day in World War II. My goodness, the United States should be able to produce nasal swabs and transport kits an adequate numbers to do testing. It's just a gross dereliction of duty that we're not there yet.

Steve Morrison: What's the hesitancy?

Senator Van Hollen: And that's a big mystery, right? Because on the one hand I heard people say, well, we just don't want to be ordering companies to produce these national requirements. But we pointed out to the president in a letter really just last week, that section three of the DPA gives the federal government lots of tools to help compensate these companies for the products they make.

Senator Van Hollen: Look, I can understand if you're a company and you're ordered to make nasal swabs, you want to make sure at the end of the day that there's someone there to buy it. I mean, at the very least we were putting our national stockpile for some reason, but the federal government has those tools. So we're not talking about takings, we're not talking about depriving these companies of any income, but we have all sorts of incentives we can provide as part of the direction to do this so we can tell them to do it, but we can also make sure they're fairly compensated and it's just outrageous.

Andrew Schwartz: The best PR these companies will ever have in the history of their companies if they're able to contribute to society in a way that really helps us overcome this disease.

Senator Van Hollen: Well, that's exactly right. And I don't think these companies are resisting, but for some reason in this administration, there's a reluctance to fully utilize this power. I mean, obviously the Congress passed this law back in the day for a reason. This is the kind of moment that it's supposed to be used.

Steve Morrison: Senator, can we shift to towards the end here to a couple of international issues. One is the World Health Organization. Today's the first day of a two-day virtual World Health Assembly. President Trump back in mid-April announced he was suspending and perhaps terminating US assistance to the World Health Organization, right in the middle of this pandemic. We've been very active in trying to oppose that and call for common sense approach. WHO is not perfect. There's plenty of areas in which its performance can be critiqued and reformed. And this is a really dangerous move by the White House. And as we were talking about earlier, it looks as though position of the White House is hardening, not softening at this particular moment in time. What is it that can be done quietly or publicly in the Senate by folks on both sides of the aisle with enough common sense in good faith to try and walk this back?

Senator Van Hollen: Well, you're right. The WHO is not perfect, but you don't make it better by walking away from the organization and taking our money and investment with it. And the WHO is an essential organization to respond to these kinds of pandemics. And if we've learned anything through this, it was a reminder that the United States is not an Island and that health problems and diseases overseas can impact Americans here at home and bring a very heavy toll. And that's why we should be taking a leadership role in these organizations, strengthening these organizations, so we will push very hard in the next round, the Heroes Act to provide funding for the WHO. It is very disappointing to hear that the president may be doubling down on his decision to walk away from the WHO. So that Ali not only hurts us on the healthcare front because WHO needs to play an important role and we need to be part of it.

Senator Van Hollen: It also provides a huge opening for China to take an even greater leadership role. I mean, they've worked to exploit the situation right now by playing a greater global role. I mean, they of course did contribute to the problem by not being more open at the beginning. Now they're using the moment to try to help a lot of other countries at a time when the United States is abandoned it's a traditional role in global leadership. So walking away from the WHO will not only hurt us from a health perspective and protecting public health here, it will give China a bigger global platform.

Steve Morrison: Yeah, we've seen some of that today. President Xi at the World Health Assembly delivered an address. And so it was conducted virtually pledging $2 billion in assistance. Of course, China's under lots of pressure now coming from many directions for its performance, but we've abandoned this stage for the time being. If I could just ask you about these packages, the funding packages so far, there's been an understandable reluctance in Congress to focus in those packages on expanding us foreign assistance for low income countries in this period. It's a sensitive issue when we have such a deep crisis here at home. Is that changing? Do you feel that's changing? Do you think that the moment is beginning to approach when members of Congress can begin to talk about, look, we need to think ahead as the pandemic is coursing through low income countries in particular, very ill prepared and very dangerous situation.

Senator Van Hollen: Well, you're right. The focus understandably has been here at home and trying to make sure that we have adequate personal protective equipment for our frontline workers and others. But I do believe that there's a recognition that what happens overseas can impact us here at home and it's really important that we play our traditional global leadership role. Now there was about $2 billion in support in the earlier packages. Obviously the need is much greater. I do think there'll be some openness to expanding that support, again, both in terms of humanitarian relief, but also because of the clear impact on the spread of this disease on the United States.

Senator Van Hollen: I mean, if you think about really reopening in the end, you need to be able to resume trade and global travel. You can't do that if you're going to have continuing outbreaks and in many parts of the world. And so I'm hopeful that we'll be able to get a consensus that let me just close though, by saying that to the extent that the Trump administration continues to demagogue on these issues, as they have with the WHO, it may make it harder. Now, at times the President has talked about providing, for example, any surplus ventilators to other countries. And so maybe some of the Republican senators will pick up on that and we'll be able to put something together.

Steve Morrison: We know that the US Global Leadership Council and one campaign and interaction have carefully together a package. I think it's around a $12 billion package on enhancing the US operational response, as well as the emergency humanitarian and health response. And I do hope that we're able to get some consideration for that. Andrew.

Andrew Schwartz: Senator, this has been fantastic, thank you so much for your time today. And it's really been a pleasure talking to you for this podcast. Best of luck. We hope to have you back at CSIS really soon.

Senator Van Hollen: I want to thank the two of you and CSIS for all that you do both in terms of policy formation and getting ideas out there in normal times, but especially what you're doing during this pandemic. So thank you.

Andrew Schwartz: Thank you, sir.

Steve Morrison: Thank you. And thank you for your leadership.