WASHINGTON, D.C. – Today, during a hearing of the Senate Homeland Security and Governmental Affairs Committee (HSGAC), U.S. Senator Jacky Rosen (D-NV) questioned Dr. Ashish K. Jha, MD, MPH, Dean of the School of Public Health at Brown University on the potential for at-home COVID-19 testing options, support for caregivers and the medical workforce, and the need to ensure food security for Americans through this pandemic’s most critical times. A transcript of the Senator’s full exchange can be found below, and a video of the Senator’s full exchange can be found here.
ROSEN: One thing I would like to bring up that I think is key to possible early treatment is robust testing. I want to talk about our at-home testing options because this could be a critical component before we [COVID-19 patients] wait to have difficult symptoms. COVID-19 is spreading rapidly. We’re about to hit the holiday season. These are events for a highly contagious disease [to spread]. We need to do more at a federal level to support testing, prevention, and treatment options, and some things that we can deliver at home that perhaps you can then be on the lookout if your symptoms get more difficult, or if you have some other underlying comorbidity that may contribute to a bad outcome for this disease.
Dr. Jha, could you please speak to how a widely available, rapid at-home test might change the way people access tests and how it might change the way that doctors might do early intervention depending on whether you have cardiac issues, asthma, whatever that might be? We know the FDA just announced this week the prescription at-home test. That’s positive news. How close are we to other types [such as a] saliva test that people might be able to do themselves, over-the-counter, and help us get treatment for everyone?
JHA: Yes, Senator Rosen. Thank you for that really important question. There are many things we could have really done to change the trajectory of this pandemic, and one of them certainly would have been if we could have made widespread home testing available. If those tests were available, it would allow people to self-quarantine so they wouldn’t be infecting others. It would allow people to seek early therapies. One of the key points of this entire hearing is about early treatment. Early treatment is only possible if you get an early diagnosis. Our testing infrastructure really is no longer managing to be able to provide that. Now, I’m heartened by the Lucira EUA [COVID-19 test] from the FDA. It’s really the first true home test, and it’s going to be months before it’s widely available, and it’s going to be prescription only. What many of us have been calling for is toward new technologies that are emerging and available that would allow for wide-spread availability of home tests. That would make a tremendous difference, and it would be much, much cheaper. That hasn’t happened. I believe we have the technology to do it, and we need those tests, and that’s going to be a critical part of controlling this pandemic.
ROSEN: Well, I hope this Congress, maybe one of our packages, we could fund that, because I do think that would really help us, just give us another tool in the toolbox to tamp down the disease. Another thing that I want to talk about is treatment, but treatment also takes health care workers across the medical spectrum. People who administer the test, read the test, analyze it, phlebotomists to technicians and highly-skilled physicians. I want to talk about our health care capacity, the role of our caregivers in this mix.
I have [supported] a lot of bipartisan bills that would provide tax credits, training, and support to caregivers, and also support increasing our medical infrastructure and provider shortages, like our Conrad 30 program, extra GME slots, federal funding for rural areas to improve nursing. All of this is more tools in the toolbox, but many people see our medical system kind of buckling under. [addressing Dr. Jha] What kind of investments would you hope that we might put forward in a future COVID package to support training across the medical spectrum to deliver vaccines and treatments and services because you can’t do it without support.
JHA: The health care system we often think about it as hospitals and doctors’ offices and pharmacies, but what it really is, is nurses and doctors and pharmacists who work in these places. And, in fact, one of the things I’ve been very worried about is that we’re not paying enough attention to the health care workforce right now. For instance, when we think about hospital capacity in the middle of this surge, we often say “well that hospital has plenty of beds available.” Those beds aren’t going to do anybody any good if there isn’t a nurse to take care of a patient in that bed if there isn’t a physician to take care of that patient. So, we have not been paying enough attention to health care workers. I think that point is absolutely critical, and I think finding ways of supporting them is obviously a critical thing. We need to make sure they’re protected through PPE, but there are more things that we could be doing. And then, when I think about the distribution challenges, we’ve all talked about the incredible vaccines that are coming and the importance of getting them out quickly. We’re going to want to vaccinate hundreds of millions of Americans over the next six months. They’re going to have to be done in all sorts of places, including pharmacies, including doctors’ offices, hospitals. We have to find ways of training and supporting these workers who can actually deliver these kinds of services. So, in any package that supports the health care system, thinking about the health care workers first, and then really making sure that they’re getting what they need is absolutely central to the success of such a package.
ROSEN: Well thank you. I see that I have just about a minute left. I’m trying to think about all the support systems for early detection, for treatment, for vaccines, whenever that is. I also think about -- in my community and of course communities across the country – families are struggling economically. That means increased food insecurity and other kinds of existential things that families need in order to stay healthy and even to get to a doctor if they don’t have health care or they’ve lost their job. We have our food banks – Three Square, Food Bank of Northern Nevada, United Way’s across the country doing that. Can you talk about some of the things that people should be able to do in their home, maybe vitamin supplements, other things that people might take, they’re not even able to purchase those if they don’t have a job. They may not even be able to put food on the table, and that contributes to bad health outcomes too. Can you speak about that?
JHA: A critical part of this response is getting people through this time period. We’ve seen very long lines at food banks, we’ve seen people going to work in dangerous situations because they don’t have any choice, because they’ve got to put food on the table, and in the middle of the biggest public health crisis of a century, I think all of us agree that helping people through this time period – we’re not talking about forever, we’re not talking about for years -- we’re really talking about the next three to six months as the critical period. Making sure people have enough food, making sure people have access to health care, those are central because if people don’t, people are going to make tough choices that will make the whole pandemic worse, and really leave everybody worse off, and certainly leave those individuals worse off. So, any strategy on pandemic preparedness and response need to take into account exactly the ones you have laid out.
ROSEN: Well, thank you. I appreciate your indulgence. Mr. Chairman, I’ve gone over my time as well, but, I like to think that we don’t live in a vacuum, so there’s other things that are going to help us succeed, and I want to be sure that we look at those, so whatever treatments are right, whatever vaccines, that we’re prepared to have everyone get them, and be able to get through this pandemic together as a country. Thank you.