WASHINGTON, D.C. – Today, during a hearing of the Senate Committee on Homeland Security and Governmental Affairs (HSGAC), U.S. Senator Jacky Rosen (D-NV) questioned Julie L Gerbeding M.D, the Honorable Nicole Lurie M.D., and Elizabeth A. Zimmerman on preparedness for COVID-19, data tracking, and early pandemic response. 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: Thank you, Chair Peters and Ranking Member Portman. This is a really important hearing, and I appreciate all the witnesses for everything you’ve done and for being here today. I want to talk about data tracking and early pandemic response. As we know, the pandemic dominated Americans’ lives last year and into this year. Our focus has rightly remained on tackling the immediate challenges before us. We have to work to save lives. I do think there were missed opportunities to get a better picture of the pandemic, which is critical to understanding how to protect people dealing with long-term effects of COVID and making sure we are not leaving anyone behind.
Moving forward, I believe we need to be sure we make comprehensive understanding a priority and while still doing research efficiently so that data collection doesn’t delay us getting help to those who need it. Last year, I introduced the bipartisan Ensuring Understanding of COVID-19 to Protect Public Health Act to make sure we get started with comprehensive long-term studies with regular reporting right away so researchers and clinicians would have the latest information. Some of these studies have started, but there are still significant gaps, so I hope all my colleagues will join me on this bill.
Dr. Gerberding, Can you please discuss the remaining gaps and research we have, especially now that we are seeing the long haulers. People will seem fine, and things will pop back up. How the virus seems to be impacting patients differently, and we need to do research?
GERBEDING: We have a lot to learn. To start with the medical dimensions of the infection, you are absolutely right. We don’t understand the actual pathogenesis or the mechanism by which this virus causes such a myriad constellation of diseases -- everything from no symptoms to all the way devastating multi-organ system failure. Some of that is related to viral load, and some of it is genetic. There is much to be learned at the very basic medical level. In addition, the syndrome of the post infectious phase of COVID is recognized as a broad constellation of findings with a durable impact on people on not just their physical health but also mental and ability to function. There are also many things we have to learn about the basic epidemiology. Again that’s where data systems can be our best friends because we may be able to probe things from existing data or more rapidly get our hands on data that are evolving through our health systems and public health systems. To be able to draw a connection and see patterns we currently don’t recognize without the use of artificial intelligence or machine learning type tools. The list of what we need to know is long. Right now, everyone is focused on the most critical things in the context of care of patients and vaccinations. We are going to be with this coronavirus for a long time.
ROSEN: I agree with you the list is long. So we need a vast amount of information, and we need it quickly. I’ve heard from some of the caregivers from up and down my state especially from smaller and more rural areas.
They are hesitating on some things because they don’t know if they have the capacity to comply with various reporting systems. How do you think we need to simplify the process so that everybody giving vaccinations and treatment, community health centers and smaller hospitals, so we have the interoperability and ease of reporting. So we can get this vast amount of data to us quickly, so Dr. Lurie and Ms. Zimmerman, maybe you might respond to this collecting of data and interoperability to give the doctors and tools they need moving forward and all of us really.
LURIE: Well, I would say a couple of things. First of all, it got going late but there is now mechanisms recently called project echo to pull doctors together every week for peer-to-peer learning about best practices and how to treat one another. I would encourage all kinds of health providers to take advantage of that. Make no mistake; our data systems are really siloed. You are right. There is a vast amount of data out there that go unanalyzed because we don’t have the tools and don’t have the workforce to do it. Going forward, I think we can ask ourselves very firmly now. What needs to be done by humans? Or can we have signals picked up by machine learning and artificial intelligence? So we have put the highly trained human capacity where they need to go and not miss signals and be able to aggregate data much more quickly. In the data end, we have made such great progress from the perspective of integrating it or health care and public health data together into the way we understand the disease and make decisions. We have a really long way to go and huge opportunity to do better.
ROSEN: Thank you, Ms. Zimmerman, what do you think we might be able to do to help improve this interoperability between partners, whether it’s health care, FEMA, mobile clinics, and hospitals. Do you have suggestions for us?
ZIMMERMAN: Thank you, Senator. Exactly because we start chasing the data, and in the beginning of COVID-19, everybody was chasing all sorts of data. There was no set parameters of what was needed to make decisions. In the beginning, your making decisions with limited data, and that’s what emergency managers do. They go forth and push. I think we have a great opportunity right now to look at what data provided us the best information in order to make those decisions. What are those immediate decisions you need to make on the onset of a pandemic or any major medical thing impacting the nation. So, I think in looking at what were the things that gave us the outcomes. So to me, you need to look at the outcomes and what is the data needed to get that. To be able to put the smart people in the room to determine what is needed in that regard is key right now. Otherwise, with all of the technology and everything out there, we go chasing a lot of data points that don’t give us an outcome that matters. We need to look at the outcomes that are going to matter to shorten the time period for all of this that we’ve been through.
ROSEN: Thank you, As a former analyst, I couldn’t agree more that data tells a story if you figure how you need to listen to it. We really need to understand the lessons we’ve learned that we can use not just going forward for this pandemic, but god forbid for the next public health emergency. So this should be able to guide us. Thank you. I will submit the rest of the questions for the record. Thank you.