Mix of Clouds and Sun at Senate COVID Hearing

Vaccine equity, global vaccination, and support for strained healthcare workers were on the agenda at a Senate Health, Education, Labor and Pensions Committee hearing Tuesday.

In her opening remarks, Patty Murray (D-Wash.) noted that the American Rescue Plan, which was passed by the Senate over the weekend, includes more funding for vaccine distribution, and for community health centers, as well as for testing, contact tracing, and sequencing to identify SARS-CoV-2 variants, along with monies to recruit and train 100,000 public health workers.

The House is expected to pass the bill this week.

Equity in L.A.

Jerry Abraham, MD, MPH, director of Kedren Health Vaccines in Los Angeles, highlighted CDC data showing that Black and Latinx people who contract COVID-19 are dying at twice the rates of other populations. His organization has taken down multiple barriers to getting vulnerable residents immunized, such as a lack of transportation, internet access, documentation, or insurance, he stressed.

The community health center also was able to reach people with physical disabilities and with language-access issues and in doing so, became a model for the nation in how to equitably vaccinate Americans, Abraham said.

Kedren Health has immunized 52,000 people in South Los Angeles, he reported, relying on 200 volunteers daily from AmeriCorps, the American Red Cross, the International Medical Corps, and others to staff its clinics.

“What we do is no secret. It’s not a magic trick. We just need more vaccines, more hands, and more resources,” he said. “That’s how we’re gonna get everyone vaccinated.”

When asked about some Americans’ distrust in science, Abraham urged approaching vaccine-hesitant patients in a nonjudgmental manner.

“Whether you’re Black or brown, white or yellow, you legitimately have every reason to have questions. It is your body, your health. What is mRNA? What is an mRNA vaccine? These are real questions and you have every right to ask them,” he said.

Abraham also stressed that trouble accessing vaccines is not the same as vaccine hesitancy: “[L]et’s not confuse not finding parking in South L.A. as ‘I don’t have time for a vaccine or I don’t want a vaccine.'”

Vaccination for All

The Biden administration announced last week that the U.S. is on track to have enough vaccine for every U.S. adult by the end of May, but that won’t be enough to defeat the virus without a focus on global vaccination efforts, said Ashish Jha, MD, MPH, dean of the school of public health at Brown University in Providence, Rhode Island.

Jha praised the administration’s decision to rejoin the WHO, and lauded the $4-billion investment in COVAX, the international effort to fund and distribute COVID-19 vaccines globally, with a focus on low- and middle-income countries. However, he warned that not “aggressively” accelerating international vaccine distribution efforts would have consequences.

On the current trajectory, vaccination efforts could take 3 to 4 years to achieve “global widespread immunity,” he estimated, and such a “slow global rollout” could allow new strains to pop up “elsewhere” that could limit the protection of current vaccines and “possibly even render them useless.”

“We will then have to re-formulate, re-test, and redistribute vaccines and re-vaccinate our population,” he said.

Sen. Tammy Baldwin (D-Wis.), who introduced a bill to invest resources in scaling up surveillance of COVID-19 variants, asked witnesses what states can do to respond to the threat of COVID-19 variants.

Umair Shah, MD, MPH, secretary of health for Washington state, said mitigation policies — mask wearing, social distancing — must be maintained while immunization ramps up. Also, scaling up genomic sequencing of variants has to be prioritized.

Shah noted that the share of tests sequenced in the U.S. is “markedly lower” than the 5% to 7% tested in the U.K. and parts of Europe. While states should continue to work with the CDC and the Association of Public Health Laboratories to determine the “optimal percentage,” he said, “it’s really not about just a percentage; it’s about making sure it’s distributed throughout the country,” he said.

Jha pointed out that full herd immunity in the U.S. can’t happen without immunizing those under age 18, but because infection rates are lower among this population, very large trials are going to be needed to show vaccine efficacy.

“We may need to look at this a bit differently,” he said. “We may need to make sure these things are safe in children and use that as a bar.”

Bolstering Healthcare

With regard to the toll the pandemic is taking on U.S. healthcare providers, Sen. Tommy Tuberville (R-Ala.) asked “Do we have a plan to help these people that are first responders once, hopefully, we see the light at the end of the tunnel in this pandemic?”

Abraham stressed that there aren’t enough providers delivering essential treatment and public health, noting that he, along with many other caregivers, have not “taken a day off since the day before Christmas and that just can’t keep happening. That’s not sustainable.”

Jha also called out the “unmitigated” attacks on healthcare workers, including accusations that doctors and nurses lied about case numbers and were “dishonest, when I think they have been anything but that.”

He also argued for rethinking payment policies to keep independent and primary care practices afloat.

“We need to find new ways of paying doctors, nurses, and healthcare providers,” he said. “So, there’s a lot of work ahead, but it certainly begins by showing people respect and understanding what healthcare workers have gone through and not questioning their motivations.”