From the U.S. Government Accountability Office, www.gao.gov

Transcript for: The Federal Response to COVID-19 Could Be Strengthened
by Timely Actions   

In response to COVID-19, Congress and federal agencies have
taken unprecedented steps to direct funding and federal assistance to
individuals, businesses, and communities. However, despite these
efforts, the nation continues to face significant loss of life and
profound economic disruptions. We've been monitoring and reviewing the
federal response to COVID-19 and issuing by-monthly reports about our
review. We talk with some of the directors who are leading GAO's effort
to audit the federal response to COVID-19. 

Related GAO Work: GAO-20-701, Federal Efforts Could Be Strengthened by
Timely and Concerted Actions

Released: September 2020

[Intro Music]

[Nikki Clowers:] The different stakeholders need a plan to help them
prepare for their roles in administering and distributing any vaccine. 

[Holly Hobbs:] Hi and welcome to GAO's Watchdog Report, your source for
news and information from the U.S. Government Accountability Office--
I'm Holly Hobbs.

In response to COVID-19, Congress and federal agencies have taken
unprecedented steps to direct funding and federal assistance to
individuals, businesses, and communities. This response includes about
$2.6 trillion in relief funds. However, despite these efforts, the
nation continues to face significant loss of life and profound economic
disruptions. 
Here at GAO, we have been monitoring and reviewing the federal response
to COVID-19, and are issuing bimonthly reports that--among
things--identify opportunities for the federal government to improve its
response and prepare for future challenges. 

Today, we talk with some of the directors who are leading GAO's effort
to audit the federal response to COVID-19. Joining us are:

•	Nikki Clowers, the Managing Director of our Health Care Team;
•	Jackie Nowicki, a director in our Education, Workforce and Income
Security team;
•	And John Pendleton, a director in our Financial Markets and Community
Investment team.

Thank you for joining us Nikki, Jackie, and John. 

[Nikki Clowers:] Thanks for having us.

[Jackie Nowicki:] My pleasure, Holly. 

[John Pendleton:] Glad to be here.

[Holly Hobbs:] So team, let's first talk about the federal government's
role in responding to COVID-19 as a public-health crisis. Nikki, the
federal government is heavily invested in supporting the development and
manufacturing of a COVID-19 vaccine. What's the status of this effort? 

[Nikki Clowers:] There are multiple agencies across the federal
government working together, as well as with the private sector, to
accelerate the development and manufacturing of a vaccine as well as
different therapeutics to help prevent and treat COVID-19. And to put
this in context for you--the traditional timeline to bring a vaccine
through large-scale manufacturing is usually about 10 to 15 years. What
we're trying to do with COVID is bring that vaccine development through
manufacturing in what could really be measured in months rather than
years. The government has invested about $11 billion--to date--to
support 7 vaccine candidates. Three of those vaccines are currently in
the phase-3 trials, which are the large clinical trials where we test
the efficacy of the vaccines. The government has also invested another
$1 billion in support of 9 therapeutics, and one of those vaccines are
currently in the phase-3 trial. 

[Holly Hobbs:] And what are the plans for getting the vaccine to the
public?

[Nikki Clowers:] What we found is the need for more clarity around the
government's role in distributing and administering any licensed or
authorized vaccine. We recommend that HHS establish a timeframe for
documenting and sharing a plan because the different
stakeholders--whether it be states or providers--need a plan to help
them prepare for their roles in administering and distributing any
vaccine.    

[Holly Hobbs:] And, Nikki, we also need to protect our frontline workers
from COVID-19. There have been news reports on shortages in medical
supplies and testing. Are there still shortages?

[Nikki Clowers:] Yes. While the government has taken action to attempt
to mitigate medical supply shortages, we continue to experience
shortages of personal protective equipment and testing supplies. Testing
supply shortages have contributed to delays in turnaround times for
testing results. And these delays in processing testing results have
multiple serious consequences, including delays in isolating those who
test positive and tracing their contacts in a timely manner, which can
further contribute to outbreaks within a community.  

[Holly Hobbs:] So, what can the federal government do to help?

[Nikki Clowers:] We identified multiple actions for the government to
take to help address these challenges. For example, we recommended that
HHS work with the states to help them better track supply requests and
estimate supply needs for the duration of the pandemic. 

[Holly Hobbs:] And looking at another aspect of the pandemic--Jackie,
this Fall, state and local school district officials assessed--and may
need to continue to reassess--their operating status and make tough
decisions about whether students will attend school in-person or not. Is
the federal government providing guidance to help them navigate this
situation?

[Jackie Nowicki:] Yes. It is. So, as with most things in the K-12
(schools) arena, state and local officials are the primary decision
makers, including for decisions about how and when to reopen schools for
in-person learning. The CDC has provided guidance to help local
officials make these difficult decisions. However, we found that some of
the guidance was unclear and it could contribute to confusion. 

[Holly Hobbs:] Can you give us an example of how the guidance was
unclear?

[Jackie Nowicki:] So at the end of July, CDC announced updated guidance
to help schools and districts and states to consider how to return to
in-person instruction, as well as how to assess their operating status
throughout the school year as local health conditions change. But for
weeks afterward, its guidance on screening for children and employees
for entering schools was internally inconsistent. So, in one example,
the updated guidance doesn't recommend that schools conduct daily
symptom screening for students; and it notes that since some people with
COVID-19 are asymptomatic, there are limitations to those kind of
screenings. However, guidance suggesting that they shouldn't open unless
they were prepared to test staff and students each day still remained on
CDC's website several weeks later. Also, the Department of Education had
posted incomplete information about key healthy habits that the CDC
described as critical in helping to slow the spread of COVID--such as
staying 6 feet apart and wearing masks. These kinds of issues could
really contribute to confusion as to whether and how schools can reopen
safely. And we raised these incongruences with CDC and Education during
the course of our work. And Education updated its information to better
align with CDC guidance. And the CDC said that it was in the process of
making corrections to eliminate these kinds of inconsistencies. So,
that's good news. 

[Music:]  

[Holly Hobbs:] While the health risks COVID-19 presents are dire, so are
the economic disruptions it has caused. As of July, an historic 16.3
million people were unemployed. The federal response to the economy has
included, among things, loans to small businesses, paycheck protection
for workers, and mortgage forbearance periods for homeowners.
John, shortly after Congress passed the CARES Act in March, there was
confusion about which kinds of businesses were qualified to get relief
loans, and concerns about the transparency of who received those loans.
Now that we have some data on the loans, what does it show? 

[John Pendleton:] Well, one thing I think you have to remember is the
Paycheck Protection Program was a massive program, and it was done fast.
Over a 4 month period--between early-April and early-August--the Small
Business Administration, through banks, pushed out over 5 million loans
that total over half-a-trillion dollars. Big loans tended to be made
early, in the first few weeks; with the smaller loans coming in the
second month or later on in the process. And over the summer, the loan
rates slowed down and by August 8, when the program ended, there was
actually still over $100 billion left. Significantly, about 15% of the
loans that were initially approved for over $2 million were later
canceled--partly because SBA provided additional guidance about what
constituted economic necessity and the folks that took the loans decided
that they would cancel them. We also saw that loans went to some
nonprofits--about 7% of the loans or about $37 billion went to
nonprofits including nonprofit-child care centers. And there's lots of
other statistics in our report. But, the thing to remember is that these
are loans, and to be forgiven the companies need to demonstrate that
they used the money to pay employees and generally keep their businesses
operating. And that forgiveness process is just now getting in full
swing. So, in many ways, the oversight work is just beginning in
earnest.  

[Holly Hobbs:] And last question, Nikki--what's the bottom line of this
report?

[Nikki Clowers:] The federal government has taken multiple actions to
help address the significant public health and economic impacts of
COVID-19. These actions have spanned the government and reflect the hard
work and dedication of the federal workforce. However, the nation
continues to face significant challenges as it relates to the pandemic
and its effects. We are making recommendations to help the federal
government prepare for the months ahead, while improving the ongoing
federal response. 

[Holly Hobbs:] That was GAO's Nikki Clowers, Jackie Nowicki, and John
Pendleton talking about our newest report on the federal-response to
COVID-19. Thank you for your time team! 

[Nikki Clowers:] Thanks for having us.

[Jackie Nowicki:] Happy to be here Holly. 

[John Pendleton:] Thanks so much.

[Holly Hobbs:] And thank you for listening to the Watchdog Report. To
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For more from the congressional watchdog, the U.S. Government
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