From the U.S. Government Accountability Office, www.gao.gov

Transcript for: Urgent Actions Needed to Improve Federal Response to
COVID-19

Description: COVID-19 cases began to increase again in mid-September,
further highlighting the federal government's role in responding to the
pandemic's continuing and devastating impacts on public health and the
economy. Here at GAO, we've been monitoring and reviewing the federal
response to COVID-19. We discuss our latest report--which looks at COVID
testing, vaccine development, and unemployment issues--with GAO's Nikki
Clowers (Managing Director of our Health Care Team) and Tom Costa (an
Acting Director in our Education, Workforce, and Income Security Team).

Related GAO Work: GAO-21-191, COVID-19: Urgent Actions Needed to Better
Ensure an Effective Federal Response

Released: November 2020

[Intro music]

[Nikki Clowers:] While states are able to fulfill most supply needs,
there are still some shortages of Personal Protective Equipment. 

[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. COVID-19 cases began increasing again in mid-September,
further highlighting the federal government's role in responding to the
pandemic's continuing and devastating impacts on public health and the
economy. 
Here at GAO, we've 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 about our latest report, which looks at COVID-19 testing,
vaccine development, and unemployment issues. With us to talk about this
report are two 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; and Tom Costa, an Acting Director in
our Education, Workforce and Income Security team;
Thank you for joining us Nikki and Tom. 

[Nikki Clowers:] Thanks for having me!

[Tom Costa:] Yeah, thanks for having me, Holly!

[Holly Hobbs:] Nikki, let's first talk about the federal government's
role in responding to COVID-19's impacts on public health--specifically,
let's talk about medical supply shortages and vaccine development. Can
you provide us with an update on how the federal government is doing in
terms of providing critical medical supplies like Personal Protective
Equipment to frontline workers?

[Nikki Clowers:] There is a number of steps the government has taken
since the outset of the pandemic to help make sure facilities and
providers have needed supplies. Nevertheless, there's shortages that
still persist. In our September report, we reported on the shortages
that we saw based on interviews with states as well as information from
FEMA and FDA. For this report, we conducted a nationwide survey of all
the states and territories and had about an 80% response rate. And we
asked them about their needs in terms of PPE, testing, and other
supplies. And, what we found is that, while states are able to fulfill
most supply needs that they get, there are still some shortages in the
areas of Personal Protective Equipment, such as gloves. 

[Holly Hobbs:] And what about COVID testing equipment like nasal swabs? 

[Nikki Clowers:] For the most part, they were able to fulfill requests
for swabs needed for testing, but again, there's still pockets of
shortages. So, for example, most states reported that they had shortages
of rapid point-of-care testing equipment as well as the reagents needed
for the analysis of the samples. And we reiterate the recommendation
that we made in our September report is that FEMA and HHS should work
together to develop plans to help mitigate these shortages moving
forward in the pandemic. 

[Holly Hobbs:] And, Nikki, since we're talking about testing--we heard a
lot this summer about shifts in CDC guidance on whether asymptomatic
individuals should get tested or not. Can you talk about that shift and
GAO's review of federal testing guidance?   

[Nikki Clowers:] Yes, there have been changes to the testing guidance
that CDC has issued. And we reviewed the guidance and the rationale for
those changes, and what we found is that the rationale for the changes
has not always been transparent in terms of explaining why they're
making the change to the guidance. And so, we make a recommendation to
CDC to address this issue to help improve transparency of any changes
they make to the testing guidance going forward. 

[Holly Hobbs:] And how about vaccines? It sounds like we're close to
having a vaccine available to the public. But, what are the plans for
getting that vaccine mass produced and distributed? 

[Nikki Clowers:] I think what you're seeing now is--with that good news
that we've had over the past couple of weeks--is really a pivot to look
toward distribution of a potential vaccine. And this is the area that
we've been talking about since the summer. And in our September report,
we made a recommendation to FDA to start working on these distribution
plans, and make sure they're involving all the stakeholders into
developing the plans because distribution presents a number of
challenges as well. For example, under distribution, you would have
issues, such as communicating to the public, educating the public,
training healthcare providers on how to use, administer the drugs, as
well as the logistics of getting the drug from the manufacturer to the
patient. And, so, this will take time in terms of rolling out and
distributing any vaccine that is authorized. And it's an issue we will
continue to track and report on. 

[Holly Hobbs:] So, it sounds like the federal government has made
progress in responding to the health risks of COVID-19. But there are
still concerns about the transparency of these efforts, and we know that
health concerns are ultimately delaying economic recovery. Tom, you
looked at unemployment insurance claims. How has the eligibility for
unemployment changed during the pandemic?

[Tom Costa:] So, the CARES Act created three new programs that
temporarily expanded eligibility for unemployment insurance. The first
program augmented unemployment benefits by providing an additional $600
per week. That expired at the end of July. And then, in August, the
president redirected some funds to support an additional $300 or $400
per week for an additional 6 weeks. The second was the Pandemic
Emergency Unemployment Compensation program that extended benefits for
an additional 13 weeks. Some Americans have already expended their
additional weeks, but the extension will expire at the end of the year
for those who have not. And the third was the Pandemic Unemployment
Assistance, or PUA program, that allowed up to 39 weeks of benefits for
individuals who aren't normally able to collect benefits, like gig
workers or self-employed employees. The PUA program is also set to
expire at the end of December.    

[Holly Hobbs:] And what trends did you see with unemployment claims?

[Tom Costa:] The Department of Labor publishes weekly news releases with
information about unemployment, and these weekly news releases show that
the number of initial claims remains really high. For example, during
the week ending November 7th, Labor reported individuals filed over a
million initial claims for the unemployment insurance program. These
numbers are lower than the peak back in April of 6.2 million, so it does
appear that workers are losing their jobs at a slower rate. That said,
the number of initial claims is still about three times higher than in
2019.

[Holly Hobbs:] And we found some issues with Labor's claims data, right?

[Tom Costa:] While the initial claims provide useful information, it
doesn't measure the actual number of people that continue to claim
benefits from week to week. We found that the continued claims data has
problems. So, prior to the pandemic, state counts of continued claims
were a good approximation of the number of people claiming benefits,
because, each week, any given person would typically file a claim for
just one previous week of unemployment at a time, but during the
pandemic, that hasn't been the case. There have been backlogs in
processing all of this historic volume of claims, and individuals are
claiming multiple weeks of benefits at one time while they wait for
their applications to be processed. So, by using continued claims
counts, individuals who submitted multiple claims at the same time get
counted more than once in Labor's estimates, potentially over-counting
the number of people collecting benefits. At the same time, not all the
states have been submitting their data in a timely fashion, so it hasn't
been included in the weekly estimates, so we're potentially
under-counting the number of people from that direction. So, as a
result, we don't actually know the number of people that continue to
claim benefits from week to week. 

[Holly Hobbs:] So, Tom, what impact does all that have on both the
individuals who are relying on those checks and then the government's
ability to oversee this program?

[Tom Costa:] Millions of Americans have relied on these benefits to get
by during the pandemic. And while many of these benefits have already
expired, the PUA program for gig workers is set to expire in
December--and that will further impact those relying on these benefits.
In addition, reliable data are also needed to understand the role that
unemployment insurance benefits are playing in the economy during this
pandemic. And without an accurate accounting of the number of
individuals who are relying on the benefits, it's hard for us to respond
to the crisis at hand. Frankly, policymakers just need better
information. So, as a result, in our November report, we're making two
recommendations. The first recommendation is that Labor should revise
its weekly news releases to clarify that they are not reporting the
number of unique individuals claiming benefits. And the second is that
Labor find a way to report the actual number of people claiming benefits
during the pandemic. The states actually have this data, so they can
find a way to get this information weekly. If they're able to do so,
this will help Labor and the Congress--our policymakers--identify
lessons learned; it could help shape a possible extension of the
programs if that does happen; or at least inform future policy should
another crisis hit.     

[Holly Hobbs:] And last question, Nikki, what's the bottom line of this
report?

[Nikki Clowers:] We really are at a pivotal time for government efforts,
in terms of helping address these challenges in the areas of supplies,
testing, vaccines, as well as efforts to help address the economic
effects of the pandemic. And so, the bottom line of this report is that
we're identifying some immediate actions the government could be taking
during this difficult time to help address those challenges. 

[Music]

[Holly Hobbs:] That was GAO's Nikki Clowers and Tom Costa talking about
our newest report on the federal government's response to COVID-19.
Thank you for your time Nikki and Tom! 

[Nikki Clowers:] Thank you for having me!

[Tom Costa:] Thank you so much.

[Holly Hobbs:] And thank you for listening to the Watchdog Report. To
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