Prepared Witness Testimony

The House Committee on Energy and Commerce

SARS: Assessment, Outlook, and Lessons Learned

Subcommittee on Oversight and Investigations
May 7, 2003

 

Prepared Statement of The Honorable James Greenwood

Good afternoon and welcome. The world continues to fight an unpredictable killer called severe acute respiratory syndrome, or SARS. Much progress has been made in containing this highly infectious disease, as we have just heard during our briefing. And shortly we will hear more details about the so-far successful efforts in controlling SARS in the United States. We will also hear that - for all the good and aggressive work of our front-line public health professionals, buoyed by some good luck - we cannot rest assured that the largest threat of this deadly menace is past us. We hold this hearing today because of the clear need to continue our vigilance in the fight against SARS, to determine whether we are appropriately prepared for any possible SARS upsurge, especially next winter, and to identify where we might improve public health response for future deadly infectious-disease outbreaks or bioterrorism attacks.

SARS continues to be of urgent concern for a number of reasons - because it is presently untreatable and its means of transmission is not fully known, because it appears to have great potential for rapid international spread in this interconnected globe, and because it has a death rate that, while low in comparison to the rates of AIDS and Ebola, would be devastating if SARS spread rapidly and infections reached numbers of a magnitude of, for example, the 1918 flu pandemic.

Fortunately, there is evidence that SARS is not as easily transmissible as influenza and that the tools of public health have been working well to contain it. On the other hand, there is much the public health authorities do not know, and the present uncertain and dynamic situation suggests that the success or failure in containing SARS will probably depend on what happens during the next few months, or perhaps years, rather than what has been done already. In other words, has the Pandora's box of SARS been permanently opened or can we put the SARS genie back in the bottle? This hearing will help us learn how to increase the chances of containing SARS.

Is SARS a harbinger of the eventual pandemic the disease experts warn we must be prepared to face? It certainly has focused our attention on broader questions of preparedness, which at present - fortunately - have not been put to the test. How would we handle large infection rates? Or isolate and treat infected people? Is our hospital infrastructure prepared? Do public health laws measure up to the realities of the day? And what about gaps in international - and local - surveillance? Will we be able to develop vaccines and other treatments? Do we have the resources? Are we proceeding now to enhance our overall ability to battle infectious outbreaks?

The broader issues that we will consider today are not new to the public health community or to this subcommittee. Three years ago, the General Accounting Office prepared for this subcommittee a report warning that the Federal government lacked a plan to combat the inevitable outbreak of pandemic influenza. It is important to see what progress we have made on that front.

Another rather sobering assessment of our current preparedness for a major disease outbreak was released this past March, coincidentally less than a week after WHO issued its global alert on SARS. The Institute of Medicine report, Microbial Threats to Health: Emergence, Detection, and Response, states quite plainly that even the developed countries of the world are unprepared for an influenza or other infectious-disease pandemic. Other assessments in recent years have called into question the ability to detect new and deadly, emerging infectious outbreaks - something that this current SARS experience may be particularly helpful to illuminate.

We have three panels of witnesses today, which I believe will provide us with a thorough and well-rounded picture of the current situation and the outlook for our ability to combat SARS. They will also provide the needed perspective for us to identify actions and tools that will help ensure that we can be successful should this or any other outbreak spread upon us.

Our first panel will feature witnesses from HHS and its component agencies - some of whom have become familiar faces to the American public. They will provide us with authoritative information on the actions taken in response to SARS, and related planning for future outbreaks. We will also hear on this panel from GAO, whose expert will discuss how state and local agencies' efforts to prepare for bioterrorist attacks can help battle infectious disease outbreaks, and whether hospitals can respond adequately to such outbreaks and other major public health threats.

Our second panel features witnesses from the public health community who will provide some differing perspectives on the SARS outbreak and its lessons for our preparedness. We'll hear from people with experience internationally, with the domestic public health community, the clinical perspective, the legal perspective, and from the true front line - the nurse who treated the first probable SARS patient identified in the United States.

Our third and final panel will provide a view from the therapeutic product industries. We will hear from companies that have produced or are attempting to produce medical products potentially useful in combating SARS and related diseases - and gain some perspective on the issues confronting them, in terms of uncertainties, planning, and the prospects for breakthroughs.

Let me say we have an informative array of expertise before us. So let me welcome the witnesses, and thank, especially, those who made special last-minute arrangements to travel here to testify. We appreciate your efforts.

I now recognize the ranking member for his opening statement.

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