The nonpartisan congressional watchdog on Capitol Hill called for "urgent action" from the Trump administration and legislators in a report released Monday that highlights numerous failures at the top levels of government which have led to "catastrophic loss of life and substantial damage to the global economy, stability, and security" since the coronavirus pandemic reached the U.S. in January.
The Government Accountability Office (GAO) report was released as Covid-19 cases continued to climb across the country and infectious disease expert Dr. Anthony Fauci warned that following many family gatherings for Thanksgiving, another surge may be "superimposed on that surge that we're already in."
Directly contradicting guidance released by the Centers for Disease Control and Prevention (CDC), President Donald Trump last week urged "all Americans to gather, in homes and places of worship."
"With the coronavirus killing more than one thousand Americans each day, I strongly agree with GAO that we need 'urgent actions' to prevent the further loss of Americans' lives and livelihoods."
--Rep. James Clyburn (D-S.C.)
Trump's potential worsening of what Dr. Jonathan Reiner said could become "the mother of all super-spreader events" came as healthcare workers continue to report shortages of crucial personal protective equipment (PPE), testing supplies, and materials to administer vaccines once they are available to the public, the GAO found.
The majority of states reported to the GAO that they have been able to fulfill PPE requests in recent months, following critical shortages last spring. But availability restraints remain with regard to nitrile gloves and boot covers, leaving healthcare workers vulnerable to the spread of Covid-19.
Nearly half the states in the U.S. reported shortages of rapid point-of-care tests, and 21 said they're currently facing shortages of reagents used to determine test results. Sixteen states reported shortages in testing instruments other than swabs, which are currently widely available in all but nine states.
The GAO report comes two months after the agency released recommendations on medical supply shortages. In Monday's report, officials "underscore[d] the critical imperative of implementing our September 2020 recommendations," including calling on the Health and Human Services Department and FEMA to mitigate the medical supply gaps, help states track the status of supply requests, and document responsibilities for supply chain management.
Rep. James Clyburn (D-S.C.), chairman of the House Select Subcommittee on the Coronavirus Crisis, said in a statement that according to the GAO, "more than 10 months into this pandemic, the Trump administration still refuses to learn from its repeated failures, leading to more disease, more deaths, and more economic devastation across this country."
The GAO also expressed concern about states' preparedness to administer Covid-19 vaccines once they become widely availableto the public, with one-third of states telling the agency "that they were 'greatly' or 'completely' concerned about having sufficient vaccine-related supplies," particularly expressing doubts about the federal government's ability to supply enough needles, amid challenges to maintain supplies of needles to vaccinate against influenza this season.
Beyond supply concerns, the GAO said the federal government has done an insufficient job of building trust among the public regarding the effectiveness and safety of future vaccines, leading to fears that many people will go without vaccinations and make it more difficult for the U.S. to reach herd immunity.
The FDA has made four Covid-19 treatments available through emergency use authorization (EUA) in recent months, and pharmaceutical company Moderna announced Monday it was applying for EUA for its vaccine. Pfizer and German manufacturer BioNTech applied for EUA earlier this month.
"The evidence to support FDA's Covid-19 therapeutic authorization decisions has not always been transparent, in part because FDA does not uniformly disclose its scientific review of safety and effectiveness data for EUAs," said the GAO. "We recommended that FDA identify ways to uniformly disclose information from its scientific review of safety and effectiveness data to the public when issuing EUAs for therapeutics and vaccines, and, if necessary, seek authority to do so."
The government has failed to provide transparency regarding its decision-making in other areas as well, the report said, further endangering public health.
Four times between May and September, the CDC altered its recommendations for Covid-19 testing for asymptomatic individuals, sometimes without providing a scientific rationale.
"The lack of transparency regarding these changes, coupled with the inconsistent messaging on several changes in a short time frame, led to confusion and could ultimately hinder consistent application of testing approaches to best control spread of the virus," the GAO wrote. "This lack of transparency in CDC guideline updates is inconsistent with CDC's Crisis and Emergency Risk Communication Manual, which states that 'by fully and clearly explaining your messages and their reasoning, your audiences will be less likely to doubt you.'"
In addition to failures in preserving public health, the GAO raised concerns about the federal government's response to the economic hardships faced by individuals and businesses as a result of the pandemic.
As part of the CARES Act, passed in March, the federal government sent $1,200 direct payments to individuals across the country, but nearly nine million people have still not received a payment. The Department of Labor has also not kept an accurate count of the number of people claiming unemployment benefits, due to "backlogs in processing a historic volume of claims, among other data issues," the GAO said.
"Without an accurate accounting of the number of individuals who are relying on these benefits in as close to real time as possible, policymakers may be challenged to respond to the crisis at hand," the report read.
In what Washington Post economics correspondent Heather Long called a "red flag on deteriorating state finances," the GAO reported that to keep up with the demand of at least 11.1 million unemployed people, "an increasing number of states are taking out federal loans to pay UI benefits."
In negotiating another round of coronavirus aid, House Democrats have been adamant in their demand for more robust emergency funding for state and local governments, but Republicans have not agreed.
"With the coronavirus killing more than one thousand Americans each day, I strongly agree with GAO that we need 'urgent actions' to prevent the further loss of Americans' lives and livelihoods," said Clyburn.