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 hear more podcasts, subscribe to us on Apple Podcasts. And make sure you leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at gao.gov.