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Vaccine Distribution, Supply Chain, Testing Still Present Challenges in Federal Pandemic Response

Posted on January 28, 2021

Since November 2020, the number of COVID-19 cases in the U.S. has dramatically increased, further straining health care systems across the country.

Today’s WatchBlog looks at our newest report on the federal pandemic response, which describes the status of ongoing efforts and outlines ways to improve the response and prepare for future challenges caused by COVID-19. The full report covers our work through January 15, 2021, on areas such as vaccines and therapeutics, COVID-19 testing, medical and drug supply shortages, data collection, stimulus payments, drug manufacturing, small business loans, workplace safety, and more.

As of January 15, 27 of our 31 previous recommendations related to the federal response to COVID-19 remained unimplemented. In today’s report, we reiterate some of our previous recommendations, while also making 13 new ones that focus on improving vaccine distribution, creating a national testing strategy, improving data for tracking COVID cases and the impacts on communities, and addressing medical supply shortages. As the new Congress and administration establish their policies and priorities for pandemic response, we urge swift action on our recommendations.

We’ll focus on a few key areas for improvement here. You can also tune in to our latest podcast on this work, which features 3 of the directors leading our pandemic response review.

Vaccine Distribution and Administration Fell Short of Expectations

Operation Warp Speed set a goal of having 300 million vaccine doses available. After emergency use authorizations for 2 vaccines, about 12.4 million doses have been distributed and about 2.8 million initial doses have been administered as of December 30, 2020. These initial numbers have fallen short of expectations set by federal officials, further underscoring the need for careful planning and clear and consistent communication.

In our September report, we stressed the importance of having a vaccination plan that focused on coordination and communication, and recommended documenting and sharing a national strategy. This recommendation has not been fully implemented; we reiterate the importance of doing so.

No National Testing Strategy Yet

Diagnostic testing for COVID-19 is critical to controlling the spread of the virus, according to the Centers for Disease Control and Prevention. With federal, state, and other organizations all involved in the testing process, it’s important to ensure that they all have the information they need to accomplish their shared goals. We recommended developing and publicly releasing a comprehensive national testing strategy that incorporates our 6 characteristics of effective national strategies. Such a strategy could build upon existing strategy documents that the Department of Health and Human Services has produced for the public and Congress to allow for a more coordinated pandemic testing approach.

Data for Allocating Health Resources Is Incomplete and Inconsistent

Incomplete and inconsistent data on the number of COVID-19 cases, ICU headroom, and other indicators of the pandemic has made it difficult for the Department of Health and Human Services and others to prioritize the allocation of health resources. This is especially true in specific geographic areas and among certain populations most affected by the pandemic. A lack of standardized data collection and reporting makes it hard to monitor trends in the burden of the pandemic across states and regions; make informed comparisons between areas; and assess the impact of public health actions to mitigate the spread of COVID-19.

We recommended establishing a committee of professionals from the public, private, and nonprofit sectors as well as academia to focus on addressing this issue.

Agencies Don’t Have Needed Information to Strengthen Medical and Drug Supply Chains 

The Department of Health and Human Services and the Federal Emergency Management Agency have made numerous efforts to mitigate supply shortages. But in the national survey we did for our previous report, one-third to one-half of states and territories reported ongoing shortages of some testing-related and other medical supplies.

We made two new recommendations to improve coordination on medical supply chain management and to make drug supply chains more resilient. These are in addition to three previous related recommendations.

Strengthening Program Integrity and Protecting Against Fraud

Among GAO’s many recommendations in this area, of particular concern is the slow response to implementation of GAO’s recommendations to improve program integrity and reduce fraud in the Small Business Administration’s emergency loan programs. 

Further information, and our findings in other key areas of federal COVID-19 relief efforts, can be found in the full report.

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