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Biodefense: After-Action Findings and COVID-19 Response Revealed Opportunities to Strengthen Preparedness

GAO-21-513 Published: Aug 04, 2021. Publicly Released: Aug 04, 2021.
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Fast Facts

The COVID-19 pandemic shows how catastrophic biological incidents can cause substantial loss of life and damage the economy. The 2018 National Biodefense Strategy outlines how to prepare for and respond to such incidents.

The key federal agencies we examined prepared interagency response plans and conducted 74 interagency exercises from 2009-2019 to prepare for anthrax attacks, flu pandemics, and the like. However, we found the agencies don't routinely work together to monitor exercise results to identify potential patterns of problems.

We made 16 recommendations aimed at honing the nation's ability to respond to the next biological threat.

Participants in a Biological Incident Exercise

A biological incident exercise

 

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Highlights

What GAO Found

Key federal agencies, including the Departments of Homeland Security (DHS), Defense (DOD), Health and Human Services (HHS), and Agriculture (USDA), developed a range of interagency response plans to prepare for nationally significant biological incidents. These strategic, operational, and tactical level plans address responding to a broad spectrum of biological threats, including those that are intentional, accidental, or naturally occurring.

DHS, DOD, HHS, and USDA conducted numerous interagency exercises to help prepare for and respond to a wide variety of biological incidents, such as anthrax attacks, influenza pandemics, and diseases affecting plants and animals. Specifically, GAO identified 74 interagency biological incident exercises conducted from calendar years 2009 through 2019.

Number of Interagency Biological Incident Exercises Conducted, Calendar Years 2009 through 2019

HLP_5 - 104292

GAO's analysis of after-action reports for selected interagency biological incident exercises and real-world incidents, as well as the COVID-19 response, identified long-standing biodefense challenges. GAO found that the nation lacked elements necessary for preparing for nationally significant biological incidents, including a process at the interagency level to assess and communicate priorities for exercising capabilities. Further, it determined that agencies do not routinely work together in monitoring results from exercises and real-world incidents to identify patterns and root causes for systemic challenges. Assessing and communicating exercise priorities and routinely monitoring the results of the exercises and incidents will help ensure the nation is better prepared to respond to the next biological threat.

Why GAO Did This Study

The COVID-19 pandemic shows how catastrophic biological incidents can cause substantial loss of life, economic damage, and require a whole-of-nation response involving multiple federal and nonfederal entities. The 2018 National Biodefense Strategy outlines specific goals and objectives to help prepare for and respond to such incidents.

The CARES Act includes a provision for GAO to conduct monitoring and oversight of federal efforts to prepare for, respond to, and recover from COVID-19. This report addresses: (1) interagency plans key federal agencies developed, and exercises they conducted, to help prepare for biological incidents; and (2) the extent to which exercises and real-world incidents revealed opportunities to better achieve National Biodefense Strategy objectives.

GAO reviewed biological incident plans and after-action reports from exercises and real-world incidents from calendar years 2009 through 2019, including a non-generalizable sample of 19 reports selected based on threat scenario and other factors. GAO interviewed federal and state officials to obtain their perspectives on plans, exercises, and the COVID-19 response.

Recommendations

GAO is making four recommendations each to DHS, DOD, HHS, and USDA, including that the secretaries work through the Biodefense Steering Committee to communicate exercise priorities and conduct monitoring. The departments generally concurred but in response to comments GAO modified the recommendations to reflect that the secretaries work through the Committee identified above.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Homeland Security The Secretary of Homeland Security, should, with input from key nonfederal partners, work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team defines the set of capabilities needed to prepare for and respond to nationally significant biological incidents. (Recommendation 1)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Defense The Secretary of Defense, should, with input from key nonfederal partners, work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team defines the set of capabilities needed to prepare for and respond to nationally significant biological incidents. (Recommendation 2)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DOD no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Health and Human Services The Secretary of Health and Human Services, should, with input from key nonfederal partners, work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team defines the set of capabilities needed to prepare for and respond to nationally significant biological incidents. (Recommendation 3)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, HHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Agriculture The Secretary of Agriculture, should, with input from key nonfederal partners, work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team defines the set of capabilities needed to prepare for and respond to nationally significant biological incidents. (Recommendation 4)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, USDA no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Homeland Security The Secretary of Homeland Security should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team establishes a process to periodically assess and communicate exercise priorities among the capabilities they identify to support nationally significant biological incidents. (Recommendation 5)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Defense The Secretary of Defense should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team establishes a process to periodically assess and communicate exercise priorities among the capabilities they identify to support nationally significant biological incidents. (Recommendation 6)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DOD no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Health and Human Services The Secretary of Health and Human Services should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team establishes a process to periodically assess and communicate exercise priorities among the capabilities they identify to support nationally significant biological incidents. (Recommendation 7)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, HHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Agriculture The Secretary of Agriculture should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team establishes a process to periodically assess and communicate exercise priorities among the capabilities they identify to support nationally significant biological incidents. (Recommendation 8)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, USDA no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Homeland Security The Secretary of Homeland Security should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team provides guidance for federal and nonfederal partners for how to report on capabilities in after-action reports for exercises and real-world incidents in a consistent manner. (Recommendation 9)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Defense The Secretary of Defense should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team provides guidance for federal and nonfederal partners for how to report on capabilities in after-action reports for exercises and real-world incidents in a consistent manner. (Recommendation 10)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DOD no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Health and Human Services The Secretary of Health and Human Services should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team provides guidance for federal and nonfederal partners for how to report on capabilities in after-action reports for exercises and real-world incidents in a consistent manner. (Recommendation 11)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, HHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Agriculture The Secretary of Agriculture should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team provides guidance for federal and nonfederal partners for how to report on capabilities in after-action reports for exercises and real-world incidents in a consistent manner. (Recommendation 12)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, USDA no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Homeland Security The Secretary of Homeland Security should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team routinely monitors the results of interagency biological exercises and real-world incidents to identify patterns of challenges and potential root causes of identified challenges, and reports these to the Biodefense Steering Committee along with recommendations for addressing the root causes that also identify the responsible agencies. (Recommendation 13)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Defense The Secretary of Defense should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team routinely monitors the results of interagency biological exercises and real-world incidents to identify patterns of challenges and potential root causes of identified challenges, and reports these to the Biodefense Steering Committee along with recommendations for addressing the root causes that also identify the responsible agencies. (Recommendation 14)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, DOD, no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Health and Human Services The Secretary of Health and Human Services should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team routinely monitors the results of interagency biological exercises and real-world incidents to identify patterns of challenges and potential root causes of identified challenges, and reports these to the Biodefense Steering Committee along with recommendations for addressing the root causes that also identify the responsible agencies. (Recommendation 15)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, HHS no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.
Department of Agriculture The Secretary of Agriculture should work through the Biodefense Steering Committee to ensure that the Biodefense Coordination Team routinely monitors the results of interagency biological exercises and real-world incidents to identify patterns of challenges and potential root causes of identified challenges, and reports these to the Biodefense Steering Committee along with recommendations for addressing the root causes that also identify the responsible agencies. (Recommendation 16)
Closed – No Longer Valid
We are closing this recommendation as no longer valid because the Biodefense Steering Committee and Biodefense Coordination Team no longer exist under the updated 2022 National Biodefense Strategy and their respective responsibilities were not transferred to another entity. As part of our ongoing review of the 2022 Strategy, we obtained more details about how the governance structure and agencies' role and responsibilities have changed. Specifically, according to the 2022 Strategy, the White House now leads this effort. As such, USDA no longer has the authority to lead actions to implement the recommendation. We plan to continue monitoring implementation efforts related to the updated Strategy through our review of the 2022 Strategy and its associated implementation plan and structure.

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Biological warfareDisastersEmergency managementFederal agenciesFood standardsHealth careHomeland securityInfectious diseasesInfluenzaLessons learnedNational preparednessNational response frameworkNational securitypandemicsPlant diseasesPublic and private partnershipsPublic healthPublic health emergenciesSupply chain management