Sen. Warren, Colleagues Question Trump Administration's Efforts to Understand, Inform Americans About Chronic Health Effects of COVID-19

WASHINGTON, July 24 -- Sen. Elizabeth Warren, D-Massachusetts, issued the following news release:

United States Senator Elizabeth Warren (D-Mass.), a member of the Senate Health, Education, and Pensions (HELP) Committee and the Special Committee on Aging, sent a letter with her Senate HELP Committee colleagues Tammy Baldwin (D-Wisc.), Tina Smith (D-Minn.), and Bernard Sanders (I-Vt.) to Vice President Mike Pence, the head of the Trump Administration's Coronavirus Task Force, requesting information on what the administration is doing to identify, address, and communicate with policymakers and the public about the chronic health effects of COVID-19. In the letter, the senators raise questions and requests clarification from Vice President Pence on what administration officials are doing to monitor and understand the long-term health impacts of COVID-19 and also expresses concern about the Trump Administration's ongoing efforts to downplay the risks of the disease.

Several new studies have revealed numerous potentially severe chronic health impacts from COVID-19, but, "in the face of this mounting evidence President Trump and other White House officials have falsely and dangerously continued to belittle the risks of the growing pandemic," wrote the senators. "As CDC and NIH continue to conduct and coordinate research efforts, it is critical that the agencies collect and disseminate data on the long-term impacts and severity of the disease, conduct research to understand the risks, and appropriately inform policymakers, the public and medical professionals of them."

President Trump has falsely tried to assure the public that "99%" of coronavirus cases are "totally harmless" and has repeatedly claimed that the virus will one day just "disappear." Similarly, Vice President Pence claimed that Americans can "take some comfort in the fact that fatalities are declining all across the country," calling it "very encouraging news" that an increasing number of coronavirus cases are occurring in younger victims." Peter Navarro, a top adviser to President Trump, called "a falling mortality rate ... the single most important statistic to help guide the pace of our economic reopening."

Despite the White House's efforts to downplay the severity of COVID-19 based solely on mortality data, growing evidence reveals that the virus can have chronic long-term health impacts in many people. Individuals who have contracted COVID-19 have reported suffering from lung scarring, strokes, embolisms, blood clotting, heart damage, neurocognitive and mental health impacts, and childhood inflammation. CDC is investigating reports that the disease has been associated with Kawasaki-like symptoms in children.

It is not clear that the administration is doing enough to monitor and understand the long-term impacts of COVID-19, and to factor those risks into decisions about opening schools, businesses, and other parts of the economy.

Senator Warren and her colleagues have requested a response to their letter no later than July 31, 2020.

The letter is part of Senator Warren's ongoing efforts to press the Trump Administration to respond effectively to the COVID-19 pandemic. Following a hearing where Dr. Fauci told Senator Warren that the U.S. could see 100,000 COVID-19 cases a day, the Senator sent a letter to Vice President Pence demanding the administration take stronger nationwide action to address new COVID-19 surges, contain the virus, and protect the economy. In May, Senator Warren sent a letter, leading 43 of her Senate colleagues, in calling on Vice President Mike Pence to increase transparency regarding the nation's COVID-19 diagnostic testing supply and provide a detailed plan and timeline for addressing future shortages and gaps in the testing supply chain. In a New York Times op-ed this week, Senator Warren once again stressed the need for the federal government to take bold action to contain the virus.

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July 21, 2020

To: Vice President Mike Pence, Chair, White House Coronavirus Task Force, 1600 Pennsylvania Avenue, Washington, D.C. 20500

Dear Vice President Pence:

We write to you today to inquire about the research, surveillance, and public education efforts underway within the Administration regarding the long-term health impacts of coronavirus disease 2019 (COVID-19). These efforts are particularly important given that the coronavirus pandemic is spiking in dozens of states, and the Trump Administration appears to have given up on containing it based on hopes that "Americans will grow numb to the escalating death toll and learn to accept tens of thousands of new cases a day."/1

As the number of new COVID-19 cases in the United States reaches new highs on a daily basis, the failure to fully understand, communicate, and address the chronic long-term morbidity risks from the disease would represent a new and dramatic public health failure on top of the Trump Administration's initial and ongoing failure to contain the disease. President Trump has falsely tried to assure the public that "99%" of coronavirus cases are "totally harmless" and has repeatedly claimed that the virus will one day just "disappear"/2

Similarly, Vice President Pence claimed that Americans can "take some comfort in the fact that fatalities are declining all across the country," calling it "very encouraging news" that an increasing number of coronavirus cases are occurring in younger victims./3 Peter Navarro, a top adviser to President Trump, called "a falling mortality rate ... the single most important statistic to help guide the pace of our economic reopening."/4

But using fatality rates as the sole measure of effectiveness in mitigating the COVID-19 pandemic - essentially acting as if the only potential risk from COVID-19 is death - would ignore the growing evidence of the chronic health impacts of the disease. Indeed, according to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at NIH, "I have never seen a virus or any pathogen that has such a broad range of manifestations ...Even if it doesn't kill you, even if it doesn't put you in the hospital, it can make you seriously ill."/5

There is evidence of patients continuing to feel the effects of COVID-19 well after they are discharged from hospitals or beyond the average known time of recovery, and some may face long-term health problems long after the pandemic is over. It is critical that the federal government conduct appropriate research and collect and disseminate appropriate data about the potential chronic health impacts of COVID-19 - and do so without muzzling public health officials and medical professionals - in order to adequately inform decisions about reopening schools and businesses and assess the ongoing risks of the pandemic. Since the start of the pandemic, scientists across the world have undertaken heroic efforts to research and understand the epidemiology and pathology of COVID-19, including the disease's transmissibility, potential treatment options, and the development of a vaccine. But current gaps in short-term data collection and lack of long-term data hinder our knowledge of the disease's chronic health impacts. The CDC cites on its website a preliminary study of the largest cohort of reported persons with COVID-19 in which roughly 20% of those studied presented with severe to critical illness symptoms, including dyspnea, hypoxia, respiratory failure, shock or multiorgan system dysfunction./6

Earlier this month, the Journal of the American Medical Association published a detailed review of 143 patients who had been hospitalized with COVID-19, finding that almost 13% were symptom-free within two weeks of being discharged; a significant number still suffered from fatigue, difficulty breathing, joint pain, and chest pain, with many suffering multiple symptoms./7

These risks are not confined to the elderly: CDC is "investigating reports of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, which may present with Kawasaki disease-like features."/8

Anecdotal reports confirm that even young people can suffer from severe chronic symptoms/9 - and medical experts warn that:

[W]hile some patients may fully recover ... others will suffer long-term damage, including lung scarring, heart damage, and neurological and mental health effects. ... Other preliminary evidence, as well as historical research on other coronaviruses like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), suggests that for some people, a full recovery might still be years off. For others, there may be no returning to normal./10

In the face of this mounting evidence, President Trump and other White House officials have falsely and dangerously continued to belittle the risks of the growing pandemic. Earlier this month White House Press Secretary Kayleigh McEnany falsely claimed that the "the world is looking at us as a leader in Covid-19" because of the United States' "low case mortality rate," and President Trump tweeted that "we now have the lowest Fatality (Mortality) Rate in the World."/11

CDC understands that more information is still needed to answer questions regarding severity and morbidity,/12 such as why some individuals are at greater risk for complications than others and why some people experience COVID-19 symptoms lasting far beyond the average two-week expected time frame to recovery./13

As CDC and NIH continue to conduct and coordinate research efforts, it is critical that the agencies collect, analyze, and disseminate data on the long-term impacts and severity of the disease, conduct research to understand the risks, and appropriately inform policymakers, the public and medical professionals of them. To help us understand how the Trump Administration is researching, monitoring, and evaluating the chronic long-term health impacts of COVID-19, we request answers to the following questions by no later than July 31, 2020:

1. How is the Task Force evaluating the long-term health risks of COVID-19 for the millions of Americans that will survive the disease?

2. How are these risks being factored into Task Force actions and recommendations alongside the mortality risks of the disease? Specifically, how does the Task Force evaluate and assess these risks with regard to reopening schools, businesses, and the economy?

3. How are CDC, NIH, and other federal agencies conducting long-term surveillance or other research on survivors of COVID-19, including those who presented with non-severe symptoms and those who presented with severe symptoms? How is this information being transmitted to and used by the Task Force?

4. What data are CDC, NIH, and other federal agencies collecting from patients, health care providers, and other sources, and how are the agencies using this data to understand and inform long-term risk assessments? How is this information being transmitted to and used by the Task Force?

5. Please provide a list of studies that CDC, NIH, and other federal agencies are currently undertaking or funding to understand the non-mortality related impacts of the disease, and, if publicly available, the findings or preliminary findings from these studies.

6. How are CDC, NIH, and other federal agencies collaborating with each other and with other federal agencies regarding studies into the morbidity and long-term impacts of COVID-19? How is the Task Force coordinating these efforts?

7. How are CDC, NIH, and other federal agencies collaborating with state, local, Tribal, and territorial public health officials, universities, and other governments and international organizations to research and understand the long-term impacts of COVID-19? How is the Task Force coordinating these efforts?

8. What additional resources or authorities are needed from Congress to ensure that the agencies can effectively conduct this type of research?

9. On July 14, 2020, HHS announced changes to hospital reporting protocols, under which data on COVID-19 in hospitals will now be reported directly to an HHS contractor rather than to CDC./14

Will this change affect CDC's ability to obtain and analyze data on the medium- and long-term health risks from COVID-19?

See signatories here: https://www.warren.senate.gov/imo/media/doc/2020.07.21%20Letter%20to%20Pence%20re%20Long%20Term%20Impacts%20of%20COVID-19.pdf