The CDC chief told members of the House Appropriations subcommittee that oversees funding for the U.S. Department of Health and Human Services on March 10 that lawmakers must continue to strengthen the U.S. public health infrastructure.
Redfield was supposed to be on Capitol Hill to defend Trump's proposed budget request for the CDC for fiscal 2021, which calls for slicing about $700 million from the agency's annual funding.
Instead, Redfield made the case for why the CDC needs strong investment — an argument that took little convincing by members of the committee after a growing number of lawmakers on Capitol Hill are now under self-quarantines because of their recent exposure at Washington conferences to people confirmed with COVID-19, the respiratory disease caused by the new coronavirus.
"I'll make a bet: The budget for this agency is going up, not down," said Republican Rep. Tom Cole of Oklahoma, the subcommittee's ranking member.
In total, Trump wants Congress to cut over $3 billion in fiscal 2021 from global health programs, including the U.S. Agency for International Development and the nation's support for the World Health Organization — a request Cole and other lawmakers, including a number of Republicans, have made clear is not going to happen.
Trump already dismantled an office in the White House aimed at pandemic preparedness, noted Rep. Rosa DeLauro, D-Conn., the subcommittee's chairwoman.
Data systems, workforce
Redfield told the subcommittee the CDC needs better data systems.
"I want predictive analysis to be the name of the game, not just for CDC, but for the entire public health structure of this country," he said.
Had a lagging public health modernization initiative been implemented, the CDC would have been able to detect the COVID-19 outbreak in the U.S. sooner and contain it further and more effectively, Ileana Arias, the agency's associate deputy director for public health science and surveillance, told the subcommittee.
Programs aimed at building the public health workforce also need to be better supported, Redfield said.
He called on Congress to keep funding a two-year competitive training program for recent college graduates started by former CDC Director Tom Frieden, who ran the agency for President Barack Obama.
The program provides "young energetic people at the beginning of their career" the opportunity to "see what a gift it is to do public health," Redfield said.
Redfield noted Washington state's King County has one of the best public health systems in the U.S., but "they are struggling right now" with COVID-19, which has infected 190 people in the Seattle area and killed 22 — 19 in one nursing home.
Gilead drug
A number of the severely ill patients in Washington are being treated with Gilead Sciences Inc.'s experimental medicine remdesivir under the U.S. Food and Drug Administration's compassionate use program, Redfield said.
"We have provided remdesivir on a compassionate use basis to treat several hundred patients with confirmed, severe COVID-19 infection in the United States, Europe and Japan," Gilead spokesman Ryan McKeel told S&P Global Market Intelligence.
The FDA's compassionate use program, also known as expanded access, permits patients with immediately life-threatening conditions or serious diseases to obtain access to an experimental medicine outside of clinical testing when no comparable alternative is available.
The FDA oversees the program but the final decision on making the drug available rests with the manufacturer.
Labs, tests
Redfield also said the U.S. public health system needs more and better laboratories to be "so prepared that the complexities we've gone through these last six weeks are not going to be an issue, because we've invested heavily in laboratory capacity."
The CDC has been criticized for its failure to quickly get working COVID-19 test kits to public health labs, controlling the results and for its initial narrow criteria for using the diagnostics.
With commercial companies Laboratory Corporation of America Holdings and Quest Diagnostics Inc. now also providing the COVID-19 test, Redfield said any American could get one with a doctor's order.
The CDC is putting in place a new reporting and surveillance system that will receive "direct dumps" of data from COVID-19 tests from CDC-qualified public health and commercial laboratories, "so people can see all the tests done, where they're done," Redfield told lawmakers.
Worldwide, COVID-19 has infected nearly 120,000 people and killed about 4,300, according to Johns Hopkins University's Center for Systems Science and Engineering. In the U.S., about 1,000 people have been confirmed with the disease and at least 30 have died.