to call this committee meeting to order .
I want to welcome dr adam uh General
Dingle , General Hog Admiral going ham
for your testimony here today and
especially for your service to this
country . Thank you all . Nearly 9.5
million americans from private to
general . From service member to spouse
recruit . The retiree depend on you for
health care services that you oversee .
Your job is a difficult one because so
many people are depending on you to
have the right medical professionals
the right treatment at the right time
because their lives count on it . Over
the last few years , the Department of
Defense of Congress have made
significant investments in our
military's readiness , but there is no
readiness issue more important than
continuing to ensure the physical and
mental health of the force like our
witnesses . This subcommittee is
committed to doing our part to ensure
that the military force we have is as
healthy as possible . This means
meeting the medical needs of service
members and their families at home and
abroad . This challenge is even more
important as we are dealing with a
global pandemic . I would like to know
more about how the D . O . D . Is
dealing with covid both in terms of
impact to troops and their families and
whether the military health care system
is adequately funded for this emergency .
Once again , I want to thank you for
your service and for your work too
better the lives of our personnel
entrusted to your care . It is an
essential part of maintaining a ready
force . And I look forward to your
testimony . Senator Shelby .
Thank you . Mr . Chairman thank you for
holding this hearing . Um I want to him
like you welcome our witnesses today .
Um and I want to thank them for being
here today to review the defense health
program . The pandemic has tested our
military and its health system
profoundly . And I would like to
applaud the defense health programs
work and achievements during this
extremely trying time . Our war
fighters , I believe our greatest
defense assets and their readiness and
capabilities depend on strong and
sustainable military health care system .
Our military's health system is
responsible for for providing care to
9.5 million of service members and
their beneficiaries who deserve the
best quality of care that we can
provide . In order to guarantee that
standard MR chairman , we must ensure
that the system is appropriately
resourced something . This committee
has prioritized . The military health
system has undergone substantial
transformation over the last several
years . And I look forward to hearing
about the challenges each of you have
faced in this transition and how you
worked with together to overcome them .
In addition to providing healthcare ,
Our military's health system also
conducts medical research on a wide
variety of topics such as cancer ,
infectious diseases , traumatic brain
injury and burn research . Just to name
a few . Funding for these important
research efforts has grown from $210
million 191992 to nearly
$1.5 billion last year . That's a
substantial investment and I believe
one that does not take into account the
billions of dollars that we also
provide annually to the National
Institutes of Health to conduct
research in many of the same areas .
What's more the president's budget
request proposes to create the advanced
research projects , agency for Health
and NIH . This new 6.5 billion
federally funded research agency will
focus on cancer research and other
diseases such as diabetes and
Alzheimer's . With all this seeming
duplication research dollars . I
questioned at times whether D . O . D .
S . Medical research investments are
truly focused on addressing our
warfighters . Health and redness
concerns are simply investing in scarce
defense resources in medical research
that is also underway at NIH . So while
we can all agree that this research is
necessary , I hope our witnesses can
provide a clear explanation regarding
defense medical research dollars . What
they're doing that NIH funding cannot
or is not doing . In other words , is
there duplication here And if so , how
do we get away from it ? Thank you for
all of this hearing . Was chairman .
Thank you Senator Shelby . Now we'll go
to opening statements . I would ask
that each of you limit your opening
statement to five minutes each . Your
entire written statement will be put in
the record and we'll start with you dR
adam . You have the floor . Good
morning . Chairman tester Vice chairman
Shelby . Distinguished members of the
subcommittee . I am honored to
represent the military and civilian
medical professionals in the military
health system Who are serving around
the world and here at home , delivering
healthcare and supporter of our 9.6
million beneficiaries , as well as
support to millions of Americans
throughout the United States . My
testimony will provide the subcommittee
with information on major activities
that will inform our budget proposal
for the coming fiscal year . The most
significant issue looming over all of
our projections is the national
response to the COVID-19 pandemic .
Secretary Austin has made clear that
the greatest approximate challenge to
our nation's security is the threat of
COVID-19 the department has and will
continue to act boldly and quickly to
support federal government efforts to
defeat this disease . My written
testimony provides a comprehensive
review of the critical health support
the military health system is providing
worldwide in support of our primary
mission and as part of the whole of
government response to the covid crisis .
We remain deeply appreciative of the
fiscal year 20 supplemental
appropriation of $2.2 billion dollars
as part of the Cares Act . That covered
the significant costs incurred during
the initial months of the response . In
fiscal year 21 , however , costs
attributable to the pandemic continue
to accumulate . As of March 31st 2021
are mid year review of the defense
health program identified likely
shortfalls as part of the ongoing
pandemic response Projected at over
$1.8 billion . One billion of which is
private sector costs . In addition ,
the financial impact of our military
support to the fema missions which
remains ongoing are still being
assessed . We are working within the
department to try and mitigate these
shortfalls , but it's challenging the
department continues to focus on
internal business process improvements
to find greater efficiencies and
remains vigilant about variation and
year to year expenditures . We are
appreciative that Congress continues to
grant the department carry over
authority each year . We are also
grateful for this committee's long term
advocacy and support for a military
medical research program . Medical ,
military medical research , advances
the state of medical science in those
areas of most pressing need and
relevance to today's emerging threats ,
which includes the covid pandemic .
When released , our fiscal year 22
budget will present a balanced
comprehensive strategy that aligns with
the secretaries , priorities to include
the ongoing response to the pandemic .
We look forward to working with you
over the coming months to further
refine and articulate our objectives in
a manner that improves value for
everyone . Our war fighters are
combatant commanders . Our patients are
medical force and the american taxpayer .
Thank you for inviting me here today to
speak with you about military medicine .
Our response to the global pandemic ,
the essential integration between
readiness and health and about our
plans to further improve our health
system in support of the National
Defense strategy on behalf of our
uniform service members and the
families we serve . Thank you .
Chairman tester , Vice Chair Shelby and
distinguished members of the
subcommittee . Thank you for your
support and for the honor to speak to
you on behalf of over 83,000 Active
Duty Guard and Reserve Army soldier
Medics , COVID-19 and unexpected
challenges to our national security
attempted to attack the foundation of
our nation but it did not disrupt the
fabric of our constitution and its
armies response to it . I honor the
soldiers that I am privileged to lead
as General Khanh Villar , 40th . Chief
of Staff . The Army States people first
and winning matters . I am proud to say
their army is ready to win . Within
days of our nation's call , we
collaborated with Health and Human
Services , the Department of Homeland
Security and our state governments . We
expanded critical testing capacity ,
inculcated retiree recalls , deployed
vaccine and medical teams in support of
civilian entities and partnered with
medical research and development and
support of the whole of government
approach . Soldiers deployed to three
countries , 19 states and three
territories to include California
Illinois , North Dakota Washington and
Wisconsin to support and to save
American lives . You called ? We were
ready , we responded . My vision for
army medicine is clear . We will be
ready . Reformed , We organize ,
responsive and relevant in this era of
unprecedented global complexity ,
whether support of our national defense
strategy and whenever our government
calls so when the army deploys today
and fights tonight , army medicine will
be right there to return our soldiers
to duty tomorrow From the Fox Hole to
the fixed facility , we will conserve
the health and fitness of the fighting
force and reinforce our readiness
requirements through healthcare acuity
for our beneficiaries , I will ensure
that integrated medical efforts occur
with strong fiscal stewardship and
partnership between Army medicine , the
Joint Force and the Defense Health
Agency ensuring the readiness of our
soldiers . The vision and operational
focus for Army medicine remains at
building readiness and properly mad and
proficiently trained units and
modernizing to remain ready and
relevant for future conflicts and
challenges . Medical reform Directors
will be implemented to maximize
readiness in support of the army
mission . Finally , we are committed to
sustaining and improving our
partnerships foreign and domestic to
elevate battlefield interoperability
and to support our nation our National
Defense Strategy . In closing , I thank
the committee for your long standing
support to the army and military
medicine . I look forward to answering
your questions . Thank you . General
Dingle . General Hawk , chairman ,
tester , Vice Chairman Shelby and
distinguished members of the
subcommittee . Thank you for the
opportunity to testify on behalf of
more than 55,900 Total Force Airman who
comprised the Air Force Medical Service .
Your sustained confidence and support
enables us to remain mission focused ,
excellence driven and ready to fight
tonight . Over the past year , our
airmen have been involved in every
aspect of the Covid 19 response from
the early days of initial public health
emergency response to supporting the
whole of government vaccine
administration efforts . Air Force
Medics showed their ability to innovate
When COVID-19 epicenters in new york
California Texas and North Dakota were
facing critical staffing shortages . We
acted quickly , embedding critical care
strike teams directly into civilian
facilities . Today we have 1000 Air
Force medics deployed to 11 fema
vaccination sites in 10 states to
administer Covid 19 vaccines And we
expect them to surpass the one million
mark this week . A year before the
first COVID-19 case hit the us . We
established our newest see stars
training program at the University of
Nebraska in Omaha . This center for the
sustainment of trauma and readiness
skills focuses on disease containment
Are infectious disease specialists
worked alongside civilian counterparts
to treat some of the very first
COVID-19 patients using the
university's biocontainment unit , We
took our aero medical evacuation
capabilities into new territory . When
we were tasked to transport COVID-19
patients Early in the pandemic , the
rapid rise of cases drove the need to
move more patients at once while
mitigating the spread of COVID-19 to
our air crew members . We partnered
with teams across the Department of
Defense and the civilian industry to
develop a new infectious disease
transport system called the negatively
pressurized connects this contacts can
safely transport up to three times as
many patients as a previous isolation
system and as of 19 april , we have
completed 96 missions and moved
366 covid positive patients safely
while battling the while battling the
pandemic . We also remain dedicated to
the MHS transformation efforts . We
have worked side by side with the
Defense Health Agency to identify all
necessary processes needed to mature
their functional capabilities . We also
implemented a new medical reform model
to improve our airman's and guardians
readiness and deploy ability . We
reorganized our medical treatment
facilities into two squadrons . The
first squadron focuses on the health of
our airmen and our guardians , and the
second squadron focuses on the health
of our beneficiaries . This new model
has been implemented at 66 spaces and
early analysis has already shown the
model enhances force readiness and
lethal 80 . This pandemic brought
unprecedented challenges , but it also
provided opportunities to accelerate
change or lose to become more agile ,
resilient and capable to face the
unknown . This is what we trained for .
We remain ready for the fight . This
mentality must remain in focus as we
evolve to face the next major threat .
It has been an honor to serve as the
air and space for surgeon general
alongside extraordinary medical
professionals on the joint team . This
is my final time to appear before this
subcommittee as I will be retiring this
summer . Thank you for your continued
support and for the opportunity to
address you today and I look forward to
answering your questions . Thank you ,
General Hog and we appreciate your
support to the services and wish you
well in retirement . When that time
comes . Admiral Gillingham , Chairman
tester , Vice Chairman Shelby ,
Distinguished members of the
subcommittee . It's my privilege to
update you on Navy medicine . I'm
grateful for your continued leadership
and support as we execute our medical
readiness mission in support of United
States , Navy , United States Marine
Corps , World's Premier Naval Force
last year has been like no other in our
lifetimes as we confronted a deadly
adversary , the SARS COV two virus and
the disease that causes Covid 19 . The
battle continues today . Navy medicines
operational tempo remains high as we
protect the readiness and health of our
sailors , marines and their families
along with making direct contributions
to the whole of nation pandemic
response . To date , we have deployed
over 6000 active and reserve component
medical personnel in support of
operational COVID-19 missions . I want
to assure you that despite these
unprecedented challenges , one Navy
medicine team remains relevant , ready
and responsive . We continue to be
guided by our strategic priorities ,
people , platforms , performance and
power . Well trained people working as
cohesive teams on optimized platforms
demonstrating high value , high
velocity performance that will project
medical power in support of naval
superiority . With the earliest
identification of the SARS COV two
virus , it was evident that we were
battling an adversary whose behavior is
highly unpredictable , particularly
with respect to its asymptomatic
transmission . All of us and military
medicine are trained to respond to
medical emergencies . We quickly
recognize that protecting our personnel
in this public health crisis along with
maintaining operational effectiveness
would be our primary mission actions
and intervention by experts across Navy
medicine during early stages directly
impacted our ability to better
understand the virus mitigate and
contain its spread effectively .
Support ongoing fleet operations and
preserve Navy and Marine Corps
readiness out forward , we rapidly
applied lessons learned from the early
outbreaks on board uss Theodore ,
Roosevelt and Uss Kidd and continuing
incorporated the latest critical
information from the Centers for
Disease Control and Prevention as well
as Navy Medicine , public Health and R
and D . Experts . Navy leadership
quickly operas operationalized this
guidance for the fleet in the form of
standard operational guidance And this
is currently in its 4th update . This
direction incorporates the most up to
date scientific and public health
information to include testing ,
restriction of movement , isolation ,
quarantine , physical distancing , face
coverings , contact tracing and now
vaccination importantly , our sailors
and marines have demonstrated
tremendous personal responsibility ,
resilience and adaptability and
responding to the pandemic . Their work
in concert with strong commitment from
our operational leaders , has been
instrumental in allowing our ships and
personnel estate mission capable .
Despite the pandemic , our highest
priority remains ensuring that all
Department of Navy personnel have
access to the vaccine in order to
protect themselves , their shipmates ,
their families and their communities .
As the Navy surgeon general , I've been
clear in my guidance that these
vaccines are for the most effective
protection against this deadly virus .
The bottom line is that we're getting
shots and arms and providing our
personnel with what I refer to as
biological body armor . To date , Navy
sites have administrated over three
quarters of a million vaccines and over
50 of our sailors and marines have now
received at least one vaccine dose .
Navy medicine continues to answer the
call to help our nation . Navy and
Marine Corps personnel are now
currently deployed around the country
to assist with vaccine administration
in community vaccination centers
recently had an opportunity to see
firsthand the significant impact
they're making in the lives of our
fellow citizens affected by the virus .
Navy medicines , COVID-19 responses
mark , my grit , resolve and an
unbreakable spirit while battling the
pandemic remains a primary line of
effort . We remain fully engaged in all
aspects of our mission of improving
readiness and enhancing operational
capabilities to increase warfighters .
Survivability by written testimony .
Provide you details on many of these
important initiatives that directly
support physical and mental well being
of our sailors , marines and their
families . In summary , the nation
depends upon our unique expeditionary
medical expertise to support our naval
forces . The Navy medicine team , some
63,000 strong is privileged to be
entrusted with these responsibilities .
Again , thank you for your leadership
and I look forward to your questions .
Thank you Admiral and thank you all for
your for your testimony . We're going
to start with five minute rounds of
questions . Dr adam In your testimony ,
you talked about a $1.8 billion one
billion With Tricare 800 million
with with military shortfall . Do
these shortfalls um impact the delivery
of service of care to our service
members were diaries or their families ?
Make sure it was on um senator our
first priority . Our health care to our
troops and to their family members that
will never suffer any dec criminal
whatsoever . That's our first priority .
And those numbers that I cited our
projections that were making um the
currently um we have about 673
million Um in uh in costs
that were not expected due to the COVID
response but we project that it will be
over 1.8 billion . Okay . And so what
are your plans to address these
shortfalls ? This Congress needs to
step up ? The department isn't planning
to ask for supplemental . We are
looking to um other uh programs within
the D . H . P . Such as uh sustainment
modernization funding . We'll have to
postpone uh facilities maintenance .
Uh We're looking for things like that
and we'll likely have to look to the
department as well to fill these
shortfalls . So you're going to you're
going to fill these shortfalls with
transfers within the Department of
Defense . We are currently now looking
at how we can mitigate the shortfalls
in any way that we can . It's a
challenge . Okay . Um I may come back
to another question on that in a bit .
I want to talk about tricare , I'm
gonna stay with you doctor at Durham .
Can you tell me what impact is the
recent implementation of enrollment
fees for tricare select having on the
number of beneficiaries enrolled ? Sure .
I'm not aware that there has been an in
fact impact due to any historical
increase in fees . Um I can get you
more precise information for the record
if that's what you want . But I'm not
aware that that there's been a
detriment in our enrollment due to the
fees . So you are not seeing a decline
in enrollment in track here . Senator ,
I think I'd like to take that for the
record so we can get you a more precise
answer . Okay . In in 2000 and be good
in 2018 , when the military health
system was first beginning to implement
reforms , we saw increases in Tricare
copays for specially care and you know
this that includes physical therapy and
mental health to treatments that are
very common in military and veteran
community . Can you speak to the impact
these increased co pays have had on
utilization of physical therapy and
mental health care treatments under
tricare ? Sure . And again , senator ,
I'm not aware that there has been an
impact on the utilization of those
services due to the copays and I'm
happy to take that back to and get you
a more precise answer . We can compare
years . I think that would be good . I
think it's critically important . We
know that this is information that we
need to know . I'll tell you why
because I'm hearing about it on the
ground in Montana and if I'm hearing
about it , I'm sure a lot of other
senators and representatives are too
sure . So I'm happy to bring that back .
Okay , so considering the reforms that
have taken place and not to beat this
this mule anymore , but considering all
the forms that have taken place for
tricare beneficiaries over the last
three years , do you believe this
benefit has retained the same level of
historical value ? Absolutely .
Um I think it's a very rich benefit ,
especially when you compare it to the
civilian sector . Um It's it's a
uniform benefits . So all beneficiaries
have access to the same benefit and
uh menu of services um that Tricare
offers . Um I believe that with the new
T5 requests for proposal coming out and
that new contract that will see even
more benefits for beneficiaries .
I want to go back to the shortfall ,
the $1.8 billion . And this is for the
other folks who are here , the the
surgeon general's . Do you do you have
any concerns whether we are risking a
shortfall ? I mean with this shortfall
that it's going to impact um can impact
carried to your troops ? Go
ahead ? Uh General Dingle , we'll just
go down the line . I'll start it off
chairman testing . So as as the army
looks at the operational force , you
know what we do in conjunction with the
Defense Health Agency Agency and the
Defense Health Agency and Osd Health
Affairs . We identify our readiness
requirements up front . Right now we do
not have a shortfall as we've worked
through our readiness requirements as
we identify those , but we'll have to
assess that as the fiscal year
continues on . The answer right now is
now correct ? Yes . Okay . Doctor Hog .
I mean General Hog , yes . So along the
same lines uh Chairman medical
readiness of our forces paramount and
No one . And so everything that we do
will be uh directed toward that . And
so at this point , yes , no shortfall .
I do however , have a concern that um
as we move forward uh if there is a
shortfall , how that that's going to
get covered . Yeah , I got you .
Admiral Gillingham . Yes . Thank you
sir . Like my colleagues , I think this
is something that we will watch
carefully and continue continue to work
internally at present . I don't see a
threat to our medical radiance and as
always will make sure that we provide
most effective and high quality care we
can to our beneficiary appreciate that .
Senator Shelby , thank you . Mr
Chairman um
dr at Durham uh in General Dingle .
I'll direct the first questions to you
both of you . As I noted in my
statement , this committee continues to
invest in medical research without
regard to other similar feather federal
investments . It seems to me at NIH and
maybe in a she's doing things you're
doing better . I don't know that . Can
you answer the question that I posed in
my opening remarks ? Which is this what
specifically are defense medical
research dollars doing that NIH funding
cannot or is not doing ? I think that's
an important question , Senator Shelby .
I'll start with this question and I
think that's a very good question . Um
We focus our research priorities within
the department on the warfighter um and
on the needs of the joint force uh and
on those conditions which may greatly
impact our troops .
We work very closely with the NIH and
other agencies coordinate very closely
on research . Um What do you mean by
working closely ? Is that collaborative
working together on specific things ?
Names , some of them ? Sure . So for
example um uh for something like
uh suicide and mental health , um
there's uh collaborative research that
we work with um and I . M . D . S . Um
have annual meetings on the research
that comes out of um both departments
um and the the work groups work
together to ensure that the research
that is being done and sponsored by
each department or together because
sometimes these research proposals come
out of both departments are aligned to
the requirements of our uhh force . Am
I realized and I think we all do that .
The military has certain needs that the
general population doesn't need but the
military at the same time probably
needs all the needs and all the things
that the general population in addition
to the military specific things . Is
that fair statement ? Sure . Yes sir .
So What name taught your top
three research areas that you're doing
through the military research ? Sure .
I'm going to turn it over to my
colleague General Dingle . Okay .
Vice Chair Shelby . One of the things
to to tag on to what dr Darren was
saying . You know the things that the
military also brings as it takes the
National Defense strategy , the deity
guidance and our service guidances .
The focus is on the survivability of
the soldiers so prolonged real care ,
you know , in combat operations ,
trauma care , the latest technologies
that that we get from the civilian
sector or an NIH . But taking those
civilian technologies , medical
technologies , it takes that military
service research and development to
incorporate it into tomorrow's
battlefield on how it's going to be
incorporated a multi domain environment .
And I think that's one of the key
things that we bring from the military
as we couple with the civilian sector ,
academia and the industry . Okay . Uh ,
in the area that we're all see a lot
of it that is improvised explosive
devices dealing with our military . Oh ,
uh that's traumatic thing . We
see it with our soldiers everywhere .
What is is any connection between
our efforts to detect and prevent that
and the treatment of the victims are
soldiers after their they've
sustained huge blast , you know . Yes ,
sir . And that's one of the beauties of
what the Chief of Staff , the Army set
up with our Army Futures Command
because it takes that prevention mode
and the detection to get ahead of that
blast . But then even if that blast has
happens occurs , that's when the
medical research development piece
comes in and we are studying those
blast injuries and how to conserve and
save lives . So the short answer , yes ,
we are doing those preventive measures .
It's all being done under Army Futures
Command , in which medical is
incorporated across all of the cross
functional teams . Is there any
correlation in research dealing with ,
say , uh ,
trauma medicine , emergency medicine ,
domestically civilian and
what the soldiers , you know , the
soldiers are shot at their their shell
there step on mines that do this now
they don't do A lot of the civilians
were shot out too much in the country ,
but I guess is the treatment of wounds
is a correlated research . Their doctor .
Yes , I'm an emergency physician and
there's a number of , um , uh ,
uh , research , number of research that
has come out of the military that has
greatly benefited the civilian sector .
I mean , I can name the robo a , which
is a device that's used in trauma . Um ,
there's um , fresh frozen plasma which
is currently being used for battlefield ,
which will have , um , civilian
applicability . So , yes , you're
exactly right . A lot of , um , what we
do within the Department of Defense ,
especially around trauma research is
applicable to the civilian sector in
the area of warfighter , our soldiers ,
sailors , marines , air force readiness
and their health . Is there uh ,
research going on between the military
research and the NIH research regarding
with the health of our people , the
health of our soldiers , of course the
soldiers are probably uh not probably
are exposed to a lot different
environments than the average american
is well . Senator as you alluded to ,
there are multiple domains of research
that we do with um that we do in
coordination and collaboration with the
NIH and a lot of which has
applicability to the civilian sector
and to the american people at large .
Admiral getting ham . I'm on a ship to
the ambulance ship , transport ship .
The Navy recently issued a $235 million
dollar contract modification to
construct a multipurpose expeditionary
fast transport ship . Can you talk
about Navy medicine , adapting to
distributed man maritime operations and
specifically how the expedition
expeditionary fast transport ship , an
ambulance ship , will add value to
those operations ? Yes , sir , thank
you for this opportunity . Were
enormously excited about what is known
as the E . P . F . Flight to which is
the vessel that was previously known as
the joint high speed vessel designed
initially as a logistic ship . We uh ,
in reviewing medical concept of
operations for the distributed maritime
operation and expedition or advanced
basing operations in support of the
Marine Corps recognized that we had a
gap in the ability to respond quickly
uh , and much more , much more quickly
than we can with our role three
platform , the the th or the hospital
ship . So the ambulance ship as
envisioned will allow us to respond to
ships in distress ships that may have
been damaged in combat . Be able to
assist in personal also gives you a lot
of mobility . Yes , sir . Uh the
speed is , it's a , it's a catamaran by
hold . Catamaran was very quickly . It
will allow an Osprey aircraft to land
for medevac purposes . It will allow us
as as envisioned and as being built and
adapted With that . Additional funding
will have operating room that will
accommodate two operating room tables ,
room for 18 icu beds , medical enhanced
role , two medical staff of about 100
personnel . So we're we see this as
filling a critical gap in our , in the
demo environment . You would you say
this fairly say this is a high priority
for naval medicine ? Yes , sir , very
much is . Thank you . Thank you . Mr
Chairman , thank you . Senator Shelby .
We have Senator baldwin virtually .
Thank you . Thank you . Mr Chairman .
Dr Attaran . How many cases of
COVID-19 has the military seen this
year ? And uh , in 2020 .
And I also would like to hear the
breakdown of the number of military
personnel who have been hospitalized or
have Passed away from COVID-19 since we
first identified that threat . Sure ,
thank you for that question . Um , I
don't have the precise numbers and we
can get those to you . But what I can
say is having looked at our percent
positivity and following the
hospitalizations , it is much less than
in the civilian sector , which is what
you would expect for a younger ,
healthier population Currently right
now , we're seeing a test positivity
rate of about 4.4 and it's six out in
um nationally . So we have a
lower case rate than we see out in the
civilian sector and we have lower
hospitalization rates as well . Um ,
but I'll get you those precise numbers
for the record . I will appreciate that .
How many anthrax cases has the military
seen over the same period of time ?
I'm ma'am , I'm not aware of anthrax
cases . Um , Okay . Are you aware
of potential anthrax exposure incidents
that the military has experienced in
the last year or the last five or 10
years ? I ma'am , I wouldn't have that
information . I can ask one of my
surgeon general colleagues if they
might know the answer to that . Does
anyone have uh any information
about anthrax exposure or cases in the
last decade ? Senator , this is
Lieutenant General Dingle . We do not
have that information on us . However ,
we do have a very detailed
environmental health surveillance
registry , which that information is
documented in . Uh we would have to
take that for record to to come back to
you to provide you those details . Okay .
Um does the Department of Defense plan
to continue procuring anthrax vaccines
moving forward ? And if so , how many
senator the anthrax is still considered
a threat um to our forces ? Um other
governmental agencies as well has
determined that anthrax is a threat .
So to answer your question yes we
do plan to protect our forces from
uh those threats .
Okay . I think you can get a sense of
the point that I am trying to make .
There's been a lot of concern over Um
vaccine declination rates for COVID-19
vaccines . There's also been a long
history of concern over compulsory
vaccinations including for anthrax .
Beginning in the towards the end of the
1990s . I'd like it . I'd love to
hear details on how the D . O . D . Has
increased voluntary participation in
vaccines in the past . And how does the
department approach making uh
decisions about whether vaccinations
should be compulsory for our service
members ? Right . Thank you for that
question . And I can talk about covid
because we're doing um a lot with
regard to helping our service members
make their decisions about taking the
vaccine . As you know , um Under eu a
the vaccine is voluntary and we're
using every avenue possible uh
to provide information . Social media ,
town halls . We have M . T . F .
Positions available to answer questions .
We do facebook live sessions . We put
information on um websites in order to
provide accurate information about the
vaccine . And as you alluded to , um ,
we don't have a perfect acceptance rate .
We don't know what the deployment
nation rate is really . Um because we
only just yesterday opened up
vaccination to all eligible
beneficiaries . But we do track this
and we are very
interested in helping our service
members um and other beneficiaries make
the decision to get vaccinated .
Um , Dr Adami stated in your testimony
that the greatest approximate challenge
to our national nations security is the
threat of Covid 19 and I asked about
anthrax because I'm concerned that are
spending priorities are not aligned
with both current and emerging threats .
We've known that a pandemic based on a
novel virus that it would attack the
respiratory system could cripple our
country . And yet we did not purchase P .
P . E . And we did not re sure
manufacturing of critical medical
supplies or vaccines . Yet 2020 saw
one of the largest purchases of anthrax
vaccines , a threat That , to my
knowledge , hasn't been included in
annual worldwide wide threat
assessments are highlighted in
testimony to the Congress in many years .
And from 2015 through 2020 , we spent
about $1 billion dollars on anthrax
vaccines , even though many experts ,
including dr Fauci have suggested that
the best approach towards anthrax is
antimicrobial therapy . Um , I
understand the continued need to
monitor this threat , but it does seem
to me like we've prioritized the
requirement for this vaccine at the
expense of preparing to protect our
service members and families against
things like uh global pandemic . So I'm
looking forward to following up on my
line of questioning . Thank you . Thank
you Senator baldin . Um I only have one
request and then what we'll close this
hearing out is for dr adam and I would
like to have you get to me and the
committee , the research that's been
done on respiratory ailments as it
applies to burn pits . And I would ask
you be specific on the respiratory
ailments that you're looking at . Um
It's a big big , big issue that's got
some legs as Congress as far as
providing benefits to our veterans . Uh
I want to thank Senator Shelby and
Senator baldwin for their questions
today . I want to thank you for your
testimony today . The witnesses . Uh No
that senators may submit additional
written questions and we ask you to
respond to them within a reasonable
time . The defense subcommittee will
reconvene on Tuesday April 27 At 10 .
a.m . for a closed hearing on the
Missile Defense Agency . This committee
stands in recess .