“I don’t think any of us will ever forget we have lost over a million Americans from COVID,” Sen. Bernie Sanders (I-Vt.), chair of the HELP Committee, said at the start of the committee session. “And while all of our public health people worked tirelessly and did everything they could to protect the American people, it would be an understatement to say that we were tragically unprepared to respond to that crisis.”

“Months after the pandemic erupted, doctors and nurses lacked the masks, the gloves, the gowns, the equipment they needed to protect themselves and their patients,” said Sanders. “We did not have the infrastructure we needed to deal with a pandemic … Leading experts in the country are telling us that sadly, there is a real possibility that another pandemic — perhaps as deadly as COVID, perhaps worse — could occur in the near future. And clearly our responsibility is to make sure that we are better prepared next time than we were last time. And that is basically what this legislation is about.”

Sanders was discussing the reauthorization of the Pandemic and All-Hazards Preparedness and Response Act (PAHPA), which is due to expire on Sept. 30.

“We saw during COVID-19 that the PAHPA framework is far from perfect,” said Sen. Bill Cassidy, MD (R-La.), the committee’s ranking member. For example, “government bureaucracy sometimes enabled — but sometimes hampered — the private sector’s ability to quickly launch tests at the beginning of the pandemic, and bureaucracy got in the way of clear communication between federal officials and the public.”

“Although mistakes were made during COVID-19, we did learn some tough lessons,” he added. “And this legislation is here to make sure that future generations are not forced to learn on the fly should another crisis occur.”

Sen. Rand Paul, MD (R-Ky.), introduced an Amendment that would bar federal funding of “gain of function” research, in which scientists create versions of viruses that might be the basis for the next pandemic, in order to find vaccines or treatments for them ahead of time.

“The danger is this: when you mix and match these viruses, there’s a possibility you come up with a combination so contagious or so dangerous, that you end up with a virus that is 10% to 20% lethal and is devastating to mankind,” Paul said. Although the Biden administration said it won’t fund any research at the Wuhan Institute of Virology — located in the Chinese city at the epicenter of the COVID-19 pandemic — “they didn’t say they’re not going to fund gain-of-function research,” Paul said.

Paul’s amendment was defeated by the committee.

Sen. Roger Marshall, MD (R-Kan.), discussed an amendment he developed that would have provided medical liability protections to healthcare professionals, including those who cross state lines to provide voluntary care in response to state disasters. “It’s frustrating to me that I can go to Haiti or I can go to Central America or to Africa and be a good Samaritan and use my skills as a physician, but when a hurricane strikes the United States I cannot use those same clinical skills because I’m concerned about being sued,” Marshall said. “This provision takes away an important barrier that allows us to do that voluntary work.”

Marshall noted that he was forced to withdraw his amendment “as we cannot reach bipartisan agreement. I can’t tell you what a huge disappointment it is to the doctors’ groups who have reached out to me, specifically the neurosurgeons, my orthopod friends, and urologist general surgeons who would all love to do voluntary work across state lines when disaster strikes.” Sanders said that Marshall’s amendment “raises an important issue and I want to work with you and I think we can resolve it, but not today.”

Paul and Marshall’s fellow Republican Sen. Ted Budd (N.C.) had better luck with an amendment to improve the management of the Strategic National Stockpile. “My amendment would eliminate gaps in managing the Strategic National Stockpile by developing a process to assess risk, set priorities, and measure progress in managing the stockpile,” he explained. “The amendment also creates a standard operating procedure for the agency to follow in managing stockpile purchasing, while reducing unnecessary reporting requirements.”

The amendment, which was supported by Sanders and cosponsored by Sen. Maggie Hassan (D-N.H.) passed on a voice vote.

Sen. John Hickenlooper (D-Colo.) proposed an amendment that would create a new program at FDA to review medical countermeasures for emerging pathogens. “This new team will allow FDA to dedicate the necessary manpower to be able to quickly evaluate and clear what we can only hope will be many countermeasures that will come before them during a pandemic,” Hickenlooper said. “Getting these countermeasures to the public fast in a time of crisis will save lives.” He noted that the FDA “is eager to have this team authorized; they requested this specific authority earlier this year.”

Cassidy opposed the amendment. “The FDA already has an Office of Counterterrorism and Emerging Threats that works on countermeasure-related issues, so I’m not sure that we need to create a new program,” he said.

The amendment ended up passing by a vote of 12-8.

The HELP Committee vote came on the heels of a similar vote Wednesday by the House Energy & Commerce Committee to send to the House floor its version of PAHPA; unlike the Senate version, the House version does not contain any provisions to fight drug shortages, as noted by Endpoints News. The two bills will have to be reconciled into a single final bill for passage by both the House and Senate.