April 16, 2020

Casten Urges FEMA to Provide Data Behind the Distribution of PPE, Ventilators

Downers Grove, IL – Today, U.S. Representative Sean Casten (IL-06) and Region V Members of Congress received an update from the Federal Emergency Management Agency (FEMA) during a conference call in response to the novel coronavirus (COVID-19) pandemic. This is the fifth call FEMA has held for Region V Members.

Following the April 2nd call, Casten sent a letter to FEMA Region V Administrator, James Joseph, requesting more details on the epidemiological models FEMA is using to prioritize the distribution of PPE, ventilators, and other critical materiel. Specifically, the letter requests more details on models FEMA is utilizing when predicting future "hot-spots" in the absence of testing. During today's call, Casten reiterated his questions and FEMA recognized the question, tied it to his letter and said they were working on a response.

Casten said, "We are in the midst of a global pandemic and supplies to treat and mitigate the virus need to have been distributed yesterday. I asked FEMA to immediately provide the data behind how they are making the life and death decisions about where critical medical supplies are going."

The letter said in part, "Given the 1 to 2 week latency period between first infection and appearance of symptoms, the underlying data FEMA and other federal agencies are using to accurately identify those hot-spots are vital to the proper identification of those hot-spots. When I asked about this underlying data in our briefing, I was told that while there were no epidemiologists on the phone and that FEMA was relying on "models." If these models are playing an integral role in our understanding of infectious disease and supplies are being directed based on them, we must have a clear understanding of the underlying data….I am pleased to hear FEMA is focusing on hard facts and empirical models, but we must be vigilant to ensure that such assertions are backed up by hard data and in no way compromised by political influence. With that in mind, I look forward to your timely response."

Text of the letter is copied below and available here.

April 7, 2020

Dear Mr. Joseph,

Thank you for taking the time to brief the Region V Congressional delegation on April 2, 2020, and for your subsequent summary email on April 6, 2020. The meeting gave us a clearer understanding of how FEMA is reacting to the COVID-19 pandemic, although I would like more information about the question I asked on April 2 which was not included in your April 6 summary.

In light of that omission and recent comments that President Trump has made about Illinois' response to COVID-19 generally, and Governor J.B. Pritzker specifically, I write today to formally reiterate the concerns I raised on the call and to request more detail on the epidemiological models FEMA is using to prioritize the distribution of PPE, ventilators, and other critical materiel.

In your introductory remarks on April 2, you indicated that given resource constraints, FEMA was directing materiel to "hot-spots" where new cases were likely to develop, and that maximizing overall public health may require local tradeoffs. In principle, I support this policy. However – as I noted during our call – the effectiveness of such a policy depends on the accuracy of the data used to identify those hot- spots.

The deficiency in U.S. COVID-19 testing has forced us to prioritize tests for people who are symptomatic and/or front-line healthcare providers. This is necessary given resource constraints but is not a statistically diverse sample of the U.S. population. Given the 1 to 2 week latency period between first infection and appearance of symptoms, the underlying data FEMA and other federal agencies are using to accurately identify those hot-spots are vital to the proper identification of those hot-spots. When I asked about this underlying data in our briefing, I was told that while there were no epidemiologists on the phone and that FEMA was relying on "models." If these models are playing an integral role in our understanding of infectious disease and supplies are being directed based on them, we must have a clear understanding of the underlying data.

I write to ask that you immediately provide our office with details of those models, noting specifically:

  1. The inputs and the assumptions in the models FEMA is using to predict future hot-spots, including data collection, data analysis, study design, and transmission dynamics;
  2. Any risk assessments you have done to assess the probability of inaccuracies in your model, and specifically the likelihood that FEMA's models will ultimately misallocate critical resources and increase, rather than decrease total mortality;
  3. Validation of these models based on prior hot-spot identification, noting where the models predicted hot-spots would occur in prior weeks as compared to where hot-spots actually developed;
  4. To the extent that the model has not been in use long enough to provide validations per item (3), any validation of model inputs with historic data to show where the model would have predicted hot-spots had it been in use at the time, and;
  5. Where the model is predicting hot-spots will be in upcoming weeks, and where you are allocating materiel accordingly.

I appreciate that this is a very challenging time for all of us and do not wish these questions to distract you from the life-saving work you are now embarked upon. However, it is critical in this moment that we have reassurances that the federal government is doing everything in its power to maximize the health and welfare of all Americans.

On March 23, 2020, Governor Pritzker noted that "in one case we're competing for ventilators with FEMA and the federal government. So, Illinois is bidding for ventilators against the federal government. In another case, we're bidding against foreign countries and other states."

Four days later, on March 27, 2020, Donald Trump's said that he wants Governors to "be appreciative" and that "if they don't treat you right, I don't call."

The coronavirus is not constrained by state borders, nor the political leanings of its human host. Protecting all Americans requires that we prioritize public health and science over politics and petty squabbles between the President and various state Governors. I am pleased to hear FEMA is focusing on hard facts and empirical models, but we must be vigilant to ensure that such assertions are backed up by hard data and in no way compromised by political influence. With that in mind, I look forward to your timely response.