If you've come down with a runny nose or sore throat recently, you may be wondering whether it's the common cold, allergies or a COVID-19 infection.
Health officials say it can be difficult to tell what illness you're experiencing based on the symptoms, but getting tested is one way to find out -- including people who have been vaccinated, experts say.
"Even if it's a sore throat, no matter what it is," Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, said in a Facebook live last month. "I've told my own staff this, it's what I do myself... if you are sick, even a little bit sick, stay home. More true than ever right now because sick, even a little bit sick, until proven otherwise with a test - that's COVID. That's how we treat it, that's how you should treat it."
According to the Centers for Disease Control and Prevention, the common cold, allergies and coronavirus overlap in some symptoms, like the potential for a cough, shortness of breath or breathing difficulties, fatigue, headaches, a sore throat and congestion.
Symptoms more associated with coronavirus include fever, muscle and body aches, loss of taste or smell, nausea or vomiting and diarrhea.
For some people, coronavirus causes mild or moderate symptoms that clear up in a couple weeks. For others, it may cause no symptoms at all. For some, the virus can cause more severe illness, including pneumonia and death.
Even those who receive the coronavirus vaccine can also still contract the virus and may experience symptoms.
Most vaccinated people either have no symptoms or exhibit very mild symptoms, according to health officials, and the virus rarely results in hospitalization or death for those individuals.
Coronavirus and the common cold share many symptoms.
According to the Mayo Clinic, diarrhea and nausea or vomiting are the only symptoms associated with coronavirus that don't overlap with the common cold.
The hospital also notes that whileCOVIDsymptoms generally appear two to 14 days after exposure to SARS-CoV-2, symptoms of a common cold usually appear one to three days after exposure to a cold-causing virus.
Dr. Katherine Poehling, an infectious disease specialist and member of the Advisory Committee on Immunization Practices,told NBC Newsin January that a cough, congestion, runny nose and fatigue appear to be prominent symptoms with the omicron variant.
However, unlike the delta variant, many patients are not losing their taste or smell. She noted that these symptoms may only reflect certain populations.
Dr. Deborah L. Birx, President Donald J. Trumps coronavirus response coordinator, told a congressional panel on Thursday that the Trump administrations attitude toward the coronavirus had caused a false sense of security in America.Credit...Jason Andrew for The New York Times
WASHINGTON Dr. Deborah L. Birx, President Donald J. Trumps coronavirus response coordinator, told a congressional committee investigating the federal pandemic response that Trump White House officials asked her to change or delete parts of the weekly guidance she sent state and local health officials, in what she described as a consistent effort to stifle information as virus cases surged in the second half of 2020.
Dr. Birx, who publicly testified to the panel Thursday morning, also told the committee that Trump White House officials withheld the reports from states during a winter outbreak and refused to publicly release the documents, which featured data on the viruss spread and recommendations for how to contain it.
Her account of White House interference came in a multiday interview the committee conducted in October 2021, which was released on Thursday with a set of emails Dr. Birx sent to colleagues in 2020 warning of the influence of a new White House pandemic adviser, Dr. Scott Atlas, who she said downplayed the threat of the virus. The emails provide fresh insight into how Dr. Birx and Dr. Anthony S. Fauci, the governments top infectious disease expert, grappled with what Dr. Birx called the misinformation spread by Dr. Atlas.
The push to downplay the threat was so pervasive, Dr. Birx told committee investigators, that she developed techniques to avoid attention from White House officials who might have objected to her public health recommendations. In reports she prepared for local health officials, she said, she would sometimes put ideas at the ends of sentences so colleagues skimming the text would not notice them.
In her testimony on Thursday, she offered similarly withering assessments of the Trump administrations coronavirus response, suggesting that officials in 2020 had mistakenly viewed the coronavirus as akin to the flu, even after seeing high Covid-19 death rates in Asia and Europe. That perspective, she said, had caused a false sense of security in America as well as a sense among the American people that this was not going to be a serious pandemic.
Not using concise, consistent communication, she added, resulted in inaction early on, I think, across our agencies.
And those at fault, she said, were not just the president.
Many of our leaders were using words like, We could contain, she continued. And you cannot contain a virus that cannot be seen. And it wasnt being seen because we werent testing.
Dr. Birx became a controversial figure during her time in the Trump White House.
A respected AIDS researcher, she was plucked from her position running the governments program to combat the international H.I.V. epidemic to coordinate the federal Covid response. But her credibility came into question when she failed to correct Mr. Trumps unscientific musings about the coronavirus and praised him on television as being attentive to the scientific literature. She was also criticized for bolstering White House messaging in the early months of the coronavirus outbreak that the pandemic was easing.
Yet as outbreaks continued that year, Mr. Trump and some senior advisers grew increasingly impatient with Dr. Birx and her public health colleagues, who were insistent on aggressive mitigation efforts. Searching for a contrarian presence, the White House hired Dr. Atlas, who functioned as a rival to Dr. Birx.
They believed the counterfactual points that were never supported by data from Dr. Atlas, she said in Thursdays hearing.
In one email obtained by the committee, dated Aug. 11, 2020, Dr. Birx told Dr. Fauci and other colleagues about what she called a very dangerous Oval Office meeting with Mr. Trump. In that session, she said, Dr. Atlas had called masks overrated and not needed, and had argued against virus testing, saying it could hurt Mr. Trump politically.
Dr. Birx claimed that Dr. Atlas had inspired Mr. Trump to call for narrower recommendations on who should seek testing.
Case identification is bad for the presidents re-election testing should only be of the sick, she recounted Dr. Atlas saying.
He noted that it was the task force that got us into this ditch by promoting testing and falsely increasing case counts compared to other countries, she added, referring to a group of senior health officials that gathered regularly at the White House. The conclusion was Dr. Atlas is brilliant and the president will be following his guidance now.
In another email sent to senior health officials two days later, Dr. Birx cataloged seven ideas espoused by Dr. Atlas that she referred to as misinformation, including that the virus was comparable to the flu, that football players could not get seriously ill from the virus and that children are immune.
I am at a loss of what we should do, she wrote, warning that if caseloads kept mounting, there would be 300K dead by Dec. The United States ended the year with more than 350,000 Covid deaths.
I know what I am going to do, Dr. Fauci wrote in reply. I am going to keep saying what we have been saying all along, which contradicts each of his seven points listed below. If the press ask me whether what I say differs from his, I will merely say that I respectfully disagree with him.
In her interviews with the committee last year, Dr. Birx described regular attempts by others to undermine the weekly pandemic assessments she first sent to state and local officials in June 2020, which offered comprehensive data and state-specific recommendations regarding the status of the pandemic, the committee wrote.
Beginning in the fall of that year, Dr. Birx said, she began receiving a list of changes for three or four states each week, which sometimes involved bids to loosen mask recommendations or indoor capacity restrictions. In one instance, she was asked to soften guidance for South Dakota officials and remove some recommendations for the state, which had a surge in cases.
When she asked the White House to publish the reports so Americans would know more about outbreaks in their communities, the request was denied, she told investigators. In December 2020, she told them, the White House stopped sending the reports to states unless they were requested.
Dr. Birx told committee investigators that she was asked to change the reports about 25 percent of the time or else they would not be sent.
Sheryl Gay Stolberg contributed reporting.
Global impact of the first year of COVID-19 vaccination: a mathematical modelling study The Lancet
When scientists find a new disease-causing virus in humans, the first question they want answered is: Can this thing spread easily from person to person? And if not, will it someday?
Avian influenza can infect humans, but its not very good at passing from one person to another. Same with the coronavirus that causes MERS, another severe respiratory illness. Though hundreds of cases of both have been reported over the past two decades, neither virus seems inclined to evolve toward efficient person-to-person transmission.
In less than three years, the coronavirus that causes COVID-19 has mastered it.
SARS-CoV-2 has accumulated a suite of mutations over an astonishingly short period of time that have made it now one of the most infectious human pathogens on the planet. And for the first time ever, scientists have the tools and the knowledge to closely track that evolution in near-real time, studying the small but mighty genomic mutations that have transformed the virus to the point where it hardly resembles the strain that began infecting humans in China in late 2019.
Mapping the evolution of this virus has fed academically curious minds in every nation, and its had real world implications too. Identifying and describing new variants has helped guide public health responses and is now informing the next generation of vaccines and drug therapies.
The coronavirus rapid evolution also is helping scientists anticipate the future of the pandemic, and what mutations may make it a less or more formidable foe in years to come.
This is the first time in human history that weve been able to witness a global pandemic at the genomic, evolutionary level, said Joe DeRisi, president of San Franciscos Chan Zuckerberg Biohub, which has done genomic sequencing on the virus since the start of the pandemic.
Joe DeRisi, president of the Chan Zuckerberg Biohub, stands for a portrait on Thursday, Nov. 19, 2020, in San Francisco.
Whats been especially fascinating, and at times alarming, is the speed of this virus evolution. That SARS-CoV-2 would mutate to better adapt to humans was always anticipated, but the pace of that adaptation has been breathtaking.
Scientists say thats in large part due to the scale of the pandemic more than half a billion infections worldwide have afforded the virus near-boundless opportunity to mutate. But its a matter of timing, too. As a human virus, SARS-CoV-2 is still in its infancy, developing rapidly to flourish in its new environment. Meanwhile, human immunity to the virus due to infection and vaccination has become increasingly complex, applying constant pressure to further evolve.
Its normal to see this kind of evolution this constant battle between human and pathogen, said Fenyong Liu, an infectious disease expert at UC Berkeleys School of Public Health. Each of us is focused on survival. We develop a better system to beat them, and theyre going to mutate and try to escape. It happens with all infectious diseases, but for COVID, the whole process really sped up because of the scale of it.
Tanya Alexander waits in line for COVID-19 test with her grandson Sincere Perkins, 9, at Bayview Opera House in San Francisco on Thursday, Jan. 6, 2022.
Predicting how evolution will shape the next iterations of this virus is tricky, and scientists lack the technology to do it with any precision. How the virus has mutated over the past two and a half years provides some clues: Scientists have identified dozens of specific mutations mostly associated with increasing infectiousness that have recurred in multiple variants. Those mutations likely will keep showing up, re-sorting themselves in different combinations that give the virus further survival advantages. Some of the mutations could become permanently embedded in the virus genetic code. A few already have.
Recently, the virus has mutated to evade hard-won human immunity, and most experts in virology believe it will continue down that evolutionary path. It could also acquire new mutations that make it more infectious, though its already become so efficient at spreading among humans that its hard to imagine how much more gains it can make there, some scientists say.
The most critical question and possibly the toughest to answer is whether the virus will evolve to cause more or less severe disease in humans. Many experts believe that viruses tend to become more benign over time one of the current coronaviruses that now causes the common cold may have been the source of a deadly pandemic in the late 1800s but thats not a sure thing, and no one can say how long such evolution may take. Omicron and its subvariants are causing milder disease than their predecessors, but it would be nave to assume a future variant couldnt arrive with mutations that make it fiercer once again, experts say.
Social distancing circles at Dolores Park on Saturday, May 23, 2020, in San Francisco. The 10-foot circles, which were eight feet apart from each other, were an effort to curb coronavirus spread.
Hopefully it will adapt and become a very mild seasonal disease, and our immune systems will adapt, too, Liu said. But in reality, the virus has unlimited capability to adapt and mutate.
Scientists began tracking the evolution of SARS-CoV-2 almost immediately after the virus was isolated and identified in early January 2020. Once the first genomic sequence was complete and had been shared on a public database, infectious disease experts around the world started hunting for mutations, largely to keep tabs on how the virus was spreading.
Most people by now are familiar with the role mutations play in giving the virus certain advantages. But most mutations dont actually have an obvious effect on the virus, theyre simply glitches in the code. Those mutations can serve as evolutionary breadcrumbs, though, allowing scientists to follow the virus trail as it travels widely around the globe. And throughout the pandemic, public health experts have used mutations to identify and control clusters of infections.
Still, scientists are most invested in tracking consequential mutations that may alter the public health response. For example, arrival of the incredibly infectious omicron led many officials to recommend people start wearing higher quality masks, and eventually triggered another universal mask mandate in California to help curb the spread.
The most influential mutations mostly have been identified in the spike protein, the section of the virus that projects out of the surface and latches onto the ACE2 receptor, a protein on the exterior of human cells through which SARS-CoV-2 gains entry.
The first significant mutation known as D614G and nicknamed Doug arrived sometime in spring 2020; it basically made the ACE2 receptor more accessible. It was like putting a wedge in the door to keep it open, said Shannon Bennett, chief of science at the California Academy of Sciences.
Shannon Bennett, chief of science for the California Academy of Sciences, studies infectious diseases that can be transmitted from animals to humans. Here, she plays her piano at her home on March 20, 2020, in Mill Valley, Calif.
That mutation granted the virus an early boost in infectiousness, and it has stuck around in every important variant since. Identifying a mutation of that significance was surprising, and exciting, Bennett said. It was the kind of early evolutionary shift that scientists have never been able to capture before. With earlier viruses HIV, for example by the time scientists identified and were able to study them closely enough to look for mutations, they were already well established in humans and had likely gone through years of vigorous adaptations.
After D614G, the virus quickly accumulated mutations that mostly improved its ability to transmit and infect. Scientists havent yet determined exactly what all those changes are doing, at the biological level, to increase infectiousness. Some may allow the virus to replicate faster in the nose or bind more tightly to the ACE2 receptor, making it harder for the immune system to shake off an early infection. Mutations could also make the virus more durable, for instance able to survive for longer periods in the air.
By the end of 2020, it was becoming apparent that the virus was evolving quickly in an environment of widespread transmission. Troubling new variants were emerging at regular intervals, each causing new waves of infection in the country in which they emerged and sometimes on a global scale. And each new variant seemed to be at least somewhat more infectious than the one preceding it. Alpha, which dominated in the U.S. in early 2021, was perhaps 50% more infectious than the original virus, and delta, which fueled the summer 2021 surge, was perhaps 90% more infectious than alpha.
Nurse practitioner Paige Yang mixes a dose of Evusheld, a preventative monoclonal injection, at Total Infusion in Oakland, Calif. on March 16, 2022. The medication is used to prevent COVID-19 among immunocompromised patients.
Omicron, which carried dozens of new mutations, was again more infectious up to fivefold over delta. And each of its subvariants has been more infectious still. The currently circulating strains, all offspring of omicron, are nearly as infectious as measles, which is the most contagious of all known human infections.
Scientists say the virus may have hit peak infectiousness, or close to it. Now, its evolving to get around the immune response, and that trend likely will continue. Early studies show that the two up-and-coming variants in the U.S. BA.4 and BA.5, which currently make up roughly a third of cases are the most immune evasive so far; people who are vaccinated or have already been infected, or both, may still be vulnerable.
I think theres a max in terms of how transmissible it can be, said Nadia Roan, an investigator at the Gladstone Institutes in San Francisco who studies immunology. Now almost the entire world has some form of immunity, whether from infection or vaccination or both, and thats the big pressure. A virus that is able to take off right now has to be immune evasive.
Scientist Xiaoyu Luo, postdoctoral scholar Julie Frouard, lead scientist Nadia Roan, PhD, and research assistant Matthew McGregor wear masks and lab coats while walking through the lab at Gladstone Institutes in San Francisco on Thursday, August 13, 2020.
Immune evasion is such a concern that many experts believe the world needs to focus resources on developing next-generation vaccines that will target parts of the virus less prone to mutations. Manufacturers of the two main U.S. vaccines Pfizer and Moderna are working to update their products to better match the currently circulating variants, but thats difficult to do when the dominant variant changes every few months.
Ideally, scientists would develop a vaccine that neutralizes the virus preventing it from ever taking hold and stopping transmission entirely and doesnt fade over time. The latter may not be possible, though. It doesnt seem that this coronavirus will be inducing the same immunity that polio and measles induces that lasts for your entire life, said Raul Andino, a UCSF virologist.
Eventually, the pace of evolution in SARS-CoV-2 may slow down, or at least produce fewer consequential mutations that cause fresh surges several times a year. But its tough to guess when that will happen.
Virus evolution is relentless. The virus never takes a rest, never takes a break, and it never stops mutating, DeRisi said. The truce may come when we figure out what kind of yearly boosters we need, or what vaccination works.
We want to get the virus to where it just doesnt matter anymore, he said. Were not there yet. But theres reason to be optimistic, and also reason to be cautious and not let our guard down.
Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com Twitter: @erinallday
Long Covid is making it hard for millions of Americans to return to normal life, pushing some out of the workforce altogether, sometimes permanently. Yet medical efforts to figure out how best to help these patients are proceeding only slowly.
Research has zeroed in on a few probable causes of long Covid, perhaps the most intriguing of which is the idea that the coronavirus sometimes lingers in the body undetected for months after an initial infection. The theories should not be difficult to investigate, and the National Institutes of Health has $1.2 billion to spend on the work. But its not moving fast enough.
A syringe is prepared with the Pfizer COVID-19 vaccine at a vaccination clinic in Chester, Pa., on Dec. 15, 2021. Pfizer says tweaking its COVID-19 vaccine to better target the omicron variant is safe and boosts protection. Matt Rourke/AP hide caption
A syringe is prepared with the Pfizer COVID-19 vaccine at a vaccination clinic in Chester, Pa., on Dec. 15, 2021. Pfizer says tweaking its COVID-19 vaccine to better target the omicron variant is safe and boosts protection.
Pfizer announced Saturday that tweaking its COVID-19 vaccine to better target the omicron variant is safe and works just days before regulators debate whether to offer Americans updated booster shots this fall.
The vaccines currently used in the U.S. still offer strong protection against severe COVID-19 disease and death especially if people have gotten a booster dose. But those vaccines target the original coronavirus strain and their effectiveness against any infection dropped markedly when the super-contagious omicron mutant emerged.
Now with omicron's even more transmissible relatives spreading widely, the Food and Drug Administration is considering ordering a recipe change for the vaccines made by both Pfizer and rival Moderna in hopes that modified boosters could better protect against another COVID-19 surge expected this fall and winter.
Pfizer and its partner BioNTech studied two different ways of updating their shots targeting just omicron, or a combination booster that adds omicron protection to the original vaccine. They also tested whether to keep today's standard dosage 30 micrograms or to double the shots' strength.
In a study of more than 1,200 middle-aged and older adults who'd already had three vaccine doses, Pfizer said both booster approaches spurred a substantial jump in omicron-fighting antibodies.
"Based on these data, we believe we have two very strong omicron-adapted candidates," Pfizer CEO Albert Bourla said in a statement.
Pfizer's omicron-only booster sparked the strongest immune response against that variant.
But many experts say combination shots may be the best approach because they would retain the proven benefits of the original COVID-19 vaccine while adding new protection against omicron. And Pfizer said a month after people received its combo shot, they had a 9 to 11-fold increase in omicron-fighting antibodies. That's more than 1.5 times better than another dose of the original vaccine.
And importantly, preliminary lab studies show the tweaked shots also produce antibodies capable of fighting omicron's genetically distinct relatives named BA.4 and BA.5, although those levels weren't nearly as high.
Moderna recently announced similar results from tests of its combination shot, what scientists call a "bivalent" vaccine.
The studies weren't designed to track how well updated boosters prevented COVID-19 cases. Nor is it clear how long any added protection would last.
But the FDA's scientific advisers will publicly debate the data on Tuesday, as they grapple with whether to recommend a change to the vaccines' recipes ahead of similar decisions by other countries.
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New Delhi: The corona vaccine worked to prevent more than 42 lakh possible deaths in India in 2021. This has been claimed in a research published in The Lancet Infectious Disease Journal. This is based on estimates of the rate of deaths in India during the pandemic. The study found that the corona virus vaccine has reduced potential deaths by 20 million worldwide during the pandemic.
The researchers said that of a possible 31.4 million deaths in the first year of the vaccination program, 19.8 million were prevented worldwide. It has been estimated on the basis of deaths in 185 countries. It is also estimated that if 40 percent of the population in every country had been vaccinated by the end of 2021, 5,99,300 lives could have been saved.
This research has estimated the number of preventable deaths between December 8, 2020 and December 8, 2021. Which covers the first year during which the vaccine was introduced. Study lead author Oliver Watson said, 'For India, we estimate that 42,10,000 deaths due to vaccination were prevented in this period. This is our central estimate, with the uncertainty in the range of 36,65,000-43,70,000.
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The total number of new cases of COVID-19 in Evanston was 215 for the week ending June 22, 6% higher than the week ending June 16. The number of new cases in the state decreased by about 16%. Hospitalizations remained at about the same level.
Cook County, including Chicago, is in the medium community risk level. City officials say Evanston is also in the medium risk level.
The City of Evanston says that the state, the county and the city do not have a mechanism to report, verify or track at-home test results. Because a positive at-home test is regarded as highly accurate, most people who test positive at home do not get a second test outside the home that is reported to government officials. The number of new COVID-19 cases reported by Illinois Department of Public Health and the city thus significantly understates the actual number of new cases that are contracted.
Last week the Food and Drug Administration and the Centers for Disease Control and Prevention approved Modernas vaccine for children 6 months through 5 years old and Pfizer-BioNTechs vaccine for children 6 months through 4 years old.
Modernas vaccine recommends two doses given four weeks apart. Pfifzers vaccine suggests three doses, with the second dose given three weeks after the first, and the third two months after the second.
Both vaccines are currently available in Illinois this week. The IDPH recommends that people find their nearest vaccination location at vaccines.gov.
Illinois: On June 23 the number of new cases in the state was 3,493.
The seven-day average of new cases in Illinois on June 23 was 3,575, down from 4,251 on June 16, a16% decrease. The chart below shows the trend.
Evanston: Evanston reported there were 42 new COVID-19 cases of local residents on June 22.(Evanston is reporting COVID-19 data with a one-day delay.)
There was a total of 215 new COVID-19 cases of Evanston residents in the week ending June 22, compared to 203 new cases in the week ending June 16, an increase of about 6%.
The chart below shows the trend.
One Evanstonian died from COVID-19 during the week ending June 22. That bring the number of deaths due to COVID-19 to 150.
Northwestern University. The latest data reported on NUs website is that between June 10 and June 16 there were 106 new COVID-19 cases of faculty, staff or students. If the cases are of an Evanston resident, they are included in Evanstons data for the relevant period, Ike Ogbo, Director of Evanstons Department of Health and Human Services told the RoundTable. NU will update its data tomorrow.
The weekly number of new cases per 100,000 people in Illinois is 196 in the seven days ending June 23.
As of June 22, the weekly number of new cases per 100,000 people in Evanston was 290. As of June 23, the number was 164 for Chicago, and 206 for suburban Cook County. An accompanying chart shows the trend.
Hospitalizations in Illinois due to COVID-19 have stayed about the same in the last three weeks. They were 1,129 on June 22, about 60 fewer than one week ago.
The chart below, prepared by the City of Evanston, shows the trends in Evanston hospitalizations due to COVID-19.
The CDC and IDPH look at the combination of three metrics to determine whether a community level of risk for COVID-19 is low, medium or high: 1) total number of new COVID-19 cases per 100,000 people in the last seven days; 2) the new COVID-19 hospital admissions per 100,000 in the last seven days; and 3) the percent of staffed inpatient hospital beds occupied by COVID-19 patients. [1]
The City of Evanston reported June 23 that Evanston is in the mediumrisk category. IDPH reported today that Cook County, including Chicago, is in the medium risk category.
While Evanston has more than 200 new cases per 100,000 people, the city reported this evening that it has a seven-day total of 6.4 new hospital admissions per 100,000, and that it has 2.2% staffed inpatient hospital beds that are occupied by COVID patients, using a seven-day average.
The Ccty has not said which hospitals or how many hospitals it is considering in making its analysis of community risk.
The CDC and IDPH recommend that people in a community with a medium transmission rate should take the following precautions:
FOOTNOTES
1/ CDC recommends the use of three indicators to measure COVID-19 Community Levels: 1) new COVID-19 cases per 100,000 population in the last 7 days; 2) new COVID-19 hospital admissions per 100,000 population in the last 7 days; and 3) the percent of staffed inpatient beds occupied by patients with confirmed COVID-19 (7-day average).
The chart below illustrates how these indicators are combined to determine whether COVID-19 Community Levels are low, medium, or high. The CDC provides many recommendations depending on whether the COVID-19 Community Level is low, medium, or high.
https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/indicators-monitoring-community-levels.html
What GAO Found
Twenty-three of 24 major agencies GAO surveyed reported implementing regulatory flexibilities in response to COVID-19. Regulatory flexibilities can include actions that modify regulatory standards, as well as activities that modify their applicability (e.g., through waivers or exemptions) or enforcement. A majority of agencies reported increased use of multiple types of flexibilities in response to COVID-19 compared to before the pandemic (see figure).
Agencies' Change in Use of Regulatory Flexibilities in Response to the COVID-19 Pandemic
Officials from each of the five agencies GAO interviewedthe Departments of Energy, Homeland Security, and Transportation, as well as the Environmental Protection Agency and the Small Business Administrationreported designing and implementing flexibilities based on internal expertise developed from prior events. For example, officials reported that their experiences managing Ebola, constrained funding situations, and natural disasterssuch as Hurricanes Sandy and Mariahelped them develop responses to COVID-19. Officials from these agencies stated that they generally did not rely on specific plans, policies, or other tools given the unique challenges posed by COVID-19.
Fifteen of the 24 agencies GAO surveyed reported having already completed an assessment of at least one regulatory flexibility to understand successes or challenges with using them. Ten agencies reported having used at least one such assessment to inform their decision-making, such as whether to modify an existing flexibility or use a new flexibility. Officials from several of the selected agencies reported that their agencies had not conducted assessments of at least one of the flexibilities discussed with GAO. Among reasons why assessments were not conducted, officials said that some flexibilities were intended to be temporary, and that their focus remained on responding to and recovering from the ongoing pandemic.
Federal regulations can generate substantial benefits to society, but benefits can diminish if regulations are not adapted to meet emerging public needs. Federal agencies have implemented regulatory flexibilities to address the COVID-19 pandemic's substantial effect. Regulatory flexibilities are actions taken, at least in part, to temporarily reduce regulatory burdens or constraints imposed on regulated entities.
The CARES Act includes a provision for GAO to report on its COVID-19 pandemic oversight efforts. GAO was also asked to look at regulatory flexibilities available to agencies in responding to COVID-19. For this report, GAO examines (1) agencies' implementation of regulatory flexibilities in response to the pandemic; (2) the plans, policies, and other tools selected agencies used to identify and design regulatory flexibilities; and (3) efforts these selected agencies took to assess the impacts of regulatory flexibilities.
To do so, in October 2021, GAO surveyed 24 major federal agenciesthose identified in the Chief Financial Officers Act of 1990, as amendedregarding their use of COVID-19 regulatory flexibilities. GAO also interviewed officials at five agencies in part because those agencies reported using more types of flexibilities in response to COVID-19 compared to before the pandemic. GAO interviewed officials about how they identified, designed, and assessed their flexibilities. GAO also reviewed GAO's work related to major agencies' COVID-19 flexibilities, and summarized examples of these flexibilities, as appropriate.
For more information, contact Yvonne D. Jones at (202) 512-6806 or JonesY@gao.gov.
