Richard Burr looks back on what he got right and wrong in preparing for a pandemic

Former Sen. Richard Burr created the guidelines his country would use to prepare for a pandemic.

In 2006, Burr sponsored and championed the Pandemic and All-Hazards Preparedness Act (PAPA). The 51-page law created a position to oversee the country’s preparedness plans for a public health emergency, ensure stockpiles of supplies were on hand if an emergency arose and have the means necessary to quickly create a vaccine.

On Wednesday, Burr attended the Duke-Margolis 2023 Health Policy Conference to discuss his work on PAPA and what he hopes his colleagues do with the bill now that it’s up for reauthorization.

“It is a little bittersweet to see that PAPA is up for reauthorization, when I wrote it in 2006,” Burr told the audience. “We’ve been through a number of reauthorizations and the great thing was in 2019, when a pandemic hit, we had made the changes that we learned over the progression of PAPA so that it was current.”

Burr said the challenge now for Congress is to look at what they’ve learned following the COVID-19 outbreak and adjust the law accordingly.

More than 1.1 million Americans have died from COVID-19. The first confirmed case of the deadly virus was recorded in the U.S. on Jan. 13, 2020. Vaccines first became available in December 2020, but weren’t approved by the FDA until August 2021.

At the time, Burr, a Republican, represented North Carolina and served as the chair of the Senate’s Health, Education, Labor and Pension committee until an ill-timed stock trade by Burr and his brother-in-law led to an investigation into whether Burr took part in insider trading due to information he may have had about the pandemic prior to most Americans. He would later be cleared of wrongdoing.

Since then, and unrelated to those allegations, Burr retired from Congress and now serves as principal policy advisor and chair of the Health Policy Strategic Consulting at DLA Piper, a global law and lobbying firm. Burr cannot participate in lobbying until after a two-year cooling off period.

Mark McClellan, director of the Duke-Margolis Center for Health Policy, told the audience that Burr remains involved in health care emergency preparedness and response. He added that the next step for U.S. preparation and response to another public health emergency is for lawmakers to reauthorize PAPA. The HELP committee began meeting about the bill in May.

Burr told McClellan he hopes lawmakers are now looking at what they learned from COVID and focusing on things like scalability, diagnostics and surveillance. He said most crucial to him is that the next version of the bill includes surveillance, diagnostics capabilities and technology.

He also hopes lawmakers are learning from his mistakes.

“I think the one big change that I made, that I got wrong in 2006: I created the assistant secretary of emergency preparedness by statute,” Burr said. “That person was there to run any pandemic response. Well, I went through four administrations and nobody chose that person to run the response.”

And within four administrations there’s been responses to Ebola, MRSA, SARS and other illnesses besides COVID.

“I thought that would work and it didn’t,” Burr said.

Instead, the assistant secretary is the architect of the preparation, while someone within the White House is tasked with being the “combatant commander of a pandemic response” so they would speak with the authority of the president.

But he added that the assistant secretary’s role remains important to frame out the U.S. response to a public health emergency before it happens. The bill lays out exactly what role the assistant secretary takes, coordinating with federal and local agencies and scientists who could create vaccines. He said had the assistant secretary not done the job there would not have been a vaccine within 12 months.

He added that the biggest “glaring mistake” the government made was not being transparent with the data from COVID it was collecting, while still making decisions for parents, hospitals and schools. He said he wishes officials had released more data so that someone like an academic could confirm whether they were making the right choices.

Burr also referenced a report that came out of the Government Accountability Office that found gaps in coordination. He said having one person within the White House coordinating the response, instead of the HHS director, might solve that problem and he hopes for a solution before the law’s reauthorization.

Burr also cautioned Congress that it needs to act quickly to get PAPA reauthorized, saying that if lawmakers wait until after the August recess, when they take a month off from Washington, then it would be next to impossible to get reauthorization before the end of the year. He said after that it would fall victim to 2024 campaigns.