Levine takes heat, defends record on COVID-19
WASHINGTON — Dr. Rachel Levine, Pennsylvania’s former health secretary, told Senate lawmakers Thursday she would help the country put an end to the COVID-19 pandemic if confirmed as assistant secretary of health.
But she faced criticism from Republicans over the Keystone State’s lagging vaccine rollout, high number of nursing home deaths, business closures and school reopening guidelines.
The confirmation hearing, held by the Senate Health, Education, Labor and Pensions Committee, also turned personal. Dr.
Levine, nominated to become the first Senate-confirmed openly transgender official, faced attacks from Sen. Rand Paul, R-Ky., over her support for allowing minors to make the decision to transition to another gender by taking hormone blockers and undergoing surgery.
“Transgender medicine is a very complex and nuanced field,” Dr. Levine responded to his questions, offering to meet in his office to discuss specific standards of care.
The committee’s chair, Sen. Patty Murray, D-Wash., later reprimanded Mr. Paul.
“It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications and the work ahead of us, rather than ideological and harmful misrepresentations,” Ms. Murray said.
Picked by President Joe Biden for a top post in the U.S. Department of Health and Human Services, Dr. Levine, in the 2½-hour-long hearing, discussed her experience as a pediatrician and her interest in the intersection of physical and behavioral health.
Dr. Levine, working as physician general from 20152017 under Pennsylvania Gov. Tom Wolf, expanded the use of naloxone to prevent opioid overdoses. As state health secretary, she said she helped rural hospitals stay afloat by changing the payment model while also focusing on maternal mortality.
During the pandemic, she led daily briefings on the status of the state’s response. In her opening statement, Dr. Levine spoke about her efforts to distribute COVID-19 testing to vulnerable populations by creating the Health Equity Taskforce, a coalition that includes the Pittsburghbased Black Coalition Against COVID-19 and the Latino Connection.
Sen. Bob Casey, D-Pa., a top member of the committee, introduced her as someone who would bring a
battle-tested state perspective to a key federal agency. He noted Dr. Levine was confirmed three times by a Republican-majority Pennsylvania Senate.
“When COVID-19 came to our state, Dr. Levine’s leadership was marked by clear, science-based communication at her daily briefings,” Mr. Casey said. “Her early action, her collaborative style and her calm was recognized by the medical community, as well as leaders on both sides of the aisle.”
On Thursday, Dr. Levine sat alongside Dr. Vivek Murthy, the Biden administration’s nominee for surgeon general, who served in that same role in the Obama administration. Dr. Murthy was confirmed by a 51-43 Senate vote in December 2014.
But it was Dr. Levine who bore much of the brunt of Republican criticism.
Sen. Richard Burr, RN.C., the top GOP member of the committee, slammed her
over Pennsylvania’s shortcomings in rolling out COVID-19 testing and the sluggish vaccine rollout.
Mr. Burr cited statistics that show 52% of the state’s COVID-19 deaths came from nursing homes, while state infection control inspections in those facilities were lacking.
“Your state failed to adequately protect nursing home residents from the virus and is making unacceptable mistakes in the vaccine distribution process,” Mr. Burr said.
“How can you assure that the same challenges that Pennsylvania experienced in testing, nursing home care and, now, vaccinations will not occur when given the opportunity to serve in the public health policy area?” he asked.
Dr. Levine responded by defending the state’s “work to have a scientific, evidencebased response to COVID-19” while acknowledging “significant challenges —
because this was a novel coronavirus.” She portrayed the issues in the state as caused by shortages of personal protective equipment, testing supplies and other resources to handle an unprecedented health crisis.
“Things continue to improve,” Dr. Levine said.
Sen. Mike Braun, R-Ind., asked whether the state had gathered data to assess whether its economic shutdowns to stop the spread of the virus had been too “draconian.”
Dr. Levine defended the state’s approach to closures as “very sequential,” using a phased red-yellow-green approach and focusing on each county’s situation to be as focused as possible and minimize harm.
Sen. Susan Collins, RMaine, asked about inaccurate disclosure of cases and deaths in nursing homes in weekly state reports, citing a Spotlight PA story from September 2020 that showed
undercounting of deaths at those facilities.
“I do stand behind my statement: Pennsylvania was always completely transparent in terms of our data,” Dr. Levine said.
Dr. Levine explained reporting gaps by the lag time that can last “sometimes days, but sometimes weeks,” between the time of a death to the time it hits the state’s electronic reporting system.
“That lag time explains the Spotlight PA report,” she said.
Ms. Collins also asked about school reopenings and pressed Dr. Levine on whether she believed more students could safely return to the classroom. Dr. Levine did not respond specifically but said she would “look really closely at this issue.”
“We need to do everything we possibly can to have children safely go back into the classroom,” Dr. Levine said, but she pointed out the decision ultimately falls to superintendents and school boards.
While the state issued guidelines, “this is a local issue.”
Sen. Mitt Romney, R-Utah, added that recommendations to keep schools closed seemed like a “submission to the teachers unions” that donate to Democrats.
“The evidence doesn’t show so far that those with kids in classrooms are seeing a spike in COVID cases,” Mr. Romney told Dr. Levine, pressing the Biden administration to require schools to reopen as a condition of receiving federal aid.
Her exchange with Mr. Paul, which played out just minutes into the questioning, focused on her support for prescribing adolescents hormone blockers during early stages of puberty. Mr. Paul referenced her comments made during a 2017 speech at Franklin & Marshall College, during which she outlined treatment options.
During the talk, Dr. Levine said she recommends “everyone’s on board,” including parents, before beginning a gender change.
“American culture is now normalizing that idea that minors can be given hormones to prevent the biological development of their secondary sexual characteristics,” Mr. Paul said. “Do you believe minors are capable of making such a life-changing decision as changing one’s sex?”
Dr. Levine answered she would be happy to speak with Mr. Paul about the standards of care.
As assistant secretary of health, Dr. Levine would oversee a wide array of federal health programs, including the Office of the Surgeon General; the Public Health Service; and offices tasked with vaccine policy, adolescent health, women’s health, minority health and disease prevention. The assistant secretary hears from 13 advisory committees ranging from health equity to tick-borne diseases to fitness and nutrition.