WASHINGTON, D.C. – Today, Rep. Anna G. Eshoo (CA-16) wrote to National Institutes of Health (NIH) Acting Director Lawrence Tabak, urging the agency to demonstrate strong leadership in addressing ‘Long Covid.’ More than three years into the pandemic, the number of Americans reporting chronic Long Covid continues to rise, with almost 20 million currently reporting symptoms and 4 million unable to work because of their symptoms. 

Rep. Eshoo wrote:

“I urge you to treat Long Covid with the same urgency as acute Covid-19. Congress entrusted NIH with significant funding to provide relief to our constituents suffering from this life-altering disease, but so far, it hasn’t delivered that relief.”

In the letter, Rep. Eshoo asks NIH how it has managed the $1.15 billion appropriated by Congress for Long Covid research and clinical trials; how NIH plans to spend the remaining funding; and why there has been such a significant delay in launching clinical trials for treatments of the disease.

Background:

In December 2020, as part of the Consolidated Appropriations Act of 2021, Congress appropriated $1.15 billion over four years to NIH for ‘for research and clinical trials’ related to Long Covid. Four months later, Rep. Eshoo chaired a House Health Subcommittee hearing entitled, "The Long Haul: Forging a Path through the Lingering Effects of COVID-19.”  Dr. Francis Collins, then NIH Director, testified at this hearing and outlined a compelling research strategy to bring relief to Long Covid patients through the RECOVER Initiative: Researching COVID to Enhance Recovery (RECOVER). To this day, these efforts have not been fully realized by the National Institutes of Health.

A PDF of the letter can be found HERE and the text of the letter is below:

Dear Dr. Tabak,

The National Institutes of Health (NIH) has played a vital leadership role in our nation’s response to Covid-19, including helping to develop the vaccines and antivirals that dramatically changed the course of the pandemic. I write to you to request that NIH demonstrate similar leadership in addressing Post-Acute Sequelae of SARS-CoV-2 (PASC), known as ‘Long Covid,’ which continues to cause debilitating symptoms for millions of Americans.

In December 2020, as part of the Consolidated Appropriations Act of 2021, Congress appropriated $1.15 billion over four years to NIH for ‘for research and clinical trials’ related to Long Covid.[1] Four months later, I chaired a House Health Subcommittee hearing entitled, "The Long Haul: Forging a Path through the Lingering Effects of COVID-19.”[2] Dr. Francis Collins, then NIH Director, testified at this hearing and outlined a compelling research strategy to bring relief to Long Covid patients through the RECOVER Initiative: Researching COVID to Enhance Recovery (RECOVER). As I write to you, the efforts he described have not been fully realized, and I hear every day from my constituents and patients across the nation who are losing hope and feeling forgotten and ignored by our public health system. 

More than three years into the pandemic, the number of Americans reporting chronic Long Covid continues to rise, with almost 20 million currently reporting symptoms[3] and 4 million unable to work because of their symptoms.[4] There’s no standard protocol for diagnosing or treating Long Covid or a deeper understanding of the illness and its causes. To date, NIH has not signed a single patient up for a clinical trial to test Long Covid treatments or set a specific date to begin enrollment, despite telling Members of Congress that clinical trials would begin in the fall of 2022.[5]Instead, NIH has obligated over $918 million of its RECOVER funding to long-term research studies and data analytics that have not brought much-needed relief to Long Covid patients.[6] 

In the meantime, the Biden Administration recently announced the launch of Project Next Gen, a $5 billion program to accelerate the development of treatments and vaccines for Covid-19.[7] While this is an important step to bolster ongoing work to mitigate Covid-19 and prevent future outbreaks, it highlights the lack of progress and attention on Long Covid treatments and cures. I urge you to treat Long Covid with the same urgency as acute Covid-19. Congress entrusted NIH with significant funding to provide relief to our constituents suffering from this life-altering disease, but so far, it hasn’t delivered that relief.

To better understand how NIH has managed the funding allocated by Congress for Long Covid research and clinical trials, I respectfully ask you to address the following questions:

1. How much of the $1.15 billion appropriated in the Consolidated Appropriations Act of 2021 has the NIH spent as of May 9, 2023? 
   1. Please include a detailed explanation and dollar amount for each funded activity, including how funding was spent within each partner institution, such as New York University Langone Health, Duke Clinical Research Institute, Mayo Clinic, and RTI International. 

2. How does NIH plan to spend the remaining funding?
   1. Please include a detailed explanation, timeline, and dollar amount for each planned activity.
   2. Please provide an estimate for when this funding will be depleted.

3. Please provide specific dates for when the RECOVER clinical trials are to begin, including enrolling participants and administering treatments.

4. How did you select each planned clinical trial? How did you consider stakeholder and patient feedback and existing non-governmental clinical trials on Long Covid treatments?

5. Last year, RECOVER announced a clinical trial to evaluate the use of Paxlovid in patients with Long Covid, supervised by the Duke Clinical Research Institute.[8] Please provide an explanation as to why Pfizer’s Paxlovid was selected as the first treatment to study.

6. Given the urgency of the Long Covid crisis, why has there been such a significant delay in launching clinical trials for treatments of the disease? What roadblocks has NIH encountered and how can Congress help ensure that this does not continue?

7. Given the NIH has indicated that additional resources are needed to test the full range of treatments for Long Covid,[9] will any of the funding from Project Next Gen be used to accelerate the development of treatments for Long Covid?
   1. Is there a plan to continue RECOVER research and clinical trials once funding from the Consolidated Appropriations Act of 2021 is depleted?

8. In August 2022, HHS released a National Research Action Plan on Long Covid which included the establishment of a new Office of Long Covid Research and Practice to coordinate Long Covid research efforts across the federal government. In the April update from HHS on their progress in responding to Long Covid,[10] this Office was not mentioned. Please provide an update on the work to establish this critical Office and provide a specific timeline.

Thank you in advance for your cooperation and your attention to my request. I look forward to your timely response and working together to help the millions of Americans who are suffering from the debilitating effects of Long Covid.

Most gratefully,