Joint Statement from the Departments of Justice and Homeland Security Assessing the Impact of Foreign Interference During the 2020 U.S. Elections

The Department of Justice (DOJ), and the Department of Homeland Security (DHS), including the FBI and the Cybersecurity and Infrastructure Security Agency (CISA), released today key findings and recommendations from a joint report to the President issued last month on the impact of foreign governments and their agents on the security and integrity of the 2020 U.S. federal elections.

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Through contact tracing, an infected individual’s contacts are notified and may be asked to quarantine. (In reality, some contacts may not become infected, and some of those infected may not show symptoms.) How does it work? In traditional contact tracing, public health officials begin by identifying an infected individual. They then interview the individual to identify recent contacts, ask the individual and their contacts to take containment measures, if appropriate (e.g., a 14-day quarantine for COVID-19), and coordinate any needed care and testing. Proximity tracing apps may accelerate the process by replacing the time-consuming interviews needed to identify contacts. Apps may also identify more contacts than interviews, which rely on interviewees' recall and on their being acquainted with their contacts. Public health authorities provide the apps, often using systems developed by companies or research groups. Users voluntarily download the app for their country or region and opt in to contact tracing. In the U.S., state or local public health authorities would likely implement proximity tracing apps. Proximity tracing apps detect contacts using Bluetooth, GPS, or a combination of both. Bluetooth-based apps rely on anonymous codes shared between smartphones during close encounters. These codes contain no information about location or user identity, helping safeguard privacy. The apps allow public health authorities to set a minimum time and distance threshold for someone to count as a contact. Contact tracing can be centralized or decentralized. With a centralized approach, contacts identified by the app are often saved to a government server, and an official notifies contacts of possible exposure. For a decentralized approach, contact data are typically stored on the user's device at first. When a user voluntarily reports infection, the user's codes are uploaded to a database that other app users' phones search. Users who have encountered the infected person then receive notifications through the app (see fig. 2). Figure 2. Bluetooth-based proximity tracing apps exchange information, notify contacts exposed to an infected person, and provide follow-up information. How mature is it? Traditional contact tracing is well established and has been an effective infectious disease response strategy for decades. Proximity tracing apps are relatively new and not as well established. Their contact identifications could become more accurate as developers improve app technology, for example by improving Bluetooth signal interpretation or using information from other phone sensors. Opportunities Reach more people. For accurate COVID-19 contact tracing using traditional methods, public health experts have estimated that the U.S. would require hundreds of thousands of trained contact tracers because of the large number of infections. Proximity tracing apps can expedite and automate identification and notification of the contacts, reducing this need. Faster response. Proximity tracing apps could slow the spread of disease more effectively because they can identify and notify contacts as soon as a user reports they are infected. More complete identification of contacts. Proximity tracing apps, unlike traditional contact tracing, do not require users to recall or be acquainted with people they have recently encountered. Challenges Technology. Technological limitations may lead to missed contacts or false identification of contacts. For example, GPS-based apps may not identify precise locations, and Bluetooth apps may ignore barriers preventing exposure, such as walls or protective equipment. In addition, apps may overlook exposure if two people were not in close enough proximity long enough for it to count as a contact. Adoption. Lower adoption rates make the apps less effective. In the U.S., some states may choose not to use proximity tracing apps. In addition, the public may hesitate to opt in because of concerns about privacy and uncertainty as to how the data may be used. Recent scams using fake contact tracing to steal information may also erode trust in the apps. Interoperability. Divergent app designs may lead to the inability to exchange data between apps, states, and countries, which could be a problem as travel restrictions are relaxed. Access. Proximity tracing apps require regular access to smartphones and knowledge about how to install and use apps. Some vulnerable populations, including seniors, are less likely to own smartphones and use apps, possibly affecting adoption. Policy Context and Questions Although proximity tracing apps are relatively new, they have the potential to help slow disease transmission. But policymakers will need to consider how great the benefits are likely to be, given the challenges. If policymakers decide to use proximity tracing apps, they will need to integrate them into the larger public health response and consider the following questions, among others: What steps can policymakers take to build public trust and encourage communities to support and use proximity tracing apps, and mitigate lack of adoption by some populations? What legal, procedural, privacy, security, and technical safeguards could protect data collected through proximity tracing apps? What can policymakers do to improve coordination of contact tracing efforts across local, state, and international jurisdictions? What can policymakers do to expedite testing and communication of test results to maximize the benefits of proximity tracing apps? What can policymakers do to ensure that contact identification is accurate and that its criteria are based on scientific evidence? For more information, contact Karen Howard at (202) 512-6888 or HowardK@gao.gov.
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    Why this Matters Safe vaccines are critical to fighting diseases, from polio to COVID-19. Research shows that the protection provided by U.S. licensed vaccines outweighs their potential risks. However, misinformation and unjustified safety concerns can cause people to delay or refuse vaccination, which may increase preventable deaths and prolong negative social and economic impacts. The Science What is it? A vaccine is generally considered safe when the benefits of protecting an individual from disease outweigh the risks from potential side effects (fig. 1). The most common side effects stem from the body's immune reaction and include swelling at the injection site, fever, and aches. Figure 1. Symptoms of polio and side effects of the polio vaccine. A vaccine is generally considered safe if its benefits (preventing disease) outweigh its risks (side effects). In rare cases, some vaccines may cause more severe side effects. For example, the vaccine for rotavirus—a childhood illness that can cause severe diarrhea, dehydration, and even death—can cause intestinal blockage in one in 100,000 recipients. However, the vaccine is still administered because this very rare side effect is outweighed by the vaccine's benefits: it saves lives and prevents an estimated 40,000 to 50,000 childhood hospitalizations in the U.S. each year. The two messenger RNA (mRNA) vaccines authorized for COVID-19—a disease that contributed to more than 415,000 American deaths between January 2020 and January 2021—can cause severe allergic reactions. However, early safety reporting found that these reactions have been extremely rare, with only about five cases per 1 million recipients, according to data from January 2021 reports by the Centers for Disease Control and Prevention. In general, side effects from vaccines are less acceptable to the public than side effects from treatments given to people who already have a disease. What is known? Vaccine developers assess safety from early research, through laboratory and animal testing, and even after the vaccine is in use (fig. 2). Researchers may rely on previous studies to inform future vaccine trials. For example, safety information from preclinical trials of mRNA flu vaccine candidates in 2017 allowed for the acceleration of mRNA COVID-19 vaccine development. Vaccine candidates shown to be safe in these preclinical trials can proceed to clinical trials in humans. In the U.S., clinical trials generally proceed through three phases of testing involving increasing numbers of volunteers: dozens in phase 1 to thousands in phase 3. Although data may be collected over years, most common side effects are identified in the first 2 months after vaccination in clinical trials. After reviewing safety and other data from vaccine studies, the Food and Drug Administration (FDA) may license a vaccine to be marketed in the U.S. There are also programs to expedite—but not bypass—development and review processes, such as a priority review designation, which shortens FDA’s goal review time from 10 to 6 months. Safety monitoring continues after licensing. For example, health officials are required to report certain adverse events—such as heart problems—following vaccination, in order to help identify potential long-term or rare side effects that were not seen in clinical trials and may or may not be associated with the vaccine. Figure 2. Vaccine safety is assessed at every stage: development through post-licensure. Following a declared emergency, FDA can also issue emergency use authorizations (EUA) to allow temporary use of unlicensed vaccines if there is evidence that known and potential benefits of the vaccine outweigh known and potential risks, among other criteria. As of January 2021, two COVID-19 vaccines had received EUAs, after their efficacy and short-term safety were assessed through large clinical trials. However, developers must continue safety monitoring and meet other requirements if they intend to apply for FDA licensure to continue distribution of these vaccines after the emergency period has ended. What are the knowledge gaps? One knowledge gap that can remain after clinical trials is whether side effects or other adverse events may occur in certain groups. For example, because clinical trials usually exclude certain populations, such as people who are pregnant or have existing medical conditions, data on potential adverse events related to specific populations may not be understood until vaccines are widely administered. In addition, it can be difficult to determine the safety of new vaccines if outbreaks end suddenly. For example, vaccine safety studies were hindered during the 2014-2015 Ebola epidemic when a large increase in the number of cases was followed by a sharp decrease. This disrupted the clinical trials of Ebola vaccine candidates, because the trials require many infected and non-infected people. Furthermore, a lack of understanding and/or misinformation about the steps taken to ensure the safety of vaccines hinders accurate public knowledge about safety concerns, which may cause people to delay or refuse vaccination. This resulting hesitancy may, in turn, increase deaths, social harm, and economic damage. 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    In Crime News
    A Somerset County, New Jersey, man admitted today that he concealed his attempts to provide material support to Hamas, Assistant Attorney General John C. Demers of the U.S. Department of Justice’s National Security Division, U.S. Attorney Craig Carpenito, FBI-Newark Special Agent in Charge George M. Crouch Jr., and FBI Assistant Director for Counterterrorism Jill Sanborn announced.
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  • Prescription Drugs: U.S. Prices for Selected Brand Drugs Were Higher on Average than Prices in Australia, Canada, and France
    In U.S GAO News
    What GAO Found GAO's analysis of 2020 data found that, for 20 selected brand-name prescription drugs, estimated U.S. prices paid at the retail level by consumers and other payers (such as insurers) were more than two to four times higher than prices in three selected comparison countries. The U.S. prices GAO estimated for comparison reflect confidential rebates and other price concessions, which GAO refers to as net prices. Publicly available prices for the comparison countries were gross prices that did not reflect potential discounts. As a result, the actual differences between U.S. prices and those of the other countries were likely larger than GAO estimates. The price differences varied by drug. Specifically, while estimated U.S. net prices were mostly higher than the gross prices in other countries (by as much as 10 times), some were lower. The following figure illustrates comparisons for two of GAO's selected drugs. GAO found similar differences in estimated prices paid by final payers at the manufacturer level. Estimated U.S. Net Prices and Selected Comparison Countries' Gross Prices at the Retail Level for Two Selected Drugs and Package Sizes, 2020 GAO's analysis found consumers' out-of-pocket costs for prescription drugs varied across and within all four countries but likely more within the U.S. and Canada where multiple payers had a role setting prices and designing cost-sharing for consumers, and not all consumers had prescription drug coverage. In Australia and France, prescription drug pricing was nationally regulated and prescription drug coverage was universal; thus, consumers' out-of-pocket costs within these countries for each drug were generally less varied. For example, in Australia, consumers typically paid one of two amounts for prescription drugs—either about 5 or 28 U.S. dollars in 2020. In the U.S., potential out-of-pocket costs for consumers could have varied much more widely depending on the type of coverage they had. For example, for one drug in GAO's analysis, considering only a few coverage options, consumers' out-of-pocket costs in 2020 could have ranged from a low of about 22 to a high of 514 U.S. dollars. GAO provided a draft to the Department of Health and Human Services for review and incorporated the Department's technical comments as appropriate. Why GAO Did This Study While spending on prescription drugs continues to grow worldwide, studies indicate the U.S. spends more than other countries. However, various factors—such as country-specific pricing strategies, confidential rebates to payers, and other price concessions—may obscure the actual prices of prescription drugs. GAO was asked to review U.S. and international prescription drug prices. This report (1) examines how prices at the retail and manufacturer levels in the U.S. compare to prices in three selected comparison countries—Australia, Canada, and France, and (2) provides information on consumers' out-of-pocket costs for prescription drugs in these countries. GAO analyzed 2020 price data for a non-generalizable sample of 41 brand-name drugs among those with the highest expenditures and use in the U.S. Medicare Part D program in 2017. Twenty of these drugs had price data available in all four countries. For U.S. prices, GAO estimated the net prices paid using data from various sources, including estimates of Medicare Part D rebates and other price concessions, and commercially available data. Prices for the selected comparison countries were obtained from publicly available government sources. National prices were not available for Canada, so GAO used the prices from Ontario, Canada's most populous province, as a proxy for Canadian prices. GAO also reviewed country-specific guidance and other relevant information and interviewed researchers, manufacturers, and government officials. For more information, contact John E. Dicken at (202) 512-7114 or dickenj@gao.gov.
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  • Armenia Travel Advisory
    In Travel
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  • Ph.D. Chemist Convicted of Conspiracy to Steal Trade Secrets, Economic Espionage, Theft of Trade Secrets and Wire Fraud
    In Crime News
    A federal jury in Greeneville, Tennessee, convicted a U.S. citizen today of conspiracy to steal trade secrets, economic espionage and wire fraud.
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  • Defense Budget: Opportunities Exist to Improve DOD’s Management of Defense Spending
    In U.S GAO News
    GAO's previous work has shown that a number of opportunities exist for the Department of Defense (DOD) to strengthen management of defense spending, which would help the department address the challenges it faces, especially in a constrained budget environment. These opportunities include: Improving budgeting execution of funds. DOD does not fully obligate the funds appropriated to it and can improve both its budgeting for and its use of the resources that are provided to it. For example, GAO found that DOD has left billions of dollars in appropriated amounts unspent over the past 10 fiscal years. Better estimating annual budget requirements and obligating appropriations provided by Congress within the period of availability established by Congress would help DOD minimize these cases of under-execution. More clearly determining future resource requirements related to overseas contingency operations. DOD and Congress need a clearer determination of DOD's future resource requirements, in particular how and whether to incorporate enduring Overseas Contingency Operations (OCO) costs—costs that will endure beyond ongoing contingency operations—into DOD's base budget. These costs could total tens of billions of dollars a year. However, few details exist as to what makes up these enduring costs or how they were derived, raising questions about how much should be included as future requirements. Reducing improper payments. Addressing improper payments—payments that should not have been made or were made in an incorrect amount—is an area where better financial management could save DOD billions of dollars. In its fiscal year 2020 agency financial report, DOD estimated that it paid about $11.4 billion in improper payments, or about 1.7 percent of all payments it made that year. DOD has taken steps to reduce improper payments in some areas, but DOD's estimates of its improper payments in other areas indicate more remains to be done. Sustaining and refining department-wide business reform efforts. DOD must transform its overall business operations so that it can more efficiently and effectively use its resources. In recent years, DOD reported notable achievements from its most recent department-wide business reform efforts, including $37 billion in savings from fiscal years 2017 to 2021 as a result of these efforts. However, GAO previously found that while DOD's reported savings were largely reflected in its budget materials, the analyses underlying these estimates were not always well documented and the savings were not always the result of business reform. Moreover, uncertainty about the leadership structure at DOD for overseeing and reforming business operations, including the recent elimination of the Chief Management Officer position, calls into question whether efforts to fundamentally transform how the department does business can be realized and sustained. GAO has previously highlighted the importance of DOD providing clear department-wide guidance on roles, responsibilities, authorities, and resources for business reform efforts will be necessary for DOD to make progress in these efforts. Decisions by DOD and Congress regarding long-term defense needs will have a meaningful impact on the nation's fiscal future. As the single largest category of discretionary spending, defense spending is likely to play a large role in any discussion of future federal spending. GAO and others have found that DOD faces challenges that are likely to put pressure on its budget moving forward. DOD is the only major federal agency that has been unable to receive a clean audit opinion on its financial statements. This testimony provides information on how DOD can better manage defense spending, specifically related to its ability to (1) accurately estimate its budgetary requirements and execute its appropriated funds, (2) determine resource requirements related to overseas contingency operations, (3) reduce improper payments, and (4) sustain and refine department-wide reform efforts. For this testimony, GAO reviewed and summarized its recent work on DOD budget and financial management issues and departmental reform efforts. In prior work on which this testimony is based, GAO made recommendations that DOD take steps to better estimate its annual budget requirements and future fiscal needs for OCO, reduce improper payments, and refine and formalize its departmental reform efforts. DOD generally concurred with these recommendations and is working toward implementing them. For more information, contact Elizabeth A. Field at (202) 512-2775 or fielde1@gao.gov.
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