Brief Update on Initial Federal Response to the Pandemic

"In response to the national public health and economic threats caused by COVID-19, four relief laws making appropriations of about $2.6 trillion had been enacted as of July 31, 2020. Overall, federal obligations and expenditures government-wide of these COVID-19 relief funds totaled $1.5 trillion and $1.3 trillion, respectively, as of June 30, 2020. GAO also obtained preliminary data for six major spending areas as of July 31, 2020 (see table).

COVID-19 Relief Appropriations, Obligations, and Expenditures for Six Major Spending Areas, as of July 2020

Spending area	Appropriations a ($ billions)	Preliminary obligations b ($ billions)	Preliminary expenditures b ($ billions)
Business Loan Programs	687.3	538.1	522.2c
Economic Stabilization and Assistance to Distressed Sectors	500.0	30.4	19.2c
Unemployment Insurance	376.4	301.1	296.8
Economic Impact Payments	282.0	273.5	273.5
Public Health and Social Services Emergency Fund	231.7	129.6	95.9
Coronavirus Relief Fund	150.0	149.5	149.5
Total for six spending areas	2,227.4	1,422.2	1,357.0

The CARES Act included a provision for GAO to assess the impact of the federal response on public health and the economy. The following are examples of health care and economic indicators that GAO is monitoring.

 

Health care.

GAO’s indicators are intended to assess the nation’s immediate response to COVID-19 as it first took hold, gauge its recovery from the effects of the pandemic over the longer term, and determine the nation’s level of preparedness for future pandemics, involving subsequent waves of either COVID-19 or other infectious diseases.

 

For example, to assess the sufficiency of testing—a potential indicator of the system’s response and recovery—GAO suggests monitoring the proportion of tests in a given population that are positive for infection. A higher positivity rate can indicate that testing is not sufficiently widespread to find all cases. That is higher positivity rates can indicate that testing has focused on those most likely to be infected and seeking testing because they have symptoms, and may not be detecting COVID-19 cases among individuals with no symptoms.

 

Although there is no agreed-upon threshold for the test positivity rate, governments should target low positivity rates. The World Health Organization recommends a test positivity rate threshold of less than 5 percent over a 14-day period. As of August 12, 2020, 12 states and the District of Columbia had met this threshold (38 states had not). Resolve to Save Lives, another organization, recommends a threshold of less than 3 percent over a 7-day period, and 11 states and the District of Columbia had met this threshold (39 states had not) as of August 12, 2020.

 

GAO also suggests monitoring mortality from all causes compared to historical norms as an indicator of the pandemic’s broad effect on health care outcomes. Mortality rates have tended to be consistent from year to year. This allows an estimation of how much mortality rose with the onset of the pandemic, and provides a baseline by which to judge a return to pre-COVID levels. According to Centers for Disease Control and Prevention data, about 125,000 more people died from all causes January 1–June 13 than would normally be expected (see figure)...
"Federal response to pandemic 

Federal Aid to States for Fiscal Year 2010

"This report presents data on federal government aid to state and local governments by state and U.S. outlying area. Coverage is restricted to federal government expenditures for grants to state and local governments for which data are available by state and outlying area. For fiscal year 2010 (October 1, 2009, to September 30, 2010), the statistics compiled cover $630.2 billion..."

CBO’s Projections of Federal Receipts and Expenditures in the Framework of the National Income and Product Accounts
"The fiscal transactions of the federal government are recorded in two major sets of accounts. One is The Budget of the United States Government, which is prepared by the
Office of Management and Budget and is the framework generally used by executive branch agencies and the Congress and typically discussed in the press. The other set of accounts is the national income and product accounts (NIPAs), which are produced by the Department of Commerce’s Bureau of Economic Analysis.1

The purposes served by the budget and the NIPA accounting frameworks, the conceptual differences, and the relationship between those two sets of data are examined
briefly below and more thoroughly in previous publications by the Congressional Budget Office (CBO). In August, CBO reported its latest baseline projections
of federal revenues and outlays in the standard structure for budget accounting.3 This report presents those projections in the NIPA framework (see Tables 1 and 2)..".