The Government Accountability Office (GAO) is calling for “urgent actions” to respond to the COVID-19 pandemic. 

“Congress and the administration have taken a series of actions to protect the health and well-being of Americans,” GAO wrote in a report on Monday. “However, as the end of 2020 approaches, urgent actions are needed to help ensure an effective federal response on a range of public health and economic issues.” 

The report comes as health officials warn of a spike in coronavirus infections during the winter months as colder weather forces more people to spend time indoors, where the virus can spread more easily. 

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The GAO found that shortages of medical supplies persist, despite efforts from the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA) to mitigate these shortages. 

About one-third to one-half of states reported shortages in rapid point-of-care tests and reagents, according to the watchdog, while most states reported no shortages in testing supplies such as swabs or transport media. 

In addition, about one-third of states reported that they are “greatly” or “completely” concerned about having enough supplies for COVID-19 vaccines, and another 21 states said they are “moderately concerned.” 

The GAO noted that it made recommendations regarding how HHS should cooperate with FEMA in September. However, HHS and the Department of Homeland Security, FEMA’s parent agency, disagreed with the recommendations and never implemented them. 

The report also took issue with the Centers for Disease Control and Prevention’s (CDC) testing strategy and guidance, which it said raises “the risk of confusion and eroding trust in government” because it was not always transparent. It noted that the scientific rationale for changes have not always been disclosed. 

The GAO made 11 recommendations for addressing the pandemic, including ensuring that the rationale for changes to the CDC’s testing strategy are disclosed. It also advised the Centers for Medicare & Medicaid Services to develop a plan to implement the CDC’s recommendations for addressing COVID-19 spread in nursing homes. 

Sarah Arbes, HHS assistant secretary for legislation, said in a response attached to the report that the agency “does not concur with the recommendations,” adding that the findings were “too vague to guide” the agency’s response to the pandemic.