Health Law Daily Wrap Up, COVID-19—GAO REPORTS: GAO provides update of COVID-19 cases, federal response, (Aug 6, 2025)

By Jody Coultas, J.D.

There are 200 open recommendations that would allow the government to address deficiencies that hindered the original response to the pandemic.

A Government Accountability Office (GAO) released an update on key indicators, the federal response, and implementation of GAO recommendations related to the COVID-19 pandemic. The GAO reviewed data from the Centers for Disease Control and Prevention (CDC), the Department of the Treasury (Treasury), and public statements from the Department of Justice (DOJ) regarding federal COVID-19 fraud-related cases. Two hundred GAO recommendations remain open that could guide Congress and federal agencies to better prepare for inevitable future emergencies, the report said (GAO Report, GAO-25-107588, July 31, 2025).

Since March 2020, the CARES Act and five additional laws provided about $4.65 trillion in federal funding to help the nation respond to and recover from the pandemic. In accordance with the CARES Act, the GAO has issued 12 comprehensive reports examining the federal government’s efforts to respond to and recover from the COVID-19 pandemic, and issued over 200 standalone reports, testimonies, and science and technology spotlights focused on different aspects of the pandemic. The most recent report provided an update on the status of GAO recommendations related to the COVID-19 pandemic and the federal response as of March 2025.

Public health. The report noted that weekly number of COVID-19-associated deaths fluctuated over the course of the pandemic but has decreased overall in recent years. The highest weekly numbers of COVID-19-associated deaths occurred during January 2021 (with about 26,000 deaths per week), CDC data showed that provisional weekly COVID-19-associated deaths had declined in more recent months, from about 1,000 deaths in January 2025 to about 450 deaths in March 2025. Similar to COVID-19-associated deaths, the U.S. has experienced peaks and lulls in the level of COVID-19 hospitalizations. The weekly rate of COVID-19 hospitalizations peaked during January 2022 at about 35.6 hospitalizations per 100,000 people. As of the end of March 2025, the weekly rate of hospitalizations was about 1.8 hospitalizations per 100,000. Finally, the court report noted that estimates from a 2024 Census Bureau’s Household Pulse Survey found that about 18 percent of adults in the U.S. aged 18 and older had ever experienced long COVID, and about 5 percent were currently experiencing it at the time of the survey.

Economic conditions. Some areas of the economy had not returned to pre-pandemic levels as of March 2025, the report found. The national GDP has returned to its pre-COVID-19 pandemic trend. While economic growth has slowed from its 2021 rate, real GDP rates in 2023 and 2024 were in line with pre-pandemic growth rates, according to the Bureau of Economic Analysis. However, the economy weakened in the first quarter of 2025, with real GDP decreasing by an annual rate of 0.2 percent. Also, inflation had continued to decline compared to a year ago but remained elevated compared to pre-pandemic levels. The Consumer Price Index saw its first decline in March 2025 after 8 consecutive months of increases. Underlying inflation trends indicated a lack of further progress toward the easing of inflation until March 2025, when they declined. Finally, DOL data through March 2025 showed that labor market conditions had improved since the start of the pandemic, but job growth showed signs of cooling, and some labor market indicators were still trending below their pre-pandemic levels.

Relief funding and spending. The federal government had obligated a total of about $4.59 trillion of the approximate $4.65 trillion in COVID-19 relief funding. As of March 31, 2025, about $23.6 billion, or less than 1 percent, of the total amount of funding provided for COVID-19 relief remained available for obligation. Additionally, about $41.9 billion was expired, meaning that this amount was not available for incurring new obligations but was available for recording eligible obligation adjustments.

Fraud. As of March 31, 2025, the Justice Department had publicly announced criminal fraud-related charges against at least 3,205 defendants involving 20 federal COVID-19 relief programs. Nearly 85 percent had been found guilty, and 2,331 of these defendants have been convicted. 81 percent received prison time. Restitution amounts varied, with the highest amount being over $71 million. Almost 500 defendants were ordered to pay $1 million or more in restitution each.

GAO recommendations. The GAO has made 484 recommendations to federal agencies and matters for congressional consideration. Actions by agencies and Congress resulting from our work and related recommendations have yielded at least $43.9 billion in financial benefits and demonstrated other improvements in the COVID-19 response. This included $16.8 billion resulting from agency actions and $27.1 billion resulting from congressional actions. The 200 recommendations and matters that remained open as of March 2025 identify further opportunities to address concerns raised related to the pandemic response.

Although the federal public health emergency expired in May 2023, recommendations that remained unimplemented as of March 2025 identify opportunities to further improve the government’s pandemic response. Open recommendations also underscore opportunities to improve the government’s ability to respond to future public health emergencies. Addressing these recommendations is paramount as the nation continues to face threats that could impact public health and the economy, the GAO said.

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