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WASHINGTON -- Members of the Senate Health, Education, Labor & Pensions (HELP) Committee voted Wednesday to send President Biden's nominations of Vivek Murthy, MD, for surgeon general and , for assistant secretary of health to the Senate floor for an approval vote.

"The COVID-19 pandemic has been one of the most mismanaged crises in American history largely because we did not have the right people in place to properly handle this emergency," HELP committee member Tim Kaine (D-Va.) said in a statement after the votes. "Dr. Murthy and Dr. Levine each have exceptional expertise to strengthen our federal response and collaborate with state and local health officials to help implement strategies to help us recover from this pandemic. I will vote to confirm each nominee so we can quickly get to work on better addressing this crisis."

The committee -- whose very brief meeting was not webcast due to logistical issues, according to a committee staff member -- voted 16-6 in favor of Murthy and 13-9 in favor of Levine. All 11 Democrats on the committee voted in favor of both nominees, with Republican senators Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), Bill Cassidy, MD (R-La.), Roger Marshall, MD (R-Kan.), and Mitt Romney (R-Utah) also voting in favor of Murthy; Collins and Murkowski were the only Republicans to vote in favor of Levine. The committee's other Republicans voted "no" on both nominees.

Last month's nomination hearing for the two nominees was marked by controversy. Ranking member Richard Burr (R-N.C.) flagged Levine's handling of the pandemic in Pennsylvania as problematic, and Sen. Rand Paul, MD (R-Ky.), went on the offensive over Levine's support for gender reassignment surgeries.

As for Murthy, Republican members appeared skeptical of his ability to separate his policy actions from his political views and seemed to be weighing the chances that Murthy could seek to promote tighter gun control measures.

Burr suggested that the urgency to confirm the two current nominees seemed disingenuous given that Biden still hasn't nominated anyone for assistant secretary for preparedness and response, the person tasked with the larger responsibility of addressing the pandemic.

Burr also was highly critical of Levine's response to the pandemic. He noted that Pennsylvania's state public health labs provided only six COVID-19 tests per day in March 2020, limiting the state's ability to contain the epidemic, and that Levine and her colleagues failed to protect nursing home residents from the virus.

With regard to Murthy, Burr questioned his motivation to reprise his role as surgeon general, which he also held during the Obama administration.

"I worry about your ability to separate political influence from your ability to communicate healthcare decisions," he said, pointing to Murthy's appearance at the Democratic National Convention as one example of his partisanship.

Murthy stressed in his opening statement that if confirmed as surgeon general he would "serv[e] every single American" and see "beyond labels."

Paul asked Levine repeatedly whether minors should be allowed to make decisions about changing their sex.

If confirmed, Levine said she would be happy to come to Paul's office to discuss "standards of care for transgender medicine." Paul, apparently dissatisfied with Levine's response, continued to press the matter. "Do you support the government intervening to override the parents' consent to give a child puberty blockers, cross-sex hormones, and/or amputation surgeries of breasts and genitalia?" Paul asked.

For their part, Democrats argued that the two nominees are both more than qualified for their posts and that in the midst of a pandemic, Congress can't afford to dally.

"We desperately need trusted public health experts who can debunk misinformation and rumors, promote public health guidance on mask wearing, social distancing ... and encourage vaccinations and inform people about vaccine safety and efficacy," said HELP Committee chairman Patty Murray (D-Wash.). Given Murthy's experience responding to the Zika virus and the opioid epidemic, and in raising awareness for isolation and mental health issues, in a previous stint as surgeon general, Murray said he was well-prepared to reprise the role.

Murray also praised Levine as a "highly qualified and historic choice," and touted her "clear, science-based communication" around the pandemic in Pennsylvania, and her work aiming to stem opioid overdoses.

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