(CNN) The federal government must take “urgent actions” in its response to the coronavirus pandemic, a new report from the US Government Accountability Office finds.

Medical supply shortages persist, despite efforts by the Department of Health and Human Services and the Federal Emergency Management Agency to mitigate shortages and expand the supply chain, the report found.

States and US territories are concerned about ongoing shortages of some Covid-19 testing materials and medical supplies, including rapid point-of-care tests and reagents needed for testing and nitrile gloves, an October GAO survey found. About one-third of states that responded said they were “greatly” or “completely” concerned about having enough vaccine-related supplies to administer a potential Covid-19 vaccine, and another 21 states said they were “moderately concerned.”

The GAO made recommendations to HHS and FEMA in September, but they have not been implemented.

“In light of the surge in COVID-19 cases, along with reported shortages, including GAO’s nationwide survey findings, GAO underscores the critical imperative for HHS and FEMA to implement GAO’s September 2020 recommendations,” the GAO, an independent agency that serves as the investigative arm of Congress, said in its report.

In a response attached to the GAO’s report, Sarah Arbes, the HHS assistant secretary for legislation, said the agency “does not concur” with the findings about shortages and suggested the report is “too vague” in its recommendations about how best to help states meet testing and supply needs.

The new report is also concerned about the US Centers for Disease Control and Prevention’s changes in testing strategy and guidance, saying the CDC has not been transparent about the changes.

“GAO recommends that HHS ensure that CDC clearly discloses the scientific rationale for any change to testing guidelines at the time the change is made,” the report said.

The GAO report made 11 recommendations for improving the federal pandemic response. It recommended that the Centers for Medicare & Medicaid Services quickly develop a plan to respond to 27 recommendations in the Coronavirus Commission on Safety and Quality in Nursing Homes analysis, a report released on September 16.

The GAO report also recommended that the Department of Veterans Affairs develop a plan to inspect state veterans homes and “collect timely data on COVID-19 cases and deaths in each state’s veterans homes.”