LIVE: Fauci testifies at U.S. Senate panel hearing on COVID-19 | NTD

published on July 2, 2020

apart because of the fear of severe

illness or even death if that risk can

be lessened by new treatments it should

increase confidence in going back to

school I'd also like to commend dr Hahn

and the work the FDA did to get tests on

the market quickly as possible to help

understand the spread of the virus

since then FDA has worked out which

tests have not worked as well as they

should and taken steps to remove them

from the market that's what's supposed

to happen in the urgency of a pandemic

advil jaw and our last hearing you said

you expected there to be 40 to 50

million diagnostic tests available each

month by September is that still true

and exactly how does the school district

go about making sure it gets those tests

and who pays for them what are the

prospects from the shark tank at the

National Institutes of Health that there

will be new reliable and inexpensive

tests so we can have even more

widespread testing and dr Redfield

you're continuing to work on updated

guidelines about going back to school

and college safely and our CDC employee

is going to be available in our States

to help work with school districts to

develop their plans and what advice do

you have about the arrival of the flu

season this fall at the same time as

kovat 19 this is a lot to discuss but

there will be time during the next two

and a half hours to answer most of those

questions

let me quickly highlight three areas

that have come up in our four earlier

hearings this month that I think need

clarification first on contact tracing

the no doubt contact tracing is

crucially important it identifies the

people who might have been exposed so

that people who don't so that they don't

in turn expose someone else according to

an NPR report on June 18 states have

already hired at least 37,000 contact

tracers state officials and John Hopkins

center for health security issue were

issued a report estimating the need for

as many as 100,000 contact tracers

reports suggested Congress appropriates

money to pay for those tracers the

reality is Congress already has on April

24th Congress appropriated 11 billion

which has been sent to states and tribes

for the expenses of testing that

legislation explicitly said the money

could be used for contact tracing this

is in addition to 755 million from the

first emergency appropriations

legislation on March 6 that could be

used for contact tracing and that's in

addition to the March 27 legislation in

which Congress appropriated 150 billion

dollars I mean 15 billion in the cares

Act for States territories and tribes to

use for covert preparedness and response

the Carrey's Act also included the 150

billion dollars to States but a

significant amount of that 150 billion

dollars has not been spent even though

it is all designated for expenses

related to covent 19 which include

contact tracing for example Tennessee's

governor has told me he's reserving as

much as a billion of that so that he can

determine what flexibility he has in

spending the money Washington state has

not spent as much as 12 billion

Missouri State Treasurer says they've

not spent about a billion according to

the report by state health officials in

Johns Hopkins an average salary for a

contact tracer would be a little more

than $35,000 this adds up to about 35

billion for a hundred thousand contact

tracers so the point is Congress has

already sent to States plenty of money

to hire all the contact tracers that are

needed

second who pays for the testing in the

cares Act Congress voted to make all

Cova 19 tests available to patients at

no cost

this meant insurers would cover

diagnostic tests which detect whether a

person is currently infected with the

virus

and also antibody tests which indicate

whether a person has had kovat 19 in the

past and now may have some protection in

the future guidance from the Labor

Department Treasury Department and

Centers for Medicare and Medicaid

Services said last week that insurers

are only required to pay for tests

without patient cost-sharing if a doctor

orders it I agree with that but given

that the CDC specifically recommends

doctor's orders tests in two situations

when a person has signs or symptoms of

Cova 19 or recently had contact with

someone known or suspected to have a

koban 19 who pays for the testing at

other times I believe Congress will need

to take action to further clarify who

pays for the testing at other times for

example the school may want to do random

testing perhaps it should make an

arrangement with the state to pay for

that or perhaps Congress needs to

provide more money to pay for that if an

automaker wants to test all of its

employees at the plan every two weeks

perhaps the automaker should pay for

that or perhaps the state would want to

pay for that that needs to be clarified

finally flu shots CDC has said more

people need to get flu shots this fall

so health care workers can better

distinguish between Cova 19 and the flu

CD says a priority is for all children

over the age of six months to be

vaccinated for the flu so they don't

become sick and pass it to more

vulnerable populations who could have

more severe consequences On January 24th

Senator Murray and I hosted our first

bipartisan briefing on corona virus at a

time when they were only four cases in

the United States since then this is

committee has had four more briefings

today is our eighth hearing on corona

virus and us preparedness last week's

hearing was about steps to take this

year while our eye is on the ball to

better prepare for the next pandemic

I've issued a white paper outlining five

recommendations for Congress to prepare

Americans

or the next pandemic and that paper has

received more than 350 substantive

comments that are available to all

members of the committee after all

senators have had a chance to ask their

questions I will conclude the hearing by

asking our witnesses if they have two or

three suggestions about steps Congress

should take this year to deal with the

next pandemic most of which will also

help with this one

but this hearing is about what happens

now as administrators prepare to reopen

schools and colleges experts

underestimated this dangerous and sneaky

virus and there is still much we don't

know about it

but we do know the basic steps to take

to reopen schools and colleges in 2020

before there is a vaccine and those are

these social distance where a mask

wash your hands test contact trace and

isolate those exposed or sick and

hopefully by the fall there will be

treatments to make the consequences of

the disease less severe I look forward

to hearing from our distinguished

witnesses how school leaders and college

presidents can safely reopen 135,000

schools and 6,000 colleges and also

learning the latest developments on

testing and treatments that we can

expect during the year 2020 before

vaccines arrive

senator Murray well thank you very much

mr chairman thank you to all of our

witnesses for joining us here today and

of course thank you our staff for

setting up the technology so we can hold

this hearing safely I want to get to the

point quickly and I'm going to be blunt

about it

the Cova de 19 response in our country

is still a disaster a hundred and

twenty-six thousand lives lost was once

considered an estimate on the high end

of the spectrum but the year is just

half way over and it is now a grim

reality we have lost more Americans to

Kovan 19 than we lose to the flu each

the opioid crisis last year and more

lives than we've lost in every

American war except the Civil War in

World War two and despite what President

Trump claims this pandemic is not fading

far from it several states are seeing

rapid record-setting increases and the

country just saw its largest single-day

increase to date and while this public

health crisis rages across the country

we've seen a leadership crisis raging in

the White House as the president proves

time after time he cares less about how

this pandemic is impacting families and

communities and more about how it makes

him look just consider his appalling

continued failure on testing President

Trump said anyone that wants a test can

get a test they still can't

he said testing was overrated it is not

he said we prevailed on testing we have

not now he's saying we should be doing

fewer tests and testing makes us look

bad well it clearly does not and we

clearly need to be doing more the most

honest thing he has said about testing

is that he doesn't take responsibility

at all and that is exactly the problem

it's why Congress actually took

bipartisan action in the last Cova 19th

response bill to require the Trump

administration to submit a comprehensive

national testing plan and it's why I'm

still pushing for this administration to

include more details in that plan and

take more steps to ramp up testing

because we are still nowhere close to

the testing and tracing capacity we need

to safely reopen our country and ending

support for federal testing sites while

sitting on billions and testing fronts

Congress provided is not going to get us

there the ongoing struggle to get

President Trump to take testing

seriously should be a stark warning to

Congress that when it comes to vaccines

we can't just leave this administration

to its own devices we have to hold it

accountable we know this pandemic will

not end

until we have a vaccine that is safe and

effective that can be widely produced

and equitably distributed and that is

free and accessible to everyone which is

why we need a comprehensive National

Vaccine plan from the Trump

administration as soon as possible given

the testing plan which Congress only

received after forcing the

administration's hand was too little too

late we need to take the opportunity we

have right now to get a vaccine plan

much earlier and avoid the missteps

we've seen with testing so I hope

Republicans will work with me in a

bipartisan way once again to require

this administration to put forward a

plan we need the Trump administration to

show us how they will ensure a vaccine

is safe and is effective on as eager as

anyone for a vaccine but this isn't just

about doing something fast it is about

doing it right that's why we need to

know the process for developing a

vaccine is rigorous it's inclusive it's

transparent and it is science driven but

in light of the hydroxyl Arkane debacle

and the removal of dr bright from Barda

for questioning the administration's

efforts to promote that unproven

treatment we cannot take for granted

this process will be free of political

influence we have to demand serious

oversight in order to give the public

full confidence that a vaccine is safe

and effective the administration needs

to commit now to being fully transparent

about the standards a vaccine will be

expected to meet and releasing the

clinical trial data that FDA uses to

evaluate safety and effectiveness we

also need a plan detailing how to

produce and distribute vaccines

nationwide and make sure everyone can

actually give them we saw with testing

how avoidable bottlenecks create

damaging delays when the federal

government refuses to step in and lead

like it needs to do in a

crisis and unfortunately we saw how

existing health disparities are

exacerbated without a plan to overcome

them as even the incomplete data we

currently have shows black Latino and

tribal communities have significantly

less access to testing than white

communities this is an injustice that we

must not repeat when it comes to

vaccines we also need a plan to

guarantee vaccines are free so that cost

is not a barrier for patients and it's

worth noting we still need to act to

make covin 19 treatment available at no

cost to and the plan must address

barriers like vaccine hesitancy and

misinformation especially one of the

woman one of the most prominent sources

of misinformation so far has been the

President of the United States

well the discovery of an eventual

vaccine may still be far off these are

issues we need the administration to

answer now so I hope Republicans will

work with me to require the

administration to submit a comprehensive

vaccine plan and address many of the

other urgent issues stemming from this

pandemic our businesses our workers

teachers students and families do not

have what they need to safely return to

work or school period our medical system

doctors nurses frontline workers

continue to face unimaginable risk

stress and fatigue they need Congress to

step up to help them continue to save

lives and families need us to continue

to ensure they have basic services and

can keep food on their tables the House

passed the heroes act 46 days ago to get

more relief to frontline workers to

families and businesses it is well past

time for leader McConnell and Senate

Republicans to sit down with fellow

Democrats and get to work

there's no question our country is still

in crisis and every day that Senate

fails to take action is a day we allow

it to get worse

I also hope mr chairman that we will be

able to have another

hearing honest prices soon with

administration officials whose testimony

is long overdue secretary Hayes our

secretary DeVos and Secretary Scalia

Thank You mr chairman I look forward to

our witnesses today testimony and the

questions that we have for them Thank

You senator Murray we ask each witness

now to summarize his testimony in five

minutes please to welcome our witnesses

each of you are making significant

contributions to our government's

response to Cova 19 helping us go safely

back to school back to work were

grateful for your service to our country

our first witness is dr Anthony Falchi

he's director of the National Institute

of Allergy and Infectious Diseases at

the National Institute of Health he's

held this position since 1984 he's led

the agency's research related to

hiv/aids influenza malaria Ebola and

other infectious diseases he's advised

six presidents on domestic and global

health issues he's won the principle

architect of the Emergency Plan for AIDS

relief in 2014 he was involved in

treating Ebola patients at NIH and

worked on vaccine trials for Ebola next

dr Robert Redfield director of the us

Center for Disease Control and

Prevention CDC for more than 30 years

he's been involved with clinical

research related to chronic human viral

infections and infectious diseases

especially HIV he was founding director

of the department of retroviral research

within the US military's HIV research

program and retired after 20 years of

service with the US Army Medical Corps

third admiral brett jawad admiral gy is

the assistant secretary for health at

the US Department of Health and Human

Services he oversees the development of

the department's public health policy

recommendations specific to Cova 19

response

Admiral juruá has taken on tests

and focused on increasing the number of

tests we can do with existing technology

his Federal service includes directing

the defense sciences office of the

Defense Advanced Research Projects

Agency and a variety of other important

responsibilities finally we will hear

from dr Steven Hahn dr Hahn's

Commissioner of the US Food and Drug

Administration the FDA before joining

FDA he held leadership positions as

chief medical Executive at the

University of Texas MD Anderson Cancer

Center in his chair of the Department of

radiation oncology at the University of

Pennsylvania early in his career he was

senior investigator at the National

Cancer Institute at the National

Institutes of Health

he's been commander of the US Public

Health Service commissioned Corps in

2005 we welcome our witnesses

dr Falchi welcome let's begin with you

thank you very much mr chairman ranking

member Murray members of the committee

thank you for giving me the opportunity

to discuss briefly with you today the

role of the National Institutes of

Health in research addressing Co vyd 19

and as you indicated mr Chairman I will

during the question period and alluding

to in the presentation addressed some of

the issues regarding schools the NIAID

NIH strategic plan for Ovid research

involves four major components the first

is to improve the fundamental knowledge

of understanding of the biology of the

virus and the immune response to the

virus in order to better inform us in

the development of Diagnostics

therapeutics and vaccines some of the

work that has come out of that program

right now informs very greatly

how we will address vaccine development

particularly understanding the

confirmation of the components of the

virus that induce an appropriate immune

response in addition we will develop in

our developing animal models apropos of

what you mentioned about children in

school we have a program called heroes

which is human epidemiology and respond

two saws coronavirus which is

determining the incidents and

transmissibility among children a very

important issue when you talk about

opening schools and the impact that

might have in addition the development

of Diagnostics point of care sensitive

and specific Diagnostics under the rad X

program including the rat X up for

underserved populations third to

characterize and test therapeutics you

mentioned the importance of this as we

open up schools there are a number of

programs very active that have already

shown efficacy or not in some drugs as

well as a number of clinical trials that

are ongoing

one in particular was the first

randomized placebo-controlled trial

showing that the drug rammed essa via

diminishes by about 32% the time it

takes to get to recovery in people with

advanced disease pulmonary involvement

in addition we have another study

combining this with an anti-inflammatory

agent next we have vaccines as several

have mentioned it's extremely important

to have safe and effective vaccines

available for everyone in this country

as well as globally in that regard we

put together myself

and some of my colleagues and published

in science magazine a few weeks ago what

we call a strategic approach to

coronavirus 19 vaccine research and

development it's not a comprehensive

plan about every aspect a vaccine but it

is a strong plan regarding the research

and development pathway and what we have

done in this is that we have what's

called a harmonized effect because we

know there are many vaccines that are in

trial now at various stages and what we

did and the federal government thanks to

the generosity of the Congress has put a

considerable amount of money in order to

harmonize the trials of multiple

candidates from different companies so

that we have common endpoints common

data and safety monitoring board and

common immunological parameters that are

being funded

and are being pursued in addition there

are a number of different platforms that

are being pursued so that we don't have

all our eggs in one basket as you know

one of those is right now getting ready

as we approach next month of going into

Phase three trials and others will be

staggered along the way in the middle of

the summer end of the summer early on

there is no guarantee and anyone has

been involved in vaccinology will tell

you that we will have a safe and

effective vaccine but we are cautiously

optimistic looking at animal data and

the early preliminary data that we will

at least know the extent of efficacy

sometime in the winter and early part of

next year again working with the

companies in the investment made by this

Congress hopefully there will be doses

available by the beginning of next year

these are the things that we feel

aspirationally hopeful about and we

would continue to pursue this I'll stop

there mr chairman and be happy to

answer questions later thank you thank

you dr Falchi dr Redfield welcome good

morning chairman Alexander ranking

member Murray and distinguished members

of the committee I want to thank you for

the opportunity to testify before you

today with my HHS colleagues the Cova 19

pandemic is the most significant global

public health challenge that we have

faced as a nation in more than a century

in the United States daily cases are

increasing after an extended decline

we're seeing significant increases in

the southeast and southwest regions of

this nation the number of jurisdictions

in upward trajectory has continued to

increase now 29 of 55 jurisdictions fall

into this category the evidence tells us

that these cases are driven by many

factors to include increased testing

community transmission and outbreaks in

the settings such as nursing homes and

occupational settings hospitalizations

now are going up in 12 states and as of

this weekend daily death now has

increased in the state of Arizona

CDC is closely monitoring these increase

and have

forty-eight teams with more than 140

staff currently deployed in 20 states

and two territories CDC is providing

technical expertise to the health

departments and epidemiology contact

tracing and infection prevention and

control and communication beyond

providing this critical boots on the

ground CDC is working with your state's

and community in other ways

CDC is speaking with the state's tribal

local and territorial health departments

on a daily basis to develop strategies

to stop COBIT while reopening businesses

and schools the initial guidance for

Institutes of higher learning which

shared in March and the K through 12

setting was shared in February

both these guidances have been updated

since and over the past several months

as more information becomes available

we'll continue to disseminate that more

broadly CDC release consolidated

recommendations for kovat testing

including interim testing guidelines for

nursing homes as well as testing options

for high-density critical infrastructure

workplaces after a Kovac case is

identified testing guidance for higher

education and K through 12 the K higher

education should be posted today in K

through 12 later this week these

recommendations are consistent with

previously published testing guidelines

and are meant to supplement not replace

the guidance of local jurisdictions CDC

continues to advance science around the

koban 19 impact in certain populations

and those who are at heightened risk for

severe outcomes

our most recent analysis of the United

States case data from the pandemic

hospitalizations were six times higher

and death twelve times higher among

those with reportedly underlying

conditions compared to those who did not

have these conditions we've expanded the

list of underlying conditions where the

evidence is clear that they put people

at higher risk of severe illness these

conditions include chronic kidney

disease COPD having a weakened immune

system from an solid organ transplant

obesity serious heart disease sickle

cell disease and type 2 diabetes our

analysis analysis also provides further

evidence and evidence that racial and

ethnic

populations are disproportionately

affected by this epidemic

while date is the backbone of this

response containing the outbreak depends

on four core interventions readily

available testing comprehensive contact

tracing timely isolation of known cases

and quarantined to break the

transmission we are not defenseless

against this disease we have powerful

tools at our disposal social distancing

wear face cover in public and be

disciplined about the frequent

hand-washing it is critical that we all

take the personal responsibility to slow

the transmission of COBIT 19 and embrace

the universal use of face coverings

specifically I'm addressing the younger

members of our society the Millennials

and new generation Z's I ask those that

are listening to spread the word before

I close I'd like to speak briefly about

how CDC is assisting the front lines of

our health department's to fight koban

with your support CDC's awarded 12

billion dollars to 64 jurisdictions data

modernization is underway Public Health

laboratories are building resilience

number of contact tracers have grown 345

percent the disease impacts us all and

it's going to take all of us working

together to stop it together I believe

we can achieve the possible thank you

and I look forward to your questions

thank you dr Redfield Admiral Jawad

welcome chairman Alexander ranking

member Murray and distinguished members

of the committee it's good to see all of

you again first I want to clarify my

current role on March 12 secretary azar

requested that I lead the coordination

of kovat 19 testing efforts within the

department to be clear although I am

assuming some of my traditional duties

as the assistant secretary I am

maintaining my role coordinating testing

including now the NIH red X Diagnostics

program along with dr Collins to assure

that innovations are immediately

translated into practice in order to get

back safely to work in school the

overarching most

critical an essential action we must

first accomplish is to control the virus

meaning rapidly extinguishing any

outbreaks and minimizing community

transmission all of us are concerned

about recent data from several states

indicating rising infections and now an

uptick in hospitalizations and deaths

even as other states and the majority of

counties are maintaining a low infection

burden knowing what we know now about

asymptomatic transmission and the fact

that we are in a much better position

today in terms of our mitigation

strategies PPE and testing we can

reverse these concerning trends if we

work together

first we must take personal

responsibility and be disciplined about

our own behavior maintain physical

distancing wear a face covering whenever

you can't physically distance wash your

hands stay at home if you feel sick

if you have been in close contact with

someone infected or in a gathering

without appropriate precautions get

tested shield the elderly and the

vulnerable of any age and follow the

guidelines for opening up America again

the criteria are very specific and are

as relevant today as when we release

them in addition this week we are

initiating surge testing in multiple

communities of highest concern in

coordination with state and local

officials now back to schools and

businesses as dr Redfield stated the

CDC will release recommendations on K

through 12 institutions of higher

education and general business reopening

these will include considerations for

integrating testing especially

surveillance testing into a

comprehensive strategy as you asked me

mr chairman if you are a superintendent

of a school system or a president of a

university number one apply the CDC

guidelines in consultation with your

state and local public health officials

so that testing is a part of your

comprehensive plan which should also

include prevention and clear mechanisms

to isolate positive students

number two assure your testing needs are

incorporated into your state testing

plans as we outlined in the national

testing strategy each state has

developed and will continue to build

upon a customized to state testing plan

developed in full coordination with the

federal government the next iteration

covering July to December is due on July

10th these state plans drive the

allocation of certain scarce resources

for example in May and June

the federal government has distributed

nearly twenty-six million collection

swabs in over 19 million tubes of

transport media HHS also prioritizes

allocation of certain key laboratory

tests like point-of-care tests according

to state specific needs

there are also strategies particularly

relevant to surveillance testing

especially in universities and

businesses for example pooling of

samples meaning combining two or more

samples and possibly up to ten into a

single test makes sense where the

prevalence of infection is low and such

pooled surveillance testing can be

conducted in a university research lab

outside of a CLIA environment but if a

pooled sample is positive for kovat

every individual in that pool would need

to be tested through a Health System I

would like to close by recognizing my

fellow officers in the United States

Public Health Service commissioned Corps

the uniformed service that I lead 4536

officers have deployed to support the

pandemic response exemplifying the care

and compassion that all of us feel for

those who have suffered during this

pandemic I thank each and every one of

these officers and their families and on

their behalf sincerely thank all of you

in Congress for supporting our training

needs in establishment of a Ready

Reserve Corps to supplement our ranks

during inevitable future national

emergencies thank you for the

opportunity to provide these remarks

thank you

Thank You Admiral JaJuan welcome dr Han

Thank You chairman Alexander a ranking

member Mary and members of the help

committee I appreciate very much the

support that you all have provided for

our efforts during this time of koban 19

FDA has a vital role in the federal

government's response to the pandemic

one of our core missions is to advance

the public health by helping to speed

medical products that are safe and

effective we have provided appropriate

regulatory flexibilities to assure that

the American public has access to

critical metal prop medical products and

safe food and confidence that our

decisions are based on medicine and

science since the public health

emergency was declared FDA has issued

more than 100 emergency use

authorization for diagnostic tests

personal protective equipment

ventilators other devices and drug

products and we have issued more than 50

guidance documents to ensure the

continuity of health care in the food

supply I am pleased to announce that

today FDA is taking action to aid the

time timely development of a safe and

effective vaccine to prevent Cova 19 by

providing guidance for developers with

recommendations on the data needed to

facilitate manufacturing clinical

development and approval we recognize

the urgent need to develop a safe and

effective vaccine to prevent koban 19

and we want to work collaboratively with

industry researchers and other partners

to accelerate these efforts while the

FDA is committed to help expedite this

work we will not cut corners in our

decision-making and we are making clear

in our guidance what are the day that we

need that should be submitted to meet

our regulatory standards of approval

this is particularly as important as we

know that some people are skeptical of

vaccine development efforts the FDA

strongly encourages the inclusion of

diverse populations in all phases of

clinical development including

populations most affected by Cova 19 and

specifically racial and ethnic

minorities as well as adequate

representation in late phase trials of

elderly individuals and those

medical comorbidities we also have

information in this guidance about

including women who are pregnant as well

as for pediatric assessments of safety

and effectiveness the American people

should know that we have not lost sight

of a responsibility to maintain our

regulatory independence and ensure that

our decisions related to all medical

products including co2 vat19 vaccines

are based on sound science and the

available data this is a commitment the

American public can have confidence in

and that I will continue to uphold

personally while vaccine research is

ongoing rapid testing and therapeutic

development can aid in the safe return

to school college and the workplace FDA

is constantly evaluating new data we

receive on testing so that we can

promote the development of new and

better tests and remove tests that are

not reliable from the market and we have

put into place an initiative to

accelerate the development of treatments

called the corona virus treatment

acceleration program or C tab we've seen

some of the consequences of that program

such as the authorization of REM des

avear and the recent information

regarding other therapeutics that might

be a benefit to patients with koban 19

we are working day and night to provide

guidance to and review proposals from

companies scientists and researchers who

are developing therapies for Kovan 19 we

are now preparing for the next phase of

addressing this evolving crisis it is

mission-critical that the agency

constantly evaluate whether our

processes are maximal to promote and

protect the public health and therefore

we are beginning a comprehensive

real-time review and assessment of our

actions to date to address the Cova 19

panic pandemic and I'm glad to answer

questions about that review I want to

thank to more than 17,000 FDA employees

who've been working night and day to

help expedite medical products but also

to provide the necessary oversight with

the appropriate science and data we know

that the virus remains with us FDA is

committed to doing the critical work

that will get the country to the point

at which Americans judge it safe to

return to work and school as quickly as

possible I am incredibly proud of the

dedicated women

man of the FDA whose commitment to

defeating this pandemic has been

unwavering I can assure you the FDA will

continue to provide leadership expertise

guidance and information as we continue

to address this unprecedented challenge

and fulfill our mission to protect and

promote public health thank you and

appreciate and look forward to your

questions

thank you dr Han and thanks to each of

our witnesses will now begin around two

5-minute questions all the Senators are

participating today almost all and so I

would ask the senators and two witnesses

to try to keep each segment within five

minutes

dr Falchi assumed I'm superintendent of

one of 14 thousand school districts in

our community we've we understand that

their health risks for children going

back to school but we've concluded that

the risk of to their education mental

health and social development is a

greater risk if they don't go back to

school so what would your advice be to a

school superintendent about what he or

she should be thinking about as children

go back to school in a few weeks to keep

them safe thank you for that question

mr chairman it is an important question

but I think we need to point out that it

really will depend on the dynamics of

the outbreak in the particular location

where the school is and one of the

things we want to emphasize and have

been emphasizing is to take a look at

where you are in the particular area of

the so-called opening America again are

you at the gateway phase 1 phase 2 phase

3 the CDC has guidelines about the

opening of schools at various stages of

those checkpoints the basic fundamental

goal would be as you possibly can to get

the children back to school and to use

the public health efforts as a tool to

help get children back to school let me

explain what I mean in other words if we

adhere to

lines of what we've heard in many of

these presentations you just heard about

the physical distance in the community

the use of masks things like that that

will help to keep the level of infection

in the community down which will then

make it easy to get the children back to

school if you are in an area where you

have a certain amount of infection

dynamics there are things that can

creatively be done about modifying

things like the school schedule

alternate days morning versus evening

allowing under certain circumstances

online virtual lessons those are the

kind of things that we need to consider

but also importantly always make the

goal that it is very important to get

the children back to school for the

unintended negative consequences that

occur when we keep them out of school

thank you doctor fat dr Redfield one of

the concerns would be that children who

who generally speaking haven't been

damaged nearly as much as adults

particularly elderly adults by this

virus might carry the virus to their

teachers administrators or parents or

grandparents at home seems to me that

the availability of treatments this fall

medicine for the environments that

reduce the risk of sickness and death

could be very important in increasing

confidence in going back to school you

mentioned some of those in your

testimony are there others what will the

availability of treatments be this fall

and specifically what about so-called

antibody cocktails of the kind that were

developed for Ebola and approved by the

FDA well I think that'd be a great

question also for dr Fauci I'm gonna

make a small statement he may want to

add to it clearly we do have reduce very

as you mentioned we have now evidence

that steroids can improve therapy and as

you mentioned we have convalescent

plasma

Steve Hannon could comment on that's the

using the the antibodies from

individuals that have gotten better from

kovat that are currently under

evaluation and potentially be available

I have just a minute dr Redfield let me

go to dr Hahn and let him answer that

question – thank you

as I mentioned REM des Vere has been

authorized based on its reduction in

hospitalization days the steroids were

mentioned convalescent plasma we have

evaluated the safety through a large

expanded access program at the Mayo

Clinic and it's been found to be safe in

over 20,000 patients who administered it

we are waiting for the safety data and

we will be passing those data along to

Barda who's the sponsor of that program

I think that antibody data will help us

in terms of the development of

monoclonal antibodies we have a number

of sponsors who have come in for

monoclonal antibody studies we are

already well into that treatment

monoclonal antibodies are synthetic

antibodies that will provide that the

theory's will provide protection against

the infection of the virus and we're

hopeful that those studies by the late

summer early fall will provide us

information about their effectiveness

and safety so you're optimistic that

there will be more than one treatment

available this fall for teachers

administrators older adults

yes sir I'm optimistic thank you very

much senator Murray thank you very much

appreciate your service in your work dr

Sachi

last time you testified testified before

this committee you warned us of needless

suffering and death if states begin

reopening too early and just over a

month later now we are seeing a record

number of cases we do not have enough

tests and we did not have enough contact

tracers and just yesterday CDC's doctor

chuckit said we have too much virus to

control in the us arguing and I quote

this is really the beginning our

strategy hasn't worked I want to ask you

what did the federal government and the

more than 30 states with rising case

numbers need to do to reverse this

thank you very much for that question

senator Murray

I am also quite concerned about what we

are seeing of all right now in several

of the states as you know in four of the

states in Florida Texas California and

Arizona more than 50% of the new

infections are in those areas where

we're seeing surgeons the things we need

to do I think you alluded to in your

question to me we've got to make sure

that when states start to try and open

again they need to follow the guidelines

that have been very carefully laid out

with regard to checkpoints what we've

seen in several states are different

iterations of that perhaps maybe in some

going too quickly and skipping over some

of the checkpoints but even in states in

which the leadership in the form of the

governor's and the mayor's did it right

with the right recommendations what we

saw visually in clips and in photographs

of individuals in the community doing it

all a nun phenomenon which is dangerous

and by all a nun I mean either be locked

down or open up in a way where you see

people at bars not wearing masks not

avoiding crowds not paying attention to

physical distancing I think we need to

emphasize the responsibility that we

have both as individuals and as part of

a societal effort to end the epidemic

that we all have to play a part in that

and they think if you look at the

visuals what we saw were a lot of people

who maybe felt that because they think

they are invulnerable and we know many

young people are not because they're

getting serious disease that therefore

they're getting infected has nothing at

all to do with anyone else when in fact

it does because if a person gets

infected they may not be symptomatic but

they could pass it to someone else who

passes it to someone else who then makes

someone's grandmother grandfather sick

uncle or a leukemic child on

chemotherapy

sick and died we've got to get that

message out that we are all in this

together

and if we are going to contain this

we've got to contain it together well I

assume that would mean that health

behavior and wear a mask

we recommend masks for everyone on the

outside anyone who comes into contact in

a crowded area you should avoid crowds

where possible and when you're outside

and not have the capability of

maintaining distance you should wear a

mask at all times

thank you dr Redfield last week dr

Julie gerber dean who served as a CDC

director under president george w bush

testified to our committee that if she

were in charge one of her top priorities

would be the creation of a National

Vaccine plan that addresses the science

development allocation uptake and

monitoring of a vaccine saying quote we

know this is in our future and we are

not ready for it I couldn't agree more

and that plan has to detail how the

federal government will scale up

manufacturing coordinate the supply

chain so we avoid the missteps we saw

with testing needs to combat

misinformation and vaccine hesitancy and

make sure that vaccine distribution

addresses health disparities and a lot

more dr Redfield do you agree a plan

like that is needed senator I think it's

very important that we have a integrated

plan for this vaccine wait can we well

I'm gonna ask dr Hahn if you'd like to

comment I know recently they had a

vaccine plan for at least four the FDA's

perspective CDC is working on the issues

that you said that I think are so

important in building vaccine would be

writing the comprehensive plan will

we're developing a plan as we as we

speak and again to keep building on the

efforts that we have to rebuild what I

call vaccine confidence in this country

which is really critical and then

of that there'll be a very defined plan

for distribution of this vaccine

prioritization of this vaccine do you

have any estimate on will see that plan

well it's currently in development

within the group and I you know I'd

anticipate that we'll see that plan in

the in the near weeks of heads ahead

senator weeks not months in the weeks

ahead it's a collective effort that

we're doing together within the concept

of operation Wharf speed but CDC has

been working on this plan

literally for probably the last 10 to 12

weeks well mr chairman I would just say

we need to see that plan we need to know

what it is the American public needs to

know what that is

communities need to know what that is so

I hope that we urge that plan to be

public as soon as possible so we all

know what to expect

thank you senator Murray senator burr

Thank You mr chairman after working on

pandemic policy now for 17 years I'm

reminded this morning Tony felt she's

been doing it twice as long as I have

and most of you at the tas have been

doing that as well

I urge my colleagues pay attention to

what each of these individuals say

because some things are predictable up

here Congress is a full-fledged partner

and funds things when there's an urgent

need a threat that's out there and I

know Tony you've seen over the years

when there's not that threat out there

things get shelved like platforms that

we could have developed and have better

countermeasures today platforms that

then could address vaccines in a much

faster pace than maybe what we're doing

but we spend more time with the blame

game than we do with focuses on how the

future should look while all of us

members of Congress and people within

government wish that we could get back

to normalcy your agencies and members of

Congress are also charged with making

sure that we mapped the future so the

future generations have better

protections in what we have

that's why I applaud the chairman for

his white paper and I would encourage

every member of that Dyess to be

brutally honest with us about where

changes need to be made and where they

don't need to be made dr Redfield I

think you would agree with me that

testing and and surveillance on this has

not been the best performance by CDC I

don't want to dwell on where we've come

up short share with these members and

myself what can we expect over the next

several months from CDC that will be

different than what the past is looked

like well thank you senator for your

question I think CDC will continue to

work with the state local tribal

territory health departments to build

their capacity I think we all know that

for decades there's been consistent

under investment in public health in

this nation and the core capabilities to

do that job

data data modernization predictive data

analysis laboratory resilience workforce

very appreciative for the merchants II

response find that Congress provided

these are critical infrastructure issues

that the reality are have been under

invested the CDC is right now probably

providing 50 to 70% of all public health

funding to each state we need to have a

much more robust investment in these

core capabilities what you are going to

see because of the Congress acting CDC

has provided now 12 billion dollars to

the local state territorial tribal

health departments to begin to build

that core capability that we would have

liked to built over the last several

decades so that there's enhanced testing

is it's been mentioned it's complicated

here because this virus is so

asymptomatic for so many so the

traditional methods of diagnosis contact

tracing isolation are going to be

inhibited for many individuals and

that's going to require broader

community based surveillance strategies

those plans as was mentioned by the

Admiral are we've received them for June

and July we're working with the local

jurisdictions they're going to

have him in middle July for the plans

for the rest of the year and we're gonna

be working side by side with them to

continue to augment the public health

capacity responded as covent virus with

basically enhanced surveillance and

enhanced early diagnosis contact tracing

isolation to begin to bring this

outbreak under control

I hope some of that money will be used

to upgrade the systems at CDC that are

antiquated sir I agree with you there I

mean I think as those of you know when I

was given the opportunity to do this job

very early on within a month I

recognized that the core capabilities of

our public health infrastructure is not

there particularly the one that I know

you've been very supportive of data data

monitor is a ssin predictive data

analysis and and that is in progress

it can't happen too soon and we're

appreciative of the support that

Congress has given and I do think it's

fundamentally critical to bring our data

system and as you know the data

personnel that we have and we thank you

for your efforts there and as we need to

hire those individuals strategically we

will continue to do that to make sure

that the premier public health agency in

this country has the personnel and data

systems that it does need but I will say

the other big issue we have to correct

is to make sure our public health state

local territorial tribal have that

integrated health system of data dr

Hahn I think you have used your

authorities under Papa at FDA in a very

effective way and the FDA's risen to the

challenge during the public health

emergency cutting red tape and

maintaining the agency's goal standard

for review of life-saving medical

products you specifically mentioned

innovative trial clinical trial designs

and the use of real-world data as areas

where the FDA has gained ground during

the response to kovin how do you plan to

ensure that this progress is maintained

long after the corona virus response is

over thank you senator burr critical

issues that you bring up in addition

some of the things that we're doing on

the review side to actually expedite

review and work with innovators and

developers we will continue part of our

review

our actions today so amid action review

will inform how we move forward no

question the fact that real-world

evidence and modernization of our data

systems are needed particular round

supply chain and demand for medical

products but also on the review cycle

and the innovative clinical design

trials as you mentioned thank you for

that mr chairman I do hope that you or

another member will allow dr Falchi at

some point today to make any comments on

the reports that there's a new swine flu

that the Chinese have apparently

identified and how that might affect us

in the future in this country well dr

Fauci why don't you do that now if you

have anything to say about a swine flu

the Chinese over the last week or two

have identified a virus in the

environment it is not yet shown to be

infect the humans but it is exhibiting

what we call reassortment capabilities

in other words when you get a brand new

virus that turns out to be a pandemic

virus it's either due to mutations and

or the reassortment or exchanges of

genes and they're seeing virus in swine

in pigs now that have characteristics of

the 2009 h1n1 of the original 1918 which

many of our flu viruses have remnants of

that in it as well as segments from

other hosts like swine when they all mix

up together and they contain some of the

elements that might make them

susceptible to being transmitted to

humans you always have the possibility

that you might have another swine flu

type outbreak as we had in 2009 it's

something that still is in the stage of

examination it's not so called an

immediate threat where you're seeing

infections but it's something we need to

keep our eye out on just the way we did

in 2009 with the emergence of the swine

flu is called g4 is the name of it Thank

You senator Sanders

thank you very much chairman and let me

thank all of our panelists for being

here and for the great work that they

are doing on this pandemic oh let me ask

a question that has just bothered me

lately

all of you and I think most Americans

understand how important social

distancing is we're told over and over

again the chairman told us at the

beginning of this meeting stay apart at

least six feet apart if you can and just

the other day however American Airlines

announced that they were gonna fill up

all of their planes and other airlines

have done the same so you're gonna have

people going from New York to California

five six hours sitting inches apart from

each other and then you got buses all

over America where people are kind of

packed in like sardines

my question is why hasn't the government

whether it's the CDC or the Department

of Transportation issued guidelines

prohibiting those violations of what we

all know to be common sense once the

doctor voucher you want to start on

there Thank You senator well I'm I'm not

the CDC but I'd be happy to make a

comment on that and maybe Bob would also

I mean obviously that is something that

is of concern I'm not sure exactly what

went into that decision making I would

hope there would be something to

mitigate against that because I know as

we've said and I continue to repeat it

that avoiding crowds staying distance

and when in a situation like that wear a

mask I think in the confines of an

airplane that becomes even more

problematic the mass thing but doesn't

it sound a little bit silly and a little

bit in violation of everything you guys

have been talking about have people

sitting next to each other for five or

six hours in an airplane or crowded into

a bus and my question is why hasn't you

know the president issues a lot of

executive orders why haven't we stopped

that type of activity and told the

airlines and bus companies that is

unhealthy senator I appreciate your

question

and I think it's it's a critical area I

can tell you that when they announce

that the other day

obviously there was substantial

disappointment with American Airlines

number of the airlines had decided to

keep the middle seat thing I can't say

this is under critical review right now

by us at CDC we don't think it's the

right message as you pointed out again

we think it's really important in

individuals that are in whether it's a

bus or a train or a plane or a social

distancing the degree that's feasible

and at least have a reliable face

covering so thank you I just hope very

much that the CDC or the appropriate

agency basically tells these companies

that that is unacceptable behavior

they're endangering the lives of the

American people let me go to another

question I just have a few more

questions and not a lot of time so I'd

appreciate brief answers at the

University of Washington the Institute

of Health they're indicated that if 95

percent of the American people were to

wear masks we could save some 30,000

lives a number of countries including

South Korea France Turkey and Austria

have provided low-cost or free masks to

all of their people something that I

believe in would you support an effort

to greatly increase the production of

high-quality masks in this country and

distribute them free of charge

to every household in America doctor

anybody else wants to jump in on that

yes of course I think masks is are

extremely important and we keep

hammering home and I think what you just

mentioned this is is important there's

no doubt that wearing masks protects you

and gets you to be protected so it's

people protecting each other anything

that furthers the use of masks whether

it's giving out free masks or any other

mechanism I am thoroughly in favor of

and I just want to echo that the senator

in my opening statement again I called

on

an environment that we have universal

masks I think it's fundamental most

important thing we can do that's clear

but when you refer to the quote-unquote

universal masks which I agree with you

on would you be supporting the increased

production of high-quality masts and

basically distributing free of charge to

every household in America because I

think that's gonna save tens of

thousands of lives would you agree

senator Sanders this is a Brett July yes

sir I agree that that that is very

important because we need to support

mask-wearing I would also point out that

dr Cadillac the asper has contracted

for hundreds of millions of cloth face

coverings – that could be distributed

around the country and those kinds of

processes are being thought of when I'm

not in uniform I wear them they're white

they work very effective and I think

they're a great investment for the

American people

good thank you my very last question

it's an issue I've raised now for the

last couple of months all of us hope to

god that a good safe vaccine will be

developed as soon as possible but that

vaccine may not mean anything to a

low-income person who might not be able

to afford it I happen to believe that we

should make these vaccines and by the

way as you all know federal government

our tax dollars are going to the tune of

billions of dollars into drug companies

to help develop this vaccine that's ok

but don't you Duke would you agree with

me and after that kind of investment we

should make sure that every American

every person in this country can get a

vaccine regardless of their income yes

anybody else want to comment on that yes

senator yes senator oh good thank you

all very much

thank you senator Sanders senator Paul

thank you fatal conceit is the concept

that central planning with decision

making concentrated in a few hands can

never fully grasp the millions of

complex individual interactions

occurring simultaneous

in the marketplace it is a fatal conceit

to believe any one person or small group

of people has the knowledge necessary to

direct an economy or dictate public

health behavior I think government

health experts during this pandemic need

to show caution in their

prognostications it's important to

realize that if society meekly submits

to an expert and that expert is wrong a

great deal of harm may occur when we

allow one man's policy or one group of

small men and women to be foisted on an

entire nation

take for example government experts who

continue to call for schools and daycare

to stay closed or that recommend

restrictions that make it impossible for

a school to function for a time there

may not have been enough information

about coronavirus and children but now

there is there are examples from all

across the United States in the world

that showed that young children rarely

spread the virus let's start in Europe

22 countries have reopened their schools

and have seen no discernible increases

in cases these graphs behind me show no

surge when schools open the red line is

where the schools opened there is data

from Austria Belgium Denmark France

Germany Netherlands no spike when

schools are opened contact tracing

studies in China Iceland

Britain and the Netherlands failed to

find a single case of child to adult

infection here at home child care for

essential workers continued to be

available in some states throughout the

pandemic Brown University researchers

collected data on daycares that remained

open during the pandemic over 25,000

kids in their study found that only 016

percent got Kovan and when you looked at

the confirmed cases for staff there was

about 1% of more than 9,000 staff the

YMCA also has put forward statistics

40,000 kids at 1,100 sites there were no

reports of coronavirus outbreaks or

cluster

dr Joshua Sharfstein of Johns Hopkins

writes there is converging evidence that

the corona virus doesn't transmit among

children like the flu that it is a lower

risk just yesterday the american academy

of petri at Pediatrics says we got to

get kids back in school we want them

physically president school they even

cite mounting evidence that children are

less likely to contract the virus

ultimately this all comes down to the

fatal conceit that central planners have

enough knowledge some how to tell a

nation of 330 million people what they

can and can't do perhaps our planners

might think twice before they weigh in

on every subject perhaps our government

experts might hold their tongue before

expressing the opinion whether we can

play NFL football or major league

baseball not in October perhaps our

experts might think twice before telling

the whole world that a kovat vaccine

likely won't provide herd immunity we

don't know why I weigh in with these

opinions that we have no knowledge of

these are forecasts that may well be

wrong perhaps our experts might consider

the undue fear they are instilling in

teachers who are now afraid to go back

to work no one knows the answers to

these questions we shouldn't presume

that a group of experts somehow knows

what's best for everyone

Hayek had it right only decentralized

power and decision-making based on

millions of individualized situations

can arrive at what risks and behaviors

each individual should choose that's

what America was founded on not a herd

with a couple of people in Washington

all telling us what to do and we'd like

sheep blind they follow this all begs

the question what are we going to tell

the people the truth that it's okay to

take their kids back to school

dr Falchi every day virtually every day

we seem to hear from you things we can't

do but when you're asked can we go back

to school I don't hear much certitude at

all I hear well maybe it depends all of

this body of evidence about schools

around

world shows there's no surge all of the

evidence shows that it's rare I mean

we've so politicized this and made it

politically correct that the wh Oh

releases that it's rare and you have a

scientist up there honestly giving her

opinion what happens to her

she's blackballed and her a report that

she refers to has taken off the website

when you go to that that scientist

speech in you and you try to link link

on the lick the w-h-o has now screened

it from us because it said something

that's not politically correct it guess

what it's rare for kids to transmit this

but I hear nothing of that coming from

you

all I hear doctor pouches we can't do

this we can't do that we can't play

baseball even that's not based on the

science I mean flu season peaks in

February we don't know that kovat is

gonna be like the flu season it might

but we don't know that but we wouldn't

we wouldn't ban school in October you

might close some schools when they get

the flu we need to not mean oh so from

sumptuous that we know everything but my

question to you is can't you give us a

little bit more on schools that we can

get back to school that there's a great

deal of evidence and it's actually good

good evidence the kids aren't

transmitting this it's rare and the kids

are staying healthy and they yes we can

open our schools it's the chairman do I

have a little bit of time till I give

you a little well over five minutes but

well thank you so much please answer the

yeah so very quickly Senator Paul I I

agree with a lot of what you say about

you know this idea about people having

to put their opinions out without data

and sometimes you you have to make

extrapolations because you're in a

position where you need to at least give

some sort of recommendation but if you

were listening and I think you were to

my opening statement and my response to

one of the questions I feel very

strongly we need to do whatever we can

to get the children back to school so I

think we are in Lock agreement with that

the other thing that I'd like to clarify

very briefly is that I when things get

in the press of what I supposedly said I

didn't say I never said we can't play a

certain sport what happens is that

people in the sport industry they could

either be people from play as associate

owners people involved in the health of

the plays ask me opinions regarding

certain facts about the spread of the

virus what the dynamics are I give it

and then it gets interpreted that I'm

saying you can't play this sport or you

can't play that sport I agree with you I

am completely unqualified to tell you

whether you can play a sport or not the

only thing that I can do is to the best

of my ability give you the facts and the

evidence associated with I know about

this outbreak thank you thank you we

just need more optimism there it is mr

chairman thank you very much for the

hearing and I want to thank our

witnesses for their public service mr

chairman let me start with dr Hahn then

I'll move to Admiral gerar dr Hahn I

wanted to ask you about vaccines and as

your testimony indicates and as we've

been discussing over time as researchers

work to develop vaccines to protect

against kovin 19 it's important that the

final fda-approved products have the

full confidence of the American people a

vaccine doesn't help but people don't

choose to in fact be vaccinated so my

first question is given that we've seen

very high rates of both vaccine refusal

as well as skepticism what role can the

FDA play in the coming months to earn

the public's trust that the Cova 19

vaccines are safe and effective that's

question number one what role the FDA

can play and then the second question is

what steps can you take as FDA

Commissioner to bolster public

confidence Thank You senator for that

question I couldn't agree more that

public confidence in vaccines is so

important so to your first question we

have an obligation to use all of our

scientific knowledge our regulatory

framework to ensure that any vaccine

that comes before us whether for

authorization or approval meets our

stringent standards for

safety and effectiveness one of the

reasons that we issued that guidance

that I mentioned in my opening statement

was to provide regulatory clarity around

what FDA expects with respect to those

data we want to see certain parts of

those data so that we can demonstrate to

the world to the nation to the American

people that we are following our

rigorous standards with respect to

safety and efficacy the other thing that

we've done is draw a very bright line

between FDA and our regulatory

independence and all the sponsors who

are putting forth vaccine applications

to us and that includes operation

warp-speed so we are providing technical

assistance to those sponsors but we are

not part of the decision-making process

and we will maintain our regulatory

independence I will not prejudge the

agency will not prejudge any decision

with respect to this but we will use the

science and the data with respect to

what I can do personally senator I

commit to you that I will continue to be

a voice emphasizing the regulatory

independence we have a number of

communications in progress to

communicate to the American people that

the standards were going to uphold our

firm they are rooted in science and data

and that they will ensure that we meet

the usual high standards of FDA with

respect to safety and efficacy thank you

submit a question for the record to dr

Redfield as well but just so I can get

my second question and to the Admiral I

don't want to ask you about testing and

insurance coverage testing as you know

and as we've emphasized in these

hearings is so fundamental in order to

prevent the spread of copán 19 Congress

I think acted upon that knowledge by

mandating full coverage of Cova 19

diagnostic and antibody testing both in

the families first bill as well as the

cares Act we made it clear that

Americans shouldn't have to pay a dime

for Kovan 19 testing but we're hearing

alarming and reports of people not being

tested often for one of two reasons

because they're under the impression

they will have to

pay for testing and patients who have

been tested or receiving surprise

medical bills the administration has

issued guidance that appears to be in

conflict with congressional intent and

public health guidance and so we have

some confusion here I'd ask you Admiral

can you assure the American people that

the Department of Health and Human

Services will fulfill the intent of both

the families first bill in the Kerr's

Act and ensure that American the

American people will be provided wide

access to cover 19 tests without cost or

limitation so thank you senator and I

want to thank all of you for emphasizing

the importance of testing and

eliminating any barriers that there

could be I can't speak for the

department I certainly speak as the

assistant secretary and as the testing

person that we firmly believe and

support the concept of no-cost testing

there should not be a disincentive in

any single way to get the diagnostic

test that you need to get tested during

screening or sir or the serology tests

as Congress intended so thank you for

that we do need to keep getting that

message out it's a very important one to

have thank you Thank You mr chairman

thank you senator Casey

senator Collins thank you very much mr

chairman and I want to thank all of our

witnesses today for your dedication and

hard work it's really been important the

chairman raised a very important

question about who pays for the testing

when a person has no symptoms and no

known exposure to the virus and I would

add another key question and that is how

are such tests even access these are

critical questions for the reopening of

schools and for the thousands

of jobs in the tourism industry upon

which means economy depends in Maine for

tourists to come and visit bad

out-of-state visitor one option is to

show a recent negative kovat test the

problem is that when hotel owners in

Maine surveyed testing sites in ten

states they found that ninety percent of

requests for a test for travel purposes

were denied

now this lack of access to tests is

devastating for reopening Maine's

tourism businesses one innkeeper told me

that last year in the month of June she

had an occupancy rate of ninety four

percent this year it was six percent so

you can imagine the impact on employment

at that Inn given the impact on

reopening schools and on jobs in the

tourism and other industries how is the

federal government working with States

to better match demand for testing with

supply and to overcome these Geographic

variations Admiral I would direct that

question to you so so thank you ma'am I

will try to be brief and not to take

much of your time but we were very

careful in our prioritization that we do

prioritize persons without symptoms who

are prioritized by health departments or

clinicians for any reason including

public health monitoring surveillance or

screening of other asymptomatic

individuals according to state local

plan so that is a priority that if it is

important for the state those

asymptomatic individuals can be can be

screened the the second issue just again

to be brief is we work we have worked

individually with every single state

to determine what their state testing

needs are how are they organizing in the

context of the CDC and we are supplying

them with the supplies they need to meet

that so every week shipments of the

basic supplies go to every single state

according to their state testing plans

and we keep a little bit in reserve

right because when there's an outbreak

somewhere that we need to surge we do

have that so for example the state

testing goals for July or somewhere

across the country are about thirteen

point nine million tests is their first

line goals and we we will match those

state by state I hope that you will help

us get that word out to testing sites in

states from which a lot of tourists

usually come to me that would be very

helpful to us doctor Falchi let me turn

to you earlier this month higher

education leaders in Maine issued a

framework for safely returning to

campuses this fall that recognizes the

importance of testing and the need to

include financially struggling

institutions in partnerships in order to

make sufficient testing protocols

possible you'd last week spoke about the

possibility of the development of pool

testing strategies and as I understand

this but this would allow more people to

be tested using fewer resources and the

medical director of Stanford's clinical

viral viral ology lab suggests that this

makes particular sense in areas with low

rates of kovat 19 where you would expect

the large majority of tests to be

negative could you expand on the

possibility of expanding pull testing

and tell us more about that yes thank

you for the question senator what that

really is if you want to get a feel for

the penetrance of infection

in a community rather than testing

multiple each individual person which

takes resources and time what you do and

you can do a statistical analysis of not

losing sensitivity by pooling let's say

ten or fifteen or five together so you

put all the tests together and you do

one test if that test is negative then

you know those ten people are all

negative so instead of utilizing ten

tests you've utilized one test then you

get another batch of we'll say ten or so

and if you then find one is positive

then you go back track and figure out

who that person is and if you do the

mathematical calculation you can save a

lot of time a lot of resources and use

the testing for a variety of other

things that you would need so it's a

really good school it can be used in any

of a number of circumstances at the

community level or even in school if you

wanted to do that so apropos of what you

started your comment off with it clearly

can be extrapolated to that thank you so

much that sounds like an excellent

technique for our schools to use thank

you senator Collins senator Baldwin

Thank You mr chairman I want to thank

all of our witnesses today for joining

us like so many members of this

committee I'm concerned about new

outbreaks and increasing cases certainly

I've seen them in my home state of

Wisconsin and I know we're seeing that

nationally now CDC and OSHA have issued

recommended safety guidance for

businesses but this guidance is not

enforceable many businesses are truly

trying to do the right thing and

protecting workers and customers and the

public that interacts with those

businesses and so I we also had a

previous discussion I think senator

Sanders raised the issue of American

Airlines filling up their planes versus

others that are still not trying to push

to do so

because of safety concerns we also had I

think was admiral Girard pulled up the

what he called critical guidance please

follow this critical guidance so dr

Redfield should we be supporting

businesses that have taken the steps to

protect their workers and customers by

fully implementing CDC's and OSHA's

recommended safety guidance yes or no

yes we should be supporting those

businesses now can you confirm yes or no

that all businesses have adopted and

implemented this guidance says they've

opened up I think senator you know that

unfortunately that's not been the case

so it's an uneven playing field and it

hurts businesses that are trying to do

the right thing by voluntarily adopting

CDC and OSHA safety guidelines because

their competitors don't have to incur

the same safety and health costs and if

you believe that we should be supporting

the good actors then shouldn't we create

a level playing field by issuing an

emergency temporary standard to require

all businesses to adopt and comply with

enforceable safety standards I made two

comments senator first one is so

important that we've tried to say is

that this is a time that everyone in our

nation accept the responsibility that

doctor fowey and I spoke about to

recognize they have the fundamental

responsibility not just to protect

themselves to protect others by the

social distance face mask and

hand-washing secondly again is we look

at the local jurisdictions again to see

where in fact that enforceability would

be whether it's in the local health

department the state health department

or the federal health department I think

again we see that the community can get

behind that responsibility those

businesses that support that

responsibility may find in fact their

business is better than those businesses

that don't

I can tell you that – I apologize dr

Redfield but my time is limited the the

panel right now is composed of people

representing public health and public

health institutions OSHA is our lead

federal agency for protecting worker

safety and health have you had

communication with the Department of

Labor and OSHA about issuing mandatory

enforceable standards rather than this

voluntary guidance secretary Scalia is a

member of the task force and he's in the

discussions with us that the

vice-president chairs that specific

topic we have not had a discussion

directly but we have had discussions and

review of the guidance that we put two

businesses both critical infrastructure

and non critical infrastructure

businesses with OSHA so I have limited

time left but I do want to say that the

University of Wisconsin announced that

they will be reopening for classes in

the fall they've released a plan called

start smart restart it calls for about

2,000 tests per week on campus

they'll need supplies to do this

including PPE reagents and swabs and

every hearing uncovered 19 we've heard

about shortages of these supplies and

it's why I introduced the medical supply

transparency and delivery Act to unlock

the full authority of the defense

production Act to increase production of

critical supplies and the things that

are needed to conduct widespread testing

Admiral jawar can you describe how

you're working to make sure that

universities and others will have access

to these supplies needed to conduct this

testing in the fall so thank you so much

senator and I want to communicate this

and I'm happy to work with any

university we coordinate what we give to

the states through the state

plan so it's very important that

universities coordinate through the

states and we supply those materials

directly to a single point of contact in

the state who distributes them um we you

know we've been through a lot but we

have a lot of swabs now partially

because of increased domestic production

using the DPA we're distributing about

20 million swabs per month we're gonna

do a lot more than that um so reagents

we do not purchase centrally because the

market is a little bit more mature so we

can trust with an allocation strategy

that we allocate we support the

allocation to different states depending

on their needs so we've mapped every

single machine in every single state

every single County every single city

and unfortunately there's not enough of

one thing that everybody if they want

that can get it so we really do a

matching game to understand specific

state needs for example in Alaska it is

very rural and there's very limitations

to what they have so we need to make

sure they get what they absolutely need

versus other states that can be a little

bit more flexible so we do I'm afraid

we're I'm so well over well over time we

have a large number of senators who want

to ask questions so I would renew my

request that Senators and witnesses try

to keep the questions and answers within

within five minutes senator Cassidy hey

thank you gentlemen for all that you're

doing I have a couple slides can you can

I ask that the staff to show the first

two slides so here it shows that we're

doing poorly relative to the countries

that are doing it best and you can argue

that Taiwan is much smaller than week

but Taipei is a very congested City so

consider our cities just collection

Taipei's for example then our Seoul Cal

South Korea's it would suggest that what

we are currently doing is less robust

unless whatever adjective you want to

use

in the countries that are doing at best

could I have the next slide please and

so this is developed out of a group by a

harbor and just so I can put a plug in

it they will be speaking in our round

table we have Thursday morning and you

can get details from my office if you

wish but kind of that interplay between

kolecki doing the testing tracing those

you know compiling your dad I know where

your hot spots are and then Tracy and

everyone on this panel knows how it's

done and you mentioned that you're going

to have a strategy that's coming out

later on if it does beg the question why

is it been so long and I'm not accusing

I'm just curious but this has been

developed you're going to take a slide

down please so knowing that you're going

to develop the strategy and and kind of

build upon senator Burr mentioned what

is the goal of the strategy is the goal

of the strategy to achieve suppression

that's number one and number two what

metrics will you use and knowing that

CDC is the one who really gives guidance

to state and local governments I'm

hoping dr Redfield since I'll direct

this to you that it won't be up for the

states and locals to put this plan

together but it'll be the considerable

intellectual firepower of the CDC it

gives a pretty detailed if you have this

kind of community this is what you do if

you have that kind of community that is

what you do because that's the kind of

role that CDC is expected to play dr

Redfield any thoughts on this thank you

very much senator a very important

question first John your first slide

just as a quick comment and I'll try to

be quick I think it's really important

because it doesn't illustrate back to

the comment that we tried to make of the

importance of personal responsibility to

really practice the social distancing

and quickly because I have limited time

that's a given but there has to be a

testing aspect of this because people

don't you awaken people to their

responsibilities if they'd know they've

been exposed if they don't know they've

been exposed they tend to be more

complacent so please focus upon the

testing data and tracking us but yes

senator initially obviously they can was

early case identification contact

tracing isolation obviously testing and

contact tracing without isolation has

little value the challenge has been when

we learned in March that this virus is

significantly symptomatically

transmissible then therefore requiring

alternative strategies the strategy that

we're evaluating now is more of a

community led testing strategy where you

go into a broader community and you

actually test a wide number of

individuals as opposed to do you have

metrics are you following is there a

specific strategy that's going to be

given to state and locals is how to

implement this that's very high level

what we need is granularity that's my

question yeah we did the initial

strategy and as I said we're currently

evaluating this community tesla'd

strategy in a number of communities now

the metrics are simple it's the percent

cases that are positive we were doing

well there for a while you know but of

course if you take the entire city of

New Orleans or Shreveport

you're gonna have some that are hotspots

and some that are really fairly safe and

so I'm guess I'm pointing to the

granularity you know should it be a

census track should it be a hotspot I

build it with multifamily housing etc so

you're frustrated because when I speak

to my state locals they're not getting

that granularity from CDC that seems to

be where we get to where Seoul South

Korea is and I've not yet heard that as

kind of what we're doing we're sharing

right now at the county level the exact

kinetics we have about 130 counties in

this country out of the more than 5,000

Oh more than 3,000 are having trouble

and continuing to get that granularity I

think you've said it senator it's

critical it's got to be a very local

focal response at the ground level do we

have that granularity we've been at this

for three months we've got all these

data systems we know where the people

live who are tested you know we have a

federated system which you alluded to

earlier is the plan coming out tonight

to this afternoon go on to amp

that granularity I'm over time but a few

would allow mr chairman for an answer

then I'll cease I apologize yeah my

comment would be that's where we're

going with that granularity we

appreciate some of the changes in

reporting to CDC in terms of testing

that Congress recently did we are now

looking at the granular level we don't

disagree with the premise behind you

it's that granular response to control

those mini outbreaks which is going to

be fundamental to get this under control

thank you senator Cassidy senator Murphy

thank you very much mr chairman mr

chairman if this were the policy of the

United States of America the

recommendations and guidelines being

given by our panelists today we would

likely not be in the situation we are

with a virus back on the March spreading

at rapid rates throughout big parts of

the country the problem is our four

panelists do not set the policy of the

United States of America the President

of the United States does and so while

our panelists tell us about the

importance of wearing masks the

president of the United States is

retweeting articles for example entitled

mandatory masks aren't about safety

they're about social control he retweets

people that are criticizing how folks

look when they wear masks though our

panelists today are telling us about the

effectiveness of social distancing the

president united states is holding

rallies all across the country in which

he deliberately prevents people from

distancing his staff ripped signs off of

chairs encouraging people to separate

from each other

the president's allies are out there on

TV every day saying that wearing masks

are dehumanizing somebody said the other

day a member of the house that viruses

do what viruses do the only way you're

gonna get immunity is to get exposed

these are the president's allies trying

to curry favor with him and so we have

these two parallel messaging operations

and I just think it's worth stipulating

that everything we're hearing today

is responsible is based on evidence but

the agencies represented here today have

social-media followings of about 5

million people the president United

States as a social media following of 82

million and so you can understand why

folks are confused out there they hear

the recommendations from dr Fauci and

dr Redfield but then they hear the

president United States criticizing a

reporter for wearing a mask because that

reporter is being social is being

politically correct that's why we're in

the position we're in today where you

see large numbers of people not

complying with recommendations because

they're hearing something very different

from the chief executive and they're

watching him behave in a manner and

encourage behavior that is directly

contrary to what we're being told today

and it just probably requires saying

that out loud at this hearing let me ask

a few questions mr chairman if I can

about global public health because we

haven't covered that here today dr

Fauci this virus got here really quickly

and what we learned is that well travel

restrictions can help or give you time

they can't fully prevent a disease from

arriving here and so even if we do turn

the corner in the United States in a

meaningful way so long as this virus

exists in large quantities outside of

the United States we are still

vulnerable is that right that's correct

sir and so dr Redfield um what is your

understanding of why the United States

has not joined the global vaccine effort

why are we not in something like sepi an

organization that is working with other

nations to try to coordinate not only

the development of the vaccine but also

the distribution of the vaccine well I

think the US has obviously developed an

aggressive comprehensive program but

senator it wouldn't preclude being part

of these international organizations

also from my perspective we have

legislation pending

now before the Foreign Relations

Committee that would put the United

States into these global vaccine efforts

it just doesn't make a lot of sense to

many of us on both sides of the aisle as

to why the Trump administration has not

joined and finally Admiral I just maybe

help us understand what our relationship

with the w-h-o is today right around the

time that the president declared that we

were pulling out of the WH show not just

that we were not going to fund it but

his announcement was actually we were

gonna sever our relationship of the WI

show you are confirmed to a seat on the

executive board and so have you been

recalled from the w-h-o are you

attending meetings are you participating

what are the details surrounding our

withdrawal from the w-h-o which by the

way is maybe one of the most dangerous

things in my opinion but the

administration has done in the middle of

a global pandemic what's what's our

status and what's your status ISM as a

confirmed member of that board so thank

you senator and I really do appreciate

the confirmation I was confirmed on that

May 7th and I did attend the Executive

Board on May 22nd the Executive Board it

was virtual it did participate and

support our our multilateral commitments

I have not been recalled I have not been

given any direction to recall myself in

any way there would be another executive

board a meeting probably in October and

I believe all of us on our public health

standards still work with the WH o as a

wh o partner for example we participated

with a wh o on a global sickle-cell

meeting just two days ago so we work we

certainly work from the public health

aspects direction on the official

whether we're going to be a member or

whether I'm not going to go the

executive board I have not gotten that

direction yet okay thank you the

announcement was that we're terminating

our relationship with WH o so probably

some additional clarification would be

helpful Thank You mr chairman thank you

senator Murphy senator Murkowski Thank

You mr chairman and gentlemen thank you

for not only your testimony today but

all that you have been doing I think

I've had conversations with each one of

you about the alas

specific issues most notably with

regards to our our seafood processing

this is the time of year where we

typically welcome a million-plus

tourists as well as as many thousands

that come from from the lower 48 and

other places to help with our seafood

processing and it has been very anxious

time I think for all of us in Alaska as

we see Outsiders coming in we have seen

obviously elevated cases of confirmed

covin our numbers I think are enviable

when when other states look at us to

know that we're working about 500 active

cases right now about double that in

terms of what we have seen throughout

this whole pandemic but again we know

and you have stated that we don't have

resources that we can look to to

neighboring states we are kind of on our

own island there in terms of resourcing

so what you have done to help facilitate

whether it's the the plans with the

seafood processors the guidance the the

ability to to come in on an as-needed if

the situation so demands we appreciate

that we have seen the benefit of how

these very rigorous plans have have

worked an individual who comes up to to

work in a seafood processing facility is

is tested before they come to the state

they're tested when they get to the

state they're put in a 14-day quarantine

we have seen positive cases once people

have arrived but we've been able to do

what the plan calls for which is that

contact tracing and then isolation and

keeping things to a minimum so I think

it does demonstrate that these tough

plans really can work they are expensive

though if you are bringing in several

hundred or perhaps a thousand workers

and you have to put them up in a hotel

for 14 days

with pay when you have to provide for

the health protocols this is this is

costly I would ask for for your input

probably a question for the record just

in terms of which agencies can can best

help facilitate these seafood processors

with not only implementation of the

specific guidance but how we can be

dealing with the cost we do receive some

benefit from the discretionary funds

provided to the states but I think we

would all recognize like the meat pot

meat packing facilities our seafood

processors aren't important in a

critical industry not only to Alaska but

to the country so we want to work to to

address that I do want to speak very

quickly though to the to the public

health infrastructure I'm told that in

Alaska as we are doing our contract

taste tracing it is still a paper copy

Excel spreadsheet faxed to the

epidemiology labs this is how we're

doing our tracing I thought well maybe

that's just Alaska and I'm told by by

dr Zink who you have all had

conversations with that well this is

actually going on in in California as

well that to me is not a contract a

contact tracing system that works and is

sufficient so I want to ask about not

only your view of the sufficiency of of

contact tracing and this is probably to

you dr Redfield but then dr pouchy I

want to ask you about the concern that

we have with certain certain parts of

the country where you have public

mistrust of vaccines in general my fear

is that we may get to the place where we

will get to that place where we have

that successful vaccine but we still

have the concern from many and a

mistrust and whether it's vaccine

hesitation or vaccine confidence I don't

know

the buzzword is but I'm worried that we

don't have a plan for how to deal with

that so first contact tracing and then

the vaccine thank you very much senator

I think it's really important just to

highlight what you said about the

current state of data systems for Public

Health in the United States that they

really are in need of aggressive

modernization and again thank Congress

for the funding there but it is a

substantial investment that needs to

take place there are a number of

counties that are still doing this pen

and pencil as you commented and we need

to have a comprehensive integrated

public health data system that's not

only able to do something that's in real

time but actually it can be predictive

and it would be one of the great

I think investments of our time to make

that happen once and for all and that's

really fun of mental to be able to

operationalize contact tracing etc and

contact tracing in this case they'll be

very quick really doesn't have any value

unless you can do it in real time

it doesn't help like I just did with the

airlines where we had people that were

flying infected from Afghanistan and we

didn't get the information till day 14

day 15 day 16 it's irrelevant so again

we love the partnership to get an

integrated public health data system not

just for CDC but for all of our

jurisdictions across the nation into one

timely integrated system senator thank

you for the question about if you can be

succinct where over time we'll be quick

we have a community engagement program

that is embedded within the sites where

the vaccine trials will be done because

we're thoroughly aware of what you're

concerned about and it is a reality a

lack of trust of authority a lack of

trust in government and a concern about

vaccines in general we need to engage

the community by boots on the ground and

getting community particularly those

populations that have not always been

treated fairly by the government

minority populations african-americans

Latinos and Native Americans and we have

a program that's already operable right

now to do that thank you

Thank You senator Murkowski senator

Warren thank you very much mr chairman

dr Falchi you came before the help

committee seven weeks ago to discuss the

country's response to the Cova 19 and at

the time you told me that the us did

not quote by any means have total

control over this outbreak but you also

told me that we were quote going in the

right direction now on the day you

testified before the committee that was

May 12 2020 there were about 21,000 new

cases of corona virus yesterday there

were about 40 thousand new cases of

corona virus dr Falchi do these numbers

show that the country is still moving

quote in the right direction and that

the corona virus pandemic

is under control well I think the

numbers speak for themselves although we

do have a number of parts of the country

to doing well I'm very concerned about

what's going on right now particularly

in the four states that are accounting

for about 50 percent of the new

infections but the other vulnerable

states so I'd have to say the numbers

speak for themselves I'm very concerned

and I'm not satisfied with what's going

on because we're going in the wrong

direction if you look at the curves of

the new cases so we've really got to do

something about that and we need to do

it quickly

short answer some question is that

clearly we are not in total control

right now

thank you thank you very much in our

case numbers are getting worse and our

death rates are going to get worse soon

during this same period of time some

other countries around the world have

controlled the virus they're reporting

fewer cases each day and they are able

to provide targeted

testing and to keep it up so that they

can tell what's happening and follow up

if there is an outbreak in other words

controlling the corona virus can be done

but because of bad federal leadership

we have not been able to do this here in

the United States so dr Fowler the last

time you were before this committee you

told me that if the US did not have

quote an adequate response that the

country would quote have the deleterious

consequences of more infections and more

deaths now I know that we've made some

progress but half measures won't save

lives

dr pouchy I'm asking you to be very

direct with all of us on this if we

don't fully implement the widespread

testing contact tracing programs and

social distancing practices that

everyone seems to agree that we need can

we expect these spikes and infection to

keep happening in different places

around the country

Thank You senator I'm always direct with

you and I'll tell you in direct answer

to your question that if you look at

what's going on and just look at some of

the film clips that you've seen of

people congregating often without masks

of being in crowds and jumping over and

avoiding and not paying attention to the

guidelines that we very carefully put

out we're going to continue to be in a

lot of trouble and there's going to be a

lot of hurt if that does not stop and we

get our act together more and more

communities around the country are going

to see these dangerous surges of over 19

minashi back in March

you also said quote looking at what

we're seeing now you expected there to

be between a hundred thousand and two

hundred thousand coronavirus deaths and

millions of infections in the us so

let's flash forward to late June here we

are at the end of June we've already

seen a hundred and twenty six thousand

deaths with infection rates rising

rapidly doctor foul Qi based on what

you're seeing now how many covered 19

deaths and infections should America

expect before this is all over

I can't make an accurate prediction but

it is going to be very disturbing I will

guarantee you that because when you have

an outbreak in one part of the country

even though in other parts of the

country they're doing well they are

vulnerable I made that point very

clearly last week at a press conference

we can't just focus on those areas that

are having the surge it puts the entire

country at risk we are now having 40

plus thousand new cases a day I would

not be surprised if we go up to a

hundred thousand a day if this does not

turn around and so I am very concerned

any kind of estimate on what we're

looking at overall on the number of

deaths before this is over you made an

estimate back in March between a hundred

thousand and two hundred thousand but we

have a lot more information now you know

we're already at 126 thousand right i I

can't make a estimation because that

would have to be modeled out because

when models are done and that's where

those original numbers came from senator

as I've said very often models are as

good as the assumptions that you put

into the model and those assumptions

often change depending upon what your

response is so I would really be

hesitant to give a number that will come

back and either be contradicted and

overblown or under blown but I think

it's important to tell you and the

American public that I'm very concerned

because it could get very bad I

appreciate that doctor found you I just

like the same time that my Republican

colleagues got a lot more time

senator Warren I always treat you fairly

and I would appreciate your respecting

the Chairman's rules if you'd like to

make a closing statement go ahead and do

it but I don't appreciate your question

improvising over the years

what others it done that you were

allowing more time since we had such

important witnesses when you're chairman

you can open you can make that you can

make those decisions thank you you know

I just want to make the point that we

can't keep pretending this virus is

getting better when it isn't that's how

we end up with methods like the

situation in Texas racing to reopen too

soon then scrambling to close down

before the hospitals get completely

overwhelmed if we don't get our act

together this is our future see-sawing

back and forth between too few

restrictions and then exploding cases

and repeated shutdowns in this future

thousands more Americans will die and

our economy will be brought to its knees

we've got to have a national strategy

that makes testing available to every

school business every hospital every

church anywhere that Americans come

together we need to expand contact

tracing and we need leaders starting

with President Trump who have enough

backbone to face reality distribute our

resources set our standards and stick to

them because if we don't the result is

going to be more economic wreckage and

more death Thank You mr chairman

thank you senator Warren what I've tried

to do in the in this hearing is to ask

senators to stay within five minutes and

the answers within five minutes and if

if the answers go beyond that I've tried

to be respectful of that but to but I

would ask senators not to ask their

questions into well past five minutes

and then expect to make a speech at the

end Senator Scott Thank You mr chairman

and I will certainly respect your your

time limits I think we all should do

that and frankly as we were asking dr

Fauci for an estimate of how many lives

may be a loss I recall the first

estimates were between 1 and 24 million

lives so I'm certainly glad that we are

not there and perhaps one of the reasons

why we should be thankful for where we

are now and force ourselves to have a

serious conversation about continuing to

flatten the curve is because the

all-hands-on-deck approach is effective

we just need as much cooperation from as

many

people as conceivably possible in every

state around the country in order for us

to see these numbers continue to make it

dive in the right direction as opposed

to spike in the wrong direction and I

think about the operations warp-speed

along with the crucial support from

Barda and other federal agencies

public-private partnerships in

accelerating groundbreaking technologies

that could eradicate Gove in nineteen

and revolutionize frankly the vaccine

development landscape because of these

efforts by industry academia and

government working in concert we could

see a viable candidate or candidates in

a matter of months for a vaccine and

because of a growing number of

large-scale manufacturing agreements

with companies like LaDonna Weiser

and J&J producing hundreds of millions

of doses at risk which means in advance

we are already working to address issues

of access and this is critical

especially for our most distressed

communities that said affective

development and widespread access while

essential are only part of the equation

if and when and I feel optimistic that

it's win and not if we get a viable

vaccine we need to encourage folks to

choose to get vaccinated I was really

concerned when I saw a recent AP survey

that showed that only 49 percent of

American adults plan to get vaccinated

once the Cofield 19 vaccine came to

market a full 20 percent so that they

did not plan to get vaccinated and

one-third of Americans were not sure

given the public's recent and vital

focus on health disparities is worth

noting that among certain groups these

figures are even more alarming just 25

percent of black Americans 37 percent of

Hispanic Americans plan to get

vaccinated against the corona virus my

aunt my question to the full panel what

steps can we take at every level of

government and in the private sector

with health care providers to ensure a

proactive education campaign and

outreach strategy on the importance of

getting vaccinated

both for covet 19 and frankly even more

broadly I'll take a shout out at first

senator as I mentioned in response to

another question that we have a

community engagement program that

actually operates out of operation

warp-speed the vaccine development

program component of that also there

needs to be engagement of people who the

community trusts particularly

individuals who are noted sports figures

/ Meza when we were involved and

continued to be involved in community

engagement with HIV we used people in

the community boots on the ground to go

out who looked and lived and are like

the people they're trying to engage it's

very critical because I share with you

the concern that we get to the hoop and

we get through it of getting a safe and

effective vaccine only to find that a

substantial proportion of the population

do not want to get vaccinated a

particular concern is it's that

proportion of the population that

generally are the most vulnerable in the

sense of the minority communities

African Americans latina –ks Native

Americans who in fact because of

underlying conditions make it more

likely that if they do get infected they

would have a poor outcome so it's

extremely important to engage them at

the local level thank you thank you very

much for your answers let me just close

with my 40 seconds that I have left and

respecting the time and I hope that we

continue to do so the path the pandemic

has triggered a drop of 60 to 80 percent

of immunization rates among children and

even now that states are reopening we're

not seeing the rebound in these rates as

that that are necessary this creates a

real risk of secondary infections and

disease outbreaks that are not on the

general public's radar as we reckon with

the chief crisis at hand so I think is

incredibly important that we follow your

strategy dr Falchi as relates to

engaging community leader

and perhaps people with notoriety to

challenge us to get involved in taking

the vaccines Thank You mr chairman I

apologize for being four seconds over my

time Thank You senator Scott for

respecting the time we have eight

senators remaining who have questions

and we should have time for all of them

to have a chance to ask a question

senator Kaine Thank You mr chair and

thank you to the witnesses of doctor

foul he I saw an interview with you last

week where you talked about a concern

that there's two sizable a percentage of

our population that sort of done like

science and scientists and advice from

scientists and I hear real emotion in

your voice as you express concern about

people gathering in large groups and

without masks and I gather that's the

kind of anti science concern that you

were worrying about when you had that

interview last week yeah that is part of

its senator yes because a disregard of

recommendations that come from

authorities only because it's a

recommendation I think the attitude of

pushing back from Authority and pushing

back on scientific data is very

concerning we're in the middle of a

catastrophic outbreak and we really do

need to be guided by scientific

principles and and this could cause

problems down the road if we get to a

vaccine but people don't want to get the

vaccine so we all have to message this

pretty strongly um dr Redfield I want

to thank you I was going to ask you a

question today that I've been asking it

over and over again why does the CDC's

guidance for institutions of higher

education not even mention the word

testing but as soon as your testimony

was done this morning the CDC website

changed and there are now guidelines for

the Institute's of higher education with

fairly extensive recommendations and

guidance not mandates about testing I

didn't have a chance to read them but I

saw them popped up on the CDC website

and I wanted to thank you for that your

testimony dr Redfield today and some of

the written testimony talks about the

fact that the public health system

relies on timely inaccurate data systems

but that we've under invested in them

and the crisis is

highlighted the need to continue efforts

to modernize the public health systems

last year I introduced a bill called the

saving lives through better data Act it

was with Senator Isakson and Senator

King and colleagues were helpful in this

we we were able to get 50 million

dollars in December in the

Appropriations deal and then another

five hundred million dollars in the

cares Act but I would urge my colleagues

to do even more because the requests

from our public health communities is

significantly more sizeable I hope we

might be able to get that into the next

kovat package doctor foul cheap this is

a challenging question challenging how

to figure it out

the CDC last week said that a new group

that we have to consider at risk is

pregnant women and lactating women the

night's vex

Ramez severe REMS Devere testing and

vaccine testing often doesn't include

pregnant women I think for some safety

reasons but we would want to make sure

that pregnant and lactating women have

access to treatments and access the

vaccine so how will we be trying to do

research and testing you know that the

women can safely access those treatments

or beyond that is a great question it

applies also to children so what we're

doing with the vaccine is you do a phase

1 trial in normal healthy adults not

pregnant not children and you show

initial safety then when you move into

this phase 2 & 3 studies if you get even

the slightest glimpse of efficacy and

safety in that population you go back

and do a phase one in pregnant and

lactating women as well as in children

and if that is safe there you bridge the

data so that you could use the efficacy

data that you already started to apply

back to pregnant women might say that's

how you do it let me ask you this at

this point is the nation's goal with

respect to coronavirus to mitigate it or

suppress it

you know vaccines right now you're

talking about vaccines so I'm just

talking about what

what is our goal are we yeah the

indicator we trying to suppress you know

it depends on where you are there's

containment and mitigation so if you

have a level of virus that's low enough

that you can adequately contain by the

standard way of identification isolation

contact tracing particularly if you make

sure you link the identification with

isolation because if you just do contact

tracing without isolation it's not going

to work when you get into a situation if

I if I could dr pouchy because I don't

want to go over it I want to say just

one thing about testing real quick

Admiral draw when you were here last you

said we would have capacity to do 40 to

50 million tests a month in September

that's about 13 to 17 million a day on

May 12th we had done about three hundred

and ten thousand yesterday we did five

hundred sixty thousand are we gonna get

to one point three to one point seven

million tests a day by September so

thank you for asking that we won't

absolutely have the capacity to do that

it's depending on the need and again as

you might expect a few weeks ago the

need for testing was much less than it

is now we had a good system that it was

actually very good that we were able to

identify an increase in positivity very

early but obviously with the with the

outbreaks we're having now we need to

massively surge testing in those areas

we will have that capability across the

board yeah we'll have that and that's

assuming no pooling when we start

pooling these together three for tests

then you do the math so I'm never going

to be happy until we have more tests

that we never have to say the word tests

again but we're gonna be in reasonably

good shape given those parameters thank

you senator Kaine senator Romney Thank

You mr Sharon and thank you to each of

the panelists for the sacrifice and the

effort that you've been making over

these past several years past several

months as well as years as you know

because we didn't know a great deal

about this virus run on the scene in

America we ask the American people to do

basically shut

their lives cut back on flying family

reunions funerals church services

restaurants bars theaters everything

gets shut down

well now it's end of Jude and hopefully

we've learned something about how this

disease actually spreads and the

American people need to go back out

they're gonna go back out if they are

going back out we saw for instance at

the lake of the ozarks all these people

and we said oh my goodness this is going

to be a major problem but my impression

was because people are outside or who

knows what other reason it wasn't to

make a major problem so so my question

is this where is the risk greatest how

is it that it's spreading is it

spreading indoors is it spreading more

in restaurants and bars is it okay to be

outdoors and perhaps not socially

distance as our family reunion is okay

or can you give us some guidance based

on but hopefully we know as to where the

risks are greatest I know you keep

saying social distance and mass but you

know people are getting in airplanes

they're going to restaurants where is

the risk greatest and where are we

relatively safe can you help us through

that family reunions can we get together

with family reunions outdoors is it safe

for outdoors and indoors give us some

guidance could you do that to dr Fauci

and dr Redfield Thank You senator I

think first and foremost the most

important thing in that assessment is

knowing at the granular level what the

kinetics of transmission are in that

community as I mentioned we have 130

counties right now in the United States

where we consider them quote hot spots

we have many other areas whether it's

very limited transmission so first and

foremost it's knowing the if you're in

that area of active transmission then

second D it's it's knowing what you do

when you're in that area of active

transmission and what what precautions

one takes you know got to be brief

doctor I only got five minutes all right

well I think those are the two things I

will say that there's just more and more

data showing that the use of face

coverings and masks are an effective way

to prevent transmission in in these

gatherings

I think we're just going to come back

and tell you the most important thing

you're within a community with limited

transmission and you're wearing face

masks or there's significant

transmission you're wearing face masks

and you practice those social distancing

hand-washing that's the best thing best

recommendations I can tell you yeah in

addition outdoor better than indoor boss

really not good

really not a congregation at a bar

inside is bad news we really got to stop

that right now when you have areas that

are surging like we see right now but an

answer to your question a little bit

more granular outdoors always better

than indoor if your outdoor distance as

Bob said wear a mask if you can but you

can have some social interaction the one

point I want to make very briefly is

that we should not look at the public

health endeavors as being an obstruction

to opening up we should look at it as a

vehicle to opening up so that you don't

want to just restrict everything because

people are not going to tolerate that so

you can get outdoors you can interact

wear a mask try to avoid the clothes

congregation of people wash your hands

often but don't just make it all or not

we've got to be able to get people to

get out and enjoy themselves within the

safe guidelines that we have so make

public health more data for you as

opposed to against you I very much

appreciate those those responses I think

it would be extraordinarily helpful for

all of us as we're going about our lives

if there was data that indicated where

people are getting infected were they in

a bar with in a restaurant where they

outdoor outdoors at a pool I've heard

reports that virtually nobody has been

infected if they're outdoors is that

true or not true we given how long we've

been at this we've got to have more

granular data so people know we're there

there's greater risk how many people for

instance have been affected as a result

of flying on airplanes we have to know

that if we could publish that

information for the American people they

will know where they could be safe and

go back of course continuing social

business thing and wearing masks

we need that data finally all this after

one an answer who was responsible for

distributing the vaccine what person or

what agency determines how the vaccine

when it's available will be distributed

well since Thank You senator you this is

a central function of CDC where we

really help with vaccine distribution

throughout the nation childhood vaccine

but that's so that's so that's the CDC

that's not your shoulder Thank You mr

chairman back to you thank you very much

senator Romney senator Hasson well thank

you mr chair and thank you to all the

witnesses for being here and for the

teams you lead I know how hard everybody

is working dr Redfield I want to start

with a question to you

43% of the deaths in this country have

been in nursing homes or long-term care

facilities in my state of New Hampshire

80% of our deaths are attributed to

residents of nursing homes and long-term

care facilities in mid-may the White

House urged states to complete Coppa 19

testing on every nursing home worker and

resident within 14 days a month and a

half later that still has not happened

CDC has since put out different guidance

on nursing home testing calling for a

baseline test for residents and weekly

testing for nursing home workers given

the widespread outbreaks within nursing

homes and unique risks posed to

residents what is CDC doing to ensure

that states carry out the

recommendations for nursing home testing

issued by CDC on June 13th and how many

states have met these guidelines so far

thank you senator

we are working in close contact with CMS

on on that issue as you say we're not an

enforcement agency we make

recommendations but but I'm asking and

my time is short I'm asking what what

you are doing to keep track of

compliance with guidelines 43% death

rate nationwide is huge and people are

looking to you all for granular guidance

here so what are you doing to find out

who's in compliance and who's not I was

I emphasize that we're working in

partnership with CMS which has that

regulatory oversight and we're there to

continue to reinforce the guidance as

you mentioned which we think is critical

and we we think we do have to get

everyone's the screened in these nursing

homes and the employees every week

unfortunately and we still think that we

need to keep visitors isolated from the

homes right now particularly in areas

with high jurisdictions but the

regulatory function of this is CMS but

we are really meeting with them daily to

see what more we can do to try to ensure

that there's greater compliance I thank

you for that people are looking to the

CDC for not only very clear and granular

guidelines and you've heard that all

throughout the questioning but

particularly with nursing homes and

long-term care facilities there's a lot

more work to be done and we are still

hearing that they're not getting usable

personal protective equipment all the

time either let me go to another

question and dr Fadi I'll start with

you we've heard discussion already today

about the difference in the

effectiveness of measures taken for

instance in Europe in the United States

this is a graph that shows the disparity

between new confirmed cases per million

residents over the previous seven days

between the United States Europe Canada

and Japan the disparity is i popping

surveys suggest that mask-wearing in the

united states occurs less frequently

than in europe you and our witnesses

have been very clear on the importance

of mask wearing in public places do you

attribute the improvements in Europe to

more widespread use of masks or are

there also other specific aguh vermin

policies or individual behavioral

differences that you believe should be

incorporated into our national strategy

it certainly masks play at role but

there are a number of other multifaceted

things in each of those those very

disturbing graphs that you show one of

the things that became clear when we

shut down as a nation in reality only

about 50% of the nation's shut down with

regard to other things that were loud

in many of the European countries 90 95

percent of all activities was shut down

so that is one of the reasons why you

saw particularly in Italy which shut

down to a much greater extent than we

did the cases came way down in a sharp

curve downward and then stayed so it's

not only masks it's the fact that the

countries in Europe and the other

countries you have there had a much more

uniform response or a very heterogeneous

country and we had a heterogeneous

response depending whether you are in

the Northeast southern West or what have

you so there's a number of other factors

probably some that we still don't even

understand well thank you and I I'm

gonna move on to just one other issue

and it's really just to urge dr

Redfield and the CDC to issue additional

guidance for schools in particular on

reopening I understand that you are

continuing to do that

I appreciate that the CDC has released

FAQ frequently asked questions documents

on things like youth sports which

provide more concrete useful information

for families and I'm hoping that you'll

do the same kind of FAQ documents for

parents and teachers that directly

address practical questions and concerns

about school reopening plans simply like

what happens what should a school do

specifically if one or two positive

cases come up in a classroom or in a

teacher what should parents and teachers

expect school administrations to do so

we can follow up with that I appreciate

of the chairs indulgence Thank You

senator Hasson senator Braun Thank You

mrs chairman good two sets of questions

and like for a doctoral foul she and

redfield give about a minute each to the

first I want to get the broad numbers

I think dr Redfield you might have been

on a record that you think there's 10

times as many cases out there and I know

that's a guess I'd like to know because

if that's the case all of a sudden the

fatality rate goes from five percent

down to five ten two percent twenty

times as many cases of course

two and a half down to 025 what is your

start with you dr Redfield how many

cases you think we actually have out

there and then how many vaccinations and

our herd immunity combinations as a

percentage of our total population do we

need to get two for this thing to be in

the rearview mirror so we got a few big

numbers to kind of relate the journey

ahead thank you very much senator

quickly we now know that this virus

began to really spread in the United

States and in in in in March and in

between March and the end of May you

know we've been able to do antibody

testing and that's what allowed us to

understand how many people were really

infected so that during that period it

was our best estimate about ten to one

so we're probably talking over 20

million 22 million Americans have been

infected I don't want people to assume

that's the same ratio now in June and

July going forward because you think

it's more than that no I think it's be

less because we're doing more and more

testing okay but clearly it gives us a

good idea the extent of infection was

more in March April and May not two

million individuals but more more closer

to twenty million what is your opinion

how many individuals we need vaccinated

and are having herd immunity before this

thing goes into the rearview mirror yeah

Tony may comment on that too it's it's

really got to be over seventy percent of

the population it's got to be immune

before we even see any impact of herd

immunity

dr Fauci not yeah I totally agree given

the transmissibility which is highly

efficient you're gonna need some

somewhere between 70 and 85 percent I

would say seven-day at the lowest okay

second set of questions would be on the

issue of herd immunity because of course

we've got the we don't know how long

it's gonna take to have an effective

vaccine and I'm guessing when you're

talking about herd immunity it's got to

actually confer immunity if you get it

and there might be some uncertainty so

you do get the immunity

what is the how do we go about the

approaches that we've used at this point

is herd immunity gonna be something that

you think will march through if we take

the strategy of having a different

approach for younger people it seemed to

have lower hospitalization rates and

less significant consequences because I

think it's another thing we need to know

because I think that's already gonna be

done by each individual in a way as they

size up their own personal risks so how

much can we count on hurt immunity

I can answer quickly and then turn it to

Tony I think it's important to realize

even now we're probably looking at

somewhere between five and eight percent

of the American public has experienced

this virus so for me herd immunity as a

basic strategy you're talking about a

multi-year strategy this is why it's so

important that the alternative strategy

is a biological countermeasure in the

development of a vaccine but one of the

issues that might be complicating I

don't think it's gonna be something that

is going to be any kind of a showstopper

but we've got to realize and as Senator

Paul said we have to be humble and know

there's a lot we don't know and what we

don't know is what the durability is in

other words so if you wind up getting

hurt immunity to 75 80 percent what we

need to learn and only time will teach

us this is how long this immunity lasts

is it a year two three four or is it

even less is it months we don't know

when we find out then that will inform

us as to whether or not if you get a

vaccine how off you need to boost it so

we have to realize we don't really know

the answer to your question in any

definitive way at least that gives some

clarity some parameters live within

Senator Hassan stressed the point of

protecting the most vulnerable because

to me the one thing it looks like we

could certainly do is to take that

highest risk group from the data we've

already got and build in essence an iron

dome around

them as the one thing that would seem to

be the most important thing to do where

you get certain results and I think that

has to be in place as we the uncertainty

of herd immunity and when we get an

effective vaccine actually converge I

might add just we always think about

herd immunity with regard to natural

infection and or a vaccination but when

you want to talk about protecting the

vulnerable we want to see if some of the

other programs that are more

prophylactic treatment programs like

passive transfer of plasma or monoclonal

antibodies or hyper immune globulin

those are some of the things that you

can do to protect the vulnerable until

we do get an effective vaccine thank you

Thank You senator Brown senator Smith

Thank You Terry Alexander ranking member

Murray to see all of you today and thank

you panelists so we need robust

surveillance occupational testing if we

are going to safely reopen our economy

and our schools our nursing homes and

our group homes to make sure that

they're not a conduit for infection and

we're seeing this a good example of this

is in New York State where employees in

nursing homes are required to get a

kovat 19 tests twice a week so here's

the problem if you're a worker who pays

for that test is that my employer is it

my private insurance I have insurance or

do I have to pay for it out of my pocket

so I'm thinking about that low-wage

worker of working in childcare or food

processing or maybe as a security worker

or a janitor and you know the average

cost of a test is somewhere in the

neighborhood of 75 to 150 dollars though

they're reports of people being charged

over $6,000 to be tested assuming you

can find a test so this is my first

question last week federal agencies

posted guidance on this question and the

guidance said that health plans are not

required to cover the full cost of tests

for surveillance or occupational reasons

and the federal testing plan which talks

about the value of surveillance testing

occupational testing is silent on this

so let me ask you dr Fucci do you agree

that we are going to be better able to

contain the spread of Cova 19 and save

lives if we have surveillance testing no

doubt surveillance testing is going to

be a very important part of the program

to understand not only the current

penetrance of the virus in society but

where it's going short answer to your

question is it's going to be very

important in our public health measure

and also the price of these tests or the

ability to pay for these must be a

pretty significant barrier to having

that surveillance happen I think common

sense tells you that if people cannot

pay for it they're not going to do it

and that's one of the reasons why we got

to figure out how we can do it without

having the stress of people who can't

afford it

to be part of that process and of course

you know the worry of course is that

this ability to pay for these

surveillance tests for this kind of

surveillance testing that could really

tend to exacerbate underlying inequities

since a lot of front line workers and

essential workers who don't have the

privilege of working for home or much

more likely to be black and brown and

indigenous people people of color isn't

that right as in all cases that people

who are economically not able to engage

in some of the things that benefit

others they always in general get a

short end of the stick on that and

that's what we have to be concerned

about right right

well colleagues I think this is a really

important place where we have the

potential to work together sure that as

we expand surveillance testing and

occupational testing look at our schools

or higher institutions of higher

education coming back but we have the

ability to do this and that the ability

to pay for that test isn't a barrier so

I appreciate Tara Alexander you

mentioned this at the beginning others

of my colleagues have mentioned this I

think this is a place where we could

work together in a in a constructive way

I want to ask a question

specifically related to vaccines because

it's been a lot of discussion about this

a lot of discussion about how we can

make sure that people trust these

vaccines that they are safe that they

work and that the long-term consequences

potential negative side effects we

understand those so let me just ask

maybe I'll ask you again dr pouchy um

how do we trust the vaccine that has

only had a short number of months

potentially being tested in the human

body there are a couple of ways to

overcome that first is that you have a

large number of people in the trial the

trials that we're talking about now

we're going to have 30,000 people in the

trial and maybe even more in some of

them you can get it a considerable

amount of safety data but then there's a

process you know after a vaccine maybe

would show efficacy to do further

studies following licensure availability

let dr Han maybe comment on that more

because that becomes something very much

involved with the FDA's authority and

making sure we do have safe vaccines so

Steve let me just if I could maybe put a

finer point in this question for you dr

Han I mean what if the manufacturer were

to say that they could get a vaccine to

market in January but only if they were

released from liability

what's the FDA policy on that how would

you resolve that question Thank You

senator so we would not get into the

issue of liability for an individual

sponsor and what we would do and that's

why we released the guidance this

morning is we would ensure that our

normal regulatory approach and our

standards for safety and efficacy are

met so while we're all really that's not

an FDA authority that we would that we

lose how do you guard against we're

running a little late go ahead with your

question but let's this should be

hopefully this will be an easy one I

mean

what I'm worried about is that there's

some sort of October surprise and that

there is a pressure put on the

decision-makers here to announce the

vaccine in October of 2020 doctor Han

can you just tell us how we can have

transparency so that people can trust

that that isn't happening senator Smith

a very good question and really

important and leads to the issue of

public confidence it's why we released

our guidance today we want to be clear

about what the standards and the data

that we'll need to make a decision and

what factors go into those decision and

want the American people to hear me when

I say we will use the science and data

from those trials and we will we will

ensure that our high levels of the

standards for safety and efficacy are

met thank you senator Smith senator

Leffler

good morning thank you all for being

here sorry I can't be there in person I

wanted to ask dr Redfield can you

outline what steps the CDC is taking to

you know look at as we prepare for

handling both the flu and kovat 19

season simultaneously this fall I know

the CDC recently developed a test that

diagnoses both Kovan 19 in the flu but

one of their activities is the agency

engaged in and are there any novel

approaches that you see in terms of

implementing this would love to hear

about the agency's process for

approaching the season this fall and in

your thoughts there thank you very much

senator I think it's really important to

recognize that it is going to be

difficult with flu and kovat this fall

first and foremost is to try to increase

the American public's acceptance of flu

vaccine as you know less than 50%

accepted we're working hard to begin to

reach out particularly to groups that

have been underrepresented to try to

build that confidence in vaccination

we've worked with the manufacturers to

see if they can boost the amount of

vaccine that would be available they've

now increased their commitment to almost

a 189 million doses CDC bought another

71

million doses normally we buy about

500,000 to be able to be available to

the states and local health departments

for uninsured adults we've now we

increased that to 71 million doses

we've augmented our commitment to the

children vaccine program anticipating

that it would be more children that will

qualify in light of the unemployment so

those are some of the areas that we've

begun to prepare for thank you and this

question is for dr Hahn

you know the pandemic has has exposed

our vulnerabilities in the medical

supply chain and obviously we have a

reliance on imports from country like

China that can quickly pose a national

security risk in the face of an outbreak

of infectious disease we need to come up

with a strategy to boost our production

here both pharmaceuticals and supplies

I've introduced some legislation titled

the beat China Act to offer incentives

to companies that bring manufacturing

back to the United States but would like

to hear from you what additional steps

can policymakers take to boost our

capability to produce these supplies and

pharmaceuticals domestically Thank You

Senator Lafleur and thank you for your

leadership on this I think one issue

that we can all agree upon is the lack

of redundancy in the supply chain and

the dependency that we've seen during

the Cova 19 pandemic has been a problem

the agency's primary focus has been on

instilling redundancy in the supply

chain particularly of pharmaceuticals by

diversifying that supply chain and

really looking for opportunities to

encourage domestic manufacturing we of

course on the regulatory side provide

guidance as well as regulations around

the manufacturing specifications to

ensure quality of pharmaceuticals and

other medical products we will continue

to do that particularly in the advanced

manufacturing space in order to

encourage domestic manufacturing we look

forward very much to working with you

and other members of Congress to see how

we can create the proper incentives to

have that

see and particularly to have as much

domestic manufacturing as possible thank

you doctor huh no further questions I'll

yield my time Thank You senator left

where senator Jones Thank You mr

chairman thank you all for being here

today I really appreciate your testimony

your consistency over the last few

months it has got to be somewhat

discouraging to all of you as it is to

us to see these numbers I want to kind

of focus a little bit on schools as we

will start opening schools up in Alabama

in August and let me give you a little

chronology here the state of Alabama

kind of began to open up its economy

more and in May a little bit more toward

the end of May and then for Memorial Day

we saw the photographs and videos that

dr Fauci referred to with everybody

just having a big time

from a Memorial Day holiday now at the

end of June we are at our highest levels

the last 14 days have shown over 10,000

cases which is 28 percent of the cases

that we have seen have occurred just in

the last 14 days and at the end of this

week we have the July 4th holiday coming

up and we're gonna see a delay in

hospitalizations from right now if we do

the same thing on July 4th we're going

to have a huge problem at the end of

July and early August when we start

opening schools up our state school

superintendent this week said that it

would cost about 18 million dollars for

the average school system to do those

things necessary to try to protect kids

and the faculty but I heard Senator Paul

in his comments and discussing a number

of things to where you would get the

impression that we could just open

schools back up without spending any of

that money

so my question primarily to dr Falchi

and dr Redfield could you comment on

some of the statistics and some things

that you heard about children

transmitting this disease and whether or

not we need to spend some additional

monies for our schools to do things like

how have extra PPE to do things like

hiring potentially hiring additional

health officers temperature screenings

those kind of

those going to be necessary based on

what I've heard from Senator Paul and

what happened on his charts in other

countries doctor foul Qi and dr

Redfield

but I'll quickly give it a shot and then

hand it over to dr Redfield we don't

know precisely I think the data that was

very interesting that Senator Paul

showed about school openings and not

seeing any real obvious surge in cases

is important but we don't really know

exactly what the efficiency of spread is

first of all how many children get

infected that was the reason why in my

opening statement I mentioned the study

that we're doing at the NIH of 6,000

families looking at children what is the

rate of their infection and how often do

they infect their families because if

it's true that the rate is down we'd

know that they don't get seriously ill

with hospitalizations when they get

infected but if the rate of infection is

down and they don't readily transmit to

their parents and family members that's

going to be very important in the

decision making process of opening

schools hopefully we're gonna find that

out reasonably soon by this study that

we're doing I Necco at dr Fauci said

CDC has a number of what we call

household studies going on to try to get

a better understanding of how does the

virus get into a household who brings it

in what happens when it's in the

household

how does transmission vary depending on

how the household responds in terms of

social distancing etc so there is

information that we are gathering I

think we don't know the impact that

children have yet on the transmission

cycle so I think we should just

acknowledge that the greater threat

obviously is against children to the

vulnerable but I think one can actually

have social behavior that can prevent

that so I think that would be just to

emphasize I think it's a really

important it's been said already that we

we move forward and and work to

reopening schools in a safe way I think

as I've note that CDC never really

recommended closing schools it's sort of

just

happened as you know we can do targeted

school closings if we have to in a

particular region like we've done for

other viral diseases but I think we

really need to move forward now and and

work to how to reopen these school

safely Thank You Admiral girar just I

want to make sure you're we're tuned in

and we've talked about a little bit are

we going to be able to make sure that we

get vaccines distributed in the most

vulnerable of communities because that

seems to be where so much is happening

right now in the rural South and are you

making specific plans to make sure that

we get that into the rural areas so

thank you very much so we all work on

parts of this problem right so the CDC

actually controls the distribution but

what my office does running the National

Vaccine program does things like the

Morehouse grant that were a cooperative

agreement that we that we announced last

week that really reaches into the rural

into Hispanic into african-american to

really have the community the people who

are in that community not only link to

services like like testing but to lay

the groundwork for vaccine acceptance

because we know that the burden of

disease is fundamentally burdened by on

these individuals so these are the

people assuming the science works out

that we want to get vaccinated first all

right great thank you thank you mr

chairman Thank You senator Jones we know

the witnesses need to leave about one

we're going to try to respect that

Senator Rosen

hey hold on can you hear me yes we can

well morning I will try to be as quick

as I can

talking about antibodies this morning

Thank You chairman Alexander Thank You

member Murray all of our witnesses for

being here today as our communities

focus on how safely get back to work in

school just like we're all talking about

we know we have to follow the science

and adapt to new information to be sure

that we're making timely targeted and

thoughtful decisions protect both lives

and livelihoods

so dr Fauci the last time you were here

we talked about the monoclonal antibody

treatments and I'd like just like to

follow up on that conversation if we

could as we've learned more about the

virus how it functions how it's

different from other respiratory

illnesses

what updates can you tell us about the

development of preventive treatments

that block the virus from attaching to

the cells that it's targeting well thank

you for the question senator you

mentioned monoclonal antibodies

monoclonal antibodies are going into

trials right now and a number of trials

sponsored by a number of groups

hopefully within a reasonable period of

time we'll get information as to whether

or not that's effective both in the

prevention as well as in the treatment

those antibodies are directed against a

component of the virus that is what's

called a spike protein and that protein

is the one that binds to the now

well-established receptor in your body

for the virus and that's a receptacle

ace 2 there are a number of other

studies that are not necessarily

antibody studies but studies that have a

effect on the virus itself and its

initial replication an answer to a

question that the Chairman

mentions just a bit ago is that there

will be therapies that we will be giving

some for treatment early on and others

for prophylaxis and as we hope as we get

into the fall and winter we'll have

everything

from small molecule treatments and

prophylaxis to the kinds of antibodies

that you're talking about so there's a

lot of activity going on to do that

early in disease both for prevention and

for the treatment of early disease that

you've been doing a lot of serology

testing and then individuals are

presenting with antibodies so out of the

five types of antibodies that people are

most likely to have which ones do most

recovers patients which ones are they

show and if one of these specific

antibodies are present does that make a

difference and if the patient can be

reinfected or not or not are the

effectively immune least for some period

of time what kind of answers does this

give us if you do have the presence of

certain antibiotics

no I'm I'd love to give you a really

precise scientifically based answer but

the fact is we don't know standard wise

when you get an acute infection you get

an IgM antibody as you go off in time

and develop a more chuma Chur immune

response it becomes an IgG there are

some pool subclasses of IgG some more

protective than others the thing we

don't know senator that we will oh we

will know in time but it's going to take

time to know it is what the relationship

between the neutralizing antibody and

binding antibodies that don't neutralize

what is the relationship between the

titer

and the degree of protection and what is

the durability of protection we've seen

some puzzling things we've seen people

recover from kovat infection and find

out they don't have very high levels of

antibody could it be a cell mediated

response that got them through the

illness and some other individuals have

very high levels and we don't know how

long those levels last so we're getting

there with regards to our knowledge but

it is going to take several more months

to a year to really be able to

definitively answer your question about

the role of antibodies in protection

following natural infection I'd like to

ask this question then we know that this

virus affects

is multi-organ it can affect your

kidneys your lungs your hearts producing

strokes all kinds of things your

digestive system your sense of smell so

I'm the science that you're talking

about the antibodies is the science of

stopping the virus from causing harm the

same regardless of which organ it

attacks and and how do we help direct

funding for the kind of research that

you're going to need to look at this

multi organ attack of this virus if you

will this is a very perplexing virus

because it's a respiratory virus and it

gets in through the respiratory tract if

the virus stays in the respiratory tract

and doesn't go systemic to involve other

organs that's good news because you

don't get very sick the other side of

the coin is your antibody response is

not as potent because when you get

systemic involvement invariably you will

have a more potent and robust immune

response so many people and probably the

people who are the asymptomatic carriers

they have a reasonable titer of virus in

their nasal pharynx but the virus

doesn't go any other place in their body

people who get multi-system disease that

get triggered by the virus those are the

ones that unfortunately get more sick

but also the ones that make a more

potent immune response thank you so much

I appreciate you all being here today

thank you senator Rosen very interesting

questions senator Murray do you have

closing remarks one question yes ma'am

thank you I'm despite some of the

limited data we do know that Cova 19 is

infecting and killing black Latino and

Native American people at a much higher

rate than white people I want to ask you

how HHS is going to adjust its response

to reduce cases and deaths and

communities of color and specifically

can you commit to redirect some of the

14 billion dollars that is in unspent

funds Congress provided to address those

disparities Lamia

the two parts of the question first as

you know and really appreciate your

support we've tried to focus our testing

into high social vulnerability

communities so 70% of our over 600

pharmacy sites are in high svi

communities that means racial and ethnic

minorities language to disparities

socio-economic FQHCs we've made a major

push that the federally qualified health

centers that take care of one out of

three of those in poverty over 1300 of

those are now offering testing and of

course we're super excited about the

award to Morehouse School of Medicine

last week that has a large coalition to

create a national infrastructure to

reach to reach minorities and

underserved so that's what we're really

doing and you know my office this is

what we do on a on a daily basis even

without a pandemic your second question

is I don't commit the money so I

certainly think we need continued

investment in this area continued

significant investment in this area that

the forty million dollars is a down

payment on how we could best reach the

underserved community but you're going

to have to talk to OMB about how the

money is spent question I'll keep

following up in tracking that yes ma'am

thank you mr Chairman I appreciate all

of our witnesses taking the time to join

us today to update our committee on the

course of this pandemic and all of our

efforts to respond to it I hope we will

have continued to have an opportunity to

hear from all of you as well as other

key administration officials about this

because the absolute worst thing we

could do right now is to pretend this

crisis is over when it is painfully

obvious that is not true the reality is

that the losses in this pandemic so far

are nearly unthinkable and any further

delays in our response is really

unacceptable we need to take this

president to take this crisis seriously

and lead and we need Congress to act so

I hope we can all get back to work as

soon as possible we need to support our

families or frontline workers our

businesses our schools our communities

we need to get

thing where it needs to be we need to

make sure we are making progress towards

a safe effective widely available

vaccine and we need to strengthen our

ties with the global community rather

than cut them so there's a lot left to

do mr chairman I look forward to

working with you on this Thank You

senator Murray I know our witnesses have

a meeting they need to go to so I'll

abbreviate my remarks but one thing I

want to ask you and perhaps you can each

do it and a minute or less I've put out

a white paper in recognition of what

some of you have said which is in

between pandemics we have found it

difficult to do some of the things we

need to do to prepare for the next

pandemic so there were one or two things

that you thought we should try to do now

in order to be prepared for the next

pandemic what would those one or two

things be dr Falchi one of the things

that I would like to see is an

appreciation on the part of our entire

nation of the importance of responding

as a nation as a whole and not have a

situation where when you have a

challenge such as we have right now we

have very disparate responses we've got

to do it in a coordinated way because we

are all in this together the other thing

I'd like to do now is to cement in our

minds as we bridge to the future the

fact that we cannot forget that what was

thought to be unimaginable

turned out to be the reality that we're

facing right now so it relates to the

kind of appreciation that outbreaks

happen and you have to deal with them in

a very aggressive proactive way dr

Redfield

Thank You mr chairman I think the most

important thing that I could say is that

when it comes to public health threats

our nation needs to be over-prepared not

underprepared and as I mentioned before

decades of underinvestment

investing investment in the core

capabilities of public health data

modernization laboratory resilience

workforce mergers response I think is

fundamental we've really been hit with

this simple virus and I think at the end

of the day it's gonna cost our nation

trillions of dollars and I think that we

have a moment in time where I think

people are attuned and I would say now's

the time to make the necessary

investment in our public health at the

local territorial tribal state and

federal level so that this nation

finally has the public health system not

only that it needs but that it deserves

federal Jawad of course I agree

completely with my colleagues and we're

all singing from the same hymnal here

I'll say three things number one data

infrastructure is really important when

we came into this we didn't know how

many ventilators were in use how many

tests were out there where the tests

positive or negative who was being

tested I mean the complete soup-to-nuts

infrastructure that we need to make

decisions you need those data to make

decisions and to allocate resources and

now that we built this on the fly but we

absolutely have to invest in that

secondly I would say resiliency of the

healthcare system yes we need to attack

kovat but what happens to everything

else we've seen cancer screenings go

down by 80% childhood immunizations

plummet just about every other thing in

the healthcare system was sacrificed for

our kovat response so it's not just the

pandemic response but it's everything

else we need to do and the third thing I

would say is we continue have to focus

on health disparities if everyone was

healthier in this country if we invested

into

to hypertension diabetes obesity all the

things that could bring the general

health up you would not see as horrible

of outcomes as we have in any pandemic

so working on health disparities that

have been here for decades is I think

critical to raise our in general health

and prepare us for whatever is going to

hit us dr Hahn you can have the last

word Thank You mr chairman first of all

thank you for your leadership on your

white paper or I think that's really

important to put this conversation

forward there are two things I want to

emphasize one is the data modernization

but from an FDA perspective it's a very

manual process to number one collect

data on demand and also so the supply

chain we need a very robust system to

understand that we also need a robust

real-world evidence approach so that

when we make decisions in real time

during an emergency doctors do that all

the time agencies do that particularly

during public health emergencies we have

the appropriate data infrastructure to

collect real-world evidence and feedback

into our decisions and then revise those

decisions as needed critically important

for the agency and the second thing is

linked and that is to my previous

comments that Senator Lafleur asked

about we absolutely need redundancy in

the supply chain when you redundancy

manufacturing and we need to emphasize

the importance of domestic manufacturing

thank you thank you dr Hahn well the

one thing this neeki dangerous virus has

reminded us is that there will be

another sneaky dangerous virus one day

and and we know from experience that it

may be easier to take the steps you've

just described

while our eye is on the ball rather than

between pandemics because we get

interested in other issues I'm grateful

to the witnesses for your time I think

the senators on both sides of the aisle

for really careful insightful and

courteous questioning the hearing record

will remain open for 10 days members may

submit additional information within

that time if they would like thank you

for being here the committee was

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