Redfielddr. Robert testify on the outbreak. It is two hours and 10 minutes. South korea has now tested more than 196,000 people but we are not anywhere close to that. They started conducting drive through testing, but people here in the United States cant even get tested by their own doctors. This is the United States of america. Were supposed to be leading the world, instead were trailing far behind. How did south korea test so many people so quickly but we didnt test a fracture of that number . Why did it take so long . We must do better. Unfortunately these delays have been systemic. Just last week the Trump Administration promised to deliver a million tests by the end of the week but it didnt even come close. On sunday they admitted they delivered only 75,000 tests, thats over 900,000 tests short. And this was their own stated goal to the American People. Now the Trump Administration is saying they have distributed a million tests and they will be distributing four million by the end of the week. That is difficult to believe given their record. We need facts, we need information, and we need it quickly. If we dont have testing, we dont know the full scope of the problem. And if you dont test people, you have no idea how many people are infected. We dont even know where the transmission is happening. We dont know where to direct resources. Were operating in the dark. My question is whether or not the administration and President Trump is exacerbating the crisis by down playing it over and over again, we have heard blatent misstatements. He said that anybody who needs a test gets a test. He said the tests are beautiful, he was absolutely wrong. My constituents are telling me they cant guest tested. The same at larry kudlow who said we have contained this, i close to airtight, the business side, the economic side, i dont think it will be an economic tragedy at all. The numbers are saying that the u. S. Is holding up nicely. He could not have been more wrong. The stock market just had one of the worst weeks in history with the single biggest point drop in all time in history. The president and his aids may think theyre helping with political spin and happy talk but the American People want the truth, we need the facts, we need Accurate Information. The cdc now reported more than 647 cases against 36 states, but according to experts, the real number is far higher. My home state of new york has 173 confirmed cases and every member of congress is worried about their constituents. As we proceed this morning, i would like to recognize several of our Sub Committee chairman for their tremendous leadership. It is truly a team effort. Chairman lynch held a hearing last week on the nations bio defense capability. And chairman connolly has been working with states and localities on the front lines of our response efforts. I now recognize our distinguished Ranking Member. I would like to express my regret that he is moving to chair another committee. Thank you to my witnesses for being here today and for all of your hard work. We recognize that your task is ongoing. I hope the so and the important work that youre doing to help combat this. I also want to express my condolences for those that lost loved ones. Families. R those theust continue to support Trump Administration. Vice president pence has reiterated that risk remains low. Even still, as the outbreak continues, its important for all americans to follow the best practices to maintain good hygiene. You can protect yourself and your family by practicing proper handwashing techniques and washing your hands often. Second, avoid crowds as much as possible and stay home if youre sick, and third we can protect ourselves from the virus like we do other viruses. Avoid closeneezes, contact, clean and disinfect your home frequently. All good common sense protocols and procedures we should be implementing. Sense ands are common the risk to americans remain low due to the leadership and early action of the administration. Many of his team is with us today. When the threats started to emerge from china, President Trump recognized the danger to American People traveling there. That action brought our Public Health professionals important time to get a head start in preparing for the virus here at home. Weve seen clusters of communities with Community Spread where people have become sick without traveling to affected areas in the world. There are important steps we can all take to prevent Community Spread. Those who are experiencing the coronavirus can take steps to limit the spread of this virus. Today i look forward to specific recommendations to prevent the spread of the coronavirus. And i want to thank the president and Vice President for safely repatriating the passengers from the diamond princess cruise ship in california. Their leadership drew praise from government Governor Newsom. The innovation that drives our economy also helped to advance innovations in Public Health. Secretary azar has explained, are pharmaceutical industry has been distributing text kits around the country. Over a million test kits have been sent out to date and i hope with can learn more about the efforts to increase the test kits that will be deployed. We should also understand that it will show an increase in positive cases around the country. Lastly i want to say that often times in this committee we disagree on many hot button issues. We dont always see eye to eye, but on this issue i think we should all Work Together for the health and wellbeing of every american. We should not play politics with the coronavirus. We should not advance partisan objectives. Now is the time for us to come together and work to help all americans. With that i would like to thank our witnesses again for their work. Were grateful to them and their teams. Please relay our gratitude back to the people who work for you and for our country and for the american citizens. Madame chair i yield back. Thank you, i would like to begin by introducing our witnesses today, the director of the National Institute of allergy and infectious diseases. He has served well over four president s. He is truly americas doctor, were honored to have you testifying today. Thank you for coming. Dr. Robert hadley is the assistant secretary for preparedness and Response Department of health and Human Services. Think for coming. And dr. Robert redfield is the director for the center of Disease Control and prevent. Thank you for being here today. Dr. Terry roche is the acting Deputy Assistant secretary of defense for health readiness, policy, and oversight at the department of defense. Thank you for being here. Mr. Chris curry is the director of emergency manage and national preparedness. The Government Accountability office. Thank you for being here. I will begin by swearing the witnesses in. If you will all please rise and raise your right hand. Do you swear or affirm the testimony youre about to give is the truth, the whole truth, and nothing but the truth so help you god . Let the record show they answered in the affirmative. Thank you and please be seated. The microphones are very sensitive. Speak directly into them and bring them closer to you. Your written testimony will be part of the record. Thank you all for being here. We appreciate your service. With that, dr. Fauci youre now recognized to provide your testimony. Thank you very much chairwoman maloney. Thank you for calling the hearing and for giving me the opportunity to speak to you for a few minutes on the role of the nih and the Research Involved in addressing the 2009 novel coronavirus. The nih is involved in understanding the pathogenesis or how these viruses work but also in developing countermeasures. Given the limited time, i would like to have my remarks defined to two aspects. One is the development of vaccines. What is the realistic expectation . The other is the development of countermeasures in the form of therapeutics. With regard to vaccines that i mentioned publicly many times, we were able to very quickly go from an understanding of what this was to what the genetic sequence was to developing a vaccine. Theres a lot of confusion about developing a vaccine. So, wenext four weeks or will go into what is called a phase one Clinical Trial to determine if one of the candidates and there are more than one, there are probably ten or so that are at various stages of development. The one that were talking about involves a platform called messenger rna that is a prototype for other types of vaccines that are simultaneously being developed. Getting into phase one in a matter of months is the quickest that anyone has ever done in the history of backs analogy. However, the process of developing a vaccine is one that is not that quick. It will take three or four months to determine if it is safe. That will bring us three or four months to on the pike. And then you go into phase two. To determine if it works. Since this is a vaccine, you dont want to give it to normal Healthy People with the possibility that a, it will hurt them, and b that it will not work. So the phase of determining if it works is critical. That will take another eight months or so. So when you heard me say we would not have a vaccine that would be ready to start to deploy for a year to a year and a half, that is the time frame. Anyone that thinks it will go quickly than that, i believe they will be cutting corners and that would be detrimental. What does that tells us . The next month, the next several months, we are going to have to rely on Public Health measures to contain this outbreak. I would be happy to answer questions later. Let me go on quickly to therapy. The timeline for therapy is different. The reason it is different is that you are giving this candidate therapy to someone who is already ill. The idea of risk and how quickly you determine if and when it works is much more quickly than giving a lot of vaccine to normal people and determining if you protect them. There are a couple candidates now in Clinical Trial. Some of them in china, some of them right here in the United States. Particularly in some of the trials that are being done in some of our Clinical Centers including the university of nebraska, it is likely that we will know if they work in the next several months. Im hoping that we do get a positive signal. If we do then we may, and i underline may, have therapy that we could use. But that needs to be proven first. So in summary, the development is involved in the development of the vaccine in the long term and in the development shorter term. I would be happy to answer questions after all the presentations. Thank you. Dr. Redfield, youre now recognized for your testimony. Thank you very much. Good morning, chairwoman maloney, Ranking Member jordan and members of the committee. Thank you for the opportunity to share cdcs role in the u. S. Response to this novel coronavirus. Cdc is a sciencebased, datadriven organization. Science and data drives our Decision Making and will continue to do so as we form changing guidelines and recommendations. This is a new virus, and many uncertainties remain. Our Public Health response must be flexible. From the outset, cdc and the u. S. Government partners implemented an aggressive, multilayer strategy to slow the introduction of this virus to the United States, to buy time for our scientists to learn how this virus behaves, to prepare our nations Public Health infrastructure and Health Care System for the possibility of a Global Pandemic that would impact your communities, and to educate americans how best to prepare for eventual disruptions to their daily life and the potential risks to their families. The administrations interagency containment strategy relied on evidencebased Public Health interventions. Initially, early case recognition, isolation and Contact Tracing. Travel advisories and targeted travel restrictions, the use of quarantines for individuals returning from Transmission Hot zones, including china, japan and now the grand princess. Absence of immunity and treatment, our nations Public Health response has relied on traditional Public Health activities. As i said, early diagnosis, case isolation, Contact Tracing and targeted mitigation to slow the emergence of this virus in the United States. On february 25, this global outbreak reached an inflection point. This was the first day we saw more cases outside of china than inside of china. We observed rapid widespread persontoperson transmission in iran and italy and long before the first case of Community Spread in california. Science and Data Collected from here in the United States and abroad are reviewing certain characteristics about this virus. At first, the chinese scientists reported fewer than 30 cases of pneumonia confined to one province, hubei province. Today theres more than 110,000 cases worldwide and yesterday, 99 of the new cases that occurred in the world were outside of china. This virus spreads through respiratory drop letlets, sneezing, coughing, and hand contamination. Asymptomatic transmission is possible. Reports out of china looked at more than 70,000 individuals with this infection and found that 80 of the patients actually developed mild illness and recovered, while 15 to 20 developed serious illness. Children and young people seem not to get sick. This disease disproportionately affects older adults and particularly those with serious Underlying Health conditions. Two months ago, chinese science shared the genome sequence with the world and within a week, cdc scientists developed a diagnostic test that is being used in more than 75 Public Health labs across 50 states with the capacity in the Public Health system to test up to 75,000 people. As of today, cdc has received confirmation of more than 990 cases of covid19 in 38 states, plus the district of columbus. Its with Great Sadness that i report now 31 deaths in the United States. As we experience the growing Community Spread in the United States, the burden of confronting this outbreak is shifting to states and local Health Professionals on the front lines. We appreciate your support to increase the Public Health capacity of your communities and our nation. Difficult, critical conditions are being made to mitigate the spread and cdc continues to provide guidance and support as requested. Theres not a onesizefitsall approach to the mitigation decisions that need to be made. They need to be made based on local Health Authorities and leaders. 630 staffers have been put in the field to support the Health Departments and repatriation efforts. We will continue to work 24 7 to protect the American People from this significant Global Health threat. Thank you, and i look forward to your questions. Thank. Dr. Kadlec my remarks will be very brief. I think in some ways we want to retain time for your questions. But i do want to acknowledge the vital role congress has played in this outbreak. The bioterrorism act created critical programs at cdc , the Hospital Preparedness Program that i manage, as well as other critical pieces of legislation. The pandemic preparedness act. The public readiness Emergency Preparedness act. All these tools that you have given us have been vital in confronting this virus, and i also want to acknowledge the role that additional money that you provided over the years for the h1n1 pandemic in 2009, for the people outbreak in 2014, that helped us create a National Treatment network that has been vital for patients afflicted with this disease. Have fourmy role, i principal functions. First and foremost, as we transition from containment of this disease to a hybrid be the Incident Manager for the secretary of health and Human Services to ensure that we have a unified and synchronized effort across hhs and across the government consistent with the National Response framework for medical and Public Health preparedness and response. I also support the Health Care System through the Hospital Preparedness Program. Thirdly, basically work with nih, fda, dod colleagues to rapidly develop therapeutics, diagnostics, and vaccines that could be used in this outbreak. Finally, providing direct support to state and local entities. During this most recent event with the grand princess docked in oakland, we are working with the state of california, the city of oakland, and with our partners to safely disembark all those passengers and manage the crew to ensure their safe return to their homes and protect the communities that will be receiving these individuals. With that i will yield the remainder of my time back to you. Thank you very much. Chairman maloney, Ranking Member jordan, members of the committee, thank you for this opportunity. The departments top priority is the health and safety of our personnel around the world. To address the covid19 outbreak, we disseminated guidance beginning early in the outbreak and continue to issue guidance as the situation evolves. The Department Remains aligned with guidance from the cdc, while allowing limited location and command flexibility as required by mission for local circumstances. In the area of protection, the department issued initial guidance on january 30, 2020. That addressed the current situation, the risk to personnel, prevention and protection measures, health care information, patient screening, isolation information, and information on diagnosis, treatment, and reportable medical events. The guidance also listed the cdc travel advisory for china and referred to the cdc criteria for identifying a person at risk or under investigation. If they suspect they have an increased risk of exposure due to travel or close contacts. Following the initial protection 7, 2020, wefebruary issued guidance for monitoring personnel returning from china. This guidance remained in step with the cdc and provided further measures to prevent the spread of the disease. Furthermore, the guidance directed the identification of Service Members and a 14 day restriction of movement and monitoring of Service Members returning from Mainland China after february 2, 2020. It specified actions during their restriction of movement to address the potential spread of disease. Dodguidance recommended the civilian employees and contractor personnel and family members returning from china follow existing cdc guidance. 25, the department issued Additional Guidance providing a riskbased framework to guide commanders in implementing Health Protection measures based on local circumstances and their command mission. Guidancee series of may be found on our website. As the department assesses and manages risk to personnel and mission, the capability to better andovid19 help track disease spread is vital, and one important factor is diagnostic testing capabilities. Currently the department has 13 labs approved to perform diagnostic testing. Also workingt is quickly to develop lab kits which can be used in the field to mitigate risk to the force and mission. Finally, as we know there is no vaccine to protect the force, there is no antiviral to treat the force. Is working on several vaccine initiatives and antiviral treatment to protect and treat the force. This is in collaboration with the interagency efforts. Im grateful for the opportunity to provide further detail on our efforts to contain and mitigate this outbreak. Thank you to the members of this committee for your commitment to the men and women of our armed forces and the families who support them. Thank you. Mr. Curry, you are now recognized. Thank you. Gaos role is to provide oversight of other federal agencies. I want to talk about two things. First is the report on the National Bio Defense strategy for the federal government. Second is to offer some observations based on decades of work weve done looking at past pandemics and outbreaks and Public Health preparedness. For decades, weve been concerned about the u. S. Preparedness for these events. Unlike cyber events or natural disasters, they are rare, which makes it difficult to maintain once and avoid complacency an outbreak is contained. Bio defense is fragmented across the federal government. Theres over two dozen president ial appointed officials and agencies that have roles or responsibilities in bio defense. Coordination at the federal level is difficult. The good news is the strategy that was issued in 2018, according to our assessment, is the most comprehensive to date. It does a good job defining roles and responsibilities and steps agencies need to take to better coordinate. We did identify some challenges. We still dont see a good mechanism across agencies to coordinate budgets. Cdc, they all have separate budgets. They cant tell each other what to do or how to spend their money. Some sort of oversight mechanism is still critical. About theke to talk current outbreak and make it clear that we dont have enough information to conduct a full assessment of the response. Some of the challenges we are seeing in the public are highlighted by decades of work we have done in past outbreaks and things weve been concerned about. Roles andis responsibilities across the government. I think it is pretty clear that the Public Health emergency many questions are still being raised about the roles of other departments, particularly as this becomes a bigger domestic issue. Questions have been raised about whether a declaration should be brought into play, like a natural disaster, to bring in the additional funding and authority that provides. Who communicates with the public has been a challenge. Testing, we have pointed out that hhs has provided preparedness funding. That number has decreased over the years. I think this is a direct correlation to the investments we make in preparedness. It is difficult to sustain these when we dont have outbreaks all the time. The last thing i would just mention really quick is, moving forward, as we conduct reviews and exercises, there have been reviews after prior outbreaks. The reviewsis that are conducted well and that once is stopped or the disaster is over, there is no followup on the gaps. This completes my prepared remarks. I look forward to your questions. Thank you for your testimony. I want to ask about testing. I am being asked why the United States is so far behind other countries and why the American People cannot get tested. Coronavirusse of was on january 21. The u. S. Has tested approximately 4900 people so far. In contrast, south korea has already tested almost 200,000 people. They can test 15,000 people a day. South korea can test more people in one day than we tested over the past two months. Dr. Fauci, why are we so far behind korea in testing and reporting this crisis . Dr. Fauci thank you very much. Dont like to pass the buck dr. Redfield has the numbers and a map you might want to show you about that. Rep. Maloney is the worst to come . Dr. Fauci yes it is. When you have an outbreak, you can start seeing Community Spread, which means you dont know what the index case is. The way you can approach it is by Contact Tracing. When you have enough of that, you are not going to be able to effectively contain it. Whenever you look at the history of outbreaks, what you see now in an uncontained way, and although we are containing it in some respects, you keep getting people coming in from the country that are travel related, you see that in many of the states that are now involved, and when you get Community Spread, it makes the challenge much greater. We will see more cases and things will get worse than they are right now. Willuch worse it will get depend on our ability to do two ofngs, to contain the influx people who are infected coming from the outside, and the ability to contain and mitigate within our own country. Bottom line, it is going to get worse. Rep. Maloney the bottom line, if we dont test people, then we dont know how many people are infected, correct . Dr. Fauci that is correct. As dr. Redfield will tell you, looking forward, as commercial entities get involved in making a large amount of tests, when you do two aspects of testing, one, a person comes in to a physician and ask for a test because they have symptoms or a circumstance which suggests they may be infected. The other way is to do surveillance. You go out into the community and not wait for someone to come in and ask for a test, but you proactively get a test. We are pushing for that. You,. Redfield will tell the cdc has already started that in six sentinel cities and will expand that in many more cities. People to know how many are infected, as we say under the radar screen. Rep. Maloney pardon me . I really want to get to south korea and their 50 mobile testing sites theyve set up where people can drive up, get a test, and results in two days. This is a question to dr. Fauci and dr. Redfield. The centers minimize interaction between patients. It helps mitigate the risk. Why havent we set up these mobile labs . Are we planning to set them up . Dr. Fauci i will start by telling you, the nih would in no way be responsible for setting that up. Rep. Maloney dr. Redfield. Dr. Redfield cdcs role in this was, we very rapidly developed a test from an unknown pathogen once we have the sequence. We did that because we wanted to get eyes on it so Health Departments could send samples to us and we would test them. Secondly, we tried to expand that and scale it up with contractors so each Public Health lab would have that test. Agentsd out one of the wasnt working appropriately and we had to modify that. But the test was always available in atlanta if you sent the sample to us. Now our Health Departments have 75,000 tests. Most Health Departments, over 75 departments, have the test. Rep. How many rep. Maloney how many tests are we planning to produce in the United States . Dr. Redfield we put out 75,000. The other side, which is really not what cdc does traditionally, is to get the private sector to have testing for patients. Cooperation for them all to Work Together. And as we sit here today, they are offering this test in their doctors offices throughout this country. But it is not just for an individual to take a test. They need to see a health care professional, have assessment, and get that test. On february 29, Harold Zucker asked if he could and the fda worked with him within one day and got their test up and running in the state of new york. So we are working hard to get testing available. Available to get it for the Public Health system and start these large Surveillance Systems. Privatethers, theres a sector to get it to clinical medicine, and with lab quest out, those tests are rolling out. Are they reporting to cdc their results . Are they reporting now . Dr. Redfield it is being worked as we speak today. My time isy expired. I recognize the distinguished member she left. Ok, i recognize the gentleman from the great state of tennessee, mr. Green. Green i am incredibly disappointed in the politicization of this response. Criticism the president is undergoing is unwarranted and maligned the hard work done as our nation doctors and scientists in places like the cdc, nih, fda, dhs, dod have prepared. Make no mistake, this virus is a serious problem. But that concern was immediately shown by our president , as evidenced by his historic response, and i would like to correct the record. On december 31, wuhan officials posted the first notice saying they were investigating a pneumonia outbreak. On january 7, the cdc established a system just seven days later. Cdc sent staffers to airports to screen all people coming from wuhan. 21, the cdc activated its Emergency Operations center. On january 29, the president established the president ial task force. On january 30, still less than a month from the initial announcement, the state department issued a do not travel warning to china. The World Health Organization announced the coronavirus is a Public Health emergency of international concern. Before the World Health Organization even announced a global concern, the administration was working on its response for almost a month. Trumpuary 31, president proactively suspended entry of foreign nationals who had been to china in the last 14 days. Quarantinest issued and a Public Health emergency for the entire nation. On february 11, the World Health Organization named of the virus covid19. The administrations First Response a week after the announcement. The virus hadnt even been named by the World Health Organization yet. Nih, and alle cdc, agencies of our Scientific Community with acronyms that boggle the mind have been working feverishly to sequence the virus, get its proteins sequenced, and get a vaccine going. 24, the president unveiled the initial plan. Yet according to the leadership of the other party, our president has failed us. Months of response and yet they are accusing our president of failing us. On february 26, the president appointed the Vice President. That appointment is in keeping with the obama era panel on bio defense. 29, 60 days after the chinese announcement, america lost its first victim to covid19. 50 three days before america lost a single life to covid19, the administration was working diligently to prepare our country. Youve heard witnesses describe the herculean efforts there departments are taking to protect the lives of americans. I want to thank the dedicated men and women for the years of work that has gone into preparing for this type of effort. And their tireless response since the announcement just 71 days ago. America will lose lives to this virus. Appointeeed by obama and former director of the cdc friedman, had the president not responded so quickly, we would not have been prepared as we are , and more lives would have been lost. Chairman, i yield. Rep. Maloney thank you. I now recognize the gentleman from massachusetts, congressman lynch. And i want to thank him for his help in preparing this hearing. Rep. Lynch thank you. The call foro unity that was expressed by the Ranking Member early in this hearing. I am proud to say that every Single Member of this committee voted for 8. 3 billion to deal with coronavirus. Think did so, i consistent with your request from our Public Health officials. I think america is best when we have a unity of purpose, a singularity of mission. But that much being said, i have to say that the president s statements from the beginning of this has been contrary to the direction you have given us. 6, toldident, on march the people in my district publicly that the tests were ready, anybody who wants a test can go be tested. Beautiful tests. That is not a medical term. Constituents went to their local health centers, went to their hospitals. There were no tests. Zero. And i know they are rolling out now, but this was back on the sixth. That is not a good situation. He said this in front of some of you at a public hearing, at a press conference. And i saw no one step up and say the president wasnt correct, the tests are not ready, they are not beautiful, they are not available. Of purpose, but we are not going to get that when the president is telling people that the cases of coronavirus are going down, not up. They doubled yesterday in my district. And i represent part of boston. Myself and ms. Presley share that city. Medicallya backwater or technically. It is very advanced. Someresident has made bizarre statements. I want to be together with my republican colleague, but when the president said he had an uncle that went to m. I. T. And he has a natural affinity for this, it has to raise some red flags. We need you to step up. Dr. Fauci, youve been great on some of this stuff and pushing back. When the president said we are going to get a vaccine fairly quickly, you were good to step up and say no, it is going to be a year and a half. But we really need honesty here. And when the president is making statements like this, we need pushback from the Public Health officials. Standing behind him and nodding eye roll once in a while is not going to get us. When i say things, they are immediately considered political because im a democrat and im elected, but you have a certain level of credibility and honesty that should be persuasive to the American People. I just ask you to be more forthright when the president makes statements like this. We need leadership, but we need people to be aware of the dangers that are out there. The cases are not going down. The American People should be aware of that. You should be forthright in explaining that. When the president economic director says weve got this , ourined, we need you Public Health officials, to step up and say that is not true. That is hurting us. That is making the spread of this virus more extended, more , and more possible. People have to step up and make sure they are aware of the dangers. I appreciate your comments, but i can tell you absolutely that i tell the president , the Vice President , and everyone on the task force exactly rep. Lynch i dont doubt that. Dr. Fauci i have never held back telling exactly what is going on from a Public Health standpoint. Rep. Lynch thank you. Rep. Maloney the gentlemans time has expired. Ms. Fox is recognized for five minutes. Rep. Fox thank you. Since our current Ranking Member did not use all of his time, i may steal some of that in mind. To thank our witnesses for being here. And i think the very fact that we are having these hearings all over the congress and the fact that there are press conferences every day disputes what some of our colleagues are saying, that the facts are not getting out there. And i want to thank all of you all for being here and foretelling the facts to the American People. Because i do think that is important. I also want to thank my colleague from tennessee for outlining what has been done, because we tend to forget the good actions that have been taken because of the direct criticism of the president , which i think is totally unwarranted. I do think it is helpful that we explain the facts, but also not scare everybody about this beblem, but ask them to sensible about what they are doing. That barta amended its contracting process to place all proposals not related to coronavirus in q until the threat subsides. It is really all hands on deck and a focus totally on coronavirus, correct . Dr. Kadlec yes. Though we are accepting additional proposals, we are focusing on the immediate concern. Is. Foxx i know that barta a fairly small entity and not a lot of attention has been paid need our nation to remain prepared for all threats, including biological, nuclear, and influenza. So would you mention what additional personnel or authority barta needs to ensure ist its response to covid19 performed as well as possible . Dr. Kadlec some of those authorities were given. There is a proposal that was consequence of the act creating an innovation platform and we probably need some relief in terms of federal pay cap waivers there. But barta has been extraordinary in its history to get 5350 approvals for a variety of countermeasures and devices in its very short history and it is the little engine that can. And i think it is one thing, working with nih and dod, has been very successful to advanced things, like during the ebola resourcing,think with barta can, and it is a great really the team that does provide significant capability in concert with nih and with our dod colleagues. What you indicate is that theres a lot going on that people arent aware of. Groups of people working within the government to try to anticipate the kinds of things thats happened with the coronavirus. Well never be able to stop all kinds of problems like this, but at least we have people working very, very effectively in these areas. Dr. Redfield, i think dr. Fauci tossed over to you an opportunity to speak about some of the issues and the concerns about getting the necessary medical supplies out to people. Would you like to expand on what you were not able to talk about earlier . Redfield i would just like to, again, try to emphasize the development we did for the diagnostic test. I think we developed that very rapidly so that the Public Health community could have eyes on. That test was at cdc. We rapidly tried to get it to the Health Departments during our Quality Control, we basically found one of the reagents wasnt working. As i said today, we got that Public Health labs now throughout this country have adequate testing to do their Public Health mission. The other side of the mission is the clinical mission. And i think thats the concern of most american citizens. How do i get evaluated . And, again, that really has been worked through the private sector. It wasnt really the Public Health lead for cdc to get the laboratory test, but i will say that the test we did develop, we published and let everybody use it. They could redevelop it. There was regulatory release. So, any Certified Lab according to the fda was given release, could develop the test just like we did and use it. Some universities have done that. We also released it to the manufacturer that made our test for Public Health purposes, they were given the regulatory relief to make that test and sell it to hospitals. Thats the 1 million, 3 million tests that people refer to that are rolling out on that side. Most importantly, and we really need to give credit to the diagnostic companies of this nation. When they met with the Vice President , they didnt come one company at a time. They had already agreed as a group theyre going to figure out how to get this diagnostic test as rapidly as possible for the American Public that needed it. And as i said today, yesterday they began that, both lab corp and quest. So there should be, again, increase in availability across this nation through the private sector. Foxx and i worry about what we heard when we discussed hr3, that were hr3 to become law, that we would lose much of that ability through the private sector to come up with the cures that we need to come up with and so im very pleased to see this cooperation with the Public Private partnership. And thank you very much, madam chairman, for your indulgence. Chairwoman thank you. The gentleman from tennessee, mr. Cooper is recognized for , five minutes. Mr. Cooper thank you, madam chair. Im delighted to hear the bipartisan praise of our Public Health workers, our professionals. And i hope that colleagues on both sides of the aisle will heed your good advice. First question. Can u. S. Doctors or patients order some of these tests from south korea . Important question when was asked by the chairwoman about the difference. The difference between the south korean tests and our tests is they would have to go through our regulatory process and the fda to get approval to use that. Mr. Cooper so the answer is no . currently no under the regulatory issue. Mr. Cooper ok. What are the names of these south korean companies, or enterprises that offer these tests . Dr. Redfield the basic difference, congressman, is when we cdc developed our test, if you give me a second, we developed to make sure it could work on the platforms that we put in all the Public Health labs. Those platforms were based on our flu surveillance. We used a technique called thermocyclling. Not a high throughput. Koreans have a high throughput platform that is being worked on by lab corp and quest to bring it in. Its a different platform. Roche is the company, i think im not sure but can get back to you which was the platform they use. Its a high throughput that allows many, many tests to be done at a single time. Mr. Cooper so they used a swiss company, or wherever roche is headquartered, to supply the need . On redfield i will get back the specifics to you, sir, to make sure i do not misinform you. Mr. Cooper so well have to google this because were not eliciting this information today. Dr. Redfield well get back to you. Lab corp and quest are up and most american doctors use one of those two. Mr. Cooper lab corp and quest are Wonderful Companies but still we are behind south korea in terms of making testing available. So how do we solve this gap . Dr. Redfield whats going on right now, rather than the Public Health platform that we used if we had developed a test on the korean platform none of our Public Health labs could have done it, because they dont have the instrumentation. So right now, the private sector and certain labs have begun to transfer that to what we call the high throughput. And so, you are going to see those high throughput, the same technology approved in the United States and used by different private sector groups. Mr. Cooper so, finally, were turning toward what you call high throughput and it may be from roche, somewhere else, or maybe at the Wadsworth Lab in new york but finally one day we will have it . Dr. Redfield yes. I would try not to use the word finally. Maybe im not making myself clear. In my role to get it into the Public Health labs we built it on a platform that they had the instrumentation. Mr. Cooper whats the name of the company that supplied the faulty reagent . Dr. Redfield well, you should be careful. The third control did not perform the way we wanted it to perform. Theres two possibilities. One, that that reagent at that time, there was a contamination. But the other possibility is biologic, that these prime repairs folded on themselves and they didnt perform. Its been corrected. And the new tests were mr. Cooper substandard, faulty, whatever name you want to use, whats the name of that company . Dr. Redfield it was produce bid idt initially, and weve worked with them to correct that, and cdc together. Mr. Cooper are there any plans to have drivethru testing in america so we do not panic Emergency Rooms when people come in and cough . Dr. Redfield not at this time. Were trying to maintain the relationship between individuals and their Health Care Providers. Mr. Cooper thats very interesting as a response. So the professional monetary relationship comes before Public Health . Dr. Redfield no, that was not my point. Maybe dr. Fauci wants to comment. My point was ability to assess appropriateness that these individuals get the proper care, we believe this is something that still has value to be dealt with, within the setting of clinical medicine but ill ask tony to comment. Dr. Fauci it is exactly what you said. It is not anything about monetary. Thats really not a consideration at all. Its the try to get people to at least on a telephone call basis to be able to phone their physicians ahead of time and say i believe i have a situation. The physician would probably say stay at home and give them the instructions of how to get a test. Its the relationship between the patient and the physician. I have no indication at all of financial on that. Mr. Cooper well, most americans dont really have a doctor. They rely on the e. R. To help and people are panicking, e. R. S apparently. I see my time has expired. I wish i had more time. Thank you, madam chair. Chairwoman thank you. The gentleman from georgia, mr. Hice, is recognized for five minutes. Thank you for being here. You said in answer to a question you believe the worst is yet to come. Everyone up here, both sides, weve been in briefings on this. Many of us on multiple briefings and i think everyone up here would agree with you from the information were hearing. Im curious, though, with the steps that were taken early on from declaring Public Health emergency, restricting travel, giving each of your organizations the freedom to move forward, to try to combat this and a host of other things, how important were those decisions . Would we be in a worse situation, for example, had there not been some travel restrictions . I believe we would be in a worse position, sir. If i might with respect look ahead now, we need to do a lot more. There is no question. Fauci and i would like to maybe use just a few seconds to get a point mr. Hice make it quick. I want concise answers because i want to yield. Fauci i yield back to you. Thank you. One of the issues, and i do appreciate the cooperating spirit here today i know brad snyder and i, we worked together to put together a bill. He led the way on trying to make sure medical device ss are here if there is a shortage. In that spirit of cooperation, with we all need to address this issue that is critical to our country. And im curious specifically on the medical supplies and medical devices, are we going to be facing a shortage . Dr. Fauci yes. I believe that if we have a major outbreak, we are definitely vulnerable to shortages, but dr. Kadlec knows more about that than i do. C i would just characterize it at this point and again the fda has the responsibility to look at the entire supply chain of pharmaceuticals and drugs in the country. Im looking at particularly the things that we need for this outbreak right now. I want to highlight the issues around personal protective equipment. Much of it is sourced from overseas. Some of it is domestically manufactured, and, yes, we could have spot shortages. Were working with different companies, different sectors to enhance both their increased capacity here domestically, as well as obtaining supplies from overseas on affected areas to meet the demand. The most important demand is with health care workers, ensuring they have the respiratory protection and barrier protection so they can see and treat patients without the risk of getting infected and being lost to the cause. Mr. Hice ok. Thank you. Dr. Redfield, real quickly if you would, is there any way that the regulations rules that are standing in the way of the fda from getting tests here being purchased, is there any way those regs can be waived in a National Emergency . Dr. Redfield initially, the regulations were, in fact, there. Thats why we had to go through and get approval. The commissioner actually gave regulatory relief so any individual now can go back just mentionedou a moment ago we cannot purchase those tests from south korea. And you said because of regulatory interference. My question is, can those regulatory requirements be waived in a National Emergency . Dr. Redfield i would have to refer that to the commissioner of the fda. Ok. Hice last question, real quickly and , i want to yield to the gentleman from tennessee. Dr. Redfield, are our tests better than their tests . More accurate . Dr. Redfield i would say our tests are accurate. Im not going to compare it to theirs. Mr. Hice ok. I want to know if were talking apples to apples or something else. The south korean tests are accurate as well as far as you know . Dr. Redfield i would assume. I can only comment that our tests are accurate. Mr. Hice with that i want to yield to the gentleman from tennessee. Congressman hice, thank you. Dr. Redfield i was on the phone with the cdc and the nih yesterday and they suggested that the south korean tests used only a single ig and not igg and igm. Would you explain to my colleagues here why that single immunoglobulin test versus ours, why ours is so much better . Dr. Redfield congressman, youre referring to the test the test were currently using and theyre using to detect acute infection is to measure the antigen in the oral, nasal or pharangyngeal space. And they are actually using a molecular test for that. Talking about is measuring the full extent, and that is a serological test, or they can measure it in oral or nasal secretions. And measure certain, like an igg. Cdc has developed two tests that were evaluating right now so we can get an idea through surveillance whats the extent of this outbreak, how many people really are infected, and that is being moved out now to do these extensive surveillance programs. Programs. Madam chairman, can i get one more question on that same line . I can wait for someone else to yield. Thank you. Chairwoman lets wait for someone else, and i went to try to keep to the numbers, because there are important questions on both sides of the aisle. I now recognize the gentleman from virginia, mr. Connelly, and i appreciate his help. He is recognized for five minutes. I appreciate his help on this hearing. I thank the chair. Some of my friends on the other side of the aisle, including the Ranking Member, began sanctimoniously to say we dont want to politicize this situation. Too important. We didnt politicize the fact that the Global Health and security biodefense desk at the National Security council was dismantled by this administration two years ago. We didnt politicize the funding of health, Public Health in the United States in budget after budget that, in fact, made critical cuts, which weve restored. We arent the ones that called the alarm being raised about this pandemic as fake news. That came out of the president of the United States mouth. And no gaslighting is going to hide that. And politicization, when the president of the United States finally did go down to cdc with you, dr. Redfield, he appeared wearing this hat, a campaign hat in the middle of a crisis. , we will not be lectured about politicization and all of your words and sanctimony will not cover up the fact that this administration was not prepared for this crisis and it put lives at risk, american lives at risk. We didnt have the tests we needed. We didnt have the diagnostics we needed. The president made patently false assertions, which dr. Fauci correctly corrected about the development of the virus. In fact, he was more concerned about what was happening on the stock market than he seemed to be concerned about american Public Health. And thats shameful. And you cant cover that up. And we will not be silenced, nor will we be intimidated by charges of politicization in pointing it out because lives are at stake. Dr. Redfield, you indicated one size does not fit all. And i think thats true. But there is a concern that we do not have any kind of uniform protocol and guidance for localities and states, so, for example, mr. Coopers state has decided not to identify a specific county where a coronavirus victim may be present, just a region of the state. Whereas in my stead, we are being quite precise about where a victim may be identified. They corrected that today. But again, theres confusion. Do we close things . Is it a certain number were worried about . When do people get tested . How do they get tested . Whats the guidance of going to an e. R. As opposed to seeing your physician . What if you dont have a physician . There is real concern here about the need for more uniformed guidance. Granted, one size does not fit all, but that doesnt mean theres no guidance at all and no protocols that states localities could refer to. Would you comment . Dr. thank you. A very important question. First, we do have very specific guidance for a variety of things that cdc has published. Really targeting more business community, hospitals, longterm care facilities. But the point you raised, i think, is the most important. What guidance are we giving Public Health officials to figure out their public Mitigation Strategy based on their circumstance . I will say yesterday we did post for everyone an algorithm for how they can go through jurisdiction by jurisdiction for what to do for individuals and families at home, what to do for schools and childcare, what to do for assisted living, longterm care facilities, what to do for community and faith organizations, what to do for the health care setting. Because i couldnt agree with you more that we want to give guidance. And weve put that out. We are, as we speak today, working with four jurisdictions to get very specific on exactly what cdc is recommending in those four situations so the rest of the nation can see how to begin to operationalize this. and if i could just ask, was it a mistake, dr. Fauci, do you believe, to dismantle the office within the National Security Council Charge d within Global Health and security . Dr. Faucher i wouldnt necessarily characterize it as a mistake. I would say we worked very well with that office. It would be nice if the office was still there. Mr. Connolly we have a bill to solve that, a bipartisan bill. I thank you and i thank the chair. Chairwoman thank you. the gentleman from wisconsin, mr. Grossman, is recognized. Is recognized. , ma thank you for being here. I am glad youre also ready to come to washington. I am going to talk a little bit come tome things that mind, which we expected all sorts of things to happen, because all of these horrible things did not happen, and the public are not that alarmed yet. Bitnt to talk a little about the numbers in china, what we expect the numbers to be in the United States. The things i have here show that in china, there been about 3000 deaths. Do you agree that probably the worst is over in china, or do you think that number is going to continue to escalate or slowly drop . They have really come down to 50 cases per day, so they really have now gotten control of their outbreak. Hman ok. So in the United States, looking at the trajectory, looking at what happened in china and the United States, based upon what were three weeks, a month how far are we into the situation in the United States . Dr. Redfield i think thats the critical question. For a period of time, this outbreak seems to go in a very arithmetic way. And then it goes logarithmic. So, for example, you can just go back three weeks ago, and italy had no infections. Italy had 1800 infections confirmed just last night. We are fighting hard now between our containment strategy and, as dr. Fauci will say, expanded mitigation. Mr. Grothman right. Lets compare it to something the average american understands, and thats the common flu. Can you tell us every year kind of where we start and how much it grows and how many new people get the flu every day . Dr. Faucher yes. I cant give you a precise number, sir, but one of the things were trying to emphasize to the American People n i only have five minutes. Can you tell us about how many people, say, get the flu every year and how many new people are diagnosed . get theer fauci flu, i didnt hear you. Im sorry. About 5 or so, to 10 of the population. We have about 30,000 deaths. It ranges from 15,000 to about 69,000, 79,000 per year. Mr. Grothman ok. Based upon the current trajectory, how many people do you think will get this new virus and how many do you think will die . Dr. Fauci i cannot predict. I know you cannot predict, but you must we have a graph, beginning with the graph. We know this is going to go up. We have the experience of china. We have the experience of italy. Dr. Fauci it is going to be totally dependent upon how we respond to it. So, i cant give you a number. If we now sit back complacently i cant give you a realistic number until we put into the factor of how we respond. If we are complacent and dont do really aggressive containment and mitigation, the number could go way up and be involved in many, many millions. If we contain, we could flatten it. So theres no number answer to your question until we act upon it. An in sports, i think one of the basketball tournaments for the ivy league cut off their tournament all together. Nobody talks about every night they play like, i dont know, eight to ten nba games and nobody talks about shutting them down. Is the nba underreacting or is the ivy league overreacting . Recommend we would that there not be large crowds. If that means not having any people in the audience when the nba plays, so be it. But as a Public Health official, anything that has large crowds is something that would give a risk to spread. An i will emphasize again. You said about 30,000 people die every year from the regular flu. Do we know the ages of the people so far who are dying of the new flu . Redfield yes, for the coronavirus right now, for example, in italy, the average age of death is over the age of 80. Most of the deaths that weve seen are over the age of 70. Ok. Grothman i will yield, maybe give dr. Green another chance to ask a question. Thank you. Very quickly, dr. Fauci, you took the hipocratic oath, right . You took the hippocratic oath . Ok. Are you offended by someone suggesting you might intentionally not speak out when youre confronted with something that could harm your patients and violate your hypocratic oath . Yes, i just made that point a moment ago. Madam chairperson you said i , served four president s. With all respect to reagan and george h. W. Bush, i served six president s and have never done anything other than tell the exact Scientific Evidence and made policy recommendations based on the science and the evidence. Chairwoman ok. The gentleman from illinois, mr. Krishnamorthi, is recognized for five minutes. Thank you, chairwoman, and thank you for coming today. Yesterday the governor of illinois said im very frustrated with the federal government. We have not received enough tests. I want to understand why. Director redfield, director redfield, over here. The first coronavirus case in the u. S. Was confirmed on january 21. At that point cdc began developing a test kit to diagnose coronavirus cases. The fda gave cdc emergency authorization to manufacture and issue this test kit around february 4, isnt that right . Dr. Redfield [inaudible] hnamoorthi unfortunately, however testing , did not get underway because of problems with the test kits. Specifically, cdcs atlanta manufacturing facility had Quality Control problems. On february 24, one month after coronavirus was found in america, officials discovered that cdcs atlanta facility was contaminated. Whether it was because of the contamination or bilogic problems which you had alluded to, test kits coming from there were flawed and had to be replaced, dramatically slowing down our response. Dr. Redfield, i know you are investigating the cause of the investigation and the atlanta facility. Is the person who oversaw the atlanta facility at the time still in charge of the current manufacturing process . Dr. Redfield this is a currently under an investigation at this point, and i think im going to leave it there. Namoorthi sir you , cant give us assurance that the person who bungled the production process hasnt been removed . Recovering from that misstep cost us precious weeks and now months, sir, meanwhile the virus spread and people died. I respectfully disagree with your earlier karks b characterization we had an aggressive response when one month after the first coronavirus case was detected, we still had not shipped test kits to public labs. Now, lets currently discuss testing efforts underway in the u. S. And other countries. You have a copy of this chart before you. We talked about south korea and the u. S. Let me just drill down for a second, because it was very instructive. The u. S. And south korea both experienced their first confirmed coronavirus cases roughly within a day of each other, the u. S. On january 20 one and south korea on january 20. Interestingly, both countries developed a test to diagnose coronavirus roughly around the same time. The u. S. On february 4 and south korea on february 7, just three days later, but then, our testing at that point, the activities diverged dramatically. Here we have a chart that shows the testing activities of four countries, the u. S. , south korea, italy and the uk, on three separate dates in the past three weeks. Until march zero 10, south korea tested 4,000 people for every million persons in its population. Italy, in the blue bar, tested 1000 people for every one Million People in the population. The u. K. , 400 for every million. Now, where is the red bar representing the United States, dr. Redfield . Dr. Redfield i dont see it on that graph. Amoorthi i do not either, but i can assure you that the data is there. It just doesnt show up. It doesnt show up. It turns out that korea had tested tested 4,000 people for every million of its citizenry, and we are at 15 people for every Million People in this country. Thats a response, a testing response, thats almost 300 times for aggressive than whats here in this country. And the problem, dr. Redfield, is that when we dont test as rapidly as we should, the virus spreads, and people die. Now, lets talk about the situation going forward. Vice president mike pence said on monday, before the end of this week, another 4 million tests will be distributed, but the real question i submit is not when the tests will be distributed. Its when the tests will be performed on people so they can know whether they have contracted coronavirus. Now, south korea currently tests 15,000 people per day, whether it is through high throughput, medium throughput, low throughput, it does not matter. They test fraen thousand people per day. Dr. Redfield, when are we going to be reaching 15,000 per day tested in this country . Dr. Redfield well, first, id say, mr. Congressman, it does depend on the clinical indication. I think one thing i would like to point out again, the cdc developed this test for the United States Public Health system. We did not develop this test for all of clinical medicine. The tests for clinical medicine we count on the private sector to Work Together with the fda to bring those tests to bear. And i said, finally namoorthi you are blaming the private sector. Redfield no, i am not blaming them. Moorthi you are passing the but to the private sector, sir, because of this, the virus is spreading. People are getting sick. People are dying. Congresswoman mr. Comber is recognized for five minutes. Thank you, madam chairwoman. I cannot think of a more Important Committee hearing that would take place in congress this week than the one were having now. I was very glad to see Congress Come together last week in a bipartisan way, after weve spent many months in the very partisan environment here with respect to the impeachment hearings. But congress came together to pass a very important corona supplemental that i think everyone would agree is making a huge difference in americas defense against the coronavirus outbreak. But ive been very disappointed to hear some of the comments by my colleagues on the other side of the aisle. Chairwoman maloney mentioned the political spin. Theconnolly mentioned politicization and fake news. I just wanted to mention a couple of things that have been written and said by the press and democrat leadership. The New York Times, a little over two weeks ago, had a headline, lets call it trump virus. If you are feeling awful, you know how who to blame. And then House Majority whip jim clyburn asked if he had confidence in the administrations response, he said, absolutely not. Theyre just fooling around. It just reminds me so much of katrina. I take a bit of issue with the politicization with something that should be focused on bipartisanship and working together to save lives. Because we have a crisis. Americans are truly and rightfully concerned. And i think that Congress Needs to work hand in hand with the administration. I dont believe the administration has gotten the credit it deserves, especially with respect to the president s early decision to cut off the border, which has undoubtedly given the cdc and Health Officials time to prepare for this outbreak. Im not confident the last administration would have made that decision, for fear of political incorrectness or whatever. So i think the president should get a lot of credit for making that decision. But i want to focus on some things that are important to people in kentucky, because theres a lot of concern, theres a lot of misinformation. So my simple question would be to anyone on the panel, which are the best websites for concerned americans to get on to that have factual information and important tips on how average Everyday Americans can prepare for this virus . so there are two. One is the core one is cdc. Gov. And within that is cdc. Govrus. Gov, but will get you very quickly to anywhere you went to go. Mr. Comber my next question, in the era of fake news and social media, how can americans ensure that the information that theyre sharing on social media is Accurate Information . Do you have any advice on that . Yes, i think, for the most part, at least from my experience, social media can often be as detrimental as it is helpful. And thats the reason why, sir, i think the first question you asked would be the one to go to the source of data, cdc. And im not cdc, but im saying cdc is a datadriven organization. And if you really want the facts and data, i would just go to cdc. Gov. Im sure well start sharing that information. I want to switch gears in the last minute, represent along with congressman green, ft. Campbell military base, in kentucky and tennessee. But can you tell us what is being done to ensure that there is not an outbreak, first of all, on our military bases to protect our troops . Secondly, what our military is doing to be able to be in a position to help fight this if this is a mass outbreak . Dr. i will take that one. Thank you for the question. So we have put out a series of for selfprotection guidance that is aligned to the cdc recommendations. And we have tailored those that guidance for selfprotection for military commanders and particularly for installation commanders. And installation and military commanders have a lot of latitude between right and left limits within our guidance that they can command and protect their military population. Now, what were also doing is working with the interagency efforts to develop vaccines and also to develop antiviral treatments. And we are working with the interagency to develop what we call expeditionry field diagnostic kids. Because we want kits that we can push far forward. Because we have missions all over the world. We need to get our medical capability distributed. Well, thank you, and, hopefully congress can work with , you all in a bipartisan way. We can come together and help do everything we can to protect american lives. With that, madam chair, i yield back. Chairwoman thank you. the gentleman from maryland, mr. Raskin, is recognized for five minutes. Mr. Raskin thank you. Dr. Fauci, weve got two enemies in this crisis, one is the virus and one is misinformation about the virus. And i want to quickly clear up a few things that have been said over the course of this process. One was by the president in early february when he said, it looks like by april you know in theory when it gets a little warmer it miraculously goes away. Is there any scientific reason to believe that . The basis for any surmising that that might happen is based on what we see every year with influenza which actually as you get to march and april and may, it actually goes way down. And other nonnovel coronavirus but common cold coronaviruses often do that. So for someone to at least can consider that that might happen is reasonable, but, underline but, we do not know what this virus is going to do. We would hope that as we get to warmer weather it would go down. But we cant proceed under that assumption. Weve got to assume that its going to get worse and worse and worse. Mr. Raskin ok. The president predicted there could be a vaccine in a few months. I think you contradicted that today and at that time. Is there any chance we will have a vaccine in a few months . Dr. Fauci no. I made myself clear in my statement. Dr. Redfield, the first case of Community Spread of coronavirus took place on infection of someone without a february 21, clear travel history to china or with someone who did. Why wasnt the decision made on that date to expand your testing criteria for anyone displaying symptoms at that point instead waiting until march 4 to broaden the criteria . Dr. Redfield thats a good question. We always left the discretion to do testing to the local Public Health group. If you looked, we always had that discretion. We never refused testing from anybody. But we did give guidance as you pointed out originally to do testing for individuals. The percentage was certain clinical scenarios, secondary to travel to china. Those two cases in california and several others obviously led to us reconsider those and make it very clear that we wanted up front to tell clinicians if they suspect it and the Health Department suspects it they should send that sample to the Health Department or us to cdc. Mr. Raskin ok. Weve heard stories about people who have had compelling reasons to get tested. I give you one example. A nurse in california was quarantined after treating a patient who had coronavirus and then showed symptoms of the disease herself. On the day after you broadened march 5, the tisting criteria she put out ate statement, she said, the public county officer called me and verified my symptoms and agreed with testing but the national cdc would not , initiate testing. They said they would not because if i were wearing the recommended protective equipment , then i would not have the coronavirus. Are you familiar with this case . Dr. Redfield no. and i would think that this is a misunderstanding if it did occur. Raskin ok. So what is the standing criteria . The existing criteria for testing now . So we have no confusion about it . Dr. Redfield again, its the at the if a clinical nizition, nurse practicer, feels a test is indicated mr. Raskin based on what . dr. Redfield based on their clinical assessment. Dr. Redfield and thats based on does it require that the person has to have had contact with someone on a cruise or been to china . No. Were not going to judge the clinical assessment. If its the assessment of the Public Health department, those individuals these are decisions. What happens is in the time when testing was limited to Health Departments, the local Health Department makes that decision. And then they but they have followed cdc guidance. Now weve made it very clear, its up to the individual Health Care Provider and the individual Public Health to make that decision. Mr. Raskin ok. Could you make a Public Service announcement right now for people who are asking the question of whether or not they should be tested . I hear from constituents who are having flulike symptoms. They want to know what should they do. What should they do . Dr. Redfield well, as dr. Fauci said, the first thing i would do is to tell them to contact their Health Care Provider or their emergency room, and get instruction, and then they will proceed with getting the appropriate clinical evaluation. Mr. Raskin ok, so they should call someone before they go anywhere . Dr. Redfield wed like to do that. Because if you really think youre infected were trying to avoid someone to walk into a 200person emergency room. Call in advance, and theyll arrange exactly how theyll get the test, see the patient, be prepared when that patient comes to the emergency, theyre going to be able to isolate them, get them tested, properly evaluated. Mr. Raskin thank you for your work on behalf of the American People. I yield back. Chairwoman thank you. The gentleman from texas, mr. Cloud, is recognized for fine minutes. Thank you, chairwoman. It has been difficult to get information out to the public, especially in a hyper politicized environment. Id like to spend time clearing the record. As we try to find the proper balance between creating a pro active positive response to real threats as opposed to instigating overreaction on the public and finding it healthy balance. Fauci, can you, by where of comparison, briefly explain how does covid19 compared to other Previous Health situations, sars, h1n1 . Yes. Auci thank you for the question. Well, sars was also a coronavirus in 2002. It infected 8,000 people, and it killed about 775. It had a mortality of about 9 to 10 . So thats only 8,000 people. In about a year. In the two and a half months that weve had this coronavirus, as you know, we now have multiple multiples of that. So it clearly is not as lethal, and i will get to the lethality in a moment, but it certainly spreads better. Probably, for the practical understanding of the American People, the seasonal flu we deal with every year has a mortality of 0. 1 . The stated mortality overall of this when you look at all the data, including china, is about 3 . It first started off as 2 and now 3 . I think if you count all the cases of minimally symptomatic or asymptomatic infection, that probably brings the mortality down to around 1 , which means this is ten times more lethal than the seasonal flu. I think thats something that people can get their arms around and understand. But less lethal than h1n1 or sars . No, absolutely not. H1n1 is even the 2009 pandemic was less lethal than the regular seasonal flu. Pandemic. I am trying to help the American People know where to set their appropriate gauge. Set their gauges that this is a really serious problem, we have to take seriously. People always say, well, the flu, you know, the flu does it, the flu does that. The flu has a mortality of 0. 1 . This is ten times that. Thats the reason i want to emphasize we have to stay ahead of the game to prevent this. The stuff a lot of comes from china. They are going to the stores, seeing these dry up. What are we doing from the, i guess, fda standpoint to ensure supply chains that we have everything we need . Dr. Kadlec sure. I know theres been a run on purell. But i think soap and water works just as well in terms of that. It does require people to frequently wash their hands and maintain good hygiene, cover the cough and sneeze. Dont touch your face, continue to wash your hands. Understandingmy with the legislation we passed just last week, not just for everyone walking around, but theth professionals, with citizenship, putting the Legal Framework and it, is there anything being done to allow u. S. Companies to participate better . One thing the fda issued was emergency ruse authorization about expanding the use of particular masks. And 95 respirators. There are two types, one used by industry, the health care, and making that available for increased use so their numbers will be increased. There is a high demand for masks, particularly in the health care setting. Depending on what model you need, you may need up to 3. 5 billion. Thats a model. All models are wrong but some useful. It could be as low as 600 million. And so, what we are doing now is were trying to increase the thent of masks available, 95 respirators, surgical masks, which could be used in lowrisk settings by health care workers. We have issued a request mr. Cloud one more question. Testing, dr. Fauci, weve had people calling 91 showing no symptoms asking for an ambulance taking them to a hospital to be tested. Who should be tested . At what point should they be tested . At what point are the tests actually helpful . What about false negatives . Those kinds of questions. Who should be really concerned about this . So, very quickly as , dr. Redfield as responded, there are really two buckets. If you have someone who has a reason to believe that theyre infected, either that they have symptoms or they have come into contact with someone who was either travel related or is in fact documented to have been infected or exposed, that is something where you go to a physician, you get a test, and you find out if an individual is infected. The other that was discussed a fair amount over the last several minutes is the surveillance type, where youre not looking to see if anybody has been exposed, but you want ts find what the penetran are of this particular infection. And thats a different thing than the physician patient relationship. Thats what the cdc is doing now in six sentinel cities and they will expand that throughout the country, so we will be able to , hopefully very soon, to get an idea for getting the people who think they may be infected who actually is infected. Mr. Cloud thank you. chairwoman time has expired. The gentleman from california is recognized for five minutes. Mr. Rouda thank you, madam chair. Like all of the members up here, we are getting constant communication from our constituents wanting more information, and i applaud all of you for being forthright with the American Public. Thats exactly what we need. In times like this, communication is so important, and if youre going to err on one side, over communication is more important than under communication. Dr. Kadlec, i had the fortunate opportunity to be with you earlier this week and see firsthand the work you are doing to help address this as well as your peers. I wanted to talk about one of the slides you shared with me, a bell curve that showed what would happen across the United States with the spread of this disease if mitigation efforts were not taken by the American Public and your agencies, versus mitigation efforts to basically flatten that bell carve. And i think the primary purpose of that is so our Health Care Facilities and physicians as well as the supplies are not , for lack of a better term, overrun by a steep bell curve. Am i correct in making that statement . Yes, us. And i think another way to say it too, its not a question of if, its a question of when the virus continues to spread across the United States. But we want to pace it out as long as possible. Is that a correct statement as well . Yes, sir. Mr. Rouda thank you. One of the issues too in help address this is the fact we do not have enough test kits. We know that many individuals, as my fellow member to the right of me, mr. Raskin, pointed out, there are individuals who have requested test kits and have not been able to access them. My understanding is as late as last saturday, ground zero and in king county, washington, that the Health Care Professionals from that facility still did not have access to test kits. Mr. Redfield do you know if that , is true or not . Dr. Redfield we have provided test kits to the Health Department. The university of washington has developed their own tests were those available last friday . Dr. Redfield yes, sir. Thank you. And without test kits, is it possible that those that who have been susceptible to influenza might have been mischaracterized as to what they had . Its quite possible they actually had covid19 . Dr. Redfield the standard is the first thing you do is test for influenza. If they had that they would be they were only if tested. If they were not tested, we do not know what they had . Dr. Redfield correct. If somebody dies from in the lens i are we doing , postmortem testing to see which it was . Dr. Redfield there is a Surveillance System of death from pneumonia that the cdc has, its not in every city and state and hospital. Mr. Rouda we could have people in the United States dying for what appears to be influenza when it could be the coronavirus . Dr. Redfield some cases have been diagnosed that day in the United States today. Mr. Rouda thank you. I want to turn a little bit to the cdc website, because i appreciate the information youre putting out and its so important to the American Public. But i also want to make sure they fully understand it. On the cdc website, published a guide called framework for mitigation, actions for protecting communities from covid19, in that graph it , provides three levels of transmission, none, in other words youre in a community with no reports of any cases whatsoever. The secondary is minimal to moderate. And the third is substantial. Dr. Redfield, how many cases of coronavirus are considered to be mineral to moderate . Dr. Wright redfield right now, when we see basically transmission cases, it particularly if theyre nonlinked, were looking in cases in the 25 to 50 range, to see that groups begin to move into the moderate range, sir. Mr. Rouda ok. Thank you. That is helpful. I would suggest that the cdc put that on their website so that the average american can read it and understand exactly the precautions they should take. So substantial, i would assume, is when you have 50 cases or more in your community . To consider substantial . Dr. Redfield yes, sir. Thank you. And i will go back to dr. Fauci, you talked about this is serious. We are seeing activities across the nation, school closings, sporting events being discussed about having them held in other places, major events being canceled or rescheduled. This would suggest this is a really serious issue, and i share the thoughts of the member from wisconsin that i think were concerned that were not getting the full understanding or modeling that has taken place that would suggest the true impact of this virus across the United States as well as potential models for deaths. Can you elaborate a little bit . I get that theres no perfect model. But can you be helpful in helping us understand what were really looking at here . Dr. Fauci yes. If you look at the curves of outbreaks historically that are similar to this, the curve looks like this and then it goes up exponentially. Thats the reason why it depends on how you respond now. So if we wait until we have many, many more cases, we will be multiple weeks behind. You know, i use the analogy at used the analogy at the press conference yesterday, and i will use it today. Its the old metaphor that the wane gretssky approach, you skate not to where the puck is but to where the puck is going to be. If we dont do very serious mitigation now, that whats going to happen is that were going to be weeks behind and the horse is going to be out of the barn. And thats the reason weve been saying, even in areas of the country where there are no or few cases, weve got to change our behavior. We have to essentially assume that we are going to get hit. And thats why we talk about making mitigation and containment in a much more vigorous way. People ask, why would you want to make any mitigation . We dont have any cases. Thats when you do it. Because we want this curve to be this, and its not going to do that unless we act now. Thank you, doctor. Madam chair, i yield back. Chairwoman thank you. thank you so much. The gentleman from ohio, mr. Gibbs, is recognized for five minutes. Mr. Gibbs thank you, madam chair. Thank you all for the work youre doing, huge challenge, and i know the stress you must be under. And irk never think you enough i think the centers, cdc and all the agencies are doing the best they can in this unprecedented circumstance. I also was glad to see Governor Newsom of california come out and say good things about what the administration is doing and help and i think the governor of Washington State did the same. Also, i talk about politicization, which shouldnt happen. We should be together on this. One thing that astounded me was all the talking heads and some members of congress criticizing Vice President mike pence being take the lead on this, have this up because hes not a up because he is not a medical professional. I would think when i look at this, that person at that office, that level, that office, that helps bring the agencies together, maybe help clean out some of the red tape in the bureaucracy. Would you concur that thats been helpful to have top government involved in that level for especially working between agencies . Yes, sir. Absolutely. Mr. Gibbs i just want to make that point, because i hear that criticism, and i think theyre being political or dont know what the heck theyre talking about. Probably a little of both. I also think its amazing, i want to praise the work cdc has done to develop a test in one week. Is that unprecedented, to develop a test from a vial . I am going to have my friend, dr. Fauci, answer. I mean, obviously, the technologies of today are being able to develop a test as quickly as that, the same way as we were able to use the sequence to get a vaccine started at least in the trial. Mr. Gibbs i fully understand the vaccine has got all the testing to make it safe. But were relatively close for an antiviral . You know, you say relatively close. We dont know if it works. I dont want to promise anything. Were testing them. If they are effective, they will be distributed. But you dont want to do that unless you know they are effective. Mr. Gibbs i do want to talk a little bit about the timeline. You know, it broke in china, and thn south korea, japan, italy, the United States, and elsewhere. As you say, it has really mushroomed. Seems to me, i think the next four weeks are critical because, can we kind of think were getting information out of china . I know sometimes its not reliable. But also were seeing it happen in south korea and japan, maybe they have peaked a little bit, and they are on the better side of that curve . Dr. Redfield i think youre right. Clearly, china is got control of their outbreak. They had 20 cases in the last 24 hours. A real threat right now is europe. Thats where the cases are coming in. If you want to be blunt europe , is the new china. Mr. Gibbs ok. But i praise you for, dr. Fauci, talking about doing as much mitigation as we can. Its critical. But i think would you concur that my assessment, the rest of this month, the next four weeks, is really, real, real critical time for us . Yesfauci it is critical, and its critical because we , must be much more serious as a country about what we might expect. We cannot look at it and say, there are only a couple of cases here. Thats good. Because a couple of cases today are going to be many, many cases tomorrow. Dr. Redfield we would like all americans to take a good look at that Mitigation Strategy as tony said. We have zero. But they need to be fully engaged in that Mitigation Strategy, as well as those with moderate and more severe. This is the time for everyone to get engaged. This is not just a response for the government and the Public Health system. Its a response for all of americans. Mr. Gibbs i understand that. Another thing not really being reported because its not as raises the ratings when they talk about the number of cases and fa talts. But i see in the reports worldwide, we have better than a 50 recovery rate. Is that true . Right . Dr. Redfield right now, we would say its probably about right now its 80 recovery. Mr. Gibbs Johns Hopkins has chart. Altime dr. Fauci when you look at the thet its about half but at end of the day, if you look historically, for example, the 80 ofnce with china, them have disease that makes people sick but they ultimately substantialout medical intervention. Havethe 15 to 20 that the serious disease and high mortality. The bulk have been people with Underlying Health right . Ons and over 70, dr. Fauci the elderly as well as people with underlying disease,s like heart lung disease. Mr. Gibbs i think we need to do need to do and be responsible and not lose our hods this heads on this because i think well get over time. N due the gentleman from california is recognized for five minutes. You, madam chair. Thank you, dr. Fauci, i have with you and worked and have complete confidence in your leadership. Appreciate your service. Dr. Redfield, its important to that youve served our country in the army, youve served this nation. We need to focus on what we can this issue. One of the things this can teach us as a country, with all the rhetoric, whyt do we need government why dont we consider how inadequately we have been funding Public Health. C. D. C. Budget is 1. 5 of our defense budget. Dr. Redfield, do you think our country would have been safer if we had twice the c. D. C. Budget . If we put it at 3 of our National Defense budget in our capacity . Dr. Redfield thank you, congressman. I think its important to decades weveor underinvested in the Public Health infrastructure of this nation. C. D. C. s funding from congress, about 70 of it goes out to territorial and Health Departments. Myould rather see during legacy to help overprepare our nations Health System with Laboratory Capacity at the local labs, making sure we have human personnel in the communities and Rapid Response fund and build a Global Health Security Platform for the countrysou have the attention, how much would that cost . Right now were spending most is ae realize this National Security issue. Were putting 1. 5 into the the defense budget. The n. I. H. Budget is 41 billion, less than 5 of security. Why isnt there bipartisan pull double, triple these budgets . What would you ask the american prepare . D congress to dr. Redfield i appreciate the opportunity and id have to get you with an exact estimate of all that for you. Dr. Fauci . Have a view . Dr. Fauci we have been well n. I. H. But i think we need consistent well funding. At timesnconsistency but luckily over the last on for or five years, congress has been generous with us. Is w. H. O. Stion i have had tests and some of the other countries use those tests. Shouldnt we be using these tests . Dr. Redfield i think its important to understand about the key for proving tests in from othery countries. They can go ahead and apply through the f. D. A. And get be dispersed. Nd one of the reasons we developed the test we developed was to try to make it available to the public as rapidly as we could for Public Health. Do you think we need to look crises,mlining in these approval for things like w. H. O. Testing which 60 other countries are using . There are stories in the New York Times about how leading scientists had come up with seattle that werent approved. Theres got to be a better way getting tests out there. Dr. Redfield when i was practicing in the army, i could inelop a test and use it clinical medicine. Somehow between then and now, regulatoryot discussion for us to do Laboratory Developed tests. The commissioner did issue regulatory discretion so the university of washington or, columbia, could develop their own test and use it rather than have to file an emergency use authorization, they could use their test and file that 15 days later. One final question. I genuinely believe we have the scientists,nt entrepreneurs in the world in the United States and the question is, if we want to come treatment,antiviral vaccine treatment, what is it more that you need from congress . Because no one cares about lecturing people. About what we asked to do. What are the resources you need so scientists and technology and entrepreneurs can solve this . N. I. H. Ci from the standpoint, its the consistency of funding which thankfully been able to do. Back from 1998 to 2003 youve budget. The nih then we went through a flat, long period of time which difficultas very because it discouraged young investigators from getting involved. For the last few years, weve had a good consistent increase. Tot you can do is continue give the kind of investment in Biomedical Research that is predictable. D dr. Redfield i would say first most importanthe thing that you already have done thehe establishment of Rapid Response fund. We would have to our foundation and ask them to raise money. The Rapid Response fund is one the most important tools we thankful. Ere the gentlemans time has expired. Let me intervene here. I have been told that our witnesses need to leave now. I dont know what is going on at the white house. The white house is telling reporters that this meeting is an emergency. They are saying it was scheduled yesterday. Not what yours us. F just told your staff said the white house did not tell them about this until thising morning right before our hearing. There seems to be a great deal and lack of coordination at the white house. Reflect on does not the broader response to this crisis. Madam chair. We have asked your staff if you can come back and resume yourhearing at 2 00 after meeting at the white house. They have not responded to our request. Madam chair. Theyre not going to adjourn this hearing. It. Going to recess we havent even gotten through half of our members. Madam chair. Excuse me, i am have a moment . No, i am finishing my statement. We havent even gotten through half of our members. We will continue to work with your staff to have you back to finish the hearing and answer the rest of the questions from our members. This. Y, let me close with this committee sent you a request for information a week ago. We asked for basic information about the crisis and your plans response. But you have not provided us with anything. We understand that you are incredibly busy but a lot of this information should be at your fingertips. We need this information because we keep getting sometimes misinformation from the white house. An independent obligation to the American People. Have one last question. Will you commit to producing the we requested at testing,arding dr. Fauci . Dr. Fauci madam chair person, what information youre referring to that we did not provide. The National Institute of allergy we sent a letter with all the subcommittee chairs and myself requesting information to every department yours, the c. D. C. , f. D. A. Dr. Fauci i will check this immediately after to find out what the issue. Thank you. Thank you. Thank you very much. Chair, may i interject. Timely issue. I do, as well. I have a very specific districtrelated question. People in danger. Ive got the floor here. Please, we will yield to the Ranking Member and then to the gentlelady from florida for the last question. Madam chair, with all due respect i believe i was next in line. To followot going committee procedure. Point well taken. Regular order. We are going to recess after i Ranking Member for his closing statements. I appreciate the chairwoman. Recognize the importance of whats going on and its important to have level heads about whats happening and we want you to do your work but its important you come back. We have urgent questions. Fromieve the gently lady urgencyhas issues of from the people she represents. I sent a letter, dr. Fauci, to the department of defense 2 and a half weeks ago and have not received a response. I am troubled by the lack of testede about the people positive held in an air force and we dontntonio know what to do with them. I want answers to those questions when we come back and i hope that is this afternoon. There are serious concerns some of us want to the have addressed and i think right got 380 evacuees heading to a base in san antonio yet ive got an email from city inncil, mayor and leadership san antonio saying they dont have adequate plans on what to do with those who have tested i expect youall to come back down here today in accordance with that the chair is thank you. The committee will come to order. I want to thank some of our witnesses. Were deeply appreciative for your your time and your service. I have an update yourn scheduling. I want to point out two critical developments since we recessed this morning. The coronavirus outbreak has been declared a pandemic. Second, the number of cases has skyrocketed to 938. Just four days ago it was 164. That is more than fivefold increase just this week. In terms of resuming our hearing today, we have been informed redfieldfauchi and dr. Have been unavoidably detained at the white house. We dont know what is going on but they cannot come back. As a result we will resume this hearing tomorrow, thursday at 11 00 a. M. We have been informed by the agencies. They will all be here. And we hope to have enough time to finish all of our members questioning. Therefore the committee will stand in recess until 11 00 a. M. Tomorrow. Thank you. Cspans washington journal live every day with news and policy issues that impact you. Coming up this morning, well discuss the latest on coronavirus and the u. S. Response. As the house is expected to vote on an economic stimulus package as a response to the coronavirus outbreak and then maine senator joins us to discuss the commissions recommendations to depend against cyberattacks. E sure to watch cspans washington journal at 7 00 this morning. Join the discussion. Announcer President Trump addressed the nation regarding the coronavirus, announcing that all travel europe to the United States was suspended and he would be working with congress on measures to help Small Business and workers. Pres. Trump my fellow americans, tonight i want to speak with you about our nations unprecedented response to the coronavirus outbreak that started in china and is now spreading throughout the world. Today, the World Health Organization officially nnounced that this is a Global Pandemic. We have been in frequent contact with our allies and we are marsha
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