Transcripts For CSPAN White House Coronavirus Task Force Members Testify On Federal Response To... 20240712

[indistinct conversations] [indistinct conversations] [indistinct conversations] [indistinct conversations] [indistinct conversations] today, the committee is holding a hearing entitled oversight of the Trump Administrations response to the covid19 endemic pandemic. Due to the Public Health emergency, members can participate in todays hearing either in person or remotely via video, and. Theart of this hearing, microphones will be set on mute, for the purpose of eliminating inadvertent background noise. Remotelyarticipating will need to unmute your microphone speak. Participating in person, please wear your mask when not speaking. Dr. Monahan extract expressed in the updated guidelines that the use of face coverings is meant to protect other people in case the wearer is unknowingly infected. When we are not speaking, each of us is playing a vital role in tech and all members and staff in attendance, as well as leaders of the covid19 response will be testifying before the committee. Due to the anticipated length of the hearing, we will take a 15 minute recess at 1 30 to provide witnesses a restroom break. And so the documents can be sent to benjamin taylor, all documents will be entered into the record at the conclusion of the hearing. I now recognize myself for five minutes for an Opening Statement. Today, the energy and Commerce Committee continues its important work overseeing the administrations response to the covid19 pandemic. Focal to overstate the devastating impact of the disease. More than 2. 2 million americans have contracted covid19 in more than 120,000 have died. At the same time more than 45 million americans have filed for unemployment over the last three months. Covid19 has wreaked havoc on the physical, mental, and economic wellbeing, and especially has been brutal to people of color and low income communities. Thousands of families can tell stories of losing a relative without being allowed to visit them in their final days, and the social isolation felt by seniors and others in longterm care facilities area millions could tell us about the enforced to close a Small Business or losing a job. On top of the devastation of this disease, this committee must admit that it had it not aen for a sluggish response, president who has put Political Considerations over Public Health, could have done much to mitigate the destructive impact of covid19. We must correct mistakes so we are prepared to contact combat this disease as more flareups happen over the summer and a potential second wave come this in the fall. Testing has been a problem, while it has improved we are falling short of the 9000 daily tests Public Health experts need believe we need. Also we are hampered by the lack of a federal Contact Tracing strategy. I think we need federal Public Health experts to take a leadership role in this administration is ailing to allow that. Public health must be our first consideration as we accelerate research into a vaccine and treatments. Public Health Experts must there that it is safe, must be in effect just prepare the supply chain with sufficient products necessary to administer a vaccine. We also need a supply of ppe for our Frontline Workers and others through the economy. And while the supply has improved, governors have told us that we are still far from where we need to be. Last month, the house passed a heroes act, which provides the Public Health agencies with a mandate to prepare going over, the development of a Contact Tracing plan to provide 75 billion to carry it out. Provisions for the National Stock ill, and the manufacturing of vaccine entry. And ensuring that all americans will be able to receive the government of treatment drugs and vaccines area this legislation is needed, the senate has failed to act, and the Trump Administration has not put forward a policy vision. Bere is difficult work to done to prevent further destruction. This weekend, outbreaks of flared up and Public Health leaders have urged social distancing, the president put americans at risk, in my opinion, by holding a political rally in oklahoma, suggesting staff to slow down testing to mask the true infection rate. The president said this morning he was not kidding. I believe this was reckless and it continues the pattern of of publiche advice Health Experts and sends a horrible message to some americans that they can also ignore Public Health experts. As the disease continues to harm the country, its dangerous that the president , Vice President , and others, continue to downplay the risk that we face. All around the country, the warning bells are going off, and the struggle to keep up with the rate of hospitalization as well as emerging covid hotspots and the administrations unwillingness to face these hard truths will lead to more death and needless suffering. I am pleased that we have the Public Health officials with us. Thank you for coming. I have admired your role in what you have done over the last few months. I think you can help us answer questions about what has gone and howhats improving, we can be prepared Going Forward. I look forward to your testimony. I recognize our Ranking Members for an Opening Statement. Before we begin i have a parliamentary inquiry. Mr. Chairman, the committee will chairmanll Committee Shall be limited to five minutes and may designate other members to give an Opening Statement of not more than five minute, pursuant to this rule, i would like dr. Burgess to give an Opening Statement. I raise this because i know in the past at times only the chairman and ranking number have given Opening Statements. At other times we have allow the minority, and you have as well, to designate another member for five minutes. Given the importance of this hearing, i would hope we could work this out, where the subCommittee Chairman and rancors and rankers could also common. I would wonder if you would be willing to allow that . I appreciate your comments mr. Walden, but the answer is no. First let me remind members that pursuant to committee rules, all written Opening Statements will be made a part of the record. But according to our rules, only the full Committee Chair and Ranking Member must be provided five minutes for an Opening Statement. We dont have too many of these because in the tradition of the energy and Commerce Committee we try to do the hearings at the subcommittee level. But the problem with doing that today is that i thought this was important enough for a full committee hearing. And these witnesses will be testifying on areas that cross the boundaries of subcommittees. If we let the Health Subcommittee Ranking Members, we would have to let the Ranking Members of all the subcommittees , including owen i and that will oni, and that will drag things on. I have decided that we will have the full committee members. I dont want to go into a but can give you the record about how when we were when you were chair we had limited it to the two full committee members. I know you are not saying that we have to do it, you are asking that we do. Given the fact that i would have to open it to all of the subCommittee Chairs and we would be here another hour, i would rather proceed with the two of us. Walden i know in the past we would be willing to divide that simple five minutes among both mr. Guthrie and mr. Burgess dr. Burgess. I would suggest that you could do the same and limited to 10 minutes. Rep. Pallone you want to use your time . Rep. Walden i would yield it to allow the rules for the additional five minutes. No, you see my point. If you have the subCommittee Chairs, and nobodys prepared to do that at this point. Lets leave it the way it is and you use your five. Chairman, parliamentary inquiry. Do yourt of rule nine d think does not give the ranking the ranking minority member the opportunity to delegate another member to give an Opening Statement of more than five minutes area when i read this language its pretty clear, its not the decision of the chair, it is in fact built into the rules that that is the decision of the Ranking Member, if he chooses to do so. Up clearly,l opens and i did not bring my copy down, but the rules are designed to protect the rights of the minority because the majority can do whatever it wants whenever it wants. And the rules that we adopted at the beginning of this congressional session reiterated the fact that the minority Ranking Member not only gets his five minutes or her fiveminute, but that they may designate another to give an Opening Statement of not more than five minutes. So while we have waived that in the past, i dont see anything here that gives that decision to the chair. And i know you do the best you can mr. Chairman, i am not criticizing personally, what the rules are pretty clear that the ranking minority member gets to designate someone. Rep. Pallone according to the rules only the full Committee Chair and ranking number must be provided the five minutes for an opening date meant Opening Statement. Anything else is discretionary with the chair. This interpretation is not unique to my term as chairman, and as the first full committee during the Ranking Member chairman of the full mitty on october 25, 2017 full chairman on 2017, waldman announced that at the conclusion of my Opening Statement we now go to our witnesses, only the chairman and the Ranking Member give Opening Statements and now we go to our witnesses. Congress we continue to the same practice of providing the same Committee Chair with five minutes each at full committee hearings, and titled lift 22 america and monetizing the structure of the future, and july 25 entitled member day, only the full Committee Chair and ranking Ranking Member were provided time. Im continuing the same practice that existed under mr. Waldens chairmanship and mine and is clearly discretionary. The reason i am exercising discretion beyond the five minutes is because of the time limits. I guess now we are wasting time, but i dont want to tell you what to do. But i am going to insist on that. Hearld rather proceed and from everybody. You are recognize mr. Walden. Rep. Walden chairman, i am frustrated by that, i remember back to 2011 and 2013 there were rules worked out and did have others participate but i will move on to my Opening Statement at this point. I want to thank our distinguished panel of witnesses who are still working around the clock to understand this ed lee virus and develop the Public Health standards. As well as a treatment to end it. Covid19 laid bare how vulnerable we are and how much more we need to do. I commend the work of my colleagues and citizen brooks to modernize the pandemic hazard preparedness act. And the 21st century jurors legislation that is even with all of that work, covid19 hit the world like a tsunami, quick, deadly, leading disruption. Speakers are the cocaptains of americas rescue plane that we are building while we fly. Congress has supported those efforts with funding, resources, and lets ability President Trump stop flights from china and then europe, typing in the border and designated a task force that required executive includingrarely used the stafford act and the defense production act, harnessing American Innovation through project Like Operation warp speed. Through this response, the administration had to operate with conflicting data. Even with cdc guidance in hand, some governors chose to ignore that guidance and forced nursing home patients back to Nursing Homes, committing the deadliest mistake of the pandemic. Meanwhile backward looking critics attacked you and the men and women who work alongside of each of you, i commend our Witnesses Today for keeping focused on the challenges at hand and for doing Everything Possible for beating this virus. Six months ago we had barely heard of this virus area during our briefings most thought that like sars and mers we would get past this beast which did not have a name back then. We quickly went from knowing little about this virus to dating a test for it and testing more than 25 million samples with recent averages of more than 500,000 test the day. We know that there is more to be done. We have a distinguished admiral who became a selfproclaimed swap guy, because thats what america swab guy, because thats what america needed. There are two manufacturers, one in maine and one in italy. The president ordered puritan to make the swabs we needed. And then funding from congress dramatically increase production. And the president launched project air bridge to fly planes to italy to search the globe for other supplies which we found in limited plies. Helped state department 101,386 americans get abroad. From abroad get back home. Often on chartered with commercial transportation set shut down. And when coupled with the flu season i asked my team to research every aspect of this Health Crisis and to improve our mayor preparedness Going Forward. Mitigating a second wave is critical given the impact this has had on Public Health and livelihoods. We released the first recommendations on testing and surveillance weeks ago, and are preparing to release recommendations on therapeutics and vaccines soon. Less than a month in the United States, the u. S. Has conducted millions of tests, manufactured medical equipment, use 3d printers to make ppe, developed multiple vaccine candidates, authorized the use of more than 100 medical devices, weighing the known and potential benefits at the time, all at unprecedented speed. These innovations have the ability to service well and beyond this pandemic. We have seen remarkable ,rdination coordination flexibility, and cooperation. America is strongest when we Work Together to achieve common goals. We are constantly learning how to improve our preparedness. We must adjust our response based off of the facts at hand area we must unite in a common fight against this virus. Just as america mobilized in world war ii to do whatever it took, today we have to mobilize americas finest scientists, lodge attentions logisticians and entrepreneurs to beat this enemy. Thank you for your dedication to this lifesaving mission. Stir chairman, i yield back the balance of my time. Rep. Pallone thank you. I thank the Ranking Member. I would like to introduce our witnesses. House calling the white task force on coronavirus, but i dont know if that is still in existence or whether you are all members anymore. First we have dr. Robert redfield, the director of the centers for Disease Control and prevention. , the doctor ofci allergies and Infectious Diseases at the institute of health. We have admiral brett giroir, the assistant secretary of health and human services, and he is tired of hearing from me because i call him all the time. And dr. Stephen hahn, the commission of the u. S. Food and drug administration. Thank you for being here today. At this time, the chair will recognize each witness for five minutes to provide their Opening Statement. Before we begin i would like to explain the lighting system in front of you. Itres a series of lights, will be green at the start of your statement and it will turn yellow when you have one minute remaining, and you should try to wrap up your testimony at that point. It will turn red when youre latex tires. You likely know this but i will mention it again. We will start with dr. Redfield. Dr. Redfield good morning chairman, and distinguished members of the committee. Thank you for the opportunity to testify before you with my colleagues. Today the covid19 pandemic continues in the United States and around the world. This is the greatest Public Health crisis our nation and world have confronted in a century. The overall case counts are going down, several communities are seeing increased cases driven by multiple factors. Including increased testing, outbreaks, and evidence of community transmission. Right now the most powerful ispon against the disease social distancing, face coverings, and hand hygiene. These actions help us contain transmissions along with testing , timely Contact Tracing, timely selfquarantine to break the chains of transmission. I call on the American People to remain vigilant in our collective obligation to protect those who may be at risk for severe complications due to age or underlying medical conditions. We must also lessen the burden among racial and ethnic groups disproportionately impacted. The cdc continues to improve its Data Collected collection, including data on race and ethnicity from our partners. Hospital surveillance sites have increased in surveillance. The cdc is also receiving more complete data from our Public Health partners. A recent study examined more than 1. 3 million covid19 cases and found that the most Underlying Health conditions were cardiovascular diabetes, obesity, and lung disease. Hospitalizations were six time higher for these individuals and death 12 times higher. Those reporting these conditions compared to those without. The cdc is working to ensure equity in Health Outcomes and social determinants are being addressed through the response. The cdc continues to provide communities with technical expertise, tools, and information to the virus. The cdc has created more than 1500 specialized resource guidance documents which have been consulted more than 1. 5 billion times on the website create we have lloyd over 5000 personnel we have deployed over 5000 personnel in response. We have teams on the ground now providing local Health Officials and departments with expertise and epidemiology surveillance, laboratory science, and ready mitigation. We are grateful to the heroes of the response, health care professionals, first responders, the critical in structure infrastructure workers who have served and sacrificed too much. The cdc in our Public Health workers are working on the frontline of this pandemic to remedy the shortcomings in a Public Health system that has been under resourced for decades. With your support, the cdc has been able to award nearly 12 billion to states, territories, tribes, and localities, to enhance their response capabilities. Disease,ronted by any the Public Health Department Must make realtime decisions based on realtime data. Data is the backbone of any Disease Threat response. With the resources that congress has provided, data monitors nation is underway. Monitors nation monitorization is underway. We must also make sure that supplies are being sourced. The Public Health workforce must grow exponentially to address future health threats. Thousands of Contact Tracers are being routed by Public Health departments across the nation. The bottom line, sustained investment in the Public Health system is an investment in the health and prosperity of our nation. And the cdc has begun to prepare months ahead, when the next seasons influenza illness will occur simultaneously, potentially, with covid19. Increasing the challenges on hospitals, health care professionals, and the public. Before the seasonal circulation of influenza increases, i encourage the American People to be prepared and to embrace flu vaccination with confidence. This act will save lives. Thank you, i look forward to your questions. Dr. Fauchi thank you for giving me the opportunity to discuss with you today, the role of the National Institute of health and research in addressing covid19. The approach to the nih is very similar to what we do with other emerging infections. Its a four pronged approach, the study, the fundamental knowledge of the viruses valve, as well as the host response. The second is to help develop diagnostics, the third is to characterize and test their a few dix, and the fourth is to develop safe and effective vaccines. Speaking of the first, fundamental knowledge of the virus and what the virus escape will doing. We have done a number of studies that have been changing how we approach this. The precise molecular structure of the spike protein which is that part of the virus which actually gives it its name, coronavirus, because of the spikes that stick out. Bindss the way the virus to cells in the body. This has been delia needed by those we fund. The demonstration of the precise toeptor by which it binds cells in the body allowing it to cause disease. We developed animal models, we do Natural History studies like understanding the virus in them Demographic Groups. Getd, we need and will within time, based on a major investment in the protein that arediagnostics pointofcare, simple, precise, sensitive, and specific. We hope by the end of fall and early winter we will have these for wide distribution. The development and characterization of drugs. You heard of the First Successful randomized trial of a drug called brendas of your remdesivir which showed a statistically Significant Impact on decreasing the time to release from the hospital faster. Ecovery this is being used in with a drug woul that blocks other things. We are looking at other drugs and a new based therapies. Fourth, the development of safe vaccines. Defines the responses we have to disease. If you look at the history of viral diseases, it is vaccines that put the nail in the coffin. We are mounting a major effort in which we are collaborating with industry and publicprivate partnerships to get vaccine trials that harmonize with each other. They have multiple trials theo audio] compared frome one to another. You have probably heard one of those vaccines, and there are one of them will enter phase three study in july. This is one that has shown, in preliminary studies, favorable studies in the animal models developed. There will be others that will father one month, two months, three months later. Although you can never guarantee the safety and efficacy of a vaccine until you actually tested in the field. Optimistic,iously based on the concerted effort and the fact we are taking financial risks, not risks to safety, not risks to the integrity of the science, but financial risk to be able to be ahead of the game so that when and i believe it will be when and not if we get favorable candidates with good results we will be able to make them available to the American Public as i said months ago. It would put us at the end of this calendar year and the beginning of 2021. I will stop there and be happy to answer questions later. Thank you. Thank you, dr. Fauci. And thank you for all your contributions to fighting this pandemic. I will say the same thing about the admiral whom i bother the most. You are recognized for five minutes. Thank you. You can call me anytime. Distinguished members of the committee, on march 12 secretary azar request i lead the department and i would like to be clear that though i am no longer fully deployed to fema, i am core knitting testing. The nation has performed over 27 million tests averaging about 500,000 per day. Technicalut any major advances i expect the nation will have the capacity to perform 40 million or 50 million tests by fall. Approachented a phased to beach the testing needs at each stage of the pandemic, especially during reopening, when the need for testing is greatest. March fema developed and implemented 41 communitybased drivethrough testing sites and locations prioritized by the cdc in collaboration with state and local partners. These have tested nearly 300,000 highrisk individuals and served as prototypes that have been duplicated multi fold. Next, we leveraged trusted pharmacies to implement community testing, especially for minorities and the underserved. 611 is providing testing at cases and 47 districts. 70 are in communities with moderate to high vulnerability. 688,000testing over individuals. Qualified Health Centers serve millions across the nation. Fiveprovide care to one in those who are uninsured. One in three living in poverty and 1. 3 million homeless. Again, to assure we reach the most vulnerable among us. 93 offer covered 19 testing. To further expand access we authorized all licensed pharmacists to administer coping 19 testing under the prep act. Over 90 of americans live within five miles of a pharmacy. Authoritiesing provided to the secretary under guidance soeleased we can confirm all groups are benefiting equitably from coping 19 testing. Lab reports must include demographic information a race, ethnicity, age, and gender. Today i am pleased to announce houselection of moore school of medicine for a financial initiative. Officereement with the of the assistant secretary for health, office of minority health, and the school of medicine will implement a Strategic Plan of national, information tribal to bring to those hardest hit. Moore house school of medicine will receive 50 million. This massive expansion of testing created unprecedented demand. To meet this demand we secured the Global Supply chain through a military air bridge. We work with manufacturers to increase domestic production, collaborated with external partners to validate new technology, secured and prioritized care point tests for state laboratories, the Indian Health service,. And other needs. Toally, we used title iii further invest in domestic any fracturing. These have enabled our current efforts of states, territories, and tribes to implement surveillance plans. I would like to close by recognizing my fellow officers in the United States Public Health service commissioned corps. 4482 officers have deployed to support the Pandemic Response including to the diamond princess cruise ship, our military bases across america, are communitybased testing sites, fema taskforces directly inside Nursing Homes, and field hospitals across the nation. Exemplifying the care and compassion that all of us feel for those who suffered during the pandemic. I think every officer and family and on their behalf i would like to thank all of you in congress for supporting our Training Needs and the establishment of a Ready Reserve corps to supplement our ranks during a national emergency. Thank you for the opportunity to provide these remarks. Thank you for mentioning both military and civilians who are helping us during this crisis. We appreciate all they do and we have to help them as much as possible. Least, is dr. Hahn or commissioner hahn. Thank you for inviting me here today. I would like to start by thanking you for your support of the agency and the laws you have passed. It has helped create the response. The fda has a Critical Role in response to the coping 19 pandemic. We remain focused on our mission of protecting and promoting the health and safety of americans. President trump requested and we provided a flexibility to have access to critical products, safe food, and the confidence that the government is taking measures to address important Public Health issues. Fda has used our emergency authorities at the beginning of the pandemic. We issued more than 100 emergency use authorizations for diagnostics, ppe, ventilators, and other devices as well as for drug products. Since the Public Health emergency was declared which issued more than 50 guidance documents to help ensure the continuity of healthcare and safe food supply and put into place new initiatives to accelerate the development of needed products. We have kept the American Public up to date on what they need to do to protect themselves and contain the virus from spreading. We are preparing for the next phase of addressing this evolving crisis. It is missioncritical the agency continue to be diligent, assuring the safety of the products we regulate, and that we also put in place processes needed to ensure the protection the public will need. There are a number of experiences we have gained over the past few months that will inform our plans. We recognize we must be bold in our decisionmaking and advance Effective Solutions to achieve Public Health objectives. We have begun a comprehensive realtime review and assessment of our actions to date to address the pandemic. The objective is to identify and address potential organizational and Program Changes that should be implemented without delay to advance the ongoing response to covered 19. We need to assure we leverage what is working well while at the same time review our framework and policies to be positioned to effectively identify and respond to quickly evolving Public Health situations. A major focus will be to identify what regulatory policies should be continued and accelerated with executive order 13294. Changes will be consistent with advancing the Public Health mission and inform our Strategic Priorities moving forward. One of the challenges facing fda is how to assure the timely review of medical product applications despite an incredible search and volume surge in volume echo i am pleased to announce that fda has announced the same pace of meeting its goals on applications for medical products. Meet the target to goals by taking timely action on 90 of brand, generic, and similar drug applications. This work has continued at a time when the number of applications received in some centers is substantially higher than precoping times precovered 19 times. I want to think covered covid 19. Fda launched the emergency review and Development Program and we continue to work night and day to provide guidance and review proposals from companies, scientists, and researchers. Let me be clear that data and science will dictate when we have safe and effective treatments and vaccines for covered 19. Covid 19. We have not lost sight of our solemn responsibility to the American People to ensure decisions related to all medical products are based on science and data. That is the commitment they American Public and have confidence in. The fda will provide leadership and guidance information and whatever else is needed as we address this unprecedented challenge. Thank you and i look forward to your questions. Thank you. That concludes our opening from the witnesses. We will move to member questions. Each member will have five minutes to ask questions and i will start by recognizing myself for five minutes. You know i am very critical of the president for a lack of leadership from the start of this pandemic which i think continues. It is difficult because you work, in theory, for the president and i feel many of you, on many occasions, actually wanted to take more leadership nnd be as commissioner hah mentioned cognizant of the data. Im going to issue questions about the president s lack of leadership and it is hard for you to answer. I believe the president is encouraging behaviors that are not consistent with good Public Health such as encouraging thousands to attend a rally and not mandate the wearing of masks and i cannot imagine nih or cdc would suggest this is the best practice in the face of this pandemic. There are two versions of reality. One is the president s and one is hopefully yours based on data and science. I want to hear from the experts. Let me start with dr. Fauci. You are a trusted voice and always been candid with us in the American Public. Give us an untarnished view of where we are in our fight against covid19. Thank you for that question. It really is a mixed bag. We have a very large country, major differences between the new york metropolitan area and casper, wyoming. We have been hit badly. Anybody who looks at the numbers we have over 120,000 deaths in 2. 5 million infections. It is a serious situation. In some respects we have done very well. Right now the new york metropolitan area, which has been hit extraordinarily hard, has done well in bringing the cases down and using the guidelines we have very carefully put together in a stepwise fashion to try carefully reopen the city and state. We are, in other areas seeing a disturbing surge of infections that looks like it is a combination. One of the things is increasing Community Spread and that is something i am quite concerned about. You know this has been something in the press over the past couple of days. We were going down from 30,000 tw 20,000. That is youaddress have to have the manpower, the system, the testing to identify, isolate, and Contact Trace in a effective way so that when you see those increases you can understand where they are coming from and you can do something about them. Right now the next couple of weeks are going to be critical in our ability to address those florida, are seeing in texas, arizona, and other states. They are not the only ones having difficulty. Bottom line, it is a mixed bag. Some good, some now we have a problem with. Im going to have to ask about the president. He talked about testing and how important it is in the admiral and i know how important it is. The president said, when you testing to that extent you are going to find more people, more cases, so i said to my people, slow the testing down please. This morning he said he meant this. Dr. Fauci, do you agree with that . Does it make sense that we should be limiting the number of tests rather than ensuring anyone who needs a test can get one . You dont have to mention the president , i did, but tell us about the testing. I and my your microphone is not on. I and my colleagues, to my knowledge, i know that none of us have ever been told to slow down on testing. That is just a fact. In fact, we will be doing more testing as you have heard from the admiral. We will specifically identify people to isolate and Contact Trace, but more surveillance if you want to get your arms around and understand exactly what is going on in Community Spread. We are going to be doing more testing, not less. Let me ask the same of dr. Redfield. Do you agree with the president . Do you think we should be testing more people . Just tell us if you think we should be testing more people. Yes. As dr. Fauci said all of us continue to be committed to increasing timely access to testing. We have made marked improvement. We still have a ways to go. As tonyhe key things mentioned is expanding surveillance because of the nonsymptomatic nature of the infection. We are looking at ways it could substantially impact testing. Or 600,000s 500,000 test a day. We are continuing to try and enhance testing. Thank you, dr. Redfield. I recognize mr. Walden for five minutes. Thank you, mr. Chairman. Let me go to the question my colleague asked and i will ask each of you for a yes or no answer. Has President Trump ever directed you to slow down testing for covid19 in the United States . Dr. Redfield . No. No, sir. Dr. Hahn, you created a website on the fda site dealing with convalescent plasma and antibody investigational therapies. What is the status of the research into the effectiveness of convalescent plasma in fighting covid19 . Thank you. Really important question. Is where youplasma take the Natural Immunity from a person who has recovered from covid19 and administer to a person who is sick. Hhs and partnered with n the mayo clinic to expand a program. We have safety data from over 20,000 patients. Our preliminary assessment of the effectiveness is quite encouraging. We continue to look at the information. We willata holds, potentially have another army against covid19. This will allow us to have information that will feed the development of antibodies and hyper immunoglobulin. Good news story. We have to wait for the final data and we should know shortly about that. There are several randomized trials looking at this as well that are ongoing. Thank you. Dr. Redfield, the cdc developed a test to simultaneously detect two strains of influenza and covid19. They are seeking emergency use authority. How will the test be used . It is important as we get to the fall we are going to have influenza and covid19 at the same time. The cdc is developing that for the Public Health system, but the private sector is also gotten advanced development. Dr. Hahn may want to comment. Timely diagnosis of these pathogens. Dr. Hanh, would you like to comment . Yes. We have been working with companies to look at that and the admiral has been at the forefront. Admiral . I would agree with my colleagues. We are all concerned about the covid19 when it comes to flu season. We want to do everything we can to simplify the diagnosis. Usually in the lead but there are multiple factors like laboratories that will have this available. You have been subject to criticism that is leveled after we know facts we did not know at the time when things started. It is great if you have hindsight in 2020 vision and say, i should have done that then. I want to look forward. What is it from congress you need that you do not have now to get america ready for the falla echo what should we be preparing for now for the fall the echo i do not care who wants to start. I want to express our appreciation for the supplemental funding. The cdc has been able to disperse 12 billion to the states to help prepare covid responses and that is an unprecedented amount of resources. I only ask we see how to make this sustainable. Dr. Fauci, what do we need to worry about ya . We are extraordinarily unprecedentedhe amount of supplementary funding that would make it possible to do the kinds of things we need to do. We have to establish corporate memory. I have said to this Committee Many times over many years that we forget things when we get distant from them. We are going through a terrible ordeal right now. We need to have in place a stable type of support for preparedness for outbreaks. We will get through this, this will end hopefully sooner rather than later, but we need to establish a system so that we are prepared for future outbreaks. Thank you. Mr. Chair, could the others answer quickly . Admiral . I want to express my thanks to the committee, but let me get to the point. I think sustainability and commitment is very important. I was involved in ebola in 2015 in dallas trying to lead the policy options during that time and you can see over a fiveyear period we forgot all the lessons we wanted implemented. The biggest limitations are the National Data infrastructure we need. I am calling up 100 hospitals a day trying to understand who has a ventilator, how much you have left, and we got through this not by systems, but by people working 20 47. Im going to pound the vaccine infrastructure into this country. Make sure people have the right information about safety and efficacy. That we order enough flu vaccines because we need to get everybody vaccinated this winter. One thing that minimizes problems is one less virus that could kill 50,000, 70,000 people. Dr. Hahn . Thank you for the support. Is that wee learned have access to information issue. We need to collect realworld evidence in realtime like a doctor would do during an emergency to inform decisions. Your support for realworld evidence would be incredibly helpful. We are going to move to our members based on seniority and i think our next few are virtual. I just remind you to unmute. I will keep reminding you. Next we have mr. Rush from illinois. Forhank you, mr. Chairman holding this hearing. Last week the subcommittee held a hearing on the racial and disparities being highlighted by coronavirus. These are extremely outrageous. A scientific article published early this month, if people were dying at the same rate as white americans, at least 13,000 , andrs, fathers, sons. Ther loved ones would be alive have dieden and women at 97 the rate of white americans pickup. Wended did it become apparent institutional racism were playing a part in why certain racial and ethnic communities are suffering more than what communities . White communities . I did not hear quite as clear as i wanted, but i think i know with the congressman is referring to. When you are looking at the africanamerican trinity and Minority Community in general is a Demographic Group there are two elements that make it more difficult for them and why they are suffering disproportionately. Infection risk of because of economic and other considerations. The jobs the majority of them would find themselves in does not allow them to protect themselves by looking into a computer and doing telework. Most of them are essential, having to mingle in a society in which the virus is circulating. Right at the get go they have a greater risk of getting infected. We know from a lot of experience now that the situation regarding whether or not you have serious consequences, hospitalizations, and the patients, complications relate strongly to underlying conditions which are in the disproportionate African American population. That includes diabetes, hypertension, obesitys, chronic lung disease, and kidney disease. We have a situation where it is a double whammie of negative capability to respond through no fault of their own because of underlying conditions. Would you consider racism itself as being one of the factors that negatively impacts africanamerican communities . Was whatk the question i consider institutional racism as contributing . Yes. Thank you, congressman. Obviously the Africanamerican Community has suffered from racism for a very long time and i cannot imagine that that has not contributed to the conditions they find themselves in economically and otherwise. The answer is yes. Giroir, after your providesent that millions of dollars to the moore house of medicine for Contact Tracing, i have introduced a million forsts 100 testing and Contact Tracing. Sending a larger tracing andontact for testing . Thank you, congressman. Tracing,ng and contact we are going to need billions of dollars. That is the amount of investment we are doing partially through cdc. Havepecific award is to them lead a consortium like 100 black men, the National Association of community workers, the National Council of urban Indian Health to focus on the specific educational testing and linkage to care needs of underserved minorities and those in rural populations. My opinion is 40 million is a start. It will need to be more than that to reach the people we need to reach. Thank you, bobby. Thank you, admiral. Next is mr. Upton from michigan. Thank you, mr. Chairman. I really appreciate the testimonies we have heard thus have. D the interaction we the first question is for dr. Fauci. Thank you for your service. Weeks he made the statement about how we have as many as 100 million doses of flu vaccine before the end of the year. I have heard from a number of Companies Just in recent days that perhaps we could have one billion doses by the end of next calendar year. [indiscernible] maybe even get into production. The promise of getting that to the marketplace. Your thought as to how early we may see an emergency use authorization approved for any of these vaccines based on what you know today and under the scenarios we may see in the next number of months . Lay out what you think is a realistic possibility of where we might end up being. Thank you. I did not hear everything you said, but i think i got enough of it to answer your question. Opportunity to address this. The idea about the doses that would be available, a couple hundred million in the beginning with company say in a year or two they could have as many as one billion. I think that is real. Most people would raise their eyebrows and think how is that going to happen . Things are being done at risk e companies are starting things are being done at risk. Companies are starting to do things at risk. It is risk to money. Put that aside. Upton madeongressman is very important. We need to be careful that we do not jump because of our need to get vaccines for those who need it that we do not definitively beforeafety and efficacy we make decisions about distribution. We have heard a lot about emergency use authorization. Emergency use authorization is important, but it has to be done in a situation where you fulfilled the criteria for the emergency use authorization. I would be very disappointed if we jumped to a conclusion before we knew that a vaccine was truly safe and truly effective because i would not want perpetual ambiguity of not knowing whether or not it is truly safe and truly effective. That is the reason why we are doing several randomized placebo trials with power that could give us the answer. I hope that answers your question. What would be the earliest you think, under the best scenario, that we might be able eua . Ee a let me just quickly answer that and handed over to steve because he may want to answer that. Are going into phase 1 phase three efficacy trial in july. It takes at least a month to get to the second dose. You will take another couple of months to enroll enough people that if there is viral activity in the community, and we have our sites not only in the United States but all over the world, in brazil and south africa. So if we get and efficacy signal, you are going to get one the more cases there are. If it turns out there are not a lot of cases, it may take longer. That is why you cannot get an accurate prediction of when youre going to get that data. Steve, do you want to take it from here . Thank you. Just a couple of issues to your point. We are working with sponsors , those who ared developing vaccines, and providing Technical Assistance with Clinical Trial design, the number of participants, as well as the endpoints we want to see. Thatt to emphasize acceleration is around taking financial risk around the development process. Acceleration is not cutting corners with respect to the assessment of safety and effectiveness. The American People can rely on the fact fda has many experts in the vaccine area. We have been doing this for years and will rely upon data and science when it comes to that decision about a eua. I cannot prejudge when that will happen. Thank you, fred. We have the gentlewoman from california. Thank you, mr. Chairman. Good morning. With ike to start myressed to you about the most Prestigious Institution in the world on Infectious Diseases and prevention. Today isd states. Umber one in the world the American People are in pain, there is a great deal of sorrow in communities, there is confusion for many reasons. Cdc, toyou, as head of speak directly to the American People. I know the agencies are talking to each other. I consider that a whisper because the American People are not hearing you speak out. They deserve to hear the truth. We have heard dr. Fauci time and time again putting out information to the American People. The American People are divided on this issue of the virus. Imagine that i continue to urge you to speak out. You are a doctor. Put your white jacket on and speak weekly to the American People. They want to know what is coming, what is ahead. My constituents asked me on a consistent basis, whats next . What is our government doing . That is a haunting question and so while we are doing the nice backandforth this morning, good questions on the part of members, i really remain dismayed and deeply disappointed. We need leadership coming out of the cdc. Real leadership. Outrage there was a gathering in tulsa. Six of the president s people were infected and it is my understanding two secret Service Agents were. How can the cdc allow this pandemic, this virus, to be something political . You have to push back. You are a scientist, you are a doctor. Dr. Hahn, i am sure you read several articles regarding hydroxychloroquine. Every study says it does not work in any setting. In fact, it has known side effects of cardiac issues being one. There is danger in terms of side effects. As commissioner you see all of the data. Are you going to inform the American People, doctors across the country, about these facts . Thank you, congresswoman for the question. Indeed we are. I can refer the committee to several documents we have put out over the last several weeks regarding hydroxychloroquine. We issued a safety alert particularly around the combination with other drugs that might affect the heart. As you know we have taken recent action regarding have you specifically spoken directly to the American People . Yes, maam. Re was in at the aps by me a piece by me directly to the American People. I want to know if you have spoken out verbally to the American People and doctors across the country. People dont read papers with all due respect. Every opportunity i have been in the media ive been asked to that question. Another question. There have been several articles expressing concern [indiscernible] state that any political pressure is applied to you and the fda that you would immediately report that to this committee . I will unequivocally state that if i receive political pressure i will report to this committee. I have not felt political pressure nor has the fda to make any decision in any direction. Thank you. It is about a direct political pressure. Thank you for your responses. Thank you. The gentleman from ohio. Thank you, mr. Chairman and thank you to our witnesses and the hard work you have been doing over the last several months. Fauci, if i could start with you . Weldon had brought some of this up. Would you explain how a infective individual develops antibodies and how long those are effective in fighting the virus . Are you seeing Different Levels and people who have been infected and what that means in terms of immunity . We need to start off by saying we want to assume you are dealing with a Antibody Test that has been validated by the fda or nih. That is important because there are tests that are not validated. Let us assume you have a good test. Whenever the body gets confronted with a virus and recovers, even when they do not recover, the body is stimulated to make antibodies. The viruses we have a lot of experience with, those antibodies serve to protect you against exposure and infection after you are exposed to the same virus. That is what we call immunological memory. The one thing we do not know yet with covid19 is the relationship between the type of antibody because the best is neutralizing this is where the virus binds to the cell. Blockstralizing antibody the virus from bonding to the cell. Partsantibodies in other called binding antibodies. They do not mean much. You have to get the right antibody. The second thing is what we still do not know is what the terationship between the ti is and the level of protection. Third, we do not know how long or what the duration of the antibody is going to be. We are going to find these things out as we study these individuals over months and a year or more. We are only a few months into this. A, we know the make antibodies. B, it is likely they are protected for some time, but we do not know how long that is going to be. The question i always get asked is does that mean you are exposed and have antibodies your protected . Likely you are, but we do not know how long. Thank you. Redfield, when a vaccine or treatment is developed how will it be distributed to americans . Question. Ou for the that iscritical issue currently under discussion within the team. Appropriatehat the prioritization for distribution is. Dependent on what the product is. These may have differential utilization for different populations. Considerationsus to try and develop those prioritization and its is going to be important to develop them dependent on the product they will be developed for. Thank you. Dr. Hahn, thank you for all your work and thank you for taking my calls on friday nights and saturdays. I appreciate it. The fda provided a eua for a run remdesivir. S we are working closely with sponsors regarding the development of therapeutics. 130 one Clinical Trials ongoing right now. I anticipate we will receive therapies in the future. Potentially also with antiinflammatory agents as well for antibodies. Those are being accelerated. Hrough the pipeline again, i cannot prejudge because we have to see the data, but i believe we will receive data. My time is expired and i yield back. Thank you. Next we have the gentlewoman from colorado. Thank you, mr. Chairman. I want to thank the panel and welcome all of you. As part of my subcommittee just so you know we continue investigations about how we responded to this end where we go in the future. You can expect to hear from us. I have brief questions for each witness and i would like to start with admiral giroir. The comments from last weekend when you dohat testing you are going to find more people. Casesesident tweeted that are going up because we are testing far more than any other country. He also said this morning that he does not talk about cases. [indiscernible] now in charge of overseeing the tests has the president asked you to do fewer testing . Thank you and again i want to clarify yes or no will work, admiral. Neither thet president or administration has suggested we do less testing to me. We are proceeding in the opposite. We want to do more things of higher quality. Ok. Do you think it is a good or bad idea to do less testing so it will look like fewer cases . My purpose in leading is to increase the number of testing. The only way we will be able to understand who has the disease, who is infected, and can pass it, and to Contact Tracing is to test appropriately, smartly, and as many as we can. Thank you so much. Youfauci, i wanted to ask we have seen data the last few days that, while cases are going up in this country, death star going down. Reporting inome the media that that is because younger people who tend not to die from covid are the ones being infected. Should we see this as a positive sign or should we be worried . I think it is too early to make that kind of link, congresswoman. Let me explain. Lag considerably behind cases. You might remember at the time when new york was in their worst situation where the deaths were going up and yet, the cases were going down, the deaths only came down multiple weeks later. You are seeing more cases now while the deaths are going down. The concern is if those cases infect people who wind up getting sick and go to the hospital, it is conceivable you may see the deaths going up. I think it is too early to say because the deaths are going down. Thank you. I had another question, dr. Fauci. I have talkedd about this. Most vaccines take years if not anddes to be approved proved efficacious. Sometimes we do not see a vaccine. One, do you believe that we will find a vaccine for the coronavirus . Two, do you stand by the prediction you gave months ago that we could have a vaccine by early 2021 . I feel cautiously optimistic that we will be successful in getting a vaccine. There is never a guarantee, but the early data we are seeing regarding the induction of good responses makes me cautiously optimistic. Always knowing there is never a guarantee. Your member i told your thatttee a few months ago a vaccine would be available from a year to 18 months. I said that in january of 2020. A year from january is december. I think there is a reasonably good chance that by the beginning of 2021 that, if we are going to have a vaccine, we will have it by then. Thank you very much. Mr. Chairman, i yield back. I think the gentlewoman. We have ms. Rogers from Washington State. I hope. I am coming. And i hear . I here . You are recognized for five minutes. I think our witnesses for testifying today. Covid19 is the challenge of the century. It is a health and economic crisis of our lifetime. Rn the death of over 100,000 americans and we muster member we are not out of the woods yet. To express heartfelt gratitude for the healthcare workers, first responders, emergency and essential workers who have been working around the clock to fight this virus, save lives, and keep family safe. Tirelesslyrts worked to develop a vaccine im confident there is no country in the world to lead a medical breakthrough than america. We cannot trust china to lead and that is why the Trump Administration created programs Like Operation work speed warpspeed. Bringing the best to to find countermeasures to fight the virus. We are leveraging ai, machine learning, and computing to enhance our Knowledge Base of the virus. In Washington State we have top researchers as well as biotechs, pharmaceutical innovators, who continue to be at the forefront of these breakthroughs. I look forward to learning more and appreciate all of you being here to understand what the administration is continuing to do to lead in the development of tests and treatment that America Needs so we can usher in a new era of innovation and healthcare. Win the future, keep her family safe, and make sure our economy booms, we must get this right. Beenauci, as you have maximizing the effectiveness of vaccines would you explain a little further if there are any novel synthetics in the pipeline . How will they play a role in the administrations pursuit of a covid19 vaccine . Thank you for the question, congresswoman. A adjuvant is distinct from the vaccine itself, but when given in conjunction with the vaccine it enhances the power of the immune response. That gives a vaccine a level of response, when you get a adjuvant together you boosted to a higher level. Adjuvants in several vaccines. The nih has a Major Program in the pursuit and development of novel adjuvants of all types. In fact, that is part of the program right now to accelerate vaccine capability. It is a good question, but a very important part of what we do. Thank you. Thank you for that. Decentralization of test oversight has been helpful in expanding the availability of diagnostic tests for covid19, but it is temporary. Would you speak to how this has benefited the general public and how you think it would be helpful in the future for outbreaks or novel viruses . Thank you very much, congresswoman. I appreciate the question. The flexibilities have allowed us to work with test developers. This has been throughout the pandemic, with all medical products, a balance between oversight so that we have tests that are valid, accurate, reproducible, but allow the developers the freedom to develop the tests. We developed this partnership which is been very fruitful moving forward. I like it with respect to the flexibility given the states, yours in particular, which has excellent Public Health laboratories and the university of washington and new york state. Those are the sort of things we are looking at right now as we talk about how we want to move forward that we could that we could potentially put in place on a permanent basis to facilitate test development. Hopefully, we will never be in a position again where we have to develop tests over such a short time as we have remarkably done. We need to talk about how the flex is good stimulate development of tests. Great. For your all leadership, your commitment, during this time. Long hours. I especially appreciate the way we are looking forward to make sure we are prepared for whatever we face in the future. Thank you. Now we go to mr. Doyle coming from pittsburgh. Mr. Doyle . Mr. Chairman, i forgot to unmute. Recognized for five minutes. Thank you for holding the hearing and for your service on behalf of the American People. This continue to conduct oversight of the Trump Administrations shortcomings related to procuring and distribute an personal protective equipment, ppe. Withtals were faced criminal critical shortages of ppe, such as masks and downs. Theident trump has said federal government was not a shipping clerk. We saw the failure of leadership. Without a National Strategy, people had to defend for themselves and compete against each other for critical supplies. It has become so desperate that one former u. S. Disaster official referred to this as lord of the flies the edition. At a recent hearing before the oversight investigation subcommittee, the governor testified, the lack of centralized coordination at the of competition between states and federal to Procure Limited supplies driving up prices and exacerbating existing shortages. Pperal, do we have enough for every Frontline Worker who needs it . Jobproblems of others whose puts them at risk, people still having to use n95 masks, for example . If we do not have enough, why hasnt the administration greatly expanded manufacturing of these supplies . Thank you for the question. I will do my best to answer. The admiral is certainly running the supply chain but being a member of the unified Coordination Group for the past three months, im pretty familiar with this. That thereall know was a shortage of everything when this started. World wasn the looking for the same supplies and we tried to manage that from increasing supplies and using multiple times. Example, three investments for n95 to improve production. We estimate that the country in the fall, if there were a covid out break to this degree, would need about 140 million n95s or month. We should have 180 million per month produced domestically by that time. Wes was not available when started in march. The industry was not here. This was all offshore. 19, themarch 1 and june distributed or enabled commercial distribution of the air bridge of 160 million 638 million surgical and procedural masks, 281 million gallons and over 16 alien pairs of gloves. This was an enormous effort. We need to be better prepared and this all needs to be on short. We are working to have a 6290 day supply. Intalked with governors every state. Many states are doing their own supplies for 60 or 90 days. I am confident that from here on as we ramped a mastic manufacturing, that we will be in a much better physician. Since demand for ppe increased, we have seen many actors with pre little previous experience in the supply field. Report seven decatur summer selling lowquality products that dont meet safety requirements or are unable to six to fill agreements. What steps are being taken to ensure companies are not circumventing federal oversight and injecting potentially substandard ppe into United States blood . This is an important issue. Height of the epidemic and increased demand, we provided regulatory flexibility but insisted they that certification the foreign governments have in place. We did something off with respect to that. We partnered with cdc and n95s to test and verify that Self Certification over the validity was in place. Correctly identified that for a variety of reasons, subs product shipped into the company did not need those specifications. We continue to do that and monitor closely. Thank you, mr. Chairman. Time is expired and i yield back. Thank you. Next, mr. Guthrie coming to us from kentucky. Are you muted . I thought i did that. I apologize. Im interested in covid19 county testing. I have a bill that would now i willfda has follow up with a question. Im interested in and the people i talked to every day, is how we will protect ourselves moving forward. We need Lessons Learned from the past and to move forward. Answered on ppe moving forward, but if i can just if you could talk about. Thing and how that might be affected, the people i talked to want to know what it will look like in august, are the kids getting back to school, our Nursing Homes going to be safe . Flu,w we will have the covid. What will the testing be like . What do we need to be looking for . Im looking at it for you three to talk about. What will it look like in august and our kids going to be able to go back to school . First and foremost, it is important to continue to take the time to continue to accelerate our capacity to diagnose timely test results. Capacity for isolation. That is fundamental and we are working hard to do that. In the beginning of june, it was up to 28,000. We need to continue to increase toward 100,000. That will be critical for what we are doing. We have to reinforce the met to the American Public the social distancing preventions we discussed, especially six feet distancing and handwashing. K12, it will be on a jurisdiction. Guidanceissue existing on this topic in the days ahead as we continue to try and work and open up particularly school systems. Think we have i made enormous progress through Infection Control. About thet to comment commitment to provide all Nursing Homes with protective equipment for a time . Havenuing i think to aggressive surveillance in the Nursing Homes across the country where we have recommended all residents get tested so we can baseline of clean understanding where the epidemic is. I will end with, though they only make a. 6 of our population, nursing home residents have made up more than 35 of our mortality. Let me briefly addressed the question you asked about schools. We get that all the time. The most important thing to point out is we live in a very big country that is certainly not a unidimensional country. Whether you are in a new york metropolitan area or wyoming. When you ask about schools, you have to say where are you talking about because we have different regions, different states, towns, and counties. Some counties may have such a low level of confession that schools can open in a way that is exactly like normal. Others may be in a situation where it isnt really bad that you want to close the school, but you might want to make modifications, alternate alterations of scheduling. It is up to local officials to evaluate where you are in a particular region and what the recommendations are that we carefully put out about the guidance. You do not want to make onesizefitsall for the United States. You want to tailor it for the vital dynamics in the particular location you are talking about. We will really only know when we get closer to that point. It is obviously the reality. I am about out of time. Thank you and i yield back. It sounded like a monster was going to envelop you at some point. Next, from illinois. Thank you and i want to think. He witnesses i have to disagree with you, dr. Westfield. Nowhere has the Trump Administration shown a lack of leadership. And longterm care facilities. 50,000 residents and workers we have lost to covid19. Lets review some deadly failures. On delayed Data Collection Nursing Homes. You have not required states to conduct testing. Workers giving congressman doyle on that, to protect themselves. You are allowing facilities to literally kick residents out of out onto the street if there is a more profitable covid patient to take their place. The school is responsible for the safety of nursing home residents, declined the chairman profs invitation to speak. Let me refer to dr. Redfield. Thatdc website explains your mission is to save lives by informationalth that protects our nation. Why any data on covid19 cases and deaths until may, four months after you may remember you told me about the first case in illinois, january 30. To report the case of human to human transfer. On june 4, you testified before the House Operations Committee and apologize for cbcs in response to covid19 race and ethnicity. And failed to include race and ethnicity information. So when that happens, we were told to ask the cdc. When you to include race and ethnicity information moving forward so we can identify and andess Racial Disparities nursing home covid19 cases . Thank you for your question. That, i want to stress since the beginning of a pandemic, we initially occurred to all Nursing Homes to report the cases through their Health Departments and through the National Health care safety network. Interrupt,ld briefly i think that is a problem that there has been guidance and about ment, but what as i said, it is a requirement that this be as cmsd through the cdc has made that requirement. We are working to make sure this is comprehensive to include and we have worked hard to really accelerate training and retraining to try the situation that unfortunately we did experience as he pointed out where the nursing home residents take a hybrid burden of the outbreaks. This reporting will be forward facing. Cmswill forward the data to. Based on their understanding and how different Nursing Homes are performing. Recommended they screen all residents and that they screen all workers enough in Nursing Homes on a weekly basis because we believe this is an important area we have to do more as a nation to protect infections. This has clearly not been enough. This is the view of many families, workers, that there is theisis in that we insist government do more to help and i yield back. Thank you. Mr. Olson, texas . Thank you for having this very important hearing. Have been on the front line for half a year now. Or should to make the country safer and a special howdy to commissioner hahn. Hello. All, you know that texas tested a spike in covid19 cases over the last week old reopening it is not good. Dr. Peter said if this trajectory persists, houston will be the worst affected city in the United States, rivaling the worst city right now in brazil. Mn scary. A the Third Largest county in state ofn the county houston. Therespikes in houston are many factors in texas and houston. It is an increase in infectious 2039, the socalled youngsters. Hometown, cases in my and my home county. The covid19 curve, and the pandemic, is like going to heaven. Everyone wants to go there but fewer and fewer want to do the hard work to make it happen. I call it the bad attitude curve. This and makenge these people address the issue for the threat it truly is . You bring up a good point. One of the perplexing things covid19, and i have been dealing with viral out rakes for the last 40 years, i have never one a single virus that is pathogen have a range from 20 to 40 of the people, no symptoms, to some get mild symptoms, to some get symptoms enough to put them at home for a some are in bed for weeks and have symptoms even after they recover. , some go to the hospital require intensive care, and some die. You have a situation that is becausefusing to people some people think it is trivial, it does not bother me, and who cares . We do have a lack of appreciation, that you have a dual responsibility. You have a responsibility to yourself because thinking that young people have no diligent areas consequences is not true. We are seeing more complications and young people but even though the majority, the overwhelming majority of them do well, you cannot forget that if you get infected and spread the but then am at seven you might be propagating inadvertently, perhaps innocently, infecting someone who is then someone vulnerable. Who winds up dying. Message whencult someone says im young and healthy who cares . You should care for the impact you might have under the dynamics of the outbreak. Covid19 people from Nursing Homes. I yield back. Thank you. Thank you. Next, mr. Butterfield from north carolina. Thank you, mr. Chairman. And thank you to all of our Witnesses Today. In response to covid19, congress has appropriated significant funding to the cares act. The brain trust led by the congresswoman and led by all of to fight the pandemic. That hhs has formed a partnership with the school of medicine. In partnership to coordinate a Strategic Network of organizations to deliver covid19 related information the more medical school discretion to engage in aggressive Contact Tracing, and education. We need more than information. What is the mandate . Think you the question. The intent of the award is not to empower more physically do Contact Tracing themselves, but to be a lead in partnership throughout the nation so that Public Health organizations can use the 11 billion. We are funding them to be the brains behind the operation, to extend the network. Broad isyou but how it . Would be happy to get into this but they assembled a Remarkable Group of partners technologies. Very broad discretion. This is out of my office. We all know President Trump at a a Campaign Rally church and i suspect that he not you will not be wearing a mask. I know that will do disappoint you and me. Added ngton post after ant is up to 20 83 week rise. In my state of north carolina, we got it down to 7 . Up fromorth carolina seven, what is the administration specifically doing . North carolina seeing a rise, it just cannot be explained away by more testing. The percentages you are a clear of our indication there are additional infections that are responsible for the increases. When you get an increase in the percentage of your tests in the positive, it is an indication that you have additional infections. So one issue we have spoken when youy clearly is have those kinds of increases, you must implement on the ground forffectively as possible manpower, the system, the tests to do isolation and contact to flaunt the circulation. Because if not, you have the danger of having an insidious , which will be much more difficult to contain as the Community Spread amplifies itself. You do not need to respond fit to this but it seems to me that the president seems to think of it is over and he can just push it all to the states. The data shows it is a necessity for National Strategy because i think desk contained in some areas but it is conceivable we could see a resurgence everywhere. This frightens me on the American People. I yield back. You. Ank now dr. Bridges is here and well recognize him for five minutes. Thank you. I was with you virtually earlier. I would ask consent that michael at budgetement hearing on fedora 27th, we really have not heard. You for yourthank willingness to be here today. We are the oneyear anniversary of the preparedness act. We had a wonderful opportunity in january, february, and perhaps early march, to do realtime and respect introspection about whether or not the bill had gotten things performing as intended, was it going as whatever and for reason, which owes to talk about flavored tobacco, horse racing, and ticket stubs and instead. We can be critical of the administration. This committee has that responsibility as well. Since we are talking about the increase in Community Spread, im talking to my counterpart spread in that partner the border of mexico, Community Spread, which has been significant over the last week i guess the question and for the for you admiral is, since we recognize Community Spread is increasing, and we recognize there will still be vulnerabilities, what certainoing to make that the appropriate amount of personal protective equipment is available to our extended care facilities and Nursing Homes, not just in the valley but any place we see this increasing . Thank you. It is good to see you again. I am familiar with the ppe and i think you know very early that when we were able to secure ppe, to 400d send it directly Nursing Homes and the numbers are staggering. 13 million pairs of gloves already there. That is being distributed right the admiral is running this through the supply chain task force. He runs the ppe and we interact a lot. Through august and september through all 15,400 Nursing Homes with multiple shipments of that. Do you agree that is on the immediate rise in horizon ahead . We have areas where there is congregate living, people with multiple risk factors . Think as been as has been said by colleagues, we seeing Community Spread in a number of areas. About 110 counties of real concern. Forgive me for interrupting because my time is short. What i am asking is are we preparing and do the executives and nursing home facilities know how to access the vast amounts of personal protective equipment through the work you have done . It will affect all of us. Very believed briefly because of the time. I will say yes. You just cannot get that deep so the only way to do it is to ship secondly, the testing recommended by cdc are pretty excellent. Tested,rsing home gets every worker gets tested every week. In just a brief amount of time i have remaining, i you a question. People are concerned about china, and the impact it has had on our ability to fight the virus. Working who are chinese nationalists . Do you have such people on loan agency . Nese labs in the the cdc does seven office in beijing that is right next to china cdc and we work collaboratively on a series of things, particularly respiratory virus and influenza. Havent been broadened into the chinese investigation into the coronavirus epidemic, something i requested back january 3 and formally on january 6. I want to be helpful so i and iollow up with you have ideas of other things we might think about but i think that is a critical part of our discussion Going Forward and into the future. Thank you. Thank you. Next, from california. Thank you. I want to thank witnesses for being here today. We really appreciated. The question today will focus on and the mist of this pandemic. I would like to focus my question on the future and how we are preparing for the coming weeks and months for the particularly during flu season. Nice to see you there to, dr. Fauci. You have said were still in the [indiscernible] our communities, our health care workforce, and constituents, the work could come as we make decisions going to school and trying to readjust to what we consider a somewhat normal life. I want to put your cap on now. What our projected infection mortality rates for the second half of 2020 and for early 2021 . Dr. Fauci thank you for the question. It is impossible to give a question about what the fatality or case rates will be. It will depend on so many affect so many factors. I think you alluded to that when people talk about second waves and i have said multiple times public we that we are in the middle of the first wave still. So before you Start Talking about what the second wave is, we would like to get this out over the nexttrol couple of months so that when we enter into the fall, early late and early winter, that we have such a low baseline that when you do have the inedible inevitable situation of cases appearing as you try and gradually reopen the country, which were all trying to do to varying degrees depending upon what state, city, town, or county youre in, that if you get a level that is very low, when you get new cases, you can contain and that means identify, isolate, and Contact Tracer. Rather than have such a high level that when you get increases, you have to mitigate risk from the beginning. Complicates the situation and makes it impossible to predict what the case or fatality rate will be until you know where you are. Do you get down to baseline and asso, do you keep it there you enter into the complicated situation that would inevitably occur when we get into the winter and inevitably, we have is flu season and that is the reason why we were saying, all of us, why it is so important to get as many people vaccinated with influence as you possibly can so you can at least take off one ofle for many all the confounding issues we will of twois winter respiratoryborn infections simultaneously confounding each. Ther understanding we do not know yet but we have a sense that we will have a second wave. What should the public know so they can be prepared for this, and what is a country can we all the second wave and somehow or another manage it . I think something is going to be happening and we need to know what we will do now. Thank you for the second part of the question. A lot of things can be done. We know what the failings were early on. A lack of enough pe and m monday five and n95s. All of that is being stored up in the strategic National Stockpile in preparation for what we hope never occurs, but which is very well might occur. Also as weparation go into the fall, we will likely have the capability of 40 million test per month. We can get a much better grasp of what the situation is of the dynamics of the virus in the community. We, we will be much better prepared if in fact we do get this second surgeon we were months ago. Thank you and i yield back. Thank you. Next, we moved to mr. Mckinley. Thank you, mr. Chairman. Direct my question to dr. Fauci. The new york times, cnn, and Washington Post have relentlessly criticized President Trumps regime on stick covid19. A lack of leadership. But nearly 750,000 people have died in america from drug overdose. Eight have killed over 700,000 people in america and we do not have a cure for that either. The first case of covid was diagnosed america 155 days ago and according to testimony we had earlier, that we can have a in the vaccinell by january, keeping in mind it took almost 10 years to come up with a vaccine for influenza and watch her years for months mumps. The media and the left simply cannot help but criticize President Trump. It may be unfair but numerous times, you have commented and criticized or contradicted what the president did. Do you think he is being judged fairly . It depends on what you mean. I work in the white house and i believe everyone there is doing everything they pass up we can to do what they need to do. Thank you. Said it is late and raised march 31, and the president relies on your expertise. Do you now regret modify the people more forcefully to wear masks earlier . Ok, we will play that game. Let me explain to you what happened back then. It is more than yes and no, by the tone of your question. I do not regret that. Let me explain what happened. At the time, there was at of equipment that our Health Care Providers needed to put themselves daily in harms way of taking care of people who are ill. Did not want to divert masks and ppe away from them to be used by the people. Now that we have from now that we have enough i have two more questions. So thank you for that. Homes makeup 40 of all covid deaths. The cdc issued guidance on proper protocol for these facilities. York, like michigan, new new jersey, and california, apparently disregarded the guidance. Do you think the decisions of the governors led to the unnecessary deaths in these Nursing Homes . Dr. Redfield thank you for your question. Seedritical issue here is things. One is on guidance. Areas that we could impact Nursing Homes particularly for Infection Control working together with cms, very aggressively early on, was recognized in the nursing home really reach out rechanneled energy looking into the effectiveness of Infection Control and those Nursing Homes. Then restricted visitors do you think the decisions lead to unnecessary death by toowing infected residents come back into the nursing home . All of these decisions that had been made in to early days are subject hindsight. We gave clear guidance on how old should be handled if they come into the Nursing Homes. Question, we know there foreseeable future will not be a zero risk and we will not get to that. We know ourselves have to reopen. In addition to tracing, distancing, and Wearing Masks, what rate of infection is needed in your mindset, what is the rate of infection . one of the most important things is the consequence of infections. One is mortality of the other is the economy. One can open the economy safely. It requires more vigilance and we will continue to try and emphasize the importance of social distancing face masks and handwashing. It is my expectation that many jurisdictions will open schools. We will try and get guidance to help them do it safely. I think you are right that it will be influenced by the outbreak in the jurisdiction at the time. I am not prepared to give you the number but i think we will see progressive jurisdictions moved to open schools in the fall. My time is up. Go to the now gentlewoman from florida. Unmute ask everyone to before they begin. Thank you. When you compare the number of confirmed cases in the number of deaths in the United States with countries across the globe, it is really shocking. It makes me angry and sad at the same time. We have two 3 million confirmed cases. 120,000sst over americans who have lost their lives in a few months. It appears that other countries have done a better job. Ontrolling the spread they have done a better job on testing and tracing. Every advantage the United States of america has with scientists and Public Health experts, something has gone wrong here. I think it starts at the top. The president s behavior and comments have undermined Public Health officials every step of the way. I would like to know, how often do you interact with the aboutent and talk to him Public Health guidelines, bringing all your expertise to bear . Dr. Redfield i have regular interactions as part of the tote house task force, participate in each and every one of those meetings as it relates to my interactions rescue at the president , i will keep those between myself and the president. Every time the president contradicts scientists, every time he contradicts our Public Health expert, wearing a mask or tricking bleach, drinking bleach or taking hydro chloroquine, it costs lives. I agree that we expect you to be more outspoken when it comes to Public Health at pfizer is. It has cost lives. I will change direction now. For dr. Fauci, floridians are with the latest spike in cases. The Florida Department of health announced a little while ago, we have another 3300 cases and 64 deaths with what was announced yesterday. 25 of total cases in florida have been confirmed in just the past 10 days. We have a Positivity Rate of up to 13 in the past week. Do you have for the state of florida and other hotspots across the country as we have so many more young people who feel invincible that are testing positive the economy what is your advice to floridians . Advice is what i would give to anyone and everyone. Follow the guidelines we have carefully thought out and without in how one can reopen or open america again. That is to stay within the framework of the particular phase of reopening that you are in and do not throw caution to the wind. What happens related to the comment i made a little while ago about the confusion there must be particularly among young gople who have an urge to out, which is understandable, but what they need to appreciate that theyre part of the dynamics of an outbreak and although they themselves may perceive that they are at very for something that will be deleterious for them, by propagating the process of the outbreak, they may be indirectly by infectinge someone who infects someone, who infects someone vulnerable. They need to understand that. If we could get that message across, that it is not all or none phenomenon. Back to normality would be a gradual stepbystep process, not showing caught throwing caution to the wind. What about masks for young people . They look at National Leaders who are not modeling your advice and behavior. What do you say . You are a trip to its trusted scientist and expert. What do you think about Wearing Masks . Mass gatherings . And will be very consistent say yet again, you should not congregate in crowds. You should keep distance. Even though many people for a variety of reasons to not listen to the not suggestion but the plea to not congregate in crowds, some people will do it anyway. If you do, please wear a mask. As you wear a mask and youre in a situation where youre getting animated, in a demonstration or avoidor wherever you are, asbestos possible the urge to pull your mask down and shout. Plan a, do not going to crowd. , if you do, make sure you wear a mask. Thank you. I yield back. Next, in illinois. Thank you, mr. Chairman. Thank you to the guests for being here. It is a weird time and very important. Is of the discussions communication is important so governments, local governments, nonprofits, businesses, but also international governments, we need a lot more information chinesely on what the communist party new, and what real impact they had. I look forward to that being investigated more. We have seen the stories about people who tested positive for the virus and had no symptoms at all. In some cases, it spread through entire communities of people without ever knowing they were infected. The asymptomatic infections, how can anybody improve our the transmission of covid19 and help identify populations at risk . One thing we need to do and that is important and related to , the kindsquestions of surveillance studies that allow you to get a much better handle on the real percentage of a symptomaticallys, the rate at and athey infect others, variety of other things, important questions. We learned, actually to my that when you look at asymptomatic individuals and people who are systematic the level of virus in their almost the same, which is almost counterintuitive , but it is a fact which tells the danger of transmissibility is such that it is very important to understand asymptomatic infected people. Them, you need to identify, isolate, and Contact Tracing. The question asked an hour or so issue, we testing need to do much more surveillance testing. Month million tests per that would be available as we get into late summer and early fall will be able to ask some of some of the questions you are appropriately asking. If i could build on that for a second, the 40 million test assumes no advances in technology, and that is not even including cooling. The fda just put up standards for validating pulling, so we would expect, based on preliminary data, that we can at least pull 521 on many tests and maybe up to 10 to one. When you do the math i think will be validated very quickly by academic institutions and large organizations, that number, 50 million, will go up per month. Thank you. American ingenuity is amazing when we put our minds to it. Hopefully we get to a vaccine. , myeginning of the pandemic wife and i experienced what we thought were symptoms of covid19 and we recently decided to get an Antibody Tests. I have that done and found out i was negative for the antibodies. In your testimony, you stated that at this point, we do not know whether the presence of antibodies provides immunity to the virus. What are the benefits from an individual Patient Perspective . Thank you for the question. Not know what it means particularly in terms of immunity. Mean, that you have been infected in the past. We do not know what it means in terms of immunity. Is aalue to us surveillance advantage. We continue to do surveillance throughout the United States through a variety of collections and it allows us to see what the full extent of the infection is. Right now, the data at a National Level suggests that every documented infection we have is a case report. There are 10 other individuals who have actually been infected. That data will continue to be refined as we continue to expand our Antibody Testing. Nowink the major role right is an important surveillance tool. Thank you. I will add another question and submitted for the record about the virus lasting on services but with that, i yield back. I remind everyone that you can submit questions for the force and thetask witnesses and all the Opening Statements will be entered into the record. Next, from maryland. Thank you, mr. Chairman. Panel. To thank the last month, the chump administration announced the launch of operation warp speed disport Rapid Research and development of covid19 vaccine therapeutics diagnostics and so forth. Efforts across the federal government, in case the private sector, including at least five pharmaceutical Companies Developing vaccines. I am trying to understand better how it works. There have been concerns raised about the venture, including potential conflict among leadership, conflicts of interest, dr. Fauci, you have had decades of experience leading publicprivate partnerships with pharmaceutical companies to develop the vaccines. Transparency is important in these collaborations, is it not question is it not . Dr. Fauci thank you. Operation warp speed is an that is a department of defense if you just read by secretary is our to try to get diagnostics, therapeutics, and vaccines done in a way coordinated with the maximum speed possible without sacrificing scientific integrity. It is divided into three groups. The leader of this is a person with great experience in industry, as well as the general who was an army general who is inlversed and experienced supply chain processes, of getting vaccines when we do get it to be produced to the level that is needed as well as to be distributed equitably throughout our society. Let me jump in. A senior fda official was initially tasked with tech Vaccine Development of your operation warpto lead tt but then left the project about concerns over political pressures. Roleure you agree that the the fda plays and this has to be free from political pressure and they grade he must adopt the highest standards for approving any vaccine under this initiative. Thank you for the question. Your point is very well taken and i will assure you we will retain our regulatory independence. Will use the data that comes to us and our high standards to address the safety and efficacy of a vaccine. We have worldclass experts who will continue to maintain that. Sure isg i want to make that we drew a very bright line between operation warp speed and our sponsors. We do not engage in decisionmaking respect to those decisions. We provided Technical Assistance to all sponsors but have made it clear we do not participate in those decisions because we absently must maintain regulatory independence and make the right decision for American People based on science and data. Im trying to understand sort of the boundaries or reach of the operation. My initial sense is that it was focused on these five selected companies that are pursuing vaccine candidate. Right, im notot entirely clear on what this means for vaccine Exploration Development yonder that. Beyond that. For instance, i have been reading about this polio vaccine. Pportunity some inquiry may be warranted. I would like to get your publics perspective on those kind of inquiries outside of the , or is operation warp speed brought enough to accommodate those kind of things . What is your perspective and understanding . Lets start with you, dr. Redfield and then dr. Fauci. Brief responses, gentlemen. The only thing i would say is it is intriguing in terms of the interference,l whether polio or measles, that it may impact another virus. Hypothetical. Its intriguing not just for this but for other viruses. Was,think your question are there room for other vaccines . The answer is yes. It could be through operation warp speed, it could be through a number of mechanisms we have. , buterstand your concern the doors are not closed to other candidates, you can be assured of that. Perspective,das the doors are open and we are working with multiple different sponsors. Data andook at all provide Technical Assistance to all who want to develop a vaccine and therapeutics. Thank you. Going to put you on the spot because i want to talk about schools, and as you might imagine, a lot of constituents are very concerned about what is happening in school. You have made statements which led me to believe that you believe not only nationally but within the state, we ought to be looking regionally and even locally as to how we can do it and how to go forward. It is really a source of confusion. It is not onesizefitsall. You have to look at it at the local, county, state level. We often say, in america, should you or should you not be open . That is almost not a question because we are such a large country with such a range of involvement in this virus. Domoved to you because you agree with him and his assessment . Yes, it needs to be a very targeted decision. That, because my district is four hours from d. C. It ends up going further west combined into the state of new jersey. Even within the district, we may need different, regional approaches. Would you all agree with that . Yes. You recognize the importance of facilitating access to viral samples. The future,at in making samples available will be crucial to deploying tests quickly. This certainly will not be the last time we face a rapidly spreading virus. How can this be improved in the future for different access . Yankee for that. I think this is one of the Lessons Learned from the situation. Access to the samples is very important. With nih, academics, and the cdc to make sure those are available. We have made a Reference Panel now available to developers to facilitate that. Thats an example of what you could do. I think you and i apologize. Earlier this year, you informed the committee that enough has been distributed to test the recommended 2 for months, and yet according to about 20 of, only states are testing the recommended percent while another 20 are testing fewer. Has the administration been disturbing supplies to states, and if so, why he believes some are not testing more of their population . Thank you for that. Before the full state plans were just received as part of the and we that we reviewed have reviewed them extensively, we set preliminary targets for overall in may the target was about 12. 9 million tests and about 12 million were done. Good, considering many of the states tried to do three or four times as many tests as they had done during that time. You think we are on track . I think we are. On tates have underperformed, especially in may. Our preliminary review of state plans, the overwhelming majority were very good to excellent. Everyone is getting the message and i look forward to that. Dr. Fauci, i want to come back to you. When we started this, we knew it would be tough. We talked about bending the curve and making sure our hospitals were ready. Based on your comments, i believe you think we are probably ready, maybe not perfect, ready. I understand its not over anytime soon. Theyou think we have bent curve and our hospitals are now ready . Yes. We have been through a terrible lot,l, we have learned a the imperative is now clearly different than it was in the beginning. So we have bent the curve and hospitals are very. I yelled back. Yield back. We go to the senator from california. , andank you, mr. Chairman i think the witnesses thank the witnesses for your work and your expertise. We can hear you. Ok. Im deeply concerned by President Trumps vision to eliminate our relationship with the World Health Organization that the American Health association has helped this senseless action beyond this perilous moment. It appears the president is not acting on sound public guidance but is instead scapegoating who to deflect from his administrations failure in responding to the covid19 pandemic. According to a report in vanity fair. Fair, workers were not consulted or asked for Impact Analysis before the decision to withdraw. Dr. Fauci were you consulted about the attentional Public Health impact of the United States withdrawing . I apologize. We said we were going to take a break at 130 time so everyone can go to the restroom or whatever. Dr. Fauci had to step out. To start over. You will have to repeat your question. The committee stands adjourned for 15 minutes. As he heard from the chairman, the committee is taking a 15 minute break. White House Coronavirus Task force members are testifying today, including dr. Anthony fauci, the fda commissioner, cdc admiral redfield, and brett from the assistant secretary of health. It should resume shortly here in about 15 minutes or so. Also, a reminder that we will reair the entire hearing here on cspan. While we are in the short break will show you the Opening Statements from the witnesses. Chairman pulldown, Ranking Member walton, and distinguished members, thank you for the opportunity to testify before pandemic, the covid19 to news in the United States and around the world. Is the greatest crisis we have confronted in more than a century while overall cases are going down several committees are seeing multiple cases driven by several factors including increased testing outbreaks and evidence community transmission. Now, the most powerful weapon against this disease is social distancing these will help us contain transmission along with readily available and selfquarantine to break the chains of transmission. Again, i the American People to remain vigilant to protect those from severe complications due to age or underlying medical conditions. Burdent also lessen the amongst groups disproportionately impacted. Datacontinue to improve from our partners, and according to hospital surveillance states, an increase of 80 . An increase of 30 . We are also receiving complete data from Public Health partners aired a recent study found that 1. 3 million covid19 cases found that most Underlying Health conditions were cardiovascular. Hospitalizations were six times higher and deaths 12 times the cdc is working to ensure the equity and Health Outcomes are being addressed throughout the covid19 response. It will continue to provide communities with expertise, rules, and information. The cdc has created hundreds of specialized documents and has been consulted more than 1. 5 billion times we have deployed over 5000 personnel in the response. We have more than 40 teams on the ground, providing Health Departments and officials but. Xpertise we are enormously grateful to the heroes of the response, the Public Health professionals and Critical Infrastructure workers who have worked and sacrificed too much. We are actively working to. Emedy the shortcomings report 12n able to million to enhance the response capabilities. Disease,ronted by any the Health Department must make realtime decisions based on realtime data. Data is the backbone of any disease response. With the resources on the markets, data is on the way. We must ensure that the laboratories have resilience, personnel expertise and supplies to be sourced. Our Public Health workforce must grow to address future Public Health risks. Thousands of Contact Tracers are on board. Bottom line, sustained investment in a Public Health system is an investment in the health and prosperity of our nation. Begun to prepare for months ahead when the next seasons influence is most will curve with covid19, increasing the challenges hospitals, health care professionals, and the public. This fall, i encourage the American People to be prepared and embrace flu vaccination for themselves, their families, and their communities aired this single act will save lives. Thank you very much, mr. Chairman, inky member walton. Thank you for allowing me to discuss with you the role of National Health research. The approach is very similar to what we do for other emerging infections aired is a full pronged approach. The second is to help develop diagnostics and essays, the third is to characterize therapeutics and the fourth is developed safe and effective vaccines. Speaking of the first fundamental knowledge of the virus and what it escape doing. Of things weber are doing. For example, the precise of the spikeucture protein which is that part of the virus which actually gives it its name, coronavirus, because of the spikes that stick out. That is the way the virus binds to cells in the body. This has been delineated by those we fund. Second, the demonstration of the precise receptor by which it binds to cells in the body allowing it to cause disease. We developed animal models, we do Natural History studies like understanding the virus in Demographic Groups. Third, we need and will get within time, based on a major investment in the protein program, diagnostics that are pointofcare, simple, precise, sensitive, and specific. We hope by the end of fall and early winter we will have these for wide distribution. Third, the development and characterization of drugs. You heard of the First Successful randomized trial of a drug called remdesivir which showed a statistically Significant Impact on decreasing the time to release from the hospital faster recovery. This is being used in combination with a drug that blocks other things. We are looking at other drugs and a new based therapies. Fourth, the development of safe vaccines. This defines the responses we have to disease. If you look at the history of viral diseases, it is vaccines that put the nail in the coffin. We are mounting a major effort in which we are collaborating with industry and publicprivate partnerships to get vaccine trials that harmonize with each other. They have multiple trials [no common boards and tertiary endpoints so that the data can be compared from one to another. You have probably heard one of those vaccines, and there are more than one, one of them will enter phase three study in july. This is one that has shown, in preliminary studies, favorable studies in the animal models developed. There will be others that will father one month, two months, three months later. Although you can never guarantee the safety and efficacy of a vaccine until you actually tested in the field. We feel cautiously optimistic, based on the concerted effort and the fact we are taking financial risks, not risks to safety, not risks to the integrity of the science, but financial risk to be able to be ahead of the game so that when and i believe it will be when and not if we get favorable candidates with good results we will be able to make them available to the American Public as i said months ago. It would put us at the end of this calendar year and the beginning of 2021. I will stop there and be happy to answer questions later. Thank you. Thank you, dr. Fauci. And thank you for all your contributions to fighting this pandemic. I will say the same thing about the admiral whom i bother the most. You are recognized for five minutes. Thank you. You can call me anytime. Distinguished members of the committee, on march 12 secretary azar request i lead the department and i would like to be clear that though i am no longer fully deployed to fema, i am maintaining my role in coodinating testing. The nation has performed over 27 million tests averaging about 500,000 per day. Even without any major technical advances i expect the nation will have the capacity to perform 40 million or 50 million tests by fall. We implemented a phased approach to beach the testing needs at each stage of the pandemic, especially during reopening, when the need for testing is greatest. In early march fema developed and implemented 41 communitybased drivethrough testing sites and locations prioritized by the cdc in collaboration with state and local partners. These have tested nearly 300,000 highrisk individuals and served as prototypes that have been duplicated multi fold. Next, we leveraged trusted pharmacies to implement community testing, especially for minorities and the underserved. This is providing testing at 611 cases and 47 districts. 70 are in communities with moderate to high vulnerability. This is testing over 688,000 individuals. Qualified Health Centers serve millions across the nation. They provide care to one in five those who are uninsured. One in three living in poverty and 1. 3 million homeless. Again, to assure we reach the most vulnerable among us. 93 offer covid19 testing. To further expand access we authorized all licensed pharmacists to administer covid19 testing under the prep act. Over 90 of americans live within five miles of a pharmacy. On june 4 using authorities provided to the secretary under cares, hhs released guidance so we can confirm all groups are benefiting equitably from coping 19 testing. Lab reports must include demographic information a race, ethnicity, age, and gender. Today i am pleased to announce the selection of Moore House School of medicine for a financial initiative. This agreement with the office of the assistant secretary for health, office of minority health, and the school of medicine will implement a Strategic Plan of national, territorial, tribal information to bring to those hardest hit. Moore house school of medicine will receive 15 million. This massive expansion of testing created unprecedented demand. To meet this demand we secured the Global Supply chain through a military air bridge. We work with manufacturers to increase domestic production, collaborated with external partners to validate new technology, secured and prioritized care point tests for state laboratories, the Indian Health service, and other needs finally, we used title iii to further invest in domestic any fracturing. These have enabled our current efforts of states, territories, and tribes to implement surveillance plans. I would like to close by recognizing my fellow officers in the United States Public Health service commissioned corps. 4,482 officers have deployed to support the Pandemic Response including to the diamond princess cruise ship, our military bases across america, are communitybased testing sites, fema taskforces directly inside Nursing Homes, and field hospitals across the nation. Exemplifying the care and compassion that all of us feel for those who suffered during the pandemic. I think every officer and family and on their behalf i would like to thank all of you in congress for supporting our Training Needs and the establishment of a Ready Reserve corps to supplement our ranks during a national emergency. Thank you for the opportunity to provide these remarks. Thank you for mentioning both military and civilians who are helping us during this crisis. We appreciate all they do and we have to help them as much as possible. Last, but not least, is dr. Hahn or commissioner hahn. Thank you for inviting me here today. I would like to start by thanking you for your support of the agency and the laws you have passed. It has helped create the response. The fda has a Critical Role in response to the coping 19 pandemic. We remain focused on our mission of protecting and promoting the health and safety of americans. President trump requested and we provided a flexibility to have access to critical products, safe food, and the confidence that the government is taking measures to address important Public Health issues. Fda has used our emergency authorities at the beginning of the pandemic. We issued more than 100 emergency use authorizations for diagnostics, ppe, ventilators, and other devices as well as for drug products. Since the Public Health emergency was declared which issued more than 50 guidance documents to help ensure the continuity of healthcare and safe food supply and put into place new initiatives to accelerate the development of needed products. We have kept the American Public up to date on what they need to do to protect themselves and contain the virus from spreading. We are preparing for the next phase of addressing this evolving crisis. It is missioncritical the agency continue to be diligent, assuring the safety of the products we regulate, and that we also put in place processes needed to ensure the protection the public will need. There are a number of experiences we have gained over the past few months that will inform our plans. We recognize we must be bold in our decisionmaking and advance Effective Solutions to achieve Public Health objectives. We have begun a comprehensive realtime review and assessment of our actions to date to address the pandemic. The objective is to identify and address potential organizational and Program Changes that should be implemented without delay to advance the ongoing response to covered 19. We need to assure we leverage what is working well while at the same time review our framework and policies to be positioned to effectively identify and respond to quickly evolving Public Health situations. A major focus will be to identify what regulatory policies should be continued and accelerated with executive order 13294. Changes will be consistent with advancing the Public Health mission and inform our Strategic Priorities moving forward. One of the challenges facing fda is how to assure the timely review of medical product applications despite an incredible surge in volume . I am pleased to announce that fda has announced the same pace of meeting its goals on applications for medical products. We are on target to meet the goals by taking timely action on 90 of brand, generic, and similar drug applications. This work has continued at a time when the number of applications received in some centers is substantially higher than precovid19 times. Fda launched the emergency review and Development Program and we continue to work night and day to provide guidance and review proposals from companies, scientists, and researchers. Let me be clear that data and science will dictate when we have safe and effective treatments and vaccines for covid 19. We have not lost sight of our solemn responsibility to the American People to ensure decisions related to all medical products are based on science and data. That is the commitment they American Public and have confidence in. The fda will provide leadership and guidance information and whatever else is needed as we address this unprecedented. Unprecedented challenge. Thank you and i look forward to your questions. Thank you. That concludes our opening from the witnesses. We will move to member questions. Each member will have five minutes to ask questions and i will start by recognizing myself for five minutes. You know i am very critical of the president for a lack of leadership from the start of this pandemic which i think continues. It is difficult because you work, in theory, for the president and i feel many of you, on many occasions, actually wanted to take more leadership and be as commissioner hahn mentioned cognizant of the data. Im going to issue questions about the president s lack of leadership and it is hard for you to answer. I believe the president is encouraging behaviors that are not consistent with good Public Health such as encouraging thousands to attend a rally and not mandate the wearing of masks and i cannot imagine nih or cdc would suggest this is the best practice in the face of this pandemic. There are two versions of reality. One is the president s and one is hopefully yours based on data and science. I want to hear from the experts. Let me start with dr. Fauci. You are a trusted voice and always been candid with us in the American Public. Give us an untarnished view of where we are in our fight against covid19. Thank you for that question. It really is a mixed bag. We have a very large country, major differences between the new york metropolitan area and casper, wyoming. We have been hit badly. Anybody who looks at the numbers we have over 120,000 deaths in 2. 5 million infections. It is a serious situation. In some respects we have done very well. Right now the new york metropolitan area, which has been hit extraordinarily hard, has done well in bringing the cases down and using the guidelines we have very carefully put together in a stepwise fashion to try carefully reopen the city and state. However, in other areas we are seeing a disturbing surge of infections that looks like it is a combination. One of the things is increasing Community Spread and that is something i am quite concerned about. You know this has been something in the press over the past couple of days. We were going down from 30,000 to 25,000 to 20,000. The way you address that is you have to have the manpower, the system, the testing to identify, isolate, and Contact Trace in a effective way so that when you see those increases you can understand where they are coming from and you can do something about them. Right now the next couple of weeks are going to be critical in our ability to address those surges we are seeing in florida, texas, arizona, and other states. They are not the only ones having difficulty. Bottom line, it is a mixed bag. Some good, some we now have a problem with. Im going to have to ask about the president. He talked about testing and how important it is in the admiral and i know how important it is. The president said, when youre testing to that extent you are going to find more people, more cases, so i said to my people, slow the testing down please. This morning he said he meant this. Dr. Fauci, do you agree with that . Does it make sense that we should be limiting the number of tests rather than ensuring anyone who needs a test can get one . You dont have to mention the president , i did, but tell us about the testing. I and my your microphone is not on. I and my colleagues to my knowledge i know that none of us have ever been told to slow down on testing. That is just a fact. In fact, we will be doing more testing as you have heard from the admiral giroir. We will specifically identify people to isolate and Contact Trace, but more surveillance if you want to get your arms around and understand exactly what is going on in Community Spread. We are going to be doing more testing, not less. Let me ask the same of dr. Redfield. Do you agree with the president . Do you think we should be testing more people . Just tell us if you think we should be testing more people. Yes. As dr. Fauci said all of us continue to be committed to increasing timely access to testing. We have made marked improvement. We still have a ways to go. One of the key things as tony mentioned is expanding surveillance because of the nonsymptomatic nature of the infection. We are looking at ways it could substantially impact testing. We are doing 500,000 or 600,000 tests a day. We are continuing to try and enhance testing. It is a critical underpinning of our response. Thank you, dr. Redfield. I recognize mr. Walden for five minutes. Thank you, mr. Chairman. Let me go to the question my colleague asked and i will ask each of you for a yes or no answer. Has President Trump ever directed you to slow down testing for covid19 in the United States . Dr. Redfield . No. No, sir. Dr. Hahn, you created a website on the fda site dealing with convalescent plasma and antibody investigational therapies. We left off with congressman mcnerney. Youre going to have to repeat your question. And unmute. Thank you, mr. Chairman. Your video from the committee coming out or not. Im truly concerned by President Trumps vision to terminate the United States relationship with the World Health Organization. World Health Organization has called the president s move a senseless action that will have significant repercussions far beyond this perilous moment. Notoes appear they are acting on sound advice but scapegoating the who to deflect from his administrations failure in responding to the pandemic. Fair,ing to vanity officials who worked on these programs were not consulted or before the president s decision to withdraw. Dr. Fauci were you consulted, and if so, what were your recommendations . Thank you for the question. I was not specifically consulted about the attempt to withdraw. Us istuation with many of that we have longstanding relationships with the who. A Collaborative Center and i have a memorandum of understanding. Dr. Redfield and i are on a weekly call and supervised by the who. With regard to what policy comes from the white house, i have not been consulted on and it has not really impacted the consultation. Its like listening to a cell phone that is coming in and out. Same question. Where you consulted about the potential Public Impact and what would be your recommendations . No, not directly. The cdc has a long history of working with who. Continue working on drc,boration, the influenza and surveillance we continueorld working at the scientist to scientist standard level and so we continue to do that. Again, i could not hear the response. According to the faculty director of the Harvard Global health institute, following this will havenvestment outside consulates is and certainly make all of us less safe and put our lives at risk not only globally, but here in the United States. Do you have concerns about the president s decision withdraw . To withdraw . Yes i do, and thats why im sorry did not hear makes the nation. I was saying that despite any policy issues that come from higher up, we continue to interact in a very few meaningful way. How will that impact the cdcs ability . We are continuing to work with the who and Public Health efforts. Again, the implication will be where there are colleagues were able to collaborate, clearly there can be limitations on our ability to provide direct funding, but we have the ability to provide funding and so we continue the Public Health work we need to get done. Dr. As a member of congress with science background, i am concerned that science is being ignored. We must be certain of consequential decisions like withdrawing from the who are based on sound guided. Science must have a voice at the treatment,er it is current pandemics, climate change, or other issues of concern. Dangerous. Ience is chairman, i yield back. Thank you, mr. Chairman. I want to thank them for the testimony today and the work they do on behalf of our constituents. In the scientific communitys covid19 response, with the unprecedented collaboration and research sharing at a pace unlike anything before in history. Clinical trials are approved in record time will laser focus remains intense on safety. Regulators and drug manufacturers are learning from each other are joining together in a critical fight. Innovation ishat the covid19 evidence accelerator which is a Public Private Partnership Initiative launched by the Reagan Foundation in collaboration with Cancer Research to advance understanding of covid19 focus on analysis of realworld, diagnostic and clinical data. Do you believe these collaborations will lead to lasting change for drugs and vaccines . How will the innovation changes affect research into diseases like aos and alzheimers . Thank you for highlighting this important endeavor. This is an attempt to really accelerate use of realworld evidence in our decisionmaking. In a Research Point of view. A couple points i would like to make is that we have to be really careful we do this in a robust and careful way because the Gold Standard remains randomized Clinical Trials. Its important we understand that. We make decisions based on Data Available to us at the datahaving additional afterwards as that plays out gather at the ends plays out about how treatments are administered. Very pragmatic data will then allow us to go back and revisit the decision. To me, there nothing wrong about that doctors in the room now theyre taking care of the data and in fact you must incorporate that your that. Its a great opportunity and i would love to see us do more i would love to continue the conversation with congress. I i totally agree, and what think the doctor has mentioned spills over into something we do in the Clinical Trial process, which is really the Gold Standard Gold Standard in these type of decisions. Has the cdc correlated with agencies such as the administration of committed to living to protect the elderly . What steps are you taking to meet the needs of older adults during this pandemic . The cdc has a longestablished relationship to continue to work on health and wellbeing, which includes the elderly also people with together in we work trying to clear information from agencies and others. Aarpve also reached out to to help to provide tools for older adults to get out and take advantage of distribution and we will continue to do that. Obviously, it is a critical group. Again, i think we will continue to cross collaborate with the a. C. L. And try and help facilitate the mission. Question, dr. Redfield. Given that we continue to learn about the virus in real time, how often are you updating testing guidelines . It is intermittent. We recently posted guidelines last friday. I know that we have gotten some feedback from the states and there is an interim posting that will come back. Guideline,he basic we are posting specific guidelines for specific situations so we did Critical Infrastructure, Nursing Homes, and medical. This week, i expect we will do universities and i expect shortly after we will do nonCritical Infrastructure businesses. Specificying to add guidelines to specific whentions, and obviously, there is new science and situations, we update them in that setting. I think you will see a series of targeted testing guidelines will be posted over the next several be weeks. I appreciate that. Then q. Thank you. Our next member is the gentleman from vermont, mr. Welsh. Thank you very much, mr. Chairman. Patients for your extraordinarily good work. As of december of last year, there was this emerging threat from the coronavirus. My understanding is that Public Health officials always anticipate, and there are two things, essential to be ready. One is preparation and two is committed to. My understanding is that the National Security council has playbook for her response has the playbook for the response and indicated we should move swiftly to fully detect outbreaks, secure ppe, supplemental funding, and use the defense production act. Witnesses aware of that report having been . Ollowed in 2019 just a yes or no. Im not exactly sure what you are referring to, if you are referring to a document prior to the outbreak and what the response would be. Substantial substantially, what was implemented is that the amount of stockpiles at ppe and other items that were needed were not at the level we were able to respond to in an efficient way. Was a real delay in the use of the defense production act. A pandemic Global Response team eliminated. Did anybody think it was a good decision to eliminate that . I take it the answer is no. Understand, the travel ban only applies to foreign , butnals coming from wuhan did it it did not include nationalized or american citizens. Thank you for the question, mr. Congressman. Those individuals were never qualified. They went into 14 day quarantine. Quarantine wasnt enforced, is my understanding. Let me ask you a few questions about communication. Sure everyone of you who is careful about communications knows how important it is. Said that thedent stock market is starting to look very good and the coronavirus is under control, if anyone of you agrees with that, will you raise your hand . On im sorry, none of us heard that question. Can you repeat the question again . Communication is important and we have before us extremely careful communicators. They indicated that the stock market is starting to quote look very good. The stock market is quote starting to look very under control. Does anybody agree with that statement, and if so, raise your . And peter, listen to me. You have got to give them a chance to respond because you are not here. Did you hear his question . If you dont want to respond, that is fine. Nobody raised their hand. Ok. February 27, President Trump said the covid19 will disappear. Agree with that statement by President Trump . Peter. Ands were raised, finally, President Trump indicated on march 9 that covid was comparable to the common flu. Testimony and are confident about the flu making people worse. Do you agree there is any comparison between covid and the common flu . It is not the common flu. Thank you. I see my time is up. I yield back. Johnson of ohio is recognized for five minutes. Thank you mr. Chairman, Ranking Member, and to our takinges, especially for the critical time and work that you are doing. Obviously, we are not out of the woods with the virus yet, so you are still on the frontlines of it. I want to shift gears a little bit and talk about something i dont think i have heard anybody else talk about. Pandemicis covid19 and the associated distancing orders, many vulnerable isolated, andme in many cases were too fearful or unable to do essential health care, and where i live and across rural america, fortunately unfortunately, this can be the reality even in normal times. Could be three hours away or a symptom could go. Ntracked unchecked for days increased use of telehealth could help alleviate this problem. And haseen a priority taken on a new sense of urgency with so many elderly and medically compromised people finding it potentially hazardous to leave their homes. President and his administration have use the Authority Congress gave them to remove the regulations and red tape had previously entered robust employment of telehealth. Result, capless vulnerable americans now have access to their doctors from the safety of their home. We have heard patient after patient who have taken care of the services. They tell me they do not want to go back to the way it was before. It is time for congress to make robust access to telehealth permanent for all americans, especially the most vulnerable among us. I would like to start with you. Do believe telehealth practices and virtual doctors visits could be an effective tool for helping to promote or protect . Ndividuals yes, i do. Telemedicinet should have been even more implement, but as we look forward to the future, i think you will see a lot more of that not only for the reasons you bring out even the situation we are in now, but for a variety of others. Thank you. I would just like to emphasize that as well. Tremendouslearned lessons about the telemedicine most of us thought would be there. For example, just to understand the uptake. Visitsnly 500 telehealth , and by the week of april, there seen telehealth visits the instrumental in combating our issues, particularly with increasingdisorder, prescribing, so i think all of us understand the whole key is Getting Health Care to people where they are, and not making them come to a major center unless they really need to be there. We are anxious to increase the use of telemedicine Going Forward. Ok. Lastedfield, during the several months, we have seen situations where at risk, elderly and isolated individuals have missed regular doctor appointments. As an expert, can you speak briefly to the dangers of Public Health, if patient is looking to continue Mental Health treatment , to check in with a specialist, or event to consult with their doctor, are not able to do so over an extended period of time . Dr. Redfield it is important to emphasize, you know, as lee did limit as we did limit health care, to keep certain jurisdictions from overwhelming their Health Systems when working toward the peak, unfortunately, with health care being broadly limited, as you point out, there were real health consequences. Services,ental Health Services and individuals we have a market inline a marked decline visits. It is really important that we up the Health System back and operational, and i think the introduction of telemedicine is a critical component, something oft needs to stay as part the innovation, as we work more and more to move from a diseasebased system to a Health System. I think it is critical. We have seen an increase in suicides. We have seen an increase in drug use disorder. It is important a get the services up and operational and a manner that the public can access. Thank you very much. I yield back. Fromxt is the congressman new mexico. Unmute your connection there. Thank you, mr. Chairman. Dr. Redfield, under federal totute, the cdc is required treat Tribal Epidemiology Centers as Public Health authorities. Dr. Redfield, last week, your staff indicated in writing said the datasharing issues [inaudible] dr. Redfield commenting on your artwork. I apologize. Your staff indicated that the datasharing issues were merely a miscommunication with a single tribal epidemiology center. If that isnt true, my office says this goes beyond a Single Center and a report have encountered problems obtaining cdc forta from the covid19. Do i have your commitment to work with each of the 12 Tribal Epidemiology Centers to ensure they get access to all of the data they are entitled to . Dr. Redfield yes. The initial episode you brought up was obviously a significant miscommunication, but you are right. An issue to be worked out. Our team is currently working with the tribal epidemiology center, and we are committed to correcting that for all tribes. Redfield, you can direct your staff right now to release that data. Is that something youre prepared to do . Dr. Redfield i did not hear the question. Dr. Redfield, if you could direct your staff right here and now to release that data to the tribal epidemiology center, is that something youre prepared to do . Dr. Redfield we are working with that we are working with them as we seek as we speak. We want to be able to transport the data. That is what our team is working to finalize, and as soon as that is finalized to maintain the security of the data, it will be transferred. I have been told it will be completed this week, or within the next one to two weeks for all 12. Thank you, dr. Redfield very please report to the committee when that is done. The Trump Administration failed withing covid19 testing the first few month. Testing capacity is nowhere where it needs to be. Public healthd a emergency. President trump declared that anybody who needs a test can have a test. They are all set. Day, more than 3000 tests were completed. On april 28, President Trump says testing and the u. S. Will surpass 5 million per day. We currently conducting 5000 tests per day . We are doing about 500,000 single tests per day. Nearly every leading Public Health expert agrees that the centerpiece of reopening the a Contact Tracing strategy. Hasnt itt this is a direct cause of our economic suffering. Admiral gerard, we have been hearing promises on increased testing for months, and every time they have come up short, what will be different moving forward, and how does the u. S. Get to the 50 million tests promised, particularly in light of the president saying there is a lack of any for testing . I disagree with your question. I dont think we have come up short every time since march 12. I have been vary forthright very forthright with the constraints and that we are doing Everything Possible to increase that. We are doing 50 million tests per month, although we have need for more testing, our national Positivity Rate is 6. 5 percent, so we are getting the range. Right now, six or seven states are above 10 . We have to surge into those areas. When i say 50 million tests, i know every single lab producer, what they are doing and when they are providing and how they will distributed and how many swabs. The capacity will be there for 50 million tests at least, in the fall, and i have that provider by provider material by material. And hopefully, it will be greater than that when we have cooling, and hopefully some of the new technology can move into that realm. Thank you. I appreciate your leadership, and respect you vary much. The reason President Trump 5 million tests per day on april 28, and we are still and only half a million tests each day. Forward toto look work with you. I yield back. Mr. Long fromve missouri. Thank you, mr. Chairman. Dr. Hahn mother are a number of initiatives that claim federal industries and private agencies exploited the entire process for the manufacturing and distribution of covid19 therapeutics. The administration recently coronavirusa acceleration program. Can you talk about the development of therapeutics under this, and how does the fda integrate its work and its own and it should have . Approximately 10 weeks ago, the fda stood up a treatment exhilaration program. That was were a variety of reasons. We wanted to accelerate the development of therapeutics on behalf of the American People, but do it in a robust way that looked at the science and data. We had gotten a significant number of applications. At this point, our best estimate is double the applications we had during a regular time free covid. We had to prioritize applications based on the High Priorities of science. Across the spectrum of our medical products, it allowed us to prioritize the science of, and then, address those applications because what we wanted to do was to make sure in real time addressed any issues developers had parted we had people come to the fda who had never before applied to the fda warned application of any sort. Useher it be an Emergency Operation or a we had to hold hands with sponsors in academia to help you through the process. A great example of what can be remdesivirt the protocol got up and running. Eua. D to an we are providing all sponsors, including operational warp speed assistance. What are the end points we need to look at . How can we accelerate the design and the Clinical Trials . We will continue to do this as we go through the day pandemic. Thank you. Dr. Fauci, can you speak to the in accelerating manufacturing, testing, and ensuring that manufacturers work aggressively on a vaccine and protocols . Dr. Fauci thank you for that question. An important question, congressman. That is what i referred to earlier on, as part of the process of developing the vaccines in operation warp speed, there is an employment of Contracting Organizations will already start scaling up the development of vaccines, particularly the first one that i mentioned that will go into a phase three trial in july, has already had contracted through hhs for the production by a Contracting Organization of hundreds of millions of doses ultimately. The first group which would be delivered at the end of the year, and the rest in the First Quarter of 2021. Ok. Thank you. I was a little confused in your opening remarks. I cannot remember exactly everything i have heard, but i was wondering about that, so thank you for clarifying. Dr. Hahn, looking long term, what do you think the fda and [inaudible] dr. Hahn i appreciate you bringing that up. We have seen across the medical products we regulate, issues related to redundancy and manufacturing, and our dependence on the foreign sphere. During a Public Health emergency, we may have difficulty providing access to those supplies, both precursor products, such as pharmaceutical precursors as well is the final finish of the form and ppe. Very much, we have been working on Technical Assistance because manufacturers depend upon our Technical Assistance to help them develop the manufacturing procedures that lead to a quality product. We are leaning in on this. It is one of our major initiatives for advanced manufacturing but also domestic manufacturing. It would be great to work with congress further on this. It is an important lesson learned. The more we can provide that redundancy to the supply chain, i think the better off we will be in the future. Thank you. Thank you. I do yield back. Thank you. Congressman in new york, unmute. Mr. Tomko, are you muted . Can you hear me . Yes. Thank you, mr. Chairman, and to all the panelists. Last week while participating in a telephone town hall with my constituents, i got a simple question for which i have no good answer. She asked me straightforwardly, if the government is telling everyone to wear a mask in public, why doesnt President Trump refuse to wear one . Dr. Fauci, please help us set the record straight. What does the records what does the evidence tell us about face mask or face coverings when it comes to transmitting, or contracting covid19 . Dr. Fauci thank you for the question, congressman. Although we dont know the exact percentage, we can say very clearly that wearing a mask is definitely helpful in preventing acquisition, as well as transmission. Mask, andf wearing a if you are inadvertently not knowing you are infected, protecting you from infecting someone else is stronger data than the data that says you will be protected. However, everyone agrees in the Public Health sector that wearing a mask is beneficial. It may not be perfect, as we often say, wear it and dont let the perfect be the enemy of the good. It is always better to have a mask on that to not have a mask on. Both for acquisition and for transmission. Thank you. I listened earlier in the hearing to my friends. You talked about the spike in numbers in texas. I could not help but think that precautionary efforts are prime importance. They can be defined and written, or they can be shared by example. Unfortunately witnessed as the president seems to believe he is above this evidenced based recommendation you just described, and has policies or injected into Public Health. Seen onefused to be camera wearing a face mask, and last week he says that wearing a mask is a disapproval of him. Formnk, leadership has a up or cautionary instruction, is required of the president and any of us in elected office. We should be setting the right example, but the president s refusal, dr. Fauci, to wear a effortsvering and his to politicize wearing a face mask, since the long message coming from Public Health experts, like yourself, and others who are at that expert table . Dr. Fauci i dont think i can president shat the there are multiple factors going into the president not wearing a mask. Certainly, i wear a mask in public all the time. Not only because i want to protect others, and to protect myself, but also to set an example. I guess that answers your question. Directed at any time by the president to wear a mask in public . Dr. Fauci i have not directed the president to wear a mask food i think it is very clear to anybody in the country present to wear a mask in public, but i think it is very clear to anybody in the country the importance of physical distance, and if not, wear a mask. Or in a crowded, it is imperative to wear a mask at all times. Dr. Redfield, let me turn to you. On april 3, i believe, there was guidance released recommending wearing face coverings in public settings and grocery stores. Most recently, they are where faceemployees coverings, and promoting their use can someone is likely to raise his or her complaints. What is the process for these recommendation . What is the American Public need to know about the use of face masks . Dr. Redfield thank you for the question. I want to act on the calmest dr. Fauci may. Our recommendations are clear. One of the most powerful weapons we have against this virus is socialdistancing, face coverings, and our ability to practice rigorous hand hygiene. Clearly, when we recognize that asymptomatic transmission or presymptomatic transmission was significant, that is when it was clear we wanted to recommend all individuals wear a phase to protect order other individuals in case they were a symptomatically infected. We continue to recommend that. Our recent guidance on mass gatherings, we try to illustrate the importance of trying to maintain socialdistancing and to wear face coverings, and as dr. Fauci sat in the event you will not maintain that distance, it is critical you wear that piece covering. It is unfortunate that so much of administrations fromnse is not coming Health Experts. I yield back. Thank you, mr. Tomko. Next is mr. Florez from texas. Thank you, mr. Chairman. I want to thank each of our witnesses were appearing today. Is a little bit spotty today, so hopefully you will be able to hear me. Thent to brag on administration and the team of witnesses here today for the response to the spread. We have new, therapeutics underway. We have several vaccines under development, and we have had a huge expansion of testing materials, ppe, ventilators. The federal response in clearing out the road box the roadblocks has been impressive. The great example is the huge expansion in telemedicine, which has happened in the last several weeks, several weeks. Dr. Fauci made a pretty poignant statement earlier in this theing, talking about reason that things are different region by region, and i would like to talk a little bit about the responses that were done region by region. Here are some statistics on covid19 as of yesterday. New york state has 6 of the population but it has 22 of the total u. S. Deaths. Michigan has 3 of the u. S. Population but it has about 5 of the total u. S. Death. If you look at my home state of texas, we have 9 of the population would only 2 of the deaths. These are values as of yesterday. Thatop seven states represent 60 of the deaths, all of those are led by democratic governors. If you look at the number of deaths, new york states mortality rate of 6 , michigan is 9 , whereas texas is 3 , so what concerns me of the stark differences in the mortality rates in the percentages of deaths compared to their percent of the population. It is obvious some governors made big mistakes, but we are not hearing about that in addressing the spread. It is interesting that while those governors were complaining about President Trump, they were ignoring their own populations. So specifically, i think we ought to talk about our elderly at risk population who contracted covid19. Lets start with these stats. Michigan, 1947 and long [inaudible] wasew york, that number 6200. In florida, that numbers only 1637. This is despite that florida has a longterm care population far higher then michigan and new yorks. In michigan, state officials declined a proposal to new to use bacon facilities to house patients who tested positive for covid19. Instead, michigan put those patients in a nursing home in Nursing Homes with other unaffected patients, and as we heard previously in this hearing, in new york, the Health Department ordered Nursing Homes and Rehab Centers to accept covid19 patients who were discharged from hospitals. This led to more than 4500 patients who tested positive for covid19 putting back into longterm care facilities. Setlorida where authority up Isolation Centers have focused on treating patients with covid19. My question for dr. Fauci and dr. Redfield, there have been fewer deaths in florida compared to new york and michigans. You talk specifically about these approaches to elderly care anywhere there putting covid19 patients in Nursing Homes with nonaffected patients were good policy . Were they in the best interest of our seniors . Dr. Fauci . Um, obviously, if you put someone who is a potentially infected patient into a nursing home, there is a risk of there being spread. Data and a lotof of situations in which there was a moving target in whether or not there really was a facility to put individuals. I feel uncomfortable and commenting about that because i was having trouble following each and every one of the data points that you were given. Do you have any further insight . Two points. First, and we are working to try to understand the multivariance. As you pointed out, at least on the cases, there has been differential mortality both in different jurisdictions, as well as within the longterm care facilities in different jurisdictions, and really looking at the multifactors to see that if they are controlled for, is there a difference . We dont know, but we are looking at it. States had a better approach in dealing with elderly patients, florida or new york . Dr. Fauci . Think i am inont a position to evaluate that. That is not in my purview of anything im responsible for. Clearly, congressmen, as i said before, look at consequences and impact. It is mobility and mortality. The mortality rate in nursing better in clearly florida as opposed to new york, but causation is what i am not willing to speculate on, and without doing controlling for the different variables we have individuals with the same extent of comorbidities in those two nursing home settings. Investigation will be complete, and we will get an understanding of why there is differential mortality in Nursing Homes, as well as why there is differential mortality in different jurisdictions, as you pointed out. Thank you. I yield back. Now we go to iowa. Unmuted. Thank you. I should be unmuted. You are good. Thank you. This you, chairman, for important hearing today. Unwanted tank all of these witnesses i want to thank all of these witnesses for their expert testimony. I was hoping another administrator would be joining the panel. The resource needs of hospitals and Nursing Homes since she is not here, i have a few questions for admiral gerard. Of answer. Fauci kind the question already vary briefly. But do you believe our Health Care Providers who are serving on the front lines within our hospitals, have the personal protective equipment, the supplies, the resources they need today at this particular moment . This particular moment, i do believe they have the supplies they need, and let me tell you, when we get a report of a nursing home, or another facility that says they dont have the supplies, literally, we call those places individually to understand what their needs are. At this point in time, i think were meeting those needs again. The challenge is if the first wave gets worse, or we have a second wave, are we going to be able to meet those challenges . Have 90to make sure we days. Yes sir. I appreciate that. I want to move onto the future, if you well. Before i do that, i want to ask everyone whether he agrees that it is likely that we will in fact see a second wave . I know there is a lot of controversy right now as right now if we are in the first wave, if you will. There are different regions dealing with in different ways, and feeling different effects, but if i could go down the panel, beginning with dr. Redfield. A truly yes or no answer, do you believe it is likely we will see a second wave in the fall or winter . Dr. Redfield i am not sure i would call it a wave, but want to make a clear, we will experience significant Coronavirus Infection in the fall, winter of 2020. Dr. Fauci . Dr. Fauci certainly, there will be Coronavirus Infections in the fall and winter because the virus is not going to disappear. Ok. Thank you. I appreciate that. Dr. Hahn . Agreehn congressmen, i with the doctors. I wanted as admiral gerard Going Forward, what steps is the Department Taking the help hospitals and Health Care Providers prepare for a potential, or a likely surging cases in the coming months . Dr. Gerard . I dont want to take of all of your time because it is really everything from understanding what the needs are to understanding this to five chains to the individual hospital levels. We started out, it was impossible to know what supplies are being used objectively, what ventilators are being used objectively. We have gone through that all the way to the therapeutics dr. Fauci has talked about and dr. Hahn. Remdesivir, steroids, hopefully plasma, all of these things and everything in between, it is really all hands on deck. All of our taskforces are still operational, including the hospital Resilience Task force. That is not only dealing with covid, but if this happens again, we dont want our immunization rates to plummet, our mammograms to planet to plummet. All of these things are victims of the covid response, just like Covid Patients were, so we need to fix all of that. One last question to you, dr. Gerard. Hospitals have struggled ,ramatically financially especially when they could no longer perform elective surgeries. We passed legislation in congress and provided funding to providers for expenses and lost revenue. What is the status for the remaining funding that has yet to be distributed by the provider . Dr. Gerard i will have to take that for the record because a secretary people on that side is really controlling the, but we will happy to supply that answer. My time has expired. Thank you, all. I yield back. There is you proceed, an uproar on social media about the fact that dr. Fauci has changed face masks, and the implication thereof. Do you have any common . Do you have any comment . Dr. Fauci i am an avid Washington Nationals fan, so i thought i would break this up by putting on my Washington National face mask. Ok. [laughter] thank you. Next we have [inaudible] chairman, andmr. Thank you also very much. You got me going thinking about the nationals. We missed some playing baseball. I would like to talk a little bit about what you all suggested with respect to sustainability of funding. Dr. Redfield, i think for decades, we have under invested in our nations Public Health infrastructure. Can you tell us what it is we need to do . You all mentioned sustainability, but if you could all talk with us about what steps would be necessary, not as federal government, state, and local, what do we need to do to really think about our Public Health infrastructure in this country . Dr. Redfield it is so important, and i have said this, now is the time. Because for decades, we have under invested in what i call the core capabilities up data analytics. Those are all the Different Things you think everyone stay, local any federal law to be investing in at a higher level . When you look at it, if you before, we will probably spend close to 7 trillion, all right, because of one, little virus that came, which recognize vary early, and used the capacity we had, and you know, i said the critics will be there. We will do the postmortem when we are down. We have done the best we can do to tackle this virus. And the reality is that it brought the nation to its knees. Now is the time. It requires a sustained investment. The core capability. Many of you may not know the nuances of state funding for the agency i run, cdc, but there is no core funding. It is all through different ppas provided by congress. We need core Public Health finding, and many people dont now that cdc provides up to 70 of the Public Health funding for every state, local, territory, and travel Health Department in this nation. We have to invest in that with the purpose that it is core base funding. Invest at higher levels as well . This needs to be a partnership. It is not all of the burden of the federal level. If youre funding the cdc if youre funding of the cdc was to go away tomorrow, it would just crash. It should be a partnership. Dr. Hahn, i want to talk about operation warp speed. It sounds like an exciting ever, a great project. It sounds like an exciting project. We are working at warp speed, and your companys that you are working within all of the government agencies, everyone is working at warp speed. There is many who have concerns about vaccine, safety, and efficacy, and that when we get to that point, which hopefully is at the end of this year or early next year, when one of these products breaks through, what do you want to tell the American People and the world in many ways about the safety and efficacy and the steps we are taking to make sure that when that vaccine does breakthrough, that, you know, it will be safe for everyone to use . Dr. Hahn i really appreciate the question, and dr. Fauci, certainly as the worlds experts to speak to Vaccine Development. Experts inldleading the assessment of vaccine safety and efficacy. The world looks to the fda and the u. S. To actually make those assessments. Where i can promise the American People, we will work with companies, we will work with operation warp speed to provide the assistance of the right studies are done with the right information, but we will look at those data, and we will make a decision in the best interest of the American People with respect to safety and efficacy. We will use science and data to do that. Dr. Fauci, maybe i shouldve started with you. What would you like to say to the American People . Dr. Fauci dr. Hahn said it very well. There was good intentions about using the words warp speed would i flinched a little because i know people may think it is reckless. It isnt. There are risks, but the risks are all financial risk in me that is what people need to understand. They are not compromising the safety at all, nor are they compromising scientific integrity. When you do a vaccine under nonemergent conditions, there are various steps, and because Companies Make investments in this, what they do is they dont make an investment in this step until they are sure this step works. Then they go to the next step. One of the most important steps is when you start gearing up to make many, many doses. You are not going to make an investment of a half a billion or more dollars to produce doses unless you know it works. With this particular program says, we will assume it is going to work, so we will put themtment into preparing for phase three even before we knew phase one was successful. We will be making doses, even before we know it is effective. What you are doing is you are cutting down on time, but you are not cutting down on the process of safety. So, if you lose, the only thing you lose is a lot of money. Nobody likes to lose a lot of money, but we feel we would rather lose a lot of money in four to six months then have a resultant have to wait four to seven months to get the vaccine. I yield back. Thank you. Thank you, ms. Brooks. Now we go to mr. Schroeder from oregon. I want to thank everybody here for all of the hard work you are doing. Where i am. Concerned is that the American People are laboring under gross misapprehensions as a result some of the information that is out there. Dr. Fauci, what is the average time to develop a vaccine . Dr. Fauci it depends on the vaccine and the situation in which youre doing it. If your developing a vaccine align what is the average . Dr. Fauci seven years. What was the fastest a vaccine has been developed . To date . Dr. Fauci i think those egov asked we developed was about a year and a half, but it was never brought to full fruition because zika disappeared. Whaty there is a vaccine, is the probability that a vaccine comes to market actually . Successful,f it is it is a high probability. Arell these vaccines that being developed, what is the probability they will make market entry . Dr. Fauci there are more failures than successes. About 6 . What about this what about the chances with a vaccine this virus will be eradicated . I looked to influenza as an example, how effective is that vaccine . Dr. Fauci the virus changes rapidly. Much like this virus. If you knew tates. If it mutates. If i was a mother hardworking american citizen and i wanted im trying to bank on my familys future, how long do i wait . Im everywhere that many, Many Americans are waiting until there is a vaccine, maybe a year and a half at best, out there. And that will be the panacea. And they will be ok. That is a terrible miscalculation. Im not blaming anyone, but it is a terrible miscalculation on the part Many Americans. I will stay home, not go to work, not send my kid to school, and im going to hunker down and wait for that vaccine. I think we have to Start Talking as ones of the vaccine of the tools in the toolbox. Dr. Redfield . To that end, im concerned with the school year coming up, the cdc never recommended closing schools this spring. Many, Many School District across the School Across the nation the cdc guidance talks about different considerations. Is it that a secondgrader or frankly a teenager will maintain socialdistancing at 60 time . At six feet all the time . Dr. Redfield high fever you know the answer i think you know the answer to that, congressman. Dr. Redfield what about a school bus. We can barely afford the school buses we have now. What is the chance of having three feet or less . Dr. Redfield you raise the reality as we look at it. Sorry to interrupt. Some of these are rhetorical, but im just worried youre making all of these publichealth perfection recommendations that have no chance in hell of happening at the local level. They dont have the money, they are dealing with human nature, especially children. Adults are not much better from what we see around the country, but poor children, we have to have recommendations that are realistic. What is the incidence rate of this disease in children . Dr. Redfield we still dont know the infection rate in children, but internationally, it is less than 2 . Dr. Fauci made a good direct comment that they can infect others. It was seem to me a smart use of our precious dollars. You talk 7 trillion. We dont have 7 trillion, doctor. Trillion in one month for good reason, and hopefully, you guys are showing us good results, and i appreciate that, but we need to make sure that citizens arent withholding johnny and susie from going to school because they think this is all going to be over and a month and a half and ao months until half or into months. We have kids not going to school, we run a huge risk of the wealthy kids get a great Education Online with their internet and the poor kids dont get an education. Dr. Redfield we need to use the knowledge we have now which we did not have been. The cdc did not recommend closing schools. Ok. We did not recommend it because we did not think it was a onesizefitsall. We close schools jurisdiction by jurisdiction when we see issues in schools. I think we have to focus as we move forward in the fall, and now, what i set on the consequences of this virus, and those consequences are mortality and hospitalizations and the economy. Right . See you see that, you will that different recommendations of the jurisdictions will come to rise. Im confident will be opening schools. We need to open schools with the reality of how we expect those schools to act, based on the consequences of what we think this virus is going to pay for those individuals in schools. It doesnt mean we dont have to be vigilant about protecting the vulnerable. We need to work on that and those families. No longer does that mean we have the shutdown schools, shut down, you know, the economy. It means we have to focus on how to prevent the consequences of this virus. Thank you. I yield back. Now we go north carolina, mr. Hudson. Chairman, thank, mr. And for holding this hearing today. Appreciate all the work we have done together on the opioid epidemic. Thank i would like to thank everyone who worked tirelessly. The Trump Administration has taken action early and often to come back is virus to keep us safe. President trump declared a Health Emergency and restricted travel from china or any nation imposing a risk of the infection. After the first confirmed case, President Trump cleared a national emergency. The Trump Administration has gone from a few thousand tests per day to march took close to one million tests in june and being able to perform 40 million of 50 million tests by september. There have been herculean to grow the on ppe capacity. As we grapple with the outbreak, we have had to acknowledge what little we have known about it. We are still grappling with the questions such as how or if it will mutate, can our immune system can produce appropriate antibodies and vulnerabilities about the virus. What has become clear is our need for data. Getting the full picture of the data is important because of Racial Disparities. If you look a case reported in Cumberland County in my district, there were 71 white individuals, 202 africanamerican individuals, but 238 unknown. Casessparity in covid19 at a district, 57 hospital in fayetteville were africanamericans despite only being 34. 9 of the population. It is paramount we have as much data as possible to address this issue. Congress required new reporting conditions. Labs are required to submit data to the cdc to help us understand how and where the virus is spreading, such as race, ethnicity, age, sex, and other relevant factors. It is important that in most cases, lab employees are not interacting with the patients. This is important to make sure all providers are engaged on collecting this data to obtain the most complete demographic information. Admiral gerard, what actions can that all officials know to collect this Demographic Data . Dr. Gerard we feel comfortable, but we will continue our efforts to make sure everyone does know this. It was guidance that was put out, and it is essential. The ppp authorized us n it, i am absolutely committed to getting this information. It is not only africanamericans. They have suffered horribly from this disease. Latinoamerican are at very high risk, and the highest risk are native americans and alaskan natives, who suffer even higher rates, so all of these are critically important to us. Thank you. As i noted early, the Trump Administration has increased our testing capacity. One area of uncertainty is the serology testing, something that could help us as we open the economy to get people back to work. Dr. Hahn, we have seen a large number of serology tests entered the market enter the market. Thats the fda ensuring only highperforming serology tests are on the u. S. Market. Dr. Hahn thank you for the question. Original rail our or toy flexibility around serology testing, it was not known completely how these tests would be used anywhere the operating characteristics were. Our guidance allowed these to be used in a realworld setting. That time, we required the manufacturer is to certify that the tests had been validated. We found in some cases that certification was not correct, so we develop a partnership with the National Institutes of health to do a u. S. Government independent validation. As you know, over 20 of those tests have been taken off the market. We have required all manufacturers provide us with manufacturing data, and if they dont, they have to be removed. We continue to look in that and we will follow that policy, sir. Thank you. I yield back. Thank you. Next, we go to mr. Kennedy in massachusetts. Unmute. Are you there . Did you unmute . He is not here. Joe, you have to unmute. I think he is there, but you are still muted, joe. What are you want to do . Mr. Kennedy, you are speaking, but we cant hear you. Are you there . We will come back to mr. Kennedy. Nus. Is mr. Cardin unmute. Maybe there is a technical problem, i dont know. Can you hear me now . Yes. You are recognized for five minutes. Thank you, chairman, for holding this important hearing. Thank you to the expert witnesses we have before us. We all appreciate all of the word you able to do when youre allowed to do it. This february, there have been cdc beingom the sidelined. Its experts have been overruled, and in the midst of a pandemic, this is unacceptable. Dr. Redfield, earlier this month, you expressed concern the cdcs Public Health message on covid19 were not resonating with the public. Dr. Redfield, why hasnt the cdc held regular bdm briefings during the pandemic as the cdc has done during past public crises, where it can provide information directing the public anywhere the media can ask questions . Is it possible like a regular and direct communication from cdc has been contributing to the publics confusion about how to best protect themselves and this helped pandemic rices . Dr. Redfield thank you very much, congressman. The cdc has communicated in different ways, clearly, first and foremost, we put over 1500 guidance july redfield, the president has been clear that when you get in front of a podium with a press conference, there is a higher likelihood you will reach a large number of people. More oft you having those press conferences . Dr. Redfield we reached 1. 5 billion people so far. Conferences with the state department every week, almost every day, we have special conferences reaching out to special interest groups, whether it is business, face faith communities, etc. , and we have also had conferences, as you know any be reinstituted our biweekly press conference with the open press, and so, i do think that cdc does continue to communicate, but more the local level then lets say at the National Level. Thank you, dr. Redfield. You actually answered my question. In the past, the cdc has been whenof a National Presence we have crises. I hope you you will be more present on the national. The biggest boys on the National Stage has been President Trump the biggest voice on the National Stage has been President Trump. February, a doctor said the virus could possibly cause severe destruction to our everyday life. She was right. Yet she was contradicted by both the president and secretary a redfield,nable dr. You confirmed a second wave in the fall could be difficult, and President Trump contradicted you in real time. You may not said, even have corona coming back. Dr. Redfield, do you think the public would have been prepared and Health Officials better supported if the pandemic had other Public Health experts not been ignored or contradicted at the National Level, like the president contradicted you in real time . Dr. Redfield congressman, we continue to try to get our message out. I thought the doctor obviously did a service and sharing her perspectives at that time, and letting people understand what could be on the horizon we end was on the horizon. Horizon, which was on the horizon. This fall and winter will be difficult. And we need to be prepared for it. Thank you, dr. Redfield. Complementing the doctor for her bravery and willingness to speak up. Thatoncerned, gentlemen, we have a problem right now that over 120 lives have been lost in the United States due to covid19, and yet the public is not on the same page with how to protect themselves, and they are getting mixed messages at the National Level from our leaders. What i hope and pray is that the cdc make its presence more aware and more clear with evidencebased advice to the american he put, and also have to hope and pray i will ask him questions and forward them to the committee as to the misleading statements, such as s have the fact that ppe been provided to the American People to the tune of 2 million, but some of you have recorded that we should be in the billions of ppes. I will ask those questions so the public can hear those answers and we can have it on the record. I yield back. Thank you. Wahlbergwe go to mr. From michigan. Mr. Wahlberg thanks to the panel for sticking with us for this lengthy period of time. Thank you for your work, whether we agree or disagree, we are learning this altogether. As we discussed already and as you know, there were five states , including my state of michigan, where my governor ordered, required through an executive order, Nursing Homes to admit covid19 positive patients back into their facilities. This proved to be a terrible policy, as we found out, with the consequences for our seniors with almost 2000 nursing home residents in michigan having died. That is accounting for one third of our states covid19 deaths. Dr. Redfield, some officials in the five states that issued these executive orders have indicated they were following guidance from the administration. I think that that is what we do with the federal level, but what guidance did hhs and cdc released, as it released as it relates to covert dr. Redfield thank you for the question. Guidance for Nursing Homes. The guidance you are referring fact thatunded in the thatsituations were Nursing Homes were refusing to take any Covid Patients at the time. Cdc did issue a series of important prerequisites the nursing home had to have in place, in order to accept these patients they had admitted to the hospital back, when they came back. Fundamental was that they had the appropriate facilities to isolate that individual, appropriate Infection Control capacity. Saying, you have to take somebody back, it was that you have to be open to taking care of Covid Patients, provided you have the capacity to do it directly, so that pacing patient doesnt spread the infection. Some of the speeches we heard in the press failed to understand that it is the do it correctly. Over half the Nursing Homes in this nation, over 7000 Nursing Homes in this nation, have a covid patient. The question is how to do it correctly and safely. Representative and save the lives and save lives. It gets down today to as well. What are obstacles to getting the data you are requiring in that my governor is starting to put out. What are obstacles to collecting and reporting this data, particularly among seniors in Nursing Homes, and what steps has he taken to improve Data Collection . Cms now reports now requires Nursing Homes to cdc. T, and cms reports to north0 of Nursing Homes, and 90 , areen 80 actively reporting to our system already. That was required to couple of weeks ago. We are working to get all 100 percent of Nursing Homes to be working as required by cms. Complemented by ethnic group data that comes in originally now with testing. You all have helped us in that. Now any test done for covid as a series of data points including ethnicity and race, so we can maintain that for all cases, independent of if they are nursing home or not. Your nestive dr. Fauci, university of michigan announced a mixture of in person and remote classes. As schools prepare for fall semester, what factors should they consider, im thinking of Higher Education . What do we know about the transmission of covid in young adults that would inform colleges and universities, and should reopening look different for school Like University of Michigan First is hillsdale college, with 1500 students in a Rural Community . One answer could probably spillover into each question. We have to consider the state of the epidemic in the place you are at. If you have they already you cases, you can be very liberal and reopening. What schools are doing in a very creative way is to try to make sure there is separation enough that you have situations where, first of all, masks should be done at all times without exception. You have to protect the vulnerables vulnerables. You have to allow faculty and students in that category of underlie conditions to have the capability of teaching or learning online. You have to have the capability of, when you get an infected student, which you will no doubt, to be able to remove that student to a safe place for the time until they can go back. If you leave them in the community, you are going to have a situation that could make the whole thing fall apart. That is just. A few things we need to do. Important few things we need to do. But in portly, you have to look at the status of your particular situation. People who work with the students, people who feed them, people who clean, they also need to be attend paid attention to. Because often, being a cruise ship or nursing home, it is the staff might bring an infection and then infect individuals in a much larger group. We will go back to mr. Kennedy. We can hear you. Kennedy iive apologize for the disruption beforehand. Thank you, chair, for calling rehearing. And i think the witnesses for their service. Ago, i wasth commuting just outside boston that had a rate of infection roughly six times higher than the state average. With food lines longer than i have seen anywhere in the world. On my way out of the community i called one of the heads of the Community Health center and asked what else they needed for help. The individual i spoke with said they had recently received Mapping Software and war looking for cool spots in the community. Software and were looking for cool spots. They said the cool spots will tell us where we havent been testing the biggest cold spot was in the Public Housing facility, where out of a population of 900 people, four people had been tested. This administration has failed so completely to prepare our nation for this pandemic that we are testing largely people that are government and society have deemed to be essential. Yet they sicko, President Trump stood before the American Public and told them he asked his administration to slow test down because what they revealed when tests were accelerating was instrumental to his political survival. We have had testimony here that his statesman statements were not true, although the president doubled down again and said he does not joke. People in massachusetts, predominately black and brown men and women who this Administration Needs to test. It is no joke. It is deadly. Nearly 120 thousand people have died, over 2 million are sick and 45 million americans are out of work. The Administration Needs to collect longoverdue democrat Demographic Data. We know black and brown people are more to what more than twice as likely to die than people who are white from this virus, and more than six times more likely if you are black in washington dc. In massachusetts, the positive rate among black and brown residence is three times higher than among white residents. So yes, we need more data, and only because the Administration Spent months trying to ignore what happened instead of confronting it in the first place. Dr. Redfield, the cdc finally released guidance requiring, crop for debt requiring Demographic Data during testing, but it doesnt take place until august 1. Dr. Redfield we are committed to making sure we get comprehensive data, particularly as welland ethnicity, as data on the underlying comorbidities, so we can better erstand representative better understand kennedy iive appreciate that, but the virus arrived on our shores at the end of january, beginning of february. President indicates today that the federal government will stop supporting testing sites, despite skyrocketing numbers of cases. Federal support for testing sites, isnt that effective in mitigating the spread of the . Irus the first set of testing sites were 41 testing sites run under federal contracts. Retail sites are now over 600 retail sat over 600. Retail sites on their own or over 1400. There are thousands of testing sites. The only testing sites we sunsetted were 13 remaining, that were in texas, ready to go because there were so many sites around them. We matched each site to retail sites surrounding them. We are not withdrawing support for well over 2000 sites, we are just transitioning those third pain. Representative we have seen 45 million americans lose their job, yet we have an administration that continues to push new requirements for medicaid. Do you believe implementing worker core marmots work requirements is going to enhance the response to the coronavirus . Is implementing work requirements and effective remedy for the spread of coronavirus . Im not sure on qualified to answer that question. Im sorry, i really didnt even hear the question or understand it. Representative given that 45 Million People have lost their and the Administration Still goes forward with the implementation of work requirements, our work requirements going to stop the spread of the coronavirus . I dont know if your mic wasnt on, but you said it would be a problem. Mr. Carter. Carter theve administration has done an exceptional job of increasing testing. To give testing to [indiscernible] doseptember, and in order to that, we need to greatly expand testing. We need robust testing. Secondly, we need personal responsibility, that is following the advice of members of the Coronavirus Task was, washing our hands, Wearing Masks, etc. Earlier you said 90 of americans live within five miles of a pharmacist. I dont mean to correct you, but it is 95 of americans who live within five miles of a pharmacist, making them the most Accessible Health care professionals. Admiral, do you think the administration should utilize the pharmacy personnel, the profession, for expanded testing . Especially Community Pharmacists who can help underserved communities . Wheree made it to pharmacists can provide the test , but not all tests. Im trying to get to medically underserved communities and whether pharmacist is there with does well. You. Ank pharmacists are one of the most underutilized professionals in the country, for their training and expertise and their trust from the population. Anould like to put exclamation point behind every thing he said. Withder to work pharmacists, there is an organization that is an intermediary that we are working with the mixer we can bring more of the dependent pharmacists under contract through our testing program. But i am all on board, whether it is telehealth, pharmacists, Community Health workers, we need to get help into the community, and pharmacists are great way. Representative i have submitted bill text that would do just this, and all the pharmacists are on board eight is at hhs right now. All thelike to ask members of the task force if you could help me get that review completed so we could move forward. Listening colleagues on the others of the aisle who have been saying that the administration and this task force has not done enough to save live. Covide had 42 of the from. 6 of have been the population. That has been nursing home residents. I dont consider myself to have communicablee on diseases than any of you sitting there today, but in my professional career as a arm assist, i worked as a pharmacist, i spent almost 30 years in Nursing Homes. So i know Nursing Homes and know that is the last lace you would want a positive patient to be at. A 100bed servicing facility years ago that did not get the flu vaccine, and we lost almost 20 percent of our population in that nursing home, because we didnt get the flu vaccine. So i have seen this end experienced it and that is what upsets me about the decision of some governors to put patients in the nursing home, the worst place they could have put them. Andill believe in humanity, i dont think any of those governors would have done it if they would have known what it would have resulted in. And i say that to point out to all of us that the administration has done an outstanding job and have saved lives. Have they done everything right . No. Would they do things differently if they could . Yes. And i believe these governors would have done things differently if they could. But to point fingers and say no one cared about lives is despicable. I dont think that is fair. Seem to have aou bullseye on your chest today, but the cdc has done some great things. Theyou tell us some of useful materials you have released from the cdc . We put duct guidance and a variety of areas, focusing on Nursing Homes, mitigation steps to limit the spread, focusing on first responders, health care settings. I will Say Something about Nursing Homes i hope we consider. There needs to be more serious consideration in jurisdictions that have multiple Nursing Homes to look at whether certain Nursing Homes are prioritized for Covid Patients, because of the situation we went through before. But we continue to put up guidance about going back to school, going to camp, date care centers daycare centers, k12, wherever the American Public seems to have a need for guidance, we either put out a guidance document or what we call it consideration document, which gives people a better understanding of covid and how to protect themselves safely in ments. Environ we have 10 left. If you have to take a restroom break, go out and come back. Are you going to stay with us for these 10. With us for these 10 . Great. Mr. Peters from california is next. Do you want to unmute . Peters itive appreciate the witness coming today. The monumental challenge our country is facing has come in large part to the failure to deploy sufficient testing in time to control the spread of the virus. Of february 29, after it became clear cdc test would not be proved would not be able to perform, the fda began using a diagnostic test and since then has authorized 110 university authorizations for diagnostic test. That has done a lot to increase our testing capacity. We dont know much about the accuracy of these tests, and typically expect tests to undergo a patient studies to determine accuracy. Hopefully a small number of validation steps. While most screening will never be 100 accurate, false negatives can lead to devastating consequences. There have been report that the white house test they used to screen individuals before they entered the Oval Office May produce false 20 of the time. Askeds said it manufacturers to conduct followup study on tests that received emergency youth authorization. How many of these tests view requested followup accuracy testing on . And of that number, how many have been shown to be accurate . Hn in an emergency authoritiesur eua allow us to look at the riskbenefit. , withon in the pandemic limited supplies of reagents to accuracy, weic rely on certain data to make that decision initially. We have required in a postmarketing setting the collection of data for a number of companies. They have come back to us with those data. We have made adjustments to the eua for those tests. But even in situations where we havent required formal postmarketing assessments of the tests, we have collected realworld data. We incorporate those into our test assessments. Serology tests, we have taken over 20 off the market based on our evaluation. We will continue to make those efforts and look at those data and adjust recommendations, and tell users and to be very transparent about the operating characteristics of the tests, so they can use them in the best way possible. How many ve manysentative peters how have you received . Get those be glad to data for you. We have received a number. Peters if it is shown to be inaccurate, will you continue to move to take this tests off the market . Absolutely. We promise to be transparent and post that on our website. Representative peters i want to ask about digital Contact Tracing. Do you believe digital Contact Tracing can enhance initial efforts . Particularly bluetooth the knology to identify people at risk of covid19 infection . Dr. Redfield thank you. These new Digital Technologies that have been developed for totact tracing are important be evaluated, and see how they will contribute. The most foremost, important component of Contact Tracing is Human Capacity to do that. Are working to aggressively increase the number of Contact Tracers. Peters i would really think it would be a shame if we took technology from the 1980s and didnt Deploy Technology we have today. Bluetooth technology can tell you who you have been around within a certain proximity, with great accuracy, great speed. It can be anonymous so that no one knows who the particular person is, but if you have bluetooth on, you dont have to know you were standing next to a protest or restaurant or bar. If the person tested positive, you can go to a system in workingapple, m. I. T. , on these things, so you could almost in real time warrant that you have been in proximity to someone who tested positive and can behave accordingly. There is speed, there is accuracy. I hope you will give a good look to Bluetooth Technology and it could be private and accurate, certainly more than technology we had in the 1980s. Dr. Redfield we are evaluating that technology with google, facebook, to see how it impacts it. I agree it is important. We have programs evaluating it in partnership with google and facebook right now, and we will continue. The question is to see the best way for this technology to be used, it is not a question of not seeing it as something that cant that can potentially be important. Gianforte thank you. Witnessesthank the for their time today. The people of montana appreciate you. All the Health Professionals are working so hard to keep us safe and deal with this virus. As we mourn the lives of those covid19, lost from we must also continue to think about how to safely reopen our nation. Testing is important to limit the spread and restore confidence to the public. Intana has seen an uptick positive test results, but not large uptick in hospitalizations. This could be seen as indicating that increased testing is finding more mild and asymptomatic cases. I have heard from hospitals and labs that they would like to provide their own Testing Services to help communities and provide certainty to employers, as well as Rapid Response to tourists who are coming to see our National Parks in montana. Been and inre has normas increase in diagnostic testing since early stages of the pandemic. Test manufacturers rapidly scaled up production to meet the need for testing. Could you describe the administration collaboration with private industry in establishing this massive diagnostic and server logical testing infrastructure, and availability of supplies for states . Dr. Giroir thank you. It is a publicprivate partnership. We have been working very tightly with fda, because innovation has been key. To give an example, when we opened our first 41 testing sites using nasal swabs which would require full ppe and full ppe changes, if we ran those 41 sites fullblown, we would have the stockpile for ppe within one week. It was important for fda to work with sponsors to validate other types of equipment to expand our supplies. Partnership,ivate whether it is working with the labs, they have done over half the test in the country. It has been critical. Manufacturer that supplies test kits have been working with us. We have a Relationship Manager with everyone so we know what their limitations are, can we help with supplies, what we can do to maximize tests moving and with montana, it has been a real special case. Because although we have millions and millions and millions of tests, only a few are geared to rural areas and are in short supply. We have been working closely to get a test to montana, because you are not in new york city where you have multimillion dollar machines, you are in a rural area like alaska. So it is not just of the numbers, it is the type and the mix with innovation. Gianforte ite sounds like publicprivate partnerships have been central to testing capacity. Thatareas are ongoing in area to further develop partnerships . Dr. Giroir they have been critical. Public laboratories are the first line of defense but have only done 7. 5 of testing. Overall it is hospitals and academic institutions at about half the commercial sector. Swabs, when it dropped into this on march 12, we had 10 or 12 manufacturers, one was in italy, one was in maine, everyone was were busting the same product. It is the hardest to make it the most difficult to get end is the only one that was hospitalized. I never thought i would send a c17 to italy to pack a c17 fullest swabs, but that is what we needed to do. The publicprivate partnerships have been absolutely essential. Eight is the only way to scale what we needed. If you have a small operate, you can do it with traditional infrastructure outbreak, you can do it with traditional infrastructure. In this, everybody has to participate. Representative the Health Profession in montana wanted me to ask if you have confidence in the Antibody Test currently available . And what steps have you taken to avoid a crunch . Dr. Giroir we have authorized over 20 serology tests. My recommendation to users across the country and in particular Public Health, is to use tests authorized under the eua process with fda. Independentgoing evaluation of data that manufacturers have sent to us to ensure we have corroborated we can corroborate what manufacturers absent. We are being very transparent on our website. Chair pallone miss dingell, we are coming to you from the dingell room. Dingell i want to thank the patients. Believe it or not, there was widespread agreement on something, which is that we are not going to be able to safely return to what we once knew as normal, until we have a safe and effective vaccine. In congress, we have moved quickly to facilitate development of a vaccine, investing billions of dollars funding barda and nih. Publicprivate researchers have taken those resources and run with them, speeding through the phase one and phase two Clinical Trials. Multiple companies are now announcing they are about to begin phase three trials as soon as next month, or soon after. This speed is unprecedented. I want to be clear as i ask questions that i am not an anti vaxxer. Have expanded lifespans and eliminated diseases. But phase three trials are where the rubber meets the road in developing a new drug. It is where you test a new drug on human patients on a wide scale, evaluating constantly for side effects in ultimately determining the effectiveness of the vaccine. Of the vaccine candidates has announced their phase three Clinical Trial will and roll 30,000 patients. Another company has said it will 8000oll will enroll patients, much lower than historical vaccine trials which d 70,000 patients in the past. I know there can be consequences. Unluckye of those people after the swine flu shot, but to this day, i know the benefits of the swine flu shot far outweigh the risk, and that we must develop this vaccine. But we have got to talk about important issues so that people leave in this vaccine. Dr. Fauci, will you explain the importance of protecting larger populations in phase three Clinical Trials . Dr. Fauci thank you for that very important question. Of the trial is calculated on a statistical basis of the number of infections you might need to get a certain percentage of efficacy. You figure out, you need this level or this level of efficacy, and how many events do you need in the trial, and was based on that that the statisticians came up with a 30,000 person. I want to point out something i think you were hinting out, and i agree completely, you want to make sure, particularly when you have a new vaccine for a brandnew disease, that not only can you get a signal of efficacy, but you feel really good about safety. And the more people you getting a trial before your release that vaccine to the public, the more confident you are in the safety. We are going to have a different approach, congresswoman dingell, to the phasethree trial. We will have subsets that will be looked at much more carefully for safety, particularly for the concept of enhancement, because that is when of the things we are concerned about, that paradoxical we, if you get a sub response to the vaccine and you do in thing the and you get infected, you could actually have an enhancement. So i hear you loud and clear, safety is an important issue, and we are going to be paying very close attention. Early on in the hearing, i set i wanted to make sure that before we left a vaccine out to the withc, we are as confident the efficacy as we are with the safety. I promise i will be an advocate for that very strongly. Representative dingell i did hear you and i do trust you, but i still have to ask questions. Dr. Hahn, a number of observers the said we wont know vaccines longterm safety and effectiveness if we move forward with these two quickly. Take tops will fda ensure effectiveness in evaluating data from the Clinical Trial . Linde will you commit to receiving that fully effectiveness data from phase three before we approve the and will you commit to receiving that fully effective data from phase three before we approve the vaccine . Working rightre now on guidance with developers a vaccine to exactly address the question you are asking. We will be transparent at forward leaning and work with sponsors to ensure the data we need to make those decisions are available. I promise you, maam, we will wait for the data we need to make that adjudication around safety and efficacy. We are going to move to mr. Veazey of texas mr. Veazey of texas. Mark, are you there . You are recognized for five minutes. Veazey i wanted to ask about something on politicoaw this morning concerning Data Collection underway at cdc. It was implied in an article that there were attempt to downplay true statistics. The death determining count that is updated daily . If you could touch on that dr. Redfield, i would sure appreciate it. Dr. Redfield thank you. There was a report. From are reported to cdc state and territorial local health apartments, either as confirmed cases or probable cases. They come in through different data streams. Then they are verified to get the final numbers. Glitch ona coating from19 coding glitch june 19 from the state of new york where there was approximately 5000 cases that codingobable, that the glitch assumed they were counted in the confirmed case list. So that one day, there was a 5000 confirmed case under counting. It occurred on the 19th of june, was identified you 19 and corrected. Glitch is no coding that the affected deaths. Veazey so if a and they dieovid have sepsis, do you still count that as a covidrelated death . Dr. Redfield it depends on how it is coded by the state or city Health Department of the county Health Department, whoever has , becauseion for that it is coded at the local level. Representative veazey so the death count could be higher than what we are seeing on the news . Dr. Redfield yes. Each physician tries to understand in the death certificate with the primary cause of death was. Did covid cause complications that lead to sepsis . Or is it somebody who had an asymptomatic infection related to covid that got hospitalized and had a contamination in their arm that led to sepsis . These are clinical decisions made on the death certificate. Veazey based on that, what do you think the actual covid death rate is . Dr. Redfield i would continue to rely on the data we have that this basically reported through the current system, where it is based on the death certificate, actual death certificate to find why the clinician responsible for making that determination. That is the numbers we use. Veazey dr. Ve , aci, there was a grant coronavirusrelated grant that that was not renewed. I want to make sure we get the facts straight, because i was really concerned about this. Do you know why this grant was canceled, or if any with the white house pressure to her colleagues to do so . Pressured your colleagues to do so . And i want to talk about the National Institutes of health. There was a decision by the Trump Administration to Cancel Research on a grant specifically focused on coronavirus, while we are in the midst of this coronavirus pandemic. It didnt make any sense to me why this grant would be canceled. Dr. Fauci why was it canceled . Veasey yes. E why was this grant canceled in the middle of this pandemic . It seems like it we wouldve enabled the use this research in the middle of a pandemic like covid19 . Dr. Fauci it was canceled because the nih was told to cancel it read i dont know the reason, but we were told to cancel it. Easey ok. Tive v thank you. I have no further questions. Chair pallone we are going to go to new hampshire. Run me up, please unmute, please. Are you on mute . Are you there . I am, and i did on mute. Can you hear me . Chair pallone yes. You are recognized for five minutes. Representative thank you, chairman, for holding this hearing, and to all our witnesses. In addition to efforts related to the research and manufacturing of the covid19 vaccine, there will be work isded to ensure the vaccine adopted and equitably distributed, specifically decisions about distribution of the vaccine, coverage considerations, to ensure the vaccine is available to everyone in every community, including communities of color, immigrants, refugees, those living in rural areas and of course, our elders. Vaccine plane of a from the administration, im concerned attention to this necessary work is being overlooked, and we will repeat the errors and mistakes made earlier in the pandemic. Admiral, the framework and released dos has not address these details and other factors that will be critical to reaching covid19 vaccination rate goals. Could you comment on that, and the bipartisan letter this committee called on the administration to create a vaccine plan . Thatiroir im not on workgroup. That is dr. Redfield and dr. Fauci they can answer that question. Thank you. Ive i would appreciate it. You. Edfield thank this is a critical area. Dr. Fauci has commented top important duties we have begun to take the financial risk to have companies be able to start manufacturing representative im sorry to interrupt. Plansking about a national to equitably distribute the vaccine. Administrationhe to create a plan on equitable distribution. Dr. Giroir thats part of the overall working plan. It is in development. Representative it is not available luck this time . At this time . When can we expect it to be available . Chair pallone i will differ dr. Redfield i will differ, but i can tell you i will deep fer, but it is part of the strategy that will address equitably. Representative my understanding from when dr. Bright came before the committee that he could take up to a couple of years to manufacture the materials, administer the vaccine, and that those planes had not vallow had not and that those plans had not been developed. You know about the manufacturing of supplies to deliver the vaccine . Dr. Fauci that is currently a plan that is under the purview of a combination of a general who is one of the code leaders speed eration work p speed. N warm inwas specifically brought to make sure that not only the vaccine is equitably distributed, but also to make sure that all the material that is needed for proper distribution. This falls under his purview. He was specifically brought in by the department of defense to address that issue. Representative do you know if there is a plan to promote Public Health messaging and materials for vaccine taking in the country . Dr. Fauci that is a very good question. Im glad you answered. We are doing a combination of a couple of things. Deploying Community Activist groups that we put together during the days when we had the hiv group. They are now an important part of all our Clinical Trial networks. Thee are going to employ Community Outreach mechanisms we already have. Cdc traditionally, over the years, has been heavily involved in making the prioritize nation, which usually is the most vulnerably people first most Vulnerable People first. Dr. Redfield we are very involved in developing the communications strategy. It is going to be critical. We are working on developing distribution strategy, but the communication strategy is very important. It will begin to be operationalized soon, just like we are getting ahead on manufacturing. Thank you. Ne kelly. O illinois, robin kelly thank you to the witnesses. Thank dr. Redfield dr. Fauci redfield and dr. Fauci. Shoulder ammunities disproportionate burden of covid19 cases and fatalities. Health inequity stem from historically racist policies that affect health. Im concerned by this tragic reality. Cdc data shows American Indians and alaska natives have a hospitalization rate approximately five times that of whites. Black people are hospitalized at 4. 5 times the rate of whites and those who are spanish or tino are admitted to the hospital approximately four times more often than white people. Despite these disparities come the cdc racial and ethnic Demographic Data is still lacking. 52 ofy understanding of reported coronavirus cases in the u. S. Are still missing information andre and information on race and ethnicity. That is required i the heroes act the house passed in may, for the government to track and public a report covid19 racial, age, ethnic and gender data as well as require federal agencies to modernize Data Collection efforts to account for inequities. Dr. Redfield, you have admitted that the administrations covid19 report was inadequate, and while you announced cdc would require all lab test to include information about ethnicity, the most recent report from cdc shows more than half of date that you have is missing racial and ethnic information. Little, too is too late, and this new rule lacks a clear enforcement mechanism. What actions are cdc taking to address these data gaps . Why isnt cdc working with territorial and tribal labs . Dr. Redfield thank you. To makeontinuing ensure thed requirement to include race and ethnicity on all tests submitted for covid is completed. Has been a progressive improvement, as you have noted. The same with hospitalizations, i think we are up to 80 , that is not where we need to be, we are working to get to 100 cent that will continue to work with our state, local, territorial and tribal leaders to get that the compass, as well as laboratories and hospitals and longterm care facilities. Because it is critical we do have that information. Representative what steps representative what steps has the administration taken to gather data from minority neighborhoods, jails and prisons . Dr. Giroir i think i caught about half of that, maam. Because of the Internet Connection representative representative Internet Connection. Steps isative what the administration taking together missing data, including from minority neighborhoods, congregant homes, jails and prisons . Dr. Giroir all very important subgroups we are working with. Possible ink it is testing data reconstruct ethnic and racial makeup of tests done in march and april and may. I dont think that is possible. Looking forward, we are absolutely going to mandate that. On enforcement mechanisms, we might want help with that, because the authorization did not have an enforcement mechanism. We looked deeply and were not able to do criminal civil or monetary penalties, but we are working with the eua mechanism. I would like to turn the switch and have this tomorrow. I would like to have had it months ago, because it is critical. We are targeting resources to those areas but not getting feedback in the numbers we need. Laboratories, to give you an idea of complexity, they have done over half the tests. They dont collect any of those tests. That comes from tens of thousands of physicians, pharmacists, others. Very are working with this complex system to make sure each of those tens or hundreds of thousands of people provide that data. But you have my personal as the person whose day job is working on health disparities, to make sure we get this as quickly and accurately as possible. Representative thank you. My office will be in touch so we can Work Together and get you the help you need. I yield back. Chair pallone thank you. Recognized for five minutes. Representative thank you. This pandemic is still raging. 119 thousand americans have died. Cases are rising and 29 states. Over 20,000 new infections a day. State setat 12 records for daily cases in the past week. We know that black, latinx and native americans are bearing a disproportionate word and of the administrations failure to address the pandemic. Meanwhile, the Trump Administration has moved on. Waslast Task Force Briefing april 27, and the task force is winding down. The admiral is stepping down as testings czar, despite the fact we need to greatly expand testing. We dont have enough tests, we still dont have enough ppe. We dont have a vaccine. And this fall, we could see another wave of infections. President trump last month cleared, we have met the moment that we have failed. Dr. Fauci, have we prevailed . Is the fight against covid19 won . Dr. Fauci we are still in the middle of a serious outbreak. No doubt about that. Representative instead of taking the pandemic seriously, President Trumps hosting campaign rallies, packing thousands of people together without masks in opposition to the guidance of Public Health experts, just so he can hear crowds chant his name. The president has decided the best strategy to deal with the greatest threat against this country during his presidency is to bury his head in the sand that which it went away sand and wish it went away. Redfield, your advice is important on more than ever. When was the last time you spoke to the president about the countrys response to this pandemic . Interactions and discussions i have the president , i will keep to myself, but i meet with the task force barragan im not asking about the content of your conversation, im asking when you talk to him last, a day, a month . Dr. Redfield i am going to stay with my answer. I talk with the task force whenever the task force meets. Theesentative berrigan fact he wont tell the committee when the last time you spoke to him is a real concern. Dr. Fauci, when is the last time you spoke to the president . Dr. Fauci two and a half weeks ago. Representative admiral, when is the last time you spoke with the president . Dr. Giroir two and half, three weeks ago. If you dont mind me clarifying, because it is important, i remain the testing lead. A lot of that got misconstrued because i said it wasnt going to spend 100 of time at fema, because my current position also works on ending hiv, substance use. Im going to maintain testing lead but am also integrating back into my other functions. Berrigan dr. Hong, when is the less time you spoke with the president about the pandemic . Dr. Fauci we had a congress dr. Hong we had a conversation the last couple of weeks. Hahn we had a conversation the last couple of weeks. Berrigan if we dont expand testing cumber prepare for a second wave, develop strategies for Contact Tracing and vaccinations, could we see progress reverse . And could we be forced to shut down again if cases get out of control . It is a very complicated situation, and a mixed bag. Certain parts of the country, cities, states, have done very well and are following the guidelines we put together. I, phase ii,phase phase three. New york is one of them, washington, d. C. Is another. Other areas, other states and cities have not done so well. I have considerable concern about those, because i want to mixer begets everything under control. Get everything under control. It is not there yet. Thepe we mobilize identification, isolation and Contact Tracing in those state, thus states, the ones that have recently been in the news, florida, arizona, texas in those states now having a serious problem. We have a mixed bag, some doing really well and some in trouble. Agan sentative barry would you say we might have to go backwards in some progress might be taken away . Dr. Fauci i agree with what you are saying. I wouldnt say absolute shutdown lockdown, but if someone is going from gateway to phase one phase ii and get into trouble ind phase two trouble phase one, they may need trouble in phase two, they may need to go back to phase one, not necessarily lockdown. Rochester thank you to the panel. Under normal circumstances, Health Insurance, the lack of that, as well as underinsured individuals, is a big problem for our country. The current pandemic italian employment, it is enough salute crisis. It to turn this into dont want to turn this into a debate about the Affordable Care act or medicare expansion, the fact remains millions in our country are either without Health Insurance or cant afford to use it, and are especially vulnerable right now. There are close to 30 Million People without Health Insurance in this country, and for those people, it will undoubtedly be harder to receive testing and treatment. And when a vaccine is developed, they would likely struggle to access that vaccine. Dr. Fauci, as a matter of public thath, would you agree during a pandemic such as covid19, it is in dr. Fauci i agree. Rep. Rochester dr. Fauci, if approximately 30 Million People in this country cant easily access treatment and vaccines because they lack health coverage, doesnt that presented Public Health risk . Dr. Fauci i feel as a physician that the scientists and Public Health official that everyone should have access to the kinds of things we are talking about, testing as well as accessibility to a vaccine and health care. Giroir,hester admiral the administration has suggested that money from the provider relief fund, which is supposed to help struggling providers, is how it will pay for care for the uninsured. When can we expect a comprehensive plan from this administration for how it plans to provide treatment and vaccines to people regardless of insurance status . Plan, ioir the vaccine think it is currently underway, as you heard dr. Redfield do that. Hrsa onery closely with making sure everyone can get free testing. That program is underway and the forms reimbursement treatment is up to about 186 million now. I would be glad to have hrsa or anyone else answer any specific questions you do have. I agree with the premise, that is absolutely critical not only in a pandemic, but any other time that people who need testing get the testing. That they get the health care that they need. And most importantly, there are no impediments to getting vaccinated. Rep. Rochester i dont know if anyone on the panel could answer this question, but where their conversations about expanding medicaid or opening up enrollments for the aca to actually mitigate the risks . I am not a member of the task force but i am at most of the meetings as an invited guest for obvious reasons. There were discussions across the board about all options. All options were looked at and discussed. It was clear the objective needed to be that no one should be waiting at home in need of care because of a lack of coverage. And i would say that every option was really looked at and the leadership, the administration, the white house decided on this way to move forward. Level reserve mike i will reserve my comments to just say those options would have been nobrainers. Level reserve mike ilegislation included ie heroes act that would require insurers to cover covid19 treatment with no cost sharing. The act also included a provision that would provide coverage of covid19 treatment and vaccines for anyone who is uninsured. I sincerely hope our colleagues in the senate will take up the heroes act so we can make sure that everyone in this country can access the treatment and vaccines they need. I yield back the balance of my time. Chair pallone thank you. Next is mr. Soto of florida. Please unmute. Rep. Soto thank you, chairman. I want to go through a little bit of a timeline. On january 23 through 28, President Trump received two Intelligence Briefings on the coronavirus, according to white house officials. January into midmarch, President Trump deliberately misled the American People into believing the coronavirus was well under control. He declared on several occasions it will disappear. As late as march 12, he stated its going to go away. The very next day on march 13, he finally declares the national emergency. Assed byately 50 days p the time President Trump received his first coronavirus intelligence briefing until he finally declared the national emergency. Lost ramping up toting at the cdc due contamination and the result of President Trumps disastrous response have been deadly. The United States has more covid19 deaths and more cases than any country in the world. Over 120,000 americans are dead. 2. 4 million americans contracted the virus. The economic fallout has left 43 million americans out of work. To argue that President Trumps response has somehow been a success is really quite astounding. Its our job to conduct oversight and hold the Administration Accountable regardless of your party. Fauci,ng forward, dr. The house is already past the heroes act which includes 75 billion dollars in additional coronavirus testing, Contact Tracing and isolation measures. How important is this funding to our continued efforts to combat covid19 in the United States . Dr. Fauci thank you for that question, congressman. As we have said throughout this evenng, clearly, testing, more widespread testing on a surveillance basis is absolutely essential for us to really get a full understanding of this particular individuals who are a symptomatic. The short answer to your question it is very important. Rep. Soto thank you. Dr. Fauci, how important is this additional funding to stop recent increases in covid19 cases, as seen in my home state of florida . Dr. Fauci again, in tune with what i just mentioned, the more that you understand the dynamics of the infection, the more that you understand the distribution, the more chance you half of better control for either identifying, isolating, Contact Tracing, and concentrating the resources in those areas where you have the most problem. You wont know that unless you know exactly what the penitents is in your community. Rep. Soto thank you. Commissioner hahn, there is a shortage of remdesivir in Central Florida in and around my district. Will the fda be able to assist us in this shortage and have we seen other shortages of remdesivir across the country . Dr. Hahn sorry, really appreciate the question. We are working closely with hhs as well as the white House Coronavirus Task force who are responsible for the distribution of remdesivir. We do know we have a supply in this country and im very happy to work with you and others. We are glad to have our folks get in touch with years to make adequately supplied for Central Florida. Rep. Soto thank you. After we, we saw lost six weeks in ramping up testing. Now, do you think the United States relationship with the World Health Organization is important to the future of combating the coronavirus both in the United States and worldwide . Dr. Redfield thank you very much. We continue to have an important Public Health relationship with the who. Without a long history of partnership with them. Currently involved in a number of very important Public Health efforts. Polio, developing our influenza Surveillance System across the nation. Partnershipnue that at the scientific and Public Health level. Rep. Soto thank you, dr. Redfield. So, it is going to be very important not to defund the World Health Organization. For our national interest. With that, i yield back. Chair pallone thank you. Last but certainly not least is mr. Ohalloran. Rep. Ohalloran it always brings a smile to everyones face. Members of the panel, thank you for being here today. I will start out with a forest fire. I have been at three of them this week because my district has eight going on right now. When i get to incident control meetings, the commander of that Incident Control Team is there and then the Division Managers for that fire are there too or on the phone and being able to address the issues. As all the community organizations, police, fire, Emergency Response groups, they are all at those meetings. There are multiple meetings during the course of the week with the citizens of those communities at risk. Now, im in a process where i am trying to figure out how this whole process works in the standpoint of were here now. What happened happened, we can change that. But Going Forward, how are we going to address that we have enough of the testing equipment equipment,training but tracing equipment, in order to address the issues potentially in october, november, into the winter. . Aw are we will we have managed control system that does not include 50 people doing whatever they want to do and the ability to react to hotspots as they occur as quickly as they should be . Are we going to be ready . Hotspots. Navajo is my district. Apache,undtain over 1500 have gotten the virus out of 12,000 people. Navajo, the whole nation knows. It took us weeks to get enough help up there to address that problem. White mountain apache are still calling me all the time, saying where is this and where is that . Its obvious we have a shortage right now. How could we be guaranteed that we are going to have the necessary equipment and materials to be able to address it coming up during the flu season and pandemic at the same time . Then, transparency and accountability. I dont know how right now you trace the transparency and accountability in this system. Because it is almost impossible. Nobody says that was my fault. Groups every one of your has done an outstanding job. I just cant find out what you are doing on a regular basis. I hear stuff on the news but that does not mean i really end up knowing what it is. Fauci, can you explain to me where you are at now and how are we going to attack these hotspots and address all the issues i just talked about by the fall . Will we be prepared . I guess most of all, is the entire process how do we educate the public as different ideas and concepts right now to be able to understand the complicated nature that all of you have address today . And the overwhelming need to cooperate with one another as america always has. Dr. Fauci . Dr. Fauci you asked a lot. I will try to be distinct in my answer. Where we are in my answer, as i mentioned a little bit ago, it really is a mixed bag. Its a big country, it is very heterogeneous, and you cannot have essentially an approach, the difference between arizona and the things you are responsible for and the new york city metropolitan area. Some areas have done very well, are wellcontrolled. They are going through the guidelines. Others that we discussed in detail today are doing poorly and we have very concerned about them. So, you are talking about what about as we get into the fall and winter . The first thing we would need to do is try as best as possible to get the complete outbreak under control so that everything is at such a low level, that when there are cases that come up, you can contain them as opposed to mitigating. Where you are essentially chasing after a forest fire. Hopefully we will get that under control soon. The other thing we need to do is get the material, which we are doing. And admiral giroir will comment on that because he has done a phenomenal job of doing that. Getting the ppd, getting the ventilators. Getting the equipment that we need and to have that instore so that if, and i hope it is if and not when, but if we ever need them, we have them and not be in the situation we were in in february and march. Rep. Ohalleran will we have them by october, november . Dr. Fauci i believe we will. We certainly will have the testing which we did not have early on, we will have it by october. With regards to other things, perhapss and others, admiral giroir can help you with that. Adm. Giroir thank you. This is what we spend all our time working on under the cooperation with the department of defense, fema, hhs. We have already talked about testing. If you want personal accountability, it is me. It is my problem. The whole testing infrastructure is really working together. The laboratory, supplies, the laboratory testing, the nih program, all working in synergy and i am coordinating all of that to make sure it happens. In terms of ppe, we had a long way to go because almost nothing was made in the United States. I mean, literally, almost nothing was made in the United States. I mentioned earlier that a good example would be the n95 mask. As a result of everything, we will have about 180 million made in the United States by the fall. That is ramping up very quickly. We feel pretty good about that. And ventilators were just a good success story. I worked a lot on the ventilator problem early on. Im an intensive care physician. I work with children on ventilators. We were very concerned about that. By july, we will have about 50,000 in the stockpile. We only have 19,000 to begin with. We know we are going to be in good shape for that. I am going to use a word of dr. Fauci i am cautiously optimistic, but i am very cautious and i dont still sleep well at night because we have a long way to go. I just want to make the point that everyone has made. It is not like this is all going to happen to us. The American People have a lot to say about this. We want to emphasize following the guidelines, following the phases, avoiding mass gatherings, wearing these things. Using hand hygiene. We have a lot to say about where this is going to go but we all need to continue to Work Together. Rep. Ohalleran thank you. I yield. Chair pallone thank you. Let me thank all of you for bearing with us for six hours, i guess. A really thorough analysis of what is going on, so i want to emphasize again, we really appreciate you being here and your thoughtful responses to everything. Thank you so much. Im going to let you go because i have a long list here of documents to read for the record, so you dont have to stay for that. But, thank you again. I want to remind members that pursuant to committee rules, they have 10 Business Days to submit additional questions for the record to be answered by the witnesses who have appeared. I ask each witness to respond properly to any such question you receive. We would like to insert into the record by unanimous consent the following documents. A letter from the American Society of microbiology to the committee dated june 23, 2020. A letter from the Alzheimers Association to the committee, dated june 23, 2020. A letter from afme to the chairman. A letter from the American Society of her metrology, dated, june 23, 2020. A draft by representative olson of covid19 cases in the houston area. A statement from representative burgess. And a letter from Ranking Member walden on Committee Role 9d1, dated june 20 3, 2020. I will repeat again that any member who wishes to submit an Opening Statement for the record is certainly encouraged to do so. And with that, at this time, the committee is adjourned. Thank you to everyone. [captions Copyright National cable satellite corp. 2019] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] this house energy and commerce hearing on the federal Coronavirus Response is wrapping up. We just heard from dr. Anthony fauci, fda commissioner dr. Stephen hahn, and cdc director dr. Robert redfield. You can watch the hearing tonight again at 8 00 eastern on cspan. It is also online as cspan. Org. Cspan has unfiltered coverage of congress, the white house, the supreme court, and publicpolicy events. You can watch all of cspans Public Affairs programming on television, online or listen on our free radio app. Be part of the National Conversation through c spents daily Washington Journal Program or our social media feeds. Cspan, created by americas Cable Television companies as a Public Service and brought to you today by your television provider. President trump is in arizona this afternoon. He is going to speak at a students for trump rally hosted by turning point usa in phoenix. We will have live coverage beginning at 6 40 p. M. Eastern on cspan, online at cspan. Org, or listen live on the free cspan radio app. As he was leaving the white house earlier to head to arizona, President Trump stopped to talk to reporters. Pres. Trump hello, everybody. Were going to arizona. We are celebrating. We have over 200 miles of wall built. It has been incredible. Our numbers on the border, as you know, are just about at a recordbreaking low. Pe a