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

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. Live wednesday on the cspan networks, House Speaker nancy pelosi hold a News Conference to talk about the Affordable Care act and the House Judiciary Committee holds an oversight hearing for the Justice Department at noon eastern on cspan. On cspan two, the u. S. Senate returns at 10 a. M. To continue work on the judicial nomination of cory wilson to the fifth circuit court, a vote on confirmation is scheduled for 11 30 a. M. The senate will also vote on moving forward with Republican Police reform legislation. 10 00, ciaa 10 00 cspan3 at Inspector General nominee Peter Thompson appears before the Senate Intelligence committee. Coming up in one hour, dr. Ira discusses the latest developments in efforts to combat the coronavirus pandemic. California representative republican Tom Mcclintock discusses this weeks houseboat on please reform