A government review in early october. Moderna had talked about a phase three trial in september. Astrazeneca before this is in phase three. Backdrop and what happened with astrazeneca, what is your best estimate for when a safe vaccine will be available . Dr. Redfield one thing i have learned is the cdc director, i business. The opinion im in the data and signs of it. What does the data and signs suggest . Dr. Redfield based on enrollment right now that is going on with the pfizer and moderna, that it is conceptual that they will have enough data to present it to the fda for evaluation somewhere before the end of october and the end of november. The reason i cannot be more specific is because these trials are event driven trials. They are 100 dependent on how much covid occurs in the volunteer population. If it is a lot of these individuals having to get covid independent of what group they are in, and the potential for them to have enough events if the vaccine is very efficacious will be in the october timeframe. If the vaccine is 50 efficacious, it might be in the late november timeframe. If there are fewer events and it vaccine, andd might be in december. Somewhere between the end of october and the end of the year is probably it is probable one or more of these vaccines will be presented to the fda for review either for emergency authorization or potentially for approval. Timeline, what would be the time range when we would start seeing vaccinations being deployed . Dr. Redfield because project warp speed as i have said, it is not taking shortcuts on safety or scientific integrity, as we sit here today, those vaccines from a derrida and fight from my dharna and pfizer and astrazeneca are being made for use to be distributed if the fda can determine they are safe and efficacious. Normally what would happen is you would wait for the fda to review the data. They would say the vaccine is safe and efficacious. Then the Pharmaceutical Company would begin to manufacture it. This vaccine is going to be available it is either going to be a bunch of souvenirs at the vaccine does not show to be safe or efficacious. To save that time and it is important time particularly for those of us who have comorbidity over the age of 65, the sooner we can have a preventive vaccine for covid, it will translate to saving human life. There was an acceleration to make sure there was not an administrative delay just because of the Financial Dynamics of how we develop vaccines. That is what is really remarkable about operation warp speed. It is not that we are taking a safety shortcut like i said with the astrazeneca trial going on hold is a good example. Not that we are taking scientific principle shortcuts. We are taking a financial one. When you asked me when do we think the vaccine will be available broadly to the American Public, if everything goes really well, that will be sometime in the first Second Quarter of 2021. For those highrisk prioritized individuals, it is conceptual that the vaccine could be available in the late fall or early winter of this year. So important about vaccines is Public Acceptance so people get vaccinated. We have gotten a Disinformation Campaign that was stirring up antivaccine concerns. There been surveys with respect to a covid survey that shows hesitancy to get one. The politics of this election cycle has raised concerns operation warp speed could be rushed. The president has said the vaccine could be available before election day. Some say the cdc has been subject to political pressures. With all of these headwinds and that is being polite to call them headwinds, how do you convince a skeptical and divided public a vaccine when it comes out is safe . Dr. Redfield this is really important. One of the goals i have had as cdc director is to move away from what we call Vaccine Hesitancy to a culture in our nation where vaccination with confidence. Where we find that less than 50 of the American Public takes the flu vaccine, and i tell you in the last decade, 300 safety thousand people died of flu and we have a vaccine, then how do we begin to get the American Public to embrace vaccine . What is one of the most important contributions of science, modern medicine, that is vaccination. So many people leave that on the shelf for themselves, their family, their community. We are trying to build that advocacy. It is a long journey. Lets take noncovid vaccines. A lot of parents, the reason they are hesitant to vaccinate, they do not want to make a mistake for their children. I have six children. It is going to take time for the Health Care Professionals to sit down and have a dialogue about this. Maybe several times before parents embrace vaccines. Doctors will ask you, you want to get a vaccine and you say now and that is the end of the story. I am asking nurses and doctors to reengage. Some are misinformed. When someone is misinformed, you cannot say you do not know what you are talking about. You have to engage them in dialogue and get them to understand that they can come to their own conclusion they are misinformed. This is a serious issue. I am very concerned about it particularly with the covid vaccine. It is not something that should be politicized. Have you said to the president of the united states, please do not politicize this . Please do not use this in your speeches or to the other candidates for that matter that you have to have everyone around the vaccine and this cannot be an issue of politics . Dr. Redfield my comments with the president i keep to myself and the president. I will say publicly what i just said. This cannot be politicized. By either party or any individual. Hasnt he done that . Instillield once you fear in somebody, it is very hard to remove that. I have a challenge right now that i am working on, which is called disparity of vaccination. Lets take the flu vaccine for example. 2018 of in 2017 and hispanic americans took the flu vaccine. Im glad we got it up into the high 30s, that is still only the high 30s. In the africanamerican community, we went from 41 to 47 or 48 . Ont need to reinforce on either side, not taking sides, either side politicize is this, is working against the goal for what i am trying to accomplish, which is to get American Culture to be of the point of view that they can vaccinate with confidence. We have some schools where less than 30 of kids are vaccinated with measles. This is really important. The added concern when people do view that this vaccine is being rushed, it may impact safety, i am trying again to tell you that i know from the cdcs point of view, i can tell you from the nihs point of view and the fdas point of view that the only thing going to dictate this process is data and science. We would like to have us continue to do that. The pharmaceutical companies have made a recent commitment that they are in line with that whole concept. We should celebrate when we have a successful, safe and efficacious covid virus vaccine. I do not think we would have one for a couple years. I thought the rest of my cdc career was going to be kneedeep in a war against covid. Now i can see if we can get an efficacious vaccine or two or three, between now and next summer, we can get this behind us. Those are important words. Hope forget to summer, we have to get through this fall and winter. Want to ask you about the seasonal flu and how that collides with covid19. What is your assessment with the coming flu season and what that means given the pandemic . Dr. Redfield i made a couple new cycles in april when i theented that i thought october, november, december to be though worth to be the worst this nation has had. It could have been shared im hopeful it is not going to be. Almost a bad flu season, there are some Hospital Systems overwhelmed. We saw what happened in the northeast. It overwhelmed hospitals. Chicago, detroit, los angeles and down in new orleans. It is interesting what we are saying. Flu actually transmits all yearround. We actually peek in the late fall and winter. That is what we call flu season. The truth is flu is transmitted all yearround. Lowest spring, summer transmission of flu we have seen. Why is that . [indiscernible] handwashing,cing, being smart about crowds. The same things that we are now doing for covid and our colleagues down south in australia have seen the mildest flu season. I do believe that if the American Public does five things mask when they cannot social distance, social distance, vigilant about and washing, about handwashing, be smart about crowds. Indoors worse than outdoors. Indoors, stay away from crowds. The last thing i want them to do, get vaccinated against the flu. We do those five things and there is a good chance what i appeal to individuals who have not had a vaccine for flu before is, one of the things the flu vaccine does well it may not prevent infection, but it does modify illness. If you and i can get our flu vaccine so if and when we do get flu we do not end up in the hospital taking a bed from what that 72yearold woman with covid needs, then we are doing our part. Let me tell you a story. I was talking to Somebody Just the other day who just flew across the country and had to stop over in atlanta and walked through hartsfield airport in atlanta and told me it was crowded and that there were people not Wearing Masks or people wearing their mask over their mouth for not over there noses so not properly and he was concerned about that. How concerned should we be that covid fatigue or just asserting your freedom or whatever you want to call it is going to make those five things even after all this insistence you and others have had on this point, harder to do as we go into the seasonal flu season . Dr. Redfield i think you have a big issue. I was in hartsfield a couple weeks ago and i think i only observed a few people without masks. There are plenty of places in this country where people still have not fully embraced, the younger between 18 and 25 they have not embraced the importance of what i just told you. We can only continue to try to appeal to people i quote the john kennedy quote. Do not ask what your country can do for you, ask what you can do for your country. What im asking the American Public to do is become a warrior in the pandemic. Do those five things and will bring this outbreak to an end. Dr. Redfield then he ask you about another aspect, which is very important. You mentioned minority populations. Ensure c done to what has the cdc done to ensure the supply of vaccine when it comes is sufficient and the promotion of the vaccines to minority communities, which has been so hardhit, will get the attention it deserves . Dr. Redfield the biggest thing we are working hard on now as you know is to prepare for the distribution of this vaccine. You have heard the National Academy came out with some of their recommendations. We have the Advisory Committee on immunization practices that will take all the data and they will set up requirements on where this vaccine will be used. Initially, this vaccine will be in short supply. It has to be prioritized. The vaccine once it is prioritized has to be this riveted. We have gone to the initial jurisdictions to work on what we call micro distribution plans. By the end of this month, we will have put those plans to be developed in all of the jurisdictions across the country. Ultimately, we have got to get prepared for that distribution. One of the distribution in recognizing the disparities of this illness, prioritize distribution among those communities hardest hit . Dr. Redfield i think that is going to be one of the key priorities. Ultimately, that recommendation is going to come from the Advisory Committee. I think there are two major issues right now. There is the group at risk of infection. There is the group at risk for a bad outcome if they do get infected. That is where we are seeing the elderly. That is where we are seeing some of the minority populations. They are at greater risk if they do get infected because of comorbidities of a bad outcome. And is why i am not excited i would like to fight back about anybody that says things to develop fear in individuals, particularly in minority populations about taking the vaccine. Because then, you have a process where we have a vaccine and we want to distribute to groups we think our work we think our risk for bad outcome. If there is one decision for a group or another to not take the vaccine. We have programs where we are working in partnership on the flu vaccine with the africanamerican and hispanic communities to increase uptake. It is still not over 50 in those communities. We have a long way to go. We are still under 50 . I think it is important to build confidence in everyone, particularly in africanamerican, hispanic tino, native american hispanic latino, native American Population to embrace this vaccine. Are you someone who is at high risk for the bad outcome . Those will be the two priorities. Deepening on how much vaccine is originally available, it will be prioritized. It probably will not be till after the first year when we have enough vaccine and availability that it will be available to the broader American Public. The first 50 million doses will be prioritized for those two populations based on outcome or based on risk of infection. As you know, rightly or wrongly, some of the cdc guidelines as they have been expressed have proved controversial. There are those who say the cdc is advocating fewer tests are better. Right, wrong, what do you say to this . Dr. Redfield absolutely not, wrong. Testing is a critical part of our Public Health strategy. With the cdc was saying, although unfortunately was not reported correctly, was we were saying we want to place emphasis on testing individuals who have symptomatic illness or individuals who have significant exposure. They could be a symptom at a shared or vulnerable a symptomatically. Critical infrastructure workers or healthcare workers or first responders, all of which could be a symptom a symptomatic. Itt we were trying to do is testing to drive action for specific Public Health objective kid we are seeing way too many people on the way to work, stop by a drivethru, get tested and only finding out the results 5, 6, 7 days later. It was unfortunate that one of the network said we recommended against testing asymptomatic. The first sentence said you may not be tested. The second sentence was you need to engage your doctor or publichealth person. Im glad you brought it up here. Testing is a critical part of our Public Health strategy. Asymptomatic testing is a critical part of our health strategy. We just want to do it in a way that is actionable. Ask you a followup to this because it is so important. When that guidance came out however it was reported, there was not just noise in the media, but there was also noise in the political shared atmosphere the political atmosphere we will call it. Governor andrew cuomo said we are not going to follow the cdc guidance. I consider it political propaganda. His words. Hardly surprising, the public is confused, angry, whatever. What do you need to do, what are you doing at the cdc to inspire confidence, clarify this, make people understand you are pushing back against politics and trying to follow science to keep people healthy . Dr. Redfield the first thing we did is minutes after cnn reported it incorrectly as we issued a statement on guidance. Unfortunately, that did not seem to make a new cycle where we basically said testing was meant to drive action for a book health objectives. We said everyone who needs a test is going to get it. Everyone who want someone may not need it. The one who once one may not get it. Friend howardod zucker who is in the state Health Department and explained everything to him. Unfortunately, [indiscernible] a lot of people have chosen to try to politicize and i can tell you the cdc is a datadriven, sciencebased service organization. I am not a politician. My friend at fta is a great oncologist, not at fda is a great oncologist, not a politician. It is disappointing for those of us who have decided to serve that people want to assume our decisionmaking process is somehow influenced by politics. I can only tell people that i know for myself and for stephen hahn that this is not influenced by politics. Way or the other, there are people from both sides of the political spectrum that want to try to suggest these organizations are making decisions politically. I can only continue to try to lead 23,000 dedicated men and women in this nation and we are going to use our best effort to put science and data into action, try to improve the Public Health and human condition in this nation. I cannot wait until we are out of the political season because maybe then, we can get back. I can only tell you that politics is not entered in the Public Health decisions we have made. There are many people who have tried to suggest. You talk about vaccines, my team and i wrote a letter that one of the states to be prepared to deliver the vaccine. All of a sudden, because we wrote that letter, knowing we might have a vaccine my november, by november, people assumed that was political. No, we are asking states to get prepared. A problem for credibility for the cdc, it would be the project work space to have 50 million doses of vaccine and we do not know how to deliver. That would be something that is what we are doing. Immediately, some people want to suggest because we are asking states to be prepared that that is a political statement. All the words i say are not going to convince people. We are going to stay focused. In closing this, i constantly read every morning a quote over my desk, which is a quote from Teddy Roosevelt saying never mind the credit. [indiscernible] try to come up short. We try, we come up short. Day, if weof the fail, we fail by daring greatly. That is the mode we are in. The cdc is going to get a new to do what we think is in the interest of the American Public. More importantly, and youre going to ask a question or two about this, trying to make sure one of the casualties of covid is not our program on the war of were on opioids. Yearomen died last delivering their babies. We should not have maternal mortality. Look at what is happening with suicide and Mental Health. We have important programs that cannot go on autopilot. I have tried to keep my men and women at cdc enthusiastic about their job. It is the one thing i can say perhaps i can take for criticism. It hurts me and i see men and women who dedicated their lives but stuff that is not true, they may not be equipped to understand as well and it modulates their enthusiasm shared therefore come modulates their enthusiasm. Or they can demotivate. I completely agree with you, i just want to say for the fulsome mess this of the shouldation, that device not even primarily go to journalists or reporters although it certainly belongs there because there is a lot that can be done. Also to political leaders. People who also politicize who sometimes take the first steps to that. We should be listening to you, the doctors and you should be science, the, the medicine always Must Come First because this is about Public Safety and not public opinion. You raised the opioid issue and i want to get to that before our time runs out because while covid is such an urgent crisis, there are so many other crises with which we are dealing and you feel passionate about. Covid has crowded out the focus on the Opioid Crisis. The wall street journal collected data across the country and found counties nationwide are experiencing a rise in opioid death this year after more than 70 deaths last year which is a record. Complicated the Opioid Crisis and efforts to combat it . Dr. Redfield at the very beginning, if we could go back, a lack of a surgical approach to how we limited medical care. Clearly, there was an attempt not to do, look at it surgeries that were going to play people in intensive care units and we thought we run out of intensive care beds. I did not mean a shut down in Mental Health services. It did not mean a shut down to daily opioid treatment programs. There was a nonsurgical approach to this as you know. There was a huge loss in access i think to quality medical care. Either you believe if you have a drug use disorder that your interactions with the medical profession has a positive value or you do not. To shut that off i think was unfortunate. So now, up against covid, how do you regain the offense of . Dr. Redfield we are trying to get that back. We have had a significant increase. We have had almost a 17, 18 s. Crease in projected overdose we have at an increase in suicide. We have had an increase in stress disorder. We are trying to get those Services Back up and running. When i say we, i mean the medical community at large. We are trying to highlight the importance of it. The cdc found that 31 of u. S. Andts have stress, anxiety depressive disorder. Almost 26 have trauma and stress disorder. There is a huge mental, psychological consequence. It is personal to me. You have said that. , almost lost one of my sons who almost died from contaminated cocaine with fentanyl. I am proud to say he is in his fifth year of recovery. It is a real struggle. I know what it is like. I thought i knew drug use disorder. I was a physician for 22 years in baltimore. I had many patients with drug use disorder. Until it came into my own family, i had no concept what drug use disorder did. The fact that all of that treatment got cut off we are trying to get it back. You can say the same thing about what has happened to young adults between the ages of 20 and 50 in suicide. Requiresituation that medical intervention. Get thosertant to individuals back into treatment. That they have confidence in it. A lot of people with chronic pain disorder could not get treatment for their disorder, back to selfmedicating, selfmedicating led to drug overdoses. When we really look back at the casualties that occurred in our response, that is the issue. We as doctors always say, do no sharedared do no harm i personally believe there was harm s. There was harm in indiscriminately shutting down all medical care. So getting back now to making sure we prioritize the medical care individuals need, making sure we get it back. Making sure we get back education so these kids can get educated properly. Working to do it again safely and smartly. I am not advocating to be blind about it. You have to be safe and smart. We did lose ground on opioids. We have to work hard to make it up. I on behalf of everybody in this gathering and beyond wish you luck on that. Thank you for all that you do. About howur comments science and medicine and Public Health should drive everything we are doing now. Thank you for your time today. Thank you for your candor. All the best in your battle against covid and opioids. You are a doctor and you are trying and youre doing a lot more than trying to do no harm. Dr. Redfield thank you very much. God bless you. Record as a shameful rollcall of the most catastrophic betrayals and blunders in our lifetime. He has spent his entire career on the wrong side of history. Our current president has failed in his most basic duty to the nation. He has failed to protect us. He has failed to protect america. My fellow americans, that is unforgivable. The first president ial debate between President Donald Trump and former Vice President joe biden is tuesday september 29 at 9 00 p. M. Eastern. Watch live coverage on cspan. Watch Live Streaming and ondemand at cspan. Org or listen live on the free cspan radio app. Andhe state department usaid officials discussed combating plastic in oceans. Senators dan sullivan and Sheldon Whitehouse outlined bipartisan efforts to reduce Marine Debris and improve waste management. Good afternoon. Hello, senator leahy. Sorry i am late. So, the day has arrived that we are talking about plastics in the ocean. Why are we having this hearing . So that