All yours. All mine . Great. Good afternoon. ,nd thank you, secretaries are for joining us today at cbc headquarters. It is a privilege to have you with us and we appreciate your leadership throughout this unprecedented response. The most significant Public Health challenge our country has faced in more than a century. And the pandemic is not over. Earlier this week, covid virus cases reached over 40 million globally. Here in the United States, we are approaching a critical phase. Butler, moments, dr. J cadc director for Infectious Disease and the former incident cdcsr of the cbcs covid19 response will provide you an update of our current situation. I know it has been a difficult year for americans, but we are going to come through this on the other side. I am also optimistic that we will have a limited supply of one or more covid Vaccines Available for distribution before the end of this year, but were not quite there yet. That is why it is so important that all of us remain diligent in our efforts to defeat this virus and to protect ourselves, our families, and our communities. Data, andience, service have driven our response to the covid19 pandemic, and our mission is to protect the health of every american and stabilize. Personally, i am incredibly proud of the men and women of the cdc. It has been an honor for me to lead them during these extra dinner time spent to lead these extraordinary people. I would like now to introduce will maketler who remarks, followed by the secretary of health and human services, alex azar, and then we will be happy to take your questions. Jay . Dr. Butler good afternoon, everybody. Thank you for being here. Fabulous to be able to speak to you today, and thank you for that introduction, dr. Redfield. We are here to give you the latest on whats going on with the covid19 pandemic. Unfortunately, we are seeing a distressing trend in the United States with covid19 cases increasing in nearly 75 of the country. To date, we have confirmed over 8. 1 million cases, and sadly, over 220,000 deaths since january. I know these are numbers, but these are also people, and we mourn these losses. In the past week, we have seen nearly 60,000 cases a day on average as well as several hundred deaths. Here in georgia, we have also seen an increase in the number of cases despite the decline we experienced beginning in august. We are also seeing cases increase in really all parts of the country. Particularly, likely in part because people are moving indoors with the arrival of cooler temperatures. Smallerfactor is that and more intimate gatherings of family, friends, and neighbors may be driving infections especially as these gatherings move indoors and adherence to face coverings and social distancing may not be optimal. I recognize we are all getting tired of the impact covid19 has had on our allies. Masks,tired of wearing but it continues to be important as it has ever been and i would say more important than ever as we move into the fall season. It is incredibly important to continue these steps also as we look toward the upcoming holidays. We know that every activity that involves interacting with others has some degree of risk right now. There are four general rules of thumb for assessing risk and deciding how to best protect yourself and those you love. First, the more closely you interact with others. Second, the longer they direction is. Third, if they direction is indoors rather than outdoors. Fourth, interactions with the greatest number of people translates into the higher risks spread. 19 understanding these risks and how to adapt different prevention measures can help you protect yourselves, your families, and your communities. We all want to live as safely as we can and minimize the risk of covid19 well it is circulating. Ar will highlight what people can do to protect themselves. But i will talk about an additional tool we will likely have very soon, the covid19 vaccine. As dr. Redfield mentioned, we are cautiously optimistic the vaccine will be available, although likely in limited quantities, before the end of 2020 preparing for supplementing is successful covid19 program is the crucial next step as part of our overall effort to protect americans, reduce the impact of the covid19 pandemic and continue to restore more normalcy to our lives in this country. The cdc is a proud part of operation warp speed, a partnership between the h. H. S. And the department of defense to develop, make and distribute millions of covid19 vaccine doses as quickly as possible while ensuring that they are safe and effective. In other words, we want to make sure that they work. I am pleased to announce that all jurisdictions including georgia have submitted their plans. Vaccine program they are an important milestone in our efforts to ensure successful delivery and safe andation of effective covid19 vaccines so the ultimate goal is that everyone who wants to be even nice candy. Month, cbc has provided Technical Assistance to each jurisdiction including daily checkins with staff, Weekly Conference calls with immunization and preparedness managers and in some cases, onsite assistance. My colleagues are currently conducting its our review of the draft plans and will be providing feedback to the jurisdiction within the next two weeks. It is important to recognize these plans are flexible, as things may change as we learn more about which vaccines become available and what a month and when. Additionally, each plan would include an executive summary that we plan to post online later this month allowing for maximum transparency and a general understanding of each jurisdictions approach. I want to highlight also the Pharmacy Partnership we announced last week with cvs and walgreens. We anticipate that initially the vaccine will be available in a limited supply. Vaccine ispply of limited, our efforts to vaccinate may need to focus on those who are hired risk of severe disease, as well as those critical to the response high at risk of severe disease, as well as those critical to the response, such as first responders. Nursinglude people in home facilities as well as independent living facilities. The partnership for Longterm Care Program provides management of the covid19 vaccination process, including getting vaccines to facilities, providing onsite vaccinations, and fulfillment of all reporting requirements. Longterm care facilities will have the option of partnering walgreens, whose combined National Footprint will allow facilities nationwide dropped into this program. Before i close, i want to remind you that tomorrow the vaccine and related Products Committee will meet to discuss the latest covid19 vaccine development. Next week, the committee on immunization practices will be meeting. Both of these meetings with independent committees will be public,t live for the as well as the process that is being used to ensure americans have a safe and effective variety of covid19 vaccines. We know that stopping this pandemic will take all of our tools handwashing, masks, social distancing, and hopefully quite soon, vaccines. Taken together, these tools are our best chance of getting our , and Health Schools systems back into normal operation. I would like to turn the podium over to alex azar, secretary a azar, thank you for being here. thank you so much to dr. Butler and dr. Redfield and thank you so much for the cdc hosting us today. It is an honor to express my gratitude to the incredibly Hardworking Team here at cdc further efforts throughout this pandemic. While in atlanta i also had the chance to learn about the historic efforts heroic efforts of the staff and everybody at Grady Memorial Hospital as well as Emory University hospitals work on Clinical Trials for regenerons antibody cocktail and modernas vaccine. Things to operation warp speed, if and when the fda gives the goahead for these the reputed and vaccine products, we will have supplies already manufactured and ready for distribution. In conjunction with operation warp speed, the cdc, is dr. Butler mentioned, is leading the effort to coordinate Vaccine Distribution and Administration Working with 64 Public Health jurisdictions that they partner with on a vaccine each year. I want to offer a special thank you to every american who has volunteered for Clinical Trials, or helped to raise awareness, especially among Diverse Communities where we need representation in our Clinical Trials. Anyone interested in signing up for a vaccine trial can visit coronavirus. Gov. And for therapeutic trials, go to riseabovecovid. Org. While we make this exciting progress on vaccines and therapeutics, we see concerning trends in many parts of the country, as dr. Butler explained. I am briefed by cdc experts each and every morning. There is help on the way in the from of safe and effect vaccines in a matter of weeks or months. But in the meantime, the bridge to that next phase, we have to take steps to keep ourselves, our families, and our communities safe. Those are the three ws wash your hands, watch your distance, where excess covering if you cant watch your distance, and avoid settings where you cant do those things. Thank you all for joining us today. Thank you for the American People for the incredible sacrifices you have made during this endemic, and thank you again to this dedicated team at the cbc for their incredibly hard work. We are now happy to take questions. Yes. Reporter thank you, mr. Secretary. Last week, Emory Universitys dean of Public Health called your agencies undermining of the cbc and the President Trump unforgivable the president leadership science. Dr. Butler was quoted saying he theeeply concerned actions that agency was forced to take would cost less. Have you discussed any of that in your conversations today. There you have any concerns about the allegations . i came down here to thank the incredible people of the cbc for their work. For their work. We talked about the most recent data about the efficacy and wearing face coverings. We talked about the Vaccine Planning work around distribution of vaccines and i got an update on the incredible progress the cdc is making money increasinging in outreach to nursing homes. The cdc is the premier epidemiological organization on the planet. When we go to other countries, as i often did before the pandemic, they literally are named the blank centers for Disease Control and prevention, named after this very institution. This is the crown jewel of american and global Public Health. We revere it. Role incdc plays the what is a unique and pandemic. Ted it has been 100 years since we have had a Public Health crisis of this type. This is bigger than h1n1. Mrs. Is not sars or it impacts the entire government and economy. The cdc plays a role in that. But it plays a role in epidemiology. There are other key players. Even within my department there are agencies with important equity around Mental Health and opioid abuse around the pandemic. N. I. H. And fda, around research. Veterans Department Around care for our veterans. The defense Department Around force protection. Transportation around transportation issues. International commerce at the state department. International relations. The spread of disease globally. The cbc plays a vital role, but in a pandemic of this scope and this magnitude, it plays a role, not the role. I think some of the people who comment not actually having lived in and led this organization doing this type of crisis are failing to appreciate that. But make no mistake, the cdc is an independent organization. We respect their signs and conclusions. What comes out of the cdc at the end of the day is dr. Redfields conclusions around science and evidence with the support of his team. That is the way we operate and that is the way we will keep operating. Yes. The cdc guidelines on contact now says it is being within six feet of someone for a total of 15 minutes or more. Quarantine time for schoolchildren [inaudible] . An you talk about that dr. Redfield sure, thank you very much for the question. The cdc is sciencebased and datadriven. As a consequence, as we get more data and understand the science of covid, we will continue to incorporate that in our recommendations. Originally, contact, as you know, that was considered to be high risk for potential exposure to covid for someone within six feet that was for more than 15 minutes. There is some recent data that determined, been but that individual had a series of shorter contacts, but over time added up to more than 15 minutes, became infected. Clarifying that new science, that new data into our contact recommendation is what you are alluding to. That, it is raised on data one did not have four months ago but it is data now that we have based on situations so we reported it. The second part of your question , could you say it again for a second . Eporter efforts in quarantine dr. Redfield as you know, the data we have right now that is individuals that have had a highrisk exposure have a. A periodr that of time after that when they actually become undetectable of the virus. The average was a little more than five days then new data showed it was more than seven days. When you look at the data selectively, if you did the cut off at 14 days, you actually identified almost everyone that was positive. If you tried to shorten it to 10 days, we found that we missed around maybe 12 of people. Therefore, we stayed at the 14 days. All of those decisions were made without testing. Now there is a series of studies gathering data that are trying to determine, can you use testing during the quarantine to determine if you could shorten from 14 days to 10 days or seven days . Again, it is datadriven. It is under evaluation. Obviously, we dont want to have 14ple be quarantined for days unnecessarily. So we are working hard to see if there is data now that we have testing that may allow us to be more confident that if we do testing at d5 or day seven, we can use that information and more effectively understand so we can shorten quarantine. So it is not a policy, it is an area of research where we are gathering data right now. Yes. Have tried to say this but he times that i get the opportunity sciencebased, datadriven organization, the cdc is. We are not an opinion organization. If we get data that supports a change in our recommendation, those recommendations will be changed. Middle . E reporter there was a fairly new study out that said the number of covid19 deaths could be higher compared to i guess that would be a question for dr. Redfield or for dr. Butler in previous years, i think we are up nearly 300,000 deaths. And it said two out of every three deaths is covidrelated. Could you talk about that . Dr. Butler sure. The concept of excess deaths we know that all of us are going to die eventually. There is an expected periodicity to that, average life expectancies. We know that at anytime there is a certain amount of seasonal variation also. This is something we have looked out for years in terms of the number of excess deaths caused during influenza season. Using that same methodology to look at what happened during the time of the covid pandemic is how we are able to come up with the fact that we know more people have died this year. We know some people are going to die no matter what. But comparing the total number to that expected number leads to a difference that ultimately leads to the 300,000 excess deaths you just mentioned. About two thirds of those we can link directly to covid19. Third . He other one that is an important question to address as well. ,ome of those may be unrelated perhaps because of limitations on access to medical care. Some of them may be unrecognized impacts of covid19. When you look at factors like Cardiovascular Deaths that arent directly linked to covid19, there is not a great explanation for why we would see that increase in Cardiovascular Deaths. We know it is possible that covid19 could be playing a role well. Se deaths as overall, i think it emphasizes the importance of prevention measures that we have been talking about. Reporter dr. Butler, you said that the vaccine could be available for distribution toward the end of the year. How widely and how long do you think it could be before a vaccine is available for widespread distribution to anyone who needs it . March or summer of 2021 . Dr. Butler sure. These are the questions that we are asking every day as we move planning. Th vaccine as you are aware, theres a number of different products that are currently in critical trial. There is a process to make sure those vaccines are safe and effective that we have to go through as well. A number of the Clinical Trials are ongoing and still in a fairly early stage. I wish we had a crystal ball we could look at. I wish i could say everything is going to go 100 according to plan. But we also know we have to be ready for if it doesnt. Looking at the current trend in this that is Current Trends in the studies of production of the vaccine, i think we will have at least one or possibly two products available for the end of the calendar year. The next question is when. Again, no guarantees how much. That is also part of the iterative process as we continue to learn what the Production Capacity will be going forward. One of the beauties of operation warp speed is we are not waiting until we have all the studies completed and the reviews done before we start the production process. It may be that we find for instance that a vaccine is not effective and that is a vaccine and that ultimately will not be administered to americans. Azar and on your time and on quantities, as dr. Butler mentioned, we have the pfizer and madonna vaccines which are very close to his fully enrolled in Clinical Trials. When we get data out of those will be dependent on the trial. Shots outside of anyones control. We are as dr. Redfield mentioned preparing commercial Scale Production of all vaccines including of course pfizer and moderna. We expect we will have by the end of this year enough vaccines to be able to vaccinate all of our vulnerable, the most vulnerable individuals. Then by the end of january, at we expect to have enough to vaccinate all our seniors as well as Health Care Workers and first responders. Orn by the end of march early april, enough vaccines for all americans who want a vaccine. We have an overflow room because we are abiding by the cdcs restrictions on the number of people in the room. A question from the phone has been asked . Yes. Secretary azar we will try over to the phone now if somebody has a question. Do we have bloomberg on the phone . Please go ahead. Withter this is emma bloomberg. We were told by the leader of operation warp speed today that astrazeneca and Johnson Johnson trials will resume this week. Tell us more about this as well as the nature of the safety concerns . Secretary azar you broke up of it i believe the question was about the status of the astrazeneca vaccine trials. As of now in the United States unless something has changed, the astrazeneca trial remains on Clinical Trial hold in the United States because of the of the companyda as to a possible serious adverse event. As a company as well as the fda is examined the data to determine, is there a connection to the vaccine, would , there is a causative connection and if so, should the trial be restarted or continued or are there other precautions one should take. One is to modify the consent forms, anything about the that. Ol, thats part of the fda has been working to gather information from astrazeneca to assist in that evaluation. As far as the process, it is continuing as we speak and that will be a determination made by the fda. One more. Yes. Can we see who is on the phone . Could we have on the phone . We have thoughts on the phone . Secretary azar, thank you for taking our questions today. The president of the United States has held numerous rallies across the country, in the hottest of hot spots many with no social distancing and mask wearing. The president also says we are rounding the corner. Are we rounding the corner and or these rallies a good idea . The second part, the president has been critical of dr. Fauci lately. What impact do you believe as his department tries to distribute and convince americans to take a vaccine that Many Americans are now showing skeptical or concerned about taking . In terms of your first question, our guidance is the same regardless of setting. Wash your hands, we are mass, and avoid settings where you cannot do those things. Anybody we connected to school, work, going back to worship, or reconnecting to health care or in gauging in the political life of our country, every device remains the same. Wash your hands, watch or distance, where face coverings when you cannot watch for distance and avoid settings where you are not going to be able to do those things. That advice is the same regardless of any type of gathering. With regard to your second the president has assembled and has direct access to many different advisors, including the people on this stage as well as others. I try to make sure and from the beginning of this outbreak that the president is getting the best medical, scientific advice from a diverse range from the top doctors within this department. The president hears divergent viewpoints. He has made clear he has Great Respect for dr. Fauci. He said that in followup from other comments. That should have no impact on the vaccine work that we do. At the vaccine work we are doing, the American People should feel reassured by the process established here. There are five independent checks around vaccine regulation. First, a vaccine Clinical Trial has prespecified endpoints. They are statistical and these Drug Companies have been transparent for the first time in history laying out what those statistical endpoints are. There is a totally independent safety monitoring board that will look at data that comes in, determining if those endpoints have been met. If and only if those endpoints have met, the company will have its own independent process. It will estimate their ethical standards for submission for emergency use authorization. It will come to the fda, where the fda will evaluate the vaccine according to two sets of guidances, general vaccine guidance for covid and a second to guidance for what it would require and expect in terms of approval. Thank you have got the fourth chapter, which is as dr. Butler mentioned, the Advisory Committee of the fda, and external Advisory Committee that will be webcast. A public process will advise the fda and the decision about whether to approve or authorize a vaccine will be made by fdas career scientists. That, combined with how this is working so far, look at the fact that we have three Clinical Trials put on hold because of any type of safety concern. In the system is working. This is being played by the book. One antibody trial has been put on hold. Two vaccine trials put on hold to ensure fda and we are putting Patient Safety at the Center Following all regular desk regulatory ethical standards for development of a boat and vaccines. All of those elements of process should reassure the American People that when a vaccine or therapeutic comes out with the authorization of fda, it represents fda career scientistsbest judgment that it meets their scientific, legal, and regulatory standards. Thank you for coming today. Dr. Redfield and i have got to get to the airport but we appreciate your being here today and dr. Butler, we appreciate. Dr. Butler is the senior career official at cdc leading the coronavirus effort, and we are grateful to him for his leadership and as we move into the future, i want to make sure there are continued interactions and opportunities for you all to be continuing to engage with cdc as well as our career leaders here. Thank you very much. Bye. Onwe take your life to guest ott Municipal Airport in North Carolina where President Trump is holding a campaign rally. At this is live coverage on cspan. And hold it in our hearts. Please, please [indiscernible] please. So. Love you , you did me wrong you have done me wrong love, now you are gone. Please, please, please, honey, please come home. I love you so. I just want to tell you i, i, i, i, honey, please. [indiscernible] love you so baby, take my hand. Yours, loving man. , [indiscernible] i love you so please do not go. Go. Se do not please, do not go. I love you so. Please, do not go. I paid my dues time after time. I have done my sentence, but committed no crime. , bader mistakes mistakes, i have made a few. I have had my share of kicks in my face but i have come through. Champions, my friend. Well keep on fighting until the end. Champions. We are the champions. Losers, because we world. Champions of the i have taken my bow, and my curtain call. You brought me frame and fortune and everything that goes with it. I think you all. ,ut its been no bed of roses no pleasure crews. Cruise. I consider it a challenge before all the human race and i would never lose. We are the champions my friend. Fighting untilon the end. Champions. We are the champions. Losers, because we are the champions of the world. Friend. He champions, my fighting untilon the end. We are the champions. We are the champions. Losers because we. Re the champions [cheering] ladies and gentlemen, please welcome the 45th president of the United States of america, donald j