Transcripts For CSPAN2 National Press Club Discussion On COVID-19 Vaccine Development 20240712

Institute of Health Director doctor Francis Collins gave an update on, 19 vaccine trials in the current increase of coronavirus cases across the country, this is oneli hour. Welcome to the National Press, the leading professional organization for journalists, i michael freedman, 113 president of the National Press club and the former general manager of Radio Network and journalists and residents at university of maryland global campus and executive producer of the public broadcasting series moderated bl journalist marvin, we thank you for joining us for our virtual newsmaker event with doctor Francis Collins director of the National Institute of health, we are pleased to accept questions from her audience especially our journalist tuning in today ill ask as many as time permits, to submit a question please email headliners at press. Org, the National Institute of health or nih a part of the u. S. Department of health and Human Services is our nations medical research agency, the largest public funder of Biomedical Research in the world investing more than 32 billion a year to enhance life and reduce illness in disability it comprises 27 different components each with its own specific Research Agenda often focusing on diseases or body systems, all but three of the components receive their funding directly from congress. The office of the director is a Central Office responsible for setting policy for nih and for planning, managing and coordinating the programs and activities of all of the nih components, and 2009 doctor francis columns was appointed by former president barack obama to serve as the 16th director of nih and he was selected by President Trump to continue in that position in the current administration, doctor collins is a physician geneticist noted for his landmark discoveries of disease genes, he served as director of the National Human Genome Research institute at nih in 1993 through 2008 where he led the interNational Human genome project for his efforts he was awarded the president ial medal of freedom by president obama in 2005. Doctor collins in this perilous year of the coronavirus pandemic in the historic effortsts undery to develop an effective vaccine we are honored to welcome you to the National Press club and to say that our virtual podium is yours. Thank you very much and its a privilege to be your virtual newsmaker here today and its a special year 2020 where everything is a little different than we thought it was going to be aur year ago, im speaking at my home office and this is where i have been for most of the last eight months trying to runun the largest supporter of Biomedical Research in the world the National Institute of health and the budget of 42 billion a year generously provided to us by the congress on behalf of the taxpayers added time when medical research is actually making remarkable advances across the board in many areas, basic science to Clinical Trials and everything in between talking about diabetes, Heart Disease or cancer or Rare Diseases or common diseases or Infectious Diseases, nih is in the middle of all of that and we hear about a breakthrough many of those areas it is likely that it was funm from nih, to quickly explain how that was, most of our budget 83 goes out and grants to the institutions across the country and some outside the country to send us their best ideas about what they could do if they had the resources to support it and we put them through this very rigorous theory to be processed and were only able to fund one out of five of the applications, that is the cream of the crop, the best there is and we provide them with the resources and they go and make discoveries that are transforming an understanding of how light works and that is why this is such a remarkable moment to understand how the brain works and what that means about alzheimers disease and figuring out how you cand read the instructions and individual cells in developing approaches like the nobel prize a couple of weeks ago and applying them to cure disease like sicklecell, but this year being 2020, being the worst Global Pandemic and more than a century, our focus has turned very intensively to the effort to try to figure out how we can get the best science that was developed diagnostic, therapeutic and vaccines against this virus, the coronavirus, this guy which i show you a model of, a circular little devil with the spiked proteins which enable this virus to get inside i yourself which happenso be able to do so because she has inhaled it and those proteins latch on to a cell in your respiratory and find their way into the cell and turn it into a factory to make lots and copies sof the cell and yes we did not know anything about until january and here we are in october with a remarkable set of scientific advances that have happened but i want to briefly tell you and that im looking forward to hearing the questions from the group that has submitted them and advanced and some that will cement them right now, please do, first let me say were at a very serious moment in the covid19 pandemic in the United States, people might have gotten complacent after we had a terrible experience in march april and may particularly in new york of a great deal in a number of people who felt ill and many in icu and many who died in efforts were made to try to do Everything Possible and it looks like things are Getting Better but then we had the bighe outbreak in the southeast, florida, louisiana, alabama, mississippi, georgia, arizona, california, and texas, that led to a great number of increased cases, hospitalizations and deaths and then that started to get better again because people took thehe appropriate measuresf Public Health protection for themselves but now we are in the third i dont want to call it the third wave certainly were still the first because we never really drove the infection down to the baseline but now are in a very serious place, yesterday there were 75064 new cases of covid19, that is the second highest recorded in the United States since it started. I would bee willing to bet that we will have sadly a new record higher than that in the course of the next few days because the curve is going straight up, this time its in the middle of the country, the midwest and stretching to the Rocky Mountains and particularly places like wisconsin and the dakotas in montana and iowa and missouri, all those places and is not just in the cities which people are gettingha used to, it is in rural areas, this iss a very infectious virus and diabolically infectious and 40 of the people who get infected with this do not have symptoms, they do not know they have it and yet theyre spreading it by being in the public area and thus are doing like Something Like wearing a mask to prevent that, we have not seen a virus quite like that before and thats why this is been so difficult to try to manage and thats why its so critical for all of us to recognize that we need to take responsibility not to be that unwitting super spreader that happens to have the virus, does not know it and giving it to other Vulnerable People, this really does become a moment where all americans have to recognize each of us individually has a responsibility and we want to turn that around, im going to talk to about vaccines but we dont have them yet and its going to be a tough season as people are more indoors and know the time that viruses like this are spreading, all the more reason we got to take action in a very serious way, that means wearing your mask when you outside, staying 6 feet apart, that means not congregating inside where you might have the greatest chance especially if you took off the mask, please dont do that and by the way it means getting your flu shot because we dont need to have a double problem installed of covid at the same time, that is my expectation but let me talk about the science, that toy spend 100 hours a week of my time, we are working on diagnostic and the whole program and if people want to ask questions, we have developed 22 new ways to do a test to find out if somebody is affected with the virus even if they dont have any symptoms and those are many of them pointofcare test where they can be done in a particular location where you want the answerr right away, for instance if you want the staff to be tested before they start their shift, there is a lot happening and one that i hoped for an effort to have wider and wider asymptomatic testing pointofcare that gives you a quick answer and we need more of that to get people isolated before theyve infected other people, let me talkbo about treatment, no doubt seen that the treatments were offered a drug called d remdesivir and its called nih working with the Company Gilead designed and carried out a vigorous in early trial so by may we knew that that drug would provide benefits to people who are quite sick with covid19 and just this week fda has granted full approval of remdesivir, its an antivirus, basically it clogs up the gear so it cannot replicate itself and thats what you want to have, we know that steroids, dexamethasone can be helpful for people have serious lung disease and the president also received that, we have shown in several trials that that reduces the likelihood of people ended up on a ventilator or dying, those two everybody agrees are beneficial in a lot ofyb things that are on the way and one thats gotten a lot of attention is mono global antibodies, what are those, we know that people who have had covid19 and survived, they survived because their immune system made antibodies against the virus so could we learn from them and turn the antibodies into a product which can be given to people who have not made their own yet and might be getting pretty sick, that would be a very powerful strategy and its worked it works for ebola and theres a couple of companies in particular, lowly and regeneron that are far along with the developing these in a bodies to derive with covid19 turn in to pharmaceutical products and put into trials and it does look encouraging but not yet fda approved that those interventions for people who are fairly recently infected will provide some benefit, it may not be so good after while because if you wait ten days he probably started to make your own antibody and somebody else at that point will probably turn out that this will be particular tieful and maybe even for prevention give somebody antibody before they sue the virus, were thinking of that for instance, therapeutics are coming along we have a Partnership Involving 20 pharmaceutical companies, and age, cdc and a bunch of other agencies working on that together in a way thats never happened for the partnership that normally would take two years to put together because ive done some of those in my 11 years, this was put together in two weeks, now im talking about vaccines, we really want to put covid19 in the rearview mere, we have to come up that our population develops immunity may be as many as 70 or 80 of us developing immunity would be enough for this virus to not to continue to replicate, we are long way from that right now even in places like new york that had a lot of infection, maybe 20 have now got immunity because of having recovered from the illness, that is not nearly enough, the way that we will get the 70 or 80 will be a vaccine, we knew that, vaccines have been such an incredible gift to humanity ever since smallpox was figured out and we have developed ways to do this in the course of the last few years that are much faster than we think potentially, much safer than the previous methods and so on january 10 when the chinese released this sequence, the letters ofre the code of th sars vrus, within 48 hours a vaccine was being designed at the Vaccine Research center at nih and working with a Company Called the moderna within 65 days we went into phase one trial and where volunteers were getting injected, that is light years ahead of any vaccine effort that is ever been mounted before at that scale, phase one looks really good, the people who got the injection basically but not much else when you tested them they developed antibody levels that were very impressive, very similar to what you see in somebody who has had the real disease. That meant it was time to scale that up in that trial and another one pfizer started ony july 27, we had nih working with other companies had set up a way that these trials can be done in a harmonized master protocol so theyre all very similar in design and very rigorous and very large scaled, all of them involve 30000 participants and they have an agreedupon standard fda is about what would be considered safety and what would be considered efficacy and nobody would get there vaccine approved until that happens, the moderna natrona the one i know most about because they have been a partner with nih from the beginning announced yesterday that they have completed their enrollment of 40000 participants and working with them we made sure that this is a Diverse Group of participants, 37 of the people are people of color and we want to do that because the disease has had people of color particular hard and you want to know that the vaccine s really works and also has a General Number of individuals who have chronic illnesses and we need to know that and we have a lot of people over 65, we need to know that to. This trial has reached the point where they willth start lookingo see how people been protected by the vaccine from getting sick and how do you know that, we have to do this thehe way that e have learned over the decades is only way to be sure, randomized controlled trial, that means if you sign up for the trial and went through the process, you would get an injection and you would not know if that was actual vaccine or if it was a placebo and its a 50 50 chance and then we follow the 30000 people, 15000 got the vaccine 15000 did not and we look to see in their all in areas where the virus is spreading, southeast in the middle of the country and see who gets sick and the question is people who got the actual vaccine are getting a whole lot less cases of covid19 which will tell you if they werent and also are they doing okay, thats what were gonna be doing, this is now one of the four vaccines that started phase three trial to have been on a temporary hold because of a concern about a single patient that had an outcome that was concerning that they have nothing to do with n the vaccine because this many people not surprising that somebody developed a medical problem that would be surprising with this many people who did not have that were waiting to see whether they get started back up again but the two are moving along without that and in a place where i think its reasonably likely by late november where it will be possible to say it looks like its working then itll be up to the fda to look at the data and they had a big meeting about this yesterday to decide whether they met the standard and should be issued an emergency use authorization, if that happens then it would be start administering the vaccine to those who wanted at high risk and you dont want to get the vaccine too anybody because will have a limited number of doses for a while although there will be a lot, operation warp speed which was generated and put in place in may to think about all these things and already paid for the manufacturing of hundreds of millions of doses of the various vaccines in order to have them ready at the vaccine turns out to be successful, there will be 100 million by january and more after that, we dont know whether the vaccines will work and theres a fair chance that one or more will fail and will have to correct that, but if youre trying to get in the terrible pandemic you dont want to find yourself in januardecember january thing wea vaccine that works, itll take another six months before we have doses to get to the people we need it, we would not let that happen, this is an unprecedented way, that is all happening with nih working with our partners in our industry with operation warp speed and i saw the front page of the Washington Post today writing a very prominent story about whats happening with covid19, we dont see a lot of those and it was probably because of the science and the way the Vaccine Development has been unprecedented, you dont expect to see that, we arexp not done something still could go wrong and we could define how these vaccines dont work at the moment that this was breathtaking in the case that has been achieved in the promise that it carries along with it, were pretty excited about that and we still have a lotit of wok to do, that was my opening view of where we are with the disease, the therapies in the vaccines but i would like to hear what questions people have, lets have at it. Thank you very much we have a number of questions for you doctor collins and lets start, what is currently within the realm of possibility in termsitf approving a vaccine, what do you think and still before the end of this year. Let me walk you through the steps that have to be followed to get there, i think thats really important theres been a lot of concern about whether this warp speed means corners are being cut in safety is being not treated with as much seriousness as it deserves and politics involved and let me walk you through what has to happen, i really told you about the weight in which the trials have to be done, they have to be very large and they have to be randomized and controlled, this is the only way you know something works, thats what were doing, if one of a the vaccines comes to the point in the next month or so where it looks as if there is a significant number of people who got the vaccine who are protected against the illness, that is more cases than the placebo than the Vaccine Group and if it looks as over two months that at least half of the people got the injection that the safety issues are fine, we want to be sure there is not a delayed safety, if that happens there is a data safety monitoring board which is a group of individuals who dont work for companies, they are basically scientist in experts and those are the only people that get to see the unblinded data and then they would raise their hand and say i think there is something here and they would tell the company, okay we think we want to look at this data and decide its time to go to the fda and the company would look at it in the company ceos say they dont want to submit to the fda something if they dont believe its really good so they might say lets wait a little longer but mostly if they decided to hit the mark they go to the fda and the fda looks at it which will take a couple of weeks and decide whether they think the data is going in the very end of the details and they will hold a Public Meeting of the same group that met yesterday the group called the pack which ends for vaccines that related biological products, thats a mouthful but this is a group also distinguished experts who dont have any particular conflicts they are there trying to decide what to do, now a Public Meeting everybody will get to see is the data compelling or not, only then the fda was considered issuing an emergency use authorization which says were in the middle of a pandemic, the data looks really inconclusive and will allow this to be distributed but we still want to see more in term of longterm followup to ensure no other consequence and eventually a bla that the company would get and they would have full approval, all of those have to be done first, youre asking where are we now, the first two vaccines it got started the end of july will probably get to the point where theres ds in these and maybe november and will say theres enough here in the companys better have a look, or they might not because we dont know, remember vaccines are not usually 100 effective, even the very best vaccines like measles is 96 effective if you look at the flu, a lot of times the flu vaccine is no better than 50 , fda is not going to approve a vaccine that has less than 50 effectiveness. We have no way of knowing until we see the data, will they be like the measles or like the flu . Until you have the experience, we dont know. , im saying im cautiously optimistic that by the end of 2020 there will be one vaccine that is reached that stage of emergency use authorization but i dont know that for sure but it might not happen and it might take longer and one of the other vaccines is yet to get starteded and a few more in the pipeline that will start internet to be there, its a good thing that we have the diverse scientific approach in your bedding the whole thing on one vaccine id be a lot more hopeful. Thank you. The Associated Press working in partnership with Kaiser Health news is undertaken a substantive look at Public Health departments across the country and reports that they currently lack the staff, funding and tools to distribute administer and track the doses to 330 million people, how big a challenge is this going to be once we have a vaccine and how do you see that result. Thats a great question and a good thing were thinking about that now and not waiting until the end of the year, all of the states are required to send their plans to the federal government a few days ago about how they would do the distribution part looking ahead at what logistics would need to be addressed, the distribution to the states across the localities that are needed has been pretty well mapped out already between the companies that will be making the doses and they know what the capacity is going to be and then the distributors, lets be clear, this is been done before, its not the first rodeo, the cdc oversees it for the influenza vaccine every year and 80000 doses, im sorry 80 million doses go out there in a typical year, the framework for achieving this is something that we have it already had, they will have to build on, i just think the questioner was right to point out this will be a stretch, we have unfortunately underfunded under supported Health Department in this country, they have been allowed to slip into a phase really very difficult Financial Stress because it has not seemed like a priority and now here we are in the departing theres going to need to be a lot of attention on how to do that, and any of the efforts that looks like, were looking at that right now, thats the whole process that is going to happen. You talked a few minutes ago about being in the third bump of the first wave, what do you attribute the current rise in coping and cases across the country and i just suggest the increase in schooling, pandemic, the fatigue, combination of all of those and more. Its a combination of all of those and more and i think the ones that you can really see what happenedd are often an indoor gathering, sometimes people who were tired of the pandemic and wanted the party and a Family Reunion or wedding or choir practice and without stranded attention and not congregating indoors is so easy for this to happen and then you have a super spreader event where you said estimates suggested that part of the reason why youre seeing so much covid19 in the dakotas, go back to the harleydavidson gathering, im a harleydavidson motorcycle rider, i dont want to talk about bikers but this was not a good thing 500,000 people gathering without masks and congregating in bars and having no concern and clearly there was infected people and everybody got on their bikes and went back to where they came from and spread this around, we cannot afford to do that its pretty clear theres holidays, memorial day, july 4, labor day are often followed two or three weeks later by the spiking cases, as they said at the beginning there is no hightech solution to this right now, we are looking at one the vaccine with a lowtech solution which rest on the shoulder of every american, if you could be the one that is spreading this, do not do it, wear the mask, avoid the close proximity to others, 3ws, where your mass, watcher distance, wash your hands, keep that in mind, that applies not just to Vulnerable People but to young people who may think their immortal and they can be the one spreading this to their neighbors, their grandparents and resulting in a terrible outcome, i am afraid that the pickle we are right now, we have not figured out how collectively to turn this into a circumstance where we can lock the cases down to a baseline. Given everything that you shared with us how you act and respond to the questioning of science by politicians, pundits and a substantial percentage of the population, what impact is that happening as a result. It is troubling at a time where i think in many ways our best hope to get passes is to depend on the full power of the Scientific Method and reliable methods of treatment and prevention and yet there is a lot of suspicion of whether science is something to reflect none other than the fact that we have a great deal of suspicion about everything and a great sense of division between the trial attitudes and scientists probably come across as the elitist who think were smarter than everybody else and maybe we dont do a good job of communicating what we do and why we should trust it, on top of that we have cancer of social media conspiracy which come at you 24 hours a day and many people basically has that is their main feed of information, some of the conspiracies are outrageous and yet they seem to acquire followers who become quite convinced that that is a source of truth and its hard to turn away from that and that becomes part of the way you look at the world, its kind of a perfect storm, p our culture beg a bit of a fathom of difficulty and divisiveness and a source of information that is unregulated and can spread false information almost more rapidly than the truere information and scientiss are seeing distant for what real people are experiencing, ive a lot of work. When i look at the attitudes about the vaccine and who would be interested in taking it, its really troubling i been talking optimistically about how were likely to have a vaccine by the end of the year but is only 50 of americans interested, we will never get to that point of immunity across the population were covid19 goes away, it could be here for years. You mentioned tribal attitudes, and it. Where science is being questioned more than other times, you been in the business a long time or does it just feel this way because this is the top story of the news every minute of every day. I dont want to make the mistake saying it came out of nowhere because it certainly has been a problem in other areas so i look at the whole debate about Climate Change and it does seem americans have gone polarized about that in the Scientific Community would be absolutely deceptions aligned with the perspective that the Climate Change is very real in a result of human activity and is a threat to our planet with a substantial force for the coming years and we need to take action now and the general public for the most part has not really seen it that way, weve been in this issue for a while where theres a scientific Conclusion Even when its supported by evidence and it doesnt necessarily receive a warm public embrace and attends to map across divisions the tribal and how Climate Changes done and much of the discussions about whether you should wear a mask. You have a very warm and easy to understand the methodology of explaining things related to what we were talking about, perhaps one of the great challenges scientists are facing today in translating their research and finding to the larger population, getting this down to understandable levels i dont want to use the term average but for more people so that they get in simpler terms what we are doing with. I recognize not all scientists are good at that cup but im fortunate to be surrounded worldclass in that regard Anthony Fauci in this particular context because there is somebody who is one of the most highly respected Infectious Disease experts in the world and i could have a conversation with tony any run circles around me with what he knows and specific into specifics of the scientific information, and any setting ive ever seen him take the complicated and turn them into compelling evidencebased conclusions about what Public Health majors we should be undertaking without a spin attached to that, we need dr. Fauci, we dont have enough of it a lot not enough experience and to go back to terminology that is offputting because people dont quite understand a four syllable word and what its supposed to mean, we have not done a great job in educating our scientist about how to communicate what they do, theyre excited and they want to tell the story, we are working harder at that with our graduate students and our trainees to get People Better prepared to be able to do an elevator speech about what youre working on, we are working on, that is since not widely successful. At one time journalist walter was considered the most trusted man in america and as you mentioned you have an employee dr. Fauci who today is considered by many to be the voice of knowledge and reason, how do you go about defending dr. Fauci against some of the criticism that he is receiving for effectively doing his job. I dont have a problem defending him, its pretty easy, i say this is a dedicated Public Servant with a broad and deep knowledge about the problem we are facing in somebody who completely is devoid of political connections and served six president s, you can trust him because he has the track record in the knowledge and if you did not like what he had to say, okay look at the facts and try to figure out what we should do about that but it is somewhat distressing to see how its demonized tony for telling the truth and now he has full time security around him because of the threats he and his family have received, i did not expect to see that in the midst of this crisis but here we are its a reflection of how intense the feelings have become. One of the challenges for journalist and the 24 7 news environment is the pressure to bypass the traditional process which is gather, sort, report and instead rush information out and not gone through the sorting process, with this rush to find a viable vaccine for covid19, are we seeing a similar gather report and sort process playing out with the research, and other words is the public, seeing, hearing and leading about the process of the sausage making so to speak that would normally play out behind the curtain and is that more confusing, is that exciting, what are your thoughts on that. On the Positive Side i would say its great for the public to have a window into how this all works, you are right this is never had the attention and scrutiny in the public eye as this particular set of steps in developing a vaccine has now led to stories in the press all ovee the place, i would bet until a few weeks ago most reporters and most members of the public had no idea what a dsm b is and now its on the front page that it might be meeting soon to look at interim data at the vaccine trial, this meeting yesterday, i think it was covered on cspan, this is one of the government committees that most people would hardly want tobl spend fie minutes and yet six hours, the good part, we ought to be transparent, people ought to know exactly what we know, what we dont know and see what the processes, i love that part but is challenging for the press to think about the stories, ive been very impressed for the most part for the way in which the press has tackled the situation and talking to reporters im always glad to and they are diving into the and theyre not just buying the first answer that comes to the first person that they speak to, they are quizzing and asking questions and they dont quite see it that way, thats a pretty good thing and if you look at the mainstream press, theyre doing a fine job of telling their story at a level of details that youve never heard before. A question from ron, there seems to be a small group of covid19 patients that continues to experience symptoms longte longterm, some have symptoms that mimic other illnesses, can you comment on whether you looked into this and what can be done to help both patients and groups. I appreciate the question and ive spent several hours in the last 24 hours working with my Institute Director colleagues on a plan to investigate more intensively because there is something going on that isst que troubling, the people who had covid19, maybe people had mild versions arent Getting Better, not all of them when you think they were, you get the influenza bug, a week later, there is a subset of people called the long haulers who seem to not actually recover for weeks at a time, they are still fatigued in shorter breath, if you do various analyses of their body function we start uncovering things that are troubling to see, for instance a study published a couple weeks ago look to ohio state athletes, these are people in tip top shape, women and men who had covid19 and then they looked at them a few weeks later by a very sophisticated cardiac mri setting, only half of them did not have normal cardiac function in about one out of seven had frank mild, an inflammatory problem of the heart muscle, that was not expected, if you look at people older who have been sick or the frequency was even higher, are those going to get better, we do not know yet but its alarming to see what kind of consequence wreaks the illness, or people of brain fog which is very troubling that can linger weeks after we dont know what thats about is it because of inflammatory or they had a vascular event because we know the virus can make blood clots happen, we dont know. This will be a very critical thing to put effort into the understanding we need more data to understand out how common, consequences, how long does it linger, how do we prevent it and identify people with the highest risk they dont have consequences and intervene, i dont have good answers, this will be one of the longterm questions that we will wrestle with for a while. Thank you, a question from andrew show, would you talk about the characteristics that differentiate the generation vaccine candidates especially what makes the candidates more suitable for distribution to specific populations. There are several different technologies that are being studied for Vaccine Development, among the ones the operation work speed has chosen for the Largest Scale are three different things, one that got there first the new approach we basically no the actual rna sequence of the virus and you sympathize the same rna its in rna code for spike protein and when you put that in muscle you injected into the muscle and the muscle says im going to make a protein and it makes a spike protein in the immune system says i know what that isit all making antibody and there you go, this is very rapid because you dont have a lot of work to do, its wrapped up an envelope and thats why the first one getting into the phase of the trial but no mnr a vaccine has ever been approved by fda, this is a new technology, the next step the vaccine that is being put forward by Johnson Johnson in the astrazeneca are based on using a virus as a carrier for the gene, this is an approach that was successfully used for ebola, its ah vaccine vector ad its effective and we will see how those go, and then two more are based upon a simple idea, to purify the spike protein, figure out how to make and use it as a thing that gets the vaccine and left out with the immune system taken on, those coming from novavax and gsk are slower getting trust because those are harder and a few other ways as well the people have done this such as kill the virus or inactivate the virus, chinese are doing not, we are not seen those at the moment and some concern about safety circumstance, all have different pros and cons from a good thing we are not putting all her eggs in one viral basket we are trying to diversify the approaches and increase the likelihood that one will work. We had a followup question and i will ask her not sure whether you cover this in your first answer, would you please talk aboutir the inclusion in covid trials and nextgeneration vaccines. Great question, it is basically a molecule that activates the immune system to react to something more strongly and we use them with lots of vaccines to get a vigorous response, yes the last two vaccine platforms for the vaccines that i mentioned coming from novavax those of the protein and they involve. Thank you we have a question from bob who wants to mention that his spouse was at nih for 11 years, they both admired your work and they are thrilled to have you with us, is covid driving Research Support down for other critical illnesses and like cancer which killed hundreds of thousands in the u. S. Annually. Thats a very important question and theres no doubt about the fact that this pandemic has had consequences for research inn other areas, take cancer for instance, the lot of research on cancer that is required looking at a lap it has to be slowed down because researchers to keep himself safe for having to work for home and most of us dont have that at home in my own Research Laboratory at nih another ten people that work on diabetes and aging pretty much had to go home and they gradually come back, everything that involves that benchmark and in terms of things that involve Clinical Trials or the need to enroll somebody in a trial because people were uneasy coming to hospitals and clinics, those trials are slowed down and that is for cancer and a lot of other things as well, sadly that has been a consequence we are trying to keep the effort going as bests as we can in bringing back very carefully as many staff as we can to be sure that were doing in the next few month, this is not over, what is necessary to keep the i momentum going, theres no question one of the sad outcomes of the pandemic will be a slowdown in research and other things that we thought were going to be going really fast. Thank you, two questions from isaac, the first question what is the militarys role in distributing a vaccine. The military has been an incredible supporter of operation work speed, general who is overseeing a lot of the logistics and supply chain issues has quite an impressive expert in that state and gotten to know a number of folks in the distribution from what i understand, no member of the military will touch on their way to 70s arm, basically the doses will be manufactured by the companys in the facilities, they will be shift that is not military and they will end up an appropriate distribution places, much of it managed by a company onto pharmacies and doctors offices, while the military has been incredibly helpful in designing the logistics of making sure we would not have shortages of needles and vials, they will not be involved in the actual distribution of individual dose. Second question from isaac, how will the Pfizer Vaccine be able to reach rural and remote areas given the altar cold storage requirements and large minimums shipment size of a thousand doses. At a very sophisticated and important question, the Pfizer Vaccine requires degrees to keep active and thats not going to be trivial to achieve in places that dont have freezers waiting to keep it kept at that temperature, we have to figure out how to do it in ways that people have plan, if pfizer approves will have to make it work, on the other hand if we end up with more than one vaccine that turns out to be safe and effective we can imagine the distribution plan, in that regard i think a lot of us are watching closely to see the Johnson Johnson vaccine which is been on a pause in a start up again because it has real advantages, the single dose all of the other vaccines were talking about our two doses in trying to do something for people as far away for the medical care facility and also the j j vaccine will not require much coaching, itll be all right. Researchers and labs worked entirely this year in a race to develop a viable covid19 vaccine some of the greatest scientific discoveries have happened by accident while trying to develop Something Else are there any new discoveries being made in the develop of the covid19 vaccine that are particularly exciting to you. Thats a good question, we are looking for those moments of serendipity that something happens that you did not expect that you dont want to walk away from, i immediately point tuna example that in the diagnostics another part of what im trained to do with the program which stands for rapid acceleration that we have been encouraging Small Businesses and academics with ideas and how to develop new ways to protect the presence of this virus either nasal swab or a saliva sample to bring those forward and we put those in the shark tank, thats a term that the senators have applied to it in the Small Business or academic investigators and they get act to defend their idea in a panel of businesspeople and engineers and technology and supply chain experts and only a small fraction will get through in justins end of april and its breathtaking that those are being scaled up and getting ready to deploy, we all heard about christopher cabinets efforts to use edison the nobel prize, a couple weeks ago it turns out there was diagnosis two, its really good searching on finding a particular complicated mixture, and were trying to decided the virus needs a swab, that is very interesting, i dont think we will see that were inventions happening without the motivation and we will in the future have better ways of making vaccines because of what we have learned, we will have new platforms for doing diagnostics of other Infectious Diseases because of what weve been able to encourage this is not just a oneshot funeral, this will have some spinoffs and maybe the next time the board will be a little better. A question from a member, there have been reports of a possible link between blood types in kobe, said he should just people with type o blood may have a lower risk of infection and a reduced likelihood of severe outcomes, what can you tell us about this. That is a finding based upon a study done in europe, basically what they did they look to people that got very sick with covid19 and other people who got it that werent really that sick and they studied their dna and said is there something different, it turned out that the group people erwere less likely and the blood type a, it was not yet known, its not a big factor, it was statistically, then they scanned and im not sure the final answer but there seems to be a segment of dna with predisposed people to get more sick, they went and looked at that particular piece of dna and this is one of the 4 from the case of the neanderthal, what you know it happens to be inn that space and im going to take a big league, who has neanderthal dna, pretty much everybody because the neanderthal crossbreeding happened in the middle east and did not get back into africa, everybody came out and they did not go back, maybe this explains why so far covid19 despite the great fears many of us had has not been as devastating as it had been. That is a big leap. Here is the question from mike fulton with the who where the initiative to approve the code vaccine and as we know is has opted out of that collaborative effort do you believe this is a strategy . And what are the potential consequences . And then to try to correlate that development will held to work with turned national colleagues. We are pitching to do it with or without this framework and we are making sure we are playing the best hand we can see. But we do is a Vaccine Development helps americans we have a responsibility to the whole world in places that dont have their own resources that have lots of when he you think about them as we are going through the process on how to make enough doses are ready who needs one gets it and im happy to say the companies where working with have the same view. We are going to be citizens of the whole Global Health arena not just the United States. Theres a final question and this is a bit more philosophical for you. You said the principles of faith and science are complementary and as a young man exploring your own faith he eventually concluded atheism was the least rational choice because it takes the position of asserting a universal negative would scientists in general are discouraged from doing. Do you think your faith has made you better at your job . A lot of peoples faith has been shaken this year. What has helped you keep yours . Its a wonderful question. I was an atheist as a graduate student and as a medical student encountering people who are facing another lies in the realize they hadnt given it much thought on the serious issues on why were all here and what happens after you die and all of those questions that generally get shoved aside when you are young person and i became a believer in my late 20s. That is very much a part of who i am and a time like this faith is more important to me than ever. I dont understand how integral things are happening around us. I can kind of understand how it started with the transmission od this virus to a human and it says something about how we ought to be more careful about mixing together our garment of animals and people but now that its here i can feel this sense of calm to do everything i can to help put that in the people around me and for me thats a calling thats not just based on a secular view but also a perspective of faith. When i get up in the morning at 5 00 a. M. The first thing i do is try to reconnect with that spiritual part of who i am before i get plunged into all the daily challenges of what is coming at me. Maybe theres something about this terrible crisis that in some way can cause all of us to reflect a little bit about not just the material parts of life but the spiritual parts of who we are and who we want to be a what kind of calling do we have to help out those who are suffering and itll be some kind of comfort. Where did that come from . For me it comes from faith and comes from going back and reading the beatitudes in matthew five and six and its an anchor that helps me. We will allow that to be our final word today. Dr. Francis collins thank you so much for joining us. It was a pleasure. Thanks for the chance to be on this program and answer as many of you ask questions as i could. We are pleased to present you with our National Press club coffee mug rate we will get this to you along with their hoping youll join us again in person in the very nearr future. I look forward to that. Thank you good luck and please be safe. We need you sir or that thanks to producer lindsay underwent in our Headliners Team coleaders diana and laurie russo entered Wonderful National plugs press club in the operations center. Banker members and guests for your questions and for joining us. Stay safe and have a good day. Same of the candidates running for indiana governor incumbent republican governor eric will come democrats meyers and libertarian donald rainwater take part in a televised debate sponsored by the indiana debate commission. Live coverage begins at 7 00 p. M. Eastern on cspan2