Transcripts For CSPAN3 Dr. Redfield Dr. Fauci Others Testify On Coronavirus Response 20240713

We have a change in schedule. As we explained in the hearing memo, we were planning to do Opening Statements from 9 30 to 10 00 and testimony and questions from 10 00 to 1 00. This morning we were informed that President Trump and Vice President pence have called our witnesses to about emergency meeting at the white house. We dont know the details just that it is extremely urgent. Now the witnesses have to leave at 11 45. In light of the sudden change we will significantly reduce Opening Statements. We will do 10 minutes so we can get right to questions. Witnesses, please keep your oral statements as brief as possible. At 11 45 we will recess the hearing and work with the agencies to determine when the witnesses can return. With that i recognize myself for a few remarks. I want to thank everyone for being at this hearing. Our thoughts go out to everyone and our colleagues representative meadows and representative gosar who cannot participate here today. Were now in the middle of a Global Health crisis. Our response must be swift, coordinated, and based on science and the facts. That is what we all want on a bipartisan basis. Unfortunately when we look at the last three months objectively, it is clear that strategic errors and a failure of leadership failed to keep us safe from this outbreak. Lets start with testing. The Trump Administrations testing for the coronavirus has been veerly inadequate. Resulting in a substantial deficiency to determine who may be infected. The cdc has testing 4900 people. South korea has now tested more than 196,000 people but we are not anywhere close to that. They started conducting drive through testing, but people here in the United States cant even get tested by their own doctors. This is the United States of america. Were supposed to be leading the world instead were trailing far behind. How did south korea test so many people so quickly but we didnt test a fracture of that number. Why did it take so long . We must do better. Unfortunately these delays have been systemic. Just last week the Trump Administration promised to clever a million tests by the end of the week but it didnt even come close. On sunday they admitted they delivered only 75,000 tests, thats over 900,000 tests short. And this was their own stated goal to the American People. Now the Trump Administration is saying they have distributed a million tests and they will be distributing four million by the end of the week. That is difficult to believe given their record. We need facts, we need information, and we need it quickly. If we dont have testing, we dont know the full scope of the problem. And if you dont test people, you have no idea how many people are infected. We dont even know where the transmission is happening. We dont know where e to direct resources. Were operating in the dark. My question is whether or not the administration and President Trump is exacerbating the crisis by down playing it over and over again we have heard blatent misstatements. He said the tests are beautiful, he was absolutely wrong. My constituents are telling me they cant guest tested. The same at larry kudlow who said we have contained this, i wont say airtight, but pretty close to airtight, the business side, the economic side, i dont think it will be an economic tragedy at all. The numbers are saying that the u. S. Is holding up nicely. He could not have been more wrong. The stock market just had one of the worst weeks in history with the single biggest point drop in all time in history. The president and his aids may think theyre helping with political spin and happy talk but the American People want the truth, we need the facts, we need accurate information. The cdc now reported more than 647 cases against 36 states, but according to experts, the real number is far higher. My home state of new york has 173 confirmed cases and every member of congress is worried about their constituents. As we proceed this morning i would like to recognize several of our Sub Committee chairman for their tremendous leadership. It is truly a team effort. Chairman lynch held a hearing last week on the nations bio defense capability. And chairman connolly has been working with states and localities on the front lines of our response efforts. I now recognize our distinguished Ranking Member. I would like to express my regret that he is moving to chair another committee. Thank you to my witnesses for being here today and for all of your hard work. We recognize that your task is ongoing. So and the important work that youre doing to help combat this. I also want to express my con toll le doll le condolences for those that lost people. And i hope our experts will explain today the risk to the American People contracting the coronavirus remains real. We must continue the best practices to main tine good hygiene. Second, avoid crowds as much as possible and stay home if youre sick, and third we can protect ourselves from the virus like other viruss. All good common sense protocols and procedures we should be implementing. They all make sense and they should be applied. When the threats started to emerge from china, President Trump recognized the danger to American People traveling there. So that was an important time to get a head start in preparing for the virus here. We have seen clusters of communities where people have become sick without traveling to affected areaed in the world. There are important steps we can all take to prevent Community Spread. Today i look forward to specific recommendations to prevent the spread of the coronavirus. And i want to thank the president and Vice President for repatriy try the innovation drives our economy also helped to advance innovations in Public Health. They are developing test kits around the country. Over a million test kits have been sent out to date and i hope with can learn more about the efforts to increase the test kits that will be deployed. We should also understand that it will include cases around the country. Lastly i want to say that often times in this committee we disagree on many hot button issues. We dont always see eye to eye, but on this issue i think we should all Work Together for the health and wellbeing of every american. Now is the time for us to come together and work to help all americans. With that i would like to thank our witnesses again for their work. Were grateful to them and their teams. Madame chair i yield back. Thank you, i would like to begin by introducing our witnesses today, the director of the National Institute of allergy and Infectious Diseases. He is truly americas doctor, were honored to have you testifying today. The assistant secretary of preparedness and response department. Thank you for coming, and dr. Robert redfield is the director for the center of Disease Control and prevent. And the acting Deputy Assistant secretary of defense for health readiness, policy, and oversight at the department of defense. Thank you for being here and mr. Chris curry is the director of emergency manage and national preparedness. Thank you for being here. I will begin by swearing the witnesses in. Do you swear or affirm the testimony youre about to give is the truth, the whole truth, and nothing but the truth so help you god . Let the record show they answered in the affirmative. Thank you and please be seated. The microphones are very sensitive. Speak directly into them and bring them closer to you. Your temperature will be part of the record. We appreciate your service and with that, dr. Fauci youre now recognized to provide your testimony. Thank you very much chairwoman maloney. Thank you for calling the hearing and for giving me the opportunity to speak to you for a few minutes on the role of the nih and the Research Involved in addressing the 2009 novel coronavirus. They are on the path to understanding how these viruses work and to develop Counter Measures. I would like to refine me remarks to two accents. The development of vaccines and the development of Counter Measures in the form of therapeutics. With regard to vaccines that i mentioned publicly many times, we were able to quick gloi from an understanding of what this was to what the genetic swens was to developing a vaccine. But there is a lot of on fusion about developing a vaccine. We are going to go into a faze one Clinical Trial to determine if one of the candidates and there are more than one, there are probably ten or so that are at various stages of development. The one that were talking about is a platform called messenger rna that is a prototype for other types of vaccines that are multily bei simultaneously being developed. Getting into faze one is the quickest they have ever done, but the process of developing a vaccine is one that is not that quick. It will bring us three or four months down the spikpike and th you go into phase two. Since this is a vaccine, you dont want to give it to normal Healthy People with the possibility that a, it will hurt them, and b that it will not work. So the faze of determining if it works is critical. That will take another eight months or so. So when you heard me say we would not have a vaccine that would be ready to start to deploy for a year to a year and a half, that is the time frame. Anyone that thinks it will go quickly than that, i believe they will be cutting corners and that will be debt de detrimental. E let me go on quickly to sharp. The time line is dempt. The reason it is different is that youre giving this candidate therapy to someone who is already ill. So the idea of risks and how quickly you determine if and when it works is much more quickly than giving vaccine to normal people and determining if you protect them. There are a couple candidates now in Clinical Trial. Some of them in china, some of them right here in the United States. Particularly in some of the trials that are being done in some of our Clinical Centers including the university of nebraska if is likely that we will know if they work in the next several months. Im hoping that we do get a positive signal. If we do and we may, and i underline may, have therapy that we could use. But that needs to be proven first. So in summary, the development is involved in the development of the vaccine in the long term and in the development shorter term. I would be happy to answer questions after all the presentations. Thank you. Dr. Redfield, youre now recognized for your testimony. Thank you very much. Good morning, chairwoman maloney, Ranking Member jordan and members of the committee. Thank you for the opportunity to share cdcs role in the u. S. Response to this novel coronavirus. Cdc is a sciencebased, datadriven organization. Science and data drives our Decision Making and will continue to do so as we form changing guidelines and recommendations. This is a new virus, and many uncertainties remain. Our Public Health response must be flexible. From the outset, cdc and the u. S. Government partners implemented an aggressive, multilayer strategy to slow the introduction of this virus to the United States, to buy time for our scientists to learn how this virus behaves, to prepare our nations Public Health infrastructure and Health Care System for the possibility of a Global Pandemic that would impact your communities, and to educate americans how best to prepare for eventual disruptions to their daily life and the potential risks to their families. The administrations interagency containment strategy relied on evidencebased Public Health interventions. Initially, early case recognition, isolation and Contact Tracing. Travel advisories and targeted travel restrictions, the use of quarantines for individuals returning from Transmission Hot zones, including china, japan and now the grand princess. Absence of immunity and treatment, our nations Public Health response has relied on traditional Public Health activities. As i said, early diagnosis, case isolation, Contact Tracing and targeted mitigation to slow the emergence of this virus in the United States. On february 25th, this global outbreak reached an inflection point. This was the first day we saw more cases outside of china than inside of china. We observed rapid widespread persontoperson transmission in iran and italy and long before the first case of Community Spread in california. Science and Data Collected from here in the United States and abroad are reviewing certain characteristics about this virus. At first, the chinese scientists reported fewer than 30 cases of pneumonia confined to one province, hubei province. Today theres more than 110,000 cases worldwide and yesterday, 99 of the new cases that occurred in the world were outside of china. This virus spreads through respiratory drop llets, sneezin coughing, and hand contamination. Reports out of china looked at more than 70,000 individuals with this infection and found that 85 or 80 of the patients actually developed mild illness and recovered, while 15 to 20 developed serious illness. Children and young people seem not to get sick. This disease disproportionately affects older adults and particularly those with serious Underlying Health conditions. Two months ago, chinese science shared the genome sequence with the world and within a week, cdc scientists developed a diagnostic test that is being used in more than 75 Public Health labs across 50 states with the capacity in the Public Health system to test up to 75,000 people. As of today, cdc has received confirmation of more than 990 cases of covid19 in 38 states, plus the district of columbus. Its with Great Sadness that i report now 31 deaths in the United States. As we experience the growing Community Spread in the United States, the burden of confronting this outbreak is shifting to states and local Health Professionals on the front lines. We appreciate your support to increase the Public Health capacity of your communities and our nation. Difficult, critical conditions are being made to mitigate the spread and cdc continues to provide guidance and support as requested. Theres not a onesizefitsall approach to the mitigation decisions that need to be made. They need to be made based on local Health Authorities and leaders. 630 staffers have been put in the field to support the Health Departments and repatriation efforts. We will continue to work 24 7 to protect the American People from this significant Global Health threat. Thank you, and i look forward to your questions. Thank you. Dr. Radley, youre now recognized for your testimony. Thank you, chairman maloney, Ranking Member jordan and distinguished members of the committee. My remarks will be very brief. In some ways we want to retain all the time for your questions. I do want to acknowledge the vital role congress has played in this outbreak that began 2002 with the passage of bioterrorism act that created possible Preparedness Program that i manage as well as a number of other critical pieces of legislation, such as project bioshield, the pandemic preparedness hazard act and most recently pandemic preparedness act and finally the public readiness Emergency Preparedness act. All these tools that you have given us have been vital in confronting this virus and this current outbreak. I want to acknowledge the role that additional monies you provided in supplementals for the h1n1 pandemic in 2009, Ebola Outbreak in 2014, that helped us create a National Ebola Treatment Network thats been vital to manage and care for patients who have been aflikted with this disease. As far as my role in this activity at this point in time i have four principle functions. My first and foremost responsibility as we transition from containment of this disease to a hybrid support of strategy and containment is for the health and Human Services to ensure we have a unified, coordinated, synchronized effort across hhs and the u. S. Government consistent with the National Response framework and Emergency Support function number eight for medical Health Preparedness and response. I also basically support the Health Care System through the hospital Preparedness Program and our regional Disaster Response network that weve created with your support. And then thirdly is basically work with nih, with fda, with our d. O. D. Colleagues to accelerate the development of therapeutics, diagnostics and vaccines that could be used in this outbreak and, finally, providing direct support to state and local entities and during this most recent event with the grand princess that is now docked in oakland, were working directly with the state of california, the city of oakland and with our interagency partners to safely disembark all those passengers, american and nonamerican, and manage the crew to ensure their safe return to their homes, more importantly protecting the communities that will be receiving these individuals. So, with that, ill yield the remainder of my time back to you, madam chairman, and thank you. Thank you very much. Dr. Rasha, youre now recognized for your testimony. Chairman maloney, Ranking Member jordan and members of the committee, thank you for this opportunity. To address covid19 outbreak, we immediately disseminated beginning early in the outbreak and continue to issue a series of guidance as the issue evolves. The Department Remains aligned with guidance from the cdc while allowing limited location and command flexibility, as required by mission or local circumstances in the area of self protection, the department issued initial guidance on january 30, 2020, that addressed the Current Situation at the time to risk to d. O. D. Personnel, individual prevention and protection measures, health care information, patient screening and isolation information and information on diagnosis, treatment and reportable medical events. The guidance also listed the cdc travel advisory level for china and referred to the cdc criteria for identifying a person at risk or under investigation. The guidance also directed personnel on actions to take if they suspect they have an increased risk of exposure due to travel or close contacts. Following the initial self protection guidance on february 7, 2020, we issued guidance for monitoring personnel returning from china. This guidance remained in step with the cdc and provided further measures to prevent the spread of the disease. Furthermore, the guidance directed the identification of Service Members and a 14day restriction of movement and monitoring of Service Members returning from Mainland China after february 2nd, 2020. It specified actions by the Service Member during their restriction of movement to reduce a potential spread of disease. The guidance recommended the d. O. D. Civilian employees and contractor personnel and family members returning from china follow existing cdc guidance. On february 25th, 2020, the department issued additional guidance, providing a risk based framework to guide commanders in implementing Health Protection measures based on local circumstances and their command mission. The entire series of self protection guidance may be found on our defense. Gov website. As the department assesses and manages risk to personnel in mission, the capability to diagnose covid19 to help track disease spread is vital and one important factor is diagnostic testing capabilities. Currently the department has 13 labs approved to perform covid diagnostic testing. The department is also working quickly to develop Expeditionary Lab kits that can be used in the field military environment to mitigate risk to the force and mission. Finally, as we know, there is no vaccine to protect the force. There is no antiviral to treat the force. Therefore, the department is working on several vaccine initiatives and an antiviral treatment to protect and treat the force. This is in collaboration with the interagency efforts. Im grateful for the opportunity to provide further detail on our efforts to contain and mitigate this outbreak. Thank you to the members of this committee for your commitment to the men and women of our armed forces and the families who support them. Thank you. Mr. Curry, youre now recognized for your testimony. Thank you, madam chairwoman and members of the committee. Oversight of federal agencies. What i want to do is talk about two things. First is the report we issued two weeks ago on bio Defense Strategy and second is to offer some observations based on decades of work weve done looking at past pandemics, outbreaks and public preparedness. Weve been concerned about the u. S. s preparedness for these type of events. Unlike cyber events or natural disasters, they are rare, which makes it incredibly difficult to maintain focus on these types of things and avoid complacency setting in once an outbreak is contained. Theres over 2,000 president ially appointed agencies that have some sort of roles and responsibilities in biodefense. So coordination is zreemly difficult at the federal level let alone the state and local level as well. In 2018, according to our assessment, the most comprehensive to date that we have seen. It does a good job of defining roles and responsibilities and steps agencies need to take to better coordinate. We did identify some challenges we were concerned about. One of those is we still dont see a good mechanism across agencies to coordinate budgets. Dhs, cdc, hhs, they all have separate budgets. They cant tell each other what to do or how to spend their money. Some sort of central oversight mechanism is critical and we recommend they take steps to address that. I would like to pivot and talk a little bit about the current outbreak and make it clear we dont have enough information to conduct an assessment in the middle of the response. Its kind of difficult. Some of the challenges were seeing in the public are highlighted by decades of work weve done over the years, and past outbreaks and, frank ly, things weve been concerned about. If we had a large domestic outbreak here in the u. S. Roles and responsibilities across the government. While i think its pretty clear up front that the Public Health emergency, hhs, is the lead, many questions are still being raised about the roles of other departments, particularly as this becomes a bigger domestic issue. Department of homeland security, questions have been raised about whether a declaration should be brought into play, like a natural disaster, to bring in additional funding and authorities that that provides, who communicates with the public at the federal, state and local level has been a challenge. This is something weve pointed out before. On the issue of testing, you know, we have pointed out that hhs has provided over 20 billion since 9 11. That number has decreased over the years. I think that this is a direct correlation to the investments we make in preparedness. And, again, its very, very difficult to sustain these, given other priorities, when we dont have outbreaks all the time. The last thing i just want to mention really quick is moving forward, as we conduct afteraction reviews and exercises. There have been afteraction reviews done after prior outbreaks. What we see in the Emergency Management field is often the afteraction reviews are conducted really well and then once the outbreak is stopped or the disaster is over, theres no followup on the gaps that are identified in the years to come. This completes my prepared remarks. I look forward to your questions. Thank you, all, for your testimony. I now recognize myself for questions. I want to ask about testing. Ive been asked over and over again why the United States is so far behind other countries and why the American People cannot get tested. Our first case of coronavirus was on january 21st. The u. S. Has tested approximately 4,900 people so far. In contrast, south korea has already tested almost 200,000 people. They can test 15,000 people a day. South korea can test more people in one day than we tested over the past two months. So, dr. Fauci, why are we so far behind korea in testing and reporting this crisis . Thank you very much, chairwoman maloney. I would i dont like to pass the buck, but dr. Redfield has the numbers, and a little map he might want to show you about that, because i dont have that in front of me. Okay. Is the worst yet to come, fauci . Yes, it is. Can you elaborate . Whenever you have an outbreak that you can start seeing Community Spread, which means by definition that you dont know what the index case is and the way you can approach it is by Contact Tracing, when you have enough of that, then it becomes a situation where youre not going to be able to effectively and efficiently contain it. Whenever you look at the history of outbreaks, what you see now in an uncontained way, and although we are containing it in some respects, we keep getting people coming in from the country that are travel related. Weve seen that in many of the states that are now involved. And then when you get Community Spread, it makes the challenge much greater. So i can say we will see more cases and things will get worse than they are right now. How much worse well get will depend on our ability to do two things, to contain the influx of people who are infected coming from the outside and the ability to contain and mitigate within our own country. Bottom line, its going to get worse. Well, bottom line, mr. Fauci, if we dont test people therngs we dont know how many people are infected. Is that correct . That is correct. As im sure dr. Redfield will tell you, looking forward right now, as commercial entities get involved in making a large amount of test kits available, two aspects of testing. One, a person comes in to a physician and asks for a test because they have symptoms or a circumstance, which suggests they may be infected. The other way to do testing is to do surveillance. You go out into the community and not wait for someone to come in and ask for a test, but you actively proactively get a test. We are pushing for that. As dr. Redfield will tell you, that the cdc has already started that in six sentinel cities and will expand that in many more cities. Youre absolutely correct. We need to know how many people, to the best of our ability, are infected. As we say, under the radar screen. Now im about pardon me . I really want to get to south korea and their 50 mobile testing sites that theyve set up where people can drive up, get a quick swab, get a test and results in two days. This is a question to dr. Fauci and dr. Redfield. These centers minimize interaction between patients. It helps mitigate the risk, and why havent we set up these mobile labs . Are we planning to set them up . Dr. Fauci and dr. Redfield . The nih in no way would be responsible for setting that up. I cant tell you. Dr. Redfield . Just to say very quickly, cdcs role in this was we very rapidly, within almost seven to ten days, developed a test from an unknown pathogen once we had the sequence. And we did that because we wanted to get eyes on it at cdc so Health Departments across the nation could send samples to us and we would test them. We rapidly tried to expand that and scale it up with a contractor. So each Public Health lab in this country would have that test. During the Quality Control, one of the reagents wasnt working appropriately and we had to modify that with the fda. It took several weeks to get that completed. But the test was always available in atlanta if you sent us the sample to t there was never a time when a Health Department could not get a test. They had to send it to atlanta. Now we have 75,000 tests, over 75 Health Departments have the test. Dr. Redfield, how many tests are we planning to produce in the United States . Well, from a Public Health point of view, weve put out 75,000. The other side, as dr. Fauci said, which is not what cdc does traditionally, is get the private sector to get testing for patients. When the Vice President brought all the Testing Companies to the white house last week, we got enormous cooperation from them all to Work Together. Quest and lab corp are offering this test in doctors offices throughout this country. Its not for an individual just to take a test. They need to see a health care professional, have an assessment to determine whether a test is indicated and then get that test. In new york, just so you know, on february 29th, harold zucker, your health commissioner, asked if he could use our ura to get wadsworth approved. Fda worked with him in one day and got their lab up and running. Were working hard to get testing available. My role is to get it available for the Public Health system. As dr. Fauci said, start these large surveillance programs. On the other side theres a private sector to get it to clinical medicine. You will see with lab corp and lab quest out, those tests are rolling out. Will these private labs be reporting and are they reporting into cdc their results . We have set up now a Surveillance System. Are they reporting now . Its being worked as we speak today. The lab corp and quest will dump into our National Reporting base. My time is expired. And i recognize the distinguished member oh, he has left. Okay. I recognize the gentleman from the great state of tennessee, mr. Green is recognized. Thank you, madam chair. Thank the witnesses for being here. Im incredibly disappointed in the politicization of this covid19 response. The criticism that the president is undergoing is unwarranted at a minimum and absolutely maligns the hard work done over the years as our nations doctors, sciences, at places like the cdc, nih, faa, fema and dod has prepared for such eventuality. Make no mistake about it, that virus is a serious problem. It was shown by our president as evidence by his historic response i would like to take a second to correct the record. December 31st, wuhan officials posted the first notice saying they were investigating a pneumonia outbreak. On january 7th, the cdc established an Incident Management System just seven days later. On january 17th, cdc sent 100plus staffers to specific airports in the United States to screen all people coming from wuhan. January 21st, three weeks after the announcement, cdc activated its emergency center. January 29th the president established the president ial task force. January 30th, still less than a month from the initial announcement, the state department issued a do not travel warning to china. January 30th, World Health Organization announced the coronavirus is a Public Health emergency of international concern. Meaning before the World Health Organization even announced a global concern, the administration was working on its response for almost a month and had already established a president ial task force. January 31, President Trump proactively suspended entry of foreign nationals who had been to china in the last 14 days. On the 31st, the president issued quarantines and through secretary azar a Public Health emergency for the entire nation. On february 11th, the World Health Organization named the virus covid19. Let that sink in. The administrations first response, a week after the wuhan announcement. The virus hadnt even been named by the World Health Organization yet. It isnt named until day 42. Meanwhile, the cdc, nih and all the agencies of our Scientific Community with acronyms that boggle the mind have been working feverishly to sequence the rna of the virus, get its proteins messenger sequenced and get a vaccine going. February 24th, the president unveiled the initial plan. Yet according to the leadership of the other party, our president has failed us. Months of response and yet theyre accusing our president of failing us. On february 26th, the president appointed the Vice President to head the whole of government response. That appointment is in keeping with the 2015 obamaera Blue Ribbon Panel on biodefense. On february 25 29th, 60 days after the chinese announcement, sadly america lost its first victim to covid19. 53 days before america lost a single life to covid19, the administration was already working diligently to prepare our country. Youve heard the witnesses describe the herculean efforts their various departments are taking to protect the lives of americans. I want to thank the dedicated american women of cdc, hhs, fema and d. O. D. For the years of work thats gone into preparing for this type of effort and their tireless, 24 7 response since the announcement just 71 days ago. America will lose lives to this virus, but as was noted by obama appointee and former director of the cdc, tom friedman had, the president not responded so quickly, we would not have been prepared as we are and more lives would have been lost. Madam chairman, i yield. Thank you. I now recognize the gentleman from massachusetts, congressman lynch. He is recognized for five minutes and i want to thank him for his help in preparing this hearing. Thank you. Thank you, madam chair. Thank you to the witnesses. I want to echo the call for unity that was expressed by the Ranking Member earlier in this hearing. I am proud to say that every Single Member of this committee, democrat and republican, voted for 8. 3 billion to deal with the coronavirus. We all did so, i think, consistent with your request from our Public Health officials. I think america is best when we have a unity of purpose, a singularity of mission and we are all on board. That much being said, i have to say that the president s statements from the beginning of this has been contrary to the direction you have given us. The president , on march 6th, told the people in my district publicly that the tests were ready. Anybody who wants a test can go be tested. Theyre beautiful tests. Beautiful tests. Thats not a medical term. So, my constituents went to their local Health Centers and local hospitals. There were no tests. Zero zero and i know theyre rolling out now but this was back on the 6th. Thats not a good situation. He said this in front of some of you at a public hearing, at a press conference. And i saw no one step up and say, no, the president wasnt correct. The tests are not there. Theyre not ready. Theyre not beautiful. Theyre not available. So we need a unity of purpose but we are not going to get that when the president is telling people that the cases of coronavirus are going down, not up. They doubled yesterday in my district. Doubled. And i represent part of boston, myself and miss pressley share that city. Its not a backwater medically or technically. Its very advanced. The president has made some bizarre statements here. Look, i want to be together with my republican colleagues but when the president said he has an uncle who went to m. I. T. In the 1930s and he has a natural affinity and ability to this, it has to raise some red flags. We need you to step up. And, you know, dr. Fauci, youve been great on some of this stuff in pushing back. When the president said were going to get a vaccine fairly quickly, in a matter of months, you were good to step up and say no, its going to be a year and a half. But we really need honesty here. And when the president is making statements like this, we need pushback from the Public Health officials. You know, standing behind him and nodding silent ly is not going to get it. We really need you know, when i say things that are immediately considered political because im a democrat and im elected. But, you know, you have a certain level of credibility and honesty that i think that should be perfect sidewaysive to the American People. So i just ask you to be more forthright when the president makes statements like this. We need leadership but we need people to very much be aware of the dangers out there. The cases are not going down. The American People should be aware of that. You should be forthright in explaining that. When the secretary of the when the president s economic director says weve got this contained, not quite airtight but almost there, we need you we need you, our Public Health officials, to step up and say that is not true. That is hurting us. That is making the spread of this virus more extended, more prolific and more possible. The American People need to step up here and make sure theyre aware of the dangers. Dr. Fauci . I appreciate your comments, but i can tell you absolutely that i tell the president , the Vice President and everyone on the task force exactly Scientific Data is and what the evidence is. I dont doubt that. I have never, ever held back telling exactly what is going on from a Public Health standpoint. Thank you. Thank you. The gentlemans time has expired. The gentle lady, mrs. Fox, is recognized for five minute. Since our current Ranking Member did not use all of his time, i may steal some of that in mine. And since you went over a little. So granted. Thank you. I want to thank our witnesses for being here. And i think the very fact that were having these hearings, theyre being held all over the congress, and the fact that there are the press conferences every day disputes what some of our colleagues are saying, that the facts are not getting out there. And i want to thank all of you all for being here and telling the facts to the American People i think thats important. And thanks to my colleague from tennessee for outlining what has been done, because we tend to forget the good actions that have been taken because of the direct criticism of the president. Which i think is totally unwarranted. I do think its helpful that we explain the facts, but also not scare everybody but ask them to be sensible about what theyre doing. Barta placed all proposals not related to coronavirus in a queue until the threat of this virus subsides. Nobody has mentioned that. But its really all hands on deck and a focus totally on coronavirus, is that correct . Yes, maam. We are accepting additional proposals on things nonrelated to coronavirus activities but we are focusing on the immediate concern. Yeah. I know its a fairly small entity and not a lot of attention has been paid to it, but we need our nation to remain prepared for all threats, including biological, nuclear and influenza, and thats part of what barta does. So, would you mention what additional personnel or authority barta needs to ensure response to covid19 in its work for biological and Nuclear Countermeasures is performed as well as possible . Yes, maam. Federal pay cap waivers there. 53, 58 approvals for devices, therapeutics, diagnostics in its very short history. Its the little engine that can. One thing working with nih, dod, have been very successful to advance things like in the ebola crisis, diagnostics as well as what turned out to be the first fda approved licensed vaccine for ebola. With resourcing, barta can, and its a great part of the team that really, i think, does provide a significant capability with nih and d. O. D. Colleagues. What you indicate is that theres a lot going on that people arent aware of. Groups of people working within the government to try to anticipate the kinds of things thats happened with the coronavirus. Well never be able to stop all kinds of problems like this, but at least we have people working very, very effectively in these areas. Dr. Redfield, i think dr. Fauci tossed over to you an opportunity to speak about getting the necessary medical supplies out to people. Would you like to expand on what you werent able to talk about earlier . I would just like to try to emphasize the development we did for the diagnostic test. I think we developed that very rapidly so that the Public Health community could have eyes on. That test was at cdc. We rapidly tried to get it to the Health Departments during our Quality Control, we basically found one of the reagents wasnt working. As i said today, we got that Public Health labs now throughout this country have adequate testing to do their Public Health mission. The other side of the mission is the clinical mission. I think thats the concern of most american citizens. How do i get evaluated . And, again, that really has been worked through the private sector. It wasnt really the Public Health lead for cdc to get the laboratory test, but i will say that the test we did develop, we publish published and let everybody use it. They could redevelop it. There was regulatory release. So, any Certified Lab according to the fda was given release, develop the test just like we did and use it. Some universities have done that. We also the manufacturer that made our test for Public Health purposes, they were given the regulatory relief to make that test and sell it to hospitals. Thats the 1 million, 3 million tests that people refer to thats rolling out on that side. Most importantly and we really need to give credit to the diagnostic companies of this nation. When they met with the Vice President , they didnt come one company at a time. They already agreed as a group theyre going to figure out how to get this diagnostic test as rapidly as possible for the American Public that needed it. As i said today, yesterday they began that, both lab corp and quest. There should be, again, increase in availability across this nation through the private sector. And i worry about what we heard when we discussed hr3, that were hr3 to become law, that we would lose much of that ability through the private sector to come up with the cures that we need to come up with and so im very pleased to see this cooperation with the Public Private partnership. And thank you very much, madam chairman, for your indulgence. Thank you. The gentleman from tennessee, mr. Cooper, is recognized for five minutes. Thank you, madam chair. Im delighted to hear the bipartisan praise of our Public Health workers, our professionals. And i hope that colleagues on both sides of the aisle will heed your good advice. First question, can you, as doctors or patients, order some of these tests from south korea . Important question when was asked by the chairwoman about the difference. The difference between the south korean tests and our tests is they would have to go through our regulatory process and the fda to get approval to use that. So the answer is no . Currently no under the regulatory issue. Okay. What are the names of these south korean companies, or enterprises that offer these tests . The basic difference, congressman, is when we cdc developed our test, if you give me a second, we developed to make sure it could work on the platforms that we put in all the Public Health labs, based on our flu surveillance. We used a technique called thermacyc lichlt thermacycline, not a high throughput. Koreans have a high throughput platform that is being worked on by lab corp and quest to bring it in. Its a different platform. Roche is the company, i think im not sure but can get back to you the platform that they used. Its a high throughput that allows many, many tests to be done at a single time. So they used a swiss company, or wherever roche is headquartered, to supply the need . Ill get back on the specifics to make sure i dont misinform you. So well have to google this because were not eliciting this information today. Well get back to you. Lab corp and quest are up and most american doctors use one of those two. Lab corp and quest are Wonderful Companies but still we are behind south korea in terms of making testing available. So how do we solve this gap . Whats going on right now, rather than the Public Health platform that we used if we had developed a test on the korean platform none of our Public Health labs could have done it, because they dont have the instrumentation. Right now the private sector and certain labs have begun to transfer that to what we call the high throughput. So youre going to see the same technology approved in the United States and used by different private sector groups. Finally, were turning toward what you call high throughput and it may be from roche, somewhere else, or maybe at the Wadsworth Lab in new york but finally one day we will have it . I would try not to use the word finally. Maybe im not making myself clear. In my role to get it into the Public Health labs we built it on a platform that they had the instrumentation. Whats the name of the company that supplied the faulty reagent . You should be careful. The third control did not perform the way we wanted it to perform. Theres two possibilities. One, that that reagent at that time, there was a contamination. The other possibility is biologic, that these prime repairs folded on themselves and they didnt perform. Its been corrected. Substandard, faulty, whatever name you want to use, whats the name of that company . It was produce bid idt initially, and weve worked with them to correct that, and cdc together. Are there any plans to have drivethru testing in america so we do not panic Emergency Rooms when people come in and cough . Not at this time. Were trying to maintain the relationship between individuals and their Health Care Providers. Thats very interesting as a response. So the professional monetary relationship comes before Public Health . No, that was not my point. Maybe dr. Fauci wants to comment. My point was ability to assess appropriateness that these individuals get the proper care, we believe this is something that still has value to be dealt with, within the setting of clinical medicine but ill ask tony to comment. Its exactly what you said. Not anything about monetary. Thats really not a consideration at all. Its the try to get people to at least on a telephone call basis to be able to phone their physicians ahead of time and say i believe i have a situation. The physician would probably say stay at home and give them the instructions of how to get a test. Its the relationship between the patient and the physician. I have no indication at all of financial on that. Most americans dont really have a doctor. They rely on the e. R. To help and people are panicking e. R. S apparently. I see my time has expired. I wish i had more time. Thank you, madam chair. Thank you. The gentleman from georgia, mr. Heiss is recognized for five minutes. Thank you for being here. You said in answer to a question you believe the worst is yet to come. Everyone up here, both sides, weve been in briefings on this. Many of us on multiple briefings and i think everyone up here would agree with you from the information were hearing. Im curious, though, with the steps that were taken early on from declaring Public Health emergency, restricting travel, giving each of your organizations the freedom to move forward, to try to combat this and a host of other things, how important were those decisions . Would we be in a worse situation, for example, had there not been some travel restrictions . I believe we would be in a worse position, sir. If i might with respect look ahead now, we need to do a lot more. Theres no question. And i would like to maybe use just a few seconds to get a point make it quick. I want concise answers because i want to yield. I yield back to you. Thank you. One of the issues, and i do appreciate the cooperating spirit here today i know brad snyder and i, we worked together to put together a bill. He led the way on trying to make sure medical devices are here if there is a shortage. In that spirit of cooperation, with we all need to address this issue that is critical to our country. And im curious specifically on the medical supplies and medical devices, are we going to be facing a shortage . Yeah. I believe that if we have a major outbreak, we are definitely vulnerable to shortages, but dr. Kadlec knows more about that than i do. I would just characterize it at this point and again the fda has the responsibility to look at the entire supply chain of pharmaceuticals and drugs in the country. Im looking at particularly the things that we need for this outbreak right now. I want to highlight the issues around personal protective equipment. Much of it is sourced from overseas. Some of it is domestically manufactured and, yes, we could have spot shortages. Were working with different companies, different sectors to enhance both their increased capacity here domestically, as well as obtaining supplies from overseas on affected areas to meet the demand. The most important demand is with health care workers, ensuring they have the protection so they can see and treat patients without the risk of getting infected and being lost to the cause. Okay, thank you. Dr. Redfield, real quickly if you would, is there any way that the regulations rules that are standing in the way of the fda from getting tests here being purchased, is there any way those regs can be waived in a National Emergency . Initially, the regulations were, in fact, there. Thats why we had to go through and get approval. The commissioner actually gave regulatory relief so any individual you just mentioned a moment ago we cannot purchase those tests from south korea. And you said because of regulatory interference. My question is, can those regulatory requirements be waived in a National Emergency . I would have to refer that to the commissioner of the fda. Okay. Last question real quickly and i want to yield to the gentleman from tennessee. Dr. Redfield, are our tests better than their tests . More accurate . I would say our tests are accurate. Im not going to compare it to theirs. Okay i want to know if were talking apples to apples or something else. The south korean tests are accurate as well as far as you know . I would assume. I can only comment that our tests are accurate. With that i want to yield to the gentleman from tennessee. Congressman hice, thank you. Dr. Redfield i was on the phone with the cdc and the nih yesterday and they suggested that the south korean tests used only a single ig and not igg and igm. Would you explain to my colleagues here why that single immunogl obulin test versus ours, why ours is so much better . Congressman, youre referring to the test the test were currently using and theyre using to detect acute infection is to measure the antigen in the oral, nasal or pharayngeal spac. They can measure it in oral or nasal secretions. Cdc has developed two tests that were evaluating right now so we can get an idea through surveillance whats the extent of this outbreak, how many people really are infected, and that is being moved out now to do these Extensive Surveillance Program programs. Madam chairman, can i get one more question on that same line . I can wait for someone else to yield. Thank you. Lets wait for someone else i want to try to keep to the five minutes. Many members are here and they all have important questions on both sides of the aisle. I now recognize the gentleman from virginia, mr. Connelly. He is recognized for five minutes. I appreciate his help on this hearing. I thank the chair. Some of my friends on the other side of the aisle, including the Ranking Member, began sangt m n sanctimoniously to say we dont want to politicize this situation. Too important. We didnt politicize the fact that the Global Health and security biodefense desk at the National Security council was dismantled by this administration two years ago. We didnt politicize the funding of health, Public Health in the United States in budget after budget that, in fact, made critical cuts, which weve restored. We arent the ones that called the alarm being raised about this pandemic as fake news. That came out of the president of the United States mouth. And no gaslighting is going to hide that. And politicization, when the president of the United States finally did go down to cdc with you, dr. Redfield, he appeared wearing this hat, a campaign hat in the middle of a crisis. We will not be lectured about politicization and all of your words and sanctimony will not cover up the fact that this administration was not prepared for this crisis and it put lives at risk, american lives at risk. We didnt have the tests we needed. We didnt have the diagnostics we needed. The president made patently false assertions, which dr. Fauci correctly corrected about the development of the virus. In fact, he was more concerned about what was happening on the stock market than he seemed to be concerned about american Public Health. And thats shameful. And you cant cover that up. And we will not be silenced, nor will we be intimidated by charges of politicization in pointing it out because lives are at stake. Dr. Redfield, you indicated one size does not fit all. And i think thats true. But there is a concern that we dont have any kind of uniform protocols and guidance for localities and states. So, for example, mr. Coopers state has decided not to identify a specific county where a coronavirus victim may be present, just a region of the state. Whereas in my state we are being quite precise about where a victim may be identified. They corrected that today. But again theres confusion. Do we close things . Is it a certain number were worried about . When do people get tested . How do they get tested . Whats the guidance of going to an e. R. As opposed to seeing your physician . What if you dont have a physician . There is real concern here about the need for more uniformed guidance. Granted, one size does not fit all, but that doesnt mean theres no guidance at all and no protocols that states localities could refer to. Would you comment . Thank you. A very important question. First, we do have very specific guidance for a variety of things that cdc has published. Really targeting more business community, hospitals, longterm care facilities. But the point you raised, i think, is the most important. What guidance are we giving Health Officials based on their circumstance . I will say yesterday we did post for everyone an algorithm for how they can go through jurisdiction by jurisdiction for what to do for individuals and families at home, what to do for schools in child care, what to do for assisted living, longterm care facilities, what to do for community and faith organizations, what to do for the health care setting. I couldnt agree with you more that we want to give guidance. And weve put that out. We are, as we speak today, working with four jurisdictions to get very specific on exactly what cdc is recommending in those four situations so the rest of the nation can see how to begin to operationalize this. Was it a mistake, dr. Fauci, do you believe, to dismantle the office within the National Security Council Charge within Global Health and security . I wouldnt necessarily characterize it as a mistake. I would say we worked very well with that office. It would be nice if the office was still there. We have a bill to solve that, a bipartisan bill. I thank you and i thank the chair. Thank you. The gentleman from wisconsin, mr. Grossman, is recognized. Thank you for being here. Im glad youre all so ready to come to washington. Im going to talk a little bit about im not sure if the public overall is in line with the things youre telling us. In part, thats because in the past weve had crisis around sars comes to mind in which we expected all sorts of horrible things to happen and baa maybe because all these horrible things didnt happen, the public is not many members of the public are not that alarmed yet. I want to talk a little bit about the numbers and what we expect the numbers to be in the United States. The things i have here show that right now in china there have been about 3,000 deaths. Do you agree probably the worst is over in china, or do you think that number will continue to escalate, or slowly drop . I think china is a great sign of encouragement. In the last couple of days, theyve really gone down to under 50 cases per day. They really have now gotten control of their outbreak. Okay. So in the United States, when you look at the trajectory of what happened in china and what happened in the United States, based upon what were three weeks, a month or how far are we into this situation in the United States . I think thats the critical question. For a period of time, this outbreak seems to go in a very arithmetic way. And then it goes algorithmic. Italy had 1800 infections confirmed just last night. Right. We are fighting hard now between our containment strategy and, as dr. Fauci will say, expanded mitigation. Right. Lets compare it to something the average american understands, and thats the common flu. Can you tell us every year kind of where we start and how much it grows and how many new people get the flu every day . Yeah. I cant give you a precise number, sir, but one of the things were trying to emphasize to the American People i only have five minutes. Can you tell us about how many people, say, get the flu every year and how many new people are diagnosed . Get the flu, i didnt hear you. Im sorry. About 5 or so, to 10 of the population. We have about 30,000 deaths. It ranges from 15,000 to about 69,000, 79,000 per year. Okay. Based upon the current trajectory, how many people do you think will get this new virus and how many do you think will die . I cannot predict. I know you cant predict but you must are we have a graph, beginning of the graph. We know this is going to go up. We have the experience of china. We have the experience of italy. Yeah. Can you give us some projections . It is going to be totally dependent upon how we respond to it. So, i cant give you a number. If we now sit back complacently im not asking to be complacent. Im asking for a realistic i cant give you a realistic number until we put into the factor of how we respond. If we are complacent and dont do really aggressive containment and mitigation, the number could go way up and be involved in many, many millions. If we contain, we could flatten it. So theres no number answer to your question until we act upon it. Ill give you a question. We mentioned earlier today that i think one of the basketball tournaments, i think, for the i ivy league, they cut off their tournament all together. Nobody talks about every night they play like, i dont know, eight to ten nba games and nobody talks about shutting them down. Is the nba underreacting or is the ivy league overreacting . We would recommend that there not be large crowds. If that means not having any people in the audience when the nba plays, so be it. But as a Public Health official, anything that has large crowds is something that would give a risk to spread. Ill emphasize again, you said about 30,000 people die every year from the regular flu. Do we know the ages of the people so far who are dying of the new flu . Yes. So for the coronavirus right now, for example, in italy, the average age of death is over the age of 80. Most of the deaths that weve seen are over the age of 70. Okay. I yield. Maybe give dr. Green another chance to ask a question. Thank you. Very quickly, dr. Fauci, you took the hipocratic oath, right . Are you offended by someone suggesting you might intentionally not speak out when youre confronted with something that could harm your patients and violate your hypocratic oath . Yes. I made that a moment ago. Madam chairperson you said i served four president s. With all due respect, i served six president s and have never done anything other than tell the exact Scientific Evidence and made policy recommendations based on the science and the evidenc evidence. Okay. The gentleman from illinois, mr. Krishnamorthi, is recognized for five minutes. Thank you, madam chair. Yesterday the governor of illinois said im very frustrated with the federal government. Weve tests. I want to understand why. Director redfield, director redfield, over here. The first coronavirus case in the u. S. Was confirmed on january 21. At that point cdc began developing a test kit to diagnose coronavirus cases. The fda gave cdc emergency authorization to manufacture and issue this test kit around february 4th, isnt that right . [ muted ]. Unfortunately however, testing did not get underway because of problems with the test kits. Specifically, cdcs atlanta manufacturing facility had Quality Control problems. On february 24th, one month after coronavirus was found in america, officials discovered that cdcs atlanta facility was contaminated. Whether it was because of the contamination or bilogic problems which you had alluded to, test kits coming from there were flawed and had to be replaced slowing down our response. I know you are investigating the cause of the investigation and the atlanta facility. Is the person who oversaw the facility at the time still in charge of the current manufacturing process . This is a currently under an investigation at this point, and i think im going to leave it there. You cant give us assurance that the person who bungled the production process hasnt been removed . Recovering from that misstep cost us precious weeks and now months, sir, meanwhile the virus spread and people died. I respectfully disagree with your earlier karks b characterization we had an azbresive response when one month after the first coronavirus was detected we still had not shipped test kits to public labs. Now, lets currently discuss testing efforts underway in the u. S. And other countries. You have a copy of this chart before you. We talked about south korea and the u. S. Let me just drill down for a second because this is very instructive. The u. S. And south korea both experienced their first confirmed coronavirus cases roughly within a day of each other. The u. S. On january 21st and south korea on january 20th. Interestingly, both countries developed a test to diagnose coronavirus roughly around the same time. The u. S. On february 4th and south korea on february 7th, three days later. But then our testing at that point, the activities diverged dramatically. Here we have a chart that shows the testing activities of four countries, the u. S. , south korea, italy and the uk, on three separate dates in the past three weeks. You see from zero until march 10th, south korea tested 4,000 people for every million persons in its population. Italy in the blue bar tested one thousand people for every Million People in the population. Uk, 400 for every million. Now, where is the red bar representing the United States, dr. Redfield . I dont see it on that graph. I dont see it either, but i can assure you that the data is there. It just doesnt show up. It doesnt show up. It turns out that korea had test tested 4,000 people for every million of its citizenry, and we are at 15 people for every Million People in this country. Thats a response, a testing response thats almost 300 times for aggressive than whats here in this country. And the problem, dr. Redfield, is that when we dont test as rapidly as we should, the virus spreads and people die. Now, lets talk about the situation going forward. Vice president mike pence said on monday, quote, before the end of the this week another 4 million tests will be dist ribewed. But the real question i submit is not when the tests will be distributed. Its when the tests will be performed on people so they can know whether they have contracted coronavirus. Now, south korea currently tests 15,000 people per day, whether its through high tloug put, medium, low, they test fraen thousand people per day. Dr. Redfield, when are we going to be reaching 15,000 per day tested in this country . Well, first, id say, mr. Congressman, it does depend on the clinical indication. I think one thing i would like to point out again, the cdc developed this test for the United States Public Health system. We did not develop this test for all of clinical medicine. The tests for clinical medicine we count on the private sector to Work Together with the fda to bring those tests to bear. Youre passing the buck to the private sector, sir. Because of this the virus is spreading, people are getting sick, people are dying. Mr. Comber is recognized for five minutes. Thank you, madam chairman. I cannot think of a more Important Committee hearing that would take place in congress this week than the one were having now. I was very glad to see Congress Come together last week in a bipartisan way, after weve spent many months in the very partisan environment here with respect to the impeachment hearings. But congress came together to pass a very important corona supplemental that i think everyone would agree is making a huge difference in americas defense against the coronavirus outbreak. But ive been very disappointed to hear some of the comments by my colleagues on the other side of the aisle. Chairwoman ma loany mentioned the political spin. Mr. Conley mentioned the politicization and fake news. I just wanted to mention a couple of things that have been written and said by the press and democrat leadership. The New York Times, a little over two weeks ago, had a headline, quote, lets call it trump virus. If youre feeling awful, you know who to blame. And then House Majority whip jim clyburn asked if he had confidence in the administrations response, he said, quote, absolutely not. Theyre just fooling around. It just reminds me so much of katrina. I take a bit of issue with the politicization with something that should be focused on bipartisanship and working together to save lives. Because we have a crisis. Americans are truly and rightfully concerned. And i think that Congress Needs to work hand in hand with the administration. I dont believe the administration has gotten the credit it deserves, especially with respect to the president s early decision to cut off the border, which has undoubtedly given the cdc and Health Officials time to prepare for this outbreak. Im not confident the last administration would have made that decision, for fear of political incorrectness or whatever. So i think the president should get a lot of credit for making that decision. But i want to focus on some things that are important to people in kentucky, because theres a lot of concern, theres a lot of misinformation. So my simple question would be to anyone on the panel, which are the best websites for concerned americans to get on to that have factual information and important tips on how average Everyday Americans can prepare for this virus . So there are two. One is the core one is cdc. Gov. And that will get you quickly to anywhere you want to go. My next question, in the era of fake news and social media, how can americans ensure that the information that theyre sharing on social media is accurate information. Do you have any advice on that . Yeah. I think for the most part, at least from my experience, social media can often be as detrimental as it is helpful. And thats the reason why, sir, i think the first question you asked would be the one to go to the source of data, cdc. And im not cdc, but im saying its a datadriven organization. If you really want the facts and data i would go to cdc. Gov. Im sure well start sharing that information. I want to switch gears in the last minute, represent along with congressman green, ft. Campbell military base, in kentucky and tennessee. But can you tell us what is being done to ensure that theres not an outbreak first of all on our military bases to protect our troops . Secondly, what our military is doing to be able to be in a position to help fight this if this is a mass outbreak . Ill take that one. Yes. Thank you for the question. So we have put out a series of for selfprotection guidance that is aligned to the cdc recommendations. And we have tailored those that guidance for selfprotection for military commanders and particularly for installation commanders. And installation and military commanders have a lot of latitude between right and left limits within our guidance that they can command and protect their military population. Now, what were also doing is working with the interagency efforts to develop vaccines and also to develop antiviral treatments. And we are working with the interagency to develop what we call expeditionry field diagnostic kids. Because we want kits that we can push far forward. Because we have missions all over the world. We need to get our medical capability distributed. Well, thank you, and hopefully congress can work with you all in a bipartisan way. We can come together and help do everything we can to protect american lives. With that, madam chair, i yield back. Thank you. The gentleman from maryland, mr. Raskin, is recognized for five minutes. Thank you. Dr. Fouci weve got two enemies in this crisis, one is the virus and one is misinformation about the virus. And i want to quickly clear up a few things that have been said over the course of this process. One was by the president in early february when he said, it looks like by april you know in theory when it gets a little warmer it miraculously goes away. Is there any scientific reason to believe that . The basis for any surmising that that might happen is based on what we see every year with influenza which actually as you get to march and april and may, it actually goes way down. And other nonnovel coronavirus but common cold coronaviruses often do that. So for someone to at least can are that that might happen is reasonable. But underline, but, we do not know what this virus is going to do. We would hope that as we get to warmer weather it would go down. But we cant proceed under that assumption. Weve got to assume that its going to get worse and worse and worse. The president predicted there could be a vac snooen a few months. I think you couldnt bikted that today and at that time. Is there any chance we will have a vaccine in a few months . No i made myself clear in my statement. Dr. Redfield, the first case of Community Spread of coronavirus took place on february 21st, infection of someone without a clear travel history to china or with someone who did. Why wasnt the decision made on that date to expand your testing criteria for anyone displaying symptoms at that point instead waiting until march 4th . Thats a good question. We always left the discretion to do testing to the local Public Health group. If you looked, we always had that discretion. We never refused testing from anybody. But we did give guidance as you pointed out originally to do testing for individuals. The percentage was certain clinical scenarios, secondary to travel to china. Those two cases in california and several others obviously led to us reconsider those and make it very clear that we wanted up front to tell clinicians if they suspect it and the Health Department suspects it they should send that sample to the Health Department or cdc. Weve heard stories about people who have had compelling reasons to get tested. A nurse in california was quarantined after treating a patient who had coronavirus and showed symptoms herself. On march 5th, the day after you broadened the tisting criteria she put out ate statement, she said, the public county officer called me and fairr verified my symptoms and agreed with testing. But the national cdc would not initiate testing. They said they would not because if i were wearing the recommended protective equipment i wouldnt have had the coronavirus. Are you familiar with this case . No. And i would think that this is a misunderstanding if it did occur. So what is the standing criteria . The existing criteria for testing now . So we have no confusion about it . Again, its the at the if a clinical nizition, nurse practicer, feels a test is indicated based on what . Based on their clinical assessment. And thats based on does it require that the person has to have had contact with someone on a cruise or been to china . No. Were not going to judge the clinical assessment. If its the assessment of the Public Health department, those individuals these are decisions. What happens is in the time when testing was limited to Health Departments, the local Health Department makes that decision. And then they but they have followed cdc guidance. Now weve made it very clear, its up to the individual Health Care Provider and Public Health to make that decision. Could you make a Public Service announcement right now for people who are asking the question of whether or not they should be tested . I hear from constituents who are having flulike symptoms. They want to know, what should they do . What should they do . The first thing i would do is to tell them to contact their Health Care Provider or their mid emergency room, they will them their concern, follow their instruction todays where to get the test. All right . And then proceed with getting the appropriate clinical evaluation. Call someone before they go anywhere . Wed like to do that. Because if you really think youre infected were trying to avoid someone to walk into a 2hundred person emergency room first. Call in advance, and theyll arrange exactly how theyll get the test, see the patient, be prepared when that patient comes to the emergency, theyre going to be able to isolate them, get them tested would be properly evaluated. Thank you for your work on behalf of the American People. I yield back. Thank you. The gentleman from texas, mr. Cloud, is recognized for fine minutes. Thank you, chairwoman. Thank you all for being here today. Appreciate your work own this. Dr. Redfield, i appreciated that you talked about the changing every changing dynamics of the situation especially in the sense that scientists are learning more and more. Its been difficult of course to get information out to the public, especially in a hyper plit sized environment. Id like to spend time clearing the record. As we try to find the proper balance between creating a pro active positive response to real threats as opposed to instigating overreaction on the public and finding it healthy balance. Dr. Fouci, can you by way of comparison, briefly explain how does covid19 compare to other Previous Health situations . Sars . H1n1, things like that . Sure. Thank you for the question. Well, sars was also a coronavirus in 2002. It infected 8,000 people, and it killed about 775. It had a mortality of about 9 to 10 . Thats only 8,000 people. In about a year. In the two and a half months that weve had this coronavirus, as you know we now have multiple multiples of that. So it claefrl is not as lethal. And ill get to the lethality in a moment. It certainly spreads better. Probably for the practical understanding of the American People, the seasonal flu we deal with every year has a mortality of 0. 1 . The stated mortality overall of this when you look at all the data, including china, is about 3 . It first started off as 2 and now 3. I think if you count all the cases of minimally symptomatic or asymptomatic, that probably brings the mortality down to around 1 . Which means this is ten times more lethal than the seasonal flu. I think thats something that people can get their arms around and understand. But less lethal than n one h one or sars . No, absolutely not. H1n1 is even the 2009 pandemic was less lethal than the regular flu. Im trying to help the American People where to appropriate set their gauge . Set their gauges that this is a really serious problem, we have to take seriously. People always say, well, the flu, you know, the flu does it, the flu does that. The flu has a mortality of 0. 1 . This is ten times that. Thats the reason i want to emphasize we have to stay ahead of the game. We speak to the supply chain for a second. Were telling to people to wash their hands, sanitation. A lot of this stuff comes from china. They are going to the stores, seeing these dry up. What are we doing from the i guess fda standpoint to ensure supply chains that we have everything we need . Sure. You know, i know theres been a run on purell. But i think soap and water works just as well in terms of that. It does require people to frequently wash their hands and maintain good hygiene, cover the cough and sneeze. Dont touch your face, continue to wash your hands. In my understanding in the legislation we just passed last week too, face masks for Health Professionals, not for every citizen walking around, we have a u. S. Supply that could provide them but house leadership didnt put the Legal Framework in that was necessary. Is there anything the fda is doing to allow u. S. Based companies to participate better . One thing the fda issued was emergency ruse authorization about expanding the use of particular masks. There are two types, one used by industry, the health care, and making that available for increased use so their numbers will be increased. There is a high demand for masksds particularly in the health care setting. Depending on what meddel you use you may need up to 3. 5 billion. Thats a model. All models are wrong but some useful. It could be as low as 600 million. Were trying to increase the amount of masks available, res prairts and surgical masks which could be used in lowrisk settings by health care workers. Weve issued a request one more question. Regarding testing, dr. Fouci, weve had people calling 911 showing no symptoms asking for an ambulance taking them to a hospital to be tested. Who should be tested . At what point should they be tested . At what point are the tests actually helpful . What about false negatives . Those kinds of questions. Who should be really concerned about this . As dr. Redfield as responded, there are really two buckets. If you have someone who has a reason to believe that theyre infected, either that they have symptoms or they have come into contact with someone who was either travel related or is in fact documented to have been infected or ekz spoeszed, thats something where you go to a physician, get a test, and find that if an individual is infected. The other that was discussed a fair amount over the last several minutes is the surveillance type, where youre not looking to see if anybody has been exposed, but you want to find what the pene trans of this particular infection is. And thats a different thing than the physician patient relationship. Thats what the cdc is doing now in six sentinel cities and they will expand that throughout the country, so we will be able to hopefully very soon, to get an idea for getting the people who think they may be infected who actually is infected. Thank you. Time has expired. The gentleman from california is recognized for five minutes. Thank you, madam chair. Like all of the members up here, we are getting constant communication from our constituents wanting more information, and i applaud all of you for being forthright with the American Public. Thats exactly what we need. In times like this communication is so important, and if youre going to err on one side, over communecation is more important. Dr. Kadlec, i had the fortunate opportunity to be with you earlier this week and see firsthand the work you are doing to help address this as well as your peers. I wanted to talk about one of the slides you shared with me, a bell curve that showed what would happen across the United States with the spread of this disease if mitigation was not taken. Versus mitigation efforts to basically flatten that bell carve. I think the primary purpose of that is so our Health Care Facilities and physicians as well as the supplies are not overrun by a steep bell curve. Am i correct in making that statement . Yes, sir. And i think another way to say it too, its not a question of if, its a question of when the virus continues to spread across the United States. But we want to pace it out as long as possible. Is that a correct statement as well . Yes, sir. Thank you. One of the issues too in help address this is the fact we do not have enough test kits. We know that many individuals, as my fellow member to the right of me, mr. Raskin, pointed out, there are individuals who have requested test kits and have not been able to access them. My understanding is as late as last saturday, ground zero and king county, washington, that the Health Care Professionals from that facility still did not have access to test kits. Mr. Redfield, do you know if that is true or not . We have provided test kits to the Health Department, the university of washington has developed their own tests were those available last friday . Yes, sir. Thank you. And without test kits, is it possible that those that who have been susceptible to influenza might have been mischaracterized as to what they had . Its quite possible they actually had covid19 . The standard is the first thing you do is test for influenza. If they had that they would be only if they were tested. If they werent tested we dont know what they had . Correct. If somebody dies from influenza are we doing postmortem testing to see which it was . There is a Surveillance System of death from pneumonia that the cdc has, its not in every city and state and hospital. We could have people in the United States dying for what appears to be influenza when it could be the coronavirus . Some cases have been diagnosed that day in the United States today. Thank you. I want to turn a little bit to the cdc website, because i appreciate the information youre putting out and its so important to the American Public. But i also want to make sure they fully understand it. On the cdc website, published a guide called, quote, framework for mitigation, actions for protecting communities from covid19. In that graph, it provides three levels of transmission, none, in other words youre in a community with no reports of any cases whatsoever. The secondary is minimal to moderate. And the third is substantial. Dr. Redfield, how many cases of coronavirus are considered to be minimal to moderate . Right now when we see basically transmission cases, it particularly if theyre nonlinked, were looking in cases in the 25 to 50 range, to see that groups begin to move into the moderate range, sir. Thank you. Thats helpful. I would suggest that the cdc put that on their website so that the average american can read it and understand exactly the precautions they should take. Substantial ai would assume is when you have 50 cases or more in your community . Yes, sir. Thank you. And i would go back to dr. Fouci, you talked about this is serious. We are seeing activities across the nation, school closings, sporting events being discussed about having them held in other places, major events being canceled or rescheduled. This would suggest this is a really serious issue, and i share the thoughts of the member from wisconsin that, i think were concerned that were not getting the full understanding or modeling that has taken place that would suggest the true impact of this virus across the United States as well as potential models for deaths. Can you elaborate a little bit . I get that theres no perfect model. But can you be helpful in helping us understand what were really looking at here . Yeah. If you look at the curves of outbreaks historically that are similar to this, the curve looks like this and then it goes up exponentially. Thats the reason why it depends on how you respond now. So if we wait until we have many, many more cases, we will be multiple weeks behind. You know, i use the analogy at the press conference yesterday and ill use it today. Its the old metaphor that the wane gretssky approach, you skate not to where the puck is but to where the puck is going to be. If we dont do very serious mitigation now, that whats going to happen is that were going to be weeks behind and the horse is going to be out of the barn. And thats the reason weve been saying, even in areas of the country where there are no or few cases, weve got to change our behavior. We have to essentially assume that we are going to get hit. And thats why we talk about making mitigation and containment in a much more vigorous way. People ask, why would you want to make any mitigation . We dont have any cases. Thats when you do it. Because we want this curve to be this, and its not going to do that unless we act now. Thank you, doctor. Madam chair, i yield back. Thank you. Thank you so much. The gentleman from ohio, mr. Gibbs, is recognized for five minutes. Thank you, madam chair. Thank you all for the work youre doing, huge challenge, and i know the stress you must be under. And irk never think you enough i think the centers, cdc and all the agencies are doing the best they can in this unprecedented circumstance. I also was glad to see Governor Newsom of california come out and say good things about what the administration is doing and help and i think the governor of Washington State did the same. Also, i talk about politicization, which shouldnt happen. One thing that astounded me was all the talking heads and some members of congress criticizing Vice President mike pence being take the lead on this, have this up because hes not a medical professional. I would think when i look at this, that person at that office, that level, that office, that helps bring the agencies together, maybe help clean out some of the red tape in the bureaucracy. Would you concur that thats been helpful to have top government involved in that level for especially working between agencies . Yes, sir. Absolutely. I just want to make that point, because i hear that criticism, and i think theyre being political or dont know what the heck theyre talking about. Probably a little of both. I also think its amazing, i want to praise the work cdc has done to develop a test in one week. Is that unprecedented, to develop a test from a vile im going to have dr. Fouci answer. I mean, obviously the technologies of today are being able to develop a test as quickly as that, the same way as we were able to use the sequence to get a vaccine started at least in the trial. I fully understand the vaccine has got all the testing to make it safe. But were relatively close for an antiviral . You say relatively close. We dont know if it works. I dont want to promise anything. Were testing them. If they are effective, they will be distributed. But you dont want to do that unless you know they are effective. I do want to talk a little bit about the timeline. You know, it broke in china, and thn south korea, japan, italy, the United States, and elsewhere. Its mushroomed. Seems to me i think the next four weeks are critical because, can we kind of think were getting information out of china . I know sometimes its not reliable. But also were seeing it happen in south korea and japan, maybe theyve peeked a little bit and are on the better side of that curve . I think youre right. Clearly china is got control of their outbreak. They had 20 cases in the last 24 hours. A real threat right now is europe. Thats where the cases are coming in. Europe is the new china. Okay. But i praise you for, dr. Fouci, talking about doing as much mitigation as we can. Its critical. But i think would you concur that my assessment, the rest of this month, the next four weeks, is really, real, real critical time for us . Its critical, yes. And its critical because we must be much more serious as a country about what we might expect. We cannot look at it and say, there are only a couple of cases here. Thats good. Because a couple of cases today are going to be many, many cases tomorrow. We would like all americans to take a good look at that Mitigation Strategy as tony said. We have zero. But they need to be fully engaged in that Mitigation Strategy. This is the time for everyone to get engaged. This is not just a response for the government and the Public Health system. Its a response for all of americans. I understand that. Another thing not really being reported because its not as raises the ratings when they talk about the number of cases and fa talts. But i see in the reports worldwide, we have better than a 50 recovery rate. Is that true . Its probably about 85 . 85 of people are affected are recovering. 80 to 85. About 15 to 20 . Johns hopkins has that realtime chart. Theres about 60,000 or Something Like that. Realtime when you look at the chart its about half. At the end of the day if you look at historically, for example the experience weve had with china, about 80 of them have disease that makes people sick but they ultimately recover without substantial medical intervention. Its the 15 to 20 that have the serious disease and high mortality. And the bulk of them have been people with Underlying Health conditions and over 70, right . The elderly as well as people with underlying conditions like heart disease, lung disease. I think we need to do what we need to do, be vigilant and be responsible and not lose our heads. I think were going to get over this in due time with all the good work youre doing. Thank you. The gentleman from california, mr. Connor, is recognized for five minutes. Thank you, madam chair. First, let me thank you, dr. Fouci. I have known you, worked with you, and i have complete confidence in your leadership, appreciate your service. Dr. Redfield, i think its important to realize youve served our country in the army, served this nation. We need to be focused not on personalizing this but figuring out what we can do to solve the issue. Now, one of the things that i think this should teach us as a country, with all the antigovernment rhetoric, lets why do we need government . Government is the problem. How about we consider how inadequately we have been funding government and Public Health . The cdc budget is 11 billion. 1. 5 of our defense budget. 738 billion. Dr. Redfield, do you think our country would have been safer if, lets say, we had twice the cdc budget . If we had put it at 3 of our National Defense budget in our capacity . Thank you, congressman. I think its important to realize that for, you know, decades, weve under invested in the Public Health infrastructure of this nation. Cdcs funding we get from congress, about 70 goes out to local and state territorial and travel Health Departments. Theyre the backbone of our health system. If anything, i think you can look, i would rather see during my legacy, to help overprepare our nations Public Health system with the core capabilities of data, predictive analysis, Laboratory Analysis at local labs, making sure we have the human personnel, the Rapid Response fund that were appreciative that Congress Gave us, and build a Global Health security platform. While you have the countrys attention, how much would that cost . Because right now were spending i think most people realize, this is a National Security issue. And were putting 1. 5 into the cdc of the defense budget. The nih is 41 billion, which is less than 5 of National Security. Why isnt there a bipartisan call to double or triple these budgets . What would you ask the American People and congress to prepare . I appreciate the opportunity, congressman. And id have to get back to you with an exact estimate of all that for you. Dr. Fouci, do you have a view . Yeah, i mean, weve been wellfunded at the nih. But i think we need to continue to have a consistent wellfunding. What happens is that theres inconsistency at times. But luckily over the last four or five years, the congress has been quite generous with us. One question i do have is the w. H. O. Had tests and some of the other countries use these tests. Why shouldnt we be using these tests . I think its important to understand about the key for approving tests in this country from other countries. They can go ahead and apply through the fda and get registration and be dispersed. One of the reasons we developed the tests we did was to try to make it available to the American Public as rapidly. I would defer to the commissioner, what the exact hoops are for the Foreign Companies to get their tests approved. Do you think we need to look at streamlining and these types of crises, approval for things like w. H. O. Testing, which is 60 other countries are using or there are stories in the New York Times about how leading scientists had come up with tests in seattle that werent approved . Theres got to be a better way of getting these tests out there. I will say that, when this was recognized when i was practicing in the army, i could develop a test and then use it in clinical medicine. Somehow between then and now there was not regulatory discretion for us to do that. The commissioner did though, and i think it was on february 29th, issue regulatory discretion so the university of washington or columbia could develop and use their tests. Rather than have to file an emergency use, they could use their tests and file that 15 days later. I generally believe we have the most brilliant scientists, entrepreneurs in the United States. If we want to come up with an antiviral treatment, vaccine treatment, what is it . And i want both to answer what is it more that you need from congress . No one cares about us lecturing people. What we have to do. What are the resources you need so the scientists and technology and enter persons can solve this . From the nih standpoint, its the consistency of funding, which thankfully youve been able to do. Back from 1998 to 2003 you doubled the budget. Then we went through a flat period of time which was difficult because it discouraged young investigators from getting involved. For the last few years weve had a good increase. You can continue to give the kind of investment in Bio Medical Research that is consistent and predictable. I would say first and foremost, the most important thing that you have done is the establishment of the Rapid Response fund. Prior to that we would have to go to our foundation and ask for them to respond. The more flexibility you can do to enable the Rapid Response fund i think is one of the most important tools. Were thankful. Thank you for that important point. The gentlemans time has expired. And let me intervene here. Ive been told that our witnesses need to leave now. I dont know what is going on at the white house. The white house is telling reporters that this meeting is not an emergency. They are saying it was scheduled yesterday. However thats not what your staff just told us. Your staff said the white house did not tell them about this sudden meeting until this morning. Right before our hearing. There seems to be a great deal of confusion and a lack of coordination at the white house. I hope this does not reflect on the broader response to this crisis. Mad am chair. We have asked your staff if you can come back and resume this hearing at 2 00 after your meeting at the white house. They have not responded to our request. Madam chair. I am not going to adjourn this hearing. I am going to recess it. We havent even gotten through half of our members. Madam chair. Excuse me. When you have a moment. No, i am finishing my statement. We havent even gotten through half of our members. We will continue to work with your staff to have you back to finish the hearing and answer the rest of the questions from our members. Finally, let me close with this. This committee sent you a request for information a week ago. We asked for basic information about the crisis and your plans for the response. But you have not provided us with anything. We understand that you are incredibly busy. But a lot of this information should be at your fingertips. We need this information because we keep getting sometimes misinformation from the white house. And we have an independent obligation to the American People. So i have one last question. Will you commit to producing the information we requested at least regarding testing, dr. Fouci . Madam chairperson, im not sure what information youre referring to that we did not provide. My we are talking about the National Institute of allergy and Infectious Diseases . We sent a letter with all the subcommittee chairs and myself requesting information to every department, yours, the cdc, fda. I will check this immediately after to find out what the issue is. Thank you. Madam chair, may i say, interject, ive got a timely issue. I know you need to go down to the white house. Madam chair, i do as well. I have a very specific district related question. There are people in stage danger in my community. Ive got the floor. Please, we will yield to the Ranking Member and then to the gentle lady from florida. Madam chair, with all due respect, i believe i was next in line. Okay. If were not going to follow committee procedures. Regular order. Point well taken. We are going to recess after i recognize the Ranking Member for his closing statement. Well, i appreciate the chairwoman. We all recognize the importance of whats going on. I think its important to have level heads about whats happening. We want to make sure you guys can do your work. But it is important that you come back. It is extremely important. We do have urgent questions. I believe that the gentle lady from florida has extreme concerns of urgency to the people she represents. I can tell thaw i do representing san antonio. I sent a letter to the department of defense two and a half weeks ago and not received a response because i am troubled about the lack of response to the department of defense in especially hadding us deal with the fact that we have people who have tested positive held at an air force base there and we dont have a plan. I want an answer to these questions, and i want to be able to have you all respond when we come back. And i hope that will be this afternoon. Regardless of whatever needs to be discussed at the other end of pennsylvania avenue, i think there are very serious concerns that some of us want to have addressed. I think that right now weve got 380 evacuees heading to a base this san antonio. Ive got an email here from city council and leadership there saying they dont have adequate plans on what to do with those who have tested positive. So i expect you all to come back down here today in accordance with what the chair is asking for to have those questions answered. Thank you. Responding to the Ranking Member, will you all be back at 2 00 today . Were going to have to just chair, the reason im saying that, madam chairperson, is that we have a Task Force Meeting at what time is it . We have a Task Force Meeting at 3 30 in the white house. I will get myself down here at 2 00 if you would like. But i would have to be at the Task Force Meeting at 3 30 in the white house. Well continue discussion. Well stand at recess so that you can get to this meeting. We are in recess. Thank you. Thank you. Thank you all for your service, your testimony, tremendously helpful. Thank you. If you missed any of this coronavirus update, it is available to view online at our website set aside, cspan. Org coronavirus. This was scheduled to go until about 12 30. The chair announced at the start it was being cut short because of an emergency meeting at the white house which at least two of the witnesses would be attending. Then the chair said the meeting was not an emergency but had been previously scheduled. Chairman malone then announcedel meeting will go into recess until about 2 00 p. M. To hear more testimony. In news related to the federal response to the coronavirus, the Trump Administration is racing to develop contingency plans that would allow hundreds of thousands of employees to work remotely from home. Fulltime. This Washington Post story goes on to say the office of Personnel Management which oversees policy for the workforce of 2. 1 million has urged heads to review their telewok policies, sign paperwork with employees, issue laptops and grant access to computer networks. You can read more at washingtonpost. Com. Well hear from ken cuccinelli, hes heading to capitol hill to testify before the House Homeland Security committee on how his committee is responding to the cro coronavirus. Watch that here at 2 00 p. M. The white house will brief reporters today. Vice president pence has been leading the task force updates. We expect to see him this afternoon as well. Now set for 5 30 p. M. Eastern. Well have it live here on cspan ther cspan3, also online, or listen live with the radio app. Follow the federal response to the coronavirus at cspan. Org coronavirus. You can find white house briefings, hearings with key Public Health officials, and interviews with Public Health specialists, review the latest events anytime at cspan. Org coronavirus. John Charles Fremont brought the Pacific Coast into the United States. At the beginning of this story the United States didnt have a posk coast. There was territory in oregon that was disputed with britain, and california, which belonged to mexico. Fremont encouraged the american settlement of oregon and took part in the american conquest of california, just in time for the gold rush. And so he did play a ra he will role in changing the map of the United States. Nph Steve Inskeep on his book imperfect union, how jessie and john fremont mapped the west. Sunday night at 8 00 eastern on cspans q a. And next former ebola czar ron cane and others evaluate the coronavirus response. The house homeland subcommittee on Emergency Preparedness, response and recovery hosted this event. From yesterday, this is about an hour and 40 minutes. Subcommittee on Emergency Preparedness response and recovery will come to order. Subcommittee is meeting today to receive testimony on Community Perspectives on Coronavirus Preparedness and response. Without objection the chair may declare the subcommittee in recess at any point. Without objection, members not sitting on the subcommittee will be permitted to participate in todays hearing. I now recognize myself for an opening statement. Good afternoon. We are here today to discuss the coronavirus, also known as covid19. We are at a critical point in responding to the Coronavirus Crisis that is facing our nation. Americans are concerned. Hundreds of americans are sick. Sadly, there are families mourning the loss of loved ones from the coronavirus, and our hearts are with them. The nation is seeing cases on the rise, and experts say the outbreak is getting worse. In new jersey we were ju