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

Outbreak a global pandemic. Cdc has now reported that we have almost one thousand confirmed cases. That is up from 100 reported cases a week ago. A 900 increase. Americans are worried. They are scared. It is essential that we are able to hear directly from the Health Officials leading this effort with just the facts. Im going to go to the republican side first, which is where we left off. Before i do that, without objection, the following three letters we sent on march 3rd to hhs and cdc requesting basic information including about testing are entered into the record. We have not gotten any response to those letters. And with that i recognize mr. Higgins. Thank you, madam chair. Dr. Fouci, gentlemen, thank you for returning today. And let me ask dr. Fouci, do you lead the executives task force regarding our nations response to coronavirus . No, i dont, sir. Your status is what on the task force . I dont lead the task force. The task force is led by the Vice President. Youre the lead scientist . We have several scientists. We have myself, dr. Redfield, dr. Burkds, dr. Kadlec, several scientists. All right. Did the scientists ive spoken with in committee see you as the lead man. And i believe most of american does. And we greatly respect you and these gentlemen being here today. However let me clarify for america watching that according to the rules of this committee, members have the opportunity to submit our questions in writing. And given the nature of this challenge and the president s announcements of last night, with all due respect, madam chair, i believe that this hearing should have been canceled or postponed, these gentlemen should be able to go and do their work. Theres a time and battle when you need your frontline men on the front line, not in the rear with the gear. These gentlemen showed us Great Respect to be here today. An oversight role is incredibly important. But you gentlemen have work to do. Ill be submitting my questions if writing. My office will publish those questions and your answers in a press release at a later date. Madam chair, i urge you to tr adjourning this hearing. I yield my time to the Ranking Member. Thank the gentleman for yielding. I chair would yield to the gentleman from tennessee, mr. Green. Thank you. My first question is for mr. Kadlec, i want to talk a little bit about ppe if i could, and a concern about liability and the Liability Protections that might be very important r for, you know, the fact that this is such a catastrophic event and we are pushing to the extreme our stocks on ppe. If you could comment on that and the liability issues . Youre correct. A great demand for personal protective equipment, particularly res prairtsz. We have a limited supply in our stockpile annually, about 350 million are used. Only a small percentage of that is used by the health care industry, about 35 million. We believe the demand could be several hundred million to up to a billion in a sixmonth period. Its a very high demand item. There has been a strategy and cdc has provided guidance on reuse. Weve gone to the manufacturers and how they could surge more. Many of themself are doing that. Domestically even though sources some finished product is from overseas like china. The third thing, what can we do to use masks that havent been used for the medical area . Nonmedical n95s could be used. Its certified through an emergency use, that n95 respirators used in manufacturing, mining and construction could be used in health care settings. Theyre not the same but could be used. The only thing thats keeping a lot of manufacturers from selling those to the Broader Health care workers is because of lack of users of these masks or of users of the products that are defined as a device or covered counter measure. When we happen to be on the staff that did that legislation in 2005 we did not consider a situation like this today. We thought about vaccines. We thought about therapeutics. We never thought about respirators being our first and only line of defense for Health Care Workers. We think thats a important capacity and capability to include language or modify the prep act to include language to include respiratory devices. Thats significant. Thank you very much for that answer. Dr. Redfield, i had a bunch of con stit wents ask me after yesterdays hearing, whats the difference between a Public Health lab and commercial . Everybody in this room kind of understands that. But would you for the record and for the folks watching on tv make the clarification between those in the few seconds i have left . Thank you very much. We have a series of Public Health labs throughout this country whose primary purpose is to do surveillance. To kind of get eyes on whats going on in the community. And cdc has worked cooperatively with them, as you know, about 70 of our funding that we get from you all is in distributed to the state and local territory including their Public Health labz. Theres also clinical medicine. The practice of clinical medicine. The private sector. That actually tries to provide diagnostics so we can dying nose diabetes or anemia, lots of different diseases. Its really the engagement of the private sector to get these tests into clinical medicine, which is a martnership between the private sector. Cdc usually develops the test first, gets it out into the Health Departments, and then the private sector comes in to provide the tools we need to diagnose patients, not the surveillance of the community. Thank you. The gentle lady from florida, miss warrerman schultz, is recognized for fine minutes. Yesterday my colleague mr. Raskin asked you about a nurse in california who was quarantined after treating a patient with coronavirus and showing symptoms herself. She couldnt get tested even though her local Public Health department recommended one. She said the public county officer called me and verified my symptoms and agreed with testing. But the cdc would not initiate. They would be test because if i were wearing the protective equipment i wouldnt have the coronavirus. When you were asked about this yesterday you said, this is a misunderstanding if it did occur. You testified that quote, the test was always available in atlanta where cdc is located. If you sent the sample to us and there was not a time when a Health Department could not get a test they had to send it to atlanta. You claimed they never placed restrictions on who got tested, rather that that was only guidance, and quote, we always left the discretion to do testing to the local Public Health group. The Committee Staff reached out to the nurse. They sent us the following Statement Last night. I ask unanimous consent this statement be entered. Granted. According to National Nurses united in recent weeks our union has been made aware of multiple circumstances and the statement is up on the screen, multiple circumstances in which Health Care Workers have been exposed to covid19 and have not received covid19 tests despite requests. There have been too many cases where exposed Health Care Workers have been refused at the timing for this to be considered misunderstanding. There have been countless cases when its been refused. Dr. Redfield, the National Union that represents nurses just issued a statement publicly contra ticketing your testimony yesterday. I ask, will you admit that there is a serious problem in this country with individuals even Health Care Workers obtaining access to testing for coronavirus . [ muted ]. You have to turn your mic on. Thank you for your question. Ill look into this in depth as i said yesterday. Clearly we need to protect the Health Care Workers on the front lines. In general, these are local decisions on which Health Care Workers need to be tested and exposed. These are people who contacted cdc and at cdc that they say turned them down and said they couldnt be tested. I will look into that in detail and get back to your office as soon as i can. As soon as you can hopefully will be today. There are countless more examples of problems of people getting access to tests including m my home state of florida. We need to have someone in charge of making sure that as many people as possible across this country have access to getting tested as soon as possible. Who is that person . Is it you . Is it the Vice President . Can you give us the name of who can guarantee that anyone but especially Health Care Workers who need to be tested can be . As i tried to explain to congressman green, from the cdc perspective im asking for a name. Who is in charge of making sure that people who need to get tested who are indicated to be tested can get a test . Who . I was trying to say that the responsibility that i have at cdc is make sure all the Public Health labds have it and they can make the judgment an how they can use it. Theyre referencing people advised to be sent to you and turned down. Im going to basically you seem to be saying because you cant name anyone that theres no one in charge that we can make sure people who need to be tested, theres not one person that can ensure these tests can be administered . Yes or no . My colleague is looking at me to answer that. Here we go. Okay. All right. So and i do have another question. If we can get to the meat of the question. Quickly, the system is not really geared to what we need right now. What you are asking for. That is a failing. A failing . It is a failing. Lets admit it. The fact is the way the system was set up is that the Public Health component that dr. That dr. Redfield was talking about was a system where you put it out there in the public, and a physician asks for it, and you go et it. The idea of anybody getting it easily the way people in other countries are doing it, were not set up for that. Do i think we should be . Yes. But were not. Okay. Thats really disturbing and i appreciate the information. Madam chair if i can quickly ask my other question which is the question i wanted to ask yesterday. We have four in my home county four positive port every glood workers who were tested positive. These employees likely contracted it with interactions with infected passengers on ships they were working at the time. Ships that held six so eight ships that likely held upwards of 50,000 passengers. The people on these ships who were potentially exposed should have been notified. They deserve to know they had been exposed to someone with the virus. When i asked our department of heath what deps being table, when i asked the port, the cruise lines, the department of health, the department was not forthcoming, didnt direct the cruise lines to notify the passengers. The public and those passengers, i couldnt get a straight answer. They said they were going by cdc guidelines. Dr. Redfield, what are the guidelines for notifying people potentially exposed to a confirmed case and shouldnt passengers on the ships worked by the port ever glade employees be notified in a timely manner . They still havent been notified . Thank you very much, again, for both your concern and your question. I know you got a chance to speak to admiral redding i think yesterday about that. Yes. And cdc last night spoke with the princess cruise staff about this situation. They agreed to send a notice to all passengers on the ship where the greeters have worked. Were obviously in contact today with the florida Health Department. We would concur that individuals that have been exposed, particularly in a cruise shedding, should be notified. I think the controversy here is its i think the state actually thinks they may have gotten infected in the community. But i think we should err on the side of concern. In the epidemiological study they did they said these employees had not traveled internationally and not had contact in the community with anyone in the coronavirus. Days and days have gone by, thousands of passengers floated around the ocean with people who had coronavirus likely on the ship they were on, and days and days have gone by with no notification, no precautions, and they could be out there spreading coronavirus right now, and stood the cruise line have not been notified and urged to notify their passengers to make sure they can figure out whether theyve been exposed. My only comment was after you brought this to admiral reds attention, we did that have conversation. And the princess its not just princess. This is the the members time is expired by the witness may answer the question. Thank you. I just said that based on that, the company, the cruise ship staff, agreed to send a notice to all passengers that were on a ship in which any of these greeters worked. I want to point out it was not just princess. This is the second largest cruise port in the world, and there is more than just Princess Cruise Lines that these employees worked. We will follow up to see with the state that any ship that had passengers at these individuals could have exposed will be notified. Thank you. From south carolina, mr. Norman, is recognized for the equivalent time. Point of order, do i get seven minutes . Yes, you do. Thank you so much. I just want to thank each and every one of you for coming here. I agree with my congressman higgins that, you know, you all need to be on the front lines. I admire you for coming here. Theres nobody watching across this country that has listened that doesnt recognize youre doing all you can do. There are certain groups that want to find every fault. We are on unchartered waters. You are drinking from a tidal wave. Please know the majority of the country understands why we werent aware, we didnt anticipate this. You all are handling it and we do appreciate it. First question, what i i just met with a company, fortune 500 company, who is looking at testing their employees as they come in the door. And yet their concern was one, frivolous lawsuits, class action suits by trial lawyers, hipaa violations, health you just cant take temperatures of people without getting into all type of issues. What would for any of you, what would you say for them to do . Cdc has published our guidance for businesses and encourage them i heard the first day it got over 500,000 downloads. I would like people to look at that guidance carefully. Secondly, there are complexities as we spoke, about testing. Probably most importantly the number of people could have this and actually have no symptoms. The other reality is when the test turns positive after you are infergted is still a skein tichkt question. I can defer to dr. Fouci. So at this stage, we really would like to see the tests provided to those individuals that feel they were exposed in the clinical setting, as we continue to try to expand that. Those individuals that obviously are presented with flulike symptoms in the hospitals. Obviously we want to see the tests used for broader Public Health sur advantage. I think thats the stage were in. Id like to see if tony wants to add something . No, it is. There are two situations dr. Redfield described, one, the tried and true cdcbased situation, where its based on the doctor patient interaction, where a doctor as a patient who wants to get tested for cause, theyre sick, theyve been exposed, what have you, that worked well. The system right now as it exists, of doing a much broader capability of determining what the pentrance is in society right now is not operational at all for us. And what the cdc is doing now is that theyre taking various cities. They started with six, and then theyre going to expand it. Where theyre not going to wait for somebody to ask to get tested, theyre going to get people who walk into an emergency room or a clinic with an flaunsalike illness, and test them for coronavirus. If you do that on a broader scale throughout the country, youll start to get a feel for what the penetrance is, and thats a different process. Unfortunately our system from the beginning was not set up to do that. And thats the reason why were not able to answer the broader skez of, how many people in the country of infected right now . We hope to get there reasonably soon, but were not there now. What is your opinion on the question i was asked by this employee, do i give do i take the risk of when you walk in that door, no symptoms, you just see what whether its a temperature, whether its asking questions, they are petrified of the outcome if they do that. Theyre also petrified of somebody having the virus when they walk in the door and them being held liable if they infect and this company has 500 employees. They do shifts, working three shifts. Whats your advice . You know, at this point, our strongest advice is that people sick need to stay home. Those companies that are in areas where were having significant cases, if they can, you know, telework, were recommending that. Those companies that are with cases, were asking for social distances. Were not asking for everybody he to come at lunchtime and sit at the same table. Were not advocating, and obviously individuals that just returned from italy or france or germany, wed like them to stay home for 14 days. But were not advocating the use of these tests in a broad way in the absence of a relationship with a physician or Public Health official to make that determination. Second question, weve got probably 80 people in this room. The questions that im getting asked, what are the in this room today, what are the likelihood, i dont know whos got what in this room. Walk me through the likelihood of any one of us in this room getting the virus, assuming somebody here has the symptoms . Again, still, the real risk in general right now, and this is why the president took the action he did last night, within the world now, over 70 of the new cases are linked to europe. And in the United States i think it was now 30 states in our country, 30 of your states or more were linked actually to cases in europe. Europe is the new china. And thats why the president made those statements. Clearly we can only continue to emphasize the basics that weve all said about washing your hands, obviously staying away from people who are sick, learning how to cough correctly, dont touch your face. Although we all know its very complicated to try to not touch your face during the day. But i think its really important that we also are moving quickly with broader mitigation strategies based on the virus. And tony may want to add to this. So some of that is really encouraging social distances in the workplace. Really encouraging social distances in restaurants. Really encouraging social distances at sporting events. So tony you want to add . Yeah, so sir, its a great question, youre right. Everybody is asking it. And the issue is in the spirit of staying ahead of the game, right now we should be doing things that separate us as best as possible from people who might be infected. And there are ways to do that. You know, we use the word social distancing but most people dont know what that means. For example, crowds. We just heard that theyre going to limit access to the capitol. Thats a really, really good idea to do. I know you like to meet and press the flesh with your constituencies. Not now. I think you need to really cool it for awhile. Because we should be practicing mitigation, even in areas that dont have a dramatic increase. I mean, everyone looks to Washington State. Pe look to california. Theyre having an observe serious problem. But their problem now may be our problem tomorrow. So weve got to act like theres going to be a problem. And that means doing everything you possibly can to do the guidelines that the cdc puts up, which sound very sim splitsic, but theyre really important. Common sense. Common sense, yes. Finally i know when this first became public, we, i think this country had test kits out in an effort to find a vaccine, to those willing i guess to be tested. Where are we on that . I want to just sort of stress the complexity of getting tests, as weve heard from a number of your colleagues, is not just about having the reagents that cdc originally made for a test. You obviously need that test kit. And weve put out in the Public Health system over 75,000. So the Public Health labs have that. But the Public Health labs actually have to have the people to do the test. And what is their capacity . They have to have the equipment. And whats the capacity of the equipment . Some of the early reagents that they need. You got to extract nukeleic assit in order for it to go into our kit. Theres a whole system that we can see that theres different limitations, as we expand. Cdc tried to use the thermo psycheler which is not one you can do tens of thousands of tests. Youre limited some labs between 20, 50, cdc can do 320 to 350 a day. Theres others that can do really thousands. And those systems are what are coming online with lobcore and quest, and actually new york state recently got approved to put their system online. I want people to sort of understand that, you know, that whole scenario in terms of actually. And then one of the great things about labcore and quest coming in is they already have the distribution system, the collection system. The more they get into the clinical marketplace, the faster the American Public are going to have access to this. I want to thank you. Madam chairman, i appreciate you letting me have eight minutes. Thank you so much. Thank each one of you. Youre getting good questions and answers. The gentleman from vermont, mr. Welsh, is recognized for five minutes. Thank you very much. The question for us now is, what can we do and how best do we do it . And if i understand it, this is directed to dr. Fouci and dr. Redfield, is that the two essential things are testing and the social distancing or quarantine or separation, keeping us apart from one another. Is that more or less correct . Yeah. I would put the social distancing and other issues of preventing infection ahead of the testing. But the testing is very important. Dont get me wrong. Let me go on the testing. I heard two different emphasis from each of you. Dr. Redfield, you were, as i understand stood it, focusing on the doctor patient relationship and the doctor triggering the toast. Dr. Fouci, i understood you to say surveillance testing is useful. Were seeing that with dri drivethrough testing. Am i describing a difference . There is, but we should be doing both. Thats what im saying. Do you agree . Yeah. Cdc, we have multiple Surveillance Systems for respiratory disease and flu. We have multiple we dont want to hear about that. This is right now with this virus, what should we be having our states like vermont be doing surveillance testing and figuring out how to do that . Were now moving the covid19 into that system. We started with the six. Were going to expand jurisdictions. Yes or no . She we in addition to be doing the individual testing, the surveillance testing . Both. I agree with dr. Fouci. So information data is power, correct . Its critical. And thats what ive said i think at the last part of the hearing as now. You did. The system was geared for the individual doctor patient. What were going through now transcends that. We need to do more than that. Theres a Public Health issue. So a person who presents has got a problem, but its a problem that unfortunately that individual is going to share with a lot of other folks. Correct . Yes. And when that individual is confirmed, it triggers the Public Health response around that individual. Let me keep going. One of the things we have to get here, all of us represent folks who are going to be getting sick. So this is not a red state blue state type of deal. Were all in this together. If were not, well all get sick together. So on this question of travel, which is one of the big issues, the president is banning travel from a number of European Countries. Does it make sense to exclude a single country, Great Britain . Dr. Redfield . Is there a medical reason to do that . We were looking at the extent of new cases in different areas, and the reason that shengan area, because theres no borders i dont have that much time. Ill tell you. Im mystified. If you have a number of European Countries where theres a travel ban, i can accept that if thats the medical recommendation about how to combat this. But then you have one country singled out for exemption even though the cases for that country are higher than a number of others, how does that medically make sense, dr. Fouci . Well, ill do it quickly. Hopefully. So when we were looking at the pure Public Health aspect of it, we found that 70 of the new infections were coming from of the new infections in the world were coming from europe, that cluster of countries. And of the 35 states, 30 out of 35 of them who were more recently getting infections were getting them from them. That is predominantly from italy and from france and from germany. Okay, thank you. So when did this no. There is an answer to your question. So when the discussion was, why dont we just start off and say ban from italy . We were told by the state department and others that in fact you really cant do that, because its sort of like one country, the whole european thing. And the reason i believe that the uk was left out was because there is a difference between the ease of transportation between the European Countries and the uk. Thats brexit. Thank you. But let me go into amy last question. My understanding is that the best preparation is advanced preparation. It turns out we dont have the tests that we need. Theres a lot of confusion about it. If before this virus hit us, we had those tests in place, we had systems and backup plans in place, thats where you get the head start to keep that curve lower. Im going to ask you, as mr. Curry, as the head of gao, was it helpful in our advanced preparation to have disbanded the National Security team Global Health security and bio Defense Directorate . I dont think it was. There has to be a central coordinator above the departments and agencies. They cant tell each other what you to do. That is one thing on the administration. I dont or mr. Roy, i agree with you, but i say we ought to put that back in place. We got to be prepared in advance. And i hope we could Work Together to do that. I yield back. Gentlemans time expired. The gentleman from texas, mr. Roy, is recognized. I thank the gentle lady. If i might reserve my time for a minute. I want to make one observation, first of all i want to thank the chair. I think its important that the witnesses come back today. And i would respectfully disagree with my colleague from louisiana. I think its important we hear this. Because youve got 435 members of congress who have to go home and explain whats going on. I think this is important we have this hearing and continue to have it and thank the gentlemen for being here. I would observe when we have these intervals, the gentle lady from florida was able to explore the questions long enough to get responses and have a backandforth. And i think thats important. I think we ought to have that kind of a dialogue instead of getting these short increments instead of firing away and having our camera time. I think thats a good thing. And i appreciate it. Okay, thank you. Back to on my time, i would say, first of all thank you to dr. Kadlec, dr. Ross, you addressed the issue were dealing with in san antonio. I think thats a good example of how to deal with these. I appreciate you doing that. Weve resolved that. Thank you. I think we have. Secondly, our job as leaders is to present in my view calm resolve, focus on the facts. And go through this so that the person American People know were on top of this. I believe we are but were trying to move forward positively. I think we need to we know now we need to minimize social ingaugement while importantly maintaining commercial activity. Our lives demand on vibrant commercial activity. We have a responsibility to talk about this in a rational and sane way so we maintain commerce, the very commerce that will save lives, that will allow us to be able to produce wealth and opportunity, create jobs and pay for things, while having the social distances. Weve got to come up with ways to do that. Last night i spoke on the phone with dr. Sherran at the fda and got some updates on some of the testing information, because i wanted to talk to somebody at the fda. My understanding and response from them, hes not here to testify, so i want to validate this, was that he talked about upwards of 2 million tests, not individual test kits, but the ability to test 2 million times were coming to availability this week, 3 million more in the next week, and weve got a rather large and robust testing ability coming to market shortly, that weve got private enterprises producing these tests, universities, state Public Officials that have the ability of to test, and we are now getting to the place of scalability to ramp up and have a fairly sizable launch amount of testing ability in our robust federal system. Would awe agree, dr. Redfield, that is the trajectory . Since march, ive been told there are over 4 million tests that have entered the market. The test isnt the whole answer. Right. You need people to do the tests, laboratory equipment, some of the reagents that are now in short supply to prepare the tests. You need the swabs to take the tests. Were working very hard with the fda to make sure all these different pieces, you know, right now the actual test to do this coronavirus test i think we have the test in the marketplace. The question is how to actually operationalize them. I think thats awhat what tony and i are saying is the big challenge. I appreciate that. Theres a lot of rhetoric flying around both sides of the aisle all over the place about kits, test kits, what we can do. We have a significant amount of scalability in this country that weve got to recognize, but also realize weve bot 350 Million People. We have states, navigate through that. We have to make sure we have the right tests and theyre effective. Theres some questions about whether the korean test was as effective as we might prefer. Theres debate about that. Is that a fair statement, about making sure were working through to make sure weve got the right tests while were working to make sure weve got all of the materials . By the way remembering weve got supply chain issues weve got to deal with given the worldwide connection and the splay chain . Yeah. A critical regulatory role that the fda really holds which is important that we have tests that actually work. And we actually can be assured of that. I can tell you that the tests that are currently being put out both by to the Public Health labs and by labcore and the private labs, they actually work. The challenge is really, and this is why i want to really emphasize we focus so much on the actual kit of the test. Right. We have to focus now on the whole system to get that testing really rolled out, bough both for surveillance which is cdcs main job, and to clinical medicine. An assertion was made or a question was raised about whos in charge, right . One of the difficulties of a federal republic like ours is that there isnt one person in charge of making all of this happen, right . Isnt that also, you know, some people might say thats a bug versus a feature. Some might argue its a feature with 50 labs and universities being able to coming up with ways of navigating this and our markets being able to scale up and produce. Keeping in mind that the American People are listening and were trying to explain how this system works, there isnt a singular topdown approach in our country of doing this, but that is the same america that has, you know, stomped out naziism, put a man on the moon, cured polio, gone through the things in 9 11, built and rebuilt southern manhattan, this is the america that rises up. I think its important that we talk about that in its complexity and wholeness . Bob kadlec is here and in charge of overall incident management structure. I appreciate that. Thank you, sir. And thank you, dr. Redfield. Simply given the nay tour of our system and the federal government where there are Health Departments across the domain, department of homeland security, the responsibilities fall to my position to basically manage and integrate and synchronize those efforts so we can come with a unified response. Most importantly to support state and local authorities in disasters. Thank you, dr. Kadlec. Madam chair, appreciate it. Thank you. The gentleman woman from illinois, miss kelly is recognized. Thank all of you. I know youve been working very hard and ive seen you multiple times myself. Im the chair of the Congressional Black Caucus trust and also my district is urban, sub urban and rural. When i hear you talk about theres 30 States Affected so far, but within those states do you see it more urban or is it a mixture . And i know im talking about the people that have it by no obvious means, not the people that were in italy and where they go back to live, but just the people that are getting it by not an obvious means . Just for clarification, when tony and i were mentioning the 30 out of 35 it comes from europe. As of this morning we have 44 states and the District Of Columbia that have reported at least one case. And i will say that im not going comment in the distribution. I can get that exact information for you. But it is we are seeing more and more jurisdictions report their initial case across the country now. I think this is one of the big reasons why the president made the decision we need to use our efforts right now to really continue to try to contain this outbreak with the cases we have and let the Public Health system focus on that around those clusters, do aggressive mitigation. But if we continue to have individuals coming in that seed new communities all through the country, it will be very hard for us to get control of this. Thats why this is sort of an integrated, muleilayered Public Health effect. Dont under estimate our local Public Health system to do its job. My concern is in under served communities they have a lack of access to some of the Public Health or health care. I will say its our concern too. Were trying to look at strategies now for homeless populations. We really are concerned for really all of america. Uhhuh. The other thing is a doctor i know told me she received a fax and the fax said that she could im trying to think of her exact words work around or go around the cdc and get tests herself and swab the nose, like you talked about, and then quest lab would pick up the test. Is that correct . Shes in new jersey . Yeah, thats correct. Getting the again, the spirit of america, when Vice President met with all of the major diagnostic companies, they didnt come there as individual companies. They said were in this together. How can we step up . Theyre all moving up, quest and labcore being the biggest. Theyre all theyre activated their entire system in. The kick will come in when theyre able to transform to what we develop the high through put system. Theyre working hard to develop that, like new york state was validated yesterday, chairwoman. So theyre up and running with the high through put flat form now. Also quarantine is with those exposed but not yet sick. If someone in quarantine gets sick, do you switch them to isolation on site or move them to a prevent hospital . What happens . If they get sick, and someone is in selfisolation or quarantine at home, theyre being monitored for symptoms, if they do become symptomatic, they get a comprehensive medical evaluation, and then obviously either return to home isolation if thats the medical appropriate decision for them, its a sore throat, or if they look like they need medical attention theyll get hospitalized and managed in isolation. How are those costs covered for a private hospital . Does cdc offer cover the outofpocket costs . How does that work . Well, the department has the authority to reimburse those. Cdc has the authority. The department has the authority. The department were working now the best way to accomplish that. And have you, maybe someone asked you this, looked over the legislation that we will be considering today . Have you i havent seen the legislation. Okay. Okay. Thank you. I yield back. Thank you. The gentleman from pennsylvania, mr. Keller, is recognized for five fientsu minutes. Thank you, madam chair. And thank you to the panel for being here again today. I know theres been a lot of things that have happened, and weve actually been trying i know we did the supplemental appropriation and made the funds available. Also communicating with many federal and state agencies to make sure we get information out to our constituents. So thats a lot of what weve done. Even this morning had a couple briefings, bipartisan briefing in the Capital Visitor Center and on the phone with the white house and other people. In addition to that, in pennsylvania our secretary general, or physician general, excuse me, physician general of the commonwealth, Rachel Levene had a call with all members of our delegation and members of the pennsylvania general assembly, to go over what the Wolf Administration is doing. So theres been a lot of activity as far as what ive seen, trying to make sure people are informed. I know we talk about social distancing. So maybe i can cover that. I know one of my colleagues had a question about that, too. You mentioned social distapsing. But what does that mean for i know we talked about a lot of sporting events and schools. But are there any other private events where people might want to think about social distancing and what might those places be . Ill have tony add. But were giving out guidance in terms of the size of events that should happen. You know, and really discouraging people from having large events. Now, its different in different kmurnts by the kinetics of the outbreak right now. And were looking at each community to develop it. Thats why we put our matrix out there. Social distancing, we want people to stay six feet away or more. If you can have an event and ev people stand outside and theyre ten feet away from each other, thats how we refer to social distancing. We really are in a mode, this is time for big events like march madness, big events like the sports arena things to take a pause for the next four, six, eight weeks until we see what happens with this outbreak in this nation. Thank you. Again, ill reference back what the physician general said so far. I know theres been a lot of questions about testing. Dr. Levine said so far in p pennsylvania where every doctor deemed a covid19 testing happen, that has been performed. She said the state has the capacity to do the number of tests per day that they can, and mentioned actually labcorp and crest diagnos Quest Diagnostics are able to perform the tests in pennsylvania and will report the positive results to the state and those will be made public. It appears pennsylvania, the fifth largest state by population in the nation and the worlds 18th largest economy has figured this out. She goes on to say we will meet the demand for testing and were following the guidelines to do that. So pennsylvanias able do that. What things might have happened in pennsylvania that we could put in place in other parts of the country if were having trouble with testing . Thank you. I think the Biggest Issue is effective communication. Quest and labcorp is really in all of the states in the country. Weve gotten all the Public Health labs have gotten the resources from cdc. I was told by the head of the american Public Health labs in the last 24 hours that hes gone through all the Public Health labs, not a single lab lacks the kit, the reagents, the capacity to do testing right now. So i do think a lot of it is just effective communication. It seems like dr. Levine and the people in the Pennsylvania Department of health seem to be headed in the right path. So im glad for that. Im just hopeful that we can replicate that. I would like to add my congratulations to them. I know rachel well. Theyre a very serious Health Department and they stepped up. Thank you. Dr. Fauci, what can we do as congress to continue to work with the Trump Administration and state Health Agencies to ensure the Public Health experts and private Sector Health care providers have what they need to continue to respond to covid19 . I believe you already have done that to a big extent by the supplement you have done, the 8 8. 3 billion supplement which allowed to us do the kinds of things each of us responsible for different aspects of the response. I know speaking for myself and my agency, the nih, the amount that we got from that supplement that we will get from that supplement will allow us to really accelerate what weve done in the arena of therapy as well as the development and acceleration of fvaccines. The other thing thats important is what youre doing now to have the opportunity to come before you within reasonable you dont want to come every day, but to come enough to be able to get the American Public to really hear from us. This is an evolving situation. Its not static. Its not one off and youre done. Its going to evolve over the next several weeks. I just want to add one point. Its been so important. Cdc announced well award over 5 560 million to the front line of this response. Thats the local, state and territory Health Departments. Thank you. Does the gentleman yield back . I yield back. Thank you. The gentle lady from the Virgin Islands, miss plaskett is recognized. Thank you very much, madam chair. I want to thank you, gentlemen. I was there at the briefing you had this morning. I know that you went over to the senate, you were here yesterday, youve come back. So your openness is appreciated and the information that you are sharing with us that we will get out to the American People to try to make sure the right information is there. One of the things that i just want to mention that im concerned about is as we are doing this containment and we close schools, there is a Digital Divide in this country where young people will have issues with keeping up with work. Some of the areas, the urban areas that my colleague, miss kelly was talking about, in the Virgin Islands we have the highest broadband capacity in the United States outside of new york city, but the lowest rate of connectivity to homes. And so these are the things that i think we also need to be concerned about. Were looking at supporting economies, but just our children alone as well as the issues of health and nutrition that i think many kids will face if theyre restricted from going to school when so many of them rely on School Lunches and breakfasts for their nutrition. I wanted to ask you about isolated areas like the Virgin Islands. Were concerned right now. We have an individual of interest that has been isolated. But like ourselves in puerto rico like puerto rico is like us, we have not fully recovered from the hurricanes of 2017. We have seven hospital beds available between the two hospitals for a population of over 100,000. That is very troublesome. As to whats going to happen to us. So im glad you said, dr. Redfield, that you have the funds you believe in place now to do a response. Can you tell me, one, in terms of personnel, what d how do w get these out . How do you get your personnel out . Along with a shortage of beds, we have a shortage of personnel. Thank you, maam, for the question. Theres two elements for our ability to respond to thesarye y scenarios. One is through the dmats, disaster medical assistance teams. They work across the nation at some of the premiere hospitals and medical institutions around the country, mass general, stanford, the like. So in a scenario when theres a potential event of this nature that can happen anywhere and everywhere in the country, we have to be selective in how we do that. We have been deploying those assets to respond to events. Thats one part. The other part is the Public Health Commission Corps who are a part of our team. They belong to the assistant secretary of health. Theres several thousand of them. I think the intent of the admiral is to expand their expa di expeditionary role. Today in seattle, in the nursing home afflicted by the covid virus, there are two Public Health corps officers working to assist Public Health officers there. Are you able to bring people to locations that are in need . How do you prioritize what those locations are . Its based on the need and what the capabilities are domestically or in that area. I already contacted my Principal Deputy about your situation and we are intent to find ways to augment or support what is needed for your constituents. Great. Can i mention something really quick . Yes, please. I cant help myself because i do work on Disaster Recovery with fema. I was to the Virgin Islands after hurricane irma. I would suggest you talk to fema as well. They still have an open disaster declaration on the island. Ive been to the hospital on sost. Croix. I know its destroyed. We have a temporary hospital. We dont have a temporary hospital. Its been approved. I suggest you contact fem a and see what they can do under the umbrella of the current recovery. I found fema has been great in disaster initial recovery, but rebuilding is a little slower. The fact we still two years later do not have our mobile unit for a hospital shows that there are gaps in fema as el. I do understand. Theres a question should all of these things is this a disaster and should this be within one umbrella so were not talking to disperate agencies at the same time. The other thing i wanted to bring up quickly is cruise ships. You talk about containment. We know that individuals coming off of a cruise ship cannot be tested immediately. So when you have individuals who places like the Virgin Islands which relies heavily on tourist populations, what is your advice to us in terms of ensuring that we contain ourselves so that we do not have a spread of this . Maam, one thing that is ongoing is the cruise industry is trying to advance Healthy Practices for their own cruise ships so they can monitor people. They submitted a proposal to the u. S. Government outlining what the approach is. I think one of the things they include there is monitoring, doing surveillance of passengers, being able to do testing of passengers on the boat, having medical referral capacity to medevac them if they have to and having quarantine capabilities. Thats an ongoing dialogue between the cruise industry and the u. S. Government. They see it as an important responsibility to customers and passengers, we agree. Dr. Redfield, did you want to add something . Weve definitely put out our guidance that were strongly advising individuals with serious medical conditions that they should reconsider all cruise travel. That supports the passengers there being infected by others, but what about those who are passengers and infecting individuals when they come off ooft cruis of the cruise ship. Thats why its so important, surveillance. Theres 12 cruise ships across the world that have been looked at for potential covid19. As the doctor said, theres active discussions going on to what decisions should be made about the cruise industry at this time. Tony, i dont know if you want to add anything. There was a meeting with the cruise ship executives to tell them they have to comfort with a plan to tighten up the protection of people who go on as well as what happens when they go off. Theyve been given the mandate to fix it. If they dont fix it, they may be given recommendations they dont like. I yield back. Gentle woman from massachusetts, miss presley is recognized. Thank you, madam chair. Thank you to our esteemed witnesses for returning today. Since the beginning of the covid19 outbreak, weve seen not only the spreading of the virus but also a rapid spreading of racism and xenophobia. We witnessed it at the highest level of the Republican Party fanning irresponsibly these flames. One colleague tweeted that everything you need to know about the chinese coronavirus. This painful rhetoric has consequences. Restaurants across chinatown have seen up to an 80 drop in business. I believe this has everything to do with the rapid spread of misinformation and paranoia. It is critical we stand against these insightful messages and assuage fear in our communities. We do that by dispelling untruths and misinformation. We do that by sharing the facts. Im grateful youre here today so we can get to the truth about this virus. 30,000 residents across mysuins access access to health insurance. Many are food service worker, hotel workers, a day off from work due to illness could mean losing a months worth of groceries. The cdcs web side advises people with symptoms related to coronavirus to stay home and seek medical care, but it doesnt address the realities of living uninsured. Dr. Redfield, if im a symptomatic hotel worker who is prediabet prediabetic, uninsured and lacks the savings to cover the cost of testing and treatment, what specific guidance do you have for me . Very important question. Obviously we want you to be able to stay at home and this, i think i dont know where it is, tony, but i think theres clearly great recognition of this issue by the White House Task force. I dont know where it is in its way to getting to you, but weve addressed this as a critical Public Health component. We need these individuals to be able to do their 14 days at home and not have to sneak out for an hourly job because they have to pay for their cost of living. I can tell you that the White House Task force is addressing this. Dr. Redfield, if i might, will the cost of testing be covered . Cost of testing will be covered. What about treatment . Cost of treatment will be cover covered. I appreciate these conversations are happening. In terms of information thats public facing and accessible to the general public, as of this hearing, neither the cdcs portal for the coronavirus or its faq, frequently asked questions page has information about what the tests cost, who will cover it and whether uninsured people can be tested. So this is contributed to the confusion and the panic. So can you please make a commitment today to add this information to the website . We will do our best to clarify. Related to costs, particularly for labcorp and quest, they have not defined it, but they have shown their leadership independent of rolling it out. I can take that as an affirmative. A yes. Okay. Dr. Fauci, im uniquely concerned about people with auto immune disorders and those with Underlying Health conditions like hiv, lupus. Any specific guidance for how these vulnerable groups can protect themselves . Thats a great question. Thank you for asking it. They fall into the category of those that i have been saying multiple times at this hearing and other places that are in that category, if they get infected, likely many of these people are on immunosuppressant drugs, they need to take extra special precaution. They are vulnerable and they need to help protect themselves and Society Needs to help to protect them. In other words, keep people who are sick away from them. Keep them even more stringently apart from crowds. Dont travel unless its necessary on long trips. And above all, stay away from cruise ships. Okay. All right. So i want to turn to another issue, one group we have not heard much about, the 2. 3 Million People who are in prison or jail. Mr. Redfield, about 10 of federally incarcerated people are over the age of 60, many of these people have Underlying Health conditions, and based on your own criteria are most at risk for severe complications due to infection from the coronavirus. These individuals often lack access to alcoholbased sanitizer, hand soap, warm water and regular showers. Dr. Redfield, yes or no, has the cdc offered guidance to the federal bureau of prisons about the coronavirus . Let me get back to you about the specifics of what we have done. I know we have guidance to the correctional system in general. Rather than answer and give you a half answer, let me get back to you. I will do that today. So not a yes or a no. Unsure. Want to be accurate. Okay. All right. Certainly prisons can be incubators for infectious disease, that puts those in prison at risk as well as those employed there. What recommendations or protocols has the cdc provided to federal, state and local Correction Systems about preventing or responding to an outbreak . Again, i want to i will get back to you today. I want to be accurate with my response. Okay. Youll get back later today . I will. Thank you, doctor. And just because the administration has touted an expressed commitment to criminal Justice Reform as a priority, this president has granted less commutations than the prior administration, with overcrowding the federal Correction System is a breeding ground for a deadly outbreak. Has the president or any member of the task forced raised clemency power as a method of alleviating a potentially devastating outbreak . To my knowledge, no. They may have done it, but to my knowledge, they have not. Thank you. The gentleman from ohio, Ranking Member jordan is recognized for five minutes. Thank you. As much time as he may seek. Thank you. I appreciate our witnesses being here today. I will yield to dr. Green and let him have some followup. Thank you. I want to make a couple points and then have some questions. The first point is on the 2015 biodefense study that was done under the Obama Administration. The Trump Administration has followed that. That recommended that the Vice President be the person in charge of the task force and president Trumps Administration followed the recommendations of the Obama Administration on that. I want to be clear about that. Because there has been some criticism. On the south korean tests, we had a lot of comparisons about how theyve done testing much faster than us. I have a letter from the fda has says the south korean test is not adequate. A vendor wanted to purchase it and sell it and use it in the United States,s the fda said im sorry, we will not even do an emergency use authorization for that test. So i have that letter. I would like to ask a question about the d. O. D. And their as i understand it, they have assessed Field Hospital resources, they have their icu beds, ventilators. Can you tell us about what the d. O. D. Is prepared for or has looked into should we exceed private hospital bed capacity . Yes. Thank you for that question. We have done a Current Assessment of our military treatment facilities. We know the number of beds. We know the amount of staff per bed. We know the amount of occupied beds. We know the icu capability. We know our alternatives for increasing the number of beds. Increasing the staff for those beds. We know the inventory of our personal protective equipment for the medical force. Thats for the mtfs. We know the current status of our military operational deployable medical assets. We have that, stand ready to respond to the commander in chiefs needs. As the nation needs. Thank you. Most of the people on this panel are not scientists. I consider myself to have the equivalent of an orange belt in this i know just enough to get myself in trouble. The speed with which you guys have gotten this vaccine up and you know, ready to go into stage one is unprecedented. It is breaking records. I want you to just brag a little bit on yourselves. Tell us how hard that is and why we should all be very grateful for the folks that put that together. Why dont i just describe what it is instead of selfc selfcongratulatin selfcongratulating. Thats fair. Its really the culmination of a lot of basic research over the years, we thank the committee as always for the kind of support that congress has given the nih, which not only does research oufrsrselves but funds investigators throughout the world. The platform that we used were not this is not the only one. There are more than a handful of vaccines going. But the ability to use technologies that we never had before, to take the sequence, so the chinese didnt have to send us the virus. They just published the sequence on a public database. We knew the gene that would code for the protein that we wanted to make our vaccine. All we did was pull the information right out of the database. We made it, synthesized it easily overnight, stuck it in to a platform, and started making it. We said at that point it would take i would say two to three months to have it in the first human. I think well do better than that. I would hope within a few weeks we may be able to make an announcement to you all that weve given the first shot to the first person. Wow. Having said that, i want to make sure people understand i say that over and over and over again. That doesnt mean we have a vaccine we can use. Its time to get it tested. It will take a year to a year and a half to make sure it works. I wanted to make that clear as well. If i could make one other quick statement. I will be fast. You have to be fast. Were told this is their third meeting of the day. We have go back to a strikt five minu strict five minutes. Over the weekend, i had a cruise ship, a constituent who had ran out of meds, the coast guard flew that womans out to the ship. You guys are doing great work. Thank you very much. The gentleman yields back. The gentle lady, miss tlaib, is recognized for five minutes. Sorry im all the way in the corner here. I think this is an important conversation about the extent and earlier this weekend it was said 150 Million People will eventually contact the coronavirus in the United States. Dr. Fauci, is that wrong . Who was it . Congresss attending physician. Yeah. I think we really need to be careful with those kinds of predictions. Sure. Because thats based on a model. So what the model is all models are as good as the assumptions that you put into the model. So, if you say that this is going to be the likely percent of individuals so, what can we do to define that . Testing . No, its unpredictable. Testing now is not going to tell you how many cases youre going to have. Mmhmm. What will tell you what youre going to have will be how you respond to it with containment and mitigation. So i want to make a point that irhope the publi hope the public gets. When people model. This is the lower level, this is the higher level. What the press picks up is the higher level. They say you can have as many as. The model during the Ebola Outbreak said you could have as many as 1 million. We didnt have a million. Thats great. I spoke to federally accredited clinics in my district theyre noticing capacity with the front line Health Care Workers and various hospitals that rely on one hospital in my district relies on nurses from canada that comes acro across. Theyre very worried about borders being closed, not getting access to those front line communities that need help. I do want to air it for folks. Im concerned because one of the federally accredited clinics said that is her biggest worry that folks will not be able to come back to work. While you do this, i want to submit for the record congressional doctor predicts 70 to 100 million coronavirus cases. We need to continue with a sense of urgency, and not try the more we do that, i think the more importance that my colleagues understand the supplemental build that is told to be held up for two weeks for help to communities like ours around the country is now being held up and politicized when this is really theres no rd next to this coronavirus, it needs to move forward. Can you answer the question . This is exactly what i heard from the hospital two of the hospitals. Two parts to deconstruct your question. One is the question about whether or not border crossings would be inhibited. I would have to defer to the department of homeland security. There are work practices that have to be evaluated. Others questioned about whether or not the issues of furloughs are necessary for people who have been exposed and potentially at risk for coronavirus and how that works. Theyre continuing to work on coronavirus patients so that they dont pose a hazard to someone who is not ill with coronavirus. Be great. One thing, is i caution us because were all so worried about the commercialized economy stopping, we shouldnt be risking our lives for corporate greed. When we dont pass a supplemental of making sure we have, you know, people that have to not go to work one of my state agencies right now where you get your i. D. S closed down because people didnt show up to work because they want to make sure theyre getting protection, they can get access to testing. I think its critically important we understand that urgency because on the ground, offices are being closed and businesses are being closed, not just large events. The gentle lady from california, miss porter is recognized for five minutes. For someone without insurance, do you know the out of pocket cost of a complete blood count test . No, maam, not immediately. Do you have a ballpark . Out of with a copay . No. The out of pocket typical cost. I do not. Cbcs typically cost 36. What about the cost for a complete Metabolic Panel . I would have to pass on that as well. Any idea . You want to take a ballpark . 58. Getting closer. How about flu a . The flu a test . Maybe 50 . 43. This is like the price is right. Flu b. I would say 44. Thats good. How about the cost of an er visit for someone identified as high severity and threat . What was the question again . The cost of an er visit for somebody identified as having high severity or high threat . Maam, thats probably about 3,000 to 5,000. Okay. That is 1,151. This all totals up to assumina kept in isolation. Fears of these costs will keep people from getting tested. We live in a world where 33 of americans put off medical treatment last year. And we have a 1,331 expense. Conservatively. Just for testing for the coronavirus. Dr. Redfield, do you want to know who has the coronavirus and who doesnt . Yes. Not just rich people, but everybody who might have the virus . All of america. Dr. Redfield, are you familiar with 42 cfc 71. 30 . 42 cfr 71. 30. The code of federal regulations that applied to the cdc. 42 cfr 71. 30. If you could frame what it talks about, that would help me. Dr. Redfield, im well known as a questioner on the hill for not not tipping my hand. I literally communicated to your office last night and received confirmation that i was going to be asking you about 42cfr71. 30. This provides the director may authorize payment for the care and treatment of individuals except for exam and quarantine, isolation and release. That i know about. My office did tell me about that. So youre familiar. Dr. Redfield will you commit to the cdc right now using that existi ining authority to pay f diagnostic testing for every american who doesnt have insurance . I can assure you not good enough. Reclaiming my time. You have the existing authority. Will you commit right now to using the authority that you vested in you, under law, that provides in a Public Health emergency for testing, treatment, exam, isolation, without cost, yes or no . What im going to say is i will review it in detail with cdc no. Reclaiming my time. Dr. Redfield, i wrote you this letter along with my colleagues, rosa delora and laura underwood. We wrote you this letter one week ago. We quoted that existing authority to you and we laid out this problem. We asked for a response yesterday. The deadline and the time for delay has passed. Will you commit to invoking your existing authority under 42 cfr 71. 30 to provide for coronavirus testing for every american regardless of Insurance Coverage . What i was trying to say is that cdc is working with hhs now to see how we operationalize that. Dr. Redfield, i hope that answer weighs heavily on you. Because it is going to weigh heavily on me and on every american family. Our intent is to make sure every american gets the care and treatment they need at this time at this major epidemic. Im currently working with hhs to see how the best operationalize it. You dont need to do any work to operationalize. You need to make a commitment to the American People so they come in to get tested. You can operationalize the payment structure tomorrow. I think youre an excellent questioner, so my answer is yes. Excellent. Everybody in america hear that, you are eligible to go get tested for coronavirus and have that covered regardless of insurance. Please, if you believe you have the illness, follow precautions, call first, do everything the cdc and dr. Fauci god bless you for guiding americans in this time. But do not let a lack of insurance worsen this crisis. I would just like to echo what you said, its a Public Health a very important Public Health, those individuals in the shadows can get the health care they need during this time of us responding to this outbreak. Thank you. And the gentlelady from new mexico, miss holland is recognized for five minutes. Thank you, madam chair and thank you gentlemen for being here today. We appreciate you answering our questions. The dr. Redfield, i want to start with you first. The first four cases of coronavirus have been found in new mexico, my state. We had a Conference Call with governor lou hunt grisham yesterday. She mentioned that two of the cases, its a couple who lives in new mexico, a small town, you know, 70,000 people perhaps, and they were on a cruise ship themselves. They came back to new mexico. Nobody notified the state or the Health Department about them being on a cruise ship where coronavirus was found. So they were in new mexico just doing their normal everyday life for 10 days before the governor or the state was alerted to have them tested and it turned out they were positive. So i am you know, were worried. In a small town like that the virus could spread rapidly. A lot has a lot of attention that been paid to testing. Will we have adequate testing and i want you know, id like to know this adequate testing, i have to believe it will reveal an exponential number of cases throughout the country. How what is the responsibility to just make sure that we are getting this information out to people . People on a cruise ship where coronavirus was known to be found shouldnt be Walking Around for ten whole days before were alerted to that fact. Thank you very much, congresswoman. Obviously the complexity of tracking down people, whether its ships or planes is a complicated issue. First you have to have accurate contact information. And i can tell you one of the things with the with the interim federal rule we recently did for airlines, in the past maybe 20 to 30 of the information we would get would be actually actionable. Im happy to say now were probably over 90 . Were getting the manifest from cruise ships and working with local Health Departments to try to track down these individuals. We do have a confirmed case. And this is why dr. Fauci and all of us have now really weighed heavily this is not the time to be cruising. We really do realize that these are environments that can amplify transmission. Thank you. Thank you, dr. Redfield. Thank you. I want to turn our attention i think you mentioned you know, all of you have mentioned several times today that big crowds need to be avoided. Is that correct . And i want first of all, i want to just talk about our president for a moment. On march 8th he tweeted that Fake News Media is doing Everything Possible to make us look bad. On february 28th he called virus a democratic hoax in front of a huge rally on national tv. Brazilian official, who met with President Trump at maralago has just tested positive for the virus. And hes just boasted recently about his march 25th rally in florida that its all sold out and hes yet to cancel it. And this behavior this is the behavior our country has to contend with. Hes our president. Hes the leader of our country. You have been sitting here for hours and yesterday telling us that we need to avoid big crowds, and im going to tell you that i have republicans in my district who i care deeply about. I dont want them getting infected. Every single one of us here have constituents all over our districts who we dont care who they support for president , we dont want them getting sick. I applaud my governor who just canceled all Mass Gatherings in our state, and i almost feel like saying the president can do whatever he wants. Hes an adult. He can be careless with his own health if he wants to. Thats his choice. By the millions of americans who would go to a rally because hes told them its a hoax, they dont know the truth apparently and its up to all of us to make sure they do know the truth. I understand the position youre in. If you cant tell the president to his face stop all your rallies, cancel every single rally you have planned because american lives are at stake, i implore you to give that message to every governor of every state in this country. We have to we have to stop this where it is and i appreciate you being here. Thank you, madam, chair, i yield. The members time has expired. Mr. Sarbanes is recognized for five minutes. Thank you, mr. Chairman. Thanks to the panel. Dr. Fauci, i have been trying to distill the testing issue against the backdrop of moving from containment to mitigation. In my mind, and id like you to make comment on it very briefly, our failure to get the testing done early in effect means that we missed the containment window, and now have to move rapidly to the mitigation stage of this thing. In other words, you kind of have been intimating dont wait for the surveillance testing, dont wait for the person to person testing to make a judgment about what we have to do. We are past containment, well past it. There might have been a moment when we could have had an effective strategy around there if the testing had been deployed better. The Community Spread has been happening for weeks and so forth. Is that a fair characterization . With all due respect, sir, its not totally fair. Let me briefly try to integrate what you said, part of which was true, part of which i think is maybe a little misleading. Clearly weve said many times i said p ublicly we had a problem with the testing and if we needed the surveillance, were not there yet. I dont think you can draw that line of lack of having it in the beginning to the fact that were now doing mitigation. Number two fair enough. You dont necessarily give up containment when you go to mitigation. You can do some containment at the same time youre doing mitigation. I would emphasize im glad youre giving me the opportunity to state it yet again, because you can never state it too much, that right now all of us, regardless of what testing is going on need to be doing the kind of distancing, avoiding crowds, teleworking where possible. I said it many times, ill say it again. This is not business as usual. If you live in a state or a region where there are just a few or no cases, it doesnt matter. You really need to do the thank you. Thats a very good clarification. Let me ask you a science question. Sure. So i understand. If somebody got the virus three, four weeks ago, just thought they had the flu or a bad cold or something, recovered from it, theyre now essentially immune from getting the virus again, is that correct . We have not formally proved it, but it is strongly likely that thats the case. Okay. Because if this acts like any other virus, once you recover, you wont get reinfected. If they then came down with another cold, not related to coronavirus, thought maybe it was coronavirus, got tested, would that test show that they had gotten the coronavirus or not . If do you an Antibody Test, if you wait weeks and months after you have recovered, the Antibody Test will tell you whether that person was formerly infected with coronavirus. Following up on that, if somebody has the immunity and in that sense is not a carrier, they could still transmit, right, if they were in a space where they got the virus somehow on their skin or Something Else so they could still put someone else at risk, even though in their mind theyre thinking im immune so im safe to move around in a sense. Is that true . No . Absolutely not. Thank you for asking the question. Lets say i get infected. And whether i get sick or not, i clear the infection from my body. I do two tests 24 hours apart, which is the standard to say im no longer infected. A month and a half from now, you do an Antibody Test and that test is positive. Im not transmitting to anybody because my body has already cleared the virus. So even though my Antibody Test says you were infected a month or two ago, right now if theres no virus in me, im not going to be able to transmit it to anyone. Im asking a slightly different question. I will run out of time. Ill ask you offline, so i understand that better. I did in the last 25 seconds here just want to say that id like to follow up dr. Kadlik, i believe, in terms of the federal governments plans around telework. Obviously thats going to be critical in terms of continuity of operations. A lot of folks are doing that on a discretionary basis. Im interested in what the agencywide response is there. I have something i would like to enter into the record, madam chair, which is testimony from afge in part relating to the importance of telework and what they would like to see in that space. I would ask for unanimous consent to submit that into the record. Thank you. Thank you, madam chair. Thank you all for being here. Last night, President Trump announced that starting on friday at midnight, he is suspending all travel from and to europe to the United States for the next 30 days. Only the United Kingdom and appropriately screened americans are exempt from this band. The cdc previously recommended that all americans avoid travel to china, iran, south korea and italy. It has recommended that older adults or those with chronic medical conditions postpone travel to japan. Dr. Fauci, will a travel ban like this have a Significant Impact on reducing the Community Spread of the coronavirus . That is cases that are already in the United States . Yes, that is the the answer is a firm yes. That was the reason, the rational, the Public Health rational why that recommendation was made. If you look at the numbers, its very clear that 70 of the new infections in the world are coming from that region, from europe, seeding other countries. Second thing, of the 35 or more states that have infections, 30 of them now most recently have gotten them from a travel related case from that region. So it was pretty compelling that we needed to turn off the source from that region. Let me so, ive been in a lot of the briefings, ive been listening to you carefully. What changed between, you know, when you were here to last night, to all of a sudden we impose this ban . We, as you probably know as i mentioned, we meet physically once a day every day and Conference Calls between briefings, and things evolve as you see the cases. When you look at the data, all of a sudden we had china being the seed, we did that with china. As the days and weeks go by, it became clear it wasnt china anymore. It was another region. So something changed, right . So this was always an option that was on the table . But the dynamics of the outbreak changed it shifted from a china to the rest of the world to europe to the rest of the world. You yesterday quoted gret zi. Y you want to be where the puck is. Do you expect the administration will issue additional travel restrictions in the future . I think if the dynamics of the outbrakeman dates that, they would seriously consider that. I can tell you it would be seriously considered. What other countries is the cdc watching for similar recommendations . Clearly it was korea, italy, iran that became the next epicenters. Because of the italy spread, the spread to the region, now we have a major regional outbreak now in europe. Were continuing to really watch the whole world at this point in time. Its iran, korea and the mainland europe that are the epicenters right now. With europe driving the global outbreak for sure for the last couple of days. Okay. One of the things that has been expressed is that the president also warned Older Americans to avoid nonessential travel to crowded places. Cdc recommended the vulnerable individuals avoid travel like long plane rides and in particular avoid cruises. I know this means older adults with Chronic Health conditions. What is older adults . How do you define that . Its not a loaded question. The reason i laugh, my standard answer is anybody older than me. But thats not a good answer. Being here in congress, some people are young, im 45. Whats the age . Generally people refer to it as 60, 65 years old as elderly. The thing we need to point out thats important is that theres new m numerical age and physiological age. Theres a great deal of variability of a person based purely on age. You could have a 75yearold person who is vigorous, has a robust immune system, you could have somebody 60, 65 not nearly as good. The reason why were asking these questions is that con sta constituents want specifics. If im 60 and out of shape, maybe i should not be traveling. If im 70 or older, im a marathoner, i do x, y, z, everything looks great, it might not be as severe, correct . I was just going to say, this is driven by the mortality of this infection. Clearly individuals that are under 30, under 40, under 50, weve seen these individuals may get a severe cold and recover or they may be asymptomatic. When you look at the mortality in italy, the average age of death was between 82 and 84. When you look at the overall mortality across china and everything, its in the 70s. So were trying to get the most vulnerable out of an environment where they may catch this virus. The members time has expired. Thank you. The gentlelady from the District Of Columbia, miseleanor Holmes Norton is recognized. Thank you, madam chair. Were here in the Nations Capital where a state of emergency has been declared by the mayor of the District Of Columbia. This is a tourist mecca. Millions come from all over the world and all over the country. Im concerned about our Health Care Providers and our first responders. Social distancing is not really an option for them. They are in a real sense the last line of defense. For example, in new york we heard of doctors and nurses who reportedly been exposed to the virus. Let me ask you, dr. Redfield, can any medical provider who wants to be tested today be tested . Again, i think that would be a decision that the hospital would make and the individuals physician, but your point, the importance of protecting our providers with the proper Infection Control procedures is critical. We put out guidance. We need to continue so there needs to be prior yo prioritization, people who expose themselves, it seems to me, ought to be given first priority. Let me ask what hhs is providing advising providers to do to ensure there is not a shortage of medical staff. Yes, maam. Thats a critical issue here in terms of evaluating not only the personal protective posture of physicians managing patients with this particular virus, but also those working in Emergency Rooms and other areas where theres a risk they could be exposed in that setting. A couple areas considered are what are the particular work related rules as it would require people to be furloughed from work if they were exposed. There was a question earlier about someone being appropriate protective posture, exposed and then a question if they would be furloughed. It gets back to your possible question of testing. If thats an appropriate intermediate means to keep a Health Care Worker on the job in lieu of that kind of absence or excuse from work. We awoke this morning to find the World Health Organization officially declared this to be a pandemic. Im worried about personal protection equipment. I guess i should ask you. Should shortages of personal protection equipment, face macs, gloves, hamper Public Health response . The what priority is given as to who gets these this Vital Equipment . Maam, thats a great question. Quite frankly theres a potential risk. Much of what we get is sourced from overseas. Were working with manufacturers and distributors to make sure two things happen. One, supply chains run uninterrupted. Second, allocations go to Health Care Workers over others. Is the health and Human Services Department Taking any steps here in the United States to boost production . Yes, maam, they are. Of these supplies so yes, maam. Who is manufacturing these spl supplies . Is that continuing . Yes, we are. We released a request for proposals for a half billion n95 masks to boost production. Working with manufacturers to make sure they have the Raw Materials which are sourced in the United States so they can surge. So all these plysupplies, th gloves theyre boosting them and looking to source them. One thing i mentioned earlier is the importance for Liability Protection for these manufactur manufacturers that should be in our bill then. Thats a mustpass bill. Thats critical to enable more masks were working on a bill as i speak, trying to make it a bipartisan bill. Let me ask you about italy. Italy is the worst case scenario, cit can educate us about what could happen to us. I hear hospitals may run without beds within a week in italy if the spread continues. If the rates continue here let me ask you, are we doing anything to keep the United States from running out of beds . For example, in Washington State . Yes, maam. Were doing a couple things there. The state is working with hhs and doing things on their own. But theyre using alternate care facilities to offload some of the people who are mildly ill and putting them in settings and segregating them from regular in what kinds of facilities . Motels. The same thing is happening in the state of california. Hhs is working with the state there to identify alternate care facili facilities. The one thing that is a concern is if high acuity beds could be at risk and looking for alternative solutions that we can use to make sure we can take care of anyone who has this virus, but more importantly take care of people who dont have the virus but who have other medical needs. Gentleladys time has expired. The gentleman from missouri, mr. Clay, is our last member to question today. Thank you, madam chair for this hearing and, yes, im batting cleanup. I would like to ask about a story that broke yesterday. According to reuters, since midjanua midjanuary, the nfc has ordered hhs to classify toplevel discussions related to the coronavirus. The topics of these discussions have reportedly included and i quote, the scope of infections, quarantines and travel restrictions. Doctor kadlik, is it true that hhs has been holding classified coronavirus meetings . Were holding them in a classified room, but the nature and the content of those conversations are not classified. Weve been doing secure Video Conferencing across interagency and that requires going into a classified space. I can see how it would be misinterpreted as such, but the nature of the conversations are unclassified. So how many meetings since midjanuary have been held . Too numerous to count honestly. Too numerous to count . Were meeting several times a day if not more. At Different Levels of the organization to address critical questions as it relates to the safety of americans, adequacy of supplies and the health care system. But its my understanding that some officials are left out because they dont have the correct level of security clearance. Sir, that that is an administrative challenge times because these secure places are administered by classification rules that have nothing to do with the content of the conversation, but just the physical access to the place. So these individuals have to be escorted in and, again, the nature of the conversations have to unclassified in those settings and they are unclassified by the virtue of the content. Did oes that inhibit our abiy in any way to get the expertise we need into the room . No, sir. I think in the case of the white house situation room which is the highest level of classification you can have, we have all the appropriate people in the room to make those decisions including individuals who have no security clearance at all. According to one official because these meetings have been held in a scif, critical Government Experts have been excluded in these discussions. And this practice, quote, seemed to be a tool for the white house, for the nsc to keep participation in these meetings low. Are you familiar with 28cfr section 17. 22 . Well, sir, id have to have you hum a few bars so i could guess it. But i worked on the Senate Intelligence committee and i have to admit i believe its related to the security practices in these heres what the section describes. Information shall not be classified in order to conceal inefficiency violations or administrative error to prevent embarrassment to a person, organization, or agency. To restrain competition or to prevent or delay release of member information that does not require protection in the interest of National Security. Information that has been declassified and released to the public under Proper Authority may not be reclassified. Do you know that weve discussed at length today the need for our Government Agencies to be transparent with the American People. And they deserve answers to be able to protect themselves and their families from this pandemic. Is the information being discussed in these meetings all actually classified under the definition of classified security information . Sir, they are totally unclassified and i think its been the intent of secretary azar and our department to be radically transparent. To make sure that anything we can share and look to my colleagues on the right of me, dr. Fauci and dr. Redfield who have been participants to offer their thoughts as well. I totally agree with dr. Kadlec. There is no functional classification. Its merely an access thing. And the people that we need are in there and theres nothing that we say in there that were not that were afraid to say you to right here. So you would be willing to share that information with us. We have been. In fact, all the questions weve asked are reflective of whats gone on in that room. Well, and i appreciate that. Appreciate your openness and transparency. I look forward to working together to resolve the issues that we face as a nation. And with that, i yield back, madam chair. Gentleman yield back. I just want to thank all of you for testifying. Would you like to make a statement, mr. Redfield . Dr. Redfield. Thats right. Id like to make two clarifications one of which i did yesterday and one today if i could have a second to do it. Absolutely. So yesterday i want to clarify that when i was asked about manufacturing of the tests, the original tests, i just want to clarify that cdc did manufacture the original cdc tests that we used at cdc. And we also manufactured the initial tests we sent out to states. Its an idt manufactured kits after that. I want that on the record. Secondly, my comments today. I wanted to just clarify that were currently examining all avenues to try to ensure that uninsured have access to testing and treatment. And were encouraging the use of the federal qualified Health Centers that can do this reduced or free. And we will continue to update both the congress and the public and all available resources for this population. Thank you for clarifying that. Yes, uhhuh . Madam chairman, i do have one thing from yesterday. I misspoke when talking about barta. I mentioned it had 53 approvals. Thats incorrect. Its actually 54. Thats very accurate. Would anyone else like to make a statement . Well, i want to thank all of you for testifying today. We realize that this is the third testimony, third meeting that youve taken today. We appreciate it. We appreciate you coming back. Thank you for your public service, your hard work, your dedication. Particularly i want to thank dr. Fauci for serving six preside s president s, six president s and speaking to truthfully and honestly to the public as all of you have. I cant tell you how many people have contacted me that they now understand more about it. They feel better about it. You have truly performed an incredibly Important Public Service by speaking really to the American People as you are today on this panel. We thank you so, so very much. And i do want to say a very special thank you to mr. Jordan. This is his last day as Ranking Member of this committee. We all thank him for his service. He will be moving to Ranking Member on the judiciary committee. But not leaving the committee. So we can continue working together. And i understand that you will be taking your staff with you. So i want to thank them for their excellent hard work and also my own staff that has really worked on this hearing and on all of the matters before it. I just also understand that you will be going next door, as i understand it. So im wondering if you would i yield to you. Im very sorry youre leaving, quite frankly and ive enjoyed working with you. Same here, madam chair. That was very nice and i appreciate those kind words. Ill be sitting right here. Ill be just one seat further, but thank you for your work and its been a pleasure to work with you. Thank you to our witnesses again and for the work youre doing for the American People. The American People are very grateful. Without objection, all members will have five legislative days within which to submit additional written questions for the witnesses to the chair which will be forwarded to the witnesses for their response. I ask our witnesses to please respond as promptly as you are able. This hearing is adjourned. If you missed any of this coronavirus update, it is available to view online at our website cspan. Org coronavirus. The house is scheduled to work on a coronavirus Economic Relief bill. Right now there is no bill. But the house is in recess as negotiations continue behind the scenes on legislation. Speaker pelosi has been speaking by phone with Steve Mnuchin to help craft a measure. You can watch the house live on cspan when members return. More from capitol hill. The house and Senate Sergeants at arms announce today a temporary closure of the capitol complex. They state following the guidance of the medical community, particularly the recent recommendation of d. C. Health and in consultation with the office of attending physician, the sergeants at arms of the house of representatives and the senate have issued a temporary closure of the Capitol Visitors Center to all tours. In addition, access to the capitol and the house and Senate Office buildings will be limited to members, staff, credentialed press, and official business visitors. This temporary closure will begin at 5 00 p. M. Today, march 12th. It will end on wednesday, april 1st. Colorado congresswoman Diana Degette spoke with members after learning the news. Heres what she had to say. I think i can safely say the main concern of the members right now is how many tests that we can process every day. Because while were getting a number of the kits out there, the because of the way our Public Health system is organized, we dont have the ability to process more than a handful every day. And were concerned as the disease seems to spread through Community Spread that were going to need much more capacity to actually process the tests and get results back to people. Will you tell how many people are impacted on capitol hill and whether or not you should close your offices now and go home and what the situation . We have not been told that. I think each office is making that decision for themselves at this point. And do you think it was too late in coming that the tours were canceled . There were a lot of members yesterday who were very worried and concerned that hundreds of people running around the capitol on those tours was just a bad idea. I think this has been a pretty fast progression of the situation. And i think people are trying to make decisions on a realtime basis. You know, im not going to we made that decision about the tours and i think that was the right decision. Do you have any reaction to the europe travel ban . Was that a smart move at this point . One of my colleagues asked the question, how does it make a difference if somebody is a u. S. Citizen or not . Whether or not theyre infected by the coronavirus doesnt seem to make much of a difference. Was there any answer on that . No. Thanks. All right. Thank you. And some news breaking today about President Trump coming in close contact with the coronavirus. Reuters and others are reporting brazilian president s communication secretary has been diagnosed with coronavirus following a second confirmatory today. He accompanied the brazilian president on a recent trip to the u. S. And posted a photograph on instagram standing next to President Trump. In the statement, brazil said it had already notified u. S. Authorities of the positive test. The hill quotes President Trump relative to the incident saying, lets put it this way, im not concerned. The president responding to reporters who were in the oval office when asked about those developments today. You can read more at reuters. Com and also at thehill. Com. President trump today welcomed the Prime Minister of ireland to the white house. During the meeting he spoke with reporters. This is about 25 minutes. Well, thank you all very much. Its an