Is and communities need to know what that is, soy hope that we urge that plan to be public as soon as possible so we all know what to expect. Thank you. Thank you, senator murray. Senator burr. Thank you, mr. Chairman. After working on pandemic policy now for 17 years, im reminded this morning tony fauci has been doing it twice as long as i have and most of you at the dais have been doing that as well. I urge my colleagues to Pay Attention to what each of these individuals say because some things are predictable up here. Congress is a fullfledged partner and funds things when theres an urgent need, a threat thats out there, and and i know, tony, youve seen over the years when theres not that threat out there things get shellofed like platforms that we could have developed and had better countermeasures today, platforms that then could address vaccines at a much faster pace than maybe what were doing but we spend more time with the blame game than we do with focuses on how the future should look. While all of us, members of congress and people within government, wish that we could get back to normalcy, your agencies and members of congress are also charged with making sure that we map the future so that future generations have better protections than what we, have and thats why i applaud the chairman for his white paper, and i would encourage every member that have dais to be brutally honest with us about where changes need to be made and where they dont need to be made. Dr. Redfield, that testing and surveillance on this has not been the best performance by cdc. I dont want to dwell on where weve come up short. Share with these members and myself what can we expect over the next several months from cdc that will be different than what the past has looked like . Well, thank you, senator, for your question. I think cdc will continue to work with the state, local, tribal Territory Health departments to build their capacity. I think we all know that for decades theres been consistent underinvestment in Public Health in this nation, and the core capabilities to do that job data monitorization, data analysis, laboratory investigation, workforce, very necessary for the Response Fund that congress provided. These are Critical Infrastructure issues that the reality are have been underinvested. The cdc is right now probably providing 50 to 70 of all Public Health funding to each state. We need to have a much more robust investment in these core capabilities. What you are going to see because of the congress acting, cdc has provided now 12 billion to the local, state, territorial tribal Health Departments to begin to build that core capability that we would have liked to have built over the last several decades so that theres enhances testing. Its been mentioned that its complicated here because this virus is so asymptomatic for so many so the traditional methods of diagnosis, Contact Tracing, isolation are going to be inhibited for many individuals, and thats going to require Broader Communitybased surveillance strategies. Those plans as was mentioned by the admiral are, weve received them for june and july. Were working with the local jurisdictions. They are going to have them in middle july for the plans of the rest of the year, and were going to be working side by side with them to continue to augment the Public Health capacity response to this covid virus with basically enhanced surveillance and enhanced early diagnosis, Contact Tracing are, ice lies to begin to bring this outbreak under control. I hope some that have money will be used to upgrade the systems at cdc that are antiquated. Sir, i agree with you there. I mean, i think as those of you know, when i was given the opportunity to do this job very early on within a month i recognized that the core capabilities of our Public Health infrastructure is not there, particularly the one that i know youve been very supportive of, data modernization and data predictive analysis and that is in progress. It cant happen too soon, and were appreciative of the support that congress has given, and i do think its fundamentally critical to bring our data system and as you know the data personnel that we, have and we thank you for your efforts there, and as we need to hire those individuals strategically well continue to do that to make sure that the premier Public Health agency in this country has the personal and data systems that it does need, but i will say the other big issue we have to correct is to make sure that our Public Health, state, local, territorial and tribal have that integrated system of data. Dr. Hahn, i think you have used your authorities under papa at fda in a very effective way, and the fda has risen to a challenge during the Public Health emergency cutting red today and maintaining agencys Gold Standard in terms of lifesaving medical products. Youve mentioned innovative lynn call trial designs and use of real world data in areas where fda has gained ground during the response to covid. How do you plan to ensure that this progress is maintained long after the Coronavirus Response is over . Thank you, senator burr. Critical issues that you bring up. In addition, some of the things that were doing on the review side to actually expedite review and work winnow rate issors and developers, we will continue. Part of our review of our actions to date, so a midaction review, will inform how we move forward. No question the fact that real world evidence and an modernization of our systems are needed around supply chain and demand for medical psych will and also on the clinical trials. I hope you and other members will allow dr. Fauche toe make any comments on the reports of the swine flu that the chinese have apparently identified and how that might affect us in the future in this country. Well, dr. Fauci, why dont you do that now if you have anything to say about a swine flu. The chinese over the last week or two have identified a virus in the environment. It is not yet shown to be infecting humans, but it is exhibiting what we call reassortment capabilities. In other words, when you get a brandnew virus that turns out to be a pandemic virus, its either due to mutations and or the reassortment or exchanges of genes, and they are seeing virus in swine in pigs now that have characteristics of the 2009 h1n1 of the original 1918 which many of our flu viruses have remnants of that in it as well as sess n segments like other hosts like swine and when they mix together and contain elements of things that are susceptible to the transmission of humans you always have the possibility that you might have another swine flu type of outbreak as we had in 2009. Its something that still is in the stage of examination. Its not socalled an immediate threat where youre seeing infections, but its something that we need to keep our eye out on just the way we did in 2009 with the emergence of the swine flu. Its called g4 is the game of it. Thank you. Senator sanders. Thank you very much, mr. Chairman, and let me thank all of our panelists for being here and for the great work that they are doing on this pandemic. Let me ask a question that has just bothered me lately. All of you, and i think most americans understand how important social distancing is. Were told over and over again. The chairman told us at the beginning of this meeting stay apart at least six feet if you can, and just the other day, however, American Airlines announced that they were going to fill up all of their planes and other airlines are going to do the same. Youll have people going from new york to california more than five hours sitting inches apart from each other and buses across america where people are packed in like sardines. Knew question is why hasnt the government, whether its the cdc or the department of transportation issued guidelines prohibiting those violations of what we all know to be common sense. S if dr. Fauci, you want to start on that . Thank you, senator. Well, im im not the cdc but id be happy to make a comment on that and maybe bob would also. I mean, obviously thats something that is of concern. Im not sure exactly what went into that decisionmaking. I would hope there would be something to mitigate against that, because i know and weve said and continued to repeat, it avoid willing crowds and staying distant and when in a situation like that wear a mask. I think in the confines of an airplane that becomes even more problematic. But generally i understand the mask thing, but doesnt it sound a little bit sill and a little bit in violation of everything you guys have been talking about to have people sitting next to each other for five or six hours in an airplane or crowded into a bus. And my question is why hasnt, you know, the president the president issues a lot of executive orders. Why havent we stopped that type of activity and told the airlines and Bus Companies that it is unhealthy. Senator, i appreciate your question, and i think its its a critical area. I can tell you when they announced that the other day obviously there were substantial disappointment with American Airlines. A number of airlines had decided to keep the middle seat open. This is under critical review by us at the cdc. We dont think its the right message, as you pointed out. Again, we think its really important in individuals that whether its a bus or a train or a plane and social distancing to the degree thats feasible, and at least you can have a reliable face covering. I thank you, and i just hope very much that the cdc or the appropriate agency basically tells these companies that that is unacceptable behavior, that they are endangering the lives of the American People. Let me go to another question. I just have a few more questions and not a lot of time so i would appreciate brief answers. At the university of washington, the institute of health there indicated that if 95 of the American People were to wear masks we could save some 30,000 lives. A number of countries including south korea, france, turkeyed a austria have provided lowcost or free masks to all of their people, something that i believe in. Would you support an effort to greatly increase the production of highquality masks in this country and distribute them free of charge to every household in america . Dr. Fauci or anybody else who wants to jump in on that. Yes, of course, i think masks are extremely important,able we keep hammering home, and i think what you just mentioned is this important . Theres no doubt that Wearing Masks protects you and gets you to be protected so its people protecting each other. Anything that furthers the use of masks, whether its giving out free masks or anything other mechanism, im thoroughly in favor of. And i just want to echo that, senator, and in my Opening Statement, again, i called on an environment that we have universal masks. I think its fundamentally and the most important thing we can do. Thats great. But when you refer to quote, unquote universal masks which i agree with you on, would you be supporting the increased production of highquality masks and basically distributing them free of charge to every household in america because i think thats going to save tenses of thousands of lives. Would you agree . Senator sanders, this is brett giroir. Yes, sir, i agree that that is very important because we need to support maskwearing. I would also point out that dr. Cadillac has contracted for hundreds of millions cloth face conversation that could be distributed around the country and those kinds of processes are being thought of. When im not in uniform i wear them, they are white and work very effective, and i think they are a great investment for the American People. Good. Thank you. My very last question. Its an issue ive raised now for the last couple of months. All of us hope to god that a good, safe vaccine will be developed as soon as possible, but that vaccine may not mean anything to a lower income person who might not be able to afford it. The i happen to believe that we should make these vaccines, and by the way, as you all know, federal government, our tax dollars, are going to the tune of billions of dollars into your companies to help develop this vaccine. Thats okay, but would you agree with me that after that kind of investment we should make sure that every american, every person in this country, can get a vaccine regardless of their income . Yes. Okay. Anybody else want to comment on that . Yes, senator, agreed. Yes, senator. Well, good. Thank you all very much. Thank you, senator sanders. Senator paul. Will. Thank you. Fatal conceit is the concept that Central Planning with decisionmaking concentrated in a few hands can never fully grasp the millions of complex individual interactions occurring simultaneously in the marketplace. It is a fatal conceit to believe that any one person or small group of people has the knowledge necessary to direct and economy or dictate Public Health behavior. I think Government Health experts during this pandemic need to show caution in their prognostications. Its important to realize that a society meekly submits to an expert and that expert is wrong, a great deal of harm may occur when we allow one mans policy or one group of small men and women to be foisted on an entire nation. Take, for example, Government Experts who continue to call for schools and day care to stay closed or that recommend restrictions that make it impossible for a school to function. For a time there may not have been enough information about coronavirus in children, but now there is. There are examples from all across the United States and the world that show that Young Children rarely spread the virus. Lets start in europe. 22 countries have reopened their schools and have seen no discernible increases in cases. These graphs behind me show no surge when schools open. The red line is when the schools open. There is data from oughtia, belgium, denmark, france, germany, threat lands, no spike when schools are opened. Content tracing studies in china, iceland, britain and the netherlands failed to find a single case of childtoadult infection. Here at home child care for essential workers continued to be available in some states throughout the pandemic, Brown University researchers collected data on day cares that remained open during the day care. Over 25,000 kids in their study found that only. 16 got covid and when you looked at the confirmed cases for staff, there was about 1 of more than 9,000 staff. The ymca also has put forward statistics. The 40,000 kids at 1,100 sites, there were no reports of coronavirus outbreaks or clusters. Dr. Joshua sharfstein of john hopkins writes that there is converging evidence that the coronavirus doesnt transmitt among children like the flu, that it is a lower risk. Just yesterday the American Academy of pediatrics says weve got to get kids back in school. We want them physically present in school. They even cite mounting evidence that children are less likely to contract the virus. Ultimately this all comes down to the fatal conceit that central planners have enough knowledge somehow to tell a nation of 330 Million People what they can and cant do. Perhaps our planners might think twice before they weigh in on every subject, perhaps our Government Experts might hold their tongue before expressing the opinion when we can play nfl football or major league fool, not in october. Perhaps our experts might think twice before telling the whole world that a Covid Vaccine likely wont provide herd immunity. We dont know why why weigh in with these opinions that we have no knowledge of. These are forecasts that may well be wrong. Perhaps our experts might consider the undue fear they are instilling in teachers who are now afraid to go back to work. No one knows the answers to these questions. We shouldnt presume that a group of experts somehow knows whats best for everyone. Highiac had it write. Only decentralized power in Decision Making based on millions of individualized situations can arrive at what risks and behaviors each individual choose. Thats what america was founded on, not a herd with a couple of people in washington all telling us what to do, and we like sheep blindly follow. This all begs the question when are we going to tell the people the truth, that its okay to take their kids back to school . Dr. Fauci, every day, virtually every day we seem to hear from are you things we cant do, but when youre asked can we go back to school, i dont hear much certitude at all. I hear, well, maybe, it depends. All of of this body of evidence about schools around the world shows theres no surge. All of the evidence shows that its rare. I mean, weve so politicized this and made it politically correct that the w. H. O. Releases its rare and you have a scientist up there giving her opinion. What happens to her. Reporter shes blackballed and the report that shes referred to is taken off to the website. If you go to that scientists speech and you try to clink on the link the w. H. O. Release it had for us because something was said that wasnt blittically correct. All i hear from you, dr. Fauci, we cant do this. We cant play baseball. Thats not based on the science. I mean, flu season peaks in february. We dont know covid is going to be like the flu season but it might. We dont know that. We wouldnt ban school in october. You might close some schools when they get the flu. We need not to be so presumptuous that we know everything. But my question is cant you give us a little bit more on schools that we can get back to school, that theres a great deal of evidence and that its actually good, good evidence that kids arent transmitting this, its rare and kids are staying healthy and, yes, we can open our schools. Mr. Chairman, do i have a little bit of time to ill give you a little bit. That went well over five minutes so please answer the question. Very quickly, senator paul. I agree with what you say, you know, this idea about people having to put their opinions out without data, and sometimes you you have to make extrapolations because youre in a position where you need to at least give some sort of recommendation, but if you if you are listening and i think you were to my Opening Statement and my response to one of the questions, i feel very strongly that we need to do whatever we can to get the children back to school, so i think we are in lock agreement with that. The other thing that i would like to clarify very briefly is that i when things get in the press of what i supposedly said i didnt say. I never said we cant play a certain sport. What happens is that people in the sport industry they could either be people from players association, owners, people involved in the health of the players ask me opinions regarding certain facts about the spread of the virus, what the dynamics are. I give it and then it gets interpreted that im saying you cant play this sport or you cant play that sport. I agree with you. I am completely unqualified to tell you whether you can play a sport or not. The only thing that i can do is to the best of my ability give you the facts and the evidence associated with i know about this outbreak. Thank you. Thank you. We just need more optimism. Thank you, senator paul. Senator casey. Mr. Chairman, thank you very much for the hearing, and i want to thank our witnesses for their public service. Mr. Chairman, let me start with dr. Hahn and then ill move to admiral giroir. Dr. Hahn, i want to ask you about vaccines and as your testimony indicates and as weve been discussing over time, as researchers work to develop vaccine to protect against covid19, its important that the final fdaapproved products have the full confidence of the American People. A vaccine doesnt help if people dont choose to in fact be vaccinated. So my first question is given that weve seen very high rates of both vaccine refusal as well as skepticism, what role can the fda play in the coming months to earn the Publics Trust that the covid19 vaccines are safe and effective . Thats question number one. What role the fda can play, and then the second question is what steps can you take as fda commissioner to bolster Public Confidence . Thank you, senator, for that question. I couldnt agree more that Public Confidence in vaccines is so important, so to your first question, we have an obligation to use all of our scientific knowledge, our regulatory framework, to ensure that any vaccine that comes before us, whether for authorization or approval, meets our stringent standards for safety and effectiveness. One of the reasons that we issued that guidance that i mentioned in my Opening Statement was to provide regulatory clarity around what fda expects with respect to those data. We want to see certain parts of those data so that we can demonstrate to the world, to the nation, to the American People that were following our rigorous standards with respect to safety and efficacy. The other thing that weve done is draw a very bright line between fda and our regulatory independence and all the sponsors who are putting for the vaccine applications to us. That includes operation warp speed so were providing Technical Assistance to those sponsors, but we are not part of the decisionmaking process, and we will maintain our regulatory independence. I will not prejudge. The agency will not prejudge any decision with respect to this, but we will use the science and the data. With respect to what i can do personally, senator, i commit to you that i will continue to be a voice emphasizing the regulatory independence. We have a um in communications in progress to communicate to the American People that the standards that were going to uphold are firm. They are rooted in science and data, and that they will ensure that we meet the usually high standards of fda with respect to safety and efficacy. Thanks very much, doctor. I might submit a question for the record to dr. Redfield as well, but just so i can get my second question in for the admiral. Admiral are i want to ask you about testing and insurance coverage. Testing, as you know, and as weve emphasized in these hearings is so fundamental in order to prevent the spread of covid19. Congress, i think, acted upon that knowledge by mandating full coverage of covid19, diagnostic and antibody testing, both in the family first bill as well as the cares act. We made it clear that americans shouldnt have to pay a dime for covid19 testing, but were hearing alarming reports of people not being tested often for one of two reasons, because they are under the impression that they will have to pay for testing and patients who have been tested are receiving surprise medical bills. The administration has issued guidance that appears to be in conflict with congressional intent and Public Health guidance, and so we have some confusion here. I would asked you, admiral, can you you a sure the American People that the department of health and Human Services will fulfill the intent of both the Families First bill and the cares act and ensure that the American People will be provided wide access to covid19 tests without costs or limitation . So, thank you, senator, and i want to thank all of you for emphasizing the importance of testing and eliminating any barriers that there could be. I cant spoke for the department. I certainly speak as the assistant secretary and as the testing person that we firmly believe and support the concept of nocost testing. There should not be a disincentive in any single way to get the diagnostic test that youed need, to get tested during screening or or the serology test as congress intended so thank you for that. We do need to keep getting that message out. Its a very important one to have. The. Thank you, admiral. Thank you, mr. Chairman. Thank you, senator casey. Senator collins. T thank you very much, mr. Chairman, and i want to thank all of our Witnesses Today for your dedication and hard work. Its really been important. The chairman raised a very important question about who pays for the testing when a person has no symptoms and no known exposure to the virus, and i would add another key question, and that is how are such such tests even accessed. These are critical questions for the reopening of schools and for the thousands of jobs and the Tourism Industry upon which maines economy depends. In maine for a tourist to come and visit, that outofstate visitor, one option, is to show a recent negative covid test. The problem is that when hotel owners in maine surveyed testing sites in ten states, they found that 90 of requests for tests for travel purposes were denied. Now, this lack of access to tests is devastating for reopening maines tourism businesses. One innkeeper told me that last year in the month of june she had an occupancy rate of 94 . This year gas 6 , so you can imagine the impact on employment at that inn. Given the impact on reopening schools and on jobs in the tourism and other industries, how is the federal government working with states to better match demand for testing with supply and to overcome these geogeographic variations. Admiral, would i direct that question to you. Thank you, maam, ill try to be brief and not take much of your time but we were very careful in our prioritization that we do prioritize persons without symptoms who are prioritized by Health Departments or clinicians for any reason, including Public Health monitoring, surveillance or screaming of our asymptomatic individuals according to state and local plan, so that is a priority that if it is important for the state, those asymptomatic individuals can be can be screened. The second issue, just, again, to be brief, is we work we have worked individually with every single state to determine what their state testing needs are, how are they organized in the context of the cdc, and we are supplying them with the supplies they need to meet, that so every week shipments of the basic supplies go to every single state, according to their state testing plans, and we keep a little bit in reserve, right, because when theres an outbreak somewhere that we need to surge, we do have that, so, for example, the state testing goals for july are somewhere across the country about 13. 9 million tests is the first line goals, and we will match those state by state. I hope that you will help us get that word out to setting sites in states from which a lot of tourists usually come to maine. That would be very helpful to us. Dr. Fauci, let me turn to you. Earlier this month Higher Education leaders in maine issued a framework for safely returning to campuses this fall that recognizes the importance of testing and the need to include financially struggling institutions in partnerships in order to make sufficient testing protocols possible. You last week spoke about the possibility of the development of pool testing strategies, and as i understand it, this would allow more people to be tested using fewer resources and the medical director of stanfords Clinical Virology Lab suggests that this makes particular sense in areas with low rates of covid19 where you would expect the large majority of tests to be negative. Could you expand on the possibly of expanding pool testing and tell us more about that. Yes, thank you for the question, senator. The what that really is. If you want to get a feel for the penetrants of infection in a community rather than testing each individual person which takes resources and time, and what you can do is do a Statistical Analysis of not losing sensitivity by pooling, lets say, 10 or 15 or 5 together. You put all the tests together and you do one test. Ful that test is negative, then you know those ten people are all negative, so instead of utilizing ten tests, youve utilize one test. Then you get another batch of well see ten or so, and if you then find one is positive, then you go backtrack and figure out who that person is, and if you do the path mat calculation you can save a lot of time, a lot of resources and use the testing for a variety of other things that you would need so its a really good tool. It can be used in any of a number of circumstances at the Community Level or even in school if you wanted to do that, so a proof what you started your started your comment off on, it sounds like a very good use for our schools. Thank you, senator collins. Senator baldwin. I want to thank all our Witnesses Today for joining us. Like so many members of this committee im concerned about know outpokes and certainly ive seen them in my home state of wisconsin and i know weve seen that nationally. Cdc and osha have issued recommended safety guidance for businesses, but this guidance is not enforceable. Many businesses are truly trying to do the right thing and protecting workers and customers and the public that interacts with those businesses. And so we also had a previous discussion. I think senator sanders raised the issue of American Airlines filling up their planes versus others that are still not trying to push to do so because of safety concerns. We also had, i think it was admiral giroir pulled up what he called the critical guidance, please follow this cried call guidance. Dr. Redfield, should we be supporting businesses that have taken the steps to protect their workers and customers by fullivelimenting cdcs and oshas recommended safety guidance. Yes or no . Yes. Yes, we should be supporting those businesses. Now, can you confirm yes or no that all businesses have adopted andism president ed this guidance as they have opened up . I think, senator, you know, that, unfortunately thats not been the case. So, its an even uneven Playing Field and hurts businesses that are trying to do the right thing by voluntarily adopting cdc and osha safety guidelines because their competitors dont have to incur the same safety and health costs, and if you believe that we should be supporting the good actors, then shouldnt we create a level Playing Field by issuing an Emergency Temporary Standard to require all businesses to adopt and comply with enforceable Safety Standards . Ill make two comments, senator. The first one its so important that weve tried to say is that this is a time that everyone in our nation accept the responsibility that dr. Fauci and i spoke about to recognize they have the fundamental responsibility not just to protect themselves to protect others by the social distance, face mask and handwashing. Secondly, again, as we look at the local jurisdiction, again, to see where in fact that enforceability would be, whether its in the local Health Department, the state Health Department or the federal Health Department, i think, again, we see that the community can get behind that responsibility, those businesses that support that responsibility may find in fact their business is better than those businesses that dont. Let me interrupt you. I apologize, dr. Redfield, but my time is limited. The the panel right now is composed of people representing Public Health and Public Health institutions. Osha is our lead federal agency for protecting worker safety and health. Have you had communication with the department of labor and osha about issuing mandatory, enforceable standards rather than this voluntary guidance . Secretary scalia is a member of the task force, and hes in the discussions with us that the Vice President chairs. That specifically so thats a yes . Weve not had a discussion directly, but weve had discussions and review of the guidance that weve put to businesses, both Critical Infrastructure and nonCritical Infrastructure businesses with osha. So i i have limited time left, but i do want to say the university of wisconsin announced that they will be reopening for classes in the fall. They have released a plan called smart restart. It calls for about 2,000 tests per week on campus. They will need supplies to do this, including ppe, reagents and swabs. At every hearing on covid19 weve heard about shortages of these supplies, and its why i introduced the medical supply transparency and delivery act town lock the full authority of the defense production act to increase production of critical supplies, the things that are needed to conduct wyatt spread testing. Admiral giroir, can you describe how youre working to make sure that universities and others will have access to these supplies needed to conduct this testing in the fall . Thank you so much, senator. And i want to communicate this, and im happy to work with any university. We coordinate what we give to the states through the state plan, so its very important that universities coordinate through the states, and we supply those materials directly to a single point of contact in the state who distributes them. We you know, weve been through a lot, but we have a lot of swabs now, partially because of increased domestic production, using the dpa. Were distributing about 20 million swabs per month. Well do a lot more than that. How about reagents . So reagents we do not purchase centrally because the market is a little bit more mature so we can trust with an allocation strategy that we allocate, we support the allocation to different states depending on their needs so weve mapped every single machine in every single state and every single county and every single city and, unfortunately, theres not enough of one thing that everybody if they want that can get it, so we really do a matching game to understand specific state needs. For example, in alaska, it is very rural and theres very limitations to what they have so we need to make sure they get what they absolutely need versus other states that can be a little bit more flexible, so we do have this controlled. Thank you very much. Im afraid im so sorry. Well well over time. We have a large number of senators who want to ask questions so i would renew my request that senators and witnesses try to keep the questions and answers within within five minutes. Thank you, mr. Chairman. Senator cassidy. Thank you, gentlemen, for all that youre doing. I have a couple of slides. Can i ask the slide to show the first two slides. So here it shows that were doing poorly relative to the countries that are doing it best, and you can argue that taiwan is much is smaller than we but taipei is a very congested city, so if you consider our citys collection of taipeis, for example and seoul, south korea, it would suggest that what were doing currently is less robust and less whatever adjective you want to do than the countries who are doing it the best. Could i have the next slide, please and so this has developed out of a group by harvard and just so i can put a plug in it, they will be speaking in a roundtable that we have thursday morning and you can get details from my office if you wish, but the kind of that interplay between collecting and doing the testing, and tracing those, you know, compiling your data, knowing where your hot spots are and then tracing, and every one on this panel knows how its done, and you mention that had youre going to have a strategy thats coming out later on, and it does beg the question why has it been so long, and im not accusing, im just curious, but this has been developed. You can take the slide down, please, so knowing that youre going to develop the strategy and and kind of build upon what you are . Burr mentioned, what is the goal of the strategy . Is the goal of the strategy to achieve suppression . Thats not run, and number two, what metrix will you use, and and knowing that cdc is the one who really gives guidance to state and local governments, im hoping, dr. Redfield, since ill direct this up, that it wont be up to the states and locals to put this plan together but it will be the consider intellectual firepower of the cdc that gives a pretty detailed if you have this kind of community, this is what you do. If you have that kind of community, that is what you do. Because thats the kind of role that cdc is expected to play. Dr. Redfield, any thoughts on this . Thank you very much, senator. Very important question. First on your first slide and oil try to be quick. Its really important pause it illustrates back to the comment of the importance we put on social responsibility to really practice the social distancing and that is a given, dr. Redfield. I want to ask you just real quickly, because i have limited time, thats a given, but there has to be a testing aspect of this because people dont you awaken people to the responsibility if they know they have been exposed. If they dont know they have been exposed they tend to be more complacent so please focus upon the testing data and tracking aspect. Yes, senator, initially obviously the the early case identification and Contact Tracing and isolation . Obviously testing and Contact Tracing without isolation has little value. The challenge has been when we learned in march that this virus is aestimatematically transmissible and, therefore, requiring alternative strategies. The strategy that were evaluating now is more of a communityled testing strategy where you go into a Broader Community and you actually test a wide number of individuals as opposed to it . What metrics are you following, and is there a specific strategy thats going to be given to state and locals as to how to implement that . Thats very high level. What we need is granularity. Thats my question. Yeah. We did the initial strategy. As i said, were currently evaluating this community testled strategy in a number of communities now. The metrix are simple. Its the percent cases that are bossive it. We were doing well there for a while, you know. And sorry to interrupt, but, of course, if you take the entire city of new orleans or scle shreveport, youll have some that are hot spots and some that are really fairly states, and i guess im pulling into the gran tearity. Should it be a census track, a hot spot, a building with multifamily housing, et cetera. Im just frustrated because when i speak to my state and locals they are not getting that granularity from cdc. That seems to be where we get to where seoul, south korea, is and ive not heard that thats what were doing. Were saying right now at the county level the exact kinetics. We have 500 areas out of 3,000 that are having trouble and to get that granularity, as you said, senator, its critical. Its got to be a local response at the granular level. But dr. Redfield, do we have this granularity. Weve been at this for three months and we have all the data systems and we know where the people live who are test. You know, we have a federated system which you alluded to earlier. Is the plan coming out tonight or this afternoon going to implement that granularity . Im over time, but if you would allow, mr. Chairman, for an answer, they be ill cease. I apologize for going over. My comment would be thats where were going with that granularity. We appreciate some of the changes in reporting to cdc in terms of testing that congress recently did. Were now looking at the granular level. We dont disagree with the premise behind you. Its that granular response to control those mini outbreaks which is going to be fundamental to get this under control. Thank you, senator cassidy. Senator murphy. Thank you very much, mr. Chairman. Mr. Chairman, if that were the policy of the United States of america, the recommendations and guidelines being given by our panelists today, we would likely not be in the situation we are with a virus back on march spreading at rapid rates throughout big parts of the country. The problem is our four panelists do not set the policy of the United States of america. The president of the United States does, and so while our panelists tell us about the importance of Wearing Masks, the president of the United States is retweeting articles, for example, entitled mandatory masks arent about safety. They are about social control. He retweets people that are criticizing how folks look when they wear masks though our panelists today are telling us about the effectiveness of social distancing, the president. United states is holding rallies all across the country in which he deliberately prevents people from distancing. His staff rips signs off of chairs encouraging people to separate from each other. The president s al us are on tv every single day saying Wearing Masks are dee humanizing. Somebody said the other day, a member of the house, that viruses do what viruses do. The only way youre going to get immunity is to get exposed. These are the president s allies trying to curry favor with him. And so we have these two parallel messaging operations, and i think its worth stipulating that everything that were hearing today is response. Its based on evidence, but the agencies represented here today have social media follows of about 5 Million People. The president of the United States has a social media following of 82 million, and so you can understand why folks are confused out there. They hear the recommendations from dr. Fauci and dr. Redfield, but then they hear the president of the United States criticizing a reporter for wearing a mask because that reporter is being is being politically correct. Thats why were in the position that were in today where you see large numbers of people not complying with recommendations because they are hearing something very different from the chief executive and they are watching him behave in a manner and encourage behavior that is directly contrary to what were being told today, and it just probably requires saying that out loud at this hearing. Dr. Fauci, this virus got here really quickly. And what we learned is that while travel restrictions can help or give you time they cant fully prevent a disease from arriving here so even if we do turn the corner in the United States in a meaningful way so long as the virus exists in large quantities outside of the United States we are still vulnerable. Is that right . Thats correct, sir. And so, dr. Redfield, what is your understanding of why the United States has not joined the global vaccine effort . Why are we not in Something Like sepi, an organization thats working with other nations to try to coordinate not only the development of the vaccine but also the distribution of the vaccine . Well, i think the u. S. Is obviously developed an aggressive, comprehensive program but, senator, it wouldnt preclude being part of the international organizations, also, from my perspective. We have legislation pending before the Foreign Relations committee to put the United States into the global vaccine efforts. Doesnt make a lot of sense to us why the Trump Administration has not joined. Finally, admiral, just maybe help us understand what our relationship with the w. H. O. Is today. Right around the time that the president declared that we were pulling out of the w. H. O. , not just that we were not going to fund it but the announcement to sever our relationship with the w. H. O. , you were confirmed to a seat on the executive board. Have you been recalled from the w. H. O. . Are you attending meetings . Are you participating . What are the details surrounding our withdrawal from the w. H. O. , which, by the way, is maybe one of the most Dangerous Things in my opinion that the administration has done in the middle of a global pandemic. What is your status as a confirmed member of that board . Thank you, senator. I do appreciate the confirmation. I was confirmed may 7th and attended may 22 pd executive board. It was virtual. I did participate and support our multilateral commitments. I have not been recalled. I have not been given any direction to recall myself in any way. There would be another executive Board Meeting probably in october and i believe all of us on the Public Health standards still work with the w. H. O. As a w. H. O. Partner, for example, we participated with the w. H. O. On a global sickle cell meeting two days ago so we work certainly from the Public Health aspects direction on the official whether were going to be a member or whether im not going to go to the executive board, i have not gotten that direction yet. Thank you. Anounment is terminating the relationship with the w. H. O. So probably some additional clarification would be helpful. Thank you. Thank you, senator. Senator murkowski. Thank you, mr. Chairman. Gentlemen, thank you for not only your testimony today but all that you have been doing. I think i have had conversations with each one of you about the alaska specific issues, most notably with regards to our seafood processing. This is the time of year where we typically welcome a million plus tourists as well as many thousands that come up from the lower 48 and other places to help with our seafood processing and it has been very anxious time i think for all of us in alaska as we see outsiders coming in. We have seen obviously elevated cases of confirmed covid. Our numbers i think are enviable when other states look at us to know that were working about 500 active cases right now. About double that in terms of what we have seen throughout this whole pandemic. But again, we know and you have stated that we dont have resources that we can look to to neighboring states. We are kind of on our own island there in terms of resourcing so what you have done to facilitate, whether its the plans with the Seafood Processors, the guidance, the ability to come in on a asneeded if the situation so demands we appreciate that. We have seen the benefit of how these very rigorous plans have worked. An individual who comes up to work in a seafood processing facility is tested before they come to the state, theyre tested when they get to the state, theyre put in a 14day quarantine. We have seen positive cases once people have arrived but we have been able to do what the plan calls for which is that Contact Tracing and then isolation and keeping things to a minimum so i think it does demonstrate that these tough plans really can work. They are expensive, though. If you are bringing in several hundred or perhaps a thousand workers and you have to put them up in a hotel for 14 days, with pay, when you have to provide for the health protocols, this is costly. I would ask for your input and probably a question for the record in terms of which agencies can best help facilitate these Seafood Processors with not only implementation of the guidance but to deal with the costs. We do receive some benefit from the discretionary funds provided to states but i think we would all recognize like the meat packing facilities, our Seafood Processors are an important and critical industry not only to alaska but to the country so we want to work to address that. I want to speak very quickly though to the Public Health infrastructure. Im told that in alaska as we are doing our Contact Tracing it is still a paper copy xl spreadsheet faxed to the epidemiology labs. This is how were doing our tracing. I thought, well, maybe thats just alaska and im told by dr. Zinc that, well, this is actually going on in california, as well. That to me is not a Contact Tracing system that works and is sufficient so i want to ask about not only your view of the sufficiency of Contact Tracing and this is probably to you, dr. R redfield, but then, dr. Fauci, i want to ask you about the concern that we have with certain parts of the country where you have public mistrust of vaccines in general. My fear is that we may get to the place where we will get to the place of a successful vaccine but we still have the concern from many and a mistrust and whether its vaccine hesitation or vaccine confidence, i dont know what the buzzword is, but im worried we dont have a plan to deal with that. First Contact Tracing and then the vaccine. Thank you very much, senator. I think it is important to highlight what you said about the current state of data systems for Public Health in the United States. That they really are in need of aggressive modernization and again thank congress for the funding there but it is a substantial investment that needs to take place. There are a number of counties still doing this pen and pencil as you commented and we need a comprehensive, integrated Public Health data system not only able to do something in realtime but actually can be predictive and it would be one of the great i think investments of our time to make that happen once and for all. Agree. And thats really fundamental to be able to operationalize Contact Tracing, et cetera. Ill be very quick it doesnt have any value unless you can do it in realtime. It doesnt help like i just did with the airlines where we had people that were flying infected from afghanistan and we didnt get the information until day 14, 15, 16. It is irrelevant. We love the partnership to get an integrated Public Health data system not just for cdc but for all of the jurisdictions across the nation into one timely integrated system. Appreciate it. Senator, thank you for the question about if you could be succinct. We are well over time. We will be quick. We have a Community Engagement program thats embedded within the sides where the vaccine trials will be done because were aware of what you are concerned about and it is a reality, a lack of trust of authority, a lack of trust in government, and a concern about vaccines in general. We need to engage the community by boots on the ground and getting community particularly those populations that have not always been treated fairly by the government. Minority populations, africanamericans, latinx and we have a program thats operable right now to do that. Thank you. Thank you. Thank you, senator. Senator warren. Thank you very much, mr. Chairman. Dr. Fauci, you came before the Health Committee seven weeks ago to discuss the countrys response to the covid19 and at the time you told me that the u. S. Did not quote by any means have total control over this outbreak. But you also told me that we were quote going in the right direction. Now, on the day you testified before the committee may 12th 2020 there were about 21,000 new cases of coronavirus. Yesterday there were about 40,000 new cases of coronavirus. Dr. Fauci, do these numbers show that the country is still moving quote in the right direction . And