comparemela.com

Supply chain capacity and projection of shortages . Thank you for that question and statements, senator murray. Yes, as i stated, we continue to have a work in progress as we build the testing capacity. We have established the targets with the states of over 12 million tests over the next four weeks. We think those targets are going to be good in may and june, but as dr. Fauci said, we really have to be evidence based. We expect those targets to go up as we progressively open, as communities go through phase 1 and then into phase 2, and certainly those numbers will need to go up significantly again in the fall when we potentially have influenza circulating with covid. So, yes, there will be targets. The targets will need to change based on the evidence that we see, but we are highly committed to securing the supply chain. We work daily with every manufacturer, and im just pleased were, in may and june, able to get ahead of the states so that we can supply them what they need so they have those assurances so theres not going to be any doubts about that. My question to you is when you put out that specific plan that you are required to do, we will see numbers that you are going to tell us that you will reach, targeted for testing and supply chain capacity and protection, rather than saying we hope to have a million next week, you will give us specific targets, correct . Ill say, yes, maam, we know the specific amounts of tests we have over the summer. Not have, how many we need. So, yes, maam, we developed the need statements by working with the states individually, with epidemiologists, with the cdc so that overall in may well be testing about 3. 9 of the overall u. S. Population. Thats fine, but were over time, senator murray. Youre telling me how many you have, but how many we need in may and the coming months so we can be prepared to have them. Yes, maam, and not to be repetitive, but we need to be evidence and data driven, because what we may see in may or june will drive distances in the amount of test goals we have. So we really just need to be very humble about this, we need to look at the data. We know that the testing needs will go up over may and june as we progressively open, and we will do our best to predict that, but you have to understand we have to see what the data and the evidence show at that time. I appreciate that. Mr. Chairman, again, what our Strategic Plan requires is what is the goal. Not how many we have but how many we need, and thats what well be looking for. Thank you. Thank you, senator murray. Senator inzee. Thank you, mr. Chairman, i particularly appreciated your Opening Statement where you had a very succinct list of preparations we need to learn from this pandemic for the next one. Not only should we be working on this and preparing, but we need to look to the future, too. I think we learned a lot. Were fighting a virus at the same time that scientists are learning about it, so we need to be nimble, we also need to be sure that we are prepared for a second wave of outbreaks that could coincide with the start of the flu season, potentially stressing our Health Care System even more than it already has been. Admiral giroir, i thank you for your comments. I think theyve been comforting about what has been done and what can be done. I agree with senator murray that we need to have some specific goals. As an accountant, thats always one of the things im looking for. For questions, dr. Hahn, our understanding of the clinical picture of covid19 continues to evolve. What first looked like a respiratory illness now seems much more comprehensive, potentially affecting the heart, the brain, the kidneys and other organs. How does this evolving picture impact the ability to evaluate the appropriate clinical or surrogate end points for review of vaccines and treatment . Thank you, senator, for that question. The evolving clinical picture, and obviously, the way this is manifesting around the country clinically does, in fact, inform the end points that we will work with developers of therapies so that we can get the absolute most efficient but also the most Accurate Information and appropriate end points to make the necessary authorizations and approvals. We have set up this program called the Coronavirus Treatment Acceleration Program where our top scientists and clinicians have been at the table consulting with our colleagues at nih and cdc to actually address those questions. What are the appropriate end points . To give you an example, we do know that in some circumstances, patients who have had severe covid disease have developed thrombotic clotting processes, so we prioritized a review of agents that we think might be beneficial, and obviously the clinical end points for those trials will be different than an agent that might be viral like remdesivir which dr. Fauci mentioned were looking at time to recover. So we want to adapt to the clinical circumstance as well as the type of therapy thats put before us. Thank you. Another question to dr. Hahn. We have made a lot of progress in Vaccine Development already, but barta has identified that investing in syringes is a financial gap in preparedness. What has nih done for the National Vaccine campaign to ensure we have capacity to administer a vaccine . Thank you for that question. This is a really important point, because as you mentioned, its not just about the vaccine or, hopefully, vaccines that are developed, its also about the supplies that are needed as well as an Operational Plan for administering the vaccine. This is an all of government approach. There is a program thats been set up called operation work speed that includes dr. Collins, dr. Fauci, his colleagues at nih, the department of defense as well as other members of hhs and fda. Dr. Peter marks from our center of biological research has been helping to coordinate that and has been working very closely with dr. Fauci and his team. Weve created whats called a grand chart to determine what is the need for needles, syringes, et cetera. Weve been leaning in on the supply chain to ensure that when a vaccine is ready to go, we will have the necessary supplies to actually administer it and operationalize the vaccination. Thank you. I have a couple more questions, but i suspect ive used up my time. Ill submit those in writing. Thank you, senator inzee. Senator sanders. Thank you very much, mr. Chairman, and let me thank all of the panels for the hard work theyre doing and for being with us today. It is sad to say we have a president of the United States, a leader of our country, who from day one downplayed this pandemic, who told us the crisis would be over in a few months, that we did not have to worry, who fired those members of the government who wanted to act aggressively, among other things, at a time when we need international cooperation, cut funding for the world health organization. Let me also say that i think we understand that facts are terribly important. Not everybody that we dont fully understanded all of the ramifications of the covid19 epidemic, but let me ask dr. Fauci a few questions, if i might. To start, the official characteristic, dr. Fauci, is that 80,000 americans have died from the pandemic. There are some epidemiologists who suggest the number may be 50 higher than that. What do you think . Im not sure, senator sanders, if its going to be 50 higher, but most of us feel that the number of deaths are likely higher than that number, because given the situation particularly in new york city when they were really strapped with a very serious challenge to their Health Care System, that there may have been people who died at home who did have covid who are not counted as covid because they never really got to the hospital. So a direct answer to your question, i think you are correct that the number is likely higher. I dont know exactly where it sits higher, but almost certainly is higher. Dr. Fauci, let me ask you this. In the terrible pandemic of 1918, the virus exploded in the fall, came back with a vengeance. Are we fearful that if we dont get our act together, as bad as the situation is now, it could become worse in the fall or winter . Senator, thank you for that question. Its a frequently asked question, and i think that possibility does exist. However and the reason i say that is when you talk about will this virus just disappear, and as ive said publicly many times, that is just not going to happen because its such a highly trantransmissible virus, even if we get control over the next several months, its likely there will be the virus somewhere on this planet that will eventually get back to us. So my approach towards the possibility of a rebound and a second wave in the fall is that, a, its entirely conceivable and possible that it would happen, but b, i would hope that between now and then, given the capability of doing the testing that you heard from admiral giroir and the ability of us to stock up on personal protective equipment and the work force that the cdc or dr. Redfield will be putting forth to be able to identify, isolate and contact trace, i hope that if we do have the threat of a second wave, we will be able to deal with it very effectively to prevent it from becoming an outbreak not only worse than now but much, much less. Let me ask weve heard a lot of discussion about vaccines. Obviously everybody in congress and in this country wants a vaccine. We want it as quickly as possible, as effective as possible. Let me ask the honorable fda commissioner, sir, if, god willing, a vaccine is developed and if were able to produce it as quickly as we all hope we can, i would imagine that that vaccine would be distributed to all people free of charge, make sure that at least everybody in america who needs that vaccine will get it regardless of their income. Is that a fair assumption . Senator, i certainly hope so. Fda is very committed to making sure that all populations in the United States, including those most vulnerable, are included in the Clinical Trials sir, thats not what im asking. What im asking is if and when the vaccine comes, it wont do somebody any good if they dont get it. And if they have to pay a sum of money for it in order to profit the drug companies, that will not be helpful. Are you guaranteeing the American People today that that vaccine will be available to all people regardless of their income . Sir, the payment of vaccines is not a responsibility of the fda, but im glad to take this back to the task force. I share your concern that this needs to be made available to every american. Does anybody else want to comment on that . Mr. Giroir, do you think we should make that vaccine available to all regardless of income . Or do you think the poor people should be last in line for the vaccine . Im sorry, senator, were you asking me . Yes, i was, sir. Yes, i was. My office is one of the offices committed to serving the underserved, and we need to be absolutely certain that if a vaccine or an effective therapeutic or preventive is available that it reaches all segments of society regardless of their ability to pay or any other social determinant of health that there may be. Good. So when youre telling people regardless of income, any american should be able to gain access to that vaccine when it comes . They should gain access to it. I dont control you represent the administration that makes that decision. I will certainly advocate that everyone is able to receive the vaccine regardless of income or any other circumstance. Let me just youre out of time, senator sanders. Im sorry. Thank you, mr. Chairman. Those are important questions. I dont want to cut senators off and its hard to see the time clock, but if we could stay as close as possible to five minutes, then all senators can get their questions in. Thank you, senator sanders. Senator burr. Thank you, mr. Chairman, and thank our Witnesses Today for what youve done to people in this country for their safety around the globe. Let me ask you, dr. Fauci, because youve been in the task force and at a majority of the press conferences. Has anybody in this administration ever asked you or any member to take the foot off the gas of trying to find a cure or any type of countermeasure . No, senator, not at all. As a matter of fact, we at nih, as you know, have from the very beginning put our foot right on the accelerator in every aspect, including the development of a vaccine in therapeutics. We actually started that in january, literally days after the virus was known and a sequence was published. So, no, i have never been told by anyone to pull back on the development of any countermeasure or any basic part of the Research Project weve been involved in. Thank you, dr. Fauci. This question is for dr. Redfield. Dr. Redfield, we have authorized in this committee and appropriated out of congress multiple times over the last few decades money for biova biosurveillance and you talked about it. In the past four years from fy16 to fy20, with the cares act its over a billion dollars in biosurveillance. Weve seen the product go out and use Data Available to track the product and spread of coronavirus around the world. Why has cdc not contracted with private Sector Technology companies to try to use their tools for biosurveillance . Senator, thank you for the question. This is a critical question and also comes into one of the core capabilities. I talked about Data Analytics and data modernization which we are privy to the additional Funding Congress has given. I can tell you this is under critical review now. We do have contracts with some of the private sector groups now to try to make the type of availability of data that weve seen with florida available in all of our jurisdictions across the country and were in the process of making that happen. Dr. Redfield, in june of last year, we reauthorized the pandemic an all hazards legislation which authorized at that time 30 new employees at cdc specifically in surveillance. I asked dr. Shuget in march how many of those 30 had been filled. She said zero. As of midapril, zero of those 30 billets had been filled. How many of those 30 employees this committee authorized cdc to bring on for biosurveillance have been filled today . Sir, again, thank you for the question. I know our staffs have been in discussion since dr. Shugets testimony, and i know were in the process of continuing to try to figure out how to move that forward, sir. I can get back to you on it as i discuss what progress has been made since we had that discussion post her hearing with you when you brought that to light. I brought it to light the 1st of march and now were in midmay. Im hopeful we wont just talk about surveillance, well actually execute it and well focus the unbelievable amounts of money that weve provided for you, that they will show some d benefit to the American People. Dr. Fauci, let me come back to you. This is one of the fastest Development Timelines weve ever seen for vaccines. And the American People, and hopefulfly people around the world, will be the beneficiary of what you find and the eventual license eventual licensure of that product . And dr. Fauci, if you have anything to add. Thank you very much. There are a couple things that are inherent in all Vaccine Development. First of all, there is no guarantee that the vaccine is actually going to be effective. As you well know, because weve discussed this many times in the past, and you can have everything you think thats in place and you dont induce the kind of immune response that turns out to be protected and durably protected. So, one, the big unknown is it will be effective. Given the way the body responds to viruses of this type, im cautiously optimistic that we will, with one of the candidates, get an efficacy signal. The other thing thats an unknown and of concern, we will be able to get around that with the tests done properly that you get an enhancement effect. Namely there have been a number of vaccines, two in particular, when the vaccine produces a suboptimal response and when a person gets exposed, they actually have an enhanced pathogen for the disease, which is worrisome. So we want to make sure that doesnt happen. Those are the two unknowns. Putting those things all together, i still feel cautiously optimistic that we will have a candidate that will give some degree of efficacy, hopefully a percentage enough that will induce the kind of herd immunity that would give protection to the population as a whole. Anything to to add to that . The approach led by peter marks is a free clinical pathway so we can appropriately access one vaccine against another, and a master protocol that allows for a common control group and an assessment of very common end points that will let us be as efficient as possible for the development of vaccine. We will evaluate approximately ten candidates preclinically in the phase 1 and phase 2 studies and then take phase 3 and 4 in these studies. So thats what can speed up the development and also ensure safety and effectiveness. Dr. Fauci, North Carolina has started to publicize the recovered numbers, those who have had the coronavirus but recovered. Its my hope that nationally we will start reporting the recovered numbers. I think thats important for the American People to hear. I yield back. Thank you, senator burr. Senator casey . Mr. Chairman, thank you for the hearing as well as Ranking Member murray. Mr. Chairman, i wanted to start today with a question regarding Nursing Homes. In particular, across a state like ours, weve had, as you know, a high number of cases in pennsylvania. At last count over 57,000 cases. The number of deaths have gone about 3,700. Of course, a lot of those deaths are in Nursing Homes. Were told that nationally, more than a third, as high as 35 of all deaths have been in Nursing Homes, either the death of a resident of a nursing home or worker. I want to start today with a question for dr. Redfield. Doctor, when we consider this challenge in our longterm care facilities, when we look at the number of deaths in Nursing Homes, i think a lot of families want basic transparency, and thats one of the reasons why senator widen and i sent you a letter dated april 2nd. It was directed to you as well as the administrator of the centers on Medicare Medicaid services, sema verma, and in that letter we asked for basic information about what the administration was doing to track the outbreaks in Nursing Homes to provide information, basic information, to families and residents, the families of residents in Nursing Homes, certainly to the workers as well as to the community and Public Health professionals. Now, it took you about a month to respond to that, but in your response, you didnt give us any information about the timeline. These families need this information. And now were told by the cms administrator, after pressing her as senator widen and i did, that this information may not be available until the end of may. I need to hear from you today, why has there been a delay, a threemonth delay, in basic information that families and people within a Community Need about the outbreaks in Nursing Homes, the number of cases, what is happening in Nursing Homes . Tell us when were going to see that information. Well, thank you very much, senator, and youve highlighted one of the great tragedies that weve all experienced together. Clearly the longterm care facilities have been particularly hardhit by this pandemic. Several things. I know that, again, the cms who has oversight, several things have been done, and i can get back to you in terms of where theyre at in terms of activation, but all Nursing Homes now are required to report cases in either their individuals that are patients there or staff to the cdc. Second, we put a policy in place that all Nursing Homes are required to notify their members of that nursing home of the existence of covid in that nursing home. That would include family members to verify in terms of if thats operational today or last week. I will get back to you with that. One of the most important, we have decided, as we talk about the key in reopening, as tony mentioned, we need symptomatic cases, we need to do contact tracing. But the other thing we really need to do is to do surveillance, because this virus does appear to have high propensity for systematic infection, which means traditional ways of identifying cases is going to be blunted. So were developing a National Surveillance system, and first and most important to do that, is to do comprehensive surveillance in all the Nursing Homes in the states. Cdc will be doing that in partnership with the state and local Territorial Health departments. I think they are going to have the responsibility to do it in the inner city clinics that are tested and the Health Service clinics. But this is critical we get in front of this and do comprehensive surveillance of everybody in these Nursing Homes. Weve also done, you know, aggressive outreach in all of them and in enhancing Infection Control procedures, et cetera. Cdc has been out to help these Nursing Homes with that. Ill get back to you on the timing. Im pretty confident its operational, but i need to doublecheck just to make sure, because i know sema has announced theyre all reporting to cdc now of infection in patients and they are required now to notify other members in the nursing home as well as family members when covid is in one of those Nursing Homes. Mr. Chairman, i just have one question for dr. Fauci. Doctor, i wanted to ask you, in your testimony earlier in response to a question by senator murray, you outlined a basic concern you have with regard to states reopening. Can you restate that for us . Yes. Thank you, senator casey. My concern is that if states or cities or regions near attempt, understandable, to get back to some normality disregard the checkpoints we put in our guidelines about when it is safe to proceed on pulling back on mitigation. Because i feel if that occurs, there is a real risk that you will trigger an outbreak that you may not be able to control, which, in fact, will paradoxically set you back, not only leading to some suffering and death that could be avoided but could even set you back on the road to trying to get economic recovery. We will almost turn the clock back rather than going forward. That is my major concern, senator. Thank you, doctor. Thank you, mr. Chairman. Thank you, senator casey. Senator paul. Dr. Fauci, scientists have shown that research monkeys that have been inserted with covid19 cannot be reinfected. Several studies also show that plasma from recently infected covid19 patients neutralizes lab experiments. In addition, infusion of c convalescent plasma shows that they can be beneficial as donated. Studies show that the recovering covid19 patients from the asymptomatic to the very sick are showing significant antibody response. Studies show that sars and mers, also coronaviruses, induced immunity for two to three years, yet the media reports that we have no evidence that patients who survive coronavirus have any immunity. I think its the opposite. We have no evidence that coronavirus survivors dont have immunity and great evidence to suggest that they do. In workers who have regained immunity can be a strong part of our economic recovery. The Silver Lining to so many infections in the Meat Processing industry is that a large portion of these workers now have immunity. Those workers should be reassured that they likely wont get it guenin steagain instead alarmed by media reports that there is no immunity. You stated that coronavirus survivors have some sort of immunity. Can you help set the record straight and that its supportive that recovery of the coronavirus leads to some form of immunity . Yes, you are correct, but i have said given what we know about the recovery of viruses such as coronaviruses in general, or even any Infectious Disease with very few exceptions that when you have antibodies present it very likely indicates a degree of protection. I think its in the semantics of how this is expressed. When you say has it been formally proven by longterminal history studies, which is the only way that you can prove, one, is it protected, which i will say and repeat, it is likely that it is, but also, what is the degree or type of antibody that gives you that critical level of protection and what is the durability . Ive often said and again repeat, you can make a reasonable assumption that it would be protective, but Natural History studies over a period of months and years will then tell you definitively if thats the case. I think thats important, because in all likelihood, is a good way of putting it, the vast majority of these people have immunity. Instead of saying there is no evidence the w. H. O. Kind of fed into this by saying no evidence of immunity. In reality there is every evidence stacking up, in fact, a lot of the different studies have shown that it is very unlikely you get it again in the short term. With regard to going back to school, one thing that was left out of that discussion is mortality. I mean, shouldnt we be at least sugge discussing what the mortality of children is . This is for dr. Fauci as well. The mortality rate approaches zero. Its not going to be zero but it almost approaches zero. Between 18 and 45, the mortality was 10 out of 100,000. Really we do need to be thinking about that. We need to observe with an open mind what happened in sweden where kids kept going to school. The mortality rate in sweden is less than france, less than spain, less than belgium, less than the netherlands, about the same as switzerland, but basically i dont think there is anybody arguing that what happened in sweden is an unacceptable result. I think people are intrigued by it and we should be. I dont think any of us are certain, when we do these modelings, there have been more wrong with modelings than right. We are opening more economies in the u. S. And i hope the people who predict doom and gloom who say, oh, theres going to be a surge, will admit they were wrong. In the United States weve never reached such pandemic levels in other states. We have less deaths in kentucky than we have in an average flu season. Its not to say this isnt deadly, but really, outside new england, weve had a relatively benign course for this virus nationwide. And i think the one size fits all, that were going to have a National Strategy and nobody is going to go to school, is kind of ridiculous. We really ought to be doing it School District by School District, and the power needs to be disbursed because people make wrong predictions. Really, the history of this when we look back, will be wrong prediction after wrong prediction after wrong prediction starting with ferguson in england. So i think we ought to have a little bit of hue mimility in o belief that we know whats best for the economy. As much as i respect you, dr. Fauci, i dont think youre the endall. I dont think youre the one person who gets to make a decision. We can listen to your advice but there are people on the other side saying there is not going to be a surge and we can safely open the economy, and the facts will bear this out. But if we keep kids out of school for another year, whats going to happen is the poor and underprivileged kids who dont have a parent to teach them at home will not get to learn for a full year. I think we ought to look at the swedish model and look at letting our kids back to school. I think its a huge mistake not sending our kids back to school. Thank you. May i respond to that even though theres 30 seconds left . Do you have a comment on how we shouldnt go back to school in the fall . First of all, senator paul, thank you for your comments. I never made myself out to be the aenendall in this. I am a scientist and i give information based on scientific evidence. The people have the need to get the country back economically. I dont give advice about economic things, i dont give advice about anything other than Public Health. So i wanted to respond to that. The second thing is that you used the word we should be humble about what we dont know. And i think that falls under the fact that we dont know everything about this virus, and we really better be very careful, particularly when it comes to children, because the more and more we learn, were seeing things about what this virus can do that we didnt see from the studies in china or in europe. For example, right now, children presenting with covid19 who actually have a very strange inflammatory syndrome, very similar to kawasaki syndrome. I think we should be careful, if were not cavalier in thinking that children are completely immune to the deleterious effects. So, again, youre right in the numbers that children in general do much, much better than adults and the elderly and particularly those with underlying conditions. But i am very careful and hopefully humble in knowing that i dont know everything about this disease and thats why im very reserved in making broad predictions. Thank you. Thank you, senator paul. And senator baldon. Thank you, senator murray, chair, and our witnesses. I would be appreciative of concise answers, but i want to start with dr. Redfield. Dr. Redfield, do you think that the current testing protocols at the white house presents a model for other essential workplaces . Im sorry, senator, you broke up at the beginning of your question. If you could just say it again. Im sorry. Yes. Dr. Redfield, do you think that the testing protocols currently in place in the white house present a model for other essential workplaces . Well, i think thank you for the question. I think one of the important things you bring up is the essential worker guidance that cdc put out. I think it was originally modeled, obviously, on health  care workers where there was Significant Health care shortages in individuals that were im asking you if you think the white house protocols testing are a model for other essential workplaces. I would just say that i think each workplace has to define their own approach to operationalize our there was a comment that osha has not stood up an enforcible, mandatory and temporary standard for workers in all sorts of work settings. But that aside, would you say that the ppe rules and protocols in effect right now are a model for other essential workplaces . We would in my own view, it would go back to the guidelines the cdc has put out about central workplaces, that if they are in a central workplace, they go out in public, maintain six feet and wear face coverings. Admiral giroir, you have testified about how far youve come with regard to testing assessments. I want to ask you if you believe we already have a National Testing strategy today that spans from the nationwide testing Needs Assessment to the nationwide testing supply assessment and a strategy to fill that gap to procure domestically what we need in terms of bridging that gap with testing platforms, swabs, specimen collection media and reagents and the ppe need to e conduct those tests. Thank you for that. We do have the ability at least to the fall and beyond. As i mentioned, we are working individually with each state, and i think senator paul is correct that kentucky, wyoming or new jersey, rhode island are different and there are vastly different testing needs. The east coast will have multiples of testing versus other states, and were working those individually. So i know you testified earlier that not only are you working with the states but youre working with every lab in every state to try to increase capacity. Correct. What about working with those who would be the those who would need testing to, say, reopen their school, their university, their business. Each of them have identified what they think are their testing needs based on, you know, guidance, not mandatory, enforcible rules, but are you in contact at that level . Does your dashboard have visibility at that lowest level, or are you mostly in contact with the states and with the labs . So over the last few months weve done a lot of the individual work at Nursing Homes, at meat packing plants and really down to the very granular level. Where we are right now, however, is we are really working with the state leadership, with the Public Health lab, the state epidemiologist, the state health officials, because they really need to understand what their sum is going to be in their state. And in the funding, were asking very specifically in the cdc funding for specific plans for schools, Nursing Homes, underserved, et cetera. Thank you. I have two more points im going to make. I dont have time for questions. One is about the transparency of that Needs Assessment. Can the public see it, can the states see it, can the Public Committee members see it, is it publicly available . And secondly, the delivery of this supply is a critical issue, and it seems to me that the logistics for getting this out, whether its ppe, testing or medical equipment, is still extremely fragmented, leading to price gouging and many other inefficiencies. We need to stand up the full power of the defense production act. Would you like me to comment on that, maam . Im sorry. Im happy to have you comment with the indulgence of the chairman. Weve gone over time. Try to give a succinct answer to seniority, please, admiral giroir. Yes, sir, and particularly for things like swabs and media, there is still a very, i would say, nonmature industry within the country, and thats why weve made the decision to procure that all centrally through december and then distribute that to the states. Because there are too many small companies, too many variables to control without a really heavy federal hand. Thats just an example of where we really moved into that and used the dpa for swabs to help support american industry. In more mature aspects of the industry, like some of the large test producers, we feel that by helping direct them to make sure that the states get what they need in the right distribution that were not procuring them directly by us, but again, were going to be very evidence and datadriven as we move on. Thank you, sir. Thank you very much, senator baldwin. Senator collins. Thank you, mr. Chairman. Let me begin by first thanking each of our Witnesses Today for their expertise, their dedication and their hard work. Dr. Redfield, i want to start with you. I am hearing from dentists all over the state of maine that the fact that they cannot practice in our state despite following very strict Infection Control protocols is causing growing health problems. Dentists tell me that teeth with cavities that could have been filled are now going to need root canals. Teeth that could have been treated with root canals are now going to require extractions. People with oral cancers cannot get the treatment, the cleanings that they need before beginning their treatment. Dental health is clearly so important, and maine state officials as well as our dentists, are seeking assistance in reaching the right decisions. 47 other states either have reopened dental practices or have a day certain to reopen. So my question to you is this. If dentists are following the American Dental Association guidelines, if theyre instituting strict protective measures for their patients, their staffs, their hygienists, themselves, and if theyre closely examining and seeing a decline in the number of covid19 infections in their county, are these reasonable factors for states to consider in reopening the practice of dentistry . Yes, senator, thank you for the question. You know, we have been interacting and talking with dentists and working with the state and local Public Health divisions to update our guidelines on reopening a variety of medical services, as you know. And i think you raise a very important point, and i would not disagree with what you said about looking at the American Dental Associations as well as the reality of the outbreak in the area. But we are in the process of updating those guidelines, and they will include direct guidelines for dental practices. Thank you very much, doctor. Dr. Giroir and dr. Hahn, recently theres been a significant demand for remdesivir. I may be mispronouncing it, which transitioned to receiving an emergency use authorization. Last week maines two largest Hospital Systems contacted me with questions about how this therapeutic will be allocated going forward. Hhs finally released a statement on saturday about allocations going to states, interestingly, not directly to hospitals, but once again the Decision Making behind these allocations is very unclear. Hhs and the assistant secretary for preparedness and response say that each state is expected to receive an allocation, but no timetable has been provided. Beyond those who are being treated with this drug at a Medical Center through a clinical trial, im concerned that hospitalized patients in maine will have little or no ability to be treated with this promising therapeutic for the foreseeable future. As this and more therapeutics and ultimately a vaccine come onto the marketplace, how can these allocation and distribution issues be resolved so that patient care is not delayed and so that it doesnt depend on which state you live in whether or not youre going to get access to these treatments and ultimately a vaccine . Senator collins go ahead, admiral giroir. Go ahead, commissioner. Senator collins, i think we completely agree with you that this has to be an evidencebased approach getting the medical therapeutics vaccines, remdesivir, whichever it happens to be, to the people in need. I think we can all agree on the fact that we learned a lot of lessons from the remdesivir situation, and as you mentioned, thats being led by hhs and asper. What youve seen in the most recent announcement is that what the test scores did was provide guidance to hhs regarding where the most significant outbreak of hospitalization outbreak occurred and where those hospitalized patients were. This represented about a quarter of the supply of drug that we have and more will be allocated according to methodology of where those hospital patients are. I think lessons can be learned with respect to other therapies and vaccines in particular, and we must incorporate those in our Operational Plans moving forward. Thank you, doctor. Admiral, do you have anything to add . Im over time, sorry. Thank you. If you have anything to add, if you would do so for the record. No, maam, i agree with the commissioner. Its absolutely critical that its evidencebased based on the people who can benefit from it and also fair and just throughout our country. Thank you, senator collins. Senator murphy. Thank you very much, mr. Chairman. Thank you to you and senator murray for convening this, thank you to all the witnesses for your service. This is obviously an exceptional i want to start by asking a simple yes or no question that i think i know the answer to. Dr. Fauci, dr. Hahn and dr. Redfield, all of you are withdrawing your salary as you are in quarantine, am i correct . We are essential workers. I was at the white house yesterday and perhaps today and in my office at the nih. It is not strictly speaking of the quarantine as you know it. Performing our duties is strict work. Senator murphy, i agree with dr. Fauci. Yes, i have continued to work during quarantine and as essential worker, we participate in meetings. My point is you should draw salary when you are taking precaution steps because of the contact you made. Quarantine is easy for people like you and me. We can still work and telework, there are millions of americans who cant perform work from home or paid by the hour. It is remarkable to me that this administration has not yet develop a quarantine system thatll work for all americans, you plan r plan to reopen amer america dr. Fauci and redfield, you made news today by warning of the states reopening too early. This is infuriating to many of us because it comes hours after the president declared that we have prevailed over coronavirus. I am going to tell you is going to make it much harder on state leaders to keep social distancing restrictions in place, it comes days after the president called citizens to liberate their states. You say states should not open too early but then you dont give us the resources to succeed. You work for a president who is frankly undermining our efforts to comply with the guidelines that you given us. The guidance that you provided is criminally vague and i want to ask my last question on this topic, obviously the plan to reopen america was meant to be followed by more detailed nuance guidance. What happens if the trajectory is downward in somersetings a sd reopen in others. You knew this because you developed this guidance, this Additional Guidance thats sites specific. Some of this is on the cdc website and some of it is not. We need this. We dont have all the experts you have and we rely on you. This guidance developed by you and other experts was shelled by the administration that it was withheld because of the decision made by the white house. Why didnt this plan get released and if it is just being revi reviewed, when is it going to be released . States are reopening right now and we need this Additional Guidance to make decisions. Senator, i appreciate your question, clearly we have generated a series of guidances as you know and if this outbreak response evolves from the cdc and as we work through the guidances and a number of them go for Agency Reviews and agency input to make sure these guidances are followed broadly for different parts of our society. The guidances that you talked about, i anticipate to go backup into the task force for the review. We are reopening in connecticut in five days or ten days. This guidance is not useful to us in two weeks. Is it this week or next week . When are we going to get this expertise from the federal government . Through your state and other states upon requests, i do anticipate these guidance so to be posted on the cdcs website soon. I cant tell you. I can tell you your state can reach out to the cdc and well give guidance directly to any one in your state. Thank you, mr. Chairman. Thank you, senator murphy. Senator casey. Gentlemegentlemen, thank you much for your service. Dr. Hahn, you mentioned testing for population and the vaccine trial now include americans. I guess my question is does it include children and the diabetic and obese, can you comment on that please . Thank you senator cassidy. Yes, theyll include our most vulnerable population including individuals that you just described. Phase two is only checked for safety, did you not have to do a separate phase two of the patients that are younger. Could you assume the safety data from adults supply to children . We want to assess safety as well in children. So the current phase two includes children. Theyre in phase one study right now. Oh, i thought we had a phase two going on. Well, it is about to start. Senator cassidy, i said we are in the second dose of phase one and well proceed when we finish phase one to go to phase two. It will be included in the phase two trial . Thats under discussion between nih at this time. Dr. Redfield, the public guidelines for School Openings you are about to modify but i noticed as i read through them, there is nothing about speaking. We speak about testing and how we use testing. The guidelines of the schools system have nothing how to integrate those testings. Will it be in the guidelines being released . Clearly there needs to be testing strategy for Different School settings as well as different jurisdictions and thats going to have to be integrated. There is a general over arching guidelines and i do think the testing strategy which is important is included in the surveillance strategy, needs to be an individualized let me comment about that dr. Redfield. With all due respect, i think children whether your rules or fronti frontier, suburban or urban, the resources that the federal government has greatly exceeds all but the most sophisticated populist wealthy states and even then it exceeds in some extent. In a Primary School setting, these are the best practices and these are the three options and choose between one of these three. To say each School District or Independent School work with your state board to figure it out seems a wasted effort. I say that because Children Play such a role in both protection of disease, the spread of the disease and etcetera, your thoughts on that. Because it seems thatsts the s story that you can have not a cookie cutter but a pattern that you can be followed. Senator, i must have been misunderstood. I was talking about differences of elementary and high school and college and in terms of how we have trade school, there may be differences how you interrogaintegrate testing strategies. You argue the risk of reopening prematurely is great. Children in particular, the

© 2025 Vimarsana

comparemela.com © 2020. All Rights Reserved.