Down to discuss the coronavirus pandemic and response, preparing for the flu season, and resource priorities within the department. This is 15 minutes. What should be the hhs later Research Agenda as the nation six to understand what has happened during the pandemic and what kind of efforts should be sustained afterwards . Proven to be a valuable part of the covid response. This is such an unprecedented disease and its impact on the Health System is so unique. We are really learning. You can see we are learning how to treat patients with covid so much better as the time has progressed over the last several months. One of the key things we are doing as a funding opportunity with investigations as you mention, telemedicine and also treatment pathways and protocols in the idea would be to Fund Investigations to get information out on a short four to six month timeframe so we can replicate that and enhance learnings. We saw one of the key impacts of this with the south in the southwest. What we saw was we went through marchith the height in and early april in new york and new jersey and connecticut. As we were convening Health Care Providers, Health Systems and they were learning from each other, so much of the rest of america was not terribly impacted. When it did hit places like florida, texas and arizona in southern california, we had to work very aggressively to essentially bring those Health Care Providers on the journey that new york, new jersey and connecticut went on a couple months before. Replicateof learn and and disseminate information out is quite vital. There is one other initiative we are harnessing that i am excited about. Our Nursing Homes are homes have struggled with how to protect the vulnerable and how to engage in good Infection Control at their facility. We have the traditional cms approach of surveying, inspecting and sanctioning through fines, but we have started a new approach, which is much more of a quality system by design approach, using the provider relief funds. We just rolled this out at the end of the week. We are finding Nursing Homes to support their testing, their Infection Control, personal protective equipment. We have created an incentive equipment incentive system to keep their infection rates below Community Levels as well as below peer levels of Skilled Nursing facilities and added a component where it is an issue of skill, not will with our Nursing Homes. Can we get Academic Medical Centers and others who are experts in Quality Systems to educate, mentor, bring along our Nursing Homes . Some of whom are really just momandpop operators, on how to do some real basics of Quality Systems. Helping to do quality work. Im hoping we will see a real improvement in nursing home quality as a result. Thank you for bringing those incredible capabilities to bear on this pandemic. So, the federal response to the pandemic has been at best uneven. There are areas where the government has taken a very robust, extremely proactive role, spurring the publicprivate collaboration around development of therapies and very importantly, vaccines. The support from barda has been invaluable to the Pharma Companies that are developing those vaccines. We presume there is going to be ample payoff in terms of effective vaccine. There have been other areas where the response has been mixed. We do not have any Real National covid testing strategy. There has been sporadic leadership on areas like the supply chain. If we were resetting the clock on the pandemic, what do you think should have gone differently in terms of the federal response . Sec. Azar i have to respectfully beg to differ on both of those characterizations. There has been a National Testing strategy. It is coronavirus. Gov. It is right there. We are following that testing strategy and that has what let us to have 92 million test performed. We have capacity for 3 million tests per day. We are doing 820,000 tests per day. We have brought rapid pointofcare antigen and antigen and, rapid pcr testing to pointofcare at speeds that nobody thought were even possible when we began that journey in february. Capacities that nobody thought were possible. We are following a strategy of ensuring that we have a system of diagnosis, for individuals who are symptomatic or suspected of having covid. For asymptomatic individuals for whom a doctor or Public Health individual believe should be tested, get them tested and diagnosed and having Surveillance Systems and having statistical sampling to determine if we are facing outbreaks in different communities. We have been working with universities and colleges and states to set up alternative Surveillance Systems. Schools are doing wastewater surveillance. That is a product of our research where you can at a dormitory test wastewater to determine if you have a positive case and in surge in with testing. We have developed for colleges comprehensive testing strategies and Surveillance Systems. I disagree. We have built from the ground up a completely novel publicprivate testing system of both diagnosis and surveillance that no other country could come close to. In terms of supply chain, we have taken a supply chain that really was totally not engaged in by the federal government before and made that where here at the strategic stockpile, we have built complete visibility into the commercial supply chain. We used to have a half 1 billion a year in supplies of the national stockpile. The mission of that was to have countermeasures for chemical and biological incidents and a small amount of personal protective equipment and other Hospital Capacity in the event of a regional disco location like a hurricane regional dislocation like a hurricane or tornado. This is a completely different mission. We are working with our gpos and distributors, complete visibility of the 1 trillion commercial med surge pharma supply chain in the United States. We know where things are, and we can use our defense production powers to reallocate them within the system. We have crated purchase orders to the making of ventilators. We are bringing pharmaceutical production back to the United States. A more copperheads of approach than we have ever seen before. Those are all Lessons Learned from this pandemic, but they have also been lessons adapted to rightofway right away with historic action that has put us not just in a better position but as we prepare for any future pandemic. Thate you then satisfied we have all the capabilities now in place for what is widely deemed a possibility, which is a second severe wave of covid this fall and winter . Sec. Azar i still do not know why we speak of the second wave. That was a concept that was talked about when there was this thesis that somehow there was seasonality of covid, it would go into a dormancy in the summer weather by transmission vectors or otherwise. We did not see that. We sell continued spread we saw continued spread in the south and southwest. We are seeing cases in other parts of the United States. I do not know that this notion of a second wave remains a valid concept. For spreadto prepare anywhere as well as to ensure we have Health System capacity to deal with it. Certainly to prevent further spread through the three ws of washer hands, watch your distance and wear your face coverings if you cannot want your different or distance and stay out of settings where you are not going to be able to do those things. We are in this period that i call a bridge. We are so better positioned in the context of testing and supply chain then we were five month ago. We are going to be in the next several months in such a better position in terms of vaccines and therapeutics. We are in this bridge. Right now, the key is for all of us to engage in good, personal and collective responsible behaviors of those three ws as we bridge to this better place we are going to get to. Whether we call it the second three, wave 2. 5 or obviously there are lots of concerns about the coincidence outbreaksential flu alongside other viral outbreaks, possibly rs a b and all of that coming to bear at the same time as a resurgence of covid in many areas. Is that it is that particular set of issues i am probing on. Do you think we have the adequate response built to respond in the case all of those things come together . Sec. Azar in terms of influenza, we always take influenza seriously and we have increased our vaccine production. We have close to 200 million doses available this year. We are going to work aggressively to make sure people get their flu vaccines. We are extending the vaccination period, the Campaign Season for flu vaccination. We want to get as many people vaccinated as possible this season. As we look at flu incidents and of course, nothing is a guarantee, but if you look at flu incidents in the southern hemisphere, look at data from australia and i believe it was south africa and chile, and what we have seen has been very anomalous, low influenza like activity in the southern hemisphere. We andve in part because other countries are practicing those three ws of community mitigation, washing our hands and washing and watching our distance and wearing face coverings. We saw if we look back at the data in march, we sell a bottoming out of influenza activity prematurely in the United States when we went to shelter in place methodologies. No guarantees. We prepare for every scenario. We have the full Vaccination Campaign going. The very same mitigation efforts we are doing for covid may have a beneficial effect as we look at it hitting the influenza season. That would indeed be a Silver Lining of all of this. Ceos ofnow, the nine the major vaccine manufacturers engaged in the work of operation warp speed issued a strong statement they would not seek Regulatory Approval for any of their vaccines before phase three trials are completed and safety and efficacy is fully established. They indicated they were going to stand with the science. What to you does it say that these ceos felt it was necessary to make that statement . Sec. Azar we welcome the statement because it exactly what the president and i and the fda have said. We are going to move quickly on vaccines and therapeutics. We want to vaccines and therapeutics as quickly as possible. We are going to use the full publicprivate power of the u. S. Government. We are derisking the financial investments. We can talk more about how we are doing that. We are not cutting corners on fda standards. This is by the book. We have been transparent at fda. We have put out guidance on what the fda is looking for in terms of faxing approval. We have made it clear there will be a process with the fda. I welcome the statement and i think it may help with a lot of those who are spreading these terrible antiPublic Health, antivaccine messages. We have got to ensure Public Confidence in our systems and our processes just like our influenza season. We need to get people vaccinated. If we do get an fda Gold Standard vaccine are vaccines, need to make sure people are willing to take them once they are available. Hard to see is outside of the pandemic at this point, but outside the pandemic, what are your priorities for hhs at this moment . Wewe continue sec. Azar continue to drive and all the things we have been working on before. We are working on Health System transformation. We are still driving towards that transparency of pricing and quality of information and from insurance companies. We have implemented the health and Information Technology interoperability platforms. We continue to work on some of retractable disease states like sickle cell anemia. We remain hopeful we will have a literal cure for sickle cell. It has been a year and a half ago i was in boston childrens and i got to see a young man who was exiting the hospital after 30 days of treatment on one of the experimental treatment with no sickles. Left in his blood we went to bring that promise to people. I went to drive forward on ending the hiv epidemic so we can continue to make progress there. We have this underlying Opioid Crisis still with us. The pandemic and social isolation have certainly harmed the progress made on that. We have to get back to getting people into medication assisted treatment and ensuring people have the tools they need for longterm treatment and recovery for them. That is some of the things we continue on even as we deal with this unprecedented pandemic. The rest of our Mission Remains also. We want to thank you for your service to the nation at this very difficult and challenging time and for moving forward on those important priorities. Thank you on behalf of the Research Community for your leadership. Sec. Azar announcer live to capitol hill now, where nancy pelosi will speak with reporters about the issues facing congress. She is likely to get questions about the senate vote on their pandemic bill put the other by republican put together by republican leaders. Possibly questions on Bob Woodwards new book on President Trump. Here is a look at this mornings washington journal. Host the headline from one of the audio releases from yesterday, i always wanted to play it down this is from will be rage this the Biggest NationalSecurity Threat you face in your presidency, that was Robert Obrien telling the president , according to that book, going on to say that this will be the roughest thing that you face. In the article, it was 10 days later that the president called bob woodward and revealed he thought the situation was more dire than what he had been saying publicly. It is a tricky situation. You breathe the air and that is how it is passed. Than,also more deadly even your strenuous flues. We lose 25,000 people a year here. Who would ever think that . I know. This deadly stuff. Host that was the president from february this year. Other audio excerpts were released in relation to this book, but it was the president yesterday at the white house talking about the release of the audio. [video clip] can you address the concerns with regard to whether did you mislead the public by saying or how you downplayed the coronavirus, and how you repeatedly did that in order to reduce panic . Im a cheerleader for this country. I love this country. And i do not want people to be frightened. I do not want to create panic. And certainly i am not going to drive this country or the world into a frenzy. We want to show confidence. We want to show strength as a nation. And that is what we have done. Numbers compared to other countries and other parts of the world, it has been an amazing job we have done. The Vice President and others have done this great job and they have not been acknowledged by the news media, and they should, whether it is on ventilators, soon with vaccines and with therapeutics the job we have done has been incredible. But we do not want to instill panic. We do not want to jump up and down and being shouting that we have a problem that is a tremendous problem and scare everybody. We do not want to cause pricing to go to a level that becomes unaffordable. Yeah, in that sense, i agree with it. How do you reassure the American Public that you can trust that they can trust what you are saying . Pres. Trump the last thing you want to do is created panic. This was a horrible thing, it was sent to us by china. It should have never have happened. This is a terrible situation that was hoisted upon us. And we have to show we just do not want to use the best word is panic, we are not going to show panic. That is exactly what i did. I was very open, with woodward t anotherdy else jus political hit job, but with woodward or anybody else, you cannot show pin it. Host you can call us on the phone lines. You can text us at 2027488003. You can also post on facebook. In texas, a supporter of joe biden, go ahead. My question is, why we still listening to this man . He was saying he didnt want us to panic, but he was trying to get the to panic just a couple days ago. That wejust appalling have to listen to this. The last thing i wanted to say was if anybody looked at the of hof hitlers in 19 itler in 1933, we are on the same track. He is saying the same kinds of stuff. I do not know who these people are, that they have the same ideology that they will believe anything. Host from maryland, a supporter of President Trump, we will hear from chris. Caller thank you for taking my call. Thingmaybe this is the that one knock down donald trump. I do not know. This is another situation where i am a father of children, small children, and if there is a thunderstorm coming toward my house, do i look at the radar and to say what is going on, sure. Is it going to hit my house . Do i tell the kids it will be horrible when you go to bed, it will be awful, then send them to bed that way, or do i say, do not worry about it . As a father and a