Press Briefing by White House COVID-19 Response Team and Public Health Officials 7/12/22 Transcript

Dr. Ashish Jha: (00:01) Good morning, everybody. My name is Ashish Jha. I'm the COVID-19 response coordinator for the White House. Thank you for joining us this morning. I'm honored to be here by two very close colleagues that you know very well, Dr. Tony Fauci and Dr. Rochelle Walensky. Today, we're going to be focusing on BA.5. Dr. Walensky, after I speak, will provide an update on the state of the pandemic and BA.5 in the United States. And then Dr. Fauci will follow that with a discussion about what we know about the science of BA.5. But first, I want to talk about how we viewed this moment, and I want to talk about our strategy for managing BA.5. As you'll hear from Dr. Walensky, we have been tracking BA.4 and BA.5 for months. We've been clear eyed that these kinds of sub variants were always a possibility. Dr. Ashish Jha: (00:51) We have been watching this virus evolve rapidly, and we've been planning and preparing for this moment. And the message that I want to get across to the American people is this, BA.5 is something we're closely monitoring. And most importantly, we know how to manage it. If we think back to two years ago, we had a very limited set of tools to manage viruses like this. But today, thanks to the president's leadership and the comprehensive response we've built up over the last 18 months, we have all the capabilities we need to protect the American people. Vaccines and boosters, treatments, tests, masks, ventilation, and so much more. But beyond just having these capabilities, we have the infrastructure we need to make these tools widely available and easily accessible. Dr. Fauci will discuss in much greater detail, but I want to emphasize, we can prevent serious illness, we can keep people out of the hospital and especially out of the ICU, we can save lives and we can minimize the disruptions caused by COVID-19. Dr. Ashish Jha: (02:02) And even in the face of BA.5, the tools we have continue to work. We are at a point in the pandemic where most COVID-19 deaths are preventable. Our strategy to manage BA.5 relies on making sure Americans continue to have easy and convenient access to these tools. We're going to continue mobilizing the entire federal government, working with state and local leaders, healthcare provider organizations, employers, community based organizations, and others to do this. We're also going to communicate clearly about common sense steps Americans can take to protect themselves. To that end, let me walk through a few key things every American should know. First, vaccines remain our single most important tool to protect people against serious illness, hospitalizations, and death. Dr. Ashish Jha: (02:58) And staying up to date is essential as we see BA.5 rise across the country. We encourage all Americans to get vaccinated if they haven't already. Americans, age five and above should get their first booster shot after five months after their initial vaccination. And if you haven't, don't delay. Do it now. Getting vaccinated now will not preclude you from getting a variant specific vaccine later in this fall or winter. And for people who are 50 years of age or older, my message is simple. If you have not gotten a vaccine shot in the year 2022, if you have not gotten one this year, please go get another vaccine shot. You are eligible for your first booster or second booster wherever you are in your vaccination schedule. If you've not gotten a vaccine shot this year, go get one now. It could save your life. Dr. Ashish Jha: (03:58) My second message to all Americans is we have highly effective treatments that work against BA.5, including PAXLOVID. This is an oral antiviral that reduces the risk of hospitalizations and death by 90%. We have worked very hard to acquire more of these pills than any other country in the world. And we've moved quickly to make these treatments widely available at more than 41,000 locations across the country. And we've built up a large network of Test to Treat sites. Let me talk about Test to Treat. These sites are great. People can walk in, they can get tested. If they're positive, they can speak with a medical provider. And if they're eligible, they can get a prescription and have that prescription filled all in one convenient stop. And if you test positive in the days and weeks ahead, please consult your healthcare provider about your eligibility for treatments, or please visit covid.gov to find a Test to Treat location where you can get tested and treated all in one place. Dr. Ashish Jha: (05:05) Treatments can save your life. Now, vaccines and treatments will help prevent serious illness and death. We also need to make sure we reduce the spread of illness. And we have several tools to help do that. So let's start with talking about testing. As we face BA.5, here's how we think about testing. Before attending a large indoor gathering or visiting with a high risk immunocompromised individual, please consider taking a test. That's what I do. You don't want to be the person who brings COVID to your grandparents or COVID to a wedding. The administration has made tests widely available. We've required health insurers to cover at home tests for free. We've been sending free tests straight to households through covidtest.gov. Testing not only helps you identify whether you're infected, but it helps prevent spread. Another thing that helps both prevent infections and spread is masks. Dr. Ashish Jha: (06:05) There is broad consensus in the scientific community that wearing a high quality mask in indoor public spaces is an important tool to control the spread of COVID-19. It prevents you from getting infected and it prevents you from spreading it to others. We have made high quality mass widely available. And the CDC has developed COVID-19 community levels, which include clear recommendations on when individuals should consider masking in indoor public spaces. And we continue to encourage Americans to visit covid.gov to find their level of COVID-19 in their community, and to find places where masking is available... or masks are available. And we continue to encourage Americans to follow the CDC recommendations for their community. And finally, I want to take a minute to talk about ventilation. We know that improving indoor air quality by improving ventilation, putting in indoor air purifiers, they can make an enormous difference in reducing infections and spread. Dr. Ashish Jha: (07:03) So if you are a business or a school or any kind of institution that brings people together indoors, please work to improve the quality of that indoor air. Let me close with this. We are closely monitoring BA.5 and its impact. We're encouraged that serious illness, hospitalizations, and deaths have remained relatively low based on the level of infections. That's not by coincidence, by the way. It's not random. It's in large part due to our successful vaccination program, our efforts to get people boosted and our incredibly focused effort on making sure that treatments and testing are widely available. But let me make another really important point. We are experiencing about 300-350 deaths a day. That is unacceptable. It's too high. And we will continue to use the infrastructure we have built and the tools we have to lower suffering and death as we manage BA.5. And it is clear that with every American doing their part, we can get through the BA.5 infections together. So with that, let me turn it over to Dr. Walensky. Rochelle. Dr. Rochelle Walensky: (08:12) Thank you, Dr. Jha. And good morning, everyone. It's great to be back again with you today. As always, I'm going to start by walking you through the latest data. The seven day average of hospital admissions is about 5,100 per day. And while this represents only a slight increase week-over-week, it does represent a doubling of hospital admissions since early May. The seven day average of daily deaths are still too high, as Dr. Jha just said. We are at about 350 per day. As you all know by now, each week, CDC updates genomic surveillance data so that we can monitor what variants are present in each region of the country. Over the last several weeks, Omicron sub lineages, BA.4 and BA.5, have increasing in the United States. These are sub lineages of the Omicron variant or variations of the initial Omicron strain and decedents of the virus that initially circulated in 2020. CDC has been closely monitoring both BA.4 and BA.5 since it first emerged in South Africa. Dr. Rochelle Walensky: (09:15) And we've been reporting on these sub lineages in the United States since their detection in April. On this slide, CDC's weekly now cast estimate indicates that BA.5 is predicted to represent 65% of circulating variants. And BA.4 is predicted to represent 16%. Omicron sub lineage BA.2121 is predicted to be most of the remainder of circulating virus at about 17%. These data will be made available later today on CDC's COVID Data Tracker. We do not know yet about the clinical severity of BA.4 and BA.5 in comparison to our other Omicron sub variants. But we do know it to be more transmissible and more immune abating. People with prior infection, even with BA.1 or BA.2 are likely still at risk for BA.4 or BA.5. We continue to learn more about these Omicron lineages and CDC is closely monitoring the public health impact they have. Dr. Rochelle Walensky: (10:18) Several factors will play a role in how BA.4 and five will impact the United States and impact of these sub variants will likely be felt differently around the country. These factors include the level of vaccination and boosting in communities, the amount of prior infection a community experienced, and the level of public health mitigation measures that are in place. While there's no evidence available to suggest that BA.4 or five cause more severe disease, and we're still collecting data on the vaccine effectiveness against BA.4 and BA.5. We know that vaccine effectiveness against severe disease and death remains high for other Omicron sub lineages and likely also for BA.4 and five. So staying up to date on your COVID-19 vaccines provides the best protection against severe outcomes. Currently, many Americans are under vaccinated. Meaning, they are not up to date on their COVID-19 vaccines. Dr. Rochelle Walensky: (11:18) Not all people over the age of 50 have received their first booster dose. Of those who've received their first booster dose, only 28% of those over 50 have received a second booster dose. And of those over the age of 65, only 34% have received their second booster dose. So my message right now is very simple. It's essential that these Americans, as Dr. Jha said, get their second booster shot right away. Dr. Rochelle Walensky: (11:48) Now, on this slide are data from April that illustrate the importance of staying up to date on your COVID-19 vaccines. Among those 50 and older, those vaccinated with a primary series and only one booster dose, represented by the Navy blue line, had four times the risk of- Dr. Rochelle Walensky: (12:03) That's represented by the navy blue line, had four times the risk of dying from COVID-19, compared to those who had a primary series and two or more booster doses shown by the purple line. This graph shows our COVID-19 community levels, and allows individuals and communities to take action to protect themselves and others based on their local level. They also allow us to focus efforts on protecting those who are most at risk of severe COVID-19 illness, and I want to emphasize the importance of monitoring your local COVID-19 community level to know what precautions are needed to protect yourself, your loved ones, and your community. We update COVID levels every week on Thursday. Dr. Rochelle Walensky: (12:43) Last week, CDC reported 32% of the U.S. population is living in a high COVID-19 community level represented by orange. In these areas, the CDC generally rep recommends masking policies, and that individuals wear a mask in indoor public settings to protect themselves against infection. We also reported last Thursday, that 42% of the U.S. population is living in a medium community level represented by yellow. In these areas. CDC encourages individuals to make decisions about masking based on their own individual level of risk. To find your COVID-19 community level, please visit cdc.gov or visit covid.gov and type in your county to see your own community level. Dr. Rochelle Walensky: (13:28) At CDC, we will continue to monitor COVID-19 and provide timely updates regarding the latest guidance, as we have done throughout the course of the pandemic. We know that as the virus continues to evolve, our response and guidance must evolve with it. Thank you, and I'll now turn things over to Dr. Fauci. Dr. Anthony Fauci: (13:47) Thank you very much, Dr. Walensky. I'd like to talk a little bit more specifically now about the evolution of variants, particularly focusing on BA.5, so if I could move to the first slide, please. Just as a background, as you see here, and you look temporally from June of 2021, how successive variants due to mutational changes have essentially bumped one variant off the table after the other, leading to the broader category of Omicron where we are right now. Next slide. And if you look at that, that really gets translated into what we've experienced from a public health and clinical standpoint in the different waves or surges that we in this country have seen with Alpha, Delta, and then as you see on the far right with Omicron, but Omicron as a broad category has been particularly problematic. Dr. Anthony Fauci: (14:45) Next slide. Because as you see here on this family tree of SARS-CoV-2, which shows all the variants that we hear in the United States and throughout the world have experienced with Alpha Beta Delta, but note that Omicron as a broad category has multiple sub lineages with BA.1, BA.2, BA.2.1 2.1, and now what we're currently challenged with is the BA.4, five, particularly the BA.5. Next slide. As you see here, if you look in the United States from March to July, how we've had successful evolution and increasing dominance of the BA.4, BA.5, such that now shown on this slide, it's about 70% total; whereas the BA.5 is more than half, and as you'll be hearing from the CDC, those data will be updated and showing it even greater percentage. Why does this happen? Dr. Anthony Fauci: (15:55) Next slide. If you look here at this slide, there's increasing growth capacity of new variants, Alpha to Delta, but then notice the big jump when Omicron came in November. It had a much, much greater transmission capability than Delta, but over the last several months, we've seen each successive variant have a bit of a transmission advantage over the prior one. And right now, we're with BA.4, five, and we don't know what the future will hold as we might get even more sub variants, so let's focus now just for a minute on BA.5. Next slide. What do we know about it? As I mentioned, it has a growth advantage compared to the earlier Omicron sub variance. It substantially evades, neutralizing antibodies induced in people by vaccination and infection, but the vaccine effectiveness against severe disease, fortunately for us, is not reduced substantially or at all compared to other Omicron sub variants. Dr. Anthony Fauci: (17:08) Next slide, more on BA.5. We know now from experience that we've had over the last couple of months and others in other countries, that it doesn't appear to be associated with greater disease severity or hospitalizations compared to the most recent sub variant. Also, good news is that the current antivirals and bebtelovimab is predicted to work as treatments, as is Evusheld predicted to work as a preexposure prophylaxis. So what does this all mean, and what is the message that all of us have for you? Next slide. And that is meeting the challenge of SARS-CoV-2 and BA.5. Variants will continue to emerge if the virus circulates globally and in this country. Dr. Anthony Fauci: (18:05) We should not let it disrupt our lives, but we cannot deny that it is a reality that we need to deal with, but as you'll hear from all of us, the good news is that we have the tools to do this. We need to keep the levels of virus to the lowest possible level, and that is our best defense. If a virus is not very robustly replicating and spreading, it gives it less of a chance of a mutation, which gives it less of a chance of the evolving of another variant. Importantly, we have the tools, as you've heard from Dr. Jha. Vaccines continue to provide strong protection against severe disease; however, and this is something that we all recommend, immunity wanes, so it is critical to stay up to date with COVID-19 vaccines as primary vaccines, and as boosters where appropriate. Dr. Anthony Fauci: (19:14) Next slide. Also, we need to monitor the COVID levels in your community, which the CDC does well, and in that regard, follow the CDC guidance for masks and other mitigations, depending upon the density of infection in the community. In addition, treatments for COVID-19 are widely available, as you've heard from Dr. Jha. If you test positive for COVID-19, talk to a healthcare provider as soon as possible about treatment options, including test to treat. Once again, the bottom line, it's something that A, we don't panic on; B, we don't let it disrupt our lives, but we take it seriously enough and utilize the tools that we have to mitigate, and the final point is looking forward. We are doing now and it is critical to do so to develop the next generation of vaccines and therapeutics, and for that, we do need the support of the Congress and resources for us. I'll stop there and back to you, Dr. Jha. Dr. Ashish Jha: (20:31) Right. Thank you. Thank you, Tony. Thank you, Rochelle. So let's open up to Q & A, and we're going to have moderating the Q & A session is Serhan Chima from the White House Team. Serhan, to you. Serhan Chima: (20:44) Thanks, Dr. Jha. Let's go to Zeke Miller at the Associated Press. Zeke Miller: (20:50) Thank you all for doing this. Just to follow up on Dr. Fauci's point there regarding waning immunity. There's been some reporting in recent days that the Administration's considering expanding eligibility for fourth shots or second boosters to all adults given that waning immunity. Can you update us on the Administration's thinking on that? And then on the multivalent vaccine development, have orders been placed with that money that you identified last month with manufacturers? How many of those doses do you expect to have in hand for high risk populations once the fall hits? Dr. Ashish Jha: (21:26) All right, so two good questions, Zeke. Let me get started on the first one, and then I'm going to love to hear from Tony on it as well. In terms of opening up boosters to people under 50 or to all adults, let me be very clear. We have conversations all the time about what are possible things we can be doing to better protect the American people, so those conversations have been going on for a while. We are also very, very clear. I am very, very clear that these are decisions made by our regulatory agencies, the FDA and the CDC, and so I know that the FDA is considering this, looking at it, and I know CDC scientists are thinking about this and looking at the data as well. Dr. Ashish Jha: (22:05) The decision is purely up to them, but those conversations, as I said, along with a whole lot of other conversations. We're always thinking about what else can we be doing to protect American people? So let me just say it again, that decision here really is an FDA and CDC decision. Tony, anything else to add on that? Dr. Anthony Fauci: (22:23) Well, Ashish, just to underscore what you said, we are a team here. The FDA is part of the team. The CDC is part of the team. The White House Group is part of the team. We're all part of the team, and we discuss this continually, but as Dr. Jha said, we also have the situation where there are certain elements of the team that are the decision makers, and in this case, it's a regulatory decision on the part of the FDA, and the CDC will examine it with regard to whether or not they'll recommend it or allow it, or what have you. So we always talk about it. It's not something new, but we all recognize what the lines of authority are, and that's what we'll be depending on. Dr. Ashish Jha: (23:06) Great. Zeke on your second question around purchasing for bivalent vaccines for this fall and winter, as we, I think I announced, again, the date's wrong. I'm going to say about a week or 10 days ago, we have put in one order so far with Pfizer for 105 million doses, if I recall. Obviously, that will not be enough for all Americans. We are continuing to think about other orders, talking to other companies, but that order has been placed to get the next generation of bivalent vaccines as directed by FDA and FDA's recommendations about what specific makeup of that vaccine will be. Serhan Chima: (23:49) Thank you. Let's go to Cheyenne Haslett, ABC. Cheyenne Haslett: (23:55) Hi, guys. Thank you for doing this. Can you talk to the Americans who have gotten COVID in all of this discussion... Cheyenne Haslett: (24:03) ... the Americans who have gotten COVID in all of this discussion of being up to date on your booster shots and your vaccinations, including the many who have gotten it just in the past month, very recently, and explain why they should still get a booster or should they wait any number of months or weeks before doing that. And really, what is the argument, if the BA5 variant evades vaccine immunity to still do so, even post-infection? Dr. Ashish Jha: (24:30) That's a great question, and I think there are two parts of it in my mind, and I'm going to turn it both to Rochelle and Tony to take on. But there are obviously a lot of Americans who got infected with BA1, BA 1.1 in the January wave. I think we have very clear evidence that their level of protection at this point is very minimal, certainly against infection from BA5. But let me open up to Tony, if you want to start us off and then maybe Rochelle on how to think about reinfection, especially for people who might have gotten infected recently and what to recommend in terms of vaccines. Dr. Anthony Fauci: (25:03) Yeah. Well, well, Dr. Jar, it's very, very clear, as I mentioned in my brief presentation, that immunity wanes, whether that's immunity following infection or immunity following vaccine, even though the immediate protection following infection or vaccine is generally good protection. But the point that Dr. Ja made should be noted. That is good data now that if you were infected with BA1, you really don't have a lot of good protection against BA4, 5. And in other countries, particularly that have BA4, 5 anti dating ours, the reinfection rate is clear that that's the case. But the overall principle is that we know immunity wanes with corona viruses, whether that is natural infection or vaccination. And so if you've been infected or vaccinated and your time comes for a boost, that's when you should go and get the boost. And I might say myself, having been someone who's been vaccinated and infected, when we get the next round of having vaccines available months later, I will be in line to get another boost after that. Dr. Ashish Jha: (26:19) Rochelle, any further reflections on this issue of infections and whether to still get a booster? Rochelle: (26:27) Yeah, and maybe I'll just add two important points. One is that we know that these vaccines are working well against severe infection. So much of the motivation to get these, is to protect yourself against severe infection and death. And secondly, we do know and have seen large amounts of data that have demonstrated that if you've previously been infected and you also get vaccinated, you have much more protection than prior infection alone. So all of those reasons, in addition to what both Tony and Ashish have said, lead us to the recommendation to get vaccinated. Dr. Ashish Jha: (26:58) Great. Subhan. Subhan: (27:00) Thank you. Let's go to Brenda Goodman, CNN. Brenda Goodman: (27:04) Hi, thanks for taking my question. I've been watching the steady increase in ICU visits, and I just wondered if somebody could talk a little bit about why they think ICU visits are going up in the midst of the BA5 wave? And then I also wanted to ask about potential timing for the bivalent vaccine rollout in the fall. I've been talking to people about second boosters and trying to motivate people to get second boosters. And they say there's a lot of confusion about whether to get a second booster now, if you're eligible, or maybe wait for the updated vaccine in the fall. And can you talk about your thinking on what might happen now and then again in the fall? Dr. Ashish Jha: (27:47) Yeah. So let me start, and Brenda, can you remind me of your first question again? Sorry. Subhan: (27:51) ICU. Dr. Ashish Jha: (27:52) ICU, right. Sorry, thank you. So let me start with the second one first, which is we don't have exact timing again. Obviously just a couple of weeks ago was when FDA made its recommendation around getting a BA4, BA5 bivalence, so we don't have exact timing. Our expectation is that it'll happen sometime in early October, could be a little earlier, could be a little later. These vaccines are being built now. And the entire 105,000,000 doses will not show up on day one. So there will be a rollout period here where I expect some Americans will get in October if everything sticks to timeline, others will get it in November or December. Dr. Ashish Jha: (28:32) In terms of what to recommend people right now, it's very clear to me if you've not gotten a booster, if you're over 50, if you've not gotten a shot in 2022, first of all, getting one now protects you for the rest of the summer into the fall. Second, does not preclude you from being able to get a bivalent vaccine in the fall. So that's why I think for me, it's a very, very clear recommendation. If you're over 50, you haven't gotten a shot this year, you should go get a shot. It's going to save your life. Tony or Rochelle, any thoughts on what we're seeing with ICU stays also increasing in some parts of the country? Dr. Anthony Fauci: (29:10) It's a situation of the relative number. Even though as Rochelle and I have said that even when you're vaccinated, you get good protection against severe disease, if quantitatively, you get a lot of infections, a certain proportion of those are going to be severe disease. And that's the reason why we're seeing an uptick in hospitalization, and likely we might see even a following uptick in ICU. And the reason is, although we're having a hundred to 150,000 infections that are reported, it is very clear that is an underestimate, and there are many people who are getting infected with mild to moderate symptoms who do home testing, who do not report it. So if you get three, four, 500,000 infections a day, you are going to get an increase in hospitalizations that would be proportionate. The ratio of hospitalization, ICU and death to cases is much lower now than it was many months ago. But when you have a lot of cases, a certain proportion, it might be a small proportion, are going to be hospitalizations and are going to be ICU. So I think that easily explains what we're seeing. Rochelle: (30:33) And maybe I'll just add if I might, we have seen a doubling in the number of hospitalizations since April. And by doubling the number of hospitalizations, we could well anticipate, as Dr. Fauci said, increases in ICU. We also know that about two thirds of Americans over the age of 65 are eligible for a fourth shot and should be getting it now to prevent severe infections. So there's a lot we can do to try and prevent these ICU stays. Dr. Ashish Jha: (30:59) Yeah and let me make one last point on this, which is, again, it's been hard to tease apart the data, but some states have tried to look at ICU stays, certainly death or even hospitalizations by vaccine status, boosting status. Very, very, very clear in my mind that your risk of ending up in the ICU is dramatically higher if you have not gotten a booster, if you've not gotten that third shot and for high risk people who are more than six months out, who've not gotten their fourth shot. So there's a lot we can do to prevent those. And then also very clear both from clinical trial data and real world data that getting treated with Paxlovid as well as with the monoclonal antibody, both of them reduce your risk of ending up in the hospital and end up reducing your risk of being in the ICU. Next question. Subhan: (31:50) Thank you. Let's go to Jeff Mason, Reuters. Jeff Mason: (31:55) Hi, thanks very much. Just a follow up on some of the questions about boosters. Will there still be a four month minimum between booster shots for the new variant vaccines? And can you just clarify what the benefit of getting vaccinated with the current vaccine now is versus waiting until the fall. And I guess one other follow up on the age, I know you say that this is a decision for the FDA and for the CDC, but what should people who are under 50 otherwise be doing? Dr. Ashish Jha: (32:27) Okay, Rochelle, you want to start us off? Maybe think about that issue of the four month gap and then what to recommend people on our 50, and then we'll go to Tony after that. Rochelle: (32:37) Yeah. So for those who are, we're going to be evaluating these data, whether it's four months or five months or six months, we'll be evaluating these data as they come in. So I don't have a recommendation right now for regarding exactly what time horizon, what cadence we will be making those recommendations for your next booster for the fall booster. The reason to get a booster now is to prevent infection now. There's a lot of infections now and increasing number of hospitalizations now. Certainly, those are hospitalizations infections, severe disease that we want to prevent right now, and potentially more infections to come before that fall booster is available, which is why we really want to make sure people have as much protection as they can right now. Of course, there are many other things as Dr. Ja enumerated in the beginning that we can do. We certainly can mask to prevent infection, increasing ventilation. If you're eligible for, or you're infected and you're eligible for Paxlovid, we encourage you to get treatment to prevent severe disease. So many of the things that we've been saying you can continue to do right now. But getting that booster if you're eligible would be high among them. Dr. Ashish Jha: (33:46) Tony, anything to add on that? Dr. Anthony Fauci: (33:48) Well, just to underscore what Rochelle and you have been saying, Ashish, that the threat to you is now. If you are not vaccinated to the fullest, namely you have not gotten your boosters according to what the recommendation are, then you're putting yourself at an increased risk that you could mitigate against by getting vaccinated. And getting vaccinated now will protect you now, does not at all preclude if we get a bivalent vaccine to be available in the fall. It does not preclude you're also doing it in the fall. So if the risk is now, address the current risk. Dr. Ashish Jha: (34:28) And let me make one more add on point that I think often gets confusing for people, because people say, "Well, why do I want to get a prototype vaccine booster now, when I'm going to have a variant specific vaccine in four months or five months?" And what I remind people is that this prototype vaccine, this is the original vaccine that was built. If you get a booster shot now, it does reduce your risk of infection. Does not drive it to zero. You still can get an infection, but it reduces that risk. But the biggest thing, and the data on this is very clear, is if you're over 50, that extra booster dramatically lowers your risk of getting into the hospital, going to the ICU and dying. And there are very few things we do in medicine that have the kind of benefit that we see from that extra shot. And so these vaccines, they continue to work to prevent people from getting seriously ill. And let me be clear, if you get vaccinated today, you're not going to be ineligible to get the variant specific vaccine as we get into the later part of fall and winter. So this is not a trade off. We've got plenty. It's a great way to protect yourself. Subhan, to you. Subhan: (35:40) Thank you. Let's go to Peter Sullivan at the Hill. Peter Sullivan: (35:48) Hi, thanks. With BA5 especially, there's been more calls from some experts for developing next generation vaccines, beyond even bivalent, doing a nasal vaccine, for example, or a pan coronavirus vaccine. Peter Sullivan: (36:03) ... nasal vaccine, for example, or a pan coronavirus vaccine. Why is there not a sort of similar operation warp speed 2.0 effort around those vaccines? Is it just that you don't have the money from Congress to do that? Or are there regulatory steps you could take to speed those up even without funding from Congress? How do you kind of view the effort there? Dr. Ashish Jha: (36:23) It's a great question. Let me be very clear, we clearly need a true next generation vaccines and you've listed them, Peter. Pansarvacovirus vaccines, mucosal vaccines. Look, the vaccines we have right now are terrific. They have saved millions of lives, but they continue... Given the virus and how quickly it's evolving, it continues to pose a challenge and we have to constantly be updating these vaccines to meet what's happening. We need a strategy to get to a very different place. The administration has been working across government on this. NIH has been playing a very pivotal role. BARDA within HHS has been playing a very critical role. So there's a lot of effort here. You'll hear more from us in the days and weeks ahead. This is something that we have been working quite assiduously on. I don't know if, Tony, if you want to add to this from your purview at NIAID. Obviously, you have been overseeing and tracking very closely the great science that's been happening here. Dr. Anthony Fauci: (37:25) Well, there are certainly advances being made. There are recent studies that have come out. Most recently, one in science that showed some really promising data from one of the laboratories that the NIH funds with Pamela B Yorkman and her colleagues about what looks really good as a step towards a pan beta coronavirus vaccine. But as Dr. Ja and all of us have said, we need resources to continue that effort and to accelerate that effort. So although we're doing a lot and the field looks promising, in order to continue it, we really do need to have a continual flow of resources to do that. Sivan: (38:08) Let's go to Adriana Rodriguez from USA Today. Adriana Rodriguez: (38:14) Hi, thank you so much for taking my question. I was wondering if Dr. Walensky could clarify something that you mentioned in your presentation about updating guidance. Should Americans expect the CDC to update guidance amid the BA5 wave? And if so, what would they be? Rochelle: (38:31) Thank you. We're constantly evaluating whether our guidance is relevant for the moment, so we will continue to do so. But what I would say with BA4 and BA5 is we certainly are updating our COVID-19 community levels, updating our NowCast, but much of our guidance related to masking, vaccination, boosting, ventilation, all of that is very much still relevant with regard to BA4 and five, as it has been with BA1 and BA2. Dr. Ashish Jha: (39:00) Right. Sivan. Sivan: (39:01) Thank you. Let's go to Lauren Gardner at Politico. Lauren Gardner: (39:12) Hi, thanks for taking my question. I know this has been asked about several different ways, but I want to put a finer point on it. There's been a repetition throughout this that if you get boosted now, it won't preclude you from getting a bivalent booster in the fall, but as been kind of hinted at, that's an FDA and CDC decision. So can you describe, how can you say that confidently when we don't know what the month long intervals are going to be as these vaccines continue to evolve in their formulation? Dr. Ashish Jha: (39:48) That's a great question. So we have the CDC director here who can certainly talk about it from a CDC perspective, but I think that, look, even so far, we've had four, five, six month intervals between booster doses. If you got boosted now, even if there was a five month interval, you'd be eligible in December, but there's no reason to believe that interval is somehow fixed. I think what FDA and CDC are going to do, and again, I'll turn it over to Rochelle in a second, are going to look at the data and see what the data tells us about when the benefits of a new booster would be and how to weigh that against risk. But Rochelle, how do you answer the question of how can we be so sure that Americans will be able to get a bivalent vaccine in the fall if they get boosted now? Rochelle: (40:37) Ashisha, I don't have a lot to add to what you just said. Just as we've looked at the cadence of where we've needed to get boost before, it's been four, five months. We anticipate that's going to be a similar cadence. We also really want to emphasize that there are many people who are at high risk right now and waiting until October, November for their boost. When in fact, their risk is in the moment is not a good plan. And so we really do want to say, now get your boost. We have every anticipation that the data will suggest that you will be eligible for a boost in the fall. We will, of course, continue to evaluate those data. Sivan: (41:13) Yeah. Thank you. Last question. Let's go to Joyce Frieden, MedPage Today. Joyce Frieden: (41:24) Hi, thanks for taking my question. I think one thing a lot of people are concerned about in addition, obviously, to death and the hospitalization is long COVID and there hasn't been any mention of it today. So I wondered if you wanted to address people concerned about that. Maybe tell us what you're learning about it. I think a lot of people are alarmed by the one in five statistic that CDC recently put out. I'm also interested, if you go to any airport, you see, or in public transit, a lot of people not masked at all. I'm wondering when the time comes to talk about reinstituting vaccine, sorry, mask mandates. Dr. Ashish Jha: (42:17) So let me start off by talking about long COVID and maybe, Rochelle, I can pump the question of where we are with masks on public transport to you in a second. So we've, back in, I think it was March, I'm going to get the dates right, March, maybe early April, the president put out a presidential memorandum, asking HHS and asking the secretary of HHS to put together an all of government response to long COVID. That has been work that's been ongoing. We expect two reports out in early August. So really about three weeks away. I say that not just punt to those reports, which are going to be very, very important, but it is to say that we, as an administration, take long COVID very seriously. And we have been doing an enormous amount of work to think through how do we prevent long COVID? How do we take better care of people with long COVID both clinically? How do we address your other needs? And then obviously, we're tracking the data on how often these occur, how the clinical scenarios from long COVID is almost surely not one clinical condition. Dr. Ashish Jha: (43:20) It's probably multiple different things. How do we understand that, break that apart? That work has been ongoing and then recovered, the recover trial that NIH is overseeing is a massive investment in trying to really understand long COVID. So I think this is something that, and when I brought up the importance of preventing infections, obviously infections are disruptive. They're annoying, but also can lead people to have significant long-term symptoms and long-term disability, and that's long COVID. So there's a variety of ways in which we are thinking about and trying to address long COVID. It continues to be an important problem, and certainly the president has highlighted this as an important area for this administration and has tasked all of us to come up with an all of government response on this. Rochelle, to you on masking on public transport. Rochelle: (44:10) Yeah. Thank you for that question. So let me just reiterate that CDC recommendations have been and continue to be to mask in our public transport corridors. So in our airports, in our airways, on our trains. That has not changed. It has not wavered. It has been reversed in the courts and that is currently under legal consideration, but the CDC guidance continues to be to mask in these quarters and I continue to wear mine. Dr. Ashish Jha: (44:37) Okay. Thank you. Sivan, are we done? Sivan: (44:40) That was the last question. Dr. Ashish Jha: (44:43) Great. Well, thank you everybody. Let me just finish off by saying thank you for joining us today. As I started off with, and I want to just finish, BA5 and the arrival of BA4, BA5, the fact that BA5 is now the dominant variant, subvariant in the United States, this is not a surprise. We have been tracking this. I remember the early reports when B4, BA5 combined represented less than 1% of all infections in the United States. We have tracked this carefully. We are not surprised that we are here at this moment and more than not being surprised, we are prepared. We have been planning for this moment, and it is really important that if we do the things that we know that we have learned over the last two years, we can get through whatever mother nature throws at us in the next four, six, eight weeks ahead. Dr. Ashish Jha: (45:31) And also, whatever mother needs to throws at us this fall and winter, we can get through those things because science has delivered for us a series of capabilities that allow us to manage that virus and is now important for all of us in government, private sector, Americans across the country to work together, to make sure that we get through these moments without substantial disruption, without people getting sick. That's really up to us. So thank you for joining us and look forward to seeing you the next time we get together.