White House COVID-19 Response Team, Dr. Fauci Press Conference Transcript January 27

Jeff: (00:07) [inaudible 00:00:07] and other local leaders to update them on our progress and plans. Jeff: (00:13) Today, we are here because we have to (silence). Jeff: (00:23) ... on the state of the pandemic, engage the American people and all of you to ensure everyone has accurate and up-to-date information. The president strongly believes that the scientists who are leading the effort should communicate directly to the American people. To that end, going forward, you can expect to hear directly from people, including Dr. Fauci, Dr. Walensky, Dr. Nunez-Smith and Surgeon General. Dr. Murphy. Jeff: (00:56) My role as coordinator of our federal response is to ensure that we are empowering our experts and using the full capabilities of the US government to respond to and recover from this pandemic. I will participate in these briefings periodically and have asked Andy Slavitt, senior advisor to our White House COVID 19 response to lead [crosstalk 00:01:20] Speaker 1: (01:20) [crosstalk 00:01:20] he's not muted, but I can't hear him. Okay. Speaker 2: (01:25) All right. I can hear. Yeah. Speaker 3: (01:25) [inaudible 00:01:27]. Speaker 2: (01:25) Yeah. Speaker 3: (01:26) [inaudible 00:01:26] Jeff: (01:26) The president believes the federal government should be the source of truth for the public to get clear, accessible, and scientifically-accurate information about the pandemic. We will not always know the answers to your questions. Speaker 3: (01:43) Hello? Jeff: (01:44) When we don't, we will tell you, we will update you on our progress and we will be open about any setbacks, hospitalizations, and deaths. Second, developments on the scientific front, including in areas around vaccines, therapeutics and possible variance. And, third, operational updates and how we're executing against the president's national strategy, including our efforts to get shots in arms, increase testing, secure, adequate supplies of PPE and other critical materials and reopened K through eight schools. And we will provide regular updates on our efforts to ensure that equity remains at the core of all we do, that those who need help (silence) our strategy and execution. Jeff: (02:52) I want to highlight an important action that we'll take today to expand the number of vaccinators in the field to put needles in arms. HHS will amend the current Public Readiness and Emergency Preparedness Act, otherwise known as the PREP Act. They're going to amend it to permit retired doctors and nurses to administer shots and also to permit licensed doctors, nurses, and other practitioners who are licensed in their home states to administer shots across state lines. As the president said, we need to increase the number of places where people can get vaccinated and also at the same time increase the number of vaccinators. This action by HHS today will help get more vaccinators in the field. Jeff: (03:46) We're lucky to have so many trusted experts on our team to help the country fight and recover from this pandemic, and everyone will benefit from hearing directly from them. So with that, I'll turn it over to Dr. Walensky at the CDC. Dr. Walensky? Speaker 4: (04:12) [inaudible 00:04:07]. Jeff: (04:20) Dr. Walensky, can you hear us? Jeff: (04:27) I think we're having some technical difficulties. Dr. Fauci? Speaker 5: (04:30) [inaudible 00:04:32]. Speaker 3: (04:47) [inaudible 00:04:42]. Speaker 5: (04:47) [inaudible 00:04:45]. Speaker 3: (04:47) [inaudible 00:04:46]. Speaker 6: (05:06) [inaudible 00:05:06] Jeff: (05:06) Okay. Dr. Walensky, can you hear us? Dr. Rochelle Walensky: (05:30) I can. Can you hear me? Jeff: (05:33) Great. We had some operational difficulties. We're over to you on the state of the pandemic. Dr. Walensky from the CDC. Dr. Rochelle Walensky: (05:41) Thank you, Jeff, and thank you all for joining us today. My name is Dr. Rochelle Walensky and I am the new director of the CDC. Dr. Rochelle Walensky: (05:48) I'd like to start by recognizing the truly tragic toll that the COVID-19 pandemic has taken on all of us, especially those who have lost loved ones and who continue to suffer in the wake of this disease. This is the first of many briefings, and I look forward to speaking with you often, updating you on the state of the pandemic and sharing continued actions that the public can take to protect themselves and their loved ones. Dr. Rochelle Walensky: (06:12) Let's start with an overview of the data. There are some hopeful signs that we are watching very closely. 25.1 million COVID-19 cases have been reported to the CDC through January 25th. During the week of January 19th through the 25th, the seven-day average of new cases decreased by 21% to over 166,000 per day. Dr. Rochelle Walensky: (06:38) During the week of January 18th to 24th, the seven-day average of new hospital admissions of patients with COVID-19 also decreased by 15% to nearly 13,000 per day. However, over 78,000 patients were hospitalized with COVID-19 as of January 24th. 419,827 deaths have been reported since January 22nd, 2020. During the week of January 19th to January 25th, the seven-day average number of deaths decreased by 4.9% to 3,113 per day. While these data are trending downward is a good sign, the number of deaths reported in a single day during the outbreak was reported on January 20th, the peak number of 4,383 deaths. Dr. Rochelle Walensky: (07:37) Though I am encouraged by these trends, our case rates remain extraordinarily high and now is the time to remain vigilant. If we continue on the current trajectory, the CDC most recent national ensemble forecast predicts that 479,000 to 514,000 COVID-19 deaths will be reported by February 20th, 2021. I know this is not news we all want to hear, but this is something we must say so we are all aware. But if we are united in action, we can turn things around. Dr. Rochelle Walensky: (08:11) Continuing to expand safe, effective vaccination is key to ending the COVID-19 pandemic and bringing our country back to health. Daily vaccine doses administered continued to rise to more than 1.6 million doses per day over the past week. Over 23.5 million doses of COVID-19 vaccine have been already administered. This includes 3.4 million people who have already received their second dose. I want to take a moment here to emphasize that the COVID-19 vaccines are safe and they work, and this is backed up with data that I would like to share with you. Dr. Rochelle Walensky: (08:53) Last week, the CDC released an MMWR on severe adverse events, most notably anaphylaxis for those who received the Moderna vaccine, as well as the Pfizer vaccine. Based on our most recent data, we found that there were 2.1 cases of anaphylaxis per million administered doses of Moderna and 6.2 cases of anaphylaxis per million doses administered of Pfizer. Let me be clear: These are rare, treatable outcomes and the COVID-19 vaccines are safe. Dr. Rochelle Walensky: (09:27) It's also important to put this into context. The risk of getting sick with COVID-19 are much higher than the risk of allergy or anaphylaxis from the vaccine. In the US, sadly, approximately 16,500 people for every 1,000,000 million who are diagnosed with COVID will die. While anaphylaxis can be scary, there are effective treatments and patients generally do quite well. Dr. Rochelle Walensky: (09:55) It's also important to note the mild side effects, like pain where you got your shot, feeling feverish or tired and muscle aches after getting your shot. These are all normal, an expected part of getting the vaccine, especially the second dose. These symptoms mean that your immune system is revving up and the vaccine is actually working. CDC is actively monitoring for safety signals associated with these vaccines, and we are committed to sharing those safety data with you as they emerge. Dr. Rochelle Walensky: (10:24) Also last week, CDC updated guidance to reduce barriers associated with returning for a second vaccine dose on a specific date, or when circumstances change between a first and second dose. Dr. Rochelle Walensky: (10:37) There are two important updates that I want to clarify. First, in our updated guidance, the CDC still recommends that people get their second dose as close to the recommended interval as possible, that would be three weeks for the Pfizer vaccine and four weeks for the maternal vaccine. However, we also know that life can get in the way and that some of those doses may be missed in the best time window. In those rare circumstances, the second dose may be given up to six weeks or 42 days after the first. Dr. Rochelle Walensky: (11:12) Second, the CDC has reiterated that the COVID-19 vaccines are not interchangeable. However, it's also true that in extremely rare circumstances, people may not simply remember or have documentation of which first dose they received. In these extremely rare situations, we have said that any available mRNA COVID-19 vaccine may be administered as the second dose if people are unaware of which first dose they received, and that would be at least 28 days after their first. Dr. Rochelle Walensky: (11:43) I also know that there are concerns about variants. Viruses mutate and we have always expected that variants would emerge and we have been looking for them. The variants have been identified recently seem to spread more easily. They're more transmissible, which can lead to increase number of cases and increased stress on our already taxed healthcare system. In the United States, 308 cases of B117 variant that originated from the UK have been confirmed in 26 States as of January 26th. We also identified this week, our first case of the P1 variant in the United States in Minnesota. To date no cases of the B1351 variant that was first detected in South Africa has been identified in the US. CDC is committed to working with international and state and local partners and increasing surveillance to monitor this situation and share as soon as we learn more. Dr. Rochelle Walensky: (12:44) The emergence of variants underscores the need for public health action. First, get vaccinated when it's your turn. Also, some people may need help getting vaccinated. Please consider helping your neighbors and loved ones schedule or travel to their appointments. Second, wear a mask, practice social distancing, and wash your hands. Finally, now is not the time to travel, but if you must, be safe and follow the CDC guidance, this includes wearing a mask as well as testing and quarantine protocol. Please do your part to get cases down by simply taking these actions. Dr. Rochelle Walensky: (13:24) Thank you. I will now turn it over to Dr. Fauci who will share some scientific updates. Dr. Anthony Fauci: (13:28) (silence). Dr. Anthony Fauci: (14:14) ... [inaudible 00:14:14] about therapeutics. In [crosstalk 00:14:17]. Jeff: (14:18) Dr. Fauci? Dr. Anthony Fauci: (14:19) Yeah? Jeff: (14:20) I believe your audio just came on, so if you could come back to the beginning and start again, that'd be great. Dr. Anthony Fauci: (14:28) Okay, so in other words, nobody heard anything from me. Is that correct? Dr. Anthony Fauci: (14:32) Okay. Well, I said a lot of really good stuff. Thank you, Dr. Walensky. What I'm going to do is talk about three areas: One is therapeutics. The other is a summary of where we are with vaccines. The other is looking at some of the implications of the variants of concern that Dr. Walensky mentioned. Dr. Anthony Fauci: (14:55) When you think in terms of therapeutics, you think in terms of therapeutics for advanced disease and therapeutics for early and moderate disease. Dr. Fauci : (15:03) ... For advanced disease and therapeutics for early and moderate disease. But also buried in that is targeting the virus itself versus targeting the aberrant inflammatory responses that often are the stores and the cause of the morbidities and mortalities that we see with this particular disease. Dr. Fauci : (15:23) So first, if you look at the therapeutics for moderate-advanced disease, one of the ones that has shown clearly to be very efficacious is dexamethazone in people who are hospitalized, who are on ventilators, or have high-flow oxygen requirements, it has shown to significantly diminish the 28-day mortality. There have been another group of studies such as pyrazinamide and remdesivir which have received an Emergency Use Authorization Dr. Fauci : (15:51) Moving over to the left-hand part of the slide, there are a number of interventions that have been used for more early or moderate disease. For example, remdesivir, which is a direct antiviral, has received FDA approval. And a variety of monoclonal antibodies have also received Emergency Use Authorization, as have convalescent plasma. Other antivirals, hep B immune globulin, and things like anticoagulants are currently in clinical trial. Dr. Fauci : (16:21) One comment about things like monoclonal antibodies and convalescent plasma, since they are giving antibody to someone who would need a direct antiviral effect of the antibody, it is best to use it early before individuals actually have had the opportunity to progress. And that's what we're going to be seeing in the future, is an attempt to, as early as possible, get these interventions to the patients in their particular state, hopefully, as outpatients, if we can logistically get that done. Dr. Fauci : (16:55) If we can move on to the next slide, and that is vaccines. As many of you know now, the federal government has been involved either in the development of and/or the facilitation of the testing of a number of vaccines that represent three separate platforms. Shown on this slide is what we all know is the extraordinary efficacious and safe results of the Moderna and the Pfizer BioEnTech product, with 94 to 95% efficacy and a good safety profile, both having received an EUA. Dr. Fauci : (17:32) What we're looking at closely now is others that you see on the slide, Yonson, AstraZeneca, and Novavax, which are in various states of trial. Of particular importance that you'll be hearing about, likely within the next few days to a week, are the results from the Johnson J&J trial. and the reason they're important, it relates to some of the things that Dr. Walensky said. And that is, it's a phase three trial with a different platform, a human adenovirus vector, but it is going to be looking at efficacy, not only in the United States, but also in South Africa and in Brazil. Dr. Fauci : (18:11) So we will get a good feel from those, I hope, I believe we will. We'll let the data speak for itself. But when we will see was the relative efficacy against the wild type virus that is predominantly in the United States, as well as the South African isolate, which in fact is something that we will be able to get a feel for the efficacy there. So we'll have some comparative efficacy, which will inform us on where we would go if the eventuation occurs that we do have that particular lineage that would seed itself in the United States. Dr. Fauci : (18:54) Let me move on to the last slide because that relates to what I said. Dr. Walansky gave you a good feel for the distribution of the various lineages, the 117, which is in the UK, the 351, South Africa, which I just mentioned, and the B.1 in Brazil. She mentioned about the increased transmissibility and the likelihood of an increase, actually, in some lethality in the B117. Dr. Fauci : (19:21) The important question that people ask is what is the impact on both monoclonal antibodies and on the vaccine-induced anybodies related to the vaccines that we are currently distributing now? When you're looking at the 117, namely, what we refer to as the UK variant, what we're seeing is a very slight, if at all, impact on vaccine-induced antibodies and very little impact on anything else. So we are covered with that. Dr. Fauci : (19:52) Things get a bit more problematic when you go to the 351, or what we're seeing as the dominant one in South Africa. Because in that regard, there is a moderate diminution, namely a multi-fold diminution in the in vitro neutralization by vaccine-induced antibodies. However, and this is an important however, it still is well within the cushion of protection. Dr. Fauci : (20:21) So you could diminish the vaccine-induced antibody efficacy by a few fold and still be well within the protective range of the vaccine. And that's the reason why you've seen announcements that actually the vaccines that we're using are still effective. However, given that as a fact now, we have to be concerned looking forward at what the further evolution of this might be. Dr. Fauci : (20:49) Now, I want to make one mention about the monoclonal antibodies because they are more seriously inhibited in the sense of impacting on their efficacy by this South African strain. That's the reason why there will be attempts to develop even other antibodies that might be able to avert this particular problem. Dr. Fauci : (21:10) So looking forward, what we plan to do in collaboration with the companies is to develop what we would call alternative or boosts that would use the same platform, but that would incorporate a particular immunogen that would address these particular variants. And for that reason, we will always want to be a step or two ahead of what might be a problem in the future. So I'll stop there now and hand it over to Andy Slavitt. Andy Slavitt: (21:42) Thank you, Dr. Fauci. [inaudible 00:06:45]. Thank you, Dr. Fauci. And also thank you, Dr. Walensky. The country is truly lucky to have the two of you leading the charge on both our nation's best scientists and our nation's best public health officials. I want to pick up where doctors Walensky and Fauci left off, public health and science. I'm going to talk about another topic, which is execution of the plan to combat the COVID crisis, namely the strategy, the progress, and the challenges openly and transparently. Andy Slavitt: (22:18) Now, to begin, I'd like to start with one of the core pillars of our plan. And that is the equitable health care access and outcomes for all Americans. So let me introduce Dr. Marcella Nunez-Smith, who is head of the Health Equity Task Force, to make some comments on where we stand as a country in the battle to make sure we get every American equitable access to medical care and the vaccinations that they need. Dr. Marcella Nunez-Smith: (22:51) Great. Thank you so much, Andy. And that's correct. Equity is absolutely a foundational component of our national plan. There's the moral imperative, it's simply the right thing to do to ensure that those who are hardest hit or at highest risk, have the opportunity to stay safe and healthy through this pandemic. And there's also the science of it. We cannot beat this virus without making sure we're executing a plan that works for all communities. Dr. Marcella Nunez-Smith: (23:18) So we've committed to taking an equity lens to every aspect of this pandemic response. That includes minimizing the risk of getting infected. And for those who get COVID, minimizing the risk of hospitalization or death. So that includes ensuring access to PPE, testing, treatments, and vaccines. It also includes making it possible for people to safely quarantine and isolate and to monitor the impacts of long COVID. Dr. Marcella Nunez-Smith: (23:44) So from what the data show us, we still have a long way to go. Latino, indigenous, and black people in America are dying at high rates from COVID-19. And folks in communities have case and death rates that continue to climb, and they're dying at higher rates than people in metropolitan areas. So, by race, ethnicity, sexual orientation, gender identity, disability, geography, based on where you live, COVID-19 is leaving a terrible imprint on far too many communities. Dr. Marcella Nunez-Smith: (24:17) Next line. The president took immediate action to combat COVID-19 health equities. Last Thursday, President Biden signed an executive order on ensuring an equitable pandemic response and recovery. And a key part of his approach to ensuring equity is through the COVID-19 Health Equity Task Force. So this task force is responsible for providing specific recommendations to the president, through the COVID-19 response coordinator, for mitigating the health inequities caused or exacerbated by the COVID-19 pandemic, and also for preventing these kinds of inequities in the future. Dr. Marcella Nunez-Smith: (24:54) The task force will include individuals with insights into these groups that have been hardest hit. So their role will be advisory in nature, but the president has asked them to make some recommendations on a range of issues; optimally allocating COVID 19 resources by agencies and by state local tribal and territorial officials, dispersing COVID-19 relief funds in a way that advances equity, ensuring effective, culturally-aligned communication messaging, and outreach to our hardest hit communities, and addressing ongoing health and equities faced by COVID-19 survivors that may merit a public health response. Dr. Marcella Nunez-Smith: (25:33) So it's going to be essential that we collect data for the hardest hit communities and identify data sources that would enable development of short-term targets for pandemic-related actions, and address longer-term data shortfalls and challenges to better prepare and respond to future pandemics. So we will be announcing the members of this task force soon, as President Biden is adamant they hit the ground running, especially now as so many people and communities are disproportionately hurting from this pandemic. Dr. Marcella Nunez-Smith: (26:03) And for the last slide. Finally, it's critical everyone has equitable access to all of the resources necessary to make it through this pandemic. And that includes equitable distribution of COVID-19 vaccines to all communities. So all Americans, everyone in our country, should have the benefit of a safe, effective vaccine that can prevent them from getting sick or dying from COVID-19. It takes intention and deliberate action to advance equity in this vaccine distribution process. So we're going to do that through a series of important actions. We're leveraging data sources, both from government and other sectors, to find and remedy inequities. We're eliminating all out-of-pocket costs for vaccines. Your ability to pay should not play a role in your decision of whether or not to receive this vaccine. Dr. Marcella Nunez-Smith: (26:49) We're removing structural barriers to access an underserved communities. We'll do this by making sure that it's convenient and accessible to get to vaccination sites, by increasing the clinical and community-based workforce for outreach, education, vaccination, and wraparound services. We're working to make sure that transportation and paid time off are available so people can make it out to get their vaccine. Dr. Marcella Nunez-Smith: (27:12) We're going to increase in support core venues of vaccination, including federally qualified health centers, and Andy is going to talk about some of our other venues for vaccination that we're ramping up, but it will be important to make sure a vaccine is available for everyone. And oftentimes, that will mean bringing the vaccine right to people. Next, we're already talking to states about their pandemic plans and strategies for equity. We're here to provide technical assistance when needed, but when local health officials are making great progress in equity, we're sharing some of those great ideas with their peers around the country. Dr. Marcella Nunez-Smith: (27:43) And finally, we're launching a robust national public education campaign to make sure people know about this vaccine, the facts and not the misinformation. We want people to know that the vaccines are safe and effective. We want everyone to be able to make decisions with the best information possible. And we're going to make sure that the information comes to them in places and in ways that are most likely to reach them. It's critical this public education work be very local in nature, critical that we in the federal government support the relationships that already exist between faith and community leaders and their communities. Dr. Marcella Nunez-Smith: (28:16) So while there is no single way to do this work, there are best practices that must define our approach, and supporting those best practices will be our focus in the days and weeks to come. So there's so much to do to get through this pandemic, and we want to make sure all communities are cared for and supported along the way. So with that, I'm going to turn it back over to you, Andy. Andy Slavitt: (28:38) Thank you, Dr. Nunez-Smith. It's appropriate that I follow in my report, doctors Dr. Walensky, Fauci, and Nunez-Smith. Very simply because it's important to send the message to the public, that the White House respects and will follow the science, and the scientists will speak independently, and that our core values of science, public health, and equity, are going to drive our actions here at the White House. Andy Slavitt: (29:05) The president launched the national strategy just as he assumed office on the second day. And at the heart of that plan, it's the most aggressive actions possible to stem the pandemic and follow the science. So Dr. Walensky spoke about the high levels of spread still in this country, even as they decline, Dr. Fauci talked about the threat from the new variants, and Dr. Nunez-Smith spoke about our difficulty and challenges in getting access to vaccines all across the country. Andy Slavitt: (29:40) So given those realities, accelerating the availability and the administration of vaccines are all the more important. So it's been a busy seven days. You've seen us begin to execute our strategy. We've set up a team, began working with states and vaccine manufacturers, launched community vaccination centers, take an action to improve supply, provide travel restrictions... Andy Slavitt: (30:03) ... take an action to improves supply, provides travel restrictions and more. Now I know that many Americans are anxious and eager to get vaccinated. I want you to know we're taking this issue on with incredible urgency and purpose, despite not inheriting a fully developed strategy or the infrastructure to make vaccines readily available to Americans as quickly as they need to be. So far this week, we've been hitting our target of an average of 1 million vaccinations per day, necessary to meet the president's early commitment to administer 100 million shots in 100 days. Now, as you heard from the president this week, he is pushing us to view one million per day as the floor, not the ceiling. To that end, we are releasing more supply, activating FEMA and deploying many more personnel. In fact, just this week, FEMA announced that they had obligated $1 billion to support state vaccination sites. Andy Slavitt: (31:09) Now I want to step back for a moment and put our vaccination plan in some context, to vaccinate every American over the age of 16, we are looking at a total need of well over 500 million doses of vaccines. Now, that assumes two shots for every American 16 and older. Now I want to pause and say that everything we're talking about today in terms of vaccines reflects the vaccines currently on the market, that is a two dose regimen. We are not counting on things that are not in existence today. Our plan will be to make sure that we prepare for as many contingencies as exist. Right now, I want to level with the public that we were facing two constraining factors. The first is getting enough supply quickly enough and the second is the ability to administer the vaccines quickly once they're produced and sent out to the sites. We are taking action to increase supply and increase capacity, but even so it will be months before everyone who wants a vaccine will be able to get one. Andy Slavitt: (32:23) Now, let me start with what's happened so far, we've delivered 47 million doses to States and to long-term care facilities. We've administered about 24 million doses. Now, we've gotten several questions on this, so I want it to be clear, as you heard us announced yesterday, any stockpile that may have existed previously no longer exists. Our practice is to maintain a rolling inventory of two to three days of supply that we can use to supplement any shortfalls in production and to ensure that we are making deliveries as committed. But we are passing doses directly along to States very much in real time as they order them, and we are confident that we will receive the supply on a rolling basis from the manufacturers to allow us to continue to do so. Andy Slavitt: (33:22) Now we know there are places in the country with not enough vaccines and at the same time, there are places with vaccines that they're not using yet. This is a natural challenge States are facing, and we will give them more visibility into their forthcoming supply and providing technical assistance that will help them make sure to make quicker use of these doses. But I want to emphasize, an essential ingredient to increasing the administration of vaccines is passage of the American Rescue Plan, which dedicates needed money for vaccinators and for the administration of vaccines. Andy Slavitt: (34:02) Now, let me take you through what we're doing to increase the supply. So the president invoked the Defense Production Act last week as a big first step to increase the supply of vaccines. We're going to make sure that we get six doses out of Pfizer vials everywhere in America, because that's their potential, and we're going to do that by acquiring something called low dead space syringes. I'm sure everybody knows what low dead space syringes are, I now do. And yesterday, we announced a 16% increase in supply flowing to States every week for the next three weeks to a minimum of 10 million doses per week. That's good news, but what's also important about it is it gives States the visibility that they have lacked to know how many vaccines are coming in so they can make commitments to their partners in States and to the citizens and residents of their state so they know when to expect vaccines to arrive. Andy Slavitt: (35:06) Pfizer and Moderna are committed to delivering a total of 200 million doses by the end of March with much of it coming at the end of the quarter, so it will accelerate. Pfizer yesterday announced that they think they can deliver 120 million doses this quarter. And as you heard from the president yesterday, the United States plans to purchase an additional 200 million doses from Moderna and Pfizer this year, which will be sufficient to vaccinate every American over the age of 16, and we expect those doses this summer. This entire thing is an unprecedented undertaking. We will run into unanticipated issues, but our plan and the actions we're taking in the days and weeks ahead is to deliver on these commitments to the public. Finally, we've also announced that we're creating additional paths to get Americans vaccinated. These will include standing up what we call community vaccination centers. We are going to launch 100 community vaccination centers this month. We will be supplying vaccines directly to pharmacies. We will be standing up mobile clinics to reach hard to reach areas, particularly for pursuit of the health equity goals that Dr. Nunez-Smith has outlined. And we're going to partner with community health centers that reach hard hit communities and have infrastructure to deliver vaccines. Andy Slavitt: (36:47) But again, I want to close with this, it's critically important that Congress act. The American Rescue Plan is an important and vital part of getting America vaccinated. It's got bold and ambitious legislation that will help fund the effort that we're outlining today in providing the resources we need to defeat this pandemic, so we need immediate action. With that I'm going to pass it back so that we can take some of your questions. Speaker 7: (37:23) Okay, great. If folks have a question, you can use the raise hand feature on your screen and we will try to get to as many as we can here in the time that we have left. So let's start with Anjalee at Yahoo News. You should be unmuted. Speaker 8: (37:46) This is a technical [inaudible 00:37:49]. Anjalee: (37:52) Hi there, thank you for taking questions. Can you hear me? Speaker 7: (37:56) Yep, we can. Anjalee: (37:57) All right, great. Thanks so much. I just wanted to get some clarity about the rollout of these vaccines. It seems like we are getting an increase in vaccinations and administrations. Can you clarify what the sudden change was to be able to get to this point? Jeff: (38:20) Andy? Andy Slavitt, can you hear us? Andy Slavitt: (38:21) Yes, I can hear you. Jeff: (38:25) Okay, did you hear the question? It was about the increase, the recent increase and what it was driven by. That the minimum of 10 million to States in the next three weeks, how was that achieved, Andy? Andy Slavitt: (38:37) Okay. Yeah, thank you, Jeff. It's a good question. Look this entire effort is not about just big blast goals, but it's about day-to-day execution. This is the result of the work of Pfizer and Moderna. And in this case, much of the increase came from our work with Moderna, there were planned increases, and scrutinizing what's available so that we can make a commitment to States. Very importantly, we need to add predictability into this process, so I think this is due to the hard work of everybody involved in the process. Speaker 7: (39:19) Great. Let's go to Sheryl Stolberg at The Times next. Sheryl Stolberg: (39:23) Thank you for doing this call, I appreciate it. I was wondering if you could be specific about what you will not be able to do if Congress does not pass the American Rescue Plan. And separately, I'm interested in hearing from Dr. Walensky, how accurate is the CDC data from the States and localities not using about half the vaccine distributed to them? And if that data is the wrong picture, what is the accurate picture? Jeff: (39:54) Thank you, Sheryl. I'll take the first question and then I'll turn it over to Dr. Walensky. It's essential that Congress passed the act. We are committed to 100 shots in a hundred days, and that piece of it is not dependent upon Congress providing funds, but as we all know, that's just the start. We need Congress to provide money for additional vaccinations, sites that provide for more vaccinate tours. So in order to get all Americans vaccinated, we need Congress to provide funds for vaccinations. We still do too little testing in this country, we need to ramp up testing significantly, so we need Congress to fund more testing in order to reopen schools and businesses and take care of people in congregate settings. Jeff: (40:48) Furthermore, believe it or not, we still have shortages of PPE and other critical materials. We do need emergency funds in order to make sure that we have those materials. So those are just three of the key areas that need to be funded by Congress in order for us to execute on the president's national plan. Maybe you can repeat the question for Dr. Walensky and I'll hand it over to her. Sheryl Stolberg: (41:11) Yes, the question for Dr. Walensky is... It's, how accurate is your data showing that states and localities are using only half the vaccine supply. And if that is not the real picture, than what is the accurate picture? Dr. Walensky: (41:26) Yeah, it's a great question. We have a database that actually looks at the vaccine supply. I want to reiterate that not all vaccine that is sort of allocated or delivered or whatnot is available for inserting into people's arms, and that where in the pipeline that is varies by the day of the week whether it's available that singular day. We are working very in ensuring we understand exactly where the vaccine is at any given day. And the reporting of the data is actually also behind, so we're getting when vaccines are reported rather than when they are actually administered. So much of our work over the next week is going to make sure that we can tighten up the timelines, understand where in the pipeline the vaccine actually is, and when exactly it is administered. Jeff: (42:18) I want to make two points. One, most States are getting better at putting needles in arms and the federal government is beginning to support those efforts through all the vehicles that Andy described in partnership with the States. Some of what the States have right now is inventory to do the very, very important second shot. I think it's important that when you're looking at State's inventories, that you recognize some of that inventory is being held for the very important second shot, which we all believe that everyone should follow the FDA guidelines as Dr. Walensky said earlier. So States are getting better. The federal government is ramping up its support. We've got a long way to go, and we're very committed to the hundred million shots in the first hundred days. Speaker 7: (43:13) Great. Let's go next to Ed O'Keefe at CBS News. Ed O'Keefe: (43:22) Thank you all for doing this. I've got a question for The Defense Production Act and the aspects of how the administration can maybe hasten the production of the vaccine related products. Regarding these new doses from Moderna and Pfizer you all announced yesterday, have those two companies specifically told you when these extra 100 million doses will be available? I know some administration officials said yesterday, over the course of the summer. Moderna said third quarter of 2021, that's a broad range, so I'm curious if you can sort of narrow that down? Now, why isn't it being used yet, the BPA to perhaps compel to other companies or even other pharmaceuticals to help make already approved vaccines? Jeff: (44:05) So let's take it a question at a time. Andy, why don't you start with the DPA and then also touch on the likely delivery of the additional 200 million doses. Andy Slavitt: (44:16) Great, and thanks for the question. The Defense Production Act is a very important vehicle for us and we have an entire team that's focused on how to maximize and speed supply. Now, in it's first instance, getting the syringes and all of the other ancillary capabilities necessary to get Americans their vaccines is one of the core areas. We've identified 12 areas where the president has authorized us to use the Defense Production Act, including masks, including more testing, including many spaces. To the very specific question of whether or not a factory can be retrofitted to mass produce another vaccine, that's something that's under active exploration. As you can imagine, it's not as simple as walking... Andy Slavitt: (45:03) It's under active exploration. As you can imagine, it's not as simple as walking in and flipping a switch. These are delicate processes, very sterile processes, and have to be done in a way that actually completely works. But we will not be afraid to explore every option to get more vaccines to the public as quickly as possible. Andy Slavitt: (45:19) As for the timing of the Moderna and Pfizer contracts, look, it is no secret that it is our goal to accelerate that as much as possible. To the extent that we run into those physical limitations, we have to make sure that the vaccines that are produced are done the right way so that we could sign off and get them to the states and get them to the public. So right now, that looks like sometime over the summer. Speaker 9: (45:48) So hypothetically then, what you're saying is you're exploring the possibility of saying, again, just hypothetically, potential of having someone like Merck produce the Moderna vaccine by using the DPA to do that? Andy Slavitt: (46:06) Well, I don't want to talk about specific names per se, but I will say that we are exploring every possible option. We do not believe that in a emergency crisis situation that we're in, that it is responsible to just pick one path and pin our hopes on that. Obviously there are other vaccine manufacturers that are submitting emergency use authorization applications. There are other manufacturers that are not pursuing their own vaccine. And for all of those, we will be looking at ways to accelerate. But when we make a commitment to the public, we don't want to make a commitment to the public based on things that have not been accomplished. We want to make our commitment based on the things that we know about today. And that's why we're talking about through the course of the summer, we'll do everything in our power of course to accelerate that. Jeff: (46:56) Yeah. And just to summarize it, this is a national emergency. 400,000 people died. Everything was on the table across the whole supply chain, from the deadweight syringes, to other pharmaceutical companies, to anything we can do to increase the vaccine supply in the timing of the delivery is on the table and we will execute accordingly. Speaker 10: (47:23) Great. Let's go to Kristin Welker at NBC news. Kristin Welker: (47:27) Thank you so much. A couple more questions. Just to follow up on that, I just want to be very clear, has the president actually signed the DPA? And can you speak to the timeline and raise the issue of summer? And just so we're clear on the expectations, by the end of summer, President Biden said that he was confident by the end of summer, 300 million people would be vaccinated. Is that still your expectation? And then can you speak to some of the concerns that we've heard from governors who have cheered this announcement and said they welcome more supplies, they welcome more vaccines. But in the words of Larry Hogan, "We are going to need much more supplies." Are you able to meet what the governors are asking for, not just increasing it in this first [inaudible 00:03:17], but continue to meet what they're asking for? Andy Slavitt: (48:20) So thank you for the question. Let me speak to that. First of all, I think it's important to clarify the difference between 300 million or 600 million vaccines being produced and the process of getting that across the country to providers and pharmacies and community clinics and into people's arms. There are many more challenges. So what we've talked about yesterday, what the president announced was a first step, namely, to make sure we have enough production. Making sure that 300 million people get vaccinated have a lot of other elements, including community conversations to discuss people's concerns about vaccines as we get into the summer, including making sure that to our earlier points, we are getting every community access to vaccinations. So there is a huge process, which we are undertaking to do this. And so I don't want you to hear that just because they will be manufactured and produced by a certain date that that is the same thing as taking every step necessary, to get them to the public. Andy Slavitt: (49:24) As for Governor Hogan's comments about wanting more vaccines, we hear you, Governor Hogan, and we couldn't agree more. I would love to tell you that we inherited a situation where there were stockpiles and stockpiles of vaccines sitting there. That is not the case. And it is our job to level both with the governors and with the public. Having said that, what we have been able to do is make a commitment to increase by 16% the amount of vaccines going out and to provide three weeks of visibility, which will allow them to plan better. And we hope to do our best to increase and accelerate more vaccines as we see them. Speaker 10: (50:09) Great. Great. Let's go to Yamish Alcindor, CBS. Yamish Alcindor: (50:13) Hi. Thanks so much for taking my question. I have two questions. First is can you [inaudible 00:50:19]? I just want to make sure how many vaccinations are currently available and what's left in the federal stockpile? Are we dealing with a finite number of vaccinations or are they coming in at a certain ... I'm just kind of wondering if you could talk through the numbers again. And then the second question I have is what percentage of vaccinations, people that are already vaccinated, is coming back with racial and ethnicity information? Because I'm wondering how we know who is getting and how you're gauging success when it comes to the people that are getting vaccinated. Jeff: (50:48) So Evan, why don't you take the first question and Dr. Nunez, the second, please? Andy Slavitt: (50:53) Yeah. So to date, we've delivered 47 million vaccines to states and we are committed to delivering an additional 10 million per week for the next three weeks to states. Now we do not keep a stockpile of a large number of vaccines. We keep a two to three day supply as a practice, just to account for variation in manufacturing production. That's it. The rest of moves out to states. Yamish Alcindor: (51:27) So thanks for ... Sorry. Jeff: (51:32) I think part of the confusion here is there was a practice early on, before we were in office, of having a stockpile. The president elected [inaudible 00:51:46] two to three days on hand, he said, to deal with any unforeseen situations. Dr. Nunez-Smith? Dr. Nunez-Smith: (51:54) Great. Thank you. And thank you for that question. So we are 100% committed to making sure that when it's your turn, that you have access to the vaccine, and we know that access in many communities that have been hard hit might be a challenge. To your specific question around race ethnicity data, we are making a call to get better, more consistent data, particularly around some of these demographic points. We see right now around 16 states or so that are releasing race ethnicity data, but it's true that those data are incomplete. But it's not our only sort of visibility into what's happening. The CDC, for example, has a metric around social vulnerability. Many states are using that now. We encourage the use of equity metrics such as that as states are doing their mapping and planning. So we can think about things like neighborhoods and communities as metrics and ways to track as well. And we're building our equity dashboard right now and we rely on government sources as well as sources of data external to government. Yamish Alcindor: (53:07) And [inaudible 00:53:08] as a follow up, how soon do you think that the plan to roll out vaccines to communities of color will have a real impact? I know we talked about summer and other months for the nation as a whole. I wonder if there are any estimates for communities of color in vulnerable populations. Dr. Nunez-Smith: (53:24) Absolutely. So that that work is happening right now. So in states and localities, depending on kind of what's on the ground as far as prioritization, but in those communities that have been hard hit, I say kudos to all of the local health officials who are making those pushes to get to those who are over 75 who are in affordable housing communities, who are bringing vaccine to people in homeless shelters. So again, who meet the criteria for the prioritization. So I think that's the key is when we say everyone over a specific age is eligible that we're going to have to take an extra step to get to some of the people who are hardest to reach. And that work is already happening now. Yamish Alcindor: (54:09) Thank you. Speaker 10: (54:11) And we're coming up on the top of the hour. So we have time for one more, which will go to Alice Park at Time. Alice Park: (54:17) Hello. Thank you so much for taking my questions. So this is more for the scientists, [inaudible 00:09:25]. It seems that the [inaudible 00:54:29] and it's really a matter of staying on top of them to figure which ones are going to be denied and which ones can potentially affect disease outcomes and ultimately vaccine immunity. Are there plans to expand on the current sequencing efforts on a national level, by provide states with additional funding for collecting samples or conducting the sequencing themselves? And how high a priority is this to have one national sequencing effort for surveillance purposes? Jeff: (54:58) Dr. Nunez, if you want to take that first. Dr. Nunez-Smith: (55:00) Great. Thank you. And yes, we are actively working on this. These are data and samples that are collected in the states, as well as with academic and pharma collaborations. I will highlight again, there is money in the American Recovery Act to move this forward and we really need to have access to those resources to do the amount of sequencing and surveillance that we need in order to be able to detect these when they first start to emerge. Jeff: (55:31) Just to add and to expand, believe it or not, we are 43rd in the world at genomic sequencing. So it's essential as part of the American Rescue Plan [inaudible 00:55:50]. I'm getting signal that I'm going in and out. Can you hear me now? Okay. So I'll back up for a second. We're 43rd in the world in genomic sequencing. Totally unacceptable. As part of the American Rescue Plan and remedy that situation, and do the appropriate amount of genomic sequencing, which will allow us to spot variants early, which is the best way to deal with any potential variants. Dr. Fauci? Dr. Anthony Fauci: (56:26) Yeah. One other thing I think people need to understand is that as we all know, RNA viruses mutate all the time. That's what they do. That's their business. And there are very few, but they do have happen, occur, and that is that you get one that has a functional relevancy to it, the way we've seen with greater transmissibility, possibility of greater virulence. But also importantly for us, what I mentioned in my opening comments is that what is the relationship between the mutant and the induction of antibodies by the vaccines that we do? Dr. Anthony Fauci: (57:04) So supplementing what Dr. Walensky said that together with the CDC's expansion in getting more real time sequence genomic surveillance, the NIH will be collaborating with the CDC in looking at what the functional characteristics of these are. For example, we will be monitoring in real time the effect of antibodies that we induced with the current vaccines and with future vaccines as to what impact they have on the ability to neutralize these mutants. And as we see them getting further and further to a more vulnerable part, that's when we trigger the kinds of things that I mentioned in my opening remarks, namely making a version of the same vaccine that in fact would be directed specifically against the relevant mutant. All of that is going on in real time literally as we speak. Speaker 10: (58:17) Okay. I think we're going to wrap it up here. I want to thank everybody for joining. As you can see, lots of information on the disease front coming from CDC, science, Dr. Fauci, and the operations from Andy Slavitt. We will be [inaudible 00:58:41] plan on doing these on a regular basis. The next briefing will be on Friday. Thank you for your patience and for all your great questions. Appreciate it.