White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript February 24

Jeff Zients: (00:00) Thank you for joining us. I want to begin by acknowledging that we have passed a grim milestone in this pandemic; half a million people dead from COVID-19. This pandemic has touched each of us. So many have lost loved ones. We've been separated from our friends and families. Too many of our businesses and schools have been closed for way too long. Jeff Zients: (00:26) President Biden is clear, we are at war with this virus and we're using every resource at our disposal to defeat it. We're keeping equity at the front and center of our response, partnering with states, tribes, and territories to increase vaccinations in the hardest hit and hardest to reach communities. Increasing supply to convenient and trusted locations like community health centers, deploying mobile units to meet people where they are and improving data collection so that we have a better understanding of the inequities currently experienced. Jeff Zients: (01:09) Today we're announcing another action we're taking to ensure an equitable response. In the month of March, we will begin to deliver millions of masks to food banks and community health centers around the country. These are nation wide networks that serve populations hit hard by the pandemic. While masks are widely available in many different shapes and sizes, many low income Americans still lack affordable access to this basic protection. That's why we're taking this important action to keep Americans safe. Jeff Zients: (01:46) We will deliver more than 25 million masks across the country. These masks will be available at more than 1300 community health centers and at 60,000 food pantries nationwide. Any American who needs a mask will be able to walk into these health centers or food pantries and pick up high quality American made masks. These masks will be available at no cost. They'll be well-fitting cloth masks, available in children's and adult sizes, and they can be washed for reuse, all consistent with CDC guidance and all made in the USA. Jeff Zients: (02:29) Once again, our decisions here have been made with equity at the center. Not all Americans are wearing masks regularly, not all Americans have access and not all mastered equal. With this action, we are helping to level the playing field, giving vulnerable populations quality well-fitting masks. Jeff Zients: (02:52) When president Biden delivered his inaugural address, he made a very clear request to the country; mask up. And he's taken action to require masks in federal buildings, on federal lands and on public transportation like planes, trains, and buses. The action we're announcing today is a targeted step to help Americans respond to the president's challenge to mask up, to protect themselves and their fellow Americans. Jeff Zients: (03:21) As we encourage people to continue to mask up, we're focused on vaccinating people quickly and equitably. Today I'll give you the latest update on our execution on vaccinations in the three key areas that we're focused on; more vaccine supply, more vaccinators and more places to get vaccinated. Jeff Zients: (03:47) First on vaccine supply. Yesterday we announced the fifth consecutive week of supply increases to states, tribes and territories from 8.6 million doses when we took office, to 14.5 million doses this week. That's an increase in vaccine allocations to states of nearly 70% during the Biden-Harris administration. The retail pharmacy program we launched a few weeks ago has performed well so far, and this week we will increase the allocation to pharmacies to 2.1 million doses. So with 14.5 million doses allocated to states, tribes and territories, and 2.1 million through the federal retail pharmacy program, we've nearly doubled weekly supply of doses in just five weeks. Jeff Zients: (04:45) Second, we're mobilizing teams to get shots in arms. We've deployed over 800 federal personnel as vaccinators and the federal government is now funding 1200 national guard members to serve as vaccinators. We've also deployed 1000 federal personnel to support community vaccination sites in operational and support roles. Jeff Zients: (05:12) Third, we continue creating more places where Americans can get vaccinated. We've now expanded financial support to bolster community vaccination centers nationwide with over 3.6 billion in FEMA funding to 44 states, tribes and territories for vaccination efforts. We're bringing vaccinations to places communities know and trust; community centers, high school gyms, churches, and stadiums nationwide. And we continue to work with states to set up innovative, high volume, federally run sites that can each give over 30,000 shots a week. These sites are up and running in California and are ramping up in Texas, Florida, and Pennsylvania. We've also launched federal programs to get vaccines to pharmacies and local community health centers. As we've always said, we're committed to providing clarity on our progress, and that includes when we hit bumps in the road. Last week, we got hit with the very severe weather, which impacted the vaccination supply chain from manufacturing to shipping, to the ability to get shots in arms. The manufacturers, the shipping firms, the states, the tribes, the territories and pharmacies worked to overcome these challenges. And despite all the temporary weather related delays, our seven day average daily doses administered is at 1.4 million, and we've already caught up on the weather related shipping backlogs. Jeff Zients: (06:55) Teams worked throughout last weekend to pack and ship doses. On Monday, yesterday, seven million doses... Two days ago... Seven million doses were delivered. That coupled with the 14.5 million doses allocated this week results in record supply going to the states. We've encouraged states to get needles into arms by extending vaccine clinic hours, offering services 24 hours a day where possible, adding weekend appointments and having more staff on hand. On this point, I want to stress that if states do not have the staff to work around the clock and on the weekends, the federal government stands ready to help. Jeff Zients: (07:37) I also want to spend a couple of minutes on our plans for the Johnson & Johnson vaccine, which is currently pending approval for emergency use authorization by the FDA. Yesterday, I again updated and reviewed with our nation's governors our plans to distribute the Johnson & Johnson vaccine if the EUA is granted. The governors are carefully planning their efforts and getting ready for the possible new vaccine. If authorized, we are ready to roll out this vaccine without delay. Jeff Zients: (08:13) Our distribution approach will mirror the current allocations process across jurisdictions, pharmacies, and community health centers. If an EUA is issued, we anticipate allocating three to 4 million doses of Johnson & Johnson vaccine next week. Johnson & Johnson has announced it aims to deliver a total of 20 million doses by the end of March. We're working with the company to accelerate the pace in timeframe by which they deliver the full hundred million doses, which is required by contract by the end of June. Jeff Zients: (08:49) While we await the FDA's decision, we want the American people to know that we're doing the work so that if the EUA is granted, we will waste no time getting this life saving vaccine into the arms of Americans. Jeff Zients: (09:02) Lifesaving vaccine into the arms of Americans. With that, let me turn it over to Dr. Walensky to talk about the state of the pandemic. Dr. Walensky. Dr. Walensky: (09:10) Thank you Jack. I am again delighted to be with you today. We continue to see trends heading in the right direction. In the past week average daily cases declined 25% to approximately 64,000 cases per day. This is slightly less than the summer peak of 67,000 daily cases reported last July. While this is good news, cases still remain high and we continue to watch this data closely. Dr. Walensky: (09:35) We also see continued declines in new hospital admissions for the most recent week. An average of 6,500 patients with COVID-19 were admitted per day, a decrease of 16% from the week prior. The number of reported deaths is also dropping, with a seven day average of slightly less than 2,000 per day. This represents a 35% decline compared to the prior week. On Monday, I announced that we were kicking off our three day national COVID-19 vaccine forum and since that time we have had an extraordinary few days. Our final tally, we've virtually assembled over 12,000 participants from across the United States, representing state, tribe, local, and territorial governments, private sector partners, medical and public health institutions, community-based organizations, faith-based groups and educators among others. The discussions and presentations from over 100 speakers showcased promising practices and critical scientific information for those involved in vaccination efforts in communities across the nation. Dr. Walensky: (10:42) I'd like to share a few examples of what we learned over the last three days. First, trust and community confidence are cornerstones of our national vaccine efforts. Trusted voices are critical to building confidence in vaccines and addressing misinformation. Our community leaders are often those trusted voices. We heard from national, state and local health leaders about communication and public education campaigns they are deploying to combat myths and disinformation and instill confidence and interest in COVID-19 vaccines as well as tools and strategies healthcare providers can use when talking with their patients about COVID-19 vaccination. Dr. Walensky: (11:22) For example, we learned about a new communications campaign in New Orleans that is grounded in the local flavor and culture as a way to resonate with the city's residents. Second, one of the most powerful benefits of the forum of learning about on the ground experiences and new innovations to expand vaccination efforts. We heard about creative ways providers and volunteers have been getting vaccinations into communities using boats, ferries and snowmobiles in Alaska, leveraging emergency medical services to provide vaccinations to homebound individuals in Indiana and using awareness campaigns featuring trusted elders and healthcare workers in the Cherokee Nation of Oklahoma. Finally, forum sessions taught us that every person, community, faith-based organization, governmental and non-governmental partner and business has a role to play in supporting our nation's COVID-19 vaccination strategy. We learned about faith-based efforts like the outreach to people of color being led by the Metropolitan International Church in Nashville, Tennessee, where faith ambassadors engage with local clergy to help spread accurate information on COVID-19 vaccines to these high risk communities. Dr. Walensky: (12:38) We also heard about successful public-private partnerships, like in San Diego where vaccination super sites like the one in Petco Park Stadium are vaccinating thousands of people a day, and in Colorado where there is a government-private partnership, the Champions for Vaccine Equity Taskforce, where the health department and 10 medical champions of color are working with and through community-based organizations to create opportunities for listening and sharing information about COVID-19 vaccines. Dr. Walensky: (13:08) These are just a few of many practical innovations and solutions shared during the forum and I want to let you know that all of these sessions as well as resources and materials will be posted on the CDC website following the forum. I encourage you to check it out when you are able. Dr. Walensky: (13:25) Next I would like to take a moment to highlight the progress made so far in our efforts to rapidly expand genomic sequencing nationally, including through our $200 million announced last week. This work is more important than ever given the continued spread of COVID-19 variants in the United States. As of February 23, we now have identified nearly 1,900 cases of B117 variant in 45 states, 46 cases of the B1351 variant in 14 states, and five cases of the P1 variant in four states. The pace of our genomic sequencing has scaled up from about 400 samples a week when I started as CDC director to now more than 9,000 samples as of the week of February 20. We are continuing to increase this pace with our state public health and private lab partners with the goal of 25,000 samples per week in the coming weeks. The increased volume of sequence information is helping us to better understand the diversity of variants circulating in the United States, where they are located and how they are spread. With the samples in hand, we can then scientifically examine how variants impact vaccines and therapeutics moving forward. Dr. Walensky: (14:38) Finally, I want to say that we are proud to be partners in the announcement made today about sending masks to underserved and vulnerable populations. One of the most impactful things we can do is wear a mask and this is so important during this critical period where cases are declining but variants that spread more easily are increasing throughout our country. The CDC continues to recommend that everyone two years of age or older wear a mask when in public and around others in the home not living with you. The mask you should wear should have two or more layers, completely cover your nose and mouth, and fit snugly against your nose and the sides of your face. It's essential that you wear your mask correctly and that it fits well in order to get the most protection. By wearing masks in combination with social distancing, washing your hands, avoiding crowds and travel and getting vaccinated when it's available, we can bring an end to this pandemic. Thank you. I of course look forward to your questions but I'll first turn things over to Dr. Fauci. Dr. Fauci. Dr. Fauci: (15:37) Thank you very much Dr. Walensky. What I'd like to do over the next couple of minutes is just update you on an important component of the spectrum of COVID-19 disease. If I can have the first slide, many of you are now aware of what had long been called long COVID, but actually what that really is is post-acute sequelae of SARS-CoV-2 infection which we're now referring to as PASC, or P-A-S-C. The reason I'm bringing it up with you today will become apparent in just a minute or two. Just to refresh your memory, the symptoms of this include fatigue, shortness of breath, sleep disorders, fevers, GI symptoms, anxiety and depression and what some have been referring to as brain fog or an inability or difficulty in concentrating or focusing. Remember, these are post-acute sequelae, after the virus essentially has been cleared from the body, and actually new symptoms sometimes arise well after the time of infection or they evolve over time and they may persist as I'll get to in a moment for months and can range from mild, annoying to actually quite incapacitating. The magnitude of the problem is not yet fully known. Dr. Fauci: (17:01) Next, there have been a number of papers that have described in some detail large cohorts. Here is one from China which was published online on January 8 and more than 1,700 patients whoa actually had been hospitalized. I point out that you can get this post-acute syndrome even in individuals who did not require hospitalization. The six month follow-up showed a variety of signs and symptoms shown here with many having fatigue and weakness, as I mentioned on the prior slide sleep difficulties, anxiety or depression, and the greater proportion of patients with more severe illness and impaired lung diffusion capacity. Dr. Fauci: (17:49) Next, most recently in a study from the University of Washington that appeared just a few days ago, it was found [inaudible 00:17:58] something alarming, that approximately 30% of the patients who are - Dr. Fauci: (18:03) ... that approximately 30% of the patients who were enrolled at the University of Washington reported persistent symptoms for as long as nine months after illness. Fatigue was the most common reported symptom, and persistent symptoms were reported by one third of outpatients with mild disease. Next slide. Dr. Fauci: (18:24) What we did, we being an inter-agency group, the NIH, the CDC and others, put together a workshop in Rockville, just a little bit North of Washington, D.C. on December the 3rd and 4th of last year in which we looked at various organs systems and brought in experts in all of these areas, cardiovascular, pulmonary, renal, neurologic, immunologic, and pediatrics, to scope out the kinds of things that we would need to be looking at with this puzzling syndrome. Now, the reason I'm bringing it up at this press conference, next slide, is that just yesterday on February 23rd, the NIH launched a new initiative to study this PASC or post acute sequelae. Dr. Fauci: (19:15) Now, looking back a bit in December of last year, the Congress provided $1.15 billion in funding over four years for the NIH report research looking into this, and I'm happy to say that yesterday, there was the first in what will be a series of research opportunity announcements released for NIH initiative on this puzzling syndrome. The research studies will be looking at SARS-CoV-2 recovery cohorts, some that are already established and some that will be established. They'll be looking at large data banks from resources such as electronic health records and health symptoms, and they'll be studying a number of biological specimens. Dr. Fauci: (20:05) And finally, on the last slide, there are selected questions that this initiative hopes to answer, and they are important. What does the spectrum of recovery from this infection look like across all the entire population? Young individuals, middle-aged, elderly. How many people continue to have symptoms of COVID-19 or even, as we've seen, develop new symptoms that they did not have even as part of their acute infection? Importantly, what is the underlying biological cause of these prolonged symptoms? We refer to that as pathogenesis. What makes certain people vulnerable, while others recover fully and quickly and have no sequela? And finally, does SARS-CoV-2 infection triggered changes in the body that actually increase the risk later on of such abnormalities such as chronic heart or brain disorders? A lot of important questions that are now unanswered that we hope, with this series of initiatives, we will ultimately answer. So I'll stop there and hand it back to Jeff. Jeff Zients: (21:25) Well, thank you, Drs. Fauci and Walensky. why don't we open it up for questions? Speaker 1: (21:33) First of all, go to Meg Tirrell at CNBC. Meg Tirrell: (21:39) Hi. Thanks so much. Just to follow up, Dr. Fauci, and then I've got another couple of questions, one for Dr. Walensky and then one for all of you. On long COVID, I wonder if you could tell us just a little bit more about, and it's early, but what the epidemic of PASC or long COVID might look like even beyond the pandemic and how worried you are about that, and if you're seeing any early work going on in trying to develop sort of therapeutics or other ways of addressing it? And I wonder for Dr. Walensky on the masks, a lot of people are so excited about this announcement. I wondered how you decided on cloth masks, if you considered or are considering N-95s at all, even though we know that there is know constrained supply of those. Meg Tirrell: (22:23) And then finally, just a question on the vaccines in general on the plan going forward. With J and J potentially coming out next week, we also know AstraZeneca will have U.S. phase three data in a few weeks, and Novavax has said Q2 it all planned to file and could have 110 million doses in the third quarter. It seems like we're going to have a glut of vaccines potentially later this year, which is a great situation, but what is the plan for all of these different vaccines if they do succeed? Dr. Fauci: (22:53) Hey. Thank you, Meg. I'll take the first question related to this syndrome. Very important question about what we can do about it, and that's the reason why we are creating these cohorts and we're looking at what might possibly be hints at pathogenesis. It's very difficult to treat something when you don't know what the target of the treatment is, and that's the reason why it's extremely important to take a look at these individuals, not only the scope of this and not only the depth and breadth of the symptoms, but also to try and have some correlate that actually is a pathophysiological correlate. Once we get that, an important part of this, as I mentioned, would be to design therapeutic approaches hopefully by medications that we already have. We just need to know how to use them. Dr. Walensky: (23:45) And maybe I'll chime in and just discus the CDC guidance now is to wear cloth masks. The distribution of these masks, which we're also super enthusiastic about, is intended to ensure that both the source and the receiver are wearing a mask that's compliant with the CDC guidance that is comfortable, easy to wear, and when worn will prevent infection, and we believe these masks will do so. Jeff Zients: (24:12) I want to handle, Meg, your question on vaccines, and we do not want to get ahead of FDA decision-making here on any of the vaccines that have not been yet approved, but on J and J, obviously the prospect of a potential third approved vaccine is very encouraging and will help to increase the overall vaccine supply, which will allow more Americans to get access to getting vaccinated sooner. Keep in mind that the J and J contract is to deliver 100 million doses by the end of June, but we're working to accelerate that delivery schedule. And I think the thing that you will hear from our doctors and from President Biden is as soon as it is your turn to get a vaccine, get vaccinated. Next question. Speaker 1: (25:06) Next, we'll go to Ricardo at the Associated Press. Ricardo: (25:11) Hi. Thank you for taking my question. And Jeff Zients mentioned that you're caught up from weather-related delays on shipping. However, if we look at the CDC information on vaccinations, vaccinations are still down markedly from before the weather. And so my question to you is what is your timetable for getting caught up on actual shots in arms, and where do you think the level has to be? And then finally, even before the weather hit, we were seeing a leveling off in first doses. What explains that, and does it concern you? Jeff Zients: (26:06) So I showed the data that we averaged 1.4 million per day last week, which was down from 1.7 prior to that. Each week it was going up. I think in the most recent day-to-day information, there's a little bit of a lag effect, so you're seeing the lag of the weekend weather and the weekend overall. We anticipate that the rate of vaccinations will increase markedly this week, given that all that supply did arrive over the weekend and on Monday, and that we've increased the weekly allocations to states, tribes and territories up to 14.5 million, which is up 70% from the 8.6 where we started five weeks ago, and that the pharmacy program is now being allocated 2.1 million. So I think and hope that you will see a marked increase in the vaccination rate ... Jeff Zients: (27:03) ... And hope that you will see a marked increase in the vaccination rate, given that the weather issues are largely behind us, and absent any other type of weather or unexpected event. Speaker 2: (27:16) Next we'll go to Jeremy Diamond at CNN. Jeremy Diamond: (27:21) Hey. Thanks for doing this. A couple of questions. First, on the issue of vaccines, Jeff, you said today that about three to four million doses will be available to be shipped out, if and when an EOA is granted. Yesterday I believe you told governors it would be two million doses. So, could you explain that discrepancy? Jeff Zients: (27:41) Sure. Jeremy Diamond: (27:41) And then also, how do you believe that the arrival of this vaccine, if in fact it is approved, will affect the president's goal of 100 million shots in 100 days? Do you expect to increase that goal? And then just lastly, on the question of the mask shipments, I'm wondering how much it is costing the administration to ship these masks. At this point, given that Americans who want to wear a mask largely aren't having trouble actually finding masks, what's the rationale behind this? And how does this help solve the problem of mask hesitancy, which seems to be one of the bigger issues here? Thank you. Jeff Zients: (28:23) Okay. That was a lot at once, so you'll have to help me here as we go along. But I think my exact language yesterday was around two million to the governors. It might end up being a little more than that. But remember, we also allocate to pharmacies and to community health centers, so that's the primary delta or difference, if you will, between around two million and three to four million. Jeff Zients: (28:45) Your next question was around the 100 million goal. That goal, when we set it, was an ambitious goal. Many people talked about one that we'd have real trouble reaching. So far, we are pacing ahead of that goal. The president pushes us every day to figure out everything we can do as a whole of government effort, partnering with governors, local health officials and others to do all we can to vaccinate as many Americans as fast, efficiently, and as importantly, equitably as possible. So we view the 100 million shots in 100 days as a floor, and we intend to exceed that goal. Jeff Zients: (29:28) On masks, the cost will be $86 million, and we really believe that this policy makes a lot of sense, in that it allows people who are not able to in some situations find or afford a mask to get a mask. It's part of our equity strategy, and central to that. Speaker 2: (29:59) Next we'll go to Sharon Lefner at New York Times. Sharon Lefner: (30:09) Thanks for taking my question. So, J&J was supposed to have 12 million doses by the end of the month, and 37 by the end of March. Instead it's going to be under four million and 20 million. Can you tell us what exactly happened to cause these delays? Secondly, how confident are you that Pfizer and Moderna are going to be able to deliver the full 220 million doses that they've promised by the end of next month? And then finally, if you could address to what degree is the vaccination program really hobbled by lack of sites and vaccinators. Isn't lack of supply the principal obstacle? Jeff Zients: (30:49) Just to start with the beginning, I think to date we have been... As we've ramped up the number of places, the number of vaccinators, that supply has been, as you suggest, the primary constraint. On J&J, when we got here five weeks ago we learned that J&J was behind on manufacturing, and our team has been working with them since. You know, I think they're in a better place now. We've helped them with equipment and raw materials, which I think is helping to increase greater capacity and accelerate. The contract, as you stated, is to deliver 100 million by the end of June. The initial production ramp, you gave the data, was slower than we'd like, so we will continue to work with the company to accelerate that ramp. I would refer you to J&J for any more specifics, but I think it was disappointing when we arrived. I think the progress is real, and we look forward to continuing to work with the company to accelerate their delivery and their capacity. Jeff Zients: (32:02) Moderna and Pfizer, as you know, we've done a lot to help both companies with their manufacturing processes. We're in touch with them all the time, daily, hourly, to make sure that we're doing anything we can to help them, and to monitor their production. I think just yesterday they articulated that they are on schedule, Moderna, to deliver the 100 million doses by the end of March. And as you know, the president visited Pfizer last Friday, and the Pfizer CEO reassured the president that they're doing everything they can to accelerate production, and that they will deliver 120 million doses by the end of March, and 200 million doses by the end of May. Next question? Speaker 2: (32:48) Last question, and we're going to make it really quick. Josh Wingrove with Bloomberg. Josh Wingrove: (32:57) Hi there. Thank you for taking the time. Can you speak a little bit about first the mask decision. It was deliberated whether to send them to all Americans. Can you talk a little bit about that sort of decision? Was that just sort of too big an undertaking? You get more sort of impact to send it more targeted? And can I ask specifically, do you think the allocations are going to change if you do get a third approval? In other words, will governors still get a similar share of the stream, or will expanded vaccination sort of help you change the math a little bit, and open up some other streams? Thank you. Jeff Zients: (33:36) Yes. So, let me do the second question about allocation. We talked to the governors yesterday as part of their preparation, and we're talking to the pharmacies and community health centers, our federal partners, about the allocation mirroring the current allocations. So, the same percentages going through each channel. You know, across time we'll monitor channels, make sure channels are performing in two ways. Efficiency, and also fairness and equity. So, future allocations across channels could be changed based on performance, but we're starting... If the FDA does approve Johnson & Johnson as our third effective vaccine, it will be distributed along the same lines as our current percentages. Jeff Zients: (34:22) You know, months ago, sending a mask to every American would have been a good idea. Today, masks are widely available in many different shapes and sizes. Yet still, not all Americans are wearing masks regularly, and not all masks are equal. Many Americans need access to a mask that provides effective protection, in line with the CDC guidance that Michelle articulated. So, this plan of sending masks to community health centers and to food pantries is an effort that focuses on people who may be particularly in need of the extra support to stay safe, and to meet the president's mask challenge of masking up for the first 100 days. Jeff Zients: (35:14) With that, I just want to thank everybody for joining, and we look forward to Friday's session. Thank you.