White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript March 17

Andy: (00:00) ... The White House testing coordinator, she will introduce Dr. Willinsky and then Dr. Fauci. Between all of them, you will hear how various elements of our testing strategy come together. And with that, I'll turn it over to Dr. Nunez-Smith. Dr. Nunez-Smith: (00:18) Thanks so much, Andy and good afternoon, everyone. As Andy said, we are continuing to advance robust efforts to ensure equity in our federal COVID-19 response, making sure there is equitable access to all COVID 19 resources. So whether that is access to PPE or masks, access to vaccines, access to testing, as you will hear much more about in today's briefing or access to treatments. And today I'm here to provide an important update on how this administration is making COVID-19 treatments more accessible and available for the American people, particularly those in the hardest-hit, highest-risk communities. Dr. Nunez-Smith: (00:59) We are working to improve access to one specific class of therapies, the monoclonal antibodies. And you've heard Dr. Fauci discuss the benefits of these therapies previously. There are currently three monoclonal antibodies that have been authorized by the Food and Drug Administration for emergency use with the most recent authorization coming just in February. The positive impact of these treatments has become pretty clear. Dr. Nunez-Smith: (01:25) For individuals who are diagnosed early with COVID-19 that's early testing and who, although they're currently doing okay, are really at risk of getting pretty sick, these treatments can make a huge difference in preventing them from developing severe illness from COVID. In fact, Eli Lilly's newest monoclonal antibody combination therapy has shown the ability to reduce COVID-19 related hospitalizations and deaths by up to 87%. So the National Institutes of Health and the Infectious Disease Society of America, that's an association of over 12, 000 physicians, scientists, and public health experts, they specialize in infectious disease and they both formally recommend the use of this treatment in patients with mild or moderate COVID-19 who are at high risk of progression to severe disease. Dr. Nunez-Smith: (02:15) So these recommendations by the NIH and by IDSA send a really strong signal to patients, as well as providers all over the country. A message that these treatments are efficacious. They show enough promise in clinical studies to recommend their broader use during this pandemic to help us save lives. And we are certainly tracking all the latest science and updating clinical recommendations as needed. For all Americans, these treatments for COVID-19 are free. And the cost of administering them is covered by Medicare and Medicaid and most private insurance companies. And these therapies are already available across the United States and we've shipped these treatments to over 5,000 sites across the country. So that's hospitals and emergency rooms, urgent care settings, physician's offices, and infusion centers. Dr. Nunez-Smith: (02:59) But there is still work to do to make sure that these treatments are available and accessible to the highest-risk communities. Those communities that have faced high burns of COVID-19 over this past year. So today we're announcing a new $150 million agreement signed by the Department of Health and Human Services specifically to help us make sure that any individual in any community who meets the clinical criteria can have access to these important therapeutics. These funds will help us go beyond those existing 5,000 sites to help get these therapies to folks in other settings as well, giving us the ability to continue to meet people where they are. This new effort is going to speed assistance to hit communities, really increasing the use and administration of the monoclonal antibody therapies, preventing hospitalization and death. This assistance may include additional staffing, infusion center capacity in both traditional and non-traditional healthcare settings, and the equipment necessary to administer this intravenous infusion, as well as being sure we increase awareness among healthcare providers and patients about the treatment options that are available, including where and how to access them. Dr. Nunez-Smith: (04:12) So this is just another example of how we are committed to an equitable COVID-19 response. We're working absolutely to keep people from getting COVID-19 in the first place. The vaccines that are currently being administered across the country are key to doing just that. But for those individuals who get COVID-19, we want to make sure that they too have the benefit of the latest in scientific discovery to help them hope and help toward a safe and speedy recovery. So you can learn more about these monoclonal antibodies and how to access them by going to combatcovid.hhs.gov. Dr. Nunez-Smith: (04:46) And with that, I'll turn it over to Carol Johnson, the testing coordinator and the White House COVID-19 response team. Carol? Carol Johnson: (04:53) Thank you, Dr. Nunez-Smith. When the president announced his national strategy to fight COVID, he outlined a comprehensive plan to scale and expand testing in order to safely reopen schools and society. Today, thanks to the American Rescue Plan, we're turning that plan into action. We know that school districts want to reopen, but up to this point, many lack the resources to set up COVID screening programs for students, teachers, and staff, to help keep COVID out of our schools. Today, that all changes. Earlier today, the Department of Education announced the state funding allocations for the $122 billion in the American Rescue Plan to help schools invest in mitigation strategies like PPE, additional space, more teachers, and extending their critical learning and enrichment programs. And today the Department of Health and Human Services announced plans to distribute $10 billion to support COVID-19 testing in schools across our country. With this funding for testing, every state in America will have access to millions of dollars to set up screening testing programs, to add a layer of protection for schools, teachers, and students. Carol Johnson: (06:02) This funding can be used to test teachers and staff, students, and others with symptoms of COVID, those who may have been exposed, and to establish sustained regular screening testing programs across the school system. We recognize that establishing COVID testing program is new for many schools, and that's why CDC will work with state and local health departments to support technical assistance to help schools and States in standing up and implementing these programs. With this critical findings from the American Rescue Plan, we hope more schools will be open across the country and more kids will be back in the classroom soon. We know the testing works. We know that it works to identify cases and slow the spread of COVID. And we look forward to working with schools to implement this exciting new program. Carol Johnson: (06:50) Finally, I want to note that this work builds on additional actions the administration has already taken to scale up taste testing nationwide, like establishing regional coordinating centers to help accelerate testing and make the process easier, increasing domestic manufacturing of testing supplies, and rapidly increasing genomic sequencing. The American Rescue Plan, which was signed into law last week will invest nearly $50 billion overall in testing. Carol Johnson: (07:16) We believe it was important, we believe it is important to get the first a hundred billion dollars out to states for school reopening as quickly as possible. So with that, I'll turn it over to Dr. Wilensky, who will share additional testing news for today. Thank you, Dr. Wilensky. Dr. Walensky: (07:31) Thank you, Carol. And good afternoon. I'm glad to be back with you today. Let's start first with an overview of the data. Cases continue to hover around 50 to 55,000 cases per day and the most recent seven day average is 53,000 cases per day. Hospital admissions continued to fall with the most recent seven day average just over 4,700 admissions per day. We continue to see declines in the number of deaths from COVID-19, averaging slightly more than 1100 deaths per day over the last seven days. Today- Dr. Walensky: (08:02) ... 100 deaths per day over the last seven days. Dr. Walensky: (08:03) Today, I want to spend a little time discussing COVID-19 testing and why this remains a critical component of our comprehensive approach to ending this epidemic. Reliable and widely available testing is a crucial part of our efforts to stop the spread of COVID-19, but several factors can make testing strategy decisions complex, including the different kinds of tests available, the changing dynamics of the pandemic and communities, and the increasing proliferation of new variants that are more transmissible. Having clear evidence-based recommendations to help state and local public health departments and the medical community make informed decisions about COVID-19 testing is paramount to an overall national testing strategy. Dr. Walensky: (08:47) Today, CDC is releasing a suite of five updated guidance documents on COVID-19 testing, building on the latest science, available testing options, and what we have learned about testing during this pandemic. Our testing overview guidance describes the available tests that are used to detect COVID-19, how to choose the tests, and the reasons for using them. They also explain the impact of vaccination on testing. Dr. Walensky: (09:13) Importantly, until now, limited test capacity has resulted in our use of tests for largely diagnostic purposes, when someone presents with symptoms or has been exposed. Only in selected places, have we capitalized on the benefits of how testing can be used as a screening intervention with frequent tests to identify asymptomatic disease and prevent clusters before they start. Testing can also be used as a surveillance tool to monitor the burden of disease in communities. Our newly released set of guidances offers a comprehensive approach to testing and helps to prevent the spread of COVID-19 through the rapid identification and isolation of people who are infected, including those who do not know they are infected because they do not have symptoms. The updated overview also provides new information about health equity issues related to testing. To end this pandemic, everyone must have equal access to affordable and timely testing with fast turnaround time for results. To identify infections and reduce community spread. Dr. Walensky: (10:21) In addition to the overview guidance, we are also releasing four complimentary guidance documents that focus on testing in specific settings, including correctional and detention facilities, non-healthcare workplaces, institutions of higher education, and homeless shelters and encampments. Each of these companion documents and guidance documents provide tailored recommendations that take into account the unique circumstances and risks for COVID-19 spread in the different settings. Today's updated guidance is intended to help public health officials, medical providers, school and justice system administrators, and others, make decisions about setting up testing programs in their communities. All five guidance documents are now posted on our website at cdc.gov. Dr. Walensky: (11:06) And while guidance is critical for decision-making for COVID-19 testing, it's equally important that testing programs and communities are supported with resources to do the work. This requires much needed and long overdue resources. So I'm proud to share that CDC is announcing new funding for $2.25 billion in grants to public health departments, on average $20 million per grant, to more than a hundred health departments to address COVID-19 health disparities and advance health equity among people or at high risk and underserved, including racial and ethnic minority groups and people living in rural areas. A large component of this funding will focus on strategies to improve testing and contact tracing, along with funding to support continued implementation and of prevention strategies for COVID-19. These funds will provide much needed funding to states, cities, counties, and rural locations. I'm so excited to report that this funding represents CDC's largest investment to date to support communities that are affected by COVID-19 related health disparities, especially those in high-risk and underserved groups. This is truly a historic investment for CDC and an important step forward to help hard-hit communities turn the corner on this pandemic. Thank you. And I'll now turn it over to Dr. Fauci. Dr. Fauci: (12:34) Thank you very much, Dr. Walensky. I'm just going to change topics somewhat just for the next minute or two, to give you an update in the context of vaccines and what we are learning in the longer range as we go from the EUAs. This slide is a familiar slide that I've shown a couple of times at these briefings. Just to summarize, we have three vaccines that have been proven to be highly efficacious, namely, within the context of the clinical trial, they work. Now, the question is, what happens when you get out into the real world? Dr. Fauci: (13:12) Next slide. We refer to this as the difference between efficacy and effectiveness. Efficacy is what you show in a clinical trial. Effectiveness means what happens when you use that in the real world. And what we are seeing is that in fact, these types of vaccines that I just mentioned are working. Dr. Fauci: (13:35) Let me give you just a couple of quick examples among several. This is a study from Israel in which 600,000 newly vaccinated people with the Pfizer BNT vaccine were matched against 600,000 controls. Look at the right hand part of the slide. Seven or more days after the second dose, the effectiveness of this vaccine in the community was well within the range of the efficacy of the trial. 92 to 94%. Dr. Fauci: (14:07) Next slide. This is a slide from the UK in which regular asymptomatic testing was done among healthcare providers who did the same kind of routine testing that many of us do. It was shown that in an arena and a context in which there was a variant, B117 predominated in England, again, you had a very high degree of effectiveness seven days after the second dose as shown here with 85%. Dr. Fauci: (14:41) Next slide. Back to the United States in the Mayo Clinic. In this study of individuals who underwent routine pre-procedural testing, coming into the hospital for a sigmoidoscope, a colonoscopy, dental procedures, or what have you, they were tested, and it was found that after adjustment for confounding factors, there was an 80% reduction in the risk of a positive screening test in people who received two doses of an MRNA vaccine. Dr. Fauci: (15:16) And then finally on this last slide, in Israel and in Spain, the study in Spain show that viral load is a proxy for infectivity. And then in a study in Israel, they found out when there were breakthrough infections, either among vaccinated individuals or those who are not vaccinated. And you look at the viral load in the nasal pharynx, it was decreased four fold for those who actually were within 12 to 28 days of the first dose of vaccine. Dr. Fauci: (15:48) Bottom line, the vaccines work in the real world. Not only are they efficacious, but they are effective. Dr. Fauci: (15:57) Now back to you Andy. Andy: (15:59) Thank you. All right. Why don't we take questions? Speaker 1: (16:03) All right. Andy: (16:03) All right, why don't we take questions? Moderator: (16:04) All right. First question, we will go to Shannon Pettypiece with NBC. Shannon Pettypiece: (16:09) On the school testing, there's been concern from schools that they are not able to use the rapid test for asymptomatic students, unless they get one of these CLIA waivers. And they say there's been a big issue with them being able to use the rapid test. So does this guidelines, that you're putting out today, is that going to open the door for schools to use the rapid test more easily in asymptomatic students? Andy: (16:36) Let me ask Carol to take that. Carol Johnson: (16:39) Yeah. So I will say that the CDC is putting out guidance today, but there's more work to do. We're putting these resources out to help schools plan, but we continue to work on the policy background here and there continues to be work to do. We have seen some states do some creative work around CLIA waivers. And we have seen some work from the Department of Health and Human Services to make it easier to access CLIA waivers, and we're going to continue to work on that issue. Carol Johnson: (17:10) I will also point out that just yesterday, the FDA made a policy announcement about making it easier for tests to get authorization for asymptomatic screening use. So, again, much more work to do,. but we are continuing to move forward on the policy environment here to support screening testing. Andy: (17:29) Dr. Walensky, is there anything you want to add to that? Dr. Walensky: (17:32) Nothing to add. Andy: (17:32) Nope? Okay, next question. Moderator: (17:36) Next we'll go to Sheryl Stolberg with the New York Times. Sheryl Stolberg: (17:40) Thank you for taking my question. Sheryl Stolberg: (17:43) I'm wondering what metrics you are going to apply to measure the effects of the spending on testing and the other mitigation measures. How much will this hasten the end of the pandemic, or bring about the reopening of schools and the economy? How quickly will that happen? And how will you measure it? Andy: (18:01) It's a broad question so I would invite anyone to take that. Carole, is that something you want to start with? Carol Johnson: (18:09) Yeah, let me just start by saying that our goal from the front end was that we have heard, from folks who work directly with school districts, about schools that are anxious to have the resources to be able to do testing to support their reopening. So as part of our broader goal, the president's broader goal, to safely reopen schools, we want to make sure there are resources available to do that. And we are continuing to track school reopening with our colleagues at the Department of Education. But our main message here is that we want schools to have the resources so that they can add this layer of mitigation that the CDC guidance on school reopening has pointed out can be an added protective factor. We know there are many schools that want. We know there are schools that have tried to do it and have struggled to have the resources to do it. And so we want the resources out there, and we want to attract school reopening. Andy: (19:04) Anybody want to add to that? Dr. Walensky: (19:06) Maybe I'll just add that there are a lot of metrics that people are using. We're looking at wastewater for disease burden in communities. We're looking at hospitalization rates. We're looking at clusters and outbreaks in these schools that implement these screening strategies. So I think there are a lot of metrics that we can impose. Of course there are a lot of moving parts. Not only are we ramping up testing, we're also ramping up vaccination. Andy: (19:29) I would just add as a reminder for everyone that's since the president's call for schools to be open, we have issued a set of guidelines from the CDC to help with a roadmap to do that, prioritized vaccinations for teachers, and now this commitment around testing. So the question I think for the Administration and for the schools in the country is not whether they can be opened, but how. And I think with this roadmap, with these testing resources, with these vaccinations, there is a clear path there. Andy: (20:07) Next question. Moderator: (20:10) Next we'll go to April Ryan with The Grio. April Ryan: (20:15) Thank you. April Ryan: (20:16) I want to get back to the issue of children and vaccinations. What is the current research showing right now, as it relates to vaccinating school aged children? And I ask that because I'm hearing from doctors that there is a concern about the possible change in the genetic profile by two of the vaccinations versus the Johnson & Johnson. If you can give me a comment on all of that, all of the above. April Ryan: (20:45) Thank you. Andy: (20:47) Dr. Fauci? Dr. Fauci: (20:48) Yeah. Thank you, Andy. Thank you for that question, April. Dr. Fauci: (20:52) Right now, there are a couple of studies from multiple companies looking at vaccines in children. Just to let everybody know where we are, the vaccine studies that are done right now are looking at both safety and immunogenicity. It's not looking for vaccine efficacy signals, because you would need tens of thousands of people in those trials. We're trying to do bridging studies to show comparable immunogenicity, at the same time of looking at safety. We will know answers to that for high school level individuals by the time we get to the fall. And when you do an age deescalation in younger children, we just started a study with Moderna, literally this past week, in which we're going to do age deescalation from 12 to 9, 9 years to 6 years, 6 years to 2 years, and 6 months to 2 years. We're going to be looking at multiple aspects of safety. Dr. Fauci: (21:58) There is really no biological reason at all to indicate, or even predict, that you would even see any modification of the genetic profile when you're dealing with an mRNA, which has no way of integrating into the genome of a cell. So it is a question, April, that gets asked frequently. But there's no biological mechanism why we can see how that would happen. We're going to be looking at all aspects of safety, but I really don't predict you're going to see anything in that space. Andy: (22:31) Next question. Moderator: (22:36) Next, we go to David Lim at Politico. David Lim: (22:40) Hi, thanks for taking my question. David Lim: (22:42) I wanted to ask about the testing announcement today, specifically supply of tests and what types of tests school districts will have access to, and if CDC is setting up a mechanism for purchasing those tests for distribution. Because it seems that there are still relative limitations considering the number of students that are in K through 12 schools. Andy: (23:09) All right? Why don't we start with Carole? Carol Johnson: (23:12) Yeah. Thanks, David. Carol Johnson: (23:14) We are obviously closely monitoring supply, and expect that some of the efforts onto a supply will start to dovetail with the increases associated with this screening testing. We hope that the president's commitment to testing, with a nearly $50 billion investment in the American Rescue Plan, is a strong signal to all about our commitment to testing and the importance of continuing to ramp up and expand testing. And we are using those resources to not only expand testing, but to address critical supply issues, as we announced earlier last month, that we were going to invest critical resources in raw materials and other issues that have presented ... Carol Johnson: (24:03) ... in raw materials and other issues that have presented shortage issues in the past. The awards from CDC, I should let Dr. Walensky add anything that she'd liked, but these will be awards to state health departments for the purposes of helping to help schools stand up testing programs. Some schools have testing programs. And so the intent is not to disrupt the relationships that they have. Others need help in connecting to programs. And the federal government is continuing to work to build up the federal supply schedule, to ensure that people have easy access to affordable testing. Dr. Walensky: (24:43) And maybe I'll just add that we're excited because it's not just to the state health departments, but this goes to the local health departments, it goes to rural and urban health departments so that we can really facilitate not just the testing, but the contact tracing, the other prevention interventions, the technical support that these local health departments will need to implement this testing. Andy: (25:03) Thank you. Next question. Press Staff: (25:08) Next we'll go to Shira Stein at Bloomberg. Dr. Nunez-Smith: (25:13) Hi, thanks. You used to break down all of the vaccines that we're getting by various streams. So one, by states, tribes and territories, then by pharmacies and then now we're seeing community health centers. Can you break down how many vaccines, specifically for the 22 million total doses the White House press secretary announced for next week? So basically, so we can better understand where all the vaccines are going. Andy: (25:46) This is not a precise answer, but I'll give you a rough approximation. Somewhere in order of a third of vaccines are going to retail pharmacies. Something in the order of half are going to the healthcare systems, healthcare providers, hospitals, et cetera. Got a large piece after that going most of the rest to big community vaccination centers and then an increasing share to community health centers, mobile vans, et cetera. Now, the reason that that can't be precise is there's some overlap in that states are each distributing their vaccinations into a variety of those channels. And so you can't really give a complete picture because we're sending vaccines directly to, say, community health centers and so are states. But the numbers are certainly rough in there. But Dr. Walensky, anything you want to add or change about that? Dr. Walensky: (26:49) No, that's exactly... If the states are distributing to pharmacies, but there's also getting a federal supply, it makes it hard to tease apart. But that's exactly what I would have say. Andy: (27:00) Okay. Next question. Press Staff: (27:02) Last question will go to Ricardo Alonzo-Zaldivar at AP. Dr. Fauci: (27:09) Hi. Thank you for taking my question. Can you hear me? Andy: (27:13) We can. Dr. Fauci: (27:14) Okay. Thank you. My question's for Dr. Walensky. And I was just wondering, with the new guidance today, could you please review, on the line for us, what is the value added from this new guidance when compared to the previous layers of CDC guidance that we've had? Dr. Walensky: (27:40) Thank you for that question. So this new guidance actually is really quite extensive compared to prior. It's an expansion of the description of the kinds of tests, how might one choose a test, the addition of the intended use of each of the individual tests, the addition of health equity as how we would use these tests to ensure that we have equitable distribution, that there's a rapid turnaround time in all of these settings. The expanded availability of screening tests and how one might consider using diagnostic tests as well as screening tests. And then some discussion about how we would interpret these tests in the context of vaccinated individuals. And then of course, a menu of guidance on specific settings and how you would use the tests both from a diagnostic standpoint, but as well as from a screening and surveillance standpoint. Andy: (28:29) We're going to close with one of the comments that President Biden made the other day which is that help is here. It's not even 60 days into the administration and I would just summarize that your government is acting with urgency. Even as people are being asked to maintain wearing masks, the government is moving as quickly as possible. Acting with speed of moving checks to the American public, near 100 million already. Speed of vaccinations near 100 million since January 20th. The speed of testing dollars moving out into the field as Carol Johnson said today with over $10 billion getting out the door quickly. And the speed action on all of the areas needed to support the public from the most recent legislation that was passed. So I want to thank everybody at the government and who is part of this effort for the great speed with which we're acting on behalf of the public. With that, thank you and we will be here again on Friday.