Dr. Fauci testifies on reopening US after coronavirus pandemic

yes the local public health department the governor so good is if in doubt get attached properly sent his testing goals and made to the federal government is every state has done federal government is helping him make sure that he has enough supplies in case she has trouble getting them through the labs and the other commercial sources as a result our status tested about four percent of the population governor hopes to increase that by seven percent in may that’s one of the best in the country this impressive level of testing is sufficient we believe to begin phase one of going back to work but as I said last week it’s not nearly enough provide confidence to thirty one thousand students in faculty members well we hope will show up at the university of Tennessee campus in August when school starts last week I talked with UT Knoxville chancellor Dondi Plowman about that we said what would persuade those thirty one thousand students as well as the fifty million K. through twelve students in the country and the other five thousand university students what will persuade them to go back to campus in August that’s where the new shark tank comes young doctor Collins the national institutes of health calls it red X. we had our hearing about that on Thursday said it really remarkable scientific exercise just take a few early stage concepts or swimming around what we call that competitive shark tank receive doctor Collins and his associates can find a few new technologies great millions of new tasks that will scale up rapidly and make it more likely that students will go back to school in August for example of the FDA authorized last week its first diagnostic test using saliva that a person provides at home instead of a nose swab or blood it authorized its first antigen test reading a lot about those like the ones used for flu or strep throat which involves a swapping of the nose and you can get the result just a few minutes another proposal not yet approved is to put in your mouth sort of lolly pop sponge thank you photo of that with your cell phone and send that to your doctor it lights up your house or the university might send that saliva lolly pop to a nearby laboratory which could be a gene sequencing laboratory which can deal with thousands of those samples overnight not that same process could occur at a middle school or could occur in a factory course anyone testing negative one day can test positive the next but such widespread screening of entire campuses schools or places of work will help identify those who are sick trace down those three phones that internship helped persuade the rest of us go back to school and back to work in addition to more testing I expect doctor felt she talked to us about additional treatments that will be available to reduce the risk of death and the administration’s plan to do something that our country is never done before which is to start manufacturing a vaccine before it actually has been proven to work in order to speed up the results in case it does work those vaccines those treatments are the ultimate solution but until we have them all roads back to work in school go through test more test we conduct the better weekend identify those your chicken exposed and we can quarantine the second exposes that of trying to quarantine the whole country well in my opinion this require millions of new yes many from new technologies some of these will fail well we only need a few successes to get where we want to go that’s why I said on Thursday that what our country had done so far in testing is impressive but not nearly enough first squeeze all the tests we can out of current technologies next try to find new technologies to help us contain the disease to persuade us to go back to work I will one of the this is a bipartisan hearing examined how well we’re preparing to go safely back to work into school and to determine what else we need to do in the United States Senate such an exercise sometimes encourages finger point before we spent too much time finger pointing I like to suggest that almost all of us the United States in almost every country so far as I can tell under estimated this buyer underestimated how contagious it

would be under estimated house out can travel silently in people without symptoms to infect other people how it can be especially deadly or certain segments of our population the elderly those with pre existing conditions Nordic population let me go back to the March third hearing that we had in our committee on corona virus six weeks after the first case was discovered in the United States a day when only two deaths were recorded in this country I read at that hearing this paragraph from a New York times two days earlier on March the first they reported this much about the corona virus remains unclear the times reported and it’s far from certain this is March third that March one that that the outbreak will reach severe proportions in the United States or affect many regions at once with its top notch scientists modern hospitals and sprawling public health infrastructure most experts agree United States is among the country’s best prepared to prevent or manage such an epidemic the new York times on March one a lot of effort is gone into trying to make our country well prepared over the last twenty years for president several congresses in response to nine eleven bird flu could Traina boleh H. one N one burst past nine major laws to try to help get this country ready or what we’re going through today these are stirred up the strategic national stockpile created Assistant Secretary for preparedness it it not straightening great incentives for the developments of vaccines and and medicines that were using today strengthen the centers for disease control rated R. a thanks to the leadership of senator blasted senator Murray for five straight years we significantly increased funding to the national institutes of health all this was part of a shared goal Democrats Republicans or president several congresses you try to get ready for what we’re going through today whether it was known like anthrax or unknown like it’ll be nineteen but despite all that effort even the experts underestimated cold and nasty this hearing is about how we improve our response to this virus as well as the next during the oversight here I also intend to focus on as I just said the next endemic which we know is coming what can we learn from this one to be ready for the next can we what can we learn from the fast tracking of vaccines and and and treatments that we’re about to hear about that we’ll make it even faster the next time how can we keep hospitals in states from selling off protective equipment when the budget get tough how can we make sure Congress does our share of the funding responsibility and do we provide enough extra hospital beds without without canceling elective surgery hurting other patients bankrupting hospitals whose job should be coordinate supply lines so that protective equipment and supplies get where they’re supposed to go when they’re supposed to go what’s the best way to manage the stock class my preacher once said I’m not worried about what you do on Sunday it’s the rest of the week the concerns me I’m afraid that during the rest of the week between pandemics we relax our focus on prepared we become preoccupied with other important things our collective memory is short just three months ago this country was pre with impeaching a president now that seems like ancient Roman history now while this crisis sales are well attention I believe we should put into law this year whatever improvements need to be made to beep well prepared for the next end up there is to be finger pointing over there pointed in that direction fortunate today to have four distinguished witnesses were at the heart of the response the corona virus we’re grateful for their service to our country a massive each to summarize their remarks in five minutes then we’ll have five minute round of questions from each senator I’ve agreed will end are hearing about twelve thirty after we have a full round of questions every center will have a chance to have his or her five minutes senator Murray will then have an opportunity to ask S. the question or to close the hearing and I will then close the hearing there will be other hearings to follow this hearing like last Thursday’s hearing and senators may submit their questions in writing within the next ten days just staying at

home and definitely is not the solution to this fandom there not enough money available to help all those hurt by a closed account all roads back to work back to school lead through testing tracking isolation treatment and vaccines this requires widespread testing millions more tests rated mostly by new technologies by Dennis by those who are sick and have been exposed so they can be quarantine and by containing the disease and this way give the rest of America untuk competence to go back to work and school for the near term help make sure those thirty one thousand you students and faculty members show up in August we need widespread testing millions more test read mostly by new technologies to identify those who say you’ve been exposed so they can be quarantine by containing the disease in this way in the rest of America enough confidence to go back to work and back to school senator mark well thank you very much Mr chairman my thoughts are with you and your team right now as you try to navigate the same jobs so many in our country are worried about we all wish your staff member a speedy recovery and it’s everyone works to take appropriate safety precautions today I’d like to thank not only are witnesses for joining us today but also our committee staff are working to set up a state form after members and witnesses and the public to participate in this hearing remotely families across the country are counting on us where the truth about the covert nineteen pandemic especially since it is clear they will not get it from president truth is essential so people have the facts so they can make decisions for themselves and their families and their communities lives are at stake the president isn’t telling the truth we must end our witnesses must and we’re counting on you today and families need us to take this opportunity to dig into the facts about where things did go wrong so we can finally get them on track because the trump administration’s response to this public health emergency so far has been a disaster on its own delays missteps have put us way behind where we need to be on diagnostic tests and allowed inaccurate antibody test that’s what the market corruption and political interference have impeded efforts to secure desperately needed personal protective equipment and provide loaded dangerous unproven treatments and we recently learned that after experts at the centers for disease control and prevention yeah weeks developing a detailed guide to help our communities I understand how to safely reopen when the time comes the trump administration tossed it in trash bin we’re being too prescriptive but this is far from the first time this administration missiles experts who were doing their job and putting public health first after the matter is president trump has been more focused on fighting against the truth than fighting this virus and Americans have sadly paid the price since this committee last heard from these witnesses on March third we have seen over nine hundred gas in my home state of Washington over eighty thousand gas nationally and the numbers continue to climb still president trump is trying to ignore the facts and ignore the experts who’ve been very clear we are nowhere close to where we need to be to re safely my hope today is that we can cut through this and have a serious discussion about what is needed to safely open how close we are as a country to meeting those needs and how we actually get there one thing that’s abundantly clear we need dramatically more testing it is unacceptable we still don’t have a national strategic plan to make sure testing is very fast and everywhere that is why I want to make sure our last call the package included an initial twenty five billion dollars testing front end to requirement that the administration submit a plan by may twenty four and when I say a plan I don’t mean a PR plan I mean the plan with specific timelines and numeric goals for supply and funding needs one that actually addresses the issues we’re seeing on testing acetate and distribution and dispirited and building out our public health

system and makes clear to states and tribes and employers and the American people what they can expect and what the administration will do to keep America safe but testing alone won’t be enough to reopen our country we still make far more personal protective equipment that has been available for healthcare workers on the frontline line and we will meet for more for other workers as we re open so we desperately need this administration to step up and get that equipment just states were doing everything in their power to purchase supplies but simply cannot get nearly I’m not because the reality is unlike states the federal government has the tools to actually fix the problem it’s only the administration would use that and we also need that equipment to actually work with the FDA to act promptly as it does not not weeks later when people may have already been exposed and just as importantly we can expect people to go back to work or to restaurants started confidently send their kids to school if there isn’t clear detailed guidance about how to do that safely schools early childhood your college need to know how to keep their students their staff and their educators say when should they wear masks how do you run a school cafeteria or a school bus if they can’t reopen classrooms schools and families need to know we are working to ensure every student gets an education tools like online learning can only get us so far if we don’t address the digital divide that so that every student can access that and even then there will be a learning loss that could deepen existing educational disparities among low income students students with disabilities English language learners and other vulnerable populations if we don’t make sure they get equal access to resources and support EMCOR schools aren’t the only workplaces places we’ve got to be thinking about we need to make sure that industries across the country know how to safely reopen and that people know their workplace is say secretary Skolian needs to stop dragging his feet will do its job and have the department of labor set forward a rule that makes clear worker safety is not optional Mister chairman I hope this committee can hear about those critical issues from secretary scholiast secretary Abbas as well other experts in the space in the days ahead and this is especially important to protect workers and residents are nursing homes and other congregate care facilities where we seen some of the most deadly outbreaks and that’s the rash about brexit meat packing plants shows this isn’t just an issue for the health care industry it is an issue for everyone and just as we need to plan before we can start for reopen we also need a plan well before we have a safe and effective vaccine to guarantee that we can quickly produce and distribute it on a global scale and make it free and available for everyone so I’ll be asking about our progress on those issues today today safely re opening our country maybe a ways off and the administration’s planning maybe way behind but there’s still a lot that Congress needs to do there isn’t time to spare some including the White House say we’ve already provided enough economic relief well my question them as what good is a bridge that only gets you to the middle of the river we don’t need to wait around to see if people need more help we know they do we need to work quickly on another aggressive relief package and we we need to make sure our priorities in that bill are protecting our workers our students and our families and addressing this public health crisis not bailing out corporations are protecting big business from accountability people across the country are doing their part they are washing their hands and wearing masks and social distancing and staying home they need their government to do its part to you they need leadership they need a plan they need honesty and they need it now before we open so they can rest assured that we are doing things safely and competently with their health and well being as a top priority thank you Mr chairman just kidding it’s an important hearing I know lots of people maybe be watching it for the first time if they are I hope they notice that we have twenty three members of this committee I believe one more Republican than Democrat we have some very strong views but were able to work together and to express those views and respect each other and our witnesses and I and a big part of that goes to senator Murray and her staff so thank you for that each witness will have up to five minutes to give his or his testimony thank you for making an

exception and agreeing to testify by video because of these unusual circumstances and thank you for what you’re doing for our country our first which witnesses Dr Anthony I’ll cheat I he’s director of the national institutes of allergy in infectious diseases at the national institutes of health you sell that positions for not since nineteen eighty four which meant using biased six residents and worked on HIV aids influenza malaria it ball and other inspection inspections through the season he was involved in treating a bowl we should set and I H. and also worked on vaccine trials for your ball up next we’ll hear from Dr Robert Redfield he’s director of the U S. centers for disease control and prevention which has its headquarters in Atlanta more than thirty years he’s been involved with clinical research related to chronic human viral infections infections diseases especially HIV was the founding director of the department of retroviral research related U S. military’s research program he spent twenty years with the US army medical corps third admiral breast you walk your walk Edward you why is Assistant Secretary for health at the US department of health and Human Services that puts him in charge of development of public health policy recommendations he’s taken on the responsibility coordinating testing and focused on the increasing number of tests that we can do with existing technology is federal service includes a variety of activities with our defense our department in advanced research threat reduction he was part of the Blue Ribbon panel reform the US veterans L. system and finally will hear from Dr Stephen Hart I he’s commissioner of the food and drug administration for Jones joining FTA he was the chief medical executive the university of Texas MD Anderson cancer center he was chair of the department of radiation oncology at the university of Pennsylvania was a senior investigator at the national institutes of health is commander of U. S. public health service commissioned corps twenty twenty five now we’ll ask each of our witnesses to summarize their remarks in five minutes following that each senator will have five minutes request and answers and an order of seniority doctor felt she let’s begin with you welcome thank you very much Mr chairman ranking member Murray and members of the committee thank you for giving me the opportunity to discuss with you today the role the national institutes of health in a covert nineteen the strategic plan that we have is for full one to improve our fundamental knowledge of the virus and the disease it causes next to develop new point of care diagnostics next to characterize and test their reputed X. and finally develop safe and effective vaccines first with regard to diagnostics as you probably heard from Dr Francis Collins last Thursday the NIH has developed a rapid acceleration of diagnostics program called red X. with the war to that specific program up to a half a billion dollars the support the development of covert nineteen diagnostics it is a national call integrative technologies that will be evaluated and a shark tank like selection process to get either success or failure rapidly moving on to therapeutics I’ll talk a bit about the room does to be a success antiviral in a moment let me emphasize that there are a number of broad spectrum antivirals that are in various stages of testing in addition we’ll be looking at convalescent plasma which is plasma from individuals recovering from covert nineteen to be used in passive transfer either in prevention or treatment in addition our premium globulin which can be used as a gamma globulin shot we’ll be looking at repurposed drugs as well as immune based therapies and host modify and finally monoclonal antibodies let me take a moment to describe the room disappear we’ll CBOE control randomized trial which was done internationally the power of more than a thousand individuals insights throughout the world it was hospitalized patients with lung disease the end point was primarily time to recovery the result was statistically significant what really modest and we must remember it was only a modest results showing that the drug may thirty one percent

faster time to recovery we hope to build on this modest success with combinations of drugs and other drugs moving on to vaccines there are at least eight candidate code nineteen vaccines in clinical development the N. I. H. as been collaborating with a number of pharmaceutical companies at various stages of development I will describe one very briefly which is not the only one but one that we have been involved in a heavily developing with mark Danner it’s a messenger RNA platform you might recall in this committee that in January of this year I said that it would take about one year to eighteen months if we were successful in developing a vaccine the NIH trial moved very quickly on January tenth the sequence was known January eleventh the vaccine research center next to develop a plan on the fourteenth of January we officially started the vaccine development sixty two days later we are now in phase one clinical trial with the two doses already fully in role it would be animal safety the phase one will directly going to face two three in late spring and early summer and if we are successful we hope to know that in the late fall and early winter there are some important issues however in Kogi nineteen vaccine development we have many candidates I hoping to have multiple winners in other words it’s multiple shots on goal this will be important because this will be good for global availability if we have more than one successful candidate we also as the chairman mentioned will be producing vaccine at risk which means we’ll be investigating considerable resources in developing doses even before we know any given candidate what candidates work I must warn it is also the possibility of negative consequences what’s certain vaccines can actually enhance the negative effect of the infection the big unknown is efficacy will be present for absence and how durable will it be and finally I want to mention the NIH has launched a public private partnership called accelerating Colbert nineteen the reputed interventions and vaccines the purpose of that is to prioritize and accelerate clinical evaluation of therapeutic candidates with near term potential hopefully our research efforts together with the other public health efforts will get as quickly to an end to this terrible ordeal that we are all going through thank you very much happy to answer questions later thank you doctorate wealth good morning no chairman Alexander and ranking member Murray and members of the committee our nation is confronting the most serious public health crisis in more than a century yet we’re not the we have powerful tools to fight the sentiment in me we have tried and true effective public health interventions such as early AS a dedication isolation in contact tracing combined with important mitigation strategy includes social distancing frequent hand based coverage these public health tools have and will continue to slow the spread of government nineteen I appreciate pertinent in this morning to provide a brief overview of some of the CDC’s ongoing work in response to go tonight TD she’s been working twenty four seven to combat and them CDC’s emergency operations center supporting state tribal local territorial other health partners in building core capabilities vertically work force laboratory in data and predictive analytics epidemiologist are conducting surveillance for Coleman nineteen as well as conducting health system surveillance many mitigation teams are providing guidance on section control and contact tracing in our laboratory experts are performance arrests are logical testing to better define the extent to a populations as local leadership makes decisions to re open no require varying degrees of federal support each location will be different and will face unique circumstances CDC has conducted a state by state assessment of public health testing capacity and keep contact tracing capacity as well as search plans GDC is providing technical assistance and funding to the state provided through the supplemental cares act in the paycheck protection program and health care enhancement well working directly with the state public health leaders to define their needs we’re testing and testing devices supplies and manpower surveillance data collection and reporting contact tracing section control an outbreak investigation I want to spend a moment to focus on several key elements first testing Rappin extensive and widely available timely

testing is essential re opening in America CDC’s role in testing continues to support diagnosis and contact tracing surveillance and outbreak we work with the public health partners to define their particular testing strategy there restriction and will draw will address the testing components of the response contact tracing increasing in state rival local territorial contact tracing capacity is critical to critical part to stop the chain to transmission and prevent the occurrence of sustained community transmission did he seize role is to provide technical training assistance and support to the states as they hire and build a workforce necessary to be fully prepared to effectively respond to the public health challenges posed by the on going Coleman pandemic this will be an expansive after surveillance our nation’s surveillance program is built on a combination of systems including existing existing syndromic influenza and respiratory viral disease surveillance systems the men combined with commercial and research lab platforms in our case reporting form system EDCs adapting these an optimized in it and to have a surveillance system in response to come in nineteen importantly in light of the significant occurrence of a symptomatic the surveillance for asymptomatic infection becomes an important public health tool early case identification EDCs working with each public health care section to develop a perspective the valence program to include active surveillance among those that are most vulnerable such as individuals in long term care facilities inner one X. and homeless shelters we need to rebuild our nation’s public health data and data analytics public health laboratory resilience and our nation’s public health work for now is the time to put it in place the generations to come not only for the public health system that our nation needs but for the public health system our nation deserves before I close I want to recognize the tireless commitment the dedicated CDC staff who deployed every corner of this nation to fight cove in more than four thousand employees have deployed globally science and data continue with technical expertise in public source service I mean the backbone of CDC’s contributions to the US response extend my sincerest gratitude to the health care workers in front lines as well as their family and the essential emergency personnel as well as the American people say thank you for hearing to stay at home guidelines in protecting the most vulnerable it’s important to emphasize that we’re not out of the woods yet battle contains only months but we are more prepared we need to stay vigilant was social distancing it remains imperative we are resilient nation and I am confident that we’ll emerge from this pandemic bonded together thank you thank you Dr Redfield admirable welcome here to provide you with an update on the nation’s progress in testing for COPD at nineteen on March twelfth secretary aides our requested that I leave the code nineteen testing efforts within HHS including oversight in coordination of the FDA and CDC with regard to testing since then the nation has performed more than nine million coated nineteen cap a number far greater than any other country and double the per capita task performed to date in South Korea to reach this point we implemented a phased approach to me testing needs during mitigation and now during phase one re opening of America beginning March twentieth we pioneered at forty one community based drive to testing sites in locations prioritized by the CDC these sites have been a profound success testing over one hundred and sixty seven thousand high risk individuals and demonstrating a prototype that is being duplicated of multi fold in nearly every state yeah the administration leverage trusted retailers including CVS rite aid Walgreens Walmart Kroger and health Mart for are now providing testing at two hundred and forty locations in thirty three states sixty nine percent of which are in communities with moderate to high social vulnerability to meet the need for collection supplies like swab in immediate too we first secure the global supply chain for a military bridge we worked directly with manufacturers to increase domestic production we collaborated with the private sector in the FDA to validate multiple swab immediate type that vastly expanded supplies while minimizing the need for PP finally we used the title three of the defense production act to further invest in domestic

manufacturing to prepare us for re opening to support the need for surveillance testing during re opening on April twenty seventh we issued a new testing framework that also prioritize testing for persons without symptoms who are prioritized by health departments or clinicians for any reason including screening of asymptomatic individuals according to state and local plan next our federal multi disciplinary team conducted multiple calls with leadership from each state to set state specific testing objective collectively state and territories established an overall goal to perform a twelve point nine million cast over the next four weeks the federal government is able to stand it support the achievement of this goal specifically the federal government is shipping to a state twelve point nine million swabs and over nine point seven million tubes of media in may hello last month we also detailed the location and capacity of every lab machine in every state that could potentially run code nineteen after eight and our team has worked with test suppliers to match three agents to these machines looking forward between now and the end of twenty twenty the federal government will procure over one hundred and thirty five million swab and one hundred and thirty two million tubes of media and distribute these to states S. requested to supplement the now robust commercial supply we anticipate marked increases in current task as well as a dramatic expansion of new point of care test like the first in class Quidel antigen test authorized by the FDA just last Friday Quidel anticipates being able to distribute three hundred thousand tests per day within just a few weeks so by September taking every aspect of development authorization manufacturing and supply chain in the we project our nation will be capable of performing at least forty to fifty million tests per month if needed at that time and if new technologies are authorized by whole genome sequencing approaches or any novel solutions on covered NIH’s new diagnostics initiative that number will be much higher finally I want to acknowledge and express my heartfelt gratitude to the officers of the U. S. public health service commissioned corps the you service I am honored to lead three thousand four hundred and seventy one men and women have deployed in support of this pandemic on the cruise ship in Japan to our military bases repatriating Americans to our community based testing sites and international Airport the FEMA and our task forces to nursing facilities including king county Washington and a field hospital in hard hit communities across our nation I thank each and everyone one of these officers and their families and on their behalf I thank the members of this committee for supporting our training needs and the establishment of a ready reserve to supplement our ranks in future national emergency thank you for the opportunity to provide these remarks thank you and Roger wa and now Dr Steven Hahn R. for violence German Alexander ranking member merry members me thank you for inviting me to participate in this hearing today the first want to start by thanking the American people or their incredible efforts at mitigation and extend my condolences to those who have lost loved ones from day one of this pandemic the eighteen thousand FTE employees are just incredible scientists doctors and nurses have taken an active role in the all of government response to this pandemic FDA has worked to facilitate the development of medical countermeasures to diagnose treat and prevent will be nineteen we work closely with laboratories manufactures academia product developers are federal partners in companies companies that don’t even make medical products one of kitchen for example by making hand sanitizer personal protective equipment and ventilators every decision we have made it been Trippin by data with the goal of protecting the health of the American people in a public health emergency however a responses balance the urgent need to make medical products available with the provision of a level of oversight it helps ensure the safety and effectiveness of those medical products I’d like to take a few minutes to tell you what FDA is doing to help the country at this point in which just American judges safe to return to work in the school it starts with testing as others have mentioned after his work with more than five hundred developers have said they will be submitting emergency use

authorization request for only nineteen yes this includes some newer technologies that not that here to for not being used as part of diagnostic testing response to endemic we appreciate ninety two individual emergency use authorizations for casket manufacturers and laboratories and we’ve been informed by more than two hundred and fifty laboratories they began testing under the regulatory flexibilities we outlined in March we are conducting rolling reviews if you you a submissions so that we can quickly authorized test which the data support in a public health emergency the accuracy of diagnostic chess is important not only for the individual patient but for the patient large public at large FDA is helping to ensure the availability of tests that are providing accurate answers we are also monitoring the market place for fraudulent Castaner taking appropriate action to protect the health and we are working to provide more clarity about which tests have been reviewed and authorized by FDA and which have not sheer logic tests will play a role in our recovery unlike diagnostic test which detect the presence of the virus your logic test measures the amount of antibodies are protein present in the blood when the body is responding to an inspection like Kobe nineteen these tell test can help identify individuals who can overcome an infection developed an immune response we will continue working with labs manufactures and across the government just find a balance between insurance that in antibody test accurate and timely access to such tests of course the way eventually beat this virus with a vaccine NXT is working closely with our partners including the NIH Chester I mean that scene developers manufacturers and experts across the globe we intend to use our regulatory flexibility to help insure the most insure efficient development of a safe and effective vaccine to prevent co in nineteen until a preventative vaccine is approved however we need medical products to bridge the gap FDA has been working for several months to facilitate the development unit they’ll ability if they’re as expeditiously as possible and we created an emergency program for this acceleration called corona check treatment current buyers treatment acceleration program receipts that we to reassign staff to work with urgency your review requests from companies scientists doctors were developing therapies and we’re using every available starting next year regulatory flexibility that’s appropriate Jeff is still at the development of safe and effective products to treat code nineteen all right is there to to Kerry’s are being evaluated as mentioned by doctor asking others including antiviral drugs you need therapies as well as convalescent plasma hyper immune globulin in modern times she also mentioned we recently announced positive results of the N. A. IDE trial opened disappear and issued an easy way for treatment at patients with COPD nineteen two other promising treatments that I mentioned of the antibody rich products listed Bosnian make room bloodline and I am certainly to go into more detail members of this committee had question questions about this we are working very aggressively and close to stakeholders to do this so let’s take a developmental of monoclonal antibodies which is shown to be safe and effective could act as a bridge there each of development of a vaccine we recognize that developing vaccines and therapies need to go hand in hand with insuring that there will be sufficient supplies for our companies black country so we’re also working with manufacturers to make sure that this supply chain robust Mr chairman ranking member members of the club committee please know the NFTA haven’t dedicated team of some of the nation’s finest scientists healthcare providers and public health professionals we are guided by science and data and we won’t let up until we can still take the development of products that our nation needs to get back to work I look forward to your questions thank you Dr Han and thanks to all four of you for your expertise for your dedication to our country and your hard work will now begin around a five minute questions for from each senator on the committee alternating between Republicans Democrats are each senator has if you’re a video conference you have a little time placard the bottom and I would ask you to try to stay within five minutes for your questions and answers I will start I’m I’m gonna a question for Dr algae and then add room your walk Dr let’s look down the road three much there will be about five thousand campuses across the country trying to welcome twenty million college students hundred thousand public schools welcoming fifty million students what would you say to the chancellor of the university of

Tennessee Knoxville or at the president our principal of a public school about how to persuade parents and students to to school in August so start with treatments and vaccines first doctor thought you could about half my five minutes for at one you’re what you’re testing I would appreciate thank you very much Mr chairman well I would be very realistic with the chancellor and tell him that when with thinking in terms of her this case okay I would tell her I’m sorry Sir that in this case that the idea of having treatments available or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far as I mentioned the drug that is shown some degree of efficacy was modest and was in the patients not yet or maybe ever to be used either yet as prophylaxis or treatment so if the issue is that the young individuals to be going back to school would like to have some comfort in that there’s a treatment probably the thing that would be closest to you then would likely be passive transfer of convalescent serum but we’re really not talking about necessarily treating a student do Gaskill but how the student will feel safe going back to school if this were a situation where we had a vaccine that would really be the end of that issue in a positive way but as I mentioned in my opening remarks even at that top speed we’re going we don’t see a vaccine playing in the ability of individuals to get back to school this term what they really want is to know if they are safe and that’s the question that I have to be do what we discussed earlier about testing so I’m about halfway through the remarks I’d like to just pass the baton to adults you walk who would address the question of the availability of testing and what role that might play in returning to school thank you Sir I cannot imagine aperture while you you said that while we’re doing about ten million test this month that we might be as high as forty or fifty million by September and and a month which is a significant increase so if I’m chancellor of the university of Tennessee could I well the strategy right shade all my students we have for example energy test which is quick and easy you want everybody on campus to come by and take it once were you bit again school L. it least let everybody know that on that day we’ve isolated anybody who’s positive and then we can continue to monitor is that strategy possible in August and September so says thank you Mr chairman I may reserve twenty second or Dr Redfield as well on the strategy that’s going to be employed really depends heavily on what’s the community spread at that time if there’s almost no community spread your strategy will be different if there’s high community stress spread it will also be different but yes technically all we will have the ability in your cancer will have the ability we expect there to be twenty five to thirty million point of care test Montebello all ideas certainly possible to test all of the students or it is much more likely that there would be a surveillance strategy done where you may cast some of the students at different times to give an assurance that there’s no circulation that would be done in conjunction with the CDC in the local health department there’s also a that are still needing to be validated but off pulling samples aren’t we know in some experimental labs as many as ten or twenty samples can be pooled so what is actually one test to test twenty students and finally there are some experimental prose approaches that look interesting if not promising that for example waste water from an entire dorm or an statement again this could be tested to determine whether there’s coronavirus in that that sewerage the waste water on so there are other strategies being developed and I’d like to at least give twenty seconds to Dr Redfield’s who we really will be working on the strategy how to employ this given right like to read read yeah just some quick comments Sir I mean first I think it’s really important valuation critically the role of changes in social distancing on college campuses and in schools and the situation not to forget the importance of what we’ve learned I clearly also developing an aggressive program for wellness education and making sure people understand whether symptomatic you need to seek evaluation I think you are going to have to look at the role of testing I think there is going to be an important roles testing in the circumstances and I think it will be individualized based on where these different schools are where they how much infection isn’t it I’m going to

wrap it up there so I can set a good example for the other senators for their five minute center work thank you very much Mr chairman and and thank you to all of our witnesses I’m doctor felt she you have warned of needless suffering and death if we push to reopen to stand but the president has actually been sending the opposite message I want to ask you today what is the most important message you have communities and states that are re opening even as our public health experts make it clear it’s to stand tell us what the consequences are thank you very much for that question senator Murray as I said many times publicly what we have worked out is a guideline framework of how to safely open America again and there are several check points in that with the gateway first of showing the pending on the dynamics of an outbreak in a particular region St city or area that would really determine the speed and the pace with which one does re enter or re open so my my word has been and I’ve been very consistent in this that I get concerned if you have a situation with the dynamics of an outbreak in an area such that you will not see that gradual the fourteen day that would allow you to go to phase one and then if you pass the checkpoints of phase one go to phase two and phase three what I’ve expressed then and again is my concern that some areas city states or what have you jump over those various checkpoints and prematurely open up without having to keep of being able to respond effectively and efficiently my concern is that we will start to see little spikes that might turn into outbreaks so therefore I have been being very clear in my message to try to the best extent possible to go by the guidelines which have been very well thought out and very well delineated so if a community or a state or region doesn’t go back by those guidelines and reopened the consequences could be pretty dire correct the consequences could be really a serious particularly and this is something that I think we also should pay attention to that state even if they’re doing it added an appropriate pace which many of them are in will mainly a pace that’s commensurate with the dynamics of the outbreak that they have in place already the capability that when they will be cases there is no doubt even under the best of circumstances when you pull back on medication you will see some cases up here it’s the ability of the capability of responding to those cases with good identification isolation and contact tracing will determine whether you can continue to go forward as you try to re open America so it’s not only do it at the appropriate time with the appropriate constraints but having in place the capability of responding when the inevitable return of infections occur well thank you for that and it’s very clear in order to do that we need knowledge which is about testing and for months this administration’s approach to testing is really been plagued by unrealized schools in this for systemic problems within that supply chain and last week an average of just two hundred fifty thousand tests per day were performed in the United States that is a small fraction of what we need and yesterday president trump had the gall to declare the you expect more veiled on testing in a press press conference that was filled with missing information and distortion Dr Gerard public health experts do not think the US has prevailed I’m glad you finally committed that states including my home state of Washington will receive enough gas to meet their goals for may and June but this administration has had a record of giving us broken promises that more testing supplies are coming and they don’t and we don’t know by the way the testing is gonna needs will persist one past year round I’m so I wanted to ask you today will be in forthcoming strategic plan that is now required under the covert package that was just passed and signed into law will that strategic plan on testing include specific numeric targets for testing capacity supply chain capacity and projection of shortages thank you for that question and and statement senator Murray

yes we are as stated we continue to have a working in as we build the testing capacity we have established the targets with the state of over twelve million tapped over the next four weeks all we think those targets are going to be good in may and June but as a doctor Fauci said we really have to be evidence based we expect those targets to go up by as we progressively opening it as communities go to phase one and then interface two and certainly those numbers will need to go up significantly it that so yes there will be targets the targets will need to change based on the evidence that we see but we are highly committed securing the supply chain we work daily with every manufacturer on and I’m just pleased were in may and June able to get ahead of the state that we can supply them what they need to they have those are that P. any doubts do you is when you put out that specific plan that you were required to do we will see numbers that you are going to tell us that you will reach targeted for testing and supply chain capacity in production of sort instead of just saying we hope to have a million this week next week so you will give us the specific targets correct we know specifically I’ll also yes ma’am we know the specific we know the specific amount the test we have over the over the summer we you have how many we need so yes ma’am we developed the need statements by working with the state individually with epidemiologist with the CDC on this so that overall and may will be casting about three point nine percent of the overall US S. population what I’m I’m telling you senator Byrd many we have how many will need will need not just for me but in the coming months so that we can be prepared to have yes ma’am and and not to be repetitive but we need to be evidence and data driven because what what we may see and may or June will drive differences in the amount of capital we have so we we really just need to be very humble about this we need to look at the data we know that the testing needs will go up over me in June as we progressively opens and we will do our best to predict that but you have to understand we have to see what the data in the evidence show at that time okay I appreciate that Mr chairman again what our strategic plan requires is what is the goal not how many we have but how many we need and that’s what we’ll be looking for thank you thank you senator Murray senator Enzi thank you Mr chairman and I am you appreciated your opening statement where you at it’s very succinct list of operations you need to learn from this and then make the next one I only should we be working on this recurring but we need to look at future too and I think we learned a lot we’re fighting a virus the same time that I had to start learning it so we need to be nimble we also need to be sure that we are prepared for a second wave of upgrades good coincide with the start of the flu season a potentially stressing our healthcare system even more than it already as admiral drought I I thank you for your comments I think it’s been I’m putting about what has been done and what can be done I agree with senator Murray that you need it at some specific goals as an accountant that’s always one of the things that I’m looking for for questions doctor doctor Han our understanding of the clinical picture opened nineteen we’ve all of what first looked like a respiratory illness now seems much more comprehensive a potentially affecting the are the green teas and other organs how does this evolving your impact the ability to evaluate the appropriate clinical or surrogate endpoints for review of vaccines and thank you senator up for that question the idea of arming clinical picture and obviously the way this is manifesting around the country clinically does in fact inform the end points that we will work with developers of therapies on on it so that we can get the absolute most efficient but also the most accurate information in appropriate and points to make the necessary authorizations and approvals we have set up this program called the coronavirus unix operation program where our top scientists and clinicians I’ve been at the table consulting with our colleagues at an and CDC actually address those questions what are the appropriate endpoints giving

example we do know that in some circumstances of patients who had severe Kobe disease that develops robotic or clotting I think that the so and so we prioritized review of agents that we think might be beneficial and obviously the clinical endpoints for those trials will be different than an agent that’s an antiviral like when does appear where is the doctor felt she mentioned we’re looking at time to recovery so we want to wait that the clinical circumstance as well as to the type of therapy that were us thank you another question to doctor Han we have made a lot of progress in vaccine developed but a bird is identified in mesquite and you back needles and syringes is a significant gap in pandemic and what it has HHS done in advance of the initial national vaccination campaign to ensure that we have sufficient as to minister thank you for that question this is a really important point because as you mentioned it’s not just about the vaccine or Oakley back scenes better are developed it’s all about it’s also about the supplies that are needed as well as an operational plan for a ministering that the vaccines so this is an all of government approach there is a program that’s been set up called operation works B that includes doctor concept that she his colleagues at NIH the department of defense as well as other members of HHS and FDA Dr Peter marks from our center for biological evaluation research on this been helping coordinate that is working very closely with doctors out to Eugene and we created what’s called a Gantt chart to look forward what are the necessary supply chain issues syringes needles etcetera I depending on the various vaccines are being developed how many times they have to administered and the roots of the ministration so we’ve been leaning in on the supply chain to ensure that when a vaccine is ready to go we will have the necessary supplies to actually minister it now operationalize the vaccination thank you I have a couple more questions but again the visible there’s active use that might I am also middle isn’t right thank you senator Enzi senator Sanders thank you very much Mr chairman well I let me thank all of the panelists for the hard work they are doing and to with us today all it is sad to say but we have a president of the United States the leader of our country from day one downplayed are the dangers facing this country from the pandemic who told us that the crisis would be over in a few months that we did not have to worry who fired those members of the government who wanted to act aggressively in among other things the time when we need international cooperation cut funding for the World Health Organization well let me also say that I think we on that fax are terribly important not everybody all that we don’t fully understand all all of the ramifications of the covert nineteen epidemic but let me see your questions up on my offer as far as the officials statistic doctor Fauci is that eighty thousand Americans have died from the pandemic there are some epidemiologist who suggests the number may be fifty percent higher than that of what do you think I’m not sure senator Sanders if it’s going to be fifty percent higher but most of us feel that the number of deaths are likely higher than that number because given the situation particularly in New York City when they were really strapped with a very serious challenge to their health care system that there may have been people who died at home who do you have help with it who are not counted as Colby because they never really got to the hospital so we direct answer to your question I think you are correct that the number is likely higher I I don’t know exactly what tire but almost certainly it’s higher I felt she looked P. O. ask you this Albom all in the terrible on pandemic of nineteen eighteen the virus in the fall came back with a vengeance all we fearful that if we don’t get our act together as bad as the situation is now it could become worse

all in the fall or winter thank you for that question it’s a frequently asked question and I think that possibility does exist however and the reason I say that is that when you talk about will this virus just disappear and as I said publicly many times and that is just not going to happen because it’s such a highly transmissible virus and even if we get better control over the six months it is likely that they will be virus somewhere in this on this planet that will eventually get back to us so my my approach towards the possibility of a recount in the second wave of the fall is that he is entirely conceivable and possible that would happened but B. I would hope that between now and then given the capability of doing the testing that you heard from July and the ability of us to stock up on personal protective equipment and the work force that the CDC and the Redfield putting forth to be able to identify isolating contact trace I hope that if we do have the threat of a second wave we will be able to deal with it very effectively to prevent that from becoming an outbreak not only worse than now but much much less okay Columbia slow we’ve heard a lot of discussion about vaccines obviously everybody in Congress in this country once the vaccine we wanted as quickly as possible as effective as possible our number yes the are honorable FDA commissioner Sir are if god willing a vaccine is developed and for able to produce it as quickly as we all hope we can I would imagine that the vaccine would be distributed to all people are free of charge to make short lease that everybody in America we need topics and we’ll get it regardless of their income is that a fair assumption US senator I I I certainly hope so an FDA is very committed to making sure that all populations in the United States including those most vulnerable all are included in the clinical trials and when I that’s not what I’m asking what I’m asking is if and when the vaccine columns it won’t do somebody any good if they don’t get it and if they have to pay a sum of money for it in order to profit the drug companies that will not be helpful are you guaranteeing the American people today that dot taxi will be available to all people regardless of their income sure the payment of vaccines is not a responsibility FTA I’m glad to take this back to task force I share your concern that this needs to be made available to every American is anybody else want to comment on that well do you think we should make that faxing but hopefully it it is created available to all regardless of income what do you think that poor people working people should be last online the boxing I’m sorry center where you asking me yes I want yes almost no I I I my office is one of the office is committed to serving the underserved and we need to be absolutely certain that if a vaccine or effective therapeutic or preventive is available that it reaches all segments of society regardless of their ability to pay or any other social determinants of health that there may be some when you’re telling the American people today that regardless of income every American will be able to gain access to the faxing when it comes they should gain access to it I don’t control you know I think you represented ministration that makes that decision aha I will certainly advocate that everyone is able to receive the vaccine regardless of income or any other circumstance US senator Sanders I’m sorry thank you Mr Jones was reporting questions up I don’t want to get senators off but and it’s hard to see the the the time clock would we could stay as close as possible five minutes that all senators can get to questions you have thank you senator Sanders senator Burke thank you Mr chairman thank our witnesses today for what you’ve done for the people in this country and their safety and people around the globe let me ask you doctor felt you because you’ve been in the task force and and a majority of of the press conference is anybody in this administration ever asked you or any member to take the foot off the gas of trying to find a cure or any type of counter measures no Sir not all as a matter of fact we had in ages you know happened right from the very beginning

up put our foot right on that accelerator in every aspect including the development of vaccines and therapeutics and as I described my opening statement we actually started that in January literally days after virus was known in sequence was published seven no I have never been told by anyone to hold back on the development of any countermeasure or any basic and clinical research project that we’ve been involved in thank you doctor fell to this question is for Dr Redfield a doctorate feel we have authorized in this committee and appropriated out of Congress multiple times over the last few decades money for buyers available bio surveillance and you talked about it in the past from FY sixteen to acquire twenty any three million dollars a year and with the cars acted over a billion dollars in buy was a very we’ve seen the private sector go out and use data available to track the progress and rate of one of our surroundings why is CDC not interacted with private sector technology companies to try to you know there are tools for bio surveillance senator thank you for the question this is a critical issue is you know and and also comes into one of the core capabilities I talk about data analytics and data monetization which were appreciative of the the additional funding Congress has given I can tell you that the this is under a critical review now we do have a with some of the private sector groups now to try to make the type of availability of data that we’ve seen with Florida available in all of our jurisdictions across the country and mmhm and then in the process of making that happen doctorate field in April of last year June of last year we re authorize the pandemic and all hazards legislation which authorized at that time thirty new billets thirty new employees at CDC specifically in surveillance now I asked doctor she could in March how many of those thirty had been filled she said zero as of mid April zero of those thirty billeted been filled how many of those thirty employees that this committee authorized CDC to bring on a per bio surveillance had been filled today Sir again thank you for the question I know our stats have been in discussions since doctor show concern testimony and I know we’re in process of can continuing to try to figure out how to move that forward Sir I can get back to you on it as I discuss with progress has been made since we had that discussion poster hearing with you and then you brought that to light well I brought it to light this is the first of March and now we’re in mid may so I’m hopeful that we will just talk about surveillance will actually executed and will focus on of the unbelievable amounts of money that we’ve provided for you that they will show some some benefit to the American people Dr Fauci let me come back to you this is one of the fastest development timelines we’ve ever seen for vaccines and the American people and hopefully of people around the world will be the beneficiary of what you what you find in the eventual licensure of of that product one of the biggest unknowns with this particular virus of that can affect the development process and Dr Han if you’ve got anything to add after that to this please do doctor foster yeah thank you very much senator Byrd whether a couple of things that I think are inherent in all vaccine development first of all there’s no guarantee that the vaccine is actually going to be affected as you well know because we’ve discussed this many times in the past and you can have everything you think that’s in place and you don’t induce the kind of immune response that turns out to be protected and durably protect so one of the big unknown is it will be affected given the way the body responds to viruses of this type I’m cautiously optimistic that we will with one of the candidates get an efficacy signal the other thing that’s not known that’s of concern but we’ll be able to get around that by doing the tests probably is that do you get an enhancement effect namely there have been a number of vaccines to a particular day D. and respiratory syncytial virus when the vaccine induces a suboptimal response and what a person gets exposed they actually have an instant pathogenesis of the disease which is always worse than if you want to make sure that doesn’t happen those are the two major announced putting all those things together senator mark I still feel cautiously optimistic that we will have a candidate that will give some

degree of efficacy hopefully a percentage enough that will induce the kind of herd immunity that would give protection to the population as a whole Dr on anything to add to that yes Sir thanks for the question the obstacles from a regulatory review I think are being met by the the approach is being taken out of HHS and led by Peter marks and that is it common pre clinical development pathway so that we can appropriately assess one vaccine against the other and then a master protocol that allows for a calming control group and assessment of very common and points that’ll let us be as efficient as possible for the development of vaccines we will evaluate approximately ten candidates pre clinically and then in the phase one and phase two studies and then takes four to five in the three studies I’m in this HHS efforts so I think those are the obstacles that can be broken down to speed the development but also allow us to ensure a safety and effectiveness Mr German yesterday the state of North Carolina started to publicize the recovered numbers those individuals who had corona virus but have recovered it’s my hope that nationally we will start reporting the recovered numbers I think that’s important for the American people here I yield back thank you senator Burr senator Casey Mr chairman thank you for the hearing as well right you member very Mister chairman I want to start today with a question regarding nursing homes in particular across the state like ours we at as you might know a high number of cases in Pennsylvania at last count over fifty seven thousand cases the number of deaths have gone above three thousand seven hundred of course a lot of those deaths are in nursing homes were told that a nationally more than a third as high as thirty five percent of all deaths have been in a nursing either the death of a resident of a nursing home or worker I want to start with today with a question for Dr Redfield Dr when when we consider this challenge in our in our long term care facilities we look at the number of yes the nursing homes I think a lot of families want basic transparency and that’s one of the reasons why senator Wyden and I sent you a letter dated April the second it was directed to you as well as the minister of the centers on Medicare Medicaid services Seema Verma and in that letter we ask for basic information about what the administration is doing to track the outbreaks in nursing homes to provide information basic information to families in there and and residents of the the families of residents in nursing homes shortly to the workers as well as to the community and public health professionals now it took over about a month to respond to that then your response you didn’t give us any information about that I might ease families need this information and now we’re told by the CMS administrator after pressing errors senator Wyden idea that this information may not be available until the end of may I need to hear from you today why is there been a delay a three month delay and basic information about their families and and people on it within a community need about the outbreaks in nursing homes the number of cases what is happening in nursing homes tell us when we’re going to see that information well thank you very much senator and you’ve highlighted one of the great tragedies that we’ve all experienced together clearly the long term care facilities have been particularly hard hit by this pandemic several things I know that again the state mass who has oversight several things have been done and I can get back to you in terms of where they’re at in terms of activation but really all nursing homes now are required to report cases in either their individuals that are patients there or or or staff to the CDC secondly I didn’t Irma and I have to put a policy in in place at all Christian homes are required to notify members of that nursing home of the existence of over in that nursing home when close family members verify in terms of when that’s

if that’s operational as of today last week and I will get back to you with that one of the most important we have decided is we talk about you can re opening as Tony mentioned we need goals symptomatic cases we need to be your into the tech tracing but the other thing that we really need to do is to do surveillance because this virus does appear to have a high propensity for it’s symptomatic instruction which means for traditional ways of assigned cases is this gonna be blunted and so we’re developing a national surveillance system and and first of all important that is to do a comprehensive surveillance in all the and states CDC it will will be doing that in partnership with the state and local health departments I see cursor is gonna have the responsibility to do it within the inner city clinics that intellect that in the Indian health service within the past service clinics but this is critical we get in front of this sent to apprehensive surveillance of everybody in these nursing homes is also done you know aggressive outreach in all of them and in enhancing infection control procedures eccentrics CDC’s men out of of help these nursing homes with that into the guidance along with the C. N but I’ll get back to you in terms of time I’m pretty confident there already it’s at the operational but I need to double check just to make sure because I I know seem as announced that they’re all reporting the CDC now any infection in workers or or our patients and that they are required now you notify other members in the nursing home as well as family members of one of it is in one of those and I did not Mister chairman just have one question for Dr Fauci doctor I want to ask you in your testimony earlier and response to a question by senator Murray you outlined a basic concern you have with regard to states re opening can you restate that forms yes thank you senator Casey yes my concern is that a state or cities or regions up their attempt understandable to get back to some form of normality this regard to a greater degree the checkpoints that we put in our guidelines but when it is safe to and pulling back on medication because I feel if that occurs there is a real risk that you will trigger an outbreak you might not be able to control which in fact Prodoxidae will set you back not only leading to some suffering and death it could be avoided but could even set you back on the road to try to get economic recovery but you would almost turn the clock back rather than going forward that is my major concerns thank you thank you doctor Mr chairman thank you senator Casey senator Paul not found send scientists have shown that rhesus monkeys that are infected with code nineteen cannot be mean factor several studies have also shown that plows most recently infected coronavirus patients neutralize the virus in the lab experiments in addition fusion of convalescent plasma is based on the idea that recovering coronavirus patients are developing immunity and that it can be beneficial as donate studies show that the recovering cove in nineteen patients from the a symptomatic to the very sick are showing significant antibody response sorry and murderers also court of viruses induce immunity for at least two to three years and yet the media continues to report that we have no evidence that patients who survive court of ours have immunity I think actually the truth is the opposite we have no evidence that survivors of crying of ours don’t have immunity and a great deal of evidence to suggest that they do the question of immunity is linked to health policy in that workers who have gained immunity can be a strong part of our economic recovery in the silver lining to so many infections in the meat processing industry is that a large portion of these workers now have a unity those workers should be reassured that they likely won’t get it again instead of being a by me reports that there is no evidence of immunity you’ve stated publicly that you’d better all that survivors of coronavirus have some form of immunity can you help set the record straight to the scientific record as is being accumulated is support of that infection with crown of likely leads to some form of immunity Dr out yeah yep thank you for the question senator Paul yes you’re correct but I have said that given what we know about the recovery from viruses such as corona viruses in general or even any infectious disease with very few exceptions that when

you have anybody present it it very likely indicates the degree of protection I think it’s in the semantics of how this is express when you say has it been formally proven by long term natural history studies which is the only way that you can prove one is a protective which I said and would be Pete it’s unlikely that it is but also what is the degree are tighter of anybody that gives you that critical level of protection and what is the durability as I’ve often said you may get B. T. you can make a reasonable assumption that it would be protective but natural history studies over a period of months two years what does it tell you definitively if that’s the case and I think that some important because in all likelihood is a good way of putting it the vast majority of these people have immunity instead of saying there is no evidence you know the W H. O. kind of fed into this by saying no evidence of immunity and in reality there’s every evidence stacking up in view in fact a lot of the different studies have shown that it is very unlikely you get it again in the short term with regard to going back to school one thing that was left out of that discussion is mortality I mean should we at least be discussing with the mortality of children is on this is for doctor felt she is well you know the mortality between zero and eighteen in the New York data approaches zero it’s not gonna be absolutely zero but you’re almost approaching zero between eighteen and forty five the mortality in New York was ten out of a hundred thousand so really we do need to be thinking about that we need to observe with an open mind what went on in Sweden where the kids kept going to school the mortality per capita in Sweden is actually less than France less than Italy lesson Spain less than Belgium less than the Netherlands about the same as Switzerland but basically I don’t think there’s anybody arguing that what happened in Sweden is an unacceptable result I think people are intrigued by it and we should be I don’t think any of us are certain when we do all these modeling serving more people wrong with modeling then right we’re opening up a lot of economies around the around the U. S. and I hope that people who are predicting doom and gloom and saying oh we can’t do this is going to surge will admit that they were wrong if there isn’t a surge because I think that’s what’s going to happen in rural states we never really reached any sort of pandemic levels in Kentucky and other states we have less deaths in Kentucky that we have in this in an average flu season it’s not to say this isn’t deadly but really outside of New England we’ve had a relatively but course for this virus nationwide and I think the one size fits all the we’re gonna a national strategy and nobody’s going to go to school it’s kind of ridiculous we really ought to be doing at school district by school district and the power needs to be dispersed because people make wrong predictions and really the history of this when we look back will be of wrong prediction after wrong prediction after wrong predictions starting with Ferguson in England so I think we ought to have a little bit of humility and and are belief that we know what’s best for the economy and as much as I respect you doctor Fauci I don’t think you’re the end hall I don’t think you’re the one person I guess to make a decision we can listen to your advice but there are people on the other side saying there’s not going to be a surgeon that we can safely open the economy in the fax will to bear this out but we keep kids out of school for another year what’s going to happen is a poor and underprivileged kids who don’t have a parent it’s able to teach them at home are not going to learn for a full year and I think we got a look at the Swedish model we are look at letting our kids go back to school I think it’s a huge mistake if we don’t open the schools in the fall thank you Mr chairman can I respond to that even though they’re only thirty two seconds left yes you might make it clear whether or not you suggested that okay we shouldn’t go back to school in the fall well first of all center to pull it thank you for your comments I I have made myself out to be the end all and only voice in this I’m a scientist position at a public health official I give advice according to the best scientific evidence there are a number of other people come into that and give advice that are more related to the things that you spoke about the need to get the country back open again and economically I don’t give advice about economic things I don’t give advice about anything other than public health so I want to respond to that the second thing is that you use the word we should be humble about what we don’t know and I think that falls on the fact that we don’t know everything about this virus and we’ve really got to be very careful particularly when it comes to children because the more and more we learn we’re seeing things about with this virus can do that we didn’t see from the studies in China or in Europe for example right now children presenting with Colbert at sixteen when the company nineteen who actually have a very strange inflammatory syndrome very similar to cover sake syndrome I think we better be careful if we are not cavalier in thinking that children are completely immune

the deleterious effects so we get your right in the numbers that children in general do much much better than adults and the elderly are particularly those with underlying conditions but I am very careful hopefully humble in knowing that I don’t know everything about this disease and that’s why I’m very reserved in making broad predictions thank you thank you senator Paul and senator Bob thank you Mr chairman and ranking member Murray and our witnesses I wanted to cover a lot of territory in my five minutes so I’d certainly be appreciative of concise answers but I want to start with Dr Redfield after rex field that the testing protocols at the White House presents a model for other essential workplaces I’m sorry your center I’m are you broke up in the beginning a question if you could just say it again I’m sorry yes doctor I feel do you think that the testing protocols currently in place in the White House I present a model for other essential workplaces well I think what thank you for the question I think one of the important things you bring up is the essential worker guidance in CDC put out and I think it was originally modeled obviously on health care workers when they were significant healthcare shortages individuals that work work places I’m asking are you saying that the White House or call has being are a model for other essential workplaces all right I would just say that I think each workplace has to define their own approach that’s how to operationalize our had some considerable a comment on the fact that OSHA has not stood up and enforceable mandatory emergency temporary standard for workers in all sorts of work settings but that aside would you say that the P. rules and protocols in effect right now in the White House are a model for other essential workplaces we would in my own view and would go back to the guidelines in CDC’s put out about century workplaces for people if they are an essential work force that going publicly maintain six feet distance in and they wear face coverings okay admirable you are you have testified about how far you’ve come with regard to testing assessments I want to ask you if you believe that we already have a national testing strategy today that spans but that spans from the nation testing needs assessment to the nationwide testing supply assessment and a strategy to fill that gap issue I hear domestically what we need in terms of bridging that gap with testing platforms swaps specimen collection media and reagents and the PP I needed to conduct tests so thank you for that we do have a strategy that spans us at least to the at least to the fall on and beyond as the as I mentioned we’re working individually with every state and I think that senator Paul is correct that Kentucky Wyoming or New Jersey Rhode Island or different in there there are definitely different testing needs the east coast will have multiples of testing versus other states and we’re working those into individually yes I know you testified earlier that not only are you working with the state that you’re working with every lab in every state his capacity what about working with those who would be the I those who would need testing to say re open their school there university their business each of them have identified what they think are their testing needs based on our you know guidance not mandatory enforceable rules but are you in contact at that level is your dashboard have visibility at that lowest level in contact with the states and with the lapse so over the last few months we’ve done a lot of the individual work at nursing homes that meat packing plants that either I mean really down to the very granular level where we are right now however if we are really working with the state leadership that with the public health lab the state epidemiologist the shows the state health

officials because they they really need to understand what they’re some is going to be in their state and on and in the funding we’re asking very specifically on in the CDC funding for specific plans for schools nursing homes under served it says so I have two more points that I’m gonna to make I don’t have time for questions one is about transparency of that needs assessment and the public see yet and the states yet can the help committee members yet is a publicly available and secondly the delivery of the supply is a critical issue and it seems to me that the look we’re getting this out hi whether it’s P. P or a medical equipment is still extremely fragmented leading to price gouging and many other inefficiencies we need to stand up to full power of the defense production act would you like to comment on that ma’am I’m sorry I’m happy to have you come into it with the indulgence of the I chairman we’ve got over time and it was assisting to answer to the senator we just had Wonder why should our yes ma’am and yes our particularly for things like swaps in media there is still a very I would say non mature industry within the country and that’s why we’ve we’ve made the decision to procure that all centrally through December on and then distribute that to the state because they’re just too many small companies too many too many variables to control without a really heavy federal hand on that just an example of where we really moved into that and use the DPA for swap on to help support American industry on a more mature aspects of the industry like some of the large task producers on we feel that by helping direct them to make sure that the states get what they needed the right distribution that were not procuring them directly by us but again we’re gonna be very evidence and data driven as we move on thank you Sir thank you very much senator Baldwin senator thank you Mr chairman let me begin by first thanking each of our witnesses today for their expertise their dedication and their hard work Dr Redfield I want to start with you I am hearing from Dennis all over the state of Maine that the fact that they cannot practice in our state despite following very strict infection control protocols is causing growing health problems Dennis tell me if that teeth with cavities that could have been failed are now going to need root canals teeth that could have been treated with the root canals are now going to require extractions people with the oral cancers can not get the treatment the cleanings that they need but for their treatment dental health is clearly so important and Maine state officials as well as our tenants are seeking it in reaching the right decisions forty seven other states either have re opened down practices or have a days sent for their and to reopen so my question to you is bets if dentists are following the American dental association guidelines if there instead strict protective measures for their patients our staffs there hi Janice themselves indeed there closely examining and seeing a decline in the number of cobit nineteen infections in their county are these back actors for states to consider in re opening the practice of dentistry yes Sir senator thank you for the question you know we’ve been interacting and talking with the dentist and working with the state and local public health divisions to update our guidelines on reopening a variety of medical services you know and I think yeah you raise a very important point and I would would not disagree with what you said about at the American dental association’s as well as the reality of the

outbreak in the area but we are in the process of updating those died died lines and they will include direct guidelines for dental practices thank you very much doctor Dr Girod in Dr Hon recently there’s been a significant demand for ram ram does so far I may be mispronouncing at which transitioned to receiving an emergency use authorization last week mains to largest hospital systems contacted me with questions about how this therapeutic will be allocated going forward HHS finally that statement on Saturday about how to to states interestingly not directly to hospitals but once again the decision making behind these allocations is very unclear HHS and the Assistant Secretary for preparedness and response say that each state it is expected to receive an allocation but no time has been provided beyond those who are being treated with this drug at Maine Medical Center through a clinical trial I’m concerned bed hospitalized patients in Maine will have little or no what bility to be treated with this promising therapeutic for the pacy opal future as vezes N. more therapeutics and ultimately a vaccine come on to the market place how can dis allocation and distribution is used to so that patient care is not delayed and so that it doesn’t depend on which state you live in whether or not you’re going to get access to these treatments and ultimately a vaccine senator Collins this okay Abidjan dot had died commissioner senator Collins I think we completely agree with you that this has to be an evidence based approach getting the medical therapeutics vaccines and does appear whichever happens to be the to the people in need I think we can all agree upon the fact that we learned a lot of lessons from around getting your situation and courses you mentioned that’s being led by HHS and and ask for what you see in the most recent announcement is that what detest receivers provide guidance to HHS regarding where the significant outbreak of hospitalization outbreak occurred and where those hospitals they should ask like patients work on this represented about a quarter of the supply of drugs we have and more will be allocated according the methodology gets drawn to where those hospitalized patients are I think valuable lessons can be learned and will be learned with respect to other therapies and to vaccines in particular and we must incorporate those into our operational plans moving forward thank you doctor at well do you have anything to add I’m overtime sorry thank you if you have anything to add a few do so for the record no ma’am no ma’am I agree with commissioner its it’s absolutely critical that it’s evidence based based on the people who could benefit from it also fair and jobs throughout our country thank thank you for calling San senator Murphy I thank you very much Jim thank you to you and senator Murray for convening this thank you to all of our witnesses for your service this is obviously an exceptional hearing today in the three of our witnesses are in quarantine and so I just want to start by asking a pretty simple yes or no question that I think I know the answer to Dr Fauci Dr Hahn Dr Redfield I’m correct that all of you are drying a salary as you should during your period of quarantine is that correct let me sleep I think we better be careful about the issue of quarantine we are essential work is this part of the essential infrastructure and we are when needed which is often what duties respectively says at the White House I was at the White House yesterday and I would likely even perhaps even beating today and in my office at the end I. gates so it is not really strictly speaking the quarantine as we know it but is performing duties

as critical work and I’d be happy to have my colleagues also respond to senator Murphy this is us Steve Hahn I agree with that doctor felt she yes I am drawing a salary and I had continued to work during my quarantine on N as an essential worker will participate in meetings face to face when that attendances is considered critical it might my point here listen you all should draw a salary well you are taking precautionary steps because of the contacts you have made my point is that quarantine is relatively easy for people like you and me we can still work and get paid we can telework but there are millions of other Americans who work jobs that can’t be performed from home or are paid by the hour ends it’s just remarkable to me that this administration has not yet developed a mechanism for states to implement and pay for a quarantine system that will work for all Americans your plan to re open America requires states develop that plan and yet my state has no clue how to implement and pay for that system without help from the federal government which leads me to my second question Dr Felton Dr Redfield you’ve made news today by warning us appropriately of the dangers of states opening too early but as senator Murray mentioned this is infuriating to many of us because it comes hours after the president declared that we have prevailed over corona virus which I’m just gonna tell you is going to make it much harder on state leaders to keep social distancing restrictions in place it comes days after the president called on citizens to liberate their states from social distancing orders and I think you’re all noble public servants but I worry that you’re trying to have it both ways you say this state shouldn’t open too early but then you don’t give us the resources to succeed you work for a president who is frankly undermining our efforts to comply with the guidance that you’ve given us and then the guidance that you have provided is criminally vague and I want to ask my last question on this topic I’m obviously the plan to reopen America was meant to be followed by more detailed nuanced guidance right what is a downward trajectory I mean what happens if the trajectories downward in some settings but upward and others what happens if you re open and there’s a spike in one location or another setting and of course you knew this because you developed this guidance this is a guidance that is site specific that frankly is helpful some of this is on the CDC website but some of it is not and we need it my state needs it we don’t have all of the experts that you have a man so we rely on you so reporting suggests Dr Redfield this guidance was that what was developed by you and other experts was shelved by the administration that it was withheld from states in the public because of a decision made by the White House so my specific question is why didn’t this plan get released and if it is just being reviewed when is it going to be released because states are re opening right now and we need this additional guidance to make those decisions senator I appreciate your question clearly we have generated a series of guidance is is you know and is this outbreak responses involved from a the CDC to an all of government response as we work through the guidance is a number of them go for inter agency review and then every agency input to make sure that these guidances are more broadly applicables for different parts of our society the guidance is that you’ve talked about I have gone through that inter agency review their comments that have come back to CDC and I anticipate they’ll go back up into the task force for final review before re opening in Connecticut in five days in ten days this guidance isn’t going to be useful to us and two weeks so is it this week is it next week when we gonna get this expertise from the federal government the other thing I would just say is that the CDC stands binding of technical assistance you’re staying in any state up on any request that I do anticipate this broader guidance though to be posted on the CDC website that soon I can tell you so in in I can tell you your state can reach out to CDC and will give guidance directly to anyone in your state on any circumstances your state desires guidance from soon isn’t

terribly helpful thank you Mister chairman thank you senator Murphy senator Cassidy a German thank you very much for your service and I will have a set of questions so if your questions can be brief I appreciate your answers can be brief Dr Han in your testimony you mention that the testing for the populations in the vaccine trials now includes older Americans I guess my question though is what about children doesn’t include children does it also include the obese the diabetic the immuno compromised those who are at risk of having a less non response or mitigate a response to vaccination can you comment on that please yes Sir thank you senator Cassidy when the phase two phase three trials are in place they will include our most vulnerable populations including individuals that you describe we’re working very closely in second interrupt phase two is only check for safety you would not have to do a separate phase two in the patient who was younger you farm center can you just assume the safety data from the adults applies to that of the children so no we we we also want to assess safety Sir as well in children so the current phase two trials today include children they’re in phase one studies right now Sir thank defensive end of phase two going on well I think it’s about to start for the mature not seen perhaps technology can answer that yeah I know syndicate Cassidy no I did not say a phase two is I think we are in the second dose of the phase one and we will proceed when we finish the first one to go to phase two you’re not I’m hearing the children will be included in phase two trials yeah that’s so that’s under discussion between FDA and NIH sponsored because we do realize that it’s important for us to understand what the season children but doesn’t Dr Redfield the bill back upon one hundred Murphy said the published guidelines for school school opening obvious you’re about to modify but I noticed as I read through them there’s nothing about testing so we speak about testing targeted testing how we use testing but the guidelines for the school systems has nothing about how to integrate testing our will these be in those guidelines that are being released senator thanks for the question clearly there’s got to be is already been stated in any competition of a testing strategy that is gonna be different for different school settings as well as different jurisdictions where there’s setting and that is going to have to be integrated into each of those there’s a general overarching guidelines and then as I say I do think detectives strategy which is important as including the surveillance strengthening needs to be a individualized to them in the car the card lines Dr Redfield and all due respect I think children whether your rule front tier suburban or urban is the one setting in which there is a remarkable commonality and and I will echo what senator Murphy said the resources that the federal government has greatly exceeds all but the most sophisticated populace wealthy state and even then it exceeds by some extent so I do think it would be good to have okay in a primary school setting this is best practices are these are three options and choose between one of these three to say to each school district each private or parochial Independent independent school work with your state board of health figured out seems a wasted effort I say that because children play such a role in both protection of disease the spread of disease X. cetera so your thoughts on that because it really seems that’s the one setting where you can have you know not cookie cutter but certainly a pattern which can be followed the senator I I must have been misunderstood when I was talking to a difference is I was thinking of the difference between an elementary school high school college in terms of how we a trade school there may be differences and how you integrated testing strategy but I do think having an interesting strategy with different options for people to evaluate based on different principles will be important in terms of guidance that out she you persuasively argues that the a risk of re opening prematurely is great but I think the frustration if I think of children in particular the the the the risk benefit ratio of a child being at home attention away from enhanced nutrition without the parent able to work because Jules school provides day care without the monitoring is sometimes occurs for incidences such as child abuse but perhaps

most importantly for all children the opportunity cost of a brain which is forming not having access to the information that will help that brain form optimally now as there any been any sort of kind of risk benefit ratio for the child yes they are reciprocal Sakis but they are particular risk for missing out on a year of education particularly for those from less rich backgrounds I guess I’m very concerned about the attention what are your thoughts on that no you get points Cassidy this is very difficult of the unintended consequences of trying to do something that broadly is important for the public health and the risk of having a return a resurgence of an outbreak and the unintended deleterious consequences of having children out of school we fully appreciate that I don’t have an easy task I just don’t need to sleep on a step by step basis as we get into the post appeared of time with the fall about re opening the schools exactly where we can access the outbreak I might point out something that I think it’s been alluded to throughout some of the questions that we have a very large country and the dynamics of the outbreak of different in different regions of the country so I would imagine that situations regarding school will be very different in one region versus another so that it’s not going to be universally are homogeneous I don’t have a good explanation or solution to the problem of what happens when you close schools and it it triggers a cascade of events that could have some common circumstance are you a four or five minutes Mister chairman I’ll close by asking the permission of the the chair to submit for the record article just came out the journal pediatric nursing children are at risk of a nineteen so it’ll be included thank you senator senator Warren our eight thank you Mister chairman and thank you to our witnesses for being here today all hope everybody staying safe and healthy in the past sixteen weeks over one point three million Americans have been instructed with corona virus we now know that about eighty thousand people have died and thirty three million people were out of work doctor felt she you have a slightest six presidents you’ll have battled deadly viruses you’re in our career so I just like to hear your honest opinion we have the corona virus change thanks for the question right now it depends on what you mean by containment if you think that we have a completely well I mean if you look at the dynamics of the outbreak we are seeing a diminution of hospitalizations and infections in some places such as in New York City which has plateaued and started to come down New Orleans but in other parts of the country we are seeing spikes so when you look at the dynamics of new cases even though some of coming down the card looks flat with some slight coming down so I think we’re going in the right direction but the right direction does not mean we have by any means total control of this upper right you’re actually as I understand it we have about twenty five thousand new instructions a day and over two thousand yesterday I I think that’s the right numbers and summer estimating we could be at two hundred thousand cases today five G. is that right Dr actually I don’t I don’t foresee that as two hundred thousand new cases by June I am hoping and looking at the dynamics of things starting to flatten often come down that we will be much much better that sentiment just just so I understand we are right now two thousand new infections a day and two twenty five thousand new infections in two thousand yesterday right and that’s where we are right now yeah yeah yeah so so let me just ask you it is it is possible that this virus under better other countries have done it like self reaction but we are now three months into this pandemic and basically we continue to set records for the number of people who are diagnosed in the number of people who died Dr felt you recently said that a second wave runners armor skins always quote inevitable but that if America well what’s in place all of the counter measures that you need to address this we should do reasonably well and the countermeasures you identified with things like you need social distancing significantly more testing widespread contact are you see also CEO of the American

doesn’t do what it takes and this is your quote will be for a bad foul in advance which so right now we’re about sixteen weeks thanks from Labor Day that’s about the same length of time since the virus was first detected here in the US you have a not robust countermeasures in place that we don’t have to worry about a bad fall winter right now the projection as you’ve heard of that merger law with regard to the testing and other elements that would be needed to respond the projection is that by the time we get to the end of the summer and early fall and we will have that in place at junction I guess we don’t have it in place now that we are projecting the place and let me just ask the other side of this if we don’t do better testing on contact freezing AnnaLynne social distancing will deaths from corona virus necessarily increase up of course if you do not do an adequate response we will have the deleterious consequence of more infections and more debts and that’s the reason why you quoted me senator quite correctly everything you said and I will stand by that we do not respond in an adequate way when the fall comes given that it is without a doubt that they will be infections will be in the community and we run the risk of having a resurgence I would hope that point in time in the fall that we have more than enough to respond attic but I don’t there will be problems I appreciate your help and I wish we could help people that the federal government has this pandemic under control but we can in fact have said that the virus is not under control in US we haven’t yet taken pictures necessary to prevent a second wave of death and we all know that the people who are going to be most effective read two key seniors essential workers of the people who are out on the front lines the president needs to stop pretending that it’s just ignores bad news it will go away it Wong the time for magical thinking is over here president trump listing knowledge that the several responses been suspicion and that more people are dying as a result we are running out of time to save lives and we need to act now so thank you Dr Saanchi for all you’re doing Preciado the urgency of the moment not thank you thank you senator Warren senator Roberts thank you very much Mr chairman and thanks to all the witnesses are are you all are likely have the tab for I guess it was a vampire back into JPEG or shining the light of truth in the darkness that individual flashlights for sure thank you Mr chairman for emphasizing that we have to be bipartisan this approach we’re not gonna get anywhere and that obviously is on the rise of the beholder happy to say that we have a very good relationship governor Calley who happens to be a Democrat lobbyist and her energy her emergency management team is spot on after the enormous going out the job the rest of this morning I talked to Lee situate and captures a very good I’m reading here Candace received seven top the new coverage as for caps with food processing facilities you say this girl behind me that’s a stage coach coming in to Dodge as opposed to getting out of Dodge Dodge city is my home town we are the hot spot in regards to and is mainly because of two packing plants we have five next up a twenty six percent of the cattle mark at any rate Candace is going through a tough time at it we should be worried about the safety of the food but the food supply chain I think nationwide it is under a great deal of stress we see that in theory we see that in poultry review that and park there Houston I think pigs in office and opposite the livestock industry Sonny Perdue with the department of agriculture has a stepped up so is the president declaring that these are packing plants are a national assn we progress and Dodge city when we first started out had five attached five it’s between four and six five not fifty million as we hope to receive a

it has been said by having one of the witnesses the reason I’m really harping on all of the problems are having an exposure on the fact that the relationship with China is such that even at first breakthrough with regards to trade to China seems to be on hold are and that’s another price depression and this is going on five or six years our prices have been below the positive action in result our consumers are really figuring out that there doesn’t come from a grocery store and I am very worried that the harm to good value chain as a is very real not to mention the financial situation that our farmers ranchers and growers all right now having said all that I want to ask admiral juror you spoke about the importance of having diversity in kinds of tests that are available the pie packing plants we have a campus if we could get a rapid test and we can get it as we yeah okay ask for because of the hot spots that are developing not only in Kansas but also doing great harm to the food value chain that would be absolutely wonderful would speak to that Sir yes thank you senator both doctor red hill and I have been very actively involved in getting strategies for the industry particularly in Kansas we are supplying very heavily the public health labs with rapid diagnostics as well as urging them to to areas like that the one trade off however is that the rapid the quote rapid point of care diagnostics are very slow so each machine can only do four per hour and that’s very very slow so it’s a mix of testing that you needed these kinds of situations on sort of that the high throughput tests that are available at a major lab with a quest lab right there in Kansas bomb as well as a mix of the rapid that testing and that’s what we’re supplying in order to provide a comprehensive holistic solution on and I I believe CDCs on the ground as well in Candice supporting that I appreciate you only do it for an hour that’s not a rapid test maybe to rapid slow test I’m not quite sure how you define that term I for one think it is we re open and by the way governor Calley started the opening process first of this month and next may eighteen and then we go to June and then the hope is we hope not but we do have contingency plans that if that doesn’t work as a aptly described by now doctor Fauci hi hi I think we’ll be all right but this is gonna be a tough go hi I have to tell you that it earns of agriculture we’re not in good shape I appreciate everybody’s and the job that you were doing I will stand beside you when you’re taking the booze and behind you when you’re taking out thank you senator Roberts senator Kay I thank you Mr chair to the committee leadership and witnesses for calling this important hearing the last time Dr Fauci and hard work force was March three I have a slide that I want to put up that shows what’s happened in America since then the chart which is here compares the experience of United States and South Korea on three dates on January twenty one both nations experienced their first case of covered nineteen at that time the unemployment rates in both countries were essentially I on March three when the witnesses were last year so after he had experienced twenty eight Copa nineteen deaths in the U. S. and experienced nine again the economies of both nations as measured by the unemployment rates were nearly identical but now the story changes as of yesterday more than eighty one thousand Americans have died in the U. S. economy has experienced job losses not seen since the Great Depression meanwhile the economy of South Korea has not changed dramatically at all and the death toll is now at two hundred fifty six South Korea is smaller than the United States won six of our population but even if you bulk up the death toll to reflect the difference the per capita death toll in the U. S. is more than forty five times the rate in South Korea and health care carnage here is causing a near to while South Korea has protected its economy by managing correctly I could have done this chart with other nations the U. S. has the seventh highest per capita death rate in the world are death rate is off the charts higher than that in India Australia New Zealand Japan and Mexico it’s nearly three times the death rate in Germany twice as high as Canada’s rate the question is why if we want to open up our economy in schools we have to learn the lessons of nations that have managed as well here are some things that don’t explain the difference our hospitals are as good or better

than those in South Korea our health care providers heroes are as good or better than those in South Korea our research capacity is as good or better than sap that in South Korea and we have more resources than South Korea our GDP is twelve times south Korea’s and our per capita income is fifty percent higher so to Dr Fauci the general in the United States the death rate United States especially when compared with other nations is unacceptable isn’t sorry Sir yes of course I mean a death rate at that height is something that in any matter of form in my mind is unacceptable and doctor found she the experience of other nations shows that the U. S. death rate is not only on but it’s unnecessary isn’t that correct I don’t I I I don’t know if we could say that Saturday but would you say that the U. has to do better of course you always have to do better I mean as a vision and I and the experience of South Korea shows that our nation manages the health care crisis has a huge impact also it’s an on its economic condition is not the case that is the case Sir I I understand where you’re going with this but I have to tell you there is a big difference between South Korea and the United States and the outbreak and let and let me get and let me get to that I want to get to factors to do explain the difference and we know it’s not resources are our health providers the first is testing South Korea began began aggressive testing much trailers in the U. S. now in the fifth month of the pandemic we surpassed South Korea in per capita testing but in the critical month of March South Korea was testing its population at a rate of forty times the testing in the U. S admiral Gerard Dr drive has sat out the standard for us when we get to September he says the United States needs to forty to fifty million tasks a month to be safe at data points to about one point three million to one point seven million tasks a day yesterday we did three hundred ninety five thousand tests we’ve got a long way to go a second factor is contract race contact tracing South Korea embraced a rigorous contact tracing program right from the beginning the United States still has not engaged in a national contract tech tracing program isn’t that right with the Redfield so I think that question would best be directed to the CDC where the outbreak started Sir we had a an aggressive contact tracing program but unfortunately as cases written rose it went beyond the capacity we want the mitigation so we lost the the containment edge clearly have data on and that was key to the economy as well because South Korea did testing contact tracing protected server isolate the sick and then they didn’t have to shut down switch up their economy social distancing is a third factor we talked about it but find the last one health care systems would you agree with me that it helps keep people safer either from serious conditions or death from covered nineteen if they have access to health yes of course of course of course that’s the case in South Korea ninety seven percent of the population have health insurance in the United States before covert nineteen millions didn’t happen and lacked access to health care the massive job losses in the last months threatened to take health insurance away from millions more and president trump is doing all he can to dismantle the affordable Care Act which would take health insurance away from tens of millions more let’s learn the lessons from those who are doing this right thank you Mister chair I yield back I can make a clarification please Mister chairman this is our bread or why I just wanted to clarify that I did project that we will have the ability to perform forty to fifty million tests per month in in in that time frame but I said if needed that that at that time I am not making a proclamation all we have to really understand what we’re the epidemic is what the community spread is before we can estimate the number of tests that are needed I was simply stating the fact that our combination of testing capabilities will be at that level even boring on new input from the NIH thank you very much senator Kaine senator McCain ski thank you Mr chairman and chairman thank you for being here this morning virtually but also for all you have been doing for these many many months Alaska’s doing okay right now from a numbers perspective and quite honestly we want to keep it that way because we know we have exceptionally vulnerable populations we know we have a a

geography that is challenging we know that we have facilities that are very limited last hearing we had an opportunity to hear from doctor Collins and he shared where they are with the red X and also spoke to red X. up which was very interesting about what we can be doing in rural areas but but focusing on hot spots and as I reminded him we don’t want to be a hot spot in Alaska so every effort that we make to keep the virus out of Alaska is our lives that are saved I I educated him on the community of Cordova that is just getting ready to open its up it’s a copper river salmon fishery in two days and was able to share that they had had one worker tested positive as he was coming in from the lower forty eight to come to work the good news on that is that all the protocols that we had put in place seem to be working the quarantine the isolation on not only for that individual but for others that he had come in contact were secured I want I want to recognize the assistance that we have received from the administration doctor Eastman is in the state at this moment the the chief medical officer for the department of homeland security going out to rural communities to really better understand our our vulnerabilities go to some of our fishing communities to again I how we can successfully prosecute a fisheries when you have to bring workers in from the outside we thank you for the assistance with regards to additional testing capacity I’ve been in contact with our chief medical officer of the state this morning in the mayor of Cordova his better understanding again do we have the test that we need what do we need on the ground and one of the things that I would like to have clarified in and this is probably to you doctors you are confused because you have been so helpful in in kind of shining a light on what we need to be doing in these rural areas but so much of the focus has been on hot spots and responding to the hot spot but how do you keep those rural and remote small communities from becoming the hot spots in the first place are we doing enough and right now the strategy has been we just lock it off the travel restrictions that are in place our our apparently working on but they’re also they’re also devastating our economy whether it’s tourism our weather is are a resource industries or whether it’s the potential for our fisheries so admiral if you might speak to to that aspect of it and then I have a very important question as it relates to contract a contact tracing that I’d like to direct to either enrolled your raw or Dr Redfield thank you senator and and as you know you have an outstanding state health officer and in sync and we do I’ve had the privilege of working with her on in you have a very good protocol in in trying to keep Alaska safe by isolation over a period of time when you come in as you know we also work with the state to meet your your very challenging testing requirements because you can’t really you know send labs out a thousand miles away so we put out will customize mixed appointed here and also the sexiest machines I think we sent nine or ten you to Alaska and about fifty thousand task which is about four times then you’ve done to date collectively in order to provide that support so again I do think there’s a comprehensive strategy that you do have but again the mitigation it to the degree that you can given the circumstances the face mask the hand washing the hygiene we understand fully the challenges particularly in the fishing remark environment and the remote but all these have to come together the testing the tracing the mitigation the hygiene factors ought to try to keep by your safe and we really understand culturally that many of your communities all were almost annihilated in the nineteen eighteen influenza pandemic so and that memory is still very sharp and very hurtful to many of the citizens so we want to do our best to assure them that we are giving them all the protection we can and will let me let me turn to Dr Redfield because this relates to contact tracing I think that this is very very key part of how we move forward into getting people back to work getting people back to school right now we have about a hundred people that are involved in canton contact tracing Alaska

that’s clearly not sufficient there’s been talk about a national strategy but I think we recognize that we have teams in place whether it’s American or whether it’s Peace Corps whether it’s our our our public health corps what more do we need to be doing to make sure that once you’ve been tested positive you know then what happens after that who else needs to be brought into into this and I’m not convinced that we’re focusing enough on that aspect of how we moved to to re opening if we haven’t done the contact tracing thank you very much senator I want to just re emphasize what you said I think kinda tracing can capabilities is critical it’s going to be the difference from succeeding in in N. containing this outbreak from one sick as in wide scale community transmission or not well we’re positioned as you know do you deploy and redeploy the number CDC over five hundred CDC individuals we have another about six fifty that you’re trying to put into our nation but most importantly we’re trying to work with your health department with the resources that we’ve been able to give because of the August the mantles also if you mentioned with these other agencies with lab core I mean with americorps with the census bureau to work together and have the state developed there could you sing capacity some states of the reallocated state work some states of ria it international guard well they begin to do this but I agree with you and I said it’s gonna be and I think it’s significant effort to build a contact with bass city that we need in this night will be state by state but it’s going to need to be augmented prop in your state from what you just said that control and we’re there to work with the states to help them push that needs to get in place before September here we need to move thank you thank you senator McCaskey I don’t want to commit any senator off but we have eight more senators who have five minute rounds and and it’s twelve thirty so I’d like to request that the senators and the witnesses just saying questions and try to stay within five minutes would be appreciated but senator hash well thank you Mister chair thank you and ranking member for having this hearing thank you to our witnesses today and please pass our thanks along to all of the hard working women and men in your agencies who I know have been working on virtually around the clock to try to improve our response and keep Americans safe and Mister chair I hope you and all the witnesses are healthy and safe today as is everybody on your team I’m off I wanted to start by echoing comments my colleagues and made about eating leadership from the CDC and our public health experts on how we are going to use fax and evidence as guidance so that our schools in our day cares in our businesses happy information they need to create safe and sustainable plans to re open and of course that means to that are testing capacity not only has to be a but it has to be flexible enough to meet our needs date key distinction between South Korea and the United States is not how many times per capita over a certain amount of time we’ve done but the fact that at the onset of this endemic South Korea was much more able to do a lot more tests per capita then we work and then follow that with all the other measures you’ve talked about so that we continue to need to identify the need and then build our capacity towards the need not the other way around I’m I wanted to start with a question to you doctor Fauci first of all thank you for your work and your expertise I wanted to talk about nursing homes for a minute in New Hampshire and across the country a huge number of protests from covert nineteen that we are seeing have been in nursing homes we all know people who have lost a friend or family member in nursing homes and the reef compounded by the fact that you could be at that level one specified if they die yesterday Dr Brooks said the old one million nursing home residents should be tested within the next two weeks as well as all nursing home staff Dr Fauci as a short term goal that makes sense to me but after that what will be ongoing federal recommendations look like how frequently do we need to test patients and staff on a continuing basis and what other measures will be necessary to keep our loved ones in these facilities say thank you for the question a

single assn the general plan as you mentioned that was recommended by Dr Brooks is a sound plan as you said it in the immediate question is in the long range we will have to have infection control capabilities in nursing homes that are really pristine and it really unassailable we have to do the kinds of surveillance is and have to have the capability of when you get a five someone you get out of that particular environment so they don’t spread the infection throughout general testing for all I think it’s a good start but when you look where you’re going to go in the future it has to be a considerable degree of surveillance capability thank you doctor the White House is not requiring all staff with masks and anyone in regular contact with the president tested daily do you think nursing homes should implement those same measures to help make sure that our seniors can get the same level of protection I think they should be a certain age you have a system in place the optimal protection of people in nursing homes and that would be necessarily testing every person every day that’s one approach that might not be practical when you think of all the nursing homes in the country but the strict relations and guidelines about who is allowed to go into the nursing home and the staff I believe needs to be monitored very carefully with two men testing to make sure that we don’t have an introduction into the nursing home affected individuals I’m not sure you can practically do it testing every day that I don’t think would be feasible but something that is much more aggressive than has been the past I believe should be done well thank you I have a one last question for doctor touching Dr Redfield I would also just say that if we are able to get masks to everybody in the White House I hope we can get masked every nursing home employee needs set up Dr fetching Dr Redfield U. S. needs to be preparing now to ensure that we have to ask any actor an administer vaccines something you’ve both touched on both for an eventual quoted nineteen vaccine as well as other illnesses such as the flu the failure to ramp up production of testing and personal protective equipment early on during this crisis made things worse here it was mistakes can’t be repeated when it comes to vaccine production and distribution we are already seeing reports that some children are not receiving the cheesy music immunizations as it becomes more difficult to access in person care doctor felt she what steps should we take now to ensure that we have sufficient manufacturing distribution capacity broke nineteen vaccine without putting at risk our capacity manufacture and distribute other important products such as the flu or measles vaccine and my follow up question to Dr Redfield would be whatever works are underway at CDC to ensure that all routine vaccines are accessible during the Copa nineteen public health concerns yeah thank you for that question said it hasn’t always served as quickly as possible I am new to this in my introductory remarks when I was talking about vaccines for coffee nineteen and what we said that as we do the testing on these vaccines we are going to make production risk which means we will start putting hundreds of millions of dollars the federal government money into the development and production of vaccine doses before we even know what works so that when we do and I hope we will have cautious optimism that we will ultimately get an expected and save like scene that we have doses available to everybody needs it in the United States and you can contribute to the what is the needs globally because we are partnering with a number of other countries the other part of the question about making sure that we get into a situation like this so called shut down that would be and now that we make sure that children get the vaccinations that they need because that would be an unintended consequence of shutting down as we are right now it’s a very good point we want to make sure we don’t fall behind on adults thank you thank you very much and I’ll take my answer from Dr Redfield offline you so much for allowing me to go thank you senator hacen senator Scott thank you Mr chairman into the panel thank you all for being here virtually without any question we find ourselves in a situation that we wish we were not I’m very thankful for foci data burst out of algae and many others for your dedication twenty four seven without any question our nation a safer because of your hard work I want to do right by questions towards doctor foster really one specific question Dr Fauci and I’m thinking about the re opening of American specifically the re opening of South Carolina I’m taking into consideration the fact that in South Carolina a think overall our cases are moving in the right direction we

have a little less than a thousand cases unfortunate F. D. is actually better now I found was when the pandemic started our ability to isolate hot spots and mitigate the spread of the virus is I think where it needs to be with that in mind I flew in the Washington from South Carolina yesterday we have plans to test additionally two hundred twenty thousand more residents by the end of this month focusing on at risk populations by the end of this month we will have tested one hundred percent one hundred percent of nursing home residents and the staff that takes care of them and after increasing our contact tracing work force twenty fold in the matter of weeks our state’s health department announced yesterday that we’re going to increase it by an additional fourteen hundred contact tracers we have built and we continue to build the tools necessary to better detect and isolate cases to map their exposure and to prevent substantial spikes moving forward most importantly our health care system thanks in part to flexibilities from this administration has the beds and the equipment necessary to address the most serious cases when they arrived now with these tools in hand we have begun to re open to be clear we continue to scale up testing it to make to take measure to protect the most vulnerable and the data points are increasingly clear for older Americans and for those with chronic conditions like diabetes and high blood pressure this virus remains a threat a dangerous threat a recent report suggested that in New York roughly ninety percent of the fatalities had underlying issues two thirds of fatalities were seventy years or older ninety five percent over the age of fifty and South Carolina the meeting age of patients who have died from the virus seventy six and a half nearly two thirds of fatalities have been patients older than seventy one in nearly ninety percent were over the age of sixty and roughly ninety eight percent in South Carolina are over the age of fifty contrast that with those aged twenty and younger where we seen no deaths fewer than one percent of deaths in my state have been under the age of forty every single death is a tragedy every single one and we mourn with our family members who’ve lost their love ones we are taking every measure to protect our older south Carolinians as well as those with underlying conditions but we set out to flatten the curve by taking aggressive unprecedented measures like staying at home orders and mass small business closures we didn’t set out with the goal of preventing one hundred percent fatalities that would be unrealistic it is impossible and we didn’t set out to keep quarantines in place until we found a safe and effective vaccine that would take too long doctor ready feel your agency put out a helpful graphic showing two curves one was spied quickly and Pete hi reflected daily cases without protective measures the other flatter curve showed cases with those measures in place and the whole point was to graphic illustrated was to make sure that we did not exceed hospital capacity so while I respect the need for caution we are too often presented with a false dichotomy either saving our economy are saving lives we’ve seen the goal posts around flattening the curve move and I think that’s an because at the same time we’re doing that business have collapsed mental and physical health have declined depths of despair escalade educational outcomes nosedive as we wait in our living room praying for some good news around therapies and around vaccines we set out to flatten the curve and I think we’ve done a pretty good job with that we need to do better we will do better my question doctor Fauci is as we start the process of moving towards re opening South Carolina what else would you suggest that we could do to protect our most vulnerable populations thank you the Senate up Scott not you gave a really very eloquent description of what I think is one of be a model way to wave of protesters I mean you have to put things in place that I think would optimize your capability of the opening and I was as I was thinking as you were speaking I don’t want to

clone that and make sure other people hear about that and see with what you’ve been doing the issue of your direct question to me about the vulnerable populations is that as we have said in our guidelines and I looks like you are ready to progress carefully because you put in the place of very good system that the vulnerable the elderly and those with underlying conditions should be those who at the very last let me of medications should be those who are left in a situation where they might be in danger of getting infected in other words protect them right up until the very end of the relaxation of your medication because as you said very correctly those are the individuals that are the most vulnerable the morbidity and mortality so those of individuals particularly might say Sir those in the minority group the African American and Hispanics who for a variety of of of of situations that other social determinants of health have a great likelihood is not only getting infected but also having the underlying conditions that would make their risk for high degree of morbidity mortality higher so looks like you’re doing things very very well and I would encourage you to continue and to follow the guidelines as you get closer to normalizing your state thank you thank you talk about you know just simply close with this amount of time thank you for the many conversations that you and I have had about those vulnerable populations to include minorities as well as our senior citizens I will say that without any question you look at nursing homes is typically African Americans and Hispanics are the certified nursing assistants who are providing care for the elderly population so your focus on those two very vulnerable groups is much appreciated thank you for your expertise thank you senator Scott and senator Smith thank you so much Alexander and ranking member Murray and and thanks to all of you for being here today and for your service some doctors actually I have to say you are in the unenviable position of being a person that so many Americans Minnesotans trust to get the straight scoop and tell us what’s really happening you’re about that facts are not about the politics and that’s a really good thing as I have to start by asking a question that I think a lot of a lot of Americans want to know which is how are you doing how are you holding up it’s been an unbelievable effort I’m doing fine thank you very much for asking this is this is such an important problem it it transcends all of us individually and has to be working as a team and and I I enjoy very much working with your senators and the governor is because it’s at the local level that we’re gonna make this thing works I’m fine I appreciate your concern well a lot of people are thinking about you and are grateful for your service as we are for all of you and you know so we’re gathered today to think about what we need you to reopen our economy and I think first about what’s happening in my home state of Minnesota where agriculture is such an important part of how our state works as a part of our history and our work processors right now are looking at the reality of euthanizing thousands of hogs a day because there is no place to process them because of what’s happening in the processing plants and the working people who do the hard work in those processing plants are getting sick so here’s one story this is a one worker and the Star Tribune wrote about this named home aren’t that excuse she’s an asylum seeker and a mom who works for a contractor that does the cleaning in the processing plants and she works for fourteen dollars an hour seven hours a day five days a week and her job is to sanitise the machines that process the the meat into a ground meat and she feeling sick on April eleventh but she kept going to work and on April twenty first when one of her coworkers fainted as she told her supervisor that she felt sick and so she was told to go home but that if she didn’t show any signs of illness she should come back she went to the doctor and she paid a hundred and fifteen dollars to get a test and found out a few days later that she was called the positive and she’s still at home she’s still she’s not getting paid I’m and she doesn’t have health insurance and nearly two weeks ago president trump deployed the defense production act you keep these processing plants open but the U. gave really limited guidance about what would be safe for those workers it said for example in response to testing which has been such a big part of what we’ve been talking about today they said this is a quote this should be considered the appropriate role of testing in the workplace context tracing a code nineteen

positive workers in a worksite and assessment so doctors actually as we think about how we move forward we all want to open up the economy what what guidance would you give us in a situation like this here in Minnesota well I can give you my common sense guidance although this is not the area of my expertise it’s more than others but it would seem that if you want to keep things like acting plans open that you really got to provide the optimum degree of protection for the workers involved the ability to allow them to go to work safely and if and when individuals get infected to immediately be able to get them out and give the proper care so I would think when you’re calling upon people to perform a sexual services you really have almost tomorrow responsibility to make sure they’re well taken care of and well protected and again that’s not an official proclamation that’s just me speaking as a physician and as human beings thank you Dr Koch and I think that you speak as a human being but you also speak as the chief deputy neurologist of our country and the person that we all trust and this is the point that I want to I want to make it drive home with everybody which is this is the kind of guidance that you should be getting and following and then this is the kind of these tools that we we have got to have in our country if we are going to reopen our economy as we all want to do and this if we move forward with re opening our economy and yet we still have circumstances like we had in these processing plants I’m in another other places around the state we are going to be we’re gonna be right back where we started and accept even in the worst place as I think you pointed out Dr I G thank you senator and again it really does relate to one of the questions that one of your colleague senator asked me before that one of the things that I keep emphasizing it I’ll just repeat it again because it’s important that when you are in the process of opening up and pulling back on medication you really must have in place the capability of responding when you do have the inevitable upticks in cases that will absolutely occur it’s how we deal with this and how successful we are in putting the clamps on it that will prevent us from getting the kind of rebound that not only from the standpoint of illness and death would be something that’s unacceptable but it would set us back in our progress towards re opening the country thank you very much senator Smith US senator Robert this hearing at the participants and it every year or I need to take off work senator hacen unspoken I understand the politicians are gonna frame data in a way the most positive politically of course there expect that from admirals but yesterday you celebrated that we had done more tests and more tests per capita even that South Korea but you ignore the fact that they accomplish theirs at the beginning of the outbreak well we try to water during February and March and and as a result of five March six the U. S. A. completed just two thousand tests whereas South Korea had conducted more than a hundred and forty thousand yes so partially as a result of that they have two hundred fifty six deaths and we have almost eighty thousand deaths I find artistic record nothing to celebrate whatsoever the fact is there test numbers are going down down down down now because they don’t have it got about right we are going up up up as they have to I think that’s an important lesson for us as we think about the future under a separate topic that I my impression is that with regards to vaccines that the war I’m critical of what we’ve done and testing and vaccines we’ve done a pretty darn good job of moving ahead pretty aggressively and yet the president said the other day that president Obama is responsible for our lack of a vaccine at Dr Fauci is president Obama or or by extension president trump did they do something that that made the likelihood of creating a vaccine less likely are are either president trump or president Obama responsible for the fact that we don’t have a back seat now or or in delaying it and someone in some way no no Senado not it’ll certainly president Obama nor president trump responsible from not having it sixteen we moved as you said because I described in my opening statement rather rapidly one is ever gone mmhm knowing what the virus was to a phase one trial as fast as we’ve done so I don’t think that’s something that one should say anybody is responsible for doing anything wrong and that I think that’s right that’s the correct way to do it thank you that that was my impression I was surprised by the comment but that was my

impression Dr Redfield center cinema and I wrote a letter to you expressing our dismay at the lack of real time data at the CDC I’m talking about granular demographic hospitalization treatment data how is it possible in this day and age the CDC has never established such a real time system with accurate data and and what can Congress do to rectify that so we never have to look at something like this again your sorry thanks for the question I think you hit one of the important they are the first one I focus on it stated data modernization in analytics and protected data analysis really Congress that has a forward in providing funding for data monetization and we’re in the process of implementing it at there the reality is there there is an archaic system a non integrated public health system each public health department has their own systems and this nation needs a modern highly capable of data analytics system that can do predictive analysis I think it’s one of the many shortcomings that have been identified as we went through this outbreak and I couldn’t agree with you more it’s time to get that corrected thank you please help guide us as to what we need to do to make sure that happens and I presume it’s not build it ourselves but work with companies that have that capacity and use that capacity in in our favor it’s not your fault you want one last thing which which relates to a virus and I I know I’m asking you the impossible question but we’re all hoping for a vaccine obviously is the objective of our administration to get it as soon as they can and from what I can tell they’re pulling out all the stops to do exactly that at given our history with vaccine creation for other coronaviruses how likely is it I mean is it extremely likely we’re going to get a vaccine within the year or two is it just more likely than not or is it kind of a long shot it’s definitely not a long shot the center on the I would think that it is more likely than not that we will because this is a virus that induces an immune response that people recover the overwhelming majority of people we cover from this virus although there is good morbidity and mortality at eleven certain populations the very fact that the body is capable of spontaneously clearing the virus tells me that at least from a conceptual stage right we can stimulate the body with a vaccine that would induce a similar response so although there’s no guarantee I think is clearly much more likely than not that somewhere within that time frame we will get a vaccine for this virus thank you Mr chairman I yield thank you senator Romney I want to thank the witnesses for their patients we have four more senators and we’d like to give them a chance to ask their questions so senator Jones thank you very very much Mr chairman and thanks to all our witnesses for your being here virtually and also for your incredible service during this time I want to follow up quick whether an additional statistic that senator Romney talked about with regard to South Korea and that is about the fact that you are a nation that has about six times the population of South Korea but yet we have about three hundred and ten times the number of deaths from this pandemic so I think we have to be very careful in making comparisons around the world comparing the United States other countries are Dr Redfield a follow up just a little bit with what senator McAllister and I think senator Kaine talked a little bit about contact tracing and we’re we’re going understand you are working with states are to try to develop plans for re opening the testing is important the contact tracing is important but using that data as well as also going to be important in terms of the quarantine plants that senator Murphy talked about child care to help allow people to put their kids in a facility while they are still on go back to work all of those issues including maybe even Basilides like vacant hotels or motels that may be used for self isolation how is this plan being developed within the CDC is are those plans going to be individualized prostate will we as a member of Congress access to those plans I know how how are states going to pay for these that because most states already using the money that we’ve already given them as a wish list I mean you’re talking

about building a two hundred million dollar state house as opposed to developing the test and doing the contact tracing show I like bridges to drill down a little bit on how these plans are going to develop what access we will have to have those plans and be able to see them thank you very much senator this is a private citizen before this is a critical component of us take this time out to get prepared for next fall and winter in building that comprehensive contact tracing capacity we’re working individually with the leadership of the state health departments to look the part and Sir tourism travel try to let them yes I understand what they think their capacity needs are in those discussions of RT happens that will grow our said there’s been a variety of middle age together I’m testing in contact tracing CD season position that we reprogrammed are individuals that we have across the country or five hundred begin to help each of these states man did that with some additional personnel that we’re bringing on board state by state through our foundation we’ve got about a hundred and six billion dollars of the money that Congress has appropriated into the states so they can begin to start thinking about other they want to return contact tracing capability and then of course it was mentioned that we’re all other government programs like americorps just peace corps so that each group is going to ask trucks there hi tech tree seen peace L. what they think their needs are and I do think it is going to be similar to what we heard from senator from South Carolina is your significant increases he said the increase only fall into the other gonna increase again but the point you brought up is also critical Orton and we found that is we already struggled through the repatriation of different Americans from around the country where we had to put many of these in quarantine issue you know is Terry bases because many of the state or local health departments really kind of developed that system where did they put somebody who looked to be in isolation is homeless how do you develop the system so this has to be part of it too is it there’s there’s certain actually that’s intrinsic for hotels as you mentioned at the point that was made by one of the other senators is so important about individuals that protects like they the meatpacking individual that has to go home and self isolate maybe I have ability to comb self isolated it to general generals generation house with about twelve other people mechanisms to be brought in we have an S. the way the Dennis I cases there thanks and then do the appropriate public health measures and if you just have to be comprehensive it’s going to be developed and jurisdiction Annika at a time I see no reason why these are not a transparent documents as they get it completed and it really is a tribute to what the congressional support given so far as I said one point six billion dollars spent in the state and then begin to do this in addition of the resources that we’ve gotten but it is fundamental people underestimate how important it is that we have a highly functional comprehensive aggressive I thank you seem program so that the next to this outbreak we stay in payment we don’t have to switch mitigation right thank you thank you doctor read feel appreciated it sounds to me like we still got a lot of work to do so thank you thank you very much senator Jones senator brought thank you chairman been so much discussion about testing in general listen to center Romney earlier I think center Kane mentioned it everybody has doctor Han if you remember when we first met I said is the FDA going to be more entrepreneurial is the FDA gonna kind of not be a stodgy talking then about how we fix the health care system in general now this is brought into clear focus I’ve got a timeline and I’m gonna submit for the record it shows from January twenty fourth through March fifth and I want to emphasize what senator Burr asked earlier has the administration ever put an impediment in front of trying to get to testing Dr Han this all end up in a question in a moment but there was a span of time from January twenty fourth through March fifth that I hope the American public looks at it it gets back to what’s wrong with our health care system in general

early testing from what I’m seeing was created by the fact that the CDC said it was going to do its own task the south Korean Tessa gets cited so often was not going to be looked at we had to do our own I know the FDA work with the CDC but the long and short of all of this is that for nearly a month this was in mad your cap Craddick swirling the FDA prevented private and academic development of task for weeks the CDC decide denied access to functioning tests as I cited in South Korea this created through all the red tape and bureaucracy to where we had to come up with a one size fits all approach due to the uncertainty of the virus and we are stuck with that now I don’t want to dwell on that necessarily because I think those are mistakes that we made I’m tired of having it heard that it’s the administration’s fault Dr Han I’d like to ask you this question in that spirit of what we talked about during your nomination process here going forward will we shed some of that stodgy miss will we look to get therapeutics and vaccines through the system in a quicker method because I fear if we don’t and if we treat through bureaucracy how we did the early period of testing we can be labor this end of the distant future and at that point there there’s going to be not only the carnage from the disease itself but from the economy to deal with so I’d like your comment on that one month stretch what accountability the FDA and the CDC have a man whether it looks better in terms of moving more quickly into the future US thank you said a run for the question on our timeline of that purity it demonstrates that we began working with test developers beyond CDC on January twenty fourth and had double digit number of test developers working with us one of the issues that we identified was in fact availability of the virus on and other supplies to actually get that test development done in a timely fashion senator I completely agree with you that this is an opportunity for us to take a look and determine how we can do things better and I think that’s a really important thing for all of us to do and certainly the FDA can promise you would do that looking forward cirque I can convince you that we will look at every one of regulatory authorities have done so during this outbreak we have provided significant flexibility and I tried to provide the right balance between regulatory flexibility enabling of the great test developers in therapeutic developers in this country with the need to ensure that our gold standard of safety and efficacy is in place we have renamed it manufactures we’ve learned a lot from them as well as the other stakeholders and we will continue to learn and we will like to meet you Sir implement the changes that are necessary to make sure that we can act in a more nimble way but still protect the safety and efficacy of medical products thank you I’m doctor found she had taking a page from your anti aids playbook and then implemented a formal clearly defined treatment review pathway can we do that for covered nineteen in a similar parallel track you put in the place back then in the nineties in fact I’ve got a bill called the promising pathways act that is based upon that protocol you put into place can we do that more quickly get through to therapeutics and vaccines here with over nineteen well it’s it’s a different story but some similarities if you’re referring to the parallel track that I put into place back in the in the late eighties which was when there was no availability of drugs at all H. ID N. mode with testing drugs within a protocol that we would make it available outside of the protocol in what is ultimately turned out to be compassionate use so what we did is we didn’t want to interfere with the integrity of the protocol to determine the control way what was safe in what was effective but there was a dire need for some sort of accessibility to those drugs outside of a clinical trial those who might even have some chance of having it and in fact that was really in many respects the birth of the really firm concept of compassionate use and

in fact there is a version of that we shall handover to too commissioner on that is you know when you have expanded access in emergency use authorizations but drugs that have not yet been fully proven in a clinical trial so there is somewhat of an analogy the similarity between what I did in the nineteen eighties and what is actually being done the FDA announces Steve if you might want to comment on that I think that’s right a judge found G. the emergency use authorization process by statute allows us to have flexibility and assess the risk benefit ratio on a public health emergency and we’ve done that on the therapeutic side in three separate occasions and continue to look at those requests as they come in thank you very much thank you of thank you senator Braun senator Rosen here I am I thank you Mr chairman for up and bringing this hearing and I want to thank the dedicated doctors today for their a lifetime of work in study and passion we are a great nation for all of your your lifelong commitment in fighting disease and not just the United States but around the world and you know as I talk to Nevada’s about safely re opening the economy one question that frequently comes up is that what are we going to have a vaccine like everyone’s talked about in about a travel and tourism of course a lifeblood for us and the jobs associated with those industries can only fully come back and we know it’s safe to travel and visit our our our work in our hotels casinos restaurants and attractions ultimately to make this happen we have to build confidence in our visitors it’s safe we need a vaccine and that research is extremely important however understanding that this takes time to develop and insure both safety and efficacy I’d like to hear more about what research is happening regarding preventative medication research and could be helpful in the time frame before a out especially before one is widely available so I’d like to ask if this could be part of the path helping us begin to re open our economy safely and bring visitors not only back to the data entry slip doctor strategy what research is currently happening to identify potential monoclonal antibody preventative treatments are other therapeutics if the right antibody is identified or can be identified but this be used as a preventative medication to block open nineteen virus I’m latching on to those whole cells much like the treatments for rheumatoid arthritis severe asthma or other diseases and secondly what preventative medication options like this complimenting the effectiveness of acts of the vaccine once it’s a saleable yes thank you for that question senator Rosen and that’s an excellent question and then all of the therapeutic interventions that we are developing and you mentioned several of them they could be direct antivirals along the line of room that Serbia but that’s just on one of a number of possibilities since there are several viral targets replication cycle using convalescent plasma into preventive modality as well as monoclonal antibodies in a preventive modality are in fact all feasible and will be pursued in parallel with the development of a vaccine the model using drugs and other interventions that are effective is really a great success story in the issue with HIV aids because many of the interventions that were developed for the full treatment of an infected person are exquisitely effective in preventing infection of HIV so that’s the kind of model that we work out in parallel with treatment for disease is he using as treatment as prevention I believe that will be a part of our effort at the same time as we’re putting a full court press I’m trying to get the vaccine so it’s an excellent question I know I am a time lapse I’m just going to kind of abbreviate this the second most important question that I get not just from our first responders and people worried about but generally what does the next generation of PP need to look like for all of us as we go about our lives not just as workers say depending on your work you may need something stronger more specific as all of us as we want to go out and shop around to eat or whatever those things are get on an airplane should mask made of a certain material loves our handkerchiefs effective can you talk about PP for the general public

well you know the best VPN for the general public if possible right now is to maintain the physical and social distancing but as we said and I think all of us would agree there are certain circumstances in which it is beyond your control when you need to do necessary things like go to the drug store to get you cation go to the grocery store and get your food that in fact you need some supplementation it just physical distancing that’s the reason why some time ago the recommendation was made I believe it was Dr Redfield at the CDC first said that about getting some sort of a covering we we don’t want to call it a mask because back then we were concerned we’ll be taking masks the healthcare providers but some sort of mask like facial covering I think for the time being should be a very regular part of how we prevent the spread of infection in fact the more more as you go outside right here in where I’m sitting in Washington DC you can see many people out there with massed on which gives me some degree of comfort but people are taking this very seriously thank you queues Rosen on senator thank you all for being here and for your service US admiral draw before I start my questions I want to recognize her new role as the US representative to the world Health Organization mitigating a resurgence of this pandemic we’ll take global cooperation in order to do that we need accountability and transparency at the WHL this organization was established to ensure the timely flow of accurate unbiased information on global health emergencies just as this performance reforms must be made in order to restore the trust that we need here I hope you’ll work with our allies to push for these reforms this question I have two questions the first one is for Dr Redfield Ella and and Dr Redfield George wondering how we got here today fourteen hundred deaths the third of George’s work force out of work I’m incredibly concerned about the cover up in the misinformation coming from China and their efforts to suppress lifesaving saving information at the outset of this outbreak as we can set as we continue to reopen our economy safely we have to take steps to ensure that another outbreak cannot take hold of the world in this way I understand CDC has worked with the Chinese CDC on global health security for decades can you comment on the level and the timing of the M that you received and relied upon from your Chinese counterparts as this virus emerged thank you very much senator and I hope I want to echo how important global health security is as national security priority for this nation and we’re gonna need to be able to be able to respond to that as long as we are a nation CDC PCS had relationships with countries around the world we have offices and over forty five countries right now people over sixty and one of those happens to be China where we have a U. S. CDC that’s with the Chinese CDC we work together for decades particularly on influenza and emerging infectious diseases and that it’s been a very productive collaborative scientific to scientific interact when this regional outbreak of pneumonia of unknown etiology came from the regional seafood market obviously discussions with US personnel that being with Chinese CDC I personally had discussions as early I think CDC did is anyways and myself January third counterpart to discuss this so I decided I difficult we had very good interaction I think you know that’s different than the the broader Chinese government level thank you Dr Redfield I have a final question for each of our our great witnesses today and it’s one that my constituents often ask me of the mainstream media and indeed some of my colleagues in the Senate seem to want to paint each of your relationships with our president during this wartime effort is confrontational and lacking consensus can you categorically say here to the American people today whether this is true or untrue from your testimony today I’ve seen a very coordinated effort to address this with the administration to combat this pandemic can you give me a sense of whether this character is what the characterization is right isn’t whether it’s true or untrue thank you I asked Dr

Fauci to answer that first yes No there is certainly not a confrontational relationship between me and the president as I mentioned many times I give advice and opinion based on evidence based scientific information here is that the respects it gets opinions from a variety of other people but in no way in my experience over the last several months has there been any confrontational relationship between us thank you doctor Redfield Dr Han again I put it with the doctor and she said then we’re there to give our best public health device and that’s what we do is grounded in data science and I’ve always felt free to give the best public health I said I think it needs to be given at the time and it’s always been done in a very professional senator Loeffler this is Steve Hahn I do not have a confrontational relationship at not had a confrontational relationship with the president he asks questions I had given him my honest answers rooted in data science I mean he’s listen respectfully to those incorporating that into his decision making and so I have nothing else but to to echo my colleagues we work very closely together all the scientists all the physicians of course and after Burke’s other scientists within our group we have a very productive working relationship with each other and also with the president and vice president it would not be confrontational and I certainly feel that we have the ability to honestly state our opinions and recommendations and that has been that way since the thank you senator left for us Murray do you have closing comments I I do and if it’s already have a couple two quick questions sure well thank you you know I don’t doubt you well president trump and otherwise there is no question that essential part of re opening our economy seat is exactly developing and distributing a vaccine for Coleman nineteen we need to plan now for a vaccine once it’s proven safe and effective but it is absolutely crucial this planning process from the clinical trial to distribution and administration recognizes and addresses racial and ethnic disparities in our health care system that we all know for too long we’ve been overlooked and kind of knowledge in this country and we have to ensure equitable axes access to this vaccine for everyone Dr Balaji when we start with you what steps is NIH taking to make sure that clinical trials Rickover nineteen back to vaccines and therapeutics accounts for racial and ethnic disparities yeah thank you very much that’s a relevant question senator Murray and in fact in the design of a clinical trials and the sites that we chosen in a clinical trial network it’s going to be very representative of being able to get an already and pay and and populations at most risk to be part of the trial so that we know during the trial what the relative efficacy as well as potential adverse events it’s something we started back in the days of HIV when we try to get good demographic representation and we’re going to do that with these guys thank you thank you and doctor Han tell me what steps FDA is taking out to make sure the United States is prepared to produce a sufficient number of vaccines including the necessary manufacturing supply chain capacity supplies my brows and stoppers and syringes thank you senator this is an effort that started as a partnership with the vaccine developers and the NIH in their efforts so one of the most important things man has been the data transparency sharing of data well of the agency and and with the manufacturers so we can understand what they capacities are what the needs are from the supply chain and then how to actually share that so that if one manufactures vaccine doesn’t go forward we can use the key and of that manufacture for another manufactures backseat I’m very happy to report that on the work of Dr marks and doctors out just as lead to that sort of effort we ought we developed as I mentioned before this Gantt chart that describes all the steps to go forward with faxing ation including those supplies to describe it is somewhat complicated ma’am in that we may very well have hopefully five to seven different candidate vaccines that may need different supplies associated with them we’ve been up front and then a final supplies where they’re available in then working with

the manufacturers to make sure that they available okay thank you thank you very much Mr chairman thank you and thank you for all of our witnesses or joining us today it is really clear to me that we have more work to do before we can safely get back to work and school and some semblance of normal life in our country we still need testing could be fast free and everywhere and we need the White House the lay out each details plan to make that happen we still need adequate personal protective equipment both turned off your workers and for workers at our businesses and schools when the time we still need guidance from our experts so our communities have the information that they need to reopen schools and businesses safely confidentially confidently and complete competently and so public health workers and health care providers have the information they need to keep their patients and communities safe and well experts have been clear that the day we can safely be often maybe a ways off there’s plenty for us to do in the meantime both the plan ahead for example to make sure that once we have a safe and effective vaccine we can produce and distributed to everyone quickly at no cost I do address the immediate challenges for example making sure there are mental health resource for everyone’s coping with the challenges that are prevented presented by this virus from the stress of physical isolation loss of income to the trauma anxiety patients and workers to go on the front lines so I’m gonna keep pressing Congress and the White House to drive the action and leadership that our communities need and I hope Mister chairman that will continue to have the opportunities like this year directly from the experts and ask pressing questions about how to get our country through this crisis it’s clear we’ve got a lot further to go a lot more to do and so I hope that is our efforts continue will be able to bring any of you back our witnesses for another hearing seeing again thank you to all of you thank you senator Murray I I’ve got a clarification question apple quick comments and then we’ll we’ll take the witness is wind up here in my is I want to make sure I didn’t create some confusion either way I asked a question about going back to school last doctor felt you first about treatments and vaccines have docked at Roger Waters about this but I thought I heard was the doctor felt she shared that the actions are coming as fast as they ever have but it’ll it’ll be later in the year at the at the earliest performances at that there’s some treatment so of that that have there are modest but they’re promising there could be more but that that doesn’t mean you shouldn’t go back to school that that that would be more we’re testing strategy it in my right adductor approaching you didn’t you didn’t say you should go back to school because we will do it now see but for now absolutely not Mr chairman what I what I was referring to is that going back to school would be more in the realm of knowing the landscape of infection with regard to testing and has admitted you are set it would depend on the dynamics of the outbreak in the region with the school is but I did not mean to imply it all any relationship between the availability of the vaccine treatment and our ability to go back to school you’re quite correct thank you and what I heard from Andrew Jr what was that you’re ramping up current technologies you are hopeful for doctor Karlan doctor Collins shark tank at the national institutes of health but in any yeah you would expect to have the capacity in the fall of forty to fifty million test a month and that ought to be adequate for the principal of a middle school or even a chance of a campus okay shoot divine at the design and testing strategy that could provide for example a antigen what yes the screen all the students in the school investor sector yes Sir Mister chairman and and again we want to make its many tests available as as absolutely possible what I eat what I said is what I feel comfortable with knowing all the production schedules on being in the position of being able to work with the FDA and CDC that we should have forty to fifty we will have forty to fifty million I test available per month that need to be deployed in a smart strategic way depending on the dynamics you know in that area in in region still having testing even widely does not nullify the need that we’re gonna have to change our

practices in terms of sanitation personal cleanliness distancing face masks things like that given what the dynamics could be could you thank you for those comments because given the given that number of chess that will be available in the state three months or as we ramp up to that number three months from now that should give every principal every every every chancellor of every college campus and again we have about five thousand campuses and a hundred thousand schools eight eight some reassurance that testing as well as the common sense hygiene practices you talked about could be used to develop a strategy for re opening school or school in August and then two quick comments one is a server Marie talk about the national land which was in the legislation that we all go to war there’s a little bit of a push and tug between what’s national what’s federal what Washington should do what the state should I’ve always thought it’s a mistake to save federal equals national in other words over nineteen is clearly a national problem but that doesn’t mean the federal government supposed to do everything for example in testing the law actually requires states Joe you had will draw up a what their plans are with their needs are and then you said that during the month of may you had a series of state plans that are twelve and a half million yes and you thought you could help me that all the other hand you also noticed missions in the marketplace for some supplies to the federal government is buying those and allocating them to the state so we don’t want to get in a situation where Edward Jr was telling all states what do governor Lee Tennessee doesn’t really want you to tell him what to do he wants to tell you what he’s doing and let you comment on it I don’t think governor Cuomo wants president trump building work to do so I ate a question between what Washington does and what stage did I think we have a testing contact tracing isolating national strategy and plan led by the governor’s are designed by the federal government is a national effort in the national effort clearly is to do the research the treatments and vaccines what we’ve heard today is that’s coming along on a faster track than we’ve ever seen received before finally I want to reiterate I thought this was a very helpful hearing I thank the senators and the questions I think anybody who I am watch would be impressed by the diversity of opinion and the honest answer is we got from four really remarkable experts you are in the midst of this every day I want to re emphasize what I said earlier that I intend to make sure that we focus senator Murray suggested we need to have more hearings I agree with her and as we deal with this pandemic we need to make sure we’re ready for the next one what can we learn about faster treatments and vaccines for the next one what can we learn about the stockpile well to be in it want to be magic for the next one what can we learn can we learn anything about having hospital bed so we don’t have to shut down the and bankrupt them and we push Asians out in order great beds for sick people from the pandemic what about states and hospitals it sell off their EP in between pandemics how do we keep our focus in between pandemics when we’re have so many important things to be worried about this country how do we make sure that we in Congress sustained and fund all the things that we need to do so and and I want to make sure that we do that this year I mean we are collective memory is short so while we’re all worried about this we need to not only deal with this crisis but get ready for the next I thank the witnesses would choose for their extra time I hope they get a sense that our job we see is the create an environment in which you can succeed because abuse succeed our country succeeds which is what we desperately want the hearing record will remain open for ten days members may submit additional information from the record within that they would like thanks to everyone for being here today hearing is a jerk thank you very much Mr

chairman thank you senator Murray