White House COVID-19 Response Team, Dr. Fauci Press Conference Transcript February 1

Andy: (00:00) ... national strategy to defeat COVID-19 at the end of the briefing. But first, let's get a quick CDC report from Dr. Walensky, an update from Dr. Fauci, and Dr. Nunez-Smith, who will talk about the challenges we are facing to improve health equity in the face of this pandemic. Let's start with Dr. Walensky. Dr. Rochelle Walensky: (00:21) Thank you so much. Good morning. I'm glad to be back to share the latest updates on the state of the pandemic. I'll start with an overview of the data. Overall, while we continue to see decreases in COVID-19 cases and new hospital admissions, deaths also continue to rise. Cases remain at elevated levels. So let's start with the cases. Through January 30th, 25.9 million COVID-19 cases have been reported to the CDC. During the week of January 24th to January 30th, a seven day average of new cases decreased 14.5% to 149,000 cases per day. The seven day average of new hospital admissions for patients with COVID-19 during the week of January 23rd to January 29th also decreased by 14.6% to 11,800 admissions per day. However, 85,655 people were hospitalized with COVID-19 on January 29th. Through January 30th, 438,035 deaths have been reported to the CDC. During the week of January 24th to January 30th, the seven day average of deaths increased 2.4% to 3,146 per day. While the recent decline in cases and hospital admissions are encouraging, their count counterbalanced by the stark reality that in January we recorded the highest number of COVID-19 deaths in any months since the pandemic began with over 90,000 deaths recorded in January alone. Next, I want to give you an update on COVID-19 variants surveillance. Variants remain a great concern and we continue to [inaudible 00:02:10] them in the United States with at least 33 jurisdictions reporting 471 variant cases as of January 31st. 467 of these cases are now B117 variants first detected in the UK, and cases of this variant have now been detected in 32 states. Three of the cases are the B1351 variant first detected in South Africa. Dr. Rochelle Walensky: (02:38) Two states have reported cases of this variant. This includes one confirmed case in Maryland over the weekend and two confirmed cases from South Carolina last week. CDC has followed up with Maryland to offer technical assistance, including additional case investigation and laboratory support. CDC is also a working with the health department of South Carolina to provide laboratory support for local contact tracing activities related to the two cases there. Finally, there's also one case of the P1 variant for one first detected in Brazil, which has been confirmed in one state, Minnesota. CDC is not currently providing technical assistance in this case, but stands ready to assist if the state requests. CDC has been working on multiple fronts to improve our ability to adapt and understand these variants and the recent rise in the number of variants detected in the United States is likely due at least in part to our expanded ability to sequence virus samples. Dr. Rochelle Walensky: (03:40) Since November, state health departments and other public health agencies have been sending virus samples to CDC for sequencing and further analysis. This system called National SARS-CoV-2 Strain Surveillance or NS3 continues to be scaled up. We've also established contracts with large commercial lab partners to conduct much of this work. They are currently analyzing 3,000 samples per week and have committed to analyzing 6,000 samples per week by mid February. As a result of these efforts, our throughput of sequences has increased tenfold in the recent weeks, going from 251 sequences that were sequenced during the week of January 10th to 2,238 sequences that were done during the week of January 24th. Additionally, CDC is collaborating with seven universities that are working with public health agencies to identify variants. Dr. Rochelle Walensky: (04:38) And we have provided $15 million in COVID-19 supplemental funding to several health departments in the United States to accelerate the integration of next generation sequencing and bioinformatics into the US public health system. Finally, we are leading a coalition of 200 cross sector organizations to set standards and share information about SARS-CoV-2 sequence-based surveillance. This is a good start. However, we recognize that more resources and capacity are needed to increase our country's sequencing surveillance and outbreak analytics capacity at the levels demanded by this crisis. Overall, this means with the support of these activities, we will now be able to sequence at least 7,000 samples weekly. With cases high and variants emerging, I want to stress to the American people the importance of taking a few simple actions we can all take to protect each other and to stop the spread of COVID-19. Dr. Rochelle Walensky: (05:38) First, wear a mask, stay six feet apart when you are in public and around others who do not live in your household. Second, please avoid crowds and poorly ventilated areas. Third, now is not the time to travel, but if you must travel, you must wear a mask and follow other CDC and local guidance in order to protect yourself and others while you travel. And finally, please get vaccinated when it's your turn. More than 25 million people have now received at least one dose of the COVID 19 vaccine in the United States and our latest safety data continue to show that vaccines are safe with no new safety signals and rates of rare serious adverse events like anaphylaxis comparable to other vaccines. When we take these actions, there is less virus spreading and the conditions that produce variants are decreased. Thank you. I look forward to your questions in a few minutes, and I will now turn it over to Dr. Fauci. Dr. Fauci? Dr. Anthony Fauci: (06:42) Thank you very much, Dr. Walensky. I'd like to address three separate points very briefly and then we could leave that open for questions and discussions. As you know, last week with the data that came out from the J&J [inaudible 00:06:57] vaccine trial, as well as information from the Novavax trial. I think it is important for people to appreciate that we now have the three separate vaccine platforms, MRNA, soluble recombinant protein and viral vectors, in the mix right now. Obviously, the J&J will be putting their information into the FDA for an application for an emergency use authorization. The reason I bring this up is that as these things roll out, they will have different degrees of what's called point vaccine efficacy. So we know that we had a 72% overall efficacy in the United States for the J&J, but important to point out when people ask about the difference between 72 and 94, 95 with the Moderna and the Pfizer is the fact that when you look at serious disease, hospitalizations and deaths, it has had a profound effect on that. Dr. Anthony Fauci: (07:57) So as we get into the next weeks and months and more vaccines come out, there'll be common use of them in the big pool of vaccines, not only for the United States, but worldwide. But there may be some advantages that you might see with one versus the other. For example, the idea of a single dose, the lack of a very strict cold chain, as well as the availability of having a large number of doses. So I just bring that to your attention. Now, Dr. Walensky mentioned the issue of variants, and there's a real relationship now between the vaccines that have already been given an EUA, those that will get any UAE and how we address the variants. When the variants were first recognized in South Africa and in the UK and in Brazil, one of the important things that one does is take a serum from individuals who have been vaccinated with the available vaccines and see how well they do against the variants. Dr. Anthony Fauci: (09:04) What became clear is that with regard to the variant, namely the 117, that was a variant that was predominant in the UK, there was very little impact on that. And actually that was shown by the Novavax study, which was done in the UK when they had a 90% efficacy and the dominant variant there was the 117. So you would expect that it reflected what you would see. But we do know that antigenic variation does have clinical consequences because when you looked at the South African isolates, namely the 351, that one had a multifold diminution in the efficacy of antibodies induced by various vaccines that are in use now, but it was still within the cushion level of providing some protection. The reason that was important is that that was reflected in the J&J trials. So we're learning not only that we have more vaccines, but we're learning about the virus and how it interacts with our ability to protect with vaccines. Dr. Anthony Fauci: (10:15) Because when you look at advanced disease, hospitalizations and deaths, there was a profoundly positive effect by the vaccine, even though the effect numerically was diminished. So for example, there was about virtually no hospitalizations or deaths in there. Now getting to the third point, which I believe is important and relates to what Dr. Walensky said, that it is important even when you have of a variant circulating in which you may not have a 95% efficacy to prevent infection, it is very important that you might very, very positively prevent serious illness and serious disease. We've been asked questions often, well, if you have these variants and they seem to be alluding the vaccine a little, should we really be getting vaccines or should we wait for the next generation of vaccines? The answer is, you need to get vaccinated when it becomes available as quickly and as expeditiously as possible throughout the country. Dr. Anthony Fauci: (11:29) And the reason for that is that there is a fact that permeates virology and that is that viruses cannot mutate if they don't replicate. And if you stop their replication by vaccinating widely and not giving the virus an open playing field to continue to respond to the pressures that you put on it, you will not get mutations. So when we're looking at what we have here in the United States, as well as globally, when we talk about efficiently- Dr. Anthony Fauci: (12:02) Well as globally, when we talk about efficiently and getting these vaccines out there and into people as quickly as we possibly can, not only are you going to protect individuals from getting disease, not only are you going to protect them from getting infected, but you are going to prevent the emergence of variants here in our country. And when you look at the global situation, which is the reason why we want to make sure we're part of a global community, and we recently have joined the COVAX, which is a consortium to get people vaccinated throughout the world, is that the only way we're going to completely stop mutans is if we stop this throughout the world. So again, Dr. [Walensky 00:12:45] gave you the four or five things you need to do to protect yourselves. I want to emphasize the last thing she said, which is very important. When the vaccine becomes available to you, please get vaccinated. So I'll stop there and hand it over to Dr. Nunez-Smith. Dr. Nunez-Smith: (13:06) Thank you so much, Dr. Fauci. So today, I want [inaudible 00:13:10] assess the data that we need to drive an equitable response. Achieving equity requires an understanding of the disparities that exist, and we do that through understanding the data. So to be very sure, COVID-19 equity must be achieved through a very broad lens, including by age, disability, justice involvement, poverty and income inequality, world geography, sexual orientation, and gender identity. Dr. Nunez-Smith: (13:39) But today, however, I want to provide an overview of the current state of our nation's COVID-19 data as broken down by race and ethnicity. So here's what we know about COVID-19 and equity. We know that this disease has not affected all racial ethnic groups the same. So as you can see here, the rates of COVID- 19 hospitalizations and deaths are higher among individuals who identify as black, Latino, as well as among American Indians and Alaska natives. Dr. Nunez-Smith: (14:09) Compared with white people, American Indian and Alaska native persons are 3.6 times more likely to be hospitalized while Latino persons are 3.2 times more likely and black people, 2.9 times more likely to require hospitalization. So similarly, when we look at death rates, 2.5 times higher among American Indian or Alaska native persons, 2.3 times higher among Latinos, and 2.1 times higher among black people. So with regard to cases, it's a bit of a different story and graphs like these, though, don't tell the full picture. So at first glance, it may look like racial and ethnic minority groups do not have a substantially higher risk, especially following the increase of cases you've seen among white Americans [inaudible 00:14:53], but just a couple of caveats to that conclusion. Dr. Nunez-Smith: (14:56) So the higher rates of hospitalization among black, Latino, and American Indian, Alaska native persons are due in part to higher rates of chronic disease, but also reflect [inaudible 00:15:05] access to testing in many communities of color. So among these particular groups, testing does happen more frequently at the point of symptomatic illness requiring hospitalization, which is often a function of inadequate access to testing in the first place. Dr. Nunez-Smith: (15:20) So in these groups, we are not capturing many people who have asymptomatic or mildly symptomatic infection. And as you see, when we advance into the next slide [inaudible 00:15:29] with our cases data is the denominator reflects different factors in different populations. And those differences are really built upon preexisting inequities. So still taken together, these insights from our data are critical for our ability to target and triage our response. Without good data, we are at a disadvantage in terms of equity planning. Dr. Nunez-Smith: (15:49) So what we don't know about COVID-19 and equity, there's still far too much that is in this unknown category. So the numbers you see here are current, as of this past week. This is the current state of the data being reported to us from states and localities across the country. So returning to cases, you see that 49% of COVID 19 cases have no reporting race or ethnicity. And that means we don't know the race or ethnicity for nearly half the people diagnosed with COVID-19 in the country. Now that 49% of COVID-19 cases may, in fact, marry the demographics of the other 51%, but it is more likely that it reflects some inherent inequities in how our data are collected and reported in different places, based on resources and how much equity is prioritized. Dr. Nunez-Smith: (16:34) So our hospitalization data still has nearly a quarter of race, ethnicity data missing. And at this point, we have race or ethnicity for nearly all of those who have unfortunately died from this disease. Dr. Nunez-Smith: (16:45) So I want to highlight these last two, as they mark significant improvements in the completeness of data from the earliest days of the pandemic, when the percentage of unavailable data was much higher for both of those categories. Dr. Nunez-Smith: (16:57) So we saw that through advocacy, through commitment and a call for an emphasis on equity, an improvement and reporting on those hospitalization and mortality data from the great majority of our state and localities. Dr. Nunez-Smith: (17:10) So I want to turn out to our most recent vaccination data. As of January 30th, we're missing 47% of the race and ethnicity data on vaccination. So let me be clear. We cannot ensure an equitable vaccination program without data to guide us. The CDC will be releasing additional data regarding race of ethnicity and vaccine uptake soon, but I'm worried about how behind we are. We must address these insufficient data points as an urgent priority. There are a few reasons why we were already behind on this, only a month and a half into the vaccine rollout. The lack of federal coordination previously, the uneven roll out among the states, inconsistent emphasis on equity in the earliest days of vaccination. But those dynamics, they don't just hurt our statistics. They hurt the communities are at the highest risk and have been the hardest hit. Dr. Nunez-Smith: (17:58) So finally, on our last slide, what actions are we taking? When the Biden-Harris administration began on January 20th, we knew we would be starting without the full data picture necessarily to drive equity. And that's why President Biden issued an executive order on advancing racial equity and support for underserved communities on day one. And this order does a few things to help us in this work. So first, it forms a new equitable data working group. It requires we collect data that are often not desegregated by key demographic variables. And it improves efforts to measure and advance equity. Dr. Nunez-Smith: (18:31) So coupled with the executive order, ensuring an equitable pandemic response and recovery, we also established a COVID-19 health equity task force, which will offer additional recommendations on how to expedite data collection for communities of color and other high risk groups. Dr. Nunez-Smith: (18:46) So again, these challenges reflect longstanding and deeply rooted systemic challenges. We're not suggesting that these problems are easily solved. What we do believe, though, is that the way we get America vaccinated and the emphasis we place on reaching the hardest hit communities is just as important as hitting those goals for the number of people vaccinated. This is complex, but we want to be held accountable and wanted to use today to set the baseline for where things are and to let everyone know that we're committed to making progress from here on out. So thank you for your time. And with that, I'll turn it back over to you, Andy. Andy: (19:23) Thanks, Dr. Nunez-Smith. So in his second full day in office, President Biden introduced our national strategy to defeat COVID-19 with seven principle components: transparency, speeding vaccinations, public health measures like masking, driving manufacturing, increasing testing, health equity, and global engagement. Today, I will update you on progress and developments across several of these areas. Andy: (19:55) I want to start with an exciting announcement. The Department of Defense and HHS made an announcement today about what will be the country's first over the counter at home COVID test. The test is made by a company called Ellume, and it's on a testing platform that was developed in the NIH's RADx initiative. Now, these are over the counter, self-performed test kits that can detect COVID with roughly 95% accuracy within 15 minutes. They can be used if you feel symptoms of COVID-19 and also prescreening for people without symptoms, so they can safely go to work, to school, and to events. They are appropriate for people ages two and older. Andy: (20:50) The test is performed in what is called a mid-turbinate nasal swab, which basically means it's less invasive than the long nasopharyngeal swab that people may have seen on the news. After you take the swab, you put the sample into a digital analyzer, which will send a results to your smartphone in about 15 minutes. Andy: (21:16) Making easier to use tests available to every American is a high priority with obvious benefits. Ellume has been ramping up manufacturing and will ship 100,000 test kits per month to the US from February through July. That's good, but it's obviously not where we will need to be. Andy: (21:37) So I'm excited to announce that today, the Department of Defense and HHS has awarded $230 million to Ellume, in order to scale the manufacturing base and capacity of this easy to use test. Thanks to this contract, they'll be able to scale their production to manufacturer more than 19 million test kits per month by the end of this year, 8.5 million of which are guaranteed to the US government. Andy: (22:10) The ability to quickly test, to contact trace and quarantine, is a linchpin of our national strategy and will be a vital part of containing the virus and stopping community spread. But in the interim, and while vaccines are still being rolled out, as Dr. Walensky repeatedly reminds us, wearing a well-fitting mask is vital. Without masks, the virus and the new variants will have too easy a time continuing to grow. The CDC is systematically looking at strategies to minimize spread and locations where spread is highest, and public transportation is one of their priority areas. Andy: (22:53) On the President's first full day in office, he issued an executive order requiring mask wearing during travel. Now on Friday afternoon, the CDC issued an order requiring travelers to wear masks when utilizing public modes of transportation, like planes, buses, trains, and ships. And after that order was issued, the TSA announced directives to the public transportation sector to require masking. This is a very meaningful step, and it's also a patriotic one that improves safety and demonstrates respect for those around us. Andy: (23:37) Next, I want to give an update to our vaccination program. We know that even as millions of Americans are getting vaccinated, many who are eligible for the vaccine are still frustrated as they try to make appointments and determine where vaccines are available. We have been steadily increasing the rate of vaccine administrations, the seven day average now of 1.3 million vaccines a day. As of last- Andy: (24:03) ... 1.3 million vaccines a day. As of last evening, over 25 million Americans have had at least their first shot. That's one in 13 Americans, one in 10 adults. We've talked here about the difference that exists between the amount of vaccine we have shipped to states and the number of vaccines that have been administered. We've now delivered 50 million vaccines and 31 million have been administered. Okay, so one question everyone has is why is there such a difference, 19 million between the doses delivered and administered? Let me explain some of the source of that difference. When the rollout of the vaccine first began in December and early January, it's no secret that the program got off to a slow start. This slow start obviously caused a delay in people getting their first doses. But not only did this delay first doses, but it created a backlog of second doses that have been sitting at states waiting for the three to four week period to pass before they can be administered. Andy: (25:16) That's three weeks in the case of Pfizer, and four in the case of Moderna. Given this, as people begin to come back for their second shots, in addition to all of the other continued improvements that we are witnessing and participating in state vaccination programs, we expect the efficiency of doses being administered will steadily improve. On January 20th, states had administered 46% of their inventory. Today, that number is 62%. We are focused on this every hour of every day. There is another thing going on that I want to alert people to, particularly the nation's providers. We believe that some health care providers are regularly holding back doses that are intended as first doses, and instead keeping them in reserve for second doses for patients. We want to be clear that we understand why healthcare providers have done that, but that it does not need to happen and should not happen. Andy: (26:29) In some cases, providers are canceling appointments with patients they could take, preventing Americans from getting their first dose of the vaccine as quickly as it needs to happen. We completely understand that this has been a direct result of the lack of predictability many states and providers have had regarding how many doses that they would receive. That's one reason why last week we announced that the federal government will be providing a continual three-week window into vaccines that will be shipped. With this action, states and vaccine providers will more rapidly use their allotment of first doses to vaccinate as many people as quickly and as equitably as possible because they now have the predictability that the second dose will be there when the time comes. Lastly, I want to give an update on the topic of low dead space syringes. Low dead space syringes are the syringes that allow the sixth dose of the Pfizer vaccine to be administered. Andy: (27:39) On Friday, in answer to a question, I said, "100% of Pfizer kits contained low dead space syringes." As promised, I went back and checked. The facts are that every vial of Pfizer does indeed come with the equipment to get six doses out of a vial. To further clarify this, approximately 80% of Pfizer kits include the most common low dead space syringes and 20% use other syringe types that can be used to get the sixth dose out. This accounts for the fact that in some cases, a different type of syringe is preferable. More to come later this week. But as of 11:30 on Monday, we think this is a productive start to the week. With that, we're happy to take a few of your questions. Speaker 1: (28:30) Thank you, and thank you everybody for joining. As always, we have time for a few questions. And as a reminder, we'll have time throughout the week to answer some more. So if you haven't already, please raise your hand. First. We're going to go to Joe Henke at channel 11 in Atlanta. Joe Henke: (28:52) Hello, this is Joe Henke here, 11 live news, NBC affiliate in Atlanta. Quick question, is there a position from the White House on some of the interviews we've heard, if whether states should be focusing on just a single first dose and getting as many people vaccinated as possible versus doing the full two doses of the Moderna and Pfizer vaccines? Andy: (29:13) So maybe I will turn it over to Dr. Fauci to explain the posture. And of course, Dr. Walensky, please feel free to add as well. Dr. Anthony Fauci: (29:23) Yes. So the policy is that we certainly want everyone who gets a first dose to get their second dose when you're dealing with a two dose regimen, namely Moderna and Pfizer. And as you all know, that's 21 days for Pfizer and 28 days for Moderna. What sometimes leads to confusion among people when you say we want to get as many people to get their first dose as possible, means rather than holding back on doses that would be designated for the second dose, given that we now have more and more confidence in the even flow of doses to go to locations, and as Mr. Slavitt said that we're going to give a three week window so that people will know the doses that they're going to get and when they're going to get them, we don't want to hold back things. Dr. Anthony Fauci: (30:18) In other words, if you give 50 million doses to individuals, and then the next time around you get more doses, when you're at that third or fourth week, the first priority will always be to get the people who've gotten their first doses to get their second doses. And then additional doses will be given to the next group of people who will get their first doses. In this way, there are no doses that are hanging around. A dose that's available is going to go into someone's arm. If a person is ready for their second dose, that person will be prioritized. If a person has not gotten their first dose, but you've taken care of all of the second dose people, then you go ahead with the first dose. So that's the policy that we've had, and that is working well now. Andy: (31:09) Thank you, Dr. Fauci. Dr. Walensky, anything you would add? Dr. Rochelle Walensky: (31:13) I would just comment that the clinical trials with the two vaccines that have been authorized now, had two doses in the trials. We said we would follow the science in rolling out these vaccines, and that is our intent. 21 days is what was done in the Pfizer trial, and 28 days is what was done in the Madonna trial. There're obviously concerns if we don't go with what was done in the trials themselves, that the vaccine would be less durable, it wouldn't work for as long. And then of course there was an ongoing concern that we would see the emergence of more variants if there was low level of virus and it was allowed to mutate. So until we have further data, and there are data that are being sought, but until we have further data, we intend to follow the trials and to use the science to say 21 days for two doses with Pfizer and 28 for Moderna. Andy: (32:10) Thank you. Next question, please. Speaker 1: (32:13) Next, we'll go to Sabrina Siddiqu at The Wall Street Journal. Sabrina Siddiqui: (32:17) Thank you so much for doing this. You've obviously signaled that you're encouraged by the developments with the Johnson & Johnson vaccine. I was wondering, if authorized, how does that get incorporated into the administration's distribution framework, particularly with respect to the timetable of vaccinating most Americans by the end of the summer? And secondly, given the broader goal, of course, of vaccinating as many people as possible, what kind of a messaging challenge might be posed by its lower effectiveness when compared to the other available alternatives? Andy: (32:47) Thank you for the question. I think I'll take the first half and I'll pass the second part to Dr. Fauci, because I think he does a very nice job explaining what is actually different and what's important about those differences. So the short answer to your question is it would help. Obviously, it would help. But I want the public to understand that this administration is not getting ahead of the FDA and we are not planning for facts that aren't yet in evidence. So the numbers and the dates that we've talked about here are relative to what are the two vaccines and the two dose regiments that are on the market. Andy: (33:26) Obviously, there would be some improvement should there be a third dose. I will tell you that the expectation, however, should not be that that is an immediate dramatic shift. The expectation should be that their commitment, the schedule, if it were to be approved under EUA, would be about 100 million doses by the end of the second quarter, that's the end of June. And I would not, at this point, be overly confident that those doses would come evenly. I would expect that they would come towards the end of that contract, so just to set expectations. Dr. Fauci, do you want to add anything and take the other part of the question? Dr. Anthony Fauci: (34:12) Yes. Sure. You explained it well, Andy. Let me take the other part of the question. Certainly when the J&J data were rolled out, I actually made a comment at the NIH Press Conference that this would likely be a messaging challenge when people just think superficially of a number, 72% versus 94% to 95%. But the thing that's important that you need to put into the equation is what you really want to do. You want to prevent people from getting seriously ill. You want to prevent them from getting into the hospital, and you want to prevent them from dying. And if you look at the data, and again, the data is going to be looked at in a more granular way by the FDA and we'll be hearing more about that, that the J&J, with it's 72% overall efficacy in the USA, actually had a very good a record with regards to severe disease. Dr. Anthony Fauci: (35:11) To the point of virtually, when you were looking at South Africa, which was an important part of that trial, there were virtually no hospitalizations or deaths in the individuals, even though the number was lower when it comes to any kind of disease. So there will be situations where people will say to themselves, "Do I want to get a single dose vaccine and know that I'm protected against serious disease? Or do I want to go with a number that's a 94 to 95?" And I can tell you that there are many people who would rather have the convenience of a single dose disease, And there may be areas of the country and or different age groups, depending upon the data, as we'll wait until we get it from the FDA, that might make that more attractive. So I don't think we should be put aback- Dr. Anthony Fauci: (36:03) That more attractive. So I don't think we should be put aback by the fact that there was a difference in the initial number of any kind of efficacy, because there's a lot more to protection than just preventing from getting infected. We want to keep people out of the hospital, and we don't want people to die. And in that regard, this will be value added not only in the United States, but certainly in the developing world. Dr. Anthony Fauci: (36:25) I just got off the phone this morning with some colleagues from South Africa, and you cannot imagine how excited they are about the idea of getting a minimal cold chain required, cheap, one-shot vaccine, means an awful lot. Thank you. Andy: (36:44) Thanks, Dr. Fauci. Dr. Rochelle Walensky: (36:47) Maybe I will just add that after the FDA meets the advisory committee on immunization practices of the CDC, we'll also be meeting and we'll be giving advice on how best to utilize the vaccine once we see the primary data. Andy: (36:58) Thank you. Next question, please. Speaker 2: (37:01) All right, next we're going to go to Francesca Chambers at McClatchy. All right. I don't know what's going on there so we'll- Francesca Chambers: (37:32) Can you hear me? Sorry. Speaker 2: (37:34) Yep. You're there, Francesca. Francesca Chambers: (37:36) Okay, great. Sorry. I wasn't unmuted before. I asked, what is the demographic breakdown of who is getting the vaccine based on the data that you have? And what is the federal government doing to improve the reporting of that data? And relatedly, what is your recommendation to states based on that data to improve racial equity and how the vaccine is distributed? Thank you. Andy: (37:57) Thank you, Dr. Nunez- Smith? Dr. Nunez-Smith: (38:00) Well, thank you so much for the question. So, the data that I showed is that we really don't have as much information as we need in terms of race, ethnicity data. I know the CDC will be releasing more specifics on that shortly and soon. We have to just double down on our commitment in terms of following and leading, really, this equitable response. I think it's very encouraging, and I shared that at the beginning of the pandemic, in terms of race, ethnicity data on hospitalization, as well as mortality, the data were insufficient and incomplete and we've made great progress there. So, I think there's reason for optimism. Dr. Nunez-Smith: (38:42) We are continuing to meet with states and locals to talk with them about their equity plan, provide technical assistance along the way. So that's certainly going to continue to be part of the work that we do as we seek to get better data for equity priorities. Andy: (39:00) Yeah, so we are, of course, a lot of burden falling on states, public health departments, people giving vaccines. We recognize that, we want to support them, but we do have to ask them to really make an extended effort now to report race and ethnicity data as they submit their vaccinations. It is extremely important. There are many people in this country that will find their way to a vaccine, no matter how difficult it is. There are many other people in this country who are at greater risk of hospitalization and death, as Dr. Nunez-Smith pointed out, who we need to assist in getting the vaccines to. We can't do that, as Dr. Nunez-Smith so eloquently put it, until we have the information at our fingertips. So, that's a call-out we're asking for. Next question. Speaker 2: (39:49) All right. We have time for a couple more questions next. We'll go to Jonathan Cohn, at The Huffington Post. Jonathan Cohn: (39:56) Hi, thanks for, I think, sort of calling the question. In terms of vaccines that have been allocated to states but not yet gotten into arms, I know in a lot of states there's a lot tied up in the federal long-term care partnership that CVS and Walgreens is running, and there are reports out there, everything from they're not vaccinating and quick enough to the criteria is causing them to hold off too many on the side. I'm wondering, do you guys feel like that's going as well as it could be? Do you have any plans to either try to speed up that process with them or change the way those doses are set aside so that some of them can go elsewhere and get used more quickly? Just, what's your assessment of that? Andy: (40:39) Jonathan, so the CDC is going to release information later today, I believe, about vaccination levels in long-term care facilities. I'm not going to front run that other than to say that I think you'll get a sense, you'll get a picture, of how successful that program has been. Now, I think one of the things that we understand is that irregardless, just regardless of the success rate, there also was an overestimation made as to how many people are in long-term care facilities, and so there are in some places excess doses. And we had been working with states and with those distributors to make sure that those excess doses quickly get to the places that they're needed when they exist. Next question. Speaker 2: (41:34) All right. Last we'll go to Tamara Keith, NPR. Tamara Keith: (41:41) Thank you very much. So, I have a few questions about this new test that is being pushed out at $30 a pop. That sounds cheap compared to the tests that are available now, but it's also a lot of money if you're thinking, I don't know, am I going to test my kindergartener every day? Once a week? So how do you really see this working? Who would be paying for these tests? How does a $30 test fit with your equity goals? And are there even going to be enough of them for it to be used for screening? Andy: (42:19) Thanks, Tamara. So look, the purpose of today's announcement, which is very exciting, is to move to mass production in scale, and obviously the unit cost will come down only when we can get to that mass production in scale. So, there's a chicken and egg problem that I think we have taken a step to solve today by creating mass production so that we will have tens of millions of these tests out there. Andy: (42:48) Secondly, we know there are efforts to create even lower cost and more innovative approaches. And we welcome those. The RADx program, and many of the other programs to drive innovation, has unleashed, in many respects, a side of America that we haven't talked a lot about during the response to this virus, which is the entrepreneurs and the innovators and the inventors. And so I couldn't agree more that things that are not low-cost and accessible don't do as all the good we need. Andy: (43:22) Third point you make is a good question, which we don't have a complete answer for today, which is a question about policy. What will the federal government, state governments, local governments, school districts, what steps will they take to make these tests more available and more affordable? And I think that is an important equation for everyone at the state, federal, and local level to factor into their thinking and their planning, because you're absolutely right that life doesn't change until we create more ubiquitous capability, not only around what we've talked about here, vaccines, but also testing, and also many of the therapies. So, that's the work ahead of us. I think with that, I want to thank everybody for joining this briefing. We will be back on Wednesday to do the next COVID-19 response briefing.