White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript April 7

Andy: (00:00) Good morning. Thank you for joining us. Yesterday afternoon, President Biden delivered a report to the nation on the progress of our vaccination program and our fight against this pandemic. As the President communicated, our job is to bring the public the truth, both the good news and the bad news. We're in a period when there's a fair amount of both. We're making real progress, even amidst continued challenges. First, there's good news to report. The President announced yesterday that all adult Americans will be eligible to be vaccinated by April 19. This is ahead of the original May 1st timeline that he set last month. This means that there is no better time for seniors who haven't been vaccinated to get their shot now. At this point, over 76% of seniors have had at least their first shot. If you know a senior who has not yet had the opportunity to get a shot, consider helping them arrange that opportunity and see what help they need. Andy: (01:30) A number of seniors live alone and may need transportation or other help. The good news is that there are more and more locations and more places available for them. President Biden also announced that we crossed 150 million shots in just 75 days of his administration. We also have progress to report in our effort to open school safely. At the beginning of March, the President directed states and the Federal Retail Pharmacy Program to prioritize the vaccination of teachers, school staff and childcare workers during the month of March. As the President announced yesterday, as of the end of March, the latest CDC estimates show that almost 80% of pre-K through 12th grade teachers, school staff and childcare workers received at least one shot. Today, the Department of Education released the latest round of data from its own ongoing survey on the impact of COVID-19 on K through eighth grade students in the state of school reopening in the nation. This is encouraging early data covering the month of February and shows progress toward the President's goal to have K through eighth grade schools open five days a week. Andy: (02:55) Then the final piece of good news, to help meet our goal of ensuring Americans have a vaccine site within five miles of where they live and to advance equitable distribution of the vaccine, we're announcing today that we are expanding our Community Health Center Vaccine Program so that the nearly 1,400 community health centers can sign up to receive and administer doses to their patients. Many community health centers are located in underserved communities and serve patients that are predominantly either uninsured or under-insured. As of today, more than 108 million Americans have gotten at least their first shot. Our vaccination program is progressing ahead of schedule, due to the aggressive steps we've taken at the President's direction to increase vaccine supply, the number of vaccinators in the field, and the places for Americans to get vaccinated. As well, of course, as a strong work of our partners. As the President also underscored, even as we vaccinate Americans in record numbers, we're still not even halfway there. The progress we've made can be reversed if we let our guard down. Better days are on the horizon. Andy: (04:14) We do believe a more normal 4th of July holiday is within reach, but that's nearly three months away. As the President said, the real question is how much death, disease and misery are we going to see between now and then? Before I turn Dr. Walensky, let me just close by reminding Americans, it is in our power to minimize death, disease and misery. If all of us do our part, we can help save lives in April, May and June. Wear a mask, socially distance, get vaccinated when it's your turn, and now over to Dr. Walensky. Dr. Rochelle Walensky: (04:56) Thank you, Andy, and good morning, everyone. I'm glad to be back with you today. As always, I'll begin with an overview of the data. CDC's most recent data showed that the seven-day average of new cases is a little more than 63,000 cases per day. This is up approximately 2.3% compared to the prior seven-day average. Hospital admissions also continue to increase. The most recent seven-day average about 5,000 admissions per day is up about 2.7% from the prior seven-day average. Deaths decreased 19.7% to a seven-day average of 745 per day. Vaccinations continued to increase with the most recent seven-day average of nearly 3 million vaccinations delivered daily, up 8% from the prior seven-day period. While these rates of vaccination are incredible and so encouraging for all of us, trends are increasing in both case numbers and hospitalizations. Across the country, we are hearing reports of clusters of cases associated with daycare centers and youth sports. Hospitals are seeing more and more younger adults, those in their thirties and forties admitted with severe disease. Dr. Rochelle Walensky: (06:11) Data suggests this is all happening as we are seeing increasing prevalence of SARS-CoV-2 variants with 52 jurisdictions now reporting cases of variants of concern. Based on our most recent estimates from CDC surveillance, the B.1.1.7 variant is now the most common lineage circulating in the United States. Testing remains an important strategy to rapidly identify and isolate infectious individuals, including those with variants of concern. These trends are pointing to two clear truths. One, the virus still has hold on us, infecting people and putting them in harm's way, and we need to remain vigilant and two, we need to continue to accelerate our vaccination efforts and to take the individual responsibility to get vaccinated when we can. We have to recognize the high risk of infection in areas of high community transmission. I encourage communities to consider adjustments to meet their unique needs and circumstances. Dr. Rochelle Walensky: (07:16) For example, in areas of substantial or high community transmission, CDC guidance specifically suggests refraining from youth sports that are not outside and cannot be conducted at least six feet apart. Similarly, large events should also be deferred. We have guidance on CDC's website on how to host small events safely, recognizing that our goals are to decrease transmission of COVID-19 and importantly, to keep schools open and students engaged in in-person learning. To this end, I'm pleased to report that an important mitigation strategy educator vaccination was rolled out in the month of March, and it worked. As the President announced yesterday and Andy reiterated, by the end of March, 80% of all teachers, school staff and childcare workers across this country had received at least one dose of a COVID-19 vaccine. That's nearly 8 million people educating our children and working in our schools who have some protection against the virus. Dr. Rochelle Walensky: (08:22) We must continue to vaccinate as many Americans as we can each day, because when we invest in vaccination and other public health prevention measures, we are seeing case counts decrease and deaths decrease. This is the case in older adults where over 55% of adults over 65 and older are fully vaccinated, protecting those that were so vulnerable a year ago when this pandemic began. The trends in increasing cases in transmission also underscore the importance of President Biden's announcement that all US adults will be eligible to receive a vaccination by April 19th. We are vaccinating on average 3 million Americans every single day, getting shots into arms, providing protection. I urge everyone who has not received a COVID-19 vaccine to roll up their sleeves and join the nearly 108 million people who have already received at least one dose. I want to close by acknowledging the two important truths of this moment. There is still reason for us to be concerned with rising case counts, rising variants reported and increasing hospitalizations. There is so much reason for so much hope. Thank you. I'll now turn things over to Dr. Fauci. Dr. Anthony Fauci: (09:42) Thank you very much, Dr. Walensky. What I like to do over the next couple of minutes is to just talk a bit about the duration of immunity. If I could have that first slide, I'm going to break it up into two components. The duration of immunity to natural infection and the duration following vaccination. Next slide, with regard to natural infection, we now have a considerable amount of information related to the duration of what we hope we'll be able to delineate more confidently. Namely, what's called the correlate of immunity. In other words, what are the things that protect you against re-infection, both from natural infection, as well as the first infection following vaccination. Next slide. This is a paper from Science from a couple of months ago, which looked at the multiple immune memory responses, including both antibodies, CD4 and CD8 T-cells following natural infection. Dr. Anthony Fauci: (10:47) About 95% of the subjects in this study, which was done by a group of immunologists, including Sean crowded, Shane Crotty and Alex Sette, and they went out to six months after infection. I want people to realize that that's at least six months. They did not look further than this, so it might be much longer. Next slide, and here's an example from another study in which it was looked after both mild and severe episodes of COVID-19. On the right hand part of the slide, the darker blue line is the neutralizing antibody level following hospitalization. The lighter blue line is the level following mild or asymptomatic infection. If you look at it, it peaks up at around 30 days, but then gets a nice level, which is maintained out to beyond 180 days. Dr. Anthony Fauci: (11:46) Next slide. Let's look now at the important post-vaccination durability of immunity. Next slide. One representative study, which came out yesterday in the New England Journal of Medicine, looked at the persistence of responses through six months following the Moderna vaccine, but there's every reason to believe that similar results will be seen with the Pfizer as well as the J and J. If you look at this, antibody activity remained high in all age groups out to 209 days to three serological assays. I'll explain in a second what they are. Next slide. If you look at this slide, just follow it going from the left to the right. Notice that you have here, looking purely at binding antibodies, all age groups from 18 to beyond 71 years of age, peaked up. On the bottom of the slide, you'll see the second arrow at 29 days. It peaked up and stayed up well beyond the 209 days. Dr. Anthony Fauci: (13:01) Next slide. If you look at pseudo virus neutralization, which is just an assay that does not look at the live virus, but that's sort of a virus that has been built up to resemble the appropriate virus. This is a very striking slide. Take a look at the left-hand part of the slide at the level of this neutralization. Then look at day 29, where you get the boost. Look at the sharp inflection of the level of neutralizing antibodies, which again, go out to beyond 209 days. Dr. Anthony Fauci: (13:37) Next slide. If you look at the neutralization of the live virus, you see the same thing. Look at the second arrow following the boost at 29 days, a very sharp inflection. Well above a protective level that goes out well beyond 209 days. On the final slide, the conclusion that although we are still working out the precise correlate of immunity, antibodies delivered by vaccination persist at least through six months and likely from the shape of the curve, well beyond that. In that regard, ongoing studies are monitoring these immune responses beyond six months, as well as determining the effect of a booster dose to extend the duration and breadth of activity against not only wild type, but also emerging viral variants. Back to you, Andy. Andy: (14:41) Thank you. All right. Let's take questions. Speaker 5: (14:46) Let's go to Anjalee Khemlani at Yahoo Finance. Anjalee Khemlani: (14:50) Thank you all, and thanks for taking the questions. I know that in this time last year, we were looking at acceptable daily case counts and with California looking to open up more regularly by June, I wondered if we have a new number to include vaccinations on what the new threshold might be for reopening broadly? Andy: (15:13) Well, why don't we start with Dr. Walensky and if you would like to add something Dr. Fauci, you can add after that. Dr. Rochelle Walensky: (15:19) Thank you for that question. I think Dr. Fauci over the summer had been talking about case counts below 10,000, below 5,000. We're at 62,000 today, so what I would say is in the context of vaccination, we still need to have our case counts be really low to stop circulating virus, to stop the emergence of variants, to stop hospitalizations and ultimately to stop deaths. I'm really encouraged by these decreased numbers of deaths that I believe to be an impact of vaccination, especially the vaccination of our elderly communities, but I think we're way too high to be thinking that we've won this race. Andy: (15:57) Dr. Fauci, anything you'd add to that? Dr. Anthony Fauci: (15:59) No, no very well said. It's going to be the question of the case counts. What we will almost certainly see as we get more and more proportion of the population vaccinated, that those case count numbers will come down, but we would not recommend doing anything different than till we get well below the level where we are right now. Andy: (16:18) Great. Thank you. Next question. Speaker 5: (16:21) Kristen Shamus of the Detroit Free Press. Kristen Shamus: (16:25) Thanks for taking my question. Michigan's COVID-19 case rate leads the nation and this surge is filling hospitals here once again. Is there a plan on the federal level to push more vaccines to Michigan and other states nationally that are once again fighting a sharply rising COVID-19 curve? Andy: (16:44) Well, let's talk about what we're doing in Michigan and Dr. Walensky, since you've got a team on the ground there, maybe you can kick that off. Dr. Rochelle Walensky: (16:53) Yeah. Thank you so much for that question. We are working closely with the state of Michigan and the state health officials there. We have CDC teams on the ground working to assess outbreaks in correctional facilities. We're working to facilitate increased testing that is happening on the ground in the context of youth sports. We're doing more surveillance and sequencing so we can understand what is happening with B.1.1.7 and variants. We're working with the state to try and encourage that areas that have increased amount of outbreaks that we can really see are the state is surging vaccine supply to those areas. Andy: (17:31) Yeah. Now, just to follow the rest of that question and emphasize some things that Dr. Walensky said. We have, within the state, the ability to move vaccine around, of course, but we are in close contact, both through the CDC and direct conversations with the governor and her team around what are the resources that could be most helpful at this point in time, as we do with other governors that find themselves in this situation. Nothing is off the table in those conversations in terms of the kind of support that we can provide, and we'll keep all options open as we stay close. There are really a menu. I want to leave you with the impression that there is not one tool. There are a menu of things, including staff, personnel, therapeutics, locations, and other kinds of things that we review with states in this kind of situation. Next question. Speaker 5: (18:29) Let's go to Jonathan Cohn at Huffington Post. Jonathan Cohn: (18:33) Hi, thanks for taking my question. Actually, I have something of a follow-up on that, because I also happen to be based in Michigan where the numbers are looking really scary. I'm wondering, and this is for Dr. Walensky, I think, you mentioned in your statement that it might be time to sort of have some clearer guidance on after school activities, maybe staying out of indoor sports. I'm wondering should States like Michigan, where the numbers are peaking, should there be stronger guidance? I mean, should we be looking at a pause? Should there be pause in restaurants, [inaudible 00:19:07], should there be, or at least guidance to sort of stay out of indoor dining? Should that be coming from the state? Does the CDC have any plans or are you considering stronger guidance that when the numbers are spiking like they are, especially with the possibly of vaccines, we're in this race and it feels like we're close, but we're falling behind. I'm just wondering if there should be more aggressive guidance than we're seeing from either the state or federal officials? Dr. Rochelle Walensky: (19:33) Yeah. As I mentioned, we've been in close touch with the state. Our guidance on youth sports is actually pretty articulate with regard to having substantial or high transmission and that these activities should be happening outdoors and more than six feet apart. In the context of that, testing should happen at least twice a week, if these are high-risk sports. We're pretty clear on that guidance. We've been working with the state and I would advocate for sort of stronger mitigation strategies as you note, to sort of decrease the community activity, ensure mask wearing, and we're working closely with the state to try and work towards that. Andy: (20:14) Next question. Speaker 5: (20:16) Kaitlan Collins at CNN. Kaitlan Collins: (20:21) Thank you very much. I have two questions. One for you, Dr. Walensky, just to follow up on something you just said. I think you said that the UK variant is now the most common lineage in the US. Do you mean it's the most common variant or it's the most common, like even compared with the original strain? Then I think this question probably is best for you, Andy. Sorry, just one quick. Yesterday, the President said we're not at the finish line yet, but can you kind of clarify or qualify what does the finish line look like? What should people be looking for to know that we are approaching that since we know we're not at it now? What does that look like? Dr. Rochelle Walensky: (21:03) I'll start, Kaitlan. Thank you for that. It is the most common lineage period. There are many different lineages of the ... Many different potential variants, there are several different kinds of sort of wild type variants. This is in fact, the most common lineage right now. Andy: (21:20) I think your second question, let me begin on, and then I would invite both Doctors Walensky and Fauci to comment. We're at about three quarters of seniors that have had their first dose. We think that can go higher. Again, as the President did yesterday, we urge seniors and people who are in contact with seniors to help them get vaccinated. Right now, we are in between 40 and 45% of adults in the US that have had their first vaccine, which means sometime likely this month, over the next couple of weeks, we're going to get to about half. What's important to remember for those who are getting vaccinated is that, that still means that we've got half of the adult population that will not have had had their vaccine yet. While it is very tempting as we each get vaccinated to think about the things we can now do, we need to remember that when we're at our best as a country, we bring everyone along. Andy: (22:19) We don't just bring ourselves along as we get over the line, but we bring the whole country with us. We've got to continue to do this together. As for a "finish line," I'm not sure that that's necessarily the correct metaphor for what we're going to experience. I think Dr. Walensky, I would offer has been leading commentary through kind of gradual steps along the dial that we can do as a country to get back to our old lives. That began weeks ago with conversations around what I kind of refer to as the hugging guidance between grandparents and grandchildren who are not high risk, and it has extended into travel and other types of things, but let me then turn it to Dr. Walensky and Dr. Fauci to describe what their view of the question. Dr. Rochelle Walensky: (23:09) I think you're right on, Andy. We are working to vaccinate more and more people. As we do so, we're seeing really encouraging trends that the vaccination is working. We're seeing demographics, age demographics change that hospitalizations are now not happening as often in older populations. They're happening now more often in younger populations. That said, we're still seeing older people hospitalized. It's the ones that have not yet been vaccinated. We're still hearing stories of, "I got my vaccine yesterday and today I have COVID." What we really want to do is just scale up that vaccination more and more and more so that we can be in a place where we have more vaccine out there and less ... More vaccinations out there, and really less disease circulating. 65,000 cases, that's 65,000 opportunities for mutations to occur, for more variants to spread, and so we're just watching this very carefully. Andy: (24:11) Great. Any reflections, Dr. Fauci on that question? Dr. Anthony Fauci: (24:15) Yeah. I mean, there's not going to be an absolute number, but I think what we're going to see, Kaitlan, is that as we get more and more people vaccinated, you're going to see a concomitant diminution in the number of cases that we see every day. With that, the cascading domino effect of less hospitalizations and less deaths. I don't think it's going to be a precise number. I don't know what that number is. I can't say it's going to be this percent, but we'll know it when we see it. It'll be obvious as the numbers come down rather dramatically. When they do, we're going to wind up getting really step-wise much, much more towards what we consider approaching a degree of normality, which everyone really quite dramatically notices it. It's on the way, hang in there. Andy: (25:03) Great. Another question? Speaker 5: (25:05) Last question. Let's go to Lev Facher at STAT News. Lev Facher: (25:10) Hey everyone. Thanks for this. Another question on Michigan and vaccine allocation. Is it accurate to say that as of today, the overriding or even the sole factor in determining state-by-state allocation is still population? I guess if given what's going on in Michigan and the fact that there's at this point, frankly, excess supply it seems like in other States, if not now, is there a time when you would consider tweaking that formula or even targeting specifically the J and J vaccines, just really any change in approach to respond to the urgency of the situation there? Andy: (25:47) Yeah. Thanks for the question. It's a smart question, because, clearly there are phases that we will go through over time with this virus. To answer the question generally, we have a long way to go today to get the country to a place where each of our states has reached the number of vaccinations that the population can handle. By and large today, we are still not entirely, but by and large, we are still allocating vaccines based upon population until we get to that point. Clearly, we will get to a place where targeted strategies will work, but right now, I would commit to you that we're doing both. I'll give you an example. Community health centers will now be able to order vaccines for their communities directly. Retail pharmacies, we are locating surgically in places that have had the greatest disease, and have people greatest exposure, largely in underserved communities. Andy: (26:49) We're locating our federal vaccination sites in places where we think there's the greatest need to fill. I wouldn't want to give the impression that we are someone who's sitting back and managing this pandemic and the vaccination program, according to some formula. It's not true in the least. We are getting the amount of vaccines we think are needed for the population because that's fundamental. Then we are working on very tactical areas on how to both maximize that, how to maximize that vaccine distribution, so we get the things we want, efficiency, health equity, and the other goals that we have. It's a massive project. It takes a lot of work and a lot of very smart and good people are involved. There's a lot of dialogue with the States directly as Dr. Walensky also indicated. With that, I want to thank you for your attendance and your questions, and we look forward to talking later in the week.