White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript March 15

Andy: (00:01) ...who are interested in increasing their Medicaid reimbursement rates for vaccinations so that we can make sure that we have most effectively reached vulnerable communities. Andy: (00:13) This is an important health equity step as working and lower-income Americans have faced the brunt of this crisis and must receive the resources needed to protect them. What do these changes mean for people across the country? Well first, it means that vaccines will continue to be free to you. You do not need insurance to get vaccinated. You do not need cash or a credit card or worry about a copayment or deductible. You will not get a bill. The vaccines are free, they are safe, and they are effective. Andy: (00:46) It also means that doctors, nurses and healthcare providers you trust will be out in your communities administering vaccines. Because the federal government will now pay them more for each shot they deliver. Now with that, I will turn it over to Dr. Walensky and then to Dr. Fauci and then we'll take your questions. Dr. Walensky: (01:07) Thank you Andy. I'm glad to be back with you all today. Let's begin with the data. CDC's most recent data show cases continue to fluctuate somewhere between 50,000 and 60,000 per day with the most recent seven-day average approximately 52,500 cases per day. The most recent seven-day average of hospital admissions has also declined to just over 4,700 per day. We also continue to see a decline in deaths with the latest seven-day average just over 1,200 deaths per day. We have come a long way from where we were in early January but we still have much work to do. In some parts of the country, the weather has started to warm up and with the clocks change this weekend, our days have seen a little bit more sunshine. And with the coming warmer weather, I know it's tempting to want to relax and to let our guard down, particularly after a hard winter that sadly saw the highest level of cases and deaths during the pandemic so far. Dr. Walensky: (02:06) This past Friday, we saw more travelers pass through our airports, over 1.3 million. This is the most travelers that we have had in a single day since last March before the WHO declared the global pandemic. We have seen footage of people enjoying spring break festivities maskless. This is all in the context of still 50,000 cases per day. Equally concerning are the resurgences we are now seeing in some European countries. Countries that have had strikingly similar trends and surges during the pandemic as the United States. Each of these countries has had nadirs like we are having now and each took an upward trend after the disregarded non-mitigation strategies. They simply took their eye off the ball. Dr. Walensky: (02:54) I'm pleading with you for the sake of our nation's health, these should be warning signs for all of us. Cases climbed last spring, they climbed again in the summer, they will climb now if we stop taking precautions when we continue to get more and more people vaccinated. Please follow our recommended public health prevention precautions and be ready to get your vaccine when it is available to you. We are just starting to turn the corner. The data are moving in the right direction but where this goes is dependent on whether we all do what must be done to protect ourselves and others. We continue to see positive information emerge from our vaccines. A new CDC MMWR published today looking at data from mid December to mid February found that the vast majority of people getting both doses of these vaccines within the recommended timeframes. Based on the report, only about 3% miss their second doses and systems were in place to make sure that those missed doses were not wasted, a very encouraging finding. Dr. Walensky: (03:56) We also found that 96% of people who got both doses did so within the recommended timeframe, on or within four days of the 21 days for the Pfizer vaccine and 28 days for the Moderna vaccine. These findings are incredibly reassuring as we continue to scale up our vaccination efforts. They show that our systems are working and that people are taking vaccination seriously, even when it means taking time to show up for their second appointment. Dr. Walensky: (04:24) It is remarkable what we can do as a nation when we are united against the virus. This report also shows that a small percent of people did miss their second dose. It may be hard for some people to get back for their second dose but it's essential for everyone who receives a two-dose vaccine to get both shots and get the full protection of these vaccine officers. CDC is working across the government and with state and local partners to identify and address barriers to getting both doses. Some strategies include working with trusted messengers and communities to spread science-based messages on the importance of getting fully vaccinated, partnering with jurisdictions and vaccination providers to schedule both vaccination appointments upfront or schedule the second appointment when you get the first shot, and having systems in place to send appointment reminders to patients, reschedule canceled appointments, and repurpose missed second doses to avoid vaccine wastage, and finally, making available the single dose vaccine, Johnson & Johnson as a terrific option for individuals who may prefer a one-dose vaccine. Dr. Walensky: (05:32) Importantly we have a role to play. I encourage those who can to help others get vaccinated. This can be as simple as helping family members and other loved ones with scheduling of appointments, reminding them about their appointments, and driving or accompanying them to their appointments. These small acts will go a long way toward protecting health and helping to end the pandemic. Dr. Walensky: (05:55) Finally I want to briefly discuss a technical update to our vaccination data on the CDC website. I know many of you watch our data closely and when something changes it can prompt questions. Last Friday, CDC implemented an improvement to how we calculate the age of people who have received vaccinations. This was done to correct for differences in how states report date of birth to CDC and to more accurately determine the age of people getting vaccinated. Dr. Walensky: (06:23) [inaudible 00:06:23] there was a slight change in our age distribution of those vaccinated, with the percentages in all age groups under 75 increasing slightly, and those 75 or older decreasing slightly. This largest shift occurred among people aged exactly 75 when more than one million individuals previously classified as 75 were reclassified as age 74. This should not be concerning as we are vaccinating exactly the right cohorts and those people will be 75 some time in the next 12 months. As CDC director, a key principle is leading with transparency and reflecting this principle I believed it was important for me to clarify this new approach to our public-facing data. Thank you. I look forward to your questions and with that I'll turn things to Dr. Fauci. Dr. Fauci: (07:09) Thank you very much Dr. Walensky. I'm just going to give a brief what we'll call science update on something that is being asked much more consistently is that how do we approach the entire issue of pandemic preparedness currently and for future pandemics. [inaudible 00:07:27] the first slide. Dr. Fauci: (07:29) There are three components that have been pursued now for some years. The first is priority pathogens. Pick out a pathogen that you might be risky in the future. That could be Nipah, that could be Ebola, that could be any of a number. The other is to develop platform technologies. We've already spoken about the real advances that have been made with messenger RNA technology, and the third is one I want to spend just a couple of minutes on and that's called prototype pathogens. Dr. Fauci: (08:02) What do we mean by how prototype pathogen approach helps us for future pandemics? Next slide. This slide looks complicated but it's simple because it really tells you that this is all of the phylogenetic tree of the coronaviruses, and in red are the human coronaviruses but noticeably in the yellow boxes are the four coronaviruses that each year cause about 15 to 30% of all the common colds that we all experience repetitively usually during the winter months. So we've been studying these viruses now for decades and decades. If you go to the next slide, then in 2002, with the appearance of SARS, which we all remember, and then in 2012 with the appearance of MERS, which we all remember, we got more and more experience - Dr. Fauci: (09:03) ... which we all remember. We got more and more experience within this group of coronaviruses. Then the next slide. Came ... Nope, go back one. Next slide, comes the SARS coronavirus 2, which is the current virus that we're dealing with. And in the next minute or so, I want to show you how previous experience has allowed us to make the kind of advances that have been so successful in COVID-19 vaccine. Next slide. Dr. Fauci: (09:39) This is a slide from 2017. When we were attempting to make a vaccine for MERS, the Middle East Respiratory Syndrome coronavirus. We had found, interestingly, that that spike protein that we talked about was unstable in its pre-fusion form. Namely, the one that we really wanted to vaccinate people with. So we made a bunch of mutations to stabilize it and to have what would be a successful MERS-CoV-2 vaccine. Dr. Fauci: (10:16) But however, given the fact that MERS is smoldering right now, and even though we're pursuing the vaccine for MERS, we use that same knowledge that we gained from the prototype pathogens of coronaviruses ... and on the next slide, what you see is what we're dealing with now. That squiggly structure on the right hand part of the slide is the spike protein that the messenger RNA codes for. That the adenovirus vectors express, and that the soluble proteins that we have using in the Sanofi and in the Novavax all use the same sort of structure. Dr. Fauci: (11:04) The point I want to make is that we didn't start doing this in January of 2020. This was literally decades of fundamental research on the broad prototype pathogens of coronavirus. And these are the kinds of things that we're going to be doing with other viruses that could in fact pose risks as future pandemics. So let me stop there and go back to Andy. Thank you. Andy: (11:35) Thank you, Dr. Fauci. Okay. Let's take questions. Speaker 1: (11:40) All right. We have time for a few questions. First question, we'll go to Tamara Keith at NPR. Tamara: (11:47) Thank you very much. A question about the variants. CDC had predicted that the UK variant would be dominant in the US in March. Is it yet? Is it dominant in certain states? Which ones? And what effect is that having on the trajectory? Andy: (12:06) Dr. Walensky would you like to start? Dr. Walensky: (12:08) I can start with that. Yeah. Thank you. You know, it's not evenly distributed across the United States. We do have B117 reported in 50 jurisdictions over 4,700 cases reported so far. That's just based on what we're evaluating and sequencing. In some States, Florida and California, it's up to 25%. In other states it's lower. Our current models still project, by the end of March, early April, B117 will be the dominant variant. Andy: (12:39) Okay, next question. Speaker 1: (12:41) Next question. We'll go to April Ryan at theGrio. April Ryan: (12:46) Thanks for doing this call. A couple of questions. Doctors, do you, by any chance, have solid numbers at this point on how many people have been vaccinated successfully with both vaccines, as well as the one from Johnson & Johnson? And do you have adequate numbers of the breakdown on minority numbers? Because there is now a report from Brilliant Corners that talks about the reason why black people have not gotten it ... It's not what the original thought was about Tuskegee or Henrietta Lacks. The hesitancy was basically about misinformation or no information. Can you expound please? Andy: (13:28) Dr. Walensky? Dr. Walensky: (13:34) We keep updated numbers on our CDC website. They're updated every day. I can tell you that 37.45 million people have received two doses. Are fully vaccinated. And that 107.6 million people have received at least one dose of a vaccine. I don't have off the top of my head, the racial breakdown this morning, but that is available on the CDC website. I think we still have a lot to learn with regard to why some communities are not choosing to be vaccinated. Some communities are more hesitant. I would be reluctant to say that it's the same reason for every community. I think we have to meet people where they are, as we try and get all the communities vaccinated, and we have to understand that there's not a singular, underlying reason, but many reasons. Dr. Fauci: (14:22) Yeah, let me just maybe extend that just for a minute. We also are very, very much involved in trying to get better access for the minority populations. It is not just the idea of hesitancy, but the fact that we have been, and then you've heard the president himself say very clearly, that with the community vaccine centers, with the community health centers, with the pharmacies that we're giving vaccine to, particularly in areas where minorities are represented, as well as the mobile units that are going out ... so we are right now being very actively in going out in a proactive way to make sure that any inequities that exist, we can then essentially eliminate them. Dr. Fauci: (15:10) That will be one of the things that are now going forward we're putting a lot of effort into. Andy: (15:16) That's critical. Okay. Next question. Speaker 1: (15:19) Next we'll go to Elizabeth Wise at USA Today. Elizabeth Wise: (15:24) Let's see. Thanks so much for taking my question. We're hearing so much about other countries requiring some type of vaccination proof to enter those countries. Is there anything under discussion at the federal level to provide some type of vaccine, for want of a better word, passport? Andy: (15:47) Yeah. Let me take this, Elizabeth. It's an important question. As more people get vaccinated, Americans are asking the question, how will I be able to demonstrate reliably that I've been vaccinated? We have a couple of core beliefs about that. One is, that it's not the role of the government to hold that data and to do that. But we do believe that whether that gets done, there is a right way, and a way that is not as good. The right way is these should be private. The data should be secure. The access to it should be free. It should be available both digitally and in paper and in multiple languages. It should be open source. Andy: (16:34) Those are the right kinds of principles for someone to be able to have, be able to demonstrate that they have had a vaccine. We know that there are efforts that are underway, led by non-profit collaboratives and the private sector, all working on exactly that type of thing. Next question. Speaker 1: (16:58) Next, we'll go to Anne Flaherty at ABC. Anne Flaherty: (17:05) Hi. Thanks for taking my question. I wanted to ask about this study, that found that three feet in schools might be safe as long as they are masked. Dr. Walensky, are you revisiting the CDC guidance on this? And also, can you tell us where the six feet came from? Was that ever studied with masks? Dr. Walensky: (17:26) Thank you for that question. Yes, we're looking at this carefully. The six feet data came from early studies with and without masks from all other respiratory viruses, flu viruses, as well as SARS and other coronaviruses, the MERS virus that Dr. Fauci just spoke about ... and how far aerosols and droplets can travel in that context. Dr. Walensky: (17:49) As soon as we put out our guidance, among the biggest challenges that we were aware of was the fact that schools were having a hard time with the six-foot guidance. And that, of course, prompted more studies to say, is six feet necessary in the context of mask wearing? Dr. Walensky: (18:03) ... studies to say is six feet necessary in the context of mask wearing. The study that you're remarking on is the first study that has been published that looked at three feet versus six feet. It was in Massachusetts schools where there was a hundred percent mask wearing and it demonstrated that students, when there was a hundred percent mask wearing, had similar infection rates at six feet versus three feet, as well as staff had similar infections rate at six feet versus, six feet when they were masked. We are looking at these data carefully. The question actually prompted more studies to be done so we know more forthcoming. We're taking all of those data carefully and revisiting our guidances in that context. Andy: (18:43) Great. Next question. Kevin: (18:46) Next, we'll go to Shira Stein at Bloomberg. Andy: (19:06) Shira, are you with us? Kevin, maybe we should take the next question and come back. Kevin: (19:15) We'll come back to you, Shira. We'll go to Zeke at AP. Zeke: (19:19) Thank you all for doing the call. As I was hoping you might be able to explain what your assessment is of the early rollout of the J and J vaccine. On the CDC tracker right now, it's showing under 1.3 million doses administered with 3.7 million distributed, but obviously the dose has been distributed for a couple of weeks. Zeke: (19:39) Are you seeing any hesitancy with the uptake in that shot versus the two dose regimes? Thank you. Andy: (19:48) Let's let's start this way. Let me ask Doctor Fauci, for people who haven't heard the review before, for you to talk about the Johnson and Johnson vaccine and how people should view it relative to the other two vaccines in Moderna and Pfizer, then I'll more specifically go into your question. Doctor Fauci: (20:06) Thanks Andy. Just to reiterate what we've said multiple times on these briefings, that we have three highly efficacious, safe vaccines that are now available to the American public. Doctor Fauci: (20:20) They have not been compared one to the other, which the only way you could effectively do that would be in head-to-head comparisons. So that's the reason why you hear all of us always say continuously, is that the way to look at it is that there are three vaccines that are highly efficacious. If you go into a place and you have a certain vaccine available to you, take that vaccine rather than waiting for another vaccine because all three of them are highly efficacious. Andy: (20:50) Yep and let me address the other part of your question. Andy: (20:53) So look, we watch this data, as you can imagine, incredibly closely. We don't have reason for concern at this point. To remind everybody, the Johnson and Johnson vaccine came out with a it's no secret, a relatively small amount of doses. Given that, we know that states are metering how they're putting out the doses to be a little bit more straight line. Andy: (21:20) And then third that we are seeing it continued to ramp. There was a day this weekend where we saw 300,000 Johnson and Johnson doses. So, I think it continues to climb where I think the key operative word in your question is early. When we get... By the time we get to the end of the month, I think we will see the ramp pattern where we expect it to be. Andy: (21:47) Next question. Kevin. Shira Stein: (21:55) Hi. Thanks. All. Kevin: (21:56) You're there. Shira Stein: (21:57) There we go. Sorry about that earlier. Can you tell me why you decided to change the reimbursement number for the Medicare administration of vaccines? And then can you also talk, it looks like you're going to be doing some more public service announcements to provoke vaccination. What's the budget for that? Andy: (22:19) Well, look, I think CMS who focuses on making sure that our nation's seniors and our nations people who live on low and fixed incomes are getting access to the same high quality care that they deserve and that others in the country should get, determined that an additional level of reimbursement was going to increase vaccination rates, particularly in hard to reach communities. Andy: (22:43) So asking people to do as Doctor Fauci indicated mobile vans, reach out into communities and make the extra effort to meet people where they are, to reimburse them. We believe that the medical professionals that are on the frontline to this vaccination effort, by the way, the same people that are on the front lines of this entire pandemic, need to be taken care of and we think that's going to do a job of both increasing vaccinations, as well as improving equity and that's the reason behind it. Andy: (23:15) Your second question was about education campaigns. Is that what it was? Kevin: (23:21) Yep. Andy: (23:22) Yeah. So look, let me say this. Today, I think the latest data shows from my belief Pew, that 69% of Americans are definitive in saying that they either have had a vaccine or plan to take a vaccine. That's significantly higher. It's at least 10 points higher than it was a short while ago and more significant than, than from... but when the Biden administration began. Andy: (23:54) We think this is for a number of reasons. These are very good vaccines with an incredible track record. Large clinical trials. Years, as Doctor Fauci has indicated, of research into them and many Americans got vaccinated early and the people who I think have been watching this and seeing the process and seeing how it has had an impact on them and in their communities, they increasingly makes some want to take the vaccination. Andy: (24:27) So we believe this is, in some respects, the easiest education effort ever, as if we'd let people see the truth and not get information on say Facebook or somewhere where there's less reliable information, people are capable of making these decisions for themselves. Andy: (24:43) We know that people are not looking to be convinced by the government or by some other entity. They want to have conversations with people locally in their community, whether it's a doctor, their pharmacist, or other people that they trust and our job and I think the CDC had been doing a marvelous job at this, is to get reliable information out to people. Andy: (25:04) These briefings are another example of this. Very clear scientific information. The good and the bad. Now we will be supporting that effort with all kinds of additional education efforts, including some paid efforts, including other types of conversations but it's most important that the people who are the local trusted people, continue to have the reliable information about these vaccines and we believe that will continue the pattern it's already begun, which is that more and more people will be comfortable taking the vaccine. Andy: (25:41) Kevin, is that- Kevin: (25:42) We're going to squeeze one more question in. Brian Karem at the [inaudible 00:25:46]. Brian Karem: (25:49) Thanks. I'll I'll be brief. I want to follow up on April Ryan's question about the number of people, the millions that already been fully vaccinated. Brian Karem: (25:57) Today we heard that 30% of the adults, or 20% of the seniors, had received some vaccination. Is that... Are the 20% seniors, 20% of the total number, or is that a subset of all adults first? Brian Karem: (26:12) And secondly, if we use the number of shots that we are getting on a daily basis, a number of new cases and the number of people who have been fully vaccinated, can you all using those metrics, give us a better idea of when we'll either reach herd immunity or be in the clear, and thus when can we start sharing our dosage of vaccines with our allies and neighbors internationally? Andy: (26:43) It sounds like an SAT math question. So let me first clarify the basic of the numbers. I think they made not have come through clearly. Andy: (26:53) We are talking about close to two-thirds of seniors and close to 30% of all adults that have now received their first shot. Andy: (27:02) All adults that have now received their first shot. And I think it's important for reasons that I think both doctors Walensky and Fauci could articulate that people will get their second shot, largely because of the durability and the variant. So as we report these numbers out, this is to report on the progress and the very hard work of tens of thousands of people. But it by no means should be perceived as declaring victory. There's much more work to do. I think the question that you're asking in some senses, when will we reach herd immunity? When will we have enough doses? Et cetera. And what I would tell you is that as the president articulated last week, we believe that we will have enough for the adult population produced by the end of May. And with some time after that, those vaccinations will have occurred. And it is with that that the president indicated that if we all do our part by the 4th of July, we should be able to take a really important step to bringing the things, the people, the events of our lives back into our lives. That's an if. That's really on all of us. So no matter what math you use, we will have enough vaccine doses. We do need people to actually get vaccinated. We do need everybody that's been doing this enormously important work to keep doing it. And if we do that, we should be in a position right around then when the adult population will have the vaccines they need. Now, if you're asking questions about our supply, we have indicated that there are other pieces of our supply that are important to us. Dr. Fauci has mentioned this several times. Teenagers, adolescents, children, potential booster shots down the road, other things. Andy: (28:54) So it's a very big equation with a lot of scenarios and our job is to be prepared for every scenario. Now, having said all of that, I think there was a part of your question about the world, about the globe. And so maybe I can ask Dr. Fauci to talk about the efforts that we have undertaken already, even as we've accented in our country to make sure we're playing a leadership role in the globe. Dr. Fauci: (29:18) Yes. Thank you, Andy. So as you will know, on the first day of the president's presidency, his tenure, he had me go out early in the morning and make a speech to the executive board of WHO saying we're going to rejoin WHO and we're going to be part of COVAX, which means A, that we've made a commitment of $4 billion that the United States will be giving to COVAX, which is a multi-organization, multi-country effort to help those countries that do not have the resources to be able to vaccinate their people to get them vaccinated. In addition, it's become clear that after we get our people in the United States vaccinated, and remember, we've suffered terribly with over 530,000 deaths thus far. So our responsibility of getting our people vaccinated first before we start giving doses to other countries, which we will be doing that if and when we do have a surplus, which it looks very much like we will. But that will not occur until we actually have our people vaccinated. Dr. Fauci: (30:36) But the $4 billion has already been implemented. Part of it, two billion and then two billion to come. So we're very actively involved in thinking about and caring about the plight of other countries. Andy, if I might just make one comment that was made part of the question. We should not get so fixated on this elusive number of herd immunity, we should just be concerned about getting as many people vaccinated as quickly as we possibly can, because herd immunity is still somewhat of an elusive number. We made a projection of it would likely be, I've said many times, somewhere between 70 and 85%. But we don't know that for sure. So rather than fixating on that, why don't we just say get as many people vaccinated as quickly as you possibly can. And every day that goes by now with more than two million doses going into people we're getting closer and closer to control of this pandemic. Thanks, Andy. Andy: (31:38) Great. Thank you. And thank you all for the sitting in, and I really want to thank again the doctors, nurses, physicians, vaccinators, people around the country who've been and are continuing to be part of this extraordinary effort that we need to keep going. We will be here Wednesday to do this once again. Thank you.