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

Jeff Zients: (00:00) We will have the resources to fully implement this strategy and put the pandemic behind us. I'm currently at a community health center in New York City where I joined Leader Schumer on a tour of the Ryan Health Center to see what's working, thank the folks on the front lines, and hear what else we can do to support them. I also want to thank Leader Schumer for his critical leadership in passing the American Rescue Plan. Today, I'll give a brief update on our three-part strategy on vaccinations. First, our vaccine supply, second, more vaccinators in the field, and third, more places to get vaccinated. Jeff Zients: (00:44) On vaccine supply, the President has taken aggressive action to move up the production timelines for all three vaccines, Pfizer, Moderna, and Johnson & Johnson. As a result by the end of May, we will have enough vaccine for every adult in the United States. This week, about 22 million doses went out to states, tribes, and territories, and through the federal channels, including pharmacies and community health centers. That's more than two and a half times the weekly supply that was being distributed when we took office. Jeff Zients: (01:23) On vaccinators in the field, we've deployed nearly 6,000 federal personnel to serve as vaccinators and support vaccinations, including over 2,000 active duty military men and women. At the President's direction, that number will grow to more than 6,000 active duty troops over the coming weeks. On places to get vaccinated, we've increased the number of convenient and trusted places for people to get a shot. We provided federal support for more than 600 community vaccination sites. We've administered more than one million shots at federally-run community vaccination sites across the country. More than 60% of those vaccinations have been administered to minority populations. That includes two sites right here in New York City, one in Brooklyn and one in the Queens. The American Rescue Plan will allow us to continue to increase the number of community vaccination centers. Jeff Zients: (02:27) We launched the Federal Pharmacy Program, which has allowed millions of Americans to get a shot in their local pharmacy the same way they get their flu shot. Last week, the President committed to doubling the number of pharmacies participating in the program. Already people can get vaccinated at one of 14,000 pharmacies around the nation. For Americans who aren't near a pharmacy or community vaccination center, we've supported more than 500 mobile clinics to meet people they are. Today I'm at the Ryan health Center. Community health centers like Ryan Health serve 30 million people, 60% are people of color and two thirds of patients are below the poverty line. Jeff Zients: (03:16) The administration is already sending vaccines directly to 250 of these community health centers. By the end of April, we will deliver vaccines to an additional 700 community health centers. This work is a result of the Biden administration's partnership with state and local officials, federal workers, and the nonprofit and private sectors. It is leading to significant progress. As you can see in our weekly vaccination progress report, the current seven-day average is 2.5 million shots per day, 2.5 million shots per day. That's a new record pace that we will continue to build on. Jeff Zients: (03:59) Importantly, now two out of three adults aged 65 and older have gotten at least their first shot. This is critical because 80% of COVID deaths have been individuals 65 and over. Given our progress on increasing supply, coupled with increasing the number of vaccinators in the field and creating more places to get vaccinated, the President announced last week that all adults in the country will be eligible for vaccinations no later than May 1, all adults eligible no later than May 1. Jeff Zients: (04:39) Finally, I want to provide an update on how we are working with our North American partners on efforts to stop the spread of COVID-19 across the continent. As part of a national strategy to end the pandemic, the United States is committed to engaging with the international community in supporting global efforts to address public health and humanitarian concerns. Under the President's direction, the US re-engaged with the WHO on day one of his presidency. We committed to providing the most funding to COVAX in any country in the world, $4 billion. We also announced with our Quad partners last week that we are working to achieve expanded manufacturing of safe and effective COVID-19 vaccines at facilities in India. Now given our visibility into vaccine supply in the US, we're able to announce that we're lending a portion of our releasable AstraZeneca vaccines to Mexico and to Canada. Our approach to this wartime effort is to have as many tools in our toolkit as possible. Right now we have three effective vaccines that went through a rigorous review process to be authorized by the FDA. We have other vaccines going through that process now, including one from AstraZeneca. As we await the results of these trials here in the US, many countries have already approved AstraZeneca, but need more supply. That includes Canada and Mexico. Jeff Zients: (06:20) Balancing the need to let the approval process of the AstraZeneca vaccine take place here in the US with the importance of helping to stop the spread in other countries, we will loan a portion of our releasable AstraZeneca vaccine to Mexico and Canada. This action will allow our neighbors to meet a critical vaccination need in their countries providing more protection immediately across the North American continent. In total, we will loan Mexico and Canada around 4 million doses. To be clear, this loan will not reduce the available supply of vaccines to Americans. The doses we are loaning are not approved for use in the United States. No American will be without a vaccine because of this action. Jeff Zients: (07:08) With that, I'll turn it over to Dr. Walensky. Dr. Walensky? Dr. Walensky: (07:13) Thank you, Jeff. I'm glad to be back with you all today. Let's begin with the data. COVID-19 cases continue to remain between 50,000 and 60,000 cases per day with the most recent seven-day average at 53,200 cases per day. The most recent seven-day average of hospital admissions is slightly below 4,700 admissions per day similar to the seven-day average we had on Monday. Deaths continued to decline with the current seven-day average of 1,025 deaths per day. Dr. Walensky: (07:45) Today, I want to talk about a top priority for us at CDC and for me as a parent, CDC's efforts to support the safe reopening of schools for in-person instruction. We have frequently said CDC believes schools should be the last place to close and the first place to open. The benefits of in-person instruction are well-recognized. As a mother of three myself, I know all too well the difficulties that arise for our children and parents and caregivers when children are not able to attend in person for school. These challenges are especially difficult for children and families from low-resourced communities, as well as those from racial and ethnic minority communities and those with disabilities. Safe in-person instruction gives our children access to the critical social and mental health services that prepare them for the future in addition to the vital educational needs that they need to succeed. Dr. Walensky: (08:46) When I became CDC director, I promised that I would lead with science. To rebuild trust in our public health institutions and to keep people safe, it's critical to make decisions based on evidence and facts. On February 12th, CDC released our operational strategy for- Dr. Walensky: (09:03) On February 12th, CDC released our Operational Strategy for K to 12 Schools, based on the latest science at the time, to help schools open and remain open for safe in-person learning. Dr. Walensky: (09:14) The science told us then, just as it tells us now, that K to 12 schools that implement strong layered prevention strategies can operate safely while protecting teachers, staff, and students. We have seen data demonstrating that this is safe, even in areas of high community spread. Dr. Walensky: (09:33) CDC's operational strategy focuses on five key layered mitigation measures for schools conducting in-person learning. These include universal and correct use of masks, physical distancing, hand-washing and respiratory etiquette, cleaning to maintain healthy facilities and the testing with rapid and efficient contact tracing in combination with isolation and quarantine and in collaboration with local health departments. When we released the operational strategy, I said that CDC was going to follow the science and would update our guidance as new evidence emerged. This is essential, since the science of COVID-19 is rapidly changing with new data emerging every week. Dr. Walensky: (10:17) Since the initial release, CDC scientists have been actively reviewing the latest science and conducting their own studies to expand the evidence phase. And we now have new information to help us refine our recommendations, specifically for physical distancing. Dr. Walensky: (10:33) Last week, the journal Clinical Infectious Diseases published a study that looked at COVID-19 in 251 Massachusetts school districts over a four month period of time. It found that physical distancing of at least three feet between students could safely be adopted in school settings when everyone, students and staff, wore a mask at all times. Dr. Walensky: (10:56) And today, CDC is publishing three new studies in the MMWR that add to this evidence phase. One study looked at data from Utah elementary schools and found that COVID-19 spread was low with students placed less than six feet apart in classrooms, even though levels of virus spread in the community were high. Dr. Walensky: (11:17) Another report examined data from kindergarten classrooms in Springfield and St. Louis Missouri. This study found that transmission occurred at lower rates in classrooms than in the community because the schools used multiple layered prevention strategies together. Dr. Walensky: (11:34) And the third study looked at COVID-19 rates among students in Florida, and found that 60% of cases in students were not related to spread in schools. It also found that resuming in-person activity was not associated with proportionate increase in COVID-19 cases. Dr. Walensky: (11:51) Importantly, this study also found that COVID-19 rates were higher among students in school districts that did not have mandatory mask use policies in place. Dr. Walensky: (12:02) Layered mitigation strategies, including strict use of masks among students and a distance of at least three feet between students were common factors among the schools in these studies that demonstrated decreased transmission from COVID-19. Dr. Walensky: (12:19) This additional evidence continues to underscore why it is so important for schools to use layered prevention strategies to provide the greatest level of protection. Dr. Walensky: (12:29) So in light of the expanded evidence on physical distancing, today, CDC is pleased to update our recommendations for physical distancing between students in classrooms in our K to 12 Operational Strategy. Specifically, in elementary schools, CDC is now recommending that all students remain at least six feet apart in classrooms where everyone is wearing a mask, regardless of whether community COVID-19 risk is low, moderate, substantial, or high. Dr. Walensky: (13:03) In middle and high schools, CDC is also recommending that students be at least three feet apart in classrooms where everyone is wearing a mask and the community level of risk is low, moderate or substantial. Because COVID-19 is spread more likely among older students, CDC recommends that middle and high school students should be at least six feet apart in communities where COVID 19 risks is high unless cohorting is possible. Dr. Walensky: (13:34) Cohorting is when groups of students are kept together with the same peers and staff without close interaction with other groups or cohorts to reduce the risk of spread throughout the school. Dr. Walensky: (13:45) We recognize that cohorting is harder in high school students, but the science indicates that these students are also at higher risk of transmitting SARS-CoV-2. Dr. Walensky: (13:56) I want to emphasize that these recommendations are specific to students in classrooms with universal mask wearing. Dr. Walensky: (14:04) CDC continues to recommend at least six feet of distance between teachers and staff and other adults in the school buildings and between the adults and students in common areas in the school when masks cannot be worn such as when eating, during activities, such as singing, band practice, sports, exercise, and other activities that can increase exhalation. These activities should be moved outdoors or to large well-ventilated spaces when possible. And six feet should also be used in community settings outside the classroom. Dr. Walensky: (14:39) Today's announcement builds on our ongoing efforts to support teachers, school, staff, and students, as well as our work and educational and public health stakeholders to provide the guidance, tools, and resources to get our nation's schools open as quickly and safely as possible. Dr. Walensky: (14:57) This includes our plan to invest $10 billion dollars to support COVID-19 diagnostic and screening testing for teachers, staff, and students, which we announced on Wednesday. And our ongoing work to get teachers and school staff vaccinated during the month of March through more than 9,000 pharmacies in our Federal Retail Pharmacy Program that are now prioritizing vaccination appointments for teachers and staff who work in K to 12 schools. Dr. Walensky: (15:27) If you are an eligible educator or school staff member and have not yet been vaccinated, I encourage you to go to cdc.gov to learn more about how you can sign up for an appointment through this program. Dr. Walensky: (15:38) I'm hopeful that we are turning a corner on this pandemic. Getting our children back to school in-person instruction as soon as possible is a critical first step in doing so. I'm grateful to all the scientists who produced the evidence to address the key question, such as the distance required to remaining safe, so that we can move quickly to this end. Thank you. I look forward to your questions and I'll now turn things over to Dr. Fauci. Dr. Fauci: (16:04) Thank you very much, Dr. Walensky. I liked to spend the next couple of minutes in addressing an issue, which is on the forefront of the minds of many people. And that relates to the threat of variants of concern, particularly the B.1.1.7 variant, which right now, as we know, is causing a significant degree of concern in Europe where the flare and the surge that they are seeing is directly related to the variant 1.1.7. Dr. Fauci: (16:34) This variant, as you know, is every day getting more and more dominant in our own country. So very first, let me take just a few seconds to refresh your memory about the variant. It was first detected in the UK in December of 2020, it was reported in over 90 countries. The first US cases were detected in the United States in Colorado at the end of December of 2020. And since then, it has been detected in 50 jurisdictions in the United States and likely accounts now for about 20 to 30% of the infections in this country. And that number is growing. Next slide. Dr. Fauci: (17:19) So I want to do again, is take a look, first, of the concern that we have, and then some encouraging news, and then I'll end with a caveat. Dr. Fauci: (17:28) Of concern is that there are about 50% increase in transmission with this particular variant that has been documented in the UK. And there is likely an increase in severity of disease if infected with this variant. Next slide. Dr. Fauci: (17:45) This is an example of that. If you look at the daily confirmed cases in certain selected European countries over a period of time, and as you can see, the last date on this slide is March 17th, this is what I refer to- Dr. Fauci: (18:03) ... 17th. This is what I referred to previously about the surges that are going on in Europe at a time when we've reached this point of plateauing that Dr. Walensky mentioned to you, where we're now at 53,200 cases per day on a seven day average. This strongly suggests that there's an increase in transmissibility in the European countries associated with 117. What about severity of disease? Next slide. Dr. Fauci: (18:35) In a couple of UK studies, this one looking at over 54,000 matched pairs of participants in the UK in which one person was infected with the B-117 and another one with the previously circulating variant, it was a 64% increased risk of death for those with the B-117. Dr. Fauci: (18:59) Next slide. In this similar study in the UK, there was about 5,000 deaths that were analyzed, where there was the presence or absence of 117, and again, an estimated 61% higher risk of death with B-117. Next slide. Dr. Fauci: (19:19) What about some encouraging news? There has been a minimal impact on viral neutralization by EUA monoclonal antibodies. And importantly, for what we are doing in the United States with vaccines, there's been a minimal impact on viral neutralization either by convalescent plasma, or importantly, by post vaccination serum. Next slide. Dr. Fauci: (19:45) And so on this last slide, as you can see with Israel as an example where the B-117 predominates, as their vaccine doses into the arms of individuals increase, you're seeing a very dramatic and steady diminution of cases, which is underscoring the effect and the capability of the currently utilized vaccines against 117. Dr. Fauci: (20:12) With that encouraging note, I want to end with a big caveat. The way we can counter 117, which is a growing threat in our country is to do two things. To get as many people vaccinated as quickly and as expeditiously as possible with a vaccine that we know works against this variant. And finally, to implement the public health measures that we talk about all the time, and that was on Dr. Walensky's slide. Masking, physical distancing, and avoiding congregate settings, particularly indoors. I'll stop there and back to Jeff. Jeff Zients: (20:53) Thank you, Dr. Fauci. And before we open up for questions, I spoke at the beginning about reaching the president's goal to administer 100 million shots in his first 100 days. And we accomplished that in just 58 days. This week, we've also announced a number of steps to help deliver on the president's goal to get our schools reopened. Jeff Zients: (21:17) As Dr. Walensky just discussed, the CDC continues to work to update its guidance for schools as the science evolves. Earlier this week, we announced the schools will receive $10 billion in funding for testing programs and nearly $130 billion to help schools invest in mitigation strategies like PPE, additional space, hiring more teachers. Jeff Zients: (21:43) And at the president's direction, we're also working to get all educators vaccinated. With that, we'll open it up for a few questions. Press Staff: (21:53) All right. I know there's a lot of questions today, so please keep your questions to one question. First, we'll go to Anne Flaherty at ABC. Anne Flaherty: (22:01) Thanks for taking my question. Dr. Walensky, can you address the criticism by some of the unions that the research that you're looking at in schools does not address underfunded urban schools. And on the testing you've encouraged testing, but these tests, these rapid tests are not widely available on the market, even with the additional $10 billion. How soon before schools can test? Dr. Walensky: (22:26) Yeah. Thank you for that question, Anne. We have now increasing evidence for many different school settings that did not control for ventilation as to demonstrating that it is safe in classrooms when 100% masked, to be at three feet. And so, what I would say is we are following the science and we have done the science, and we've seen the science to ensure that this is safe for those schools. Our strategies for mitigation when layered integration strategies that we have demonstrated talk about distancing, masking, as well as respiratory etiquette, hand washing and contact tracing. Dr. Walensky: (23:08) We have added indeed layered mitigation strategies, further layer mitigation strategies for both ventilation, as well as testing and teacher vaccination. So while we don't believe those to be essential, all of those are scaling up simultaneously through the American Rescue Plan. Jeff Zients: (23:24) Next question. Press Staff: (23:31) Next, we'll go to Erin Billups at Spectrum News. Erin Billups: (23:35) Hi. Thanks for taking my question. So a growing number of studies are finding that the second shot of the MRNA vaccines are unnecessary for people previously infected with COVID-19. In France, they've changed their policy based on this. Are there any discussions happening to consider a change in dosing policy for the US in light of these findings, particularly because research is showing that second doses are effectively wasted on those with preexisting immunity. Press Staff: (24:04) Let's go to Dr. Fauci. Dr. Fauci? Dr. Fauci: (24:06) Yeah, yes. There's no doubt that for the preliminary studies that we have seen right now, that vaccination of an individual who has been previously infected has a much greater increment in the level of neutralizing antibodies compared to an individual who has just been vaccinated and received a second dose. Dr. Fauci: (24:31) Now, obviously the places that are now looking at that are those that have a true paucity of vaccine doses. But as you've heard from Jeff, just recently, we are now at a position where we are giving between 2 and 3 million doses a day. If there were a dramatic shortage, I think that's something that you would want to consider, but that's not something that we'll be making a policy about soon. Thanks. Jeff Zients: (24:58) And importantly, we have enough doses now driven by the president's action for all adult Americans by at the end of May. Next question. Press Staff: (25:11) Next, we're going to Michael Wilner at McClatchy. Michael Wilner: (25:14) Thanks everyone for doing this. I'd like to ask about these FEMA run federal mass vaccination sites and clarify some confusion on hearing that's out there. In Florida, we understand that the sites are now transitioning to only administering second doses and we'll then close up shop. So two questions. Specifically, one on Florida, are those mass sites closing? And then secondly, and more broadly are all of these federal mass vaccination sites intended to stand up for only a couple of weeks at a time? Thanks. Jeff Zients: (25:50) I don't know the specific specifics on Florida. We can follow up on that, but I can say across the board, these sites are really an important opportunity to increase the number of places where Americans can get vaccinated. Jeff Zients: (26:04) And as I said, in my opening comments, we're now well over a million shots doses administered at the federal sites. The federal sites are seen as very well run. And importantly, not only efficiently and effectively delivering vaccines, but doing so in an equitable way. So the plan is for the federal sites to continue. We'll get back to you with any specifics on the Florida site. Next question. Press Staff: (26:31) Next, we'll go to Kaitlan Collins at CNN. Kaitlan Collins: (26:37) Thank you very much. I have a question for Jeff and a question for Dr. Walensky. Jeff, can you just explain what do you mean by loan? When you're saying that we're loaning vaccines to Mexico and to Canada, these AstraZeneca vaccines, does that mean that they're going to reimburse the US for these or return this amount of AstraZeneca doses? Could you just explain that? And then Dr. Walensky, could you say, was the CDC pressured by teachers' unions- Kaitlan Collins: (27:03) Could you say was the CDC pressured by teachers' unions, not to change this guidance to three feet from six feet in schools? Jeff Zients: (27:10) So thank you, Kaitlan. The structure of [inaudible 00:27:15], that's what makes most sense given what we're balancing here, which is helping our global partners while they have a critical need and we await the results of the clinical trials here in the US and FDA action on AstraZeneca in the next several weeks. So this arrangement helps Canada and Mexico in the moment meet that critical need, while ensuring that they return those doses through the company, through AstraZeneca, later in the year. Dr. Walensky. Dr. Walensky: (27:47) Great. Yeah, thank you, Kaitlan, for that question. First, let me just acknowledge what the teachers have had to do this year in the context of COVID-19 and how they have had to evolve their thinking and their curricula and how they teach their students in truly an overwhelming and challenging time. I've spoken to the teacher's unions. They know that we need to follow the science and to make our guidance based on that science and they've been very respectful of that. Jeff Zients: (28:19) Next question. Kevin: (28:19) Next we'll go to Kristen Welker at NBC. Kristen Welker: (28:23) Hi everyone. Thanks for doing the call. Can you address the fact that there has been an uptick in cases in some states? New Jersey, New York, Rhode Island, to name just a few. Why do you assess this is happening now given the fact that people are getting vaccinated and how concerned are you about it? And can you just be crystal clear why is it okay for kids to be three feet apart, but adults in the workplace, for example, still need to be six feet apart? Thank you. Jeff Zients: (28:56) So let's have Dr. Fauci answer the first question about increases in some states and Dr. Valensky on three versus six feet. Dr. Fauci. Dr. Fauci: (29:03) Yeah. Thank you very much, Jeff. Yes, that's an excellent question. And it really relates to what we have been saying on the past few briefings that we've given. We're at a position right now where we have a plateauing at around 53,000 cases per day. The concern is that throughout the country, there are a number of state city regions that are pulling back on some of the mitigation methods that we've been talking about. The withdrawal of mask mandates, the pulling back to essentially non-public health measures being implemented. This is something that each of us have expressed concern about that is really quite risky to declare victory before you have the level of infection in the community to a much, much lower level than 53,000 cases per day. Dr. Fauci: (30:01) So it is unfortunate but not surprising to me that you are seeing increases in number of cases per day in areas, cities, states, or regions, even though vaccines are being distributed at a pretty good clip of two to 3 million per day. That could be overcome if certain areas pull back prematurely on the mitigation and public health measures that we all talk about. Dr. Walensky: (30:36) Maybe I'll chime in. Thank you for that question, Kristen. The evidence shows that the risk of COVID-19 transmission among younger children is much lower than it is among teenagers and adults. And in particular, our school studies have shown that when children, young children, are masked, the distance of three feet is in fact safe and has a lower transmission risk. For adults, we don't have that evidence and for older children, and so we're continuing with the six foot guidance. Jeff Zients: (31:04) Just want to reiterate what the president said yesterday, which is consistent with what Dr. Fauci just said, which is it is a time for optimism, but not a time for relaxation. We need to follow the basic public health standards. We need to mask up and then we need to make sure everyone gets their vaccine when it's their turn. We cannot let down our guard at this point. Jeff Zients: (31:32) Kevin, one more question. Kevin: (31:34) One more question. We'll go to April Ryan with The Grio. April Ryan: (31:40) Thank you for letting me ask this question. What are the concerns with the variant and its severity as it relates to school age children? We're understanding that the variants are hitting the children harder than the original strain, and how does this play into these new guidelines for schools and the distancing three feet apart? Thank you. Jeff Zients: (32:03) Let's start with Dr. Fauci on the variant in kids, and then over to you, Dr. Walensky. Dr. Fauci: (32:08) Well, yes, obviously, as I mentioned in one of the first slides that I showed, that there is an increase in severity, but also it appears that the likelihood of a child getting infected is greater with this variant. That might relate not to anything specific about children, but that it is just in general more easily transmitted. So that would explain that. Regarding the school situation, I'll hand that back to Dr. Walensky. Dr. Walensky: (32:39) And what we can say is that it is in fact, while these variants are concerning, it is in fact the same disease and the same mitigation strategies, the masking, the distancing, work just the same with the variants as they do within wild-type disease. Jeff Zients: (32:54) Good. Well, thank you everybody for joining us. We'll look forward to Monday's briefing. Thank you.