White House COVID-19 Task Force, Dr. Fauci Press Conference Transcript March 5

Andy Slavitt: (00:00) ... A moment to step back and remind people where we've come from, where we're going. Over the past six weeks, we've seen the nation rally together in an unprecedented way. Together, we've recovered from a storm, kept vaccination sites open late, packed and shipped vaccines throughout the night, seen companies across America make major commitments to masking in vaccinations and to underserved communities. Just this week, we went from a J& J authorization to shots in arms in three days. All that was topped by an announcement from two rival drug companies, Johnson & Johnson and Merck have an unprecedented collaboration to increase our vaccination capacity along with the U.S. Government. We've increased the vaccine supply to states, tribes and territories by more than 77%, launched programs to get vaccines into thousands of additional convenient and trusted locations like pharmacies, community vaccination centers, community health centers. Andy Slavitt: (01:04) There are thousands of Americans from our military servicemen men and women, to retired doctors and nurses, to members of the national guard, all vaccinating Americans across the country. The nation is coming together on this pandemic response and we are throwing everything we have at this virus. As much sacrifice as this is required from everyone, we were making progress. Six weeks ago, only 8% of seniors, those most vulnerable to COVID, had received a vaccination. Today, nearly 55% of people aged 65 or older have received at least one shot. Altogether, we've administered more than 82 million shots, more than any country in the world and we've opened or expanded more than 450 community vaccination sites. Today, we are announcing the addition of two new FEMA-supported, high- volume sites. Andy Slavitt: (02:09) The Atlanta Falcons stadium in Georgia and the Wolstein Center in Cleveland, Ohio will turn into FEMA- supported community vaccination sites with the capacity to deliver 6,000 shots per day each. Both of these sites sit in neighborhoods hit hard by the pandemic and are well-known in the community. This brings the total to 18 FEMA-supported sites across seven states with the ability to administer more than 60,000 shots per day. But I want to be clear, we owe the public straight talk, whether the news is promising or challenging. Progress demonstrates we can defeat COVID-19, but it does not equal success. It may seem tempting in the face of all of this progress to try to rush back to normalcy as if the virus is in the rear view mirror. It's not. Andy Slavitt: (03:12) Now years of watching football on TV has shown me that it's better to spike the football once you're safely in the end zone, not after you've made a couple of completions. The CDC and public health officials, locally, at the state level and nationally are all clear: wear a mask, not forever, but for now. Wear a mask now so we can get to a place where you don't have to. This is not just the voice of cautious public health experts. It is what businesses who want to remain open and many public officials of both parties who've lived through the last year are saying. As you will hear in a moment from Dr. Walensky, it is also what the data from the last year is telling us. With that, I'm going to turn it over to Dr. Walensky. Dr. Rochelle Walensky: (04:07) Thank you so much. It's a pleasure to be back with you today. I know there've been many questions about when CDC is going to release its guidance for fully-vaccinated persons and activities they can resume. These are complex issues and the science is rapidly evolving. CDC is working to assure that the communication we release on this guidance are clear and that the American public can act on them. Our goal, and what is most important, is that people who have been vaccinated and those not yet vaccinated are able to understand the steps they can take to protect themselves and their loved ones. We are making sure and taking the time to get this right and we will be releasing this guidance soon. Now, let's shift to an overview of the pandemic. Dr. Rochelle Walensky: (04:59) CDC's most recent data shows cases continue to fluctuate around 60,000 to 70,000 cases per day, with the most recent seven day average of 62,000 cases per day. We also continue to see deaths hovering around 2,000 deaths per day, with the latest seven-day average of 1,900 deaths per day. The current numbers remain concerning. Cases and deaths are still too high and have now plateaued for more than a week at levels we saw during the late summer surge, following six weeks of steady declines. This is why I'm asking you to double down on our prevention measures. I know the idea of relaxing mask wearing and getting back to everyday activities is appealing, but we're not there yet and we have seen this movie before when prevention measures like mass mandates are rolled back, cases go up. Dr. Rochelle Walensky: (05:57) An article published today and CDC's Morbidity and Mortality Weekly Report highlights the critical importance of these prevention strategies and the real risks when prevention measures are eased. This study looked at the relationship between COVID-19 cases and deaths and both state-issued mask mandates and restaurant resuming on-premises dining from March to December of 2020. The researchers found that increases in both daily death rates and COVID cases and deaths slowed significantly within 20 days of putting mask mandates into place and protective effect of the mask mandates grew stronger over time. In contrast, increases in daily death rates of COVID-19 cases and deaths grew more quickly within 40 to 80 days following restaurants being allowed to resume on-premises dining. Dr. Rochelle Walensky: (06:55) This report is a critical reminder that with the current levels of COVID-19 in communities and the continued spread of more transmissible virus variants, which have now been detected in 48 States, strictly following prevention measures remains essential for putting an end to this pandemic. It also serves as a warning about prematurely lifting these prevention measures. There's a light at the end of this tunnel, but we must be prepared for the fact that the road ahead may not be smooth and that half is within our control. By continuing to wear a mask and following CDC's public health recommendations while we get more people vaccinated, we can bring this pandemic to an end. Thank you. I look forward to your questions, but first I'll turn things over to Dr. Fauci. Dr. Fauci? Dr. Anthony Fauci: (07:44) Thank you very much, Dr. Walensky. I'd like to take up a bit on what Dr. Walensky just said. If I could have the first slide I'm going to spend the next couple of minutes talking about the daily trends in the numbers of cases that have been reported and how this relates to both the evolution of variance and how you handle variance. If you look at the far left part of the slide on the area between January and June, you remember many of us will recall very, very vividly in the end of the winter and the beginning of the spring, we had a surge that was dominated by the New York Metropolitan Area. Dr. Anthony Fauci: (08:28) After the surge. What we came down to was a baseline of about 20,000 cases per day. That is a very high baseline, relatively speaking. When we try to open up the country on the second peak, in the middle of the slide, the same thing. After we peaked, we started to come down, but we plateaued again at a very high baseline, in this case, 40,000. We've just now recently experienced the worst surge on the right hand part of the slide, which now- Dr. Anthony Fauci: (09:03) ... on the right-hand part of the slide, which now as you see, is starting to come down in a very nice deflection curve. The issue is if you look on the very far right of the slide, as Dr. Walensky has said, we are starting to plateau. I've blown that up in a little section, which is now sitting in the middle of the slide. That plateau is about 60 to 70,000 cases a day. When you have that much of viral activity in a plateau, it almost invariably means that you are at risk for another spike. Next slide. In fact, as the Washington post reported yesterday, many countries in Europe have seen just that. They had a decrease in cases over a six week period, they plateaued. And now over the past week, they saw an increase in cases by 9%. Something we desperately want to avoid. Next slide. Dr. Anthony Fauci: (10:06) How does that relate to variants? Let me just go through this. I refer to it as virology 101. What it really is, is some fundamental tenants of virology, namely RNA viruses like SARS-CoV-2 tend to mutate. They have poor proofreading mechanisms. A virus cannot mutate if it doesn't replicate and it replicates an infected individuals. A high baseline level of community spread of virus favors mutations and the evolution of variants. Now, variants get evolved because of selection pressures, namely just fundamental pressure to enhance its own replication and propagate itself, as well as pressure to evade neutralizing antibodies. This has important implications for vaccines, as well as the potential role of immunosuppressed people who get infected, don't clear the virus very rapidly and allow it to mutate in the individual. So a sub-optimal immune response favors the generation of variants. That's very, very clear when you're dealing with RNA viruses. Next slide. In fact, I had showed you in a previous press briefing, what the issue was when you have a first dose of, let's say, for example, Pfizer vaccine, very similar to the Moderna. You get a response that is protective, in this case, it would be about 52%. However, the second dose brings that level of antibodies quite high, which gives it redundancy to prevent the evolution as well as to protect against viral variants. Next slide. Said in a just plain and simple way, sub-optimal immune responses to wild type virus promotes the generation of variances and the lack of potency or redundancy of an immune response to protect and suppress variants is another issue of concern. Next slide. And so how do you address these threat, which we clearly are facing of a number of viral variants? On the one hand, vaccination. Maximize the immune response against the wild type virus. Dr. Anthony Fauci: (12:51) You can do that by the proper adherence to the regimens shown on the clinical trial or even plan as some companies are doing of in the distance, giving a booster to the wild type. Also, as I mentioned in a prior conference, perhaps plan as we are doing, with Moderna to boost with a variant specific vaccine. But importantly, there's another tool in our armamentarium. And that is what was emphasized by Dr. Walensky, namely adherence to the public health measures in an arena of a high baseline of infections with masks, distance, avoiding congregate settings, washing hands. And on the next and final slide just yesterday evening in JAMA, John Moore, a very accomplished biologist actually gave a nice description and hit upon many of the things that I just described to you. So if you want to look at it in some detail, I recommend you take a look at this article that came out yesterday. I'll stop there and back to Andy. Andy Slavitt: (14:04) Thank you. Okay, let's go to a Q&A. Speaker 1: (14:10) Great. First question. We will go to Sam White with WAB Atlanta. Dr. Rochelle Walensky: (14:15) Hey, thank you all for taking my question. I'm wondering if you can share some more details on this mass vaccination site you all are going to be setting up here in Atlanta? I have been covering the active mass vaccination effort from our county health department there. And I've heard from people in some parts of the South side of Atlanta, that Mercedes-Benz is still kind of a hard place for them to reach. So is there going to be further outreach to make sure people have access to this site and not just that it's set up? Andy Slavitt: (14:47) Sam, thank you for the question. So I can't give you the specifics on this site on this call, we will be glad to follow up with you. But I will say that with all of our mass vaccination site efforts, the first week, we really see a lot of adjusting to the needs of the local community, including how appointments are reserved, including whether there are mobile vans and clinics that need to be set up, including transportation issues and in arranging transportation. You may be aware that Uber and Lyft, the big two, have donated millions of rides. So we're going to try to make sure all those things are packaged neatly so that it is easier for people, particularly those who have more challenging time getting vaccinated to get there and get vaccinated. So thank you for the question. Next, please. Speaker 1: (15:40) Next, we'll go to Arla Sans at CNN. Arla Sans: (15:44) Hi there. Thanks for taking my question and doing this call. I have a few questions when it comes to the Johnson & Johnson vaccine. You guys have acknowledged that there's going to be a little bit of a break as far as the shipment and distribution of that. So what are you doing to prepare for the coming lull in the J&J supply and how is that going to impact places that have already incorporated this into their vaccination operations? And then separately, you've spent a lot of time stressing that J&J is equal to the other vaccines and that everyone should take it as, as soon as whichever vaccine is available to them. But we heard Detroit's Mayor Duggan saying that he's declining that initial allotment of J&J in part, because he believes that Pfizer and Moderna are better vaccines. So what exactly do you guys plan to do to counter this type of messaging, especially if it's coming from a local official? Andy Slavitt: (16:37) Yeah. Yeah. So look, I'm going to actually ask Dr. Fauci to talk about the comparability of these three very successful vaccines in a second. But I do think it's important to clarify that that was not actually the mayor's intent and that was that the mayor's comment. We've been in constant dialogue with Mayor Duggan, who said, in fact, that was not what he said or however it was reported. In fact, he is very eager for the Johnson & Johnson vaccine. And I think we would reiterate the message that for all of us, the first vaccine we have an opportunity to take makes absolute sense to take. So thank you for allowing us to clarify that. But Dr. Fauci, maybe you want to reiterate the guidance around these three vaccines. Dr. Anthony Fauci: (17:24) Yes. Thank you, Andy. As we've said many times and happy to reiterate it right now, we have three highly efficacious vaccines with a very good safety profile. Each of them are very effective in preventing clinically apparent disease. But importantly, all three of them have a very important effect of being extraordinarily effective in preventing severe disease and particularly, preventing hospitalizations and deaths. That's point number one. We don't compare- Dr. Anthony Fauci: (18:03) Deaths that's point number one. We don't compare one to the other. The only way that you can effectively do that is by having head-to-head comparisons in a clinical trial, which was not done. And so, as Andy said, and I'll reiterate, it's a question, if you go in and a vaccine is available to you, I would take the first available vaccine, because the most important thing to do is to get vaccinated and not to try and figure out what one may be or may not be better than the other. Stop there, Andy. Andy Slavitt: (18:38) Thank you. And I realized I didn't answer one element of your question which is, how are we preparing States and others in the distribution system for the pattern of vaccines that are coming off the line at Johnson & Johnson. And the same thing is true for Johnson & Johnson, as it is for Moderna and Pfizer, everyone we're distributing to, all the States and jurisdictions have at least a three week forward view as to their vaccinations that are coming. They're able to plan for them. And thankfully to date, even if you just look at the Pfizer and Moderna vaccines, we've taken them up about 77% so far and we will aim to continue to increase as much as possible. So next question. Speaker 2: (19:24) Actually we'll go to Tamara Keith at NPR. Tamara Keith: (19:30) Great. Can you hear me? Andy Slavitt: (19:31) I can. Tamara Keith: (19:32) Okay. Excellent. And you probably don't have the answer to this, but how soon is soon on this guidance for people with vaccines? There are now millions of people who are fully vaccinated and making life choices, like some grandparents I know who are getting on an airplane today. So there is a sense of urgency there and then I have one other question. Andy Slavitt: (19:58) So noting your sense of urgency, maybe I will and look, you're not alone. Everybody is eager to see what's next. The burden that falls on the CDC is not only to get the science right, but to communicate clearly in a way that's not confusing. But maybe I'll go back to Dr. Walensky for you to reiterate some of your points. Dr. Rochelle Walensky: (20:19) Yeah, I will just reiterate it's coming soon. We know that people are interested. I think the anecdote that you raise is one that is exactly why we want to make sure that the communication is crystal clear, and that is because everyone has their specific scenario of what they're trying and wanting to do. And so we really just want to make sure that it's very clear and can be easily adapted for individuals, their households and our loved ones. Tamara Keith: (20:42) And the other question I have is, when do you expect this crossover to happen, where it will go from a scarcity problem to then an administration problem, having enough people to put shots in arms and then from there to a hesitancy problem? And on the hesitancy, has anyone in this administration tried reaching out to President Trump, who got his vaccine privately, about maybe doing a PSA? Andy Slavitt: (21:15) So Tamara, thanks for the question. So question is, when do we go from having a situation where we have a shortage situation, which we have today, to one where we have an oversupply situation. And I think the best way to answer that question is, not with a precise date, but the fact that it's not a switch that flips, but it's a sliding scale that it happens differently community by community. And I will tell you that there are some communities we're already very engaged and very focused on communicating with people about the questions they have about getting off the fence and taking the vaccine. That's already begun. This has been a massive week of outreach led by Dr. Marcel Smith. But with many people across, not just this administration, but experts across the country, participating in that dialogue and it's happening increasingly on a local basis. Andy Slavitt: (22:06) So from our view, this is not something that will start at some magical day in the future. It has begun today, and it's something that we have to make sure we're addressing too. Did you have another part of your question? I'm sorry. I feel like I've forgotten one thing you asked. Okay. Well- Tamara Keith: (22:26) Um. Andy Slavitt: (22:27) Yes. Tamara Keith: (22:27) Yes, here I'm back. The question was whether anyone in this administration has reached out to President Trump, who quietly and privately got his vaccine, but would seem to be a perfect spokesman for a public service announcement to supporters who might be experiencing hesitancy. Andy Slavitt: (22:43) Well, we're glad that everybody who has taken the vaccine is talking about it, including him. We'll also note that we have governors of both parties who have taken the vaccine and who are being very public about it and others as well. I think many people are waiting their turn, but we find it helpful for everybody. I particularly liked the Dolly Parton song myself. That's one of my favorites. All right, next. Speaker 2: (23:13) Next [inaudible 00:23:16] Elsie Nord with PDS. Elsie Nord: (23:21) Hi, thanks so much. You guys can hear me? Andy Slavitt: (23:23) Yes. Elsie Nord: (23:24) Great. And it sounded like you touched on this a bit, but I want to go back to the idea of the Detroit mayor declining his city's allotted J & J vaccine and saying, in fact that it's a good vaccine, but Moderna and Pfizer are the best. How often is that happening and what are you doing to try to avoid this and what else can be said or done to make sure that cities aren't going to follow in his footsteps and how problematic, if at all, is that? And then I have a second question on vaccine hesitancy, but I want the first... I would ask the first one about the mayor of Detroit. Andy Slavitt: (23:56) Yeah. Let me reiterate. The mayor's office is indicated, after we talked to them, that that was a misunderstanding. That was not attended those remarks. So, and thankfully, I think as Dr. Fauci has said and we're seeing widely across the country, people are grateful and we're seeing an overwhelmingly positive response to having this third vaccine. And I think people understand the fact that they are not directly comparable given the time periods and with which they were tested and that they all make it pass the most important test, which is that they are able to prevent a disease, a particularly severe disease and death and at the 28 day at a hundred percent level. And by the way, that's including testing in South Africa, where we have one of the most dangerous variants. Maybe I'll go back to Dr. Fauci, again, because I don't think we can say it enough. And I think I will tell you that it's a great question, but the message is getting through. Dr. Anthony Fauci: (24:56) Yeah, Andy, we've got to get away from this issue of comparing one with the other, except to say that we have a highly efficacious group of three vaccines. And the critical issue that you said to repeat again, in the important area of preventing against very severe disease leading to hospitalization and death, it is virtually a hundred percent, in that regard. That is really good news. And again, people want to get vaccinated and you go to a place that will have a vaccine, almost all will have one or the other. I would just take the vaccine that is the most readily available to you. Andy Slavitt: (25:38) Thank you. And did you have follow-up on hesitancy? Elsie Nord: (25:41) Yep. I had a follow-up on hesitancy. I know there's been a lot of talk about obviously African-Americans and hesitancy, but I was also looking at hesitancy among Republican voters, in particular. There was a poll that showed in Michigan only about 29% of Republicans said they would get the coronavirus vaccine. I'm wondering if there's a special push for Republican voters, for conservative voters, who according to polling are showing a big amount of vaccine hesitancy. Andy Slavitt: (26:10) Yeah. And the only thing I would say, we've seen obviously a lot of the same information. We are engaged in swift stakeholder groups across racial and ethnic minorities, rural Americans, to reach young Americans, all of those are important. Our whole perspective is leave nobody behind. And in fact, I just, the only thing I would take a slight issue with is, we don't think this decision is a better political identity. And I think, and I can tell you everybody from evangelical leaders to media figures like Hugh Hewitt and others, reinforced the fact that while there may be different pockets of populations that may in fact identify with whether it's their location or their political identity and so forth. It's not driven necessarily by their politics. That's a good and important thing. Andy Slavitt: (27:03) ... Necessarily by their politics. That's a good and important thing because we don't think that this is about political identity. So, we are targeting specific groups with conversations and answering questions that people have, and those questions may differ based on where you live or how you identify. But this is not and nor should it ever become something that is a question of politics. We have another question. Speaker 3: (27:27) Last question will go to Kristen Welker at NBC. Kristen Walker: (27:32) Hi, everyone. Thank you for the question. Really appreciate it. Want to follow up with you on the report that you all referenced today, the fact that areas with mask mandates have seen decreases in their daily cases, and yet, areas where restaurants were open have seen increases in cases and even deaths. What's the broader message here, and does this mean that restaurants should close down, or does there just need to be more vigilance? And then, just as a quick follow-up, I know that the CDC data shows that a larger share of the white population has been vaccinated as compared to Hispanic, Asian, black populations. What's being done specifically to address that right now? Andy Slavitt: (28:15) Okay. Dr. Walensky, do you want to take the first? And welcome to, obviously, talk about the second if you'd like, as well? Dr. Rochelle Walensky: (28:22) Yeah. I think that the science is now following the messaging that we have. The messaging is follow the science. We have demonstrated that masks work. We have demonstrated that in-person dining, this is not the first report that demonstrates the impact of in-person dining and how cases and deaths will follow after in-person dining. So, I think all of this is very consistent. I think we've known that restaurants have led to cases, have led to clusters. So, I think this is yet another report at a population level, of a large population level over a durable period of time that has demonstrated that you have decreases in cases in deaths when you wear masks, and you have increases in cases in deaths when you have in-person restaurant dining. And so, we would advocate for policies, certainly while we're at this plateau of a high number of cases that would listen to that public health science. Andy Slavitt: (29:15) So, I'll just add to that. Number one, we are following the science, and we were following the data. We were following with the work of the CDC says. It's very clear that these interventions work, and they save lives. Why somebody wouldn't take advantage of a small intervention to save people's lives, that would be surprising. Just very clear. We'll say it. All three of us have said this. We're not done. We're not done. We're making progress, but there are also disturbing signs on the horizon. And every time we've gone through this pandemic, we've learned that you can look a few weeks ahead, and the world you see a few weeks ahead will not look like the world you live in today. And the signs of what you will see ahead are with you at the present, if you look at them. Andy Slavitt: (30:03) And I think Dr. Fauci and Dr. Walensky have been very clear about what we're seeing today. Very clear. And so, we have to be straight with the public. In terms of health equity, particularly with racial and ethnic minorities, we have been, I think, the first ones, the first ones to come out and say, "This is a challenge. And this is a hard challenge. And this is an important challenge." And it's been a pillar of everything we focused on. It doesn't mean it's easy, but I will tell you that there are three major thrusts to this initiative. Andy Slavitt: (30:35) The first is we have to meet communities where they are. We have to go to where people are. We have to make sure the transportation, working hours, et cetera, hit people to allow them to get vaccinated. And this is, in large part, as we all know now, an occupational disease, and it's a disease of living conditions. So, we can not allow just a system where we generically throw out vaccine supply and let whoever comes to get it, get it. We have to make these focused efforts. And we have some evidence in the case of our community vaccination centers, in the case of retail pharmacies, in the case of the emerging program on community health centers that these steps are working. Andy Slavitt: (31:20) Second trusted messengers. We are spending a lot of time with people locally, who people need to hear from and want to hear from to feel comfortable, whether they should be taking the vaccine. People have legitimate questions. Let me be clear. A question about whether I should take the vaccine or not is not an illegitimate question. These are legitimate questions. They need to be answered in a straightforward way with people who they trust because the record of these vaccines is just outstanding from an efficacy and safety standpoint. Andy Slavitt: (31:47) And third, data, data, data. The more we can look at this, the more we can see the problem, the better we can solve it, the better we can focus on solutions. So, we need more states to be contributing data to this effort. We are committed to trying to solve it. Doesn't mean it's easy, but we're committed to trying to solve it. Thank you for all the questions today. And I hope everyone has a good weekend.