White House COVID-19 Task Force Omicron Spike Press Conference Transcript January 5

Jeff Zients: (00:00) ... very transmissible variant. But it's important to stay focused on three things. First, we have the tools to keep ourselves, our loved ones, and our communities safe. And importantly, we have the tools we need to keep our schools open. The Biden administration has provided $130 billion in American Rescue Plan funding to schools to implement proven prevention measures, including ventilation and social distancing, and an additional $10 billion to support testing in schools. Jeff Zients: (00:36) Last March, we put teachers and school staff at the front of the line to get vaccinated before most adults. Most teachers are vaccinated and now eligible for boosters and all kids ages five and older are eligible for vaccinations. So we have the tools. We know how to keep our kids safe in school. About 96% of schools are open. Parents want schools open and experts are clear that in-person learning is best for kids' physical and mental health and for their education. The president couldn't be clearer. Schools in this country should remain open. Jeff Zients: (01:22) Second, the impact of rising cases depends on a person's vaccination status. While we are seeing COVID cases among the vaccinated, if you're fully vaccinated, and especially if you've gotten a booster shot, if you're eligible for a booster shot, you're highly protected and it's very unlikely that you'll get seriously ill. But if you're unvaccinated, you have a good reason to be concerned. If you get COVID, you're at a high risk of getting severely ill, being hospitalized, and even dying. So please get vaccinated, get your kids vaccinated, and if you're eligible for a booster, get a booster shot. Jeff Zients: (02:06) Third, the Biden administration is deploying every available measure to help states, communities, and hospitals confront this Omicron challenge. Military doctors, nurses, and EMTs are now in place assisting local hospital staff and states across the country with additional teams ready to deploy as needed. We've shipped 2.4 million pieces of personal protective equipment, PPE, in the last two weeks alone to help keep healthcare workers safe. We've established free testing locations across the nation with additional new sites opening soon in Maine, Maryland, Nevada, Delaware, Texas, and Washington state. Jeff Zients: (02:53) We've worked aggressively to stock our nation's medicine cabinet with a diverse portfolio of COVID treatments. It's important to remember that we have more effective treatments available now that at any point during the pandemic. Yesterday, the president announced that he's instructed the team to double the US government's purchase of the Pfizer antiviral pill from 10 million treatment courses to 20 million. In addition, we're working with Pfizer to accelerate the delivery of these pills and will now have the first 10 million treatment courses by the end of June, instead of the end of September. Jeff Zients: (03:32) These pills can dramatically decrease hospitalizations and deaths and are a game changer with the potential to alter the impact of COVID on people and on our nation. Bottom line, we have the tools we need to manage this surge in Omicron cases. With that, I'll turn it over to Dr. Walensky. Dr. Walensky? Dr. Walensky: (03:54) Thank you, Jeff, and good morning, everyone. I'd like to start by walking you through today's data. The current seven- day daily average of cases is about 491,700 cases per day, an increase of about 98% from the previous week. The seven-day average of hospital admissions is about 14,800 per day, an increase of about 63% over the previous week. The seven-day average of daily deaths are about 1200 per day, which is an increase of about 5% over the prior week. Over the last several weeks and over the holidays, we have seen a significant and rapid increase in COVID-19 cases. Dr. Walensky: (04:34) This increase reflects both cases caused by the Delta variant, and more importantly now, cases surging from the Omicron variant. Over the past month, we have seen the percentage of Omicron cases increase and the percentage of Delta cases decrease. Based on CDC genomic sequencing, we now estimate that Omicron represents about 95% of cases in the country and Delta represents the remaining 5% of the cases. The sharp rise in cases and the emergence of the more transmissible Omicron variant emphasizes the importance of vaccinations and boosters. Dr. Walensky: (05:09) This week, FDA made several vaccine authorizations and CDC followed these authorizations by making additional vaccine recommendations. First, FDA authorized and CDC recommended shortening the window in which people who receive the Pfizer COVID-19 vaccine can get a booster dose from six months to five months. Second, FDA authorized and CDC recommended that children ages five to 11 who are moderately or severely immuno compromised should get an additional primary shot of the Pfizer COVID-19 vaccine 28 days after their second shot to provide them additional protection. Dr. Walensky: (05:54) Today, CDC's Advisory Committee on Immunization Practices is meeting to discuss boosters for those 12 to 15 years old after FDA's authorization on Monday. I look forward to listening to the committee's discussion that will take place this afternoon. Current data demonstrate that receiving a booster dose is critical to provide against COVID-19 and the Omicron variant. CDC surveillance data and other studies from around the world have demonstrated the benefit of a booster dose after receiving only a primary series, including decreased risk of infection, severe disease, and death caused by COVID-19. Dr. Walensky: (06:36) In large national studies from Israel comparing those who are boosted with those who are fully vaccinated, a booster dose decreased infection by 10 times in all age groups. Similarly, in those studies, boosters resulted in a decrease in severe disease in individuals over 60 years old by 18 times and decreased severe disease in people age 40 to 59 years old by 22 times, and people who received a booster shot had 90% lower mortality due to COVID-19 than those who did not receive a booster shot. While these studies were done when Delta was the dominant variant in Israel, we expect to see a similar trend of increased protection over those who are boosted with Omicron. Dr. Walensky: (07:25) Vaccines and boosters are protecting people from the severe and tragic outcomes that can occur from COVID-19 infection. We're asking everyone to follow these four steps; get vaccinated and get boosted if you are eligible, wear a mask, stay home when you're sick, and take a test if you have symptoms or are looking for greater extra reassurance before you gather with others. With that, thank you. I will now turn things over to Dr. Fauci. Dr. Fauci: (07:57) Thank you very much, Dr. Walensky. What I'd like to do over the next couple of minutes is talk about the Omicron variant and some concerns particularly in the area of severity of disease, if I can have the first slide. I'm going to focus predominantly on severity, but let me just make a few comments to underscore many of the things that Dr. Walensky said. First of all, without a doubt unequivocally, we are dealing with a highly, highly transmissible variant that spreads rapidly. The data are overwhelming in that regard. Dr. Fauci: (08:28) Number two, immune evasion. Omicron evades immune vaccine protection against symptomatic disease, and to some extent to severe disease. However, as underscored by Dr. Walensky again, laboratory and clinical data indicate that booster shots reconstitute vaccine protection even against Omicron. Let's spend a moment now on severity of disease, which is less likely that Omicron will cause severe disease. I'm going to give you data from four separate sources just to underscore that, but then to... Dr. Fauci: (09:03) ... separate sources. Just to underscore that, then to end with a caveat. Next slide. Dr. Fauci: (09:06) These are data from South Africa. If you look at the three variants in blue, red, and yellow, with omicron being yellow, and take a look at admissions, oxygen necessity, severe disease, and death, in each case the yellow bar is significantly less than the red and the blue bar, which represent beta and delta. Next slide. Dr. Fauci: (09:33) If you look at data from the United Kingdom from three separate sources, the UK Security Agency, the University of Edinburgh at Scotland, and Imperial College, each of these show that in various parameters of disease severity, omicron appears to be less than delta. Next slide. Dr. Fauci: (09:55) Although this data is a bit more preliminary, but nonetheless indications from Houston, Texas indicate that we are seeing similar situations here in the United States. Next slide. Dr. Fauci: (10:08) This slide is from Canada, again showing that the risk of hospitalizations or death was 65% lower among omicron compared to delta, and the risk of intensive care was 83%. Next slide. Dr. Fauci: (10:25) If you go now to in vitro animal studies, these are interesting, but remember there is always a caveat associated with animal studies. In a number of studies, ones that have done individually and pooled, in mice and hamster models, it was shown that the virus of omicron proliferates very well in the upper airway and bronchi, but actually very poorly in the lungs, which actually goes along with, doesn't prove but goes along with, the concept that you have a very transmissible virus with upper airway secretion, but a virus that has less pathogenicity in the lung. Next slide. Dr. Fauci: (11:09) So let's look at the bottom line of what I said, and I'll get to the caveat in a moment. Multiple sources of now preliminary data indicate a decreased severity with omicron. However, we really do need more definitive assessment of severity with longer-term follow-up here and in different countries. But the big caveat is, we should not be complacent, since the increased transmissibility of omicron might be overridden by the sheer volume of the number of cases that may be of reduced severity but could still stress our hospital system, because a certain proportion of a large volume of cases, no matter what, are going to be severe. So don't take this as a signal that we can pull back from the recommendations that you just heard from Dr. Walensky about the need for vaccination, for boostering, for wearing masks, and all the other CDC recommendations. Dr. Fauci: (12:17) So let me close with the final slide, just a word about children, because we're getting asked about that. The omicron variant so far appears to be less severe than the delta, but remember the caveat. Rapid community of spread is seeing larger numbers of children being hospitalized, again, mostly among the unvaccinated. Dr. Fauci: (12:42) And about vaccination, just to refresh your memory, the Pfizer-BioNTech is now authorized and recommended for children from five to 17. Children from 12 to 17 can get a booster. The FDA authorized 12 to 15, and as Dr. Walensky said, today the ACIP will meet about that for recommendation. Dr. Fauci: (13:03) And finally, a question that many ask, and I'm sure many of the reporters who have children are asking this. What about kids from six months to five years? Those studies are ongoing now to get the right dosage regimen to get to where we want to be. And likely the clinical trial are ongoing in individuals less than five years. Hopefully in the first half, hopefully towards the earlier part of the first half, we may have some information so that we can vaccinate children of that age. I'll stop there, and back to you, Jeff. Jeff Zients: (13:38) Well, thank you, doctors. With that, let's open it up for some questions. Kevin? Kevin: (13:44) Thanks, Jeff. We have a lot of questions today. Please keep your questions to one question. We'll get through as many as we can. First let's go to Jeannie Baumann at Bloomberg. Jeannie Baumann: (13:54) Hi. Thank you so much for taking my question. I know Dr. Walensky has said part of the reason that CDC is not requiring a test after five days of isolation is that's not what the tests are designed to do. So I was just wondering if there are plans by RADx or other programs to develop tests that could actually detect how infectious you are, how contagious you are. Thank you. Jeff Zients: (14:17) Dr. Walensky, do you want to clarify the [crosstalk 00:14:20] Dr. Walensky: (14:19) Yeah. The FDA rapid tests are authorized, as you say, Jeannie, for diagnosis. They are not a quantitative test. They are a qualitative test to diagnose. They're authorized for use in the first seven days of symptoms. They are authorized for use serially in things like test-to-stay, where you have a negative and another negative. You can confirm that people continue to be negative. Maybe I'll pass it to Dr. Fauci to talk about RADx and what is going on in the design of other tests for quantitative purposes. Dr. Fauci: (14:57) Yeah, okay. Obviously there's a lot of work going on in the Bioimaging Bioengineering Institute looking at refining and fine-tuning tests from every aspect, from sensitivity, specificity, and predictability. Those are ongoing studies now with a considerable investment and a number of investigators. Thank you. Jeff Zients: (15:18) Next question. Kevin: (15:22) Let's go to Zeke Miller at AP. Zeke Miller: (15:26) Thanks for doing this today. For Dr. Walensky, I know there's been a number of questions about this over the last several months, but given the data you've discussed today about the benefits of booster doses, and Dr. Fauci's comments yesterday about potential changes to CDC policy, is the CDC going to change its definition of booster doses? And then for Jeff, for people who are not fully up to date with their vaccination, meaning they're eligible but haven't gotten a booster, should they be expecting to see that some of the prohibitions that people who are not fully vaccinated, whether it comes to travel or employment with the federal government, that they would be subject to some of those prohibitions down the line? Kevin: (16:10) Dr. Walensky first. Dr. Walensky: (16:12) Yeah, super. Thank you, Zeke. Individuals are considered fully vaccinated against COVID-19 if they've received their primary series. That definition is not changing. But consistent with how public health has historically viewed or even talked about how we recommend vaccines, we are now recommending that the individuals stay up to date with additional doses that they are eligible for, and we have now available how you can stay up to date with your COVID-19 vaccines based on what vaccine you have received and what age group you are in. That is available now on the CDC website. Back to you, Jeff. Jeff Zients: (16:47) Zeke, to repeat what Dr. Walensky just said, someone is considered fully vaccinated if they received their primary series of vaccines. If you think about the different requirements, I think you mentioned travel, the OSHA and CMS rules as other examples, that has not changed, and we do not have any plans to change that. I do think it's really important to recognize the vast majority of hospitalizations and deaths are among the unvaccinated Americans, and completing the primary vaccination series is clearly a critical step to prevent severe outcomes, with boosters, as Dr. Walensky said, giving the highest level of protection. So we'll encourage everybody to get vaccinated, and when eligible, boosted. As to the definition, someone is considered fully vaccinated if they've received their primary series of vaccine. Next question. Kevin: (17:39) Let's go to Jacqui Heinrich with Fox News. Jacqui Heinrich: (17:42) Thank you guys for doing this briefing. I wanted to ask about the FDA's recommendations that have come out since November, and seemingly happening without consulting the panel of independent experts that were consulted for approvals on the vaccines themselves. Has there- Jacqui Heinrich: (18:03) [inaudible 00:18:00] for approvals on the vaccines themselves. Has there been a policy change or sort of a shift away from standard practice when it comes to recommendations for boosters versus the process that everyone went through for the vaccine itself? Jeff Zients: (18:19) Well, I would defer to the FDA on the specific FDA question, though, I do know that FDA like CDC, where I will ask Dr. Walensky to comment about her reliance on the expertise of the ACIP, does consult with its experts on a regular basis and formally convenes them as you know, regularly. Jeff Zients: (18:40) Dr. Walensky, do you want to talk about the CDC experience with your group of outside experts in the ACIP? Dr. Walensky: (18:46) Yeah, absolutely and thank you for that question, Jackie. So obviously these are unprecedented times where there's so much action happening right now with regard to vaccination. And given those unprecedented times, we've convened our advisory committee on immunization practices, more than ever before. We had a meeting the week prior to Christmas and we are now having a meeting today. So the week after New Year's and I am in regular touch with these experts to ensure that they are confident as to the discussions that they feel like need to be had as we're making decisions about vaccination for the country. Jeff Zients: (19:26) Great. Next question, please. Speaker 1: (19:27) Let's go to Jeremy Diamond at CNN. Zeke Miller: (19:32) Hey, thanks very much for doing this. Couple questions for Dr. Walensky. Dr. Walensky, last week, you said that we actually don't know how our rapid tests perform and how well they predict whether you're transmissible during the end of the disease. But now the CDC guidance says people who test positive on an antigen test at day five should continue to isolate for another five days. So I'm hoping you can explain, which is it? Do these tests serve a purpose to assess transmissibility or not? Zeke Miller: (19:58) And secondly, amid the additions to the new guidance yesterday, you say that people should avoid travel, restaurants, and eating around others at home and at work until 10 days. So why wasn't that information included last week and how do you expect people to keep track of what they can and can't do? Dr. Walensky: (20:19) Yeah. Thank you for that question, Jeremy. So first I will say, as noted before, the FDA has authorized these rapid tests for early in the disease course, the first seven days. They've clarified that, or they've said that these tests are for qualitative purposes, not quantitative purposes, meaning we can't tell how transmissible you are based on a positive or a negative test. And that negatives are often most helpful when we're using them serially, multiple times in a row. Dr. Walensky: (20:49) That said, after we released our guidance or our recommendations early last week, it became very clear that people were interested in using the rapid tests, though not authorized for this purpose, for this purpose after their end of isolation period. And because there was interest in using them for this reason, we then provided guidance on how they should be used. So if one is to take an extra step and perform a test at the end of their five day isolation period, we wanted to make sure people understood how they should be interpreted. Dr. Walensky: (21:24) If that test is positive, people should stay home for those extra five days and if that test is negative, people really do need to understand that they must continue to wear their mask for those extra five days to complete a 10 day isolation period. Back to you, Jeff. Jeff Zients: (21:44) Next question, please. Speaker 1: (21:47) Go to [Amed 00:21:48] at Reuters. Amed: (21:53) Hi. Yeah, thank you. My question is for Dr. Walensky. Is the CDC considering ending the practice of releasing daily infection counts for the US, given that there are so many test results that are not being reported? And are you considering only focusing on hospitalizations and deaths? Thank you. Dr. Walensky: (22:18) Yeah, thank you for that question Amed. Obviously we need to focus not only on severity of disease and importance of our healthcare infrastructure, but also case counts are often a leading indicator because the severity of disease and healthcare infrastructure might lag behind what is happening in case counts. So we're thinking through all of that right now. Thanks for that question. Jeff Zients: (22:43) Next question. Speaker 1: (22:45) Let's go to Cheyenne Haslet at ABC News. Cheyenne Haslet: (22:49) Hi, thank you. This is for Jeff. I know the RFP just closed and exact contracts are still in the works for the 500 million plan in January, but big picture can you say the confidence that the rapid test companies authorized in the US can actually produce 500 million extra tests in January for the plan and will those tests be coming off of the shelves at pharmacies at all? Jeff Zients: (23:16) No, these are additional tests and this is made possible by the fact that the FDA across the last few months have authorized many more rapid tests. So there's a lot more capacity for rapid tests. Back in September, there were about 50 million, fewer than 50 million a month. We're now running above 200 million, but with all the companies that have now been authorized as the capacity for the US government to purchase the 500 million now and not disrupt or in any way cannibalize the tests that are on pharmacy shelves, and on websites, and used in other settings. Jeff Zients: (23:53) Overall, we're making significant progress on the 500 million as of yesterday. As you mentioned, the public contracting process is closed. Deliveries of tests from manufacturers to the US government will begin over the next week or so. Americans will start receiving free tests in the coming weeks. We will set up a free and easy system, including a new website to get these tests out to Americans. Obviously this is an unprecedented action to have a half billion test bought by the US government and distributed for free and we'll continue to do more and more to increase access to testing, given the extreme demand that's been driven by the transmissibility of Omicron. Next question. Speaker 1: (24:38) Let's go to David Lima at Politico. David Lima: (24:44) Hi, thanks for taking my question. I wanted to ask, Quest Diagnostics announced last night that its turnaround time is now on average two to three days up from one day for lab-based PCR test. Their labs have told me that they're having challenges with staffing, infections among staff, and difficulty finding and hiring enough qualified lab techs as a bottleneck, not necessarily the supply chain pipette or reagent chemicals like last time. I wanted to ask what, if anything, can the federal government do to alleviate staffing issues at labs before turnaround times continue to deteriorate? Jeff Zients: (25:24) Well, I think we need to do everything we can across all aspects of testing. I think that it's clearly, as I just said in the prior question, there's unprecedented demand given the transmissibility of Omicron. And as the president said, we know this remains frustrating for people getting tested in many parts of the country. So we are working to do all we can, including setting up additional testing sites, as I mentioned in my opening comments, across many states. Jeff Zients: (25:57) There are 20,000 free testing sites. FEMA is going to go ahead and add sites in Maine, Maryland, Delaware, Texas, and Washington states. Drug stores are restocking and starting next week, those are the at home tests, as opposed to the PCRs that you're asking about. They are restocking and as of next week we'll be able to have at home tests reimbursed by commercial insurance. So a lot's going on with testing. As the specific issue with staffing at the labs, that's something that I'll have the team look into and we'll get back to you, David. Next question. Speaker 1: (26:37) Let's go to Catherine Yuam at [inaudible 00:26:41]. Catherine Yuam: (26:44) Thank you very much for taking my question. On December 23rd, the CDC issued a guideline saying that healthcare workers with COVID-19 could return to work after seven days with a negative test. About four... Catherine Yuam: (27:03) ... with a negative test. About four days after that, the CDC issued a guidance not requiring a negative test after five days for people to return to work. Can Dr. Walensky just explain the distinction between those two guidances and whether the omission of a testing requirement to emerge from isolation was driven by the shortage of available tests? Dr. Walensky: (27:36) Maybe I'll take that in two parts. First of all, this has nothing to do with the shortage of available tests, because you can see in our quarantine guidance that we actually do recommend a test for people to emerge from quarantine, and we do anticipate that there will be more people in quarantine than there are in isolation. But to your question about healthcare workers, our infection control and prevention guidance for healthcare workers is historically, and always, much more conservative than it is for the general public, and that is by design. That is because our healthcare workers are routinely caring for people who are immunosuppressed, routinely caring for vulnerable populations. So it's absolutely the case that all of our healthcare worker guidance with regard to COVID-19 and all other transmissible diseases are much more restrictive and much more conservative with regard to return to the workplace for our healthcare workers. And that's the reason for the discrepancy. Jeff Zients: (28:35) Next question. Speaker 2: (28:36) All right, a couple more questions. Let's go to Meg Tirrell at CNBC. Meg Tirrell: (28:41) Thanks. Folks have been noticing that the prices of rapid tests at retailers like Walmart just went up from the $14 at cost price, and the retailers say it's because this White House program that held the test at cost for three months has ended. I'm wondering... Obviously, the 500 million free tests are coming and we're about to start getting the reimbursement for the tests, but was there any consideration or discussion about trying to continue keeping these tests at cost? And are you confident that when the insurers start to reimburse for the rapid tests, that we won't see the retail prices spike because insurance will cover them? Jeff Zients: (29:20) So Meg, thanks for the question. You are right. Amazon, Walmart, Kroger all stepped up a few months ago and did the right thing by selling at-home tests for the past 90 days or so. During that period of time, as we've talked about, we have worked to really scale up and expand the number of at-home tests, both the quantity and the choices. And there are now tests at lower price points, including single-pack tests. In addition to that, we have 20,000 free testing sites, and we increase the number of sites each day. As you said, Americans will start to get reimbursed by insurance, and so we can expect that those tests will be reimbursed by commercial insurance starting next week. So the 500 million new tests that are going to become available through the website, those are all going to be free. So the cost of getting a test should be free through reimbursement, through the 500 million, through the 20,000 sites for Americans who want free testing. Next question. Speaker 2: (30:34) Last question. Let's go to Sabrina Siddiqui at the Wall Street Journal. Sabrina Siddiqui: (30:40) Thank you. In our coverage, we're hearing from a lot of parents who have children under five for whom there's no vaccine. These parents are boosted, but given Omicron's transmissibility even among boosted people, I think the questions they have are one, is there a more specific set of guidelines for parents with children under five? Should they be avoiding indoor gatherings or taking additional precautions to protect their kids? And two, what do we know about severity of illness and possibility of long COVID in children under five? Jeff Zients: (31:04) Let's do the severity piece first. Dr. Fauci, you covered some of this earlier, and then Dr. Walensky on any specific guidance for parents with kids under five. Dr. Fauci: (31:13) Yeah. Again, just to reiterate what I said I believe was on the last slide, that in general, Omicron appears to be a less severe disease across the board, but the sheer volume of infections because of its profound transmissibility mean that many more children will get infected. And as many more children will get infected, a certain proportion of them, usually children that have underlying comorbidities, are going to wind up in the hospital. That is just an inevitability. Given the high degree of transmissibility, we should follow all of the guidelines of the CDC. One of the best ways to prevent infection in children who are not able to be vaccinated because of their age is to surround the children with people who are vaccinated and to do the important things of... When they are out, make sure that if they're old enough to be able to tolerate a mask, put a mask on them, particularly in congregate settings. The CDC is very clear about that. Just follow those guidelines. Jeff Zients: (32:19) Dr. Walensky, anything to add? Dr. Walensky: (32:21) I don't have much to add, except to say that the best way to protect your children under five is to put a mask on if they're over two, to surround themselves by people who are vaccinated and boosted, and then to take those precautions that you can as a parent: wearing a mask in public indoor settings, taking all those layered mitigation strategies so that you are at lowest risk of bringing disease home to your children. Jeff Zients: (32:45) All right. Well, thank you, everybody. Talk to you soon. Thank you