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Dr. Anthony Fauci: Death Toll "Likely Is Higher" Thank 80,000 Plus Reported; Dr. Anthony Fauci: Go By Guidelines On Reopening To Avoid Spikes; Dr. Anthony Fauci: "We Had Better Really Careful" Since All Effects Are Not Known; Dr. Anthony Fauci: "Going In The Right Direction," But Outbreak Not Controlled; Dr. Anthony Fauci: Shouldn't Be "Cavalier" Thinking That Kids Are Immune To Virus. Aired 12-12:30p ET
Aired May 12, 2020 - 12:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SEN. BILL CASSIDY (R-LA): --seems a wasted effort. I say that because children play such a role in both protection of disease, the spread of disease et cetera. So you're thoughts on that because it really seems that's the one study where you can have you know not cookie cutter but a certainly a pattern which you can be followed.
DR. ROBERT REDFIELD, CDC DIRECTOR: Senator, I must have been misunderstood. When I was talking about differences I was thinking of the difference between an elementary school, a high school and a college in terms of how we have trade school, there may be differences in how you integrate a testing strategy, but I do think having a testing strategy with different options for people to evaluate this on different principles will be important in terms of guidance.
CASSIDY: Dr. Fauci, you persuasively argued that the risk of reopening prematurely is great. But I think the frustration if I think of children in particular, the risk benefit ratio of a child being at home potentially away from enhanced nutrition without the parents able to work because schools provide daycare without the monitoring at sometimes occurs for incidents such as child abuse.
But perhaps most importantly for all children the opportunity cost of our brain which is forming not having access to the information that will help that brain form optimally. Now has there been any source of risk benefit ratio for the child?
Yes, there are risks for Kawasaki, but they're particular risk for missing out on a year of education particularly for those who less in rick backgrounds I guess I am very concerned about that tension, what are your thoughts on that?
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: You make a very good point Senator Cassidy. It is very difficult of the unintended consequences of trying to do something that broadly is important for the public health and the risk of having a resurgence of an outbreak and the unintended consequences of having children to school. We fully appreciate that. I don't have an easy answer to that. We just have to see on a step by step basis as we get into the period of time with the thought of reopening schools, exactly where we'll be and the outbreak?
I may point out something that I think has been alluded to throughout some of the questions that we have a very large country and the dynamics of the outbreak on different in different regions of the country.
So I would imagine that situations regarding school will be very different in one region versus another. So it is not going to be universally homogenous and I don't have a good explanation or solution to the problem of what happens when you close schools, it triggers a cascade of events and could have some circumstances.
CASSIDY: Mr. Chairman, I close by asking the permission of the Chair to submit for the record the article that just came out in the journal - children are at risk from COVID-19.
UNIDENTIFIED MALE: It will be included. Thank you Senator Cassidy. Senator Warren.
SEN. ELIZABETH WARREN, (D-MS): Thank you Mr. Chairman and thank you to our witnesses who are being here today. I hope everybody is staying safe and healthy. In the past 16 weeks of 1.3 million Americans infected with Coronavirus, we now know that about 80,000 people have died and 33 million people are out of work.
Dr. Fauci, you have advised six Presidents, you have deadly viruses - in your career. So I would just like to hear your honest opinion. Do we have the Coronavirus contained?
DR. FAUCI: Senator, thank you for the question. Right now it depends on what you mean by containment. If you think that we have it completely out of control, we don't. I mean, if you look at the dynamics of the outbreak and we are seeing hospitalizations and infectious in some places such as in New York City which is plateauing down and started to come down.
New Orleans but in other parts of the country we are seeing spikes. So when you look at the dynamics of new cases, even though some are coming down, the curve looks flat with some slight coming down. So I think we are going in the right direction. The right direction does not mean we have by in means of total control of this outbreak.
WARREN: So right direction is I understand it we have about 25,000 new infections a day and over 2,000 deaths a day. I think those are the right numbers and some are estimating we could bet at 200,000 cases by June, is that right, Dr. Fauci?
DR. FAUCI: I don't foresee that as 200,000 new cases by June. I am hoping and looking at the dynamics of things starting to flatten often come down that we'll be much, much better than that, Senator.
[12:05:00] WARREN: Just to understand we are right now at 2,000 new infections a day and 25,000 new infections a day and 2,000 deaths a day.
DR. FAUCI: Right.
WARREN: And that's where we are right now?
DR. FAUCI: Yes.
WARREN: So let me just ask, if we know that it is possible to have this virus under better control, other countries have done like South Korea, but we are now three months into this pandemic and basically we've continued to set records for the number of people who are diagnosed and the number of people who died.
Dr. Fauci, you recently said that a second wave of Coronavirus in the fall was quote "Inevitable" but that if America puts in place all the counter measures that in need to address this, we should do reasonably do well. And the counter measures you identified are things like continued social distancing, significantly more testing, widespread contact tracing.
You also said that if America does not do what it takes, and this is your quote, we would be in for a bad fall and a bad winter. So right now we are about 16 weeks away from Labor Day. That's about the same length of time since the virus was first detected here in the U.S., do we have enough robust counter measures in place that we don't have to worry about a bad fall in the winter?
DR. FAUCI: Right now the projection as you heard from Admiral with regarding to testing and others elements that would be needed to respond. The projection is that by the time we get to the end of summer, and early fall and we'll have that in place. That is the projection--
WARREN: We don't have it in place now but we are projecting that we'll have it in place. And let me just ask the other side of this. If we don't do better on testing on contact tracing and on social distancing, will deaths from Coronavirus necessarily increase?
DR. FAUCI: Of course, if you don't do an adequate response, we'll have the deleterious consequences of more infections and more deaths. That's the reason why, you quoted me Senator quite correctly. Everything you said and I will standby that.
If we do not respond in an adequate way when the fall comes, given that it is without a doubt, that there will be infections that will be in the community and we run the risk of having a resurgence. I would hope by that point in time in the fall that we have more than enough to respond but if we don't, there will be problem.
WARREN: I appreciate your hope and I wish we can tell the American people that the Federal Government has this pandemic under control. But, we can't. In fact, you said that the virus is not under control in the U.S. We have not yet taken the measures necessary to prevent a second wave of deaths. We all know that the people are going to much infected are going to be seniors, essential workers, the people who are out on the front lines.
The President needs to stop pretending that if he just ignores bad news it will go away. It won't. The time for magical thinking is over here. President Trump must acknowledge that the Federal response has been sufficient and that more people are dying as a result. We are running out of time to save lives and we need to act now.
So, thank you Dr. Fauci for all you are doing. I appreciate it but the urgency of the moment is not here. Thank you.
UNIDENTIFIED MALE: Thank you, Senator Warren. Senator Roberts.
SEN. PAT ROBERTS, (R-KS): Thank you very much Mr. Chairman and thanks to all the witnesses. You are like the Fab Four. I guess it was the Fab Five back in a day. You are shining the light of truth in the darkness at individual - lights for sure. Thank you Mr. Chairman for emphasizing that we to be bipartisan as approach we're going to get anywhere and that obviously in the eyes of the--
I'm happy to say that we have a very great relationship with the Governor - who happens to be a Democrat obviously I'm a Republican. And her emergency management is spot on, Dr. Lee Morgan is doing enough jobs that are a rest of this morning I talked to Lee, situation in Kansas is not very good, I'm reading here Kansas receives 7,000 new COVID - with food processing facilities.
ROBERTS: That's a stage goats coming into Dodges, are supposed to getting out of Dodge. Dodge City is my home town. We are the hot spot in regards to and it's mainly because of two packing plants we have five that's up a 26 percent of the cattle market.
At any rate Kansas is going through a tough time at. - We shouldn't be worried about the safety of the food but the food supply chain. I think nationwide is under a great deal of stress. We see that in theory, we see that in poultry, we see that in park there. You can I think pigs in opposite the livestock industry.
It is only produced with part of agriculture has a stepped up so is the President declaring that these are packing plants are a national asset with progress Dodge City when we first started out ahead five - that's between four and six, five it is not 50 million as we hope to receive and it has been said by having one of the witnesses.
The reason I'm really harping on all of the problems we're having in agriculture on top of the tactics the relationship with China is such that even at first breakthrough with regards to trade to China seems to be on hold now.
And that's another price depression and this is going on five or six years where our prices have been below the poultry production. In resolve our consumers are really figuring out that food doesn't come from a grocery store. And I'm very worried that the harm to good value chain is very real not to mention the financial situation. There are farmers, ranchers and growers all stages. Now having said all that I want to ask. Admiral Giroir you spoken about the importance of having diversity in kinds of tests that are available, the five packing plants we have in campus if we could get a rapid test and we can get it as we - hope we ask for because of the hot spots that are developing not only in Kansas but also doing great harm to the food value chain that would be absolutely wonderful? Would you speak to that sir?
ADMIRAL BRETT GIROIR, MD, ASSISTANT SECRETARY FOR HEALTH DEPARTMENT OF HHS: Yes, thank you Senator both Doctor Redfield and I have been very actively involved in getting strategies for the industry particularly in Kansas. We are supplying very heavily the public health labs with rapid diagnostics as well as urging them to areas like that.
The one trade off however is that the rapid the "Rapid point of care diagnostics" is very slow. So each machine can only do four per hour and that's very, very slow. So it's a mix of testing that you need at these kinds of situations on sort of the high throughput tests that are available at a major lab in our Quest Lab right there in Kansas as well as a mix of the rapid testing and that's what we're supplying in order to provide a comprehensive holistic solution. And I believe CDCs on the ground as well and Kansas supporting that.
ROBERTS: I appreciate that if you only do it for an hour that's not a rapid test made which a rapid slow test. I'm not quite sure how you define that term? I for one think that it is we reopen and by the way Governor Kelly started the opening process first of this month and this May 18 and then we go to June and then the hope is we hope not.
But we do have contingency plans that if that doesn't work as an aptly described by. Dr Fauci I think we'll be up right. But this is going to be a tough go. I have to tell you that in terms of agriculture we're not in good shape. I appreciate everybody's - and the job that you were doing. I will stand beside you when you're taking the booze and behind you when you're taking ops.
UNIDENTIFIED MALE: Thank you Senator Roberts. Senator Kaine.
SEN. TIM KAINE, (D-VA): Thank you Mr. Chair to the committee leadership and witnesses for calling this important hearing. The last time Dr Fauci and Hahn were before us was March 3. I have a slide that I want to put up that shows what's happened in America since then.
The chart which is here compares the experience of United States and South Korea on three dates. On January 21 both nations experienced their first case of COVID-19 at that time the unemployment rates in both countries were essentially identical.
On March 3 when the witnesses were last year South Korea had experienced 28 COVID-19 deaths and the U. S. has experienced 9. Again the economies of both nations as measured by the unemployment rates were nearly identical but now the story changes.
As of yesterday more than 81,000 Americans have died and the U. S. economy has experienced job losses not seen since the Great Depression. Meanwhile the economy of South Korea has not changed dramatically at all.
KAINE: And the death toll is now at 256. South Korea is smaller than the United States one sixth of our population but even if you bought up the death toll to reflect the difference the per capita death toll in the U. S. is more than 45 times the rate in South Korea.
And health care carnage here is causing a near depression while South Korea has protected its economy by managing correctly. I could have done this chart with other nations the U. S. has the 7th highest per capita death rate in the world. Our death rate is off the charts higher than that in India, Australia, New Zealand, Japan and Mexico.
It's nearly three times the death rate in Germany, twice as high as Canada's rate. The question is why? If we want to open up our economy and schools we have to learn the lessons of nations that have managed as well.
Here are some things that don't explain the difference. Our hospitals are as good as or better than those in South Korea. Our health care provider's heroes are as good as or better than those in South Korea. Our research capacity is as good as or better than in South Korea and we have more resources than South Korea.
Our GDP is 12 times South Korea's and our per capita income is 50 percent higher. So to Dr Fauci, the death roll in the United States - the death rate in the United States especially when compared with other nations is unacceptable isn't it?
DR. FAUCI: Sorry sir. Yes, of course. I mean our death rate at that height is something that in any matter of form in my mind is unacceptable.
KAINE: And Dr. Fauci, the experience of other nation's shows that the U. S. death rate is not only unacceptable but it is unnecessary isn't that correct?
DR. FAUCI: I don't know if we could say that Senator.
KAINE: But would you say that the U.S. has to do better?
DR. FAUCI: Of course you always have to do better. I mean as a musician--
KAINE: And the experience of South Korea shows how our nation manages the health care crisis has a huge impact also it's an on its economic condition is not the case.
DR. FAUCI: That is the case sir. I understand where you're going with this but I have to tell you there is a big difference between South Korea and the United States in terms of the outbreak.
KAINE: And let get to that. I want to get to factors that do explain the differences since we know it's not resources are our health providers. First is testing, South Korea began aggressive testing much earlier than the U. S. now in the 5th month of the pandemic we've surpassed South Korea in per capita testing but in the critical month of March, South Korea was testing its population at a rate of 40 times the testing in the U. S.
Admiral Giroir, Dr Giroir has set out the standard for us when we get to September he says the United States needs to do 40 to 50 million tests a month to be safe and that equates to about 1.3 million to 1.7 million tests a day.
Yesterday we did 395,000 tests. We've got a long way to go. A second factor is contract tracing. South Korea embraced a rigorous contact tracing program right from the beginning the United States still has not engaged in a national contract tracing program isn't it right? - That to Dr. Fauci or Dr. Redfield?
DR. FAUCI: So I think that question would best be directed to the CDC.
DR. REDFIELD: When the outbreak started sir we have an aggressive contact tracing program but unfortunately as cases rose it went beyond the capacity and then we want to mitigation. So we lost the containment and it is clearly not--
KAINE: And that was key to the economy as well because South Korea did testing, contact tracing, protect, isolate the sick and then they didn't have to shut down which helped their economy. Social distancing is a third factor we talked about it but finally last one health care system.
Would you agree with me that it helps keep people safer either from serious conditions or death from COVID-19 if they have access to health care?
DR. FAUCI: Yes of course.
KAINE: Of course, that's the case. In South Korea in 97 percent of the population have health insurance. In the United States before COVID-19 millions didn't have it and lacked access to health care. The massive job losses in the last months threatened to take health insurance away from millions more.
And President Trump is doing all he can to dismantle the Affordable Care Act which would take health insurance away from tens of millions more. Let's learn the lessons from those who are doing this right. Thank you Mr. Chair I yield back.
GIROIR: Can I make a clarification please Mr. Chairman. This is Brett Giroir. I just wanted to clarify that I did project that we will have the ability to perform 40 to 50 million tests per month in that time frame. But I said if needed that, that at that time I am not making a proclamation.
All we have to really understand what where the epidemic is? What the community spread is before we can estimate the number of tests that are needed? I was simply stating the fact that our combination of testing capabilities will be at that level even boring new input from the NIH.
UNIDENTIFIED MALE: Thank you very much Senator Kaine. Senator Murskowski.
SEN. LISA MURSKOWSKI, (R-ALASKA): Thank you Mr. Chairman and gentlemen thank you for being here this morning virtually but also for all you have been doing for these many, many months. Alaska's doing okay, right now from a numbers perspective and quite honestly we want to keep it that way because we know we have exceptionally vulnerable populations.
We know we have a geography that is challenging. We know that we have facilities that are very limited. Last hearing we had an opportunity to hear from Doctor Collins and he shared where they are with the Red X and also spoke to Red X Up which was very interesting about what we can be doing in rural areas but focusing on hot spots.
And as I reminded him we don't want to be a hot spot in Alaska. So every effort that we make to keep the virus out of Alaska is our lives that are saved. I educated him on the community of Cordova that is just getting ready to open it - it's a Copper River Salmon Fishery in two days and was able to share that they had had one worker tested positive as he was coming in from the lower 48 to come to work.
The good news on that is that all the protocols that we had put in place seem to be working. The quarantine, the isolation is not only for that individual but for others that he had come in contact was secured.
So I want to recognize the assistance that we have received from the administration Doctor Eastman is in the state at this moment the Chief Medical Officer for the Department of Homeland Security going out to rural communities to really better understand our vulnerabilities. Go to some of our fishing communities to again understand how we can successfully prosecute fisheries when you have to bring workers in from the outside?
We thank you for the assistance with regards to additional testing capacity. I've been in contact with our Chief Medical Officer of the state this morning and the Mayor of Cordova. His better understanding again do we have the test that we need? What do we need on the ground?
And one of the things that I would like to have clarified in and this is probably to you Doctors because you are being so helpful in kind of shining a light on what we need to be doing in these rural areas?
But so much of the focus has been on hot spots and responding to the hot spot. But how do you keep those rural, remote and small communities from becoming the hot spots in the first place? Are we doing enough? And right now the strategy has been we just lock it off.
The travel restrictions that are in place are apparently working but they're also devastating our economy whether it's tourism or weather is our resource industries or whether it's the potential for our fisheries. So Admiral if you might speak to that aspect of it and then I have a very important question as it relates to contact tracing that I'd like to direct to either Admiral Giroir or Dr. Redfield.
GIROIR: Thank you Senator. And as you know you have an outstanding state health officer Doctor.
MURSKOWSKI: We do.
GIROIR: I've had the privilege of working with her and you have a very good protocol in trying to keep Alaska safe by isolation over a period of time when you come in. As you know we also work with the state to meet your very challenging testing requirements because you can't really - you know send labs out a thousand miles away so we put out real customize mixed point of care and also the safety of machines.
I think we sent 9 or 10 new to Alaska and about 50,000 tests which are about four times then you've done to date collectively in order to provide that support. So again I do think there's a comprehensive strategy that you do have.
But again the mitigation it to the degree that you can given the circumstances, the face mask, the hand washing the hygiene.
GIROIR: We understand fully the challenges particularly in the fishing environment in the remote but these entire have to come together the testing, the tracing, the mitigation, and the hygiene factors to try to keep your community safe.
And we really understand culturally that many of your communities all were almost annihilated in the 1918 influenza pandemic. So and that memory is still very sharp and very hurtful to many of the citizens. So we want to do our best to assure them that we are giving them all the protection we can.
MURSKOWSKI: So Admiral, let me turn to Dr. Redfield because this relates to contact tracing. I think that this is very, very key part of how we move forward into getting people back to work getting people back to school?
Right now we have about a hundred people that are involved in contact tracing in Alaska that's clearly not sufficient. There's been talk about a national strategy but I think we recognize that we have teams in place whether it's American or whether it's Peace Corps or whether it's our public health corps.
What more do we need to be doing to make sure that once you've been tested positive you know then what happens after that? Who else needs to be brought into this? And I'm not convinced that we're focusing enough on that aspect of how we move to re opening if we haven't done the contact tracing?
DR. REDFIELD: Thank you very much Senator. I want to just reemphasize what you said. I think contact tracing capabilities is critical. It's going to be the difference from succeeding and containing this outbreak from once again in a wide scale community transmission or not.
Our positions as you know to deploy and redeployed the number CDC over 500 CDC individuals. We have another about 650 that you're trying to put into our - but most importantly we're trying to work with your health department with the resources that we've been able to give because of the - the mantles.
Also as you mentioned with these other agencies with Lab Corp, I mean with AmeriCorps with the Census Bureau to work together and have the state developed their contact tracing capacity. Some states have reactivated state work some states have reactivated National Guard while they begin to do this.
But I agree with you and I said it's going to be a significant effort to build the contact tracing capacity that we need in this nation. It will be state by state but it's going to need to be augmented probably in your state from what you just said that 5 to 10 folds and we're there to work with the states to help them push that needs to get in place before September.
UNIDENTIFIED MALE: Here we need to move.
MURSKOWSKI: Thank you.
UNIDENTIFIED MALE: Thank you Senator Murskowski. I don't want to commit any Senator off but we have eight more Senators who have 5 minute rounds and its 12:30 so I'd like to request that the Senators and the witnesses' just same questions and try to stay within five minutes would be appreciated. Senator Hassan.
SEN. MAGGIE HASSAN, (D-NH): Well, thank you Mr. Chair. Thank you and Ranking Member for having this hearing. Thank you to our witnesses today and please pass our thanks along to all of the hard working women and men in your agencies who I know have been working virtually around the clock to try to improve our response and keep Americans safe.
And Mr. Chair I hope you and all the witnesses are healthy and safe today as is everybody on your team. I wanted to start by echoing comments my colleagues have made about needing leadership from the CDC and our public health experts on how we are going to use facts and evidence as guidance so that our schools and our day cares and our businesses have the information they need to create safe and sustainable plans to re open?
And of course that means too that our testing capacity not only has to be enough but it has to be flexible enough to meet our needs. The key distinction between South Korea and the United States is not how many tests per capita over a certain amount of time we've done.
But the fact that at the answer to this pandemic South Korea was much more able to do a lot more tests per capita then we work and then follow that with all the other measures you've talked about so that we continue to need to identify the need and then build our capacity towards the need not the other way around.
I wanted to start with the question to you Dr. Fauci. First of all thank you for your work and your expertise. I wanted to start-