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Nation's Top Health Experts Testify On Coronavirus Pandemic; Dr. Anthony Fauci: Next Two Weeks "Critical" As Number Of Cases Surge; Dr. Anthony Fauci: Yes, Institutional Racism Factors Into Higher Rate Of Serious Complications And Death Among Minorities; Dr. Anthony Fauci: Seeing A Disturbing Surge In Infections In Parts Of Nation; Dr. Anthony Fauci: Going To Be Doing More Testing, Not Less. Aired 12- 12:30p ET
Aired June 23, 2020 - 12:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: The majority of them would find themselves in does not allow them to protect themselves by looking into a computer and doing Telework most of them are essentially on outside having to mingle in a society in which the virus is circulating.
So right at the get go they have a greater risk of getting infected. And then we know from a lot of experience now that the situation regarding whether or not you have serious consequences, hospitalizations, intubation, complications and death relate very strongly to the prevalence and incidence of underlying co-morbid conditions which are clearly disproportionately more expressed in the African-American population than in the rest of the population.
And that particularly includes hypertension, diabetes, obesity, chronic lung disease and kidney disease. So unfortunately we have a situation where it's sort of a double whammy of a negative capability of them to respond through no fault of their own because of underlying conditions and the conditions in which they find themselves with.
REP. BOBBY RUSH (D-IL): --would you consider racism is no as we want - turning - African-Americans to really need a more and - this co- morbidity?
DR. FAUCI: I think the question was what I consider institutional racism as contributing.
DR. FAUCI: Yes, thank you Congressman. Well I mean I obviously the African-American community have suffered from racism for a very, very long period of time. And I cannot imagine that that has not contributed to the conditions that they find themselves in economically and otherwise. So the answer Congressman is yes.
RUSH: --after your announcement that - $100 million I mean $20 million as we move into more house ties a medicine. So contact tracing and testing. - Which calls for $100 million for testing and contact tracing? We're seeing a larger amount, the $100 million or more towards contact tracing and for testing.
ADMIRAL BRETT GIROIR, ASSISTANT SECRETARY FOR HEALTH, HHS: Thank you Congressman, for testing and contact tracing we're going to need billions of dollars. I mean that's the amount of investment that we're doing partially through CDC. This specific award is to have more House lead a consortium of organizations like 100 black men who do U. S. the National Association of Community Health Workers.
The National Council of Urban Indian Health et cetera, et cetera to really focus on the specific educational testing and linkage to care needs of underserved minorities and some of those also in the rural population.
My personal opinion is $40 million is a start. It's going to be a lot more than that in order to reach the people that we need to reach.
UNIDENTIFIED MALE: Thank you Bobby. Thank you Admiral. Next is Mr. Upton from Michigan.
REP. FRED UPTON (R-MI): Thanks very much Mr. Chairman and I really appreciate the testimony that we've heard thus far and the interaction that will have between all of our. I guess the first question I have is to Dr. Fauci. Good friend, thank you great your service for sure.
In recent weeks of course you made the statement that we have as many as 100 million doses of - flu vaccine before the year. I've heard from a number of companies that get tested in recent days after Pfizer both have grabs billion doses before the end of next year calendar year 21.
So is - move through the phase two processes - maybe even get into some production a little bit but by early August. But the approval is yet - the market place and really saving the world. What is your first thought is to how early we may see E-way an emergency use authorization approved for any of these vaccines based on what you know today and under the scenarios that we may see something in the next number of months in terms of an approval. Lay out what you think is a - real distinct possibility where we might end up be?
DR. FAUCI: Okay, thank you. I did not hear--
DR. FAUCI: I didn't hear everything you said but I think I got enough of it to answer your question. At least the last part that I think it's very important. And I welcome the opportunity to address this.
The idea about the doses that would be available you know a couple 100 million doses in the beginning of the year some companies saying that in a couple of years or year or two we'll have as many as billion doses.
I think that do real most people would raise their eyebrows and think that how is that going to happen? And it is because things are being done at risk. People, companies are starting to plan to make doses this even before you know the vaccine works.
So the risk of the speed is not risk to safety, is not risk to scientific integrity. Its risk to money so put that aside. The point that Congressman Upton made I think it's very important. We need to be careful that we don't jump because of our need to get vaccines for those who need it that we do not definitively prove safety and efficacy before we make decisions about distribution.
We've heard a lot about emergency use authorization emergency. An emergency use authorization is important but it has to be done in a situation where you fulfill the criteria for the emergency use authorization.
I would be very disappointed if we jump to a conclusion before we knew that a vaccine was truly safe and truly effective because I wouldn't want to perpetual ambiguity of not knowing whether or not it is truly safe and truly effective?
That's the reason why we're doing several randomized placebo controlled trials with power enough that could give us that answer. I hope that answers your question Fred.
UPTON: Just one quick what would be the earliest that you think under the best scenario that we might see in you - issue - now along with it? I guess but actually beat it FDA core right? They would actually issue that?
DR. FAUCI: Yes, the answer is yes. Let me just quickly answer that and handed over to Steve because he may want to answer that we're going into the first phase one - phase 3 efficacy trial in July it takes at least a month to get to the second dose because it's a prime boost.
You'll take another couple of months to accrue or enroll enough people that if there is a viral activity in the community. And we have our sights not only in the United States but all over the world in Brazil and in South Africa.
So if we get an efficacy signal you're going to get an efficacy signal more quickly the more cases there are. Now if it turns out that they're not a lot of cases it may take longer and that's the reason why you can't give an accurate prediction of when you're going to get those data. Steve you want to take it from here?
DR. STEPHEN HAHN, FDA COMMISSIONER: Yes. Thanks Dr. Fauci. So just a couple of issues to your point Congressman Upton, one is we are with the sponsors across the board private industry, operation works feed et cetera those who are developing vaccines and we're providing technical assistance regarding clinical trial design.
The number of participants in the clinical trials as well as the end points that we want to see to make adjudication about safety and effectiveness. And I want to emphasize what Dr. Fauci said and that is the acceleration is really around taking financial risk around the development process.
The acceleration is not cutting corners with respect to the assessment of safety and effectiveness. The American people can rely upon the fact that FDA has many experts in the vaccine area. We've been doing this for years and we will rely upon the science and data when it's available to us to make that adjudication and decision regarding anyway I cannot pre judge when that will happen?
UNIDENTIFIED MALE: Thank you. Thank you, Fred. Next we have the gentleman from California Ms. Eshoo.
REP. ANNA ESHOO (D-CA): Thank you Mr. Chairman and morning everyone. I'd like to start with Dr. Fauci. Doctor we had a conversation on the weekends and I express to you really my name's - treatment on about SEC Director the most prestigious institutions in the world. That's just diseases and prevention. The United States today is number one in the world in infections and in tests.
ESHOO: This is not anything any of us can be proud off. The American people are in pain, they're grieving. There's a great deal of sorrow - there is confusion for many reasons. And I urged you as Head of the CDC just speak directly to the American people.
I know the agencies are talking to each other. I consider that a whisper because the American people are not hearing you speak out. They deserve to hear the truth. We have heard Dr. Fauci time and time again putting out information to the American people.
The American people are divided on this issue of virus imagine that. So I continue to urge you to speak out your. Doctor, put your white jacket on and speaking weekly to the American people. They want to know what's coming. What is ahead?
My constituents ask me on a consistent basis what's next. What is our government doing? That's a haunting question and so while we're doing the nice back and forth this morning good questions on the part of members.
I really remain dismayed and deeply disappointed. We need leadership coming out of the CDC real leadership. It was an outrage that there was a gathering in Tulsa. 6 of the President's Advance Team people were infected and it's my understanding the 2 secret service agents were.
How can the CDC allowed this pandemic, this virus to be something political. You have to push back. You're a scientist. You're a doctor. Now to Dr. Hahn, I'm sure you've read the several articles regarding Hydroxychloroquine every study states it doesn't work in any setting.
In fact it has known about side effects cardiac issues being one. So there's a danger in terms of the side effects. As Commissioner you see all the data. Are you going to inform the American people doctors across the country about these facts?
DR. HAHN: Thank you Congresswoman for that question. And indeed we are - I can refer the Committee to several documents that we have put out over the last several weeks regarding Hydroxychloroquine with respect to the issues we issued a safety alert particularly around the combination of Hydroxychloroquine within other drugs that might affect the heart. And as you know us taking recent action regarding the UA.
ESHOO: Have you specifically spoken directly to the American people so aren't this - about Hydroxychloroquine?
DR. HAHN: Yes ma'am. There is an FDA voices piece that's authored by me as well as a piece that's directly to the American people about the status of Hydroxychloroquine.
ESHOO: It's not in the paper. I want to know if you have spoken out verbally to the American people to doctors across the country. I don't - people don't hear paper with all due respect.
DR. HAHN: Yes ma'am. And I appreciate the question but every opportunity I've had to be in the media I've been asked that question and I have communicated that same information about the current status.
ESHOO: Question Dr. Hahn, there have been several disturbing articles expressing concerns - political interest being placed on the FDA by the - will you state unequivocally that any political pressure is applied to you and to FDA and you will immediately report that to this Committee?
DR. HAHN: I will certainly unequivocally state that if I receive political pressure I'll report this Committee. I can tell you that I have not felt political pressure nor has the FDA to make any decision in any specific direction.
UNIDENTIFIED MALE: Thank you.
ESHOO: It's about a direct political pressure so, thank you for your response. I will yield back.
UNIDENTIFIED MALE: Thank you Ms. Eshoo. Next is Mr. Latta from Ohio.
REP. BOB LATTA (R-OH): Thank you Mr. Chairman and thanks to our witnesses and all the hard work that you have been doing over the last several months not only in United States but for individuals from around the world. I really appreciate it.
Dr. Fauci, if I could start my questions with you. And I know that our leader Mr. Warren has brought some of this up would you further explain how an infected individual develops antibodies? And how long those antibodies remain effective in fighting off the virus? And are you seeing different levels of antibodies in people who have been infected and what that means in terms of immunity?
DR. FAUCI: Thank you very much for that question Congressman Latta. So we need to start off by saying that we want to assume you're dealing with an antibody test that has been validated by the FDA or by the NIH that's important because a lot of the confusion out there, there are tests that are not validated. But let's assume you have a good test. Whenever the body gets confronted with the virus and recovers even when they don't recover the body is stimulated to make antibodies. In general for viruses that we have a lot of experience with those antibody serve to protect you against exposure and infection after you're exposed to the same virus.
So that's what we call immunological memory and these proteins blocked the virus. The one thing we do not know yet with COVID-19 is the relationship between the type of antibody because the best thing antibodies called neutralizing antibody.
Namely if this with the virus and this is where the virus binds to the cell the neutralizing antibody blocks the virus from binding to the cells. There antibodies against other parts of the virus that are called binding antibodies they don't mean much.
So you got to make sure you get the right antibody. The second thing is what we still don't know is what the relationship between the tighter of the antibody his name the level of the antibody and the degree of protection.
The third thing we don't know is how long or what the duration of that antibody is going to be? We're going to find these things out as we study these individuals over months and a year or more but remember we're only a few months into this.
So a we know they make antibody. B it's likely that they're protected for some period of time but we don't know how long that's going to be? So the question I always get asked which a subtext is does that mean if you're exposed you have antibody that you are protected. Likely you are but we don't know how long you are protected?
LATTA: Thank you. Dr. Robert Redfields, when a vaccine or treatment is developed how will it be distributed to Americans?
DR. ROBERT REDFIELD, CDC DIRECTOR: Thank you for the question. This is a critical issue that is currently under discussion within the team to look at what the appropriate prioritization for distribution is?
I want to just comment that it may be very dependent on what the product is? Each of these vaccine products that are currently being developed may in fact have differential utilization for different populations.
So there are serious considerations to try to develop those prioritizations and it's going to be important to develop them depending on the product that they're going to be applied to.
LATTA: Thank you. Dr. Hahn and thanks very much for your all your work and thanks for taking my calls especially on Friday nights on Saturdays I appreciate it. The FDA providing emergency use authorization for Remdesivir do you expect envision the FDA to issue anymore easy ways for potential treatments in the fall?
DR. HAHN: Congressman for potential therapies is that what you asked sir? LATTA: Right.
DR. HAHN: Yes. Yes sir, so we are working very closely with sponsors regarding the development of therapeutics including with operation work speed 131 clinical trials on going right now. I anticipate that we will receive data regarding a several therapies in the future.
Plasma being one of them but we just discussed with Congresswoman, potentially also with some anti inflammatory agents as well as for monoclonal antibodies. Those are being accelerated through the pipeline and then our potential therapeutics as well as prophylaxis and moving forward.
Again can't pre judge the EUA process because we have to see the data? But I do anticipate that we will be receiving data.
LATTA: Thank you very much. Mr. Chairman my time has expired are you back.
UNIDENTIFIED MALE: Thank you next we have Ms. DeGette from Colorado.
REP. DIANA DEGETTE (D-CO): Thank you so much Mr. Chairman. I want to thank the panel and welcome all of you and if you heard every part of my Sub-Committee, The Oversight Investigation Subcommittee a number of times.
And just to let you know the ONI Sub-Committee is going to be continuing its investigations both about how we responded to this and where we go in the future? So you can expect to hear from us.
I've had some brief questions for each witness and I'd like to start with you Admiral Giroir. The check I've been talking to - last of his comments last weekend saying that the - because when you do testing you're going to find more people.
And then again these word the President tweeted cases are going up U.S. because we're testing far more than any other country and ever expanding. The smaller testing - shall further cases. This is what he says and he also said this morning that he doesn't talk about each.
So it Chairman asked Dr. Fauci and Dr. Redfields, - started to test last. I going to ask you as you are now in charge of overseeing the task have the President asking you to do fewer tests?
GIROIR: Thank you and again I want to clarify that--
DEGETTE: Yes or no won't work out Admiral.
GIROIR: No the President has - neither the President nor anyone in the administration has instructed or suggested that we should do less testing have said that to me and we are proceeding in just the opposite. We want to do more okay a higher quality.
DEGETTE: So I want to ask you Admiral, do you think that it's a good or a bad idea to do less testing? So it will look like your cases.
GIROIR: My purpose - my purpose in leading is to increase the number of testing the only way that we will be able to understand who has the disease? Who is infected and can pass it in to do appropriate contact tracing is to test appropriately smartly in as many people as we can.
DEGETTE: Thank you so much. Dr. Fauci, I wanted to ask you I see some data the last few days that while cases are growing up in this country deaths are going down and I've seen some reports in the media that in part that's because younger people who tend to not to die from COVID are the ones being infected. Should we see this as a positive sign or should we still be worried?
DR. FAUCI: I think it's too early to make that kind of link Congresswoman. Let me explain deaths always lag considerably behind cases. You might remember at the time that New York was in their worst situation where the deaths were going up and yet the cases were starting to go down.
The deaths only came down multiple weeks later. So you're seeing more cases now while the deaths are going down the concern is if those cases then infect people who wind up getting sick and go to the hospital it is conceivable you may see the deaths going up. So I think it's too early to say because the deaths are going down.
DEGETTE: Thank you Doctor. And I have another question to Dr. Fauci for you. We've seen I think you and I have talked about this most vaccines take years if not decades to be approved and to be proved efficacious. And sometimes we don't find a vaccine at all.
I have 2 questions for you. Number one, do you believe that we will find a vaccine for the Coronavirus? And number two, do you still stand by the prediction you gave us some months ago that we could actually have a vaccine by early 2021?
DR. FAUCI: I feel cautiously optimistic Congresswoman that we will be successful in getting a vaccine. There's never a guarantee of that but the early data that we're seeing regarding the immunogenicity and the induction of good responses makes me cautiously optimistic always knowing that there's never a guarantee.
You remember I told your Committee a few months ago that a vaccine would be available from a year to 18 months.
DR. FAUCI: I said that in January of 2019, 2020 a year from January is December. I still think there is a reasonably good chance that by the very beginning of 2021 that if we're going to have a vaccine that we will have it by then.
DEGETTE: Thank you very much Doctor. Mr. Chairman I'll yield back.
UNIDENTIFIED MALE: Thank the gentlewoman. Next we have Ms. Rodgers from Washington State. I hope.
REP. CATHY MCMORRIS RODGERS (R-WA): I'm coming. Cathy McMorris Rodgers is here. Am I here?
UNIDENTIFIED MALE: You're recognized for 5 minutes.
RODGERS: Thank you Mr. Chairman. I want to thank the Chair and the Ranking Member for holding this hearing and appreciate our witnesses for testifying today. COVID-19 is the challenge of this century as others have said. It's a health and economic crisis of our lifetime. We mourn the deaths of over 100,000 Americans and we must remember that we're not out of the woods yet.
I want to especially express my heart feel gratitude for the health care workers, the first responders, the emergency and essential workers who have been working around the clock to bite this virus, save lives and keep our family safe.
As our experts worked tirelessly to develop a vaccine and treatment I'm confident that there's no country in the world who's better equipped to lead for a medical breakthrough than America. We can't trust China to lead and that's why the Trump Administration has created programs like Operation Warp Speed.
We're bringing together the very best in the public and private sector to develop countermeasures that will fight the virus. We're leveraging the power of artificial intelligence supercomputing and machine learning to speed up discoveries and enhance our knowledge base of the virus.
In Washington State we have talked researchers as well as biotech pharmaceutical innovators who continue to be at the forefront of these breakthroughs. I look forward to learning more and appreciate all of you being here to understand what the administration is continuing to do?
To lead in the development of these tests and treatments that American needs so that we can usher in a new era of innovation and healthcare cures. To win the future to keep our families healthy and save lives and to ensure our economy booms again we must get this right.
Dr. Fauci, as you know Adjuvant maximize the effectiveness of vaccines. Would you just explain a little bit further what an Adjuvant is and are there any novel synthetic Adjuvant in the pipeline and if so how will they play a role in the administration's pursuit of a COVID-19 vaccine?
DR. FAUCI: Thank you very much for that question Congresswoman. An Adjuvant is a product distinct from the vaccine itself. But when given in conjunction with the vaccine it enhances the power of the immune response.
So if you have a vaccine that gives a level of response that here when you get an adjuvant together with it you often boosted to a much higher level. We use adjuvant in several vaccines. The NIH as a major program in the pursuit and development of novel Adjuvant of all different types and in fact that's part of the program right now to accelerate our vaccine development capability. So it's a good question, but it's a very important part of what we do. Thank you. RODGERS: Thank you. Thank you for that. Dr. Hahn as you know FDA's decentralization of diagnostic test oversight is been very helpful in expanding the availability of diagnostic tests for COVID-19 but it's temporary. Has this - would you just speak to how this flexibility has benefited the general public? And how you think it would be helpful in the future for outbreaks or novel viruses?
DR. HAHN: Thank you very much Congressman. I appreciate the question. As you pointed out the flexibilities have allowed us to work with test developers. This has been throughout the COVID pandemic with all of our medical products a balance between the oversights.
So that we have tests that are valid reproducible accurate but at the same time allow the developers the ability to have the freedom to develop those tests. And we've developed this partnership that I think has been very fruitful moving forward.