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4 Top Trump Administration Health Officials Testify Before Senate Committee. Aired 11:30a-12p ET
Aired June 30, 2020 - 11:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SEN. SUSAN COLLINS (R-ME): One innkeeper told me that, last year, in the month of June, she had an occupancy rate of 94 percent. This year it was 6 percent. So you can imagine the impact on employment at that inn.
Given the impact on reopening schools and on jobs in the tourism and other industries, how is the federal government working with states to better match demand for testing with supply and to overcome these geographic variations?
Admiral, I would direct that question to you.
ADMIRAL BRETT GIROIR, ASSISTANT SECRETARY FOR HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES: Thank you, ma'am. I'll try to be brief and try not to take much of your time.
But we were very careful in our prioritization that we do prioritize persons without symptoms who are prioritized by health departments or clinicians for any reason, including public health monitoring, surveillance, or screaming of our asymptomatic individuals according to state and local plan,
So that is a priority that if it is important for the state, those asymptomatic individuals can be -- can be screened.
The second issue, just, again, to be brief, is we work -- we have worked individually with every single state to determine what their state testing needs are, how are they organized in the context of the CDC, and we are supplying them with the supplies they need to meet that.
So every week shipments of the basic supplies go to every single state, according to their state testing plans. And we keep a little bit in reserve, right, because when there's an outbreak somewhere that we need to surge, we do have that.
So, for example, the state testing goals for July are somewhere across the country, about 13.9 million tests is the first line goals, and we will match those state by state.
COLLINS: I hope that you will help us get that word out to setting sites in states from which a lot of tourists usually come to Maine. That would be very helpful to us.
Dr. Fauci, let me turn to you.
Earlier this month, higher education leaders in Maine issued a framework for safely returning to campuses this fall that recognizes the importance of testing and the need to include financially struggling institutions in partnerships in order to make sufficient testing protocols possible.
You, last week, spoke about the possibility of the development of pool testing strategies. And as I understand it, this would allow more people to be tested using fewer resources.
And the medical director of Stanford's clinical virology lab suggests that this makes particular sense in areas with low rates of COVID-19 where you would expect the large majority of tests to be negative.
Could you expand on the possibly of expanding pool testing and tell us more about that?
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: Yes, thank you for the question, Senator.
What that really is, if you want to get a feel for the penetrants of infection in a community, rather than testing each individual person, which takes resources and time, what you can do -- and you can do a statistical analysis, of not losing sensitivity by pooling, let's say, 10 or 15 or five together.
You put all the tests together and you do one test. If that test is negative, then you know those 10 people are all negative. So instead of utilizing 10 tests, you've utilized one test.
Then you get another batch of we'll see 10 or so, and if you then find one is positive, then you go backtrack and figure out who that person is.
And if you do the mathematical calculation, you can save a lot of time, a lot of resources, and use the testing for a variety of other things that you would need.
So it's a really good tool. It can be used in any of a number of circumstances at the community level or even in school if you wanted to do that.
So apropos to what you started your started your comment off with, it clearly can be extrapolated to that.
COLLINS: Thank you so much. That sounds like an excellent technique for our schools to use.
SEN. LAMAR ALEXANDER (R-TN): Thank you, Senator Collins.
SEN. TAMMY BALDWIN (D-WI): I want to thank all our witnesses today for joining us.
Like so many members of this committee, I'm concerned about new outbreaks and increasing cases. Certainly, I've seen them in my home state of Wisconsin. And I know we're seeing that nationally.
Now, CDC and OSHA have issued -- recommended safety guidance for businesses, but this guidance is not enforceable. Many businesses are truly trying to do the right thing and protecting workers and customers and the public that interacts with those businesses.
And so we also had a previous discussion. I think Senator Sanders raised the issue of American Airlines filling up their planes versus others that are still not trying to push to do so because of safety concerns.
We also had -- I think it was Admiral Giroir -- pulled up the -- what he called the critical guidance, please follow this cried call guidance.
Dr. Redfield, should we be supporting businesses that have taken the steps to protect their workers and customers by fully implementing CDC's and OSHA's recommended safety guidance? Yes or no?
DR. ROBERT REDFIELD, DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION: Yes. We should be supporting those businesses.
BALDWIN: Now, can you confirm yes or no that all businesses have adopted and presented this guidance as they have opened up?
REDFIELD: I think, Senator, you know, that, unfortunately, that's not been the case.
BALDWIN: So, it's an uneven playing field. And hurts businesses that are trying to do the right thing by voluntarily adopting CDC and OSHA safety guidelines because their competitors don't have to incur the same safety and health costs.
And if you believe that we should be supporting the good actors, then shouldn't we create a level playing field by issuing an emergency temporary standard to require all businesses to adopt and comply with enforceable safety standards?
REDFIELD: I'll make two comments, Senator. The first one it's so important that we've tried to say is that this is a time that everyone in our nation accept the responsibility that Dr. Fauci and I spoke about to recognize they have the fundamental responsibility not just to protect themselves to protect others by the social distance, face mask and hand-washing.
Secondly, again, as we look at the local jurisdiction, again, to see where in fact that enforceability would be, whether it's in the local health department, the state health department or the federal health department, I think, again, we see that the community can get behind that responsibility. Those businesses that support that responsibility may find in fact their business is better than those businesses that don't.
I can tell you that --
BALDWIN: Let me interrupt you. I apologize, Dr. Redfield, but my time is limited.
The -- the panel right now is composed of people representing public health and public health institutions. OSHA is our lead federal agency for protecting worker safety and health.
Have you had communication with the Department of Labor and OSHA about issuing mandatory, enforceable standards rather than this voluntary guidance?
REDFIELD: Secretary Scalia is a member of the task force, and he's in the discussions with us that the vice president chairs. That specifically --
BALDWIN: So that's a yes?
REDFIELD: -- we've not had a discussion directly. But we've had discussions and review of the guidance that we've put to businesses, both critical infrastructure and non-critical infrastructure businesses with OSHA.
BALDWIN: So I -- I have limited time left, but I do want to say the University of Wisconsin announced that they will be reopening for classes in the fall. They have released a plan called Smart Restart.
It calls for about 2,000 tests per week on campus. They will need supplies to do this, including PPE, reagents and swabs.
At every hearing on COVID-19, we've heard about shortages of these supplies. And it's why I introduced the Medical Supply Transparency and Delivery Act to lock the full authority of the Defense Production Act to increase production of critical supplies, the things that are needed to conduct widespread testing.
Admiral Giroir, can you describe how you're working to make sure that universities and others will have access to these supplies needed to conduct this testing in the fall?
GIROIR: Thank you so much, Senator.
And I want to communicate this, and I'm happy to work with any university.
We coordinate what we give to the states through the state plan. So it's very important that universities coordinate through the states. And we supply those materials directly to a single point of contact in the state who distributes them.
We -- you know, we've been through a lot, but we have a lot of swabs now, partially, because of increased domestic production, using the DPA. We're distributing about 20 million swabs per month. We'll do a lot more than that.
BALDWIN: How about reagents?
GIROIR: So reagents we do not purchase centrally because the market is a little bit more mature so we can trust, with an allocation strategy, that we allocate, we support the allocation to different states depending on their needs.
So we've mapped every single machine in every single state and every single county and every single city. And, unfortunately, there's not enough of one thing that everybody if they want that can get it. So we really do a matching game to understand specific state needs.
For example, in Alaska, it is very rural and there's very limitations to what they have. So we need to make sure they get what they absolutely need versus other states that can be a little bit more flexible. So we do have this controlled --
ALEXANDER: Thank you very much. I'm afraid we're --
GIROIR: I'm so sorry.
ALEXANDER: -- well over time.
We have a large number of Senators who want to ask questions so I would renew my request --
BALDWIN: Thank you, Mr. Chairman.
ALEXANDER: -- that Senators and witnesses try to keep the questions and answers within -- within five minutes.
SEN. BILL CASSIDY (R-LA): Thank you, gentlemen, for all that you're doing.
I have a couple of slides.
Can I ask the staff to show the first two slides?
So here it shows that we're doing poorly relative to the countries that are doing the best. And you can argue that Taiwan is much is smaller than we, but Taipei is a very congested city. So if you consider our city's collection of Taipei's, for example, or Seoul, South Korea, it would suggest that what we're doing currently is less robust and less whatever adjective you want to use than the countries who are doing it the best.
Could I have the next slide, please?
And so this has developed out of a group by Harvard. And just so I can put a plug in it, they will be speaking in a roundtable that we have Thursday morning and you can get details from my office if you wish.
But the kind of that interplay between collecting and doing the testing, and tracing those, you know, compiling your data, knowing where your hot spots are and then tracing. And everyone on this panel knows how it's done.
And you mentioned that had you're going to have a strategy that's coming out later on. And it does beg the question, why has it been so long -- and I'm not accusing, I'm just curious, but this has been developed.
You can take the slide down, please.
So knowing that you're going to develop the strategy and -- and kind of build upon what Senator Burr mentioned, what is the goal of the strategy? Is the goal of the strategy to achieve suppression? That's number one.
And, number two, what metrics will you use?
And knowing that CDC is the one who really gives guidance to state and local governments, I'm hoping, Dr. Redfield, since I'll direct this you, that it won't be up to the states and locals to put this plan together.
But it will be the consider intellectual firepower of the CDC that gives a pretty detailed -- if you have this kind of community, this is what you do. If you have that kind of community, that is what you do. Because that's the kind of role that CDC is expected to play.
Dr. Redfield, any thoughts on this?
REDFIELD: Thank you very much, Senator. A very important question.
First, on your first slide, just as a quick comment -- and I'll try to be quick -- it's really important because it does illustrates back to the comment that we tried to make of personal responsibility to really practice the social distancing and --
CASSIDY: That is a given, Dr. Redfield. I want to ask you, just real quickly, because I have limited time, that's a given.
But there has to be a testing aspect of this because people don't -- you awaken people to the responsibility if they know they have been exposed. If they don't know they have been exposed, they tend to be more complacent. So please focus upon the testing data and tracking aspect.
REDFIELD: Yes, Senator. Initially, obviously, the -- it was early case identification and contact tracing and isolation. Obviously, testing and contact tracing without isolation has little value.
The challenge has been when we learned in March that this virus is significantly symptomatically transmissible. Then, therefore, requiring alternative strategies.
The strategy that we're evaluating now is more of a community-led testing strategy where you go into a broader community and you actually test a wide number of individuals as opposed to it --
CASSIDY: What metrics are you following? And is there a specific strategy that's going to be given to state and locals as to how to implement that? That's very high level. What we need is granularity. That's my question.
REDFIELD: Yes. We did the initial strategy. As I said, we're currently evaluating this community test-led strategy in a number of communities now.
The metrics are simple. It's the percent cases that are positive. We were doing well there for a while, you know --
CASSIDY: Yes. Sorry to interrupt.
But, of course, if you take the entire city of New Orleans or Shreveport, you'll have some that are hot spots and some that are really fairly states. So I guess I'm pulling into the granularity, should it be a census track? Should it be a hot spot, a building with multi-family housing, et cetera?
CASSIDY: I'm just frustrated because when I speak to my state and locals they are not getting that granularity from CDC. That seems to be where we get to where Seoul, South Korea, is. And I've not heard that that's what we're doing.
REDFIELD: We're saying right now at the county level the exact kinetics. We have about 130 counties in this country. Out of the more than 5000, more than 3,000 that are having trouble.
And continuing to get that granularity, I think you said it, Senator, it's critical. It's got to be a local focal response at the granular level --
CASSIDY: But Dr. Redfield, do we have this granularity? We've been at this for three months. We have all these data systems. We know where the people live who are tested. You know, we have a federated system, which you alluded to earlier.
Is the plan coming out tonight or this afternoon going to implement that granularity?
I'm over time, but if you would allow, Mr. Chairman, for an answer, they be I'll cease. I apologize for going over.
REDFIELD: My comment would be that's where we're going with that granularity. We appreciate some of the changes in reporting to CDC in terms of testing that Congress recently did. We're now looking at the granular level.
We don't disagree with the premise behind you. It's that granular response to control those mini outbreaks, which is going to be fundamental to get this under control.
CASSIDY: Thank you.
ALEXANDER: Thank you, Senator Cassidy.
SEN. CHRIS MURPHY (D-CT): Thank you very much, Mr. Chairman.
Mr. Chairman, if this were the policy of the United States of America, the recommendations and guidelines being given by our panelists today, we would likely not be in the situation we are with a virus back on the march spreading at rapid rates throughout big parts of the country.
The problem is our four panelists do not set the policy of the United States of America. The president of the United States does.
And so while our panelists tell us about the importance of wearing masks, the president of the United States is re-tweeting articles, for example, entitled, "Mandatory Masks Aren't About Safety. They Are About Social Control."
He re-tweets people that are criticizing how folks look when they wear masks.
Though our panelists today are telling us about the effectiveness of social distancing, the president of the United States is holding rallies all across the country in which he deliberately prevents people from distancing.
His staff ripped signs off of chairs encouraging people to separate from each other.
The president's allies are out there on TV every single day saying wearing masks are dehumanizing. Somebody said the other day, a member of the House, that viruses do
what viruses do. The only way you're going to get immunity is to get exposed. These are the president's allies trying to curry favor with him.
And so we have these two parallel messaging operations. And I think it's worth stipulating that everything that we're hearing today is responsible. It's based on evidence.
But the agencies represented here today have social media follows of about five million people. The president of the United States has a social media following of 82 million.
And so you can understand why folks are confused out there. They hear the recommendations from Dr. Fauci and Dr. Redfield, but then they hear the president of the United States criticizing a reporter for wearing a mask because that reporter is being -- is being politically correct.
That's why we're in the position that we're in today where you see large numbers of people not complying with recommendations because they are hearing something very different from the chief executive. And they are watching him behave in a manner and encourage behavior that is directly contrary to what we're being told today.
And it just probably requires saying that out loud at this hearing.
Let me ask a few questions, Mr. Chairman, if I can, about global public health because we haven't covered that here today.
Dr. Fauci, this virus got here really quickly. And what we learned is that, while travel restrictions can help or give you time, they can't fully prevent a disease from arriving here.
So even if we do turn the corner in the United States in a meaningful way, so long as the virus exists in large quantities outside of the United States, we are still vulnerable. Is that right?
FAUCI: That's correct, sir.
And so, Dr. Redfield, what is your understanding of why the United States has not joined the global vaccine effort? Why are we not in something like CEPI, an organization that's working with other nations to try to coordinate not only the development of the vaccine but also the distribution of the vaccine?
REDFIELD: Well, I think the U.S. has obviously developed an aggressive, comprehensive program. But, Senator, it wouldn't preclude being part of the international organizations, also, from my perspective.
MURPHY: We have legislation pending right now before the Foreign Relations Committee that would put the United States into the global vaccine efforts. It just doesn't make a lot of sense to many of us on both sides of the aisle as to why the Trump administration has not joined.
Finally, Admiral, just maybe help us understand what our relationship with the WHO is today.
Right around the time that the president declared that we were pulling out of the WHO, not just that we were not going to fund it but his announcement was actually we were going to sever our relationship with the WHO, you were confirmed to a seat on the executive board.
Have you been recalled from the WHO? Are you attending meetings? Are you participating? What are the details surrounding our withdrawal from the WHO?
Which, by the way, is maybe one of the most dangerous things, in my opinion, that the administration has done in the middle of a global pandemic.
What is our status and what's your status as a confirmed member of that board?
GIROIR: Thank you, Senator. I do appreciate the confirmation.
I was confirmed May 7th and I attended the May 22nd executive board. The executive board was virtual. I did participate and support our multilateral commitments.
I have not been recalled. I have not been given any direction to recall myself in any way. There would be another executive board meeting probably in October.
And I believe all of us on the public health standards still work with the WHO as a WHO partner. For example, we participated with the WHO on a global sickle cell meeting two days ago.
So we work certainly -- from the public health aspects direction on the official whether we're going to be a member or whether I'm not going to go to the executive board, I have not gotten that direction yet.
MURPHY: Thank you. The announcement was we were terminating our relationship with the WHO. So probably some additional clarification would be helpful.
Thank you, Mr. Chairman.
ALEXANDER: Thank you, Senator Murphy.
SEN. LISA MURKOWSKI (R-AK): Thank you, Mr. Chairman.
Gentlemen, thank you for not only your testimony today but all that you have been doing.
I think I have had conversations with each one of you about the Alaska specific issues, most notably with regards to our seafood processing. This is the time of year where we typically welcome a million-plus
tourists as well as many thousands that come up from the lower 48 and other places to help with our seafood processing.
And it has been very anxious time I think for all of us in Alaska as we see outsiders coming in. We have seen obviously elevated cases of confirmed COVID.
Our numbers I think are enviable when other states look at us to know that we're working about 500 active cases right now, about double that in terms of what we have seen throughout this whole pandemic.
But again, we know and you have stated that we don't have resources that we can look to, to neighboring states. We are kind of on our own island there in terms of resourcing.
So what you have done to help facilitate, whether it's the plans with the seafood processors, the guidance, the ability to come in on an as- needed if the situation so demands, we appreciate that.
We have seen the benefit of how these very rigorous plans have worked. An individual who comes up to work in a seafood processing facility is tested before they come to the state. They're tested when they get to the state. They're put in a 14-day quarantine.
We have seen positive cases once people have arrived. But we have been able to do what the plan calls for, which is that contact tracing and then isolation and keeping things to a minimum. So I think it does demonstrate that these tough plans really can work.
They are expensive, though. If you are bringing in several hundred or perhaps a thousand workers and you have to put them up in a hotel for 14 days, with pay, when you have to provide for the health protocols, this is costly.
I would ask for your input and probably a question for the record in terms of which agencies can best help facilitate these seafood processors with not only implementation of the guidance but to deal with the costs.
We do receive some benefit from the discretionary funds provided to states. But I think we would all recognize, like the meat packing facilities, our seafood processors are an important and critical industry not only to Alaska but to the country. So we want to work to address that.
I want to speak very quickly, though, to the public health infrastructure.
I'm told that, in Alaska, as we are doing our contact tracing, it is still a paper-copy XL spreadsheet faxed to the epidemiology labs. This is how we're doing our tracing. I thought, well, maybe that's just Alaska. And I'm told by Dr. Zink (ph), that you've all had conversations with, well, this is actually going on in California, as well. That, to me, is not a contact tracing system that works and is sufficient.
So I want to ask about not only your view of the sufficiency of contact tracing -- and this is probably to you, Dr. Redfield.
But then, Dr. Fauci, I want to ask you about the concern that we have with certain parts of the country where you have public mistrust of vaccines in general.
My fear is that we may get to the place where -- we will get to the place of a successful vaccine. But we still have the concern from many and a mistrust -- and whether it's vaccine hesitation or vaccine confidence, I don't know what the buzzword is -- but I'm worried we don't have a plan to deal with that.
First contact tracing and then the vaccine.
REDFIELD: Thank you very much, Senator.
I think it is really important to highlight what you said about the current state of data systems for public health in the United States, that they really are in need of aggressive modernization.
And again, we thank Congress for the funding there. But it is a substantial investment that needs to take place.
There are a number of counties still doing this pen and pencil as you commented. And we need a comprehensive, integrated public health data system that's not only able to do something in real time but actually can be predictive.
And it would be one of the great, I think, investments of our time to make that happen once and for all.
REDFIELD: And that's really fundamental to be able to operationalize contact tracing, et cetera.
And the contact tracing in this case -- and I'll be very quick -- really it doesn't have any value unless you can do it in real time. It doesn't help, like I just said with the airlines where we had people that were flying infected from Afghanistan and we didn't get the information until day 14, 15, 16. It is irrelevant.
Again, we love the partnership. To get an integrated public health data system not just for CDC but for all of the jurisdictions across the nation into one timely integrated system.
MURKOWSKI: Appreciate it.
FAUCI: Senator, thank you for the question about --
(CROSSTALK) ALEXANDER: If you could be succinct. We are well over time.
FAUCI: We will be quick.
We have a community engagement program that's embedded within the sites where the vaccine trials will be done. Because we're aware of what you are concerned about, and it is a reality, a lack of trust of authority, a lack of trust in government, and a concern about vaccines in general.
We need to engage the community by boots on the ground and getting community, particularly those populations that have not always been treated fairly by the government, minority populations, African- Americans, Latinx, and Native Americans. And we have a program that's operable right now to do that.
MURKOWSKI: Thank you.
ALEXANDER: Thank you, Senator Murkowski.
SEN. ELIZABETH WARREN (D-MA): Thank you very much, Mr. Chairman.