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Fauci, Top Health Experts Testify on U.S. Virus Response. Aired 9:30-10a ET
Aired July 31, 2020 - 09:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
REP. STEVE SCALISE (R-LA): And in fact, there were meetings in the White House -- I think Dr. Fauci and Dr. Birx were there, as that plan was being carried out, that we determined maybe we need to go longer, to go 30 more days. And in fact, by going 30 more days, you could save 1 million, maybe 2 million more lives. And then President Trump announced that plan, and did save those lives.
The Trump administration then released a plan called "Guidelines: Opening Up America Again," on how states could safely reopen. That's this part of the plan, by the way. Maybe some people are so busy reading tweets that they haven't actually read the plan. it's really good guidance, issued by some of the most recognized international experts on disease prevention, some of you here today represent parts of this plan.
And so on Opening Up America Again, should our (ph) states could safely reopen? The plan was developed by public health experts. Some complained that President Trump didn't have the power to force states to reopen, so the administration actually released guidelines so that states had discretion.
Each state -- we all understand how the 10th Amendment work -- each governor is in charge of their state. Nursing homes are actually regulated by the states, not by the federal government. But we give guidance, and it's been really good guidance. And in fact, that guidance has saved lives.
We hear cities, and we hear (ph) people talking about the cries of the need for testing. So let's talk about what HHS has done to lead on testing. Zero tests -- again, go back a few months ago -- zero tests, to now over 800,000 tests a day, in a matter of just months. Over 52 million tests have been conducted nationally.
And again, nobody's slowing down, we're actually increasing that number. We will be over a million tests a day; maybe we'll have a hearing on how much progress we've made there, and we want to continue to make progress.
I know Dr. Giroir was in Baton Rouge with me just a few weeks ago with the vice president, talking about what we're doing to increase testing, even to limit the number of days as a goal to get below seven days for anybody to get results, and that -- that number has narrowed dramatically. Now more than half of America -- half of Americans who get tested get their results in less than 24 hours because of the rapid work that this team has done carrying out the president's plan.
And testing's not just about numbers; it's about targeting testing to the right people at the right time. To that point, the Trump administration's begun distribution of rapid point-of-care tests to nursing homes. I've talked to nursing home heads recently who said that decision by the Trump administration to purchase nursing -- an -- an actual testings (sic) kit for every single nursing home in America, over 15,000 nursing homes. Each of them will have their own 15-minute test. That will save lives. That's part of this plan.
On May of -- 15, 2020, President Trump announced Operation Warp Speed -- again, part of a very directed national plan to combat this deadly virus. Operation Warp Speed's a public-private partnership between several federal agencies to accelerate the development, manufacturing and distribution of a COVID-19 vaccine, as well as therapies, diagnostics, other things to -- to direct the specific goal of delivering 300 million doses of a safe, effective, FDA-proven vaccine for COVID-19 by January, 2021, and we're seeing that happen at remarkable speed. Now, we're not just going to wait for FDA approval; they're mass-producing those vials right now so that if there is one of those vaccines approved by the FDA it's ready to go. We don't start manufacturing at that point and cost us more weeks; We're actually ready to go.
By the way, that's -- some of that money was money that we passed in the CARES Act that President Trump has used effectively to be ready as the vaccines are being developed in testing phases.
Dr. Fauci, I look forward to learning more about the stunning progress that we've seen researchers make on cures and vaccines. I know you've been involved in research of some the most awful deadly viruses that we've known in the history of the world: HIV, Ebola, of course, now, corona. We still don't have a vaccine for HIV. There's been over 10 years of work that you're -- you've done remarkable work to at least give therapies so that people can extend their lives, but not a proven vaccine for so many of these diseases years and years later. And here we are, six months into corona, and we are this close to a vaccine.
So you look at where we've seen the Chinese government. We, hopefully, will get into conversations about how costly it was, how many lives were lost because the Chinese Communist Party lied to the world -- not just the United States, but the world, getting the World Health Organization to give false information in those critical early days.
But why don't we now talk about moving into August. A lot of work is being done to talk about how to safely reopen schools. In fact, more guidance was just given as part of this plan by CDC to safely reopen schools. We saw, of course, the American Academy of Pediatrics gave great guidance on how to safely reopen school, and went further and talked about the damage to children when you don't reopen schools. So much damage being done to our children in those systems where they're talking about not reopening. Hopefully, we can shine some light and show those other school systems how they can safely reopen and serve those children, millions and millions of children who are counting on us to get it right. Those school -- school systems have to get it right.
There's money, by the way, still available at every state for sanitizer, for masks, for all the things you would need to safely reopen. It's not about money; it's about the will, the desire to do it. We have the will. You've had the will. You have been carrying out the president's plan. Every day, we will learn more. Every day, we will continue to strive to address the new challenges. But let's not forget the things that have already been done as part of this plan that have saved millions of lives. We mourn every loss, but let's also recognize the lives that would have been lost if you weren't on the job, carrying out President Trump's plan to contain this, to find a vaccine -- which we're on the brink of -- and to help safely reopen our economy, safely reopen our schools so that we can get back to our way of life as we combat this deadly virus.
With that, I'll look forward to hearing from our witnesses. Thank you, Mr. Chairman. I yield back.
CLYBURN: Thank you, Mr. Ranking Member. I would now like to introduce our witnesses.
Today, the select committee is pleased to welcome Dr. Anthony Fauci, the director the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. We welcome back Admiral Brett Giroir, the assistant secretary for health at the Department of Health and Human Services. And finally, we welcome Dr. Robert Redfield, director of the Centers for Disease Control and Prevention. Thank you to all of our witness (sic) for being here today.
Will the witnesses please stand so I may swear them in? Please raise your right hands. Do you swear or affirm that the testimony you are about to give is the truth, the whole truth and nothing but the truth, so help you God? You may be seated. Let the record show that the witnesses all answered in the affirmative. Without objection, your written statements will be made part of the record.
Dr. Fauci, you are recognized for your opening statement.
FAUCI: Thank you very much, Mr. Chairman, Ranking Member Scalise, members of the committee. Thank you for giving me the opportunity to discuss with you today the role of the National Institutes of Health in a research endeavor to address COVID-19.
Our strategic plan, which we put together several months ago, imply -- embarks (ph) on four separate points. The first is to improve fundamental knowledge of the virus and the biology of the virus and the response to the virus. This has led to a delineation of the cryo- EM structure of the famous-now spike protein, which is the target of virtually all of the vaccines that are being produced today; in addition, to delineate the nature of the receptor in the body to which the virus binds -- very important in understanding the pathophysiology and pathogenesis; in addition, a number of natural history studies, including a study that was started in May to understand better the role of infection in children and what role they -- they play in spreading the virus. In addition, we've been involved in the second component, which is the development of diagnostics and assays, one of which I'll point out to you is the NIH rapid acceleration of diagnostics, referred to as RADx, including that that is gained -- aimed at underserved populations, with a very large investment of money to develop point-of-care diagnostics to facilitate even more our diagnostic capability.
Next is the characterization and testing of therapeutics. It is well- known now that over the past several weeks there have been two therapeutics that have passed randomized, placebo-controlled trials for individuals late in the course of disease.
One of these is remdesivir, a trial run by the NIH, which showed a statistically significant improvement in the time to survival in individuals who were hospitalized with pulmonary disease. That has now been part of the standard of care in individuals with moderate to advanced disease.
In addition, a placebo-controlled randomized trial of dexamethasone showed an improvement in death rate in a highly significant manner in individuals on respirators, as well as those requiring oxygen.
And then, finally, the development and testing of effective vaccines. Several months ago, we put together what we call a strategic approach to COVID-19 vaccine research and development.
And the reason we did this is because there are multiple candidate vaccines that are moving along at a very rapid pace, and we wanted to make sure that they learn from each other, so we made standardized protocols, common data and safety monitoring boards, common primary and secondary end points, and common individual laboratory tests.
There are three separate platforms that are being pursued with government help: nucleic acid, including the mRNA of Moderna; viral vectors such as adeno vectors and VSV; and protein subunits.
One of these is -- is a trial that started last Monday, this past Monday, the 27th, the beginning in a phase three trial. It's a trail that will go over several months, involving 30,000 individuals. We hope that as the time we get into the late fall and early winter, we will have in fact a vaccine that we can say would be safe and effective.
One can never guarantee the safety or effectiveness unless you do the trial, but we are cautiously optimistic that this will be successful. Because in the early studies in humans, the phase one study, it clearly showed that individuals who are vaccinated mounted a neutralizing antibody response that was at least comparable and, in many respects, better than what we see in convalescent serum from individuals who have recovered from COVID-19. As I mentioned, the phase three trial has already started, 30,000 individuals, we are already starting to enroll.
I might also conclude, members of the committee, to point out that there is a website called CoronavirusPreventionNetwork.org, where individuals can actually indicate their willingness to participate in the clinical trials, and to make sure that we have a diverse representation. Already as of last night, there have been over 250,000 individuals who have registered their interest in being in these trials.
And I just want to use my last couple of seconds to urge anyone who's listening who wants to participate to please go to that website and register so that you can be part of the solution of this terrible scourge.
Thank you, Mr. Chairman.
CLYBURN: Thank you very much, Dr. Fauci.
We will now hear from Dr. Giroir -- or Admiral Giroir.
GIROIR: Both are fine. Chairman Clyburn, Ranking Member Scalise and distinguished members of the committee, it is good to see all of you again.
Testing is an essential component of America's public health response to COVID-19. Testing enables clinical decision-making. It heralds impending outbreaks, it informs resource allocation and it assists in minimizing economic and social disruption.
But we cannot test our way out of this or any other pandemic. Testing does not replace personal responsibility. It does not substitute for avoiding crowded indoor spaces, or washing hands, or wearing a mask. A negative test does not mean that you won't be positive tomorrow. A negative test does not substitute for avoiding crowds or wearing a mask or protecting the vulnerable with your actions.
All of that being said, as of this morning, the nation has performed over 59 million COVID-19 tests, now averaging over 820,000 tests per day, up from 550,000 tests per day when I appeared before this committee, just earlier this month. Since March 12th, we have increased our daily testing over 32,000 percent.
Half of these tests are done in either point-of-care technologies with results in 15 minutes or less, or at local hospitals, for which the turnaround time is generally within 24 hours.
Because of unprecedented demand, large commercial labs that do approximately half of the nation's testing have become strained. But because of expanded capacity and newly authorized techniques like pooling and novel extraction methods, turnaround times are definitely improving. This week, LabCorp announced turnaround times of two to three days.
But numbers don't tell the complete story, because this is not only about numbers, it is about getting the right test at the right time to the right person, with timely and actionable results. So we will continue to execute in accordance with our national testing plan. This plan was initially outlined in the testing blueprint, Opening Up America Again, and the addendum to that blueprint. It was operationalized in the federal requirements for each state's testing plan.
Our plan was further detailed in the administration's testing strategy report, provided to Congress on May 23rd. In short, we are one, identifying newly emergent outbreaks early to facilitate swift community action. Two, diagnosing COVID-19 rapidly in hospitalized patients to accelerate receipt of those proven treatments. Three, protecting the vulnerable, both the elderly and high-risk racial, ethnic and socioeconomic minorities.
Four, enabling identification and isolation of those who are infectious, coupled with contact tracing. Five, advancing state testing plans to achieve overall national objectives as well as state- specific goals. And, six, supporting safe reopening of schools and businesses through surveillance testing that does not impinge upon the clinical diagnostic system.
With the limited time I have remaining, I want to highlight two of these objectives. Protecting the elderly has been, is and will continue to be a foremost priority for this administration. So on July 14th, we announced that every single nursing home in the nation would receive a point-of-care instrument, and enough tests for their residents and staff to be tested.
We are delivering on this promise. By the end of this week, we will have delivered, according to schedule, nearly 1 million point-of-care tests to 1,019 of the highest-risk nursing homes, with another 664 nursing homes scheduled for next week.
My next point is about surveillance testing. We should separate the clinical diagnostic system from the public health surveillance system. Diagnostics are for those who are hospitalized, symptomatic, or with high-risk exposures. Surveillance testing can be for college students, or potentially students in K through 12, or workers in environments that are not high-risk, or other similar situations.
This type of surveillance can occur in non-CLIA labs like university research labs or veterinary diagnostic labs, outside of the FDA authorization system at low cost and very high throughput. We are working closely with states and universities to implement this type of system, and many of them -- like LSU -- already have. We have all the tools, the supplies and the regulatory framework to enable a robust surveillance system throughout the nation.
In closing, we know how to flatten the curve, slow the spread and save lives: Wear a mask, practice physical distancing, avoid crowded indoor spaces, practice good hygiene by washing your hands frequently, if you feel sick, stay at home, and protect the elderly and vulnerable populations of all ages through your actions.
I look forward to your questions, and thank you for the opportunity to provide these remarks.
CLYBURN: Thank -- thank you, Admiral Dr. Giroir.
REDFIELD: Good morning, Chairman Clyburn, Ranking Member Scalise and members of the subcommittee. Thank you for the opportunity to be here today with my interagency colleagues.
On behalf of CDC, I want to extend our deepest sympathies for the loss of our nation's esteemed Georgia congressman and your colleague, John Lewis. Our nation will remember him for his courage, his conviction, his patriotism and his commitment to equity for all. CDC also remembers him as a fierce advocate for public health. Working together, we are positioned to honor his lifelong commitment to social justice by advancing health equity and mitigating the negative impacts of racism on public health in our nation.
The three of us here today are united in delivery of critical initiatives to stop the spread of COVID-19, to gain the upper hand on this pandemic in the United States and to protect all Americans, while dedicating even greater attention to overcoming the health disparities experienced by populations at increased risk for this disease.
We are seven months into this global pandemic, and it is with great humility that I share with you, this is the most complex public health response this nation has undertaken in more than a century. This virus is indiscriminate regarding whom and when it strikes.
We continue to learn its characteristics, its behavior and its effect on Americans across social economic spectrum. We are operating in a highly-dynamic environment. We are adapting evidence-based strategies and pushing for innovative solutions to confront this unprecedented public health crisis.
While I'm optimistic and look forward to discussing the promise of the COVID-19 vaccine, I want to strongly emphasize that we are not defenseless now. We have powerful tools, and if all of us -- not just some of us, but all of us embrace these tools we will get a handle on this pandemic. I am appealing to all Americans to be part of the public health solution. Wearing a simple mask properly -- it's critical to limiting the transmission. Be smart about social distancing and being in crowded spaces. Stay six feet apart from others if possible, and be vigilant about hand hygiene. And together, we can turn the tide of this pandemic.
With emergency funding, CDC's distributed more than $12 billion to the state, tribal, local and territorial health departments to begin building the public health infrastructure this -- this nation needs, but more importantly, that our nation deserves. This system has been under-invested-in for decades, and needs to be put on a path for sustained funding now.
Data modernization is underway to ensure real-time actual data and data analytics, and to include predictive data analysis. Public health labs are restructuring, instituting the necessary resilience to rapidly respond to emergencies. Public health talent is being hired to enhance lab capacity, deploy cutting-edge technology solutions and conduct effective community-based contact tracing. A legion of public health care workers are deployed on the front lines of this pandemic, and working 24/7 to protect the health and safety of Americans. CDC staff are on the ground in communities across the nation, supporting public health partners with an array of technical expertise. Our state and local partners are committed to advocating and educating about the needs to embrace public health strategies that best serve families and their communities, and essential workers, first responders and health care professionals are steadfast in their service, sacrifice and commitment to save lives. Please take note, and please tend to them as they are attending to us. We cannot afford to do it without them.
As I recently told a group of CDC aspiring leaders this week, we are in the arena. We're dedicating -- committed to doing our best, and I'm confident that united, we will emerge a better, stronger and more resilient nation.
Adversity requires all of us pushing harder, thinking differently, being innovative and perhaps most importantly, always seeing the possible of what we can accomplish when we unite and work together. This pandemic has challenged us with its persistence, its uncertainty and its unpredictability, and yet, I'm confident that together, we'll prevail over this virus. But we must lead together in the best interest of our children, our grandchildren, our great-grandchildren and our nation's generations to come.
Thank you, and I look forward to your questions.
CLYBURN: Thank you very much, Dr. Redfield, and thanks to all of you for your testimonies. And as I said earlier, you submitted to us fuller testimony and they're all entered into the record.
I'll now recognize myself for five minutes for questions.
On January 31st, 2020, exactly six months ago today, the secretary of Health and Human Services declared the coronavirus outbreak, and I quote, "a public health emergency for the entire United States." But rather than immediately bringing our nation together to tackle the problem, the Trump administration downplayed the crisis, ignored scientific experts and deferred to states and the private sector to lead the response.
Dr. Fauci, on March 11th of this year, you testified before the Oversight Committee saying, and I quote, "It's going to get worse." I regret to say you were right: It did get worse. On March 11th, the country had confirmed just over 1,200 cases and 31 deaths. Today, we have confirmed more than 4.4 million cases, and we have just reached 150,000 deaths.
Now, there's a chart that I have up here. This chart compares the number of new daily coronavirus cases in the United States with those in Europe. It shows just how much worse the outbreak has been in the United States. It is Europe, the little line here, the European Union; here, the United States, and here's where we were on the way, restarted, going up while the European countries, the European Union plateaued and is going down.
Dr. Fauci, can you help us understand why Europe has largely contained the virus, the United States has seen a continued rise in new cases?
FAUCI: Thank you very much, Mr. Chairman.
The answer to that question is really somewhat complex, but I'll try maybe to very briefly go through what I believe are at least some of the factors that were involved.
If you look at what happened in Europe when they shut down or locked down or went to shelter-in-place -- however you want to describe it -- they really did it to the tune of about 95-plus percent of the country did that. When you actually look at what we did, even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50 percent, in the sense of the totality of the country.
Which means when we reached our peak -- as they did -- they came down almost to a low baseline, as you've shown very clearly. But take a look at what happened to our baseline. We came up, down, and then we plateaued at about 20,000 cases a day. So we started off with a very difficult baseline of transmission that was going on, at the time that we tried to open up the country.
And when we opened up the country, what we saw particularly most recently in the southern states, was an increase of cases to 20, 30, 40, 50 and a couple of weeks ago it was up to 70,000 per day, and now it's down between 50 and 60. And the reasons for that are complex. There were some states that did it very well, and there were some states that did not.
And when I say "did not," I mean, you know, we put out -- as Ranking Member Scalise mentioned -- the guidelines of a gateway, phase one, phase two, phase three. Some were followed very carefully and some were not. And in those situations in which it were not, that led to the surging that you're showing on your chart there.
And one of the reasons is not doing some of the things that Dr. Redfield mentioned in his opening statement: universal wearing of masks, avoiding crowds, physical (ph) distancing, et cetera, et cetera.
So it's a complicated reason why those charts are that way. And hopefully, as we're going forward, we can turn those around -- and I do believe we can, Mr. Chairman -- by doing some of the fundamental things that we're talking about, five easy things to do that were mentioned by Dr. Redfield. Thank you.
CLYBURN: Thank you very much.
At the risk of going over my time, because of the votes (ph), what I'm going to do is yield to you, Mr. Ranking Member, for five minutes. When Ms. Waters gets back, I'll let her get in the chair so we can go vote, OK?
SCALISE: All right, thank you, Mr. Chairman.
And again, appreciate all of you being here. I know when we talk about President Trump's team that he has been relying on to help put together this plan and, like I said, this is just a small part of the plan, there are thousands and thousands of more pages online of various aspects of President Trump's plan to combat the coronavirus.
But we have of course Dr. Fauci, Dr. Giroir, Dr. Redfield. We see Dr. Birx, there's a whole array of doctors, medical experts -- best in the world -- that are helping work with President Trump to develop this plan. Is that correct, if I could ask any of you all? Is that correct?
By the way, were any of you sidelined from coming here? I know some people try to use that term. I haven't heard of anybody sidelined, but if...
SCALISE: ... any of you were sidelined, please share it because I haven't seen it. Good to see all of you here.
Dr. Fauci, let me ask you about some of the decisions that you worked with President Trump on -- and the whole team did. I know when you go back to the beginning of this the China ban was very heavily discussed.