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Fauci: Seeing A "Disturbing Surge" In Infections In Parts Of Nation. Aired 12:30-1p ET

Aired June 23, 2020 - 12:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[12:30:00]

DR. STEPHEN HAHN, FDA COMMISSIONER: -- 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.

I particularly like it with respect to the flexibility given the states, your state in particular, which has an excellent public health laboratories, as well as University of Washington, and New York state is another example of this, those are the sort of things that we're looking at now, as we talk about how we want to move forward that we could potentially put in place on a permanent basis to facilitate test development.

Hopefully, we'll never be in a position again where we have to develop tests over such a short period of time, like we've remarkably done during this time. But we really do need to talk about how these flexibilities could stimulate innovation and development of tests.

UNIDENTIFIED FEMALE: Great. Well, thank you all. Thank you all for your leadership, your commitment during this time, the long hours. And I especially appreciate the way that we're looking forward to make sure that we are prepared in the future whatever we may face. Thank you. Good to be with you.

REP. FRANK PALLONE (D-NJ): Thank you. Now we go to Mr. Doyle coming to us from Pittsburgh. Mr. Doyle? Is Mr. Doyle --

REP. MICHAEL DOYLE (D-PA): Sorry, Mr. Chairman, I forgot to unmute.

PALLONE: Thank you.

DOYLE: Can you hear me now?

PALLONE: Yes, you're recognized for five minutes.

DOYLE: Thank you, Mr. Chairman for holding this hearing and the Ranking Member also and to our witnesses for your service on behalf of the American people.

This Committee has continued to conduct oversight of the Trump administration shortcomings related to procuring and distributing personal protective equipment or PPE. When states and hospitals were faced with critical shortages of the PPE, such as masks and gowns, President Trump passed the buttons said that federal government was, quote, not a shipping clerk.

We saw the result of failure of leadership. Without a national strategy, states have had to fend for themselves and even compete against each other for critical supplies has become so desperate out there that one former U.S. disaster official refer to the scramble as, quote, Lord of the Flies: PPE Edition.

At a recent hearing before the Oversight and Investigation Subcommittee, Michigan Governor Gretchen Whitmer testified quote, the lack of centralized coordination at the federal level created a counterproductive competition between the states and federal government to secure limited supplies driving up prices and exacerbating existing shortages.

Admiral Giroir, let me ask you, do we have enough PPE for every frontline worker who needs it, whether they be healthcare workers, first responders, are thousands of others whose job puts them at risk or people still having to reuse N95 masks, for example? And if we don't have enough, why hasn't the administration in both DPA to greatly expand the manufacturing of these supplies?

ADM. BRETT GIROIR, ASSISTANT SECRETARY FOR HEALTH, HHS: Well, thank you for the question. And I will do my best to answer that Admiral Polowczyk is certainly running the supply chain with also Dr. Kadlec from ASPR.

But being a member of the Unified Coordination Group at FEMA for the past three months, I'm pretty familiar with this, I think as Admiral Polowczyk testified before and I think we all know is that there was an absolute shortage of everything when this started. Everyone in the world was looking for the same supplies and we tried to manage that both from increasing the supplies and using the DPA multiple times.

For example, there were three investments, DPA Title 1, for N95s, 3M, Honeywell, and Owens & Minor to improve production. We estimate that that the country in the fall, if there were a COVID outbreak to this degree, would need about 140 and -- 940 million N95s per month. We should have 180 million per month being produced domestically by that time.

This was not available when we started in March. The industry was not here. This was all offshored. And I'll just say cumulatively, between March 1st and June 19th, the government distributed or enabled the commercial distribution through the air bridge of 160 million N95 masks, 638 million surgical and procedural masks, 281 million gowns and over 16 billion pairs of gloves.

So this was really an enormous effort. We need to be better prepared. This all needs to be on shore. We're working with SNS 2.0 to have a 60 to 90 day supply. We talked to governors in every state. And many of the states are also doing their own supplies for 60 to 90 days. So I'm confident moving from here on as we ramped domestic manufacturing that we're going to be in a much better position than we were three months ago. [12:35:14]

DOYLE: Thank you, Admiral. Dr. Hahn, let me ask you. Since demand for PPE improves the spring, we've seen many actors with little previous experience in the supply field enter the market. Reports have indicated that some are selling counterfeit or low quality products that don't meet safety requirements are unable to fulfill agreements. What steps is the FDA taking to ensure that companies are not circumventing federal oversight and injecting potentially substandard PPE into the United States market?

HAHN: Thank you, Congressman. This is a really important issue. During the height of this epidemic and the increased demand, we provided regulatory flexibility for companies, but insisted that they provide certification often foreign FDA's if you will, certification that the PPE met the requirements that we have in place and that the foreign governments had in place.

But we did something else with respect to that. And that is we also partnered with CDC and NIOSH, for example, with N95s to test, to verify that, in fact, that self certification over the validity of the efficacy of the PPE was in place.

And you've correctly identified that for a variety of reasons, subsequent product that was shipped into the country did not meet those specifications. We immediately took action to make sure that those were off of the market and continue to do that and monitor it very closely.

DOYLE: Thank you, Mr. Chairman. I see my time has expired. I yield back.

PALLONE: Thank you, Mr. Doyle. Next we have Mr. Guthrie coming to us from Kentucky. Are you muted? Do you want to unmute.

REP. BRETT GUTHRIE (R-KY): I thought did that, I apologize. Hi. It's Brett Guthrie. I apologize. Hi, Dr. Hahn, I'm interested in the COVID- 19 counterfeit testing and I have a bill that would bring, it's called the Safeguarding Therapeutics Act that would ensure FDA has the authority to destroy the counterfeit tests and devices.

Now I follow up with a question with this. What I'm interested and what the people that I talk to every day are interested in is what's going on in the future? How we're going to protect ourselves moving forward? We need lessons learn from the past. We need to look forward.

And Dr. Hahn kind of answered on -- I mean excuse me, Admiral Giroir, answered on the PPE kind of moving forward. But if I could just go with Dr. Redfield, Dr. Fauci, and then Dr. Hahn, if you'll talk about pool testing and how that might be effective. Well, the people that I talk to, what's it going to look like in March? I mean, excuse me, what's it going to look like in August? Are kids going to be getting back in school? Are nursing homes going to be safe? That's what people are looking for.

So Dr. Redfield, I know we're going to have flu, we'll have COVID. What's the testing going to be like? Dr. Fauci, what do we need to be looking for? And Dr. Hahn, full testing? And I'll just open it up for you three to talk about, what's it going to look like in August and are kids going to be able to go back to school? I think I'll start with Dr. Redfield?

DR. ROBERT REDFIELD, CDC DIRECTOR: Thank you, Congressman. I think first and foremost, it's really important that we continue to take this time to continue to accelerate our capacity to diagnose, obviously, readily available timely test results, build that capacity for isolation, contact tracing, and self quarantine. That's fundamental. We're working hard to do that.

As I mentioned, in January, we had about 6,000 contact tracers in this country. In the beginning of June, it was up to around 27, 28,000 that needs to continue to increase in my view towards 100,000 if we get that operationally functional. That's going to be critical for what we're doing.

Secondly, we do have to reinforce in the American public the importance of the social distancing interventions that we've discussed, particularly face covering, six feet distancing and hand washing. I anticipate that the states will begin to open up higher education and K through 12. It's going to be on a jurisdiction to jurisdiction decision.

CDC will be issuing additional guidance on this topic in the days ahead as we continue to work and then keep guidance to open up these particularly the school systems, how to open them up safely. I will end with nursing homes. I think we've made enormous progress in the long term care facilities enhancing infection control.

Admiral Giroir may want to comment about the commitment that FEMA made to provide all nursing homes protective equipment for a period of time. And we're continuing I think to have aggressive surveillance in the nursing homes across this country where we've recommended that all residents get tested so that we can start with a clean baseline of understanding where the epidemic is.

[12:40:21]

I will just end with the fact that although they only make up 0.6 percent of our population, nursing home residents have made up more than 35 percent of our mortality.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Let me very briefly --

DOYLE: Thank you Dr. Redfield. Dr. Fauci?

FAUCI: Yes. Let me briefly address the question you asked about schools because we get asked that all the time, I think the important thing to point out is that as you all know, we live in a very big country that is certainly not a unidimensional country. It's very, very different whether you're in a New York metropolitan area or Casper, Wyoming. So when you're asking about schools, you have to say, where are you talking about? Because we have different regions, different states, different cities, towns and counties, so some counties may have such a low level of infection that schools can open in a way that's exactly like normal. Others may be in a situation where it isn't really bad where you want to close the school but you might want to make some modifications, alterations of scheduling, things like morning, afternoon, one day or another day.

So it's up to the local officials to evaluate where you are in the particular region, what the recommendations that we really very carefully put out about the guidance opening schools. So you don't want to make a one size fits all for the United States. You want to tailor it to the degree of viral dynamics in the particular location that you're talking about.

DOYLE: So looking forward, we're really only going to know when we get closer to that point so we can make those decisions. That's unfortunate, but obviously that's the reality. I'm about out of time Dr. Hahn. I slip in a question for the record for pool sampling.

Thank you very much and I yield back.

PALLONE: Thank you, Mr. Guthrie. It sounded like there was a monster that was going to envelop you at some point there. Next we have Ms. Schakowsky from Illinois.

REP. JANICE SCHAKOWSKY (D-IL): Thank you. Thank you, Mr. Chairman. And I want to thank the witnesses. I have to disagree with you, Dr. Redfield. I think nowhere has the Trump administration's lack of leadership than more apparent than in our nation's nursing homes and long term care facilities where we've lost 50,000 residents and workers to COVID-19.

So let's review some of the deadly failures. You delayed data collection on cases and deaths in nursing homes. You have not required states to conduct testing. You are not giving workers adequate PPE and I agree with Congressman Doyle on that to protect themselves. You are allowing facilities to literally kick residents out of -- out onto the street if there's a more profitable COVID patient to take their place.

And since CMS Administrator Verma, who is responsible for the safety of our nursing home residents, has declined Chairman Pallone's invitation to speak. Let me refer then to Dr. Redfield, the CDC website explains that your mission is to save lives by providing health information that protects our nation. So why didn't you require nursing homes to report any data on COVID-19 cases and deaths until May, four months after, you may remember, you told me about the first case in Illinois, January 30th. And to report the case of human to human transparent -- transfer.

On July 4th -- on June 4th, you testified before the House Appropriations Committee and apologized for CDC's inadequate, I quote, response to COVID-19 race and ethnicity data. Yet, the same day, CMS and CDC finally published COVID-19 data from nursing homes and failed to include race and ethnicity information. So when my office asked CMS about the exclusion, we were told to ask the CDC. So will you promise to include race and ethnicity information moving forward so that we can identify the address the -- and address the racial disparities in nursing home COVID-19 cases?

[12:45:22]

REDFIELD: Thank you, Congresswoman for your question.

First, I want to stress that since the early beginning of the pandemic, we've initially encouraged all nursing homes to report the cases through their health departments. And through our National Healthcare Safety Network as of May 8th --

SCHAKOWSKY: If I just briefly interrupt on the word encourage. That I think is a problem. That there's this guidance, there's been encouragement but what about mandated?

REDFIELD: As I said that as of May 8th now it is a requirement that this be reported in through CDC, as CMS has made that required. And we are working to make sure this reporting is comprehensive to include ethnic and racial data, as well as I would argue -- put forth that we've worked hard to really accelerate training and retraining of infection control procedures in these nursing homes to try to mitigate the situation that unfortunately we did experience as you pointed out, where the nursing home residents have taken a high burden of this initial outbreak.

We will continue to work to get this reporting. This reporting is going to be forward facing. CDC will forward the data to CMS. CMS will forward face it. So families can make decisions based on their understanding of how different nursing homes are performing.

We have recommended that the nursing homes, as you mentioned that they screen all residents, and we've recommended that they screen all workers in nursing homes on a weekly basis because we do believe this is an important area that we have to do more as a nation to protect infections.

(END VIDEOTAPE)

JOHN KING, CNN HOST: We're listening to a remarkable hearing of the House Energy and Commerce Committee up on Capitol Hill, the President's top coronavirus experts up there to talk to lawmakers. We will go back in live if there is additional important news.

But it has been a remarkable hearing updates on a number of topics vaccine, research, the spread of the coronavirus. The biggest headline, the biggest headline, you cannot believe the President of the United States in the middle of a pandemic, that the words of his own experts in translation, if you will.

The President over the weekend said he had asked his experts to stop the testing, to slow the testing. He says he doesn't like to see the higher case numbers. All four of the administration officials on hand saying that has never happened. The President has not asked them to slow testing although even just this morning, the President said he was not kidding about that.

Also watch the President's interviews in recent days. He says the coronavirus is fading. It is dying out. It is in the rearview mirror. The President wants you to believe. Listen here. This is Dr. Anthony Fauci, the top infectious disease expert in the United States of America.

(BEGIN VIDEO CLIP)

FAUCI: We're now seeing a disturbing surge of infections that looks like it's a combination. But one of the things is an increase in community spread. And that's something that I'm really quite concerned about. The next couple of weeks are going to be critical in our ability to address those surgings that we're seeing in Florida, in Texas, in Arizona, and in other states. They're not the only ones that are having a difficulty. Bottom line, Mr. Chairman, it's a mixed bag some good and some now we have a problem with.

(END VIDEO CLIP)

KING: Let's bring in our chief medical correspondent Dr. Sanjay Gupta and also Dr. Rochelle Walensky, she's the chief of Infectious Diseases at Massachusetts General Hospital in Boston.

Dr. Gupta, I want to start with you. The President of the United States says fading, dying out if you've been listening for the last hour plus, the coronavirus is anything but fading and dying out. Dr. Fauci saying this is a crucial couple of weeks as he sees a surge in cases in many places and starting to see an increase in hospitalizations following it.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. And he also went on to say after that sound that you just played that we have been, quote, hit badly was how he described it.

And, look, I mean, if you were looking to this briefing, this hearing to feel better about things, you probably are not going to feel satisfied after listening to this. There's a lot of concern, you know, as softly sort of spoken as they are. And all of these members of the Coronavirus Task Force are quite expert at what they're saying.

But if you listen closely to what they're saying, there's obviously a lot of concern. You can see the numbers on the right side of the screen, the United States versus the rest of the world. Twenty-five percent of the overall case is 25 percent of the deaths.

One thing I want to also point out is that, you know, you talked about the testing a lot and this discussion question about testing. All of the members there said that they had not been directed as you said, John, to slow down testing. But it is also worth pointing out that we are nowhere near where we should be with testing.

[12:50:11]

OK. So whether they were told this or not, the outcome is that some 500,000 or so tests are being performed per day. Admiral Giroir said, by the fall, maybe they'll get to 40 million per month. But it's clear, you know, that we need a lot more if you look at these roadmaps to recovery, they say by this point, we should be at 5 million per day at testing, that's in order to really get good surveillance on this.

So, you know, that was a significant concern. But again, the idea that things are ticking up that we are close to where we were at our peak in terms of numbers of cases and things like that, that was a, you know, a common theme from everyone that was speaking today.

KING: And one of the challenges Dr. Walensky is who do we trust and who must we trust in the middle of a pandemic? I say that in the context of the President says, I told myself people to slow down the testing, all of his people saying, he did no such thing. Good, good. That's great that he didn't actually do it because that testing is what gives us the goldmine of information that allows you to understand the challenge in front of you.

But when the President says he did ask that, and then he says he wasn't kidding, and the Republicans in Congress have to ask the officials to go on the record and make clear that he did not. That's one issue. And then there's the point of again, are we going up? Are we going down? Are we in better shape or worse shape? The President says dying, fading out. You heard from Dr. Fauci, saying a crucial couple of weeks says there's a surge, his word, in several states.

But the CDC director who we know the President is mad at for the testing mishaps early on. Dr. Redfield said, while overall case counts are going down, several communities are seeing increased cases. How can he say that? How can he say that? Six weeks ago, when Dr. Fauci last testified, we had 82,000 deaths, 24,000 new cases each day. Six weeks later, we're up to 120,000 plus dead, 28,000 new infections each day. How can you say overall case counts are going down?

DR. ROCHELLE WALENSKY, CHIEF OF INFECTIOUS DISEASES, MASSACHUSETTS GENERAL HOSPITAL: Right, it's a really key point. You know, one of the things that I want to emphasize is to think about where we were, if we were to rewind the clock when things shut down, when the economy shut down. End of March, we were all talking about mitigation, flattening the curve.

At that time, we had 20,000 new infections per day. We have about 50 percent more new infections per day now as we did then, when we were talking about all of these mitigation strategies of the masks, of social distancing, of staying home, of stopping travel.

And so I want to say, you know, we're really in a worse place now than we were before. Now, what we did do was flatten the curve, what we did worked. The problem is that as we open things up again, as people get more cavalier, we're really not in a better place now than we were at the time all of those draconian measures were taken.

It's really hard to think about how we're going to contain this now in the setting of things opening up when what you really need to do is contact trace 30,000 people, we simply don't have the resources. We don't have the capacity to be able to do that in any structured way. KING: And A, ramification of that came up in the hearing right before we dropped out. Dr. Redfield raising the possibility said this will be done jurisdiction by jurisdiction. But so much so much of the country is planning to reopen schools in a couple of months and that could be in play and serious question if this continues.

I want to bring in our Kaitlan Collins. She's over at the White House as well. Kaitlan, the President of the United States is on his way to Arizona, a state that is in the middle of a surge, a state that's reporting more than 50 percent new cases this week than it has last week.

He said this morning as he was leaving that he doesn't kid. He said at the rally over the weekend, I've asked my officials to slow down testing. Then it was scrambling the administration for officials to say the President was just joking. He has not asked that. The President says he's not kidding. But I want you to listen, these are two of his experts this morning at the hearing saying no, the press has never told us that.

(BEGIN VIDEO CLIP)

FAUCI: None of us have ever been told to slow down on testing. That just is a fact. In fact, we will be doing more testing.

REDFIELD: We're continuing to try to enhance testing. It's a critical underpinning of our response.

(END VIDEO CLIP)

KING: In the middle of a pandemic, two the nation's top experts need to take time to say, now the President didn't tell us to do that thing he said that he told us to do.

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: Yeah. And John, you also did not hear those officials testifying that they believe testing is a double edged sword because of course, if there is more testing, the argument that you've seen the President and the Vice President make in recent weeks is they're saying that's the reason that you're seeing these new cases.

And Dr. Fauci and the other health experts are telling a different story, saying that they are troubled by the surges in certain states where the numbers had looked good for a little bit of time. But now they're concerned states like Florida, Arizona, where the President of course is going to be today, Texas, all of these others that they're talking about, and they say we're not going to be slowing down on testing at all. We're going to be ramping it up.

Because as, you know, Sanjay was pointing out, the levels that they're at right now is still not where a lot of health experts say that they need to be. But this just adds to the confusion that you're seeing that plays out here at the White House over who's speaking with authority on what's going on with the taskforce because the President made that comment. They said he was being tongue in cheek. It was in jest. You saw that repeatedly, from the White House press secretary yesterday.

[12:55:18]

And then, as we have seen so many times before, the President undercuts his own spokespeople, his own top aides by saying, I don't kid. He actually believes that about testing when it comes to coronavirus. And so they say they've never been instructed to slow down testing. John, that's interesting.

And it makes me think back to the impeachment hearings, when we were talking about the hold on the aid to Ukraine when so many officials were saying they hadn't been explicitly told do this to get this. But they said it was clear what the President wanted them to do. And the question is, you know, is this one of those situations.

KING: When they when the President staff has to tell us to pay no attention to the President in the middle of a pandemic, it is quite remarkable.

Kaitlan Collins, Dr. Walensky, Dr. Gupta, thank you for your insights. And thanks for joining us today. Brianna Keilar picks up our coverage after a very quick break. Have a good day.

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