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White House Task Force Holds COVID-19 Briefing Amid Surging Cases; Pence To Travel To States Hit Hard By Coronavirus Next Week. Aired 1-1:30p ET
Aired June 26, 2020 - 13:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
MIKE PENCE, U.S. VICE PRESIDENT: Continue to practice good hygiene, wash you hands, avoid touching your face, disinfect frequently.
People who feel sick should stay home, and when it comes to businesses, social distancing, protective equipment, temperature checks, testing and isolation.
These are the guidelines for all of the phases, and they are good practices to implement, if you're in a community that's affected or even if you are not, because we're all in this together. And the progress that we made, that you saw illustrated in those charts in places like New York and New Jersey, Connecticut and New Orleans, was a result of the American people stepping forward, heeding the guidance of federal, state, and local authorities.
And we encourage you to continue to do just that and implement the guidelines for all phases, at home and at work and in your community. But for those in the areas most affected, we just want to encourage you to listen to and respect the guidance of your state and local authorities.
I recognize that this is different than two months ago both in our ability to respond and in the nature of those that are being infected and that younger Americans have a particular responsibility to make sure that they're not carrying the coronavirus into settings where they would expose the most vulnerable.
And, lastly, as I prepare to bring Dr. Birx to the podium, I would encourage every American to continue to pray. Pray for all the families that have lost loved ones. Pray for our healthcare workers on the frontlines. And just continue to pray that by God's grace, every single day, will of each us do our part to heal our land.
With that, I'll introduce the coordinator of the White House effort on the coronavirus, Dr. Deborah Birx.
DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS TASK FORCE COORDINATOR: Thank you, Mr. Vice President. Thank you for that great introduction.
Just to remind everybody where we have come from in the last four months, we have a great deal of understanding now about the differential disease. Differential infections, no, we believe everyone is susceptible to infection. But we know infection leads to a spectrum of disease, and we have much better details about who is vulnerable and why they are vulnerable.
And as the vice president said, at one time, we were diagnosing people in the ICU after they came into the emergency room. And thanks to the millennials who have been heeding our guidance, they have been coming forward and getting testing. And so whereas before we told them to stay home, now we are telling them to be tested. And this is a great change for us because it allows us now to find the asymptomatic and the mild diseases that we couldn't find before.
As Dr. Redfield talked about yesterday from the serology tests, we have a great understanding of what was happening in March, and the number of asymptomatic and mild conditions that led to individuals to have antibodies but never come forward with significant disease.
We now know who's at risk for significant disease, and we now know it's particularly the elderly individuals over 80, and individuals with co-morbidities. And, remember, those co-morbidities span the entire age group. We do know that we have people in the younger age groups with significant type-one diabetes, and may also have individuals with significant obesity. We know that those are risk factors. And so risk factors go with your co-morbidity, not necessarily with your age.
And so as we call on individuals to protect one another, by passing someone on the street, you don't know what co-morbidities they have. And this is why we've been focused on trying to protect one another.
We also know who's at risk for the highest mortality, and because of that, we've been able to -- clinical care has dramatically improved, and I want to thank NIH who's been working constantly to update the clinical guidelines. So physicians around the United States and, frankly, around the world who are using those have the most updated information about how to actually improve disease courses of those individuals that are in the hospital.
We, of course, have improved treatment in the hospital that we didn't have in March and April. With improved methods of oxygenation, which is really quite important, improved treatment of acute respiratory distress, that's individuals on a ventilator, and we know now they respond quite well to steroids. And then research that is ongoing and what we call acute cytokine storm, not as when often in that later stage when people are on ventilators, the seriously ill may need steroids and other items, and that's being researched, and the work that's being done on clotting research by the NIH.
We also have new therapeutics out of the news both as compassionate use, like convalescent plasma and now remdesivir, that we just reallocated and ensured it was available to the states that are facing the increased hospitalization, as well as the monthly allocation that we have been sending out. If we can go to the first slide, please, and start where the vice president left off, really, this disease has tackled community by community, testing at the community level and working with community groups to understand the spread in those communities. And so we've spent the time to really map this epidemic and new positives down to the level of communities to understand where spread is occurring so that we can match our prevention interventions to those areas.
Next slide, please.
As we discussed and it's difficult for you to see on this graphic because the top line is New York. And we should remember where we were in that slope, that early slope that you can see in the case of the New York cases, that rapid acceleration. On the same slide, you can see California, that is the blue line, that is just passing the orange line, and also on the slide is Texas in green, Florida in orange and Arizona at the bottom.
As dramatic as these slopes are, they are not equivalent to the original acceleration that we saw in New York. That doesn't mean that we aren't absolutely focused on working with the governors in those communities to stop the spread of the virus in those four states.
Next slide, please.
This shows you through the entire country that we're tracking state by state. Now, obviously, this axis is vastly different than the one on the prior slide because that slide included all of the cases in New York City. But you can see on this slide that we've been tracking very closely North Carolina. A team has been with North Carolina working with the state and local public health authorities to really respond to the changes there, as well as the South Carolina at the bottom.
Next slide. I'll just go quickly through these so you can see Oklahoma's at the bottom of this slide, and next slide, you can see on this slide Idaho and Oregon. Those are the ones in the light blue and the dark green where you see an inflection in their slopes.
These inflection points and understanding when they occur and why they occur are critical for understanding how to prevent the spread.
Now, what the vice president talked about is we've created an alert system that brings together what we just talked about, rising cases with an understanding of test positivity. And so this really, this chart which is difficult for you to see, those states on that far side that have the highest tests positive that you can see at the higher level of the graph, those are the states that we have concerns about because of the rising number of cases and the rising tests positive. This explains the extent of community spread.
In states that have increasing cases but falling test positives, it tells us that they're getting into the communities to find the asymptomatic cases. And so these are the things we put together to understand the full picture. Next slide, please.
So this really puts on one slide the states that we have that we've been talking about across the south, where we have our greatest concerns. The two top states with the largest increase in test positives are Texas and Arizona, followed by Florida, Mississippi, South Carolina, Alabama, Georgia, Louisiana, Nevada and Utah. Those last few states are under still 10 percent, but we're tracking them closely as we look at that individually.
Finally, next slide, you can see on this slide we are tracking -- and this is when you hear about we have a certain 2 percent or 3 percent of the counties under specific alerts. So it doesn't matter the size of the county. We're tracking the increase and the rate of increase of new cases at the county level. We currently have about 130 counties out of the 3,100 in the United States in that category.
Next slide, the level that shows the case positivity by the metros, and the number of tests that have been done. Next slide, and then this shows you specifically the change over time of test positivity and the largest metros where we have concerns. And this is Austin, Phoenix, Houston, Dallas, San Antonio, Tampa, Orlando, Miami, Riverside, California and Atlanta at the bottom.
And so this is how we continue to integrate data on cases, data on testing and data on hospitalizations so that we can work with the states for a comprehensive, integrated response.
I know many of you will be interested in seeing how high the test positivity rate became in April and -- March and April. So that top line is New York City metro. And you can see it reached over 50 percent on a series of days for almost two weeks. 50 percent of the tests were positive for COVID-19. Underneath that, you see New Jersey and Minnesota and a whole series of individuals. Detroit is the second -- the second large mountain.
So, quickly, to show you how we look at this at the state level and work with the governors and the local health authorities. So this is Florida. We tracked testing, it's done, the number of test positives that are in the blue line, the total number of cases seen in the black bar, and what we call the syndromic presentations of early respiratory diseases and pneumonias.
This then we look at the county level to look for changes in the slope of the number of new cases. So you can see that top county that has the largest increase in sloping cases is Miami, Miami-Dade, followed by Broward and Palm Beach. All the other counties are much lower in their daily case increases. This allows us to focus resources and testing along with the state and to the specific sites.
That all comes together to keep -- create this graphic so that individuals can understand and we can understand precisely what the rate of growth is and where the rate of growth is occurring by the shading of the boxes.
Now, I'm going to quickly take you through Texas because it's the same story.
So this shows you the exact same graphics, now shown for Texas, showing a continued rise in the daily tests performed, but also a rise in the test positivity, the blue line. You can see throughout May after opening, their test positivity continued to decline as the testing increased. It was in the last 2.5 weeks that we saw this inflection of rising test positivity along with rising testing. But it was the increase in test positivity that alerted us along with the increased cases that this was becoming an alert.
You can see in the red boxes, everything is heat mapped. So at a glance, you can tell those two boxes that are in the middle that are red, that's the heat map showing that this has rising cases and rising test positivity.
But even in Texas -- next slide, please -- and this gives a map of Texas. It shows where the cases are and where they're rising the most rapidly.
And, finally, I'm just going to go through Arizona very quickly along with California. So, next slide? Same situation that we're showing here with Arizona, rising number of testing performed but also rising test positivity, rising cases.
Arizona is unique and they have essentially one county that is primarily represented by the depth of the new cases, and this is in the Phoenix area.
Next slide, then next slide.
So this is California. And so you can see California over the last week has had that increase in test positivity. You can see that dramatic increase at the end of that bar in the blue line along with still increasing test positivity, testing that has been done.
And we just want to thank all of the governors and all of the work and all the laboratories that has allowed us along with HHS and Brett Giroir, who ensured that the supplies were there to really increase these orange lines.
You could see in each of these cases, these orange lines have dramatically gone up over the last four weeks.
And like New Mexico, the primary infections right now in California at the highest level are in the L.A. area. But because L.A. is a large metropolitan area -- next slide -- you really need this kind of more specific and local graphic to really show that it's also increasing in the Central Valley. And this gives us the ability to focus resources among agricultural workers, to improve testing and isolation for those who become positive.
So I just wanted to take you through how we've been looking at data, how we consolidate that data, and then Monday, report it out to the governors. We hope over the next week to be able to really have this data available in real-time on the White House website so that everybody across the country can see where the cases are, because in the end, we really want a call to action.
When we started talking about what can be done, we said the most important thing that would change the spread -- and I'm going to turn that over because I know Tony is going to talk about it -- is really individual behavior. And our respect for one another through social distancing, wearing a mask and ensuring that we're protecting the most vulnerable that may be in multigenerational households.
And I just want to end by thanking again the millennials who have come forward. And I know during the protests, we asked a lot of them to go forward and get testing, and we see those testing rates really improving in the under 40 age groups. That is going to be important to continue to accelerate testing among the under 40 age group because that's the group most likely to have asymptomatic spread and be spreading the virus unbeknownst to them.
And I want to really make it clear, no one is intentionally spreading the virus, but they don't know that they're positive. They don't have symptoms and need to be tested in order to have that awareness.
And so we really want to thank them again for coming forward and really enriching the amount of testing that has been done in the under 40-year-old age group.
And to our older population, you know if you have co-morbidities, you know if you're over 80, we ask you if in the hotspots, in the states that are having expansion in cases, to continue to shelter as much as you can. And use your grandchildren to go and do your shopping.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Thank you very much, Dr. Birx. And thank you, Mr. vice president.
So I want to extend just for a couple of minutes some of the comments that were made both by the vice president and by Dr. Birx, and it has to do with the situation that we find ourselves facing right now. It's very clear from the maps that you saw that there are certain areas in the country, states, towns, cities, regions, that are doing very well, that have followed the guidelines and are opening up in a prudent way that's been effective. However, as you can see, we are facing a serious problem in certain areas.
Now, when you look at the map, it's very interesting because you see some dark parts of the map and some light parts of the map. We have a very heterogeneous country, but heterogeneity does not mean we are not intimately interconnected with each other. So it goes on in one area of the country, ultimately could an effect on the other areas of the country.
So let's take a look at this problem that we're facing, this resurgence of cases. I don't think there's time enough now all day to try and analyze and figure out the multifaceted elements that went into that, everything from maybe opening a little too early on some to opening at the right time but not actually following the steps in an orderly fashion, to actually trying to follow the steps in an orderly fashion, but the citizenry did not feel that they wanted to do that for a number of reasons, likely because everyone feels the common feeling of being pent-up for such a long period of time.
So we're not going to say blame, we're not going to analyze it, but there is something that's very important about it that I would like to get a message to the country, in general. When you have an outbreak of an infectious disease, it's a dynamic process that is global. So, remember, what happened in China affected us, what happened in Europe affected us, what's happening here is affecting others. We can't get away from that. It's interconnected.
So, therefore, if we are an interconnected society, we've got to look at the fact on what our role is in trying to put an end to this. Everybody wants to end it. Everybody wants to get back to normal, and everybody wants the economy to recover. I think we all are pretty common in that. That's a given.
So what can we do? What I think upon talking to a lot of people and reflecting on it, we have such an unusual situation because of all of the decades that I've been involved in chasing infectious diseases, I've never seen anything that is so protean in its ability to make people sick or not.
There's no other infectious disease that goes from 40 percent of the people having no symptoms to some having mild symptoms, to some having severe, some requiring staying at home for weeks, some going to the hospital, some getting intensive care, some getting intubated, some getting ventilated and some dying. So that depending on where you are in that spectrum, you have a different attitude to this particular thing.
But anyone who gets infected or is at risk of getting infected, to a greater or less degree, is part of the dynamic process of the outbreak.
[13:20:01] And I know because I can understand when I was at a stage in my life when I said, well, I'm invulnerable. So I'm going to take a risk. I think what we're missing in this is something that we've never faced before, is that a risk for you is not just isolated to you. Because if you get infected, you are part innocently or inadvertently of propagating the dynamic process of a pandemic because the chances are that if you get infected, that you're going to infect someone else.
And although you may feel well and because we know if you look at the numbers that you're probably here later on, the overwhelming majority now of people getting infected are young people, likely the people that you see in the clips and in the paper, who are out in crowds enjoying themselves, understandably no blame there, understandably.
But the thing that you really need to realize, that when you do that, you are part of a process. So if you get infected, you will infect someone else who clearly will infect someone else. We know that happens because the reproduction element of the virus is not less than one. So people are infecting other people.
And then, ultimately, you will infect someone who's vulnerable. Now, that may be somebody's grandmother, grandfather, uncle who's on chemotherapy, aunt who's on radiation or chemotherapy or a child who has leukemia. So there is what I call -- and, again, I just want to bring this out without making it seem that anybody is at fault, you have an individual responsibility to yourself. But you have a societal responsibility. Because if we want to end this outbreak, really end it and then hopefully when a vaccine comes and puts the nail in the coffin, we've got to realize that we are part of the process.
So when the vice president went back, pulling back a couple of months ago, when we showed about the guidelines to safely reopen the country, we've got to make sure we drop back a few yards and think about that, that this is part of a process that we can be either part of the solution or part of the problem.
So I just want to make a plea with people when they understand the stress that they're under as we try tackle not only those states but the light colored part of the country, even though they've done well, they may have gotten hit badly like New York and then came down, or they may not have got hit badly at all. They are vulnerable. If we don't extinguish the outbreak, sooner or later, even ones that are doing well are going to be vulnerable to the spread.
So we need to take that into account because we are all in it together, and the only way we're going to end it is by ending it together. Thank you.
ALEX AZAR, HEALTH AND HUMAN SERVICES SECRETARY: Well, first, thank you all for joining us here at HHS to update the American people. I want to begin by thanking everyone around the country working to defeat this virus. All of the health care providers on the front lines, those working to reopen our economy safely, the American people who have sacrificed so much in this fight, and the incredible members of our HHS team who have been working tirelessly to protect the health and well-being of all Americans. Before covering today's topic, I want to mention a major milestone for global health yesterday, the end of the second largest Ebola outbreak in history in the Eastern Democratic Republic of the Congo. We congratulate the Congolese government and all of the healthcare workers and community members involved, some of whom I had the chance to meet and thank in the DRC last fall.
Under President Trump, the United States was proud to play a bigger role in this major public health victory than any other single nation.
And now, thanks to the president and the vice president's leadership and the hard work of our team, America has never been readier to combat COVID-19. We built up our readiness under the strategy we developed to address surges, save lives, and in time defeat the virus. We're in a much stronger position to support states, hospitals, and individuals as they fight back.
There are six parts to the strategy, surveillance, testing, containment, healthcare capacity, therapeutics and vaccines.
First, we've been strengthening surveillance so that we can be aware of and respond to surges. That means, for instance, being able to track more cases among younger Americans that we never would have caught earlier in the pandemic.
Second, we have the world's greatest testing capabilities, enabling us to confirm the presence of the virus when it crops up. And we're confident that capacity will continue to rise in the coming months.
Third, states are building the capacity to track and contain outbreaks of the virus.
With federal help, many states have substantially expanded their own capabilities and were deploying knowledgeable, experienced CDC and HHS public health teams to the areas now seeing increases with a focus on community testing and community-based interventions.
Fourth, we're helping healthcare systems secure sufficient capacity and supplies. We've dramatically expanded American manufacturing of PPE and the FDA has authorized new technologies to sterilize equipment for reuse.
We've spoken with hospitals and states that are building up their own PPE reserves, many of them getting up to 60 or 90 days of supplies. Through the Strategic National Stockpile, we have far more visibility into the supply needs across the country, including centralized coordination capabilities that we lacked just a few short months ago.
Visiting healthcare providers around the country, I've seen how they're adapting to bring patients back while taking appropriate precautions. America's hospitals are ready to get back to business while maintaining the readiness for COVID-19.
the fifth and sixth elements of strategy are thanks to the president's Operation Warp Speed. We now have promising therapeutics that are benefiting tens of thousands of American patients, and all likelihood have already saved thousands of lives. We've identified two very promising pharmaceutical treatments, remdesivir and dexamethasone.
As of today, we've allocated more than 120,000 courses of remdesivir to all of the 50 states. We've added dexamethasone, a very low-cost steroid, to our treatment guidelines, and we believe it's reasonable to assume that other corticosteroids, which may be more readily accessible in some places, would have similar immunological effects.
Another promising therapeutic, convalescent plasma, has been used to treat more than 25,000 Americans in nearly 3,000 sites across the country.
There are no certainties in science, but with more than 140 clinical trials underway in the U.S., it's a pretty safe bet that more good news on therapeutics is on the way and on the way soon.
Finally, we've announced large investments to support three different vaccine candidates all the way through to manufacturing. These candidates are now in human clinical trials, some with the potential to start delivering safe and effective doses before the end of the year, and will be adding support for several more candidates.
We're expanding manufacturing capacity and already making the vials, needles and syringes that we may need.
Our capabilities have grown exponentially in the time allowed by the patriotic sacrifices of the American people. We have a much better grasp of the viruses, Dr. Birx said, and much more data with which to model it.
With that data, as you've heard today, we can focus on local trends. We have some very concerning hotspots. And we can track when other hotspots emerge, as we expect they may. We're focused on the states and the counties within those states, just 3 percent of counties that represent hotspots.
It's important for the American people to be aware of this variability and variation across the country. Americans need to understand their local trends because we want to help people make the right decisions for themselves.
Making decisions for yourself has to be based on three axes of risk, as our surgeon general taught us in March. You want to assess where you are, who you are, and whom you live with, and what activity you're thinking about doing.
There are gradations of risk within each of these axes. Going to an outdoor restaurant in Montana is a great deal different from a crowded indoor bar in Houston. When you interact with fewer people in an activity, when you interact with them for a shorter period of time, your risk is reduced. And individuals can balance these kinds of factors.
What I've laid out today is remarkable progress by the president's administration and a particular credit to the team here at HHS. We've got a lot of work ahead of us. But Americans can be confident that we have a rock-solid foundation to help us get safely back to work, back to school, back to worship and back to healthcare while we tackle surges of the virus where they occur.
Thanks to President Trump's leadership, we've got the capabilities, the knowledge and the strategy to protect Americans' lives and their livelihoods at the same time. And every American should feel proud of that. Thank you.
DR. ROBERT REDFIELD, CDC DIRECTOR: Thank you, Mr. Vice President.
I wanted to add some comments. Once again, I want to stress and thank all Americans to embrace the importance of social distancing recommendations to slow the spread of COVID. As I've said before, we're not defenseless.
These are, in fact, very powerful weapons, and it's our collective responsibility to recommit ourselves to put them into routine practice.