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4 Top Trump Administration Health Officials Testify Before Senate Committee. Aired 11-11:30a ET
Aired June 30, 2020 - 11:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[11:00:00]
SEN. PATTY MURRAY (D-WA): Can you be confident that the CDC would be giving us their plans since the CDC would be writing the comprehensive plan?
DR. ROBERT REDFIELD, DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION: We're developing a plan as we speak and, again, to keep building on the efforts to rebuild vaccine confidence in this country, which is really critical.
And then on top of that, there will be a very defined plan for distribution of this vaccine, prioritization of this vaccine --
(CROSSTALK)
REDFIELD: -- monitoring for safety of the vaccine.
MURRAY: But you can't tell us if it's going to be a couple weeks, a couple months, end of the year? Do you have any estimate of what we'll see the plan?
REDFIELD: Well, it's currently in development within the group. And I would anticipate we'll see that plan in the near weeks ahead, Senator.
MURRAY: Weeks, not days, months?
REDFIELD: In the weeks ahead. It's a collective effort that we're doing together within the concept of Operation Warp Seed. The CDC has been working on this plan, literally, probably for the last 10 to 12 weeks.
MURRAY: Mr. Chairman, I think we need to see that plan. We need to know what it is. The American public needs to know what that is. Communities need to know what that is.
So I hope that we urge that plan to be public as soon as possible so we all know what to expect.
Thank you.
SEN. LAMAR ALEXANDER (R-TN): Thank you, Senator Murray.
Senator Burr?
SEN. RICHARD BURR (R-NC): Thank you, Mr. Chairman.
After working on pandemic policy now for 17 years, I'm reminded this morning Tony Fauci has been doing it twice as long as I have and most of you at the dais have been doing that as well. I urge my colleagues to pay attention to what each of these individuals say.
Because some things are predictable up here. Congress is a full- fledged partner and funds things when there's an urgent need, a threat that's out there.
And -- and I know, Tony, you've seen over the years, when there's not that threat out there, things get shelved, like platforms that we could have developed and had better countermeasures today. Platforms that then could address vaccines at a much faster pace than maybe what we're doing.
But we spend more time with the blame game than we do with focuses on how the future should look.
While all of us, members of Congress and people within government, wish that we could get back to normalcy, your agencies and members of Congress are also charged with making sure that we map the future so that future generations have better protections than what we have.
And that's why I applaud the chairman for his white paper. And I would encourage every member that have dais to be brutally honest with us about where changes need to be made and where they don't need to be made.
Dr. Redfield, I think you would agree with me that testing and surveillance on this has not been the best performance by CDC. I don't want to dwell on where we've come up short.
Share with these members and myself, what can we expect over the next several months from CDC that will be different than what the past has looked like?
REDFIELD: Well, thank you, Senator, for your question.
I think CDC will continue to work with the state, local, tribal territory health departments to build their capacity.
I think we all know that, for decades, there's been consistent underinvestment in public health in this nation. And the core capabilities to do that job, day to day monitorization, predictive data analysis, laboratory resilience, workforce, very appreciate for the emergency response fund that Congress provided.
These are critical infrastructure issues that the reality are have been underinvested. The CDC is, right now, probably providing 50 percent to 70 percent of all public health funding to each state. We need to have a much more robust investment in these core capabilities.
What you are going to see, because of the Congress acting, CDC has provided now $12 billion to the local, state, territorial tribal health departments to begin to build that core capability that we would have liked to have built over the last several decades so that there's enhanced testing.
It's been mentioned that it's complicated here because this virus is so asymptomatic for so many, so the traditional methods of diagnosis, contact tracing, isolation are going to be inhibited for many individuals. And that's going to require broader community-based surveillance strategies.
Those plans, as was mentioned by the Admiral, are, we've received them for June and July. We're working with the local jurisdictions. They are going to have them in middle July for the plans of the rest of the year.
And we're going to be working side by side with them to continue to augment the public health capacity response to this COVID virus with basically enhanced surveillance and enhanced early diagnosis, contact tracing, isolation, to begin to bring this outbreak under control.
BURR: I hope some that have money will be used to upgrade the systems at CDC that are antiquated.
[11:05:04]
REDFIELD: Sir, I agree with you there.
I mean, I think -- as those of you know, when I was given the opportunity to do this job, very early on, within a month, I recognized that the core capabilities of our public health infrastructure is not there, particularly the one that I know you've been very supportive of, day to day modernization, predictive data analysis.
And that is in progress. It can't happen too soon. And we're appreciative of the support that Congress has given.
And I do think it's fundamentally critical to bring our data system and, as you know, the data personnel that we have -- and we thank you for your efforts there.
And as we need to hire those individuals strategically, we'll continue to do that to make sure that the premier public health agency in this country has the personal and data systems that it does need.
But I will say the other big issue we have to correct is to make sure that our public health, state, local, territorial and tribal have that integrated system of data.
BURR: Dr. Hahn, I think you have used your authorities under PAPA (ph) at FDA in a very effective way. And the FDA has risen to a challenge during the public health emergency, cutting red today and maintaining agency's gold standard in terms of life-saving medical products.
You've specifically mentioned innovative clinical trial designs and the use of real-world data as areas where FDA has gained ground during the response to COVID.
How do you plan to ensure that this progress is maintained long after the coronavirus response is over?
DR. STEPHEN HAHN, COMMISSIONER, FOOD AND DRUG ADMINISTRATION: Thank you, Senator Burr.
Critical issues that you bring up. In addition, some of the things that we're doing on the review side to actually expedite review and work with innovators and developers, we will continue.
Part of our review of our actions to date, so a mid-action review, will inform how we move forward.
No question the fact that real-world evidence and an modernization of our systems are needed, particularly around supply chain and demand for medical products, but also on review cycle and the clinical design trials as you just -- as you mentioned.
BURR: Thank you for that.
Mr. Chairman, I do hope that you or other members will allow Dr. Fauci today to make any comments on the reports of the swine flu that the Chinese have apparently identified and how that might affect us in the future in this country.
ALEXANDER: Well, Dr. Fauci, why don't you do that now if you have anything to say about a swine flu.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: The Chinese over the last week or two have identified a virus in the environment. It is not yet shown to be infecting humans.
But it is exhibiting what we call reassortment capabilities. In other words, when you get a brand-new virus that turns out to be a pandemic virus, it's either due to mutations and/or the reassortment or exchanges of genes.
And they are seeing virus in swine, in pigs now, that have characteristics of the 2009 H1N1, of the original 1918, which many of our flu viruses have remnants of that in it, as well as segments from other hosts like swine.
When they all mix together and they contain some of the elements that might make them susceptible to being transmitted to humans, you always have the possibility that you might have another swine flu-type of outbreak as we had in 2009.
It's something that still is in the stage of examination. It's not so- called an immediate threat where you're seeing infections. But it's something that we need to keep our eye out on, just the way we did in 2009 with the emergence of the swine flu. It's called G-4, is the name of it.
ALEXANDER: Thank you. Senator Sanders?
SEN. BERNIE SANDERS (I-VT): Thank you very much, Mr. Chairman.
And let me thank all of our panelists for being here and for the great work that they are doing on this pandemic.
Let me ask a question that has just bothered me lately. All of you, and I think most Americans, understand how important social distancing is. We're told over and over again. The chairman told us at the beginning of this meeting stay apart at least six feet if you can.
And just the other day, however, American Airlines announced that they were going to fill up all of their planes. And other airlines have done the same. You'll have people going from New York to California, five, six hours, sitting inches apart from each other. And then you've got buses all over America where people are packed in like sardines.
My question is: Why hasn't the government, whether it's the CDC or the Department of Transportation, issued guidelines prohibiting those violations of what we all know to be common sense?
[11:10:11]
Who wants to -- Dr. Fauci, you want to start on that?
FAUCI: Thank you, Senator.
Well, I'm -- I'm not the CDC but I'd be happy to make a comment on that and maybe Bob would also.
I mean, obviously, that's something that is of concern. I'm not sure exactly what went into that decision-making.
I would hope there would be something to mitigate against that, because I know and we've said and continued to repeat it, that avoiding crowds, staying distant, and when in a situation like that, wear a mask.
I think in the confines of an airplane that becomes even more problematic.
SANDERS: But generally -- I understand the mask thing. But doesn't it sound a little bit silly and a little bit in violation of everything you guys have been talking about to have people sitting next to each other for five or six hours in an airplane or crowded into a bus?
And my question is: Why hasn't -- you know, the president issues a lot of executive orders. Why haven't we stopped that type of activity and told the airlines and bus companies that it is unhealthy?
REDFIELD: Senator, I appreciate your question. And I think it's -- it's a critical area.
I can tell you, when they announced that the other day, obviously, there were substantial disappointment with American Airlines. A number of airlines had decided to keep the middle seat open.
I can say this is under critical review right now by us at the CDC. We don't think it's the right message, as you pointed out.
Again, we think it's really important in individuals that -- whether it's a bus or a train or a plane are social distancing to the degree that's feasible, and at least you can have a reliable face covering. So --
SANDERS: OK, I thank you.
I just hope very much that the CDC or the appropriate agency basically tells these companies that that is unacceptable behavior, that they are endangering the lives of the American people.
Let me go to another question. I just have a few more questions and not a lot of time so I would appreciate brief answers.
At the University of Washington, the Institute of Health there indicated that if 95 percent of the American people were to wear masks, we could save some 30,000 lives.
A number of countries, including South Korea, France, Turkey and Austria have provided low-cost or free masks to all of their people, something that I believe in.
Would you support an effort to greatly increase the production of high-quality masks in this country and distribute them free of charge to every household in America?
(CROSSTALK)
SANDERS: Dr. Fauci or anybody else who wants to jump in on that.
FAUCI: Yes, of course. I think masks are extremely important. And we keep hammering home.
And I think what you just mentioned is as important. There's no doubt that wearing masks protects you and gets you to be protected. So it's people protecting each other.
Anything that furthers the use of masks, whether it's giving out free masks or anything other mechanism, I'm thoroughly in favor of.
REDFIELD: And I just want to echo that, Senator. And in my opening statement, again, I called on an environment that we have universal masks. I think it's fundamental --
SANDERS: Good.
REDFIELD: -- and the most important thing we can do.
SANDERS: That's great.
But when you refer to, quote, unquote, "universal masks," which I agree with you on, would you be supporting the increased production of high-quality masks and basically distributing them free of charge to every household in America? Because I think that's going to save tens of thousands of lives.
Would you agree?
ADMIRAL BRETT GIROIR, ASSISTANT SECRETARY FOR HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES: Senator Sanders, this is Brett Giroir.
Yes, sir, I agree that that is very important because we need to support mask-wearing.
I would also point out that Dr. Kadlec, at ASPR, has contracted for hundreds of millions of cloth face coverings that could be distributed around the country. And those kinds of processes are being thought of.
When I'm not in uniform, I wear them. They are white and work very effective. And I think they are a great investment for the American people.
SANDERS: Good. Thank you.
My very last question. It's an issue I've raised now for the last couple of months. All of us hope to god that a good, safe vaccine will be developed as soon as possible. But that vaccine may not mean anything to a lower-income person who might not be able to afford it.
I happen to believe that we should make these vaccines -- and by the way, as you all know, federal government, our tax dollars, are going to the tune of billions of dollars into drug companies to help develop this vaccine. That's OK.
But would you agree with me that, after that kind of investment, we should make sure that every American, every person in this country, can get a vaccine regardless of their income?
[11:15:10]
FAUCI: Yes.
SANDERS: OK.
Anybody else want to comment on that?
REDFIELD: Yes, Senator, agreed.
HAHN: Yes, Senator.
SANDERS: Well, good.
Thank you all very much.
ALEXANDER: Thank you, Senator Sanders.
Senator Paul?
SEN. RAND PAUL (R-KY): Thank you. Fatal conceit is the concept that central planning with decision-
making concentrated in a few hands can never fully grasp the millions of complex individual interactions occurring simultaneously in the marketplace.
It is a fatal conceit to believe any one person or small group of people has the knowledge necessary to direct an economy or dictate public health behavior.
I think government health experts during this pandemic need to show caution in their prognostications.
It's important to realize that, if a society meekly submits to an expert and that expert is wrong, a great deal of harm may occur, when we allow one man's policy or one group of small men and women to be foisted on an entire nation.
Take, for example, government experts who continue to call for schools and day care to stay closed or that recommend restrictions that make it impossible for a school to function.
For a time, there may not have been enough information about coronavirus in children, but now there is. There are examples from all across the United States and the world that show that young children rarely spread the virus.
Let's start in Europe. Twenty-two countries have reopened their schools and have seen no discernible increases in cases.
These graphs behind me show no surge when schools open. The red line is when the schools open. There's data from Austria, Belgium, Denmark, France, Germany, Netherlands. No spike when schools are opened.
Content tracing studies in China, Iceland, Britain and the Netherlands failed to find a single case of child-to-adult infection.
Here at home, childcare for essential workers continued to be available in some states throughout the pandemic.
Brown University researchers collected data on day cares that remained open during the pandemic. Over 25,000 kids in their study. Found that only .16 percent got COVID. And when you looked at the confirmed cases for staff, there was about 1 percent of more than 9,000 staff.
The YMCA also has put forward statistics. Forty-thousand kids at 1,100 sites, there were no reports of coronavirus outbreaks or clusters.
Dr. Joshua Sharfstein, of John Hopkins, writes. "There is converging evidence that the coronavirus doesn't transmit among children like the flu, that it is a lower risk."
Just yesterday, the American Academy of Pediatrics says we've got to get kids back in school. We want them physically present in school. They even cite mounting evidence that children are less likely to contract the virus. Ultimately, this all comes down to the fatal conceit that central
planners have enough knowledge somehow to tell a nation of 330 million people what they can and can't do.
Perhaps our planners might think twice before they weigh in on every subject. Perhaps our government experts might hold their tongue before expressing the opinion whether we can play NFL football or Major League Baseball. Not in October.
Perhaps our experts might think twice before telling the whole world that a COVID vaccine likely won't provide herd immunity. We don't know!
Why -- why weigh in with these opinions that we have no knowledge of. These are forecasts that may well be wrong.
Perhaps our experts might consider the undue fear they are instilling in teachers, who are now afraid to go back to work.
No one knows the answers to these questions. We shouldn't presume that a group of experts somehow knows what's best for everyone.
Hayek had it right, only decentralized power and decision making, based on millions of individualized situations, can arrive at what risks and behaviors each individual choose.
That's what America was founded on. Not a herd with a couple of people in Washington all telling us what to do, and we, like sheep, blindly follow.
This all begs the question: When are we going to tell the people the truth, that it's OK to take their kids back to school?
Dr. Fauci, every day, virtually every day, we seem to hear from are you things we can't do. But when you're asked, can we go back to school, I don't hear much certitude at all. I hear, well, maybe, it depends.
[11:20:08]
All of this body of evidence about schools around the world shows there's no surge. All of the evidence shows that it's rare.
I mean, we've so politicized this and made it politically correct that the WHO releases that it's rare and you have a scientist out there honestly giving her opinion. What happens to her. She's blackballed and her report that she's referred to is taken off to the Web site.
If you go to that scientist's speech and you try to clink on the link, the WHO has now screened it from us because it said something that isn't politically correct, that, guess what, it's rare for kids to transmit this.
But I heard nothing of that coming from you. All I hear, Dr. Fauci, is we can't do this. We can't do that. We can't play baseball. Well, even that's not based on the science. I mean, flu season peaks
in February. We don't know that COVID is going to be like the flu season. It might. We don't know that. We wouldn't ban school in October. You might close some schools when they get the flu.
We need not to be so presumptuous that we know everything.
But my question is: Can't you give us a little bit more on schools that we can get back to school. Because there's a great deal of evidence and it's actually good, good evidence that kids aren't transmitting this, it's rare, and that kids are staying healthy and, yes, we can open our schools.
FAUCI: Mr. Chairman, do I have a little bit of time to --
(CROSSTALK)
ALEXANDER: I'll give you a little bit.
(CROSSTALK)
ALEXANDER: That went well over five minutes --
FAUCI: Thank you, Senator Paul.
ALEXANDER: -- but please answer the question.
FAUCI: Very quickly, Senator Paul, I agree with a lot of what you say about, you know, this idea about people having to put their opinions out without data. And sometimes you -- you have to make extrapolations because you're in a position where you need to at least give some sort of recommendation.
But if you -- if you were listening -- and I think you were -- to my opening statement and my response to one of the questions, I feel very strongly that we need to do whatever we can to get the children back to school. So I think we are in lock agreement with that.
The other thing that I would like to clarify very briefly is that I -- when things get in the press of what I supposedly said, I didn't say. I never said we can't play a certain sport.
What happens is that people in the sport industry, they could either be people from the players association, owners, people involved in the health of the players, ask me opinions regarding certain facts about the spread of the virus, what the dynamics are. I give it. And then it gets interpreted that I'm saying you can't play this sport or you can't play that sport.
I agree with you. I am completely unqualified to tell you whether you can play a sport or not. The only thing that I can do is, to the best of my ability, give you the facts and the evidence associated with I know about this outbreak.
Thank you.
PAUL: Thank you. We just need more optimism --
(CROSSTALK)
ALEXANDER: Thank you, Senator Paul.
Senator Casey?
SEN. BOB CASEY (D-PA): Mr. Chairman, thank you very much for the hearing.
And I want to thank our witnesses for their public service.
Mr. Chairman, let me start with Dr. Hahn and then I'll move to Admiral Giroir.
Dr. Hahn, I want to ask you about vaccines.
And as your testimony indicates and as we've been discussing over time, as researchers work to develop vaccine to protect against COVID- 19, it's important that the final FDA-approved products have the full confidence of the American people. A vaccine doesn't help if people don't choose to, in fact, be vaccinated.
So my first question is, given that we've seen very high rates of both vaccine refusal as well as skepticism, what role can the FDA play in the coming months to earn the public's trust that the COVID-19 vaccines are safe and effective? That's question number one. What role the FDA can play.
And then the second question is, what steps can you take as FDA commissioner to bolster public confidence?
HAHN: Thank you, Senator, for that question.
I couldn't agree more that public confidence in vaccines is so important.
So to your first question, we have an obligation to use all of our scientific knowledge, our regulatory framework, to ensure that any vaccine that comes before us, whether for authorization or approval, meets our stringent standards for safety and effectiveness.
One of the reasons that we issued that guidance that I mentioned in my opening statement was to provide regulatory clarity around what FDA expects with respect to those data.
We want to see certain parts of those data so that we can demonstrate to the world, to the nation, to the American people that we're following our rigorous standards with respect to safety and efficacy.
[11:25:03]
The other thing that we've done is draw a very bright line between FDA and our regulatory independence and all the sponsors who are putting for the vaccine applications to us. And that includes Operation Warp Speed. So we're providing technical assistance to those sponsors. But we are not part of the decision-making process. And we will maintain our regulatory independence.
I will not pre-judge. The agency will not pre-judge any decision with respect to this, but we will use the science and the data.
With respect to what I can do personally, Senator, I commit to you that I will continue to be a voice emphasizing the regulatory independence.
We have a number of communications in progress to communicate to the American people that the standards that we're going to uphold are firm. They are rooted in science and data. And that they will ensure that we meet the usually high standards of FDA with respect to safety and efficacy.
CASEY: Thanks very much, Doctor.
I might submit a question for the record to Dr. Redfield as well.
But just so I can get my second question in for the Admiral.
Admiral, I want to ask you about testing and insurance coverage.
Testing, as you know, and as we've emphasized in these hearings, is so fundamental in order to prevent the spread of COVID-19.
Congress, I think, acted upon that knowledge by mandating full coverage of COVID-19, diagnostic and antibody testing, both in the Families First Bill as well as the CARES Act. We made it clear that Americans shouldn't have to pay a dime for COVID-19 testing.
But we're hearing alarming reports of people not being tested often for one of two reasons, because they are under the impression that they will have to pay for testing, and patients who have been tested are receiving surprise medical bills.
The administration has issued guidance that appears to be in conflict with congressional intent and public health guidance. And so we have some confusion here.
I would asked you, Admiral, can you assure the American people that the Department of Health and Human Services will fulfill the intent of both the Families First Bill and the CARES Act and ensure that the American people will be provided wide access to COVID-19 tests without costs or limitation?
GIROIR: So, thank you, Senator.
And I want to thank all of you for emphasizing the importance of testing and eliminating any barriers that there could be.
I can't speak for the department. I certainly speak as the assistant secretary, and as the testing person, that we firmly believe and support the concept of no-cost testing. There should not be a disincentive in any single way to get the
diagnostic test that you need, to get tested during screening or -- or the serology test, as Congress intended. So thank you for that.
We do need to keep getting that message out. It's a very important one to have.
CASEY: Thank you, Admiral.
Thank you, Mr. Chairman.
ALEXANDER: Thank you, Senator Casey.
Senator Collins?
SEN. SUSAN COLLINS (R-ME): Thank you very much, Mr. Chairman.
And I want to thank all of our witnesses today for your dedication and hard work. It's really been important.
The chairman raised a very important question about who pays for the testing when a person has no symptoms and no known exposure to the virus.
And I would add another key question, and that is, how are such tests even accessed.
These are critical questions for the reopening of schools and for the thousands of jobs in the tourism industry upon which Maine's economy depends.
In Maine, for a tourist to come and visit, that out-of-state visitor, one option is to show a recent negative COVID test. The problem is that when hotel owners in Maine surveyed testing sites in 10 states, they found that 90 percent of requests for a test for travel purposes were denied.
Now, this lack of access to tests is devastating for reopening Maine's tourism businesses.
[11:29:55]
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.
