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White House COVID Response Team Holds Briefing; South Carolina Reports First Known Cases of South African Variant in U.S.; Johnson & Johnson Vaccine 66 Percent Effective, 85 Percent for Severe Disease. Aired 11-11:30a ET

Aired January 29, 2021 - 11:00   ET

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

[11:00:12]

KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan. Thank you so much for joining us this hour.

We are standing by right now for some critical updates from the Biden administration's COVID response team. This is actually the second briefing from this team this week.

Moments from now, Dr. Anthony Fauci, the head of the CDC and other top officials will be taking questions from reporters. And there are a lot of big questions with regard to the coronavirus, the pandemic and the vaccines today.

We now have South Carolina confirming two cases of a variant of the virus first identified in South Africa. A more contagious strain. What does the government do about this today?

And this morning, there is new concern about how well the current vaccines protect against this variant and others. And there's also Johnson & Johnson, just releasing the results from its phase three trials. Saying in its announcement it is 66 - it has 66 percent efficacy - an efficacy rate overall. 85 percent against severe disease. Still notably less effective than the vaccines from Pfizer and Moderna.

What does the Biden team say about that? The White House press secretary just said this morning that President Biden is encouraged by the data coming out from J&J but also said that the politicians are going to leave it to the scientists whom we should hear from any moment now. We will bring it to you when it begins.

While we are standing by for that. Let me bring in CNN's Elizabeth Cohen who is following all of these latest developments. So, Elizabeth, on this announcement from Johnson & Johnson, what are they saying?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Basically, the bottom line here, Kate, is that this vaccine does work well against COVID-19, this J&J vaccine. However, it does not work as well --

BOLDUAN: Elizabeth, I'm going to jump in. Andy Slavitt, one of the members of the COVID response team, he is beginning the briefing right now.

ANDY SLAVITT, CDC ACTING ADMINISTRATOR: What we're working on. What actions we're taking and on both the successes and the hurdles we face. I hope on these calls, that the public will get a regular and consistent dose of what the CDC believes are the right public health actions on an array of challenging topics and how our leading infectious disease expert, Dr. Fauci, is advising the president and the country. I will have a couple of remarks but first, I will turn it over to director of the CDC, Dr. Walensky.

DR. ROCHELLE WALENSKY, CDC DIRECTOR: Thank you. I'm glad to be back with you all today. Good morning. To give you the latest update on the state of the pandemic.

Let's begin with an overview of the data. Despite some encouraging trends in COVID-19 cases and hospital admissions, the occurrence of COVID-19 remains extraordinarily high in the United States. We continue to have over four times the daily number of cases as we had over the summer.

Through January 27th, 25.4 million COVID-19 cases have been reported to CDC. During the week of January 21st to January 27th, the seven-day average of new cases decreased 16.6 percent to 161,832 per day. The seven-day average of new hospital admissions of patients with COVID-19 during the week of January 20th to January 26th decreased by 14 percent to 12,720 per day. However, over 99,000 people were hospitalized with COVID-19 on January 26th. 427,626 deaths have been reported since January 22, 2020. During the week of January 21st to January 27th, the seven-day average number of deaths increased 7.5 percent to 3,277 per day. And yesterday, we saw our sixth day of over 4000 deaths.

We continue to remain concerned about the emergence of variants in the United States and are rapidly ramping up surveillance and sequencing activities as we work to closely monitor and identify variants as they emerge. Any information we have, we will then share with you as rapidly as possible. The B117 variant that was first detected in the UK has now been confirmed in 379 cases in 29 states as of January 27th.

Yesterday, South Carolina public health officials notified the public about the first two documented cases of the B1351 variant, which was first detected in South Africa, and now in the United States.

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These cases were identified in different parts of the state and not believed to be epidemiologically linked. They each did not have any travel history. We are still learning more about their exposures.

And earlier this week, Minnesota identified the first U.S. case of the P1 variant. This is a variant that originally emerged in Brazil.

CDC will continue communicating with international, state, and local partners to monitor the presence and impact of variants in the United States and around the world, and we are actively working with National Reference Laboratory, state health departments, and researchers across the country to improve our understanding of these variants and how they may impact the pandemic.

We also know viruses mutate, and they tend to mutate in ways that are advantageous to the virus. We expected this, and this is why I feel compelled to underscore for you the need for each of us to remain steadfast in our commitment to taking all of the appropriate steps to protect ourselves and our communities.

You're going to hear me say this a lot, so here it is. Wear a mask, stay six feet apart, avoid crowds and poorly ventilated spaces. Also, now is not the time to travel. If you choose to travel, please follow the CDC guidelines and be aware that you must wear a mask as you travel. And when it's your turn, please roll up your sleeve and get vaccinated. If we do all these things, there is less virus spreading and the conditions that produced variants are lessened.

Before I turn it over to Dr. Fauci, I would like to just address school reopening which I know has also been in the news a lot this week.

CDC continues to recommend that K-12 schools be the last setting to close after all other mitigation measures have been employed and the first to reopen when they can do so safely.

Accumulating data suggest school settings do not result in rapid spread of COVID-19 when mitigation measures are followed, including masking, decreasing density, and proper ventilation. Implementing community-based strategies that reduce transmission when there is a lot of virus in a particular area is also important to supporting the safe reopening of schools. But we recognize many communities lack sufficient capacity to do all that is needed. That is why it is essential that the guidance, tools, and resources called for in the national strategy for the COVID-19 response and the American Rescue Plan are provided to communities.

Thank you. I look forward to taking your questions in a few minutes, and I will now turn it over to Dr. Fauci. Dr. Fauci?

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Thank you very much, Dr. Walensky. Well, as alluded to by Andy Slavitt, this past week, and particularly the past 24 hours, have been really interesting, and I think value added to the issue of vaccine protection in the government attempt to contain this outbreak.

In previous briefings, I had mentioned that the federal government had been involved in the development and/or facilitation of three separate platforms of vaccines. One was the MRNA. The other were vector, either an adeno vector or a chimp vector, and the other was the soluble recombinant proteins.

We all know now of the recent data that came with regard to Moderna and Pfizer with their MRNA showing a 94 to 95 percent efficacy and a very, very good efficacy against advanced or severe disease. Over the last 24 hours, there have been the announcements of two other trials that represent two additional platforms. One is the soluble protein platform in a study that came out of the UK, using from the company Novavax, and the other one that we discussed this morning at a press conference at the NIH was the Janssen, or Johnson and Johnson adeno 26 trial that took place in the United States, in South Africa, and in Brazil. And the results really are very encouraging.

Let me just very briefly outline for them, for you, and then maybe make a couple of comments regarding nuances of the study. In the study that was just reported by Janssen, Johnson and Johnson, it was a trial using their Ad26, and the overall vaccine efficacy in the study was 66 percent. But for the United States, it was 72 percent.

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Now the important issue, because the first thing people do is compare a 72 percent efficacy with the previously reported and other trials of 94 to 95 percent, that is true. But when one looks at the potential impact on a very important aspect of what we look at carefully is namely severe disease, that overall in the United States, in South Africa, and in Brazil, the overall efficacy for severe disease was 85 percent.

And in fact, in the study, including in the South African isolate, there were essentially no hospitalizations or deaths in the vaccine group, whereas in the placebo group, there were. So, this really tells us that we have now a value-added additional vaccine candidate that will, of course, as happens with every candidate, will present the details of their data to the FDA.

But I want to point out that this has important potential and real implications, both domestically and globally, because as many of you are aware of, this is a single shot vaccine in which you start to see efficacy anywhere from seven to 10 days following the first and only shot. It is very, very good with regard to cold chain requirements, namely, requiring only a refrigerator. It is inexpensive, and the company is capable of making doses in the numbers of billions.

Of note, and this is something that relates to what Dr. Walensky just said, we are being faced with variants. We're all aware of the variants that we knew dominated in the UK, the 117, the 351 in South Africa and other variants, such as the P1 in Brazil.

When these variants were first recognized, it became clear that we had to look at, in vitro, in the test tube, whether the antibodies that were induced by the vaccines that we had available would actually neutralize these new mutants. And it was reported in several pre-print journals over the past couple of weeks, that although it diminished particularly the troublesome South African isolate, although it diminished the efficacy of the antibodies, it still was not below the cutoff where you would expect some degree of efficacy.

But what we know now from this study, namely the J&J and the Novavax study that antigenic variation, IE mutations that lead to different lineage, do have clinical consequences. Because as you can see, even though the long-range effect in the sense of severe disease is still handled reasonably well by the vaccines. This is a wakeup call to all of us that we will be dealing as the virus uses its devices to evade pressure, particularly immunological pressure, that we will continue to see the evolution of mutants.

So, that means that we, as a government, the companies, all of us that are in this together will have to be nimble to be able to adjust readily, to make versions of the vaccine that actually are specifically directed towards whatever mutation is actually prevalent at any given time.

And finally, this all tells us that it is an incentive to do what we've been saying all along. To vaccinate as many people as we can, as quickly as we possibly can. Because mutations occur because the virus has a playing field, as it were, to mutate. If you stop that and stop the replication, viruses cannot mutate if they don't replicate. And that's the reason to continue to do what we're doing, namely intensify our ability and our implementation to vaccinate as many people as possible as quickly as possible.

So, now I'll hand it back to Andy Slavitt. Andy?

SLAVITT: Thank you, Dr. Fauci. Before I turn it over to all of you for some questions, I want to offer a few updates and a sense of the action and activities and our progress against executing our plan to defeat COVID-19. One of the core elements of our plan is accelerating process of vaccinating the country to protect people from COVID-19 as quickly and as safely as possible. For the past week, our seven-day average number of shots administered was 1.2 million per day. We view this number of 1 million doses per day, as a base to build from in the coming days, weeks and months.

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In total, we've now delivered 48 million doses and 26 million of those doses have been administered.

As I've said before, we're facing two challenges. The first is increasing the supply of vaccines safely and more rapidly and speeding up the time it takes to administer them efficiently, and importantly, equitably. I want to call out seven states that have already provided first vaccinations to more than 10 percent of their adult populations. Alaska, West Virginia, New Mexico, Connecticut, North Dakota, Oklahoma, and South Dakota. Well done.

So, we have taken steps to announce last week, that we will increase supply week over week by 16 percent and vastly improve the predictability of ordering vaccines by giving everyone a three week forward window into how many vaccines they will be getting delivered. And we announced plans to purchase 200 million additional vaccines, which means that no matter what happens with other approvals, we will have sufficient supply to vaccinate the country. We're also taking steps to speed the vaccination administration process.

At the president's direction, FEMA has increased its support to states, tribes and territories for vaccination sites. FEMA is providing nearly $1 billion to support vaccination sites in states and territories. More than 200 FEMA staff members are on the ground today, providing logistical support in eight states, and the agency is providing federal equipment and supplies to support states across the country.

In addition, we're getting more vaccinators into the field to continue to escalate the pace of vaccinations. Yesterday, the Department of Health and Human Services amended the PREP Act, declaration to permit recently retired doctors and nurses to administer COVID-19 vaccines, and to permit anyone currently licensed to vaccinate within their home state. That's doctors, nurses, EMTs, to be able to administer shots across state lines.

We're looking at every possible step to make it easier to get more vaccinations out in the field. We encourage individuals to contact their local and state health departments, their local medical reserve corps unit to sign up to volunteer if they're qualified.

And today, the acting Health and Human Services secretary will continue the activation of the US Public Health Service Commission Corps. He's requesting public health service officers from all available categories to support national COVID-19 vaccination efforts.

I want to also touch on our efforts to make the workplace safer. The Department of Labor announced that its Occupational Safety and Health Administration or OSHA, has issued stronger worker safety guidance to help employers and workers implement a coronavirus mitigation program and better identify risks, which could lead to exposure and infection. Ensuring the health and safety of all of our country's workers is a national priority and a moral and economic imperative.

Healthcare workers and other essential workers, many of whom are people of color, immigrants, have put their lives on the line during the coronavirus pandemic. And this updated guidance provides a roadmap for businesses to protect the health of their workers.

Now, one of the purposes of these briefings is to demonstrate the transparency that's within our national plan.

And so, I want to close by mentioning some of the steps we're taking to improve public access, the information they should have at their fingertips to stay safe.

This week, we released previously non-public data on the pandemic trends across all 50 states in detail. This detailed information was previously reserved solely for governors, and it is now available to everybody to see. These will be weekly reports, publicly posted online.

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So, our team is working hard to make the process more transparent and easier for the public to understand, beginning with these briefings and the very clear messages from doctors Walensky and Fauci.

So, let me turn and spend the balance of our time taking questions for Dr. Walensky, Dr. Fauci and myself.

PRESS STAFF: Great. Thanks Andy. Right now, we have time for a couple of questions. If you have not already, you can go ahead and raise your hand on the Zoom feature. First up. We're going to go to Christopher Rowland at "The Washington Post."

CHISTOPHER ROWLAND, REPORTER, "THE WASHINGTON POST": Yes. Thank you. Thanks for doing the briefing. On the subject of the low dead space syringes, I was wondering what percentage of the administration kits now are being sent out with the Pfizer vaccine contain those specialized units, how many millions more do you need to get to 100 percent, and what companies are being ordered to procure more under the DPA? And also, on the state allotments and Pfizer's credit, are state allotments based on five doses in the vile or six, and is Pfizer getting credit for all six doses?

SLAVITT: Thanks for the question. At risk of somebody coming back and correcting my answer, I believe the answer is 100 percent. And they're getting credit for six precisely because everybody should now have the tools to be able to get the sixth Pfizer dose out. That's thanks to the work of our DPA and supply chain team.

Next question.

PRESS STAFF: Great. Next, we'll go to Kaitlan Collins at CNN.

KAITLAN COLLINS, CNN CHIEF WHITE HOUSE CORRESPONDENT: Thank you. I have two questions actually. One, on these new variants that we're seeing. And the expectation seems to be that they could really start to have an impact on cases by March, maybe gain a foot hold by April and become the dominant cases that we're seeing. So, what specifically is the administration doing to stop that from happening beyond recommending that people's social distance and wear masks?

SLAVITT: Well, let me turn first to Dr. Fauci to talk about the science behind these variants and what is likely to happen or what we know and what we believe, and then to Dr. Walensky after that so she can discuss the actions we're taking as a country and the actions we expect Americans to take to help with your question. Thank you.

FAUCI: Well, Kaitlan, there a number of variants that we're concerned about and one that is quite well-established already in the United States and that is the 117 that is in about 28 or 29 States and more than 315 cases that have all been reported. As you alluded to, the fact is that when you have a virus that has ability to transmit more efficiently than the wild type in the community, sooner related by pure viral dynamics itself, it will become more dominant than the wild type.

So, we have that already there. We have a situation where there have now been reported in very specific places in South Carolina, for example, the isolate or the mutant that is the 351 from, dominant in South Africa.

Again, that seems to have a very good fitness for spread. So, whether or not that's going to ultimately take over in the sense of being dominant is unclear by now. The projection that is made with regard to the UK is that probably by the end of March, the beginning of April, it actually will become more dominant in this country.

As I mentioned at the very end of my remarks, I'll leave it to in a moment to Dr. Walensky to talk a bit about what we're doing from a surveillance and other standpoint, but the fundamental principle of getting people vaccinated as quickly and as efficiently as you possibly can, will always be the best way to prevent the further evolution of any mutant because when you do that you prevent replication and replication is essential for mutation. So, over to you, Dr. Walensky.

WALENSKY: Thank you, Dr. Fauci, and for that question.

So, there are numerous things that we are doing. As Dr. Fauci noted, the prevention measures, the mitigation measures for variants are actually exactly the same, regardless of what variants you have. We have scaled up surveillance dramatically just in the last 10 days.

In fact, but our plans for scaling up surveillance are even more than what we've done so far. We have partnerships with commercial labs. We are now asking surveillance from every single state, at least 750 surveillance strings per week.

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And we have seven collaborations across universities to scale up surveillance to the thousands per week, so that we can get a foothold to see whether these projections of having this stake hold by the middle of March or middle to late March are actually true.

What we're also doing is offering support to the states that have identified these surveillances, specifically South Carolina, with the 351 variant reaching out to help with vaccination, as vaccination is again one of these things we need to do, with resources for increased testing, increased surveillance, as well as increased resources for vaccination and funding. So, we're working hard to make sure that we can actually do the mitigation measures, the vaccination, do the surveillance.

And then finally, we have a cross-agency collaborations with CDC and NIH, ARDA, DOD, so that when we get these strains, we can do the science and understand the impact of these variants on our vaccines, as well as in our therapeutics.

SLAVITT: Let me add one more comment. Look, if we as a country want to turbocharge our efforts at sequencing, which I believe should be a shared bipartisan perspective, we can do that. And what we need is the Congress to quickly pass the American Rescue Plan, which contains the resources necessary to get all of our very, very talented people around the country, who are world experts at sequencing, to get on this as quickly as possible. So, I couldn't urge people to - people in the Congress to be more and more focused on the American Rescue Plan than I can, given the state of the variance.

WALENSKY: Maybe if I could make one more point and that is that by the time someone has symptoms, gets a test, has a positive result, and we get the sequence, our opportunity for doing real case control and contact tracing is largely gone. And so, I think, and I believe, that we should be treating every case as if it's a variant during this pandemic right now.

SLAVITT: Thank you. Thank you for the question. Next.

PRESS STAFF: Great. Now we'll go to Ed O'Keefe at CBS.

Ed, I think you can speak.

All right. Ed, we'll try to come back to you. In the meantime, let's go to Caroline Chen.

CAROLINE CHEN, REPORTER, "PROPUBLICA": Hi, thanks for taking my question. This is a question for both Dr. Walensky and Dr. Fauci. So, when epidemiologists talk about herd immunity, they often say about 70 or 80 percent of the population is the goal. Given that about 20 percent of the U.S. population is children, do you think it's important to have eligibility expanded to children for vaccination as soon as possible? And if so, what is being done to get to that goal?

FAUCI: Yes, that's a very good question. In the candidates that we're talking about now, certainly the Moderna and the Pfizer, the two that have been given the EUA, we've already started on what's called an age de-escalation testing.

What that means, that you start off, for example, we know with one of the vaccines it's 16 and then one is 18-years old. We're going to go down from 16 to 12, from 12 to nine. And what you do, because you don't want to have to, and I'll explain why in a moment, to go through an efficacy trial where you're involving tens of thousands of children to show efficacy.

What you can do is in a much smaller trial, measured in hundreds to a couple of thousands to do what we call safety and a Phase Two A for immunogenicity. If you can show that it's safe and that in fact it induces the kind of response that is reflective of the protection, namely the correlate of immunity, what you can do is then bridge that to the efficacy data that you got from the 30,000 trial with Moderna and the 44,000 trial that we did with Pfizer.

So, in direct answer to your question, over the next couple of months, we will be doing trials in an age de-escalation manner so that hopefully by the time we get to the late spring and early summer, we will have children being able to be vaccinated according to the FDA's guidance.

CHEN: Thank you.

SLAVITT: Dr. Walensky do you want to add anything?

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