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CDC Releases New Guidelines for Vaccinated Americans. Aired 11- 11:30a ET

Aired March 08, 2021 - 11:00   ET

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

[11:00:26]

ANNOUNCER: This is CNN breaking news.

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

At this hour, we are standing by to hear from President Biden's COVID response team and to hear the long awaited guidance from CDC on what fully vaccinated people should and shouldn't do. This is a very big deal. This is a big step, could be a big step toward normal life returning and hope on the horizon for all of us.

Many health experts have also -- have also said that this type of guidance is long overdue. Nearly 60 million Americans have received at least one dose of the coronavirus vaccine and more than 30 million Americans are now fully vaccinated. And while the vaccine rollout has accelerated rapidly in recent days, the timing remains critical.

The top health experts in the country say new infection rates have plateaued at a very high level after falling for several weeks. And highly transmissible variants continue to spread throughout the country even as states are starting to loosen restrictions and in some places completely remove any masking requirements. So, there is a lot that we're waiting to get some more guidance, to hear some from the COVID response team when they begin the briefing any moment now.

Joining me now is CNN's Elizabeth Cohen, and CNN medical analyst, Dr. Jorge Rodriguez, a viral specialist. He's also an internal medicine and viral specialist.

So, Elizabeth, this has been long awaited guidance that we'll be hearing. What do you know about the level of detail or how granular this guidance is going to get?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: You know, Kate, if people are expecting guidance that said if you're fully vaccinated, you could now sit here and go here and like getting very specific with specific scenarios, they're going to very disappointed. But I think the biggest question that people have on their mind after being vaccinated is can I visit with the people that I love who I have not been able to visit with for over a year.

And that they are very specific on. So, first, let's take a look at what we mean when we say fully vaccinated. When the CDC says these are guidelines for those who are fully vaccinated, what they mean is that you are two weeks after your Johnson & Johnson vaccine or two weeks after your second dose of Moderna or Pfizer. So once you hit the two week mark, from then on in you are fully vaccinated.

So what the new guidelines say and these are being announced by CDC director, Dr. Rochelle Walensky, as we speak, as if the new guidelines say you could visit indoors with other fully vaccinated with no need more mask or social distancing. So you could be indoors if everyone else is fully vaccinated and no need to wear a mask or social distance, and you can visit indoors with people who are unvaccinated, if -- and this is a big if -- they are from one household. So, not like, one person here, one person there. These people all need to be from one household and they are at low risk for severe COVID-19.

If you fulfill those two things, you can visit indoors with no need more masks or social distancing. Now, let's go on to a few more items that they have. No need to test or quarantine if you've been vaccinated and you've been exposed to someone with COVID-19, as long as you're asymptomatic.

So, you're vaccinated, you are exposed to someone with COVID-19, you don't need to test or quarantine as long as you're asymptomatic. You do need to wear masks and keep social distancing in public and you do need to avoid medium and large gatherings.

So in other words to bottom line this, you could not just, like, go to a concert, or, you know, go to some kind of sporting event just because you're vaccinated. That -- the CDC is saying avoid those kinds of gatherings. But if you want to go visit your grandma, your fully vaccinated, she's fully vaccinated, you haven't seen her for a year, you can go and hug her -- Kate.

BOLDUAN: And, look, and it might not be everything, but I have to say, even, Dr. Rodriguez, hearing as Elizabeth is laying out there is no need to quarantine after an exposure, that's life-changing for so many people because of what the necessary quarantine period could mean for your life and your family. I mean, that in and of itself feels huge.

Why do you think this guidance is so important?

DR. JORGE RODRIGUEZ, CNN MEDICAL ANALYST: I think it is important not only because of what happens to us socially but also at work. Does it mean now that we could come back to work if we've been vaccinated as opposed to losing maybe four -- I mean, exposed as opposed to losing maybe 14 days of work.

[11:05:01]

BOLDUAN: Right.

RODRIGUEZ: Yes. All of that is going to be important guidance. But what I want people to keep in mind when these guidelines come out is that they are going to be evolving. So it doesn't mean that science is wrong. It means that we're getting more data. Remember, there are people that were on studies, starting in

September, or August of last year, and we are seeing how long these people are going to have immunity, for all we know it could be six months. It could be a year.

So in a few months, these guidelines -- these guidelines may change. So we have to keep an open mind and we have to realize that right now, the flood gates are not open. And we have to come out cautiously, cautiously.

BOLDUAN: Also, Dr. Rodriguez, just in -- we'll wait to hear more of what we hear from Dr. Walensky, the CDC director when they begin, but what more -- oh, actually, I'm being told it is beginning right now.

Let's jump over to the White House and listen in to the White House Coronavirus Response team.

(BEGIN COVID RESPONSE TEAM BRIEFING)

DR. ROCHELLE WALENSKY, CDC DIRECTOR: Good morning and thank you.

I'm glad to be back with you today. Let's get started with an overview of the pandemic. The most recent seven day average of cases is about 59,000 cases per day. Importantly on the far right of the graph, you could see there is a leveling off of the decline.

And the most recent seven-day average of deaths is slightly lower than 2,000 deaths per day. These numbers show us that the pandemic still remains a very serious situation, with the most communities continuing to have high levels of COVID-19 transmission. We are watching these data closely to see where the pandemic will head in the coming days.

But I'm also hopeful. As of today, 59 million people in the United States have received at least one dose of a COVID-19 vaccine, and approximately 31 million or 9.2 percent of the U.S. population is fully vaccinated, putting us on a strong path to eventually end this pandemic. And as you just heard, we're now vaccinating more than 2 million people per day.

We've been through a lot this past year and with more and more people getting vaccinated each day, we are starting to turn a corner. And as more Americans are vaccinated, a growing body of evidence now tells us that there are some activities that fully vaccinated people can resume at low risk to themselves.

This is why today, CDC is releasing its initial guidance for the public that, for the first time, lays out some of the activities considered safe for those who are fully vaccinated. When I say fully vaccinated, I mean people who are two weeks after their second dose of either the Pfizer or Moderna vaccines, or two weeks after a single dose of the Johnson & Johnson vaccine.

Before I talk about the specific recommendations, I want to underscore a few important points.

First, robust clinical trial data demonstrate that the current COVID- 19 vaccines are highly effective at protecting vaccinated people against severe illness, hospitalization or death from COVID-19. However, there is still a small risk that vaccinated people could become infected with milder or asymptomatic disease, and potentially even transmit the virus to others who are not vaccinated. Understanding the size of this risk in vaccinated people, and to the risk of transmitting the virus to others who are not vaccinated, is an ongoing area of research.

Second, it's important to note that this is initial guidance. The science of COVID-19 is complex, and our understanding of the virus continues to rapidly evolve. The recommendations today are just a first step, as more people get vaccinated and the science and evidence expands, and as the disease dynamics of this country change, we will continue to update this guidance.

Importantly, our guidance must be -- must balance the risk to people who have been fully vaccinated, the risk to those who have not yet received a vaccine and the impact on the larger community transmission of COVID-19 with what we all recognize to be the overall benefits of resuming everyday activities and getting back to something -- to some of the things that we love in life.

It is against this back drop and the current state of the pandemic that we've developed these new recommendations. With today's initial guidance, it is important to note that we are focusing on activities of fully vaccinated people can resume in private settings such as their homes under two scenarios. The first scenario is fully vaccinated people visiting with other fully vaccinated people.

[11:10:03]

In this slide, these individuals are represented by solid green circles. In this scenario, CDC recommends that fully vaccinated people can visit with other fully vaccinated people in small gatherings indoors without wearing masks or physical distancing. Remember, here we're talking about private settings where everyone is vaccinated.

So what does this mean? If you and a friend or you and a family member are both vaccinated, you could have dinner together, wearing masks, without distancing. You could visit your grandparents, if you have been vaccinated and they have been too.

Now, I want to talk to you about another more complicated scenario. It involves vaccinated people visiting with unvaccinated people. When fully vaccinated people visit with unvaccinated people, we have to consider the underlying risks of the unvaccinated people. And any unvaccinated members of their household. We take this approach because all of our guidance is rooted in making sure we are keeping people safe.

So, CDC recommends that fully vaccinated people can visit with unvaccinated people from one other household, indoors, without wearing masks or physical distancing as long as the unvaccinated people and any unvaccinated members of their household are not at high risk for severe COVID-19 disease. In the slide, people who are vaccinated and at low risk for severe COVID-19 are indicated by solid orange circles. This means that none of the unvaccinated people or any unvaccinated members of households, for example, an adult over age 65 or have an underlying condition such as cancer or heart disease or diabetes that could increase the risk of COVID-19 related hospitalization or death.

Here is an example. If parents have been vaccinated they could visit their daughter and her family even if they have not been vaccinated so long as the daughter and her family are not as risk for severe disease. They are solid orange circles.

Second, if an unvaccinated individual or any unvaccinated member of their household are at high risk for severe disease, shown here by hollow orange circles, everyone regardless of vaccination status should still wear a mask and physically distance and choose to meet outdoors or in a well-ventilated space. This is recommended to keep the individuals at high risk who are unvaccinated safe.

Similarly, when fully vaccinated people are visiting with unvaccinated people from multiple households, everyone should wear a mask and physically distance and meet outdoors in a well-ventilated space.

Moving on to quarantine, away from visiting. In addition to these new recommendations on visitation and private settings, CDC's new guidance also recommends that fully vaccinated people do not need quarantine or get tested following a known exposure to someone with COVID-19 as long as they have asymptomatic.

At this time, the CDC is not adjusting current guidance on travel.

We believe the new recommendations are an important first step in our efforts to resume everyday activities in our communities. However, we remain in the midst of a serious pandemic. And still, over 90 percent of our population is not fully vaccinated -- though we are working hard to get there.

Therefore, everyone, whether vaccinated or not, should continue to avoid medium and large side gatherings as well as nonessential travel and when in public spaces, should continue to wear a well-fitted mask, physically distance, and follow other public health measures to protect themselves and others.

COVID-19 continues to exact a tremendous toll on our nation. Like you, I want to be able to return to everyday activities and engage with our friends, families and communities. Science and the protection of the public health must guide us as we begin to resume these activities.

Today's action represents an on the first step. It is not our final destination. As more people get vaccinated, levels of COVID infection decline in communities and as our understanding of COVID immunity improves, we look forward to updating these recommendations to the public.

I know this is complex and I covered a lot of ground this morning, so I want to recap the main points of our initial guidance released today.

[11:15:02]

In summary, fully vaccinated people can visit with other fully vaccinated people indoors without wearing a mask or physical distancing. Visit with unvaccinated people from a single household who are low risk of severe COVID-19 disease indoors without wearing masks or physical distancing, and refrain from quarantine and testing following a known COVID-19 exposure if the vaccinated person remain asymptomatic.

For now, we will continue to examine this in the upcoming weeks and update our guidance accordingly, fully vaccinated people should continue to take precautions like in public like wearing masks and physical distancing, wear well-fitted masks and physically distance and adhere to other prevention measures when visiting with unvaccinated people at increased risk of COVID or who have an unvaccinated family member, household member, who that has increased risk of COVID.

Wear masks, physically distance and practice other prevention measures when visiting with unvaccinated people from multiple households, avoid medium and large size crowds. Get tests when experiencing COVID-19 symptoms, follow guidance issued by individual employers and follow CDC and Health Department travel recommendations.

As I close, I want to stress that we continue to have high levels of virus around the country and more readily transmissible variants have been confirmed in nearly every state. While we work to quickly vaccinate people more and more each day, we have to see this through.

Let's stick together. Please keep wearing a well-fitting mask and taking the other public health actions we know work to help stop the spread of this virus. Thank you so much for your time today.

And I will now turn things over to Dr. Fauci.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Thank you very much, Dr. Walensky.

I'd like to just spend a couple of minutes on a different topic and that has to do with investigational therapeutics for COVID-19.

If I could have the first slide. On a previous briefing, I had mentioned to the group that there were a number of investigational therapeutics, including monoclonal antibodies, convalescence plasma, immunomodulates, et cetera.

What I want to do today for a couple of minutes is talk about the issue of direct acting antivirals. If I could have the next slide. The strategy for direct acting antivirals in the future will be a process that we have done with other infections which I'll get to in a moment. And that is the identification of vulnerable targets after study of the replication cycle of the virus in this case, SARS-CoV-2 and then to design drugs to directly inhabit that vulnerable target. Next slide. We have been extraordinarily successful in this with HIV.

Now, targeted drug development, which is the terminology we use for this approach, targeted drug design, has occurred before HIV, particularly with the herpes viruses. But it really got into its own frame with HIV.

And the reason I say that is that that was the first of the extraordinarily successful results of targeted drug design. And the reason and the mechanism that we got there, next slide, was to delineate the replication cycle of the virus. In this case, you see in the upper left HIV binding to its now well described receptors, the CD-4 molecule and one of his co-receptors.

It fuses, it enters the RNA, reverse transcribes, it integrates its DNA into the cellular DNA, then transcribes out and buds off. Over the years of intensive study, next slide, each of those vulnerable targets has led to a different class of a highly effective anti-retroviral drug, including the reverse transcript inhibitors, the protease inhibitors, the integrate inhibitors and the fusion and entry inhibitors.

Next slide. This is led to now an extraordinary number of drugs which when used in combinations have transcribed -- has transformed, excuse me, the life of HIV infected individuals giving them almost a normal life span, although the drug needs to be given essentially for the rest of their lives.

[11:20:01]

Next slide. That same principle is now being applied to SARS-CoV-2, because here is a comparable life cycle. Obviously, there are differences here. Again, in the upper left, you see SARS-CoV-2 by virtue of its spike protein, binding to its age two receptor, binding to the membrane, infusing, entering and then a whole bunch of steps that I need not go through that involve a variety of enzymes which ultimately lead to the release of the lower right hand part of the slide.

Next slide. With the same strategy that was used with HIV, we will be screening and then proactively designing entry inhibitors, protease inhibitors, polymerase inhibitors and others.

Next slide. And then if you look at what has been going on right now, and taking each of these very briefly, there are early stage non- monoclonal antibody candidates in preclinical developments such as peptides and small proteins blocking entry. With regard to polymerase inhibitors, the FDA has already approved Remdesivir from Gilead, and just this past week, we heard of Molnupiravir from Ridgeback Biotherapeutics and Merck, in which they published the preliminary analysis of the phase two trial that showed a quicker decrease of infectious virus in participants with symptomatic disease.

Just two days ago, Atea Pharmaceuticals reported favorable and pharmacokinetic data from phase one trial and Pfizer now is in a phase one trial with a protease inhibitors. I show this to the group because this is really the beginning of the

phase of looking in a strategic way for direct acting antivirals which are going to be used to prevent people from progressing in their disease, namely keeping them out of the need for hospitalizations.

And on this final slide, for those of you who want to get more detail, just this past November, the NIH had an NIH-SARS-CoV-2 summit looking at the state of therapeutics, gaps in the field and a number of our public/private partnerships. You could get this on the NIH website.

And I encourage you for those who have any interest in it to take a look at that because that is the direction that we'll be going over the next weeks to months, to years.

I'll stop there and hand it over to Dr. Marcella Nunez-Smith.

DR. MARCELLA NUNEZ-SMITH, CHAIRWOMAN, COVID-19 HEALTH EQUITY TASK FORCE: Thank you so much, Dr. Fauci. And good morning to everyone.

I want to talk of course today about equity and you've heard us describe that equity is at the foundation, the center of this administration's COVID-19 response. And over the last month in my time with you, I've detailed why that needs to be the case. So we've taken a look at the differences in COVID-19 outcomes, for instance by race and ethnicity.

And since the beginning of this pandemic, we have all seen that factors, you know, like race, ethnicity, rural versus urban geography, poverty, disability, living situation, and type of employment, they all are exerting tremendous influence on the outcomes we see in COVID- 19.

So I want to begin this morning by giving an update on the ongoing inequities related to COVID-19. So, first, let's take a look at the rates of COVID-19 cases and deaths and vaccination by race and ethnicity. As you could see here, Latino individuals continue to bear more than their share of COVID-19 cases, while black people continue to bear more than their share of deaths.

Notably you see the share of vaccinations is significantly lower from Latino and non-Hispanic black individuals relative to their share of the general population. And the same is true for Asian individuals.

This all still only (AUDIO GAP) be limited by the (AUDIO GAP) of our data. We only have race and ethnicity data for 53 percent of those who have received a first dose of a COVID-19 vaccine. This varies widely among the states as you could see in the next slide and we're not getting from individuals and from providers and from straights about who has access to these three life saving vaccines that need to be equitably distributed across our country.

So I want to emphasize here, it is possible to do better.

[11:25:02]

The final slideshows us the information that providers and states are reporting to us and the age of people who they are vaccinating. So contrast that with the data on the race and ethnicity of the same individuals. Again we have critical ground that we must make up but we cannot get discouraged or feel like it is insurmountable.

You know, all of the evidence points to one simple truth. We could do this.

So like many of you, we've also seen a lot of conversation about vaccine confidence. About how some communities due to a range of historical as well as contemporary factors are less inclined to believe that the vaccines are safe and effective, and less inclined to trust the systems offering these vaccines and less inclined to trust the government to ask them to get vaccinated.

So, we still have some work to do to meet people where they are. The administration is implementing a comprehensive national public education campaign and where we've been hosting round tables with key constituents to make sure that we get that effort right.

We're building relationships with trusted messengers all over the country to make sure they have the best information possible to share with their communities. But we cannot and we will not accept that these differences in vaccine confidence are the end all and be all of the difference in vaccine uptake that we're already seeing. In the context of inequitable systems, we must take significant steps at every level of intervention to bend the vaccination process toward justice.

Now our success depends on our ability to build a robust and coordinated effort at the local, state and federal level to overcome all of the dynamics that are in place and this moment calls for that kind of effort. So in light of everything that we've seen in the 84 days since our nation began COVID-19 vaccines, we're turning up expectations for the vaccine program on all fronts. And we have a series of federal programs that are a key part of our approach to ensuring that all communities have vaccination access.

First, we have our large community vaccination sites all over the country. So far, we have over 580 operational federally supported sites. And over 170 sites are actively receiving on site support by federal personnel.

And we've also been able to set up a series of federally established community vaccination centers and by the end of this week, we'll have 18 of those sites running across seven states but with the ability to administer 61,000 total shots per week. And each of our federal sites has been designed with key equity oriented features. So targeted geographic eligibility, weekend extended hours, reserve slots for registration through community and faith based organizations, as well as deployment alongside mobile vaccination units to help vaccinate surrounding communities.

So we're going to keep pushing to launch more and more of these sites and dive into the data to make sure they are achieving the goal of improving vaccine equity in those communities. Second, we have our federal retail pharmacy program and this program

features chain and independent pharmacies across the country. And as of last week we are administering 2.5 million doses of the Pfizer, Moderna vaccines, plus the additional supply that we received from the Johnson & Johnson vaccine.

We designed this retail pharmacy program to ensure that one-third of the pharmacy sites are placed in communities with higher scores on the CDC social vulnerability index. Those are populations at higher risk due to factors like socioeconomic status, the composition of the household, people of color, as well as housing types and transportation dynamics.

So, we're going to press toward this mark to ensure that pharmacies are selecting the communities with the greatest need and we're going to prioritize those pharmacies that do a better job addressing equity.

And finally we rolled out our federal community health centers partnership program. Over the past three weeks, we have been unboarding the first 250 centers. They collectively serve 12.5 million people and span all 50 states.

You know, as a whole, these community health centers provide services for large number of public housing residents, people of color and individuals with limited English proficiency.

So as we look to the next phase of this program, we will prioritize filling gaps in our coverage to the highest hit. I'm sorry hardest hit, highest risk communities whether they'd be urban or rural.

And as we double down on the reach and impact of our federal programs, we'll continue increasing our vaccine supply to the states and as we move forward, we're calling on every state to show their work, too. We're asking our partners in the states to offer clear transparent equity goals for their residents and we're also calling on the states to help us get the data to work with us to find creative solutions to the inequitable vaccine uptake that has already emerged in the first months of the vaccination program.

So just want to be clear that achieving equity is not an aspirational goal. This is mission critical. Absent equity, we'll not be able to stop this pandemic from continuing to claim lives, strain our health care system and weaken our economy.

But by working together, we believe we can hit the mark.