Transcripts For CSPAN2 CDC Director Dr. Redfield Others Testify On Coronavirus Response 20240712

Cspan radio area cspan, your unfiltered view of politics area. This week cdc director doctor Robert Redfield took questions from senators on the us Coronavirus Response and how soon a vaccine might be available to the public. He said a vaccine might not be widely available until next year and that facemasks are an effective way of fighting the disease. Afterwards President Trump contradicted doctor redfield coronavirus treatments on timing for a vaccine. Heres a look at thatsenate appropriations hearing from wednesday. Appropriations subcommittee on labor health and human services, education and related agencies will come to order. Ri want to thank our witnesses for appearing before the subcommittee today. To provide an update on where we are on the areas that they are so involved in on the covid19. As we continue to be challenged by this pandemic in the country we know that 195,000 961 americans have died as part of the pandemic and 6. 6 million have tested positive during the process of testing in the pandemic. This is rapidly swept across the globe and even countries who thought their cases were contained are facing new outbreaks and dealing with those new and unanticipated outbreaks. This new disease in many ways even after nine months, we still know relatively little or about this disease or coronavirus generally. This has hindered our Public Health response in many ways this has been like trying to build theplane while we were flying a plane. That is a challenging, challenging thing to deal with. The, thats not to fully exonerate certainly the way the administration has dealt with it or the way its been funded and im sure that justified criticisms can and will be level l but history allows us to look back over past events and put current ones intoperspective. If we wanted to look back just six years to 2014 for instance when west africa face the largest evil okoutbreak the world hadever seen , and unlike covid19 we knew a lot about people at the time. Its a disease that had been around since the mid70s. It was a disease that scientifically we knew a lot more about in 2014 and we do about covid19 even today. And frankly we just didnt handle it very well. We made significant mistakes and weve seen those mistakes occur in other disease areas. Members of congress use words when they talked about the cdc response like cryptic and misleading and thought that the information provided wasnt enough. We even had a case that was found in a dallas hospital and the cdc director blamed the hospital. At the same time one of nurses in the hospital was allowed to board a commercial flight with cdcs consent. So we seem to keep having to learn these lessons over and over again that we have to be better prepared. Public health is hard. And it seems to be hard for us to keep our eye on what might happen in the future once we get beyond that moment. We should have learned and more importantlyimplemented more than we did from evil up or from h1 and one , both of which created real response problems but the real lessons we tried to learn and hopefully we will do a better job learning the lessons we need to learn right now. Neither this ministration one last one frankly prioritized Research Like this committee has. And h1we know that in our Committee Report card in the last six years and in the last five budgets in a bipartisan manner to increase the funding and the annual Appropriations Bills for the nih by nearly 40 percent for cdc by 21 percent and for preparedness by 84 percent. But those numbers all have to be coming together before we begin to use them the way that our Witnesses Today or this committee would like to see them used. Weve proven in our committee medical research, Public Health preparedness are all priorities and because weve done so we are more ready than we were. Where more ready than we were last time or hopefully more ready anin the future for the next pandemic. Right now, 238 fda emergency use authorizations for diagnostic tests and antigen test are on the market and every day we get closer to an affordable rapid test where you can get an answer in a way that allows us to really fight the pandemic rather than have another data point. When someone get gives a History Lesson about our response there will be criticism and it will go back about 20 years and it will be significant but i know there are things we all agree on. We need to have more testing, more resources for our vaccine candidates to finish their files, manufacture the vaccine and or cdc to distribute prophetic, wellthoughtout plan. I hope we learn more about and im going to insist that we learn more about all of those things today. I hope you might be able to include childcare in our hearing today. We werent able to do that because of time but clearly if youre going to get back to school, back to work and back to better health, child care has to be part of that and do something this committee bahas to stay focused on so again, welcome our witnesses and senator murray is joining us from her office i believe. Senator murray, were ready for your opening comments. Thank you very much mister chairman and thank you to all of our witnesses are joining us today. Rr as our country approaches a tragic milestone in this pandemic, 200,000 dead. I want to recognize there are Rising National death count represents countless personal losses. Family parents and grandparents and children. Communities have lost educators and Healthcare Providers and other frontline workers dand people have not only lost loved ones but many have lost those comfort zones they care about in their final moments. My heart goes out to everyone who is struggling with hardship caused by this virus whether they are suffering with the loss of life or likelihood. You all deserve leaders who take this crisis seriously, who take action to support and protect you. Your families and your communities. Argue with the facts you need to stay safe. Unfortunately we have yet to see that leadership from the president. Like Many Americans i was deeply angered last week to hear President Trump admitting that even though he understood covid19 was more deadly and even your flu, he was intentionally playing down this crisis. But i was not surprised. These recordings were not a revelation. The reality has been painfully obvious for months. Early on, President Trump not only claimed this virus was contained, control, going away, he claimed it was a democratic hoax. His Vice President wrote on an oped arguing there would be no second wave just before we saw a heartbreaking and recordbreaking increase in new cases and deaths across our country. When it came to testing, President Trump didnt just say he no responsibility at all. He said he liked the renumbers where they were. He said he wanted to slow down testing and he blamed testing for the rising case numbers. When it came to Wearing Masks , he not only said masks cause problems to also shared a tweet saying masks represent a culture of silence, slavery and social death and a video falsely claiming people dont need to wear masks and there is no cure. He made false claims on treatments as well. Continuing to promote hydroxychloroquine and suggested we look at leach as an option and he is still, still downplaying this virus. He is still in it will just go away. He is saying we are quote, rounding the finalturn. Doctor found she has made it clear that not true and pointed out we have plateaued at around 40,000 cases a day. Daily deaths are still regularly around thousand. And experts warned that we still need to come prepare for a wave that will coincide with the flu season President Trump has not been listening to the publichealth experts. He has been fighting them and suggesting that fda is part of a deep state conspiracy and the cdc is overstatingthe death count. Not only is he spreading inaccuracy and outright lies at the time when truth is a matter of life and death and trust in our Public Health agencies is paramount, his administration has been recklessly interfering nwith the work of these agencies for political benefit to promote unproven treatments, alter cdc guidance on reopening and testing and more. Just over the last week we have learned that President Trump put pressure on the nih and fda to authorize convalescent plasma and political appointees at hhs have worked unsuccessfully to dictate talking points or doctor fauci and demanding oversight of cdc scientific publications for morbidity and mortality which they report. That is a cornerstone of Public Health works across the world. It is dangerous and unprecedented political appointees are editing, censoring and openly undermining a report that is intended to give family Public Health professionals, researchers and Healthcare Providers what they need the truth. The Trump Administrations political meddling shows a dangerous disregard for truth , facts, science and most importantly peoples lives. Data and science are key tools in our fight against any Health Crisis and the damage being done to public trust ain those tools by this administration threatens to undermine our ability to respond to thispandemic , public trust and an eventual vaccine and Public Health efforts for years to come. The trumpet Administration Needs to leave the science to the scientists immediately. The leaders of our Public Health agencies need to provide a full account of what political pressure has been and what steps they are taking to make sure it does not influence their work or the work of the agencies they leave. Congress needs to act now to demand that transparency we do all thisand is accountable. Democrats will be laying out soon for how we can do that and i hope every republican who has said they believe we need to follow science will prove it by working with us on this. Because you cannot be for science if you are against political interference. I also hope republicans will come to the table to work with us in earnest on a larger package our communities so desperately need. Unfortunately i have not taken this seriously so far and when democrats put forward the heroes acting may republicans said there was no rush. I would wait to see if more was needed. When republicans finally did put forward a proposal much later it was woefully inadequate to address the crisis at hand. All while democrats have moved to find Common Ground and even offered to negotiate towards a lower top line number republicans refused the offer and instead put forward a bill moved even further away from Common Ground. This isnt tereus negotiating and the ideas that have been put forward are not solutions. But the crisis we face remains deadly serious. We cant afford to waste anymore time. We need to stabilize the childcare sector and make sure pools and educate students safely whether there remotely or in person. We need to make significant investments in Public Health, particularly regarding testing and Contact Tracing and distributing and administering a safe effective and trusted vaccine. E and we need to demand the type of comprehensive National Plans for those efforts that have been long overdue. The Distribution Plan that the cdc finally put out just today is a long overdue step forward but there is still more to do area im still reviewing this and ill have more to say but its clear that this is still not the kind of comprehensive and and National Plan as called for and that we desperately need. We are still missing important details on research and review area thats what standards fda would use authorized vaccine for emergency use. Like how we make sure that addressing Clinical Trials and manufacturing like how we address the supply chain issue and a bottleneck and we still need more details on addressing disparities. We also need to protect the safety and civil rights of those going to work and provide for those who have lost their jobs. We need to support families struggling to make rent and get nutritional meals and we need to address the severe disparities were seen and how much harder this crisis is hitting black and latino and tribal communities. We need to provide relief around state, local and federal governments last as we have seen recently certainly not least, we need to make sure once and for all , that political interference from the President Trump does not further undermine our response to this crisis. And im going to have several questions for our witnesses i hope we are all able to get more than just answers in the daysahead. I hope we are all able to finally come together and take action before we lose anymore time to save lives and present possibly mistakes. Thank you mister chair. Thank you senator murray and let me welcome our guests today, our Witnesses Today. The admiral is the assistant secretary for health, Robert Catholic is the assistant secretary for preparedness and response and doctor Robert Redfield is the director of the center for Disease Control and prevention. We are pleased you are here. Id like to give you time to makean Opening Statement. We have statements you presented, you can summarize those if you want but we are eager to get to o questions you are also eager to hear from you though admiral why dont you start with your Opening Statement. Chairman blunt, Ranking Member murray and the state was members of the c subcommittee on honor to update you on our nations d efforts to combat covid19 with a focus on testing. Testing is an essential component of americas Public Health response to the. Recommended practice like wearing a mask, avoiding crowds, especially indoor and washing your hands combined with smart testing is the formula to effectively slow the spread, flatten the curve and stabilize. Fighting evidencebased providing avcounty specific weeklyguidance to governors , expanding supplies and managing their distribution, providing the right tests to the right person at the right time, and developing and allocating safe and therapeutics , we are seeing promising results. Specifically, since the post memorial day from Community Spread the number of new covid19 cases is down 40 percent. The number of people hospitalized with covid19 is down 49 percent. The number of people in an intensive care unit due to covid is down 62 percent deaths associated with covid are down 38 percent say emphatically that these gains could be fleeting or even reversed if we do not continue to follow the National Plan and exercise personal responsibility, especially Wearing Masks and cavoiding crowds. Now specifically regarding testing, the nation will surpass 100 million viral tests completed this week. We have purchased and shipped over 95 million slot slot and 81 million tubes of media. The states, tribes and federal partners. Starting april 7 we have purchased and delivered to Public Health laboratories in the Indian Health service 2. 3 million pointofcare molecular tests to support outbreak control and rural testing. We have established federal search testing in 19 different sites helping to squelch emerging outbreaks typically among asymptomatic young adults. These sites are in addition to the over 2700 federally supported or federally enabled communitybased testing sites and trusted retailers focusing in areas of moderate to high social durability area and a literally thousands of federally qualified Health Centers offer testing to predominately racial or ethnic minority patients. We are now at an Inflection Point in testing. This month we anticipate the availability of approximately 3 million tests per day and at least half of these will be rapid pointofcare. We will have available more pointofcare tests in september and the total number of tests performed in august. We have been building towards this Inflection Point and ive previously testifiedto pits coming of old times over the past month. As a result of regulatory flexability , investments and coordinations of public and private sectors we have limited comprehensive cuttingedge testing initiatives to flatten the curve and save lives while supporting reopening of f america to let me discuss two of these. Protecting the elderly has been, is and will continue to be a foremost priority for this administration. On july 14 announced every single eligible nursing home in america would receive a pointofcare instrument and pointofcare testing supplies area we have delivered on this promise. All 13,850 eligible Nursing Homes have now received a total of 13,985 instruments and over 4. 9 million rapid pointofcare tests ahead of schedule. On august 27 after months of planning and only one day after its fda authorization the administration announced a 760 Million Contract for the delivery of 150 million rapid pointofcare tasks. This test is easy to perform, does not require an instrument, delivers test results in 15 minutes or less and costs five bucks. It can easily be deployed to many settings across the country and it comes with a companion n that enables instantaneous reporting area we have already people and 50,000 of these in support of disaster operations in california texas and louisiana and now another 15,000 to support wildfire operations in oregon. This week we will ship our effort to million tests to further prevent spread of it in Nursing Homes, assisted living and in tribes. In the coming weeks we will begin shipping millions of desperately and in support of our teachers and students to open and keep open k12 schools and to support vulnerable populations at hbcus. Thank you for the opportunity to provide these remarks and i look forward toyour questions. Thank you admirable, class. Thank you once, Ranking Member murray existing with members of the committee. Im not bob catholic, director of response. As a medical doctor and former senate staffer, retired military officer and having served in the white house i spent my adult career working to serve and protect the american people. I appreciate the opportunity to testify before you to highlight the response to the pandemic. A progress and vaccine elements in our efforts to confront and expand. I want to thank his committee for providing both supplemental resources or response as well as supporting and sustaining organization in the past. Your investments have been critical to support our operations and ensure we have tools available to respond to the pandemic. Throw out 2020 after has use these resources to protect american lives andassisted the repatriation of americans from china and japan at the start of the pandemic. After provided medical service in louisiana, texas and mississippi after hurricane laura and today we have teams going to louisiana and mississippi prepared to assist response and recovery operations following hurricane sally. We have deployed personnel and teams to california and oregon to support Wildfire Response foand the secretary has just signed a Public Health emergency for oregon to assist in the search and rescue of personnel of ec individuals who been affected there. We deployed personnel to assist the government in lebanon with hospital recovery following the catastrophic explosion. With that we supported these calls to action while responding to state local territorial and tribal requests for assistance in the Covid Response. Its an honor to leave this organization and im hobbled by the selflessness and dedicationof the men and women have passed. While we seen a decline in new cases , we know it takes constant vigilance and personal responsibility by every american to wear masks, wash hands and feet are social distance. But as everyone does their part , we continue to work hard to enhance our response capabilities. Im proud casper has been part of thedriving force in this american effort. Since early 2020 after barton began working to accelerate Vaccine Development. This work was foundational to the development ofoperation work speed. Whole governance approach working with our private sector partners to produce and deliver a safe and effective vaccine as fast as possible. The supplemental operation provided by this committee as been essential in permitting a significant advancement under whats the and as a result americas arbiter position and before the americans safe, protect vulnerable communities and defeat the covid19 virus. Today we awarded 13. 6 billion to support over 50 medicalcountermeasure projects. Some of these awards are vaccine contracts. Were making significant progress in advancing these vaccines through clinical l trial problems and three candidates are the three Clinical Trials. The network closer than ever to a safe and effective vaccine available to the public. Three others are in phase 1 and two safety is our top priority in the development of vaccines and therapeutics which is why science is driving the development of all countermeasures to ensure they meet fdas Gold Standard of approval. In the meantime, we implement an intensive efficient process to promote Vaccine Development and in parallel manufacturing. Supporting these efforts simultaneously in short we are positioned to distribute and administer the vaccine quickly once approved. Astor continues to support advancement and therapeutics and has taken a data driven approach to oversee the fair and equitable distribution of remdesivir. As a result weve also supported the mitigation efforts to slow virus transmission. Since march astor has distributed more than 500 million cloth facial coverings across the country to protect vulnerable populations and essential workers. This month were supporting the administrations school facial coverings initiative by sending an additional hundred 25 million cloth facial masks to states and territories for distribution to low income students in order to support safe reopening of american schools read as a federal agency leaving the Emergency Support functioning asked for is capitalizing on existing relationships with dod and dhs to coordinate a more comprehensive nationwide response. Responded to requests from 32 states, five tribes with nearly hundred medical support missions with over 5700 staff, the Public Health service, the a and dod. We provided personal protective equipment that i know will be subject to these questions and under dthis 2. 0 initiative to extend our stockpile, close the Us Industrial base. We have used the defense production act as well. Thank you for your support and the opportunity to testify before you and ask first efforts during the pandemic and im happy to answer any questions you may have at this time. Thank you doctor kadlec, doctor redfield. Thank you for the opportunity to be here today. On behalf of cdc and also for your continued support of our Public Health professionals and the lifesaving work they committed to do 24 seven. Over 6700 cdc staff have been engaged in agencies response area 12 hundred of whom have been deployed to more than 200 locations in the United States and abroad. And i know you share with me the gratitude for their resilience, dedication and service to our nation throughout this Global Pandemic cdc has scientific expertise to the front lines conducting rapid investigation of disease outbreaks that identify the highest risk populations and settings. Understanding which populations are at risk and how the virus is spread in various settings is critical to developing the guidance and protecting the health of americans. Today and even after we have a vaccine easy encourages all americans to embrace the powerful tools that we have right now. To wear a mask, particularly when they are in public, maintain social distancing. Routine vigilance handwashing, be smart about proud and stay home when youre sick area and as we move into the hall, were having one of the most significant scientific contributions in medicine to our evidencebasednavigation strategies. Lubrication. Vaccine is safe and easy encourages americans to embrace lube vaccine with confidence for themselves, families and communities. These civil actions combined to help this nation avert a very difficult fall, lessening the burden on our Healthcare System and saving lives. Cdc has awarded 140 million to 64 jurisdictions to our existing immunization operative agreements to scale up flu vaccination this season. This funding supporting staff and preparedness with a focus on ensuring flu Vaccine Coverage can reach populations most risk. This year cdc lupurchased an additional 9. 3 million doses of adult influenza vaccine up from the usual annual 500,000 dose purchase. In prior years as well as 18. 5 million doses for children. And cdc has developed a new multiplex Laboratory Tests and check for three viruses at the sametime , influenza a and b plus cars come into a single test from a single sample. The staff was friendly and easy way by the fda will say public laboratories time and resources and help better understand and identify coinfection with influenza one. Today cdc has exhibited over 135 multi flex kits to more than 100 laboratories across the country with each kit having enough reagents to do approximately500 guests. Tec is also working with 64 immunization grant recipients to build readiness for timely and most importantly equitable administration. When a vaccine becomes available. Cdc is leveraging expertise in immunization infrastructure to support operation work speed and vaccine promotion distribution and monitoring. In coordination with operation its working closely with state and local Tribal Health departments and Community Organizations to prepare a detailed plan for Vaccine Distribution to critical and doctor, to work with people atincreased risk for serious outcomes. At this time cdc continues to support partners for this Ongoing Community mitigation effort includingcase identification, Contact Tracing, surveillance and reporting as well as testing capacity. To support these activities, cdc has awarded 12 million to the jurisdictions in 2020 back to the support of congress included in that amount was more than 200 million to support the American Indian and alaska native communities which have had some of the most significant effects from covid19. Timely, accurate and equitable data are fressential if were going to learn to impact covid19 on all americans particularly the populations at greater risk such as older americans, those with chronic medical conditions, racial and ethnic minority populations. Cdc report monthly to congress the most recent Data Analysis on the impact and racial groups. As i emphasized in my prior bearings, now is the time to commit to prior prioritize a sustained investment in the core capabilities of Public Health. That is a data analytics, laboratory resilience, workforce expansion and Rapid Response capabilities. Years of underinvestment in Public Health have led toa system that has been sorely tested by the current pandemic. Covid19 is the most significant Public Health challenge to face our nation and more than acentury. Now is the time to build not only the public lthealth core capability ournation needs , but the people of our nation deserved. As we were together collectively to fight to end the pandemic, cdc is committed to the mission to protect all americans from the disease to save lives now and in thefuture. Thank you for the opportunity and i look forward to your questions. Are going to have a series of fiveminute round of questions here, there are a dozen members either here or virtually here. Ready to ask questions. There will be an 1130 vote we will walk around those votes come in at 1130 and certainly we hope to have an opportunity for a second round of questions if people have been after their first round is gone. Let me start admiral gerard with you. On oftests, i think tests are essential to get back to school, back to work and for tests to work, they have to be easily taken. Quickly, there needs to be a Quick Response and they need to be affordable. It seems to me that with the shark tank effort that members of this committee particularly senator alexander and i were involved in trying to encourage, looking at ideas that are out there i think the shark tank has approved these 16 different tests now. And your testimony you mentioned number of these tests were pointofcare response tests. What should we expect in october or this month, but lets talk abouttold in october we can reach 100 million tests between the toshark tank and have alone. Is that the number that you think is close toright . Yes sir and thank you for the question and thank you for the support of the shark tank and all the nih efforts. Weve seen a tremendous blending of programs at darpa and nih and in my office with the defense production act. All coming together and wedo meet every week to put these together in a very cogent synergistic way. In october and again these are conservative estimates based on what we know and what the manufacturing will be. In october were looking at somewhere in the neighborhood of 125 235 million tests available. That does not mean hundred 25 235 million tests will be done but these will be easily and readily available and the majority of them we had that Inflection Point will be pointofcare. Many of them will be made at approximately 48 to 50 million per month. Again, 5 million tests, 15 minute results, no instruments. Very important but were starting to see the point of care coming from the shark tank hitting the streets so the next egeneration sequencing, the micro phone explant forms with advanced pointofcare. I think you said in your testimony sometime this month we will have passed the first hundred million tests that people have taken, is that right . Todays total as of about 5 00 this morning was 9. 3 million tests having been performed in the us. 3 those are viral tests not serological tests starting the first of the year. This is from the outbreak of the covid19, right. Right, when i took over march 12 there were 15 or 20,000 tests, that was a small number so this has ramped in a historic way not just in numbers. Numbers are important. The pointofcare, laboratory, these all have to fit betogether. I think im right in assuming but the three of you would know this better than anybody. If you take a test and you dont get a result for three or five or seven days, you find out the data point and you find out that individual, the problem they have that youve generally done nothing to tell them that they could be spreading this disease, is that correct . Clearly we want tests to be turned around as rapidly as possible and thats why pointofcare is so important. The issue with most pointofcare tests is there not as good, sensitive and specific as a very important Laboratory Tests. Everybodys making progress but you are right, we want rapid turnaround and because we have more pointofcare tests and because were doing more in the Nursing Homes , for the major referral labs er that had such an issue with turnaround time, our average turnaround time this month is 1. 49 days so thats been improved dramatically because an expansion of their capability but also the insertion of pointofcare tests. That averages out to pointofcare tests that averages all this down to one point. Thats just the referral laboratories. It sounds like to me that we are finally getting to where that is a realistic likelihood. All right, senator murray. Thank you very much mr. Chairman and i just want to say i am deeply troubled by reports of rampant political interference in scientific decisionmaking atat the cdc. It is unprecedented and its unacceptable. We learned last week that in january how serious covid19 was him President Trump has been working to downplay this crisis and on friday night we learned that trump was on cooperate if in hhs Communications Office and manipulating cdcs blank ship publication for months to align with that messaging. Doctors redfield did anyone is cdc advised the president to downplay this crisis . No. Did you agree with the president. No would advise the president to downplay this crisis. Well understanding the danger, why have you not done more to push back on President Trumps political interference and his efforts to downplay this . I want to make it really clear senator and i appreciate your question and the opportunity about the respect for what science, the cbc and the independent integrity of the hh are. No time is a scientific integrity been compromised and i can say under my watch it will not be compromised. Well, i understand the effort to edit the cdc publication started in response to a may report that reviews the threat of covid19 in the u. S. Authored by the cdc highly respected deputy doctors schuchat. Hhs political officials perceive this report as reflecting negatively on the president. Dr. Redfield yes or no did that may report as drafted by a doctors schuchat adhere to the agencys strict code of scientific integrity . Yes. The spokesperson for hhs claimed there is a Resistance Unit at the cdc and voice concerns about ulterior motives and President Trump has put skepticism into the agencys death toll. Do you agree with me that there is no truth to all of those claims . Absolutely senator. I want to make a comment that not only is it not true, it deeply saddens me when i read those comments because as i said in my statement, the cdc is made up of thousands of dedicated men and women, highly competent. Its the premier Public Health agency in the world dedicated 24 7 to use their skills to protect the American Public and the world from Health Issues and it deeply saddens me that those false accusations were made by a group of really unbelievably professional people that served this nation. I agree so let me ask you then what can congress do to make sure we are hearing directly from Public Health officials about political interference . Well againir im going to commit that we are going to continue to give congress and the nation the best Public Health advice. We are not going to let political influence tried to modulate that. As i mentioned the mmwr and some other things that is said to hear the concern that somehow that the integrity of this really important publication was somehow compromise and i just want to assure you and the other senators andnd the american pubc that the scientific integrity of the mmwr has not been compromised, it will not be compromised on my watch and i will stand by the men and women and the scientific experts that are there to do their job to express what they know in a way that can be interpreted to the American Public. Well i hear you but i do think Congress Needs to make clear that there is no personal interference and i will be pursuing that. On the same issue you are among hhss top health official. Whatat are you doing to protect the scientific integrity of the work done by the scientists and Public Health experts at cdc and keep nih from political interference . Part of my job as a scientific, Senior Scientific adviser to the secretaries to make make sure that he gets the best science and the best evidence. I do that every single day. I worked with bob redfield and bob kadlec and Francis Collins and i run speed dial. You have my commitment as uis have senator that i will provide staff advice to the decisionmakers that will be based on science and thats how we operate going forward. Can you right now reject the unfounded harmful Conspiracy Theory that career professional of cdc or any of our Public Health agencies have deep stayed ulterior motives that compromise their ability to act in the best interest of Public Health as other Trump Officials have claimed . Can you ensure that yes or no . I have not seen anything out of the agencies that i work with that is anything but people acting in the best interest of the american people. I have certainly not seen anything that you describe. Thank you senator murray. Senator alexander. Thank you mr. Chairman and thanks to the witnesses for coming. This committee has shown on many occasions good capacity to work in a bipartisan way so i would like to Say Something to mike democratic friends as well as my republican colleagues on the subject that i think we agree on but congress has had a hard time doing over the last 20 years and that is preparing for the next pandemic. I have been rereading Jared Diamonds book guns, germs and steel and he wrote an article in the wall street journal a few months ago about the current infectious disease. He said, the most different thing about covid19 is not that its moreas infectious, but the jet plane is what is different about this disease. It can spread instantly from wuhan to San Francisco to nashville to boston and that the next pandemic could be next year. A hearing about preparing for the next pandemic and people like bill frist who is the majority leader 20 years a ago said we keep trying to do things to prepare for the next pandemic but we go and dr. Tom friedens word from panic to neglect to panic. In other words while we are in the middle of a pandemic it has gotten our attention but as soon as its over we dont do all the things that we should do. My hope is that with any action that we take this year, we would include the three or four things that we should take to make sure that we sustain funding which is the hardest thing to do. How do you fund for more than one year for onshore manufacturing of vaccines for example, for stock piles that were depleted between vaccines, or making sure that fema and their kadlecs organization are aligned properly and operating together. Dr. Redfield has talked about it and mike leavitt did to Art Committee the former governor of utahe that we have been underfunding Public Health for a30 or 40 years. I think its important we do it this year and so in the republican bill that we offered last week we did have in their sum authorization from our committee to fund onshore manufacturing and continuous funding of stockpile so they would be full. I would just like our committee to give that the same kind of attention to the subcommittee that we gave for example to funding for nih because it will take some sort of mandatory funding orr advance the preparation as the subcommittee did under senator greg a few years ago for bio shield. Its not a lot of money. I think what we suggested was a half a billion dollars a year for 10 years, for onshore manufacturing. Why is that important . In 2012 we created three manufacturing plants just for this purpose but two of them in governor leavitts words went cold and they werent available instantly to do what we needed done in the third one had a hard time finding anything to do between pandemics so we need some funding for it and then stockpiles got depleted at the federal level the hospitals and states because of budget cuts. Ck so we were ready for what we needed to be ready for and then Public Health funding is a separate one and bioshield is another one. I think we are not talking about lots of money. What we are talking about that is different is sustained funding for a period of years. Dr. Kadlec ive taken most of my time but would you comment on then precisely in the ideal world what should we do now to prepare for the next pandemic which Jared Diamond says might be next year. Will thank you very much senator alexander and i agree entirely with your proposition that we do need to make investments over the longterm over the long term and we need to look at this problem is a National Security problem messages up Public Health problem. We lose on that day. Yeah but whether they specific things. We have about 30 seconds. Domestic manufacturing for biologic vaccines. We also basically need to have the capacity to basically manage those stockpiles effectively to both commercial and state and we need to require hospitals and other Health Care Institutions to have somerc day flying level. So we need to keep the stock pile full. Regarding talking about a lot of money . No sir i think in your bill you identified 2 million i think thats where you started again most of these items are commonly used in a way in hospital usees and health care e and just maintaining that stockpile over time. Does require business to support that. Thank you mr. Chairman. Thank you senator alexander. Chairman durbin. Dr. Kadlec the president said and ile quote we are weeks from getting the vaccine. It could be three weeks or four weeks, true or false . Sir, its possible. With operation warp speed we have basically worked to do simultaneously the Clinical Trials as well as the manufacturing of the vaccines so if ands when whether thats two weeks, three weeks, two months or four months once a Clinical Trial is complete and that Scientific Data is reviewed by the fda and approved then we have vaccines potentially availables immediately to use. Thats the strategy that has been adopted and operation warp speed, sir. I want to make sure this is on the record. You are saying three weeks to four weeks for a vaccine . Sir, thatss manufactured ys sir. Is it approved by the fda . Thats a decision not to do based on the, Scientific Data that we receive from the Clinical Trials. Would you are saying to me is that they can manufactured that beforeh its approved as being safe and effective for distribution in america is going to be beyond three or four weeks. Cert depends on the outcome of those Clinical Trials. I cant predict that. They are ongoing right now and some of them completed in october in the up d. A. Is the one who makes the decision to determine safety and efficacy. The president predicted it last night. We have 4. 5 of the worlds population in the United States. We have more than 20 of the deaths. Covid19. Last night the president said we have 20 of the cases inof the world because of the fact that we do much more testing. If we wouldnt do testing you wouldnt have cases, you would have very few cases so let me ask admiral giroir would endinge covid19 disease . No, sir. Could you explain the president s explanation last night and it doesnt make sense to you . I didnt hear. We have heard this over and over again, comee on. Its just repeating what he said over and over again. Let me gisclair by the number of cases are going to be the number of cases. We do know more testing so we can test more and more cases and oithats a good thing. We want to test as many cases as we can so we can appropriately isolate through Contact Tracing etc. It is true the more testing you do the more cases you will discover but the cases are there no matter what. You talk in your testimony about expanding testing and i couldnt endorse that more heartily. The president says just the opposite. If we wouldnt do testing we wouldnt havend cases. Dont we want to create the mindset of america regular teste not positive in spreading this disease and it should be routine until he come to grips with the vaccine to deal with this . So i do want to state what i did say earlier in multiple testimonies. I have never been asked, told her suggested we should decreas. In fact basically every time at the task force we work to expane and thats hundreds of billions eof dollars in that so my job is to expand testing as much as feasibly and even in feasibly possible and get the right test to the right people at thean rit time. That is then my mission and no one has told me to alter that. In july 2017 United States Senate Considered repealing of the Affordable Care act on the floor of the senate. I will remember that morning and at night forever. A few feet away from me the late senator T John Mccain cast a no vote on the Affordable Care act and is survived by the president said repeatedly he has a replacement plan for thehe Affordable Care act. As head of the agencies responsible for dealing with such Public Health undertaking i would like to ask you does the replacement plan exist that you are aware of . Any of you . Yes, or no. Admiral . I am not involved in the replacement plan. I dont know what that is progress supply Public Health advice as much as they can forever whatever that plan would be. Dr. Kadlec area where of the oureplacement plan . Its not in my portfolio and i have no awareness of that. Dr. Redfield are you aware of her placement plan . Again its not in my main lane but im not aware of one. Just a few weeks ago the nine major fours pharmaceutical companies and fullpage ad saying they would not bow to political pressures to a vaccine. Were any of you consulted before they made the decision to buy that bad across the United States . Sir, not consulted or where verdana conforms with the feelings and commitments that leadership and warp speed in my organization are committed to as well. Do you know why they didnt . To the point of making sure that everyone is believing in the same way which is the safe and efficacious vaccine has to be trusted. Thank you. Thank you senator. Senator capito. While we are trying to figure out how we get senator capito for her question senator kennedy why do you go ahead with yours and then we will go to senator reed after senator kennedy and ready. Senator capito is senator kennedy. Thank youe mr. Chairman. Thank you gentlemen for being here today. You are all ndn medical doctors, is that correct . Yes, sir. Would any of you do anything to violate your hippocratic oath . Never. No, sir. Have any of you as senator Murray Leslie interfere with the treatment or prevention of covid19 . Ntno serve. No, sara . You know anyone who has in the Trump Administration . Nowsi serve. Dr. Redfield have you ever had polio . Now. Me neither, thank you science. When the coronavirus was first discovered, we didnt have much science about it, did we . No, sir. You can go to web mdm look it up could you . No, sir. We have learned a lot about it havent we . Would be fair to say and disagree with me if you do and i will, that the coronavirus is a lot more contagious than we originally thought. Is that fair . Yes, sir. Now i read on the cbc site and tell me if ive misinterpreted this that out of people who get coronavirusut, not out of every 1000 people but out of every 1000 people who get the virus six are going to die. Is that accurate . It depends on age group and risk theirs. If you were to look right now individuals under the age of 18 comets about. 01 . 18 to 19, 69 and its more like. 3 and if you are over the age of 70, its about 5 now. But if you look at population as a whole, its about six out of 1000. Is that correct . I would have to get back to you. Overall we are probably looking at an overall mortality in the range of somewhere between point foreign. 6 . That would be six out of 1000. Thats on the highend. Obviously the olderr you get the more at risk you are. Tell me, tell me when you think we will have a vaccine as best you can, ready to administer to the public. Dr. Redfield. As dr. Kadlec said i think there will be a vaccine that initially will be available sometime between november and december but very limited supply and it will have to be prioritized. If you are our ask me when its going to be available to the general public so we can begin to take advantage of the vaccine to get back to our regular life i think we are probably looking at the late second quarter, Third Quarter of 2021. And so you think either late second or Third Quarter we will have started to vaccinate people . I think vaccination will begin in november and december and we will take up and itll be in a prior ties way. First responders and those of the greatest risk for death and eventually that will expand. Its hard to believe that there are about 80 Million People in our country that have significant comorbidities that put them at risk. They have to get vaccinated. And then the general public. Im about to run out of time. What do you call this worldwide effort but to the United States of america to develop a vaccine . What is the term for its . Operation warp speed, sir. Have ever seen anything Like Operation warp speed . Is unprecedented. This will be my last question mr. Chairman. How long doesun it take to devep a vaccine . The fastest was 46 years. Senator reed. Thank you gentlemen for your testimony. Iu, was particularly struck with how emphatic you all were in insisting that the use of face masks is absolutely critical in a social setting. You are all wearing face masks. I a have mine yet last evening r president once again, he he does not wear one usually. He has conducted rallies in which many of the participants are not with a face mask and he doesnt have a face masks select any just ask all of you, adam roach you are uniformed officer, is the president providing appropriate leadership when itu comes to a critical issue, one of the most direct and important things anyone can do to protect themselves and the community from this disease . As a uniformed officer im not going to comment about the president but i do want to emphasize that wearing l, a mask is one of the most important things we can do to prevent the spread particularly because people who are asymptomatic, you can feel totally be fine and still spread the virus. Thats why its absolutely critical and i think i speak for my other two colleagues. I think you just directly contradicted the president s behavior and that persons comments. Dr. Where supporter of the mask and thats why we. A half a billion of them and made them available to the American Public at large . The question is the president undercutting what you all said and you repeated, one of the most important steps that americans can take to defend themselves and the country against this disease . So my view is that he is an individual can exercise his right to do what he pleases as we see a other americans doing. Hes also the leader of the country trying to cope with the disease and the pandemic that has killed over 100,000 people and he a is rejecting the emphac advice that he gives repeatedly and you yourself gave. Dr. Redfield your comment . Im not going to comment directly about the present but im going to comment that the cdc director that face masks, these basements are the most important Public Health tool we have and i will continue to appeal for all americans, all individuals in our country to embrace the space coverings. As i said if we did it for six, eight, 10 or 12 weeks we bring this pandemic under control. We have Clear Scientific evidence that they work and they are our best defense. I might even go so far as to say this face mask is more guaranteed to protect me against covid then when i take a Covid Vaccine because the immunity may be 70 and if i dont get an immune response its not going to protect me put this face mask will. I want to ask the American Public to take responsibility particularly the 18 to 25yearolds where we are seeing the outbreak in america continue to go like this because we havent got any acceptance in the personal responsibility we need from all americans to embrace this face mask. Once again i think you have virtue to the president more eloquently than i have heard. You are the expert. Leaders have to depend on expert advice. Thats why they have people like you are and when they dont take your advice and when they disregard it and said so in radically here, its not a question of any doubt at all in your view. Just a final quick question and i only have a bit of time and dr. Redfield and dr. Kadlec quickly your vaccine has to involve the states. Can you very briefly. Or redfield is their conscious integration of the state in healthf their Public Services and their Resources Available for the state in the plan because they will need them. Yes, sir. Its critical and we have done microplanning already with five jurisdictions in north dakota, minnesota, california, florida and philadelphia and this plan will be going out today to all of the states. Riupbeat talking to the topic of leaders this week. We will be working with them so they can integrate this plan in their own unique way for their own state and there will be support to help them begin to read sources plan. Thank you mr. Chairman. Thank you senator reed. Senator capito. Thank you senator blunt and i thank all of you. Pleased to be a part of this hearing today and i will start off with dr. Redfield. I am not sure if you are where dr. Redfield but i am looking at the cdc guidelines and i was made aware that on one day i had been exposed to somebody who tested positive for covid. According to what the physician told me i had been ined and arod that individual for at least 15 minutes within 48 to 72 hours of when he exhibited symptoms. Out of abundance of caution and your o guidelines i went immediately to the physician at the capital who advised me then that i should quarantine for 14 days. I did subsequently take a test and it tested negative which i was obviously pleased about but i want to ask you, or your guidelines on quarantines, for those of us quarantined in following the rules what kind of success does that ring in terms of isolating and containing the spread and do you further recommend further testing as people are coming out of their quarantine and what point in the quarantine would they need to gett retested if thats necessary . First i want to thank you for setting the example and embracing these guidelines. Although misinterpreted some of the changes we put in our guidelines, the whole purpose of those guidelines was to engage the Public Health and medical Community Back in the decisions when people get tested as was talked about earlier. There was the appropriate Public Health action so the test lead to action. It wasnt just a test, and so i want to thank you for setting that example. The reality is if you have had close contact, it could take seven days, it could take 10 days, could take 12 days it took for you turn positive and thats why we have our current recommendations based on the data we have and isolation for 14 days. As we get more data that may change but the reality is the data that we have today we still support the 14 days of isolation. We do have very good data in our household studies. Households that have introduced covid, where individuals practice masks and handwashing and distancing, we have been able to show there is limited transmission and those household settings and the households that didnt, we have seen rates of 20 , 30 , 40 , 50 within the households of the is where the state of knowledge is now. There may come a time when we have better data that can shorten it by right now even if we shortened it to 10 days and a number people if asked to look at the data we would still send home probably 10 to 12 of people who would later turn outd virus positive. Thank you for that. Admiral giroir dr. Redfield brought up an issue that i know was cascading across the country and that is a the sum of our colleges and universities are opening the incidents to testing and the incidence of positives have gone way up because of some behavioral issues than just the whole attitude at times in the college and University Setting. Theres great interest in the rapid turnaround test and they have the test is of interest in the university. Iro know youre beginning to deploy these in Nursing Homes and highly challenged communities which i applaud. How do do you deal with, you call at the University Setting come in terms of testing of whaw you recommend for the future . So thank you for that question. Universities generally have a very substantial capability to do testing in their Research Laboratory and thereby generate diagnostic light of laboratory. We have had to pull calls and seminars and webinars to allow the university to turn on their research equipment. We have done the waivers and all that of that to really use that to support testing. Eventually we want to get to a point that rapid point of care tests are available to everyone. What we are advising universities is to use those data funded by the nih that they have to use them. A nursing home can do that. Many universities use their veterinary laboratories which are very successful and again university of illinois has done really tremendous. We have them on one of our leadership calls as an example for the rest of the country. Thank you very much and in closing i know my time is up, im concerned dr. Redfield as we talked about the four they were writes an overdose in Overdose Deaths during this pandemic is extremely alarming and imin vey concerned as we go forward what kind of impact its going to have on the community. You and i talked about it and we have got to keep our eye on it. Thank you so much. Dr. Redfield. Yes, couldnt agree with you more. We have seen an increase and almost 18 in our overdose, suspected overdose submissions into hospitals. Clearly the isolation has been associated also the ability to get access to the proper pain control and a lot of the medical services cut back. Cdc recently did a survey and it shocks me just a survey across our nation down 31 of adults reported now significant anxiety and depressive disorder. This is a significant comorbidity that has been negatively influenced by the Covid Response and it is something we have to continue to double our efforts to try to prevent death from overdose. Thank you dr. Redfield and thank you senator capito. Senator shaheen. Thank you to each of you for being here. Admiral giroir in your Opening Statement talks about the importance of protecting the elderly which i think all of us would agree is critical and get the elderly have been impacted the most by this covid19. In New Hampshire over 80 of our deaths from covid19 have been in longterm care facilities. That is why i am so concerned roabout the slow pace that hhs s provided in giving support for control of these facilities. The cares act provided up to 200 million for nursing home Infection Control efforts and today only 70 million of that has been dispensed. On top of that hhs is only half of the 16 billion that congress has provided for the acquisition of personal protective equipment which continues to be a need. Nursing facilities and providers across the care system in New Hampshire desperately need the supplies. Soid admiral, the Infection Control center is vital and helping Nursing Homes reduce the spread of diseases and you alluded to that. When can we expect the remaining equipment to be distributed . I cant answer that. I dont know when it will be distributed. I can say, what i can say is that i know even in the last couple of months there has been 5 billion of extra funding to Nursing Homes, 2. 5 ill unit that is to support testing which is really in our regime. We do give the other at on the team, everyday we get 99 of Nursing Homes reporting so we knowry exactly what their ppe situation is but in terms of that specific fund i will have to have the team get back to you with that. I would appreciate that there were the challenges with the 5 billion that was just distributed is a canalwi may be used for hiring only, not retention in the biggest challenge our Nursing Homes have in New Hampshire is retention of employees. Is there going to be any thought given to providing more flexibility for longterm care facilities that have those funds to be used . Im really sorry. Im going to have to get the secretary to respond to that. Thats not within my responsibility. I would urge you to do that to cause if we are providing funds to longterm care facilities that cant be used in accomplishing the concern that all of us share. I want to go on to another issue because there was a report that just came out about hhs seeking bids for 250 milliondollar contracts for Public Relations campaign to did inspire hope and defeat fear in the pandemic. All of us want to make sure americans know theres going to be a better time ahead. The timing of this contract raises real concerns about the potential intersection with the president s Reelection Campaign and more importantly congress didnt direct hhs to conduct the amcampaign so its 250 million coming from funding that should be going out to our longterm care facilities or hospitals and their medical providers to actually respond to the threat of covid19 and what is the purpose of this contract at this time to do a Public Relations campaign . Wouldnt o it be better to give the information to the American Public about, as all of you have said so eloquently this morning about what we need to do to respond to this virus and what we need to do to ensure that people have the health care they need if they contract it. Admiral, can you answer that . Maam i really do apologize but i dont know anything about Public Affairs campaigns or where that money comes from. That is just not something that i deal with. We all try to provide the best information we can do whatever vehicle we can but i dont do public arrears contracts. C. Were not aware that the department would be spending 200 to 2 billion on that Advertising Campaign . I mean im generally aware from what i read in the news but im really not involved in that valley know about Public Affairs is that we do want to get all of this in front of the public to make sure number one they get their flu vaccines this year because thats critically very important. Thank you, think thats very helpful. Doctors kadlec were you aware of this . No maam. Mr. Chairman i would hope this committee would ask very tough questions about whats going on here because thats a lot of money for a campaign that we have to be spending to address this pandemic and senator alexander i totally agree with you on this, doing some work now to respond to the next pandemic and i would suggest that we also ought to restore the Global Health security and biodefense unit either at the National Security council or somewhere where it can provide Early Warning for whats ahead. Thank you senator shaheen. Senator hydesmith. Thank you mr. Chairman and to the panel i truly thank you for all you have done and your tremendous tireless efforts in guiding this country through covid19. You are to be commended and applauded and im certainly one that appreciates you being here today and answering the questions that we have and being willing to serve in the capacity that you serve them. I represent mississippi. We are less than 3 Million People and one of our largest challenges is the Rural Health Care and getting these vaccines to rural area such as those in mississippi. Of course im very concerned about the university and colleges and the protection that we need their third that age population but im just going to ask you what your agencies workingou on two help address te challenges and americas response to covid19 but mainly how can the subcommittee support you in that . How can we help you address thoseis issues there and i would like to hear from all three of you on that. And getting the vaccines to Rural America where it needs to be where we have such a o challenge. Thank you very much senator. Very, very important. We have continued to try to develop outreach for Vaccine Distribution particularly in the heart of the rural areas. This is part of the effort that we have celebrated with their. Lu program right now with the idea of how to vaccinate to try to protect communities. We have developed rural partnerships with the Rural Health Association and the National Association of Rural Health Clinics inie the National Association of rural Health Offices with a goal to really work to improve the acceptance of w vaccinations in general, lubing an important one. I do think the recent decision that the secretary made in e,expanding the ability of pharmacies to vaccinate down to age three to age 18 is going to be anva important expansion of being able to engage pharmacies throughout our nation as vaccine centers. We are continuing to work with those rural organizations to see if there are other Innovative Solutions to try to expand vaccination. Im hopeful that the pharmacy expansion can have a significant impact. Thank you very much. Maam with regard to Rural Health Care and with the house has been doing prior to the covid event was tried expand where we need regionalization of the aftercarere and emergency ce to really focus on areas where yound have critical access for underserved populations. In the current covid event we have been working with the department of defense to employ something they were to start or which is called the National Emergency Critical Care network by which to do telemedicine to again rural and critical access hospitals, to make them available with the best information Critical Care specialties support as well as transportation and referral of cases to a higher level of care. We are actively doing that rigt now. We have done it in many parts of the country as a result of our work with Covid Response and we are also trying to do that for ambulatory Care Medicine as well. So by building out a regional approach ourur hope is not to oy create those established referral patterns but also established telemedicine to bolster support so that we can support the rural hearts of this country. Thank you. I will add on again going back to guidance that allows pharmacies to use Covid Vaccines and i issued that last week to give it to the Pharmacy Community but i want to be a cheerleader for federally qualified Health Care Centers. Weh have 221 federally qualified Health Care Centers performing. I think fqhcs our role jamman they take care of 30 Million People very much in the underserved migrant farmworkers and homeless. They do so at a savings Better Outcomes at less cost so again thats a major point for mississippi where we are breaching people both urban and rural and anything that i can do to help will be money well invested. R thank you all for those answers and i truly appreciate that because it is one ofmo my p prior days. We have a young lady not long ago that died of an asthma attack because the Emergency Rooms had been closed in her area. I certainly appreciate the work they are. Thank you senator hydesmith. Senator merkley. Thank you very much. Erector redfield i am concerned the cdcs revised guidelines that no longer recommend testing for someone who is common to contact with someone with covid19 few days ago in a media interviewr on september 10 at most dijon kizzee at all of us in the room had been hearing from Public Health experts we need to test asymptomatic individuals so explain this to me. As the admiral right or wrong . Thank you very much senator for the opportunity to address your question. First and foremost i want to say the cdc guidance they came out was clearly misinterpreted and within 24 hours i published a statement to try to make it clear what the cdc was recommending. We were never recommending not to test asymptomatic and never recommended not to do the Public Health Contact Tracing. What was attempted was to replace the emphasis of testing so that as we talked about earlier the testing lead to an action. It drove Public Health object gives. Replaced the emphasis on testing asymptomatic contesting those with significant exposure full mobilen populations such as Critical Infrastructure Workers Health care workers and First Respondersor and the last groupe talked about was individuals who may be asymptomatic and rather than just get tested but we asked them to do was like we heard from the senator of West Virginia consult with your medical Public Health officials and follow their directions because as you saw with the senator when she chose to get tested even though the test was negative there was a critical Public Health action and that was for her to stay home for 14 days. We arerecr going to continue toy to make sure our guidance isnt interpreted incorrectly exposed as the admiral said and as i said asymptomatic infection and priests and thematic infection is a critical component of the transmission cycle of this virus. Thats another question i think youve answered it and even the example you have given shows the positive impact of tes because theyy can get appropriae guidance on how to behave there after. We know that a tremendous amount of infections are happening with people who are asymptomatic. I think that is such an important point to keepp driving home. I would like to also ask you, you told to be careful of the distribution of the vaccine on november 1. It states no ones perspective that you are are deliberately laying it out two days before the election. Who in the up and straighten asked you to choose that particular day . No one, sir. You take your own political motivation to place it in the election and what happened the science . There was no clinical interest in whatsoever. It was repaired by her subject Matter Experts because we wanted to get to the point of realizing that a vaccine may be available. We dont know when and we wanted the governors to be able to not have red tape interfere with the distributor from setting up their Distribution Sites. I dont argue that the thing that i was most concerned of and my subject Matter Experts were who actually generated the letter, which i signed, was the worst thing that could happen is we have the vaccine delivered and we are not ready to distribute. I can tell you there was absolutely no political thinking about it. You couldd say retroactively someone shoulda have thought moe but there was no political intention whatsoever. I must say as i dont find that persuasive. You are saying that there was not a single contact for made administration after the presence ofv that like to have a vaccine before the election, no one from the administration contacted your team at any level to say can you please emphasize that message . There was no email, no meeting, no phonecall, no check connected with that particular day . Absolutely not pretty was independently developed by her subject Matter Experts that were laying out this document to start to plan for the jurisdictions that we needed to get that letter out and to get the Licensing Agreements that they needed to get the Distribution Sites up and they drafted a letter and the subject Matter Experts that i signed. There is a misrepresentation by the administration. Americans find it hard to believe that there were noan conversations that the administration is actively pushing every piece of the federal government to engage in actions to promote their election. It undermines yourve credibilit. You should have at least thought about how it undermines your credibility because its so important to have the cdc be above politics. Thank you senator merkley. Senator langford. Its interesting about how much a day is about politics and the election. I doo appreciate the work youre doing regardless of politics appreciate the ongoing work you have done for a very long time to be able to work us through this prettier days are are very long and your work is very important so we appreciate the work that you continue to be able to do and this hearing shouldnt try to be some sort of political trap for the president. It should be about the facts and details so i appreciate that. Let me ask a couple of quick questions on this. The first one is there has been a lot of conversation about the amount of resources for the vaccines especially and for vaccine production and distribution. What do you still need for vaccine production and distribution as far as supplemental appropriations . Senator thanks for that question. This point we have funded six vaccine candidates for both development and manufacture. I think at this stage of 13. 6 billion that has been appropriated or committed to this purpose is adequate for the initial part of this. You are talking about this point in time when one vaccine candidate may fail and we have two replace them with another candidate or expand production and that can change your counting in our calculus for what whitney but at this stage we have all we need. At least at this point by the end of this month and to early october we willby lease have the funds would be to basically provide for the first several candidates. That is good to know. There obviously six different candidates going to the vexing process right now because no one knows if anyone is going to be successful so you basically six books in the water basically but im going to drill down on the candidates there out there and also the treatments for some of the pharmaceutical companies have chosen to do ethical production and that is they are not using tissue from aborted childrenro for the production of the treatment are the vaccine. Some of them have chosen to use aborted fetal tissue in the production of the vaccine. How are you balancing out to be able to make make sure there will be an ethical alternative for individuals that dont want to take a vaccine thats. Using the tissue of an aborted child . Sir thank you for that question. I will have to take that for the record and get her details on those particular matters. I dont haveha those immediately available and i do not want to speak on this issue. Do you have any comments on that on the production and . Again i would have to go back and see specifically. I think my recollection is we are going to have a number of candidates that arent going to compromise on ethics related to the use of human tissue but i will have to get back to you too because i dont want to Say Something that is incorrect. And its not just human tissue in the production. There are some companies that are using adult stem cells and some using placentas from children after birth. Those are not objectionable and i dont find anyone challenging that. Its not just ther use of human tissue but specifically the use ofha tissue that is from aborted children that becomes the challenge perimeter and is using embryonic cant kidneys and cells from aborted children. Johnson johnson is using aborted children embryonic retinal tissue for its production of the vaccines. There are others that are not choosing to use those tissues from children. I think there needs to be as many options out there as we can and again i just wonder on the science side if we dont have to use tissue frompt aborted children, why would we do that when there are others that are choosing to be able to develop vaccines that are not being used that way. So i want to build a followup with you on that and see what options are out there and how we are handling the funding and what direction we are going to go and longterm for vaccines most of the vaccines we have in america now dont use embryonic tissue and there are still some that still do and that is the line that is line that still use for it again when we dont have to do that why would we do that and to have it as ethical as we possibly can. I appreciate the work could we will follow up in the days ahead on this particular topic or does i think its very important that as many people get vaccinated as possible and i dont want to have a reason for people to not get a vaccine because they are concerned about the vaccine could i want as many people as possible to actually get a vaccine because i thinknk its important and its been about conversation to hear people saying im challenging whether we are going to get a vaccineta because the Trump Administration may be rushing this so i dont want to go and get one. I think we need to have no distraction or details when we walk through as well so appreciate your work. Thank you senator lankford. Senatori schatz royce thank you mr. Chairman thank you to the palace for being here. I will start with admiral giroir. In july there was a question we would be soon running 1 million tests per day. We have gone from about 800,000 tests perg day to 675,000 tests per day. What isab happening . I want to be clear that we are talking about capability to produce that and i think we need to have a distinction between how many tests we have that can be deployed and what the states are doing. In august for example the states total, the states combined goals were in the low 20 millions tests which they exceeded to 25 million t but what we are seeing in some parts of the country is testing is going down. We are trying to change that. I know you are from hawaii. We have a site in honolulu right now. I c guess the question is, is this a supplychain problem or are you saying. This is not a supplychain problem. We will have we have doubled the availability of tests done in august and we will be over 90 million tests available in september. I would presume a higher proportion will be done. It would be very easy to do. Its not a supply problem. He. Can we talk about the testing because i guess were a lot of people are coming from is that we hope you are right that this new test is a gamechanger and we are pleased and i think it will be very helpful in the context of First Responders and in Nursing Homes with her hats in educational contexts as well and as you know you cant really process that many tests at once thisis way. Although its really useful in certain contexts, its not going to get you to your 90 million tests, goals in your testimony today, today you say we should have 90 million tests completed by theou end of september. We are about halfway through september and we are at 10 million tests. I did not say that. I said we will have the availability of 90 million tests in september. I never stated that we would do 90 million tests in september. We are certainly hoping the tesy about by next, it only takes a swab. I could probably go through this room and swab everyone and do that within five or 10 minutes. But you could do them rapidly and quickly. So i would expect that as many as these as get put in the market particularly using in Nursing Homes and assisted living and so sen. Brian schatz what is the difference between testing availability because it seems like it sort of is a distinction that is lost on the ground. To know that theoretically there are availability but the First Responders and the firehouses, they do not have the test available. So what is the main then theoretically available to do 99 test and yet, people cannot get their hands on the test. I dont think that is true. Think people can get their hands on the a test even with federal size we have 2700 and retailers. We have other sites. There is enormous capability in the referral lab so the testing is available even when we do sites. Unless there is not a public order the demands people to come in and get a swab of the nose. This isno voluntary. And sometimes the demand is not there. We turn this around and say that it is one reason why we purchase them all for the federal government, the first 150 million to make sure the got to sites that would use them and really get benefits from them like Nursing Homes and assisted living. Hbcus and disaster situations. And in just a couple of weeks to support k12. I know youre working on this. And are trying to do this in good faith but i just want to convey to you that when the testing happened on the island of aey walkthrough over the lat two weeks, it was only then we were able to test our firefighters and only then we are able to test our First Responders and only then that we were able to have the test available to do what it is that is theoretically possible under other circumstances. It is only because you saw a precipitous spike in covid19 cases. So it is notun true. It is not true the tests are available for firstse responder. I totally disagree with you. As the state of hawaii. The turnaround time is under 24 hours with the ac la labs. And im happy to work with your state. But there is no reason for for the search, you can fire this company to come into the search for you. We did it and senate down there. In the demandy was great. The hawaii has been unbelievable to work with. We been doing fully subscribed 5000 test today. But a very happy to work with hawaii and they Surgeon General just went down and were expanding on the big island. There is no reason that the First Responders could not have been tested before the search. It. Willow and with this because my time is a must up. Continues to be a disconnect with how things are represented in this committee and in the United States congress. How things are felt on the ground. C this was evident in february when we met with hhs and it seems to be the case with triumphant statements. But on the ground, people still lack resources. Thank you mr. Chairman. Senator baldwin. Think mr. Chairman. The administrations failure to confront this deadly pandemic is led to lost lives. There is still in urgent need to provide more support to our communities. Im increasingly concerned the fund is appropriated thus far have not been handled as well as they could. They been misused and mishandled. Thus month i wrote to Vice President pets about a system in my stateul temporarily suspended testing for patients undergoing surgery. Because of supply shortages. I heard from assisted living facilities they cannot get the test theyve ordered created an Academic Medical Centers that are not able to secure and reliable source reagent. However with some that we did received the hydroxychloroquine, before never received a ventilator. Congress provided more than 16 billion for the Strategic National stockpile for critical supplies of ppe. Trless than 9 billion of that hs been obligated for the stockpile. Doctor catholic, what percentage of the fund this appropriated the stockpile this year have help stays get the ppe and testing supplies they need as of this moment. When set percentage. Up get back to you with the percentage. We have done in terms ofom our approach to basically manage the referred toe another about the the pieces that we basically made available everything that we have in our stockpile. Those by may and in beginning in march, with the monies that were available in the cares act, subsequent cares act having basically planning if you will the purchase of personal protective equipment to bebs distributed through commercial distributors directly to the hospitals. And only beginning in june andn july, have we been replenishing ouro stockpiles as part of the strategy to make available three months of supplies for the fall and winter should that be necessary. We are by the virtual of tele trackingr now getting informatin from hospitals in last week about 95 percent hospitals have been reported to us and thinking about your statement. Weve identified about 15 percent of the hospitals have one shortage of ppe that may be one type of ppe the maybe three days of supply or less. Eeim aware of the wisconsin statistics but im also aware of the 16 billion that we appropriated to address stockpilee issues. So if you my have chosen a different strategy but i think when we are six months into this pandemic, and we still getst the supplies we need. And weve identified the supplies that are in high demand that you should use the money we appropriated to obtain those things. Congress also provided 1 billion for department of defense for similar purchases and the president delegated authorities under the protection act to hhs to increase production of personal protective equipment. The department of defense is only used 300 million per ppe. And said they would use the rest to support the Defense Industrial base. How much funding have you spent on increasing domestic manufacturing capacity with all the authorities available to you so that weom can prepare for the remainder of this pandemic or future pandemics. It. So far weve awarded 638 million for the purpose. Runs the gamut from addressing shortages of diagnostics and supplies and respirators and injection technologies for use of vaccines. And masks and ventilators and gloves surgical masks as well as the ventilator supply chain. There are other things are being considered at this point in time. To use those rest of those funds were trying to be very strategic. T what is thats the fiber material used in disposable surgical masks, the 95 respirators. Have you used the either increase production of that in the u. S. Im not talking about contracting, talking about using the dpa authorities. s family have. Have you used it to shut off thee. Export when is obviously o needed here. Enough to get back to you but my recollection is that we have. Weve limited the export of the material. But i have to be sure. Please do. Doctor redfield have you been part of the taskforces the beginning. Yeses. So see if i have the timeline a bully present trump was briefed by mr. Brent on january 28 we got a major problem coming out of china when it comes to the coronavirus. And sets up the task force on correct. 9th is that that is my recollection serve on january 302,001st, the president issued an order called the china travel band. His does that sound right. Yes or the 31st of january is when the request was. So onn february 29, dr. Fauci was asked by the host of the oktoday show, the saturday morning, people waking up right now, were concerned about this they want to go to the malls and movies made the gym as well. Should we be changing our habits and if so how. And dr. Fauci says on the china, right now theres no need to change anything that youre doing on a day by day basis. Right now the risk is still low. But this could change. This general view back in february, did you agree with that assessment. At that time, there is limited evidence of Community Transmission in the United States. Gr okay. In march, there was an order basically issued declaring this a National Emergency. Do you recall that. March 11th. Yester, i believe the secretary is our call today for Public Health emergency. I believe it was january 27th and the president of the National Emergency. It. Arts 11th we did ay. Travel band from europe. And between january 29 and marce ever recommended shutting the country down. No sir. When they recommended to the president , the National Emergency and to basically encourage shelter in place orders, did the president responded to the recommendation of the task force. Yester rated. With anytime the president reese and trent refused to with the task force recommended about shutting the economy down before he made the decision. Night into the decisions that i was involved in. Thank you so the vaccines, if we found a vaccine lets say next month at the end of october, how long would it take me to be distributed throughout the country and become effective. I think that is the critical question because currently we have use the supplemental resources to get this distribution capacity of about 600 million but the funds we currently have are not thsufficient for us to get all 4 jurisdictions to be able to implement this plan that we issued today. Im sure you may have requested the committee for additional money im sure will respond. But what i want the market people to know is a vaccine was developed, is considered to be safe and acceptable. How long would it be before it would have an effect in terms of controlling the virus. I think we have to assume had a vaccine say released today that it will take probably in the order of nine months, six nine months to get the American Public vaccinated. So i just want everybody to understand that we are working operation warp speed. Do you think it is going well. Yes there. It. So forget a vaccine in the near future, before it was really have a massive impact, it would take six nine months to get it distributed and for to begin to take effect. In order to have enough of us to be immunized for enough of us to have immunity i think it will take six nine months. Said during the time, will continue to do. Much what were doing now that correct. Yes sir, thats why it is so important to gracies litigations that we talk about. So is it fair to say that at no time to President Trump leject their american intent recommendation when he came to slowing down the economy are putting shelter in place orders that when it was recommended that for him to take those actions, he complied is that correct. Yes sir. Is a fair to say that is latest for boy the 29th dr. Fauci one of the experts of our time was telling people its okay to go to the gym and okay to go out and about. So at that time, without the risk was relatively low. I have to deferred that. It and follow the statements but i would say in general we all felt the city set on national television, thats 27th of her remdesivir. So the sergeant that President Trump didnt respond to my think is ridiculous for the president to be shutting the whole economy down when the leading expert is telling people to go to the gymnasium in the movies now thing about. Celeste dont rewrite history here. Thank you. Thank you before we go to senator murphy. Doctor a redfield, be sure we ae clear here on the vaccine. Youre not saying that it would take six nine months before theu vaccine would do any good for anybody. You are trying to come up with a priority the country in the governors should look at that he was the most at risk that would get that vaccine first. Is that right. Yes. And if the vaccine works, with the efficacy that we could hope for, most of the people they get the vaccine are then protected from the virus for at least the near term future is not right. The fda because that god is that if it is 50 percent similar to the flu vaccine, that would meet their threshold for approval. I do want to be clear that as soon as this vaccine gets approved by actually approved, we want to be in the position to distribute that within 24 hours. Because as you point out very clearly, this vaccine has the potential to save a lot of lives. In november andu december. But we need to be able to get the vaccine once it is ready or approved we need t to get it distributed as rapidly as possible. And in july, i asked you specifically to focus on being able to report back on a plan and hopefully well get to later. I just want to leave this moment with any thought it just because everybody that was to have the might not have a before memorial day rated it is not mean that any people who do have it and hopefully would be the most in need, would be substantially better off than they are right now. His thatsst right. Yes mr. Chairman. He will have an enormous impact we believe on the mortality and the mostt vulnerable an enormous impact and protecting those a greater risk from infection we should see that impact terelatively immediately. Thank you sir. Senator murphy. Thank you. Thank you for spinning so much time with us today. First, a non communications. This committee and congress. Earlier was asked about a 250 milliondollar contract is being awarded by hhs to defeat despair and promote hope which is not a lot like a political reelection oriented message of the administration. To have two deputy secretaries before us neither one of them can testify as to whether that contract is awarded her why and with reasons for work. Its increasingly impossible for any of us to know who is in charge. We have two people who are the highest echelon of hhs cannot answer question about a massive contract. Is been awarded. I think is the same thing for the American Public. Doctor birch was in charge. Vice president pence was in charge. We need to have these basic questions answered. Its hard. Going back to the change guidance with the present study was less testing. Since that out loud paredes as for equivocation he double down. Since a lot less testing and then right around the time, you issue this guidance that dramatically scales back recommendations for who gets tested in the New York Times reports that is because been part, instruction from the white house. And you say today, that report is in fact untrue. But to any of us, its reasonable to think or encouraging fewer people to get tested today given the massive expansion of this virus. On the day that we passed the cares act, there were 10000 new cases reported in this country. And on average we are sing 34 cases all across this country. Your testimony was you werent necessarily saying that are asymptomatic get tested, youre saying just see your doctor first is that correct. Your clarification today. No, when you get a test like any physician who doesnt testimony as we cling to an action. And what we were trying to do is reemphasize that testing is linked to an action just like the senator said. Good tested and quarantined and she got l sted and she was negative. Was happening was people were getting tested and there was no action. So we were trying to bring action back into testing and we were not trying to limit and ill be very clear. [inaudible]. Earlier in the week this is from the american journal of managed care. Earlier this week, the they wee to single even if you are coming into contact of test is not necessary if no symptoms. That is not true. They were attempting to say, is true that some people interpreted that way. This way issued a very clear statement in 24 hours afterwards. Cdc is not trying to emphasize that. I do believe that more tests as was sent by senator, more tests actually can think of this cases if testing is linked to Public Health action. He didnt say they dont need a test. We said they may not necessarily need a test. Is speaking to the emergent public. [inaudible]. The Public Health action can be taken in conjunction with this. [inaudible]. When you tell them that is not automatic that they needed test that they should a doctor first grade it gets communicated the urgency is much lower. And all contacts are, or recommending that all of them be tested. It is a misinterpretation by some. Again will continue to clarify because we are not recommending bus tests. I do believe more tests ultimately lead to less cases in the country because of allowts Public Health action to happen. Just like you did for the senator. We can use those to stop the pandemic. There is a report earlier this month that the United States is going to scale down for the who. To include in recalling details from who headquarters, regional offices and Country Offices and then reassigning these experts. I acknowledge that i do not have time to get the answers today. But i think that is incredibly concerned that we might not have american personnel on the frontlines to sort of watch this virus and others through who field offices so i would appreciate an answer for the record regarding is going to replace those individuals inside the countries of concern and how we keep our eyes on this virus in future viruses. Thank you senator murphy. Senator moran. The thinktu it. We start wih you, want to talk a moment about ventilators. Hhs is entered into a number of contracts most of which were canceled a week or so ago. Before a they reached their intended i guess conclusion. And is there an accounting of how any ventilators which is troublesome to me because even week before that was the failure of responsibility to first usaid and i come back and do the contract is hhs and than a week later the messages, we are wanting more ventilators. Thats interesting to me that the contract requires hhs and the figures pay for. Compared to a more standardd ventilator. Thank w you sir for the question. And yes, sir, we have been looking at our ventilator supply. Just to put this in context, when the covid19 event occurred in january, we had 17000 ventilators in our stockpile. With another 10000 ordered. As a consequence of the modeling and concern we may need much more ventilators, by prepandemic calculations, for pandemic influenza m it was to calculate you need about 170,000 ventilators. The course of this event there was a concern that we may actually need moreat than that onumber. And that as we went into agreements with seven Companies Across the country. A few from outside of the United States to basically produce over 200,000 ventilators. With that as things progressed as we learned more aboutut the disease and more importantly how to clinically manages these disease both more respiratory setting as well as intensive care setting with undivided we need to may be strange change our strategy with the ventilators. Maybe needing less and different kinds of machines butt with your point the higher acuityt ventilators were over 120,000 of was to basically diversify that so we could use some that could be high flow nasal,v which has better clinical outcomes. Adjusting that number with these modifications to some of the orders we made, we basically also identified we could meet our pandemic requirements of 170,000, make available to other countries, an additional 20000 ventilators that we decided to then cut back on the number of ventilators that we need to order ands to have shippedk. With the cost of that there is a significant cost on the back end of this with the maintenance c requirement you need to contain these ventilators. And that iai am the responsible party. Is we need to get with you and your staff to provide you any other details you need. Doctor thank you parade let me quickly turn to admiral, i think this the end, the witness the position have taken this morning is you are incapable of telling us they would take back these issues for the record. You are incapable of telling us about future spending from the Provider Relief Fund. Let me just suggest to you, please take back for the record that the ability to get information from hhs on any spending through Provider Relief Fund has been minimal at best. As United States senator who appropriates money who supported the cares package, my ability to communicate with my constituents on how youre going to spend the money, how to spend it and what the plan is is next to nil. I have but hhs has failed time and time again to respond to congressional inquiry and provide us with information about how taxpayer money is being spent. But how to help our constituents prepare for what you might be doing or what you are not going to do. Admiral, in somewhat that regard, the increasing costs associated with complying with hhs rules and regulations by our Nursing Homes, our Skilled Nursing facilities, arst Senior Living facilities is significant. My question for hhs, i understand you would defer to somebody else then who is here today to answer the question, what can they expect to help them pay for the tremendous increase in cost in compliance with covid regulations and policies that they are attempting to comply with to protect the safety and wellbeing of their residence but have little Financial Capability to actually pay for. Thank you for that question. Independent of whatever regulations that are, Nursing Homes has the responsibility and the ethical responsibility to do the type of testings we recommended. On the only way to protect the elderly. Number two the reason we distributed pointofcare test homes is that gives about 20 of the costs that they would incur as opposed to a laboratory test. The buyer next test we are distributing to all of those right now, 2 million this week are at no cost to the Nursing Homes. And they come with automated reporting. And finally again, do deferred to fema about sending money but i know 5 billion was sent to Nursing Homes of which 2. 5 billion was to support testing i know thats the detail i know im happy to bring anything back from her or our assistant secretary admiral im using you as a conduit for expressing my concern, and expressing my desire for a lot more information. Yes or i would point out that every time i have raised this issue, this issue with hhs a talk about seniorr living , Nursing Homes, in Skilled Nursing facility. And every response just as i think yours was, comes back to what we are doing for Nursing Homes. And again i cant determine if theres any plan to be helpful, which i think is necessary for Senior Living. I will bring that back a little take it to the record. The moment we had the buyer next test, we are sending to 5000 assisted Living Centers this week. To support that is supported living t environment for their still 6000 of those are those that dont have a clear waiver we i need to work with. We are going to work with them, soon as we get that technology it is out the door to support our seniors. Admiral you cost me to it change my commentary slightly. Every time a racist topic topic now you mention two of the three topics and i still would raise for you and for hhs, Senior Living which never seems to be a component of any conversation that i haveor had with what few conversations i have had with hhs. Yes, sir. Iank you, senator my time has expired. Think you have got a couple of other questions. Senator murray has eight other questionu. Or two, on the points that senator moran raised what is going to happen at the hartman is a reluctance by this committee to appropriate money and give the department flexibility. We appropriate money for the provider fund. We expect that money to go to that provider fund. Not to go to whatever other fund of the Department Thanks its better spent so effectively appropriated the second 75 billion to the provider fund, which absolutely prohibited spending that money any other way or some language close to that thats all because of the department actions. They appropriate based on your request in your response to that request a ways we think is appropriate. You cant just decide to ignore that on the vaccine we specifically did not appropriate to warp speed we appropriate money to the partners at least 16 billion has come through those agencies for the vaccine, up until now. Hhs has told us that to have 300 million copies of vaccine available, vein need another 20 billion that they do not have been any specifically expropriated line. Do you agree with that number . s are based on the Current Situation yes or that seems to be the number. Doctor redfield, the plans that you expect to get back from the states by november 1, on distribution of the vaccine , to you think you will be ready shortly thereafter that to announcehe your final Distribution Plan for vaccine . Senator, it is going to be dependent upon the Advisory Committee of immunization practices. Which make the final recommendation to prioritization. I think im asking another question. Maybe i didnt ask it well. Prioritization want to talk about that too. Surely, prior to prioritization will not impact how you send this out to the states. It might impact the number they get, but in terms of the protection of the vaccine, the way it is distributed, to be sure you have a plan to get this in response to state plans as soon as possible is that your intention . Yes, sir. Argosy the issue i tried to mention earlier, i said this in an earlier testimony some people some people doesnt seemed like they see this. Just as it was it important, it is important as a second issue and it was important and thats my second question. Where are we on the prioritization . That will be recommended to the states or will that be prior to route physician we expect the states to comply with . Isnt recommendation of the Advisory Committee for how this vaccine, which everyones are approved, are recommended to be used. When will that be available . That will be available after the committee gets to see the data on the particular vaccine. But to answer your first question, because i think it was very important and i want to get to it. This plan for distribution is what we are now to get. What i was trying to say is, i said before this committee it is as important that we start that plan back in june as manufacturing. E and right now we have leveraged about 600 million. But we do not have the resources to support 64 jurisdictions to get this plan operational. So to me it is an urgency that we get that. Done this in the past. We have experienced what it will take for us to do distribution and monitoring safety and get the vaccines we mention. We distributed 80 million vaccines. This will take substantial resources. Like i suggested in june, the time is now for us to be able to get those resources out to the state and we currently dont have those resources. The best i could tell there were no resources provided in the house int in both the bill we voted on in theo senate and the bigger bill we proposed in the senate. We had roughly 6 billion is at the right number is that close to the right number . Senator my professional opinion i think youve got that really nailed. I was somewhere between five and half and 6 million is what he thanks going to take to distribute this vaccine. And you dont have this money right now . And you needed to distribute the vaccine . I think it is as urgent as it is manufacturing siltys up. I think i said in july and you agreed, that if you have the vaccine and dont have either the plan or the resources to distribute it, that is a huge failure on the part of congress to provide thee resources we know are going to be necessary. I hope it is part of whatever package wery put together this very month to make sure we have the capacity to do that. Senator murray. She may have gone to vote. Mr. Chairman kenny see me . I see you now. Thank you so much i appreciate it. Just going back to my desk here hold on one Second Period thank you very much i appreciate it. I wanted to followup on senators question in the contracted Public Service to inspire hope amidst a coronaviruss pandemic. Based on that it looks Like Administration attempted to use a quarter of a billion dollars of art Massive Media campaign to mislead the public to actually downplay the pandemic. That is really unacceptable. Congress provided these funds despite covid19. Not to support the campaign or Reelection Campaign. Let me just ask you, can you clarify if cdc was tapped to provide that funding . s thank yous editor. The cdc received direction from hhs to transfer 300 million to hhs. What role has cdc played in developing that Media Campaign . We have h not played a role. We were just, as i mentioned, instructed by hhs and omb to transfer the transit hhs asked for. Then what role is cdc going to play at making sure the messages put out will include accurate Public Health information based on science . And again, center, at this moment we have not i been involved other than given the directive from hhs and omb to transfer the funds. So funds only, youre not going to help with information to make sure it is accurate . Well again i would assume they will want our instruction to do all of that. We have not been involved in this other than the extent the funds were transferred to hhs. I assume they will come back to the different subject Matter Experts. But again we have notnd been involved in that. What role are you going to play to make sure the Media Campaign will be dissemination of Public Health information based on science . Select thank yous editor. I have not been involved in any discussions. I have only been asked peripherally, which i think is the same campaign to be subject to questions and to have a dialogue about Public Health issues. But ive notgn been involved in the development of the contents. The same way doctor redfield mentioned. Do ihaen you think its a rof either of you to weigh in to make sure this is accurate . I certainly believe that the cdc director has Important Role in messaging part and i am the senior Public Health advisor to the secretary. Wed certainly welcome the opportunity to help support the correct messages to the american people. I dont mean to speak for bob, again i would update if given the opportunity to cdc would obviously want to put forth the accurate messaging for the American Public. Will finally, doctor redfield, Public Health groups of really set up billion dollars is needed for distribution the cdc should be leading the effort. I want to know what activities should be included in the Distribution Campaign . And how you plan to make sure you w are involved . Scenic pinky barry much senator. I think it is critical. Cdc does have the lead with operation warp speed. Again, the playbook that we put out again it is version one. It is going to go through i am sure iteration as estates get involved and help improve the plan. And sohr cdc is in the lead of work with the state and territories to do this. As a mention since the last time, i think it was when you asked me and we really did not have funds. And we have been able to leverage about 600 million to start some of the most critical activity. But as i mentioned toto the chairman, now is the time, it is now. Thee rubber is hitting the road now to get the 64 jurisdictions up to speed. This is a very resource intensive distribution. Weve never tried to distribute a vaccine that has a we are prepared. We did meet with five of the jurisdictions, to go down to micro planning. So we have got a pretty good idea. But now we are going the plans for the rest of the 61 jurisdictions. And it really is going to require resources. The jurisdictions are not going to bee able to put these plans in place without resources. Let me emphasize that responsepl. We just heard one of these vaccines is going to repeat choir close of minus 60 or minus 80 degrees. Distribution across the countrys going to be extremely challenging. We need to make sure has a National Plan for distribution. And communities that dont actually havees access to healthcare really get access to this in the distribution and all the things that go along ishi going to be very complex, will require resources. And again requires a National Plan. Thank you, senator maria could not agree more. Its all about priorities. This should be one of our Top Priorities at this moment. For the lastio question for a select thank you for that courtesy and i know the second vote has been called. So this question is for the admiral. I think that should be brief at least if ist start asking it. Admiral, we were alerted just recently been hhs request for information that was posted by think it was posted last week. It was soliciting interest from laboratories that could scale up withk, additional equipment from Thermo Fisher. Cientific its in kansas and we have just recently it had an expansion to create more test tubes to do the test results. Could you tell me with the ultimate plans are assuming you receive interest from these laboratories . And more specifically what is the budget for the strategy . How many labs you plan to support and to be accomplished . Let me say first is an nihsu solicitation. With information from about 27 universities that had interest. A topline peace, particularly now is that there are certain retypes like hologic, and those that are relatively flat. But there is huge supply of other outstanding which Thermo Fisher has. They have a huge industrial capability predeath instruments, that everything that goes with it. Soup to nuts, for happy meal however you want to say it. We are trying to encourage laboratories around the country including universities to use these because Thermo Fisher can make tens of millions of high Quality Laboratory based. We have supplied some of these two private laboratories like sonic, we are trying to make sure the universities use what they have. But also if they need help we are happy to find that. The relatively small amount of money to get them thees capabilities and they have been really good to work with. Really knocking down the prices particularly for surveillance. We try to get the message out Great Company is too early to tell if your outreach has any effect to exercise three times a week we match a laboratory with Thermo Fisher getting their instruments together with their supplies. So it is absolutely having an effect. Again, we have a lot of capability. Just want to make sure people understand where capabilities are in thermo is one of them. Admiral thank you for your work. Thank you, senator iran, im going to turn to senator alexander for final question. But before i do that we are going to go vote. Want to thank all of you for being here. The country is dependent on all three of you to lead in these critically important issues. As doctor redfield and one way or another all of you have saidt this, we are at a critical moment in testing and vaccines and therapeutics. In distribution and prioritization, all of these things need to come to as much of a conclusion as they can so we can move forward. Think evolving great Witnesses Today for the questions you are asked or outside of your area of responsibility print of course the proper answer to that is, that is not what im doing every day. And that is totally fine print we are grateful for your time. I know this is a critical time for all of you. And im grateful to you for having been here. Senator alexander will mention the record will stay open for a week for additional questions. But we hope you respond as quickly as possible to those questions. We are intensely involved in being your partner in this effort. But we need to know what we need to do so we can do it in the right way. Senator alexander. Thank you, mr. Chairman. Thank you just senator blunts for me aggressive on all these issues and leading especially in the area of the port for the maximum number of tips. Show some wrap up questions. Doctor redfield lake heard the questions senator merkley asked about whether thereon is some scheme and asking the states to get ready to receive the vaccine, you said no, it had been recommended. I remembering right that when we had a problem with the virus called h1n1, the administration and the companies had a virus to distribute but the states werent ready to receive it, andad that was a big problem, is that right . Yes editor. When was that . 2009, 2010. What happened . I was out there. Were very fortunate to have the gentleman who is part of that and had the opportunity tona learn from all of the experiences and now leading our distribution for this to ensure we do not have the same hiccups. That is why i was stressed how important it is for us now to be able to operationalize this plan. Yeah, more than f a hiccup. It would be a tragedy if we had vaccines ready and available we could not disturb them because no one had asked the states to be ready. Now i believe you said, doctor kadlec said, i believe you said, that vaccines could be ready as early as november, december, is that correct . Yes, sir. And they would be ready in larger, much larger volume, most likely after the first of the year end into the second and Third Quarter, correct . Yes, sir. And how long does it take a state to manage the distribution of these vaccines and make sure they go properly to the right people with the right equipment, the right time. I will defer to doctor redfield. I think this is why said his origin. G i meann what we say the vaccine could be ready in november, that is really six weeks away. So it is really urgent that we operationalize as rapidly as possible. What you suppose this committee and many others would say to you if you had a vaccine or ready in november and december and he had not asked the states to get ready to receive it . Would probably be recommending that i get replaced. I think so. I think this criticism of you and the professionals at the cdc for asking states to get ready to receive the vaccine when we know full well that it isis likely to begin to be available in november and december, is very, very misplaced. And i appreciated your comment, and the way you handle them. A dentist told me that there is no evidence, doctor redfield, of transmissibility of covid19 a dentist office, is that true . I would not necessarily state that. Think the dentist is probably going toto say there has been no proven transmission in a dentist office. I i was a little surprised by that. That the dentist said they have a history of handling infections all the time, all the back to hiv. And so they are trained to do that. They know how to where protective equipment. They note top practices. Do you any of you know if its true in other parts of the world and the United States theres been problems with going to the dentist because of transmissibility of covid . I i would just come back to the statement i tried to make earlier, these masks work. And one thing you will know about when you go to a dentist, everyone is maxedan out. I can say we have not had evidence of outbreaks that we have a link to back to dentist. I will not say will never happen. Just like we reported recently to hair salon people there were highly infected they went and did their work over 150 people but they wore masks. There is no evidence of transmission. We keep coming back to the importance of Wearing Masks. I have one last question and understand senator murray would like to makei a closing question but im finished. I want to back to the cdc on asymptomatic testing which you acknowledged has created confusion. Wonder what else you might be able to do to alleviate that confusion and why its important. My feeling all along has been that it was a good idea to produce tens of millions of rapid tests so that anybody who wanted a test could get one basically. Now from a medical point of view there is no reason to do that. But that is not the only concern we have in the United States right now. I mean we would like to go back to school. Would like to go back to colleg college. Wed like to go back to childcare would like to go to childcare would like to go out to eat or surveillance testing are whole number of strategies that tests a lot of people who dont have symptoms, to build confidence we dont have schools a safe place, College Campus is a safe place, your childcare, workplace, if we have better comets we can have better lives. Seems to me particularly since they have said we are now heading towardsis a situation or we mayla have 100, 120, 150 million tests a month, we are going to have plenty of tests. We are going to have capacity for plenty of tests. By frequent tests what if a school wanted to test every student at the beginning of school. At the beginning of a week for two or three weeks, just to make sure wanted to create a regime or you do random testing, surveillance testing is that i think is a word for the kind of testing when you go to the airport they pull you out of the line every now and again to make sure and see if you have explosives on your hands. That makes us feel better when we get on an airplane we dont blow up, so people fly to million a day so youe, dont get blown up bike passengers with explosives on their hands. The university of illinois, think one of you mention is testing twice a week. I think they must have 40 or 50000 students and faculty member and staff on that campus. I know president brown said she would to test everybody before they came back. I can imagine in a workplace someone would worry about working next to somebody who is infected and where theyor might have just be afraid that they might have covid. Wouldnt it be good idea for the managers to say take a 15 minute test and you dont have it today. Thats all that means. Are you could say to all of your employees, we give your testing are symptomatic but we also give random tests on a regular basis throughout the plant so you can have more confidence in you come back to work. So it seems to me that it is a good thing for our country to have more tests than we need. More rapid test than weoo need, so that anyone who wants a test canor get one. If they feel it is necessary. Think once they feel that know that they can they wont want one. I think that is one of the reasons we are seeing a lower demand and other parts of the country because they understand a limited value of a diagnostic test. It tells on that one day whether you have it. This is a little bit of a long question. I am trying to get around to, is there some way that the cdc could clear up whatever confusion has been caused and make it clear that since we now have such a largeen supply of test that different strategies for testing people without symptoms is a perfectly goodth idea. And doesnt take tests away from Healthcare Professionals are people in Nursing Homes or assisted living, for people like that. That clearly would help i think as we move into october, november, december, to encourage people to use this growing number, especially of rapid tests that we have to build confidence that the school, the college, the childcare centers, the workplace and the restaurant are safe places to go regularly check. And that would help us restore our economy. What could you do about clearing up the confusion . I appreciate the comments senator. First, there are three areas but ill be very brief. First is we are working on clarification documents, related to the diagnostic and Public Health use of testing. And again, we have never recommended against asymptomatic testing. Veryag clear that asymptomatic and presymptomatic transmission is important. We make it very clear that if you have been exposed to somebody, you need to be tested and contact traced. So that is going to come out, hopefully, ive done my clarification statement in 24 hours after. But it did not solve the problem but we are going to come out with that hopefully sometime in a the next, i hope before the end of the week. Secondly, and infect the admiral may want to comment, wee are working on guidance. Because in addition, there is screening and screening can be very powerful. For maybe nonPublic Health reasons. They be getting us back to life and screening in schools, k12. Screening in universities and business you can see the cdc will be coming out in conjunction will be coming out with some guidance around screening. And then, there is the other word you use which we also believe is really important, which is surveillance or you can actually systematically begin to look at random individuals to get an idea is this outbreak starting to pop into a new community . So all three of those are important. All three of those you are going to see we are developing followup guidance for. It really was not possible to have a lot of that guidance when there was no test. But as you point out, the admiral is really done the job with the private sector. It is really gotten to the point now so we have were going to try to clarify the clinical Public Health issues pedro going to try to give guidance to screening also going to have a role in businesses and also in entertainment activities like sports. Then there is the other side of how to set up systematic surveillance so we dont get blindsided by all decided finding that there is a huge new cluster, outbreak that we just not have eyes on until it got too big. Admiral did you want to add to that . I just agree one 100 with everything that has been said. We are going to continue to invest in a number of different types of platforms. But clearly, low cost, ultra available, specific tests, like the bioav next now, there will be more like that coming through. And again, we are going to increase that supply as much as possible. There are also going to be some new pointofcare tests that are actually very sophisticated, very sensitive and specific that can be layered on top of the by annex in our goal is to provide as many tools as possible in the right domain that we can implement this type of guidance. Again, and march it is not make sense to talk about random screening of children going to school because you did not have thatme available. Now that we have a very robust ecosystem of testing, this is the exact right time. Which is why we purchase one or 50 million of this card based test we have pointofcare in distributing them, first to protect the vulnerable but they within a couple weeks they are going out to states to support reopening and otherwi infrastructure according to their priorities. We are at that point were at that inflection. Civic how many are going out to states in the next couple of weeks can you give me a rough idea . When by annex, when aven gets their full production capability about 12 million. Week which will be within a few weeks, we anticipate, depending on how things go with the Nursing Homes, somewhere between five to 8 million. Week going to states that we can provide them for those needs. Again, if the cases continue to go down in Nursing Homes, we will need less and less test to protect the Nursing Homes. If it stays high. So thats five to 8 million a week . So five to 8 million oe, tennessee is about 2 of everything. Too that would mean a state like tennessee would be getting a few hundred thousand a week, or several hundred thousand tests a month at least. That the state could distribute according to its priorities. Is that the general idea with that five to 8 million . Yes, sir, there are some policy discussions. We certainly want to support the states. We think it is a priority, as i know you do to open education k12. Even preschool. In potential universities. I think universities are in a different class because they have resources for redoing to emphasize very strongly the protection of teachers and the reopening of k12 aste a significant priority preselector certainly do too. Some states are doing something some states are doing others. I think it is a good idea to reserve some of first i congratulate the administrationrs on buying the full three month supply of that which is on i understand about 50 million tests a month learning in october, with several million this month. And then assigning it to priorities like Nursing Homes et cetera. And then giving a lot to states which would be, if the state of tennessee got 200,000 tests a week, that they could distribute during the rest of the school semester, my guesses many of them would go to schools because the ones who are most worried about that or not kids, it is the teachers. And the parents, grandparents of the kids go home. So i think that is a tremendous reassuring prospect that estate might receive that many rapid tests just from that source. Doctor redford we will complete this because i think senator murray does not want to say anythingg now, one time you and i hadfi a discussion about a guidance that use examples and think we talked about colleges. Think you did that. I think one way to help clarify for a symptomatic individuals, would be to list five, six, 810 examples of schools, colleges, workplaces that are doing that now. That makes sense. Whether, i will let you decide what those might be. It would not beet only those things. I think you said these are all the kinds of ways that this large number of tests we have may be used effectively to build confidence and a back to school, work, childcare out to eat, that might be easier for people to read and understand the words in a guidance. To the use of examples is a suggestion i would make. Dsso back i appreciate your advice. Thanks to the three of you, senator blunt said we are grateful to you for your long hours for your effective work, your planning, and the money this appropriations subcommittee has targeted for you is not forthcoming in the way congress intended it for it to be, expect you to let senator senator murray and others of us on the subcommittee know w that. The record will stay open for one week. The subcommittee stands adjourned. Bc [background noises] [background noises] [background noises] [background noises] [background noises] follow the federal response to the coronavirus outbreak at cspan. Org coronavirus. Watch congress, white house briefings comment updates from governors, track the spread throughout the u. S. And the world with interactive maps. Watch on demand, anytime, unfiltered at cspan. Org coronavirus. The Senate Homeland security and Governmental Affairs committee voted eigh s