Make sure that we are being radically transparent what we know when we know it as well as the uncertainties we face. We acknowledge this is a time for concern by many people and trying to educate people about what we know and dont know in these times. We had a lot of discussions especially about testing. We are happy to provide you with more information and answer your questions as we did the house and the senate, because there has been some confusion around those issues and want to make sure everything is being clear. A major focus in both the senate and house discussions today was around the issue of just the Patient Experience and the provider, the doctor experience and we were able to point them and handed out from c. D. C. s website, and information sheet that says i am an individual, im concerned i might have covid19. What do i do . I dont think a lot of them had been aware of that. We want to ensure senators and members of the house are armed their constituents and provide that kind of information. That is available on the cdc website. We have fact sheets also available on the website, basic background information, q a. Becausethese questions it is helpful to know where the information gaps are, what people might need to understand better and how we can give best guidance. We also reminded them that the state and local Public Health departments are the leaders in this country on any type of response like this. We get our information from them. Theyre experts. We provide background report. Support. We surge in to help them. We provide a lot of infrastructure. Of course we provide about 50 of the funding for their work. But they really are a trusted local source of authority in this space. We count on them, members of the house, senate and public should count on our local and state Public Health leaders also. Im going to stop and then well take your questions. But i want to ask dr. Fauci if he can say a couple of words. Then well open it up for questions. Tony . Dr. Fauci thank you very much, mr. Secretary. I want to address one issue we continually get asked about. I would just like to clarify it a bit, and that question is, what is the risk to the American Public . You have to divide it into two general areas. When you look at the country as a whole, what is the risk of actually getting infected with the coronavirus . The risk in the United States as a whole is still low. When you look at what were seeing, and were following it literally on a daily basis, this issue of Community Spread, as were seeing right now in the seattle area, which they are addressing by a variety of ways, the risk of getting infected when you have Community Spread in a certain area is a bit higher. Quantitatively, im not sure. But still, when you look at the country as a whole, the risk of getting infected is low. However, if a person is infected, like in seattle where several people have gotten infected, the risk of getting into trouble widely varies. If youre a young, otherwise healthy, individual, the risk of your requiring any kind of medical intervention is low. And we know that from data from china and from recent data from korea and recent data from italy. And that is about 80 or more of individuals who get infected will do well without needing any medical intervention. However, if you are elderly and have underlying conditions, the common ones that we use with flu, heart disease, chronic lung disease, diabetes, obesity, or being immunosuppressed for reasons like cancer chemotherapy, if you get infected, the risk of those individuals getting into trouble is significantly higher. So it isnt like a uniform risk across the board. Which tells us that the vulnerable among us, those with those conditions, need to be particularly paid attention to protect them, not only from getting infected, but to give them the care they need when they get infected. Ill stop there and we can answer questions. Do you mind talking about the fatality rate data issue . That is something that came up quite often. I think youd all like to know the latest information and assessments weve got. Sure, thank you, mr. Secretary. We are still very early in understanding, all the evidence isnt there so i want to caveat that, but to set some foundation. The typical mortality rate for seasonal flu is about. 1 or 0. 15 . The best estimates now of the overall mortality rate for covid19 is somewhere between 0. 1 and 1 . Thats lower than you heard probably in many reports. Why is this . Number one, its because many people dont get sick and dont get tested. So probably for this reflects the overseas experience so probably for every case, there are at least two or three cases that are not in the denominator. So i just want to scale that, that it certainly could be higher than normal flu. It probably is. But its not likely in the range of 2 to 3 . Now, full stop, i want to what dr. Fauci said. For young or healthy people, it is very unlikely, still possible, but very unlikely to have severe illness or death. But it is an extremely severe condition in elderly or those with Chronic Health conditions. Ok . So that is a very important population and one reason why administrator verma leaned in very hard yesterday to support all her quality measures and education for all the facilities that she governs that deal with the elderly. Hi dont know if you want to to clarify on the mortality rate. When youre saying. 1 to 1 , are you talking about within the u. S. Specifically . So, we believe that is the overall rate that we might expect in the United States between. 1 and 1 overall for all groups. But again, thats lower than the w. H. O. Figure. Why . So, again, were very early here now. Right . Were very early. But the modeling suggests that we have a denominator problem, right . If youre really sick and you have respiratory failure, you go see someone and you get tested. But if youre not very ill, as most people are not, they do not get tested. They do not get counted in the denominator. Especially in a crisis situation like in china. So again, we very early in this and i hope people dont the main point of this is, number one, this is likely more severe in its mortality rate than the typical flu season but its certainly within the range. So we dont want people to crazy like its 30 mortality like in mers. But main point is, if youre young and healthy, you are likely to have a very mild illness. Theres always a oneoff here or you are there where a young person could be severely ill or even die. So thats one batch. But we need to make sure that those who are elderly, particularly those in nursing facilities, or those who are chronically ill. If you have chronic pulmonary disease or severe diabetes and hypertension and heart disease, you are at a very highrisk and precautions need to be taken. [talking simultaneously] reporter are you going to meet your timeline of having a million coronavirus tests available by the end of the week . Secretary azar i want to walk you through whats going on in terms of the lab tests. Because i think its really good to have clarity. Ill ask the admiral to make sure and clarify. So there are basically three stages to the availability of lab testing for the novel coronavirus. The first stage is the test that the cdc developed, that the cdc is producing and is sending out to Public Health labs. Thats a little over 70 Public Health labs here in the United States. There currently is the capacity to test, at the beginning of the week, 15,000 people. Each person needs more than one test as part of the testing regiment. By the end of the week we believe well have shipped enough for 75,000 people to be tested. These tests are sent out free, they go to the 70 or more Public Health labs that are part of our network. What that means for those tests is a doctor or a hospital wishing to test somebody for novel coronavirus, they work with these Public Health labs on testing all the time. They would reach out to their Public Health lab and say, i have a suspect case, i would like to get this person tested. And they would work on how to do that. That might involve the patient going to a lab, it might involve the doctor getting instruction on what type of swab to use, how to swab the sample, what type of medium to use, how to transport it, etc. The second step here is i. D. T. , which is the manufacturer that has worked to get its own authorization to develop and market that same cdc test. They believe by the end of the week they will have sent out, to their hospitals, other labs, around the country, commercial, Public Health, whatever labs, enough tests to test one million specimens, which would be the equivalent of being able to test about 400,000 people. From that. They also believe they can scale up their production so that by the end of next week they can be in the range of perhaps four million, is that correct . Yes. Four million tests. Specimens which would then come down to a million and a half. Million seven people, ramp up very rapidly. Secretary azar so for that that means more traditional things like youre in the hospital, that hospital might very well have that test in their lab, be able to test you right there. If that hospital buys that test and has it. Or other labs. Commercial labs. The third stage, the third stage is the guidance we put out on saturday morning from the fda that said since the obama administration, if youre developing a Clinical Lab Test like this, as cdc did, you need and get approval, and emergency use authorization to send this test out. Cdc did that. What we said on saturday is if you are a certified clinical lab able to handle highcomplexity tests, these are labs that are regulated by the administrator and cms, you may develop your test and you dont have to wait for us to approve it before you can start using it in patients, send us your validation data and send us your emergency use authorization after the fact within 15 days of beginning use. Thats your lab corps, your Large Diagnostic Companies and that will also radically expand availability. It will also make for a much easier experience for doctors and clinicians because theyre very used to working with Lab Companies like this to get tests done. There is a work process flow thats very patientsent rick , and easier. Ntric i was very candid with both the house and the senate that as this expands, that experience will get better. But right now there is it is a challenge if you are a doctor wanting to get somebody tested, you do need to reach out to your Public Health lab, see if they have a test. Were going to be putting up on cdcs website information about which Public Health labs have the tests. Also by this weekend that Broad Network of hospitals, other labs, will be receiving from idt those million tests that we referred to, and they will then work they have to validate in the facility and then once theyre validated theyll be up and running. So that experience will get better over the next week, week and a half, two weeks. But do not be surprised if you hear concerns of doctors saying, i have a patient, i dont know how to get this done, well try out if more guidance out from cdc to help with that experience. Reporter youve been trying to get out Accurate Information to the public on selfquarantine, what the numbers are, the testing, all those things. Isn the president countermanding things by saying the number of who are wrong, when he says people who might have this can go to work anyway, is it helpful to get your message out when youre being countermanded by the president on tv fairly regularly . I dont think im being countermanded reporter the president said last night that people who had the mild disease could essentially go to work. He suggested that. Ive not heard that. I cant comment. , had not heard that either. Reporter he thinks its wrong, the who is wrong . I do think the admiral just walked you through the difference [talking simultaneously] thats based on international data. Reporter the who has been wrong . Its how one describes it. Our best modeling, again, you have a denominator problem and i want you to understand that. That only the people who are really sick or have symptoms come in and get tested. So based on the models we have right now, we estimate the mortality as. 1 to 1 . It is likely not in the range of 2 to 3 . Now, remember, if you have a if you have a if you have a [talking simultaneously] if you have a cruise ship where people are 70 or 80 years old on the cruise ship, the mortality is going to be higher as it is in a Skilled Nursing facility. And let me make it clear that for the best guidelines of what people should do, go to cdc. Gov. Theres a huge banner across the top. What you need to know if youre a patient. What you need to know if youre a provider or a health care. Thats the current guidance. And remember, the guidance will change over time as we learn more and more about the disease and it will also change over time depending on were in a full containment situation or whether were in a Community Mitigation situation like they really are in seattle. Because the rules do change depending on what phase youre [talking simultaneously] reporter why did the cdc decide not to use the World Health Organizations test . Would you like to talk about that . Yeah. Thank you. Theres a process of developing tests when theres a new disease. We followed that procedure. There wasnt a need to follow the who test. We developed a test very rapidly after china produced the sequence. We were in the process of value validating that and thats the test that were going to be using. Reporter why is it that once we realized the first c. D. C. Test had several faulty tests, you didnt go to the w. H. O. Test . And we knew how quickly this was spreading . So the process as weve described, the emergency use authorization, really getting the test out and then using that initial experience to make sure that its working the ways that supposed to, when we found that that wasnt the case, we really looked at what was going on and thats where the new test has come from. The one that were talking about today. Reporter shouldnt we have been prepared given that we had weeks ahead of time, that we knew this was coming . We heard from Health Officials literally for months that this was going to spread here, that there was only a matter of time before an outbreak. And yet still the tests werent working when it got here. We Began Development of the tests within hours of the posting of the china sequence. So i dont think there was any delay on our side. Reporter even though in south korea, for example, they are testing 10,000 people a day once they had a diagnosis, and it took us a week, i dont even know if we have tested 10,000. As of sunday, it was 3600. I think the steps the secretary outlined will ramp up our capacity to test many, many more people than weve been able to test before. I think thats the right step at this time. [talking simultaneously] in our in our in our testing in the United States has been very consistent, if not even more aggressive than aggressive than similarly impacted countries. We are not korea. Korea is in a active hot zone outbreak as is northern italy. We have been ramping up our testing. Where we stand in the next weekend to have will place us impacted of similarly major countries around the world. We have been progressing on par with our peer countries. In europe, similarly impacted. Reporter do you think seattle should be shut down . Saysormer fda commissioner a city like seattle should be shut down. Let me ask the cdc if you might talk about Community Education steps. Community mitigation steps. When there is widespread virus transmission, there is a different approach to controlling that disease. That moves away from identifying more to moves that are communitybased. We have seen that some schools have been closed and that is to reduce transmission among children. There are discussions underway within the local government for how to keep people from congregating who might be affected. These are not individuals who are known to be affected should all to reduce the chance infectious person come into contact with a susceptible person. Reporter how will you make sure this vaccine is covered by medicare and medicaid . It is covered in medicare and medicaid. People in those programs can get tests. This is a common type of test. You get a swab for strep throat or for the flu test. These are the kinds of things that are covered. Private insurance companies, it does depend on coverage. This is something that is commonly covered. Reporter you cannot mandate this be an essential Health Benefit for private insurers. The essential Health Benefits are defined in law cared it is not enough i laboratory tests. Exchanges andual the products being offered, this is a covered service. That is provided. For private insurance, however Many Americans are not are covered, they cannot be certain this test will be covered by their insurance. People should check with their insurance company. This is a common type of test. A laboratory test. This like would cover they cover a flu test or strep throat. It is a commonly covered service. Do you all not moved by executive and executive action to mandate this . At this time with medicare and medicaid, we know that is being covered. We are going to continue to look at that. If it becomes an issue, we are going to make sure people have access to tests. The test is provided free by the state health department. People can always get a test. If there is an issue, that can be sent to the public labs. Put out someto information about costsharing. A medicaid program. It should not be an issue. The medicare program, we are going to put out information about what people should expect. The test is available free at the Public Health department. Are you investigating the kirkland nursing home. If so, what are you looking at . Thee a