We are tracking the increase and the rate of increase of new cases at the county level. We currently have 130 counties out of the 3100 in the u. S. In that category. This level shows you case positivity by the metros and the number of tests that have been done. This shows the change over time of test positivity and the largest metro where we have concerns. Phoenix, houston, dallas, san antonio, orlando, riverside, california and then to the bottom. This is how we continue to integrate data cases, data on testing and on hospitalization so we can work with the states for comprehensive integrative response. I know many of you would be interested in seeing how high test positivity became. March and april, the top line is new york city metro and you can see it reach over 50 on a series of days for almost two weeks. 50 of the tests were positive for covid19. Under that, you see new jersey and minnesota and a series of individuals. Detroit is the second one. To show you how you look at the state level and work with the governors and local health authorities, this is florida. We track testing, the number of test positives in the blue line, total number of cases in the black bar and what we call syndromic presentation of early respiratory diseases and pneumonia. Then we look at the county level to look for changes in the slope from the number of new cases. You can see the top county with the largest increase in scope and cases is miami dade, followed by broward and palm beach. All of the counties are much lower in the daily case increases. This allows us to focus resources and testing along with the state and these specific specific sites. This comes together to create this graphic so individuals can understand and we can understand precisely the rate of growth and where it is occurring. By the shading of the boxes. I will quickly take you through texas because its the same story. This shows you the same graphic, now shown for texas showing a continued rise in daily tests performed but also a rise in the test positivity, the blue line. You can see throughout may after opening, their test positivity continued to decline as their testing increased. It was the last two and a half weeks that we saw this inflection of rising test positivity with rising inflection. But it was the increase in rising test positivity that alerted us along with increased cases that this was becoming an alert. Everything is heat mapped so you can tell at a glance two boxes in the middle that are red, its a heat map showing of rise in cases and rising test positivity. But even in texas, this gives you a map of texas, it shows you where the cases are and where they are rising most rapidly. Finally, im going to go through arizona quickly along with california. Next. Same situation we are showing here with arizona, rising number of testing but also rising test positivity rise in cases. Arizona is unique and they have essentially one county primarily represented by the depth of the new cases and this was in the phoenix area. Next slide. This is california. Can see california over the last week has had that increase in test positivity, you can see the dramatic increase at the end in the blue line along with increasing testing that has been done and we want to thank the governors and the work and laboratories that has allowed us along with hhs to ensure the supplies were there, to increase these orange lines. You can see in each cases, they have dramatically gone up over the last four weeks. Like new mexico, the primary infections right now in california, at the highest level are in the l. A. Area but because l. A. Is a large metropolitan area, you really need this kind of more specific and local graphic to show that is increasing in the central valley. This gives us the ability to focus resources among Agricultural Workers to improve testing and isolation for those who become positive. I wanted to take you through how we look at data, how we consolidate the data and report out to the government monday. Out to governors on monday. We hope to over the next week have this Data Available in realtime on the white house , website so everybody across the country can see where the cases are because in the end, we want to call to action, when we started talking about what can be done, we said the most important thing that would change the spread, i know tony is going to talk about it. Is individual behavior and respect for one another social distancing, wearing a mask and ensuring we are protecting the most vulnerable that may be in multigenerational households. And i want to end by thinking thanking millennials who have come forward and i know during the protest we asked a lot of them to go forward to get testing. Testing rates are improving in the under 40 age group. Its important to continue to accelerate testing among the under 40 age group because thats the age group most likely to have asymptomatic spread and be spreading the virus unbeknownst to them. No one is intentionally spreading the virus but they dont know they are positive, they dont have symptoms and need to be tested to have that awareness so we want to thank them for coming forward and enriching the amount of testing done in the under 40yearold age group. Our older population, you know if you have comorbidity, if youre over 80, we ask you in these states having expansion in cases to continue to take shelter as much as you can use your grandchildren to do your shopping. Dr. Fauci thank you very much. I want to extend some of the comments made by the Vice President and doctor birx. It has to do with the situation you find ourselves facing right now. It is very clear from the maps you saw that there are certain areas in the country states, towns, cities and regions doing well. They have followed the guidelines and opened up in a prudent way thats been effective. However as you can see we are , facing a serious problem in certain areas. Know when you look at the map, it is interesting because you see some dark parts of the map and some light parts of the map. We have a heterogeneous country but that does not mean we have not intimately interconnected with each other. So what goes on in one area of the country, ultimately, it could have an effect on other areas of the country. Lets look at this problem we are facing now, this resurgence of cases. I dont think theres time to try to analyze and figure out the multifaceted elements, everything from opening a little too early on some, to open at the right time but not actually following the steps in an orderly fashion to actually trying to follow the steps in an orderly fashion but the citizenry did not feel they wanted to do that for number of a number of reasons likely because everyone feels the common feeling of being pent up for a long period of time. So we are not going to say blame, were not going to try to analyze but theres something important about it that i like i would like to get a message to the country in general. When you have an outbreak of Infectious Disease, its a dynamic process that is global. So remember what happened in china, it affected us. What happened in europe affected us. What is happening here is affecting others. That. Not get away from it is interconnected. So we are and interconnected society. We half to look at the fact of what our role is in trying to put an end to this. Everybody wants to end it and get back to normal. Everybody wants the economy to recover. I think we are all pretty common and that. That is a given. So what can we do . What i think upon talking to people and reflecting on it, we have such an unusual situation because in all the decades ive been involved in chasing Infectious Diseases, ive never seen anything so protean in its ability to make people sick or not. Theres no other Infectious Disease that goes from 40 of the people having no symptoms to some having mild symptoms to some having severe, some requiring staying home for weeks, some going to the hospital some getting intensive , care, some getting intubated, some ventilated and some going dying. On where you are in that spectrum you have a , different attitude to this particular thing. But anyone who get infected is at risk of getting infected to a greater or less degree is part of the dynamic process of the outbreak. And i know because i can understand when i was in a stage in my life when i said im invulnerable so i am going to take a risk, i think what we are missing is something weve never faced before. A risk for you is not just isolated to you because if you get infected, you are part, innocently or inadvertently, of propagating the dynamic process of the pandemic because chances are, if you get infected, youre going to infect someone else. Although you may feel well and if you look at the numbers, the overwhelming majority of people getting infected are young people, likely the people you see out in crowds, enjoying themselves, understandably, no claim there. No blame there. But the thing you need to realize, when you do that, youre part of the process. If you get infected, you will infect someone else. We know if that happens because the reproduction element of the virus is not less than one so people are infecting other people. Ultimately, you will infect someone who is vulnerable and it may be somebodys grandmother or grandfather, uncle who was on chemotherapy, aunt whos on radiation, or a child who has leukemia. There is what i call and i want to bring this out without making it seem anybody is at fault, we have an individual responsibility to ourselves but you have a societal responsibility because if we want to end this outbreak, really end it, we got to realize that we are part of the process. So when the Vice President went , back, pulling back a couple of months ago, when we showed about the guidelines to safely reopen the country, weve got to make sure we drop back a few yards this is part of a process that drop back a few yards and , think about that, this is part of a process that we can be either part of the solution or part of the problem. Witht to make a plea people who understand the stress we are under as we try to capital not only those states but the lightcolored part of the country, even though theyve done well, they may have gotten hit badly like new york or they may not have got hit badly at all, they are vulnerable. If we dont extinguish the outbreak, sooner or later, even ones doing well are going to be honorable to the spread so we need to take that into account because we are all in it together and the only way we will and it is by ending it together. Thank you. Thank you all for first, joining us to update the American People. I want to begin by thanking everyone around the country working to defeat the virus. All of the Healthcare Providers on the front lines, those working to reopen our economy safely, the American People who have sacrificed so much and the incredible numbers of our hhs team who have been working tirelessly to protect the health and wellbeing of all americans. Before covering todays topic, i want to mention a major milestone for Global Health yesterday. The end of the secondlargest Ebola Outbreak in history in the eastern democratic republic of the congo. We congratulate the government and healthcare workers and Community Members involved some of whom ive had the chance to meet and thank in the drc last fall. Under President Trump, the u. S. Was proud to play a bigger role in this major victory than any other single nation. Now thanks to the president and , Vice President of leadership and hard work of our team, america has never been readier to combat covid19. We developed readiness under the strategy we developed to address searches and defeat the bars. Defeat virus. We are in a much stronger position to support hospitals and individuals as they fight back. There are six parts to the strategy. Surveillance, containment, healthcare capacity, therapeutics and vaccines. We have been strengthening surveillance so we can be aware of and respond to surges. That means being able to track more cases among younger americans we never would have caught earlier in the pandemic. We have the worlds greatest we have the worlds greatest testing capabilities enabling us second, to confirm the presence of the virus when it crops up and we are confident the capacity will continue to rise in the coming months. Third, states are building the capacity to track and contain outbreaks of the virus with federal help, many states have substantially expanded the arewn capabilities and we deploying knowledgeable experienced cdc and hhs Public Health teams to the areas now seeing increases with a focus on Community Testing and Community Based interventions. Fourth, we are helping Healthcare Systems secure sufficient capacity and supplies. We have dramatically expanded American Manufacturing of ppe and the fda authorized new technologies to sterilize equipment for reuse. Weve spoken with hospitals and states building up their own ppe reserves, many of them getting up to 60 or 90 days of supplies. Nationalhe strategic stockpile, we have more supply visibility into needs across the country including centralized , coordination capabilities that we lacked a few short months ago. Using Healthcare Providers around the country and seeing how they are adapting to bring patients back while taking appropriate precautions. Americas hospitals are ready to get back to business while maintaining their readiness for covid19. The fifth and sixth elements of the strategy are thanks to the president s operation warp speed. We have promising therapeutics benefiting tens of thousands of american patients and in all likelihood have already saved thousands of lives. We identified two promising pharmaceutical treatments, and dexamethasone. Nd allocatedy we have 120,000 courses to all 50 states. We have added eczema zone to our treatment guidelines and it is reasonable to assume other corticosteroids which may be , more readily accessible in some places would have similar immunological effects. Another promising therapeutic, convalescent plasma has treated 25000 americans and 3000 sites across the country. There are no certainties in science but with more than 140 Clinical Trials underway in the u. S. , it is a safe bet more good news on therapeutics is on the way soon. Finally we have announced large investment to support three different vaccine candidates through to manufacturing. These are now in human Clinical Trials, some with potential to deliver safe and effective low safe and effective doses before the end of the year end and we will be adding support for several more candidates. There expanding manufacturing capacity and already making the files, needles and syringes we may need. Our capabilities have grown exponentially in the time allowed by the patriotic sacrifices of the American People. Give a much better grasp the virus and much more data to model it. With that data, we can focus on local trends. We have some very concerning hotspots. And we can track when other hotspots emerge as we expect they may. We are focused on the states and counties within the state, 3 of counties that represent hotspots. Its important for the American People to be aware of this variation across the country. Americans need to understand their local trends because we want to help people make the right decisions for themselves. Making decisions for yourself has to be based on three axes of risk as our Surgeon General taught us in march. You want to assess where you are, who you are and who you live with and what activity you are thinking about doing. There are gradations of risk within each of these. Going to an outdoor restaurant in montana is different from a crowded indoor bar in houston. When you interact with fewer people in an activity, when you you interact with them for shorter period of time, your risk is reduced and individuals can balance these kinds of factors. What i have laid out today is remarkable progress by the president S Administration and a particular credit to the team here at hhs. We have got a lot of work ahead of us but americans can be confident we have a Rock Solid Foundation to help us get safely back to work, back to school, back to worship and back to healthcare while we tackle surges of the buyers where they where theyrus, occur. Thanks to President Trumps leadership, we have got capabilities, knowledge and strategy to protect americans livelihoods at the same time and every american should feel proud of that. Thank you. Dr. Hahn thank you mr. Vice president. I wanted to add some comments, once again, i want to thank all of dr. Redman i wanted to add some comments, once again, i want to thank all americans to embrace the importance of social distancing recommendations to slow the spread of covid. We are not defenseless, these are very powerful weapons and is our collective responsibility to recommit ourselves to put them into routine practice. Stay 6 feet apart from each other as much as possible, where wear Face Coverings in public. And practice figures hand practice vigorous hand hygiene. As we heard today, do our part to protect the vulnerable. I also want to appeal to the millennials and those under 40, it is important that this group commit themselves to these practices to protect those at risk and its not just the elderly at risk. Many of us may have friends and colleagues who are younger and may not advertise their underlying comorbidities. As the case would be with type one diabetes or an underlying immune deficiency. Again, asking this team, millennials and younger people in this country to commit themselves. I agree with ambassador birx, we are thankful the group is coming forward to get tested but i also want this group to put into vigilant practice the importance of our social distancing. One thing i want to stress is there are differences in what we are expanding today and what we all experienced in march and april and may. One of the things i want to focus on is not the case is what not the cases, per se, but consequences, the impact of those cases. It was not too long ago probably , within two months a