Do more to help support these states. Congress has, uh, spent a lot of money. Theres a need for that. Ill speak for Ohio Governor mike dewine and california governor gavin newsom, in moments. President trump cuts loose another Inspector General, this one investigating his secretary of state. Will any of his republican allies act . Wisconsin republican senator ron johnson joins me to discuss, next. Hello, im jake tapper in washington where the state of our union is opening. This morning there are nearly 89,000 americans dead from the coronavirus. The speed at which this virus has killed is just horrifying. Just two months ago the number of dead was 87. As the death count continues to rise, life during this pandemic is beginning to change. The majority of states across the u. S. Are taking steps to reopen as the number of new cases across the country are falling. While the nation grapples with how to balance reopening and staying safe, former president obama made rare Public Comments criticizing American Leadership in two different televised commencement addresses. More than anything, this pandemic has fully, finally torn back the curtain on the idea that so many of the folks in charge know what theyre doing. A lot of them arent even pretending to be in charge. The criticism from obama comes at a time when President Trump anding h ing hihis team ag an unprecedented Smear Campaign against any rival, ranging from bizarre false conspiracy theories to spreading false allegations of pedophilia to even suggesting one tv anchor committed murder. These Smear Campaigns are unmoored from reality, theyre deranged and indecent and seem designed to distract from us this horrific health and economic crisis. It is that pandemic well focus on today. Joining me now to talk about the pandemic, secretary of the department of health and Human Services alex azar. Secretary, thanks for joining us. 48 states will have eased restrictions in some form by tomorrow. Its unclear how many of these states have met the Coronavirus Task force guidelines to begin stage 1. We see a crowded bar in wisconsin, a boardwalk in new jersey, another crowded bar in ohio. Does it concerns awe heal you a secretary to see these images . Jake, thanks to the president s historic response efforts and the collaborative work of our governors and heroic Health Care Workers on the front lines, were in a position to reopen. The president has left it up to the states to know their local situation the best. Its very hard to judge in any Community Whether a bar being open, a restaurant, a school is the right thing. Thats why the local leaders lead this, the state supervises, and the federal government provides expertise and support from our level. It depends so much on what the Disease Burden is. In almost half of our reported counties, weve had not a single death. 62 of covid cases come in just 2 of the reported counties in the United States. These are very localized determinations. There should not be one size fits all approaches to reopening. But reopen we must, because its not health versus the economy. Its actually health versus health. There are Serious Health consequences to keeping us shut down, whether its the suicide rates or cardiac procedures not being received, pediatric vaccinations declining. All of these are Critical Health needs that are part of reopening the economy. But in a crowded cities, ill pick one, for example, columbus, ohio, the u. S. Surgeon general says, if you go out, wear a mask, practice social distancing. You see these images from crowded bars in places like columbus, theyre not Wearing Masks, theyre not practicing social distancing. That doesnt concern you . In any particular instance youll see people doing things that are irresponsible, thats part of america. If youre in crowded areas and if youre in an area that has Ongoing Community spread of disease, there are steps you should take. Thats what our guidance is there for. We count on local leaders to implement and interpret that according to the local situation. But weve got to get this economy and our people out and about, working, going to school again, because there are Serious Health consequences to what weve been going through. Yeah, i dont think anyone disputes that we need to take steps to reopen. Its just a question of whether were doing so responsibly. Let me ask you, this is intrigue to go m ing to me, because some states have been reopening despite warnings of dire consequences from Health Experts. States like georgia and colorado began reopening weeks ago and it seems at least so far that we have not seen a dramatic spike in new cases from those two states, georgia and colorado. What have you seen from those states . Is there any cause for concern that they reopened early . Is it still too early to tell . Or are they taking measures such as social distancing and masks that make this reopening work . Jake, i think your question is very insightful. We are seeing that in areas that are opening, were not seeing the spike in cases. We still see spikes in some areas that are in fact closed, very localized situations. And so this is going to be very important for us to watch the circumstances on the ground. With reopening, whats the key to reopening . First we need to have good surveillance. So we need to look for influenzalike illness and other respiratory disease. We have a great Surveillance System for that. We look for spikes and early indicators. We have adequate testing capacity. We need to make sure anybody who is symptomatic is tested and that we have adequate asymptomatic surveillance in areas of greatest burden. Senior living, congregate living situations like prisons or meat packing facilities where people are close together. So we look for early indicators. Then we use the traditional Public Health tools to surge in there. We would test everybody there. We would do Contact Tracing and isolation. Thats where places like georgia and colorado, as they reopen, its these tools that allow us to be reopened, but do so in a safe way that lets the economy function but allows us to use the traditional tools of Public Health to move forward as we would with any other disease. Lets talk about surveillance testing and Contact Tracing, because the white house has been able to keep its workers and you and President Trump and others who go to the white house safe because you are conducting at the white house regular testing, surveillance testing, Contact Tracing. That would be a great way to keep, as you know, a meat packing home or retirement plant safe, regular testing, Contact Tracing. But when will the rest of us get that same kind of protection that the white house gets . Because i dont think there is that level of testing at the most vulnerable places like youre talking about, prisons, meat packing plants, nursing homes. So thats actually part of the ongoing plans for the country that you have targeted. But the notion that you would test 330 million americans every morning to say whether they have covid is not realistic nor seriously treated by Public Health experts. Even at the white house not everybody is tested everyd day. Its only if you will have contact with the president or Vice President that day. I think youll agree, jake, those two roles are unique. In our meat packing plants and nursing homes, we are testing, were connecting them with testing at labcorp and quest, as part of syndromour plan to surgd contain outbreaks when we have syndromic cases. Well be progressively moving from mitigation back to containment, outbreak, circle, contain, and control situations like that. I dont think anybody expects that were all going to be given the same Health Benefits as the president of the United States, the commander in chief, of course. But i do think, if were trying to get our economy open, lets take schools, as an example. I have two children. If my two children went back to school in september and every student, every teacher, every person who worked at that school were tested before they could go in, and then the ones who tested positive would be isolated, and then a test like that happened, i dont know, every month, i would feel a lot more secure about sending my kids to school if there was that kind of aggressive testing for that school. Now, im not saying every american should be tested every morning, of course not. But every Health Official ive talked to, including you, says there needs to be more aggressive surveillance testing. When are we going to get up to the level where people could have some peace of mind, i know i can go back to work because we tested everybody before we went back to work and we isolated people and we do this every month now or Something Like that . When will we be able to do widespread broad based testing and Contact Tracing for every american . We have had 10 million tests done. Public Health Experts say as a gauge of whether you have adequate testing for surveillance purposes you want to be seeing a Positivity Rate of 10 or below. Nationwide were at 9 . 38 of our states are at that 10 or below goal. The others are progressing towards that. Well have 12. 9 million tests administered as the projection just in the coming weeks, doing 300,000 tests a day. And were going to be bringing online something, jake, that i think is quite exciting, which is going to be these antigen tests which are rapid tests, antigen tests, the look would be Something Like a pregnancy test, whats called a lateral flow device. Were working with manufacturing on improving those. Those are very high volume, point of care tests. That will be part of the recipe for the future. For those kinds of situations like you rightly say as a parent, those concerns for our nursing homes, our prisons, our meat packing facilities, to aid us with broad surveillance and testing. President trump has, over the last couple of months delivered just a historic transformation of testing thats now become one of the models in the world with the most tests administered of any country in the world and were really on the right track here for the future. Okay. I dont want to belabor the point but 10 million tests over the course of 3 1 2 months is not sufficient for 328 Million People. I know you know that it needs to increase. I want to ask about the vaccine, because that was a big focus for the administration this week. President trump at that same press conference, at which you are heralding, the administration was heralding the possibility of a vaccine by the end of the year, the president said, quote, vaccine or no vaccine, were back, unquote. For americans who are listening to the president , can you explain in practical terms what he means when he says were back . I mean, we still need to wear masks. Can we have weddings or large gatherings . Will grandparents be able to visit new grandchildren . How are we back . So what the president was making the point on is, everything does not depend on a vaccine. Were committed to delivering a vaccine, well put the full power of the u. S. Government and our private sector towards getting a vaccine, but thats one of a multifactorial response program. First is the testing we talked about before, broad surveillance to find cases, surge in and contain. Also therapeutics. Were driving forward on convalescent plasma to be able to treat people. Well take hypo immunoglobulin and create concentrated protective immunity for individuals. We have monoclonal antibodies that will allow to us replicate in an individual immune response from somebody who has already recovered from covid. From that we deliver a vaccine. Its a multifactorial approach that will help us get the Disease Burden down and use traditional Public Health tools so we have our weddings, so we visit our grandparents, so we resume normal life at school and work. Secretary azar, you were saying our testing is now the model of the world. But i have to ask, the u. S. Has less than 5 of the worlds population but has 30 of the worlds officially reported coronavirus deaths. You said back in january that, quote, the risk is low, our job is to work to keep it that way. Did the u. S. Government fail . Why is this virus hitting our country so much harder than its hitting other countries . So, first, just in terms of the actual case counts, were testing more than other major countries so were seeing a tremendous number of cases. Remember, were actually flushing out significant asymptomatic individuals in the United States. Other countries are not testing asymptomatic individuals in any way like what were doing. Look, for instance, at japan, which has a very low case count, but does very little testing on individuals. In fact i think you have to be several days febrile in order to even get a test there. That leads to a significant difference. What did the president do here . We defined in january a core strategic objective. We said, i said this very clearly, we cannot hermetically seal off the United States from a virus. This virus will spread, this virus will come here. We said our goal is to delay the curve and to flatten the curve and that is exactly what we did through the historic Border Control measures and then through working with our Health Care Systems and our governors, our heroic front line health workers. While the burden has been tragic and terrible, it has remained within our Health Care Systems capacity. As the president said, we havent had any individuals to our knowledge who had to die because they didnt have a ventilator or didnt have an icu bed and thats a really important measure of Health Care System resilience and thats whats enabling us now to do what weve talked about, move towards reopening and getting back towards a normal state. I understand that, but we have almost 90,000 americans who are now dead because of this. I dont think that this is anything to celebrate. Oh, jake, you cant celebrate a single death. Every death is a tragedy. But the results could have been vastly, vastly worse. Its also important to remember, jake but its worse for us than it is for anyone else. Thats actually not factually correct, when you look at mortality rates as a percent of diagnosed cases. The number of dead bodies. Every death is tragic, but we have maintained our Health Care Burden within the capacity of our system to actually deal with it. Unfortunately the American Population is a very diverse it is a population with significant unhealthy comorbidities that do make many individuals in our communities, in particular africanamerican, minority communities, particularly at risk here because of significant underlying Disease Health disparities and disease comorbidities and that is an unfortunate legacy in our Health Care System that we need to address. But no, the response here in the United States has been historic, to keep this within our health care capacity, even in new york city, to keep this within capacity, is genuinely an historic result. I want to give you an opportunity to clear it up because it sounded like you were saying the reason there are so many dead americans is because were unhealthier than the rest of the world. I know thats not what you meant. Oh, no, we have a significantly disproportionate amount of obesity, diabetes, these make any type of Disease Burden of course, but that doesnt mean its the fault of the American People when the administration didnt take adequate steps if february. Please dont distort, jake, this is about simple epidemiology and stating that if we have hypertension, if we have diabetes, we present with greater risk of severe complications from this coronavirus. Thats all i was saying, and you know that. This is not one doesnt blame an individual for their health conditions. That would be absurd. Its simply a statement that we do have greater risk profiles here in the United States. And this is why weve all highlighted the surgeon general, the president , weve highlighted the special Disease Burden and risk factors in a lot of our communities that weve got to address. No, of course, no one would dispute that. Let me ask you one last question. There is a lot of disinformation out there, as you know. Last night on cable, someone said that the shutdowns that the states have taken, the governors, are just an effort to hurt President Trump by preventing him from holding rallies, the same person said the day after the election, the virus will disappear. I know you know thats not true. Whats your response to that . We need to have balanced information, thats all Public Health leaders are trying to do, present the fact that were now in a position where we can be reopening. We want to tak