Home, potentially away from enhanced nutrition, without the parent able to work because schoolprovided day care, without the monitoring that sometimes occurs for instances such as child abuse, but perhaps most importantly, for all children, the opportunity cost of a brain which is forming not having access to the information that would help that brain form optimally. Has there been any sort of riskbenefit ratio for the child . Yes, they are at risk for kawasakis, but at particular risk of missing out on the year of education, particularly those from less than rich backgrounds. Im very concerned about that. What are your concerns on that . You make a very good point, senator cassidy. The unintended consequences of trying to do something that broadly is important to the Public Health, and the risk of having a return or a resurgence of an outbreak, and the other deleterious consequences of having children out of school. We surely appreciate that. I dont have an easy answer for that, i just dont. We will have to see on a stepbystep basis as we get into the period of time, reopening the schools, exactly where will be in the outbreak. Something thats been alluded to throughout some of the questions, we have a very large country and the dynamics of the outbreak are different in different regions of the country. So, i would imagine that situations regarding school will be very different and one reason versus another. So its not going to be universally homogenous. I dont have a good solution when you close schools, and it triggers a cascade of events. Mr. Chairman, i would close by asking the permission of the chair sue to submit it for the record, an article that just came out in the journal of pediatric nursing, that children are at risk for covid19. It will be included. Thank you, senator cassidy. Senator warren . Thank you, mr. Thank you, mr. Chairman, and think you two are witnesses for being here today i hope everybody is staying safe and healthy. In the past 16 weeks, over 1. 3 million americans have been infected with coronavirus. We now know that about 80,000 33 Million People out of work. Dr. Fauci, you have advised six president s. You have battled i would just like to hear your honest senator, thanks for the question. If you think we have it completely under control, we dont. If you look at the dynamics of the outbreak, we are seeing hospitalizations and infections in some places, such an new york city, which has plateaued and starting to come down. New orleans. In other parts of the country we are seeing spikes. When you look at the dynamics of new cases, even though some are coming down, the curve looks flat with some slight coming down. So, i think were going in the right direction. But the right direction does not mean we have, by any means, total control of this outbreak. As i understand it, we have about 25,000 new infections a day, and over 2,000 deaths. I think those are the right numbers. Some are estimating we could be at 200,000 new patients a day y june. Is that right, dr. Fauci . I dont foresee that is 200,000 new cases by june. I am hoping and looking at the dynamics of things starting to flatten off and come down, that we will be much, much better than that, senator. Just so i understand, we are, right now, at 2,000 new infections a day, and 25,000 new infections a day, and 2,000 new deaths a day. Thats where we are right now. So let me just ask, we know that its possible to get this virus under better control. Other countries have done it, like south korea. But we are now three months into this pandemic, and basically weve continued to set records for the number of people who are diagnosed and the number of people who died. Dr. Fauci, you recently said the second wave of coronavirus is inevitable. But that if america puts in place all the countermeasures you need to address this, we should do reasonably well. And the countermeasures you identified were things like continued social distancing, significantly more testing, widespread Contact Tracing. He also said that if america doesnt do what it takes and this is your quote would be in for a bad fall into bad winter. Right now we are about 16 weeks away from labor day. Thats about the same length of time since the virus was first detected here in the u. S. Dont you have enough robust countermeasures in place that we dont have to worry about a bad fall and winter . Right now the projection, as youve heard from the admiral with regard to testing and other elements that are needed to respond, the projection is but by the time we get the end of the summer and early fall, that we will have that in place. We dont have it in place now. But we are projecting itll happen. Let me just ask, the other side of this. If we dont do better on testing, on Contact Tracing, and on social distancing, with will from coronavirus necessarily increase . Of course. If you do not do an adequate response, we will have the deleterious consequence of more infections and more deaths. Thats you quoted me, senator, quite correctly. Everything you said. I will stand by that. Because, if we do not respond in an adequate way, when the fall comes, without a doubt there will be infections that will be in the community. And we run the risk of having a resurgence. I would hope that by that point in time, in the fall, that we have more than enough to respond adequately. If we dont, there will be no problem. I hope we can assure the people that the federal government has this under control, but we cant. The virus is not under control in the u. S. We havent yet taken the measures necessary to prevent the second wave of deaths. We all know that people are going to be affected. See news essential workers, the people were out on the front lines. The president needs to stop pretending that if he just endorses that news itll go away. It wont. The time is over. President trump must acknowledge that the federal response has been insufficient and that more people are dying as a result. We are running out of time to save lives, and we need to act now. Thank you, dr. Fauci, for all youre doing. The urgency of the moment is not there. Thank you. Thank you, senator warren. Senator roberts . Thank you very much, mr. Chairman. Thanks for all the witnesses. You all are like the fab 4. I guess it was the fab 5 back in the day, but youre shining the light of truth in the darkness, the individual flashlights, for sure. Thank you, mr. Chairman, that the life or emphasizing we have to be bipartisan in our approach if we are going to get anywhere. Thats obviously in the eyes of the boulder. We have a great relationship with governor kelly, who happens to be her Emergency Management system is spot on. This morning i talked to josh and reading here you see this mirror behind may come of that is a stage coach coming into dodge as opposed to getting out of dodge. That city is my hometown. The hot spot in regards to kansas, mainly because of two packing plants. We have 26 of the cattle. At any rate, kansas is going through tough time. We shouldnt be worried about the safety of the food supply chain. Nationwide, its under a great deal of stress. We see that in derry, in poultry, in pork. They are euthanizing pigs. The department of agriculture has stepped up, so the preside president. Declaring these packing plants are a national asset. With progress, and dodge city, when we first started out, had five tests. Thats between 4 and 6, five. Not 50 million as we hoped to receive, as has been said by one of the witnesses. The reason i am really harping on all of the problems we are having in agriculture, on top of the fact that the relationship with china is such that even the first breakthrough with regard to trade to china seems to be on hold now. This is going on five or six years, where prices have been below the cost of production. In result, or consumers are figuring out that food doesnt come from grocery stores. Im very worried that the harm to the value chain is very real, not to mention the financial situation that our farmers, ranchers, and growers all face. Having said all that, i want to ask. Admiral giroir, he talked about the kinds of tests that are available. The five packing plants we have in kansas, if we could get a rapid test and we could get it as we boldly ask for because of the hot spots that are developing, not only in kansas but also doing great harm for the food chain, that would be absolutely wonderful. Would you speak to that, sir . Yes. Thank you, senator. Both dr. Redfield and i have been very actively involved in getting strategy for the industry, particularly in kans kansas. We are supplying very heavily the Public Health labs with rapid diagnostics, as well as surging them to areas like that. The one tradeoff is the rapid pointofcare diagnostics are very slow. Each machine could only do four per hour, and thats very, very slow. It is a mix of testing that you need in these kinds of situations, on sort of the tests that are available at a major lab, a quest lab right there in kansas, as well as a mix of the rapid testing. Thats what we are supplying in order to provide a comprehensive, holistic solution. I believe cdc is on the ground as well in kansas, supporting that. I appreciate that. If youre only doing 4 an hour, thats not a rapid test. Maybe its a rapid slow test, im not sure how you define th that. As we reopen and, by the way, governor kelly start of the opening process the first of this month, may 18th, then we go to june. But we do have contingency pla plans. As aptly described by dr. Fauci, i think well be all right. But this is going to be a tough go. I have to tell you, in terms of agriculture, we are not in good shape. I appreciate everybody in the job that you are doing. We will stand beside you when you are taking the boos and beside you when you are taking the bows. Thank you, senator roberts. Senator kaine . Thank you to the chair, community leadership. The time that dr. Fauci and dr. Hahn were before it was march 3rd, i have a slide that i want to show whats happened in america since then. The chart, which is here, compares the experience of the United States and south korea on three days. January 21st, both nations experience their first case of covid19. That that time the on employment rates in both countries were essentially identical. On march 3rd, when the witnesses were last here, south korea had experienced 28 covid19 deaths, and the u. S. Had experienced 9. Again, the economies of both nations is measured by the end employment rates were a newly identical. Now the story changes. As of yesterday, more than a 1,000 americans have died, and the u. S. Economy has experienced job losses not seen since the great depression. Meanwhile, the economy of south korea has not changed dramatically at all. The death toll is not 256. South korea is smaller than the United States, 16 of our population, but even if you bulk up the death toll to reflect the difference, the per capita death toll in the u. S. Is more than 45 times the rate and south korea. This is causing a new depression while south korea has projected its economy by managing correctly. I could have done this chart with other nations, the u. S. Has the seventh highest per capita death rate the world. Our death rate is off the charts higher than that of india, australia, new zealand, japan, and mexico. Its nearly three times the death rate in germany, twice as high as canadas rate. The question is, why . If we want to open up our economy and schools, do have to learn the lessons of nations who have managed this well . Here are things that dont expend the difference. Our hospitals are as good or better than those in south korea. Our health care providers, heroes, are as good or better than those in south korea. Our Research Capacity is as good or better than that of south korea. And we have more resources than south korea. Our gdp is 12 times south koreas, and our per capita income is 60 higher. So come to dr. Fauci, the death rate in the United States, especially when compared with other nations, is unacceptable, isnt it . Excuse me, sorry, sir. Yes, of course. A death rate that high is something that, in any manner or form, in my mind, is on except it will. Dr. Fauci, the experience of other nations chose the u. S. Death rate is not only unacceptable, but its unnecessary. Isnt that correct . I dont know if we can say that, senator. But would you say the u. S. Has to do better . Of course. You always have to do better. And the experience of south korea shows how a nation manages the Health Care Crisis has a huge impact also on its economic condition. Isnt that the case . That is the case, sir. I understand where youre going with this, but i have to tell you, is a big difference between south korea and the United States in terms of the outbreak. And let me get to that. I want to get two factors that do explain the difference. Its not resources or health providers. First, testing. South korea began aggressive testing measures in the u. S. Now in the fifth month of the pandemic we surpassed south korea in per capita testing. But in march south korea was testing its population at a rate of 40 times the testing in the u. S. Admiral giroir, dr. Giroir, has set out the standard for us. When we get to september, he says the United States needs 4050000000 tests a month to be safe. That equates to about 1. 3 million1. 7 million per day. Yesterday we did 395,000 tests. We got a long way to go. A second factor is Contact Tracing. South korea embraced a rigorous Contact Tracing program right from the beginning. The United States still has not engaged in a national Contact Tracing program. Isnt that right . Would that be dr. Fauci or dr. Redfield . I think that question would best be directed to the cdc, not the nih. When the outbreak started, sir, we had an aggressive Contact Tracing program. Unfortunately, as the case grows, it went beyond the capacity of mitigation. So, we lost the containment edge clearly and that was key to the economy, as well. South korea did a testing, and Contact Tracing, protect, serve, isolate the sick. They didnt have to do shut down, which protected their economy. Finally, the last one, Health Care Systems. Would you agree with me that it helps keep people safe from serious conditions or death through covid19 if they have access to health care . Yes, of course. Of course, thats the case. And south korea, 97 of the population has Health Insurance. The United States, before covid19, millions didnt have it and lacked access to health care. Demands of job losses in the past months threatened to take Health Insurance away from millions more. And President Trump is doing all he can to dismantle the Affordable Care act, which would take Health Insurance away from tens of millions more. Lets lay in the lessons from those who are doing this right. Thank you, mr. Chair. I yield back. Can i make a clarification please, mr. Chairman . This is brett giroir. I just want to clarify that i did project that we have the ability to perform 4050000000 tests in that time frame. If needed, at that time. Im not making a proclamation. We have to understand where the epidemic is, with the Community Spread is, before we can estimate the number of tests that are needed. I was simply stating the fact that our combination of testing capabilities will be at that level, even barring new input from the nih. Thank you very much, senator kaine. Thank you, mr. Chairman. Gentlemen, thank you for being here this morning virtually but also for all you have been doing for these many, many months. Doing okay right now, from a numbers perspective. Quite honestly, we want to keep it that way. Because we know we have exceptionally vulnerable populations. We know we have a geography that is challenging. We know we have facilities that are very limited. Last hearing, we had an opportunity to hear from dr. Collins, and he shared where they are with a red x and spoke to red x up, which is interesting about what we can be doing in rural areas. By focusing on hot spots. As i reminded him, we dont want to be a hot spot in alaska. Every effort that we have made to keep the virus out of alaska is lives that are saved. I educated him on the community of cordova, that is getting ready to open its fishery in two days. And was able to share that they had one worker testing positive, as he was coming in from the lower 48 to come to work. The good news on that is that all the protocols we have put in place seem to be working. The quarantine, the isolation, theyre not only for that individual but for others he had come in contact, were secured. I want to recognize the assistance that we have received from the administration. Dr. Eastman is in the state at this moment, the chief medical officer for the parent of homeland security, going out to rural communities, to really better understand our vulnerability. Going to our fishing communities to, again, understand how we can successfully prosecute a fishery when you have to bring in workers from the outside. We thank you for the assistance with regard to additional testing capacity. Ive been in contact with our chief medical officer, and the mayor of cordova, to better understand what we need on the ground. What are the things that i would like to have clarified . And this is probably to you, dr. Giroir, because youve been so helpful and kind of shining the light on what we need to be doing in these rural areas. So much of the focus has been on hot spots, and responding to the hot spots. But how do you keep those rural, remote, small communities from becoming hot spots in the first place . Are we doing enough . Right now the strategy has been that we just walk it off. The travel restrictions that are in place are apparently working, but they are also devastating our economy. Whether its tourism, whether its our resource industries, or whether its the potential for our fisheries. Admiral, if you might speak to that aspect of it, and i have a very important question as it relates to Contact Tracing that i would like to directed to either admiral giroir or dr. Redfield. Thank you, senator. As you know, you have an outstanding state health officer. We do. Ive had the privilege of working with her, and you have a very good protocol in trying to keep al