Be protected. Please wait until we have those tests available and validated. People are working around the clock to make those available to the American People. We all understand how important that is, because youve heard us talk about asymptomatic cases. We really want to know how broad that is and how common that is. Telling places like new york city where i described that they had 7 per thousand, sometimes two or three or four times any other place in the United States, being able to know what the number of people who never had symptoms but do test positive would be really critical at this point. Particularly as we planned for any reoccurrence in the fall or in the future. Thank you. At the center for medicaid and medicare services, we will discuss what we have done in hospitals to help support Health Care Workers. We will be sure the institutions are providing the environment for care are wellfinanced and she has a couple of funding streams and help is on the way. Thank you mr. Vice president. Let me start with echoing the president and Vice President s comments about our condolences to all the people out there that have lost somebody to the coronavirus. And also a sincere appreciation and thanks to all our Health Care Workers that are on the front lines. We know the impact on the Health Care System isnt just those front care and frontline workers. Health Care Organizations across the nation are having increased expenses and having to spend more on supplies. You are seeing all of the supplies that are being sent to them, and many of them are having increased expenses because they are taking advantage of some of the flexibilities that weve given them. Hospitals without walls, and we are doing testing and screening. We are doing a lot of increased expenses as well. Other health Care Organizations are not performing essential surgeries for other services. A lot of them are moving to a telehealth and that represents a lost revenue for these health Care Organizations across the country. Their president address this issue a few days ago, and medicare revenues that they received. In ten days weve been able to provide payments to providers. That request about 70 of these that have happened in about five days and the total on that is about 34 billion that weve managed to put into the health care yet. Those are essentially loans. And that provides youve heard secretary azar focusing on the dollars going toward the uninsured. This week we will be putting out another 30 billion which are grants. This is going to be based on medicare revenue. There are no strings attached. So the Health Care Providers that are receiving these dollars can essentially send that as they see fit. We actually do direct deposit with them and so those dollars will just go right into their bank accounts. For other providers all that will require is some simple registration and be able to give them that money as well. The other thing to note is that this is not a firstcome, firstserved basis because we are basing this on their medicare revenue. Even if it takes a few days there shouldnt be any panic in the system as well. As quickly as possible, we heard that from the many Health Care Providers across the country that weighed in on this. They said the most important thing is to get these dollars out as quickly as possible. But we recognize that getting these dollars out based on medicare revenues, pediatricians, childrens hospitals, obgyns and even our nursing homes, a lot of our revenue comes from other sources, medicare or other payer sources. Those will be addressed in that second tranche of funding. Also, i just want to say, so together between the loans that i put out there in the accelerated payments in the 30 billion, thats about 64 billion for the Health Care Systems this week alone. I think again this is part of our effort to support the Health Care System and i also again want to say thank you to our Health Care Providers out on the front line. And all we can do is to adhere to those guidelines to slow the spread. I just want to make a brief comment to get back to the discussion about the Health Disparities. It really is very important. I couldnt help but sit there reflecting about sometimes when you are in the middle of a crises like we are now with the coronavirus, it really does have ultimately shined of very bright light on some of the weaknesses. The greater proportion of my professional career has been defined by hiv aids. There was an extraordinary stigma, against the community. It was only when the world realize how the Community Responded to this outbreak with incredible courage and dignity and strength and activism, i think that changes some of the stigma against the community, very much so. I see similarity here because Health Disparities have always existed for the africanamerican community. Thats how its shining a bright light on how its unacceptable it is because yet again when you have a situation like the coronavirus they are suffering disproportionately. As dr. Byrd said correctly, its when they do get affected their underlying medical conditions. The diabetes, hypertension, obesity, the asthma. Those are the kind of things that wind them up in the icu and ultimately get them a higher death rate. So when all this is over, and as we said, it will end. We will get over coronavirus but there will still be Health Disparities which we do need to address in the africanamerican community. Thanks. Questions for the panel please . On the ventilator issue with 8400 of them in the stockpile and thousands more coming, why are states like california and washington to send ventilators to other states, and may they need them later on . Is a real credit to the people in both states to see the progress that weve made. We continue to witness that the numbers, weve seen that the governor of california do and the governor Washington State do, and the governor of oregon, where the coronavirus hasnt arrived to a large extent in oregon, i think in keeping with the highest tradition of the american spirit. And they are understanding. I think americans are understanding more and more that while we tend to think of this as one large curve in our minds for when it began in our country and we long for the day that it will end, and we want to hasten that day. If by putting into practice all these mitigation efforts. The reality is what these, theyve explained to this layperson that what we are actually going to witness as a number of small curves that will cumulatively let curve. For oregon, Washington State and california to recognize where the need is hand it to partner with us in the fema to make sure the resources are there at the time of the need and the point of the need i think is really inspiring. Dr. Burks, did you want to speak to that . I want to be clear, we didnt ask for ventilators, they looked at their epidemiological curves. These states have Amazing Health commissioners and i think when this is over we will really all of the models were based on something we had never attempted to do anywhere in the world. We have never attempted to do this kind of medication. It was always theoretic to many individuals. And now we see across the globe, people mitigating against this virus. Realizing that their own behavior have changed the course and future of this virus. And we are competing against this virus and doing well. We looked at their curves and looked at their hospitals, and we decided to make that needed at this time. We are doing that three per thousand, seven per thousand and four per thousand. We need other states and other communities to understand how to do this better next time. And i think thats what this will teach us because we never attempted anything like this. And, weve never put out information like that. I think you are the cdc director talk earlier in the model about how different individuals thought communities would mitigate, and the rate at which they would mitigate, and i think you can see that across the world, we are learning you need to understand whats going on and you are Transparent Community is can be a part and transparent. That education and dialogue is always critical. I think when i first started five weeks ago i said we will win based on what the communities are able to do. I think we are all deeply impressed with what we are able to do so it was the governors who decided. The detecting backlog. And what is the status of the self swapping tests . We are tracking all of that very closely. Thats the health of advocates, and to my lab directors, i really need the vet m2000 online. That means we can do an extra 100,000 that way. The last time i had my self. I self test data it can be done and, it works very well with that rapid fiveminute test. What we now have to create, and i know thats always difficult because everybody wants one of something, we now have to create a mosaic that brings together where we know every single machine is in the United States. Where our gaps are, and where we align with resources and the need and gaps of testing. And thats the reality of where that avid i. D. Now kit could be incredibly helpful. They are shipping it all the way to capital, maybe three states away and that will add two or three days to the wait time which we are trying to get away from. Is the backlog two or three days or is very statebystate and we will talk with all of the states about how we are changing the testing in the community to really ensure that we are testing optimally. Because right now we have still focus very much on hospital diagnosis because we know it will make a difference in treatment. So these major laboratories are still putting drivethrough tests at the back to all the hospital tests. So thats where the backlog is in the drivethrough test. So if you are an outpatient, not an inpatient, but that is where the delay right now is. It statebystate and so some states have 24 hours or 48 hours or both. Outpatients and inpatients, others have shorter inmate inpatient and longer an outpatient. Thats how we are reconciling those pieces. One of the data points we review is literally on a statebystate basis with the turnaround time is for testing, and we continue to work that. These avid Laboratory Devices are, there are 18,000 of them across the country. When you go to the Doctors Office and get the strep tests, its that device. Thats a 15 minute test. Find your abbott device and we will work our hearts out to get a test to you. One for you and one for either of the doctors. We back this idea, and how did the administration envision this happening . Is it guidance for the white house and we hope the governors follow it or do we put it in the governors hands . How do you envision that all working together . One thing i can ensure you is the president has been informed by what the data shows. And that is what we can reopen for america and put america back to work. I can tell you the cdc will have new guidance tomorrow that the cdc will be publishing for people who were in proximity to an individual that tested positive for coronavirus but had no symptoms and the cdc will be publishing new guidance about how those individuals and circumstances under which they might be able to return and go back to work using some facial protection and monitoring their temperature but we will detail that for you. What we are going to be doing over the weeks ahead is while we focus every day at the point of the need and as the president said many times, our First Mission is to save lives and that means to slow the spread, bend the curve, continue to engage the American People which they are admirably doing to continue to put social distancing into practice. There is a dual track that the president has already initiated. Some of the best minds here at the white house are beginning to look at what recommendations will look like that we give to businesses, that we get to states, but it will all, i promise you, being informed on putting the health and wellbeing of the American People first. For doctors to be 18 or dr. Fauci, would any of you want to take data . Many parents have been sitting at the home with their kids for weeks, what do you think summer holds and what do you think the start of next school year holds . Can i say a word on behalf of teachers since im married to one . My wife was all day yesterday at the Elementary School she teaches loading up about 500 bins of art supplies for kids. Shes 1 of millions of teachers across this country who find themselves having to distance teach kids. Im proud of karen, but i am proud of every teacher in this country. The secretary of education was here not long ago talking about our efforts to distance teach. Thank you for what you are doing, to continue teaching learning even in this challenging time and to all of the kids. Just because you are home doesnt mean you dont have to do your schoolwork. What i will tell you is i will yield to the health experts. It will be part of what we are looking at in terms of guidance going forward, whether it be Summer School or whether it be returning to school. The most important thing we can do is but this epidemic behind us as quickly as possible. Thats the same question. You know, it is on predictable but you can get a feel for, the curve going down. How we respond and what kind of rebound we see or dont see. Its going to have a lot of influence boomer immediately on things like summer camps than it does in the fall. I fully expect, although im humble enough to know that i cant accurately predict, but the time we get to the fall that we will have this under control enough that it certainly will not be the way it is now, where people are shutting schools. My optimistic side tells me that we will be able to renew to a certain extent but it will be different. Remember now because this is not going to disappear. We will have to have in place the capability of doing the things that we talk about all the time on the stage to identify and isolate the contact trace, number one. Number two, but that time we will have a better feel with the Antibody Test about what the actual penetrance of this infection was in society. Who is, who is vulnerable, do you treat them differently then you treat the people who are protected. Thats just how much back to the fall. The bottom line is no x production but bottom line i think we will be in good shape. Can you talk about your concerns about deaths being recorded by coronavirus. I think in this country with taken a very liberal approach to mortality, and i think the reporting here has been pretty straightforward over the last 56 weeks. Prior to that when there wasnt testing in january and february, thats a very different situation and unknown. In other countries if you had a preexisting condition and lets say the virus caused you to go to the icu, and have a heart or kidney problem, that was part of a heart or kidney issue and not a covid19 death. And the great thing about forms that have the ability to market, if someone dies with covid19, we are counting not as a covid19 death. Do you have the data you are trying to collect . I think that would apply to more rural areas that may not have the same level of testing but im pretty confident in new york city and new jersey in places that have these large outbreaks, and covid19 only hospitals, i can tell you they are testing. New york and new jersey together have by proportion, testing extraordinarily well as Washington State and louisiana so i dont see that there has been a barrier in testing to diagnosis. I think theres so much focus now, having a disproportionately higher proportion of the burden of the entire country right now in new york. If someone with coronavirus goes to the icu and they have an underlying heart condition and they die, they say cause of death, heart attack. I cant see that happening, so i dont like it will be a problem. A question for dr. Fauci on the virus hitting black communities the hardest. The numbers are staggering. Do you expect that pattern to continue nationwide . Some have not even reported their data yet. You know i cant be confident to predict the patterns, but the underlying reason thats happening doesnt change from state to state. I expect that when africanamericans get infected, given the disproportionate disparity of the underlying conditions that lead to complications like the ones i mentioned, i expect that we still see the pattern that when you look at the proportion of people who get into serious trouble and die again will be disproportionate for the africanamericans. I do expect that. Is a federal government now leading the charge of collecting information from the states and when will it be published . The answer is yes, it will be public as soon as we get enough data to make a meaningful statement. Will that be a week or a couple of days . It is a great concern its probably a good reminder that you have to be especially careful around people with serious Underlying Health conditions. But for anyone from any community especially citizens with Underlying Health conditions, the risk of tragedy is very real. We will be diligent by studying this and providing information and guidance in accordance with our best scientists. So i do want to say that to each and every american, the president s coronavirus guidelines for america about, wash your hands. If you are sick, stay home. If you can work from home and you are not in Critical Infrastructure like our incredible Health Care Workers and all those heroic people working to keep food on the shelves, and we ask you to work from home if you can. Avoid unnecessary travel. Avoid gatherings of more than ten people. Used drivethrough is at the restaurant and dont go in the restaurant. Not just