In a question in a moment. But there was a span of time from january 24 through march 5 that i hope the American Public looks at. And it gets back to what is wrong with our Health Care System in general. Early testing from what im seeing was created by the fact that the cdc said that it was going to do its own test. The south korean test that gets cited so often was not going to be looked at. We had to do our own. I know the fda worked with the cdc. But the long and short of all of this is that for nearly a month this was in that bureaucratic swirl. The fda prevented private and Academic Development of tests for weeks. The cdc kdenied access to functioning tests as i cited in south korea. This created through all the red tape and bureaucracy to where we had to come up with a one sized fits all approach due to the uncertainty of the virus. And we are stuck with that now. I dont want to dwell on that necessarily because i think that those are mistakes that we made. Im tired of having it heard that it is the administrations fault. Dr. Hawn, id like to ask you this question. In that spirit of what we talked about during your nomination process, here going forward, will we shed some of that sto y stodgine stodginess, will we look to get therapeutics and vaccines through the system in a quicker method because i fear if we dont, and if we treat through bureaucracy how we did the early period of testing, we belabor this into the distant future and the at that point there is going to be not only the carnage from the disease itself but from the economy to deal with. So id like your comment on that one month stretch, what accountability the fda and the cdc have and then whether it looks better in terms of moving more quickly into the future. Thank you for the question. Our time line of that period demonstrates that we began working with Test Developers beyond cdc on january 24th and had double digit number of test develops working with us. One of the issues that we identified was in fact availability of the virus and other supplies to actually get that Test Development done in a timely fashion. Senator, i agree that this is an opportunity for us to take the look and determine how we can do things better and i think that that is a really important thing for all of us do and certainly the fda will promise do that. Looking forward, sir, i can commit to you that we will look at every one of our regulatory authorities. We have done so during this outbreak. We have provided significant flexibility and have tried to provide the right balance into regulatory flexibility and enabling of the great Test Developers and Therapeutic Developers in this country with the need to ensure that our Gold Standard of safety and efficacy is in place. We have leaned in with manufacturers, we have learned a lot from them as well as the other stakeholders and we will continue to learn and we will i commit to you implement the changes necessary to make sure is that we can act in a are more nimble way but still protect the safety net of the medical products. Thank you. Dr. Fauci, taking a page from your antiaids playbook that had a treatment review pathway, can we do that for covid19 in a similar pair rely track that you put into place back then in the 90s . In fact, ive got a bill called the promising pathways act that is based upon that protocol you put into place. Can we do that more quickly get through to therapeutics and vaccines with covid19 . Well, it is a different story, but some similarities. If you are referring to the parallel tract that i put into place back in the late 880s, which is when there was no availability of drugs at all for hiv and when we were testing drugs, within a protocol that we would make it available outside of the protocol, in what has ultimately turned out to be compassionate use. So what we did, we didnt want to interfere with the integrity of the protocol to determine the controlled way what was safe and effective, but there was a dire need for some sort of accessibility to those drugs outside of the Clinical Trial for those who might even have some chance 6 having it. And in fact that was really in many respects the birth of the really firm concept of compassionate use. And in fact there is a version of that which ill hand to commissioner ha commissioner hahn, when you have drug s that have not been yet fully proven, so there is a somewhat analogy between what i did in the 1980s and what is being done with the fda now. So steve, if you might want to comment on that. I think that is right, dr. Fauci. The emergency use authorization process by statute allows us to have flexibility and assess the risk benefit ratio in a Public Health emergency. And weve done that on the therapeutic side on three separate occasions and continue to look at those requests. Thank you very much. Senator rosen. Thank you, mr. Chairman, for bringing this hearing. And i want to 2457thank the dedicated doctors for their lifetime of work and study and passion. Were a grateful nation for all of your life long commitment in fighting disease not just in the United States but around the world. And as i talk to nevadians about safely reopening the economy, one question that frequently comes up is when are we going to have a vaccine like everybody has talked about. And travel and tourism of course is a life blood for us and the Jobs Associated with those industries can only fully come back if we know that it is safe to travel and visit or work in our hotels, casinos and restaurants and attractions. Ultimately we have to build confidence in our visitors that it is safe, we need a vaccine and that research is extremely important. However understanding that this takes time to develop and ensure both safety and efficacy, id like to hear more about what research is happening regarding preventive Medication Research and could be helpful in the time frame before a vaccine. And especially before one is widely available. So id like to ask if this could be part of the path helping us to begin to reopen our economy safely and bring visitors not only back to nevada but across our country. So dr. Fauci, what research is currently happening to identify potential monoclonal preventive treatments and other therapeutics, if the right antibody can be identified, could it be used as a preventive medication to block covid19 virus from latching on to the host cells much like the treatment for Rheumatoid Arthritis or asthma and other diseases, and secondly, would Preventive Options like this help complement the effectiveness of a vaccine once it is available. Thank you for that question, senator rosen. That is an excellent question. And in all of the therapeutic interventions that we are developing, and you mentioned several of them, they could be direct antivirals along the line of remdesivir, but that is just one of a number of possibilities since there are several viral targets in the replication cycle. Using con have a less seva con other modalities are feasible and will be pursued in parallel with development of the vaccine. The model of using drugs and other interventions that are effective treatment is really a Great Success story for the issue of hiv aids because many of the interventions that were developed for the full treatment of an infected person are exquiz itaex exexquiz italy effective in preventing hiv. So that is the kind of model that we work out in parallel with treatment for disease using as treatment as prevention. I believe that that will be a part of our effort at the same time that were putting a full court press on trying to get a vaccine. So it is an excellent question. Very relevant. I know i have a short time left so ill just kind of an abbreviate this. The second most important question that i get, what does the next generation of ppe need to look like for all of us as we go about our lives . Not just as workers depending on your work you may need something stronger, more specific, but as all of us as we want to go out to shop or eat or whatever those things are, get on an airplane. Should masks be made of a certain material, gloves, handkerchie handkerchiefs, can you talk about ppe for the general public . Well, you know, the best ppe for the general public if possible right now is to maintain the physical and social distancing. But as weve said and i think all of us would agree, there are certain circumstances in which it is beyond your control when you need to do necessary things like go to the drug store and get your medication, go to the Grocery Store and get your food, that in fact you need some s supplement tags than just physical distancing. So i believe dr. Redfield made the recommendation about getting some sort of a covering. We dont want to call it a mask because back then we were concerned that wed be taking masks away from the Health Care Providers. But some sort of masklike facial covering. I think for the time being to be a very regular part of how we prevent the spread of infection. And in fact the more and more as you go outside right here where im sitting in washington, d. C. , you can see many people out there with masks on which gives me some some degree of comfort that people are taking this very seriously. Thank you. Thank you, senator. Senator leffler. Thank you all for being here and for your service. Admiral, before i start my question, i want to recognize your new role as the u. S. Representative to the world health organization. Mitigating a resurgence of this pandemic will take global cooperation. In order to do that, we need accountability and transparency at the w. H. O. This organization was established to ensure the timely flow of accurate unbiased information on Global Health emergencies just as this. Reforms must be made in order to restore the trust that we need here. I hope that you will work with our allies to push for these reforms. This question i have two questions. The first is for dr. Redfield and dr. Redfield, georgians are wondering how we got here today. 1400 deaths, a third of georgias workforce out of work. Im incredibly concerned about the coverup and misinformation coming from china and their efforts to suppress lifesaving information at the outset of this outbreak. As we continue to reopen our economy safely, we have to take steps to ensure that another outbreak cannot take hold of the world in this way. I understand cdc has worked with the chinese cdc on Global Health security for decades. Can you comments on t on the led timing of the information that you received and relied upon from your chinese counterparts as this virus emerged . Thank you very much, senator. And i want to echo how important Global Health is security is as a National Security priority for this nation. And well need to be able to respond to that as long as we are a nation. Cdc has had relationships with various countries around the world. We have offices in over 45 countries right now. And one of those happens to be china where we have a us cdc that is with the chinese cdc and weve worked together for decaddecade decades particularly on emerging infect issuious diseases. And that has been a productive collaborative. And when this original outbreak came from the original seafood market, there were obviously discussions between the u. S. Personnel and chinese cdc. I personally had discussions early i think the cdc did as early as january and myself january 3 with my counterpart. So at a scientific level, we had very good interactions. That is different than the broader Chinese Government level. And a question for each of our great witnesses, and it is one that my constituents often ask me. Ed the Mainstream Media and some of my colleagues in the senate seem to the want to paint each of your relationships with our president as confrontational and being laing c inin ining lackin. Can you say to the American People today whether this is true or untrue . From your testimony today, ive seen a very coordinated effort to address this with the administration to combat this pandemic. Can you give me a sense of what the characterization is whether it is true or untrue . Thank you. Id ask dr. Fauci to answer that first. No, there is certainly not a confrontational relationship between me and the president. As ive mentioned, i give advice and opinion based on evidence based scientific information. He hears that. He respects it. He gets opinions from a variety of other people. But in no way in my experience over the last several months has there been any confrontational relationship between us. Thank you. Dr. Redfield, dr. Hahn. And i would echo what dr. Fauci said. Were there to give our best Public Health advice and that is what we come grounded in data and science. And ive always felt free to give the best Public Health advice that i think needs to be given at the time and it has always been done in a very professional way. Senator, this is steve hahn. I do not have a confrontational relationship, have not had a confrontation at relationship with the president. He asks questions. I have given him my honest answers rooted in data and science. And he has listened respectfully to those incorporating that into his decision making. And i have nothing else but to echo my colleagues. We work very closely together, all the scientists, all the physicians. Of course the ambassador and other scientists within our group. And we have a very productive working relationship with each other and also with the president and Vice President. It would not be confrontational and i certainly feel that we have the ability to honestly state our opinion bes as and recommendations and it has been that way since the beginning. Thank you. Senator murray, do you have closing comments . I do. And if it is all right, two quick questions. Sure. Thank you. You know, dr. Fauci, while President Trump may think otherwise, there is no question that an essential part of reopening our economy safely is successfully distributing a vaccine for covid19. We need to plan now to deploy a vaccine once it is proven safe and effective, but it is absolutely crucial this planning process from a Clinical Trial to distribution and administration recognizes and addresses racial and ethnic disparities in our Health Care System that as we all know for too long have been overlooked and unacknowledged in this country. And we have to ensure equitable access to this vaccine for everyone. Dr. Fauci, let me start with you. What steps is nih taking to make sure that Clinical Trials for covid19 vaccines and therapeutics account for racial and ethnic disparities . Thank you very much. That is a very relevant question. And in fact in the design of our Clinical Trials and the sites that we have chosen in our Clinical Trial network, it will be very representative of being able to get minority populations and populations most at risk to be part of the trial so that we know during the trial what the relative efficacy as well as potential adverse events. It is something that we started back in the days of hiv when we tried to get good demographic representation and well do that with these. Thank you. And dr. Hahn, tell me what steps fda is taking to make sure that the United States is prepared to produce a sufficient number of vaccines including the necessary manufacturing supply chain capacity for supplies like vials and syringes. Thank you, senator. This is an effort that started as a partnership with the Vaccine Developers and the nih and their efforts. So one of the most important things, maam, is data trance parn transparency, sharing of day it so that we with understand what the capacities are, what the needs areday it so that we with understand what the capacities are, what the needs are and how to sthans tha so if one vaccine doesnt go forward, we can use the capacity of that manufacture for another manufacturers vaccine. And im happy to woreport that e work has led to that effort. It is somewhat complicated in that we may very well have hopefully five to seven candidate vaccines that may need different supplies oerkts assoc with them, but weve been upfront working with the manufacturers to make sure that they are available. Thank you for all of our witnesses. It is clear that we have more work to do before we can safely get back to work and school and some semblance of normal life in our country. We still need testing to be fast, free and everywhere. And we need the white house to lay out a Detailed National plan to make that happen. We still need adequate personal protective equipment both for our Health Care Workers and for workers at our businesses and schools. We still need guidance from our experts so that our communities have the information that they need to reopen schools and businesses safely, confidently and competently. And so Public Health workers and Health Care Providers haves information they need to keep their patients and communities safe. And while experts have been clear that the day that we can safely reopen may be a ways off, there is plenty for us to do in the meantime both to plan ahead for example to make sure that once we have a safe and effective vaccine that we can produce and distribute to everyone at no cost and to address the immediate challenges for example making sure that there are appropriate Mental Health resources for everyone who is coping with the challenges that are presented by this virus. From the stress of physical isolation, loss of income, to the trauma and anxiety of patients and workers who have been on the front lines. So im going