Live: Fauci, Top Health Officials Testify At Senate Coronavirus Hearing | NBC News

redfield FDA Commissioner Dr. Stephen Han and Undersecretary of Health and Human Services Dr. Brett Guerard and this will be a

hearing

unlike any other we have seen with all four witnesses and many members of the Senate committee itself appearing remotely via zoom video conferencing, a precaution that has become all too familiar in this pandemic as we wait for the

hearing

. Go right now, this is President Lamar Alexander and get tested, our Governor Bill Lee is also testing every prisoner, every resident staff member in a nursing home that he has offered over the weekend. He prospered through trials.

He has done targeted outreach to testing in low-income communities in Tennessee and you can get a free test at your local Department of Public Health the governor's motto is, when in doubt, get a test Governor Lee sent out his goals testing to the inmate and the federal government, as all states have done, the federal government is helping you make sure you have enough supplies in case you have trouble obtaining them through laboratories and other commercial sources, as a result, our state has tested approximately 4% of the population. The governor hopes to increase that by 7% in May, which is one of the best in the country.

This impressive level of evidence is sufficient. We believe we will begin phase one of returning to work, which, as I said last week, is not enough to provide confidence to 31,000 students and faculty, but we look forward to showing up on the University of Tennessee campus in August when classes finally begin. time. Last week I spoke with UT Knoxville Chancellor Don D Plowman about what we said would persuade those 31,000 students, as well as the 50 million K-12 students in the country and the other 5,000 college students, what would would persuade him to return to campus in August. That's where the new Dr.

Shark Tank comes into play. Collins at the National Institutes of Health calls it a red X. We had our hearing on that on Thursday, so it's a really remarkable scientific exercise to take some early stage concepts that they're swimming in and what we call that competitive shark tank, see dr. Collins and his associates may find some new technologies to create millions of new tests that will scale up quickly and make it more likely that students will return to school in August. For example, the FDA last week authorized its first diagnostic tests using saliva that a person provides at home instead of a nasal swab or blood, and authorized its first antigen test.

We are hearing a lot about those like those used for the flu or strep throat, which involves taking a swab from the nose and you can get the result in just a In a few minutes another proposal not yet approved is to put a species in your mouth of popsicle sponge, take a photo with your cell phone and send it to your doctor, if it lights up, you are positive or the university could send that popsicle of saliva. to a nearby lab that could be a gene sequencing lab that can process thousands of those samples overnight, that same process could happen in an average Stuart could happen in a factory, of course anyone who tests negative one day can give positive to the next, but testing is so widespread. of entire campuses, schools or workplaces will help identify those who are sick, track those who are exposed and that, in turn, should help persuade the rest of us to return to school and work, as well as perform more tests.

I hope the doctor is bad. The chief told us about additional treatments that will be available to reduce the risk of death and the administration's plan to do something our country has never done before, which is to start manufacturing a vaccine before it has been proven to work to speed up review the result in case it works those vaccines those treatments are the definitive solution, but until we have them all the ways back to work and school go through the tests the more tests we perform the better we can identify those who are sick and exposed and we will be able to Quarantine the sick and expose them instead of trying to quarantine the entire country.

In my opinion this requires millions of new tests, many of them of new technologies, some of them will fail, we only need a few successes to get where we want, that's why I said. on Thursday that what our country has done so far in testing is impressive, but not enough. First, squeeze all the evidence we can out of current technologies. Then trying to find new technologies to help us contain the disease and persuade us to go back to work now. Another thing is a bipartisan hearing to examine how well we are preparing to safely return to work and school and to determine what more we need to do in the United States Senate.

Such an exercise sometimes encourages finger-pointing before spending too much. long time pointing fingers I would like to suggest that almost all of us, the United States and almost all countries, as far as I know, underestimated this virus they underestimated how contagious it would be they underestimated House out can travel silently in people without symptoms to infect other people now it can be especially deadly for certain segments of our population the elderly those with preexisting conditions minority populations let me go back to the March 3 hearing we had in our committee on

coronavirus

six weeks after the first case in the United States was discovered one day in which only two deaths were recorded in this country I read at that hearing this paragraph from the New York Times two days before, in March, the first time they reported so much about the corona virus remains unclear, the Times reported and is far from I'm certain that, between March 3 and 1, the outbreak will reach serious proportions in the United States or will affect many regions at once with their world-class scientists, modern hospitals and expanding public

health

infrastructure.

Most experts agree that the United States is among the best prepared in the country. To prevent or control sex and epidemics, was the New York Times on March 1, many efforts are being made to try to make our country well prepared over the last 20 years for the presidency, several congresses in response to 9/11 September. Bird flu Katrina Ebola h1n1 MERS passed nine important laws that try to help prepare this country or what we are going through today these laws raised the strategic national stockpile created an undersecretary for preparedness, straightened created incentives for the development of vaccines and drugs that we are Today we strengthen the Centers for Disease Control and build our thanks to the leadership of Senator Blunt and Senator Murray for five consecutive years.

We have significantly increased funding for the National Institutes of Health. This was all part of a shared goal. Democrats, Republicans or various presidents. conferences to try to prepare us for what we are going through today, whether known as anthrax or unknown as coal in the mid-nineteen, but despite all that effort, even the experts underestimated covin 19, this hearing is about how to improve our response to this virus. In addition to the next one during the oversight hearing, I also intend to focus, as I just said, on the next endemic that we know is coming. What can we learn from this one to be prepared for the next one?

What can we learn from the fast track? of vaccines and treatments that we are about to hear about that will make it even faster and next time, how can we stop hospitals and states from selling protective equipment when their budget is tight? How can we make sure Congress knows our share of the funds? liability How can we provide enough additional hospital beds without canceling elective surgery, harming other patients, and bankrupting hospitals whose job it should be to coordinate supply lines so that protective equipment and supplies get to where they are supposed to? What should they go, when are they supposed to go?

What is the best way to manage reservations? My preacher once said: I don't care what you do on Sunday. What worries me is the rest of the week. I'm afraid that for the rest of the week between pandemics we relax our focus on preparation we worry about other important things our collective memory is short just three months ago this country was worried about removing the president now that seems like ancient Roman history now while this crisis has our full attention I think we should sign any improvements into law this year. Efforts must be made to be well prepared for the next endemic if we want to point the finger.

I hope they point in that direction. Today we are fortunate to have four distinguished witnesses. We are at the center of the response to the

coronavirus

. Grateful for their service to our country, I asked each of them to summarize their comments in five minutes and then we will have a five-minute round of questions from each senator. I have agreed that we will end our hearing around 12:30 after a full round of questions each senator will have the opportunity to have their five minutes. Senator Murray will then have the opportunity to ask the final question or close the hearing and then I will close the hearing.

There will be other hearings after this one. hearings like last Thursday and senators can submit their questions in writing within the next 10 days staying home indefinitely is not the solution to this pandemic there is not enough money available to help everyone affected by an economy closed all roads back to work to school through testing, follow-up isolation treatment and vaccinations, this requires widespread testing, millions more tests created primarily by new technologies to identify those who are sick and who have been exposed so they can be quarantined and, by containing the disease in this way, give the rest of the United States enough confidence to return to school work in the short term help ensure that those 31,000 UT students and faculty show up in August we need testing widespread millions of more qualified tests primarily by new technologies that identified those who are sick who have been exposed so they can be quarantined containing the disease this way, the rest of the United States is confident enough to return to work and school, Senator Murray, well, thank you very much, Mr.

President, my thoughts are with you and your team right now as you try to address the same challenge that concerns so many people in our country. We all wish your staff member a speedy recovery and, as everyone works to take the proper safety precautions today, I would like to thank not only our witnesses for joining us today, but also our committee staff for working to establish a safe format for members, witnesses and the public to participate in this hearing remotely. Families across the country are counting on us to learn the truth about the Cova. Tonight, a teenage pandemic, especially since it's clear they won't get it from presidents.

The truth is not essential for people to have the facts and be able to make decisions for themselves, their families, and their communities. Lives are at stake if the president does not tell the truth. we must and our witnesses must do it and we are counting on you today and the families need us to take this opportunity to dig into the facts about where things went wrong so that we can finally get them on track because the Trump administration's response to this public

health

situation Until Now, the emergency has been a disaster in itself: delays, missteps have left us far behind in diagnostic testing and allowed inaccurate antibody tests to flood the market.

Corruption and political interference have impeded efforts to secure desperately needed personal protective equipment and fraught dangerous unproven treatments, and we recently learned that after experts at the Centers for Disease Control and Prevention spent weeks developing a detailed guide to help our communities understand how to safely reopen when the time comes, the Trump administration tossed it in the trash for being too prescriptive. But this is far from the first time this administration has silenced experts who were doing their jobs and prioritizing public health. The fact is that President Trump has been more focused on fighting the truth than fighting this virus and, unfortunately, Americans have paid the consequences.

Since this committee last heard from these witnesses on March 3, we have seen more than 900 deaths in my home state of Washington, more than 80 thousand deaths nationally, and the numberscontinue to increase. Still, President Trump is trying to ignore the facts and ignore the experts who have been very clear: We are nowhere near where we need to be to reopen safely. My hope today is that we can get through this and have a serious discussion about what it takes to open safely. How close are we as a country to meeting those needs. and how we will get there one thing is very clear: we need much more evidence.

It is unacceptable. We still don't have a national strategic plan to ensure testing is free, fast and everywhere. That's why I thought about making sure that our last Kovan 19. The package included an initial $25 billion test fund and a requirement that the administration submit a plan by May 24, and when I say plan I don't mean a PR plan, I mean a plan with specific timelines and numerical targets for supply and financing needs. one that truly addresses the issues we are seeing about testing capacity, distribution and disparities and the construction of our public health system and makes clear to states, tribes, employers and the American people what they can expect and what that the administration will do to keep Americans safe, but testing alone will not be enough to reopen our country, we still need much more personal protective equipment that has been available to our frontline healthcare workers and we will need much more for other workers as we reopen, so we desperately need this administration to step up and get that equipment to the states that are doing everything in their power to buy supplies but just can't get enough because the The reality is that, unlike the states, the federal government has the tools to fix the problem if only the administration would use them and we also need that equipment to actually work and for the FDA to act promptly if it doesn't weeks later, when people may have already been exposed and, just as importantly, we cannot expect people to return to work or restaurants or confidently send their children to school if there is no clear and detailed guidance on how to do so. in a safe way.

Schools from early childhood through college need to know how to keep their students, staff, and educators safe. When should they wear masks? As? You run a school cafeteria or a school bus If they can't reopen classrooms, schools and families need to know that we are working to ensure every student receives an education. Tools like online learning can only take us so far if we don't address digital. break that up so that all students can access them and even then there will be learning loss that could deepen existing educational disparities among low-income students, students with disabilities, English learners, and other vulnerable populations if we don't ensure that they have equal access to resources and support and of course schools are not the only workplaces we need to think about, we need to make sure that industries across the country know how to reopen safely and that people know that your workplace is safe, Secretary Scalia needs to stop dragging his feet and do his job have the Department of Labor make a rule that makes it clear that worker safety is not optional, mr.

Chairman, I hope that this committee will be able to hear about these critical issues from Secretary Scalia and Secretary de Vos, as well as other experts on the subject in the coming days, and this is especially important to protect the workers and residents of our homes from nursing homes and other congregate care facilities where we have seen some of the deadliest outbreaks, and as the series of outbreaks at meatpacking plants demonstrates, this is not just a problem for the health care industry, it is a problem for everyone and just as we need a plan before we can begin to reopen, we also need a plan long before we have a safe and effective vaccine to ensure that we can quickly produce and distribute it on a global scale and make it free and available to everyone, so that today I will ask about our progress on those issues.

Today, safely reopening our country may be a long way off and the administration's planning may be long behind schedule, but there is still much Congress needs to do. There is no time to lose. Some, including the White House, say we have already provided enough economic relief. The question for them is what good is a bridge that only takes you to the middle of the river? We don't need to wait to see if people need more help. We know they need it. We need to work quickly on another aggressive relief package, and we need to make sure our priorities in that bill are protecting our workers, our students, and our families and addressing this public health crisis, not bailing out corporations or protecting big companies. accountability companies.

People across the country are doing their part, washing their hands and wearing masks. and social distancing and staying home they need their government to do their part too they need leadership they need a plan they need honesty and they need it now before we reopen so they can be sure that we are doing things safely and confidently with their health and well-being as top priority Thank you sir. The president simply maintains that it is an important audience and I know that many people may be seeing it for the first time if that is the case. I hope you realize that we have 23 members on this committee.

I think there is one more Republican than one Democrat. We have very strong opinions, but we can work together and express those views and respect each other and our witnesses and that and a big part of that goes to Senator Murray and her staff, so thank you for each witness will have up to five minutes to give your opinion. her testimony thank you for making an exception in agreeing to

testify

by video due to these unusual circumstances and thank you for what she is doing for our country, our first with witnesses dr. Anthony Falchi is director of the National Institutes of Allergy and Infectious Diseases at the National Institutes of Health.

He has not held those positions since 1984, which meant using six partial chairs and worked on HIV/AIDS, influenza, malaria, Ebola and other infectious diseases in which he was involved. in treating Ebola patients at the NIH and also worked on Ebola vaccine trials. Next we will listen to dr. Robert Redfield is director of the US Centers for Disease Control and Prevention, which is based in Atlanta. He has been involved for more than 30 years in clinical research related to chronic human viral infections, diseases especially HIV. He was the founding director of the retroviral research department. Within the US Army's HIV research program, he spent 20 years with US Army Medical Corps Third Admiral Britt yeo-hwa yeo-hwa.

Admiral Wah is assistant secretary for health at the U.S. Department of Health and Human Services, which puts him in charge of developing public health policy recommendations. He has assumed responsibility for coordinating testing and has focused on the growing number of tests we can do with existing technology His federal service includes a variety of activities with the Department of Defense in advanced research on threat reduction in which he was a part of Frontline Panel that reformed the US government. Veterans Health System and finally we will hear from dr. Steven Hon, is Commissioner of the Food and Drug Administration for joining the FDA, was the executive medical director of the University of Texas MD Anderson Cancer Center, was chair of the department of radiation oncology at the University of Pennsylvania, was a principal investigator of the National Institutes of Health as commander of the US Public Health Service Corps 2025, we will now ask each of our witnesses to summarize their comments in five minutes, after which each senator will have five minutes to questions and answers in order of seniority, dr.

Falchi let's start with you welcome thank you very much sir. Senior Chairman Murray and members of the committee thank you for giving me the opportunity to discuss with you today the role of the National Institutes of Health in research addressing kovat 19. One strategic plan we have is, for complete, improve our fundamental understanding of the virus and the disease it causes will next develop new point-of-care diagnostics, then characterize and test therapies, and finally develop safe and effective vaccines first with respect to the diagnosis, as you probably heard from Dr. Francis Collins last Thursday the NIH developed a Rapid Diagnostics Accelerator Program called Network a selection process similar to that of a shark tank to reach success or failure, quickly moving to therapeutics.

I'll talk a little bit about the topic of deciding to be a successful antiviral in a moment, but let me emphasize that there are several broad-spectrum antivirals. which are in various stages of testing, we will also see convalescent plasma, which is plasma from individuals who have recovered from Kovat 19 to be used in passive transfer, either in prevention or treatment, in addition to our immunoglobulin, which can be used as a gamma globulin injection, we will look at repurposed drugs as well as immune therapies and host modifiers and finally monoclonal antibodies. Let me take a moment to describe the randomized control trial of renessa through osebo that was conducted internationally with a power of over a thousand people at sites around the world was in hospitalized patients with lung disease the endpoint was mainly the time to recovery the result was statistically significant but really modest and we must remember that it was only a modest result showing that the drug accelerated the time by 31% We hope that the recovery will build on this modest success with combinations of drugs and better medications, moving on to vaccines.

There are at least eight candidates covered. 19 vaccines in clinical development. The NIH has been collaborating with several pharmaceutical companies at various stages of development. I'll describe one very briefly, which is not the only one where we have been involved in intense development with more Danner. It is a messenger RNA platform. You may remember in this committee that in January of this year I said it would take about a year. to 18 months if we were successful in developing a vaccine the NIH trial advanced very quickly on January 10 the sequence was known On January 11 the vaccine research center met to develop a plan on January 14 we officially began the development of the vaccine 62 days later we are now in phase one of the clinical trial with the two doses already fully enrolled, there will be animal safety.

Phase one will move directly into phase two three and in late spring and early summer and if we are successful, we hope to know in late fall and early winter there are some major issues, however, in the development of the vaccine undercover 19 we have many candidates and we hope to have multiple winners; In other words, his multiple shots on goal will be important because it will be good for global availability if we have more than one successful one. candidate, we, as the president mentioned, will produce vaccines at risk, meaning we will put considerable resources into developing doses before we even know that any candidate or candidates work.

I must warn that there is also the possibility of negative consequences when certain vaccines can actually improve the negative effect of the infection, the big unknown is its effectiveness, whether it will be present or not and how long lasting it will be and, finally, I want to mention that the NIH has launched a public-private partnership called accelerate nineteen therapeutic interventions and vaccines from Cova with the purpose of that is to prioritize and accelerate the clinical evaluation of therapeutic candidates with near-term potential. Hopefully, our research efforts along with other public health efforts will quickly lead us to putting an end to this ordeal we are all going through.

Thank you so much. Answer questions later thanks dr. Redfield, good morning, Chairman Alexander, Ranking Member Murray and members of the committee, our nation faces the most serious public health crisis in more than a century, but we are not helpless, we have powerful tools to fight the feeling we have tested and it is true. Effective public health interventions, such as early sadness, isolation, andContact tracing, combined with an important mitigation strategy, including social distancing, frequent handwashing, which these public health tools cover, have slowed and will continue to slow the spread of covered diseases. 19 I take the opportunity this morning to provide a brief overview of some of the CDC's ongoing work in response to Cove at night.

The CDC has been working 24/7 to combat the endemic. CDC's Emergency Operations Center supports Gulf state, tribal, local, and territorial partners in building core capabilities, particularly workforce laboratories and predictive data and analytics, epidemiologists are conducting coab surveillance in nineteen, in addition to conducting health system surveillance, community mitigation teams are providing guidance on infection control and contact tracing, and our laboratory experts are conducting Sauron serology testing to better define the extent of asymptomatic populations as local. leaders make decisions to reopen will require varying degrees of federal support each location will be different and face unique circumstances CDC has conducted a state-by-state assessment of public health testing capacity and key contact tracing capacity, as well as plans Increase CDC is providing technical assistance and funding to the state provided through the Supplemental Care Act in the Paycheck Protection and Health Care Improvement Program.

We are working directly with state public health leaders to define their testing needs, testing device supplies, and workforce surveillance data collection. and notification contact tracing infection control and outbreak investigation I want to take a moment to focus on several key elements first rapid, extensive and widely available testing timely testing is essential to reopening the United States CDC's role in testing continues to support the diagnosis and contact tracing surveillance and outbreaks when We work with public health partners to define their particular testing strategy. Your animal management jurisdiction will address the testing components of the response. More detailed contact tracing.

Increasing state rival local territorial contact tracing capacity is critical. It is a critical part of stopping chains of transmission and. prevent the occurrence of sustained community transmission CDC's role is to provide technical training assistance and support to states as they recruit and build a workforce necessary to be fully prepared to respond effectively to the public health challenges posed by the ongoing codified pandemic. Expanding Surveillance Effort Our nation's surveillance program is based on a combination of systems that include existing syndromic influenza and respiratory viral disease surveillance systems that have been combined with commercial and research laboratory platforms and our reporting form system. of cases, EDC, is adapting and optimizing them to have a surveillance system in response to Covent 19 It is important that, in light of the significant incidence of asymptomatic infections, surveillance of asymptomatic infections becomes an important public health tool .

Early identification of cases. EDC is working with each public health jurisdiction to develop a prospective surveillance program that includes active surveillance among those who are most vulnerable, such as people in long-term care facilities, commuter clinics, and homeless shelters, we need to rebuild the our nation's public health infrastructure and the resilience of our nation's health laboratory and public health workforce, now is the time to implement it for generations to come not only for the public health system our nation needs but for the public health system that our nation deserves before we close I want to recognize the tireless commitment of the dedicated CDC staff who deployed every corner of this nation to fight Kovan 19, more than 4,000 employees have deployed globally, the science and data continues with technical expertise and crowd-sourced service to be the backbone of CDC's contributions to the U.S. response I extend my sincere gratitude to the frontline healthcare workers, as well as their families and to essential emergency personnel, as well as the American people, to thank them for adhering to stay-at-home guidelines and protecting the most vulnerable.

It is important to emphasize that we are not out of the woods yet, but the battle lasts only months, but we are more prepared, we must remain vigilant about social distancing, it remains an imperative, we are a resilient nation and I am confident that we will emerge from this pandemic. more time together thank you thank you dr. Admiral Redfield, welcome here to give you an update on the nation's progress in testing kovat 19 on March 12. The Secretary of Aid is requested to lead COBIT 19 testing efforts within HHS, including FDA and CDC oversight and coordination regarding testing since then, the nation has conducted more than 9 million COBIT 19 taps. , a number far greater than any other country and twice the tests per capita carried out to date in South Korea.

To get to this point, we implemented a phased approach to meet testing needs during mitigation and now. During Phase 1 of America's reopening beginning March 20, we are pioneering 241 community drive-thru testing sites in CDC-prioritized locations. These sites have been a huge success, testing more than 167,000 high-risk people and demonstrating a prototype that is being duplicated several times in After nearly every state, the administration tapped trusted retailers, including CVS Rite Aid, Walgreens, Walmart Kroger and Health Mart, now providing testing at 240 locations in 33 states, 69% of which are in communities with moderate to high social vulnerability to meet the need for collection supplies. such as swabs and media tubes, we first secure the global supply chain through military airlift.

We work directly with manufacturers to increase national production. We collaborated with the private sector and the FDA to validate multiple types of swabs and media that greatly expanded supplies and minimized need. for PPE, we finally used title three of the defense production act, invested more in rod manufacturing to prepare for reopening and support the need for surveillance testing during reopening. On April 27, we issued a new testing framework that also prioritized testing for people without symptoms who are prioritized by health departments or doctors for any reason, including screening for asymptomatic people in accordance with the state and local plan.

Next, our federal multidisciplinary team held multiple calls with each state's leaders to establish state-specific testing goals. The states and territories collectively established an overall goal to achieve. twelve point nine million tests over the next four weeks, the federal government can and will support achieving this goal, specifically the federal government is sending states twelve point nine million swabs and more than nine point seven million tubes of media only last May. month we also detailed the location and capacity of each lab machine in each state that could potentially run Kovat 19 assays and our team has worked with testing providers to match reagents to these machines, hoping that between now and the end of 2020, the federal government acquires them.

Over 135 million swabs and 132 million tubes of media and we will distribute them to states as requested to supplement the now robust commercial supply. We anticipate marked increases in current testing, as well as a dramatic expansion of new point-of-care tests like the first. quenelle class antigen test cleared by the FDA last Friday. Weddell anticipates being able to distribute 300,000 tests per day in just a few weeks, so by September, taking into account all aspects of development authorization, manufacturing and supply chain, we project that our nation will be able to perform at fewer than 40 to 50 million tests per month if needed at that time and if new technologies such as genome sequencing approaches or any novel solutions discovered by the new NIH Diagnostics initiative are authorized, that number will be much higher, Finally, I want to acknowledge and express my sincere gratitude to the officers of the US Public Health Service Corps, the uniformed service that I have the honor of leading. 3,471 men and women have been deployed in support of this pandemic on the cruise in Japan to our military bases, repatriating Americans to our community testing. sites and the international airport to FEMA and our task forces, two nursing facilities, including King County, Washington, and two field hospitals and hard-hit communities across our nation.

I thank each and every one of these officers and their families and, on their behalf, I thank the members of this committee for supporting our training needs and the establishment of a Ready Reserve to supplement our ranks in future national emergencies. Thank you for the opportunity to provide these comments. Thank you Admiral Juruá and now Dr. Stephen Hahn, our fourth and final witness, Chairman, Alexander, Ranking Member, Marianm, Members of the Committee, thank you for inviting me to participate in this hearing today. I first want to start by thanking the American people for their incredible mitigation efforts and extend my condolences to those who have lost loved ones since day one of this pandemic.

The 18,000 employees of the FDA are simply incredible scientists. Doctors and nurses have taken an active role in the entire government response to this pandemic. The FDA has worked to facilitate the development of medical countermeasures to diagnose, treat, and prevent. For nineteen years we have worked closely with laboratories, manufacturers, academia, product developers, our federal partners, and companies—companies that don't even make medical products but want to collaborate, for example, by making hand sanitizers, personal protective equipment, and ventilators. Every decision we have made has been driven by data. for the purpose of protecting the health of the American people in a public health emergency;

However, our response has balanced the urgent need to make medical products available with the provision of a level of oversight that helps ensure the safety and effectiveness of those medical products. I would like to take a few minutes to tell you what the FDA is doing to help the country right now and which Americans Jones can safely return to work and school. It starts with testing, as others have mentioned, the FDA has worked with over 500 developers. or said they will submit emergency use authorization applications for mobile testing 19 this includes some newer technologies that have not so far been used as part of diagnostic tests in response to a pandemic we have issued 92 individual emergency use authorizations to manufacturers of testing kits and laboratories and more than 250 laboratories have informed us that they have begun testing under the regulatory flexibility, as we described in March, we are conducting ongoing reviews of US submissions so that we can quickly authorize tests that the data support in a public health emergency.

The accuracy of diagnostic tests is important not only for the individual patient but for the patient in general. For the general public. The FDA is helping to ensure the availability of tests that provide accurate answers. We are also monitoring the market for fraudulent evidence and are taking appropriate action. We are taking steps to protect public health and are working to provide more clarity about which tests have been reviewed and authorized by the FDA and which have not. Logic tests will play a role in our recovery, unlike diagnostic tests that detect the presence of the virus. -- measure the amount of antibodies or proteins present in the blood when the body responds to an infection such as Kovach 19 these tests can help identify people who can overcome an infection we have developed an immune response we will continue to work with laboratory manufacturers and throughout government to find a balance between confidence that an antibody test is accurate and timely access to such tests, of course, the way we will eventually defeat this virus is with a vaccine.

The FDA is working closely with our partners,including the NIH. Vaccine developers, manufacturers and experts around the world, we intend to use regulatory flexibility to help ensure the most efficient development of a safe and effective vaccine to prevent Kovat 19 until a preventive vaccine is approved; However, we need medical products to close the gap that the FDA has. We have been working for several months to facilitate the development and availability of therapies as quickly as possible and have created an emergency program for this acceleration called the corona treatment coronavirus treatment acceleration program receipt. We have reassigned staff to work urgently to review applications from companies, scientists, doctors developing therapies and are using all available authorities and registering appropriate regulatory flexibility to facilitate the development of safe and effective products to treat kovat 19.

Doctors and others are evaluating a variety of therapeutic areas, including new therapies as well as convalescent Plaza High Permian Globulin and monoclonal antibodies such as Dr. Pouchy also mentioned that we recently announced the positive results of the NIAID trial, a tram disappeared and issued an EU route for the treatment of hospitalized patients with Cova 19; Other promising treatments I mentioned are antibody-rich products, convalescent plasma and eye cream, globulin, and me. I'm certainly willing to go into more detail if members of this committee had questions about this. We are working very aggressively and closely with stakeholders to facilitate the development of monoclonal antibodies that, if proven safe and effective, could act as a bridge. therapy for vaccine development, we recognize that the development of vaccines and therapeutics must go hand in hand with ensuring that there will be sufficient supplies for our companies in our country, so we are also working with manufacturers to ensure that this chain supply is robust mr. chair ranking member members of the committee know that an FDA of a dedicated team of some of the best scientists in the country healthcare providers public health professionals we are guided by science and data and will not relent until we facilitate the development of products our nation needs to get back to work.

I look forward to your questions, thank you dr. They have, and thank you all four for your expertise, your dedication to our country in your hard work, you will now begin with five-minute questions from each senator on the committee, alternating between Republicans and Democrats that each senator has if it is a video conference. He has a little time clock at the bottom and I would ask you to try to stay within five minutes for his Q&A. I will start. I have a question for dr. ouchy and then admiral geraw dr. Let's look ahead: three months there will be around 5,000 campuses across the country trying to welcome 20 million college students. 100,000 public schools welcoming 50 million students.

What would you say to the chancellor of the University of Tennessee Knoxville or the president or principal of a public school about how to persuade parents and students to return to school in August, let's start first with the treatments and vaccines dr. Falchi, I could save about half of my five minutes because I had a jaw to test. He would appreciate it very much, mr. President, well, I would be very realistic with the Chancellor and tell him that when we think in terms, in this case it is a pain, I would say I'm sorry, sir, that in this case the idea of ​​having treatments available or a vaccine.

Facilitating students' re-entry into the fall semester would be something that would be a bridge too far, as I mentioned, the medication that has shown some degree of effectiveness was modest and has not been used in hospitalized patients yet or perhaps ever. to still be used as prophylaxis or treatment, so if the problem is that young people who would return to school would like to have some comfort and that there is a treatment, probably what would be closest to its use then it would probably be passive serum transfer convalescent, but we're actually not necessarily talking about treating a student who gets sick, but rather how the student would feel safe and return to school if this were a situation where we had a vaccine that would really be the end of that. issue in a positive way, but as I mentioned in my opening remarks, even at the maximum speed that we're going, we don't see a vaccine influencing people's ability to return to school in this turn, what they really want is know if they are safe and that is the question that has to do with what we discussed earlier about testing, so I am halfway there with the comments.

I would like to pass the baton to Admiral Jawad who would address the issue of the availability of testing and what role they could play in the return to school thank you sir well thank you thank you dr. Thatcher, why did you say that while we are doing around 10 million tests this month, we could reach 40 or 50 million in September and a month, which is a significant increase, so if I am Chancellor of At the University of Tennessee, could you develop a strategy where I would tell all of my students that we have, for example, an antigen test that is quick and easy?

You want everyone on campus to come and take it once before returning to school. At least I would like everyone to know that we have isolated anyone who is positive that day and then we can continue to monitor whether that strategy is possible in August and September, so thank you, sir. The president and I can reserve 20 seconds for dr. Redfield and the strategy that will be employed really depends a lot on what the community spread is at that time, if there is almost no community spread your strategy will be different if there is high community spread stress it will also be different but yes, technically we will have the capacity and your Chancellor will have the capacity.

We hope it will be 25 to 30 million points. Attention testing available per month is certainly possible to test all students or a surveillance strategy is much more likely where some of the students can be tested at different times to ensure there is no circulation. that would be done in conjunction with the CDC at the local health department. There are also strategies that still need to be validated, but we know that in some experimental labs you can combine up to 10 or 20 samples, so essentially a trial to test 20 students, and finally, there are some experimental approaches that look interesting, if not promising.

Like, for example, you could test wastewater from an entire dorm or an entire segment of a campus to determine if there's coronavirus in that dumping wastewater, so there are other strategies being developed and I'd like give at least 20 seconds to Dr. Redfield, we will really work on the strategy of how to employ this in the different communities Fred dr. Edsen, yes, just some quick weather, sir. I mean, first, I think it's really important to critically evaluate the role of changes in social distancing on college campuses and schools in the situation so we don't forget the importance of what we've clearly learned and also develop an aggressive program. for wellness education, making sure people understand that when they have symptoms they need to seek evaluation.

I think we will have to analyze the role of evidence. I think testing will play an important role in these circumstances and I believe it will. It will be individualized based on where these different schools are located, where they are, how much infection there is. I'll end it there so I can set a good example for the other senators. We were there for five minutes, Senator Murray, thank you very much, Mr. president and thanks to all our witnesses um dr. Falchi has warned of unnecessary suffering and death if we push to reopen too soon, but the president has actually been sending the opposite message.

I want to ask him today what is the most important message he has for communities and states that are reopening even as our public health experts make it clear that it is too soon, tell us what the consequences are. Thank you very much for that question, Senator Murray, as I have said many times publicly, what we have put together is a framework for how to safely open the United States again and there. There are multiple checkpoints in that an entry gate is shown first depending on the dynamics of an outbreak in a particular region, state, city or area that would really determine the speed and pace at which one re-enters. or reopen, so my word has been and I have been very consistent in this that I am concerned if you have a situation with an outbreak dynamic in an area or such that you are not seeing that 14-day gradual decrease that would allow you to move to phase . one and then if you pass the phase one checkpoints, move on to phase two and phase three, what I have expressed over and over again is my concern that if some areas, city-states or whatever, skip those various checkpoints and open prematurely without having the ability to be able to respond effectively and efficiently, my concern is that we will start to see small spikes that could turn into outbreaks, so I have been very clear and my message is to try , to the greatest extent possible, follow the guidelines. guidelines that have been very well thought out and very well outlined, so if a community, a state or a region does not follow those guidelines and reopen, the consequences could be quite dire, the consequences could be very serious indeed, in particular , and this is something I think we should also pay attention to those states, even if they are doing so at an appropriate pace, as many of them do and will do, that is, at a pace commensurate with the dynamics of the outbreak, since they have the ability that when there will be cases, there is no doubt, even in the best of circumstances, when you remove the mitigation, you will see some cases appear; the ability to respond to those cases with good identification, isolation and contact tracing will determine whether it can continue. move forward as it tries to reopen the United States, so not only is it doing so at the right time with the right limitations, but it also has the ability to respond when the inevitable return of infections occurs.

Well, thank you for that and it's very clear to do that we need knowledge about testing and for months this administration's approach to testing has really been plagued by missed goals and disregard for the systemic problems within that supply chain and the week Last year, an average of only 250,000 tests were performed per day in the United States. That's a small fraction of what we need and yesterday President Trump had the gall to declare that the United States had prevailed in testing in a craft press conference that was full of misinformation and distortions dr. Gerard's public health experts do not believe the United States has prevailed.

I'm glad he finally committed that states, including my home state of Washington, will receive enough tests to meet their goals for May and June, but this administration has a history of giving us broken promises. that more tests and supplies are coming and they don't and we don't know from the way the testing will be necessary will persist a long time after what you know so I wanted to ask you today if it will be the administration's next strategic plan that is now required under The Kovat package that just became law will include specific numerical targets for testing capacity, supply chain capacity and shortage projection.

Thank you for that question and statement, Senator Murray. Yes, we are as I said. We continue We have a work in progress as we build testing capacity. We have set goals with states of more than 12 million tests over the next four weeks. We think those goals will be good in May or June, but as Dr. Fauci said we really have to be evidence-based, we expect those goals to increase as we progressively open as communities go through phase one and then to phase two and certainly those numbers will have to increase significantly again in the fall when we potentially have influenza circulating with kovat, so yes, there will be targets that the targets will have to change depending on the evidence that we see, but we are very committed to ensuring the chain of supply, we work daily with each manufacturer and I am pleased that we are in May and June they will be able to anticipate the states so that we can supply them with what they need so that they have those guarantees.

There will be no question about it when you post that specific plan you should do. look at the numbers that you're going to tell us that's going to be enough for testing and a supply chain capacity and kind of production instead of just saying we hope to have a million.this week next week, so it will give us the right specific goals, we know. specifically I will say yes ma'am we know the specific amounts of testing that we have over the summer we have how many we need so yes ma'am we develop the statements of need working with the states individually with epidemiologists with the CDC so overall Approximately 3.9 percent of the general US population will be tested in May, but what I'm telling you is how many do we have from Senator Murray, how many will we need not only for myself but in the coming months so that we can be prepared to have them, yes ma'am, and not be repetitive, but we need to be based on evidence and data because what we can see in the mayor we will generate differences in the number of testing objectives that we have, so we really just have to be very humble in Regarding this, we need to look at the data, we know that testing needs will increase during May and June as we progressively open and we will do our best to predict that, but you have to understand that we have to do it. look at what the data and evidence show at that time ok, i appreciate that mr.

President again, what our strategic plan requires is what the objective is, not how many we have but how many we need and that is what we will be looking for. Thank you, thank you, Senator Murray, Senator Enzi. Thank you, mr. The President and I, Nikki Lee, appreciated your opening speech in which you presented a very concise list of the preparations that we must learn from this endemic for the next one, not only should we work on this and prepare, but we and I believe that We have learnt a lot. We're very much fighting a virus at the same time scientists are learning about it, so we need to be agile, we also need to be sure we're prepared for a second wave of outbreaks that could potentially coincide with the start of flu season. . emphasizing our healthcare system even more than it already has.

Admiral DRA. I appreciate her comments. I think they have been reassuring about what has been done and what can be done. I agree with Senator Murray that we need to have some specific goals as an accountant, that's always one of the things I'm looking for questions doctor dr. So far, our understanding of the clinical picture of Oban 19 continues to evolve, what at first seemed like a respiratory illness now appears much more comprehensive and potentially affects the brain, kidneys and other organs, how does this evolving picture affect the ability to evaluate the right clinic? or surrogate endpoints for the review of vaccines and treatments.

Thank you, Senator, for that question and the evolving clinical picture and obviously the way it's manifesting across the country clinically, in fact, informs the endpoints that we'll be working on with therapy developers so that we can obtain the most efficient information, but also the most accurate, inappropriate endpoints to carry out the necessary authorizations and approvals. We've established this program called the coronavirus human acceleration program, where our top scientists and clinicians have been at the table consulting with our colleagues at the NIH and the CDC. To really address those questions, what are the appropriate endpoints? I'll give you an example: we know that in some circumstances patients who have had severe Kobe disease have developed thrombotic-type clotting events, so we prioritize a review of the agents that we think could be beneficial and, obviously, the criteria Clinical endpoints for those trials will be different than for an antiviral agent like Brenda Beer, where, as Dr.

Fauci says, he mentioned that we're looking at recovery time, so we want to adapt it to the clinical circumstances as well as the type of therapy that is presented to us. Thanks, another question to dr. Han, we've made a lot of progress in vaccine development, but Barda has identified domestic manufacturing of needles and syringes as a major gap in pandemic preparedness. What has HHS done ahead of international vaccinations to ensure we have enough to administer a vaccine? Cindy, thank you for that question, this is a really important point because as you mentioned, it's not just about the vaccine or hopefully any vaccines that are developed, but also the supplies that are needed as well as a operational plan to administer the vaccine.

This is a whole-of-government approach. There is a program that has been established called Operation Warp Speed ​​that includes Dr. Collins dr. Fauci, his colleagues at the NIH, the Department of Defense, as well as other members of HHS and the FDA, Dr. Pierre Marks from the Biological Evaluation Research Center has been helping to coordinate and is working very closely with Dr. Falchi and his team and we have created what is called a Gantt chart to see what are the necessary problems in the chain of supply, syringes, needles, etc., depending on the various vaccines being developed, how many times they must be administered, and the route of administration.

We have leaned on this supply chain to ensure that when a vaccine is ready for use, we have the supplies necessary to administer, not just the eyes, the vaccine. Thank you. I have a couple more questions, but again, not watches. visible there, so I will send it in writing. Thank you, Senator Enzi, Senator Sanders, thank you very much, Mr. president and let me thank all the panelists for the hard work they are doing and for being with us today. It is sad to say that we have a President of the United States, the leader of our country, who from day one minimized the dangers this country faces from the pandemic who told us that the crisis would be over in a few months and that we did not have to worry who fired those members of the government who wanted to act aggressively, among other things, at a time when we need international cooperation to cut funding for the World Health Organization, but let me also say that I think we understand that the facts are terribly important, not all, that we do not fully understand all the ramifications of the kovat 19 epidemic, but let me clarify some facts, if I may.

To begin with, the official statistician dr. Falchi is that 80,000 Americans have died from the pandemic. There are some epidemiologists who suggest that the figure may be 50% higher. What do you think? I'm not sure, Senator Sanders, if it will be 50% higher, but most of us feel that the number of deaths is likely to be higher than that number because, given the situation, particularly in New York City, when they were really tied to a very serious challenge to their healthcare system, there may have been people who died at home who had solids that weren't counted. like Kovac because they never actually made it to the hospital, so in direct response to his question, I think he's right that the number is probably higher.

I don't know exactly what that tire was, but it's almost certainly older. Dr. Falchi, let me ask you this: In the terrible pandemic of 1918, the virus exploded in the fall and came back with a vengeance. Are we afraid that if we don't act together, no matter how bad the situation is now, it could get worse in the fall or winter Oh Senator, thank you for that question, it's a frequently asked question and I think that possibility exists, however , and the reason I say that is that when you talk about whether this virus is just going to go away and, as I said publicly many times, This is just not going to happen because it is a highly transmissible virus and even if we get better control during this month, there is likely a virus somewhere on this planet that will eventually come back to us, so my approach to the possibility of a rebound and a second wave of decline is that a is completely conceivable and possible for that to happen, but B I hope that between now and then, given the ability to do the testing that you've heard from Raja hua and the ability for us to stock up on personal protective equipment and the workforce that the CDC under dr.

Redfield will be contacted to identify traces of isolated contacts. I hope that if we have the threat of a second wave we can deal with it very effectively to prevent it from becoming an outbreak not only worse than now but much more so. much less is okay, let me ask you we have heard a lot of discussion about vaccines, obviously everyone in Congress and in this country wants a vaccine, we want it as quickly as possible, as effective as possible, let me ask the Honorable Commissioner of the FDA , sir, uh, yes God If we are willing to develop a vaccine and if we are able to produce it as quickly as we all hope, I imagine that vaccine will be distributed to all people for free, we will make sure that at least all people In the United States, those who need it and receive the vaccine regardless of their income is a fair assumption, Senator.

I certainly hope so. The FDA is very committed to ensuring that all populations in the United States, including the most vulnerable, are included in clinical trials and that's not what I'm asking is if and when the vaccine will arrive, it won't do any harm. It is good for someone if they do not receive it and if they have to pay a sum of money for it to benefit the pharmaceutical companies that will not receive it. It would be helpful, are you assuring the American people today that that vaccine will be available to everyone regardless of income?

Sir, payment for vaccines is not the responsibility of the FDA. I share your concern that this should be available to all Americans. Someone else? I want to comment on that mr. Joe, do you think we should make that vaccine when it's hopefully created available to everyone, regardless of income? Do you think the poor, the workers, should be the last in line to receive the vaccine? Sorry, Senator, I was wondering? Yes, yes, I was. no I I my office is one of the offices committed to serving the underserved and we need to be absolutely sure that if a vaccine or effective therapeutic or preventive treatment is available, it reaches all segments of society, regardless of their ability to pay or any other social situation. determinants of health that can be good, so when you tell the American people today that regardless of their income, all Americans will be able to have access to that vaccine, when it comes, they should have had access to it, I don't control, you know ?

I believe you represent the administration that makes that decision. I will certainly advocate for everyone to be able to receive the vaccine regardless of their income or any other circumstances, let me say I'm sorry, it's okay, thank you sir. Jenner, those are important questions. I don't want to bring senators up to speed and it's hard to see the time to start this unusual hearing of the US Senate Committee on Health, Education, Labor and Pensions, that image alone speaks volumes. true, there are only a handful of senators in the room, others along with key witnesses from the leaders of our health system appear remotely due obviously to concerns, general concern, in some cases, concern that they themselves They may have been exposed to corona. virus also this is the first opportunity for many of these experts to speak freely from the White House.

I spoke directly with members of the Senate who continue to refine the issues of testing and also the risk of communities across the country potentially opening prematurely and we heard from dr. Fauci mentioned that inevitably when we start to open society we will see more cases. His concern is that many communities may not be prepared for those consequences. This will continue for a couple more hours, but we want to start a hunt for Casey right now. Who's been watching this for us? Casey, what is the significance of this hearing and what happens next? I think what you've seen is an event that focuses on the facts, the realities of testing the realities of reopening in a way that you know.

It's very different from what we've been seeing on a daily basis during this crisis in the White House, where we've seen quite a bit of politicking and not necessarily the same set of facts from the president that we're hearing today from these

officials

dr. Fauci, of course, testified that he thought it would be a bridge too far to think we would have a vaccine in time for the fall semesters. He was answering a question from Lamar Alexander, the president, about how universities could prepare for this. He also said he was concerned that if we opened up too quickly in response to Senator Murray, we would start to see small spikes of outbreaks that could potentially grow into something bigger, so he was quite cautious in his responses here and Democrats have been. urging not to do so.

He hasn't been going after his boss, going after the president, but he has been presenting a pretty clear picture of a very serious situation across the country. One thing that also caught my attention. Lester is that he acknowledged that it is likely that the count of the number of deaths in this country actuallyis not taking into account everyone who has been affected by this, he spoke particularly about New York City and the reports of people who were dying in their homes who are probably not part of the official coronavirus. The death count is very large, both from a factual perspective and also from the perspective and reality of how this hearing had to unfold.

Yes, we are talking about trying to reopen the country, but there are a lot of signs here of how the ways we are not the fact that they are in self-quarantine II they may not be here in person there are very few senators in the hearing room this campus here on Capitol Hill almost deserted a very strange kind of seeing everything underscoring that we are still in the middle of this group, yes, it is as if we are all living in these little video boxes and certainly extending to the US Senate Casey , thank you and then of course there is the contrast and what we heard from dr. . stock market and what we've been hearing in the White House as recently as yesterday, when the president touted an increase in testing, even as we heard in the burning a moment ago from Senator Lamar Alexander that there is not enough testing to get to where we need.

Let's go to Jeff Bannard, he's in the White House right now, Jeff, what's the read on that on Pennsylvania Avenue, hey Lester? I think I'd like to underscore and amplify a point that you made that this is rare testimony and this is the first time the country has heard from the country's four top health

officials

in charge of the federal response. to the coronavirus without filters, away from the close and careful gaze of President Trump, who has at times, during previous coronavirus task force briefings, cut to the chase. I deflected or redirected some of these answers, but a couple of headlines here because there was a point of bipartisan agreement on the testing front when you mentioned Lamar Alexander, the Tennessee Republican, who chairs this committee, said that what our country has done so far in terms of testing is impressive. said, but not enough, we also heard from top Democrat Patty Murray of Washington, she said we need dramatically more testing, it's unacceptable, we don't have a national strategic plan to ensure testing is fast, free and everywhere, for which that contrasts sharply. to what President Trump told me yesterday in the Rose Garden, he says this country has prevailed in testing, another quick thing we heard from Admiral Brett Gerar, who is leading the federal response to corona virus testing, he says by September it projects that the nation will be able to perform approximately 40 to 50 million tests per month, put another way, it means that President Trump's statement a couple of months ago said that every American who wants a test can get a test which, according to Gerar, will be true in September or October.

He says okay, Jeff Bennett, thank you very much. I want to bring dr. John Torres and John one of the topics that I think Dr. Foul Chew was emphasizing that there will inevitably be more cases as society begins to open up and was concerned about the ability to respond to the consequences if he called him out. It was just over a month ago that New York was watching him speak. I think at one point there were close to 900 deaths a day and the healthcare system here was potentially strained to the breaking point, the truth is we can hear those calls once again for ventilators and PPE in some of these communities that haven't been hit yet in Leicester, that's the big concern because what he said is we know these cases are going to increase, it's just a matter of keeping it under control, isolating testing, contact tracing, it's important to have them all in place and Their concern is that some communities may have met some of the statistics as far as the 14-day decline, but they may not have those other things in place, so when they start to see these outbreaks they also can't control them, that's one great concern that they make sure to do so.

Otherwise, we start going back to where we were, back to square one, something none of us really want to do. Lester, okay, thanks doctor, let me bring in Meet the Press moderator Chuck Todd Chuck, as we noticed this was a different tone on this. We hear more than we hear from the White House, even Republican members expressing concerns about the level of testing, where does this go from here in terms of support for the president, even within his own party? Well, look, one of the things I want to point out is that this is probably one of the most functional committees on a bipartisan basis, this Senate information has always been one of those and the Senate help, as this nickname goes to the Health Committee, a lot of that is largely due to Lamar Alexander and Patty Murray, the two leaders. senators on this committee because they do a good job working together, they have some shared health priorities overall, they may be ideologically opposed, but philosophically they are close, so I would just say to them that you know I'm listening to this hearing and on the one hand, you're very encouraged because you realize that everyone is dealing with the same set of facts, whether it's a Republican asking the question or a Democrat, and I think this is a reminder that in some ways Lester is as uncomfortable as telling him to President Trump.

Doesn't his presence seem to create more chaos, create more problems at any given time, take him out of the equation and you have kind of a clear, if I would say difficult, picture of what we're facing, we need a lot more proof? To pick up on a point, Jeff Bennett said that eventually the Admiral said we will have enough tests by September. What I learned from this Lamar Alexander hearing was that we have to have a test for everyone in September or We're not opening anything, whether it's the University of Tennessee, my kids' high school or 30 Rock, so we have a ways to go and I will say that this part of me feels strangely encouraged by watching this group of senators work together.

It's probably the most functioning bipartisan committee group you'll have these days, okay Chuck Chuck, good to see you, we're getting back to regular programming, but coverage of today's hearing continues on our streaming

news

service NBC Now and I'll be back with a full recap when I see them on NBC Nightly News for now. I'm Lester Holt NBC News in New York. Good morning everyone for about a month to respond to that, but in your response you didn't. give us information about the timeline on which these families consume this information and now the CMS administrator is telling us, after lobbying Senator Wyden of Eretz and me, that this information may not be available until the end of May.

I need to hear from you today why has there been a delay? A three-month delay and the basic information that families and individuals within a community need about nursing home outbreaks. The number of cases. What is happening in nursing homes. Tell us when we will see that information. Well, thank you very much, Senator, and you have highlighted one of the great tragedies that we have all experienced together. Clearly, long-term care facilities have been particularly hard hit by this pandemic. I know several things against Kim, who oversees several things. Things have been done and I can get back to you in terms of where they are in terms of activation, but clearly all nursing homes are now required to report cases of their patients there or our staff to the CDC. secondly, I have to implement a policy that all nursing homes must notify the members of that nursing home about the existence of Ovid in that nursing home, including family members, and you verify in terms from when it is if it is operational today or last. week, but I'll come back to you with one of the biggest ones we've done as we talked about key and reopening, as Tony mentioned weenie, they are symptomatic cases.

We need to do tack tracing, but the other thing we really need to do is to conduct surveillance because this virus appears to have a high propensity for its symptomatic infection, which means that for traditional ways of finding cases, the cases will be mitigated and therefore, We are developing a national surveillance system and the first thing and more importantly, it is to carry out comprehensive surveillance throughout Newark, United States. CDC will do this in partnership with state and local territorial health departments. I think Cursor will have the responsibility to do that. within the inner city clinics that are selected in Annie and the health service for the Indian Health Service clinics, but this is critical to being at the forefront of this and for comprehensive surveillance of everyone in these nursing homes , we have also done aggressive outreach on all of them and improving infection control procedures, etc.

The CDC has helped these nursing homes with that in the guidance along with this unit, but I'll get back to you in terms of timing. I'm pretty sure they already are. is operational, but I need to double check to make sure because I know that Seema has announced that everyone is now reporting any infections in workers or patients to the CDC and that they are now required to notify other members in the nursing home as well as members of the family of the night when Ovidio is in one of those, yes, sir. The President just has one question for Dr.

Dr. Frogg, I wanted to ask you in your earlier testimony in response to a question from Senator Murray, you described a basic concern that you have with the states reopening, can you reaffirm that for us? , yes, thank you, Senator Casey, yes, my concern is that a state or cities or regions will understandably try to return to some form of normality without taking into account to a greater or lesser degree the checkpoints that we put in our guidelines, but when it comes to seeds of security and withdrawal of mitigation because they feel that if that happens there is a real risk that you will trigger an outbreak that you may not be able to control and that will actually, paradoxically, set you back and not only cause suffering and death that could be avoided, but could even get you back on track to try to achieve economic recovery. because it would almost turn the clock back instead of forward, that's my main concern.

Centon, thank you, thank you doctor, mr. president Thank you Senator Casey Senator Paul is nowhere near the sentiment scientists have shown that rhesus monkeys that are infected with co2 19 cannot be reinfected several studies have also shown that a plasma from recently infected coronavirus patients neutralizes the virus and laboratory experiments furthermore an infusion of a Convalescent plasma is based on the idea that Riccardo Baroni Cronin of our patients is developing a need and can then be beneficial as donated studies show that recovery in Kobe 19 patients from the asymptomatic to the very sick is showing a significant response.

Studies show that SARS. A MERS is also part of the viruses that induce immunity for at least two to three years and yet the media continues to report that we have no evidence that patients who survived rotavirus have immunity. I think the truth is actually the opposite, we have no evidence of survivors. of rotavirus do not have immunity and there is a lot of evidence to suggest that they do, the question of immunity is related to aid policy and then workers who have gained immunity can be an important part of our economic recovery, the positive side of so many infections. in the meat processing industry is that a large portion of these workers now have immunity, those workers should be assured that they are unlikely to get it again rather than being alarmed by media reports that there is no evidence of immunity that you has declared. publicly that you debated that all survivors of a corona virus have some form of immunity.

Can you help set the record straight? The accumulating scientific record supports that coronavirus infection likely leads to some form of immunity. Dr. Yang, yes, thank you for the question, Senator Paul, yes, you are correct in saying that given what we know about recovery from viruses like coronaviruses in general or even any infectious disease, with very few exceptions, when there is someone present is most likely indicative of a degree of protection. I think it's in the semantics of how you phrase this when you say whether it's been formally tested by long-term natural history studies, which is the only way you can test whether it's protective, which I said and would do.

I'll probably repeat that, but also what is the degree or titer of antibody that gives you that critical level of protection and what is the durability, as I've often said. You can repeat again. You can make a reasonable assumption that it would be protective. but natural history studiesthey last a period of months and two years, but then I tell you definitively if that's the case and I think it's important because in all likelihood it's a good way of saying it: the vast majority of these people have immunity rather than saying there is no there's evidence, you know, the whu-oh guy feeds into this by saying there's no evidence of immunity and actually there's all the evidence piling up and in fact many of the different studies have shown that it's very unlikely that you contract it. again in the short term with respect to returning to school, one thing that was left out of that discussion is mortality.

I mean, shouldn't we at least discuss what the mortality of children is? This is for dr. Fauci you also know that the mortality between 0 and 18 in the New York data is close to zero, it will not be absolutely zero, but it is almost close to zero between 18 and 45, the mortality in New York was ten in a hundred thousand, so that we really need To think about that, we need to look with an open mind at what happened in Sweden, where children go to school. Mortality per capita in Sweden is actually lower than in France. Less than Italy.

Reduces pain. Less than in Belgium. Less than the Netherlands. The same as Switzerland, but basically there is someone who argues that what happened in Sweden is an unacceptable result. I think people are intrigued by it and we should be. I don't think any of us are. When we work with these modelers, there are more wrong people. With more than correct models, we are opening up many economies across America and I hope the people who are predicting doom and gloom and saying "we can't do this as women in the face of the surge" will admit they were wrong.

If there's not a surge because I think that's what's going to happen in rural states, we never reached any kind of pandemic level in Kentucky and other states, we have fewer deaths in Kentucky than in an average flu season, that's not the case. . Saying this is not deadly, but actually outside of New England we have had a relatively benign course for this virus across the country and I believe that one size fits all, that we are going to have a national strategy and that no one is going to go to the school is friendly. It's ridiculous, we should really do it school district by school district and power should be distributed because people make incorrect predictions and really the history of this, when we look back, will be incorrect prediction after incorrect prediction after incorrect prediction, starting with Ferguson. in England, so I think we should have a little humility in our belief that we know what is best for the economy and, as much as I respect you, dr.

Falchi, I don't think you're the end of everything. I don't think you're the only person who can make a decision. We can listen to your advice, but there are people on the other side who say there will be nothing. an increase and that we can safely open the economy and the facts will bear that out, but if we keep children out of school for one more year, what will happen is that poor and disadvantaged children will not have a parent who can teach them. at home we are not going to learn for a full year and I think we have to look at the Swedish model and should consider allowing our children to return to school.

I think it is a big mistake if we do not open the schools in the fall. Thank you sir. President, could you respond to that even though there are only 32 seconds left? Yes, and you could make it clear whether or not you suggested we shouldn't go back to school in the fall. Well, first of all, Senator Paul, thank you for his comments. I have never presented myself as the only voice in all of this. I am a scientist, a doctor and a public health official. I give advice according to the best scientific evidence. There are other people who come into that and give advice that is more related to the things that you talked about about the need to get the country open again and economically.

I don't give advice on economic things. I don't get advice on anything else in public health so I wanted to respond to that, the second thing is you use the word, we need to be humble about what we don't know and I think that falls under the fact that we don't know everything about this virus. and we really better be very careful, especially when it comes to children because the more we learn, we see things about what this virus can do that we didn't see in the studies in China or in Europe, for example, right now children present the kovat window 16.open 19 who actually has a very strange inflammatory syndrome very similar to Kawasaki syndrome.

I think we'd better be careful if we're not arrogant in thinking that children are completely immune to the harmful effects, so again you're right about the numbers: children in general do much better. than adults and the elderly and particularly those with underlying illnesses, but I am very careful and, I hope, humble, knowing that I do not know everything about this disease and therefore I am very reserved when it comes to making broad predictions, thank you, thank you, Senator Paul and Senator Baldwin Thank you mr. Chairman and Ranking Member Murray and our witnesses I want to cover a lot of territory in my five minutes, so I would certainly appreciate concise answers, but I want to start with Dr.

Dr. Redfield. Redfield I think the testing protocols at the White House present a model for other essential workplaces. Sorry, Senator, he interrupted at the beginning of your question, if he could say it again. Sorry, yes, dr. Redfield, do you think the testing protocols currently in place at the White House present a model for other essential workplaces? Well, I guess thanks for the question. I think one of the important things you mention is the guidance for essential workers put out by the CDC. and I think it was originally inspired obviously by healthcare workers, where there was a significant shortage of healthcare, people working in any workplace.

I ask if he thinks the testing of the White House protocols is a model for other essential workplaces. I would just say that I think every workplace has to define its own approach; This is how we put into practice our considerable comment about the fact that OSHA has not established a mandatory and enforceable temporary emergency standard for workers in all types of work environments, but other than that, would you say that the PPE rules and The protocols in place right now at the White House are a model for other essential workplaces, in my view, and we would return to the guidelines that the CDC put out on core workplaces for people who, if they are a force essential work, go out in public and maintain. six feet distance and wear face coverings, ok jawar, you've testified about how far you've come with regards to testing evaluations.

I want to ask you if you think that today we already have a national testing strategy that covers the testing needs at the national level. assessment to the assessment of testing supply at the national level and a strategy to fill that gap to prepare at the national level what we need in terms of closing that gap with testing platforms swabs, sample collection media and reagents and the PPE is necessary to run those tests, so thank you for that. We have a strategy that covers us at least through the fall and beyond, as I mentioned, we are working individually with each state.

I think Senator Paul is right that Kentucky Wyoming or New Jersey Rhode Island are different and there are very different testing needs the east coast will have multiple testing compared to other states and we are working on them individually so I know you testified before that not only are you working with the states but you are working with every lab in every state to increase capacity. How about we work with those who would be the ones who would need evidence to say reopen their school, their university, their business? Each of them has identified what they believe their testing needs are based on guidance you know, not enforceable, mandatory rules, but are you in touch at that level on your dashboard, do you have visibility at that lower level, or It's mainly in contact with the states and with the laboratories, so in the last few months we have done a lot of the individual work in nursing homes in meat packing plants and others, I mean. really to the very granular level that we're at now, though, we're really working with the state leadership with the public health lab, the state epidemiologist, this shows the state health officials because they really need to understand what their sum is going to be. . be in your state and then in the fund and in the funding that we are asking very specifically in the CDC funding for specific plans for schools, underserved nursing homes, et cetera, so I have two more points that I'm going to make.

I don't have The time for questions is about the transparency of that needs assessment. Can the public see it and the State see it? Can help committee members see if it is publicly available? Secondly, the de

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ry of this supply is a critical issue and it seems to me that logistics is bringing this to light, whether it is PPE testing or medical equipment, it is still extremely fragmented, leading to increases of pricing and many other inefficiencies that we need to deal with the full power of the defense production law. Would you like me to comment on that ma'am?

Sorry, I'm glad you're commenting with the president's indulgence. We have overtime and a succinct response to the senator. Please let a jury decide. Yes ma'am and yes sir, particularly for things like swabs and media, there is still an industry that I would say is not mature within the country and that is why we made the decision to acquire all of that centrally until December and then distribute it. that to the state because there are too many small businesses, too many variables to control without a really heavy federal hand. That's just one example of where we're really moving forward on that and using the DPA as a sample to help support the US industry in more mature aspects of the industry, like some of the big test producers, we feel like by helping direct them to make sure that the states get what they need, the right distribution, we won't be procuring it directly for us, but again we're going to be very evidence-based and data-driven as we move forward, thank you sir, thank you very much, Senator Baldwin, Senator Collins, thank you, Sir.

President, let me begin by first thanking each of our witnesses today for their expertise, their dedication, and their hard work, dr. Redfield I want to start with you. Dennis has told me throughout the state of Maine that the diet they cannot practice in both of our states despite following very strict infection control protocols is causing increasing health problems. Dennis tells me that teeth with cavities that could have been filled are now going to need root canal teeth that could have been treated with root canals are now going to require extractions people with oral cancer can't get the treatment the cleanings they need before starting their treatment dental help is clearly very important and maintenance status Officials and our dentists are looking for help to make the right decisions.

Another 47 states have reopened dental offices or have a data center to reopen, so my question to you is whether Dennis is following the American Dental Association guidelines, whether to reinstitute strict protective measures for his patients, his staff, their hygienists and if they are closely examining and seeing a decrease in the number of Kovat 19 infections in their county, are these reasonable factors that states should consider when reopening the practice of dentistry. Yes, senator. thanks for the question, you know we've been interacting and speaking with the dentist and working with state and local public health officials to update our guidelines on reopening a variety of health care services, as you know, and I think you raise a point very important and I wouldn't disagree with what you said about looking at the American Dental Association and the reality of the outbreak in the area, but we are in the process of updating those dead lines and they will include direct guidelines for dental practices.

Thank you so much. a lot of dr. Dr. Gioia dr. There has recently been an important man for REM REM does safar. He may be pronouncing it wrong, whose transition to receive emergency use authorization last week, the largest hospital systems' power grid contacted me with questions about how this therapy will be assigned in the future. HHS finally issued a statement. on Saturday about allocations going to states, interestingly not directly to hospitals, but again, the decision-making behind these allocations is not very clear. HHS and the assistant secretary for preparedness and response say each state is expected to receive an allocation, but no timeline has been provided beyond that. those who are being treated with this medication at Maine Medical Center through a clinical trial.

I am concerned that hospitalized patients in Maine have little or no ability to betreated with this promising therapy for the foreseeable future as this and more therapies and ultimately a vaccine comes to market. How can these allocations and distributions be resolved so that patient care is not delayed and so that whether or not they will have access to these treatments is not dependent on the state they

live

in? and ultimately a vaccine, Senator Collins, from this good misguided Adams, go ahead, Commissioner, Senator Collins. I think we completely agree with you that this has to be an evidence-based approach to getting medical therapeutic vaccines from desi beer, whoever people need them.

I think we can all agree on the fact that we learned a lot of lessons from the Run des in your situation and of course as you mentioned it is run by HHS and I am an idiot for what you have seen in the most recent announcement. is that what the task force did was provide guidance to HHS on where the most significant outbreak of hospitalization occurred and where the inpatients were in those hospitals. This represented about a quarter of the drug supply we have and more will be allocated accordingly. I believe that valuable lessons can and will be learned with respect to other therapies and vaccines in particular, and we should incorporate them into our operational plans going forward. .

Thank you Dr. Almirante, do you have anything? Ted, I'm so sorry, thank you if you have anything to add, if you do for the record, no ma'am, no ma'am, I agree with the commissioner, it's absolutely critical that it be based on evidence and the people who could benefit. from there and also fair and equitable throughout our country, thank you Collins and Senator Murphy. Thank you very much, mr. President, thank you and Senator Murray for calling this meeting, thank you to all of our witnesses for your service, this is obviously an exceptional hearing today and three of our witnesses are in quarantine, so I just want to start by asking a pretty simple yes . -o-there is no doubt that I think I know the answer to dr.

Dr. Fauci. Hahn dr. Redfield, I am right that you are all drawing a salary as you should during your quarantine period, that is correct Senator, let me begin. I think we better be careful with the quarantine issue, we are essential. Work is part of what is essential. infrastructure and we are there when necessary, which are often duties and respect for places in the White House. I was at the White House yesterday and I'll probably even be there today and in my office at the NIH, so it's not really strictly speaking about the quarantine as we know it, but it is performing duties as critical workers and I would love for my colleagues to Also respond to that Senator Murphy, this is Steve Hahn.

I agree with dr. Falchi, yes, I am earning a salary and have continued to work during my quarantine and as an essential worker, I will participate in face-to-face meetings when that attendance is considered critical. My point here, listen, everyone should get paid. Well, they are taking precautionary measures because From the contacts you have made, my point is that the quarantine is relatively easy for people like you and me, we can still work and get paid, we can telework, but there are millions of other Americans who They have jobs that cannot be done from home or paid hourly and it is surprising to me that this administration has not yet developed a mechanism for states to implement and pay for a quarantine system that works for all Americans.

Your plan to reopen America requires states to develop that plan, and yet my state has no idea how to implement and pay for that system without help from the federal government, which brings me to my second question, dr. Dr. Chynn. Redfield, you made headlines today by appropriately warning us about the dangers of states opening too soon, but as Senator Murray mentioned, this infuriates many of us because it comes hours after the president declared that we have prevailed over the coronavirus, What did I just say. I'm going to tell you it's going to make it much harder for state leaders to maintain social distancing restrictions.

It comes days after the president asked citizens to release their states from social distancing orders and I believe you are all noble public servants. but I'm concerned that you're trying to have it both ways, you say this state shouldn't open too soon but then you don't give us the resources to succeed, you work for a president who is frankly undermining our efforts to comply with the guidance he gives us. has provided and then the guidance that you have given us is criminally vague and I want to ask my last question on this topic, obviously the plan to reopen America was to be followed by more detailed and nuanced guidance, what is downward guidance? trajectory means what happens if the trajectory is down in some configurations but up in others, what happens if you reopen and then there is a spike in one location or another configuration and of course you knew this because you developed this guide, this additional guide that is the site. -Specific which, frankly, is useful.

Some of this is on the CDC website, but some of it is not and we need it. My state needs it. We don't have all the experts that you have, so we trust you, so the reports suggest Dr. Redfield that this guidance that was developed by you and other experts was shelved by the administration, that it was hidden from the states in public because of a decision made by the White House, so my specific question is why was this plan not released and if It's just being reviewed when it will be released because states are reopening right now and we need this additional guidance to make those decisions, Senator.

I appreciate your question clearly, we have generated a set of guidelines, as you know, and it is the response to this outbreak. evolved from a CDC to a whole-of-government response as we work on the guidelines, several of which undergo interagency review and in each agency input to ensure that these guidelines are more broadly applicable to different parts of our society. I've talked about agents reviewing their comments that have gone back to the CDC and I anticipate that they will go back to the task force or the final review, but before reopening in Connecticut in five days, in ten days, I refer to this guidance.

It won't be useful to us in two weeks, so it will be this week, it will be next week, when are we going to get this experience from the federal government? The other thing I will just say is that the CDC is ready to provide technical assistance. your status in any state, upon any request, I anticipate these broader guidelines will be posted on the CDC website. Soon I can't talk nonsense, but I can tell you that your state can contact the CDC and provide guidance. directly to anyone in your state about any circumstance on which your state wants guidance soon is not very helpful.

Thank you Mr. President Thank you Senator Murphy Senator Cassidy Hello gentlemen, thank you very much for your service and I will have a number of questions so if your questions can be brief I appreciate if your answers can be brief dr. Hahn, in his testimony, mentioned that population testing and vaccine trials now include more Americans. I guess my question is, what about the kids? a less nominal response or a mitigated response to vaccination, can you comment on that? Please, yes sir, thank you, Senator Cassidy, when the phase 2 and 3 trials are underway, they will include our most vulnerable populations, including the people you described, we are working very closely, so if I can interrupt the phase 2 is only checked for safety, you wouldn't have to do a separate phase 2 and the patient who was younger, go ahead Senator, can you just assume that the safety data for adults applies to the safety data for children?

No, we would also like to evaluate the safety, sir, in children as well, so the current phase 2 trials include children. There are phase one studies going on right now, sir, you said we had a phase two going on. I think maybe it's about to start from modernity. Dr. Thatcher, you can answer that guy, no, senator, no Cassidy, I know, I didn't say a Phase Two. I said we're in a second dose of phase one and we'll proceed when we're done with phase one to move on to Phase Two, so I think. I have heard that children will be included in the phase two trials.

No, that's under discussion between the FDA and the NIH right now, sir, because we realize that it's important for us to understand what the C's are and what the children are, but dr. Redfield, the compilation based on what Hundred Murphy said, the guidelines released for schools on opening of schools, obviously you're about to modify them, but I realized when reading them that there is nothing about testing, so we talked of the tests, the specific tests, how we use the tests, except the guidelines. for school systems it has nothing on how to integrate testing, will that be in the guidelines that are being released, Senator?

Thanks for the question, clearly there needs to be an integration of a testing strategy already indicated that will be different for different school settings as well as different jurisdictions, and that will have to be integrated into each of those, there are general general guidelines and then As I say, I believe that the detection strategy, what is important is to include the surveillance strategy, must be individualized. I mean, let me get into the lines of dr. Redfield, with all due respect, I think children, whether rural, suburban, or urban, are the only environment where there is notable common ground, and I will echo what Senator Murphy said: the resources that the government has federal far outperform all but the most sophisticated, rich, populous state, and even then it outperforms it to some extent, so I think it would be nice to get the nod in an elementary school setting: these are best practices or These are three options and choose from one of these three to tell each school. district or each private, parochial or independent school works with the figure of its State Board of HealthIt seems like a useless effort.

I say this because children play an important role in both protecting from diseases and spreading diseases, etc. pattern that can be followed the senator I must have been misunderstood when I was talking about differences I was thinking about the difference between an elementary school a high school a university in terms of how we are a trade school there may be differences in how a testing strategy is integrated , but I think having a testing strategy with different options for people to evaluate based on different principles will be important in terms of guidance, dr. Falchi, you make a compelling case that the risk of reopening prematurely is great, but I think the frustration, if I think about children in particular, is the risk-benefit ratio of a child potentially being home away from improved nutrition without parents can work because the school provides unsupervised childcare, as sometimes happens in incidents like child abuse, but perhaps most importantly for all children is the opportunity cost to our developing brains of not having access to the information that will help that brain form optimally now, as there had been any kind of risk-benefit ratio for the child, yes, there is a risk for the callous Aki, but there is a particular risk of missing out on a year of education, especially for those from less affluent and less affluent backgrounds.

I guess I'm very concerned about that tension, what are your We think it's very difficult for you to know the unintended consequences of trying to do something that is broadly important to public health and the risk of having a comeback or research agents of an outbreak and the unintended harmful consequences of having children out of school. I appreciate that I don't have an easy answer for that. I just don't have to sleep step by step as we approach the fall time frame of reopening schools exactly where we begin the dynamics of the outbreak. I could point out something that I think has been alluded to in some of the questions: we have a very large country and the dynamics of the outbreak in different regions of the country, so I imagine that the situations related to school will be very different in one region versus another, so it will not be universal or homogeneous, but I don't have a good explanation or solution to the problem of what happens when schools are closed and a cascade of events is triggered that could I have some common circumstances because I have mr.

Chair, I will close by asking the Chair for permission to bring for the record an article that was just published in the Journal of Pediatric Nursing Children are at risk for Ovid 19 B, so that will be included. Thank you, Senator, Senator Warren. Thank my Lord. President and thank you to our witnesses for being here today. I hope everyone is safe and healthy. In the past 16 weeks, more than 1.3 million Americans have been infected with corona fires.We now know that around 80,000 people have died and 33 million people are out of work. Dr. Falchi has informed six residents that he has battled the fear of deadly viruses in his career, so I would like to hear his honest opinion.

Do we have the corona virus contained, senator? Thanks for the question at this point, it depends what you mean by containment if you think. that we have it completely under control, I don't want to say that if you look at the dynamics of the outbreak, we are seeing a decrease in hospitalizations and infections in some places, like in New York City, which has plateaued and is starting to get off in New Orleans. but in other parts of the country we are seeing spikes, so when you look at the dynamics of new cases, although some are going down, the curve looks flat with a slight decline, so I think we are going in the right direction, but in the right direction .

The right direction does not in any way mean that we have complete control of this outbreak, so the right direction, as I understand it, we have about twenty-five thousand new infections per day and more than 2,000 deaths per day. I think those are the correct figures and some estimate that we could be at 200,000 cases a day due to genes. That's right, dr. Falchi, no, I don't foresee that, like 200,000 new cases by June, I wait and watch the dynamics of things starting to stabilize and decline, that we will be much better than that senator, just so you understand that right now there are 2,000 new infections again and two 25,000 new infections it takes and two thousand deaths again, and that's where we are now, yes, yes, so let me ask it, we know that it is possible to control this virus better.

Other countries have done it like South Korea, but we are now three months into this pandemic and we have basically continued to set records in the number of people diagnosed and the number of people who died dr. Falchi recently said that a second wave of rotavirus in the fall was inevitable, but that if the United States implements all the countermeasures it needs to address this, we should do reasonably well and the countermeasures he identified are things like significantly continued social distancing. . more widespread contact tracing testing, he also said that if the United States doesn't do what's necessary and this is their date, we could have a bad fall in winter, so now we're about sixteen weeks away from Labor Day, that's pretty much it the same.

How long has it been since the virus was first detected here in the US, haven't there been enough strong Helder measures in place so that we don't have to worry about a bad fall and winter right now? The projection he has heard from Admiral Hua regarding? the testing and other elements that would be needed to respond to the projection are for when we get to the end of the summer and beginning of the fall and we will have it in place and I like the projection that I gave you, we don't have it in place now, but we are projecting that that will happen on the spot and let me ask you on the other side of this if we don't do better testing contact tracing and social distancing, crown of honor deaths will necessarily increase of course if you don't respond appropriately we will have the deleterious consequence of more infections and more deaths, and that is the reason.

You quoted me, Senator, very correctly and everything you said, and I will stand by it if we do not respond appropriately when the downturn comes given that there is no doubt that there will be infections in the community and we run the risk of having a resurgence. I hope that by that time in the fall we will have more than enough to respond adequately. but if we don't, there will be problems. I appreciate your hope and I wish we could tell the American people that the federal government has this pandemic under control, but in fact we can say that the virus is not under control in the country.

In the United States we have not yet taken the necessary measures to avoid a second wave of deaths and we all know that the people who will be most affected will be the elderly, the essential workers, the people who are on the front lines, the president needs to stop pretend that if you simply ignore the bad

news

it will go away, the time for magical thinking will not end, President Trump must recognize that the federal response has been insufficient and that more people are dying as a result, we are running out of It's time to save lives and we must act now, so thank you dr.

Tsao to you for everything you are doing, I appreciate it, but the urgency of the moment does not thank you. Thank you, Senator Warren, Senator Roberts, thank you very much, Mr. president and thanks to all the witnesses, you all are like the Fab Four. I guess it was the Fab Five back in the day, but we're shining the light of truth in the darkness, individual flashlights for sure. Thank you, mr. president for emphasizing that we have to be bipartisan, we are not going to get anywhere with this approach and that is obviously in the eyes of the beholder.

I'm pleased to say that we have a very good relationship with Governor Kelly, who happens to be a Democrat. obvious and his Ahmir's his in emergency management his is absolutely spot on Norman is doing enough work, that's the rest of this morning. I talked to Lee Scituate and Kansas is very good at reading hair. Candice receives 7.2 new Kovach for cabbage with food processing facilities, she sees. This mirror behind me is the stage where votes enter Dodge instead of exit Dodge. Dodge City is my hometown, BR, the hot spot regarding Candice, mainly due to two packing plants, we have five, which is 26% of the cattle brand anywhere. grade Candice is going through a difficult time, we shouldn't be worried about foot safety, but the food supply chain I think nationally is under a lot of stress, we see it and there we see that in poultry we see that in the park there slaughtering pigs in the office in front of Sonny Perdue livestock dentistry with the Department of Agriculture has stepped up, just as the president is declaring that these packing plants are a national asset, we made progress in the city when we started, we had five tests, five, it's That is to say, between four and six five does not fit with the million that we expect to receive.

That has been said by one of the witnesses. The reason why I am really harping on all the problems with the ships is the fact that China's relationship is such that Even a The first breakthrough regarding trade with China seems to continue and wait and that is another depressing factor for prices. Then this has been going on for five or six years in which our prices have been below pasta production. The bottom line is that our consumers are really realizing that food doesn't. I don't come from a grocery store background and I am very concerned that the damage to the food value chain is very real, not to mention the financial situation our farmers, ranchers and producers face.

Having said everything I want to ask Admiral Jorah what he talked about. the importance of having diversity and types of testing available at the five packing plants that we have on campus if we could get a rapid test and we could get it like we hope to order because of the hot spots that are developing not only in Kansas but it would also make a great damage to the food value chain. It would be absolutely wonderful. Could you talk to that man? Thank you, senator, both of you, dr. Red Phil and I have been very actively involved in sourcing strategies for the industry, particularly in Kansas, we are largely supplying rapid diagnostics to public health laboratories, as well as bringing them into areas like that, so the only compensation However, the diagnostics are very slow, so each machine can only do four per hour and that is very, very slow, so it is a combination of tests that are needed in this kind of situations in kind of high throughput testing that is available at a major lab, a search lab right there in Kansas, as well as a combination of rapid testing and that's what we're providing to provide a comprehensive holistic solution and I think that the CDC is also on the ground in Kansas supporting that.

I appreciate that if you only do it for an hour, that's not a quick test, maybe it's a fast and slow test. I'm not really sure how you define that term. For my part, I think as we reopened and, by the way, Governor Kelley began the process of opening. first of this month, May 18th and then we'll move into June and then the hope is not, but we have contingency plans that, if that doesn't work out as Dr. Pouchy Height rightly describes, I think that will be correct, but this is It's going to be a difficult task.

I have to tell you that in terms of agriculture we are not in good shape. I appreciate everyone and the work they were doing will be beside them when they drink and behind me when they drink. taking pops thank you senator roberts senator kaine thank you mr. Chairman to the committee leadership and witnesses for convening this important hearing. The last time Dr. Qi and Hahn were before us was on March 3rd. I have a slide that I want to display that shows what has happened in the United States since then. The chart found here compares the experience of the United States and South Korea in three days On January 21 both nations experienced their first case of Kovan 19 at which time unemployment rates in both countries were essentially identical on March 3 when the witnesses were last here South Korea had experienced 28 kovin 19 deaths in the US had experienced 9 again the economies of both nations are measured by unemployment rates were almost identical but now the story changes, yesterday more than 81 thousand Americans have died and the US economy has experienced job losses not seen since.

Meanwhile, during the Great Depression, South Korea's economy has not changed dramatically at all and the death toll is now 256. South Korea is smaller than the United States, one-sixth of our population, but even if We increased the death toll to reflect the difference. The per capita death toll in the US is more than forty-five times the rate in South Korea and the healthcare carnage here is causing almost a depression, while South Korea has protected its economy with proper management . I could have made this graph with other nations. The United States has the seventh highest death rate per capita.

In the world our mortality rate is higher than that of India Australia New Zealand Japan and Mexico it is almost three times the mortality rate in Germany twice the rate of Canada the question is why if we want to open our economy in schools we have Let's learn the lessons from nations that have also managed. Here are some things that don't explain the difference. Our hospitals are as good or better than those in South Korea. Our hero healthcare providers are as good or better than those in Korea. In South Korea our research capacity is as good or better than in South Korea and we have more resources than South Korea our GDP is 12 times that of South Korea and our per capita income is 50% higher According to Dr.

Bag the list of deaths in the United States the death rate in the United States especially when compared to other nations is unacceptable, aren't you sorry sir? Yes, of course, I mean such a high mortality rate is something that, in any matter, reform in my opinion is unacceptable and dr. The experience of other nations shows that the US death rate is not only unacceptable but unnecessary, isn't that right? No, I don't know if we can say that on Saturday, but would you say that the United States has to do better, of course, we always have to do better?

As and and South Korea's experience shows that as a nation the healthcare crisis has a huge impact and also on their economic condition, it is not like that, that is the case sir, I understand where you are going with this, but No. I have to tell you that there is a big difference between South Korea and the United States. You know the outbreak and let me, let me, let me get to it. I want to get to factors that explain the difference, since we know that it is not resources nor our health providers are testing first.

South Korea began aggressive testing long before the U.S. Now, in the fifth month of the pandemic, we have surpassed South Korea in testing per capita, but in the critical month of March, South Korea was testing to its population at a rate 40 times that of the U.S. Admiral Gerard Dr. Gerard has set the standard for us as we reach September. He says the United States needs to perform between 40 and 50 million tests a month to be safe, which works out to between 1.3 and 1.7 million tests per day. Yesterday we did 395 thousand tests. We have a long way to go, a second factor is contract contact tracing.

South Korea adopted a rigorous contact tracing program from the beginning. The United States has not yet engaged in a national contract contact tracing program.Isn't that okay with that? Dr. The bags are like red fuel, so I think it would be best to direct that question to the CDC when the outbreak started. Sir, we had an aggressive contact tracing program, but unfortunately, as the cases increased, it exceeded the capacity that we want for mitigation, which is why we lost the containment so clearly and that was also key for the economy because Korea of the South did contact tracing tests to protect, isolate the sick and then they did not have to do the closures that help their economy.

Social distancing is a third factor that we have talked about. but finally the latest healthcare system, would you agree with me that it helps keep people safer, whether from serious illness or death from Kovan 19, if they say healthcare yes, of course, of course , is that the case in South Korea 97%? of the population had health insurance in the United States before kovat nineteen million did not have it and lacked access to health care massive job losses in the last month threatened to take health insurance away from millions more and President Trump is doing everything he can to dismantle the Affordable Care Act that would take away health insurance from tens of millions more, let's learn the lessons from those who are doing this right.

Thank you, mr. President, I will give you a clarification please, Mr. President, this is an encouragement, I'm sure why I just wanted to clarify that I projected that we will have the capacity to do 40 to 50 million tests per month in that time period, but I said if it was necessary at that time, I will NOT do proclamation, we have to really understand where the epidemic is, what community spread is before we can ask for the necessary amount of testing to be done. I was simply stating the fact that our mix of testing capabilities will be at that level, even excluding new input from the NIH thank you very much Senator Kaine Senator Muskie Thank you Mr.

President and gentlemen, thank you for being here this morning virtually, but also for everything you have been doing over these many months. Alaska is doing well right now from a numbers perspective, and honestly, we want to keep it that way because we know we are exceptionally vulnerable people. populations we know that we have a geography that is challenging we know that we have facilities that are very limited the last hearing we had the opportunity to listen to dr. He and Collins shared where they are with Red in Alaska, so every effort we make to keep the virus out of Alaska is our lives that are saved.

I in the community of Cordova that is just preparing to open is a salmon fishery on the Copper River in two days and was able to share that a worker had tested positive when he came from the lower 48 to come to work. The good news is that all the protocols that we have implemented seemed to be working: the quarantine, the isolation, not only for that individual but for others that he had come into contact with were safe, so I want to recognize the assistance that we have received from the administration dr. Eastman is in the state right now and the Department of Homeland Security's medical director is going into rural communities to better understand our vulnerabilities.

He goes to some of our fishing communities to understand again how we can successfully process a fishery when we have to bring in workers from abroad. We appreciate your help regarding additional testing capacity. I have been in contact with our state medical director this morning and the mayor of Córdoba, understanding better again, do we have the tests? what we need, what we need on the ground and one of the things I would like to have clarified and it will probably be for you, dr. Shu Alchemy because it's been a huge help in shedding light on what we need to do in these rural areas, but a lot of the attention has been on the hot spots and responding to the hot spots, but how do you keep those rural areas remote?

First, small communities become hot spots. Are we doing enough? And right now the strategy has been to simply close them. The travel restrictions that are in place are apparently working, but they are also devastating our economy. it's tourism, whether it's our resource industries or the potential of our fisheries, so Admiral, if you could speak to that aspect, I have a very important question related to contract contact tracing that I would like to address. to admiral yaw or dr. Redfield, thank you senator and as he knows you have a leading state health official and dr. Anne, thank you.

I've had the privilege of working with her and you have a very good protocol for trying to keep Alaska safe by isolating for a period of time when you arrive, as you know, we also work with the state to meet their very testing requirements. challenging because you really can't, you know, laugh from a thousand miles away, so we put in a really custom combination for the point of care and also the Cepheid machines. I think we sent nine or ten new ones to Alaska and about 50,000 tests, which is about four times what they've done collectively to date to provide that support, so again I think there's a comprehensive strategy that they have, but again the mitigation It is to the extent that it is possible, given the circumstances. face maps, hand washing, hygiene, we completely understand the challenges, especially in the fishing river environment and in remote areas, but all of these have to come together, test, track, mitigate, hygiene factors to try to keep your people safe. community and we really understand culturally. that many of your communities were almost wiped out in the 1918 influenza pandemic, so that memory is still very clear and very painful for many of the citizens, although we want to do everything we can to assure you that we are giving you all the protection that we can. then the admiral let me turn to dr.

Redfield, because this relates to contact tracing, I think this is a very, very key part of how we move forward to get people back to work, to get people back to school. Right now we have about a hundred people involved in contact tracing in Alaska, that's clearly not enough, there's been talk of a national strategy, but I think we recognize that we have teams in place, whether it's the United States or the Corps. of Peace, whether it's our public health body, what else should we do to make sure that once it arrives? I've tested positive, you know, so what happens after that, who else should be involved in this?

I'm not convinced that we're focusing enough on that aspect of how we move toward reopening if we haven't made contact. tracing, thank you very much, senator, I really want to say that I think contact tracing capabilities are critical, it will be the difference between managing to contain this outbreak or once again using large-scale community transmission or not putting a word in, as you know , to display it again. the CDC number is over 500 CDC people, we have another around 650 that they are trying to put into our foundation, but the most important thing is that we are trying to work with their health department with the resources that we have been able to provide because to the Congress, the mental ones too, as you mentioned, with these other agencies with LabCorp, I mean the United States or with the Census Bureau to work together and make the state develop, they are using the capacity, some states have reacted to state work, some Riya states in a National Guard as They Start doing this, but I agree with you and said that this is how it will be and they see a significant effort to develop the contact capacity that we need in this nation.

It will be state by state, but it will probably need to be increased in your state. So from what you just said, wait and we're there to work with the states to help them get there. This must be implemented by September. Here we have to move forward. Thank you. Thank you, Senator Murkowski. I don't want to get any senator. off, but we have eight more senators, we have five-minute rounds and it's 12:30, so I would like to request that senators and witnesses ask concise questions and try to stay within five minutes. I would appreciate the senator's annoyance.

Thank my Lord. Chairman, thank you and the Ranking Member for holding this hearing and thank you to our witnesses today and please pass on our thanks to all the hardworking women and men in your agencies who I know have been working virtually around the clock. to try to improve our response and keep Americans safe and mr. President I hope that you and all the witnesses are healthy and safe today, as are all the members of your team. I wanted to start by echoing comments my colleagues have made about the CDC's food leadership and our public health experts about how we're going to use the facts. and evidence as a guide so that our schools, our daycares and our businesses have the information they need to create safe and sustainable plans to reopen and, of course, that means that our testing capacity not only has to be sufficient but it must be flexible enough.

To meet our needs, the key distinction between South Korea and the United States is not how many tests per capita we have conducted over a certain period of time, but the fact that at the beginning of this pandemic South Korea was much more capable of doing a a lot more testing per capita than we had and then follow up with all the other measures that you've talked about so that we continue to need to identify the need and then build our capacity to meet the need, not the other way around. I wanted to start with a question for you dr.

Bolsay first of all, thank you for your work and your experience. I wanted to talk about nursing homes for a minute in New Hampshire and across the country. A lot of the Kovac 19 dust we're seeing has been in nursing homes that we all know. people who have lost a friend or family member in nursing homes and the pain of the fact that people would not be able to be with the loved ones Benson died if they died yesterday dr. Burks said the 1 million nursing home residents should be tested in the next two weeks, as well as all nursing home staff, dr.

The stock market is a short-term target that makes sense to me, but after that, what will the ongoing federal recommendations look like? How often should we test patients and staff on an ongoing basis and what other measures will be necessary to keep our loved ones at home? These facilities are secure. Thank you for Hassen's question about the overall plan, as you mentioned, that was recommended by Dr. Burks is a solid plan, as you said in the immediate question, in the long term we will have to have infection control capabilities in nursing homes that are really pristine and really impregnable, we have to do the types of surveillance and we have to have the capacity.

When you identify someone, you get out of that particular environment so that they don't spread the infection by doing some general testing for everyone. I think that's a good start, but when you look at what you're going to do in the future, it has to be a considerable degree of surveillance capability, thank you doctor, the White House is now requiring all staff to wear masks and anyone in regular contact with the president take daily tests. Do you think nursing homes should implement those same measures to help ensure that our seniors can receive the same level of protection?

I think there should be a system for the optimal protection of people in nursing homes and that would necessarily involve testing. to every person every day, that's an approach that might not be practical when you think about all the nursing homes in the country, but there are strict regulations and guidelines on who can enter the nursing home and I think the staff should be monitored very carefully with intermittent testing to make sure we do not have infected people entering the nursing home. I'm not sure you can do it practically, test it every day, I don't think it's feasible, but I think something that is much more aggressive than in the past should be done well.

Thank you. I have one last question for Dr. Fuck her and dr. Redfield I would also just say that if we can get masks to everyone in the White House, I hope we can get masks to all the nursing home employees who need them, dr. Fauci and dr. Redfield US must prepare now to ensure we have a safe snack and administer vaccines, something both have mentioned, both for an eventual Koba 19 vaccine and for other diseases such as flu, the lack of increased testing production and The team of protectionpersonnel at the beginning of this crisis made things worse here, that those mistakes cannot be repeated when it comes to vaccine production and distribution.

We are already seeing reports that some children are not receiving routine music vaccines as it becomes more difficult to access them. -person medical care bag what steps should we take now to ensure that we have sufficient manufacturing and distribution capacity for a Copa 19 vaccine without jeopardizing our manufacturing and distribution capacity for other important products such as a flu or measles vaccine and my follow up? ask dr. Redfield would be the efforts being made at the CDC to ensure our routine vaccines are accessible during the October 19 public health emergency. Yes, thanks for that question, the Senate somehow responded as quickly as possible.

I mentioned this in my introductory comments to what I was talking about. about the vaccines for kovat 19 and what we said as we test these vaccines, we are going to put production at risk, which means we will start investing hundreds of millions of dollars of federal government money into the development and production of doses of vaccines even before we know it works, we will see that when we do and I hope we do, and I am cautiously optimistic that we will finally get an effective and safe vaccine, we will now have doses available for everyone who needs it in the States United, we will even contribute to what is the needs globally because we are partnering with several other countries, the other part of your question is about making sure that when we find ourselves in a situation like the so-called lockdown that we might be in now, Let's make sure children get the vaccines they need.

They need it because that would be an unintended consequence of the shutdown as we are now. It's a very good point. We want to make sure we're not left behind on that. Also thank you, thank you very much and I will take my answer. Dr. Redfield offline Thank you very much for a long reason. Thank you, Senator Hasson, Senator Scott. Thank you, mr. president on the panel thank you all for being here practically without asking questions and we find ourselves in the situation that we wish we weren't in. I am very grateful for people like dr.

Dr. Burks. Falchi and many others for their 24/7 dedication, without a doubt our nation is safer because of their hard work. I'm going to direct my question to estores dr. Fauci really a specific question, dr. Falchi and I are thinking about the reopening of the United States and specifically the reopening of South Carolina and I'm taking into consideration the fact that in South Carolina I think overall our cases are moving in the right direction, we have a little less of 8,000 cases. unfortunately, 350 deaths, our hospital capacity is actually better now than when the pandemic started. Our ability to isolate hot spots and mitigate the spread of the virus is where it needs to be.

With that in mind, I flew to Washington from South Carolina yesterday. we plan to conduct additional testing of 220,000 more residents by the end of this month focusing on at-risk populations by the end of this month we will have tested 100% 100% of nursing home residents and the staff who care for them and after increasing our contact tracing workforce increased twenty-fold in a matter of weeks, our state Department of Health announced yesterday that we are increasing it by 1,400 additional contact tracers we have built and will continue to build the tools necessary to better detect and isolate cases To map your exposure and avoid substantial spikes in the future, most importantly, our healthcare system, thanks in part to this administration's flexibilities, has the beds and equipment necessary to address the most serious cases when they arise now, With these tools in hand, we have begun to reopen to be clear, we continue to expand testing and take measures to protect the most vulnerable and the data points are increasingly clear for older Americans and those with chronic diseases like diabetes and high blood pressure, this virus remains a threat. dangerous threat a recent report suggests that in New York approximately 90% of deaths had underlying conditions two-thirds of deaths were 70 years or older ninety-five percent were over 50 years of age in South Carolina the age of compliance patients who have died from the virus seventy-six and a half, almost two-thirds of the deaths have been patients over 71 years of age and almost 90 percent were over 60 years old and approximately 98% in South Carolina are over 50 years. younger where we have not seen deaths, less than 1% of the deaths in my state have been under the age of 40 every death is a tragedy and we grieve for our family members who have lost their loved ones we are taking every step to protect our older South Carolinians, as well as those with underlying conditions, but we set out to flatten the curve by taking aggressive unprecedented measures, such as stay-at-home orders and mass closures of small businesses that we did not set out with the goal of 100 percent prevention. %. deaths that would be unrealistic is impossible and we did not set out to maintain quarantines until we found a safe and effective vaccine that would take too long dr.

Redfield, his agency, published a useful graph showing two curves, one that rose rapidly and Pete High reflected daily cases without protective measures, the other flatter curve showed cases with those measures in place and the main purpose of the illustrated graph was to make sure that did not exceed hospital capacity, so while I respect the need to be cautious, we are too often presented with a false dichotomy: if saving our economy saves lives, we have seen the goals move around flattening the curve and I think that's unfortunate because at the same time what we're doing businesses have collapsed physical and mental health has receded depths of despair educational outcomes plummet as we wait in our living rooms praying for good news about therapies and vaccines we said what I'm going to do to flatten the curve and I think we've done a pretty good job with that, we need to do better and we will do better.

My question, Dr. Fauci, is as we begin the process of moving toward reopening South Carolina, what else would you suggest we could do to protect our most vulnerable populations? Thank you, Senator Scott, you gave a really very eloquent description of what I think would be a model form. The way he's approached this, I mean he's implemented things that I think would optimize his ability to reopen and as I was thinking as I was talking, I almost wanted to clone that and make sure other people heard about it. that and look what you've been doing in the topic of your direct question about vulnerable populations is that, as we've said in our guidelines, it sounds like you're ready to move forward carefully because you've put in place a very good system that the vulnerable (the elderly and those with underlying illnesses) should be those who in the latest lifting of mitigations should be those left in a situation where they could be at risk of becoming infected; in other words, protect them until the very moment. end of the relaxation of its mitigation because, as you very correctly said, those are the individuals who are now the most vulnerable, so the morbidity and mortality are individuals in particular, you could say, sir, those in the minority group, African Americans and Hispanics, who for a time In a variety of situations that are the social determinants of health, are more likely not only to be infected but also to have the underlying conditions that would increase their risk of a high degree of morbidity and mortality, so it sounds like you're doing things very, very good and I encourage you to continue and follow the guidelines as you get closer to normalizing your condition thank you, thank you dr. felching I'll just close with this since I'm out of time, thank you for the many conversations you and I have had about those vulnerable populations to include minorities and our seniors.

I will say this without a doubt when I look at nursing homes, as typically African Americans and Hispanics are the certified nursing assistants who provide care to the elderly population, so your focus on those two very vulnerable groups is greatly appreciated. and thanks for your experience. Thank you, Senator Scott and Senator Smith, thank you. You, Chairman Alexander and Ranking Member Murray, and thank you all for being here today and for your service and Dr. Fauci, I have to say that you are in the unenviable position of being a person in whom so many Americans of Minnesota trust to give us the scoop and tell us what's really happening.

You're about the facts and not the politics, and that's a really good thing. I just have to start by asking a question that I think many Americans want to know: How are you? How are you doing? It has been a credible effort. I'm doing well, senator. Thank you so much for asking. This is such an important issue that affects us all individually and you have to work as a team and I really enjoy working with the senators and governors because it is the local level that we are going to make this work. I'm fine, I appreciate your concern, many people are thinking of you and are grateful for your service, as we are for all of you, so we met today to think about what we need to do to reopen our economy. and I think first about what's happening in my home state of Minnesota, where agriculture is such an important part of how our state works, it's part of our history, in our pork processors right now we're seeing the reality of euthanizing thousands of pigs a day because there's no place to process them because of what's happening in the processing plants and the workers that do the hard work and those processing plants are getting sick, so here's a story, this she is a worker that the starchy bune wrote about this called hamari DeJesus, she is an Asylum Seeker and mother who works for a contractor who does cleaning in the processing plants and works for $14 an hour seven hours a day five days a week and their job is to disinfect the machines that process the meat into ground beef. and he started to feel bad on April 11 but he continued to go to work and on April 21 when one of his co-workers fainted he told his supervisor that he felt bad and then they told him to go home but if he didn't If any sign of illness occurred he should return he went to the doctor and paid a hundred and fifteen dollars to get a test and a few days later he found out he was kovat positive and he is still at home he still doesn't get paid and he doesn't have health insurance and almost two weeks ago the president Trump implemented the defense production act to keep these processing plants open, but the USDA gave really limited guidance on what would be safe for workers, he said, for example, in response to the testing that has been done.

A lot of what we've been talking about today cites that facilities should consider the appropriate role of testing in workplace contact tracing of koban 19 positive workers in a workplace and screening, so that dr. It's trendy, we think about how we move forward, we all want to open the economy, what guidance would you give us in a situation like this here in Minnesota? Well, I can give you my common sense guidance, although this is not the area of ​​My experience focuses more on others, but it seems that if you want to keep things like active plants open, you really need to provide the optimal degree of protection for the job, the ability to allow them to go to work safely and, if when people get infected, to be able to get them out immediately and give them appropriate care is involved, so I think when you ask people to perform essential services, Houmas has the responsibility tomorrow to make sure they are well cared for and protected.

And again, that's not an official proclamation, that's just me speaking as a doctor and as a human being. Thank you, Dr. Kouchi and I believe that you speak as a human being, but you also speak as the leading epidemiologist of our country and the person that we all trust and this is the point that I want to make clear to everyone, that this is the type of guidance that you should receive and follow and then these are the type of tools that we must have in our country if we are going to reopen our economy like we all want to do and with this we move forward with the reopening. our economy and yet we still have circumstances like we have in these processing plants and elsewhere in the state, we are going to go back to where we started, except even in the worst place, as I think you pointed out.

Dr. doubtful, but thank you, senator, and again, it really relates to one of the questions that one of your fellow senators asked me earlier, one of the things that I keep emphasizing and I'll repeat it again because I report that when I'm in the process ofopening and withdrawing mitigation, you really have to have the ability to respond when the inevitable tics occur where they will undoubtedly occur. The way we deal with it and the success we have in stopping it. That will prevent us from achieving the kind of recovery that would not only be unacceptable from a disease and death standpoint, but will also set us back in our progress toward reopening the country.

Thank you. Thank you very much, Senator Smith, Senator Rama, this hearing and the participants in it, Admiral Jawara. I'm going to start from where Senator Hasson spoke. I understand that politicians will frame the data in the most positive way from a political point of view, of course, they do not expect that from Admirals, yesterday they celebrated that we had done more tests and more tests per capita than even South Korea, but they ignored the fact that they achieved theirs at the beginning of the outbreak while we held water during February and March and as a result of March 5. 6.

The United States had completed only 2,000 tests, while South Korea had completed more than 140,000 tests, partly as a result of them having 256 deaths and we having almost 80,000 deaths. I think our testing record is nothing to celebrate, whatever the fact that their testing numbers are going down down right now because they don't have the kind of outbreak that we have ours are going up like they have to have I think it's an important lesson for us as we think about the future on a separate topic my impression is that with respect to vaccines, I am critical of what we have done in terms of testing and vaccines, we have done a pretty good job moving forward quite aggressively and However, the president said the other day that President Obama is responsible for our lack of a vaccine, adds dr.

Fauci is President Obama or for my extension President Trump, did they do something that made the likelihood of creating a vaccine less likely? Are Trump or President Obama responsible for the fact that we don't have a vaccine now or for delaying it for someone? in some ways no, no, senator, no, not at all, certainly, President Obama and President Trump are responsible for not having a vaccine, we moved forward as you said because I described it in my keynote speech pretty quickly, no one has passed from knowing what the virus was to a phase one trial as quickly as we've done it so I don't think it's a dead thing once you would say that someone is responsible for doing something wrong in that I think that's right that's the correct way to do it, thank you because that was my impression.

I was surprised by the comment but that was my impression dr. Redfield Sender Cinema and I wrote a letter expressing our dismay at the lack of real-time data at the CDC. I'm talking about granular demographic data on hospitalization treatments, how is it possible today that the CDC has never established such a real-time system with accurate data and what can Congress do to rectify that so we never have to see it again? something like this oh, hey, sorry, senator, thanks for the question. I think you have reached one of the important points. The first ones I focus on are data, data modernization, data analytics, and predictive data analytics.

Clearly, Congress has moved forward in providing funding for a data modernization and we are in the process of implementing it there, the reality is that there is an archaic system, an unintegrated public. health system each Department of Public Health has its own systems this nation needs a modern and highly capable data analytics system that can perform predictive analysis. I think that is one of the many shortcomings that have been identified as we go through this outbreak and I cannot agree. with you more it's fun to correct that thank you please help guide us on what we need to do to make sure that happens.

I guess we don't fill it ourselves, but we work with companies that have that capacity and use that capacity in our favorite. Doctor, if you want one last thing related to a virus, I know I'm asking you the impossible question, but we are all waiting for a vaccine, obviously the goal of our administration is to get it as soon as possible and what I can say is that they are doing everything possible to do exactly that, given our track record with creating vaccines for other coronaviruses. How likely is it? I mean, is it very likely that we will get a vaccine within a year or two? it's just more likely than not or it's a long shot definitely not a long shot Senator Romney I think it's more likely that we will because this is a virus that induces an immune response that people overwhelmingly recover from. of people recover from this virus, although there is a good level of morbidity and mortality in certain populations, the very fact that the body is able to spontaneously eliminate the virus tells me that, at least from a conceptual point of view, we can stimulating the body with a vaccine than inducing a similar response, so although there is no guarantee, I think it is much more likely that at some point within that time frame we will get a vaccine for this virus.

Thank my Lord. President Cedo. Thank you Senator Romney. I want to thank the witnesses for their patience. We have four more senators and we would like to give them the opportunity to ask their questions. Senator Jones. Thank you so much. Mr. President and thank you to all of our witnesses for being here virtually and also for your incredible service during this time. I want to quickly follow up with an additional statistic that Senator Romney talked about regarding South Korea and that is the fact that you We are a nation that has about six times the population of South Korea, but we still have about 310 times as many deaths from this pandemic, so I think we need to be very careful when making comparisons around the world comparing the United States to other countries.

Dr. Redfield will continue a little bit with what Senator Murkowski and I think Senator Kaine talked a little bit about contact tracing and where we're going. I understand they are working with states to try to develop plans to reopen testing. Contact is important. Tracing is important, but using that data will also be important in terms of the quarantine plans that Senator Murphy talked about about child care facilities to allow people to put their children in a facility while they are still returning to work. . Those issues include perhaps even facilities like empty hotels or motels that can be used for self-isolation.

How is this plan developing within the CDC? Will those plans be individualized by state? Will we, as a member of Congress, have access to those plans? how our state is going to pay for this and I say that because my state is already using the money we've already given them as a wish list, I mean they're talking about building a million dollar Capitol instead of developing the test and do contact tracing, so I'd like three just to go a little bit deeper into how these plants are going to develop, what access we'll have to have those plans and be able to see them.

Thank you very much, Senator, this is obviously what I said. Before there is a critical component in us, let's take this time to prepare for the upcoming fall winter and develop that comprehensive contact racing ability. We are working individually with the leadership of the territorial tribal departments of the state health department to try to enable them. um you have to understand what they think their capacity needs are and those discussions have already happened, as has happened with her, it's said that there have been a variety of federal agencies together on testing and contact tracing. The CDC in position that we have rescheduled are people that we have Across the country there were 500 that began to help each of these states.

We've modified that with some additional staff who are on board the state-by-state wreck. We have moved about one hundred and six billion dollars of the money that Congress has appropriated. in the states so they can start thinking about how they want to get the contact racing capability back and then of course it was mentioned that we're both other government programs like AmeriCorps, this is the Peace Corps, so each group is going to pull out their contact tracing piece what they think their needs are and I think it's going to be similar to what we heard from the senator from South Carolina these are significant increases, he said he's incredibly critical of anything they're going to increase again, but the point you made is vitally important and we found that as we were already fighting for the repatriation of different Americans from all over the country, we had to quarantine many of them, as you know, using military bases because many of the local state health departments If you've really developed that system, where do you put someone to be isolated? who is a homeless person?

How is the system developed? This has to be part of it too. Are there any cities that are intrinsic to your hotels? As you mentioned, the point that was raised by one of the other senators is a very important one about people who, in particular, say Meatpacking, the individual who has to go home and isolate, but maybe has the ability to not go back home. house, so if I sleep in a multiple general generation house with about 12 other people. mechanisms to bring people in, we have an effective way of identifying cases and then taking appropriate public health measures and these have to be comprehensive, they will be developed in the jurisdiction at a time when I am not looking for any reason why these are not transparent documents as they are completed and it really is a tribute to the congressional support that you have given so far, as I said, one point six billion dollars came into the state and then again to do this, in addition to the resources that we have obtained, but It is essential that people underestimate how important it is that we have a highly functional comprehensive aggressive attack, you have already seen programs so that in the next outbreak we contain them, we do not have to change or mitigate, thank you, thank you, dr.

Redfield, I appreciate it. It seems to me that we still have a lot of work to do, so thank you, thank you very much, Senator Jones, Senator General. Thank you, president. There has been a lot of discussion about testing in general. Listen to Senator Romney earlier. I think Senator Kaine mentioned it. everyone has dr. Han, if you remember when we met I said, is the FDA going to be more entrepreneurial? Isn't the FDA going to be a boring person talking about how we fix the healthcare system as a whole now that this has come into clear focus?

I have a timeline and I will present it for the record, which shows from January 24th to March 5th and I want to emphasize what Senator Burr asked earlier: did the administration ever put up a roadblock in trying to do testing and dr? . Hahn, this will end up in a question in a moment, but there was a window of time from January 24th to March 5th that I hope the American public will look at and come back to what's wrong with our healthcare system as a whole, early testing I think was created by the fact that the CDC said they were going to do their own testing.

The oft-cited South Korean test was not going to be analyzed. We had to do our own. I know the FDA worked with the FDA. CDC, but the most important thing about all of this is that for almost a month this was in that bureaucratic whirlwind, the FDA prevented private and academic development of tests for weeks, the CDC DISA denied access to functional tests, as I cited in Korea South, this was created through all the bureaucracy and bureaucracy to the point where we had to find a one-size-fits-all approach because of the uncertainty of the virus and now we're stuck on that.

I don't necessarily want to harp on that because I think those were mistakes we made. I'm tired of hearing that it's the administration's fault. Dr. Hahn, I'd like to ask you this question in the spirit of what we talked about during your nomination process here. In the future, will we get rid of some of that heavy, heavy bloat that we're looking to get therapies and vaccines through the system with a faster method? We fear that if we don't and if we try through bureaucracy like we did in the first testing period, we may push this into the distant future and at that point there will be not only the carnage of the disease itself, but also the economy. to deal with.

So I'd like your comment on that one month period, what responsibility the FDA and the CDC have and then whether it looks better in terms of moving more quickly into the future. Thank you, Senator Braun, for the question about our timeline for that period. shows that we began working with test developers beyond the CDC on January 24 and had a double-digit number of test developers working with us. One of the issues that we identified was, in fact, the availability of the virus and other supplies to do the test development in a timely fashion Senator, I completely agree with you that this is an opportunity for us to look at and determine how we can do things better andI think it's a really important thing for all of us to do, and certainly to the FDA, I can promise you that they will do it.

Do that, I look forward to it, sir, I can commit to you that we will look at each of our regulatory authorities. We have done it during this outbreak. We have provided significant flexibility and have tried to provide the right balance between regulatory flexibility and enabling the big test. developers and therapeutic developers in this country with the need to ensure that our security and defense standard is current, we have leaned on the manufacturers, we have learned a lot from them, as well as other stakeholders, and we will continue to learn and commit, sir , to implement the necessary changes to ensure that we can act in a simpler way but still protect the safety and effectiveness of medical products.

Thank you Dr. Foul Qi, taking a page from his AIDS manual that he implemented. a clearly defined formal treatment review pathway, can we do that for Kovat 19 in a parallel pathway similar to what you implemented in the '90s? In fact, I have a bill called the Promising Pathways Act that is based on that protocol that you put up. Instead, can we do that to more quickly get to the therapies and vaccines here with Kovan 19? Well, it's a different story, but there are some similarities if you're referring to the parallel path that I set in motion in the late '80s, when there was no availability of HIV drugs and when we were testing drugs within a protocol that would make them available. disposition outside of the protocol in what ultimately turned out to be compassionate use, so what we did was we didn't want to interfere with the integrity of the protocol to determine in a controlled way what was safe and what was effective, but there was a dire need for some type of accessibility to those drugs outside of a clinical trial for those who might even have a chance of having them and in fact, that was in many ways the birth of the really strong concept of compassionate use and in fact there is a version of that that I will give you the word to the Commissioner and you will know when access has been expanded and emergency use authorization, but drugs that have not yet been fully tested in a clinical trial, so there is some analogy and similarity between what I did in the 1980s and What is really being done with the FDA now?

Steve, if you want to comment on that, I think that's correct, Dr. Falchi, the emergency use authorization process by law allows us to have flexibility and evaluate the risk-benefit ratio and a public health emergency and we have done that since the therapeutic point of view on three separate occasions and we continue to analyze those requests as they come in. Thank you very much Senator Braun Senator Rosen Here I am, thank you mr. president for bringing this hearing and I want to thank today's dedicated physicians for a lifetime of work, study and passion. We are a nation grateful for all of your lifelong commitment to fighting disease and not just in the United States but around the world and you know, as I talk to Nevadans about safely reopening the economy, a question that comes up is often when are we going to have a vaccine like everyone has mentioned and of course Nevada travel and tourism, for example, for us and the jobs associated with those industries.

We can only fully return if we know it is safe to travel and visit our work at our hotels, casinos, restaurants and attractions. Ultimately, for this to happen we have to build trust with our visitors and it's safe, we need a vaccine and yet research is extremely important. I understand that this takes time to develop and ensure and guarantee both safety and effectiveness. I would like to know more about the research that is being done regarding preventive medication research. It could be useful in the lead-up to a vaccine and especially before one becomes widely available. I would like to ask if this could be part of the path that will help us begin to reopen our economy safely and bring visitors back not only to Nevada but to our entire country, so if dr.

What research is currently being conducted to identify potential preventive treatments with monoclonal antibodies or other therapies? If the correct antibody is or can be identified, could it be used as a preventive drug to prevent the Kovan 19 virus from attaching to those host cells, much like treatments for rheumatoid arthritis, severe asthma or other diseases, and in Second, preventive medication options like this would complement the X effectiveness of a vaccine once it is available. Yes, thank you for that question, Senator Rosen, it is an excellent question and in all the therapeutic interventions that we are. in development and you mentioned that several of them would be direct antivirals similar to REM VESA beer, but that is only one of several possibilities, since there are several viral targets in the ratification cycle that use convalescent plasma and a preventive modality, as well such as monoclonal antibodies in a preventive modality are indeed feasible and will be carried out in parallel with the development of a vaccine.

The model of using medications and other interventions that are effective is truly a great success story in HIV/AIDS because many of the interventions that were developed for the complete treatment of an infected person are exquisitely effective in preventing HIV infection. HIV, so that's the kind of model we build in parallel with disease treatment; It is the use as treatment as prevention. I think it will be part of our effort at the same time that we are pushing hard to try to get a vaccine, so it's an excellent question, very relevant. I know I have a tough time ahead, so I'll abbreviate this as the second most important.

The question I get not just from our first responders is there are people who are concerned at heart, but in general, what should the next generation of PPE look like for all of us as we move forward in our lives, not just as workers? Depending on your job, you may need it. something stronger or more specific since we all want to go out shopping or go out to eat or whatever those things are get on a plane in case the dough is made of a certain material love our effective scarves can you tell us about PPE for the general?

Well, you know that the best PPE for the general public, if possible at this time, is to maintain physical and social distancing, but as we've said and I think there are certain circumstances where it's out of your control when you need to do the necessary things. like going to the pharmacy and taking your vacation, going to the grocery store and buying your food, you actually need some supplements to just physically distance yourself, that's why the recommendation was made some time ago, I think it was dr. Redfield at the CDC, who was the first to say that in terms of getting some type of coverage, we don't want to call it a mass because back then we were worried that we would take masks away from health care providers, but some type of masks like facials.

I think for the moment, covering should be a very regular part of how we prevent the spread of infection, and in fact, increasingly, as you go out here and where I'm sitting in Washington DC, you can see a lot of people around there. with masks, which gives me a certain degree of comfort, but people are taking this very seriously. Thank you, lovely Senator Rosen, Senator Leffler, thank you all for being here and for your service, Admiral Jerrod, before I begin my questions, I want to acknowledge your new role as the United States Representative to the World Health Organization for Mitigating the resurgence of this pandemic will require global cooperation to achieve.

We need accountability and transparency in the organization where this organization was established to ensure the timely flow of accurate and unbiased information on global health emergencies like this. Performance reforms must be made to restore the trust we need here. I hope you will work with our allies to advance these reforms. This question I have two questions, the first is for Dr. Redfield and dr. Redfield Georgians wonder how we got here today 1,400 deaths a third of Georgia's workforce out of work. I am incredibly concerned about the cover-up and misinformation coming from China and their efforts to suppress life-saving information at the beginning of this outbreak.

As we continue to safely reopen our economy, we must take steps to ensure that another outbreak cannot take over the world in this way. I understand that the CDC has worked with the Chinese CDC on global health security for decades. Can you comment on the level and timing of the information you received and relied on from your Chinese counterparts when this virus emerged. Thank you very much, Senator, and I want to echo how important global homeland security is as a national security priority for this nation and we are going to need to be able to respond to that as long as we are a nation, CDC has had relationships with countries around the world. , we have offices in over 45 countries right now, people in over 60 and one of them is China, where We have a US CDC that, with the China CDC, we have worked together for four decades, particularly in influenza and emerging infectious diseases, and that has been a very productive collaborative scientific interaction when this original outbreak of pneumonia of unknown etiology came from the original seafood market.

Obviously the discussions with the US staff, being with your Chinese CDC, I personally had discussions from the beginning, I think the CDC did it anywhere and I myself can Airy thirdly with the counterpart, discussed this, so I decided that on a scientific level we had a very good interaction, I think so, you know. that's different at the broader level of the chinese government, thanks dr. Redfield, I have a final question for each of our big witnesses today and it's one that my constituents often ask me in the mainstream media and, in fact, some of my colleagues in the Senate seemed to want to describe each of their relations with our president during this wartime effort.

It is conflictive and lacks consensus. Can you categorically tell the American people here today whether this is true or false based on your testimony today? I have seen a very coordinated effort to address this with the administration to combat this pandemic. Can you give me an idea if this character is the characterization of Israel, if he is true or false, thank you. I would ask Dr. Fauci to answer that first, yes, no, there is certainly not an adversarial relationship between the president and I, as I mentioned many times. I give opinions based on evidence-based scientific information.

He hears that he respects her. He receives opinions from a variety of other people. but in no way in my experience over the last few months has there been any adversarial relationship between us, thank you dr. Dr. Redfield. Hahn would again like to echo what Dr. Fauci said we are there to provide our best public health advice and that is what we do and round and date on the science and I have always felt free to give the best public health advice that I believe should be given at the time and always. It has been done in a very professional manner Senator Lafleur, this is Steve Hahn.

I don't have an adversarial relationship. I have not had a relationship with the president. He asks questions. I have given him my honest answer that is based on scientific data and then he listens to me. Respectfully to those who incorporate that into his and Brett's decision making, I'm sure why I can only echo my two colleagues. We work very closely with all the scientists, all the doctors, of course, Ambassador Birx, other scientists within our group, we have a very productive relationship. A working relationship between us and also with the president and vice president would be non-confrontational and I certainly feel that we have the ability to honestly express our opinions and recommendations and it has been that way from the beginning.

Thanks, the senator went for us. I have final comments. Yes, I have them and if they already are, I have a couple of quick questions. Good thank you. You know, Dr. Bueno, President Trump and otherwise, there is no doubt that an essential part of safely reopening our economy is developing and successfully distributing a vaccine for Koba 19. We need to plan now for the deployment of a vaccine once it is proven to be safe and effective, but it is absolutely crucial. The planning process from clinical trial to distribution and administration recognizes and addresses racial and ethnic disparities in our health care system that, as we all know, have been ignored and unrecognized in this country for too long and we must ensure a equitable access to this vaccine for all.

Dr. Fauci, let me start with you, what steps is the NIH taking to ensure that covin 19 clinical trials with these vaccinesand therapies take into account racial and ethnic disparities? Yes, thank you very much, that is a very relevant question, Senator Murray, and indeed in the design. Of our clinical trials and the sites that we have chosen in our clinical trial network, it will be very representative to be able to get minority populations and higher risk patient populations to be part of the trial so that we know during the trial. What the relative effectiveness as well as the possible negative events is something that we started in the HIV days when we tried to get a good demographic representation and we're going to do that with these people.

Thank you, thank you, and Dr. Vaughn, please tell me what steps the FDA is taking now to ensure that the United States is prepared to produce a sufficient number of vaccines, including the necessary manufacturing supply chain capacity for supplies such as vials, medical 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, ma'am, has been the transparency of the data, the sharing of data from both the NIH agency as well as the manufacturers so that we can understand what the capabilities are and what the needs are. of the supply chain and then how to share that so that if one vaccine manufacturer doesn't move forward, we can use that manufacturer's capacity for another manufacturer's vaccine.

I am very happy and report that the work of dr. ouchies inductive brands has led to that kind of effort that we have developed, as I mentioned before, this Gantt chart that describes all the steps that follow with the vaccination, including the supplies that you describe, it is somewhat complicated ma'am and it is possible that very It is We can expect to have five to seven different vaccine candidates that may need different supplies associated with them, but we have been upfront about identifying supplies where they are available and then working with manufacturers to make sure they are available.

Fine, thanks. Thank you so much. much mr. President, thank you and thank you to all of our witnesses for joining us today. It is very clear to me that we have more work to do before we can safely return to work and school and we still need some semblance of normal life in our country. testing is fast, free and everywhere and we need the White House to design a detailed national plan to make that happen; We still need adequate personal protective equipment for both our healthcare workers, our businesses, and our schools when the time comes. I still need guidance from our experts so that our communities have the information they need to safely, confidentially, reliably, and fully reopen schools and businesses competently and so that public health workers and healthcare providers have the information they need to keep their patients and communities safe and while experts have been clear that the day when we can be safe may often be a long way off, there is much to do in the meantime, is to plan ahead, for example, to ensure that a Once we have a safe and effective vaccine we can produce it and distribute it to everyone quickly. equitably at no cost and to address immediate challenges, for example by ensuring that there are appropriate mental health resources for everyone facing the challenges presented by this virus, from the stress of physical isolation, loss of income to trauma and patient anxiety. and workers who have been on the front lines, so I will continue to press Congress and the White House to provide the action and leadership that our communities need and I hope that Mr.

President, we will continue to have opportunities like this here directly from the experts and ask urgent questions about how to get our country out of this crisis. It is clear that we have much more to do, and I hope so. that as our efforts continue we will be able to bring any of you as witnesses for another hearing soon and again thank you all for joining us today thank you Senator Murray. I have a clarification question and a couple of quick questions. comments and then we will thank the witnesses and we will finish by listening to my clarification.

I want to make sure I don't create confusion by the way I asked the back to school question I asked dr. Fauci first on treatments and vaccines and dr. Admiral Draw second on the testing, what I thought I heard was the doctor said the vaccines are coming as fast as ever, but it will be later in the year at the earliest before we see there is any treatment for some of them. that that has to be modest whether it's promising there could be more but that doesn't mean you shouldn't go back to school that would be more or a testing strategy, am I right, dr.

Fauci, you didn't say you shouldn't go back to school because we were all dead, no, not at all, mr. President, what I was referring to is that returning to school would be more in the realm of knowing the infection landscape with respect to testing and, as Admiral Joss said, it would depend on the dynamics of the outbreak in the region where you are located the school. es, but I didn't mean to imply any relationship between the availability of a vaccine and the treatment and we have to go back to school. You are absolutely right and what I heard from Admiral Jorah was that you are improving current technologies. do you have hopes for dr.

Carlín dr. Collins at the National Institutes of Health, but in any case you would expect to have the capacity in the fall of May 40-50 in tests per month and that should be adequate for the principal of a high school or even the chancellor of a campus to guess it design a testing strategy that could provide, for example, a rapid antigen yes to test all students in the school if necessary Zachary yes sir sir. president and again we want to make as much testing available as absolutely possible. What I said is that I feel comfortable knowing the production schedules, being in the position of being able to work with the FDA and the CDC, that we should have 40 to 50 million tests available per month that need to be deployed in a timely manner. intelligent strategic way depending on the dynamics that are known in that area and in that region.

Continuing to have tests, even widely, does not nullify the need that we are in. We are going to have to change our practices in terms of sanitation, personal cleaning, distance, seeing a mask, things like that given what the dynamic could be. Well, thank you for those comments because given the amount of testing. that will be available in let's say three months or whatever. Let's increase to that number in three months that should give every principal, every chancellor of every university campus and again we have about 5,000 campuses and a hundred thousand schools some comfort that the tests, as well like the common sense hygiene practices you talked about. could be used to develop a strategy for reopening schools in August and then two quick comments, one is that Senator Murray talked about the national plan that was in the legislation that we all voted for, there's a little bit of a tug of war between what is national or what is federal what should Washington do and what the states should do I've always thought it's a mistake to say federal equals national in other words, 19+ is clearly a national issue, but that doesn't mean it's supposed to the federal government has to do everything, for example, in testing the law, it actually requires the states to tell the Admiral to draw out what their plans are, what their needs are and then you said that during the month of May you had a series of state plans that identified 12 and a half million kisses and thought you could help meet that, on the other hand, you have also noticed an efficiency in the market for some supplies, so the federal government is purchasing them and allocating them to the state, so we don't want to get to a situation where everyone abides by their laws. he is telling all the states what to do.

The governor leading in Tennessee doesn't really want you to tell him what to do. He wants to tell you what he is doing and let you comment on it. I don't think Governor Cuomo wants President Trump to say what to do, a tug-of-war between what Washington does and what the states did. I believe we have a national testing contact tracing strategy and a governor-led plan designed by the federal government as a national effort, another national effort clearly is to do the research for treatments and vaccines from what we've heard today is that are moving at a faster pace than ever before, I finally want to reiterate that I thought this was a very useful hearing.

I think the senators for their questions. I think anyone who took the time to look at the watch would be impressed by the diversity of opinions and honest answers we got from four truly remarkable experts who are in the thick of it every day. I want to re-emphasize what I said before and that I intend to make sure we focus. Senator Murray suggested that we need to have more hearings which I agree with and as we deal with this pandemic we need to make sure we are ready for the next one. What can we learn about faster treatments and vaccines next time?

What can we learn about the reservation? Well, to be in it, you should be managing it for next time. What can we learn? Can we learn something about having hospital beds so we don't have to close hospitals and ruin them and which patients leave? to create beds for those sick with the pandemic, what happens to states and hospitals that sell their PPE between pandemics? How do we maintain our focus between pandemics when we have so many important things to worry about in this country? We make sure that in Congress we sustain and fund all the things we need to do that and I want to make sure that we do that this year.

I mean, our collective memory is short, so while we are all worried about this, we need to not only deal with this crisis but also prepare for the next one. I thank the witnesses for their extra time. I hope you get the sense that our job is to create an environment where you can be successful, because if you are successful, our country will be successful. This is what we desperately want. The minutes of the hearing will remain open for 10 days. Members can submit additional information for the minutes within that time if they wish. Thank you all for being here today.

The hearing is postponed. Thank you very much, Mr. president Thank you Senator Murray I'm pretty sure that