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Dr. Anthony Fauci testifying before US Senate, May 12, 2020<\/span><\/p>\n <\/p>\n Today, arguably one of the more important congressional hearings in recent history occurred.<\/p>\n The US Senate Committee on Health, Education, Labor & Pensions held a hearing on COVID-19: Safely Getting Back to Work and Back to School.<\/p>\n We present it in it’s entirety in video and transcript without comment.<\/p>\n The witnesses were:<\/p>\n The Committee Membership is:<\/p>\n (Chairman, Lamar Alexander; Ranking Member, Patty Murray)<\/p>\n Republicans by Rank<\/p>\n Democrats by Rank<\/p>\n The complete video of the testimony is linked here at\u00a0help.senate.gov\/hearings\/covid-19-safely-getting-back-to-work-and-back-to-school<\/a>.<\/p>\n The transcript from\u00a0Rev Services<\/a>\u00a0follows:<\/p>\n Dr. Anthony Fauci and CDC Director Robert Redfield testified before the United States Senate today on the coronavirus, how to safely return to work & school, and reopening the US. Read the full testimony transcript here.<\/em><\/p>\n Senator Lamar Alexander: (04:32<\/a>) Senator Lamar Alexander: (05:02<\/a>) Senator Lamar Alexander: (05:28<\/a>) Senator Lamar Alexander: (05:40<\/a>) Senator Lamar Alexander: (06:32<\/a>) Senator Lamar Alexander: (07:10<\/a>) Senator Lamar Alexander: (07:40<\/a>) Senator Lamar Alexander: (08:21<\/a>) Senator Lamar Alexander: (08:55<\/a>) Senator Lamar Alexander: (09:49<\/a>) Senator Lamar Alexander: (10:34<\/a>) Senator Lamar Alexander: (11:06<\/a>) Senator Lamar Alexander: (11:38<\/a>) Senator Lamar Alexander: (12:15<\/a>) Senator Lamar Alexander: (13:11<\/a>) Senator Lamar Alexander: (13:55<\/a>) Senator Lamar Alexander: (14:24<\/a>) Senator Lamar Alexander: (15:26<\/a>) Senator Lamar Alexander: (16:07<\/a>) Senator Lamar Alexander: (16:38<\/a>) Senator Lamar Alexander: (16:56<\/a>) Senator Lamar Alexander: (17:35<\/a>) Senator Patty Murray: (18:02<\/a>) Senator Patty Murray: (18:39<\/a>) Senator Patty Murray: (19:10<\/a>) Senator Patty Murray: (20:18<\/a>) Senator Patty Murray: (20:54<\/a>) Senator Patty Murray: (21:39<\/a>) Senator Patty Murray: (22:08<\/a>) Senator Patty Murray: (22:45<\/a>) Senator Patty Murray: (23:55<\/a>) Senator Patty Murray: (24:29<\/a>) Senator Patty Murray: (25:06<\/a>) Senator Patty Murray: (25:37<\/a>) Senator Lamar Alexander: (26:29<\/a>) Senator Lamar Alexander: (26:53<\/a>) Senator Lamar Alexander: (27:38<\/a>) Senator Lamar Alexander: (28:07<\/a>) Senator Lamar Alexander: (28:48<\/a>) Senator Lamar Alexander: (29:20<\/a>) Dr. Anthony Fauci: (29:35<\/a>) Dr. Anthony Fauci: (30:09<\/a>) Dr. Anthony Fauci: (30:43<\/a>) Dr. Anthony Fauci: (31:03<\/a>) Dr. Anthony Fauci: (31:27<\/a>) Dr. Anthony Fauci: (32:06<\/a>) Dr. Anthony Fauci: (32:41<\/a>) Dr. Anthony Fauci: (33:15<\/a>) Dr. Anthony Fauci: (34:06<\/a>) Senator Lamar Alexander: (34:38<\/a>) Dr. Robert Redfield: (34:42<\/a>) Dr. Robert Redfield: (35:18<\/a>) Dr. Robert Redfield: (35:48<\/a>) Dr. Robert Redfield: (36:21<\/a>) Dr. Robert Redfield: (36:47<\/a>) Dr. Robert Redfield: (37:19<\/a>) Dr. Robert Redfield: (37:52<\/a>) Dr. Robert Redfield: (38:44<\/a>) Dr. Robert Redfield: (39:05<\/a>) Dr. Robert Redfield: (39:40<\/a>) Senator Lamar Alexander: (39:58<\/a>) Admiral Giroir: (40:09<\/a>) Admiral Giroir: (40:48<\/a>) Admiral Giroir: (41:28<\/a>) Admiral Giroir: (42:33<\/a>) Admiral Giroir: (43:13<\/a>) Admiral Giroir: (43:51<\/a>) Admiral Giroir: (44:20<\/a>) Senator Lamar Alexander: (45:15<\/a>) Dr. Steven Han: (45:22<\/a>) Dr. Steven Han: (46:18<\/a>) Dr. Steven Han: (46:38<\/a>) Dr. Steven Han: (47:07<\/a>) Dr. Steven Han: (47:40<\/a>) Dr. Steven Han: (47:59<\/a>) Dr. Steven Han: (48:31<\/a>) Dr. Steven Han: (49:01<\/a>) Dr. Steven Han: (49:35<\/a>) Dr. Steven Han: (49:59<\/a>) Dr. Steven Han: (50:39<\/a>) Senator Lamar Alexander: (51:00<\/a>) Senator Lamar Alexander: (51:29<\/a>) Dr. Anthony Fauci: (52:16<\/a>) Senator Lamar Alexander: (52:24<\/a>) Dr. Anthony Fauci: (52:25<\/a>) Dr. Anthony Fauci: (52:59<\/a>) Dr. Anthony Fauci: (53:26<\/a>) Senator Lamar Alexander: (54:09<\/a>) Admiral Giroir: (54:51<\/a>) Admiral Giroir: (55:09<\/a>) Admiral Giroir: (55:36<\/a>) Senator Lamar Alexander: (56:18<\/a>) Dr. Robert Redfield: (56:20<\/a>) Dr. Robert Redfield: (56:43<\/a>) Senator Lamar Alexander: (56:58<\/a>) Senator Murray: (57:08<\/a>) Dr. Anthony Fauci: (57:38<\/a>) Dr. Anthony Fauci: (58:11<\/a>) Dr. Anthony Fauci: (58:57<\/a>) Senator Murray: (59:10<\/a>)\n
Director<\/div>\nNational Institute of Allergy and Infectious Diseases, National Institutes of Health<\/div>\nBethesda<\/span>, MD<\/span><\/div>\n<\/li>\nDirector<\/div>\nUnited States Centers for Disease Control and Prevention<\/div>\nAtlanta<\/span>, GA<\/span><\/div>\n<\/li>\nAssistant Secretary For Health<\/div>\nUnited States Department of Health and Human Services<\/div>\nWashington<\/span>, DC<\/span><\/div>\n<\/li>\nCommissioner Of Food And Drugs<\/div>\nUnited States Food and Drug Administration<\/div>\nSilver Spring<\/span>, MD<\/span><\/div>\n<\/li>\n<\/ol>\n\n\n
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\nWell, good morning. The Committee on Health, Education, Labor & Pensions will please come to order. First, some administrative matters, based on the advice of the attending physician and the Sergeant at Arms, after we consulted with the Department of Health and Human Services and the Centers for Disease Control and Prevention, individuals in the hearing room are at least six feet apart. As a result, there\u2019s no room for the public to attend in person, representatives of the press are working as a pool to relay the observations to colleagues.<\/p>\n\n\n\n\n\n\n
\nThe hearing may be watched online, an unedited recording will be available on the committee\u2019s website, www.help.senate.gov. Witnesses are participating with the video conference in a one time exception. Some senators, including the chairman are participating by video conference. Senators we\u2019ve been advised, may remove their masks, talk in to the microphone when they\u2019re in the hearing room, as they\u2019re six feet apart.<\/p>\n
\nI\u2019m grateful to the Rules Committee, Sergeant at Arms, the Press Gallery, the Architect of the Capitol, the Capitol Police, Committee Staff Chong Check and Evan Griffith all for their hard work to keep us safe.<\/p>\n
\nAt our hearing last Thursday, I said all roads back to work and back to school, run through testing. And then, what our country has done so far on testing is impressive but not nearly enough. Over the weekend Senator Schumer, the democratic leader, was nice enough to put out a tweet quoting half of what I said. He left out the other half, the impressive part. So let me say, again, what I meant by that. When I said impressive, I met that according to the Johns Hopkins University study, the United States has tested over 9 million Americans for COVID-19. That\u2019s twice as many as any other country, we don\u2019t know what China has done and it\u2019s more per capita than most countries, including South Korea. Which, many members of our committee had cited as an example of a country that had tested well.<\/p>\n
\nAccording to Dr. Deborah Birx, the United States were double testing the month of May, which should get us up to about 10 million tests conducted. Now, here\u2019s what I mean by impressive. Here in Tennessee, where I am today. First anyone who\u2019s sick, first responder or healthcare worker, can get tested. Our governor, Bill Lee is also testing every prisoner. Every resident and staff member in a nursing home is offered weekend drive through testing. He\u2019s done specific outreach for testing to low income communities. A Tennessean can get a free test at the local public health department.<\/p>\n
\nThe governor\u2019s slogan is, \u201cIf in doubt, get a test.\u201d Governor Lee sent his testing goals in May to the federal government, as every state has done. Federal government is helping him make sure that he has enough supplies in case he has trouble getting them through the labs and the other commercial sources. As a result, our state is tested about 4% of the population. Governor hopes to increase that by 7% in May. That\u2019s one of the best in the country.<\/p>\n
\nThis impressive level of testing is sufficient, we believe, to begin phase one of going back to work. Which as I said last week, it\u2019s not nearly enough to provide confidence to 31,000 students and faculty members that we hope will show up at the University of Tennessee campus in August when school starts. Last week I talked with UT, Knoxville Chancellor Donde Plowman about that. We said, \u201cWhat would persuade those 31,000 students, as well as the 50 million K-12 students in the country and the other 5,000 university students, what will persuade them to go back to campus in August?<\/p>\n
\nThat\u2019s where the new Shark Tank comes in. Dr. Collins, at The National Institutes of Health calls it Red X. We had our hearing about that on Thursday. A really remarkable scientific exercise to take a few early stage concepts, that are swimming around and what we call that competitive Shark Tank, and see if Dr. Collins and his associates can find a few new technologies to create millions of new tests that will scale up rapidly and make it more likely that students will go back to school in August.<\/p>\n
\nFor example, the FDA authorized last week, its first diagnostic test using saliva that a person provides at home instead of a nose swab or blood. It authorized its first antigen test. We\u2019re hearing a lot about those, like the ones used for flu or strep throat, which involves a swabbing of a nose and you can get the results in just a few minutes. Another proposal, not yet approved, is to put, in your mouth, a sort of lollipop sponge, take a photo of that with your cell phone and send that to your doctor, if it lights up you\u2019re positive. Or, the university might send that saliva lollipop to a nearby laboratory, which could be a gene sequencing laboratory, which can deal with thousands of those samples overnight. That same process could occur at a middle school, it could occur at a factory.<\/p>\n
\nOf course, anyone testing negative one day, can test positive the next. But, such widespread screening of entire campuses, schools or places of work will help identify those who are sick, trace down those who are exposed and that in turn should help persuade the rest of us to go back to school and back to work. In addition to more testing, I expect Dr. Fauci to talk to us about additional treatments that will be available to reduce the risk of death and the administration\u2019s plan to do something that our country has never done before, which is to start manufacturing a vaccine before it actually has been proven to work, in order to speed up the result in case it does work.<\/p>\n
\nThose vaccines, those treatments are the ultimate solution. But until we have them, all roads back to work and school go through testing. The more tests we conduct, the better we can identify those who are sick and exposed. Then we can quarantine the sick and exposed instead of trying to quarantine the whole country. Now in my opinion, this will require millions of new tests. Many from new technologies, some of these will fail but we only need a few successes to get where we want to go.<\/p>\n
\nThat\u2019s why I said on Thursday, that what our country had done so far in testing is impressive but not nearly enough. First, squeeze all the tests we can out of current technologies. Next, try to find new technologies to help us contain the disease and persuade us to go back to work. Now one other thing, this is a bipartisan hearing to examine how well we\u2019re preparing to go safely back to work and to school and to determine what else we need to do in the United States Senate.<\/p>\n
\nSuch an exercise sometimes encourages finger pointing. Before we spent too much time finger pointing, I\u2019d like to suggest that almost all of us, the United States and almost every country so far as I can tell, underestimated this virus. Underestimated how contagious it would be, underestimated how it can travel silently in people without symptoms to infect other people. How it can be especially deadly for certain segments of our population, the elderly, those with preexisting conditions, minority populations.<\/p>\n
\nLet me go back to the March 3rd hearing that we had in our committee on coronavirus. Six weeks after the first case was discovered in the United States, a day when only two deaths were recorded in this country, I read at that hearing this paragraph from the New York Times two days earlier on March the first. They reported this, \u201cMuch about the coronavirus remains unclear\u201d, The Times reported. \u201cAnd, it\u2019s far from certain\u2026\u201d, This was March 3rd, that March 1, \u201cthat the outbreak will reach severe proportions in the United States or affect many regions at once. With its top notch scientists, modern hospitals and sprawling public health infrastructure, most experts agree, United States is among the countries best prepared to prevent or manage such an epidemic.\u201d That was The New York Times on March 1.<\/p>\n
\nA lot of effort has gone into trying to make our country well prepared. Over the last 20 years 4 presidents, several congresses, in response to 9\/111, Bird Flu, Katrina, Ebola, H1N1, MERS, passed nine major laws to try to help get this country ready for what we\u2019re going through today. These laws stood up to strategic national stockpile, created an assistant secretary for preparedness, it created incentives for the developments of vaccines and medicines that we\u2019re using today. Strengthened the Centers for Disease Control, created ARDA.<\/p>\n
\nThanks to the leadership of Senator Blunt and Senator Murray for five straight years, we\u2019ve significantly increased funding for the National Institutes of Health. All this was part of a shared goal, Democrats, Republicans, four presidents, several congresses, to try to get ready for what we\u2019re going through today, whether it was known like anthrax or unknown, like COVID-19. But, despite all that effort, even the experts underestimated COVID-19.<\/p>\n
\nThis hearing is about how we improve our response to this virus, as well as the next. During the oversight hearing, I also intend to focus on, as I just said, the next pandemic, which we know is coming. What can we learn from this one to be ready for the next one? Can we\u2026 What can we learn from the fast tracking of vaccines and treatments that we\u2019re about to hear about, that will make it even faster the next time? How can we keep hospitals in states from selling off protective equipment when their budget gets tight? How can we make sure Congress does our share of the funding responsibility? How do we provide enough extra hospital beds without canceling elective surgery, hurting other patients and bankrupting hospitals? Whose job should it be to coordinate supply lines, so that protective equipment and supplies get where they\u2019re supposed to go, when they\u2019re supposed to go? What\u2019s the best way to manage the stockpile.<\/p>\n
\nMy preacher once said, \u201cI\u2019m not worried about what you do on Sunday, it\u2019s the rest of the week that concerns me.\u201d I\u2019m afraid that during the rest of the week between pandemics, we relax our focus on preparedness. We become preoccupied with other important things. Our collective memory is short. Just three months ago, this country was preoccupied with impeaching a president. Now, that seems like ancient Roman history. Now, while this crisis has our full attention, I believe we should put into law, this year, whatever improvements need to be made to be well prepared for the next pandemic.<\/p>\n
\nIf there is to be finger pointing, I hope they\u2019re pointed in that direction. We\u2019re fortunate today to have four distinguished witnesses, with the heart of the response, the coronavirus. We\u2019re grateful for their service to our country. I\u2019ve asked them each to summarize their remarks in five minutes. Then, we\u2019ll have five minutes round of questions from each senator. I\u2019ve agreed, we\u2019ll end our hearing about 12:30, after we have a full round of questions. Every senator will have a chance to have his or her five minutes.<\/p>\n
\nSenator Murray will then have an opportunity to ask the last question or to close the hearing. And, I will then close the hearing. There will be other hearings to follow this hearing, like last Thursday\u2019s hearing. And, senators may submit their questions in writing within the next 10 days.<\/p>\n
\nStaying at home indefinitely is not the solution to this pandemic. There is not enough money available to help all those hurt by a closed economy. All roads back to work and back to school, lead through testing, tracking, isolation, treatment and vaccines. This requires widespread testing, millions more tests graded mostly 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, you give the rest of America enough confidence to go back to work and school.<\/p>\n
\nFor the near term, to help make sure those 31,000 UT students and faculty members show up in August, we need widespread testing. Millions more tests, created mostly by new technologies, to identify those who are sick and who have been exposed, so they can be quarantined by containing the disease in this way. You give the rest of America enough confidence to go back to work and back to school. Senator Murray.<\/p>\n
\nWell, thank you very much Mr. Chairman. My thoughts are with you and your team right now, as you try to navigate the same challenge so many in our country are worried about. We all wish your staff member, a speedy recovery. And, as everyone works to take appropriate safety precautions, today I\u2019d like to thank, not only our witnesses for joining us today, but also our committee staff for working to set up a safe format for members and witnesses and the public to participate in this hearing remotely.<\/p>\n
\nFamilies across the country are counting on us for the truth about the COVID-19 pandemic. Especially, since it is clear they will not get it from President Trump. Truth is essential. So people have the facts, so they can make decisions for themselves and their families and their communities. Lives are at stake. If the president isn\u2019t telling the truth, we must and our witnesses must. And, we\u2019re counting on you today.<\/p>\n
\nAnd, families need us to take this opportunity to dig into the facts about where things did go wrong, so we can finally get them on track because the Trump administration\u2019s response to this public health emergency, so far, has been a disaster all on its own. Delays, missteps have put us way behind where we need to be on diagnostic tests and allowed inaccurate antibody tests to flood the market. Corruption and political interference have impeded efforts to secure desperately needed personal protective equipment and promoted 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 bin for being too prescriptive. But, this is far from the first time this administration has silenced experts who were doing their job and putting public health first.<\/p>\n
\nThe fact of the matter is, President Trump has been more focused on fighting against the truth, than fighting this virus and Americans have sadly paid the price. Since this committee last heard from these witnesses on March 3rd, we have seen over 900 deaths in my home state of Washington, over 80,000 deaths nationally and the numbers continue to climb. Still, President Trump is trying to ignore the facts and ignore the experts, who\u2019ve been very clear, we are nowhere close to where we need to be to reopen safely.<\/p>\n
\nMy hope today is that we can cut through this and have a serious discussion about what is needed to safely open. How close we are, as a country, to meeting those needs and how we actually get there. One thing that\u2019s abundantly clear, we need dramatically more testing. It is unacceptable we still don\u2019t have a national strategic plan to make sure testing is free, fast and everywhere. That is why I fought to make sure our last COVID-19 package included an initial $ 25 billion testing fund and a requirement that the administration submit a plan by May 24th.<\/p>\n
\nAnd when I say a plan, I don\u2019t mean a PR plan. I mean, the plan with specific timelines and numeric goals for supply and funding needs. One that actually addresses the issues we\u2019re seeing on testing capacity and distribution and disparities and building out our public health system. And, makes clear to states and tribes and employers and the American people, what they can expect and what the administration will do to keep Americans safe.<\/p>\n
\nBut, testing alone won\u2019t be enough to reopen our country. We still need far more personal protective equipment that has been available for our healthcare workers on the front lines. And, we will need far more for other workers as we reopen. So we desperately need this administration to step up and get that equipment to states, who are doing everything in their power to purchase supplies but simply cannot get nearly enough because the reality is unlike states, the federal government has the tools to actually fix the problem. If only the administration would use them.<\/p>\n
\nAnd, we also need that equipment to actually work and for the FDA to act promptly if it does not, not weeks later when people may have already been exposed. And just as importantly, we can\u2019t expect people to go back to work or to restaurants or to confidently send their kids to school, if there isn\u2019t clear, detailed guidance about how to do that safely. Schools from early childhood through college, need to know how to keep their students, their staff and their educators safe. When should they wear masks? How do you run a school cafeteria or a school bus? And, if they can\u2019t reopen classrooms, schools and families need to know we are working to ensure every student gets an education. Tools like online learning can only get us so far, if we don\u2019t address the digital divide so that every student 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 language learners and other vulnerable populations, if we don\u2019t make sure they get equal access to resources and support.<\/p>\n
\nAnd of course, schools aren\u2019t the only workplaces we\u2019ve got to be thinking about. We need to make sure that industries across the country know how to safely reopen and that people know their workplace is safe. Secretary Scalia needs to stop dragging his feet and do his job and have the Department of Labor set forward a rule that makes clear, worker safety is not optional. Mr. Chairman, I hope this committee can hear about those critical issues from Secretary Scalia and Secretary DeVos, as well as other experts in the space in the days ahead.<\/p>\n
\nAnd, this is especially important to protect workers and residents at our nursing homes and other congregate care facilities, where we\u2019ve seen some of the most deadly outbreaks. And, as the rash of outbreaks at meat packing plants shows, this isn\u2019t just an issue for the healthcare industry. It is an issue for everyone. And, just as we need a plan before we can start to reopen, we also need a plan well before we have a safe and effective vaccine to guarantee that we can quickly produce and distribute it on a global scale. And, make it free and available for everyone.<\/p>\n
\nSo I\u2019ll be asking about our progress on those issues today. Today safely reopening our country may be a ways off and the administration\u2019s planning may be way behind but there\u2019s still a lot that Congress needs to do. There isn\u2019t time to spare. Some, including the White House, say we\u2019ve already provided enough economic relief. Well, my question to them is, \u201cWhat good is a bridge that only gets you to the middle of the river?\u201d We don\u2019t need to wait around to see if people need more help, we know they do.<\/p>\n
\nWe 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 business from accountability. People across the country are doing their part, they are washing their hands and wearing masks and social distancing and staying home. They need their government to do its part too. They need leadership, they need a plan, they need honesty and they need it now before we were open, so they can rest assured that we are doing things safely and competently with their health and wellbeing as a top priority. Thank you, Mr. Chairman.<\/p>\n
\nIt\u2019s an important hearing and I know lots of people may be watching it for the first time. If they are, I hope they notice that we have 23 members of this committee, I believe one more Republican than Democrat. We have some very strong views but we\u2019re able to work together and to express those views and respect each other and our witnesses and a big part of that goes to Senator Murray and her staff. So thank you for that.<\/p>\n
\nEach witness will have up to five minutes to give his testimony. Thank you for making an exception and agreeing to testify by video because of these unusual circumstances. And, thank you for what you\u2019re doing for our country. Our first with witnesses, Dr. Anthony Fauci. He\u2019s Director of The National Institutes of Allergy and Infectious Diseases at The National Institutes of Health. He\u2019s held that position since 1984, which meant he\u2019s advised six presidents and worked on HIV AIDS, influenza, malaria, Ebola and other infectious diseases. He was involved in treating Ebola patients at NIH and also worked on vaccine trials for Ebola.<\/p>\n
\nNext, we\u2019ll hear from Dr. Robert Redfield. He\u2019s Director of the U.S. Centers for Disease Control and Prevention, which has its headquarters in Atlanta. More than 30 years, he\u2019s been involved with clinical research related to chronic human viral infections and infections diseases, especially HIV. He was the founding director of the Department of Retroviral Research with the U.S. military\u2019s HIV Research Program. He\u2019s spent 20 years with the U.S. Army Medical Corps.<\/p>\n
\nThird, Admiral Brett Giroir. Admiral Giroir is Assistant Secretary for Health at The U.S. Department of Health and Human Services. That puts him in charge of development of public health policy recommendations. He\u2019s taken on the responsibility for coordinating testing and focused on the increasing number of tests that we can do with existing technology. This federal service includes a variety of activities with our Defense Department in advanced research, threat reduction. He was part of the Blue Ribbon Panel to reform the U.S. Veterans health system.<\/p>\n
\nAnd finally, we\u2019ll hear from Dr. Stephen Hahn. He\u2019s Commissioner of The Food and Drug Administration. Before joining FDA, he was the Chief Medical Executive of the University of Texas, MD Anderson Cancer Center. And, he was Chair of the Department of Radiation Oncology at the University of Pennsylvania. He was a senior investigator at The National Institutes of Health. Is Commander of U.S. Public Health Service Commission Corps in 2025.<\/p>\n
\nNow, we\u2019ll ask each of our witnesses to summarize their remarks in five minutes. Following that, each senator will have five minutes for questions and answers in order of seniority. Dr. Fauci, let\u2019s begin with you. Welcome.<\/p>\n
\nThank you very much, Mr. Chairman, Ranking Member Murray and members of the committee. Thank you for giving me the opportunity to discuss with you today, the role The National Institutes of Health and Research addressing COVID-19. The strategic plan that we have is fourfold. One, to improve a fundamental knowledge of the virus and the disease it causes. Next, to develop new point of care diagnostics. Next, to characterize and test therapeutics. And finally, to develop safe and effective vaccines.<\/p>\n
\nFirst with regard to diagnostics, as you probably heard from Dr. Francis Collins last Thursday, the NIH has developed a rapid acceleration of diagnostics program called Red X, with an award to that specific program, up to a half a billion dollars, to support the development of COVID-19 diagnostics. It is a national call for innovative technologies, that will be evaluated in a Shark Tank like selection process, to get to either success or failure rapidly.<\/p>\n
\nMoving on to therapeutics. I\u2019ll talk a bit about the Remdesivir success antiviral in a moment. But, let me emphasize that there are a number of broad spectrum antivirals that are in various stages of testing. In addition, we will be looking at convalescent plasma, which is plasma from individuals\u2026<\/p>\n
\n\u2026 at convalescent plasma, which is plasma from individuals who have recovered from COVID-19 to be used in passive transfer either in prevention or treatment. In addition, hyperimmune globulin, which can be used as a gamma globulin shot. We\u2019ll be looking at repurposed drugs as well as immune-based therapies and host modifiers, and finally, monoclonal antibodies.<\/p>\n
\nLet me take a moment to describe the Remdesivir placebo-controlled randomized trial, which was done internationally with a power of more than 1,000 individuals in sites throughout the world. It was in hospitalized patients with lung disease. The endpoint was primarily time to recovery. The result was statistically significant, but really modest. We must remember it was only a modest result showing that the drug made a 31% faster time to recovery. We hope to build on this modest success with combinations of drugs and better drugs.<\/p>\n
\nMoving on to vaccines, there are at least eight candidate COVID-19 vaccines in clinical development. The NIH has been collaborating with a number of pharmaceutical companies at various stages of development. I will describe one very briefly, which is not the only one, but one that we have been involved in heavily developing with Moderna. It\u2019s a messenger RNA platform. You might recall in this committee that in January of this year, I said that it would take about one year to 18 months if we were successful in developing a vaccine.<\/p>\n
\nThe NIH trial moved very quickly. On January 10th, the sequence was known. On January the 11th, the Vaccine Research Center met to develop a plan. On the 14th of January, we officially started the vaccine development. 62 days later, we are now in Phase I clinical trial with the two doses already fully enrolled. There will be animal safety. The Phase I will directly go into Phase II-III in late spring and early summer. If we are successful, we hope to know that in the late fall and early winter.<\/p>\n
\nThere are some important issues, however, in COVID-19 vaccine development. We have many candidates and hope to have multiple winners. In other words, it\u2019s multiple shots on goal. This will be important because this will be good for global availability if we have more than one successful candidate. We also, as the chairman mentioned, will be producing vaccine at risk, which means we\u2019ll be investigating considerable resources in developing doses even before we know any given candidate or candidates work. I must warn that there\u2019s also the possibility of negative consequences where certain vaccines can actually enhance the negative effect of the infection. The big unknown is efficacy. Will it be present or absent and how durable will it be?<\/p>\n
\nFinally, I want to mention the NIH has launched a public-private partnership called Accelerating COVID-19 Therapeutic Interventions and Vaccines. The purpose of that is to prioritize and accelerate clinical evaluation of therapeutic candidates with near-term potential. Hopefully our research efforts, together with the other public health efforts, will get us quickly to an end to this terrible ordeal that we are all going through. Thank you very much. Happy to answer questions later.<\/p>\n
\nThank you, Dr. Fauci. Dr. Redfield.<\/p>\n
\nGood morning, Chairman Alexander and ranking member Murray and members of the committee. Our nation is confronting the most serious public health crisis in more than a century, yet we\u2019re not defenseless. We have powerful tools to fight this enemy. We have tried and true effective public health interventions such as early case identification, isolation and contact tracing combined with important mitigation strategy that include social distancing, frequent hand washing and face covering. These public health tools have and will continue to slow the spread of COVID-19.<\/p>\n
\nI appreciate the opportunity this morning to provide a brief overview of some of CDC\u2019s ongoing work in response to COVID-19. The CDC has been working 24\/7 to combat the pandemic. CDC\u2019s Emergency Operation Center is supporting state tribal, local, and territorial public health partners in building core capabilities, particularly workforce, laboratory and data and predictive analytics. Epidemiologists are conducting surveillance for COVID-19 as well as conducting health system surveillance.<\/p>\n
\nCommunity mitigation teams are providing guidance on infection control and contact tracing. Our laboratory experts are performing serological testing to better define the extent of asymptomatic populations. As local leadership makes decisions to reopen, they\u2019ll require varying degrees of federal support. Each location will be different and will face unique circumstances. CDC has conducted a state by state assessment of public health testing capacity and key contact tracing capacity as well as surge plans.<\/p>\n
\nCDC is providing technical assistance and funding to the states provided through the Supplemental CARES Act and the Paycheck Protection Program and health care enhancement. We\u2019re working directly with the state public health leaders to define their needs for testing and testing devices, supplies and manpower, surveillance, data collection and reporting, contact tracing, infection control and outbreak investigation.<\/p>\n
\nI want to spend a moment to focus on several key elements. First testing, rapid, extensive and widely available timely testing is essential for reopening America. CDC\u2019s role in testing continues to support diagnosis and contact tracing surveillance and outbreak when we work with the public health partners to define their particular testing strategy for their jurisdiction. Admiral Giroir will address the testing components of the response in greater detail.<\/p>\n
\nContact tracing, increasing state, tribal, local, and territorial contact tracing capacity is critical. It\u2019s a critical part to stop the chains of transmission and prevent the occurrence of sustained community transmission. CDC\u2019s role is to provide technical training, assistance and support to the states as they hire and build a workforce necessary to be fully prepared to effectively respond to the public health challenges posed by the ongoing COVID pandemic. This will be an expansive effort.<\/p>\n
\nSurveillance, our nation surveillance program is built on a combination of systems, including existing syndromic influenza and respiratory viral disease surveillance systems have been combined with commercial and research lab platforms and our case reporting form system. CDC is adapting these and optimizing it to have a surveillance system in response to COVID-19. Importantly in light of the significant occurrence of asymptomatic infection, the surveillance for asymptomatic infection becomes an important public health tool for early case identification. CDC is working with each public health jurisdiction to develop a perspective surveillance program to include active surveillance among those that are most vulnerable, such as individuals in long-term care facilities, inner city clinics and homeless shelters.<\/p>\n
\nWe need to rebuild our nation\u2019s public health infrastructure, data and data analytics, public health laboratory resilience and our nation\u2019s public health workforce. Now\u2019s the time to put it in place for the generations to come, not only for the public health system that our nation needs, but for the public health system that our nation deserves.<\/p>\n
\nBefore I close, I want to recognize the tireless commitment of the dedicated CDC staff who have deployed to every corner of this nation to fight COVID-19. More than 4,000 employees have deployed here and globally. Science and data continue with technical expertise and public source service to be the backbone of CDCs contributions to the US response. I extend my serious gratitude to the healthcare workers on the front lines, as well as their family and the essential emergency personnel. As well as the American people to say thank you for adhering to the stay-at-home guidelines and protecting the most vulnerable.<\/p>\n
\nIt\u2019s important to emphasize that we\u2019re not out of the woods yet. The battle continues, but we are more prepared. We need to stay vigilant with social distancing. It remains an imperative. We are a resilient nation. I am confident that we will emerge from this pandemic stronger together. Thank you.<\/p>\n
\nThank you, Dr. Redfield. Admiral Giroir, welcome.<\/p>\n
\n\u2026 be here to provide you with an update on the nation\u2019s progress in testing for COVID-19. On March 12th, Secretary Azar requested that I lead the COVID-19 testing effort within HHS, including oversight and coordination of the FDA and CDC with regard to testing. Since then, the nation has performed more than 9 million COVID-19 tests, a number far greater than any other country and double the per capita tests performed to date in South Korea. To reach this point, we implemented a phased approach to meet testing needs during mitigation and now during phase one reopening of America.<\/p>\n
\nBeginning March 20th, we pioneered 41 community-based drive-thru testing sites in locations prioritized by the CDC. These sites have been a profound success testing over 167,000 high risk individuals and demonstrating a prototype that is being duplicated multifold in nearly every state. Next, the administration leveraged trusted retailers, including CVS, Rite Aid, Walgreens, Walmart, Kroger, and Health Mart, who are now providing testing at 240 locations in 33 states, 69% of which are in communities with moderate to high social vulnerability.<\/p>\n
\nTo meet the need for collection supplies like swabs and media tubes, we first secured the global supply chain through a military air bridge. We worked directly with manufacturers to increase domestic production. We collaborated with the private sector and the FDA to validate multiple swab and media types that vastly expanded supplies while minimizing the need for PPE. Finally, we used Title III of the Defense Production Act to further invest in domestic manufacturing to prepare us for reopening. To support the need for surveillance testing during reopening, on April 27th we issued a new testing framework that also prioritized testing for persons without symptoms who are prioritized by health departments or clinicians for any reason, including screening of asymptomatic individuals according to state and local plans. Next, our federal multidisciplinary team conducted multiple calls with leadership from each state to set state-specific testing objectives.<\/p>\n
\nCollectively, states and territories established an overall goal to perform 12.9 million tests over the next four weeks. The federal government is able to and will support the achievement of this goal. Specifically, the federal government is shipping to states 12.9 million swabs and over 9.7 million tubes of media in May alone. Last month, we also detailed the location and capacity of every lab machine in every state that could potentially run COVID-19 assays. Our team has worked with test suppliers to match reagents to these machines.<\/p>\n
\nLooking forward between now and the end of 2020, the federal government will procure over 135 million swabs and 132 million tubes of media and distribute these to states as requested to supplement the now robust commercial supply. We anticipate marked increases in current tests, as well as the dramatic expansion of new point of care tests like the first in class Quidel antigen test authorized by the FDA just last Friday. Quidel anticipates being able to distribute 300,000 tests per day within just a few weeks.<\/p>\n
\nBy September, taking every aspect of development, authorization, manufacturing, and supply chain into consideration, we project that our nation will be capable of performing at least 40 to 50 million tests per month, if needed at that time. If new technologies are authorized like whole genome sequencing approaches or any novel solutions uncovered by NIH\u2019s new diagnostics initiative, that number will be much higher.<\/p>\n
\nFinally, I want to acknowledge and express my heartfelt gratitude to the officers of the US Public Health Service Commission Corps, the uniformed service I am honored to lead. 3,471 men and women have deployed in support of this pandemic. On the cruise ship in Japan to our military bases repatriating Americans to our community based testing sites and international airports to FEMA and our task forces to nursing facilities, including King County, Washington, and to field hospitals in hard hit communities across our nation, I thank each and every one of these officers and their families. 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 remarks.<\/p>\n
\nThank you, Admiral Giroir. Now Dr. Steven Han, our fourth and final witness.<\/p>\n
\nChairman Alexander, ranking member Murray and 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 efforts at mitigation and extend my condolences to those who have lost loved ones. From day one of this pandemic, the 18,000 FDA employees who are just incredible scientists, doctors and nurses have taken an active role in the all of government response to this pandemic. The FDA has worked to facilitate the development of medical countermeasures to diagnose, treat and prevent COVID- 19. We\u2019ve worked closely with laboratories, manufacturers, academia, product developers, our federal partners and companies, companies that don\u2019t even make medical products but want to pitch in, for example, by making hand sanitizer, personal protective equipment and ventilators.<\/p>\n
\nEvery decision we have made have been driven by data with the goal 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.<\/p>\n
\nI\u2019d like to take a few minutes to tell you what FDA is doing to help the country at this point in which Americans should have a safe return to work and to school. It starts with testing as others have mentioned. FDA has worked with more than 500 developers who have or said they will be submitting emergency use authorization requests for COVID-19 tests. This includes some newer technologies that heretofore have not been used as part of diagnostic tests in response to a pandemic.<\/p>\n
\nWe have issued 92 individual emergency use authorizations for test kit manufacturers and laboratories. We\u2019ve been informed by more than 250 laboratories that have begun testing under the regulatory flexibilities we outlined in March. We are conducting rolling reviews of EUA submissions so that we can quickly authorize tests, which the data support. In a public health emergency, the accuracy of diagnostic tests is important not only for the individual patient, but for the public at large.<\/p>\n
\nFDA is helping to ensure the availability of tests that are providing accurate answers. We are also monitoring the marketplace for fraudulent tests and are taking appropriate actions to protect the public health. We are working to provide more clarity about which tests have been reviewed and authorized by the FDA and which have not.<\/p>\n
\nSerologic tests will play a role in our recovery. Unlike diagnostic tests, which detect the presence of the virus, serologic tests measure the amount of antibodies or protein present in the blood when the body is responding to an infection like COVID-19. These tests can help identify individuals who can overcome an infection and have developed an immune response. We will continue working with labs and manufacturers and across the government to find a balance between the assurance that an antibody test is accurate and timely access to such tests.<\/p>\n
\nOf course, the way we will eventually beat this virus is with a vaccine and FDA is working closely with our federal partners, including the NIH, vaccine developers, manufacturers and experts across the globe. We intend to use our regulatory flexibility to help ensure the most ensure efficient development of a safe and effective vaccine to prevent COVID-19. Until a preventative vaccine is approved, however, we need medical products to bridge the gap.<\/p>\n
\nFDA has been working for several months to facilitate the development and availability of therapeutics as expeditiously as possible. We created an emergency program for this acceleration called the Coronavirus Treatment Acceleration Program, or CTAP. We have reassigned staff to work with urgency to review requests from companies, scientists, doctors who are developing therapies. We\u2019re using every available authority and regulatory flexibility that\u2019s appropriate to facilitate the development of safe and effective products to treat COVID-19.<\/p>\n
\nA variety of therapeutic areas are being evaluated as mentioned by Dr. Fauci And others, including antiviral drugs and immunotherapies, as well as convalescent plasma, hyperimmune globulin and monoclonal antibodies. As Dr. Fauci also mentioned, we recently announced the positive results of the NIAID trial of Remdesivir and issued an EUA for the treatment of hospitalized patients with COVID-19.<\/p>\n
\nTwo other promising treatments that I mentioned are the antibody rich products, convalescent plasma and hyperimmune globulin. I am certainly willing to go into more detail if members of this committee have questions about this. But we are working very aggressively and closely with stakeholders to facilitate the development of monoclonal antibodies, which if shown to be safe and effective, could act as a bridge therapy to the development of a vaccine. We recognize that developing vaccines and therapies need to go hand-in-hand with ensuring that there will be sufficient supplies for our country. We\u2019re also working with manufacturers to make sure that this supply chain is robust.<\/p>\n
\nMr. Chairman, ranking member and members of the committee, please know that in FDA, you have a dedicated team of some of the nation\u2019s finest scientists, healthcare providers and public health professionals. We are guided by science and data and we won\u2019t let up until we facilitate the development of products that our nation needs to get back to work. I look forward to your questions.<\/p>\n
\nThank you, Dr. Han. Thanks to all four of you for your expertise, for your dedication to our country and your hard work. We\u2019ll now begin a round of five-minute questions from each Senator on the committee alternating between Republicans and Democrats. Each Senator has, if you\u2019re a video conference, you have a little time clock at the bottom. I would ask you to try to stay within five minutes for your questions and answers.<\/p>\n
\nI will start. I\u2019ve got a question for Dr. Fauci and then Admiral Giroir. Doctor, let\u2019s look down the road three months. There will be about 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 principal of a public school about how to persuade parents and students to return to school in August? Let\u2019s start with treatments and vaccines first. Dr. Fauci. If you can save about half of my five minutes for Admiral Giroir for testing, I would appreciate it.<\/p>\n
\nThank you very much, Mr. Chairman. I would be very realistic with the chancellor and tell him that when we\u2019re thinking in terms-<\/p>\n
\nIt\u2019s a her in this case.<\/p>\n
\nI would tell her \u2026 I\u2019m sorry, sir, that in this case that the idea of having treatments available, or a vaccine, to facilitate the re-entry of students into the fall term would be something that would be a bit of a bridge too far. As I mentioned, the drug that has shown some degree of efficacy was modest and it was in hospitalized patients not yet or maybe ever to be used either yet as prophylaxis or treatment.<\/p>\n
\nIf the issue is that the young individuals who will be going back to school would like to have some comfort in that there\u2019s a treatment, probably the thing that would be closest to utilization then would likely be passive transfer of convalescent serum. But we\u2019re really not talking about necessarily treating a student who gets ill, but how the student will feel safe in going back to school.<\/p>\n
\nIf 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 top speed we\u2019re going, we don\u2019t see a vaccine playing in the ability of individuals to get back to school this term. What they really want is to know if they are safe. That\u2019s the question that\u2019ll have to be due with what we discussed earlier about testing. I\u2019m about halfway through the remarks. I\u2019d like to just pass the baton to Admiral Giroir who will address the question of the availability of testing and what role that might play in returning to school. Thank you, sir.<\/p>\n
\nThank you, Dr. Fauci. Admiral Giroir, you said that while we\u2019re doing about 10 million tests this month, that we might be as high as 40 or 50 million by September in a month, which is a significant increase. If I\u2019m chancellor of the University of Tennessee, could I develop a strategy where I\u2019d say to all my students, \u201cWe have, for example, an antigen test, which is quick and easy. We want everybody on campus to come by and take it once before you begin school. That will at least let everybody know that on that day, we\u2019ve isolated anybody who\u2019s positive and then we can continue to monitor.\u201d Is that strategy possible in August and September?<\/p>\n
\nThank you, Mr. Chairman. I may reserve 20 seconds for Dr. Redfield as well. The strategy that\u2019s going to be employed really depends heavily on what\u2019s the community spread at that time. If there\u2019s almost no community spread, your strategy will be different. If there\u2019s high community spread, it will also be different.<\/p>\n
\nBut yes, technically we will have the ability and your chancellor will have the ability. We expect there to be 25 to 30 million point of care tests per month available. It is certainly possible to test all of the students or it is much more likely that there would be a surveillance strategy done where you may test some of the students at different times to give an assurance that there\u2019s no circulation. That would be done in conjunction with the CDC and the local health department.<\/p>\n
\nThere\u2019s also strategies that are still needing to be validated, but of pooling samples. We know in some experimental labs as many as 10 or 20 samples can be pooled. Essentially one test could test 20 students. Finally, there are some experimental approaches that look interesting, if not promising, that for example wastewater from an entire dorm or an entire segment of a campus could be tested to determine whether there\u2019s coronavirus in that sewerage, the waste water. There are other strategies being developed. I\u2019d like to at least give 20 seconds to Dr. Redfield who really will be working on the strategy of how to employ that given different community spread.<\/p>\n
\nDr. Redfield?<\/p>\n
\nYeah, just some quick comments, sir. I mean, first I think it\u2019s really important to evaluate critically the role of changes in social distancing on college campuses and in schools and the situation, not to forget the importance of what we\u2019ve learned. Clearly also developing an aggressive program for wellness education, making sure people understand when they\u2019re symptomatic they need to seek evaluation.<\/p>\n
\nI think that you are going to have to look at the role of testing. I think there is going to be an important role of testing in these circumstances. I think it will be individualized based on where these different schools are, how much infection is in their [crosstalk 00:56:59]-<\/p>\n
\nI\u2019m going to wrap it up there so I can set a good example for the other senators with their five minutes. Senator Murray.<\/p>\n
\nThank you very much, Mr. Chairman. Thank you to all of our witnesses. Dr. Fauci, you have warned of needless suffering and death if we push to reopen too soon, but the President has actually been sending the opposite message. I want to ask you today, what is the most important message you have for communities and states that are reopening even as our public health experts make it clear it\u2019s too soon? Tell us what the consequences are.<\/p>\n
\nThank you very much for that question, Senator Murray. As I\u2019ve said many times publicly, what we have worked out is a guideline framework of how you safely open America again. There are several checkpoints in that with a gateway first of showing, depending on the dynamics of an outbreak in a particular region, state, city, or area, that would really determine the speed and the pace with which one does re-enter or reopen.<\/p>\n
\nMy word has been, and I\u2019ve been very consistent in this, that I get concerned if you have a situation where the dynamics of an outbreak in an area are such that you are not seeing that gradual over 14-day decrease that would allow you to go to phase one. Then if you pass the checkpoints of phase one, go to phase two and phase three. What I\u2019ve expressed then, and again, is my concern that if some areas, city, states, or what have you, jump over those various checkpoints and prematurely open up without having the capability of being able to respond effectively and efficiently, my concern is that we will start to see little spikes that might turn into outbreaks.<\/p>\n
\nTherefore I have been being very clear in my message to try to the best extent possible to go by the guidelines, which have been very well thought out and very well delineated.<\/p>\n
\nIf a community or a state or a region doesn\u2019t go by those guidelines and reopens, the consequences could be pretty dire, correct?<\/p>\n