Press Briefing by White House COVID-19 Response Team and Public Health Officials 1 April

The White House

Via Teleconference

11:19 A.M. EDT

ACTING ADMINISTRATOR SLAVITT: Good morning, and thank you for joining us. I’d like to begin this briefing where the President left off in his remarks on Monday afternoon. As he said, we are in a “life-and-death race” against the virus. We are facing an accelerating threat. And faced with an accelerating threat, this administration is accelerating our response even further.

The most powerful way to do this is to accelerate the pace of vaccinations. Starting on day one, we began working to accelerate and increase vaccine purchases and manufacturing to have enough vaccines to vaccinate all adults by the end of July. We then accelerated that to have enough vaccine for all adults by the end of May. The President then directed states to open up vaccinations to all adults by the beginning of May.

But as we have seen this virus continue to spread, President Biden has ordered that his national vaccination effort accelerate to the next level. Within three weeks — by April 19th — 90 percent of adult Americans will be eligible for a vaccine and 90 percent of Americans will live within five miles of a vaccination site.

Already, there are more than 50,000 vaccine sites across the country. Within three weeks, there will be about 70,000 locations as we nearly double the number of pharmacies that are vaccinating Americans. More Americans will get more appointments in more convenient locations.

The President also committed to opening at least 12 more federally run mass vaccination sites. And today, we’re announcing three new sites that will open next week, in addition to the two we announced on Monday in St. Louis, Missouri, and Gary, Indiana.

The first is in Memphis, Tennessee, at the Pipkin Building at the Liberty Bowl Memorial Stadium. The second is in Milwaukee, Wisconsin, at the Wisconsin Center. And the third is in Greenbelt, Maryland, at the Greenbelt Metro Station.

Each of these sites is the first federally run mass vaccination site in its respective state. And each is capable of administering 3,000 vaccinations a day.

I can also report that previously announced sites in Massachusetts, New Jersey, Virginia, and Washington are now all open and fully operational.

In total, we’ve opened 25 mass vaccination sites, which have a combined capacity to administer over 95,000 shots per day. These sites are run by the federal government in close partnership with state and local officials, and they’re part of our work to equitably distribute vaccines and reach communities that have been hurt the most by the pandemic.

Through these mass vaccination sites, we have administered more than 2 million shots in some of America’s most at-risk and underserved communities. More than 60 percent have been administered to racial minorities.

All of these efforts are on behalf of one thing: saving lives. We need to keep case numbers down so we can save lives and give people the chance to get vaccinated in April, May, and June so we can enter the summer on the strongest footing possible.

Now, in the weeks ahead that it will take to get everyone vaccinated, for all of this effort, we need a simple thing of every governor, mayor, and local leader — and that is to heed what the President is asking in return: simply to maintain or to reinstate mask mandates. And we need every American to do their part.

Together, we can win this race and save lives. If we’re acting on our own, we will lose even more people. If we’re acting together, we can defeat this.

And with that, I’m going to turn it over to Dr. Walensky and then to Dr. Fauci for some important updates from them.

DR. WALENSKY: Thank you so much, Andy. I’m glad to be back with all of you today. As per usual, I will begin with an overview of the state of the pandemic.

CDC’s most recent data show that the seven-day average of new cases is slightly less than 62,000 cases per day. We continue to see an increase, and this is almost a 12 percent increase from the seven-day period prior.

Hospitalizations also continue to increase. The most recent seven-day average — about 4,900 admissions per day — is up from 4,600 admissions per day in the prior seven-day period.

And the seven-day average of deaths remains slightly above 900 deaths per day.

As I said on Monday, this is a critical moment in our fight against the pandemic. As we see increases in cases, we can’t afford to let our guard down. We are so close — so very close to getting back to the everyday activities we all miss so much, but we’re not quite there yet.

We need to keep taking the mitigation measures, like wearing a mask and social distancing, as we continue to get more and more Americans vaccinated every single day.

Since early in the pandemic, COVID-19 has disproportionately affected certain groups in the United States, particularly Blacks, Hispanic and Latino, and Native American communities.

In mid-February, CDC released its estimates of life expectancy in the United States in the first six months of 2020, which showed a profound impact on communities of color with a drop in life expectancy of 2.7 years among non-Hispanic Blacks and 1.9 years among Hispanics — historic and tragic declines in these populations.

Today, CDC is releasing an MMWR that provides additional detail on provisional mortality in the United States for all of 2020 with a focus on deaths associated with COVID-19.

In 2020, about 3.3 million deaths occurred in the United States overall. This represents a 16 percent increase in deaths from 2019. COVID ranked as the third leading cause of underlying death — underlying cause of death after heart disease and cancer, with approximately 378,000 COVID-19 deaths, accounting for roughly 11 percent of all deaths in the United States in 2020.

COVID-19 deaths were far — were highest for older adults and males, and were higher, as we previously saw, among American Indian and Alaska Natives, Hispanics, non-Black — non-Hispanic Blacks, and non-Hispanic Native Hawaiian and Pacific Islander persons compared to non-Hispanic whites. In fact, among nearly all of these ethnic and racial minority groups, the COVID-19-related deaths were more than double the death rate of non-Hispanic white persons.

Sadly, based on the current state of the pandemic, these impacts have remained in 2021, where we continue to see that communities of color account for an outsize portion of these deaths. The data should serve, again, as a catalyst for each of us to continue to do our part to drive down cases and reduce the spread of COVID-19 and get people vaccinated as quickly as possible.

I know this is not easy and so many of us are frustrated with the disruption this pandemic has had on our everyday lives, but we can do this as a nation working together. There is reason to be hopeful because we now know so much more about this virus — how to stop its spread; and we now have three historic, safe, and effective vaccines that we didn’t have just four months ago; and we are distributing billions of dollars into communities disproportionately affected to help mount the most aggressive, equitable vaccination campaign of modern times.

Millions more people are getting vaccinated every single day. This week, we will cross the 100 million people who have received at least one dose of the COVID-19 vaccine in the United States — a remarkable feat in such a short period of time. Further, over 70 percent of people over age 65, our most vulnerable group, have received at least one vaccine dose.

I’m proud the CDC stands with others leading the way to scale up our national vaccine effort as quickly as possible. As the President mentioned on Monday afternoon, we are working quickly to expand our Federal Retail Pharmacy Program from about 17,000 to 40,000 stores in communities across this nation to help everyone have ready access to vaccines.

With this expansion and additional efforts in partnership with FEMA and states across the country, we will be able to reach the administration’s goal of making sure that 90 percent of Americans will be within five miles of a vaccination site by April 19th. And we recognize that five miles is still too far for many Americans, and that is why we are activating resources, such as mobile units and clinics, to those communities where this is the case to ensure they can get access to vaccinations.

CDC is also excited to partner with the Administration for Community Living to support their efforts to get older, at-risk adults and those with disabilities vaccinated. This is helping to provide critical access to COVID-19 vaccines to these individuals.

Finally, I want to briefly share that, today, CDC is updating COVID-19 guidance for adult day service centers. These centers provide important social and health services to community-dwelling adults aged 65 and older, as well as to adults of any age living with disability. We know these populations are at high risk for severe COVID-19 disease, and this guidance will help center administrators and staff protect themselves and adults receiving their services by promoting and engaging in preventive behaviors that reduce COVID-19 spread and help maintain healthy operations and environments of these facilities. You can find the updated guidance and resources for center administrators and staff on the CDC website.

It’s up to us. It’s up to all of us to be part of this solution. Thank you for hanging in there with us for just a little bit longer and for doing your part to help others.

Thank you. I’ll now turn things over to Dr. Fauci.

DR. FAUCI: Thank you very much, Dr. Walensky. I’d like to spend the next couple of minutes talking to you about the subject of the potential role of vaccinations that we are currently giving in handling the variants that we see emerging in our society.

Can I have the first slide?

This is a slide which schematically diagrams the immune response to SARS-CoV-2. On the left-hand part of the slide is what happens when you get acutely infected. Multiple components of the immune response are operative: antibodies, but also something we don’t pay much attention to, and that is the cell-mediated response of what’s called CD4 and CD8 cells. On the right-hand part of the slide, is what happens when you recover, which is the state you try to mimic when you vaccinate an individual. In other words, you want to induce immune memory in the form of antibodies — CD4- and CD8-positive T cells, or what we call “cell-mediated immunity” — as well as memory B cells.

Okay. Next slide.

So what I want to talk about in the next two minutes or three minutes is that the immune protection against COVID-19 variants, which is of obvious concern to us — when you are vaccinated against a wild-type viral strain, namely the common virus in society, there are two potential mechanisms that protect you against variants:

One, a high titer of antibody that, although it’s specific against the wild-type strain, it is high enough that there’s a spillover effect against the variant.

And the second, which I’d like to emphasize right now, is the T-cell response that although it’s specific against the wild-type strain, there is a considerable degree of cross-reactivity against the range of variants, which is characteristic of T cells.

This slide here shows the high level of antibody against a prime and a boost of the Pfizer vaccine. The point I was making a moment ago is that that level is so high that even when you diminish it by multifold, which is the case with the variant, you still have a good degree of protection.

Next slide.

But the other thing that we want to concentrate on is that now we’re learning more and more that these CD4 and CD8 cells are very important in that they cross-react against certain viral variants and they last for a long time.

Next slide.

This slide is in individuals who are actually infected, showing that immune memory response lasts for several months, but it also includes — besides antibody — what I mentioned: the very important T cells, which can help against the variants.

Next slide.

When you look at vaccinated individuals, as shown on this slide, you get T-cell memory response, again, against the variants — not only against the virus to which you were vaccinated against, but as shown in this report, against a number of variants.

Next slide.

And finally, in a paper that came out just yesterday, it was shown very clearly that in individuals who recover from infection, if you look at their CD4 and CD8 positive T cells, they recognize virtually all of the variants of concern.

So on the final slide — next slide — getting back to what I said in the beginning, we are seeing now immune protection against COVID-19 variants when individuals are vaccinated against the wild-type strain on two mechanisms: the antibody response that has a spillover effect, as well as the cross-reactivity.

The bottom-line message to everyone is: Why it’s so important to get vaccinated? Because vaccination is not only going to protect us against the wild type, but it has the potential, to a greater or lesser degree, to also protect against a range of variants.

So when vaccination becomes available, get vaccinated.

Back to you, Andy.

ACTING ADMINISTRATOR SLAVITT: Thank you. That’s great news.

All right, let’s take questions.

MODERATOR: First question will go to Tamara Keith at NPR.

Q Thank you. Thank you so much for taking my question.

What we’re wondering about at NPR today is whether there might at some point — and I don’t know that this point is yet — but whether at some point there might be a shift in the allocation of vaccine doses based on demand rather than simply on population size. If there are, you know, pockets of the country where demand is a little bit more slack and there are other areas where there’s a lot of demand and not enough supply, whether there might be a calibration that you guys are now starting to consider.

ACTING ADMINISTRATOR SLAVITT: That’s a great question, Tamara. And without signaling anything specific, I want to answer that question at a high level. I think you’re exactly right: We’re going to go through stages, as we vaccinate higher and higher portions of populations, where it will make sense for us to continue to watch where vaccines are needed, how vaccines are distributed, the best way to reach more people. And we will be in a situation, unlike one we’re familiar with over the last couple of months, where we have an abundance of vaccines.

So I might not think of it as much as shifting as much as I might think of making sure that we’re putting enough vaccines in all the places that they’re needed, including doctors’ offices, including regions — including places that might have been inefficient to do at the beginning while we had a surplus.

So it is absolutely how you should be thinking about our approach going forward.

Next question.

MODERATOR: Stephanie Baker at Bloomberg.

Q Thank you. Yes, this is a question for Dr. Fauci. Can you explain why you decided to issue a public statement questioning the AstraZeneca interim results? And do you think that their updated results will enable them to secure emergency use authorization? Because I think many countries around the world that are relying on the AstraZeneca vaccine will be taking their lead from the FDA, even if Astra doses are not used in the U.S.

And then, just another quick question: When do you expect the UK variant to become the dominant variant in the U.S.? Thank you.

MR. FAUCI: Well, with regard to your first question, I believe you’re referring to the NIH statement that followed the letter that was sent by the DSMB to AZ, as well as with a copy to me. I did not have a statement questioning their data at all. I urged them to make sure that their data was up to date in the sense that the DSMB had written to them a rather harsh note saying they did not believe that the data that was in their press conference was the most recent, updated data.

The only statement that we made in our release was to encourage them to work closely with the DSMB to make sure that the data that they put into their press release is the most update and accurate data.

So I didn’t question their data at all. I just urged them to work closely with the DSMB.

And I’m sorry, your second question?

DR. WALENSKY: I think the second question was related to variants, and I can just sort of fill you in. B117, we know from our most recent data, is about 26 percent of circulating virus right now. We are looking at it by region. It varies in region from 4 to 36 — 35 percent. And so we’re watching this very carefully. But it is starting to become the predominant variant in many U.S. regions.

ACTING ADMINISTRATOR SLAVITT: I think your final question is — was asking us to consider whether the FDA was going to grant an EUA. Obviously we’re going to leave that to the FDA, but I’m wondering if, Dr. Fauci, you have any additional comments, given the data that you have seen relative to the AstraZeneca release.

DR. FAUCI: Well, the data that they made public, most recently, indicates to me that this is a good vaccine that is going to have a very important role in the global response to this outbreak.

ACTING ADMINISTRATOR SLAVITT: Thank you. Next question.

MODERATOR: Next we’ll go Lauren Clason at CQ Roll Call.

Q Hi, thank you. Yes, two questions. First, given the rise in cases in a number of schools in states that are reopening, how important is it to have a national testing strategy? And when should we expect to see that?

And then, secondly, are you anticipating any medical supply chain disruptions stemming from the backlog in the Suez Canal? Thank you.

ACTING ADMINISTRATOR SLAVITT: Okay, the first question on schools and testing — Dr. Walensky, do you want to provide some input into that?

DR. WALENSKY: Yeah. What I will say is we’re watching obviously the cases by jurisdiction. Our school-based reopening strategy does look at community transmission and is guided based on community transmission.

We have five mitigation strategies and, of course, ancillary mitigation strategies related to teacher vaccination and testing, as you note. And we’re working closely with the Department of Ed and others to input — to put forward a national testing strategy for schools.

ACTING ADMINISTRATOR SLAVITT: In terms of your question about medical supplies in the Suez Canal, we’ll get back to you if we hear differently, but none that I’m aware of, and we didn’t have to send people over to dig the ship out. So we were able to get people — to keep them focused on getting people vaccinated.

Let’s go to the next question.

By the way, let me just add one thing about the schools and the testing before I forget. I should remind everybody that last week we announced $10 billion in new testing dedicated directly to schools. So we now have the resources, thanks to the Congress and the bill signed by the President, to be able to vaccinate children on a weekly basis across the country.

So, that testing capability is there, the testing resource centers are developed and available, and the testing is quite there. So, in addition to what Dr. Walensky said.

Next question.

MODERATOR: Sharon LaFraniere, New York Times.

Q Thank you for taking my question. I wanted to follow up with Dr. Fauci. What do you think, Dr. Fauci, about the decision yesterday by the German regulators to restrict the use of AstraZeneca’s vaccine in people under 30 because of a rise in the number of cases of unusual blood clots? I think it’s sinus vein thrombosis. Does that give you fresh concern?

DR. FAUCI: Well, you know, I only have to go back to the European Medicines Agency, the EMA, which again have made the statement that it is their opinion that the clotting issues that we’re seeing with the AZ, the frequency of that was no more than in the general population not associated with vaccines.

So, I mean, I don’t have any further opinion on that except to say that you’re talking about a situation in the European Union, and the regulatory agency that’s responsible for what goes on in the European Union feels that that is not an issue; that it is, in fact, the same level as you’d expect in the general population.

ACTING ADMINISTRATOR SLAVITT: And let me just pile on to assure the public of following: The FDA will conduct a completely thorough analysis of the application that’s submitted in all the data from AstraZeneca, and Dr. Fauci, as he always does, will help the public interpret whatever comes out of the FDA when they review that data.

So people should be very assured that we have the best regulatory bodies who study these matters in the world — will be looking at this data. And the best scientists in the world will help people understand whatever comes out of that. So I think we should wait until we see what happens with that process before anybody jumps to conclusions.

Next question.

MODERATOR: Jeremy Diamond, CNN.

ACTING ADMINISTRATOR SLAVITT: Should we go to another question, Kevin?

MODERATOR: We’ll go to another question.

Q Hey. It wasn’t letting me unmute, but it just did. Can you hear me?

ACTING ADMINISTRATOR SLAVITT: Yes, Jeremy.

Q Okay, thank you. So two questions. First of all, you said that you expected the B117 variant to be dominant in the U.S. by the end of March, early April. Is it now the dominant strain? And how much of the increasing cases do you attribute to that variant?

And then, secondly, we’ve heard a lot from you about the importance of governors keeping or reinstating mask mandates, but several of the states experiencing the worst surges haven’t done away with their mask mandates; instead, it’s been loosening of other restrictions like indoor dining and gathering.

So my question is: What are you telling states about which restrictions they should be implementing, and why haven’t you published uniform gating criteria to lay out a roadmap that states should be following? Thank you.

ACTING ADMINISTRATOR SLAVITT: Great. Dr. Walensky, do you want to take those?

DR. WALENSKY: Yeah. As I mentioned earlier, we now have B117 as 26 percent of the circulating variant across the United States, and it is the predominant strain in at least five regions of the United States. So we’re starting to see it creep up.

We do know it’s more transmissible — somewhere between 50 and 70 percent more transmissible than the wild-type strain. So to the extent that people are not practicing those standard mitigation strategies, we do think that more infections will result because of B117. We believe that the current mitigation strategies of masking and distancing would work just as well against the current — the wild-type strain as they do the B117 strain.

I think we’ve been pretty clear with regard to our guidance and strategies and setting specific strategies as to how people can remain safe in these settings. And we continue to articulate in these press conferences and others the importance of masking, distancing, not traveling, and decreasing crowds.

ACTING ADMINISTRATOR SLAVITT: Yeah, I mean, just — just to reiterate: I think, three times a week for the last 10 weeks, Dr. Walensky has made the same points over and over and over again because repetition is good and it’s important. People want to know that they’re getting consistent answers. And consistently, three times a week for 10 weeks, Dr. Walensky has said, “Wear a mask, avoid crowds, socially distance, and don’t travel unless it’s absolutely essential.” Three times a week for 10 weeks.

We repeat that in all our conversations with governors. We repeat that in all our conversations with local officials. And we’re not the only one saying it; public health officials from departments and agencies across the country make the same points. So the people who are in violation of that are choosing to do that. They — they — they’re not confused about where we stand.

And to your point, Jeremy, that’s not the only factor that drives case growth. And even where there are mandates that everyone complies by them — but there are — where the variants are at any given time is obviously also another important factor.

Next question.

MODERATOR: We’re going to squeeze one more question in. We’ll go to Nsikan Akpan at New York Public Radio.

Q Hi, thank you for taking my question. So New York health — health officials continue to voice concerns about the B1526 variant. You know, early studies suggest this variant was first detected last November, and it now represents a large proportion of cases in New York City and New Jersey, and namely in counties undergoing surges.

Yet the CDC still classifies B1526 as a “variant of interest” rather than a “variant of concern.” I’m wondering what additional evidence is needed before B1526 is classified as a variant of concern. Does the CDC plan to release state-by-state case numbers on the New York variant rather than just a rough proportion? And what’s the national tally of B1526 cases so far?

DR. WALENSKY: Thank you for that question. I’m going to have to get back to you on the details on the national tally.

What I will say is that there is an interagency group that looks at these variants and classifies them, and it is that interagency group — CDC is a part of that — that is actually looking at exactly this question right now.

To view the COVID Press Briefing slides, visit: https://www.whitehouse.gov/wp-content/uploads/2021/03/COVID-Press-Briefing_31March2021_-for-transcript.pdf

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