Via Teleconference
10:36 A.M. EDT
ACTING ADMINISTRATOR SLAVITT: Good morning. Thank you for joining us.
Today, I am joined by Dr. Walensky, Dr. Fauci, and Dr. Murthy to give you a thorough update on a busy week of activity fighting the pandemic across multiple fronts.
You have heard our scientific and public health teams, led by Dr. Fauci and Dr. Walensky, talk in plain terms about the threat to ending the pandemic we face from more dangerous variants that emerge from COVID-19. Today, with their help, I want to lay out our strategy to tackle these variants.
When we arrived in January, we put together a 200-page plan on how we would tackle every element of the pandemic — from vaccinations, to inequities, to school re-openings, to testing. Part of any plan is tackling the things you can't fully prepare for but which emerge as critical threats.
All roads to defeating the pandemic go through the path of successfully and quickly vaccinating the country. To date, 125 million Americans have been vaccinated and millions more each day. But even as we accelerate our efforts to get shots in arms, more dangerous variants are growing, causing increases in cases with people without immunity.
This increases the urgency for you to get vaccinated. But it also requires us to intensify our efforts to quickly test for and find the genetic sequence of the virus as it spreads.
Now, we started in a hole. Despite having world-class researchers and dedicated state and local public health leaders, when we arrived, the U.S. was sequencing only a small fragment of what other countries were. This hampered our ability to find and react to these new variants.
What we call surveillance — our ability to spot variants as they emerge and spread — is vital, particularly as we aim to get ahead of dangerous variances before they emerge, as they are in the Midwest right now.
Today, we are announcing a $1.7 billion investment to bolster the ability of the CDC and state and local public health departments to monitor, track, and defeat emerging threats — whether it's COVID-19 variants today or other viruses in the future — through a process known as genomic sequencing.
This significant investment, which is made possible due to the American Rescue Plan President Biden signed into law last month, is critical in our fight against the new and potentially dangerous variants of COVID-19. Right now, these variants account for nearly half of all COVID-19 cases in the United States, and we need more capacity in our public health system to identify and track these mutations.
State and local public health departments are on the frontlines of beating back the pandemic, but they need more capacity to detect these variants early on before dangerous outbreaks. This funding will enable CDC and states to do more genomic sequencing as we activate the nation's great research capabilities to detect variants earlier and increase our visibility into emerging threats. This investment will give public health officials the chance to react more quickly to prevent and stop the spread.
Today's investment also builds on the major investments in testing and genomic sequencing that we made earlier this year. That includes $10 billion of American Rescue Plan funding to support COVID-19 testing in schools, another $2.5 billion to help state and local public health agencies increase testing capacity in underserved and high-risk communities, and nearly $200 million to begin to increase genomic sequencing capacity that this investment comes on top of.
We're doing a number of other things to work with individual states that are experiencing a rise in cases: providing more intensive support to get more shots in arms more quickly, more personnel to support vaccination and other public health efforts, and more testing and therapeutics. Additional sequencing efforts will be a vital tool in our battle against COVID-19.
I have one further announcement. Today, we're announcing another federally-run mass vaccination site in Bessemer, Alabama, that will have the capacity to administer 7,000 shots per week. Altogether, by next week, we will have opened 37 mass vaccination sites in 26 states, with a combined capacity of administering a total of 125,000 shots per day.
We're doing everything we can to put this pandemic behind us, and we stand ready to support states. But, before I turn it to Dr. Walensky, I want to reiterate the role all of us have to play. We need everyone to do their part. We need all Americans to take the steps we know work to stop COVID-19. So, please: Wear a mask, socially distance, and as needed — socially distance, and get tested as needed, and also go get vaccinated. As of Monday, all adult Americans will be eligible.
With that, I'm going to turn it over to Dr. Walensky.
DR. WALENSKY: Thank you and good morning. As for my usual, I'll begin with an overview of the data.
Yesterday, CDC reported 73,622 cases of COVID-19. Our seven-day average is up to 69,500, nearly 70,000 new cases per day. I know case numbers may seem similar from day to day, but just four weeks ago, our seven-day average was only about 53,000 cases per day.
In concert with the increase in cases, the seven-day average of emergency department visits, hospital admissions, and hospitalizations are all approximately 5 to 8 percent higher than they were in the prior seven-day period. And sadly, average daily deaths have increased for the third day in a row to over 700 per day.
We are also getting vaccines into arms as quickly and as equitably and safely as possible. I am proud of the progress we've made. More than one third of the U.S. population has received at least one dose, and more than one fifth of the population is fully vaccinated.
But we must continue to get many more people vaccinated. This — the increasing trends in cases, hospitalizations, and deaths are very concerning, and they threaten the progress we've already made.
As I've discussed, some of these increases are as a result of relaxed prevention efforts in states across the country, such as relaxed mask mandates or loosened restrictions on indoor restaurant seating. Another reason for these increases is the continued spread of highly transmissible variants — more than 50 to 70 percent more transmissible — which makes the race to stop the transmission even more challenging and threatens to overwhelm our healthcare system again in parts of this country.
CDC data show that the B117 variant — the variant originally identified in the United Kingdom — represents 44 percent of the virus circulating during the week of March 27th. The prevalence of B117 since that time is certainly higher, and we are expected to have new data soon.
The emergence of variants underscores the critical need for rapid and ongoing genomic surveillance. CDC has been acting on multiple fronts to increase our sequencing efforts in the United States to detect variants of the virus that causes COVID-19, and recently began receiving the sequence data from seven additional large commercial laboratories.
As Andy just announced, the administration is investing $1.7 billion from the American Rescue Plan in an effort to more effectively track emerging and circulating variants across the country and to better prepare the country for the next pandemic. This includes surveillance of breakthrough infections, as well as more and more — as more and more people get vaccinated.
With this critical and substantial investment, CDC will fund the equipment, supplies, training, staffing, electronic infrastructure, partnerships, and innovation needed to build a robust national genomic-sequencing effort.
In addition, $300 million will establish six Centers of Excellence in Genomic Epidemiology. These Centers of Excellence will operate as partnerships between state health departments and academic institutions, and today's funding will fuel cutting-edge research into genomic epidemiology. In this work, we will build our public health capacity to respond not just to COVID-19, but to future concerning emerging threats to public health.
Yesterday, I testified before a congressional subcommittee, where I shared my commitment to working with the Biden administration and Congress to address longstanding vulnerabilities and core public health infrastructure that presents challenges in the nation's ongoing effort to successfully tackle COVID-19. Today's announcement and this investment substantially contribute toward that commitment.
Finally, I want to comment on our ongoing surveillance of the safety (inaudible) with the Johnson & Johnson vaccine we discussed on Wednesday. After the press briefing on Wednesday, the Advisory Committee on Immunization Practices — or ACIP — met to discuss the six cases and provide recommendations.
I want to thank the ACIP for their thoughtful discussion and their commitment to the science. The recommendation from this group of independent experts for a continued pause will allow additional time to review any additional cases that might come in, and for them to conduct a complete risk assessment and to evaluate the emerging science. ACIP will meet again this Friday, April 23rd, from 11:00 to 5:00 to provide further recommendations.
Importantly, the vaccines produced by Moderna and Pfizer are still widely available, and we continue to work with pharmacies, states, and FEMA to make sure the vaccine supply remains robust across the country as we approach April 19th, when all Americans above age 16 or 18, depending on the vaccine received, will be eligible for vaccination.
If you have not been vaccinated, I want to encourage you to do so with one of the available vaccines as soon as you can. Widespread vaccination is the only way we will ultimately move past this pandemic.
Thank you. I'll now turn things over to Dr. Fauci.
DR. FAUCI: Thank you very much, Dr. Walensky. I would like to take this opportunity now to call your attention — can I have the first slide? — to the first — soon to be first-year anniversary of the NIH-sponsored Coronavirus Disease 2019 Treatment Guidelines Panel.
Next slide.
This is a panel of individuals co-chaired by Dr. Cliff Lane, who is my Deputy Director of NIAID, but also the Clinical Director of the Institute; Henry Masur, who is the Director of the Critical Care Medicine Unit at NIH; and Roy "Trip" Gulik, who is the Chief of Infectious Diseases at Weill Cornell Medicine in New York City.
As you can see from this group, the members — some of you may recognize — are people who are in the trenches every day, taking care of people with COVID-19. This panel was established to be able to work, literally in real time, updating guidelines for clinicians and healthcare providers throughout the country and the world on the latest information. And since information comes out not only in published work, but also the results that are pre-publication of either clinical trials or clinical observations, as well as expert opinion.
Next slide.
This is the list of the organizations that are represented on the panel by the people that you saw in the previous slide.
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As I mentioned, the anniversary is next week on the 21st of April. Since we began, one year ago, there have been close to 4 million users in the United States, about 2,600,000 of which were international. So we are serving as a resource for clinicians throughout the world. Again, since the beginning, there have been over 14 million page views, and there have been 23 separate updates to the treatment guidelines.
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This is an important slide. For those not used to looking at guidelines, there's varying degrees of strength of recommendation and what the evidence for that recommendation is. As you see on the left, there is "A," a strong recommendation for a statement; "B," moderate; "C," optional.
And on the right, it depends on what you're basing this recommendation. If you get a "1," that means there's one or more randomized trials without major limitations. "2A" is other randomized trials or subgroups. "2b" is non-randomized trials. And "3," you don't have a trial but there's expert opinion. So obviously, a "1" — an "A-1" is a very strong recommendation based on good data, but you're going to see others, depending upon what the evidence has been.
Next slide.
So, let me just then show you an example. On April the 8th, eight days ago, there was an update on the recommendation of the use of anti-SARS-CoV-2 monoclonal antibodies. And the panel, after deliberation, recommended using one of the following combinations — and I underscore "combinations" — of anti-SARS-CoV-2 monoclonal antibodies to treat outpatients — again, underscoring "outpatients" — with mild to moderate COVID-19 at a high risk of clinical progression, as defined by the Emergency Use Authorization criteria. And these are the combinations listed there: bamlanivimab, etesevimab; or casirivimab and imdevimab.
Number two, the treatment should be started as soon as possible after a positive result on SARS-CoV-2 antigen and nucleic acid amplification and within 10 days of symptom onset.
Next slide.
Now, the updated recommendations also have the following: Because the clinical outcome data are limited and there are concerns regarding the decrease of susceptibility of variants, the panel recommends against the use of bamlanivimab monotherapy. And that gets an "A-3" recommendation.
The panel also recommends against the use of these antibodies in people who are hospitalized, except if it's in a clinical trial. However, the use should be considered for persons with mild to moderate COVID-19 who are hospitalized for a reason other than the underlying COVID-19 disease but who otherwise meet the criteria.
And on the last slide. We often get asked, "If I have a patient coming into the office who I think I might want to give a monoclonal antibody to, how do I find out where and how to do that?" This is the information here. Contact the Combat COVID Monoclonal Antibodies Call Center at that telephone number and at that website.
I'll stop there and hand it over to Dr. Murthy.
SURGEON GENERAL MURTHY: Well, thanks so much, Dr. Fauci. And it's good to be with all of you this morning again. Today, I'd like to speak with you about two topics related to the national COVID-19 vaccination effort.
First, American Indian and Alaska Native people are at higher risk for COVID disease and complications. And historically, we also know that they have faced more limited access to healthcare and great disparities in health.
According to a recent CDC report, American Indians and Alaska Natives were 3.5 times more likely to get COVID than a non-Hispanic, white population. Native people are also more than four times likely to be hospitalized as a result of COVID-19.
Despite these challenges, our colleagues working in the Indian health system have heroically administered more than 1 million doses of COVID-19 vaccines. That is a remarkable achievement and a testament to their dedication.
