Via Teleconference

11:01 A.M. EST

ACTING ADMINISTRATOR SLAVITT:  Good morning, and welcome to the COVID Response update.  Thank you for joining us.  I’m Andy Slavitt, White House Senior Advisor for the COVID Response Team.  Now, we’ve been battling this pandemic for the better part of a year.  More than 450,000 Americans’ lives have been taken, we’ve been separated from our friends and family, thousands of schools and businesses have been sitting empty, and Americans have had their lives turned upside down by the pandemic. 

Meanwhile, millions of Americans are doing everything in their power to put the country and the world back on the right course.  Millions of you are wearing masks, and the evidence Dr. Walensky has discussed here demonstrates that in communities where that happens, lives are being saved.  That needs to continue and improve in the face of the threats we confront. 

We know that millions of Americans are also waiting patiently to be vaccinated.  Today, I want to begin the briefing by updating you on what is happening while you’re waiting.  In the weeks and even months that you are waiting, the nation’s efforts are being spent focused on many who are most at risk of hospitalization and death from this virus: the elderly, seniors, frontline health care workers, and many essential workers. 

According to a recent CDC report, the Long-Term Care Program has administered now over 4.8 million doses to more than 3.7 million of our most vulnerable.  Those who were dying in large numbers over the last year are now on a path to protection.  And in skilled nursing facilities that have had at least one vaccination clinic, an estimated median of almost 80 percent of residents have received at least one dose of vaccine.

As vaccinations at these facilities are completed, that will mean many more lives saved, many more vaccines that can be moved into the inventory for the next priority groups.  And in total, of the over 40 million doses that have been administered, over 17 million doses have been administered to people 65 or older. 

Now, this is a great representation of the American spirit of generosity and American selflessness because our ability to vaccinate millions of the elderly, seniors, and healthcare workers is a testament to a society that has put our parents and grandparents, those who have served us, and those who continue to sacrifice for us on the frontlines of the healthcare system first. 

Now, at the same time, we need to step up efforts to increase vaccinations of racial and ethnic communities that have suffered disproportionately.  Health equity is a cornerstone of all of our work, and we’ll be talking more about progress there in upcoming briefings.

Even with that perspective in progress, we understand that the process moves more slowly than anyone would like.  But each day, we are putting forth efforts to increase vaccine supply, including by use of the Defense Production Act; to create more places to get vaccinated, including new large community vaccination centers and retail pharmacies; and mobilize more vaccinators by allowing retired physicians and nurses and deploying the military. 

This is a national emergency and the approach we are taking reflects this.  We are putting every resource and tool that the federal government has into this battle, and we’re taking a whole-of-government — indeed, a whole-of-country approach.  As soon as the Congress puts the American Rescue Plan on the President’s desk, we will be able to further increase this effort. 

We understand this is a long journey, but thanks to the sacrifice of so many of you and the step-by-step plan we are executing, for many of our most vulnerable Americans, the risk of death is being reduced.  And we are committed to leaving no stone unturned. 

With that, I’ll turn it over to Dr. Walensky for a state-of-the-pandemic update and Dr. Fauci for the latest in science before we answer your questions. 

Dr. Walensky. 

DR. WALENSKY:  Thank you so much, Andy.  I’m so glad to be back and joining you today.  Today, I’m going to give you a brief update on the pandemic.  As I mentioned on Friday, despite trends moving in the right direction, we remain in a very serious situation.  COVID-19 continues to affect too many people, as we continue to mourn all of those lives that have been lost.

Cases have continued to decline over the last four weeks.  An average of 119,900 new cases were reported between January 31st and February 6th.  That’s a drop of nearly 20 percent from the prior week, but still dramatically higher than the last summer’s peak.  We must continue to drive these cases down. 

New COVID-19 hospital admissions also continued to decline.  An average of 9,977 admissions per day were reported between January 30th and February 5th, a decline of nearly 17 percent from the week prior. 

This is promising, but hospitalizations also remain incredibly high.  Over 83,000 Americans are hospitalized right now with COVID-19 — much higher than the summer and fall.

Today, we are reporting that COVID-19 deaths increased 2.4 percent to an average of 3,221 deaths per day from January 31st to February 6th.  As I mentioned on Friday, sometimes delays in reporting can lead to fluctuations in the data.  This is the case for the average number of deaths reported today, which includes a delayed report of 1,570 confirmed deaths from one state.  These deaths were reported last week, but actually had occurred over the prior several months.  We may continue to see the variation in daily deaths for different reasons, including reporting delays.

We are continuing to watch these data closely.  And although hospital admissions and cases consistently — are consistently dropping, I’m asking everyone to please keep your guard up.  The continued proliferation of variants remains of great concern and is a threat that could reverse the recent positive trends we are seeing. 

As of February 7th, 699 variant cases have been confirmed across 34 states, with 690 of these cases being the B117 variant, the variant first reported in the UK. 

Please continue to wear a mask and stay six feet apart from people you don’t live with.  Avoid travels, crowds, and poorly ventilated spaces.  And get vaccinated when it’s available to you. 

I recognize that the pandemic has taken an enormous toll on all of us.  But if we all work together and take these prevention steps, we can finally turn the tide.  Thank you.  I look forward to your questions, and I will now turn things over to Dr. Fauci

Dr. Fauci? 

DR. FAUCI:  Thank you very much, Dr. Walensky.  I’d like to address, briefly, two issues that have come up for discussion over the last several days, and one is the question of: Given the fact that there is a greater demand than there is supply, should we be putting all of our effort into getting the first dose into people, with less emphasis on the second dose? 

Now, the reason for that — I have explained in the past — because the science has shown in both of the vaccines that we have currently available, the Moderna and the Pfizer — the strong data indicates that a prime boost gives a maximum response of 94 to 95 percent efficacy.  But the question has arisen, “Why not study in detail whether or not you can get away with a single dose?” 

It is not an unreasonable thing to suggest a study.  The only issue is that the practicality of that really makes that a situation that I don’t think is able to be done for the following reason: If you look at the number of people that would be required in a study to answer that question — again, one versus two — with the currently available vaccines, the time it took to get information on the phase three and the number of people — that that study, with all due respect, would take several months to get a meaningful answer.  At that time, the amount of vaccine that would be available would almost be making that question somewhat of a moot point. 

So then let’s ask ourselves — the question is: What do we do know about one dose versus two dose?  And the data, I think, are important to present.  We know from the original studies that, following a single dose of either the Moderna or the Pfizer, you had a response that gave you a neutralizing antibody above the threshold of protection.  So it did give some degree of protection.  And the question was: It was protection, clearly, against the wild type.  However, the boost, either 21 or 28 days later, was tenfold higher.  So it went, for example, from 1 to 100 to well over 1 to 1,000 in the titer. 

The reason that’s important: not only because of the height of the response and the potency of the response, but as you get to that level of antibody, you get a greater breadth of response.  And by “breadth of response,” we mean it covers not only the wild type and currently circulating virus, but also the variants that we see circulating, particularly the 117 and the 351.  So it’s not just a matter of potency; it’s a matter of the breadth of what you can cover.

The other theoretical issue that could be problematic with regard to only a single dose: that if you get a suboptimum response, the way viruses respond to pressure, you could actually be inadvertently selecting for more mutants by a suboptimum response.  So, for that reason, we have continued to go by the fact that we feel the optimum approach would be to continue with getting as many people on their first dose as possible, but also making sure that people, on time, get their second dose. 

And finally, one thing I want to emphasize: As we know, and we’ve heard, and it’s true, that the projection is that the 117 lineage would likely become dominant in the United States by the end of March.  Please remember that the efficacy of the currently utilized vaccines — the two mRNA — are a quite effective against the 117 lineage.  So, underscoring what Dr. Walensky just said, the two things that we can do is, A, make sure we adhere to the public health measures that Dr. Walensky just mentioned, and, B, get as many people vaccinated as quickly as we possibly can.  That’s the best defense against the evolution of variants.

I’ll stop there, and back to you, Andy. 

ACTING ADMINISTRATOR SLAVITT:  Thank you, Doctor.  All right, why don’t we go — why don’t we go to questions?

MODERATOR:  All right, thank you, guys.  I’m not seeing any hands raised, but if you could raise your hand, we can go ahead and start Q&A.

All right, first we’re going to Kaitlan Collins at CNN.

Q    Hi.  So, I have two questions.  One about the variants.  I know that, before, we’ve gone over them and we’ve said that they — the latest numbers have been a couple hundred cases, but we also know that, you know, we’re pretty behind on sequencing and working to ramp that up.  So what number do we think is actually out there?  And how much higher do you think it could be than the numbers that we’ve actually identified positively so far? 

And then my second question is about a comment that Transportation Secretary Pete Buttigieg made, saying that they are considering requiring testing for domestic flights.  What would the benefits of that be, given we know just how much transmission there is in the U.S. right now and the data on how much it spreads on flights when everyone is wearing a mask, or the lack of, I guess?  Would there be benefits to that actually happening?

ACTING ADMINISTRATOR SLAVITT:  So maybe, first, why don’t I turn to Dr. Walensky to talk about our ongoing efforts at surveillance and increasing our knowledge, and maybe a little bit about what the current state of knowledge we think might be with regard to these variances. 

Doctor? 

DR. WALENSKY:  Great.  Thank you.  And thank you for the question.  What I can say is we’re learning more about the number of variants, and the number of variants that you’re hearing increase is very much, at least in part, due to the fact that we’re doing a lot more sequencing of these variants.  So over the last three weeks or so, we’ve increased our sequencing about tenfold.  So as we look more, we’re certainly going –anticipate we might find more.

Over the next several weeks, we are hoping — we are planning, actually, to not only get collab — have collaboration with the state labs from every state, so we’d make sure we’re sampling from every state, but also from — with collaborations from commercial labs, as well as academic labs.  So we anticipate that we’re probably going to be sequencing up to three or four more than we’re already sequencing.  And I think once we have more sequencing that’s happening, we’ll have a better idea as to how many variants there are and what proportion are out there.

     ACTING ADMINISTRATOR SLAVITT:  Thank you.  I’ll take your —

     Q    So how much higher —

ACTING ADMINISTRATOR SLAVITT:  Oh, please, go.

Q    So do we have a ballpark estimate of how much higher it is than what we actually know right now?  Because I think the understanding is that it’s a lot higher than what we know.  Is that correct?

DR. WALENSKY:  I would be reluctant to give you an estimate right now based on our current data, but I’d be happy to get back with you on that one.

ACTING ADMINISTRATOR SLAVITT:  Let me take your second question.  I haven’t heard Secretary Buttigieg’s comment.  But I would say, as — and, Dr. Walensky, you may want to comment — is that with regard to domestic travel, I think, in the words of Dr. Walensky and the CDC, now is not the time to be traveling if at all possible.

And so, Dr. Walensky, do you want to say a word about traveling and safety measures with regard to travel?

DR. WALENSKY:  Yeah, what I would add is, the more screening that we’re doing in places where people are gathering, I think the more asymptomatic disease will be — we will be detecting.  And certainly there’s a lot of — there’s more gathering that happens in airports, and so, you know, to the extent that we have available tests, to be able to do testing. 

First and foremost, I would really encourage people to not travel, but if we are traveling, this would be yet another mitigation measure to try and decrease the spread. 

ACTING ADMINISTRATOR SLAVITT:  Thank you.  Let’s go to the next question.

MODERATOR:  Next we’ll go to Brian Karem with Bulwark. 

Q    Thank you very much.  And thanks for taking the question.  This question is for Dr. Fauci.  Dr. Fauci, we are talking about the mutant varieties of this virus, and we are stressing that we need to get as many vaccinated as possible.  Now, when I speak to scientists, they tell us that, eventually, that viruses like this tend to mutate to a less harmful or a less virulent strain.  Is there any data or scientific concerns that this particular virus is mutating into a more virulent strain or a more dangerous strain and that it is more dangerous as it mutates?

And then I have a follow-up.

DR. FAUCI:  Okay.  Well, the answer to your question is: Right now, we certainly don’t have any data to indicate that it is mutating into a less virulent strain.  The initial data that came out from the UK about it having a degree of increased virulence, that is still, I think, something — I wouldn’t say that’s questionable, but I think that needs to be confirmed.  But thus far, no evidence that it is less virulent. 

Sometimes when viruses mutate, to spread more efficiently they become less virulent, but we do not have any data to indicate that that is, in fact, happening with SARS-CoV-2.

Q    And then the follow-up to that question is: If it is becoming — or if your concern is that it is more virulent, how long will the efficacy of the current vaccines under this structure — have you been able to game that out to determine when that efficacy will be dampened or will lessen?

DR. FAUCI:  Well, I think that’s obviously going to take an observation over a longer period of time.  We’ve got to really be careful because there were two things that are going on right now: A virus is transmissible and is virulent, and the degree of transmissibility and the degree of virulence can actually overlap and result — because you’ve heard us say on our briefings that a virus that has a greater degree of transmissibility will be making more people sick.  The more people that get sick, the more people that will be hospitalized.  And the more people that are hospitalized, you’ll likely get more deaths.

But on a one-to-one basis, whether or not it is truly more virulent: Right now, we don’t have any indication that that’s the case here, and we’ll just have to continue to observe, which we do.  You know, the vaccine trials, they ended and came up with an efficacy of 94 to 95 percent, but the trials go on for two years.  So we’ll learn a lot more over the next couple of years.  So they’re still following up on this, both from the study as well as being reported to the FDA.  So if there’s any information in that regard, it will become available to us as the months and year goes by.

ACTING ADMINISTRATOR SLAVITT:  Thanks, Brian.

DR. FAUCI:  Thank you.

ACTING ADMINISTRATOR SLAVITT:  Hey, Dr. Fauci, just to clarify something, if you wouldn’t mind.  Very fair question from Brian speculating about the future.  But maybe you can emphasize what we know today about the efficacy and safety of the viruses relative to what the threats we face today.

DR. FAUCI:  Well, right now, what we’re seeing now in our country is still a dominant, original, wild-type virus of which the vaccines are highly efficacious — 94 to 95 percent. 

The immediate concern that we have is that — the fact that we have the 117 in certainly a considerable number of states reported with a number of people.  That modeling would tell us, Andy, that it could become dominant by the end of March.  That’s the sobering news.

The encouraging news is that the vaccines that we’re currently distributing right now are quite effective against that particular variant, less so against the South African, the 351.  But hopefully we will get the virus under much better control by the time there’s any indication that that might become dominant.

ACTING ADMINISTRATOR SLAVITT:  Got it.

DR. FAUCI:  So, again, it gets back, Andy, to vaccinating as many people as you possibly can and implementing the public health measures. 

ACTING ADMINISTRATOR SLAVITT:  Great, thank you. 

Okay, next question, please.

Q    Hi, thank you for taking my question.  I have actually two questions.  The first is statistical for Andy.  You told us how many doses were administered in the long-term care program.  What’s the total number of doses that were set aside for that program?  In other words, what’s the denominator?  And then, secondly, on the new pharmacy program, is there going to be a separate registration system for that?  And if so, what does that mean for all the people who had already signed up at their local health departments and have been waiting in line?  Do they start over?  Is there going to be some kind of integration between these different systems now?

ACTING ADMINISTRATOR SLAVITT:  Thank you for the question.  I thought I was off the hook when you said it was statistical.  I was quite confident it was going to go to one of the experts. 

Relative to the long-term care program, there are a lot of numbers moving around.  And so I think it’s important to emphasize what I talked about earlier, which is that we’ve administered 4.8 million doses to more than 3.7 million people.

And what we don’t have for you today is a breakdown of how many doses are first and second doses; likewise, what percentage of the population in nursing homes or long-term care facilities are fully vaccinated. 

So I want to make sure I’m speaking as precisely as possible to what the CDC study said.  And I would invite Dr. Walensky, when I’m finished, if there are any additions or corrections to that, to add them. 

But it’s important that I think things are phrased that way.  We do know that for the centers that have vaccination clinics, the median number of people — and this was as of sometime in the end of January — the median number of residents that were vaccinated was 80 percent.  So, that gives you, I think, a decent approximation.

In terms of pharmacies, many of the pharmacies do have their own registration systems in place.  And so those are the registration systems that I think they will likely continue to use in the near term. 

I think your question about dealing with separate registration systems is a good one.  For example, people may want to try to understand more about how they can find a place where they can get vaccinated.  And I think particularly, as there’s more supply, that’s going to be important. 

And I have nothing to announce today, other than the — that we are looking very closely at that question and how we might be able to help people.

Should we go to the next question?

MODERATOR:  We’ll go to Kristen Welker at NBC.

Q    Hi, everyone.  Thank you.  First question is: Can you give us your assessment of some of the states that have begun to relax their protocols?  For example, Iowa, among those who has reversed some of the indoor requirements in terms of masking and public social distancing. 

And also, given that a number of schools all across the country are discussing how they are going to reopen — there is an urgency to that matter — I know that you said that the CDC’s guidelines for school reopenings would be coming soon.  When can people expect to see that?  And have you gotten to a place where you can give us any indication about whether you think teachers should be vaccinated before schools reopen?

ACTING ADMINISTRATOR SLAVITT:  Great.  Well, look, I think both of those are probably going to head for you, Dr. Walensky.  But let me — let’s do — the first one is your comment on states or local jurisdictions that may be relaxing some of the public health standards that the CDC has been recommending.

DR. WALENSKY:  So maybe I’ll just start and say, given that we’re still at over 100,000 cases a day, I would discourage any such activity, and I would say that we are still in the first hundred days where we want certainly everybody masked for the first hundred days. 

I think we have yet to control this pandemic.  We still have this emerging threat of variants.  And I would just simply discourage any of those activities.  We really need to keep all of the mitigation measures at play here if we’re really going to get control of this pandemic. 

And in that regard, as we move towards and think about schools, what we know mostly about schools, in terms of the data, are that most infections come into the schools through the community.  The data from schools suggests that there’s very little transmission that is happening within the schools, especially when there’s masking and distancing occurring, and that when there are transmissions in the schools, it is because they brought — been brought in from the community and because there are breaches in masking and distancing. 

So, if we want to get our schools open and our schools open safely and well, the best way to do that is to decrease the community spread.  So I would say we need to keep up our social distancing and our masking and all of our other mitigation measures.  Our CDC guidance on school reopening will be coming in the days ahead, and I look forward to thinking through those with everybody.

ACTING ADMINISTRATOR SLAVITT:  Great, thank you.  Do we have a next question?

MODERATOR:  Last question will go to Isaac Stanley-Becker at Washington Post.

Q    Thanks for taking my question.  It follows up on Kristen’s first question.  So, in light of the fact that this is the recommendation of the CDC, can you say a little bit more about what the administration is doing to communicate this guidance and these instructions to governors and other officials out in the country, discouraging them from taking some of these steps?  Or is — ultimately, is this largely a state and local matter where the administration’s power is limited?

ACTING ADMINISTRATOR SLAVITT:  So, I just want to confirm, not that the question was asked that long ago, but your question — you’re talking about conversations with governors about steps that they’re — those that are taking steps to relax mitigation standards?  Is that your question?

Q    That’s right.  Just if you could say a little bit more about what the administration is doing to provide counsel and instructions on issues like mask mandates, dining restrictions to — you know, especially in light of the spread of these variants. 

ACTING ADMINISTRATOR SLAVITT:  Well, all across government, we talk to the states incredibly frequently, so maybe we’ll go around and see, Dr. Walensky, if there’s anything you want to add to your previous answer.

DR. WALENSKY:  I will just say I think our stand on this is pretty well established.  I attend a weekly governors call at least — and I know that — and I’ve been in touch one-on-one with numerous governors already.  So I’m doing my best, and I’m — would be happy to do be doing more to encourage the states to decrease their community spread so that we can decrease the threat of these variants, decrease our hospitalizations, and get this pandemic under control.

ACTING ADMINISTRATOR SLAVITT:  And the only thing I’ll add to that is, you know, we understand the pressure the government — the governors are under.  We are taking a collaborative approach as much as possible, sharing with them the data, helping them understand — as we’ve covered on this call — why we’re in such a critical period to combating the virus, and hope to continue to work to persuade and partner with states and localities to continue to follow sensible public health measures until such time as we’re in a situation where the case rates are down — are down lower.  We think that’s wise. 

We think that the — that the voice of the CDC is preeminent here.  They look at all of the data.  They’re clear in communicating with the public.  And we will continue to have those conversations with the states.  But I won’t — I won’t go into any of the specific one-on-one conversations that we have with states because I think that might be counterproductive.

I want to thank you for — all for attending our briefing.  I think we hit the half-hour mark pretty precisely.  We look forward to a productive week, collectively, and to talking with you all again on Wednesday.

11:30 A.M. EST

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