Via Teleconference

11:04 A.M. EST

MR. ZIENTS:  Good morning.  And thanks for joining us.

Today, Dr. Walensky will share the latest on Omicron.  And Dr. Fauci will provide an update on COVID treatments.

First, I want to discuss next steps — new steps we’re taking to increase access to COVID testing for K-through-12 students, teachers, and school staff.

We know in-person learning is what’s best for our children, so keeping schools open safely is a top priority.

And we know what works to keep schools open: vaccinations, masks, better ventilation, distancing, and testing.

To help schools implement these proven prevention measures, the Biden administration provided schools $130 billion in American Rescue Plan funding, with an additional $10 billion to support COVID testing in schools.

These historic investments have helped schools open safely.  In fact, today, more than 96 percent of K-through-12 schools are open for in-person learning.  That’s up from just 46 percent a year ago.

The Omicron variant is driving unprecedented demand for testing, so we need to ensure school leaders have the support they need to meet that demand.

So today, we’re taking additional actions, including sending 5 million free rapid tests to schools each month and providing another 5 million lab-based tests each month.

These 10 million additional tests available each month will allow schools to double the volume of testing they were performing in November.

The President is clear: The nation’s schools can and should be open, and we have given state and local leaders the resources to ensure they can be open.

With that, over to Dr. Walensky.

Dr. Walensky?

DR. WALENSKY:  Thank you, Jeff.  Good morning.  I’d like to start by walking you through today’s data. 

The current seven-day daily average of cases is about 751,000 cases per day, an increase of about 47 percent over the previous week. 

The seven-day average of hospital admissions is about 19,800 per day, an increase of about 33 percent over the prior week.

And the seven-day average of daily deaths are about 1,600 per day, which is an increase of about 40 percent over the previous week. 

Over the past several weeks, we have seen the number of daily cases increase substantially.  The magnitude of this increase is largely related to the Omicron variant, which now represents about 98 percent of the COVID-19 cases in the country. 

We continue to learn more about Omicron with each passing day, including the severity of disease caused by this variant. 

Just yesterday, a preprint study of daser [sic] from — data from Kaiser Permanente Southern California, analyzed by academic partners with CDC collaboration and funding, provided key insight into clinical outcomes among patients infected with the Omicron variant. 

This study used mathematical modeling to estimate risk of
hospitalization and severe disease from a healthcare system that provides care to 4.7 million people in Southern California — 19 percent of the state’s total population — and noted substantially reduced risk of severe clinical outcomes in patients who are infected with the Omicron variant compared with Delta. 

In the study, there were over 52,000 cases of Omicron compared with nearly 17,000 cases of Delta.  Displayed on this slide are figures from this study. 

On these graphs, green represents infections with the Omicron variant, and purple represents infections with the Delta variant.  When compared to Delta, infections with Omicron were associated with a 53 percent reduction in adjusted risk of symptomatic hospitalization displayed in the first panel, a 74 percent reduction in adjusted risk of ICU admission displayed in the middle panel, and a 91 percent reduction in adjusted risk of mortality displayed on the third panel.  No patients with Omicron required mechanical ventilation. 

Additionally, this study found that those infected with Omicron who were hospitalized had a shorter duration of hospital stay compared to those with Delta. 

The duration of hospital stays was approximately 70 percent shorter, with the median of stays being 1.5 days for Omicron compared to about 5 days for Delta.  Looking at all hospital admissions for Omicron, 90 percent of patients were expected to be discharged from the hospital in three days or less. 

This study controlled for important key parameters such as age, sex, prior SARS-CoV-2 infection, prior vaccination, and comorbidities. 

The data in this study remained consistent with what we are seeing from Omicron in other countries, including South Africa and the UK, and provide some understanding of what we can expect over the coming weeks as cases are predicted to peak in this country. 

While we are seeing early evidence that Omicron is less severe than Delta and that those infected are less likely to require hospitalization, it’s important to note that Omicron continues to be much more transmissible than Delta. 

The sudden and steep rise in cases due to Omicron is resulting in unprecedented daily case counts, sickness, absenteeism, and strains on our healthcare system. 
The risk of hospitalization remains low, especially among people who are up to date on their COVID vaccines.  However, the staggering rise in cases — over 1 million new cases each day — has led to a high number of total hospitalizations. 

As we see hospitals and health systems caring for more and more patients in the midst of staffing challenges and faced with a highly transmissible virus that does not spare our healthcare workers, we must do — all of us do our part to protect our hospitals and our neighbors and reduce the further spread of this virus. 

As you’ve heard me say before, we know what works against COVID-19.  This means getting vaccinated and getting boosted; wearing a mask in public indoor settings in areas of high transmission — and, currently, that’s over 99 percent of our counties; and testing before you gather with others. 

Thank you.  I’ll now turn things back over to you, Jeff.

MR. ZIENTS:  Thanks, Dr. Walensky.  Before I turn to Dr.  Fauci for an update on COVID treatments, I want to emphasize that we have more courses of effective treatments now than at any other point during the pandemic.

This is the direct result of the Biden administration’s focus from day one to stock our nation’s medicine cabinet with a diverse set of treatments and the aggressive actions we have taken to expedite research, development, manufacturing, and procurement.

Today, I want to provide some context, specifically about actions the Biden administration took on Pfizer’s antiviral pills.

Last spring, the company and the administration agreed to work together to speed up both clinical research and manufacturing timelines.

Originally, the company had projected that clinical trials would not conclude until the middle of this year, 2022.

In cutting red tape and sourcing key supplies, the government and Pfizer collaborated to dramatically accelerate the clinical trial process, shaving about seven months from the original timeline.

So, instead of waiting for clinical trial results in mid-2022, we got those results late last year.  And we were able to begin shipping the first pills in December, months ahead of schedule.

At the President’s direction, we also acted early and aggressively to secure significant supply of Pfizer’s antiviral pills.

The U.S. has now purchased 20 million treatment courses.

Working closely with Pfizer, we’re further accelerating the delivery of these pills so that we’ll have the first 10 million by the end of June instead of the end of September.

And we continue to work with Pfizer to help them further expand their manufacturing capacity, including through the Defense Production Act if needed.

As Dr. Fauci will discuss, these pills are meant for those at high risk of severe disease from COVID.

We have a number of other treatment options that work against Omicron, and we’re working to increase our supply of those treatments as well.

Just this week, we completed the purchase of another 600,000 treatment courses of GlaxoSmithKline’s monoclonal antibody treatment.  That’s all of GSK’s available supply and it means the U.S. will have more than 1 million total treatment courses through the end of March.

And we’re using every tool at our disposal, including the Defense Production Act, to accelerate delivery of these GSK doses as quickly as possible.

Lastly, we’re also in the process of ordering another half-million doses of AstraZeneca’s preventive therapy for immunocompromised individuals.

The federal government was instrumental in the research and development of this product, and our latest order will also bring us to over 1 million doses available through end of March.

Bottom line: We’ve acted aggressively to support and secure a diverse portfolio of COVID treatments.  And as a result, our nation’s medicine cabinet has never been more stocked, with 4 million effective treatments available in January alone.

With that, I’ll turn it over to Dr. Fauci to talk about each of these treatments and important research into future antivirals.

Dr. Fauci.

DR. FAUCI:  Thank you very much, Jeff.  What I’d like to do over the next few minutes is talk about what Jeff referred to as the “Omicron medicine cabinet.”

First of all, before I get on to the therapy, I want to underscore the importance that the up-to-date COVID-19 vaccination with boosters prevents severe disease and keeps you out of the hospital, as underscored by Dr. Walensky.

But I want to focus now: What happens if you do get sick?  What are the therapies to prevent you to get disease progression? 

Next slide. 

I really want to refer people to the details of what I’ll be saying over the next few minutes that can be easily found in the NIH COVID-19 treatment guidelines that are accessible online. 

Very briefly, this is the state-of-the-art guidance for clinicians for the treatment of patients with COVID-19, and it is a panel which includes representatives from six government agencies, with 42 voting members from 10 professional medical societies, academia, and healthcare systems. 

We began it on March 24 of 2020.  The first guideline was released on April 21st.  And since then, we’ve had 44 updates, in which there were 30 million-plus page reviews. 

Next slide. 

So, let’s look at what we have there.  There are two major pillars of therapeutics.  One is to target the virus, and I’ll get into those individual drugs in a moment.  The other — which I won’t speak about very much, but just to let you know that to moderate the immune response and the inflammatory response with late disease by the therapies shown on this slide, such as dexamethasone, tocilizumab, baricitinib.

Let me show you how that goes when you look at the stages of disease. 

Next slide. 

As you can see, there is a spectrum from an infected person with no symptoms to an outpatient with mild symptoms; an inpatient, not requiring oxygen; low flow, high flow; and then the ultimate, which we obviously like to avoid at all costs, is mechanical ventilation. 

One targets the virus early on, with some overlap in the later stage with moderating the host response. 

Next slide. 

What we really want to do, among several other things, is to prevent people from progressing to serious disease.  And you do that by treating people as outpatients, thereby reducing the visit to urgent care setting, to hospitalizations, and ultimately deaths. 

You reduce the duration of illness.  You reduce, to some extent, infectivity and transmission.  And importantly, particularly as we’re dealing with this extraordinary situation with Omicron, you minimize the stress on the healthcare system. 

Now, the highest priority, as always, should be given to patients with the highest risk of progression.  So, let’s take a look at that. 

Next slide. 

The prioritization of therapies first, among Omicron, for these patients with mild to moderate disease at high risk.  The numbers on the right show what the clinical trials have shown is the relative risk of reduction for hospitalization or death. 

As you see at the top of the list is the drug that Jeff mentioned — paxlovid — which received an EUA.  Five days of oral therapy, 89 percent reduction. 

Sotrovimab — a single infusion of a monoclonal antibody that works against Omicron, 85 percent relative risk reduction. 

Remdesivir is an already approved drug.  It’s used off label with a three-day infusion with a very high level of a relative risk reduction. 

And finally, molnupiravir, which is a five-day oral drug with 30 percent diminution.

Next slide. 

What about the prioritization of therapies for outpatients among limited resources?

Now, I know this slide has a lot of words on it.  You can easily access this, if you want to focus on it, in the treatment guidelines. 

First and foremost, the immunocompromised.  Individuals who are unvaccinated at high risk — what do we mean by “high risk”?  Anyone greater than 75 years of age, or greater than 65 with a clinical risk factor.

Next comes the unvaccinated at increased risk — namely anyone greater than 65 or anyone less than 65 with a clinical risk.

And then vaccinated at high risk or vaccinated at increased risk.

Again, maybe difficult to remember quickly, but they’re all in the treatment guidelines. 

Next slide. 

In addition, what about the pipeline?  Where are we going?  There are a number of phase two and phase three trials of potential COVID-19 therapies that are active or pending, and you can go to to see the status of that. 

There are selective agents in late-stage testing that are antibodies, antivirals, repurposed drugs, immunomodulators, and anticoagulants. 

Next slide.

There is a program which we started early on called the Accelerated COVID-19 Therapeutic Interventions and Vaccines, referred to as ACTIV, which many of you may be familiar with. 

Next slide. 

What does ACTIV do?  They have a number of trials, six in number, looking individually at immune modulators; outpatient monoclonal antibody therapies; inpatient monoclonal antibodies; antithrombotics; big effect trials looking at treatments for larger clinical trials to identify promising drugs; and ACTIV-6, which is looking at repurposed drugs — the drugs that people want to know what the results are in a good trial, such as fluvoxamine, ivermectin, and fluticasone.

Next slide.

Finally, what’s today’s takeaway?  First, to reemphasize: Up-to-date vaccination is essential.  You can go to  You can text your ZIP code.  You can call.  But importantly, to reiterate what I was saying, the therapies and treatment guidelines are available on the website shown here. 

Back to you, Jeff. 

MR. ZIENTS:  Thanks, Dr. Fauci.

So, before we open it up to Q&A, a quick personnel update.

We have named Dr. Tom Inglesby, who was previously Director of Johns Hopkins Center for Health Security, to lead our federal testing program.  

Dr. Inglesby is one of the world’s leading infectious disease experts and is internationally recognized in the field of public health preparedness; pandemic and emerging effectiveness [sic] — effective [sic] — (laughs) — infectious disease; and prevention of and response to biological threats.  Sorry, Tom.

We continue to work across multiple fronts to increase Americans’ access to testing, and we’re all very, very grateful for his willingness — Tom’s willingness — to lead these efforts.

With that, let’s open it up for some questions.  Kevin?

MODERATOR:  Thanks, Jeff.  We have time for a few questions.  Let’s go to Berkeley Lovelace at NBC News.

Q    Hi.  Thanks for taking my question.  During Dr. Walensky’s opening remarks, she said there was a 40 percent increase in deaths over the previous week.

Does the CDC expect that those cases are Delta related since deaths tend to lag cases and hospitalizations?  Or could it be Omicron, and, just because there’s a sheer — a huge number of cases, there’s going to be a larger portion of deaths?  Thanks.

MR. ZIENTS:  Dr. Walensky.

DR. WALENSKY:  Yeah, that’s a really important question.  I believe, right now, that those deaths are still the lagging deaths from Omicron [sic].  We saw — I’m sorry, from Delta — the lagging deaths from the Delta wave.

We have seen, as you noted, that death rates are down from Omicron of about 91 percent.  And we will need to follow those deaths over the next couple of weeks to see the impact of Omicron on mortality.

As you note, given the sheer number of cases, we may see that deaths from — we may see deaths from Omicron.  But I suspect the deaths that we’re seeing now are still from Delta.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Allison Aubrey at NPR.

MR. ZIENTS:  Allison?

Q    Sorry about that; that was my mute button.  Thanks for taking my question.  I know there’s a lot of focus on the quality of masks right now.  My daughter’s elementary school is handing out N95s.

Does the U.S. have enough N95 respirators to go around if everyone were to start wearing these high-quality masks?  Or would this put stress on the — or shortages needed for N95 masks for healthcare workers?

MR. ZIENTS:  So, why don’t I go first, and then Dr. Walensky, if you want to add anything here.

One of the first things we did when we entered office was to significantly improve our manufacturing and stockpile of all PPE.

Today, N95 masks are widely available and the government has a strong stockpile of over 750 million masks for healthcare workers and first responders.

CDC, as Dr. Walensky can speak to, recommends Americans wear a well-fitting mask.  This can include multiple-layered cloth masks, N95s, K95s, or other types.

Right now, we are strongly considering options to make more high-quality masks available to all Americans, and we’ll continue to follow the science here.  The CDC is in the lead, but this is an act — this is an area that we’re actively exploring.

Dr. Walensky? 

DR. WALENSKY:  Yeah, maybe I’ll just add that CDC continues to recommend that any mask is better than no mask.  And we do encourage all Americans to wear a well-fitting mask to protect themselves and prevent the spread of COVID-19, and that recommendation is not going to change. 

So, I — maybe I’ll just note that we are preparing an update to the information on our mask website to best reflect the options that are available to people, as you note, and the different levels of protection different masks provide.  And we want to provide Americans the best and most updated information to choose what mask is going to be right for them.  Thank you.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Jeff Mason at Reuters.

Q    Thanks very much.  And good morning.  Jeff, could you expand on what you just said about planning to — or looking at more options to make sure more high-quality masks are available to all Americans? 

And can you also give us an update on your thinking with regard to timing, in terms of asking Congress for more money to fund the — this effort?

MR. ZIENTS:  Yeah.  Thanks, Jeff.  You know, in terms of the mask, as I said, we’re in the process right now of strongly considering options to make more high-quality masks available to all Americans.

In terms of money, we have the money that we need to fight Omicron.  As the President has always said, we’ll do everything that we need to do to beat this pandemic.  And if we do need more money at — more funding, at some point, we will request that money.

MR. ZIENTS:  Next question.

MODERATOR:  Zeke Miller, AP.

Q    Thanks for doing this.  First, there’s been a lot of conversation in the last few weeks about testing now that — starting Saturday — private insurers are going to reimburse testing and that the federal government’s testing websites going to be coming online soon.  How — is there a new federal guidance on how and when people should be testing themselves at home?  You know, should it be once a week?  Should it be twice a week?  Should it be after an exposure?  Should it be just to go to the grocery store?

And then secondly, for Dr. Walensky, with that preprint study about Omicron versus Delta, how does Omicron compare to other sort of seasonal illnesses — flu, the cold, other things like that — in terms of mortality and serious illnesses?  And how does that change how the federal government will be thinking about Omicron and COVID-19 as it becomes endemic?

MR. ZIENTS:  Okay.  Well, why don’t we turn to Dr.  Walensky on both.  Dr. Walensky, first, when — when American should test. 

DR. WALENSKY:  Yeah, so — so, simply put: Americans should take a test when they have symptoms that appear to be COVID-19 — so fever, cough, sore throat, respiratory symptoms, muscle aches; when they’re exposed — so five days after they’ve been exposed to someone who has COVID-19; and, certainly, if you’re going to gather with family, if you’re going to a gathering where people are immunocompromised or where there are elderly or where you have people who might be unvaccinated or poorly protected from a vaccine — that might be an opportunity you’d want to test; and then, of course, for test-to-stay and other protocols.

With regard to — this study actually only compared Omicron to Delta and not to other respiratory viruses.  Certainly, other respiratory viruses — influenza, for example — vary — the severity varies by flu season.  So, this was not a direct comparison of Omicron versus other respiratory viruses. 

But what I can say is: We are — while we’re in this Omicron surge, we are also thinking about what this looks like with endemic — when Omicron or COVID itself were to become endemic in the United States, following things such as severity of cases, hospital capacity as well. 

Thank you.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Sabrina Siddiqui, Wall Street Journal.

Q    Thank you for taking the call.  I wanted to have — ask a follow-up about the school testing expansion.  For these tests that you’re making available for K-to-12 schools, can you clarify: Would only public schools be eligible to receive those tests or private schools as well?  And can you offer any other detail on where the tests are coming from?  Have you already inked contracts with certain companies?  Or is that process still ongoing? 

MR. ZIENTS:  Well, let me just step back and say that, you know, many schools have a dedicated supply of tests that they secured months ago, thanks to the $10 billion I talked about in my opening comments that the ARP — the American Rescue Plan — gave to schools, dedicated for testing. 

And there is significant lab capacity in this country.  So, we’re working with schools to take advantage of the lab capacity that is open in the country. 

CDC and the Department of Ed are adding resources to help schools identify testing providers and implement best practices.  And the federal government is funding and strongly encouraging these testing programs.

In total, the 10 million additional tests that we’ll send out each month will leverage existing contracting authorities at both HHS and the CDC.  And this will more than double the volume of testing that took place across the nation last year.

We’ll follow up, Sabrina, with exactly which schools qualify for these additional 10 million tests. 

Next question.

MODERATOR:  Cheyenne Haslett, ABC.

Q    Hi, thank you.  My question is also on the school testing.  We already saw $10 billion go out to schools for testing, and we’re still seeing school closures.  So, I’m wondering how you expect this 10 million tests to be different. Specifically, how schools — how you’ll get schools to use these in an effective, systematic way that keeps them open consistently.

MR. ZIENTS:  Well, schools do have the resources through the $10 billion that went out through the American Rescue Plan.  And these 10 million tests add to the testing availability for schools and, as I mentioned, is double the testing that was done in the month of November. 

I think it’s important to put testing in the context of the overall school mitiga- — school strategies to keep schools open.  And for that, maybe I’ll turn to Dr. Walensky to overview the best practices for keeping schools open.

Dr. Walensky.

DR. WALENSKY:  Yeah, thank you, Jeff.  I’d just like to remind people that we had a pretty robust Delta surge in the fall, and we were able to keep 99 percent of schools open safely and our children with in-person learning.  And I will just also highlight that that was before we had pediatric vaccination. 

So, now here we are: We have pediatric vaccination.  One of the best things that we can do is get our children and our teenagers vaccinated.  And then once we do so, practicing all those layered mitigation strategies.  Masking: We’ve seen three and a half times less likely to have schools have an outbreak if you’re masking in those schools, as well as ventilation.  And then, of course, test-to-stay strategies, which these resources will really be helpful for.

MR. ZIENTS:  Next question.

MODERATOR:  A couple more questions.  Let’s go to Joyce Frieden at MedPage Today.

Q    Hi, yeah, thanks for taking my question.  During a Senate hearing yesterday, Janet Woodcock mentioned that it was going to be difficult for people to get their head around the idea that most of us are going to get Omicron.  So, I wondered what the administration’s thinking on that is — are, in fact, most of us going to get Omicron? — and whether they think that’s going to happen now during this current wave, or is that more looking at as it becomes endemic.

Dr. Fauci.

DR. FAUCI:  Yeah, thank you very much for that question. 

What Dr. Woodcock was referring to when she said most of us will ultimately get Omicron is not that most of us were ultimately going to get sick with Omicron.  Remember, she was talking about the data that we all showed about the extraordinary effect and dichotomy between people who get Omicron, who get vaccinated and boosted, how well they are protected against hospitalization and death.

And even with Omicron, it appears, as the data that Dr. Walensky just showed today from the Kaiser Permanente study, that it is going to be a less severe, particularly in those who are vaccinated and boosted.

So, if we’re going to look ahead at what happens when this peaks and it ultimately goes down — as I’ve said on previous pressers here from the White House: that we’re not going to eradicate this; we’ve only done that with smallpox.  We’re not going to eliminate that; that only happens with massive vaccination programs like we did with measles and with vaccines.  But we ultimately will control it. 

And if you control it in a way it’s at a such a low level, and people are vaccinated and boosted, sooner or later, as we begin to live with it, what she was referring to is that virtually everybody is going to wind up getting exposed and likely get infected.  But if you’re vaccinated and if you’re boosted, the chances of you getting sick are very, very low.  That’s what she was referring to.

MR. ZIENTS:  Next question, please.

MODERATOR:  Last question, let’s go to Weijia at CBS.

Q    Thanks a lot, Kevin, and thank you for having this call.  First, I have a quick follow-up for Dr. Walensky because you said that you do not intend to change the masking guidance, but we also know now that some masks provide better protection than others.  So, why isn’t it the case that the best mask for every American is the mask that offers the most protection?

And then, secondly, do we have enough data about the reinfection of Omicron?  I think there’s a sense out there that “if I catch it, I’m not going to get it again.”  Is that true?  Or do we not know yet?  Thank you.

MR. ZIENTS:  Dr. Walensky, do you want to handle the first question?  And maybe, Dr. Fauci, the second?

DR. WALENSKY:  Perfect.  Yeah, so thank you for that question.

We are updating the information on our mask website to provide information to the public.  It’s in need of updating right now.

What I will say is the best mask that you can — that you wear is the one that you will wear and the one you can keep on all day long — that you can tolerate in public, indoor settings and tolerate where you need to wear it.

We will provide information on improved filtration that occurs with other masks, such as N95s, and information that the public needs about how to make a choice of which mask is the right one for them. 

But most importantly, we want to highlight that the best mask for you is the one that you can wear comfortably.

Thank you.

MR. ZIENTS:  Dr. Fauci?

DR. FAUCI:  Yeah, thank you for that question.  There’s both sides of the coin to that.  We know from the South African data that if you’ve been previously infected — for example, with Delta or with Beta — that you have a much higher chance of getting re-infected with Omicron than you do with others.  That’s that side of the coin.

But the question you asked is: If you get Omicron and recover, what is the chances of getting re-infected with Omicron?  We don’t have enough data at this point to really give you any firm indication of that.  But as we get more and more experience, and as we follow cohorts, we’ll be able to have that information for you.

MR. ZIENTS:  Well, thank you, everybody.  We look forward to the next briefing.

11:37 A.M. EST

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