Via Teleconference

10:52 A.M. EDT

DR. JHA:  All right.  Good morning, everybody.  My name is Ashish Jha, and I’m the White House COVID-19 Response Coordinator.  Welcome to the COVID-19 Response Team update.  Sorry for the delay.  We had some technical issues, but we have solved them, I’m hoping.

I am joined today by two people who don’t need introductions: Dr. Rochelle Walensky and Dr. Tony Fauci.  And I will turn to both of them in a minute.

I want to start off by just taking about five minutes to talk about where we are in this pandemic, what’s going on, the things that are doing — going well, things that are challenges ahead.

So if we take a step back and begin with where we are as a country, we have more than 200 million Americans vaccinated, more than 100 million Americans boosted.  We have a pretty high degree of immunity in our population.

But we’re also seeing, at this moment, a lot of infections across the country.  Depending on which tracker you use, we’re at about 100,000 infections of — cases a day.  And we know that the number of infections is actually substantially higher than that — hard to know exactly how many, but we know that a lot of people are getting diagnosed using home tests.

Home tests are great, by the way.  I’ve been a huge fan of home tests for the last two years.  But what that means is we’re clearly undercounting infections — undercounting cases.

There’s a lot of infections across America.  What’s driving that?  What is primarily driving that is these incredibly contagious subvariants.

We were hit with the BA.1 — .1 — wave of infections in December, January.  We saw BA.2.  And now we’re seeing, in a large chunk of the country, BA.2.12.1.  They are more contagious with more immune escape, and they are driving a lot of the increases in infection that we’re seeing across the nation right now.  And that is — that is a huge challenge.

So how are we thinking about this moment?  And you’ll hear, by the way, more on all of that both from Dr. Walensky and Dr. Fauci.

So how are we thinking about that?  Very broadly — and we can get into more details later — very broadly, the way we’re thinking about this is: We’ve got to do what we can to prevent infections.  We’ve got to do what we can to — to ensure that infections don’t turn into severe illness.  We’ve got to continue being on the lookout for new variants, new subvariants; continue to do that surveillance.  

And then last, but certainly not least, is we’ve got to take a very glo- — much a global footing, a global strategy, because we know that there is no only — “domestic-only” strategy to a global pandemic.  And that means remaining deeply globally engaged and doing what we can — we’ve done an extraordinary job of — of acquiring vaccines and making sure they’re widely available for the world, we’ve now got to continue that work by making sure that we’re getting vaccines into people’s arms.

All right.  So I want to talk about two major things, two recent developments that have happened over the last few weeks.  And then I also want to talk about funding and Congress.  And then I’m going to wrap up and turn it over to Dr. Walensky first and then Dr. Fauci after.

So, two major developments.  If you’ve been watching, we have launched a third round of tests that you can get from COVIDTests.gov.  

What’s that about?  Why are we doing that?  We’re doing that because the administration has put in a lot of work and resources from — that we had from ARP to — to acquire tests and make sure we had adequate number of tests.

Given the — the spread of infections that’s happening across the country, we know use of rapid tests is a very effective way of keeping infections down.  You can test yourself before you go to a large gathering, before you go visit someone vulnerable.  

It is an important way of reducing spread of the virus.  There’s very good evidence that the use of rapid tests can reduce the amount of infections that’s happening out there.  So this is one of the tools we have, one of the capabilities we have.

We opened that up on Monday to a third round.  We’ve seen really impressive demand.  As of about 20 minutes ago, when we got the latest set of numbers — this opened up on Monday — about almost eight and a half million households across the country have ordered that next round of tests.

We have made eight tests available per order.  The reason is — in the past, we were able to do four.  We’ve — we’ve expanded that because of the — the testing that we’ve been able to obtain.  We know there are multi-generational households.  We know that there are households with more than four people.  And we want to make sure that we make as many tests as we can possibly make available.

And so that’s getting out there.  And I think that’s going to be an important part of how we keep infections down.

On the issue of how do we make sure that infections don’t turn into severe illness: When I came into this job about five, six weeks ago — again, under Jeff Zients’s leadership — the administration, I think, had done an extraordinary job of obtaining and acquiring Paxlovid and other therapeutics.

And yet six weeks ago, despite acquiring all that, the Paxlovid had not started really getting out there.  We put in a series of steps.  We made it much more widely available by letting pharmacies order directly from — from the federal government.  We expanded test-to-treat sites.  There’s going to be more on that coming in the days and weeks ahead.  We did a big effort to connect with providers and simplify the ordering and prescription process, making sure they understood what drug — drug interactions really mattered, who was eligible.  

And then we talked more broadly to the media — all of us did.  And what we have seen, I think, is a dramatic increase in the use of Paxlovid — about fourfold increase just in the last month.  And our latest estimates are that about 20,000 prescriptions of Paxlovid are being given out every single day.

I think that is actually a really important reason why, despite this very substantial increase in infections, we have not seen a commensurate increase in deaths.  We have seen hospitalizations rise but, again, not as much as one would have expected at this point, despite the fact that hospitalizations do lag.  When you look at ICU care, the rate of ICU hospital admissions is much lower than one — what one would expect with infections.  And then death numbers continue to be low.  Obviously, we want to continue to drive that lower.

But I really think that, beyond the vaccinations and boosting, which are making a very big difference, I think Paxlovid is making a very big difference as well.

Okay.  Just a little bit about Congress and where we are with Congress.  As you may have heard, we’ve been spending a lot of time with our friends in Congress on making sure that we have the resources we need to continue to protect the American people.

As I have laid out, the key tools, the key capabilities that we know prevent infections and reduce severity — masking, testing, vaccinations, therapeutics, ventilation, and filtration, of course, as well — those are the major tools.  And we want to make sure that as this virus continues to evolve, as we go into the fall and winter, that we’re able to continue to protect Americans.

Again, you’ll hear more about this from Dr. Fauci, but they — we’re in the middle of developing new vaccines, potentially bivalent vaccines; FDA is going to be looking at the data on this, making decisions.  Our expectation is that we’ll probably get a new generation of vaccines, or certainly we need to plan for that.  

And I want to make sure we have enough resources that we can buy enough vaccines for every American who wants more.  I think that is absolutely critical.  We do not have the resources to do that right now.  So without additional funding from Congress, we will not be able to buy enough vaccines for every American who wants one once these new generation of vaccines come out in the fall and winter.

We’re using therapeutics to save lives; we’ve got to continue doing that.  At some point, we’re going to run out of the treatments we have.  And without additional resources, we will find ourselves in the fall or winter with people getting infected and no treatments available for them because we will have run out.  There are new generations of treatments that are coming online, companies that are making them with some very promising data. 

The U.S. government and no one in the United States is in negotiations with these companies for these treatments because we don’t have the resources; the companies know that.  And therefore, we can’t ensure that Americans get access to the next generation of therapies that will also be available.

And what — if we don’t get more resources from Congress, what we will find in the fall and winter is we will find a period of time where Americans can look around and see their friends in other countries — in Europe and Canada — with access to these treatments that Americans will not have.  

Last, but certainly not least, is on the issue of testing: We’ve done a lot of work to build up domestic manufacturing capacity to purchase tests.  Obviously, demand for tests falls when infection numbers drop.  As that happened, it was really important for us to step in and keep that demand high enough so that companies could continue manufacturing.  Without additional resources, we’ve already started seeing this.  Companies and domestic manufacturers are laying off workers, they’re shutting down production lines. 

In the upcoming weeks, we’re going to see them sell off their equipment and get out of this business.  And we may very well find ourselves without additional resources in the fall, without enough tests, no domestic manufacturing capability, and us having to rely on other countries and other manufacturers outside the United States to make sure that we can get tests for the American people.  

All of this is incredibly preventable.  We should be doing everything we can to make sure that that scenario does not come to be. 

We are planning for all sorts of contingencies, but I remain very, very confident that Congress will step up and protect the American people.  

Let me just finish off by saying that we’re more than two years into this pandemic.  People are tired.  People want to move on.  

The good news is we’re in a way better place than where we were two years ago, largely because of the capabilities that science has delivered for us: vaccines, boosters, therapeutics, testing, masks — all of that make an enormous difference.  And we’ve got to keep using that as the virus evolves and as the virus continues to do what it’s doing.

We have always had — the administration has always had a strong partnership with Congress, and I’m hopeful that Congress will continue to play that critical role of providing the resources and leadership so we can continue protecting the American people.  

All right, I’m going to stop.  I’m going to turn it over to Dr. Rochelle Walensky, our CDC director, for her comments.

Dr. Walensky, over to you.  

DR. WALENSKY:  Thank you so much, Dr. Jha.  And good morning, everyone.  It’s great to be back with all of you again.  As always, I going to start again with the overview of the data.

Over the past 5 weeks, we’ve seen a steady increase in COVID-19 cases, as Dr. Jha mentioned.  While cases remain much lower than during the Omicron surge this past winter, the current seven-day daily average of cases is now at about 94,000 cases per day, which is an increase nationally about 26 percent over the previous week and a threefold increase over the last month

Similarly, hospital admissions are also increasing, but remain much lower than they were during the Omicron surge.  The seven-day average of hospital admissions now is about 3,000 per day, and that’s an increase of about 19 percent over the previous week.

And while deaths do remain low, we are still seeing a tragic seven-day average of daily deaths at about 275 per day.

And we, of course, must remember that each person lost to COVID-19 is a tragedy and that nearly 300 deaths a day is still far too many.

Our vaccines, prevention measures, and treatment options are working to save lives.  However, we know those who are not consistently using these tools when recommended continue to remain vulnerable to serious disease, hospitalization, and death.

As Dr. Jha shared, we have many tools to help prevent severe disease from COVID-19, including vaccination and boosters.

Our vaccine effectiveness cohort studies have shown COVID-19 vaccines generally remain effective in preventing severe disease, including protecting against Omicron.

However, we know that the protection from COVID-19 vaccines wanes, or because le- — becomes less protective over time, especially in the Omicron era.  This is one of the reasons vaccines boosters are so important.

One of our concerns for those at risk is outlined on this slide, which shows time since the last vaccine dose for two different age groups of adults — those 50 to 64 and those 65 and older.  The lighter blue bars indicate the percent of people whose last vaccine dose was part of their primary series, and the darker blue bars indicates the percent of people whose last vaccine dose was a booster dose.

On the top graph, you can see among those 50 to 64, 62 percent have not received a COVID-19 vaccine in the last six months.  And on the bottom graph, among those 65 and older, 57 percent have gone more than six months since their last vaccine dose.  Many of these individuals are eligible for another COVID-19 vaccine dose now, a do- — a dose that may help strengthen their protection against infection, urgent care visits, and especially hospitalization and death.

So, whether it is your first booster or your second, if you haven’t had a vaccine dose since the beginning of December 2021 and you’re eligible, now is the time to get one.

Let me close with a brief word on COVID-19 community levels.  Our COVID-19 community levels framework looks at a set of metrics, including cases, but also hospitalizations and health system capacity.  This framework was designed to be predictive — anticipating where we will see further increases in cases, in hospitalizations, and in deaths — and they’re meant to inform communities, local leaders, and individuals on when and what prevention measures should be implemented in their local settings.

Right now, as shown on this map, over 32 percent of Americans live in an area with a medium or high COVID-19 community level –- counties shown in yellow or orange.  Since the prior week, an additional 8 percent of the U.S. population is living in a county with a medium of high COVID-19 community level.

For areas currently with high COVID-19 community levels — those in orange — we urge local leaders to encourage use of prevention strategies like masking in public indoor settings and increasing access to testing and to treatment.

For individuals, COVID-19 community levels can also be used to inform personal decisions on how to best protect oneself. 

In areas where community levels are high, everyone should be using prevention measures and wearing a mask in public, indoor settings. 

In areas with medium COVID-19 community levels, in yellow, individuals should consider taking prevention measures based on their own risk, like avoiding crowds, wearing a mask, increasing their testing, especially before gathering with others indoors.

And in any COVID-19 community levels, individuals may always choose to wear a mask to protect themselves from infection. 

As we’re currently seeing a steady rise of cases in parts of the country, we encourage everyone to use the menu of tools we have today to prevent further infection and severe disease, including wearing a mask, getting tested, accessing treatments early if infected, and getting vaccinated or boosted, especially if you’re over 50 and if your last dose was more than five months ago.

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

DR. FAUCI:  Thank you very much, Dr. Walensky.  What I’d like to do over the next few minutes is to dig a little bit deeper in the issue of variants and put that in the context of what you have just heard from Dr. Jha and Dr. Walensky regarding the increase in cases. 

Let’s take a look at the global situation going from April 2021 to the present time.  And as you can see, going from left to right, we’ve had the evolution over time of different variants that have progressively dominated the situation globally as determined by the sequencing of various isolates throughout the world.

And as you can see, we went from a group of Alpha, Beta, Gamma early on, overtaken completely by Delta.  And most recently, over the last six months — five to six months, we’ve seen Omicron dominate. 

How does that spell out with regard to the different waves that we have seen in the United States?  Next slide.

As you can see here, we’re looking at the United States now.  And again, going from left to right, we had our Alpha wave, our Delta wave, and then we had a big, big spike with Omicron, which has gone down.  And now, over the last several weeks, as you’ve heard from both Dr. Jha and Dr. Walensky, we’re seeing increases in cases. 

How does that really relate to the evolution of these variants?  Next slide.

Right now, going with the United States as an example, again, the data are really very clear and really somewhat fascinating.  If you go from the left to the right, you see in the Omicron era, when we had BA.1, in the orange.  Gradually, over time, over a period of months, it got taken over by BA.1.1 and BA.2, which is the purple, that got larger and larger until around April — the beginning of April, the end of March, we started to see the very dark purple, which was the BA.2.12.1.

And when you see the gradual evolution of one particular variant overtaking another, there is a reason for that.

Next slide.

Here we see the exact same thing that South Africa is experiencing, but only a little bit different than what we are seeing here in the United States because they went through the same evolution of one variant taking over another variant, taking over another.  And now, as we’ve heard from our South African colleagues, they are seeing a BA.4 and BA.5.  BA.4, particularly in the West Cape — in Cape Town, and BA.5 in KwaZulu-Natal.  And this is what they are currently seeing and it is expected that this particular dominance will continue. 

Why is that the case?  Next slide.

This is a very simple schematic diagram of the stepwise increase in transmissibility going from left to right.  Note: The big jump was from Delta to Omicron.  That was a multi-fold increase in transmissibility.  But within the Omicron sublineages, you see what I’ve actually showed you on prior slides of why one particular sublineage has taken over the next one and the next one.  And as you go to the far right, that’s what I just showed you on the South African slide. 

So what does that tell us?  Next slide.

As you’ve heard again, both from Dr. Jha and Dr. Walensky, we are experiencing an increase in cases, certainly more increase in infections since one undercounts because of the situation with regard to home tests that people may not be reporting.

We’re seeing that due to the following: one, the increased transmissibility that I just showed you on the stepwise ladder. We’re seeing waning immunity to both protection and/or vaccination.  And I’ll get to, in a second, what we can do about that.  And also, as we all know, there has been a relaxation of mitigations — of people not wearing masks indoors and having a lot more of indoor congregating without masks.

So, on the final slide, how do we meet the challenge that has been posed to us by the variants?  Let’s look at some of the facts. 

Variants will continue to emerge if the virus circulates globally — a strong argument for what Dr. Jha said about “a global pandemic requires a global response.”  We can keep the level of virus to the lowest possible level, which is the best way to avoid variants.  Because the less replication, the less mutation; the less mutation, the less variants.

Importantly, vaccines continue to provide strong protection against severe disease.  And that’s the reason why, as cases go up and even more infections than are recorded cases, the discrepancy or ratio between hospitalization and cases clearly is much less than it was, for example, in the Delta wave.

However, immunity does wane, and that is why it is so important to stay up to date with vaccines and particularly boosters, apropos of the slide that Dr. Walensky just showed you.

Again, we can do very simple things like improving ventilation in indoor spaces where possible, and to monitor the levels in your community by the color codes that Dr. Walensky showed you, and follow the CDC guidance and recommendations for masks and other mitigations.

Now, again, as Dr. Jha had mentioned, treatments for COVID-19 are now widely available.  If you test positive for COVID-19, talk to a healthcare provider as soon as possible about treatment options, including for test-to-treat.

And finally, we do need more resources, as all of us have said over and over.  The development of next-generation vaccines and therapeutics is critical.  And in order to do that, we need the resources that we’ve been asking for.

I’ll stop there, and back to you, Dr. Jha.

DR. JHA:  Great.  Thank you, Tony.  And we’re going to — and Rochelle.  And we’re going to open up now to Q&A.

So, Kevin, open it up for us.

MODERATOR:  Thanks, Dr. Jha.  As a reminder, we’re going to take as many questions as possible, which means one question per person.

First, let’s go to Liz Weise at USA Today.

DR. JHA:  I don’t know if Liz is asking a question.  We don’t hear anything.

Q    Ah, sorry about that.  I’m muted on my computer.  Sorry about that.  Thanks for taking my question.

There’s a paper out in Nature Today from the Gladstone in San Francisco showing that the Omicron variant doesn’t induce immunity against any of the other variants.  And I’m curious if, looking forward, if that might have impacts on continuing to talk to Americans about vaccination or other issues.

DR. JHA:  Tony, do you want to take that?

DR. FAUCI:  Yeah, I have not seen that paper, since I was doing other things this morning.  (Laughs.)  But I’ll be looking at that very carefully.

Yeah, I mean, obviously, we are seeing, even before that paper, that Omicron itself, when you get infected, does not have the broader coverage of the other variants such as Delta and Alpha and Beta, which is the reason why one has to be very careful.  And we’re doing those studies about what the next boost should be — should it be a bivalent that includes an Omicron variant together, for example, either with a wild type or perhaps one of the other variants?

So we’re aware of that phenomenon.  I haven’t seen that particular paper.  But that’s exactly the reason why we’re doing studies right now to determine what the best boost would be as we get into the fall and early winter.

MODERATOR:  All right.  Next question.  Let’s go to Meg Tirrell at CNBC.

Q    Hi.  Well, thank you.  I wanted to ask about this phenomenon we’re seeing with Paxlovid rebounds, which seems potentially rare.  Pfizer says they saw it about 2 percent in their clinical trial, but we hear a lot about it.  And, you know, when people are testing positive again at day 10, I’m wondering, do you think there needs to be some federal guidance about isolation at that point, given that if people are testing positive again, they could potentially be contagious?  How are you guys looking at this?

DR. JHA:  Yeah, so let me start maybe, and then I’ll turn it over to Rochelle to see if she has any further thoughts, or Tony.

But let me start by saying, Meg, you’re absolutely right that the clinical trials showed about 2 percent in the Paxlovid group and about 1.5 percent in the placebo group.  But that was with Delta.  And so the question is: Is this more common with Omicron?  We’re actually doing a lot of work right now to try to sort that out.  We’re talking to health systems, getting real-world experience data.

But if you think about it: If you have, you know, 20,000 people getting Paxlovid every day, that would mean that about — even if it was only still 2 percent, that would mean 400 people are having rebound every day.  So it is hard to know exactly how often it happens.

I think the key points — or a couple of key points that are really important: One is that the people who have that rebound are not getting particularly sick, are not ending up in the hospital.  If the goal of this treatment, which it was, was to prevent hospitalizations and deaths, it is doing that incredibly well.

So the rebound issue is something we’re looking at very carefully.  But I think that — but it is not leading to people getting particularly sick.

On the issue of if those people are contagious, how we should be advising them, let me see if Rochelle or Tony have any thoughts on that.

Rochelle, to you first.

DR. WALENSKY:  Yeah, maybe I’ll just add that we’ve always said in our CDC recommendations that if you have symptoms, that you should put your mask on.  So we would say if your symptoms recrudesce, that we would recommend putting your mask back on.

DR. JHA:  And, Tony, any thoughts on that?

DR. FAUCI:  No, actually no.  Just confirming what Rochelle just mentioned.

MODERATOR:  Let’s go to Tamara Keith at NPR.

Q    Thank you.  On the Paxlovid rebound question, are you also looking into whether there should be a longer course of Paxlovid?  Instead of the 5 days, maybe 10 days?

And I’m just going to sneak in a point of personal privilege.  What’s up with the under-five vaccines?  It just doesn’t seem like there’s much urgency out there, and that’s a large population.

DR. JHA:  Tony, you want to start us off with the 5 versus 10 days and your thoughts and what we know?

DR. FAUCI:  Yeah, exactly.  In fact, we’re in active discussion about studies that we might do here at the NIH, with our own study capabilities, as well as with the people from Pfizer.  In fact, we have been in rather direct communication with them, and we’ll continue that, about what the best study to do to determine whether or not we need a longer course or not.

So that’s — that’s imminent.  We’re going to be not only talking about that, we’re going to be planning what studies we’re going to be doing relatively soon.  Within the next few days, we’re going to meet.

DR. JHA:  And on the under-five, I’ll just say that I think there is actually quite a bit of urgency.  The FDA now has all the — I think they have all the data for Moderna, and they’re going through it right now.  And so that continues.

And I have — you know, we’ve been in — we’ve been hearing from our colleagues at FDA that that evaluation is moving as quickly as possible.

I want to remind folks — because often people bring up, “Well, with some of the other pediatric vaccines, the time from submission to authorization was a little bit shorter.”

You know, this is the first pediatric vaccine that Moderna has submitted all of its data for.  And so there’s a lot of data here that FDA is going through. 

I think we all feel the sense of urgency; we want to get this done as quickly as possible.  But I think we also all agree we want to get it done right.  And I remain very confident, based on the conversations I’ve had, that as soon as the FDA feels like they’ve got the data analyzed, and as soon as it meets their standards, they’re going to make a determination.

All right, next question, Kevin.

MODERATOR:  Let’s go to Josh Wingrove at Bloomberg.

Q    Hi there.  Good morning.  And thank you for doing this.  Just briefly to clarify, Dr. Jha, what you just said there: Is it your expectation then that pediatric vaccines for under-fives will be rolled out separately, regardless of manufacturer?  Or is the thinking still that it would confuse or potentially confuse parents to have one arrive before the other?

And then, secondly, I’d like to circle back to the question of ordering the bivalent vaccines if, in fact, that becomes available.  What is — what are the steps?  When would you have to enter talks with these companies?  If you don’t get money from Congress in the coming weeks, is there anything you can do?  Can you get in line, you know, with dollars from the seat cushions or what have you?  Can you give us an update on, sort of, what the immediate term looks like that — looks like on that without funding from Congress if it doesn’t come through?  Thank you.


DR. JHA:  Yeah.  On the — on the FDA under-five question, what I’ve heard — and again, this is really driven by FDA, and appropriately so driven by FDA.  What I’ve heard from our colleagues at the FDA is that they’re looking at the data they have in front of them, and that is what they’re focused on.  And they will make a determination as soon as they are able.

And so that — and that’s really — like, again, ultimately, that is what we want to hear from them — right? — that they’re not going to delay, that they’re not waiting for anything else, that as soon as the analysis is done, they’re going to make a determination.  And that’s my expectation.

And our job is to make sure that as soon as FDA makes its determination, it’ll go over to the CDC, as soon as CDC makes its determination.  If the determinations are that kids should be getting these vaccines, we will make sure that those vaccines are widely available as quickly as possible for kids under five.

All right.  On the question of bivalent vaccines, the way to think about this is it takes about three months to manufacture these things.  Right?  And if we want to be ready for the fall, it’s not too early to start thinking about this stuff.  And, in fact, we’ve been — we’ve had, kind of — you know, we’ve had some very preliminary conversations with the manufacturers.

But — but the negotiations around it have not yet begun, partly because we’re waiting for resources.  And — and the truth is that other countries are in conversations with the manufacturers and starting to kind of advance their negotiations.  I obviously don’t know the details of what other countries are doing.  And so my take is: Every day we wait, every week we wait, we just fall a little further behind in line.

We are very committed to finding enough resources, and that means we’re looking across all of the other programs we have, the monies we have for other things, and asking where can we pull some dollars to at least be able to get some vaccines for the fall and winter.

I think if Congress abdicates its responsibilities, it is not acceptable for us in the administration to go into the fall and winter with zero vaccines.  I am confident we’ll find money to be able to get some Americans vaccinated, maybe just the highest risk; we don’t know.

But these are not decisions we want to be having to make.  We want Congress to just step up and fund — fund our ability to make sure that we get enough vaccines for all Americans.


MODERATOR:  Let’s go to Ed O’Keefe at CBS.


Q    Thank you, doctors, for doing this.  Just to follow up, then, on the question about vaccines for those under five: Realistically then — because this is a question we get asked a lot too — are we weeks, are we months away from those shots?

And when you say, Dr. Jha, that you feel that Congress has been receptive to what you’ve been talking about in terms of funding, can you describe a little bit more, then, what’s holding things up?  And how are they receiving these warnings that you continue to put out there that if there’s no money, then as many as 100 million infections could happen?  I mean, those are big numbers to be tossing around at a time when you’re trying to get Congress to act.

DR. JHA:  Well, I don’t know if anybody else wants to take the under-five question, since I feel like I’ve tried.  Tony or — any thoughts on how you see the under-five?


DR. FAUCI:  Well, yeah, Ashish, you said it very, very clearly: The important thing is that you want to leave the FDA to do what they do well, without unnecessary pressure or interference. 

They are totally aware of the fact that this is a pressing problem, and they will do it as expeditiously as they possibly can.  And it is a process of getting all of the data and having the time — and they don’t waste time — to analyze the data and make a decision that the United States public will feel comfortable about because they did it correctly and put all their resources into it.

So it wouldn’t be appropriate for either myself or Rochelle or Ashish to give you days versus weeks versus months.  They are going to do it as expeditiously as they possibly can.


DR. JHA:  Yeah.  And on the issue of funding, I’ll say, you know, I’ve spent a lot of time up in the Hill.  I was up on the Hill again this morning.  When I think about my one-on-one meetings and my small group meetings, I think I’ve met with more Republicans than Democrats.  I’ve met with both members of the House and the Senate.  And what I’ve been laying out for folks

is what we need the resources for and what the consequences of not getting those resources, what it means for what the fall and winter may bring. 

You know, there’s a range of models out there of what we might see in the fall and winter.  We have got to plan for a range of scenarios, including we have to plan — it would be irresponsible for us not to — we have to plan for a scenario where we don’t get any more resources from Congress.  I think it would be — I think it’d be terrible.  I think we would see a lot of unnecessary loss of life if that were to happen.  But we’re looking at all the scenarios and planning for all of them.

Look, I think, at the end of the day, Congress works in the ways that it works.  I remain confident that Congress is going to pull through on this and give us the $22.5 billion supplemental requests that we have put in.  That’s our request.  It’s an emergency supplemental.  And I remain confident that Congress will stand up and provide the resources that we need to protect the American people.

MODERATOR:  All right, we’re going to get through as many questions as possible.  One question per person.  Let’s go to Zeke Miller.

Q    Thank you all for doing this.  Do you expect the current uptick in Omicron-related cases to continue as we hit the summer and the busy travel months ahead?  Should people begin reconsidering any plans that they have?  Should they, you know, pack masks, given the uncertain situation? 

And then — clearly, heading into the fall and winter, Dr. Jha, you mentioned you’re planning for a range of scenarios and it could lead to unnecessary loss of life.  Is there a number that you can put in a range of how many unnecessary deaths there could be without the resources that you say you need in order to fight the virus?

DR. JHA:  All right.  I will see if Tony or Rochelle — Rochelle, any thoughts on kind of the summer and expectations and if people should be packing masks or not?

DR. WALENSKY:  Yeah, maybe I’ll just sort of point back to our COVID-19 Community Levels map, which demonstrates, right now, some areas of increased infection and hospitalization in the Northeast and the Eastern Corridor, as well as in the upper Midwest.  But what we’ve seen with prior increases in infections and in — in, you know, different waves of infection have demonstrated that this travels across the country and has the potential to travel across the country. 

So, I think the important thing to recognize is that we actually have the tools to prevent it.  And so, we would ask you to wisely use these tools to — we — you know, we’ve always said: You know, put your mask aside when infection rates are low and pick it up again when infection rates are higher.  We know that we have vaccines and boosters.  We know we have treatments.  We know that people can use tests before they gather so that they can work towards making sure that you have an environment that is a safer environment. 

And so, we would ask people to engage in all of the activities that they want to engage in, but to do so wisely.  Do so when you’re up to date with your vaccines, when you’ve tested before you gather.  And if you have a high risk of infection in your area, to put on that mask before you gather.

DR. JHA:  And I think, Zeke, you asked about estimates.  Look, it’s hard to make precise assessments about what’s going to happen in the fall and winter.  And right now, what we’ve been doing, because we’ve got to do scenario planning, is we’ve been talking to modelers.  We’ve been looking at internal models. 

But most modelers don’t have models that go as far out as November, December, January.  We expect those models to start coming out over the summer.  So we’ve been trying to get some preliminary data.  Because from a policy point of view, we can’t go into September without having a sense of what the fall and winter will bring. 

And the estimates right now are large — I mean, sort of, are wide. 

And if you think about it, what’s driving those estimates is how much immunity, for instance, did BA.1 — the big wave we saw — how much did that actually generate? 

If it generated a lot of population immunity, then we’re going to see fewer infections into the summer, fall, and winter. 

If it generated only a modest amount of immunity, we’re going to see more infections. 

What will happen with mitigation?  Are we going to put in any more mitigation or will mitigation remain relatively low? 

There’s a bunch of factors that will drive what happens.

I also think: Are we going to have a new generation of vaccines that we’re going to be able to deliver for the American people?  That will make a big difference in the fall and winter.  If we have no new generation of vaccines or very few or only for the highest risk individuals, that will also make a difference. 

So there’s a lot of factors here; we’re trying to scenario plan across all of them.  We’re not trying to get into the prediction business.  We’re getting much more into the scenario planning business to make sure that we know what may be ahead of us so we can plan for it and obviously also lay those out in front of Congress so they understand that if they choose not to fund — or if they choose not to fund appropriately with the resources we need to protect the American people — that what the likely consequences of that might be.

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

Q    Thanks very much.  My question is sort of a broad one about eligibility for both the treatments and for the vaccines. 

Dr. Jha, you mentioned talking to doctors and the fact that the Paxlovid is available for a lot of people.  But, at least anecdotally, a lot of doctors are telling folks that they’re not eligible for it.  Is that a disconnect between the administration and doctors not knowing?  Or is the supply — is the supply maybe not as great as — as you are suggesting?

And then, broadly, also on vaccines: Dr. Walensky, you mentioned the fact that if people are eligible, they should be getting that next boost.  What about people who are under 50?  There are lots of people certainly in that age group who are getting Omicron, again, who would like to take another vaccine or a booster.  Will the eligibility open up for them as well?

DR. JHA:  All right.  So, let me start by talking about treatments, and then maybe I’ll turn it over to Rochelle for thinking about vaccines and eligibility.

Jeff, the way I think about this is and as I said earlier: When we first got authorization for Paxlovid, we had very, very limited supply.  So, the messaging was: Keep it for the highest-risk people.  And that kind of messaging and kind of almost a scarcity mindset tends to set in, and it takes a lot of effort to get people to shift.

And usually, under normal circumstances, it would take years to get doctors to change their practice patterns in substantial ways.  Well, we don’t have years for this.  So, we have been going, I think, pretty clearly and pretty strong on helping doctors understand that the –- actually, the range of people who are eligible is quite broad.  And it’s not my definition, it’s the EUA of the FDA.  If you look at the emergency use authorization, they say anybody who’s at increased risk of severe disease.  And then they actually point to a CDC document.  If you go to that CDC document, it’s a very broad range of people.

And so my general advice has been, we’ve got to follow the EUA.  You should be relatively permissive about this.  You should not get excessively restricted.  We have plenty of supply right now.  We’re not trying to, you know, prevent Americans from getting them; in fact, the opposite.  We’re trying to make sure that everybody who’s eligible, which is a large proportion of the population. 

And whether the supply is adequate or not: What we’re doing is we’re tracking very closely ordering.  We’re making sure that if there’s any municipality or any local district or any pharmacy that feels like they want more, we’ll make sure they get more. 

But we’re making sure that the supplies are adequate.  We have substantially increased it — more than 30,000 sites now across the country.

And we’re not done, by the way.  This has been four weeks of work.  We’re going to keep going, adding more test-to-treat sites, adding more opportunities. 

So, it’s just about messaging, it’s about clarity, it’s about making sure people understand who’s eligible, and then making sure that as people get eligibility or are eligible get the prescription — that it’s available very, very widely.

Rochelle, to you on the vaccine question.

DR. WALENSKY:  Right.  Thanks, Ashish.  So, what we do know about these vaccines is they work well to prevent severe disease – they work very well to prevent severe disease if you’re up to date.

We do know that, as I showed in the graph, that there are many people who are eligible for a fourth dose and even for a third dose — have not yet received them.  So, for those over 50, those are the people who are most at risk of severe disease.  And we really do want them to go ahead and get that third or fourth dose, if they haven’t gotten either, to prevent severe disease.

For those under the age of 50, there are still quite a few people out there who have not gotten their third dose.  And we know that third dose is really important, especially against Omicron.  So, we would encourage those people to get their third dose.

With regard to a fourth dose for those under the age of 50, that is going to require action from the FDA, and we’re in conversations there as well.

DR. JHA:  All right.  So, I think, Kevin, are we — I think we’re done with Q&A, so let me just wrap up here by saying thank you all for joining us.  This is my first COVID press briefing since I took on this role from Jeff Zients.

And what I want to do is two things: First of all, we’ve both — Tony and I, and I know Rochelle as well — have been out there in the media talking.  I think, Tony, I counted that between you and me, we’ve done 50 media appearances in the last five weeks.  So, we’ve been out there.  But we want to do more of these briefings, and so we will continue — I commit to continue to do these briefings on an ongoing basis.

Obviously, when there’s major news, we’ll do it.  Otherwise, we’ll make sure that we do it on a regular basis so that we continue sharing information with people.

Thank you all for joining us, and I look forward to seeing all of you again the next time we get a chance to get together. Thank you.

11:37 A.M. EDT

To view the COVID-19 press briefing slides, visit: https://www.whitehouse.gov/wp-content/uploads/2022/05/COVID-Press-Briefing_18May2022.pdf

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