>> the senate health committee hearing is finishing up with dr. fauci, the c.d.c. director dr. walensky and others testifying on the government's covid-19 response. this hearing will air again tonight in its entirety at 9:00 eastern. here on c-span. u.s. house is back at 2:00 p.m. eastern. they'll work object mental health and suicide prevention legislation. without objection i last testified before this committee less than two months ago. since that time the dedicated professionals at c.d.c. been working diligently to provide additional resources to states, localities, territories, and tribes. thanks to support from congress. we are updating our guidance

based on the latest scientific evidence and we are working with our partners around the country and around the globe to reduce the burden of covid-19. i am pleased to report that since january we have seen a consistent downward trend with daily averages of new infections, dropping 76%, hospitalizations down 71%. and reported deaths decreasing by 75%. this progress is also reflected in our data on the county level risk. just a few months ago 85% of all counties in the u.s. were experiencing high covid-19 transmission rates and increased community risk.

we are also keeping an r our commitment to prioritize health equity. since march, we have announced a number of investments that center in health equity. these include $2.25 billion to address covid-19 related health disparities and advance health equity among high risk and underserved population. $3 billion on increasing uptake and equity administration particularly in communities hardiers hit by the pandemic. $332 million in community health workers to support covid-19 prevention and control. and $250 million to develop targeted strategies for vaccine education and outreach for uptick in specific communities. in addition c.d.c. continues to update the guidance.

this includes recent update outlining levels of risk for fully vaccinated and unvaccinated people. we'll continue to update this guidance to be clear vaccines are a means of returning to activities we stopped as a rufflet pandemic. with the cases trending down and the u.s. and more people getting vaccinated, we are cautiously optimistic. globally, the pandemic is more severe than ever. the surge of cases in india is tragic. and a reminder the veterans day russ can rapidly outstrip us. we will not end this pandemic

without working with countries around the globe to fight covid-19. i want to acknowledge that while we have made progress over the last few months, more than 579,000 in the u.s. have died from covid-19. just since i saw you in march over 39,000 have died from covid-19 in the united states. every death is a reminder of why we must remain vigilant and focus to end this pandemic. i went to close with a promise and an appeal to the american people, my promise is the cdc will continue to follow the science, and my appeal is to implore everyone to get a covid vaccine as soon as possible is the fastest way to end the pandemic. even with this tool, while we continue to have transmission, we must maintain health measures

that we know wells -- will prevent the spread of this endemic. mask, hand high again, and physical distancing. as we get to this pandemic, we must work together over the months and years ahead to build on the investments and partnerships that we have created during this crisis. this includes a public health infrastructure to be better prepared for whatever comes next. that is one way we can turn tragedy into lasting progress and improved health for all. thank you for the opportunity to testify today. i look forward to answering your questions. senator murray: thank you. dr. fauci. dr. fauci: thank you for giving me the opportunity to discuss with you this morning the role of the national institute of allergy and infectious diseases and the research addressing the pandemic. as i mentioned during the last hearing we attended, we have a plan that has four major

components, fundamental knowledge of the virus, diagnostics, therapeutics, and the development of safe vaccines. for the purpose of that discussion today, i will focus on the issue of vaccines. we get asked how it could be possible at the virus was discovered in january of 2020 and we had doses of vaccine going into the arms of individuals, a vaccine that was efficacious and safe, 11 months later in december of 2020? the story behind that has been the decades of investment in basic and clinical research that has led to the ability to accomplish this feat. some examples, the basic preclinical and clinical research in developing platform technology, particularly the

successful mrna platform, in addition, scientists at the research center as well as contractors throughout the country developed the optimal immunogen which is used by virtually all of the vaccines that are being tested now. the utilization of a clinical trial network that we have set up decades ago for influenza and for hiv, and when one thinks of efficacy, it really is what are the results of a trial? when you get into the real world, the effectiveness of vaccines fall short of the original efficacy. that is not at all the case with the vaccines for covid-19. the real-world effectiveness is even more impressive than the results of the clinical trial.

on example, the university of texas looked at 23,000 employees and found the rate of infection was markedly lower than in unvaccinated individuals. importantly, a recent paper in the lancet reported on the experience in israel, which as senator burr mentioned, has done an extraordinary job of getting their citizens vaccinated. we have seen a remarkable diminution in the number of infections that reached a critical turning point when they reached a certain percentage of individuals who were vaccinated. it was not limited only to israel. another paper in the country of qatar showed a similar result in which not only were the mrna

vaccine highly effective in over 300,000 individuals tested in preventing the original type virus, but it also had the capability of protecting against mild to moderate disease of a problematic variant from south africa, and protected virtually 100% from severe disease including hospitalization and death. so when the president makes the goal of 70% of adults receiving at least one vaccine by the fourth of july, we believe that is an attainable goal and the reason we feel it is important is that i believe we are about at that critical turning point when we get a certain percentage, we don't know exactly what it is, but clearly the majority of individuals in the country vaccinated, we will see a sharp turning point and

diminution in cases. as i said the last time i testified, we are in a race between the vaccines and the virus if left to its own devices as it will continue to surge. based on the experience thus far, i feel confident that if we continue to vaccinate people at the rate we are doing, that we will soon have a situation where we will have so few infections in the country, we will begin to return to normality that all of us desire. thank you. senator murray: thank you. dr. marks. dr. marks: thank you for the opportunity testify before you. to describe f.d.a.'s continued covid-19 response efforts and particularly our efforts on vaccines. first, yesterday evening the fda announced the expansion of the emergency use authorization for

the pfizer covid-19 vaccine to include adolescence down to age 12 years. we know this is a big step for the country as vaccinating the younger population can get us closer to a sense of normalcy after ending the pandemic. to look at the safety of the vaccines, the fda evaluated the trials of more than 2000 children aged 12 to 15. half of the participants received the pfizer vaccine and hal of received a saline placebo. the side effects experienced were similar to those experienced by individuals aged 16 and older. to look at effectiveness, the fda evaluated data about how the immune systems responded to the vaccine. exakesr comparing 190 individuals age 12 through 15, to 170 age 16 through 25. the fda also evaluated data on cases of covid-19 among children

aged 12 through 15 seven days after the second dose of vaccine was given, and no cases of covid-19 occurred among thousand five children who receive the vaccine compared to 16 cases in 978 placebo recipients, indicating the vaccine was completely effective in preventing covid-19 in the trial that was symptomatic. parents and guardians can rest assured that the agency undertook a thorough review of all available data as we have with all of our covid-19 vaccine authorizations as the cdc will review the data tomorrow. we intend to convene a virtual meeting of the committee on june 10 during which we will provide an update on the approach to

emergency use authorization in individuals aged 12-17 years of age, and we will discuss the data needed to support the authorization and a biologic license application and children less than age 12. as covid-19 vaccination expands to children, we work diligently with the cdc and others on safety surveillance of the authorized vaccine. we are grateful to congress for the american rescue plan funds which are supporting expanding vaccine safety surveillance among other critical priorities. we have seen that our safety surveillance systems are doing what they are supposed to do. recently the systems detected a safety signal for rare blood clots and low blood platelets with the johnson & johnson covid-19 vaccine. following a brief pause taken to evaluate the situation, based on the rare but increased reese of

-- risk of this adverse event, mainly in women aged 18-50, the fda modified the fact sheet for health care providers to include the warning pertaining to this risk of thom bowcies and the fact sheets for recipients was updated. we will diligently monitor the safety of these vaccines. the cdc and fda are working closely together to track the emergents of covid 19 variants. currently available evidence suggests that the three available vaccines adequately address covid-19 variants sir circulating in the united states. we are working with manufacturers and government partners to plan the composition of the vaccine so that we can administer boosternations -- vaccination if necessary. the fda recently completed inspectionsolutions to propose of manufacturing the silty for the

-- manufacturing facility for the johnson & johnson code of vaccine. the fda investigators cited several observations concerning whether the facilities practices met the requirements. we are now working with the company to address the conditions identified and it has made public that no product has been released from this facility for use in the united states and will not agree to the release of any product until we are confident that it meets our expectations for quality. . the agency is refining how to manufacture the quality during any future public health emergency. we're committed to remaining the the trust of the vaccine and hope eligible individuals consider get vaccinated in order to end this pandemic. thank you.

>> thank you. chair murray. >> first, we have delivered to date 330 million doses of vaccine in the united states, and have administered over 260 million of them. the most important thing we all need to do is to get a vaccine to everyone who wants to be vaccinated in the united states. the current vaccine supply exceeds demand. nothing is more important than achieving the president's goal of having 70% of adults with at least one shot before -- by july 4. the long-term fate of many of our communities depends on getting people vaccinated. there are many reasons why people have not yet been

vaccinated. we need to recognize at the core for many is simply a fear of the unknown. all the data support the basic proposition that these vaccines are safe and effective. getting vaccinated will prevent hospitalization and death. second, the f.d.a. took a significant step yesterday in the fight against covid-19 by expanding the pfizer e.u.a. to adolescents ages 12 to 15, pending the recommendation of the acip tomorrow, we plan to offer the pfizer vaccine to all young people ages 12 to 15. right now the pfizer vaccine is available in many local pharmacies and larger health clinics. we are working to make smaller trays available so the pfizer vaccine can be administered by

more pediatricians, rural health care providers. by late fall we expect to have data on the safety and effectiveness for the vaccine for children under 12. third, we're planning, and i underscore the word planning, to have booster doses available if necessary for the american people. increased age, the natural waning of antibodies over time and new variants all increase the probability that booster doses may be needed. fourth, it is absolutely essential that we begin sharing doses made in the united states with the rest of the world. supplying other nations with vaccines is not just the right thing to do for lifesaving humanitarian purposes. it is also in the best interest of the united states to mitigate the risk of viral evolution.

i am concerned that even after we finish vaccinating most of the people who want to be vaccinated by this summer, there will still be a significant number of cases and an unacceptable number of deaths. people who are immunosuppressed, who don't mount a number of response or choose not to be vaccinated will continue to be vulnerable, and we need options for them. the antibody treatments are one approach, but a simple oral anti-viral can add to our armatarian to bring this epidemic under control. lastly, we need to build a program for vaccine preparedness for future pandemics. this will need to be done in partnership with the private sector and build on all the lessons we have learned to date. thank you for the opportunity to testify today, and i look forward to your questions.

chair murray: dr. fauci, the surge of covid-19 that's devastating india is a painful reminder, really, we can't end the pandemic here until we end it everywhere. and i'm glad the biden administration is leading that global fight by rejoining the world health organization and funding global vaccine efforts and committing to donate 60 million astrazeneca vaccines to other countries by july 4. india's outbreak really underscores the need for a robust public health infrastructure in the u.s. to respond appropriately to this pandemic and future outbreaks as well. i want to ask you today, dr. fauci, what can we learn from india's outbreak that we should apply to our response here in the u.s.? dr. fauci: well, i think one of the important things, don't ever underestimate the situation. the reason that india is in such dire straits now, they had an original surge and made the incorrect assumption that they were finished with it.

and what happened, they opened up prematurely and wound up having a surge right now that we're all very well aware of, extremely devastating. that's the first thing. the second thing is preparedness with regard to public health preparedness, which we as a lesson learned for future pandemics have to realize we need to continue to build up our local public health infrastructure which over the last decades we have let actually in many respects go in disarray likely because of our successors in controlling so many diseases. the other lessons learned, madam chair, is that this is a global pandemic that requires a global response and we need to pay attention to the responsibility that we have, not only for our own country, but to join with other countries to make sure that we have the access to interventions, particularly vaccines, throughout the world, because if it continues to have

dynamics of virus anywhere in the world, we have a threat here in the united states, particularly with variants, and you know there's one variant in india that's also a new variant. so those are a few of the lessons i believe we can take what i believe is going on in india. thank you. chair murray: thank you. dr. marks, i'm encouraged how the f.d.a. has worked quickly to get multiple covid vaccines authorized. i am very concerned about the reports involving emergent biomarks. it's a contractor that received $628 million to manufacture covid vaccines and wanted to ask you to explain f.d.a.'s recent findings, because after receiving reports of cross-contamination with another vaccine, f.d.a. inspected the emergent facility, directed them

to pause manufacturing and it was not distributed for any use. dr. marks, what steps is f.d.a. taking to make sure the quality, safety, and effectiveness of all covid-19 vaccines? dr. marks: chair murray, thank you for that question. currently for the emergent facility we're actively working with all of the parties involved to ensure the facilities' deficiencies are all remediated so before they are able to release vaccine it meets all of our quality standards that americans deserve from vaccines. also, as we move on to other facilities that may be producing vaccines, we will take the approach of using all of our inspectional tools to ensure that the quality of those is the highest nature and as with all of our biologics license applications, we, generally, will be performing on-site inspections of those facilities

to ensure the quality of those products. chair murray: thank you. i'm really deeply concerned what happened and my expectation is in the future nothing like that happens again. dr. walensky, in my last minute here, c.d.c. says while children have been sick with covid-19 compared to adults, children can be infected, get sick and spread the virus. with the -- with the authorization of pfizer yesterday for children 12 to 15, what would you say to parents who are considering getting their kids vaccinated now? dr. walensky: i would encourage all parents to get their children vaccinated. i know many parents are enthusiastic and have been texting me, can't wait to get their children vaccinated. i recognize that there are some parents want to sort of see how it goes, first. but i'm encouraging all parents to get their children vaccinated. i'm encouraging children to ask for the vaccine. i have a 16-year-old myself, and i can tell you he wanted to get the vaccine. he wants his life back.

these kids want to go back to school. they want to go back to the things they love. chair murray. thank you. senator burr. senator burr: thank you. dr. kessler, we've shipped 2.7 million doses of astrazeneca i think to mexico. that's the only country we've shipped to. we've got additional doses of astrazeneca in inventory in this country. we talked about july 4 exporting more. why have we not mobilized that to other countries in the world today? dr. kessler: senator, it's a very important question. we have shipped a total of four million doses to date, including to mexico and, i believe, 1.5 to canada.

we are ready to ship up to 60 million doses of astrazeneca, but, as the chair pointed out and as my colleague, dr. marks, responded, there are issues with the emergent that are under review by the food and drug administration. if and when those issues are resolved and we can say that these are quality doses, we will do just as you say. senator burr: correct me if i'm wrong, i didn't know if the baltimore facility had anything to do with astrazeneca production, am i wrong, dr. marks? dr. marks: senator burr, no. the astrazeneca vaccine was being produced in that facility and the f.d.a. feels it's imperative that before vaccine can be shipped to any other partner it has to meet the

quality standards it would need for any american as well. senator burr: so how long do you anticipate testing the astrazeneca vaccine as it is currently manufactured would take to verify? dr. marks: there is a working group across our office of regulatory affairs and our center and others at f.d.a. that are working together to try to clear that -- thosedoses as quickly as we can. i can't give you an exact time, but we understand the imperative to be able to have them available so that dr. kessler can range -- to ship those in need. senator burr: dr. kessler, one of the reasons we are as successful today is that partnerships have been leveraging vaccinations around the world. over 275 partnerships have been created to scale up vaccine production, manufacturing, and i

guess i'm asking you this. if we waive intellectual property in the united states, do we not stand the risk of affecting manufacturing in the future? if we scaled up manufacturing capacity, they have done that already. shouldn't we let private sector continue to do something that i think dr. fauci and i said in the past we never anticipated this. this is novel they would have the relationship to do it. why risk a good thing? dr. kessler: senator, this is a once in a century pandemic. i think we all recognized that extraordinary circumstances call for extraordinary measures. we know -- and i agree with you, senator, that a waiver alone

won't result in the scale and speed we need to make enough vaccines to end the pandemic. that's why we will continue to rump up our efforts, working with the private sector and all possible partners to expand vaccine manufacturing and distribution around the world. our job is to do as you say, to increase that supply. that's what we're focused on. and we want to make vaccine available to the world. senator burr: david, here's the reality. when pfizer opened up its kansas plant to produce vaccine, it took them, i believe, seven months to retool and to get everything done. this belief that you can export intellectual property and you're going to have a stand-up around the world instantaneously of vaccine production is a joke. dr. marks has expressed concern

over the backlog of production and how long it would take us to inspect foreign sites if there was a vaccine pool that found its way in and out of the united states. let me just get this before my time runs out. can anybody give me the number? there has been 333 million americans infected with covid that tested positive. how many of that 33 million have then been vaccinated? anybody know what that number is? here's why i make the point and here's why i think it's relevant. if we're looking at a certain number that we don't know exactly what it is, dr. fauci, and we want to get it to and we vaccinated 115 million, it's important for us to know of the counted vaccine number, how many of those already had protection because they were co-vivid positive -- covid positive? so if we're trying to reach a

number when the president says 70% vaccination, if we get to 65% vaccinated and 5% got covid and they have protection, isn't that being at 70%? the continues is the goal post continues to be too far. we've now got the harder part, we now take the 40% that aren't real comforted getting vaccinated and have a shot of vaccinating 50% of that 40%. and it may be that our number is higher today on the protected. i think it is. i don't think 33 million have been vaccinated that have been positive but it's crucial that we figure out what that number is. not sure whose responsibility it is. that we figure out what that number is and put that into our formula of how many americans have protections. i thank the chair. chair murray: thank you. senator casey. senator casey: thank you. i want to thank our guests, dr.

fauci, dr. kessler, dr. marks, dr. walensky. i think i have one question for dr. walensky and dr. marks. i want to start with you, dr. walensky. i want to thank you for your leadership at the c.d.c. making sure that children and adolescents are up to date on vaccinations, particularly as students return to in-person learning. you noted -- you and others noted there are over 11 million doses to the vaccines for children program that have been missed. these missed doses could seriously and negatively impact efforts to protect children and their families and communities from vaccine-preventable diseases and conditions. of course, we're talking about diseases other than covid-19. at the same time with 12 to

15-year-olds now available to get covid vaccines, parents need to be aware of all the vaccines children should receive in order to remain healthy. the rescue plan contains funding to build vaccine confidence and includes provisions funding that's allocated toward increasing vaccination rates throughout the u.s. so here's the question, doctor. in addition to the public awareness efforts that you and c.d.c. have already undertaken, will the c.d.c. be releasing the funding to to communities to make sure children are caught up on routine and both recommended vaccinations, particularly as children return to in-person learning? dr. walensky: thank you, senator, for that. you raised an issue that's near and dear to my heart. more than 20% of measles vaccines were not used. and the same with meningitis

vaccines. we don't have data on whether we can co-administer the covid-19 vaccine and other routine immunizations and whether we get the same protection from the covid-19 vaccines and the routine administration of other immunizations. that is one issue that the experts at acip are going to address tomorrow as to whether that can safely be done and that potentially can get adequate protection. you're right. as we're putting forward these efforts in vaccine confidence for the covid-19 vaccine, we need to take this outreach and make sure that we are reaching these communities and if we are not able to co-administer them to make sure we get back to these children and be able to administer the routine vaccines they have lost during the school year. senator casey: in terms of the funding, that will be released, do you have a sense of the timing on that? dr. walensky: i do not but i'll

get back to you on that. senator casey: dr. marks, i want to start with you regarding for pfizer. for emergency use authorization. we know pfizer recently filed their application for full licensure of their covid-19 vaccine. i think -- we get a lot of questions at home on a range of these issues in particular. what does it mean? what does it mean -- what does full lennure mean? one of the fears we heard a lot about is the -- that vaccines are provided this emergency use authorization but what -- what's the next step for a vaccine? can you explain what it means to get full licensure? that's question number one. secondly, what additional information would a company need to submit beyond what was required just for so-called

e.u.a.? dr. marks: senator, thanks very much for that question. the full licensure is something that a manufacture smits with a -- submits with a full data package. i want to go back and pick up on something that dr. fauci said. these covid-19 packages were expedited not by cutting corners but going through a development plan through which empty space, space that would have normally not stopped happening was taken away so manufacturing was done while the clinical trials were done. the large clinical trial programs were of the size of normally licensed vaccines in the united states. the one place where we're a little bit short was the duration of safety follow-up. but we are very confident from the amount of safety follow-up at least two months safety follow-up on this safety data set from the emergency juice authorization that -- emergency

use authorization. we're very confident in recommending these vaccines for everyone. our families, all americans. the difference that will happen with the bilogic license application is that the manufacturers will send data -- safety data, rather than just the median two-month safety data. and in addition, there will be technical things there that many people may not care a lot but we do. that is manufacturing conformance slots, the formal facilities' inspections will occur, and additional ancillary studies will be put in that package. so i think the main message to the american public is that for all intents and purposes the vaccine that's being used is very close to what we would normally have in a biologics license application. there are things on the margins that will go into the biologics

license application when we have a formal murray. chair murray: thank you. senator paul. senator paul: dr. fauci, we don't know whether the pandemic started in a lab in wuhan or evolved naturally but we should want to know. three million people died from this pandemic and that should cause us to explore all possibilities. instead, government authorities, self-interested in continuing gain of function research, said there's nothing to see here. in a function research, as you know, is juicing up naturally occurring animal viruses to infect humans. to arrive at the truth, the u.s. government should admit that the wuhan virology institute was experimenting to enhance the coronavirus' ability to infect humans. juicing up superviruses is not new. scientists in the u.s. have long known how to mutate animal viruses to affect humans. for years, a vie rolgs in the --

virologist in the u.s. shared discoveries about how to create superviruses. this gain of function research has been funded by the n.i.h. the collaboration between the u.s. and the wuhan vie rolling -- virology institute continues. think about that for a minute. the sars virus had a 15% mortality. we're fighting a pandemic that has about a 1% mortality. can you imagine if a sars virus that's been juiced up and had viral proteins added to it to the spike protein if that were released accidentally. dr. fauci, do you still support funding of the n.i.h. funding of the lab in wuhan? dr. fauci: senator paul, with all due respect, you are

entirely and completely incorrect about the n.i.h. has not ever and does not now fund gain of function research in the wuhan institute. senator paul: do they fund -- dr. fauci: we do not fund -- senator paul: dr. barret gun of function research -- gain of function research? dr. fauci: it's being conducted in north carolina. senator paul: you would be in the minority because at least 200 scientists have signed a statement from the cambridge group saying it is gain of function. dr. fauci: well, it is not. if you look at the grant and you look at the progress reports, it is not gain of function. despite the fact that people tweet that. they write about it.

senator paul: do you support sending money to the wuhan virology institute? dr. fauci: i do not support it. senator paul: there was a subgrant. do you support money from n.i.h. that was going to the wuhan institute? dr. fauci: let me explain to you why that was do. the sars-cov-1 originated in bats in china. it would have been irresponsible of us if we did not investigate the bat viruses and the sirology to see who is perhaps -- senator paul: or send it to the chinese government whom we can't trust with this knowledge and this incredibly dangerous viruses. government scientists like yourself who support gain of function research. dr. fauci: i do not support gain of function research. they are not correct. senator paul: government defenders of gain of function

such as yourself say that covid-19 mutations were random and not designed by man. but interestingly, the technique that dr. barret developed forces mutation by serial passage through cell culture that the mutations appear to be natural. in fact, dr. barrett named the technique the no technique. nicholas baker said nobody would know if the virus had been fabricated in a laboratory or grown in nature. government authorities in the u.s., including you, deny that covid-19 could have escaped a lab. but even dr. xi in wuhan wasn't so sure. according to nicholas baker, dr. xi wondered if it could come to her own laboratory. she checked her paper. the director of the gain of function research in wuhan couldn't sleep because she was terrified it might be in her

lab. dr. barrett, an advocate of gain of function research said the main problem that the institution of virology had it happened in close proximity. what are the odds? could you rule out a laboratory escape? the answer in this case is probably not. will you in front of this group categorically say that the covid-19 could not have occurred through serial passage in a laboratory? dr. fauci: i do not have any accounting of what the chinese may have done. and i'm fully in favor of any further investigation of what went on in china. however, i will repeat again. the n.i.h. and niad categorically has not funded gain of function research to be conducted in the wuhan institute of virology. senator paul: we have 11 labs doing it and you have allowed it. we have a committee to do it but the committee is granted every

exception. you're fooling with mother nature here. you're allowing superviruses to be created with 15% mortality, it's very dangerous and is a huge mistake to share this with china and it's a huge mistake to allow this to continue in the united states. we should be very careful to investigate where this virus came from. foich dr. fauci: i fully agree you should investigate where the virus came from. but, again, we have not funded gain of function research on this virus in the wuhan institute of virology. senator paul: you're parcing words. there was research done with dr. xi and dr. barrett. they've collaborated where they enhanced the sars virus to infect human airway cells and did it by merging a new spike protein on it. that is gain of function. that was joint research between the wuhan institute and dr. barrett. you can't deny it. chair murray: senator paul, your time is expired. we'll let you respond to that.

we need to move on. dr. fauci: excuse me. chair murray: i'll let you respond to that and we'll move on. dr. fauci: i just want to say, i don't know how many times i can say it, madam chair. we did not fund gain of function research to be conducted in the wuhan institute of virology. chair murray: thank you. senator. >> thank you, chair murray. thank you so much to our panelists for being here today. i want to just -- following up on that exchange -- ask dr. fauci a question. dr. fauci, what is the impact of conspiracy theories told by senator rand paul and others the willingness to take this vaccine, a vaccine that is remarkable for its safety and efficacy? dr. fauci: well, conspiracy theories certainly are not

helpful in what we're trying to do, i guess i can say that with some degree of confidence. senator smith: i would agree. i think -- we are at a critical moment for our response to this pandemic. and only 14 months since we -- this pandemic started, we are here today to acknowledge we have 261 million doses of vaccine in people's arms. we have over 58% of americans with at least one dose. this has been an incredible -- an incredible accomplishment. and we also know that we have more work to do. it seems to me we ought to be focused on that work. we have to make sure that our comprehensive strategy that you have been working on, dr. fauci, for a long time, and i'm so grateful for the support that you're getting from the biden-harris administration, a comprehensive strategy that's around vaccinations, around surveillance testing, around

treatment, social distancing and masks, and also centering our work around health equity. that's what we need to be really focused on, seems to me. i'd like to ask dr. walensky a question of how we go about this question of -- this issue of getting people -- getting vaccines into people's arms now. vaccines -- vaccines seem to be a spectrum from people who are gunning ho and ready -- gung-ho and ready to go to people that are resistant to vaccines. i have a great example of that in duluth, minnesota. where public health nurses set up a pop-up vaccine clinic at the duluth transportation center. they can go to that vaccine pop-up clinic, get their shot in one dose. it's breaking down some of the

logistical challenges that americans and minnesotans are having and they are finding great success. there was a story in minnesota public radio just in the last couple of days about a woman named karen moore who was waiting to get a vaccine and hoping that she would be able to get it at a convenient location. and was able to do it all in one spot. and that made all the difference in the world to her in terms of overcoming her so-called vaccine hesitancy, which wasn't hesitancy. it was just the logistic challenges. so dr. walensky, can you tell us a little bit about the c.d.c. is doing, working with states and localities, to deploy methods like we're seeing in duluth, minnesota, to help people get easy access to vaccines? dr. walensky: thank you so much, senator. we have spent $3 billion getting money to states and localities to advance these efforts in trying to get vaccines into people and to enrich vaccine confidence. i would invite all of you to take out all your cell phones

and text 438829. you put in your zip code and get a list of vaccines that are available to you. you can go to vaccines.gov and type your zip code and find out which vaccines are available nearby to you. we're working to make it easy. we have to do some of the pivoting, as you discussed, and ensure places now have pop-up sites, they have mobile vaccination units, that we're getting out to rural areas. we can do this campaign now, a campaign with 5,000 community corps members from everyone from nascar and nfl to infectious society of america to faith-based organizations sending our messages, being the trusted messengers and we're starting to see the effect of this work. just this morning c.d.c. released new racial and equity data. the bar graph shows not just our

overall progress but what we've done in the last two weeks. in the last two weeks we've been really successful in reaching racial and ethnic minorities in ways we hadn't up until this time. we have to do more. we recognize we have to do more. we have vaccine confidence consults so local and states can call the c.d.c. and say we're having a hard time reaching people in this community. what are the things we can do? this is just a brief list of the many activities we're engaged with every single day to get vaccines into people for -- and to recognize that all hesitancy is not the same flavor. some people it's convenience. some people want to understand the science more. some people just need the time off. senator smith: thank you so much. thank you, madam chair. i want to say i appreciate the work of the c.d.c. and others to support the innovative and strategic efforts that states like mine to overcome some of those barriers. thank you. chair murray: thank you. senator collins. senator collins: thank you. dr. walensky, i used to have the

utmost respect for the guidance from the c.d.c. i always considered the c.d.c. to be the gold standard. i don't anymore. i want to tell you the conflicting, confusing guidance from your agency has undermined public confidence and contradicts the scientific guidance of many experts. the first has to do with school openings, an issue we talked about before. the new york post reported that a powerful teachers union, the a.f.t., successfully secured changes verbatim in draft guidance on school reopenings. this came about because of an outside group that did a foia request that revealed extensive

interactions between the a.f.t. and the c.d.c. this has been described by a professor who has written extensively about the coronavirus as very, very troubling. she's referring to the emails back and forth between the c.d.c. and the a.f.t. and she says, this is not how science-based guidance should work or be put together. my second example is from a new york times story that appeared today. it talks about c.d.c. guidelines on mask wearing and where the c.d.c. announced that less than 10% of covid-19 transmission was occurring outdoors. the article points out this is,

quote, almost certainly misleading. and goes on to say there is not a single documented covid infection anywhere in the world from casual outdoor interactions such as walking past someone on a street or eating at a nearby table. the third example has to do with new guidance c.d.c. has issued for summer camps. and here are the reactions of two experts. one, a pediatric immunologist at colombia said it's senseless. the editor in chief of the journal of the american medical association pediatrics called the guidance, quote, unfairly draconian.

so here we have unnecessary barriers reopening schools, exaggerating the risk of outdoor transmission and unworkable restrictions on summer camps. why does this matter? it matters because it undermines public confidence in your recommendations. in the recommendations that do make sense. in the recommendations that americans should be following. i'd like you to respond to why the c.d.c. is not following the standard procedures? why is having off-line secret negotiations with one stakeholder that was revealed only through reporting in a foia

request, why it's exaggerating outdoor transmissions? we know masks make a difference indoors. they don't outdoors. dr. walensky: thank you for that question. maybe if i could take each of your questions one by one. first, the school guidance. as a matter of practice, the c.d.c. engages with stakeholders with consumers who take our guidance, who use our guidance before it is finalized so we can understand whether it addresses their needs. for our school guidance we did that with 50 different stake holders, over 50. i personally engaged with both parents and teachers and many different stakeholders to address what can be done to improve the guidance we have. one of those stakeholders recognized that in our guidance we had addressed what you do if you have immunocompromised children, at risk of severe, but we neglected in our draft to address what happens if we have immunocompromised teachers, teachers that are getting chemo

therapy. we need to add language if you have immunoimpose mized teachers and how they should -- immunocompromised teachers and how they should behave in school. the request was to address what happens if you have immunocompromised teachers and that was an oversight in our initial draft. and we included a science-based response -- a science-based language in our guidance. with regard to "the new york times" piece, there was something published in november, i believe, where the top line result of all studies that were included in the systematic review said less than 10% of cases were transmitted outdoors. it is that meta analysis that combines science from all sorts of -- all different science from many different places. i think over 19 studies were included. the top-line result was less than 10%. published in the journal of infectious diseases, one of our top infectious journals.

that's where that came from. it was a published study that sint thighed stud -- synthesized study. i have a 16-year-old. he goes to camp. he writes the number of days before he got to camp. this year it got to zero and i said you are not going. i want our kids back in camp. we now have 38,000 new infections on average per day. last may 11 it was 24,000 and we sent a lot of kids home and the camps were closed. the guidance is to get our kids to camp and allow them to stay there. thank you. senator collins: madam chair, i would just ask unanimous consent that the full "new york times" story dated today be placed in the record because it answers -- i realize i am out of time. it answers dr. walensky's response.

chair murray: so ordered. senator kaine. senator kaine: thank you, madam chair. thank you to the witnesses for your important testimony. some of you have been before this committee so often i can remember you were first before us, january 24, 2020. and so much has happened since then and there's so much to talk about. my colleagues have done a good job addressing many of my interests. at the last hearing that we had together, which i believe was in march, dr. fauci, i talked to you a little bit about long covid. when the day comes that the president declares that the national emergency is over there's still going to be at least two challenges. long covid and the mental health challenges that have resulted. i want to ask dr. fauci and dr. walensky to dig in a little bit

how you're using the funds that have been provided to deal with the long covid issue for folks who are suffering symptoms after they've recovered from covid. dr. fauci: thank you very much for that question, senator. this is really an important problem. the n.i.h. has been given $1.15 billion to study this. and we're doing this in collaboration with c.d.c. and other organizations. long covid is a real issue. anywhere from 10 to in one study as high as 30% of individuals who recover from the acute manifestations of covid-19 who have viralogically no virus in them at all but should be on the road to an uneventful recovery. what we find out, and we're putting together a number of cohort studies for extent,

duration, any underlying pathogenesis. the symptoms is somewhat common, there is a commonality. it's extreme debilitating fatigue, muscle aches, temperature disregulation, you feel hot or cold, disordernomia, which is related to that, unexplained rapid heartbeat, neuro logical symptoms, brain fog, the inability to focus or concentrate over an extended period of time. these are real symptoms. and they can last for a long time. we have people that refollow now up to nine months -- that we followed now up to nine months or longer this occurs. this is a problem we take seriously. we have a task force at the n.i.h. multiple n.i.h. institutes, not only my own, neurology, mental health, all of which will look at this over the next year or so because it is something that we

really do feel we need to find out what's the underlying cause and what we can do about it. senator kaine: thank you, dr. fauci. that will help people grappling with these symptoms. i want to shift to the second concern i have. we are not a point where the emergency is over and yet even when we are at that point, the mental health impact of this very, very challenging time on the american public and people all around the world is very significant. i have worked closely with colleagues, including senator cassidy, really to pinpoint mental health on frontline health care workers whose the experience of dealing with death and illness at such a massive scale, dealing with end of life conversations with people, who would normally have those conversations with their own family members, this is a significant concern. my colleagues supported inclusion of provisions of the dr. laura breen act, the recent

work we've done. i understand that c.d.c. is starting to focus on public information campaign to frontline health care providers to reduce stigma to seeking mental health assistance should they need it. can you talk a little bit about those efforts and more broadly to keeping our healers healthy? dr. walensky: thank you very much for that question, senator, and for the resources. i think it would be hard to overestimate the trauma that our health care providers, our frontline workers have seen over this last year. having been there before i was here, i can tell you pulling up to driveways in your hospitals that have morgues in the parking lot is a striking thing to find. i'm grateful for the resources. niash is collaborating with our injury prevention center within the c.d.c. to create mechanisms and support tools to do outreach for our health care workers and i would also mention that, you know, we saw mental health

challenges ahead of covid-19, so these are not just the mental health challenges because of covid-19. even among our youth between 2009 and 2019 before covid started we saw a 40% increase in mental health challenges. we need this not just for our health care workers but for the society at large. senator kaine: thank you very much. thank you, chair murray. chair murray: thank you. senator cassidy. senator cassidy: doctors, thank you for being here. i approach you as a physician who has done research in vaccines more so than i'm approaching a senator -- as a senator. i'm i creditably -- i am incredibly frustrated. the american people hear your following science but they hear the lag time of that and recommendations is far too long. it's not just the american people. put it this way, not the people in my state. c.d.c. cautious messaging seems out of step at the moment. want to go back to the office

from "the wall street journal" and the liberals who can't quick lockdown from the atlantic. so first, i was struck when senator burr suggested that previous immunization actually confers immunity. do any of you agree with that? dr. fauci. dr. fauci: does previous immunization -- senator cassidy: it does confer. senator cassidy: we still recommend they be vaccinated. that seems out of step. dr. fauci: studies have shown clearly if you vaccinate someone who has previously gotten infected and recovered, the level of neutralizing antibodies in t-cells are extraordinarily high, not only against the -- against the variants. senator cassidy: i pulled some of the research. my concern that would happen if

you had another infection. all the -- all the immunization does is mimic a pre-existing infection. that's very well-established with other viruses. no one has not established it for this virus. indeed, some of this research shows that within four days, which is the window period, if you will, for an infection to become an illness, those antibodies rise quite precipitously. but we still recommend they get two doses even though the same literature shows there is an increase in side effects when someone gets a second dose and they've been previously immunized. so not life threatening but nonetheless an increase in side effects. nowhere do i see a recommendation that, don't get the second dose because the literature shows that after one dose you've topped out your immunologic response. would anybody like to speak to

that? dr. kessler: there are studies ongoing to look at the first versus second dose. i agree with you, it's a very reasonable proposition for study. but the purpose of immunizing somebody who's been infected previously is to develop higher antibody tiders. they are so critical in preventing -- senator cassidy: the studies in other viruses show -- hopefully we have other research here that a second -- that a reimmunization merely immics what would happen if somebody were exposed to the virus. all it does is kind of mimic that which would consider. dr. marks: senator, this is a different virus. senator cassidy: is there research going on which i am referring to because the research so far shows that within four days you get a significant increase in antibody tider. dr. marks: the nature of the immune response gets higher tiders antibodies --

senator cassidy: that's with every virus. that's not unique to this. dr. marks: it's superior to natural infection in preventing some of these variants and i think that's what dr. fauci was getting to. senator cassidy: i also point out the vaccines themselves and presumably the previous infection is effective against the variants. by the way, can people go back to work if they've been vaccinated and not wear a mask? assuming they're not immunocompromised? dr. walensky: we have about a third of people in this country who have vaccinated. we have about a third of counties in this country that still have over 100 cases per 100,000. we are working to review our guidance and to update our guidance. we have put out three different guidance. senator cassidy: let me ask you again. if i'm vaccinate and i have antibody and i'm exposed to somebody else, what is my risk coming down with symptomatic infection? dr. walensky: 5%. senator cassidy: 5%.

that's overall. not if i have been vaccinated and i have antibody, that's if i'm vaccinated overall. correct? dr. walensky: we don't have -- i don't think we have data in what you're looking at. we did not check antibodies on anybody who is vaccinated. senator cassidy: we could. dr. walensky: we could. senator cassidy: if we know critical mass if -- if we know herd immunity is somewhere north of 60% or 70%, if we go into a workplace where within that workplace there is 100% immunization, such as here, we've achieved herd immunity. yeah, there's somebody in here that may not be responding to the vaccine, but because everybody else has, they're protected. that's nowhere reflected. and right now we have federal agencies, which we've had employees not working for a year because the union says they have to have special workplace precautions for them to return to work. there is consequence to this kind of delay as the stat

article shows of the kind of updating of these recommendations. the american people are incredibly frustrated. and as senator collins said, they're beginning to disregard what you say that's true. because what you -- so much of what you say is patently not true, i have to wear a mask when i'm outside and the wind is blowing 20 miles per hour, that was changed but only changed recently. they seek not to believe those things which are true. you have to realize. you got to be more real time. let me finish with this. i think on the stat article, "the new york times" pointed out on the h.i.v. epidemic, the recommendations were much more calibrated to real life. listen, we know people are going to do this. if you're going to do it, please accept this recommendation. this is a blanket. walk outside and wear a mask. you're vaccinated and everybody else in the room is vaccinated but you're wearing a mask. the american people have just lost patience with us. you guys.

i ask you to kind of be aware of their frustration and get a little real time into updating these things. sorry to be so frustrated. i respect you all and thank you for your service. i yield back. chair murray: senator. >> thank you, madam chair. dr. walensky, as you know, i led the effort to ensure that the american rescue plan included funding for c.d.c.'s work to address variants of the coronavirus. specifically through genomic sequences. i am really encouraged to hear from your testimony that we are now sequencing 10% of our nation's weekly cases. senator baldwin: this is up from about -- well, less than half of 1% in february when i introduced my tracking covid-19 variants act. couple questions about what we're finding. last month, the white house announced that it would provide

initial funding to jurisdictions so that health departments could conduct, expand and improve activities to sequence genomes and identify mutations of the coronavirus. i'd like to have you describe how health departments are making use of this funding and how this investment will improve our response to future public health threats but also any new variants that we should know about that -- particularly anything troubling from the perspective of eluding the therapeutics and vaccinations that we have produced. dr. walensky: thank you so much, senator. i am -- we are so grateful for those resources and our ability to scale up. as you know, we are now sequencing about 35,000 virus samples per week. that is a broad collaboration with commercial labs, with public health labs, with academic partners and with the

public sending samples to c.d.c. in terms of moving forward, i'm looking forward to bolstering the infrastructure to be able to do these sequences at the local level. to producing the infrastructure within c.d.c. to be able to follow these in a pandemic related way, not just for this pandemic, but for future public health threats and further to expand our ability and our workforce in genomics sequences and bioinfomatics, not just address covid-19, but we need to address other threats. thank you. senator baldwin: last week the administration supported the waiver of intellectual property on covid-19 vaccines to help end the pandemic. i believe that this news is the beginning of our work to restore america's public health leadership on the world stage.

dr. fauci, can you explain how increases in new cases of covid-19 worldwide threaten the progress that we've made here in the united states? and how can we avoid repeating history when it comes to combating infectious diseases worldwide? dr. fauci: yes, indeed. as we said so often and it's true that a global pandemic requires a global response. and even if we successful ly vaccinate our population and get the level of infection down to a low level, as long as there is a dynamic of infection spread throughout the world and anyplace in the world, there's always is the danger that variants will be generated and ultimately will come to the united states because of the travel that we know makes no place in the world separate completely from any other place

in the world. so that's something we really need to pay attention to. it's for that reason i keep saying and many of my colleagues keep saying we really do have a responsibility to the united states first. we do for sore. we also need to take part in an effort, whatever effort, and it's going to be multifaceted effort to make sure that the rest of the world contains the outbreak and that could be from some of the things we're doing right now with india by giving them immediate help with oxygen, drugs, ppe. but also to provide for the availability of doses of the vaccine that we can make available to them, not alone, not just the united states, but the rest of the developed world. senator baultd win: thank you. one last question to dr. kessler. in the first few months, the biden administration has surpassed every goal and expectation it has set in terms of getting shots in arms. >> we're going to have to leave this senate health committee hearing on covid-19. it reairs begin again tonight in

its entirety at -- it reairs again tonight in its entirety at 9:00 eastern. the house is about to gavel in. this is our commitment to bring you gavel-to-gavel coverage of congress. they'll work on mental health legislation this afternoon. also, this afternoon, the speaker will swear in congressman-elect carter from louisiana. [captions copyright national cable satellite corp. 2021] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]