Press Briefing by White House COVID-19 Response Team and Public Health Officials, April 9, 2021

Via Teleconference

11:10 A.M. EDT MR. ZIENTS: Thank you for joining us for today’s briefing. Today, we will get a state-of-the-pandemic update from Dr. Walensky, Dr. Fauci will highlight the latest science, and Dr. Murthy will provide an update on our outreach and education efforts First, I want to provide a brief update on our accelerating vaccination program. As of today, overall, more than 112 million Americans have received at least one dose, and more than 66 million adult Americans are now fully vaccinated. That’s more than one quarter of all adult Americans that are now fully vaccinated. That’s up from less than 1 percent when we came into office 11 weeks ago. This is significant progress. And as you can see in our weekly vaccination progress report, we’re accelerating our number of daily shots in arms. Our current seven-day average is now 3 million vaccinations per day, up from 2.9 million last week. Three million vaccinations per day, and this includes the lower-volume days around the Easter holiday. And as the President announced on Tuesday, all adult Americans will be eligible for vaccination no later than April 19th. That’s in 10 days and ahead of the original May 1st timeline. Our vaccinations program is working, it’s accelerating, and we’re on track to meet the President’s goal of administering 200 million shots in his first 100 days. This is only possible because of our whole-of-government response and the aggressive steps we have taken to get more vaccine supply, more vaccinators in the field, and more places for Americans to get vaccinated. However, we know there’s more work to do. That’s why we are accelerating our efforts to get more safe and trusted places for Americans to get vaccinated and meet the President’s goal that by April 19th, 90 percent of Americans have a vaccine site within five miles of where they live. First, on the Federal Retail Pharmacy Program: As we expand to more pharmacies, millions of Americans are able to get their shot at their local pharmacy, the same way they get their flu shot. Today, there are around 30,000 pharmacies participating in the program. That’s an increase of over 70 percent in less than two weeks, and we are on track to meet the President’s goal of nearly 40,000 local pharmacies by April 19th. Second, on federally-run mass vaccination sites: Our mass vaccination sites, located in some of the most underserved neighborhoods in the nation, are run and staffed by FEMA and DOD personnel, in close partnership with state and local officials. And these sites have a combined capacity to administer 110,000 shots per day. On March 29th, the President challenged us to open at least a dozen new sites by April 19th. We’ve brought nine online in the last 10 days. And today, we are announcing two new sites in Tulsa, Oklahoma, and Baton Rouge, Louisiana. Third, we are making progress on meeting people where they are. More than 500 community health centers are already receiving vaccine directly from the federal government. These community health centers serve nearly 30 million Americans. Two thirds of community health center patients live at or below the poverty level, and 60 percent are racial and ethnic minorities. As we announced earlier this week, we’re expanding our community health center vaccine program so that all of the nearly 1,400 community health centers can sign up to receive and administer vaccines. Overall, across the country, there are now more than 66,000 sites where Americans can go to get a shot. And by April 19th, we will meet the President’s goal of ensuring 90 percent of Americans have a vaccination site within five miles of where they live. On vaccine supply: This week, a total of more than 28 million doses went out to states, Tribes, and territories and through the federal channels — more than enough supply to maintain and increase our current seven-day average of 3 million shots per day. In fact, over the past three weeks, we have allocated almost 90 million doses of Pfizer, Moderna, and Johnson & Johnson vaccine to states, Tribes, and through federal channels. And we are working with states, Tribes, territories, and our other partners to make sure they are administering shots as efficiently and equitably as possible. Both Pfizer and Moderna are on track to meet their commitment of each delivering a total of 200 million doses by the end of May. And on Johnson & Johnson, the company is working closely with the FDA to resolve any manufacturing issues at the Emergent facility in Baltimore and to secure FDA authorization. Johnson & Johnson is installing a new senior leadership team to oversee all aspects of production and manufacturing at the facility. And Johnson & Johnson will have full responsibility for the operation and will leverage the expertise of Merck as well. Johnson & Johnson expects a relatively low level of weekly dose delivery until the company secures FDA authorization. With FDA authorization, the company also expects a cadence of up to 8 million weekly doses in total across state and federal channels later in April. Importantly, Johnson & Johnson has also reiterated its commitment to provide at or near 100 million vaccine doses by the end of May. Now, even as we accelerate our vaccination program, we are seeing areas of the country where cases are increasing. From the beginning of the administration, we’ve been closely tracking the data on the state of the disease in each state and territory. The CDC tracks data and outbreaks at the state and county level. Since taking office, we’ve made this data public, and weekly state-by-state reports were made available for the first time. Our philosophy has been: See something, say something. So when we see metrics trending in the wrong direction, we talk regularly with state officials to offer our assistance, including deploying CDC teams to provide their expertise and resources. With recent increases in cases in some states, we’re intensifying those efforts even further. We will be offering to states with significant increases in cases a set of additional tools to help them to stem the spread, including, first, working with states to make sure they are using all of the doses they have received. Today, millions of doses have been distributed, but have not yet been administered as shots in arms. Second, we’re offering to surge federal personnel, including CDC response teams, FEMA, DOD, and other federal personnel to support vaccination efforts and get more shots in arms. Third, providing additional testing capacity, including increasing the availability of diagnostic testing, as well as screening in schools and other settings. And, fourth, offering more therapeutics and treatments. All of this is on top of the more than threefold increase in vaccines that have gone to all states and jurisdictions since the President came into office. For a medium-sized state, this translates to hundreds of thousands of additional vaccines each and every week. And as is our practice — it’s been our practice since the beginning — we make vaccines available to states as soon as they are available. In closing, to be clear, we’re working to put this pandemic behind us as fast as we can. But as the President said earlier in the week, everyone needs to do their part. That’s why he has called on every governor, mayor, and local leader to maintain or reinstate mask mandates. All of us need to keep up our guard and finish this job. So, please, please wear a mask, socially distance, and get vaccinated when it’s your turn. And with that, let me turn it over to Dr. Walensky. Dr. Walensky. DR. WALENSKY: Thank you, Jeff. And good morning, everyone. I’m glad to be back with you today. We’ll start again with an overview of the data. Yesterday, CDC reported 74,860 new cases of COVID-19. And CDC’s most recent data show that the seven-day average of new cases is a little more than 64,000 per day, up about 2 percent from the prior seven-day period. Hospital admissions continue to also increase. The most recent seven-day average — about 5,300 admissions per day — is up about 7 percent from the previous seven-day period. And deaths have continued to decrease more than 20 percent, with a seven-day average now of 711. Vaccinations continue to increase with the most recent seven-day average of nearly 3 million vaccinations delivered daily, up 4.5 percent from the prior seven-day period. Our vaccination efforts this week have continued to accelerate, moving us closer and closer to President Biden’s goal of 200 million vaccinations in his first 100 days. Yesterday, we reached over 158 million. Earlier this week, I acknowledged the complexity of our current state of — in this pandemic. On the one hand, we have so much reason for optimism and hope, and more Americans are being vaccinated and protected from COVID-19. On the other hand, cases and emergency room visits are up. And as I’ve highlighted through the week, we are seeing these increases in younger adults, most of whom have not yet been vaccinated. On this graph are the national data showing the percent of emergency room visits for each age group that are for patients with confirmed COVID-19. As you can see, those 18 to 25 in orange, 26 to 54 in light blue, and 55 to 64 in green have increasing numbers of emergency department visits. Importantly, those aged 65 to 74 in yellow, and those 74 and older in dark blue, have decreasing numbers of emergency department visits, likely demonstrating the important impact of vaccination in protecting against disease requiring hospitalization. While those are national statistics, we should recognize that these trends are magnified in some regions of the country, like in the Upper Midwest. CDC is working closely with public health officials in this region to understand what is driving these cases and how we can intervene. For example, in Michigan and Minnesota, there are also increasing number of cases linked to COVID — to B117 variants in various settings. And in both of these states, there is concern about transmission in youth sports — both club sports, as well as sports affiliated in schools. While what is happening in Michigan and Minnesota is similar to what we are seeing across the country — increasing reports of cases associated with new sports — I want to be clear: As cases increase in the community, we expect the cases identified in schools will also increase. This is not necessarily indicative of school-based transmission. If fully implemented, the CDC’s operational guidance for schools and community-level prevention measures can reduce or prevent transmission in schools. And we have not yet seen evidence of significant transmission of COVID-19 within schools when schools have fully implemented CDC’s mitigation guidance. In addition to educator vaccination, which we spoke about on Wednesday, testing remains an important tool in our overall efforts to stop the spread of COVID-19, including in our schools. This week, CDC is awarding $10 billion through the American Rescue Plan to support COVID-19 testing in schools across the country. Being able to rapidly identify new cases among students will help us slow the spread of COVID-19 while we simultaneously work to expand equitable access to vaccines. With this funding for testing, every state will have access to millions of dollars to set up screening programs to add an additional layer of protection for schools, teachers, and students. This funding can be used to test teachers, staff, and students with any symptoms of COVID-19, those who have may have been exposed to the virus, and to establish sustained screening programs across school systems. We recognize that establishing a testing program is a new venture for many schools. That’s why CDC is committed to continue our work alongside state and local health departments by providing technical assistance and support to assist schools and states in standing up and implementing these programs. As they are — these are rolled out, we strongly encourage parents, staff, and students to participate to keep our children and our staff safe in school. These initiatives, a long time — alongside with strict adherence to public health prevention precautions and getting a COVID-19 vaccine, will help us turn the corner on this pandemic. With that, I’ll 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 answer a commonly asked question, namely: How could it be possible that you went from discovering a new virus in January of 2020, to approximately, 11 months later, to actually have a vaccine that goes into the arms of individuals in December of that same year when we know generally vaccines take multiple years to develop? And this has often led to some degree of hesitancy on the part of people wanting to get vaccinated. So I’d like to answer that question. Yesterday, Science Magazine published an editorial that I wrote, which tried to give an explanation of the story behind the vaccines. And the bottom line was that the speed and efficiency with which these highly efficacious vaccines were developed, and their potential for saving millions of lives, are due to an extraordinary multidisciplinary effort involving basic preclinical and clinical science that has been underway, out of the spotlight, for decades before the unfolding of the COVID-19 pandemic. Next slide. One can look at vaccine development in two major buckets: platforms and immunogen design. Next slide. With regard to a platform, what do we mean by that? Next slide. A platform is the type of vaccine that you use. There’s genetic immunization, such as DNA and RNA, and hence the mRNA vaccines; viral vectors, such as the adeno with J&J; recombinant protein, such as Novavax; and a number of others shown on the right-hand part of the slide. Next slide. With regard to the mRNA vaccine, this work started a decade and a half ago, when Katalin Karikó and Drew Weissman were working on RNA and was able to modify the molecule to remove a key inflammatory component, which would have made use of this as a vaccine impossible. This rather transforming accomplishment of theirs led to the use of mRNA as a platform. Next slide. With regard to adenovirus, the ad26 that’s used by J&J, the NIH has been funding for decades a highly skilled and accomplished investigator, Dan Barouch, from Harvard Medical School, who had been working on this for a considerable period of time, and demonstrated how immunogenic this particular vector would be. Next slide. And then you get to immunogen design – really, the most fascinating component of this story — and it goes to a different discipline. Next slide. And that is the crystallography and cryo-EM capability of investigators throughout the country who are working to get the right confirmation of the HIV envelope trimer — nothing at all to do with coronavirus. They were using these technologies to get the most immunogenic conformation of the molecule to develop an HIV vaccine. Next slide. This work was done with great intensity also at the NIH Vaccine Research Center. And I’ve circled two investigators on this slide. The one on the lower left is Peter Kwong, who was predominantly an HIV investigator; and the one in the upper right is Barney Graham, who is much more interested in respiratory syncytial virus. Next slide. What Peter Kwong did is that he used this structure-based vaccine design to get the right conformation of the HIV envelope in what’s called a “prefusion form,” which would be the most immunogenic and could bind to broadly neutralizing antibodies. Next slide. When Barney Graham took his interest in respiratory syncytial virus, and collaborated in the same lab with Peter Kwong and Jason McLellan, they had a major breakthrough in respiratory syncytial virus vaccinology by developing mutations that stabilized the immunogen to make it be used successfully for an RSV vaccine. But the story goes on. Next slide. When MERS came about, they did the same thing in an attempt to develop a MERS-coronavirus vaccine, mainly taking the spike protein and stabilizing it by mutations into a prefusion form. And then the culmination of the story. Next slide. When we had SARS-CoV-2, with Barney Graham and Kizzy Corbett and others in the laboratory, we’re able to make a stable component of the prefusion spike protein. Why is that important? Because that’s a highly immunogenic protein which has been used in five of the six vaccines that we’re currently involved with. Next slide. And so, on this last slide, what you see on the left are the five platform — the three platforms: the nucleic acid mRNA, the adenovirus, and the recombinant protein. And with that, we already have three highly successful vaccines that have a high degree of efficacy and a good safety profile. So the bottom line is: This did not happen in 11 months. It was rid- — it was due to an extraordinary multidisciplinary effort involving basic clinical and preclinical science that had been underway, out of the spotlight, for decades before the unfolding of the COVID-19 pandemic. And with that, I’ll pass it over to Dr. Murthy. SURGEON GENERAL MURTHY: Thank you so much, Tony. And it’s good to be with all of you this morning. Before I start, I just want to take this opportunity, even though it’s a few days late, to wish Dr. Rochelle Walensky a happy birthday. Her birthday was on April 5, and, Rochelle, I will spare you my rendition of “Happy Birthday” — I don’t think anyone would appreciate that — but happy birthday, nonetheless, from all of us. I wanted just to take a moment today to talk a little bit about where we are with vaccine confidence and with our education campaign. You’ve heard a lot from us about the state of the COVID pandemic. We’ve talked about it in terms of cases and hospitalizations and vaccination numbers, but I want to start today just by sharing with you a little bit more about what we’ve learned about the toll of the COVID-19 pandemic. For many Americans, this pandemic has not only impacted our physical health and wellbeing, but also the mental health and wellbeing of our children. This week, we learned, for example, that an estimated 40,000 children in America lost a parent to COVID-19, according to a new model from researchers. This week, scientists found that one in eight people with COVID-19 were diagnosed with a new psychiatric or neurological condition in the following six months, and anxiety and depression were among the most common conditions. Millions of people are experiencing symptoms of anxiety and depression right now. And research from the CDC has showed that younger adults, racial and ethnic minorities, essential workers, and unpaid adult caregivers have experienced disproportionately worse mental health outcomes during this pandemic. These numbers are sobering, but they are not altogether surprising, because many of you know intuitively of these struggles; maybe you or a loved one has been wrestling with mental health challenges. We may not talk about them as often, but we are experiencing them nonetheless. The administration is taking mental health challenges related to the pandemic seriously. It is providing nearly $3 billion to states and territories to address mental illness and the addiction crisis. And the American Rescue Plan included around $3.56 billion for the prevention and treatment of mental health and substance use disorders. The mental health consequences of COVID are yet another reminder why people getting vaccinated is so important. It’s our quickest path to ending the pandemic. And for all the suffering that COVID-19 can bring, I’ve also personally seen firsthand the joy and relief that vaccines can bring. Just yesterday, in fact, a friend sent me a picture of her two children hugging their grandmother for the first time in 16 months. And she wrote three simple words in her text: “Hugs are back.” And I, myself, find that I breathe easier each day seeing my father, my sister go to their medical office to care for patients because I know that they’re vaccinated. And when I received my own second dose not too long ago, I felt a wave of hope that I hadn’t experienced in months. These vaccinations were made to help us return to our lives and to the people that we love. And that’s why the President has asked that by April 19th — just 10 days from now — all adults be eligible for the vaccine. Now, as more and more Americans gain access to the vaccine, I’m happy to share that vaccine confidence is rising across the country. In December, a survey showed that 34 percent of respondents were ready to get a COVID vaccine, quote, “as soon as possible.” End quote. That same survey in March, just three months later, found that 61 percent of people reported either already being vaccinated or wanting to receive a vaccine as soon as possible. This is an encouraging trend, but we still have more work to do. Millions of people still have questions about the vaccine, and misinformation and disinformation continues to spread. That is why we are working hard to give people the facts about COVID-19 through a variety of channels, the most important of which is trusted messengers. The research tells us clearly that people want to hear from people they know and trust when deciding about the vaccine. For example, a survey in January showed that more than three in four adults in the United States have said they would likely turn to a doctor or nurse or other healthcare provider when deciding whether to get the vaccine. In that same survey, more than half of people said they’d likely turn to family or friends about whether to get vaccinated. That’s why, last week, we launched the COVID-19 Community Corps, and we’re working with partners across the country to help deliver science-based information to community members, friends, and family. And in just one week since our launch, we’ve gone from 275 partners to nearly 5,000. And these partners include faith-based organizations, civic organizations, industry groups, individuals, health professional, sports leagues, and so much more. In the last week alone, I’ve heard stories about doctors and nurses who are now going door to door to help people learn about the COVID-19 vaccines. I’ve heard about churches setting up vaccine education and administration sites in their building. I’ve met grandparents who are now talking to their kids and grandkids about the importance of getting vaccinated. To end this pandemic, this is what we have to do. We’ve got to step up and help protect one another. And that’s why today I’m asking everyone to do two things: One, get vaccinated as soon as you can. And, two, help the people you care about get vaccinated as well. Ask your family and friends if they have a plan to get vaccinated. If they have questions, talk to them about the facts; encourage them to talk to their primary care provider. And you can get resources, factsheets, and toolkits at WeCanDoThis.HHS.gov. We’ve made extraordinary progress on the vaccine campaign. And what we’ve already accomplished gives us faith that we can accomplish the tasks ahead. It will take all of us stepping up to help the people we love to get vaccinated. Thank you very much, and we’ll look forward to your questions. MR. ZIENTS: Thanks, doctors. Let’s open it up for a few questions. MODERATOR: Thanks, everybody, for joining. Just a reminder: We are running tight on time, so please keep your question to one question. First, we will go to Shefali Luthra at Kaiser Health News.
 * Q Hi, thanks for taking my question. I’m actually at The 19th, but I was hoping to learn a bit about how you all plan to reach the almost quarter of seniors who are not yet vaccinated, many of whom say — right? — that no one has talked to them about whether it’s safe; who are maybe homebound — and if there are specific local- or state-coordinated efforts in partnership with you all to make sure that people are getting the message about vaccines.
 * MR. ZIENTS: Dr. Murthy?
 * SURGEON GENERAL MURTHY: Sure.  Thanks, Shefali, for that question.  And it’s very important because we know that people above the age of 65 are at the highest risk of poor outcomes with COVID, so we absolutely want to make sure they’re vaccinated.  It’s also why we’re very proud that over 75 percent of people over the age of 65 have received at least one dose of the vaccine.  More than half of people over 65 have been fully vaccinated.  So we’re glad about that.
 * MR. ZIENTS: The only thing I’d add is that I think it’s really important that we bring vaccinations to where people are.  So mobile clinics are essential for doing so; community health centers.  We’re also providing money for seniors who need transportation and transportation options so that they can get vaccinated as soon as possible.
 * DR. WALENSKY: And to follow, just this week, CDC distributed funds to states to reach, in fact, exactly those at-risk, disabled elderly who are in their homes — reaching people who are homebound.
 * MR. ZIENTS: Next question.
 * MODERATOR: Let’s go to Josh Wingrove of Bloomberg.


 * Q Hi, there. Thank you for taking the time.  Jeff, can I ask a little bit more about the J&J situation, just for clarity?  You say that if Emergent is authorized, their production will rise to up to 8 million per week by the end of the month?  Is that correct?  And the spike that we saw last week, I assume that was because of the authorization of the other plant.
 * MR. ZIENTS: So, first, on J&J: You know, J&J is working with the FDA to get the Baltimore facility authorized.  During the period that they’re working with the FDA — and the Baltimore facility is not yet authorized — we expect a relatively low level of weekly doses distributed to states, Tribes, territories, and our federal channels.
 * MODERATOR: Let’s go to Shannon Pettypiece at NBC.


 * Q Yeah, I just wanted to follow up on that J&J question just a little bit more actually. So, when do you think they will get to the 8 million doses a week?  You mean that will be by the end of the month?  So, in a week or two they’ll be getting to those eight weekly doses?  And when do you think there will be that FDA authorization?  Just to make sure we’re all clear on that, based on Josh’s question.
 * MR. ZIENTS: Yeah, so the first part of your question is, “When will J&J receive the FDA authorization?” — which is the important step for them to be able to then get into this weekly cadence that they speak of, of up to 8 million doses per week.
 * MODERATOR: Let’s go to Kaitlan Collins at CNN.


 * Q Thank you very much. I have two questions today.  One, would these breakthrough cases that we’re seeing, where people are testing positive more than two weeks after being fully vaccinated — what is the administration’s level of concern with this, given the trials — which, of course, were smaller — showed that there were no deaths?
 * MR. ZIENTS: So, let’s go to Dr. Fauci on the first question of breakthrough cases.
 * DR. FAUCI: Yeah, Kaitlan, with the number of breakthrough cases, I think the important thing is to look at what the denominator of vaccinated people is, because it is very likely — and what we’re hearing at least indirectly, and we’ll — we’re certainly going to be confirming that — that that number of individuals who were breakthrough infections is not at all incompatible with a 90-plus percent vaccine efficacy.  So, I don’t think that there needs to be concern about any shift or change in the efficacy of the vaccine.
 * MR. ZIENTS: Kaitlan, on J&J — we’ve talked about this a few times — they’re obviously earlier in their manufacturing process.  They’re not in the weekly cadence, regular cadence that Moderna and Pfizer have both achieved.
 * SURGEON GENERAL MURTHY: Jeff, may I add one thing just to Kaitlan’s question about the vaccine efficacy?  Just to build on what Tony said: We still have high confidence that these vaccines are effective, but because they are not perfect is precisely why we are still urging people to be cautious.  It’s why we still have such an emphasis on getting the overall case numbers down, which mean — which we can only do by vaccinating and by making sure that people, until we have a critical mass vaccinated, are wearing masks, keeping distanced, washing their hands, avoiding indoor gatherings.
 * MR. ZIENTS: Why don’t we have time for one more question.
 * MODERATOR: Last question.  We’ll go to Liz Weise at USA Today.


 * Q Hey, thanks so much for taking my question. On a slightly different note, I realize “herd immunity” is a somewhat problematic term, but given the data we’re seeing out of Israel and plummeting death and illness rates, where do you think the U.S. will need to get, in terms of vaccination, to start to see that kind of payoff?  And is anything like herd immunity possible here?
 * MR. ZIENTS: Dr. Fauci?
 * DR. FAUCI: Yes, I think you said it correct that — correctly, that herd immunity is kind of an elusive terminology because we don’t know what that percentage of protection is — which will be a combination of people who are protected by vaccination; as well as those who were infected, who have recovered, and now have protective immunity.
 * DR. WALENSKY: And it was in fact part of the reason that I showed that slide of emergency department visits, to show in the areas where we have a majority of people vaccinated in these demographics that are greater than 65, we can already — in this country — see those effects with decrease in hospitalizations.
 * MR. ZIENTS: Well, thank you everybody.  I mean, the clear message here is: Get vaccinated when it’s your turn.

I really appreciate everybody joining today and look forward to Monday’s briefing. Thank you.

11:54 A.M. EDT

To view the COVID Press Briefing Slides, visit https://www.whitehouse.gov/wp-content/uploads/2021/04/COVID-Press-Briefing_9April2021_for-transcript.pdf