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Press Briefing by White House COVID-19 Response Team and Public Health Officials

March 29, 2021

Via Teleconference

11:04 A.M. EDT

ACTING ADMINISTRATION SLAVITT: Good morning. Thank you for joining us. Today, I'm joined by Drs. Walensky and Fauci. The cases of COVID-19 are once again on the rise. Dr. Walensky will highlight the public health consequences and strong public health recommendations for the next few weeks.

In the meantime, we are vaccinating the country as quickly as humanly possible, now averaging 2.7 million vaccinations over the last seven days. Yesterday, the U.S. reported 3.28 million vaccinations. This is significant progress toward the President's now doubled vaccination goal of 200 million shots in his first 100 days in office and toward our ultimate goal of getting all Americans vaccinated as equitably and efficiently as possible.

As we said on Friday, vaccine manufacturers report to us that they remain on track to meet their targets by the end of the month. And Moderna announced that it had released its 100 millionth dose this morning.

As of today, 73 percent of seniors have now received their first dose. And 36 percent -- more than 1 in 3 adults -- have received their first dose. That's 36 percent of adults. Overall, now more than 50 million Americans -- approaching 1 in 5 adults -- are fully vaccinated.

The effort is an immensely complex endeavor, and pulling it off requires tens of thousands of people doing their part. And we are grateful to everybody on the frontlines of this pandemic.

This is good news. We're headed in the right direction. But we can't slow down. Millions remain unvaccinated and at risk.

We need to keep increasing vaccine supply, the number of vaccinators in the field, and adding more safe and convenient places for Americans to get vaccinated, especially as more states begin to open vaccine eligibility to all adults.

Now, today, as part of this ongoing effort to help meet the President's goal of 200 million shots in his first 100 days, we're announcing two new federally run mass vaccination sites.

The first is at America's Center Convention Complex in St. Louis, Missouri, and the second is at Roosevelt High School in Gary, Indiana. Soon, local residents will be able to get a shot at both of these sites. And together, they will be capable of administering 6,000 shots per day.

We now have 21 operational sites that have already administered a combined 1.7 million shots. These sites are run by the federal government in close partnership with state and local officials. And they are placed in communities with high risk, according to CDC's social vulnerability index, with a direct goal of ensuring we're equitably distributing vaccines and reaching communities that have been hurt the most by the pandemic.

Before I turn it over to Dr. Walensky, I want to close by reiterating what the President said last Thursday: Help is here, and hope is around the corner. But we're not there yet, as Dr. Walensky will report. The worst thing we could do now would be to let up. We cannot get complacent. We cannot let our guard down.

It's imperative for us to stick to the science and follow public health guidance. That means continuing to wear masks; masks save lives. It means continuing to socially distance; socially distancing saves lives. And it means getting vaccinated when it's your turn, because getting vaccinated saves lives -- not just your own, but your family and friends and neighbors too.

With that, I'm going to turn this over to Dr. Walensky and then to Dr. Fauci for some important updates.

DR. WALENSKY: Thank you, Andy. I'm glad to be back with you all today. I want to begin with an overview of the continuing concerning trends in the data. Yesterday, we in the United States surpassed 30 million cases of COVID-19. CDC's most recent data show that the seven-day average of new cases is slightly less than 60,000 cases per day. This is a 10 percent increase compared to the prior seven-day period.

Hospitalizations have also increased. The most recent seven-day average, about 48 admi- -- 4,800 admissions per day, is up from 4,600 admissions per day in the prior seven-day period. And deaths, which typically lag behind cases and hospitalizations, have now started to rise, increasing nearly 3 percent to a seven-day average of approximately 1,000 deaths per day.

When I first started at CDC about two months ago, I made a promise to you: I would tell you the truth, even if it was not the news we wanted to hear. Now is one of those times when I have to share the truth and I have to hope and trust you all listen.

I'm going to pause here. I'm going to lose the script. And I'm going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope, but right now I'm scared. I know what it's like as a physician to stand in that patient room -- gowned, gloved, masked, shielded -- and to be the last person to touch someone else's loved one because their loved one couldn't be there.

I know what it's like when you're the physician, when you're the healthcare provider and you're worried that you don't have the resources to take care of the patients in front of you. I know that feeling of nausea when you read the crisis standards of care and you wonder whether there are going to be enough ventilators to go around and who's going to make that choice. And I know what it's like to pull up to your hospital every day and see the extra morgue sitting outside.

I didn't know at the time when it was -- when it would stop; we didn't have the science to tell us. We were just scared. We have come such a long way. Three historic scientific breakthrough vaccines, and we are rolling them out so very fast.

So I'm speaking today not necessarily as your CDC director -- not only as your CDC director but as a wife, as a mother, as a daughter to ask you to just please hold on a little while longer. I so badly want to be done. I know you all so badly want to be done. We are just almost there but not quite yet. And so I'm asking you to just hold on a little longer, to get vaccinated when you can so that all of those people that we all love will still be here when this pandemic ends.

The trajectory of the pandemic in the United States looks similar to many other countries in Europe, including Germany, Italy, and France looked like just a few weeks ago. And since that time, those countries have experienced a consistent and worrying spike in cases. We are not powerless; we can change this trajectory of the pandemic. But it will take all of us, recommitting to following the public health prevention strategies consistently, while we work to get the American public vaccinated.

I'm calling on our elected officials, our faith-based communities, our civic leaders, and our other influencers in communities across the nation, and I'm calling on every single one of you to sound the alarm to carry these messages into your community and your spheres of influence. We do not have the luxury of inaction. For the health of our country, we must work together now to prevent a fourth surge.

And after that honest plea, I want to reflect on so many reasons we have to be hopeful and why your actions today can get us out of this soon. As I shared last week, we continue to get more and more real-world evidence on the protection of COVID-19 vaccines provide. And CDC scientists have been working since these vaccines were first authorized to expand the evidence supporting their effectiveness.

Today, I'm excited to share information about a new CDC-led study that's being published in the MMWR. This study assesses the real-world effectiveness of the Pfizer and Moderna vaccines in preventing infections among nearly 4,000 healthcare personnel, first responders, and other essential workers in six states from mid-December to mid-March.

The study found that the risk of infection was reduced by 90 percent after individuals received the two recommended doses of the vaccine. The study also found that people starting to get a protective effect, even after the first dose, the risk of infection decreased by 80 percent after two weeks. Findings of this are all consistent with the clinical trial data.

Importantly, people in the study received self-collected nasal swabs each week for laboratory testing, allowing CDC to look at evidence of COVID-19 infection whether or not people had symptoms.

A small number of infections were asymptomatic; however, most infections occurred among people whose infections were identified by testing before they developed symptoms or knew they were infected. This study also demonstrates that two vaccines can reduce the risk of COVID-19 infections, not just in symptomatic infections but also in asymptomatic or pre-symptomatic infections.

This study is tremendously encouraging and complements other recent studies published in the New England Journal of Medicine, and discussed by Dr. Fauci last week, among similar populations at a high risk of exposure to COVID-19 because of their occupations. These findings also underscore the importance of getting both of the recommended doses of the vaccine in order to get the greatest level of protection against COVID-19, especially as our concerns about variants escalate.

Our national vaccination efforts are working. As of yesterday, over 93 million people have received one or more doses of vaccine, and over 51 million people have been fully vaccinated. And CDC is collaborating across the government with our state, territorial, local, and tribal partners to get vaccines to communities and to get vaccinations into arms as quickly as possible through a multitude of channels, including the Federal Retail Pharmacy Program, through FEMA's community vaccination centers and mobile clinics, and through HRSA's Community Health Center Program.

These efforts are rapidly advancing our goal to getting 200 million shots in arms during the first 100 days of this administration. Over one in three adults in this country have already received one dose.

Finally, I want to share today that CDC is making important updates to the list of underlying medical conditions that can increase risk of severe COVID-19 outcomes. This update is keeping in -- up with my commitment to lead with science, to have clear information on our website, and to better describe the science underlying these conditions.

After a thorough review of the evidence, we have simplified the list of underlying conditions for consumers and created a new page for healthcare providers. This will make it easier for patients and the public and providers to understand the important information related to their underlying medical conditions and its potential impact on COVID-19 severity.

We've also updated the list of underlying medical conditions to include substance use disorders, based on evidence that having these conditions can increase risk of severe illness or death from COVID-19.

You can now visit the CDC website to learn more about these underlying medical conditions and the science evidence used to support their inclusion in the list.

I reach out to you both with my concerns -- my concerns and also my hope so that you can all be here to hear this message, healthy and vaccinated in the months ahead.

Thank you. I will now turn things over to Dr. Fauci.

DR. FAUCI: Thank you very much, Dr. Walensky. I'd like to make a few comments over the next couple of minutes that extend what you just heard from Dr. Walensky, and that is the importance of vaccination to prevent severe disease and why we cannot pull back on our mitigation efforts. This is a paper from the Annals of Internal Medicine from some time ago which showed that about one third of people with SAR-CoV-2 infection never develop symptoms. That's the good news.

Next slide.

Of those who do develop symptoms, about 80 percent have mild to moderate symptoms, but about 20 percent or more have severe disease with case fatality rates varying from a few percent to up to 20 percent for those requiring mechanical ventilation.

Now let me show you something that is very dramatic. If you look at the multi-system manifestations of COVID-19, they are multitudinous, the most important and common of which is the acute respiratory distress syndrome. But we know now there are neurological disorders, cardiac dysfunction, acute kidney injury, hypercoagulability. Bottom line: This is a very serious disease, which has already led to the death of about 550,000 people in the United States.

Next slide.

This slide is very dramatic. If you look on the left-hand part of the slide, it's a normal CT scan of the lung -- the area that looks black and dark on normal lung because there are air spaces. On the right-hand side of the slide is a patient that I made rounds on at the NIH Clinical Center last week. If you look at this, even a non-physician, non-radiologist can determine that there's something very, very wrong with the lungs on the right-hand side, with the white blotches being infiltration of the lung; that even with the patient being under the top medical care that we're giving them at our hospital still may very likely have residual scarring of the lung after improvement.

Next slide.

This is another patient we serve at the Clinical Center who developed a brain infarct, as shown on the left-hand part of the slide, with the arrow pointing to the infarcted part of the brain.

Bottom line, as Dr. Walensky said in her experience at Mass General, the same at the NIH Clinical Center: This is a very, very bad disease.

The fundamentals to prevent acquiring this are the public health measures that Dr. Walensky mentioned but also vaccination. Absolutely critical.

Next slide.

If you look at the prevention of hospitalization and death among the five vaccines on the left-hand part of the slide, with one exception of a hospitalized patient in the vaccine arm of the Moderna study, virtually 100 percent protection against hospitalizations and death. In other words, you can prevent what I showed you on the previous two slides by getting vaccinated.

And on the last slide, what you see in red is hospitalizations going down, as in the blue bars vaccinating people going up.

The bottom line: Hang in there, as Dr. Walensky said. We really need to hold on to the public health measures as we get more and more people from two- to three-plus million people vaccinated every day. It will be a race between the vaccine and what's going on with the dynamics of the outbreak. And we can win this by just hanging in there a bit longer.

Back to you, Andy.

ACTING ADMINISTRATOR SLAVITT: Thank you, Dr. Fauci and Dr. Walensky. Let's go to questions.

MODERATOR: The first question will go to Ed O'Keefe at CBS.

Q: Thank you, guys, for doing this again as always. I had one other question, but given what the Director just said, I guess I want to follow up a little bit and ask -- if I heard you correctly, you said you're concerned about "impending doom." What is it that you saw in the data that is causing you to sort of start to feel this way again?

And then was curious if you guys can discuss what is the government or the administration's current role in issuing these so-called "passports" or "certificates"? And why is it taking a little while longer for the U.S. to do that when places like Japan and China and the EU are further along?

ACTING ADMINISTRATOR SLAVITT: So, Dr. Walensky, why don't you take the first question, and I'll endeavor to take the second?

DR. WALENSKY: When we were stagnating at around 40- to 50,000 cases a day for a couple of weeks there, we didn't see trends going down anymore, but things were sort of holding steady. What we've seen over the last week or so is a steady rise in cases. We're now in the 60- to 70,000 range. And when we see that uptick in cases, what we have seen before is that things really have a tendency to surge and surge big.

We know that cases sometimes can be a week or two behind the behaviors that lead to those cases, the mixing that leads to those cases. We know that travel is up, and I just worry that we will see the surges that we saw over the summer and over the winter again.

ACTING ADMINISTRATOR SLAVITT: Thank you. And I'll take your second question. Let me begin with this: We recognize this is a tricky and important subject, but the core here is that Americans, like people around the world, who are vaccinated will want to be able to demonstrate that vaccination in various forms.

This is going to hit all -- all parts of society. And so, naturally, the government is involved. But unlike other parts of the world, the government here is not viewing its role as the place to create a passport, nor a place to hold the data of citizens.

We view this as something that the private sector is doing and will do. What's important to us -- and we're leading an interagency process right now to go through these details -- are that some important criteria be met with these credentials.

Number one, that there is equitable access; that means whether or not people have access to technology or whether they don't. It's also important that we recognize that there are still many, many millions and millions of Americans that have not yet been vaccinated. So that's a fundamental equity issue.

Privacy of the information, security of the information, and a marketplace of solutions are all things that are part of what we believe in, as is the ability for people to access this free and in multiple languages.

So I think you will see more from us as we complete our interagency process. But this is not slowing down the process in any way, even though the government has its own needs and so does the private sector. And the private sector and other groups working together are marching in that direction.

It is important for us, and it will be -- we will be very clear about how that will happen, that the guidelines that I just talked about are part of that process.

Next question.

MODERATOR: Next we'll go to Chris Megerian at the Los Angeles Times.

Q: Hi, everybody. I wanted to see if you can specifically speak to why this rise is happening. Are you seeing it in restaurants? Are you seeing it in people's homes? Are you seeing it in the workplaces? And also, the administration has been urging people to be careful, you know, since the new president took office in January. Why is the administration's efforts not working in this situation?

ACTING ADMINISTRATOR SLAVITT: Let's go around here, maybe start with you, Dr. Walensky, and then, Dr. Fauci, you can come after that.

DR. WALENSKY: Yeah, I think we're investigating some of these outbreaks at a local level with individual states. I think we are seeing that many of these states are opening up at levels that we wouldn't necessarily recommend. I am working with the governors. I will be speaking with them tomorrow to try and buckle down on trying to refrain from opening up too fast, you know, in the context of the fact that we're scaling up these vaccines.

I think we've seen an uptick in travel. We have seen an uptick in travel. Much more travel is happening. I think people want to be done with this. As I mentioned, I too want to be done with this. The thing that's different this time is that we actually have it in our power to be done with the scale of the vaccination. And that will be so much slower if we have another surge to deal with as well.

ACTING ADMINISTRATOR SLAVITT: Dr. Fauci, anything you want to add to that?

DR. FAUCI: Yeah. I think everyone really needs to appreciate that we really do want to get back to normal as quickly as we possibly can. But I think one of the explanations, in answer to the question that we just heard, is that if we open up completely now, that is premature given the level of infection that Dr. Walensky described in her formal presentation.

So that's the reason why we're essentially pleading with people, even though we have -- all of us -- an urge, particularly with the warm weather coming, to just cut loose. We've just got to hang in there a bit longer.

And I think the reason we're seeing this plateauing and a bit of a little increase that we hope doesn't turn into a surge is because we are really doing things prematurely right now with regard to opening up.

ACTING ADMINISTRATOR SLAVITT: Chris, will you --

DR. WALENSKY: Perhaps one other --

ACTING ADMINISTRATOR SLAVITT: Please, Dr. Walensky.

DR. WALENSKY: Perhaps one other comment on that, and that is our concern about variants. We've been watching the variants really carefully. We know about 26 percent of all sequenced virus is now the B117 variant. It is more transmissible than the wild-type variant. So we're watching that carefully, and that may be one of the reasons in terms -- if people are not doing the things -- masking, distancing -- to protect themselves, this variant is probably less forgiving, and more infections will occur.

ACTING ADMINISTRATOR SLAVITT: Chris, we recognize that it's difficult for people to both feel optimism and display caution at the same time. We believe one of the most important pieces of this formula -- and that the public tells us -- is just clear, consistent, honest, direct, straightforward information.

That's why in these briefings is you'll see Dr. Fauci talks very directly and shows data very directly, and Dr. Walensky presents information and recommendations very clearly. It's not always what people want to hear, but it's always directly what people, for the most part, say that they're looking for, which is just the straight story that they can assimilate and help them make decisions.

We hope that they're hearing quite clearly a consistent message today, which is that we don't have a long time, necessarily, to be in this state with, but we are not out of this pandemic yet. If we do our jobs, it can be short as possible.

Next question.

MODERATOR: Next we'll go to Zeke Miller at the AP.

Q: Thank you all for doing the call. Just a couple of quick follow-ups on all these points. Can you speak to specifically why you don't think the federal government is the right place to have set up a vaccination passport? I mean, given the data privacy concerns and widespread adoption and equity concerns that you've just raised, Andy, should -- wouldn't the federal government be best positioned to respond to those?

In the case of -- and then, separately, when it comes to the travel and the virus guidance, Dr. Walensky, Dr. Fauci, should we expect to be hearing more from the President about the need for people to double down on these restrictions? We've heard him (inaudible). We have not heard the President, sort of, lead the charge on that.

And then finally -- Andy, sorry -- and sorry, Kevin, for the third question here -- can you speak to how the 11 million doses of J&J vaccine that are expected to be shipped this week will be sent? Will they be allocated to the existing formula or will they be deployed in a different -- in a different way?

ACTING ADMINISTRATOR SLAVITT: Okay, so we have vaccine passport; we have travel guidelines, which I will route to you, Dr. Walensky; and then we have 11 million J&J doses. Usually, I forget the third question if there's a third question by the time we get to it.

You know, relative to the vaccine passport, we think it's very important for the public -- job one is for the public to become comfortable if they're considering taking a vaccine -- why that is in their best interest. And we think all of the data and all of the results and all the impact in the slide that Dr. Fauci showed are the preponderance of the reason we're just so fortunate to be in this position relative to these vaccines.

We do know that there is a segment of the population that is concerned that the government will play too heavy-handed of a role in monitoring their vaccinations and that mandates will be coming from the federal government and important -- in point of fact, it would discourage people to feel like that was the role we're playing.

So we think we can have the best of all worlds. We think we can essentially put forward guidelines and guidance. And given the federal government's source and role in society for everything from the TSA, to the VA, to Departments of Health and Human Services, the CDC -- I could go on and on -- you know, we have a major impact in what we'll get done.

So we're putting forward our principles very clearly. We will be even more clear in the time ahead. And we believe, based on everything we know, that that will influence the outcome in the way we describe.

So, with that, let me ask you, Dr. Walensky, to -- if you can address the travel question.

DR. WALENSKY: Yeah, our recommendations have been very consistent with travel. You should have a pre-travel test. You should quarantine for seven days. You should have a post-travel test. And then you should monitor for symptoms between 7 and 14 days. We have been consistently discouraging travel, saying, "Please keep it limited to only essential travel."

And what we're seeing now is more travel than we saw -- than we saw throughout the pandemic, including the Christmas and New Year's holidays. I think people have taken advantage of what they perceived as a relative paucity of cases, a relative lull in where we were, to take advantage of their time of spring break, of holiday travel. And what I would just say is, you know, we've seen surges after every single holiday, and so -- you know, July 4th, Labor Day, Christmas. And we're seeing the uptick of that right now.

So I would just sort of reiterate the recommendations from CDC, saying please limit travel to essential travel for the time being.

ACTING ADMINISTRATOR SLAVITT: Your final question was about Johnson & Johnson doses. And indeed, let me -- to the premise of your question, Johnson & Johnson is due to deliver 11 million doses. And as a single-dose regimen, that's an enormous step forward for the country.

My message to the states, Tribes, and territories, and everyone else is: Get ready. This is an enormous opportunity to vaccinate more people. And tomorrow, we will be talking with the governors and others about how we're going to split that up.

Next question.

MODERATOR: Next, we'll go to Kaitlan Collins with CNN.

Q: Thanks very much. I have two questions. One, if each of you could answer this: With the release of the World Health Organization report, can each of you say whether or not you trust the findings of this report? Maybe "yes" or "no" or -- to keep it short.

And then, secondly, to CDC Director Dr. Walensky, thank you for speaking so candidly about the data that you're seeing, but of course that raises questions about restrictions that we are seeing be loosened in a lot of states. And also, on the President's call for 100 days of mask wearing, do you expect him to re-up that call or extend it past the 100 days given the numbers that you're seeing?

ACTING ADMINISTRATOR SLAVITT: Okay, Dr. Fauci, do you -- would you like to go first on the WHO question?

DR. FAUCI: Yeah, Kaitlan, I'd like to see that report first, and I also would like to inquire as to the extent in which the people who were on that group had access directly to the data that they would need to make a determination.

Once I get that information, I'll be able to more adequately answer whether I trust it or not. But I want to read the report first, and then get a feel for what they -- what they really had access to or did not have access to.

ACTING ADMINISTRATOR SLAVITT: Dr. Walensky.

DR. WALENSKY: Yeah, I don't have much to add to what Dr. Fauci has said with regard to the report. And simply to say as I, too, have not yet had an opportunity to see it.

With regard to the surging, we are working closely with the states. I will be speaking with the governors tomorrow to try and reinforce the need for these -- for current restrictions to not open up. I think what we do with masking will really depend on where we are 40 days from now.

ACTING ADMINISTRATOR SLAVITT: Yep. And I would just add -- it got to my inbox this morning, so I'm going to reserve judgment as well.

Next question.

MODERATOR: We have time for one more question. We'll go to Shannon Firth with MedPage Today.

Q: Hi, thank you for taking my question. Dr. Walensky, I wondered if you could expand on what you said regarding substance use disorders and the concerns around exacerbating the risk of COVID-19 among those people. Are there other groups that there's increased risk of COVID outcomes, and are there any people that you're taking off the list? And how would that change any policies or recommendations going forward?

DR. WALENSKY: Yeah, thank you for that. I would invite you to, sort of, visit the list. It's sort of a more -- a comprehensive review. We do know that -- we've seen data that folks who have substance use disorders have increased risk of severe disease. There's a medical review -- a scientific review with that as well and an updated list of the scientific review of all the disorders that are -- or the underlying conditions that may exacerbate COVID-19.

ACTING ADMINISTRATOR SLAVITT: Thank you. Thanks for those questions. I invite everybody to tune into the President's remarks later today. And we will be doing this briefing again later in the week. Thank you.

11:36 A.M. EDT

To view the COVID Press Briefing slides, visit https://www.whitehouse.gov/wp-content/uploads/2021/03/COVID-Press-Briefing_29March2021_For-Transcript.pdf

Joseph R. Biden, Press Briefing by White House COVID-19 Response Team and Public Health Officials Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/349306

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