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

April 05, 2021

Via Teleconference

11:01 A.M. EDT

ACTING ADMINISTRATION SLAVITT: Good morning. Thank you for joining us. And I hope those of you who celebrate had a nice holiday.

I want to provide an update on our vaccination program, which is accelerating to meet the threat of an accelerating virus.

So, two weeks ago, the President outlined a number of steps that we're taking to significantly increase the number of safe places and trusted places Americans can go to get vaccinated and to ensure that at least 90 percent of Americans have a vaccination site within five miles of where they live by April 19th.

One of the steps the President announced was the opening of at least 12 more federally run mass vaccination sites.

Last week, we announced five new sites -- in Maryland, Wisconsin, Tennessee, Missouri, and Indiana. And today, we're announcing three additional sites: The first is at the Columbia Place Mall in Columbia, South Carolina. The second is at the Colorado State Fairgrounds in Pueblo, Colorado. And the third is at the Minnesota State Fairgrounds in St. Paul, Minnesota, home of the Minnesota State Fair, of course.

These three new sites bring us closer to the President's goal. Across the country, there's already 25 existing mass vaccination sites that have a combined capability to administer over 95,000 shots per day. And that number is going to continue to grow as we bring additional sites online.

So, importantly, these new sites will advance our work to equitably distribute vaccines and reach communities that have been hurt the most by the pandemic.

As I've said here before, equity is at the center of these mass vaccination sites. Each one is located in a high-risk community, as defined by the CDC's social vulnerability index or other factors.

Now, of the more than 2.1 million shots that have been administered at these sites to date, more than 60 percent have been administered to racial and ethnic minorities. We know there's more to do on this front, and we're committed to efficiency and equity as we accelerate our vaccination program.

Now, before I turn it to Dr. Walensky, I want to take a moment to provide some highlights of the progress we're making on vaccinations overall.

We're now averaging 3.1 million shots per day over the most recent seven-day period. Over the weekend, there were more than 4 million recorded vaccinations in a single day for the first time.

As of today, nearly one in three Americans and over 40 percent of adults have at least one shot, and nearly one in four adults are fully vaccinated. Seventy-five percent of seniors have now been vaccinated, and more than fifty-five percent of seniors are fully vaccinated.

So, we're headed in the right direction. But as you heard the President say: We're not there yet. The war against COVID-19 is far from over, far from won. The worst thing we could do right now would be to mistake progress for victory. If we let our guard down now, we will see more of our fellow Americans get sick and die unnecessarily.

Each of us can act to prevent this. Our message remains the same as it's been all the way through: Do your part. Wear a mask. Socially distance. Get vaccinated when it's your turn. Period.

Do all of these things, and together, we will save lives and we will put this pandemic behind us sooner rather than later.

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. And good morning, everyone. I want to begin with an overview of some continued concerning data trends.

CDC's most recent data show the seven-day average of new cases is about 64,000 cases per day. This is up approximately 7 percent compared to the prior seven-day period. Hospital admissions have also increased. The most recent seven-day trend average is about 4,970 admissions per day, up about 3 percent from the previous seven-day period. Deaths have decreased to an average of approximately 800 per day. Importantly, we are now entering our fourth week of increased trends and cases.

While we are watching these increasing case counts with concern, the good news is that millions of Americans are stepping up every day to get vaccinated.

Saturday, as Andy, mentioned CDC reported that over 4 million doses of vaccine had been administered in 24 hours. To date, more than 106 million people have received at least one dose, and more than 61.4 million, or 18.5 percent, are fully vaccinated.

As the trends and data have been indicating, cases are increasing nationally, and we are seeing this occur predominantly in younger adults. This is why you've heard me so clearly share my concern. We know that these increases are due in part to more highly transmissible variants, which we are very closely monitoring.

And as more schools are reopening, it's even more important to make sure they do so safely, with strict adherence to CDC guidance, and for all of us to roll up our sleeves for a vaccine as soon as we can.

We are learning that many outbreaks in young people are related to youth sports and extracurricular activities. According to CDC guidance, these activities should be limited, but if they are not, the risks of clusters can be pervadence [sic] -- can be prevented with cadence testing strategies, as are being rolled out in so many different places.

I understand that people are tired and that they are ready for this pandemic to be over, as am I. Please continue to hang in there and to continue to do the things that we know prevent the spread of the virus. If we all continue to wear a well-fitting mask, physically distance, and get vaccinated, America can and will get out of this pandemic. We can meet this moment if we keep doing our part. Everyone working together, getting vaccinated as soon as possible, is how we can turn the corner.

I want to briefly describe now a report in today's MMWR that describes what can happen when we do not follow proper mitigation strategies when everyone is not fully vaccinated.

The Illinois Department of Public Health and staff from a local public health department evaluated a COVID-19 outbreak associated with a bar in a rural area of Illinois. The bar accommodates about 100 people and held an opening event indoors, in February.

While table spacing and signs encouraged physical distancing and masking, people who attended the event reported that mask use was inconsistent and that six feet of distance was not maintained.

The evaluation found 46 COVID-19 cases linked to this event. Of those, 26 were patrons, 3 were bar staff. Seventeen secondary cases occurred among contacts of people who attended the opening and got COVID-19; 12 were household contacts, 3 were long-term care facility contacts, and 2 were school-related contacts.

Transmission associated with this opening event also resulted in eight households with infections, a school closure affecting 650 children, and the hospitalization of a long-term care facility resident.

As we work to get more people vaccinated and as community businesses begin to reopen, these findings underscore the vast impact of a single event affecting communities, schools, families, and fragile elderly. And it emphasizes the impressive transmissibility of this virus and the continued need for layer prevention strategies, including reducing the number of people indoors, improving building ventilation, and utilizing outdoor spaces as the weather allows.

I finally want to highlight today that CDC has updated its guidance for cleaning and disinfecting facilities and homes to reflect the science on transmission.

People can be affected with the virus that causes COVID-19 through contact with contaminated surfaces and objects. However, evidence has demonstrated that the risk by this route of infection -- of transmission is actually low.

Cleaning with household cleaners containing soap or detergent will physically remove germs from surfaces. This process does not necessarily kill germs, but reduces the risk of infection by removing them. Disinfecting uses a chemical product, which is a process that kills the germs on the surfaces. In most situations, regular cleaning of surfaces with soap and detergent, not necessarily disinfecting those surfaces, is enough to reduce the risk of COVID-19 spread.

Disinfection is only recommended in indoor settings -- schools and homes -- where there has been a suspected or confirmed case of COVID-19 within the last 24 hours.

Also, in most cases, fogging, fumigation, and wide-area or electrostatic spraying is not recommended as a primary method of disinfection and has several safety risks to consider.

The risk of surface transmission can also be reduced by wearing masks consistently and correctly, washing your hands, and by following CDC and OSHA guidance to maintain healthy facilities.

The main way people are infected with COVID-19 is through close person-to-person contact, typically between people who are physically near each other, within about six feet. Additional details on this updated guidance is now posted on our CDC website.

I want to end, again, by sharing my confidence that widespread vaccination will bring us to the end of the COVID-19 pandemic and with my enthusiasm for how quickly this is happening, and also, my strong support that we all keep taking the necessary steps to stay safe and healthy until we get there.

We are vaccinating at a rate of 3 million people on average every day. This is the spirit of the American people that will help us see this through together.

Thank you. I'll now turn things over to Dr. Fauci.

DR. FAUCI: Thank you very much, Dr. Walensky. I'd like to spend the next couple of minutes addressing a frequently asked question and concern regarding the impact of COVID-19 disease in pregnant women -- on the women themselves and on their fetus.

So, clearly, COVID-19 and pregnancy is associated, as I'm going to show you in a moment, with adverse outcomes for mother and baby. And one asks the question: What about the safety and importance of vaccination in that setting?

Next slide.

A few months ago, in November 2020 MMWR, the CDC did an analysis of about 400,000 women with symptomatic COVID-19. And though the numbers were small, it became clear then that there was very likely an increased risk among pregnant women versus non-pregnant women for adverse outcomes of the pregnancy itself and for them as pregnant women if they contracted the disease, COVID-19, as shown by the risk ratios on this slide.

Next slide.

In the Canadian Medical Association Journal of just literally a few weeks ago, they did a meta-analysis of 42 studies involving almost 450,000 pregnant women. And if you look at the odds ratio, they're comparing infection in pregnancy associated with non-infection in pregnancy. The adverse events -- such as stillbirth of the baby, preeclampsia, preterm birth -- were really quite impressive, particularly when COVID-19 was severe in the pregnant mother -- taking a look at the odds ratio of preeclampsia and pre-term birth.

Next slide.

Now, the vaccine data in pregnancy is limited thus far, in the sense of specifically looking at safety concerns with a study designed to do so, which are actually in progress right now.

But what do we know? We know that the use of adenovirus-based vaccines for other diseases were not associated with adverse pregnancy-related outcomes. Although those specific studies have not been done with the mRNA, because women were not included in those clinical trials, observational data from vaccinated pregnant individuals are currently being collected both by the company and by the CDC. And no specific safety signals have been observed thus far among pregnant vaccine recipients.

Next slide.

If you look at the recommendation from the American College of Obstetrics and Gynecology, although they don't specifically recommend vaccination in pregnant women, they make a very important statement that all pregnant individuals who choose to receive the vaccine must be allowed to do so in alignment with state and local vaccination allocation plans.

Next slide.

And the question is, what about the safety associated with this? As I mentioned, as of a few days ago, there have been close to 70,000 v-safe participants that were pregnant at the time they received the vaccination. And the CDC is currently enrolling participants to analyze the data and better understand how vaccination affects pregnant women.

Final slide, next.

So one looks at: What about the effect of vaccination? Well, in a study recently published in the American Journal of Obstetrics and Gynecology, in 131 reproductive-age vaccine recipients, it became very clear that vaccine-induced, robust immune responses in pregnant women -- similar to that in non-pregnant woman -- not only was the immunogenicity but the reactogenicity was similar.

And importantly, and very favorably, there was immune transfer to the neonates, which occurred both via the placenta in utero as well as through breast milk. So in other words, things look very good for the association between vaccination and protecting pregnant women from adverse outcomes from themselves and their fetus.

Back to you, Andy.

ACTING ADMINISTRATOR SLAVITT: Thank you. Thank you Dr. Fauci, Dr. Walensky. All right, let's go to questions, please.

MODERATOR: Let's go to Zeke Miller at the AP.

Q: Thank you all for doing the call. For Dr. Walensky, you mentioned the continuing and troubling rise in cases. I was hoping you might be able to speak to: Is there any discernible difference in who is being infected right now, and if the decline in deaths is at all related to the vaccination rates, particularly among the most high-risk seniors. And then extrapolating outward, is there -- what is the latest CDC projections for the death rate from this virus as vaccinations continue to ramp up?

DR. WALENSKY: Yeah, thank you for that question. You know, we are seeing a change in demographics, as I think we were going -- we were expecting. And it's good news with regard to the power of vaccination.

We know that about 55 percent of adults over the age of 65 have fully vac- -- are fully vaccinated. And what we're seeing is both a decrease in emergency department visits, as well as hospitalizations associated with that demographic. And I think we still have a lot to learn, and time is going to tell, with regard to the impact of both vaccination of this demographic and variants. So as we see variants continuing to spread, the numbers of cases increasing, and then what is going to happen with regard to the younger population that is not yet protected.

And it is why we are encouraging everybody to roll up their sleeves as soon as vaccine is available to them, because we see it working.

ACTING ADMINISTRATOR SLAVITT: Great. Next question.

MODERATOR: Erin Billups at Spectrum News.

Q: Hi, thank you so much for taking my question. I actually have a follow-up to that death rate question. Now that we're seeing the number of deaths decrease, is the -- would you categorize coronavirus as moving into something more like the flu: less deadly, something that is more manageable for hospitals or hospital system?

And also, just -- is there any indication, given the year of data we have on transmission patterns, of whether warmer weather will have any impact on the spread of the virus?

ACTING ADMINISTRATOR SLAVITT: Let's go to Dr. Walensky, and then maybe, Dr. Fauci, see if you want to add anything to that.

DR. WALENSKY: Yeah, I think we need to acknowledge that this pandemic has taken its toll, both in terms of transmissibility and mortality, much more than the influenza. And I think with these variants, we are still seeing increased transmissibility. We don't yet know of its increased morbidity and mortality, aside from its increased transmissibility.

So I'm not at all ready to say that we're back in flu range. We still, I think, have to remain very vigilant with regard to these -- with regard to these variants.

We have not seen seasonal trends with this virus, so far. We certainly had surges over the summer. Respiratory viruses tend to have seasonal trends as do coronaviruses, specifically. But I think it's -- we haven't yet seen that, so I think we're going to have to be careful throughout the spring and the summer here.

ACTING ADMINISTRATOR SLAVITT: Anything you'd like to add, Dr. Fauci?

DR. FAUCI: Yeah, just to underscore the last point that Dr. Walensky

DR. FAUCI: Yeah, just to underscore the last point that Dr. Walensky made: You might remember, a year ago or a little bit more than a year ago, when we were looking for the summer to rescue us from surges, it was in fact the opposite. We saw some substantial surges in the summer. I don't think we should even think about relying on the weather to bail us out of anything we're in right now.

ACTING ADMINISTRATOR SLAVITT: Okay. Vaccines, not weather.

Next question.

MODERATOR: Tom Howell, Washington Times.

Q: Hey, thanks for doing the call. Can you talk a little bit more about this demogratic [sic] -- demographic shift with the age? How much of that is, as we talked about, just because a lot of seniors are vaccinated but younger people are still waiting, versus, say, the B117 variant? Is it more efficient at attacking younger people? And also, what does this mean for schools? Do you plan to update any guidance, given this emerging trend? Thanks.

DR. WALENSKY: I think there are a lot of moving parts here, both with regard to the demographic that has been vaccinated. We know that B117 is more transmissible -- somewhere between 50 and 100 percent more transmissible. Whether it's more transmissible specifically in different age demographics, we don't yet have evidence to say.

As we've been working with states in understanding their individual outbreaks among younger people, I want to, sort of, underscore that this is among 18- to 24-year-olds where we're seeing actually some peaks in cases. And many of these, as I noted, are related to extracurricular activities and youth sports, which is why we really want to remain vigilant with regard to the guidance there, as well as testing strategies that could help prevent clusters.

ACTING ADMINISTRATOR SLAVITT: And, Dr. Walensky, maybe a follow-up to you is: If you could imagine vaccination levels among younger people eventually getting too close to the levels where we are with seniors, would you imagine that having a impact on the number of cases we're seeing?

DR. WALENSKY: I imagine it would be having a massive impact. I think what we've seen demographically is when we vaccinate large age strata -- large age demographics -- that we see less cases in those -- in those demographics. So that is just more and more -- makes it more and more important that when the vaccine is available, regardless of your age, you roll up your sleeve.

ACTING ADMINISTRATOR SLAVITT: Yeah. So we have evidence. In other words, you're also saying that these vaccines can actually address these variants effectively.

DR. WALENSKY: Absolutely. Absolutely.

ACTING ADMINISTRATOR SLAVITT: Okay. Next question.

MODERATOR: Elizabeth Cohen at CNN.

Q: Hi, thanks so much for taking my question. Several members of President Biden's Transition Advisory Board are advocating that in order to get as many people vaccinated as possible and avoid another surge, that we should be doing just one shot of Moderna and Pfizer. And now Dr. Fauci, just last week, mentioned that it's unclear how long the 80 percent effectiveness of a single dose would last -- that it could, as he said, fall off a cliff in just two to three weeks. So, Dr. Fauci, Dr. Walensky, what do you think of these continued calls for single doses of Pfizer and Moderna? Could these experts be right?

ACTING ADMINISTRATOR SLAVITT: Dr. Fauci?

DR. FAUCI: No, I don't think there's any right or wrong in this, and I think that's one of the things we need to stay away from. There really are different approaches and different opinions. We have been concerned, and still are, that when you look at the level of protection after one dose, you can say it's 80 percent, but it is somewhat of a tenuous 80 percent because the level of, for example, neutralizing antibodies against the coronavirus, when you just leave it at one dose, the question is: How long does it last?

And when you're dealing with variants that clearly might actually be diminished somewhat in their capability of the virus -- excuse me, of the vaccine-induced antibodies to essentially be able to neutralize there, you're in a tenuous zone if you don't have the full impact. So there is some merit to the arguments that they are made, and we certainly respect that.

But right now, given the number of vaccines we're able to give every day, literally every day that goes by we get closer and closer to where we want to be. And for that reason, although we always continue to keep an open mind, we consider the route that we're on now is the best route.

ACTING ADMINISTRATOR SLAVITT: Okay, next question.

MODERATOR: Last question will go to Meg Tirrel at CNBC.

Q: Well, thanks. I wanted to follow up on the situation at the Emergent plant and the AstraZeneca vaccine being moved elsewhere. And, Dr. Fauci, I saw in a Reuters interview last week, you noted the timing may just work out so that the U.S. doesn't actually need the AstraZeneca vaccine. And I wondered if you guys could just touch on, you know, is there any additional capacity for the AstraZeneca manufacturing to move to here in the U.S., and what you, kind of, expect for that vaccine, for the Emergent plant, and any effect on Johnson & Johnson's ability to meet its April goal of 24 million doses, considering that it needs FDA authorization at that plant to meet that?

ACTING ADMINISTRATOR SLAVITT: Thanks, Megan. Why don't I -- why don't I start this, and if there's anything you'd like to add, Dr. Fauci, feel free to add.

I mean, first of all, it's important to mention, anytime discussing the issue at this plant, that all of the Johnson & Johnson vaccine that's available in the U.S. has been authorized by the FDA. None of it came out of this plant in question. And I think it's very important that we begin by making sure that Americans are assured of that fact: that we have safe and effective vaccine, and no vaccine will leave any factory unless authorized by the FDA.

The second is that, as has been reported over the weekend -- for those who didn't follow -- with assistance from the Health and Human Services Department, Johnson & Johnson has taken complete control of the plant in question.

And as Meg's question just indicated, they did a cou- -- made a couple of important decisions. One is they're bringing in a senior level of expertise and management from Johnson & Johnson. And second, that they are going to make the Johnson & Johnson vaccine the only vaccine made in this plant to eliminate the potential for any cross-contamination.

We -- the HHS applauds both of those moves, and so it's important for the public to know that those steps have been taken.

I'd also want to just point out that this was a decision that HHS made with Johnson & Johnson and AstraZeneca in complete collaboration, and so AstraZeneca also agreed that this was the right course.

As for what this says about the AstraZeneca vaccine in the U.S. -- and I will go to Dr. Fauci in a second -- it says absolutely nothing about our belief one way or the other. We are still -- this was not a decision that had in any way anything to do with any concerns about the AstraZeneca vaccine. It is still scheduled to go through the FDA's authorization process as soon as an application is submitted. And they are working on where they would continue to move their production, but don't believe that there is any impact on their production schedule based upon what's happened.

So, Dr. Fauci, what would you want to add or reinforce to that?

DR. FAUCI: Well, you know, Andy, a lot of things get conflated in the questions that were asked, but I think you pointed out the important things:

A, that we still are going to rely on the FDA for the evaluation of the AstraZeneca. That's something that we do all the time, and that's really very important.

B, the J&J doses that have gone out had nothing at all to do with the situation in the plant. We want people to really appreciate that: that those who have received the J&J doses, that that had really completely dissociated from the issue that we were talking about in the plant.

And third, J&J has assured us that they will actually have the 100 million doses by the end of May as they promised. So we want to make sure those things don't get lost in the discussion about the issue at the Emergent plant.

ACTING ADMINISTRATOR SLAVITT: Great. Well, thank you all very much. And we'll be doing this briefing again later in the week.

11:29 A.M. EDT

To view the COVID Briefing Slides, visit https://www.whitehouse.gov/wp-content/uploads/2021/04/COVID-Press-Briefing_5April2021_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/349425

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