Via Teleconference
11:02 A.M. EST
ACTING ADMINISTRATOR SLAVITT: Thank you for joining us. It was an important weekend for the President and the American people.
President Biden came into office with two clear, immediate goals: mount a vaccination program to turn the tide on the pandemic and pass a rescue plan to bring the nation through these tough times successfully.
This weekend, we took critical steps on both fronts. On Saturday, the Senate passed the American Rescue Plan. In the face of what is one of the country’s greatest challenges Americans have ever faced, this historic legislation will cut child poverty in half, put $1,400 checks in the pockets of 85 percent of the country, fund our schools so they can reopen safely and so our kids can catch up quickly, and create 7 million jobs. And importantly, it gives America the resources we need to defeat the pandemic. It demonstrates government once again is working for the people.
On that very same Saturday, we set a new record for single-day recorded vaccinations. We are vaccinating a seven-day average of nearly 2.2 million Americans a day, up from about 900,000 when we came into office. Saturday was as high as 2.9 million doses reported administered — a new daily record — and we’re at a pace seen nowhere else around the world. This is a function of everyone executing to their fullest, and it depends on vaccination sites being open late and the tireless effort of vaccinators.
While all of this is challenging, our message is: Keep going. I know the pace is challenging. This is a war, and we can’t let up.
Last week, the President announced we’d have enough vaccine for every adult in America by the end of May. Turning those vaccine doses into vaccinations requires more vaccinators and more vaccination sites. We must continue to get these vaccinations efficiently and equitably distributed to the public.
We’ve already provided more than $4.1 billion to states, tribes, and territories to support more than 500 community vaccination sites. The American Rescue Plan includes tens of billions more in funding to scale up our vaccination program.
Many states are now running vaccination sites 24 by 7. Slots are being reserved for teachers and people in hard-hit ZIP codes, and we’re getting more vaccinators — from the military to retired doctors and nurses — into the field.
We are in a historic crisis, and we have reason to have confidence that we will prevail. But we are not done, and we must keep up the pace of progress and remain vigilant.
Joining me today is Dr. Walensky, Dr. Fauci, and Dr. Nunez-Smith. And with that, I will turn it over to Dr. Walensky to talk about our next steps on our path back.
DR. WALENSKY: Good morning and thank you. I’m glad to be back with you today. Let’s get started with an overview of the pandemic. The most recent seven-day average of cases is about 59,000 cases per day. Importantly, on the far right of the graph, you can see that there is a leveling off of the decline. And the most recent seven-day average of deaths is slightly lower than 2,000 deaths per day.
These numbers show us that the pandemic still remains a very serious situation with the most communities continuing to have high levels of COVID-19 transmission. We are watching these data closely to see where the pandemic will head in the coming days.
But I’m also hopeful. As of today, 59 million people in the United States have received at least one dose of COVID-19 vaccine, and approximately 31 million or 9.2 percent of the U.S. population is fully vaccinated, putting us on a strong path to eventually end this pandemic. And as you just heard, we are now vaccinating more than 2 million people per day.
We’ve been through a lot this past year. And with more and more people getting vaccinated each day, we are starting to turn a corner. And as more Americans are vaccinated, a growing body of evidence now tells us that there are some activities that fully vaccinated people can resume at low risk to themselves.
This is why, today, CDC is releasing its initial guidance for the public that, for the first time, lays out some of the activities considered safe for those who are fully vaccinated. When I say “fully vaccinated,” I mean people who are two weeks after their second dose of either the Pfizer or Moderna vaccines, or two weeks after a single dose of the Johnson & Johnson vaccine.
Before I talk about the specific recommendations, I want to underscore a few important points. First, robust clinical trial data demonstrate that the current COVID-19 vaccines are highly effective at protecting vaccinated people against severe illness, hospitalization, or death from COVID-19. However, there is still a small risk that vaccinated people could become infected with milder or asymptomatic disease, and potentially even transmit the virus to others who are not vaccinated. Understanding the size of this risk in vaccinated people and the risk of transmitting the virus to others who are not vaccinated is an ongoing area of research.
Second, it’s important to note that this is initial guidance. The science of COVID-19 is complex and our understanding of the virus continues to rapidly evolve. The recommendations issued today are just a first step. As more people get vaccinated and the science and evidence expands, and as the disease dynamics of this country change, we will continue to update this guidance.
Importantly, our guidance must balance the risk to people who have been fully vaccinated, the risks to those who have not yet received a vaccine, and the impact on the larger community transmission of COVID-19 with what we all recognize to be the overall benefits of resuming everyday activities and getting back to something — to some of the things we love in life.
It’s against this backdrop and the current state of the pandemic that we have developed these new recommendations. With today’s initial guidance, it’s important to note that we are focusing on activities fully vaccinated people can resume in private settings, such as their homes, under two scenarios.
The first scenario is fully vaccinated people visiting with other fully vaccinated people. In this slide, these individuals are represented by solid green circles. In this scenario, CDC recommends that fully vaccinated people can visit with other fully vaccinated people in small gatherings indoors without wearing masks or physical distancing. Remember, here we are talking about private settings where everyone is vaccinated.
So what does this mean? If you and a friend or you and a family member are both vaccinated, you can have dinner together [without] wearing masks, without distancing. You can visit your grandparents if you have been vaccinated and they have been too.
Now I want to talk to you about another more complicated scenario: It involves vaccinated people visiting with unvaccinated people. When fully vaccinated people visit with unvaccinated people, we have to consider the underlying risks of the unvaccinated people and any unvaccinated members of their household. We take this approach because all of our guidance is rooted in making sure we are keeping people safe.
So, CDC recommends that fully vaccinated people can visit with unvaccinated people from one other household, indoors, without wearing masks or physical distancing, as long as the unvaccinated people and any unvaccinated members of their household are not at high risk for severe COVID-19 disease.
In the slide, people who are vaccinated at a low risk for severe COVID-19 are indicated by solid orange circles. This means that none of the unvaccinated people or any unvaccinated members of their households, for example, are an adult over age 65 or have an underlying condition — such as cancer, heart disease, or diabetes — that could increase their risk of COVID-19 related hospitalization or death.
Here is an example: If grandparents have been vaccinated, they can visit their daughter and her family, even if they have not been vaccinated, so long as the daughter and her family are not at risk for severe disease. They are solid orange circles.
Second, if an unvaccinated individual or any unvaccinated member of their household are at high risk for severe disease, shown here by hollow orange circles, everyone, regardless of vaccination status, should still wear a mask and physically distance and choose to meet outdoors or in a well-ventilated space. This is recommended to keep the individuals at high risk who are unvaccinated safe.
Similarly, when fully vaccinated people are visiting with unvaccinated people from multiple households, everyone should wear masks and physically distance and meet outdoors in a well-ventilated space.
Moving on to quarantine, away from visiting. In addition to these new recommendations on visitation in private settings, CDC’s new guidance also recommends that fully vaccinated people do not need quarantine or get tested following a known exposure to someone with COVID-19 as long as they are asymptomatic. At this time, the CDC is not adjusting current guidance on travel.
We believe these new recommendations are an important first step to our — in our efforts to resume everyday activities in our communities. However, we remain in the midst of a serious pandemic and still over 90 percent of our population is not fully vaccinated, though we are working hard to get there. Therefore, everyone, whether vaccinated or not, should continue to avoid medium- and large-sized gatherings, as well as nonessential travel, and, when in public spaces, should continue to wear a well-fitted mask, physically distance, and follow other public health measures to protect themselves and others.
COVID-19 continues to exact a tremendous toll on our nation. Like you, I want to be able to return to everyday activities and engage with our friends, families, and communities. Science and the protection of public health must guide us as we begin to resume these activities.
Today’s action represents an important first step; it is not our final destination. As more people get vaccinated, levels of COVID-19 infection decline in communities. And as our understanding of COVID immunity improves, we look forward to updating these recommendations to the public.
I know this is complex and I’ve covered a lot of ground this morning, so I want to recap the main points of our initial guidance released today.
In summary, fully vaccinated people can visit with other fully vaccinated people indoors without wearing a mask or physical distancing; visit with unvaccinated people from a single household who are at low risk of severe COVID-19 disease, indoors, without wearing masks or physical distancing; and refrain from quarantine and testing following a known COVID-19 exposure if the vaccinated person remains asymptomatic.
For now, we will continue to examine this in the upcoming weeks as — and update our guidance accordingly. Fully vaccinated people should continue to take precautions in public like wearing masks and physical distancing; wear well-fitted masks and physically distance and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk of severe COVID or who have an unvaccinated family member — household member who has an increased risk of COVID; wear masks, physically distance, and practice other prevention measures when visiting with unvaccinated people from multiple households; avoid medium- and large-sized crowds; get tested if experiencing COVID-19 symptoms; follow guidance issued by individual employers; and follow CDC and health department travel recommendations.
As I close, I want to stress that we have — we continue to have high levels of virus around the country, and more readily transmissible variants have now been confirmed in nearly every state. While we work to quickly vaccinate people more and more each day, we have to see this through. Let’s stick together. Please keep wearing a well-fitting mask and taking the other public health actions we know work to help stop the spread of this virus.
Thank you so much for your time today, and I will now turn things over to Dr. Fauci.
DR. FAUCI: Thank you very much, Dr. Walensky. I’d like to just spend a couple of minutes now on a different topic, and that has to do with investigational therapeutics for COVID-19. If I could have the first slide.
On a previous briefing, I had mentioned to the group that there were a number of investigational therapeutics, including monoclonal antibodies, convalescent plasma, immunomodulators, et cetera. What I want to do today for a couple of minutes is talk about the issue of direct-acting antivirals. If I could have the next slide.
The strategy for direct-acting antivirals in the future will be a process that we have done with other infections, which I’ll get to in a moment, and that is the identification of vulnerable targets after study of the replication cycle of the virus — in this case, SARS-CoV-2 — and then, to design drugs to directly inhibit that vulnerable target. Next slide.
We have been extraordinarily successful in this with HIV. Now, targeted drug development, which is the terminology we use for this approach — “targeted drug design” — has occurred before HIV, particularly with the herpes viruses. But it really got into its own frame with HIV.
And the reason I say that is that that was the first of the extraordinarily successful results of targeted drug design. And the reason and the mechanism that we got there — next slide — was to delineate the replication cycle of the virus. In this case, you see in the upper left, HIV binding to it’s now well-described receptors: the CD4 molecule and one of its core receptors. It fuses, it enters, the RNA reverse transcribes, it integrates its DNA into the cellular DNA, then transcribes out and buds off.
Over the years of intensive study — next slide — each of those vulnerable targets has led to a different class of a highly effective antiretroviral drug, including the reverse transcriptase inhibitors, the protease inhibitors, the integrase inhibitors, and the fusion and entry inhibitors.
Next slide.
This has led to now an extraordinary number of drugs which, when used in combinations, have transcribed — has transformed, excuse me, the life of HIV-infected individuals, giving them almost a normal lifespan, although the drug needs to be given, essentially, for the rest of their lives.
Next slide.
That same principle is now being applied to SARS-CoV-2, because here’s a comparable life cycle. Obviously there are differences here. Again, in the upper left, you’ll see SARS-CoV-2, by virtue of its spike protein, binding to its ACE2 receptor, binding to the membrane, fusing, entering, and then a whole bunch of steps that I need not go through that involve a variety of enzymes, which ultimately lead to the virion release — on the lower right-hand part of the slide.
Next slide.
With the same strategy that was used with HIV, we will be screening and then proactively designing entry inhibitors, protease inhibitors, polymerase inhibitors, and others.
Next slide.
And then, if you look at what’s been going on right now and take each of these very briefly, there are early-stage, non-monoclonal antibody candidates in preclinical development, such as peptides and small proteins blocking entry.
With regard to polymerase inhibitors, the FDA has already approved remdesivir from Gilead. And just this past week, we’ve heard of molnupiravir from Ridgeback Biotherapeutics and Merck, in which they published the preliminary analysis of their phase-two trial that showed a quicker decrease of infectious virus in participants with symptomatic disease. Just two days ago, Atea Pharmaceuticals reported favorable safety and pharmacokinetic data from phase-one trial. And Pfizer now is in a phase-one trial with a protease inhibitors.
I show this to the group because this is really the beginning of the phase of looking in a strategic way for direct-acting antivirals, which are going to be used to prevent people from progressing in their disease, mainly keeping them out of the need for hospitalization.
And on this final slide, for those of you who want to get more detail: Just this past November, the NIH had an NIH SARS-CoV2 Antiviral Therapeutics Summit looking at the state of therapeutics gaps in the field, and a number of our public-private partnerships. You can get this on the NIH website. And I encourage you, for those who have any interest in it, to take a look at that because that is the direction that we will be going over the next weeks, to months, to two years.
I’ll stop there and hand it over to Dr. Marcella Nunez-Smith
DR. NUNEZ-SMITH: Thank you so much, Dr. Fauci, and good morning to everyone. I’m going to talk, of course, today about equity. And you’ve heard us describe that equity is at the foundation — the center of this administration’s COVID-19 response. You know, over the last month in my time with you, I’ve detailed why that needs to be the case. So we’ve took a — we’ve taken a look at the differences in COVID-19 outcomes, for instance, by race and ethnicity.
And since the beginning of this pandemic, we have all seen that factors, you know, like race, ethnicity, rural versus urban geography, poverty, disability, living situation, and type of employment — they all are exerting tremendous influence on the outcomes we’ve see in COVID-19.
So I want to begin this morning by giving an update on the ongoing inequities related to COVID-19. So, first, let’s take a look at the rates of COVID-19 cases, deaths, and vaccination by race and ethnicity. As you can see here, Latino individuals continue to bear more than their share of COVID-19 cases, while black people continue to bear more than their share of deaths.
Notably, you see the share of vaccinations is significantly — significantly lower for Latino and non-Hispanic black individuals, relative to their share of the general population. And the same is true for Asian individuals.
This all still only tells part of the story as we remain limited by the completeness of our data. We only have race ethnicity data for 53 percent of those who have received their first dose of a COVID-19 vaccine. This varies widely among the states, as you can see on the next slide. And we’re not getting from individuals, from providers, and from states the critical information about who has access to these three lifesaving vaccines that need to be equitably distributed across our country.
So I want to emphasize here: It is possible to do better. The final slide shows us the information that providers and states are reporting to us on the age of people who they’re vaccinating. So contrast that with the data on the race and ethnicity of those same individuals.
Again, we have critical ground that we must make up, but we cannot get discouraged or feel like it’s insurmountable. You know, all of the evidence points to one simple truth: We can do this.
So, like many of you, we’ve also seen a lot of conversation about vaccine confidence, about how some communities — due to a range of historical, as well as contemporary factors — are less inclined to believe that these vaccines are safe and effective, less inclined to trust the systems offering these vaccines, and less inclined to trust the government asking them to get vaccinated. So we still have some work to do to meet people where they are.
The administration is implementing a comprehensive national public education campaign and we have been hosting roundtables with key constituencies to make sure that we get that effort right. We’re building relationships with trusted messengers all over the country to make sure they have the best information possible to share with their communities. But we cannot and we will not accept that these differences in vaccine confidence are the end all and be all of the difference in vaccine uptake that we’re already seeing.
In the context of inequitable systems, we must take significant steps at every level of intervention to bend the vaccination process towards justice. Now our success depends on our ability to build a robust and coordinated effort at the local, state, and federal level to overcome all of the dynamics that are in place, and this moment absolutely calls for that kind of effort.
So in light of everything that we’ve seen in the 84 days since our nation began administered COVID-19 vaccines, we’re turning up the expectations for this vaccine program on all fronts. And we have a series of federal programs that are a key part of our approach to ensuring that all communities have vaccination access.
First, we have our large community vaccination sites all over the country. So far, we have over 580 operational, federally supported sites. And over 170 sites are actively receiving on-site support by federal personnel. We’ve also been able to stand up a series of federally established community vaccination centers. And by the end of this week, we’ll have 18 of those sites running across seven states with the ability to administer 61,000 total shots per week.
And each of our federal sites has been designed with key equity-oriented features — so targeted geographic eligibility, weekend extended hours, reserved slots for registration through faith-based and community-based organizations, as well as deployment alongside mobile vaccination units to help vaccinate surrounding communities.
So we’re going to keep pushing to launch more and more of these sites and dive into the data on each site to make sure they are achieving their goal of improving vaccine equity in those communities.
Second, we have our Federal Retail Pharmacy Program. And this program features chain and independent pharmacies across the country. And as of last week, we’re administering 2.5 million doses of the Pfizer/Moderna vaccines, plus the additional supply that they received with the Johnson & Johnson vaccine.
We designed this Retail Pharmacy Program to ensure that one third of the pharmacy sites were placed in communities with higher scores on the CDC Social Vulnerability Index. Those are populations at higher risk due to factors like socioeconomic status, the composition of the household, people of color, as well as housing types and transportation dynamics.
So we’re going to press toward this mark to ensure that pharmacies are selecting the communities with the greatest need. And we’re going to prioritize those pharmacies that do a better job addressing equity.
And finally, we rolled out our federal community health centers partnership program. And over the past three weeks, we have been onboarding the first 250 centers. They collectively serve 12.5 million people and span all 50 states. You know, as a whole, these community health centers provide services for large numbers of public housing residents, people of color, and individuals with limited English proficiency.
So, as we look to the next phase of this program, we will prioritize filling gaps in our coverage to the highest-hit — I’m sorry — hardest-hit, highest-risk communities, whether they be urban or rural. And as we double down on the reach and impact of our federal programs, we’ll continue increasing our vaccine supply to the states.
And as we move forward, we’re calling on every state to show their work too. We’re asking our partners in the states to offer clear, transparent equity goals for their residents. And we’re also calling on the states to help us get the data we need to know where we are and to work with us to find creative solutions to the inequitable vaccine uptake that has already emerged in these first months of the vaccination program.
So I just want to be clear that achieving equity is not an aspirational goal; this is mission critical. Absent equity, we will not be able to stop this pandemic from continuing to claim lives, strain our healthcare system, and weaken our economy. But, by working together, we believe we can hit the mark.
So I thank you for your time. And with that, I’ll turn it back over to Andy.
ACTING ADMINISTRATOR SLAVITT: Thank you. So we’ve covered a lot of ground in our report-outs. Before I turn for questions, I just want to maybe briefly summarize a few things that we heard today. Today, I think we’ve begun to describe what a world looks like where we move beyond COVID-19.
Dr. Walensky outlined a first step for those of us who’ve been vaccinated. And I think it’s important to note that, as more and more people get vaccinated, Dr. Walensky will continue to update us and that list of activities will continue to grow.
Dr. Fauci outlined ongoing strategies to allow for a life post-COVID to become safer and safer. And Dr. Nunez-Smith, I think importantly, points out that this recovery is not an even picture. And in fact, we cannot fully get back to a place where we are approaching where we were before COVID unless we do an important and good job reaching equity.
So, I think a very hopeful morning, but with some continued warning signs and hope for the future. So with that, let’s take some questions.
MODERATOR: Thanks, Andy, and we’re running a few minutes late today, so we’re going to have to take a couple less questions. But, first, we’ll go to Ed O’Keefe at CBS.
Q Hi, guys. Obviously, this is —
(Teleconference experiences technical difficulties.)
Q We’re overlapping with the — can you hear me?
ACTING ADMINISTRATOR SLAVITT: We can hear you both. Yeah. All right, can you —
MODERATOR: We’ll go ahead and go to — we’ll go to Zeke at AP.
Q Thanks, you all, for doing the call. For Dr. Walensky, I was hoping you could clarify why the CDC hasn’t — what the limiting factor is in CDC not, sort of, putting out guidance to the effect of those who have been fully vaccinated not been — not having to wear masks and being able to travel and things like that. You know, what is the limiting factor? Is it the background cases of the virus in the community? Is it the fact that enough — not enough people are vaccinated just yet to get there?
And then can you just provide potentially a step of, sort of, what the next set of guidance is going to be and what the triggers would be for — you know, for people who are fully vaccinated being advised to be able to remove their masks in public and, you know, go about a somewhat normal life?
DR. WALENSKY: Yeah, thank you for that question. I think it’s important to realize, as we’re working through this, that still over 90 percent of the population is not yet vaccinated and that it is our responsibility to make sure, in the context of 60,000 new cases a day, that we protect those who remain unvaccinated and remain vulnerable. So we’re doing our best to do that.
I think it’s also important to remember that people who are vaccinated — there’s increasing data now that suggests that they might get breakthrough infections with lesser amounts of virus, lesser amounts of disease, lesser symptomatic disease — milder disease. However, we’re still waiting for data to emerge about whether they could transmit that virus to other people.
So our next steps, in terms of putting out the guidance, as I mentioned, is really to see a larger swath of the population vaccinated — we’re actively on our way to doing that — as well as to hopefully see further cases decline in the country, as well as waiting for new data to emerge.
So we’re hoping it’s in — you know, in a relatively short period of time, but we do need to see some more new data as well.
ACTING ADMINISTRATOR SLAVITT: Next question.
MODERATOR: Next we’ll go to Shira Stein at Bloomberg.
Q Hi, thanks so much for doing this. Can you explain what the scientific justification is for not changing the travel guidance to telling folks who are fully vaccinated that they should not be traveling? And how will this guidance affect folks’ willingness to get vaccinated?
DR. WALENSKY: In terms of travel, here’s what we know: Every time that there’s a surge in travel, we have a surge in cases in this country. We know that many of our variants have emerged from international places, and we know that the travel corridor is a place where people are mixing a lot. We are really trying to restrain travel at this current period of time, and we’re hopeful that our next set of guidance will have more science around what vaccinated people can do, perhaps travel being among them.
ACTING ADMINISTRATOR SLAVITT: To the second part of your question: Obviously, it will be pure speculation on our part, but we think that this is part of a growing list of reasons why Americans do want to get vaccinated. We are already seeing increasing numbers of people wanting to get vaccinated given the highly effective vaccines and given the very good safety profiles. And this list, which, as Dr. Walensky pointed out, will continue to grow, we think, are a growing set of reasons why people want to get vaccinated.
Having said that, I think it’s important to note that the CDC makes its decisions based upon what the science and the data tells them are the right decisions, not for any other reasons.
Next question.
MODERATOR: Okay. I’m going to try Ed one more time. I think he figured it out.
Q I did. Thank you. And let me follow up on the travel question there because, Director Walensky, you explicitly said grandparents now could go visit their daughter’s house and see the grandkids. But in many cases, that’s going to result in grandparents probably getting on a train or a plane to go to a neighboring state or some other state to see them.
If a governor calls you today and says, “Okay, you just said people can gather in homes, and this is going to cause people to start traveling despite the urge not to,” what guidance would you give that governor regarding vaccinated people coming back to their state? Do they still have to quarantine for a certain amount of time? Or, at this point, can they sort of disregard those travel restrictions if they’ve been vaccinated and have been fully vaccinated within those two weeks after their final shot?
DR. WALENSKY: Our travel guidance is unchanged, and so we would maintain whatever travel guidance is currently in place. We would like to give the opportunity for vaccinated grandparents to visit their children and grandchildren who are healthy and who are local, but our travel guidance currently has been unchanged.
ACTING ADMINISTRATOR SLAVITT: Okay, the next question.
MODERATOR: All right. And final question will go to Alice Park at Time.
Q Hello. Can you hear me?
ACTING ADMINISTRATOR SLAVITT: We can.
Q Great. This is a question for Dr. Fauci, and this has to do with the studies you mentioned last week on the third dose. Can you outline for us what the metrics are that you’re going to be looking at in those dose — in those studies, and what thresholds you will set for success or to determine whether a third dose might be necessary or not?
DR. FAUCI: Alice, there were two third-dose scenarios. One was one that Pfizer is pursuing, where they’re talking about giving a third dose against the wild-type virus to boost up the level of neutralizing antibodies. The parameter there will be taking a look at what the level of boost of antibody, because we do know from in vitro studies that when you get a high level of antibody against the wild-type, it gives you a cushion of effect against the variant.
And the second third boost is one that we are doing in collaboration with Moderna, where the boost will actually be a boost of a vaccine that is directed specifically against the variant. So there are two issues there. What we’re looking for in the second one is the level of antibody that we will have boosted against, specifically, the variant, as opposed to the level of antibody against wild-type, which you will assume will give you some cross protection against the variant.
ACTING ADMINISTRATOR SLAVITT: Thank you.
Thank you all for joining. This is a — I hope people view this as a hopeful day in this next steps of the pandemic. And we are here in no small measure because of the safety and protection that many, many Americans have taken with regard to their family, friends, and neighbors. We ask people to continue to do that so we can get there as quickly and as permanently as possible.
Thank you very much, and we’ll be here again on Wednesday.
11:39 A.M. EST
To view the COVID Press Briefing slides, visit https://www.whitehouse.gov/wp-content/uploads/2021/03/COVID-Press-Briefing_8March2021_for-release.pdf
