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Health and Human Services Secretary Azar Holds Media Availability
February 28, 2020

People speaking in front of a health and human services signFeb. 25, 2020






AZAR: …I’m joined today by Dr. Anne Schuchat, the principal Deputy Director of the Centers for Disease Control and Prevention in Atlanta, Dr. Tony Fauci of the National Institute of Allergy and Infectious Disease, Dr. Robert Kadlec, HHS Assistant Secretary for preparedness and response, and Dr. Stephen Hahn, the Commissioner of Food and Drugs. As of this morning, we still have only 14 cases of the China coronavirus detected here in the United States involving travel to China or close contacts with those travelers.

We have three cases among Americans repatriated from Wuhan and we have 40 cases among American passengers repatriated from the Diamond Princess in Japan. I want to think that responders and communities that have worked with HHS and the administration to provide these Americans with the treatment they need. I’m also grateful to the governors and other state and local leaders who have worked with us in close partnership so far.

The immediate risk to the general American public remains low, but as we have warned, that has the pencil to change quickly. There is now community transmission in a number of countries, including outside of Asia. That’s deeply concerning and community spread in other countries will make successful containment at our borders harder and harder. That’s what we’ve already been working closely with state, local, and private sector partners to prepare for mitigating the virus’ potential spread in the United States because we will likely see more cases here as we have said throughout this episode.

Dr. Schuchat will provide some more details on what that will look like, including how we would treat potential cases that arise from community transmission here in the United States. This preparation has been possible in part because of how aggressively President Trump has responded to this outbreak. As soon we knew of the threat presented by this novel virus, public health leaders were monitoring it and beginning to prepare.

The travel restrictions that the president put in place at the beginning of this month have given our country valuable time to continue to prepare, and that is precisely what those measures were designed to do. That includes working with Congress. Yesterday, the White House center requested Congress to make at least $2.5 billion in funding available for preparedness and response.

There are five major priorities within the supplemental request, which I underscored this morning before the Senate Appropriations Committee. First, we need to expand our surveillance work building on an existing system we have within CDC’s influenza surveillance network. Second, we will need funds to support public health preparedness and responsible for state and local governments for what could be a very large scale response. We don’t know, but we must prepare for that just in case. This support complements the significant funds that these partners have received from CDC for preparedness, about two thirds of billion dollars a year in recent years.

Third and fourth, we need to support the development of therapeutics and the development of vaccines. Given the scale of this outbreak, the private sector sees a real market for both kinds of countermeasures as well as for diagnostics, but federal funding and guidance can accelerate this work. Dr. Fauci will address the current status of that work in more depth.

Fifth and finally, we need funds for the purchase of personal protective equipment for the strategic national stockpile, a topic that Dr. Kadlec will can address. I will conclude by noting that, though scheduling conflicts prevented this briefing from including other members of the president’s coronavirus task force, we’ll prudent be providing a new update from interagency leaders soon and we expect to continue doing so regularly. Earlier this afternoon on CNBC, the national economic Council director Larry Kudlow offered an update on how we see this outbreak affecting the economy. This morning, Dr. Messonnier from CDC provided that usual telebriefing….

SCHUCHAT:… The U.S. government’s response to the spread of the novel coronavirus into our country began as soon as reports of an unidentified flu-like illness emerged from Wuhan, China. The U.S. has been implementing an aggressive containment strategy that requires detecting, tracking, and isolating all cases as much as possible and preventing more introductions of disease, notably at ports of entry.

We’ve restricted travel into the U.S. and have issued multiple travel advisories for countries currently experiencing nearly spread. Our travel notices are changing almost daily as we get new information and we believe those precautions are working.

So far, as Secretary Azar described, our public health system has detected 14 cases in travelers or very close contacts of travelers here in the United States. Among passengers repatriated from–by the State Department from Wuhan, China and from the Diamond Princess, there are an additional 3 and 40 cases. The fact that we have been able to keep cases to the slow level is an accomplishment, especially given that we are unfortunately beginning to see community spread in a growing number of other countries.

Based on what we know right now, we believe the immediate risk here in the United States remains low and we are working hard to keep that risk low. But we must use this time to continue to prepare for the event of community transmission United States. Part of that preparation is educating the public and our state, local, and private sector partners about what transition from aggressive containment measures to community measures or community mitigation would look like, should we end up there.

However, current global circumstances suggest it’s likely that this virus will cause a pandemic. In that case, risk assessment would be different and new strategies tailored to local circumstances would need to be implement it to blunt the impact of the disease and further slow the spread of the virus. What these interventions would look like at the community level will vary depending on local conditions and on the emerging information about how severe the virus may be.

As some of you heard from Dr. Messonnier of the CDC today, we’ve begun laying out for the public what it will look like to mitigate the spread of the virus. There are obvious common sense tools like good hygiene, social distancing, things like staying home when you’re sick, things we talk about during a difficult season or things that we talked about during the 2009 H1N1 pandemic. We will be transparent with the public about these measures enter the potential that these tools will be necessary….

FAUCI: … I’m going to give you a very brief update on the countermeasure development that I introduced to this audience on a number of occasions over the past couple of weeks, and the first regarding the issue of vaccine. You might recall that I had mentioned when we first introduce the topic of vaccine that very shortly after the sequence was put on a public database, we began a vaccine development program, which was one of several supported both be by the NIH as well as Botter (SP) from Asper and even independent individuals that we have been involved in collaborating with for a period of time.

One of these vaccines I think serves as the prototype of the timing of what we were talking about. You might recall I had mentioned that from the time we had available sequence, we would hope to be in clinical trials within two to three months and I said barring any glitches, that would be the fastest ever in any vaccine that we’ve gone from the identification of a pathogen to putting it into a human in a phase one trial. Well, I am happy to report to you this afternoon that we are on time at least an maybe even a little better.

So a vaccine may not solve the problems of the next couple of months, but it certainly would be an important tool that we would have, and we’ll keep you posted on that.

Secondly and finally, the issue of therapeutic interventions. There are a number of candidates that we are now looking at that have shown some suggestion either in vitro, in an animal model, or some empiric trials that were done during the MERS outbreak. One of these, and there are several that we are considering, is called Remdesivir, which is a nucleotide analog that is produced by Gilead. Today as I speak, there are two major clinical trials going on in China, which are randomized controlled trials, which means that we will get an answer whether or not it works or doesn’t work I think within a reasonable period of time….

KADLEC: … Passengers evacuated from the Diamond Princess are in the process of completing their 14 day quarantine at two DOD installations, one in California and one in Texas. Medical professionals from our national disaster medical system in CDC are continuously monitoring the health of these passengers. Any passenger that shows signs of any illness are moved off the DOD facility and tested for this virus. Passengers who are tested positive for this coronavirus cannot stay on the military installations and these patients are being transported safely to our network of special pathogen treatment centers such as the University of Nebraska Medical Center as part of our aggressive containment posture.

These individuals are being placed in these facilities for quarantine and isolation purposes only. An intensive level of medical care is not typical typically needed by most of these individuals. At the centers, the patients who develop this infection can participate in the clinical trial that Dr. Fauci ascribed with Remdesivir. We are honored to have helped NIH to arrange the conical trial within that special network of treatment centers.

We are also prepared to support CDC and the Department of Homeland Security at designated military installations where Americans returning to the U.S. on commercial flights can be quarantined based on their travel history. The most recent location to receive such a traveler is the Naval base in Ventura County Point Mugu where one American is currently completing quarantine….

HAHN: … The FDA is an active partner in the novel coronavirus response working closely with our government and public health partners across the U.S. Department of Health and human services as well as our international counterparts.

Our work is multifaceted, focusing on actively facilitating efforts to diagnose, treat, prevent the disease, surveilling the medical products supply chain for potential shortages or disruptions, and helping to mitigate such impacts as necessary.  

With respect to inspections, for February and March, FDA has identified approximately 100 scheduled inspection in China, the vast majority of which are routine surveillance inspections. Those inspections are just postponed at this time and will be conducted at a later date. It’s important to remember that these delayed routine surveillance inspections can happen at any time during the year. And while inspections in China are delayed secondary to the State Department travel advisory, we will send investigators to other parts of the world to ensure we are on schedule for our planned inspections for the year. …

AZAR: … So, we intend to keep our travel restrictions with regard to China in place at the moment. The–the vac–the virus is still spreading in China. We’re still having hundreds of case reports per day, if that’s capturing all of the information. We’re still seeing dozens or more fatalities reported per day.

We certainly hope that China is able to engage in effective containment measures to slow the spread of this virus down. But there’s nothing at this point that would indicate a change in our posture towards our aggressive containment measures with regard to travel in China.

It’s important, though, to remember we’ve been very moderated and titrated in those travel measures. They simply are based on 14 days, which is the maximum predicted incubation period. And so, an individual who has been in China for the previous 14 days who is a foreign national would not be permitted to enter the United States. And an American or permanent resident would be permitted to return to the United States, of course, but asked to home isolate during the completion of a 14 day period outside of China.

That is not a ban. That is a temporary restriction in line with the public health measures that we’re taking. So, we’ve tried to be very respectful towards in–towards travel. And of course, those restrictions are not based on other than American and permanent resident versus non-Americans really as a matter of focusing our resources.

They’re not based on the ethnicity of an individual or–or anything else because, as you mentioned, it is important that we not engage in any–that–that–that people not believe that, because of somebody’s ethnicity, they are more likely to have this disease or not. Our criteria are all based on travel in affected areas and warning people about travel in infected areas based on–based on the epidemiology and the evidence. … 

AZAR: … So, for instance, abroad this is spreading quite rapidly. In the United States, thanks to the president and this team’s aggressive containment efforts, this disease, as Dr. Schuchat said, is contained. We’re now two weeks with no additional US-based cases, 14 cases on February 11th, 14 cases today. That is a remarkable level of containment here in the United States. The only additional cases we have are ones we imported as part of our humanitarian repatriation efforts.

Then we tried to be very transparent with the American public. We have from day one said we can’t hermetically seal off the United States. I stood here at this podium, I stood at the White House press briefing when we announced our initial–initial travel restrictions, and we’ve always said we expect to see more cases. We–that–that should–we don’t want people surprised if they see more cases here in the United States. That’s an important part of transparency. People shouldn’t panic when they see new cases. They should know their government predicted we would have them and we have plans in place. …