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hearing on the federal response to the coronavirus. also testifying fda commissioner, who was asked about the baby formula shortage. the fda and the cdc are expected to approve pfizer and modernize vaccines for children six months to five years of age. this hearing before the senate health committee is two hours and 45 minutes. >> [inaudible conversations]

good morning. the senate health education pension committee will please come to order. today we are having a hearing on the ongoing federal response to the covid-19 pandemic. i will have an opening statement followed by ranking member of her and then we will introduce the witnesses. after they give their testimony senators will have five minutes for a round of questions. today we will be having one of the witnesses doctor fauci testify remotely by video following a positive covid test. ie appreciate the work of the committee staff to make it possible for us to accommodate this so that we can hear from doctor fauci while he isolates and recovers. while we are not able to have the hearing fully open to the public, live video is available on the committee website@health dot senate .gov if anyone needs accommodations including closed captioning, please reach out to the committee or the office of congressional accessibility services. before we do gett started on ths

hearing, there is another issue we are all extremely focused on, the formula crisis. doctor, i understand flooding fromhe the storm has forced the infant formula manufacturing facility in sturgis off-line. since once again, so ranking member berger and i agreed and i would like to give you a moment before wegi begin to update the committee on the latest width of the plant and i hope you can speak directly to the families in washington state and across the country about what happened and how you're taking action to hoget them formula and making se this doesn't worsen the crisis or delay the work to get formula back on the shelves as soon as possible. so i want to return to you for that before we begin the rest of the hearing.ss >> thank you, senator murray and senator burr. to give me a minute to speak about this.

we have twice daily intensive calls about all the work strains working on the infant formula issue, and at the end of the call yesterday, i commented that it was one of the first day is that we hadn't had any surprises.su twenty minutes later, an e-mail came across about the flood which forced the facility to temporarily shut down. this is again unfortunate setback and reminder that natural weather events can cause unforeseen disruptions and supply chains. i had a call with the ceo last night. they are getting the facility up and running as quickly as possible. abbott is working to assess the damage today, and we will be talking daily and we have people in the facility to help get it open as quickly as we possibly can. to your main question which i know is about the most

importance and certainly allly f us are concerned about parents trying to get formula for their infants i do want to reassure the parents and caregivers that they all of government work to increase supply means we will have more than enough product to meet the current demand and the fda is committed to working with the data so that sturgis can restrict producing quality products quickly. thanks to the collaboration of all of the players on the market, for the first time we are getting production numbers about how much formula each company is producing and it's currently meeting the supply production quotas they were using before the shutdown. all the other manufacturers of course have formula in full swing so there are good numbers indicate the adequate supply.

we had hoped to have a super supply so that we get the shelvesnd completely restocked. the estimate is perhaps two weeks, but it's too early to give an exact estimate of what the delay will be. >> thank you.to i assure you the committee will be following this very closely. i understand. thank you. >> withle that we will turn to e hearing at hand. schools have safely returned to in person learning. businesses have reopened. if there are new life-saving lig treatments for people with covid and multiple effective vaccines and there is encouraging news to suggest vaccines for kids under

age five willmu be available so. i know parents across my state and the country are eagerly awaiting. across the country we've gotten over half a billion shots into arms. three and four people have gotten their first vaccinations and two thirds of people are fully vaccinated. the hard work that it took us to get to where we are today. covid-19 has killed over a million people in the country. that is an unthinkable lost. it closed businesses, skin shifted to schools and we know a lot more. we can't afford to get caught off guard by the virus again. we cannot afford to go back. the progress we have made so far was not guaranteed. it was accomplished through congressional actionss and through robust investments and what happens next is not a given

either. it's up to us to stay the course inth our support and investments if we are going to protect our families and communities from whatever this pandemic throws at us next. that's bypassing emergency funding to continue has to be a top priority for every one of us because make no mistake it is not a matter of if this pandemic will throw us another curveball, it is a matter of when. that's why emergency covidem funding isn't something that would be nice to have. it's something that we desperately need because if we wait until there's already a new dangerous variant or until we are in the middle of a fall or winter surge, which some experts predict will happen we will have missed the boat. we need to be doing everything we can now to get ready. that's what people back in washington state and across the country are depending on congress to do and it's why i

want to hear more about from all of our witnesses today what do we need to do right now so we are not caught off guard later because one thing we already know is when it comes to pandemics, to public health, an ounce of prevention is worth a pound of cure, so we need to be investing in prevention now. we need to be ordering the treatment were need. now especially when it could take six months by the way to manufacture, we need to be ordering the vaccines we will need now. we need to be combating misinformation that is already far too prevalent and damaging now. we need to be getting the testing. we need a ppe lined up for the schools and healthcare facilities now. and let's be clear we can't just keep buying the same tests, treatments and vaccines especially when it's getting more effective. as important as it continues to

be, we can't continue acting as though the vaccines and therapeutics we have now are the end-all be-all. we've got to support the next generation, keep several ironser in the fire and avoid getting caught in a situation where the options are limited to just a few companies. to invest in the research and development of the next generation test vaccines and treatments that are more effective or easier to store or transport or administer because once there iss a variant, that cannot be detected by the current test, that doesn't respond to current treatment, that doesn't stop the vaccines. we've got to be ready. the research and development of take time. can and let's be clear and none of that would be unprecedented. in fact, it is to be expected. when itta happens, time is of te essence to save lives and

families are counting on us right now to act like it. the reality is we are already running out of resources to prepare for the fall and we are running out of time to fix that. the democrats have been hammering for months and we've been yelling from the rooftops warning what's at risk if we do not get this done. i'm at a loss as to how i can possibly make the urgency of this more clear to all of the republican colleagues. congress take action and we need to continue to support a full robust response this is simply too important to give the

communities the guidance and technical assistance they need to get ready as well. this is especially critical for our schools. lthey want to do everything they can to keep the students safely in the classrooms. in fact, everyone wants that but we can't leave them waiting until back to school season if we are going to make it happen. schools in my state wanted to know what they can be doing right now to get ready for the next school year. how can the best position themselves to make sure if we have a false surge they have the resources into the plan in place that protects students and educators and keeps them safely in the classroom so i want to hear more from the witnesses about how they are working with of the department of education to get to schools the support they need. and of course in addition to making sure we prepare for what is next in the course of this pandemic, we need to make sure we are ready for whatever public healthth threat we face next, period. that means making sustained annual investments in the public

health system like i have proposed so we can end the cycle of crisis and complacency. it means making bold investments in pandemicc preparedness. it meansd strengthening our federal policies and like senator burr and i are working to do in the pandemics act. i will say it again and againr until we get this done it means passing the emergency covid funding we need to make sure the communities are able to continue getting back to normal. note when we couldn't get tests, when we didn't have effective treatment, but we didn't have vaccines. after everything we've been throughic it should be clear ths isn't the time to settle for not doing too little or too late. i can tell you it is clear to me and certainly to the families i'm hearing from back in washington state, so i'm going to keep pressing for us to get emergency funding passed as soon as possible and get the communities everything they need

to keep people safe. i'm asking my republican colleagues to please consider the cost of inaction. consider whatt it means for our doctors, nurses, small business owners, families and friends including seniors and immunocompromised. educators,sm students if we let covid get the better of us because we failed to make a modest investment right nowse si hope that we can work together to find a path forward. >> thank you, madam chair. i hope you are having a mild case. to the witnesses, thank you for coming back to the committee. when weil were last together in january the country was in the throes of the original omnicom surge and at that time, i asked you one basic question. what's the plan.

i hope in your opening statements, or maybe when i ask this question in the question around that somebody will give me an answer. the chair man did a fabulous job of painting republicans as an obstacle m for not enough emergency funding. i remind my colleagues we spent $1.9 billion just on covid a year ago. where is that money going and how has itar been spent? is it obligated? no plan has been presented but on multiple occasions it's been in the room when i said here's the condition, present a plan. it tells me what he would buy if you had 10 billion and what he would buy with 17.5 billion. this is in the plan. when is somebody going to share the destination we are trying to

get to and how we are going to get to that destination. we are still in crisis management and we are two and a half years into this. and i am sympathetic of doctor fauci's position because more than anybody understands, we are dealing with a virus that continues to evolve and change. but since that time we last got together, we have seen omicron sub variance take hold.nd right now they are creeping up around the country. in january i asked yet again how the administration would look to other countries. to informex the response. it caused a new wave of infections in countries where they are dominant like south

africa and portugal. 22% of the cases in the united states are currently ba four or ba five. a number that continues to increase daily. we are learning from other countries in the regions that are ahead of us like israel and europe. what do we need to be doing today to ensure to prepare for what we face in the weeks and the months to come. i've asked repeatedly about the studies out of israel and other countries. i've been frustrated by the lack of detail about what you are learning from other countries and how it informs our covid response. so quite frankly i sent my staf to israel over the memorial day recess. it's my understanding that we need regularly either by phone or in person with our counterparts. ssduring the meetings they share the latest trends in israel andh in the vaccine clinical trials and studies.

if you're getting the information, why is it taking so long for us to act on it? in january, israel became the first country to offer the fourth vaccine dose to individuals over 60 and healthcare workers that were at least four months past their first or the third dose the ministers announced new data60 t the end of january demonstrating additional protections from the fourth vaccine dose for those 16 and over. it took thed cdc three months to take similar steps. i will say it again. three months. israel has also taken steps to target the use of limited countermeasures. israel targeted the supply of the antivirals to treat those with the greatest risk of severe illness to keep them out of the hospital and to keep them alive. meanwhile, the biden administration developed a new plan, test and treat. the strategy to provide

therapeutics to anybody that presented in infection and came up positive. the terms of the emergency use authorization are that pfizer drugs should be given to high-risk o patients, not everye who tests positive. but the way we've applied from the fda is up to anybody that walks int and tests positive. the terms of the emergency use authorization, andwa i said buti will quote this people can get tested and received antiviral rl pills on the spot at no cost. either the president was confused about his own announcement or you are

deliberately giving these bills to too many patients violating the terms and putting people at risk and wasting treatments and taxpayer dollars. it's being shared between the in both countries. before you say our countries are different sizes, i would remind you we can approve drugs and devices based on samples of just a fewen thousand patients. the virus is the same in israel and in the united states. we have seen israel get hit by between 60 and eight weeks before the united states. israel is quick and decisive actions in early december delayed the onset of omicron by five weeks. a clear path and leadership. meanwhile, we've discarded over 82 million covid vaccine doses

in the united states, and this administration assumes that at least 50% of the booster doses we purchased this fall will go to waste. folks, let's figure out a different plan for inoculating these people. why do we keep falling further behind? why aren't we trying to do better and why don't we learn from our mistakes? it seems like we are striving for anything other than mediocrity. have we given up? to highlight a few of the more glaring inconsistencies, andnd april the cdc released data indicating nearly 60% of thee americans about 75% of the american people need 75% of children had at least one covid-19 infection by the end of february. the more recent data hasn't been released but i imagine the infection is even higher today given the recent spikes in cases. we know the majority of

americans age five and over are vaccinated. so the majority has some degree of protection against the virus. yet wee only removed the departure testing requirements for travelers entering the united states legally this past sunday. many countries lifted the testing requirements for fully vaccinated travelers in january and march. canada followed suit in april. this is not an isolated example of where we land behind because we either don't believe the data that they are providing, or it doesn't fit with the narrative that we are trying to carry out. in response to a letter i wrote about my concerns with the termination of title 42 order, you wrote, quote, the covid-19 risk for the communities is greatly reduced from most people compared to earlier in the pandemic. so, why are we still in an

iurgent state of emergency and taking months to remove restrictions other countries have been removing since february? the american people are fed up with confusing messaging and inconsistent response. so, let me ask again what is the plan? more than two years into the pandemic the american people are going back to work in person attending weddings, events, traveling for work and leisure and the government still allows its employees even the fda, cdc and hhs platforms to work remotely. individuals at higher risk of illness are those who live in communities where higher levels of circulating virus knew the precautions they needed to take to keep themselves and their families safe. ifcomm they get sick, we have ts and treatments to help them

recover. it's past time to think about the future. i've asked you over and over again for a plan. the plan for gaining back the trust of the american people and moving the country forward. six months later i still haven't received an adequate response to what the plan actually is. trouble getting a response to my initial question, let me end with asking each of you a slightly different one.my it's crafted around the outcome so i hope all of you canea answr this. what is your end game? may be i will respond differently to the chair man about the attacks that we are standing, republicans in the way of funding emergency money but

the cdc says it's not ans emergency anymore. that's why they are in the title 42. i can go through a litany of things that says this has transformed to somewhere. we are in a period that there needs to be an accountable for how we spend the $1.9 trillion devoted to covid. i think any country in the world laughs at the way we are spending our money relative to this crisis antivirus. so i continue to ask for a plann until we get one and i will continue to be a roadblock for those who believe we can blindly just appropriate emergency money, borrowed from the chinese thinto spend on something we dot have a clue what the plan is. thank you and i will yield back. >> i will now introduce today's

witnesses. doctor wilensky as the director of the center for disease control and prevention and the administrator of the agency for toxic substances and disease registry. doctor anthony fauci as the director of the institute of allergy and infectious diseases and a chief medical advisor in the covid-19 response team. doctor fauci, we do appreciate you joining us virtually following your positive test and of coursead we all do wish you a speedy recovery. the commissioner of the food and drug administration and don o'connell, preparedness and response. director,an commissioner, assistant secretary o'connell, thank you all so much for joining us today. we lookk forward to your testimony.le we will begin with doctor wilenskyky.

>> cherry, ranking member berg, members of the senate committee, i appreciate the opportunity to join you once again to provide an update on the covid-19 pandemic and the work the cdc continues to do to help americans live safer, healthier lives. it was just over a month ago that we surpassed 1 million covid deaths in the united states. too many, that number seemed unthinkable when the pandemic began but it is a sobering it so many of us have experienced great loss over the past two years. we recently experienced another increase in covid cases which was accompanied by an increase in hospitalizations and deaths. through this, we continue to see that unity through vaccination has resulted in fewer hospitalizations and deaths prior to omicron. at this time 67% of the population live in counties at medium or high covid community levels, twice as many as people one month ago. cdc covid community levels have been important for the localities and jurisdictions to decide where and when to use the

strategies to limit the impact. our ability to manage the virus today is in large part due to thee tools we have. vaccines, treatments and masks. we continue to work hard to increase access to these tools every day so that americans can better protect themselves. for example, we recently expanded the eligibility of the boosters for children ages five to 11 and just this week we are coordinating with our colleagues to consider recommendations for rsthose six months to four years to receive their first covid shot. at the start of the pandemic nearly 8 million children, 11 and younger have been diagnosed with covid. over 50,000 have been hospitalized, and over 600 have died. i know that many parents are anxiously waiting to vaccinate their children under five and we are committed to carefully reviewiz the data the vaccines e recommended only if they have both safe and effective profiles. as i looked towards the future of the covid response, thanks to

the congressional support, the cdc will be awarding $3 million to your state to recruit, hire and train public health workers to face current and emerging public health threats. while this is an exciting opportunity to help address a long-standing gap, i'm deeply concerned that the lack of additional funding for other response activities will end or substantially scale back critical covid response work. congress and the american people expect the cdc will continue nationwide studies to evaluate immunity and conduct long-term surveillance on covid including post covid conditions and to support the future vaccination efforts both globally and domestically. we need additional funding to do this work. as we continue to suffer the covid-19 response efforts, we must not forget that this will not allow to be the last public health challenge and we continue to face the future public health threats. this past month we have seen

outbreaks of monkeypox. the swift action has supported testing and case identification. however, threats like monkeypox emerge we run the risk of being constrained by incomplete data from the fragmented public health data reporting system. we need to work together to support the authorities for the cdc to receive timely, standardized and uniform data. this pandemic has highlightedne the need for disease agnostic investments to address the long-standing vulnerability in the public health system. the fiscal year 23 budget request proposes $28 million for cdc over five years to enhance early warning situational awareness capabilities to support the workforce programs, to bolster public health infrastructure, to invest in the data modernization and to prioritize the security initiatives.st the budget also proposes a vaccine for adults program monitored on the successful vaccine for children program.

this programam highlights mayan and the administration's commitment to help equity by creating a mandatory funding stream for which uninsured adults would have access to vaccinations sustaining the infrastructure bill during the covid pandemic. congressional support for these initiatives accompanied by additional authorities to collect and coordinate the public health data would strengthen the ability to prepare for and respond to emerging public health and bio security threats. i am committed to working with each and every one of you to find common ground to support publicic health and make meaningful strides towards achieving health security for all americans both now and into the future. thank you and i look forward to your questions. >> madam chair, ranking member berg, members of the committee, thank you for giving me the opportunity to discuss the role of the national institute of allergy and infectious diseases and conducting and supporting research and addressing the

nation's response toto covid-19. the prior hearing on january 11th, i discussed the research efforts to address the variant. the variant task involved with multiple mutations associated with an increased transmission and innovation. the current vaccines maintained effectiveness preventing however the individuals that have received only the primary vaccine regimen have a greater likelihood with the omicron variant. so importantly, booster shots have been shown to significantly constitutet and enhance the levl of antibodies that neutralize the variant and its sub lineages. they launched the trial to help learn what the variance booster regimens can further increase

mithe durability of the responss in adults who received the primary vaccination plus a single boost. we remain concerned that most children with the vaccine have not been vaccinated. we've collaborated with motor ma and the efficacy of the vaccine in children including those under five years of age initial results from the studyor have helped inform the fda advisory committee with recommendations to the fda concerning potential emergency use authorization for the vaccines in this population and also ultimately to inform the cdc of the recommendations. looking ahead to the anticipatel

emergence of the new variance, the importance of developing the next generation of the coronavirus vaccines is paramount.an i referred to a vaccine that would be effective against all variants and ultimately effective against all coronavirus is. they issued new awards to fund research focused on designing and developing such coronavirus vaccines. other involved entities also have made significant progress in the development of therapeutics. we now have a toolkit of therapeutics that remain effective against the omicron variant and it's currently circulating sub lineages variant. include theeutics antiviral drugs packs all of which have the fingerprints on the development.l

in addition, funding nine antiviral drugs for pathogens of concern thatn would develop for use in outpatient settings that target other viruses with high potential. we know even after people recover from an infection with sars and covid, some have ongoing symptoms or other negative health defects after the infection has resolved. the nih recovered the initiative and complements the studies to better understand the various manifestations of covid-19. the team is building a diverse national study cohort and supporting large-scale studies on the long-term effects of covid-19. they also are participating in

caring for children to better understandis the rare but extremely serious multisystem associated with sars covid children and adolescents. an important role in the all of government plan for the pandemic preparedness that aims to develop and implement the range of countermeasures against those that threaten the entire world. thank you for your attention and i would be happy to answer questions following the presentations of my colleagues. >> thank you, doctor fauci.

the fda remains steadfast in the commitment to fighting the pandemic and we will continue to use every tool in our toolbox to arm ourselves with the best available diagnostics, lifesaving therapeutics and vaccines to fight the virus. since the last updateto of the committee of the fda approved the second vaccine for individuals 18 and older authorized the second booster dose into the moderna vaccines for older people in certain immunocompromised individuals and expanded eligibility for the booster to children five to 11 years. we've also held advisory committee meetings this month related to the emergency use request for the vaccine tod prevent covid-19 and individuals 18 years of age and older. for the vaccine for six years and just yesterday for both six

months through five years of age and the pfizer bio intact for six months through four years of age in each case, without a dissenting vote, the committee agreed that the benefits outweigh the risks and of the intended populations. the agency is working diligently to complete the evaluation of the data for the submissions. including taking into account the advisory committee's recommendations that will make a determination as quickly as we can. authorizingg the vaccine with adequate evidence for safety and efficacy for young children and in particular it remains a top agency priority. june 28 the advisory committee will meet to discuss whether the strained composition of the vaccines should be modified and what should be selected. we also continue to apply the authorities to facilitate the availability of tests including

at-home diagnostic tests, antigen tests. for treatments as of may 31, 2022 there is more than a 700 drug development programs in the planning stages and we have reviewed more than 460 trials for the potential therapies. these include antivirals, immunomodulators, antibodies and combinationsco of these products as well as gene therapy. regarding treatment fordu covid9 in february, the fda issued. inw may approved a limit and certain hospitalized adults. i'm a cardiologist. constantly dealing with life and death. the best way to avoid dying or

getting critically ill is to be up to date on the vaccinations. and if you then get infected and you are high at risk, the new therapies offered additional protection. just like heartge attack patiens who die without proper treatment to open the blocked arteries, a person that dies of covid withoutst appropriate vaccinatis and treatment is not a necessary loss of life. therapies for four decades now this is among the most robust data for saving lives that i've ever seen. it's not too late to get vaccinated were boosted so that you are up to date with yourse vaccinations. more than two years into the pandemic wee continue working around the clock while not compromising our scientific standards. but also continue to monitor changes in the pandemics using the finite resources we are supporting the expansion of the country's arsenal of the safe and effective vaccines and

treatments and accurate and reliable tests that will protect the american people as the virus continues to evolve. we continue to face challenges particularly in the area of access to the data we need to make the best decisions. it's imperative that we have access to complete data in order to prevent shortages, track .events and evaluate the safety and effectiveness of medical products that are critical to the response efforts leading to the questions about the initial data that leads to the ua. we are constantly working to get the data that we need together with our partners in a collaborative ecosystem. but it makes it difficult for us to access complete data needed to monitor. we can do better. i hope we can continue to work together to address issues like these that will learn from the response efforts. thank you and i look forward to your questions.

>> ranking member of her and distinguished members of the committee, it's an honor to testify before you today on the efforts to respond to the covid-19 pandemic. the administration continues to apply a whole of government approach to protecting americans from covid-19 and as we leave the operational response withwh response abilities for procuring and distributing the tools needed to fight the virus. thanks to the collaboration across hhs and with partners at dod and private industry, we've delivered more than 750 million doses of safe, effective and free vaccines and 90,000 90,000n sites around the country contributing to 221 being fully vaccinated. we are preparing to support the vaccination for kids under five should the fda authorize the cdc and recommend a vaccine for that

population. we have made 10 million doses available to the states, pharmacies, community health centers and federal entities to order initially with more doses becoming available soon after. but we are also preparing for the distribution of the protein-based vaccines shouldnt receive authorization and recommendations. this would provide those that are allergic or prefer the option to get vaccinated. while vaccines remain the best way to prevent a severe illness caused by covid-19, we continue to have therapeutics available to prevent and treat infection. today it allocates for different products, to oral antivirals, one for treatment and one for pre- exposed prophylaxis for immunocompromised people. we remain focused on making sure providers and patients know the products are available.

we've made significant progress increasing the testing supply availability and affordability over the past year. in fact we went from zero over-the-counter tests in january, 2021 to approximately 300 million tests available thie winter. we've secured more than 900 million at-home tests for the distribution for free to american households throughav te u.s. postal service. so far, we've delivered more than 500 million tests to more than 70 million american households. and we just opened our third round of ordering. since may, 2021, we've also shipped over 149 rapid antigen tests and 8.1 million appointed pcr tests to the most vulnerable populations including nursing homes, federally qualified health centers and long-term care facilities. in addition to the purchase into the distribution of the tests, we continue to work with manufacturers, companies and laboratories to identify and

proactively address any supply issues. we continue to stock strategic national stockpiles to at or above to prepare for the next wave of cases. we are doing so to the extent possible with domestically manufactured supplies and equipment. we currently have 42 times the number of and 95 respirators, 8.5 times the number of surgical and procedural facemasks, 12.5 times the number of gowns and coveralls, 272 times the number of gloves and ten times the numberer of ventilators than we had prior to the start of the27 pandemic. while covid has been anything but predictable, today we are in a better position tove respond than a year ago. a big reason is because congress on a bipartisan basis provided the resources needed to make sure that americans had of these free and widely available tools to protect themselves. unfortunately without additional funding, the ability to prepare

for whatever comes next is severely limited. last week the administration notified congress in the absence of new funding it was repurposing $10.2 billion of covid supplemental funding taking it from critical programs in order to secure more of the most important tools, life-saving vaccines and therapeutics. the difficult decision was made to divert funds from the testing program and the sns at the time that both programs are finally better positioned and better prepared they and they had been at any point in the response and they require funding to be maintained and strengthened in order to stay that way. without additional supplemental forms we are at the point that each spending decisionon comes with a difficult trade-off. trade-offs that none of usne wat to make. i look forward to working with youu on these difficult funding decisions as we continue to respond to covid and prepare the country for whatever this virus might bring next. thank you for your support and i look forward to answering your questions. >> thank you to all the witnesses and we will now begin a round of five-minute

questions. i asked my colleagues please keep track of your clock and stay within the five minutes. we are quickly running out of resources to prepare for another surge, talking about vaccines thatk can keep us safe from the very end, more accurate tests, new treatments that work against new variants to prevent serious illness and death. developing the products istr essential but it takes funding and time. if we don't provide more funding now, the vaccines and treatments we need in the fall may not be available. i don't want to be in a situation again where schools and childcare centers are closed or hospitals and healthcare workers are overwhelmed. i want to make sure everyone who wants the vaccine gets one in the fall. so i want to ask each one of you individually this morning why are additional investments and how will the ability to respond to the change if we do not provide additional support. i will begin with you doctor

berlinski. >> thank you, chairman ray. we have numerous studies that will not be available to continue studies i believe the american people are interested in and need to see including the nationwide purple and studies that need to end in december of 2022.. these include the national burden incidents immunity protections. we are unable to continue the long-termm surveillance and that includes comprehensive monitoring of post-covid conditions. we would bee unable to condition our mother to baby surveillance and that includes mothers with covid. we've learned a lot about how they impact as was the vaccine impact. but we won't be able, to do those studies for things like other therapeutics including antibodies and finally the cdc will not be able to continue its vaccine efforts, and in the future its domestic vaccine efforts as well. >> to me, the most important thing that will happen is people

will die or be hospitalized or experienced long covid days to months to maybe a lifetime unnecessarily if they don't have access to the latest vaccines and antivirals but we have to keep track of all of this and adapt to this rapidly changing virus. and one more component we haven't talked about in the rsupply chains. i've learned about the food supplyen chain in the last few months and it's not just infant formula. we have multiple areas of agricultural supply that are tenuousof. >> we are going to be limited and the ability to maintain domestic manufacturing of tests. we've been able to support that over the last several months and keep it ramped up to meet the demand. the american people have had for over-the-counter tests we are now having to divert funds and

we are not going to be able to expand the domestic manufacturing of the mrna vaccines. this is one of the things thatsi think is important for the current response in the future preparedness. in addition, the strategic national stockpile was not going to be able to purchase domestically manufactured surgical i gowns as we anticipad being able to do and we will struggle to be able to maintain the current levels that i just walked through. we are t able to invest for the next generation vaccines and therapeutics. >> doctor fauci. >> as you know, the role is to the translation research to get the vaccines, therapeutics and diagnostics. as you mentioned in your opening statement, this virus is changing and we need to keep up with it. in order to do that, we have to

do better with the vaccine platforms. we cannot proceed with that unless we get additional funding. importantly, we need to prevent infection and transmission. we know that you cannot do that unless we get a highly effective vaccine. it won't be able to be funded unless we get the resources to continue the funding. these are challenges that we have that will be letting the american people down if we do not use our scientific capabilities to meet the next challenge of this ever changing virus. eothank you. >> thank you. covid-19 vaccines have done an incredible job keeping people from getting severely ill and they've19 saved thousands of lis however we only have a limited number of treatments produced by a small number of companies.

everyone in the room is worried that we are overreliance on current products and not doing enough to get ahead with of the next generation of tests and i'm worried we are not investing in the research into the products that we will need this winter. in our conversations, doctor fauci,st ms. o'connell, it is clear that the nih does not have sufficient resources to invest in that work. qe alluded to this a little bit, but talk about what you are doing to ensure the next generation research is the top priority. and what can they do to bring these products further along in the process with its existing funding? >> two examples of what we are doing with regards to therapeutics we are using both development and discovery very similar to the paradigm that was used for the highly successful development and discovery of

drugs for hiv. we will absolutely need more resources to get that done effectively. in addition, we have just awarded nine sectors that are centers for the antiviral drug discovery centers. we have investigators through the country and we could find very more and that would hasten the capability that we have for developing newer drugs. how we can continue to further that is to do what we've been doing all along, to partner wih our industrial partners to do the fundamental basic and then to continue to develop these new drugs as well as diagnostics. >> thank you. senator burr. >> i will turn to each of you for a yes or no answer.

programs that you said would be devastating if emergency funding wasn't made available. did the administration request funding for the programs listed? doctor wilensky? i'm certain parts of it were requested but not the full amount. >> we are beginning to process andta absorb the costs into the annual budgets moving forward. >> do they make a request, you came for very specific things that are not, that are going to be disastrous if emergency spending is not -- we are doing the budget request coming from the administration. dide they request these things? >> it's been over a year since we have received the covid specific funding. >> the administration just took

money from the strategic. they didn't ask for more. they took it. they asked for less. doctor fauci, are all the things you just listed, are they in the 23 administration request for congress to fund? >> some of them are but not all of them because at the time we put in that request, the opportunities to do some of the things were not apparent. >> this has been well orchestrated up toto this point. it's a done damage. it really has. the public health response where there is a commercial market for the vaccines, treatments and diagnostics. yet the fda is limiting who can purchase the treatments under the eua. nothing in the law requires the purchaser of an authorized

vaccine or treatment must be government. does the fda have a plan to allowur states or healthcare providers including purchase vaccines and treatments to help put purchasing decisions back in the hands of americans rather than the government? >> senator burr, eachpu of the majorts product areas biologicss working with of the industry to be transitioning and many have alreadyna transitioned. >> what i read in the statement was you actually write into the eua only the government can purchase these.nu >> that's correct. >> end of the law does not restrict anybody else from purchasing. it's the limitation you put in, correct? >> yes, that's correct. >> let's talk about it a little bit further. on antivirals, did i misstate anything that it should only be

prescribed individuals that are at risk? >> pfizer did a robust trial that included people at risk, at higher risk by certain factors. we looked at the data and the data was compelling. that was the basis. >> and it says to be prescribed by individuals at risk? >> at higher risk, yes. >> so, this testing violate the restrictions if individuals show up are not at risk, test positive for they are given an antiviral? >> my interpretation of the tests, it's still a prescribing within the eua and so those that meet the risk criteria would be prescribing. >> so anybody that doesn't reach the riskes criteria would be in violation?d >> prescribing as you know is a complicated area of medical practice. so, when you say in violation, i'm not sure what the main legal

meaning is good people that are low risk like a 25-year-old with covid and comorbidities wouldn't be expected to get benefit and so it wouldn't make sense to prescribe. >> was the vice president high-risk when she took -- >> i'm not awarebe of the vice president's status and as a physician i wouldn't discuss a person's medical history. >> ms. o'connell, just last week hhs announced that it had $10 billion in the couch. out of those funds, previously provided for covid responses, i was surprised and frustrated a two-year that these funds were overwhelmingly repurposed from within, including the stockpile. to be taken from the strategic national stockpile what have we given up in the stockpile so that that billion dollars can be spread across the rest? >> thanke you, senator. without additional funding we havet been forced to make

decisions and trade-offs that none of us want to make and that included finding an additional billion dollars from the strategic national stockpile. that funding would have gone to securing the purchase of domesticallyat manufactured surgical gowns to meet the requirements the strategic national stockpile has for surgical gowns, so we are going to be short. we also are jeopardizing the ability to maintain at the levels we currently are. every piece of equipment we have is warehoused. the warehousing costs money. >> by statute you're supposed to lead a pandemic, so i'm going to turn to you. tell me what the plan is. >> the administration put forward a plan march 3rd with how it would spend the additional funds -- >> i understand how you would spend it. tell me what the plan is to get to some endgame in covid. >> the plan involves short-term providing making sure all americans have access to the

critical tools needed to protect themselves medium-term making sure we have access to suppliesr moving forward and investing in domestic manufacturing so we are not caught short footed like march 2020 and long term, the moresearch and development that we've talked about to get to the next generation of vaccines that won't require multiple boosts because the therapies that can be prescribed for everybody. >> if you can take the outline you presented to me and get somebody from the administration to fill iner and between the action steps that are going to bebe taken, you might have a pl. thank you, madam chair. .. right now there's not enough

data that has been accumulated to indicate that is the case. i believe the recommendation that was made, was based on the assumption that if you look at the morbidity and mortality of bachildren within each of the ae groups, zero -- five, five -- 11. >> editor, center there are no studies in american should all thknow this. there are no studies on children showing a reduction in hospitalization or death with taking a booster. the only studies that were permitted, the only studies that were presented were antibiotic studies. they say if we give booster you atmake antibiotics. now, a lot of scientists would question what that's proof of efficacy of a vaccine. if i give you ten or if i give a patient time mrna vaccines and they make protein each time or they make antibody each time, does that prove we should give ten boosters dr., fauci?

>> know that is somewhat of an absurd exaggeration brickwork set is the proof you use. your committees use that. that is the only proof you have to tell children to take a booster as they make antibiotics. it's not an absurd that you are already at like five boosters for people you had two or three boosters. where is the proof? i think there probably is some indication for older folks that have some risk factors but for younger folks there is not. but here's the other thing there are some risk factors for the vaccine. soso the risk of myocarditis wih the second is for adolescent boys 12 -- 24 is about 80 in 1 million. this is both from the cdc and from the israeli study. it is also in the study remarkably similar for boys much higher on boars than girls much higher than the background for the background is about to perrk million. so there is risk and there are h riskier telling everyone in america blindly go out there because we made antibiotics. it is not an absurd correlated

safety of ten. in fact you probably make antibiotics if you get 100 boosters, alright? that is not science that is conjecture. we should not be making public policy audit. >> out •-middle-dot if i might respond to that, we just heard in his opening statement ranking member bert talked about his staff went to israel. if you look at the data from israel for the third shop boost and the fourth shop boost was associated even the port people in the 40s 50s that is clinical data. the thing is you are not willing to be honest with the american people. so for example 75% of kids have had the disease. why is the cdc not including this in the data? you can ask the question you can

do laboratory tests to find out who has it and who hasn't had the disease. what is the incidence of hospitalization and death with children have been infected with coviddi subsequently going to te hospital or dying? what is the possibility of your kid has had covid which is 75% of the countries had coded. what is the chance my child was going to hospital or dying? collective you look at the number pediatrics, senator, you can see there are more deaths of people who have had it. >> people have had the disease. >> we also know frompe other studies the optimal degree of protection get vaccinated in the era a micron in the sub lineages.ow >> you can't answer the question i asked for the question i asked just how many kids are dying and how many kids are going arty

have covid. the answer may be zero. so much wanted to protect the released data earlier they left out the category 18 -- 49. i was atwh left out when the critics complained taken booster between 18 -- 49 the cdc study. another question for you, the nih continues to refuse to voluntarily divulge the names o scientists who received royalties and from which companies. over the period of time from 2010 -- 2016, 27000 royalty payments were paid to 1800 nih employees. we know that, not because you told us because we force you to tell us to the freedom of information act. over $193 million was given to

these 1800 employees. can you tell me that you have not received a royalty from any entity that you ever oversell the distribution of money in research grants? >> the first of all let's talk about royalties for crack that is the question have you ever's received a royalty payment from a company that you later oversaw money going to that company? >> i don't know is a fact but i doubt it. >> here's the thing, why don't you let us know by don't you reveal how much you have gotten from what entities? the nih refuses. we asked in the nih we asked them whether or not, who got it and how much meat they to tell us. they sent it redacted but here's what i want to do is not just about you. everybody on the vaccine committee have any of them receive money for the people make vaccines can you tell me that question what can you tell me if anybody in the vaccine

approval committees ever received any money. >> soundbite number one are you going to let me answer a question? okay. let me give you some information. according to the regulations people tou receive royalties ae not required according to the act. from 2015, 2020 the only royaltiese i have was my lap and i made at monoclonal antibiotics used in the charo reagent that had nothing to do with patients. and during that period of time might royalties range from $21 d year to $700 a year. the average per year was $191.46.

>> it is all redacted you cannot get any information on the 1800 scientists. we want to know pickwick senator paul. >> we went up people got money for the manufacturer. >> interpol your time as long expired i've given you additional two and a half minutes. senator sanders. >> thank you all very much for being here. one of the concerns that i have in terms of where we are now and where we might be in the future, is that the american people do not have ready access to the information they need as to how they can receive the best treatment available for covid. an example, a 60-year-old gentleman wakes up in the morning has a bad symptoms, test positive for covid.

i worry that person and millions of them may not even know that there are therapeutics out there that can help them. they may have five days they have to take of than the first five days of symptoms. can you tell us doctor or wolinsky, what we can do to make it easier for people to get the therapeutics they need? >> thank you, senator sanders this is key in terms of our distributor and equitably distribute not only are therapeutics but even before thn therapeutics. communities and at-risk people need to understand due to a test for that's a gateway to get into therapeutics read up testing available accessible but a lot of what the experts of dented determining home we need to have therapeuticscs available average communities across the country. and then we need to give public

health campaigns so that people understand a test should be done and they have access to these therapeutics. >> but the concern is in some of them at least you should take the drug within the first five days. are you confident we have a system that if somebody wakes up they're going to have to get a prescription from a doctor, do they have a doctor they can get a prescription from within the first few days? do they know where to get the drug and do they have the money to pay for that drug? lexi drugs are free, the tests are free. i'm not sure everybody knows that. we have expanded our rollout and accessibility but i will also say just like early in our vaccine work we have seen and equities how that has been used. we'll have more data forthcoming from the cdc soon on that. we have a lot of work to do the equitable distribution to getting it to the communities you can beg health centers to

physicians in rural areas. correction arc goal be to make it nice and simple someone is feeling ill, someone has code they could dial a 1800 number and get the drug as quickly as possible. is that the goal we are striving for? >> means you that under the eua. with that caveat there are some things like renal insufficiency or drug, drug that need to be assessed. we need to make sure the assessments are complete assu well. >> i want to change course a little bit here and touch on the subject i don't think we talk b about enough as a nation. and that is that we have a significant shortage of doctors, nurses, pharmacists, dentists, other healthcare providers. and that shortage has only been exacerbated as a result of burnout related too covid. i know that is not necessarilyer within your jurisdiction.

but can you give us some thoughts about how serious that shortage of medical personnel is and what we might want to do to address it? >> yes i think it's not it's key not only but healthcare survey demonstrate we are about 80000 public health workers in deficit right now. and we need to not only retain the ones who stepped up to the plate during the covid-19 pandemic, but we need to foster and invest in future public health workers as well as healthcare workers pride h that includes loan repayment, includes investing in the time and making sure we are competitive from salary standpoint so that we can retain the best of the best in these fields. >> palet me ask a question, senator paul raise the issue of money and so w forth. his questions are valid but i looked at in a slightly different way. i am concerned and you correct wrong here, but moderna who helped create one of

the important vaccines that is saving lives received as i recall about two and half billion dollars through the trump administration. my understanding, you correctly if i'm wrong as a gentleman who is the head or was the head of moderna recently received a golden parachute c of some $800 million, to have billing of federal funding to develop the drug adjournment makes huge amounts of money the sky receives 800 million and goldenn parachute. am i right about that? >> i am not aware of that. that is not something i would keep up with particularly in this g job. >> not something you would keep up with. you are head of the food and drug administration. you would not be concerned when we are producing trying to get vaccines out to people, i am corrected 926 million-dollar goldenyi parachute. if that is true of the federal

government gives a company to and a half billion dollars in a short time later the head of the company gets a 90 million-dollar golden parachute that is not a concern to you? >> i did not say it was not a concern it's not something i keep up with. but i'm very concerned about is equitable distribution of vaccines that say lives and antivirals that save lives and we are not reaching the goals that we need. >> i think we need hope everyone agrees we need the financial resources to make sure everybody has the vaccine. but if one guy ends up with $900 million rather than usingto that money to get the medicine we need out to the people, does not make a lot of sense to me t thank you very much madame chair brickwork senator romney. >> thank you madame chair. senator sanders, i am a one of those does not understand why golden parachutes are provided

by boards everett doesn't make sense to paywh someone to leavea ton of money now that you change the law i just can't figure out why a board would do such a thing, worth looking into. i appreciate the work that eachh of you do. and the effort you make to help the people of our country have healthier lives and have long lives. and i realize science is not all-knowing and from from time to time there are mistakes. that is the nature of humankind but appreciate very much the work you do want to express my appreciation personally for that. i do have an issue that is related to what you do but related to the administration and which are part of. and that is back in march icom and another of other members of this community sent a letter to the administration asking for an accounting of how the prior

covid relief money had been spent. and then also how new money that was being requested for emergency supplemental would be spent. and as part of that response to that letter the administration released a state regarding the lack of potential p funding for the restaurant going forward but i would read a couple of xers per" the federal unable to purchase additional lifesaving monoclonal antibody treatment and will run out of supply justin to states as soon as late may be the federal government cannot purchase sufficient quantities of treatments for immunocompromised individuals the federal government will be unable to sustain the testing capacity we built over the past 14 months. and then continuing, and in the purchase of monoclonal anti- treatments, scaling back state and territorial allocations, inability to purchase additional

oral antiviral pills, inability to purchase new antivirals. scaling back plan purchase the preventative treatments. again, what the administration provided to us in congress in response to our letter, was the administration would be unable to purchase therapeutic sent monoclonal antibiotics for it unable to purchase. madame chair and ask unanimous consent this release for the administration be entered into the record. >> without objection. >> all in good faith i in a number of other people worked over a number of months with members of this party and across the aisle to develop a supplemental bill providing $10 billion to address this inability to purchase these things without $10 billion. but you can imagine my surprise when i find out then on june 8 the federal government did in fact prioritize a $5 billion for the purchase of additional vaccines, 4.9 billion for therapeutics. and three under million for additional monoclonal

antibodies. but it chose not to do so and february, march, april, or may. again saying that inability to do so. so, the administration has recklessly and unilaterally spent taxpayer money. we have runaway inflation pay but instead of taking a real inventory of funds they had at their disposal, they said hey we need more money. now, washington operates on a relationship of trust between the respective parties the administration and congress for the administration to provide information to us that wasas utterly false is something which dramatically attacks that trust, which i have come up members of my party have members of both parties have. and i hope there is an appreciation for the administration to say they could not purchase these things, and then after several months divert some funds and then purchase them is unacceptable. i makesev our ability to work

together and have confidence in what we are being told very much shake into the corporate out asked this question, if the administration knew in march is feasible to buy these things, do you know why they waited to actually do so? anyone if you can respond. doctor fact sheet on the hot seat on the camera will give it to you. hope you feel feel better by the way. >> thank you very much senator. i think that question is probably best given to assistant secretary. >> thank you doctor fact sheet thank you, senator romney think if your support and trying to get additional funds and free for us to manage the covid responsibly. >> i didn't realize they were needed i would not have worked as hard with leader schumer and with others over many weeks ins intensive negotiations and gone to my colleagues and told him these monies were necessary had i been told that in fact they were necessary. and i know money you're going to

tell me hate we need to spend money on other things we had to divert it. but that we could have been told but we weren't told that we were told we could not purchase therapeutics are monoclonal antibodies and now youad have. >> b had to do so with significant trade-offs, trade-offs none of us wanted to make. >> we should have been -- we are part of congress by me were asking us for $10 billion we should be appraised of what those trade-offs are. and to have that discussion and help make that decision together but you should not be able to say hey, or look at trade-offs were not going to tell you about them just give us some more money. is that not unacceptable in a relationship between an administration and congress? >> we work hard to be transparent with their funding needs. again have appreciate the support you've given us. making the decision to spend this money, taking away from critical programs is absolutely difficult but something we did not think was acceptable. we are now at a point because

congress has not given a suggested additional funding we have had to do these things that are unacceptable. >> my time is up i just say we agreed on one order that is unacceptable thank you, madam chair. >> thank you madame chair. now, as new mexico continues to battle the covid 19 pandemic, we are now also battling the largest wildfire the state has ever seen. wildfires that were started as a controlled burn by the federal government. two fires gotwi out of control. so while i very much respect people keep telling the 99.8% of controlled burns are always under control. i more interest in the pointnt o percent that destroyed our state. these dual crisis have stretch the resources of the state to the breaking point. as new mexicans flee natural disaster in many cases taking only the belongings they can carry, they faced increased exposure to covid-19 virus which

has run rampant in the congregate settings used to house evacuees. assistant secretary o'connell, how are you coordinating to support new mexico's covid-19 response in light of the wildfires? >> thank you, senator lujan but we continue to keep the people of new mexico who are currently experiencing these two tragedies in our minds. the secretary on may 9 realizing the extent of what was happening in new mexico declared a public health emergency. that public health emergency freed up flexibilities for the healthcare system there. in order to respond and the emergent conditions. including providing telehealth for medicare beneficiaries, freezing the medicaid rolls so no one would lose insurance during this time of tragedy. we continue to support through our hospitalee preparedness program new mexico's coalition, healthcare coalition which was

responsible for evacuating many of the hospitals and long-term care facilities, nursing homes and so we continue to work closely with our colleagues there to make sure everybody is safe and accounted for. we also run the medical reserve corps and the medical reserve corps in new mexico has been activated in order to respond to the wildfires. we continue to support our colleagues out there through that effort. and we've been in close contact with fema peru offered virtual support to fema out new mexico. and wherever we can be helpful we are trying to be. we have not stopped or covid response from your continuing to make vaccines and therapeutics and tests available to those in new mexico that need them. >> and assistant secretary o'connell this iss a follow-up o the solid answer of programs that have been made available. the follow-up is, how is hhs ensuring these resources are being communicated to those impacted? especially given the current lack of the cellular and broadband service in many regions of the state, which is

nonexistent in theseen communities. >> thank you, senator. so we continue to have boots on the ground in new mexico. we've got regional emergency coordinators in the state that continue toinun communicate with city and local leaders but we also have our cms representatives who are making sure the medicare and medicaid provisions are being well community dedicated to those beneficiariesms. and everything we can prevent several regional representatives leading this effort for us and new mexico. and continue to rely on their ability to communicate on the ground. >> i said earlier that many families were forced to evacuate. they were living in congregate settings. but they were not eligible for the fourth covid-19 vaccine. dr. walensky, will you commit to reconsidering cdc guidelines for the fourth covid-19 shot to account for the risks of people fleeing from natural disasters

who are forced into compact living conditions? >> thank you, senator lujan let me add my support and strength to the people of new mexico who are experiencing these natural disasters that may affect your backup and let you know something cdc has been doing and including drafting recommendationspe and documents like wildfire smoke and covid-19 public healthth strategies to reduce exposure to wildfire smoke during the covid 19 pandemic. going tod public health public disaster shelter drink overnight to have documents we are providing technical assistance on the ground as well as public health communication, exposure, assessment and epidemiologic data in order to support the efforts on going there. we've been working and national center for environmental health over the last decade to support health departments to prepare for, respond to and recover from wildfire disasters. specifically to your question about booster shots for this population, cdc has committed to

continuously reviewing the data on the safety and efficacy and need for booster shots but we do so all the time. we strengthen our recommendation for a fourth shots for those over the age of 50. and should we seee. a need in safety and efficacy we will continue to expandda we certainy want to file the data as we do separate. >> i appreciateho that dr.fi walensky. madam chair, my time express on a couple questions i will submitted to the he record. i am hoping that is a long way of saying yes, definitively to make these changes but not all of us are over 50. i just turned 50 i can say that now. there are a lot of young families and children and grandchildren who are in these settings above the age of five. we had them all in one place. when we would get scares of spread are those who tested positive it is the perfect place to help provides additional support in a community where it's hard to get to and we don't always have the availability. this is an area i will continue to push but i'm hopeful we can

find a positive remedy here because new mexico is not going to be the only state facing natural disasters but we are in that season right now. and so i am hopeful there will be some positive direction and how we can take care of our people. thank you very much madam chair i yield. quick sitter cassidy big bucks thank you all for being or think of your efforts on the part of our country. and of course we are hearing us there has to be more money appropriated in dire consequences if not allocated. but beg the question of the stewardship of the current dollars being allocated. and so i personally think, i think it's a great physically showing up to work is important. so it missedee o'connell, how my days in the last month read physically in your office? >> the vast majority of those days but. >> can you give me a number? it is so frustrated but have never been up to get a straight answer from one of you as to how many days you are in the office

and what is the return to work policy? how many days this past week? tell me how many days this last week. >> hhs has continued its return to work starting in april. we are bringing everybody back. >> now how many days have you personally been in your office this last week? >> multiple days of course. >> that's not hard to remember. there's only five days. if you'd dissemble it makes me think you have not been in the office and you don't want to give me a straightha answer. i am speaking on behalf of the american people were paying taxes. a lot of salads and they think aipeople are not showing up to work. how many days in the last five read physically in your office? >> we continue to work. >> okay how many days and less file be physically in your office? >> i was in north carolina monday and tuesday because the 218 -year-olds that you met at my confirmation hearing. >> five days and it wasn't a family issue go the previous

week. >> every day when i've been in washington and not on business travel i go into theit office at white oak. >> i get that. so every day you are in washington does not mean that you are here. so are you either doing business travel on part of fda but it's not your physically your office? >> yes. except for family events. >> dr. walensky how many days in the last five were you physically in your office? >> am not in my office today but. >> not feel like, how many days per. >> i believe and work outside i've been traveling i've been in my office to and i've been traveling for 21 of them i was in fact expects the last month you typically work out a washington or your home the northeast? >> we are in agency at cdc for. >> it's really hard to get a straight answer. quick some of our work is in

your state. >> i getet that, i get that lete read something from elon musk was asking tessa workers to go back to 40 hours a f week. the more senior you are the more visible you must be. that is why i've lived in the factory. companies that don't require this, it was the last time they shipped a great product? we don't ship great products bush phoning it in. there is a perception your agencies are underperforming. if you underperforming and you're not showing up that's not good stewardship. now let me ask because i understand hhs has a policyy which is allowing people to come back every two weeks for eight hours a day. you have a policy in your agency which is different with this pilot program only requesting requesting eight hours in the office in two weeks missile, yes or no? >> we require more than that in the office, thank you.

>> yes, we have talked a lot we have a pilot program which is just every individual to their optimal working situation for them to be productive. >> that tells me it's really up to the individual to decide too. >> their supervisor. >> so your laboratories,me discovery laboratory workers show up every day physically question mckenna laboratory got to be there.dir >> senator cassidy we are both doctors. everyone was adopted in the laboratory is there every day pretty alsoas know when you analyze data for. >> yes analyze data got a lab tech the lab tech has to be there for. >> absently. >> is a wabtec there every day? >> i'm sorry to be insistent but it's hard to get an answer dr. walensky? >> yes people labs are working our labs. i will also say. >> are they working full-time 40 hours a week? >> when i the data needed at midnight on a saturday night people are working for the not necessarily in the workplace but

there working. >> i get in the lab employee is only productive in the lab are they working 40 hours a week? >> people think outside the lab or outside the lab. people are deployed to the field are deployed. orthis lot people working outsie directors 18000 employees and i cannot believe they are all deployed. i'm going to finish with this. you are asking for more money. and so, you tough trade-offs have to be made. by golly if you don't give us this money some things when we sacrifice. i suspect you have not laid off a single person. i also have the ability to monitor at home work history as to whether or not they're actually logging on. i be interested to see thatsp data. you've got maintenance people who have not been employed forso two and half years. and i suspect they have not been laid off. but you are asking for moree taxpayer dollars, asking tough choices for the family at home trying to make their balance work.ey and yet it seems as if there is not a tight ship being run. i have over, i apologize, yield.

>> thank you madam chair andas ranking member for this hearing. thank you to all of ourol witnesses today for being here and for your service. doctor caleb i want to serve the question for you about the infant formulas shortage. i want to follow up on comments you made at the start of the days hearing. when you testified in front of the committee two weeks ago within two months will be quote beyond normal plethora of improper formula for that as chair murray noted avid announce less sites formula had flooded which was likely delay production and distribution of product for a few weeks". but despite that setback, as i understood your answer to chair murray earlier, you still hope to have a quote super supply" of baby formula on shelves in the

next two -- three weeks. which i take to mean more formula available that was typical prior to the sturgis plant shutting down. is that correct? and if so how do you expect to achieve that goal with abbott saving sturgis plant will remain shut down for another two weeks? >> yes that is correct with two assumptions. one is the company stick to g production data they have given us for they've already demonstrated they can do. the second is there is no other natural disaster like the unexpected one. one thing that has happened is we nugget production data from all the companies involved. it adds up to a surplus relative number of babies using formula. over the last several years. we should be over that number easily. the formula coming in. >> what you are indicating to me

is that other producers have been increasing their production? >> absolutely. all of the estimate of this only for which is another issue. the numbers show it. >> during the lasting indicated interagency committee has developed a comprehensive plan super supply on the shelves. we'll provide that written comprehensive plan to my office after this hearing? >> we will provide a plan yes. >> thank you. quick some to look at the planned event to follow up with you for a briefing does that work for you?ke okay. second question is to dr. fauci and assistant secretary o'connell. dr. fauci, for nearly two years i've been asking you want to covet a team vaccine children under age five would be ready. and they are now nearly there. while vaccines have been available for older individuals for quite some time, the infant in tyler vaccine has been much

slower leaving many families with young children in abe precarious position as they try to keep the kids safe. do you anticipate the childrench ages six months -- five years will be able to get their first dose by the end of this month? >> well again center thank you for thatt question. i do not want to get ahead of the advisory committee. you heard for my opening statement that of commissioner that in fact the advisory committee to the fda made a recommendation, a positive recommendation for emergency use authorization. the next step would bete the cdc in which dr. walensky's advisory ldcommittee in fact likely i'm sure they will, look at the data and make a recommendation. and at the end of the debris the director of the cdc obligation

and duty to make a recommendation. on so ic' hope it does but we never want to get ahead of the data. the data looked very, very good senator. as you heard from commissioner and the looked quite good. i anticipate that is going to happen but it would not be appropriate for me too get ahead of my cdc collects for. >> godfrey just briefly dr. walensky what is a time might look like for that review? >> were going to review tomorrow and working on saturday as well. we understand the urgency of this for americann parents. when it recognized even on week opening to do this to get to the american parents. >> thank you assistant secretary o'connell how will the admits racial work to educate parents on the safety of the vaccine and help as many families as possible to have the youngest children vaccinated? >> absolutely seven the decisions come through as we may expect the approval and recommendation, we have made available 10 million doses for states to order and the vast majority of them have placed

those orders were that will allow us to ship out as soon as the ua should it come comes with the expectation parents can begin getting their children vaccinated next week. that is our intention for. >> thank you very much thank you chair murray pickwick senator colin. >> thank you. doctor caleb we know the baby formula crisis was exacerbated by the fact people weren't working in the mailroom and inspectors were not working a normal schedule and the baby formula plants. in response to a question from doctor cassidy, you referred to a return to work pilot program. how many fta employees are a part of that pilot program as opposed to working full time right now and the officer in the

field? of course as you allude to they are all working full time but i would have to get back to him the exact numbers. the majority are in the pilot program in one way or another. the goal is to adjust to the maximum productivity and job satisfactionon. >> they cannot do their work if they are not present. >> if it is a job for they will do their work best if they are present, they are required to be there. >> i would really appreciate getting the data on that. it's all portably the data to i think it will be interesting but i will say is a google before this is opposed to elon musk i think google is doing pretty well with their hybrid program. >> only switch to another issue. i am very alarmed by the response that i heard to senator sanders question, or he said we should be able to just dial 1802

get a prescription and the administration has pushed very hard on the test entry program. as you test positive you get it right off. here's what i'm concerned. the first is that it interacts in a negative way with a lot of commonly taken medications including the blood thinners for example. second, just on tuesday pfizer announced it was halting enrollment in a trial for pacs logoed and standard risk patients. both vaccinated and unvaccinated after study revealed it was not effective in reducing symptoms in that group. what we have heard today and

what the administration seems to be pushing it is this notion that pacs lobe it is going to be the answer if you have a positive covet test. do you really thinkat calling 10 is a good way to handle the prescription of a drug that is been found to not be effective for standard risk patients and has the interactions with a lot of medications? >> thank you for asking that question. the place i grew senator sanders have a vastly inequitable distribution of life-saving vaccines and antivirals. i know you are from a predominantly rural state per particularly rural people are suffering because they have lower vaccination rates and less access. i do a not agree an individual calling a 1800 number with no

clinician involvement is a good idea. first of all because the drug is not indicated except in people who are at higher risk. it's not that is totally ineffective and lower risk i love to go over those with you later. just not worth the prescription and that case the benefits are minimalov. i think there does need to be an intermediary either a pharmacist or a physician who can look atso the risks and the drug interactions and make a good judgment. but the concept is right, having to find a physician, get an appointment can take over five days for many americans. so we have to have a system that deals with that issue. >> dr. walensky. david lenhart recently wrote in the "new york times" what masks can work, the evidence suggests that broad mask mandates have not done much to reduce covid caseloads over the past two

yearss. in fact is a daily average cases per capita during last winter's surge was practically the same in counties and states that had mask mandates and those that did not. we have seen hong kong despite almost universal mask wearing recently endured one of the world's worst covid outbreaks. there are proven ways to lower hospitalization and death we know that. vaccination, therapeutic but mask mandates have contributed to a of trust in public health officials given the scant evidence that they actually lower caseloads. what specific data has the cdc examined that demonstrates that broad base mask mandates lead to

lower caseloads? i cannot find any. >> thank you center columns but actually believe that is a piece that is undergone substantial criticism for moving forward but i will say there are numerous studies have demonstrated per we have to look at this over time because there secular trends with the mask mandates have occurred for their population in the aggregate data demonstrates decreased rates went mask mandates have been putdses in pe earlier in the pandemic we have to control for all of the things as to what has been open, what interventions have been available. there been other studies starting to refute that data, thank you. quick senator smith? >> thank you very much chair murray and thanks to all of our panelists for being here today. i'm going to focus my questions on questions of data and data sharing and how that reflects our ability to respond to the

pandemic. but before i do that i want to reinforce the comments chair murray made at the beginning of this hearing we are making progress on the pandemic. we are in a much better position that may have been. it is essential that we have sustained resources so that we are ready as we look to whatever comes next with this pandemic but i would associate myself with chair murray and urge of my college to support the findings of needs or covid response can continue. i appreciate very much my colleagues senator cassidy andg senator collins and their work on accountability. i just want to ask you all simple yes or no question. is the work of your agency been hampered it anyway by people not being in the office? just yes or no. >> no. >> no. >> no. >> dr. fauci?

[inaudible] resolving the issue on sharing public health data as a child's were both aware of and have been talking about for folks not paying close attention tribal centers worker by congress essential public health authority in the indian country since the beginning of the event pandemic they face real challenges accessing public health data through thetete cdc. i introduced ain bill to resolve this issue but i'm grateful for the work of my colleagues is wellness especially senator lujan. dr. walensky the gao has issued a report outlining recommendations to resolve the issues. i would appreciate knowing i know you appreciate the challenges off this, can you commit to working with us, make sure the gao recommendations for the cdc report back on that is august 31, 2022. could you please commit to us

following through on those recommendations questioned. >> thank you, senator i push at the conversations had with you as well. we are working with our tribal epidemiology consortium in i'm meeting with them later this month as well to the summit meeting with the tribe specifically about how best to work for data sharing. we are aware of the report we have two specific items to address but we are on track to provide timely response of those. i don't to comment this is not just a data issue a lot of larger data at hand for the cdc does not have the authority to request, receive, show data in a way that does is a comprehensive. not only the cdc and the national forecast the tribe, the locality from one culture to another but we do not have the authority to do so. we have gotten some of that for the public health emergency, through the cares act we were able to receive lab data through

cms authorities to been able to receive hospital data. it is been really challenging during this pandemice we still have holes in the data we are able to receive. and now it's with two monkeypox and the outbreak of monkeypox we are again revisiting the challenges that we are not able to see all of the dated that would be necessary to receive and to share so that we can hae a response thank you by. >> dr. walensky you anticipated my next question. so i appreciate that it will get to that in a minute. just a close up of a tribal daa sharing i would just ask we stay in close touch on this as we approach january excuse me august 31. so that we can resolve this in the tribal epidemiology centers can have access to the data they're legally required to have. looking more broadly i'm aware the cdc does have challenges with data. want to help to try to tease this out inwo the few seconds i have left. for example, does the cdc have

the authority to require hospitals to report their covid data? and if they do is that authority permanent or temporary? >> it is temperate to the public health emergency is now cdc is throughh cms. >> and have hospitals been reporting the data? do we have all the data we need at this moment? >> we do not receive the data cms has the authority to request that we do not receive all the data that we would like to receive. >> i want to just acknowledge senator kaine has a bill which i cosponsor the improving data inn public health which would make the crucial improvements they have come to understand we need to strengthen data sharing between public health authorities in the cdc and the federal government or broadly. make sure the data sharing is not permanent to make sure we continue to be responsive on the federal label and have the data so we can make decisions how best to respond to public health de continue towill

have regrets weda are very grateful for your support and senator keynes on the bill, much.you very >> a look forward to myre colleagues consider kate on that it's about be thank you very much. >> thank you madam chair. dr. walensky is about a month ago in an appropriations hearing i asked dr. fauci about lockdowns risk based upon the jon hopkins study that said that tactic basically was neutral on mortality. i don't think it got into it mortality might be caused due to the fact we were locked out in other areas. but, would you agree with dr. fauci on that? we probably won't ever need to use lockdowns again on covid as we currently know it? >> i certainly hope not senator brown. i know that hopkins study had some flaws in the event of the studies that have refuted that would be happy you more details on that. certainly we are doing everything in our power from

happening. covid has sent us numerous curveball so i will never say never a'r big exam i also at everything i've observed in keeping in touch with the business community, who took it pretty seriously -- make they did not think transmission was occurring at work. it was mostly elsewhere. locking those businesses down of course i think were dealing with those consequences currently. another question, when it comes to vaccine mandates, supreme court finally weighed in and said that did notue make sense when we are going to try to force businesses down to 100 employees, either have their employees get a vaccine or loseh her job. that's in like ultimate heavy hand of government. would you ever recommend doing that again? the administration seem to err on the side of vaccine mandates and lockdowns whichen i talked about earlier pickwick semantics or generate vaccine mandates are

generally a local decision. i will say is we at cdc are for promoting more people to get vaccinated because those who are vaccinated and boosted have decreased risk of severe disease and death. generally we support getting more people vaccinated because they like to cite the fact the administration forced it through all federal employees. and i believe that initiation of what would have been the biggest mandate came from the biden administration. through an executive order. i agree with you local prerogative should come into play. but this was not that. do you care to comment further on that? >> cdc stand the more people are vaccinated and boosted the decreased risk of severe outcome and death. c >> so we have now gone a couple of years. we've learned a lot. i think the data has shown this has ravaged a disproportionate

way the elderly with comorbidities. i would like your kind of assessment going forward with the general dynamic of what we know about covid. does it make sense that we protect better where the data has shown that we have had the most issues with. also parallel this with the flu. i noticed more transmissible. the flute generally has a broader fatality rate. and here's senator paul talked about a little earlier, we know it has really hit one category very hard. you think we are protecting them well enough? you think it makes sense to take the broad approaches for so much of the country that is either asymptomatic or had mild symptoms. >> i think we need to do both.

certainlypt our elder community has been among those who have been highest at risk of severe disease and death but i will also say cho was on the top leading killers of children right now, death among children during the colored pandemic have been higher than we generallyon see. some have been higher than we seen for flu.vi i actually think we need to protect young children as well as protect everyone with the vaccine. especially protect elders. i will say we have recently endorsed and recommended boosters for all those over 50 a second booster for all those over the age of 50 we will have forthcoming data demonstrate compared to a third booster those over the age of 50 of got the fourth have a seven fold decreased risk of death we are exiting both of those simultaneously that is what i think we need to be doing for. >> thank you. finally for dr. fauci, of course we read this week, after 675 years we finally have found the

origins of the black plague. care to give us an update on where we are at with tracking down the origins of covid-19? >> thank you for that question senator. there have been a number of papers that have come out from highly qualified virologist that indicate this is very, very likely a jumping species from an animal host perhaps third intermediate host into a human species which then spread throughout the human population. certainly in almost certainly originating in china and wuhan. was still open up and keep an open mind as tost whether or not this had to do with a virus that was isolated out in the environment and that came into a lab and had what most people refer to as a lab leak.

i believe that is less likely that is the case. but i also believe we need to keep an open mind and have all possibilities be investigated. the evidence from the community points strongly towards a natural occurrence. >> very quickly you think the chinese will cooperate with you to try to get the to the bottom of it? >> senator i certainly hope so. because we are not going to get an answer that's a definitive answer. even if they do cooperate we may not do that. certainly for example if we want to continue surveillance among that populations and other wild animals that might serve as an intermediary host there's understanding of what's going on in some of the laboratories. i believe it is essential to have cooperation and collaboration with the chinese.d >> thank you. senator hickenlooper. >> thank you madam chair.

i know what to first thank all of you again you have been here repeatedly. i often wonder, watching these the back-and-forth of these hearings what message it sends to young people deciding whether they want to get into public service. it doesn't always look pleasant but i appreciate your maintenance of good spirits as you go through obviously difficult by think important discussions. to try to look a little more for just because i am worried about the future equally as much is trying to review these mistakes we made in the past. the unprecedented covid-19 clinical trial landscape has allowed for timely availability of vaccines and therapies that are essential to fighting this pandemic. this increasingly global world we can and really have to work

closely with her allied partners to advance science effort spread my question is, should we be thinking about multiregional clinical trials as a way to expand in volume and scope of clinical trial data? and if so how do we get there? we talked about it before i keep coming back to this as well pickwick thanks for give me a chance to check what my favorite thing. that is what i've done for living is multiregional clinical trials and cardiovascular disease. that is what we need to do. we are all very focused on diversity in clinical trials within the united states. we are only 4% of the world's sophie really believe that, we need to begin trials that are relevant to the populations all over the world.ly and i will point out again as doctor berlinski pointed out, we have a fragmented system in the u.s. but so yes we depend on israel for data the fourth dose decision by the fda was made basedag on israeli data. and many cases we depend on the

uk for clinical trial results that are critical to us. all the technology in prowess we have in this technology we've got to do better it's going to be a focus. cdc needs that the authority to get the data it needs so we can be asit good as the israelis and producing just-in-time data that is needed. >> when i was a kid marshall mcluhan wrote a book it was elinformation is power. i think there's more true today than ever. dr. fauci, many of us here have been beating the drum loudly on pandemic preparedness and pandemic prevention. i think making investments today that will help us better understand and prepare for epviruses tomorrow. we watched some of the discussion on this already. the present is put out a pandemic preparedness plan and a mandatory five-year friending record request to congress to truly stay ahead of the curve. what progress do you think we have lost due to the inability

of congress to significantlyin invest in the pandemic preparedness? and prevention. >> thank you for that questionab senator. the pandemic preparedness involves multiple buckets. basic clinical and translational science to develop the products such as the vaccines and the antivirals that have helped us so dramatically during the current outbreak as well as a number of public health issues involving for example the cdc, the fda, and others. : : health issues involving, for example, the cdc, fda, bomb or, as britain and others. when you look at what has not been available from the standpoint of resources. we have a pandemic preparedness plan that is based on what we call the prototype pathogen approach. which was to look at various, families of viruses

particularly. to develop commonalities among them so we will be able in the next challenge with an emerging microbe. mostly likely a virus that will have enough experience that will be able to do it. in the timeframe that we get with coronavirus. as you know, it was 65 days from the recognition of the virus to a phase one trial. >> right, appropriate investments to complete thato preparedness wor? >> anytime you pull back the resources the cadence of the work slows down. sometimes you can't even start the project but the projects that are ongoing if you don't get the resources to fully implement them you delay the development of interventions. >> or you have to take money from one other pool that gets

sidelined and you interrupt somebody else. >> i'm out of time so i would yield back that i want to thank each of you for your public service. you have difficult complicated jobs and i'm grateful. >> thank you.. senator marshall. >> just yesterday we learned in the month of may the border patrol encountered an unprecedented 239,000 migrants at the southern border, the highest total in history and now thanks to the open border policy every state is now a border state. in my home state of kansas a person dies every day from fentanyl poisoning. nationwide over 200 people are dying daily from fentanyl. if the numbers on the rise and this is now an epidemic. last week in kansas city 15,000 counterfeit pills laced with

fentanyl. in yourem state of washington, five people are dying today from overdose and ranking member berg,d in your state, many die every day from drug overdose. i don't want to have to remind people of the committee or the panel no precursors were made in china than they work with the cartels to process it into a lethal sentinel leasing other opioids, marijuana, adderall, xanax among others. and all across the nation, he counterfeit oxycodone pills like the ones behind me are now laced with fentanyl and fortunately just one pill can kill and in the case of one young student in kansas it only took half a fake percocet pill to take his life. in the great state of tennessee there's a bill that would extend

title 42, expedited removal of authority for the drug overdose epidemic resulting from drug smuggling across the southern peborder. i would like to ask yes or no what you committed to expanding the title 42 authority to turn back migrants to combat this prolific drug smuggling across the u.s. mexico border. >> the question of title 42 is a public health policy. the question of title 42 that was posed to me is is there a public health emergency that should bar people from coming into the united states. we now have as of april 1st when i commented on this, we have the tools, the tests, vaccines, and the therapeutics that are available. our hospitals are not full. most people in the room are not wearing a mask. there's no longer a public

health emergency. title 42 for covid, why wouldn't you consider instituting it for fentanyl poisoning as well as what you commit yes or no to tracking this similarly the way you did for covid? >> i turned things back to you and congress to address the larger immigration question is a public health emergency which is what the titleon 42 was put up o do and there was no longeron the need. secretary o'connell, i have a question i'm going to submit for the question for the y sake of time that has too do with three doses of moderna and if my understanding is the marketplace there's still a substantial supply chain challenge for the

medical products. i hope the administration can give a plan to provide the ancillary medical products to support the vaccine eradministration and we would appreciate some type of a plan in writing. thank you.pr >> my last question for doctor fauci, the nih's funding research in china at least some $8 million since 2020. in the intelligence community's 2022 annual threat assessment, the chinese communist party is presented as one of the top threats to the united states along with russia, iran, syria and north korea. to my knowledge only china is receiving u.s. research dollars. the ccp controls there scientists and controls the release of research results they were gone. however, the grants policies require the grantees to maintain the research records which it cannot do in those records are under the control of the chinese communist party.

when will you as director of and 90 stop funding research in china? >> thank you for that question, senator marshall. we have with the federal government very productive peer-reviewed research projects with our chinese colleagues that have led to some major advances in biomedical research. so i don'tre think i will be abe to tell you that we are going to stop funding chinese. we obviously need to be careful and make sure that when we do fund them we have the review and we go through all the guidelines. the state department has clearance. to go through a clearance with the state department.

>> you do not deny the research done, the records, the studies that we still do not have access today, is that correct? >> we have access to an extraordinary amount of information that has gone. there is a question people raise and we didn't have access but if you look at the grand 120 to 130,000 that was given in china to ask the very relevant high-priority question we had received from them published literature with data that shows vewhat they were given the grant for.r. now obviously nobody knows everything that's going on in china, but if the question at hand is the small grant peer-reviewed high-priority

grant that was given, we have a lot of goodt information. >> i'm going to move on. we have a number of senators and i'm going to move on to the next person. i'm going to turn the chair over to senator hagan looper while i voted and i will call on the next senator goldman and senator hagan looper thank you for coming to chair. >> i've been encouraged by the workou of the committee and thoe of you on the panel that have helped make more treatments available. the local health departments in wisconsin have experienced some obstacles when it comes to getting to those that need. the public health officials recently contacted my office to raise their concerns about the

last of the clear policy guidance and reimbursement for this critical treatment. so, how are you working with states too ensure that local public health departments have the information that theyr need to make paxlovid available and how can folks that are uninsured received treatment and what additional resources might the administration need to make treatment available to everyone who needs it? >> i will take that into parts. in communicating with stated public health departments to make sure they know the treatment is available and how to access it we do weekly stakeholder goals and regular engagements with state health officials. we also know a it's on us. we need to take responsibility for communicating very clearly the importance of this therapy and its availability, so we've

taken thatt on in numerous ways and various outreach efforts and we continue to work with states to make sure that they are positioningbi these therapies in places where folks are at the most high-risk so that continues to be an ongoing pursuit that we will continue to look at. thanks you for the feedback on wisconsin. we will reach out and make sure that we close the loop and that they have the information they need. part two of the question is access for the uninsured. so, one of the impacts of not getting additional supplemental funding is we've had to shut down the uninsured fund and the uninsured fund is one of the easiest ways for those without insurance to get coverage during the covid response and to get the care they need. it's available for free. pharmacies are not allowed to charge a dispensing fee so those that are uninsured should be

able to access it. we understand and an important component of receiving paxlovid is also having a health care hee assessment and that comes with a fee. so we encourage those that are uninsured to go to the federally qualified health centers which provide theea services on a sliding scale and acknowledge whether you are uninsured or not to seek care at the public health department or the new federally run treating sites but itor is a challenge and one we e continuing to overcome in light of the shutdown. >> thank you. i've heardat also from state health officials about declines in vaccination coverage for routine immunizations for measles, mumps and rubella. how is the cdc working to ensure that any forthcoming

recommendation on the vaccine for kids gives parents the informationcd they need to feel confident about getting not just this vaccine but as well as all other routine immunizations and is there an opportunity to up the rate of vaccination for these other conditions at the same time that you are vaccinating kids? >> thank you so much, senator baldwin. we recently reported data that demonstrated the increase of about 1% of all income are completely vaccinated for all of the recommended vaccines. that's 35,000 children across the country that are no longer up to date on all their other vaccines even before covid. we have a lot of makeup work to do00 in addition to what we need to do with covid. on the pediatricev sites, there are children between the ages of six months to five years and the fact is we continue to enforce the importance of the

vaccinations for the five to 18-year-olds. we are seeing differences in the rates of vaccinations. we are doing a lot of work in terms of the vaccine competence putting these in pediatrician offices and federally qualified health care centers and pharmacies, places where parents trust where they normally get this information and we are also canvassing and understanding the confidence around these areas so that we can focus our attention in areas where the competence might be lacking and also importantly we are starting to see critical data that show much of the confidence is lacking in areas that we have about two times theo vaccination rate compared to the rural areas, so areas we really need to focus on the activities as well. >> thank you. i will yield back, mr. chair. >> senator casey. >> you very much and i want to thank the members for their servicing for being here today.

i just have in the interest of time if i could get one question. i want to wish you a speedy recovery as well as congratulate you on the naming of the science complex at the holy cross college. i wanted to ask a question about our parents. so many parents across the country right now are unsure about whether to get their kids vaccinated. at the uptake of the vaccine has been low for kids that are realready eligible. i am told that under something like 130% of children ages five to 11 are fully vaccinated, so when it becomes available, for children under five, we need parents where they are and with of the information that they need to make informed decisions.

thank you for that very important question senator. now that we have the data that looks very favorable we want to get these children vaccinated and to prevent the disease as you've heard from a number of us including there are more deaths and serious consequences of covid among children than there are influenza but there is a very comprehensive rollout plan which they've been literally preparing for now for several weeks to months in anticipation of favorable results on the clinical trial for moderna and pfizer that we would be able to

get the children and parents to understand where the vaccines are available and pediatrician offices and pharmacies andar clinics. so this is something the department has taken very seriously. and hopefully we, will do an uptake of the vaccines because many parents, as we all know, have been waiting some time now to give your children vaccinated. hopefully the program to hhs will facilitate that. thank you. >> thank you veryy much, mr. chairman. >> senator kane. >> thank you, senator hagan liberty and thanks to the witnesses. i want to echo the comments i know the chair made earlier about the importance in a variety of ways we are thankfully seeing hospitalizations come down dramatically in virginia. about 4,000 a day in january, about 500 a day now. that's very positive. and i'm looking at hospitalization and death data a lot more intensely than the case

data because i think the cases continue to be high, but the transmissibility is high but the severity is dropping, which is what we would want. but i still think we need more funding to deal with these issues especially for low income people. w and i would also say the u.s. vaccine diplomacy around the world has w been a positive investment that has both helped or own public health and others around the world but built up goodwill, so i'm strongly for it. i do want to just quibble with one thing, senator smith asked all the questions about whether you are equally as effective if you are working virtually or in the office and you said yes as effective. i'm going to be honest there's one area where it's not as effective and that is inspections. there was a story that was out early this week that said during the period largely from march of 2020 to june of 2021 but during

the period they missed 15,000 inspections that would normally have done. the fda is racing to catch up and has cleared the backlog of about 5,000 of those. but there is no substitute for an inspection. there is no substitute for it. and what troubled me about that is the folks working at plants that need inspection like the infant formula plant, they are essentially essential workers. we can't stop producing formula, so they have to be there. if they have to be there to do something the public needs, the inspector should be there and i recognize that poses challenges, but again, you were not at the fda during the period that the inspections were stopped. but frankly i worry a little bit about arthur other surprises around the corner in these spaces where we were not giving inspections and i'm not going to ask because i know you've taken it seriously and you're trying to catch -- >> i agree. i was asked about the office and

definitely inspections put on hold and prices to pay for that. >> everything is essential. the worker is required to go to the plant to produce medicine, to produce infant formula, et cetera. i want to ask a question that i asked if doctor fauci, and i hope that you are feeling well and able to join us virtually. i started to share my own experiences about a year ago because i was having them and they are exactly the same as they were when i got covid in march of 2020. i was running into a lot of people that were experiencing similar systems and were not being believed and i felt like sharing from this podium i believe you because i'm dealing with nerve tingling that i've never feltlt in 62 years and mit open up discussion and make people feel like they were being heard. as i expected when i started to talk about this, my office has become a nerve center for people that want to share their

experiences with long covid and ask for help, so what i want to ask you now is given the rate but in some significant funding for research, what is the current status of the recovery project? >> thank you for that important question, senator. let me assure you that from the patient's that we have seen and the input that we have seen this is a real syndrome and problem and it's something we need to get to the bottom of. there are two tracks that are legoing on. one is a cohort many people refer to aser the recover progrm with large cohorts and individuals that are now being followed in long-range to return to the uses and hopefully learn about this syndrome. they are now accumulating large numbers of individuals and one of the problems, senator is that there is no yet identifiable

pathogenic process. some people ask why aren't you treating it, what are you doing for it? it's difficult to do that because this is a heterogeneous syndrome. as you probably know from the people that are now essentially are addressing your office because of your own personalsy involvement, but there's other things going on simultaneously. for example, there is a pediatric research network that is looking at this in children particularly that might have the multisystem inflammatory syndrome of children. this what we call anything that relates to a hybrid activity or the immune response triggering some of the things you might be feeling including the tingling in your nerves. so the project and a number of individual projects. i do hope because there were so many people now whenhe you talk about the tens of millions of

people. we have to address this problem and find out the underlining mechanism and do something about it. >> i hope you are feeling alright and thank you for being here and thank you to all of you for your continued presence and work and commitment to doing that good work going forward. it's going to continue to mutate. to keep the most vulnerable population safe, to protect

lives and livelihoods. and i just want to focus for a second 11 of the highly vulnerable populations. our seniors. many of them have unique challenges because of their mobility or a variety of other issues. so, we know more than 90% of seniors were fully vaccinated. nearly 70% have received their first booster dose. but only a little over 30% of the seniors have received a recommended second booster. so what are you doing to i would say just not just approve outreach, but what about those access barriers they may have with seniors in assisted living in the context of this number of infections for the elderly, what i willon tell you is i have data forthcoming later this week that

will demonstrate compared to the third dose has decreased the riskte of death by sevenfold. so we now have actually data from the united states that has demonstrated the value of the booster dose especially among the elderly and the most frail. we now have vaccines and tens of thousands of sites and vaccines in pharmacies and providers, physicians offices and in the long-term care facilities. and we are continually looking at the vaccine canvassing the states to understand where we have challenges. one of the areas as i indicated earlier for pediatrics is also true for adults is in the rural and rural and urban divide the challenges of reaching the communities with her vaccine competence but also to get folks boosted for the first shot as well as the second. so we are continuing outreach

for media, social media. i've done media with our collaborations through the usda and the public health associations that we are continuing that. once we can understand where the data and the challenges are, we focus on the areas so that we pucan do more in those areas. the updated guidance will have access to the second booster dose for the general population because we knowal that it keeps people out of the hospital and from suffering more severe disease. we continue at the cdc to follow the data a with regards to how e vaccines are performing so the decreases of the hospitalizations and deaths have beenar limited to the elderly population but we are continuing to follow the data for the younger population to see if and

when there is waning in that population as well and if and when we should bring another dose to the populatione as wel. >> i want to keep a little bit on seniors because we know that thend pandemic has had a real mental health challenges for our children and of course all of us. so focusing on seniors today it is critical to find a balance between the patient health and caregiving and how the absence of caregivers or the caregivers themselves are vaccinated it really makes a difference. i just would like to know what lessons the cdc has learned from the pandemic about caring for theors and addressing social isolation that we felt.an what can we do they are do you think? >> through the last two and a half years with regards to mental health not just seniors

but across the age demographic end of the students and seniors and across the age demographic we are doing a lot of work across the country with the va and ngos and community organizations to strengthen mental health resources and decrease suicide and allow children to get back to school, to allow parents and caregivers the mental health resources that they needed so that they can combat the challenges right now. >> i know my time is up and i appreciate that going forward for the k-12 population, senator murkowski and i introduced bipartisan legislation to bring mentalal health down. for the universities and colleges but to bring it down k-12 because we have seen increased suicide and mental health challenges in nevada and at one place the school district wass the highest in the year

2020. i look forward to working with all of you and trying to do what we can to promote good mental health services and suicide prevention. thank you. >> thank you, senator rosen. a last question just because i don't take the people that really understand how interconnected we are i want to take a moment to see from the current covid pandemic the pathogens don't pay any attention to the national routers. the reality is i think we are in dangerer for the probability tht new covid variants were over pathogens like monkeypox can emerge and spread quickly and undetected in the interconnected world. the number i have is 62% of the

global population vaccinated against covid and there are significant disparities against those that do not have the resources to get to the significant part of their population. the therapeutics around the world just chance we get to spread to so we don't really have a number on that yet in terms of how are we increasing the probability of a new variant and allowing populations in isolationer to almost incubated the new pathogens or more importantly the new variance. howw is the cdc's tracking changing with the launch of the forecasting andle outbreak analytics and what more do we need to do now to address this global reality that we faced in terms of public health threats and again how to take

responsibility but it'sal something most people are not aware of. >> thank you, senator hagan labor. we launched the center and analytics and this is the center that will be able to scale up and look at the forecasting to look at the local jurisdictions as well as the jurisdictions to understand where the pathogens are in the risk of coming to us as well as to innovate and think about the ways we might be able to forecast and understand pathogens headed in our direction. that has been helpful in understanding the importance of the new variances. the omicron variant, they have the understanding of where we need to put the resources at the local level. i do want to take one moment to say i think that you are exactly right. we know through the pandemic no one is safe until everyone is safe. we have the vaccination coverage

around the world likely to potentially lead to new variance and if we don't control the variance they will likely reach the shores again. technical assistance on the ground into the genomic sequencing andgl ability to do vaccine surveillance and safety surveillance within the llcountries that we support, so thank your very much. >> thank you. senator burr. i'm going to wrap up. i guess the chair is not coming back. a couple of quick questions. public health emergency,co it expires july 15. do you intend to extend that?

>> i am not the one that would extend it. thank you. that is for the secretary. you will make the recommendation. >> we have removed and eliminated testing requirements. title 42 is a cdc decision and you said in your response to the letter to me that you were lifting it because, and i will refer to how you think you addressed to senator marshall. youe, said we have the tools, testing vaccinations therefore there's no longer a public health emergency. >> i misspoke. we have the tools, testing vaccinations, therefore there is

no longer a public health reason to bar people from entering the country. thank you. i appreciate the opportunity to correct that. >> there is a public health emergency still. >> i think that the question of the public health emergency is a different question for is there a public health reason to bar people from entering into the country. i would like to make that distinction. >> the majority in the record which i think basically said we don't have a public health concern. let me ask you what were you looking for to end of the public health emergency? >> maybe if i could do for that question, i think as a part of what we talked about that would be helpful. >> thank you, senator. the secretary does have this authority and the secretary declared in january, 2020 and it's been extended multiple times.

one of the commitments we have made in the administration is that we are going to give states and local governments 60 days notice before we take it down and decided whether to take it down for the daily communications with our scientists, the folksrn on the ground. with the public health emergency unlocks his healthcare system flexibilities. something cms relies on significantly. it extends medicaid coverage for folks during times of an emergency and telehealth coverage to those on medicare and it allows hospitals and nursing homes and other healthcareng facilities some flexibilities in responding to the situation at hand. so we continue to be in touch to understand whether these are still necessary. and him as doctor wilensky said, we will come together to make the decision or recommendation to the secretary for him to decide. but we will give a 60 days notice before it comes down.

>> no notifications have been made so we will be extending past there. i will write the secretary and ask him what the criteria is. i would only point out the guidance that we have going out doesn't suggest there is a public health emergency. we are beginning to dismantle everything. i'm not sure it's for any reason other than the fact everyone around the world is doing it because we are 60 or 90 or 120 days behind them. all of you told senator smith remote work hasn't happened in the agency's response efforts. the fda failed to identify a

crisis formula. let me ask about hhs staffing and were they at work when not ins the office? many people fail to see and i will leave nih out of this because the unique nature of the work, how many of you can tell me how many are not at work with the declarations that makes me wonder how you measure whether people are actually working when

at home, then i come today. i always like to bring things back to the present because i have a tremendous amount of respect for all four of you. some i've dealt with longeri thn others. there was public acknowledgment. he was here before i got here 28 because i believed you had the capacity,re intelligence, education and independence to serve in the role that you're in and for twohe of you i asked whn you were confirmed would you provide me with all the questions i asked. as the minority ranking member now we come here today. this has been the most orchestrated event that i've seenye in 28 years that i've ben

here. and for most of you, you have been willing to participate. this was designed to pressure republicans to open a checkbook, signed the check and let the administration fill in the balance. with no detail on how, when, for what. i've never in 28 years seem an attempt to get an outcome without answering questions. i leave today extremely disappointed that maybe my judgment has been flawed but i will say this to each and every one of you nobody has worked harder on this issue on the hill i think they and i have. no one has gone to bat with emergency money with no strings

attached the san i have but there is a point in time that my patience runs out where the requirement i have for my constituents in north carolina, my colleagues in the minority, exactly what's in the majority requires a degree of detail that you and this administration are not willing to share. i personally believe if the federal government doesn't believe by forcing employees back to work and google is a lot different than the fda, google can pull it off, but the federal government has to set the example for the rest of the country that p it's time to leae your house. i hate to see what the healthcare cost is goingas to be to the country for mental health nowle on the adult side. they are not used to spending

all day together, like kids need the interaction of school. folks, let's get back to running your agencies. let's bring the employees back into the office. let's answer the questions every member of congress has and not just the ones the administration wants to do. you serve ins a uniquely special capacity. and when you address public health, it's not for some, it is for all. and i hope that you will look at this and realize there is no difference between one f that ss on this side or that side. they are on the committee because they areme passionate about the issues that we take up. i think the chair for his indulgence and think the witnesses for their expertise and willingness to bere here toy and i will yield back. >> thank you, senator burr. i echo his appreciation for all of your hard work.

i realize science especially medical science is some of the most daunting, present somei of the most daunting challenges that we face.e. i remember when i was in small business the times it caused me great anxiety and serious mental health challenges when i didn't have enough information to make important decisions that would affect the lives of my employees or sometimes even my customers that the challenge of having to deal with the facts weor have ad not the facts that we would like, having to make decisions that would affect people's lives is some of the hardest decisions you can make when science doesn't give you all the answers or enough information to know you don't have the answer and yet you've all stood up and continue your work and have

dealt with these situations, so i am very grateful and i would like to thank all of my colleagues on the senate but also all of the witnesses. this is an important conversation and i hope after this discussion it is clear how critical it is that we pass emergency funding and make sure we can protect the communities from what this pandemic chose next which again we can't be certain of. for any senators that wish to ask additional questionsnd for e record they will be doing ten business days july 1 at 5 p.m. the committee stands adjourned. [inaudible conversations]

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broadband is a force for empowerment. that's why charter has invested billions building infrastructure, upgrading technology, and powering opportunity in communities big and small. charter is connecting us. >> charter communications supports c-span as a public service along with these other television providers giving you a front row seat to democracy. >> by a vote of 84-18 the senate approved a bill today expanding health care for iraq and afghanistan war veterans who've been exposed to toxic substances during their military service. veterans affairs committee chair john tester and ranking member jerry moran talking about the bill before the vote. >> mr. president, thank you for that emphatic recognition. in the next few minutes, the senatela will vote on