[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
HYBRID HEARING WITH SECRETARY
OF HEALTH AND HUMAN SERVICES
ALEX M.AZAR II
=======================================================================
HEARING
BEFORE THE
SELECT SUBCOMMITTEE ON THE CORONAVIRUS CRISIS
OF THE
COMMITTEE ON OVERSIGHT AND REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
SECOND SESSION
__________
OCTOBER 2, 2020
__________
Serial No. 116-124
__________
Printed for the use of the Committee on Oversight and Reform
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available on: govinfo.gov,
oversight.house.gov or
docs.house.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
41-988 PDF WASHINGTON : 2020
--------------------------------------------------------------------------------------
COMMITTEE ON OVERSIGHT AND REFORM
CAROLYN B. MALONEY, New York, Chairwoman
Eleanor Holmes Norton, District of James Comer, Kentucky, Ranking
Columbia Minority Member
Wm. Lacy Clay, Missouri Jim Jordan, Ohio
Stephen F. Lynch, Massachusetts Paul A. Gosar, Arizona
Jim Cooper, Tennessee Virginia Foxx, North Carolina
Gerald E. Connolly, Virginia Thomas Massie, Kentucky
Raja Krishnamoorthi, Illinois Jody B. Hice, Georgia
Jamie Raskin, Maryland Glenn Grothman, Wisconsin
Harley Rouda, California Gary Palmer, Alabama
Ro Khanna, California Michael Cloud, Texas
Kweisi Mfume, Maryland Bob Gibbs, Ohio
Debbie Wasserman Schultz, Florida Clay Higgins, Louisiana
John P. Sarbanes, Maryland Ralph Norman, South Carolina
Peter Welch, Vermont Chip Roy, Texas
Jackie Speier, California Carol D. Miller, West Virginia
Robin L. Kelly, Illinois Mark E. Green, Tennessee
Mark DeSaulnier, California Kelly Armstrong, North Dakota
Brenda L. Lawrence, Michigan W. Gregory Steube, Florida
Stacey E. Plaskett, Virgin Islands Fred Keller, Pennsylvania
Jimmy Gomez, California
Alexandria Ocasio-Cortez, New York
Ayanna Pressley, Massachusetts
Rashida Tlaib, Michigan
Katie Porter, California
David Hickton, Select Subcommittee Staff Director
Russell Anello, Chief Counsel
Senam Okpattah, Clerk
Contact Number: 202-225-5051
Christopher Hixon, Minority Staff Director
------
Select Subcommittee On The Coronavirus Crisis
James E. Clyburn, South Carolina, Chairman
Maxine Waters, California Steve Scalise, Louisiana, Ranking
Carolyn B. Maloney, New York Minority Member
Nydia M. Velazquez, New York Jim Jordan, Ohio
Bill Foster, Illinois Blaine Luetkemeyer, Missouri
Jamie Raskin, Maryland Jackie Walorski, Indiana
Andy Kim, New Jersey Mark E. Green, Tennessee
C O N T E N T S
----------
Page
Hearing held on October 2, 2020.................................. 1
Witnesses
The Honorable Alex M. Azar II, Secretary, Department of Health
and Human Services
Oral Statement................................................... 8
Written opening statements and the written statement of the
witness are available on the U.S. House of Representatives
Document Repository at: docs.house.gov.
Index of Documents
----------
Documents entered into the record during this hearing and
Questions for the Record (QFR's) are listed below/available at:
docs.house.gov.
* Pfizer.com, ``An Open Letter from Pfizer Chairman and CEO
Albert Bourla to U.S. Colleagues'' article; submitted by Rep.
Foster.
* Sciencemag.org, ``Trump Once Again Requests Deep Cuts in U.S.
Science Spending'', article; submitted by Rep. Foster.
* The-Scientist.com, ``Trump Proposes Significant Cuts to NIH
2021 Budge'', article; submitted by Rep. Foster.
* Sciencemag.org, ``What's in Trump's 2018 Budge Request for
Science?'', article; submitted by Rep. Foster.
* Journal of American Medical Association, ``Mortality,
Admissions and Patient Census at Skilled Nursing Facilities in
Three United States Cities During the COVID-19 Pandemic'', open
letter; submitted by Chairman Clyburn.
* Letter from NACCHO; submitted by Chairman Clyburn.
* Letter from IDSA, and HIV Medicine Association; submitted by
Chairman Clyburn.
* Letter from HIV Medicine Association; submitted by Chairman
Clyburn.
HYBRID HEARING WITH SECRETARY
OF HEALTH AND HUMAN SERVICES
ALEX M. AZAR II
----------
Friday, October 2, 2020
House of Representatives
Select Subcommittee on the Coronavirus Crisis
Committee on Oversight and Reform
Washington, D.C.
The subcommittee met, pursuant to notice, at 9:10 a.m., in
room 2154, Rayburn House Office Building, Hon. James E. Clyburn
(chairman of the subcommittee) presiding.
Present: Representatives Clyburn, Waters, Maloney,
Velazquez, Foster, Raskin, Kim, Scalise, Jordan, Luetkemeyer,
Walorski, and Green.
Chairman Clyburn. Good morning. The committee will come to
order.
Without objection, the chair is authorized to declare a
recess of the committee at any time.
I now recognize myself for an opening statement.
Today, the Select Subcommittee welcomes Secretary of Health
and Human Services, Alex Azar, the Trump administration's top
health official.
Secretary Azar, this is the first time you have testified
before Congress since February. In the seven months since your
last appearance, more than 207,000 Americans have lost their
lives to the coronavirus and over 7 million have been infected.
And all of us woke up this morning to the news that the First
Family and at least one of their close staff members have been
diagnosed with COVID-19. And we wish all of them a speedy and
complete recovery.
As Americans, we pride ourselves on being the most
scientifically advanced Nation in the world, with the best
doctors and public health experts. We have led the world in
countless medical breakthroughs, from inventing the polio
vaccine, to mapping the human genome, to battling AIDS and
Ebola. That is why it has been so heartbreaking to watch the
administration squander this legacy by refusing to lead,
ignoring our scientists, and putting politics over the health
of the American people.
Let there be no doubt, the President's response to the
coronavirus crisis has been a failure of historic proportions.
COVID-19 has claimed more American lives than the battles of
World War I, the Korean war, Vietnam War, Afghanistan war, and
Iraq war, combined.
While the President claims that he saved millions of lives,
more people have died from the virus in the United States than
in any other country on Earth. We have four percent of the
world's population but 20 percent of the coronavirus deaths.
More than 140 other countries have all had fewer deaths per
capita from this virus than we have had in the United States.
Behind me are the images of a few of the Americans we have
lost. At my far right, is Skylar Herbert, the daughter of two
first responders in Michigan. Skylar was a healthy five-year-
old who loved playing dress-up and dreamed of becoming a
pediatric dentist when she grew up. She died from the
coronavirus in April.
Next is Cheryl Fink Lolley. At 81 years old, Cheryl was
sharp as a tack, loved visiting with family and friends. She
died in April after contracting the coronavirus. Cheryl's
daughter, Alison Lolley, told her mother's story to our
committee in June.
To my immediate left is Jason Hargrove. Many people like I
saw Jason as he drove his bus. He was a 50-year-old bus driver
in Detroit. He caught the coronavirus after being coughed on by
a passenger, and many of us watched as he yelled out in
disgust. He died in early April. Jason's best friend and
colleague, Eric Colts, spoke to our committee in May about
Jason and the dangers faced by frontline workers around the
country.
The final photo is Demi Bannister. Demi was a 28-year-old
third grade teacher in my home state of South Carolina, in my
hometown of Columbia. She tested positive after returning to
school for training early in September and died three days
later. Last Sunday, Demi's mother, Shirley Bannister, also died
from the coronavirus. Shirley tested positive for the
coronavirus the day her daughter died. Shirley was a 57-year-
old constituent of mine and served as the chair of the nursing
department at Midlands Technical College.
Tragically, it is not hard to see why Americans like
Skylar, Cheryl, Jason, Demi, and Shirley were more likely to
die than people in most other countries. Even though the
President knew early in February that the coronavirus was,
according to him, here, deadly stuff, in March, he said--and
I'm quoting him again--``I wanted to always play it down.''
Consider with this desire--or consistent with this desire,
the President has refused to step up and lead a national
response to stop the spread of this deadly virus. Rather than
implement a national testing strategy, the White House deferred
to the states, reportedly because they believed blaming
Democratic Governors for coronavirus deaths would be, in the
words of a public health expert involved in the discussions,
``an effective political strategy,'' end of quote. The result
was widespread testing shortages and delays that let the virus
spread widely throughout the country.
The White House also refused to purchase and distribute
masks and other protective equipment because Trump saying--and
I'm quoting him again--we are not a shipping clerk, end of
quote.
As a result, the national stockpile overseen by you, Mr.
Secretary, quickly ran out. States were forced to compete for
scarce supplies while first responders and medical workers
reused old masks and wore garbage bags to try to stay safe.
As HHS Secretary and the first chairman of the White House
Coronavirus Task Force, Mr. Secretary, you should have been at
the helm of an ambitious national response, rather than follow
the science, they tried to hide, alter, or ignore the signs
whenever it contradicted the President's wish to downplay the
crisis for perceived political advantage.
This morning, my staff released the report that I hold.
This report identifies 47 separate times that political
appointees interfered with career scientists who were trying to
help Americans stay safe during this pandemic. Forty-seven
documented times.
When the President complained the CDC guidance on reopening
schools was, quote--and I'm quoting him--very tough and
expensive, very tough and expensive, how expensive was Demetria
Bannister's life when she went back into that classroom?
After the President complained the testing was revealing
too many new coronavirus cases and said--I'm quoting him
again--slow down the testing, HHS altered key testing guidance
to claim that people without symptoms did not need a test, even
if they were exposed to the virus. That decision was reversed
only after this select subcommittee and many others objected.
And when the President complained that the--and I'm quoting
him--``deep state'' at the FDA was not moving fast enough to
approve treatments before the November election, the FDA
authorized plasma therapy over the objection of top scientists.
Mr. Secretary, you stood by the President at the press
conference and repeated false statistics about the therapy's
effectiveness. Now the administration appears intent on
politicizing a vaccine, with the President pressuring the FDA
to approve a vaccine before election day and casting doubt on
the agency's efforts to ensure that a vaccine will only be
approved based on science.
Now, I know there are about four companies that are--that
have moved to a third phase of testing, but I would hope that
whatever they come up with--and I'm sure there'll be more than
one vaccine--I'm hopeful that it will be a safe and effective
vaccine. But even in the best case scenario, as Dr. Fauci said
last week, most Americans will not receive a vaccine until mid
to late 2021. That means Americans could be waiting up to
another year to get vaccinated.
I often share with the public that I was around during the
polio vaccine, and I remember political decisions that were
made for that vaccine. I'm sure many remember the Salk vaccine
and then the Sabin vaccine. The Salk vaccine required a shot in
the arm. The Sabin vaccine was a little drop of serum on a lump
of sugar. Political decisions were made as to who would get the
shot and who would get the serum. And I think all of us can
imagine back in the forties and fifties who got the shots and
who got the serum. I would hope that we won't have a repeat of
this kind of political assistance being made by whatever
vaccine is developed.
In the meantime, coronavirus infections are rising again in
more than 25 states, and hundreds of Americans are still dying
every day. Tens of thousands more will die unless this
administration provides a national plan for testing, tracing,
mask wearing, and other public health measures to contain the
virus.
I urge the Administration to put partisan politics and
ideology aside, embrace our Nation's long history of science,
and finally show the leadership we need to get this pandemic
under control.
We can't bring back Skylar, Cheryl, Jason, or Demi, or
Shirley. But whether other Americans just like them live or die
depends on whether the Administration improves its response to
this pandemic.
I now yield to the ranking member for his opening
statement.
Mr. Scalise. I want to thank the chairman for yielding.
I want to thank Secretary Azar for coming before our
committee, and look forward to hearing your testimony to
actually get to the facts of what is happening, the great work
that your team has done.
But first, I want to express my prayers and support to
President Trump and First Lady Melania Trump. We know they
tested positive. I know how tough and strong of a person
President Trump is and how tireless he is, and I know he's
going to continue working for the American people. But Jennifer
and I surely keep he and the First Lady in our prayers for a
quick and speedy recovery as I join with the chairman in
expressing those thoughts.
Secretary Azar, I truly want to thank you, as well as the
80,000 men and women who work for your agency, who have been
working tirelessly so well for the American people, completely
focused on learning more about this virus, which we learn more
about every day, as well as working so feverishly now toward
finding one or more vaccines and therapies, which, by the way,
your agency has already identified and approved a number of
therapies that are working well to save lives, truly saving
American lives as we speak. It's not gone without notice, the
tireless work that your men and women at HHS and all the
healthcare workers across this country are doing to save
Americans lives. They are the frontline heroes of this virus.
Today, the Republicans on the subcommittee are releasing a
report. It's ``President Trump's Plan: A Whole of America
Response.'' Yes, there is a plan. For those who choose not to
read the plan, they might walk around saying there's not a
plan. There are tens of thousands of pages of plans that
continue to be updated by your agency and so many other Federal
agencies that are all directly involved in helping us get
through this.
The plans cover so many things, from how to properly
protect yourself and your family, how to safely reopen schools.
We've actually had hearings on a number of items of those
plans. We've talked about them. We've given the links to
websites to people who deny that there's a plan, who hold their
head in the sand and say there's no plan. And, again, just
because you don't want to read a plan doesn't mean there isn't
a plan. So, in this report we detail so many aspects of the
plan.
I want to go through some of the Trump Administration's
national plan, some of the things that he's done, which include
thousands of pages of guidance backing all of these up.
First, it's a plan to procure personal protective
equipment. We know this has come up many times. On March 29 of
2020, President Trump launched Project Airbridge and began to
carefully and thoughtfully leverage the Defense Production
Act--that's right, the President multiple times has invoked the
Defense Production Act--to secure PPE, to secure ventilators
and other needed resources to combat this pandemic.
As of September 20, 2020, the Trump administration
coordinated the delivery or production of 243 million N95
masks, 1.1 billion surgical and procedural masks, 45.5 million
eye and face shields, 429 million gowns and coveralls, and over
27.5 mil---billion, billion gloves.
Further, as of September 20--or September 10 of 2020, the
Strategic National Stockpile is fully stocked with 135,784
ventilators. There was not one hospital in America that ran
short of ventilators. There was not one American through this
whole pandemic that was denied a ventilator who needed one. In
fact, today, most doctors will tell you, if someone comes in,
the last thing they want to do is put them on a ventilator
because the science has advanced. Doctors know a lot more about
this virus today than they did just a few months ago. And I
credit our medical community for learning and sharing that
information with others as we learn more every day to save
American lives. That has been part of President Trump's plan.
In addition, a plan to slow the spread. On March 16, 2020,
President Trump announced national guidelines entitled, quote,
``15 Days to Slow the Spread.'' In fact, Dr. Fauci testified
right there where you're sitting, Secretary Azar, just a few
weeks ago before this committee. When I asked him, was that
part of the President's plan, he said, yes. I said, did that
plan save American lives? He said yes. President Trump made
those decisions. That was part of the President's plan.
These guidelines outline how to help slow the virus' spread
and keep our most high-risk populations safe. Again, as we
learn more about this virus, we learn it doesn't affect
everyone equally. So, as there are populations that we identify
as higher at risk, there are more resources given.
Part of the President's plan, by the way, as Secretary Azar
is well aware, was to acquire and distribute testing machines
to every nursing home in America. Admiral Girard sat right
there at that table just a few weeks ago in this committee to
talk about that aspect of President Trump's plan and how it's
being carried out today to protect our Nation's seniors, which
we uncovered over 40 percent of all deaths in America came from
less than one percent of America's population, and that is
seniors in nursing homes.
It was through the work of some of us on this committee
that we identified that, yes, 45 Governors actually followed
the President's plan, the CMS guidelines, which were issued for
how nursing homes could properly take care of seniors in
nursing homes. That was part of the President's plan.
Unfortunately, five Governors might have read that plan, but
they ignored that plan, completely threw it in the trash can
and said, we're going to do our own thing. Sadly, it had deadly
consequences. At least 25,000 seniors died who shouldn't have
died in nursing homes because those five Governors went against
the President's plan.
As we know, in America, nursing homes are governed at the
state level, not at the Federal level. The guidance came from
the Federal level, but these five Governors chose to go the
other way. Some of them are still trying to hide the facts.
Many of us have asked on this committee to get those facts. Not
all have. I wish the majority would join us in getting the
facts for those families, thousands of families who still want
and deserve answers for why their loved ones died, many of whom
could not even go and visit their father, their aunt, their
grandmother who died in those nursing homes, who shouldn't have
died if those five Governors would have followed the
guidelines.
Shouldn't be a political issue. Forty-five Governors got it
right, Republicans and Democrats. If five got it wrong, we
should all be wanting to find out why they got it wrong and
find out how many people actually were victimized by those
decisions. The fact that months and months later we still don't
know and that data is being hidden, hidden by those five
Governors is a disgrace. Everybody should be demanding those
answers. But, again, the President laid out that plan. Forty-
five Governors followed it.
A plan to have increased testing. On May 24, 2020, the
Trump administration released a report to Congress called
``COVID-19 Strategic Testing Plan,'' which built on the April
27 national testing blueprint. This report explains that,
quote, ``State plans must establish a robust testing program
that ensures adequacy of COVID-19 testing, including tests for
contact tracing and surveillance of asymptomatic persons to
determine community spread.'' Through these robust national
testing plans, President Trump built the world's greatest
testing apparatus from scratch.
Again, we didn't even know this disease existed at the
beginning of this year. China was lying to us. This committee
still has yet to hear a single--hold a single hearing on
holding China accountable for their role in creating and
spreading this virus while they lied to the world, while they
hoarded PPE from us and every other country. We ought to have
that hearing.
But through the robust testing plans, what the President
did to build this from scratch allowed the U.S. to conduct over
100 million tests in only five months, hundred million tests,
and that testing number continues to grow every day. We
continue to see more companies come up with testing equipment
that has been approved by the FDA to test people for COVID-19
quicker, faster, and more readily available; but over a hundred
million tests in over five months.
A plan to safely reopen the economy. On April 16, 2020,
President Trump unveiled the guidelines for opening up America
again. Yes, that is part of the plan. You can still go read it.
You could have read it months ago. It's been widely available.
It's a three-phased approach to help state and local officials
reopen their economies safely under the direction of each
state's Governor. That's right, the President respects that
each state is run by a Governor who's duly elected, who answers
to the people of their state, who has legislators who have been
meeting, determining the best safety guidelines for each of
their states as well. Guidelines come out to help every state
do the things they need to do to take care of the people in
those states, and those guidelines get updated as we learn
more, as the scientists learn more.
The Atlanta Federal Reserve is predicting third quarter
growth is on track to increase by 32 percent annualized.
Because under this plan, President Trump has focused on helping
rebuild what was the strongest economy in the history of our
country and in the history of the world. Before COVID, we saw
one of the strongest and healthiest economies our Nation's ever
experienced, and it was working for every income level. In
fact, the lowest income levels--and the data is out there very
clearly--the lowest income levels were the ones who were
benefiting the most. That's because under the previous
administration we had lost our middle class. Literally,
thousands of great American companies fled America, left
America to go to other countries. Our tax structure was
anticompetitive, crushing our ability to manufacture to make
things in America again. And now we saw those jobs being
brought back, those manufacturing facilities be brought back,
and everybody was participating, every income level was
benefiting, and then COVID hit.
So, as we battle the virus through the plan that the
President's laid out, working with the smartest people in the
world, the best scientists in the world, Secretary Azar and his
80,000-plus employees who are working hard to make sure that we
keep learning and keep getting this information out.
The President also is focused on rebuilding that strong
economy again, and it's starting. We're seeing every month over
a million jobs being created, people getting back in the work
force using safety protocols, knowing that they can go get
about their way of life again, differently, but start doing the
things they need to do again, taking their tests again, going
and getting their mammograms and colonoscopies again, which,
unfortunately, we saw a dramatic drop. During the shut-in,
people weren't going to their doctor to get their other tests
run, and we are concerned that that's going to cause problems
down the road. We need to encourage people to get back out and
go see their doctor again, go get tested again, get their
chemotherapy again if you're battling cancer. That will save
American lives as well.
The President, again, as part of his plan, put out a
detailed plan to safely reopen our schools. We've had hearings
on this. The American Academy of Pediatrics has laid out
guidelines. The CDC has laid out guidelines for safely
reopening school. The scientists and physicians at the American
Academy of Pediatrics and the National Academies' Committee on
Guidance for K-12 Education on Responding to COVID-19 recommend
schools implement policies which enable students to learn in
person.
We've seen the science on the detrimental impacts on kids
that are not learning in school. Many school systems have
reopened because the guidelines are there for how to safely do
it. Some have chosen not to follow those guidelines and are
holding those kids back because other kids are learning, and
the kids that aren't learning in the classroom----
Mr. Raskin. Mr. Chairman, we're falling behind regular
order here.
Mr. Foster. Could we have some semblance of regular order,
Mr. Chairman?
Mr. Scalise. I think we both have given opening statements,
Mr. Chairman.
Chairman Clyburn. I have given the ranking member the
liberties on opening statements, and I would hope he will
conclude soon.
Mr. Scalise. Clearly, both of us have experienced the same
openings.
And, finally, part of this plan, as we detail it, a plan to
create a safe and effective vaccine. That's right, something we
should all be applauding, the fact that there are four American
companies, internationally respected, are in final stages of
FDA approval for a safe and effective vaccine, not something
where corners are being cut. I know the Secretary is going to
talk about this more in detail, but it's very important on this
point that we make a note that these companies are all
following the best guidelines, not just in America, but in the
world. The FDA guidelines are the gold standard. No corners are
being cut, but, more importantly, all the focus of the best
medical research in the world is now being put on finding a
vaccine to protect Americans.
And it is a dangerous idea that somebody would try to
undermine public confidence in any one of these vaccines if
they're approved by the FDA. If they don't work, they will not
be approved. But if they're approved, it's because they went
through all of the rigors of the gold standard of the FDA
testing on thousands and thousands of people who have signed
up. And I applaud, again, the 250,000-plus Americans who have
agreed to participate in these trials. It's helped us get to
this point in revolutionary pace because of the President's
plan. Operation Warp Speed is part of that, which President
Trump laid out.
So, all of these, Mr. Chairman, are part of a comprehensive
plan that continues to grow as we learn more, as we find out
more, as scientists discover more in advance in ways that we
maybe never seen in modern times. And we need to continue that
approach. We need to continue that advancement.
I look forward to hearing your testimony, Mr. Secretary.
And, Mr. Chairman, I yield back the balance of my time.
Chairman Clyburn. I thank the ranking member for yielding
back.
I would like now to introduce our witness. Today, the
Select Committee is pleased to welcome the Honorable Alex M.
Azar II, Secretary of Health and Human Services.
Thank you, Secretary Azar, for being here today.
Will you please stand so I can swear you in.
Please raise your right hand.
Do you swear or affirm that the testimony you're about to
give is the truth, the whole truth, and nothing but the truth,
so help you God?
Secretary Azar. I do.
Chairman Clyburn. You may be seated.
Let the record show that the witness answered in the
affirmative.
Without objection, your written statement will be made a
part of the record.
Secretary Azar, you are now recognized for your opening
statement.
STATEMENT OF THE HONORABLE ALEX M. AZAR II, SECRETARY,
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Mr. Azar. Chairman Clyburn and Ranking Member Scalise, it's
an honor to appear before the House Select Subcommittee on the
Coronavirus Crisis. I wish to express my gratitude on behalf of
the Department of Health and Human Services and the Trump
administration for the support that Congress has provided
throughout this unprecedented crisis.
This morning, we wish the President and the First Lady and
every American fighting COVID-19 a swift and complete recovery.
We also mourn the losses of Skylar, Cheryl, Jason, Demi, and
all the other victims of COVID-19. But thanks to the heroism of
so many frontline healthcare workers, scientists and others we
are making progress. This progress is possible in large part
because of the incredible women and men at HHS, the world's
finest scientists and public health experts.
I want to say a personal thank you to each and every member
of the HHS team who has contributed to this response, and I
want to underscore my commitment to their work today.
I started my first job at HHS nearly two decades ago. Since
my first day on the job, I have recognized and promoted the
value of science and evidence and the civil servants who are so
dedicated to our mission. That does not mean, especially in an
unprecedented crisis, that there are no debates or
disagreements within an agency or an administration, but my
highest priority will always be to ensure that our efforts are
science and evidence driven and consistent with the rule of
law.
Institutions like the CDC, the FDA, and the NIH are
household names and gold standards for good reason, and I
intend to keep it that way. No institution is infallible, but
Americans deserve to know that the actions and communications
coming out of our agencies, whether FDA approvals or CDC,
MMWRs, or NIH guidelines, are grounded in science and evidence.
Of course, that standard also applies to authorization or
approval of a COVID-19 vaccine. I will be confident that my
family and I should take the vaccine, and you should be
confident that you and your family should take it too, because
any vaccine will have met FDA standards as judged by FDA career
scientists.
We are as close as we are to distributing a safe and
effective vaccine because of the dedication and humanitarian
spirit of America's scientists and because of work that began
long before the whole world recognized what an unprecedented
threat we faced.
Back on January 7, long before China had even admitted that
human-to-human transmission was occurring, NIH researchers
began vaccine development planning with Moderna. On Saturday,
January 11, the morning after the viral sequence was finally
shared by Chinese researchers, NIH scientists began work on
that vaccine, which entered human trials on March 16.
On February 3, with just 11 cases in the United States,
BARDA began obligating flexible funds to go to private partners
to support vaccine and therapeutic development. The next day we
made our first therapeutic funding announcement to help
Regeneron develop a therapeutic for monoclonal antibodies,
which is now in phase three trials.
On February 25, NIH began a clinical trial for Remdesivir,
reporting positive results at the end of April. On May 3, we
secured approximately 150,000 donated treatment courses
distributed to the hardest hit areas of the country, and later
secured more than 90 percent of Gilead's global production
through September. Starting this week, Remdesivir is being
distributed on the commercial market because it is no longer a
scarce commodity.
We built on these early efforts with Operation Warp Speed
an unprecedented mobilization of HHS, the Department of
Defense, and industry to simultaneously undertake all of the
tasks necessary to deliver lifesaving products to the American
people.
Today we have four candidates in U.S. phase three clinical
trials, and industrial scale manufacturing is underway on all
six vaccines as to which we have contracted or invested. These
are extraordinary results made possible by the men and women of
HHS, by the support we have received from the Congress, and by
the bravery and sacrifices of the American people.
Thank you. And I look forward to your questions today, Mr.
Chairman.
Chairman Clyburn. Thank you very much, Mr. Secretary.
We will now proceed with questions for the witness.
I recognize myself for five minutes.
Mr. Secretary, I really have only one question that I want
to ask, and you may take the rest of my five minutes to answer
it if you wish. We have experienced more than 207,000 deaths.
And in a very memorable quote, the President said, in talking
about the death toll--and I'm quoting him--it is what it is,
end of quote. And the President says that he puts America
first. However, of the 150 countries for which there is
reliable, in this instance, data or reliable data, we rank
142nd. Of 150 countries, we rank 142nd. That seems, to me, to
be pretty close to last.
Will you tell us why this Administration is coming in
closer to last?
Mr. Azar. So, Mr. Chairman, first, I'd like to just address
the question of the 206,000 Americans who have perished. We
regret any loss of life, let's be very clear about that. We
wish we didn't have this unprecedented coronavirus pandemic,
but people do die in pandemics. And our job, our mission, what
gets me up every morning and what motivates the 83,000
dedicated people of HHS, is the chance every day to make
advances that help save some of those lives. So, people die. We
try to minimize that. We try to mitigate human suffering. It is
our mission. It's the core of everything that we do. And we
work to save those lives.
If we hadn't taken some of the aggressive early steps that
we took, for which we are criticized as being xenophobic,
overly aggressive, or alarmists, like shutting down travel with
China, shutting down the economy, we could have lost, according
to Dr. Birx and Dr. Fauci, as many as 2 million Americans. So,
any loss of life is tragic and horrible, and we don't want to
see a single loss of life, but our actions have made a
difference, and our actions now with Operation Warp Speed will
make a difference saving countless millions of lives in the
United States and abroad in the future.
But as we think about international comparisons, it's
important to think about the data that you're looking at. The
best way epidemiologically to measure a country's death rate in
a pandemic, because there are various ways of counting deaths,
attributing deaths, et cetera, is what's called excess
mortality rate, how many people died in the previous year, how
many people would have been expected to die this year, and what
was the excess rate. And if you look at excess mortality from
March to July among over-65 age people in the United States,
those were 37 percent lower in the United States than in
Europe. Excess deaths from April to June across all ages in the
U.S. were substantially lower than the excess death rates in
Spain, the United Kingdom, Belgium, Italy, and the Netherlands.
Today, in fact, Spain and France actually have higher case
counts per capita than the United States. France, I think I
figured out, has about 126,000 cases per day at this moment,
when we have 42,000 approximately. We don't want any cases, but
I don't hear people talking about Emmanuel Macron that way.
This is a pandemic. Disease spreads. It's dependent on all
of us acting with individual responsibility, the three Ws--I
hope we'll talk about this--wash your hands, watch your
distance, wear a face covering when you can't watch your
distance, and avoid settings where you can't do those three
things, because that's the bridge. If we do that, that's the
bridge to that day in the weeks and months ahead where we'll
have those FDA gold standard vaccines. We'll have monoclonal
antibodies to prevent and treat people at early stage of
disease. It makes me very optimistic for our future, Mr.
Chairman.
Chairman Clyburn. Thank you, Mr. Secretary.
I now yield to the ranking member for five minutes, five
minutes.
Mr. Scalise. Thank you, Mr. Chairman.
And I join you in mourning the loss of every life. I wish
that China didn't lie to America and the rest of the world. We
could have done so much more to stop the spread of this disease
out of China to save American lives, to save lives in every
country, as you note, other countries that have seen, in many
cases, higher death rates.
If five Governors would have followed the guidelines that
the President put out, we wouldn't even be on this list. Over
25,000 deaths that should have never occurred, we wouldn't be
on this list, but we still would have had deaths because it's a
pandemic, and we mourn those.
But we also want to learn how to properly respond to it.
And, again, we've had hearings from some of the most respected
doctors and scientists on this. Dr. Fauci, again, sat where you
were, and he said decision after decision after decision, that
President Trump actually made the right decision. First big
decision was, after we figured out China was lying, China
corrupted the World Health Organization, who, by the way,
everybody had listened to them, and they were saying the
disease doesn't spread from human to human. Well, we know that
was a lie. Maybe we should have a hearing on why WHO was
corrupted by China to do that. It cost lives.
But once we figured it out, the President had a tough
decision to make. Do we ban flights from China? Now, as you
pointed out, not everybody was in agreement on that. Dr. Fauci
noted President Trump made the right decision in banning those
flights from China, and that decision saved American lives.
While some called it xenophobic and wouldn't have done it, we
would have had more deaths.
Same thing with Europe. Dr. Redfield talked about the
decision to ban flights from Europe, wasn't an easy decision
because, as you know, some people were saying, well, you know,
if we ban flights from Europe, we've got a lot of Americans
that go back and forth to Europe. But President Trump was
presented the scientific data that said we will save American
lives if we do it. Dr. Fauci noted, as Dr. Redfield did, that
decision saved American lives as well, tens of thousands,
hundreds of thousands of American lives saved. Wish there were
none. Wish China didn't lie.
But as we sit here today, Dr. Azar, can you share, were you
in some of those meetings where some of those tough decisions
had to be made? And if you were, was the President's
decisionmaking based on that scientific input that he was given
to ultimately make those tough decisions that did save American
lives?
Mr. Azar. First, Congressman Scalise, if I could just
correct. While a J.D., not a doctor, but thank you very much.
Mr. Scalise. Secretary Azar, I apologize.
Mr. Azar. Listen, the President, whatever you read in the
media--I was with him in January, February, March, in those
moments of tough decision, in those early days, and at every
step took decisive, swift action without debate or hesitation.
When we shut down--when we first, on January 17, started
doing health screening of people from Wuhan, they had 67 cases,
I believe, in Wuhan. This was a remarkable action. January 17
we started health screenings at our airports for people coming
from Wuhan, 67 cases, while China was still talking about no
human-to-human transmission, no asymptomatic transmission.
China was refusing to share the viral samples with us or
provide any information or allow the CDC or WHO teams to come
into their country.
When we shut down travel with China on January 31, the
President didn't hesitate, not at all, to shut that down,
despite the economic dislocation that would happen with our
trade with China.
When he brought thousands of Americans and others back to
the United States, we imposed the first Federal quarantine in
50 years, and the President didn't hesitate on that.
When the Diamond Princess was docking in Tokyo with all the
infections on board and the Japanese were going to allow those
people to get off into the homeland of Japan and get onto
commercial flights to come back to America, we didn't hesitate
to impose a quarantine on those people and bring them back to
the United States through Federal quarantine.
And we wrestled with Europe. People--some people thought it
would cause a global depression, shutting down travel with
Europe, and yet the President decided that day, shut down
travel with Europe.
Mr. Scalise. Thank goodness, he did.
And I do want to ask you about the vaccine, because I'm
very concerned by some of the people that are trying to
supplant seeds of doubt with the vaccine because--first of all,
have any corners been cut on a vaccine?
Mr. Azar. Absolutely not.
Mr. Scalise. Do you think it would cause even more deaths
if people were led to be suspicious of a vaccine because of
politics when, in fact, the vaccine, as we know from these
great American companies, is going through the gold standard
process?
Mr. Azar. It would be a terrible disservice to public
health to try to create vaccine hesitancy around the
coronavirus. People will die.
Mr. Scalise. Thank you, Mr. Chairman. I yield back.
Chairman Clyburn. Thank you very much.
The chair now yields to Ms. Waters for five minutes.
Ms. Waters. Thank you very much for this hearing, Mr.
Chairman. It's very important.
I would like to ask, Secretary Azar, will you describe the
increase in the coronavirus infections in this country right
now, and name the states where the increases are taking place?
Mr. Azar. So, we're facing increases at the moment
primarily in the upper Midwest and further West. So, as we look
at Montana, Wisconsin, I think North Dakota, Nebraska, that's
where we're seeing primarily increases, which are
overcompensating or equaling out some of the decreases that
we've been seeing from the South, the outbreak in the Southwest
and the Southeast that we----
Ms. Waters. Give us some numbers. Tell us. Tell us.
Mr. Azar. We'll be happy to get you those numbers.
Ms. Waters. Give us the numbers.
Mr. Azar. We'll be happy to provide you with those. Those
are also available at coronavirus.gov. All of that data is
right there.
Ms. Waters. I would like to know, do you think that the
President's rallies that he has gone to where people are not
social distancing the 6 feet that our experts tell us they
should be doing or wearing masks, does that contribute to the
increase?
Mr. Azar. So, we have consistent advice, which is to
practice the three Ws for all individuals----
Ms. Waters. I'm sorry.
Mr. Azar [continuing]. Wash your hands, watch your
distance, wear face coverings, avoid settings where you can't,
and that applies to any setting, and people need to assess
their individual circumstances.
Ms. Waters. So, what you're saying is that these rallies
where the President is and the people are not wearing masks and
they are not socially distancing themselves the 6 feet,
certainly adds to the increase in the possibility of these
infections. Is that correct?
Mr. Azar. Our advice is always the same, the three Ws,
whether it's in any type of activity, to engage in those
protected activities, but always to evaluate your individual
circumstance.
Ms. Waters. Have you ever talked to the President about
that and given him any advice?
Mr. Azar. I don't----
Ms. Waters. Have you ever interacted with the President
about him being a possible role model in this country and being
one that could either help us to decrease the deaths and the
infections by being a role model himself, wearing the mask and
having social distancing, have you ever had that conversation
with him?
Mr. Azar. I'm not going to discuss my discussions with the
President. But the President's guidelines since April have said
wear face coverings--wash your hands, wear face coverings,
practice social distancing. That's----
Ms. Waters. Mr. Secretary, are you proud of the job that
you have done?
Mr. Azar. I don't like to speak in those terms. 206,000
people have died.
Ms. Waters. So, you don't like to speak in those terms
about what you're doing. You don't like to talk about what you
are saying to the President, who should be a role model to the
people of this country. You can't give me any numbers about the
increases that are taking place. You don't even know where
those increases are taking place. And you come here today and
testify with this paltry testimony that you're giving us and
you expect us to be happy. We're very unhappy about what's
going on, and we feel sorry that the President and his wife and
others are now experiencing, you know, a positive test, et
cetera.
And how can you as the Secretary, with the responsibilities
that you have, come here and not be very, very open with us
about what is happening in this country, the increases and the
deaths and what we need to do and the role modeling that we
need to have, how can you come here without being prepared to
do that?
Mr. Azar. I am happy to do that if you would actually ask
questions that illicit on that point. I will gladly talk to you
about what the state of the disease is in the United States and
the steps being taken.
Ms. Waters. Well, talk to me about DPA.
Mr. Azar. Yes.
Ms. Waters. And tell me why, in fact, money has been
diverted from DPA to build ships and military equipment instead
of being directed toward PPE.
Mr. Azar. I'm the Secretary of Health, not the Secretary of
Defense. We've exercised 78 distinct domestic--Defense
Production Act actions. We've been aggressive with it, whether
on PPE, ventilators, on testing equipment, with regard to
vaccines and therapeutics. We've used it anytime we've needed
it across the entire supply chain.
Ms. Waters. Mr. Chairman, I'm going to yield back my time.
And I want to conclude by saying that the Secretary is not here
with credible testimony today answering the questions that need
to be asked. All that we hear is basically a defense,
basically, of the President of the United States and a lack of
openness and information about what is happening in this
country, the increase in the infections and the deaths, and an
unwillingness by this Secretary to be candid about what we need
to do.
I yield back the balance of my time.
Chairman Clyburn. Thank you, gentlelady, for yielding back.
The chair now recognizes Mr. Luetkemeyer for five minutes.
Mr. Luetkemeyer. Thank you, Mr. Chairman.
Secretary Azar, I've got some questions for you here that I
think will help respond to Ms. Waters' sort of out of the box
questions here.
Question No. 1, did those initial shutdowns actually work?
Did the shutdowns, the initial shutdowns, did they actually
work to stop the spread of the virus and save lives?
Mr. Azar. They did absolutely. And Dr. Fauci and Dr. Birx
said they saved upwards to possibly as many as 2 million lives.
Mr. Luetkemeyer. Today, what percentage of those who are
getting tested are COVID positive?
Mr. Azar. We're about 4.4 percent positivity rate today.
Mr. Luetkemeyer. Is that rate down or is that up?
Mr. Azar. That's down substantially.
Mr. Luetkemeyer. OK. So, Ms. Waters wanted some
information, so now we've got that on the record.
OK. What percentage of Americans who test positive end up
in the hospital?
Mr. Azar. Of those who test positive, those who end up in
the hospital, I believe it's approximately--it's a very small
number. I know upon more age that it's about 10 percent, but I
want to get you the accurate----
Mr. Luetkemeyer. Is that up or down back from where it was
back in July?
Mr. Azar. So, hospitalizations are down substantially----
Mr. Luetkemeyer. OK. So, again, we again answered Ms.
Waters' question.
Of those who need hospitalization, what percentage of those
individuals have unfortunately passed away?
Mr. Azar. Of those who go into the hospital, it depends on
the age group that we're talking about. For instance, age--if
we stay out of the hospital setting, just age 70 and above, in
April, about 30 percent of those individuals passed away who
tested positive----
Mr. Luetkemeyer. Is that number----
Mr. Azar [continuing]. Now 5.7 percent.
Mr. Luetkemeyer. Is that number up or down from where it
was?
Mr. Azar. It's down about 80 percent.
Mr. Luetkemeyer. OK. So, again, we've answered Ms.--and
most of the information, as you said, is on the website that
Ms. Waters could actually go find.
Mr. Azar. Coronavirus.gov.
Mr. Luetkemeyer. Thank you very much.
Mr. Azar. Incredibly transparent.
Mr. Luetkemeyer. So, is it safe to say those initial
efforts have worked, and the continuing guidelines that are out
there and the things that are being done by the administration
to guide and put out there for the Governors and the mayors of
the various cities around the country, is actually working in
those areas where they implement the guidelines correctly?
Mr. Azar. Absolutely. That's why Florida, Texas, Arizona,
California have turned around. Absolutely.
Mr. Luetkemeyer. Thank you very much.
Back in May, you wrote an article, and it's posted in The
Washington Post here, ``We have to reopen--for our health.''
And in there, it's--you know, you make the comment--this is
something that I've been talking about over and over again.
You're talking about balancing health versus health. The health
risk of COVID-19 balanced against the health, socioeconomic
costs of keeping Main Street open and across the United States
which are closed for business. And you could also add on there
opening of schools.
You know, you make--you make a comment here, one percentage
point increase in the unemployment rate, increase of suicides
one percent, three percent increase in opioid deaths. The lack
of mammograms, 80 percent, and colonoscopies are down 90
percent of testing. Normally you would have 1.7 million new
cancer cases diagnosed. You see 80 percent drop in cancers that
are identified.
And then back in May as well, there's an article that
appeared in The Hill, and they make the comment, as they go
through and analyze all this, that there's probably about
65,000 people per month die as a result of the lack of focus on
these healthcare conditions that you identify in your article
here versus, at that point in time, we had about 40,000 people
dying per month. So, we actually have a 50 percent higher death
rate among the population for the lack of attention because of
the total focus on COVID.
Not that we shouldn't do that, but my point is, and the
point of your article is, we need to be looking at both sides
of this. And I think it's important, because as we've found
ways to manage this--I always tell people we have to keep this
in perspective. The perspective is, yes, COVID is serious. We
have to watch this. But as you just testified, 70 and over,
that's where we really need to focus our attention. Those under
70, if they live a managed healthcare life, can do this
unafraid and function well.
So, it's important, I think, that we understand how we can
do this, how we can manage this. And your information is
extremely important today, especially as we've opened schools
around the country. Many in my district have in-person learning
because we don't have broadband, we don't have much choice. As
a result, there's minimal cases of problems that have popped
up. And I think it goes back to point out that your information
with regards to children, people that are certain ages, have
minimal impact with--impacts on a minimal basis.
I think it's important that we understand how this is all
being driven, and I just wonder if you have a couple of
comments on that, because I know that this article is quite
extensive and quite informational.
Mr. Azar. Well, it's what you said, there's got to be a
balance. We need to protect the vulnerable from coronavirus,
but we also have to recognize that mammographies are down 87
percent, pap smears down 83 percent, colonoscopies down 90
percent, CAT scans down 39 percent. Millions of kids haven't
gotten their pediatric vaccinations because of the shutdown.
Emergency rooms have seen drops--dramatic drops in people
coming in with stroke and heart attack. They didn't stop having
them.
Mr. Luetkemeyer. The mental health aspect of this is really
serious. I wish for your you to comment on that as well.
Thank you, Mr. Chairman.
Ms. Waters. Mr. Chairman, point of personal privilege.
Chairman Clyburn. The gentlelady is recognized.
Ms. Waters. Mr. Luetkemeyer attempted to answer the
questions that I directed toward the Secretary. I did not raise
questions of Mr. Luetkemeyer, and I do not appreciate that his
attempt to put words in the mouth of the Secretary in order to
protect him and use me as an excuse for having asked questions
that certainly should have been understood by me.
I yield back.
Mr. Luetkemeyer. Mr. Chairman, I would love to respond to
that if you give me a second. I think it's important that we
allow the Secretary to answer questions, which she refused to
do. And my testimony and my questions allowed the Secretary to
answer her questions, which she wouldn't allow him to do.
Ms. Waters. If he wants a colloquy on this, Mr. Chairman--
--
Mr. Luetkemeyer. I'd love to colloquy.
Chairman Clyburn. All right. We will do that at the end of
the hearing or after the hearing, should I say. Thank you very
much.
The chair now recognizes Mrs. Maloney for five minutes.
Mrs. Maloney. Thank you, Mr. Chairman, and I thank the
witness for being here. I join my colleagues in wishing the
President, the First Lady, his family, and the White House
staff a speedy recovery. The news that we have watched unfold
this morning underscores the importance of testing asymptomatic
individuals who may have been exposed to the coronavirus.
We do not know who exposed the President to the virus or
who he may have exposed, but it's imperative that everyone who
has come in contact with him get tested. And, in fact, everyone
should be tested in America.
On August 24, new guidance appeared on the CDC's website
stating that most asymptomatic people should not be tested even
if they have been exposed to the virus. So, Mr. Secretary, this
guidance was directly contrary to the scientific consensus. And
it has since come to light that this change was not made by CDC
scientists but by the President's political advisers who edited
the guidance over CDC's objections.
One Federal official told The New York Times, and I quote:
That was a doc that came from the top down, from the HHS and
the task force. And it said, quote, ``does not reflect what
many people at the CDC feel should be the policy,'' end quote.
So, Secretary Azar, did you authorize the publication of
this inaccurate guidance on the CDC website?
Mr. Azar. So, I want to be clear because you've made a
misstatement there regarding the guidance of August 24. The CDC
has never recommended against asymptomatic testing. What the
guidance posted on August 24 said was testing for individuals
with symptomatic illness, individuals with significant
exposure, including those who are asymptomatic, vulnerable
populations, and healthcare essential workers. What happened
was, there was a statement in the guidance that said
asymptomatic close contacts do not necessarily need to be
tested. The idea was they wanted to ensure that people not view
a negative test as a get-out-of-jail card, that they were done
because, of course, you have an incubation period. They wanted
to make sure that you consulted with a medical professional or
public health person to guide you through the period of your
potential incubation. That was misinterpreted outside, that the
CDC then later revised that to clarify and say, yes, test
asymptomatic close exposures.
Mrs. Maloney. Well, I think from the very beginning
scientists were saying that asymptomatic, you could get the
virus from an asymptomatic person. You could get it from
molecules in the air, and then if you were next to, that's why
we're all supposed to wear masks, to protect people from us if
we may be asymptomatic. So, to say that on the guidance at the
time and according to the CDC officials that were quoted in
various papers, they said that it was overruling them and their
position.
So, who is responsible for making that change at that time?
Mr. Azar. So, guidance that comes out of CDC is CDC's
guidance. So, Dr. Redfield is the director of the CDC. And as I
said in my opening statement, we harness the best doctors, the
best scientists throughout the government throughout our
agency. Dr. Fauci, Dr. Giroir, as well as Dr. Birx at the White
House as the National Coordinator. There's debate, there's
discussion on any of these critical guidances, but at the end
of the day, if guidance comes out from CDC, it's Dr. Redfield
supporting that and authorizing that; or if it's an FDA
approval, it's FDA approving; or if it's NIH trials and data,
it's NIH.
Mrs. Maloney. Well, I'm glad that, on September 18, you
reversed yourself and recommended that asymptomatic people do
get tested if they're exposed to the virus. We are currently
seeing a spike in many cases in many states.
Has HHS determined how many of these new infections may be
the results of Americans following your inaccurate guidance
that they first read before it was corrected?
Mr. Azar. That would have had nothing to do with the spread
of disease. What we're seeing is community-based transmission
right now in the upper Midwest and the Northwest. We had an
initial--some cases coming from universities getting back
together, but that seems to have settled down now. And what
we're facing now is just plain old community spread as we saw
in the Southeast and Southwest that comes from individuals not
practicing the three Ws: wash your hands, watch your distance,
wear your face coverings, stay out of settings where you can't
do that, especially indoor restaurants that are overcrowded or
bars that are overcrowded. And especially, I want to emphasize
this to the American people: Home gatherings, you are not
immune from catching the disease from extended family and
multigenerational housing. You've got to be careful.
Mrs. Maloney. Reclaiming my time. Reclaiming my time. In my
opinion, changing what was on the CDC website is another
example possibly of political interference with the select
committee's recent analysis found that was directed by your
department. The chairman mentioned 47 political interference
with scientific actions, and another example is, just weeks
ago, a report appeared on the CDC website concluding that the
coronavirus is spread through airborne particles.
Now this is a big deal, and it could change the way
Americans protect themselves. Two days later, this information
disappeared and officials claimed that an early draft was
posted in error.
So, Mr. Secretary, who directed that this information be
removed from CDC's website and why? I can remember when reading
it----
Chairman Clyburn. Mrs. Maloney.
Mrs. Maloney [continuing]. Very concerned about just
walking down the street and now--so who directed this
information be removed and why?
Chairman Clyburn. Mrs. Maloney, your time has expired.
Mrs. Maloney. Well, may he answer the question, Mr.
Chairman?
Chairman Clyburn. The chair now recognizes Mrs. Walorski
for five minutes.
Mrs. Walorski. Thank you, Mr. Chair.
I'd like to agree with my colleagues on sending prayers and
best thoughts, quick recovery to the President, President Trump
and our First Lady for a quick recovery.
Secretary Azar, thanks for being here. I wanted to start
with the unprecedented efforts that are under way to develop,
produce, and distribute a vaccine because, at the end of the
day, that's our best shot, to get to some kind of normal in
this country. All of America is praying that one or more of
these promising candidates prove effective.
Dr. Fauci appeared before the subcommittee back in July,
and I asked him about that topic because that is the topic that
every American is talking about at the kitchen table. I want to
ask you the same questions I asked him.
So, first, between existing government programs that cover
the cost of vaccines and the fact that many, if not all, the
companies working on a vaccine have said they will provide it
at a not-for-profit price or low cost. Is it safe to say then
that every American will be able to get a vaccine once it is
approved?
Mr. Azar. Yes. Everyone for whom it's indicated, yes.
Mrs. Walorski. Next, Operation Warp Speed is enabling
clinical trials for the most promising candidates to be run
simultaneously which will help get a vaccine to market more
quickly. Has this or any other aspect of Operation Warp Speed
eliminated any safety steps in the vaccine approval process?
Mr. Azar. No. We are, in fact, moving quickly because we
can take the financial risk away from the drug companies, both
on development and manufacturing, but the clinical trial
standards remain the same.
Mrs. Walorski. Again, just to be clear, the government is
not compromising any safety standards in order to speed up the
vaccine approval process, correct?
Mr. Azar. That is correct.
Mrs. Walorski. And the vaccine approval process is not
subject to political interference, correct?
Mr. Azar. The vaccine approval process, as I said in my
opening, will be determined by career officials at FDA. Dr.
Peter Marks, who is the center director for the Center for
Biologics.
Mrs. Walorski. Thank you, Secretary Azar.
Dr. Fauci gave similar assurances of a safe, affordable,
and widely available vaccine. However, this vaccine will only
be as effective as the American people's faith in it.
Secretary Azar, the other day, former Vice President Joe
Biden said that he is the Democratic Party. So, when Democrats,
including Joe Biden and Senator Harris sow doubt about the
process, undermine the American people's faith in the vaccine
and repeatedly say they do not trust President Trump's
administration approval process, do these statements help or
harm efforts to defeat coronavirus and overcome this crisis?
Mr. Azar. So, I don't want to speak about those individuals
in a political context. But I will say, as a general matter,
that anybody that works to undermine confidence in the FDA's
approval process or makes unfounded allegations that somehow
politics will warp science, data-driven processes undermines
public confidence in an eventual vaccine. Those vaccines can
save lives, and they're so vitally important, especially for
those who are disproportionately impacted by COVID--American
Natives, African-American community, Latinx individuals.
We have to get those individuals in our clinical trials,
and we have to ensure that they will have confidence in the
vaccine if and when it is authorized or approved by the FDA.
Mrs. Walorski. Secretary Azar, Joe Biden has also said that
he only trusts Dr. Fauci on a vaccine, but as we've discussed
and as the record shows, Dr. Fauci has voiced his full support
for Operation Warp Speed and assured us that any vaccine that's
approved will be safe and effective.
If Joe Biden says he trusts Dr. Fauci and Dr. Fauci says
it's a safe vaccine, should Joe Biden and the Democrats be
sowing doubt among American people about the vaccine and the
need to rebuild our economy, safely get kids back in school,
and otherwise return to a normal way of life?
Mr. Azar. I hope nobody will undermine the public health by
undermining confidence in the safety and efficacy of the
vaccine that's approved by the FDA.
Mrs. Walorski. Thank you.
Mr. Chairman, I yield back.
Chairman Clyburn. Thank you.
The chair now recognizes Ms. Velazquez for five minutes.
Ms. Velazquez. Thank you, Mr. Chairman, and good morning,
Mr. Secretary.
So, you know, as a New Yorker and as someone who contracted
COVID-19, who went through--at the beginning of the crisis in
New York, I would ask you if there is any value to wear masks?
Mr. Azar. Absolutely. We recommend it.
Ms. Velazquez. So, how do you describe or assess or what is
your reaction to the fact that the First Family that was
sitting at the political debate, Presidential debate, were not
wearing masks? Does that make your job more difficult?
Mr. Azar. Our recommendations are always to wash your
hands, watch your distance, wear a face covering when you can't
engage in social distance, and avoid settings where you can't
do those three things. Now, the First Family and the protective
aspect around the President is a different situation than the
rest of us because of the protocols around the First Family,
but our recommendations----
Ms. Velazquez. No, no, no. Sir, reclaiming my time.
Reclaiming my time. It sends the wrong message to the American
people that the First Family, despite the fact that officials
from the university went to them and asked them to follow the
rules, that they were sitting there were not wearing the mask.
That's the point.
So, Mr. Secretary, President Trump said at a rally to slow
the testing down, please. And it is also quoted as saying that
testing is overrated.
Did President Trump tell you to slow the testing down?
Mr. Azar. I'm going to talk about the actions that we've
done. We just this week announced 150 million----
Ms. Velazquez. No. Can you please--I asked the question
here. Reclaiming my time.
I'm asking you, did the President tell you to slow the
testing down?
Mr. Azar. I will not discuss my interactions or
conversations with the President.
Ms. Velazquez. But it's a matter of public policy, sir.
It's a matter of lacking a national strategy to combat the
virus.
Mr. Azar. The national strategy is available for all to see
at coronavirus.gov, including the national testing strategy,
including the reports that you received here at Congress about
the national testing strategy on a periodic basis.
Ms. Velazquez. Thank you.
Rather than implement a national testing strategy, the
administration has pushed down the responsibility down to the
states, letting them scramble to develop their own strategy and
find their own supplies. According to a report in Vanity Fair,
White House officials refused to adopt a national testing plan
this spring because they believe that outbreaks were primarily
in Democratic states, and it will be an affective political
strategy to blame Democratic Governors. And we have seen time
and time again from the other side blaming Democratic
Governors.
Sir, can you tell me what is the situation in nursing homes
in Texas and some of the other states right now?
Mr. Azar. So, we've been improving in terms of deaths and
infection rates in our nursing homes and what we've done is
publish a list of red and yellow nursing homes that are
experiencing excess cases, and we've had enhanced testing
requirements that we've now imposed by force of law on nursing
homes and including with financial penalties and conditions of
participation if they don't maintain control of cases and also
fatalities.
Ms. Velazquez. So, isn't it true that nearly half of all
nursing home cases have occurred in states led by Republican
Governors?
Mr. Azar. I don't know. I don't think in terms of
Republican or Democratic Governors. I do think in terms of
humans.
Ms. Velazquez. You don't know. The point is that this is
not a blue or red issue. This is an American issue, and so I
resent when the other side comes here making statements time
and again about Democratic states. It's the same situation that
is happening in other states.
Mr. Secretary, were you involved in discussions during the
spring about whether to adopt an aggressive national testing
strategy for the state-led strategy?
Mr. Azar. We have an aggressive national testing strategy
that also has states involved in it.
Ms. Velazquez. OK. Secretary Azar, early this summer, CDC's
guidance on schools clearly stated that fully reopening created
the highest risk. I will come back with just this question on
the second round.
Thank you.
I yield back.
Chairman Clyburn. I thank the gentlelady for yielding back.
The chair now recognizes Mr. Foster for five minutes. I'm
sorry, Mr. Foster.
Mr. Green had left, and so I see he's back.
I now recognize Dr. Green for five minutes.
Mr. Green. Thank you, Chairman, Ranking Member, and
Secretary Azar. My Democratic colleagues take numbers out of
context to blame President Trump for every death from COVID-19.
They cite that there have been over 7 million positive cases in
the U.S., and what they fail to mention is that the United
States is one of the world's leaders in testing. We test more
per capita than major countries like the U.K., Australia,
Germany, Canada, South Korea, Italy, and many others. And
that's according to factcheck.org.
According to Johns Hopkins, our daily percentage of
positive tests is also very low at 4.68 percent in comparison.
India is at 7.2 percent. France is over 14 percent. Mexico is
over 54 percent. Last month, The Wall Street Journal noted
COVID-19 death rates in America had been on the decline. In
April, the United States briefly peaked at 5.46 deaths per
million, but for the past month, the United States has remained
below three deaths per million. Despite the vast increase in
testing, Mexico, the U.K., France, Spain, and Indonesia, and
others have higher case fatality rates than the U.S., but the
left says just the opposite. The left manipulates numbers of a
global pandemic and makes every death and every diagnosis the
responsibility of the President. That is despicable.
We continue to learn new information daily and constantly
change previous assumptions about this new pathogen. I'm
following the medical literature constantly, and it is changing
over time. The last mantra, though, is the same: Oh, there's no
plan.
Despite multiple plans like Operation Air Bridge and Warp
Speed, to say there's no plan, that's just deception. They may
not like the plan, but if you say there's no plan, that's not
true. The administration's swift response prevented the rest of
this country from facing the fate like the early days in New
York City. And they blame COVID-19--what really--what they
really fail to do is blame the CCP. I mean, they're the ones
that lied about the virus, botched the response, hoarded PPE,
and silenced whistleblowers.
If China had acted two weeks earlier, according to a study
by Columbia University--we've cited it before--84 percent of
deaths in the United States could have been prevented. Now the
total number of American deaths is over 207,000. If China has
been transparent and we had been warned earlier, 173,000
Americans would be alive. Yet Democrats, like our Vice
President--former Vice President Biden, called President
Trump's China travel ban xenophobic.
I mean, that's crazy. Even Democrat Governors refused to
accept the facts. I mean, I understand the previous comments,
but Governor Cuomo refused to close down New York even after
President Trump said we needed to. Recently, he even had the
gall to cast doubt on the efficacy of the vaccine. He said, and
I quote: The first question is, is the vaccine safe? Frankly,
I'm not going to trust the Federal Government's opinion.
He then added, quote: New York state will have its own
review when the Federal Government has finished with their
review.
I don't believe New York has that capacity. Rather than
trusting the nonpartisan experts at the NIH, CDC, and FDA, he's
putting politics before science. He said he will not recommend
New Yorkers get vaccinated until his team conducts a second
review. That's going to lead to people dying. It's despicable.
The fact is he's lost all credibility. A Columbia
University study also found that, if New York had shutdown two
weeks earlier, 20,000 people would be alive. Dr. Thomas Frieden
said--he was the former commissioner of New York City's Health
Department, head of the CDC, told The New York Times that New
York City's death toll could have been reduced by 50 to 80
percent had social distance measures been in place a week or
two earlier. Trump even had to threaten a quarantine of New
York. Remember that? Everybody seems to have forgotten that.
And Cuomo--because Cuomo so badly botched the response.
Additionally, his idiotic order to send COVID-positive
patients back to the nursing home against CMS guidance likely
contributed to thousands of elderly deaths in New York state.
My fellow GOP colleagues and I have requested that this
subcommittee investigate that. Unfortunately, no answer. They
don't want to hold their fellow Democrats accountable. They
don't even want to hold the Chinese Communist Party
accountable. They're more interested in smearing President
Trump in a desperate attempt to win back the White House.
That's despicable.
Since their radical leftist base has embraced socialism and
communism, we can no longer expect Democrats to push back on
China. They will continue to prioritize politics over people,
over good oversight, and the lives of the American people.
I yield.
Chairman Clyburn. I thank the gentleman for yielding back.
The chair now recognizes Mr. Foster for five minutes.
Mr. Foster. Well, thank you, Mr. Chairman, and Mr.
Secretary.
I believe that public confidence will be crucial in the
development and deployment of COVID-19 vaccines and
therapeutics and that this will require robust and bipartisan
oversight by Congress.
So, in July, Chairman Clyburn, Congressman Dr. Green, and I
sent a bipartisan letter to the Comptroller General asking for
the Government Accountability Office, the GAO, to conduct real-
time oversight into Operation Warp Speed. The purpose of this
GAO oversight is not to second-guess the work of our Nation's
respected scientists, but rather to ensure that crucial vaccine
and therapeutic research precedes as efficiently and
effectively as possible, and that Congress and the public has
confidence in the process.
Part of the response to this has been excellent. For
example, immediately after this, the Representative Dr. Green,
who is a conservative Republican who obviously I agree with on
approximately nothing. He and I are actually getting a
classified briefing on the classified aspects of Operation Warp
Speed. So, unfortunately, I also understand that HHS has been
slow to provide full access to GAO to conduct this review,
including even basic documents on decisionmaking processes,
procurement, contracting, and so on.
In my time as a scientist, I've had experience having a
project, billion-dollar projects under real-time oversight by
the GAO. And it seems like a nuisance at the moment but really
can improve the quality of the project. The GAO is very
sensitive to its role as a nonpartisan and a professional
interface to Congress and GAO's operation under the bipartisan
direction of Representative Green and myself really represents
your best shot at having a high-quality scientific oversight by
Congress into this.
So, Secretary Azar, will the Department commit to providing
full and prompt access by the GAO to this important oversight
material?
Mr. Azar. So, we've received your letter. We're working on
a response. We are responsive and cooperative with our auditors
from GAO. We actually have 32 open GAO COVID audits just on
that subject alone, and we're working with GAO to assist them
in fulfilling their responsibilities without negatively
affecting the Department's life-saving mission during this
historic pandemic. And we remain committed to working with and
accommodating GAO in its COVID-19-related work.
Mr. Foster. All right. It would be nice to see some
improvement in the speed of response there.
You are also absolutely correct in identifying the danger
of vaccine hesitancy due to political interference. Do you
believe this problem was improved or made worse by the
political interference in the approval of hydroxychloroquine
that was identified in Rick Bright's whistleblower complaint
and his testimony to Congress?
Mr. Azar. Well, I'm not going to discuss a matter of
litigation----
Mr. Foster. Was it improved or made better?
Mr. Azar [continuing]. But what I will tell you is, the
emergency use authorization for hydroxychloroquine, there's so
much misunderstanding about that. What happened was, we
received a donation of, I think, it was 3 million tablets from
Bayer of product manufactured in Pakistan that was not in an
FDA approved GNP facility. It's Bayer----
Mr. Foster. OK. Well, there have been long congressional
hearings on the details of this, so, please, if I could reclaim
my time.
Do you believe that the public misstatements by President
Trump and the FDA Director on convalescent plasma made the
problem of vaccine hesitancy better or worse?
Mr. Azar. I know that the Commissioner was very sorry for
that statistical misstatement that he made.
Mr. Foster. Correct. And he is a scientist, and he as a
good scientist acknowledged his mistake and apologized for it.
Have you apologized for the mistake? Has President Trump, his
boss and your boss apologized----
Mr. Azar. Could you tell me which mistake I made? Because
my remarks were actually reviewed before I walked on stage by
Dr. Peter Marks----
Mr. Foster. No, no. He works for you.
Mr. Azar [continuing]. The career scientist who approved
everything, and I was very clear about the 35 percent relative
risk reduction----
Mr. Foster. OK----
Mr. Azar [continuing]. I used to be at a drug company. I
know how to talk about----
Mr. Foster. No. No, I understand that, but I think it's
appropriate when a significant misstatement is made by
someone----
Mr. Azar. But what did I misstate?
Mr. Foster. When someone who works for you makes a
significant public misstatement, I think you have a duty----
Mr. Azar. I'll be honest with you, on the stage there, I
did not notice Commissioner Hahn's misstatement. It was an--I
can assure--an honest misstatement by the Commissioner----
Mr. Foster. But I think we can agree that that did not
improve the problem of hesitancy, vaccine hesitancy going
forward when you see that sort of--now, on August 22, President
Trump insinuated that the government scientists who worked for
you are trying to delay the approval of a vaccine, saying in
his tweet: The deep state, or whatever, over at the FDA is
making it very difficult for drug companies to get people in
order to test these vaccines and therapeutics. Obviously, they
are trying to--they are hoping to delay the answer until
November 3.
So, my question to you, do the scientists that work for you
over at HHS represent a deep state dedicated to politically
sabotaging the President?
Mr. Azar. Our people at HHS are dedicated to the American
people. I don't ever use terms like ``deep state.''
Mr. Foster. Do you understand how demoralizing it is when
the President makes statements like this about the scientists
and then you do not stand up and confront the President for his
demeaning of their motives?
Mr. Azar. It's important that we have confidence in the
work of FDA. I support our scientists. I support our career
officials, and I support our agencies.
Mr. Foster. Thank you. My time's up.
I yield back.
Chairman Clyburn. The chair recognizes Mr. Jordan for five
minutes.
Mr. Jordan. Thank you, Mr. Chairman.
Secretary Azar, let me thank you for testifying today,
being with us this morning, and for your good work at HHS. We
appreciate that.
Secretary Azar, can states safely open up their economy?
Mr. Azar. Yes. States can and should reopen their economy.
There are ways to do that very safely.
Mr. Jordan. You know, we've heard some talk earlier from
some of my colleagues about New York state. I was just kind of
interested in a little comparison here. Which state has more--
has a greater population, Florida or New York? Do you know?
Mr. Azar. In terms of population, I believe New York is 20
million--about 20 million, and I believe Florida is about 22
million. So, I think they're roughly the same.
Mr. Jordan. Roughly the same, but, of course, Florida has 2
million more people. Do you know which state has more seniors
in their respective state?
Mr. Azar. I would have to believe Florida does. I don't
have the exact data, but I would assume Florida does.
Mr. Jordan. Yes. You'd be right in that assumption. Do you
know which state has more seniors in nursing homes, Florida or
New York?
Mr. Azar. I, for the same reason, believe it would be
Florida.
Mr. Jordan. Sure is. And which state had more
hospitalizations for COVID-19? Do you know?
Mr. Azar. So, in terms of--and I wanted to correct
something. I actually did have a note here on Florida has
70,000 nursing home residents; New York has 100,000 nursing
home residents. So, I did want to be precise on that. I don't
have the numbers on hospital--hospitalizations: Florida had
24,656 hospitalizations; New York City plus the state: 73,238.
Mr. Jordan. Three times as many approximately.
Is that right?
Mr. Azar. Yes.
Mr. Jordan. And then which state and, look, this is
terrible no matter where it happens and we wish we had zero
deaths from COVID-19, but which state had more of their
residents, their citizens pass away from COVID-19? New York or
Florida? Do you know?
Mr. Azar. New York had over twice the number of deaths,
32,864 COVID deaths versus Florida with 14,320.
Mr. Jordan. And might that be because the leadership in New
York didn't follow the guidelines that came from the Trump
administration, specifically, as my colleague from Tennessee
pointed out, didn't follow the guidelines for 46 straight days
when they put COVID-positive patients back into nursing homes,
might that have something to do with that terrible number that
we saw just in New York?
Mr. Azar [continuing]. We see from the data on nursing home
deaths, New York had 4,650 nursing home deaths and Florida had
3,200 nursing home deaths. I got to see first-hand the
difference in treatment what Governor DeSantis did creating
COVID-only nursing homes and COVID-only wing and then see what
New York did where they scattered COVID-positive patients out
of hospitals and basically sprinkled them across nursing homes,
contrary to guidance, and then tried to blame us for having
said that that should happen when our guidance was directly
contrary, saying you should do COVID-only wings and protect the
vulnerable.
Mr. Jordan. So, Florida followed the guidelines, and guess
which state is opened up today, has their economy much more
open, guess which state is more open, Secretary Azar?
Mr. Azar. I believe Florida has more open in terms of its
removing restrictions.
Mr. Jordan. Yes. It shouldn't surprise anyone that when
you're able to follow the guidelines, do things in the safe and
proper way, you can open up your state. And guess which state
has the lowest unemployment, Florida or New York? Which do you
think it is?
Mr. Azar. Florida, I believe, has lower unemployment.
Mr. Jordan. Yes. Like half. They got twice the unemployment
level in New York that Florida has. And this is maybe the final
thing. If we would've had states follow the guidelines, if we
had states open up safely, imagine what our economy could be
doing now. I mean, I think what the great American comeback is
under way, but it's under way and you're seeing these good
numbers that we're seeing as the economy starts to reopen in
spite of the fact that New York, New Jersey, Pennsylvania,
Michigan, Illinois, and California are still largely locked
down.
So, there are six of, I think, the 12 largest states
population wise in our country still largely locked down, and
yet, in spite of that, you've got the economy moving in the
right direction. Imagine if they had followed the guidelines
and be in a position where they could open up, like the state
of Florida did, how much better off the country would be, how
much better off families would be.
Mr. Azar. We can open this country's economy up and we get
the issues that we spoke of earlier, health versus health by
being opened up and doing it in a safe way practicing good
behaviors, it can solve all the other health issues that
counterbalance against the impacts of COVID.
Mr. Jordan. Well said. Again, thank you for being here
today, thank you for your service to the country.
Mr. Chairman, I yield back.
Mr. Azar. Mr. Chairman, would you mind if I--could I
correct something. I accidentally gave a wrong number earlier
in reference to France. I said 126,000 per day. I had
accidently--I believe their per capita rate is three times the
U.S.' per capita daily rate, and I accidentally multiplied that
out to the U.S. population. So, if I could--I just would like
to correct that. I didn't mean to misstate that. My point was
that France's daily cases on a per capita basis are higher than
the United States' cases, but the 126,000 number was incorrect.
I apologize for that, Mr. Chairman.
Chairman Clyburn. Very good. Thank you very much.
The chair now recognizes Mr. Raskin for five minutes.
Mr. Raskin. Thank you, Mr. Chairman. And I want to add my
thoughts for swift and complete recovery to the President, the
First Lady, and the other 43,752 people who contracted COVID-19
yesterday. And my thoughts are with the families of the 857
Americans who died yesterday.
Mr. Secretary, we now are over the 206,000 mark for
Americans who have died from this terrible disease. That's more
than--more Americans than we lost in World War I, 53,000 Korea;
33,000, Vietnam; 56,000 Afghanistan and Iraq combined; more
than 7 million infected. We are the world's leader in absolute
case count and absolute death count, and we are the world's
leader, unfortunately, in COVID denialism and conspiracy
theory.
We've heard from our colleagues to date that there is a
plan, or there are multiple plans some said.
Secretary Azar, has your plan been a success or a failure
so far?
Mr. Azar. Congressman, it's not useful, productive, or
appropriate to talk about success when dealing with----
Mr. Raskin. Well, how are we going to decide whether to go
forward with this plan or to adjust the plan?
Mr. Azar. We have saved, we think, millions of lives to the
aggressive early action that we took. And while we mourn the
loss of 206,000, these aggressive actions have actually
delivered. Excess mortality rates----
Mr. Raskin. Excuse me. I'm going to reclaim my time, sir.
Do you agree with the President that there's nothing more that
the administration could have done to prevent these deaths?
Mr. Azar. I can only tell you that I wake up every day, and
my whole team wakes up every day from the beginning of this
doing everything we can to save lives.
Mr. Raskin. OK, but let's take one simple action that could
have saved tens of thousands, if not hundreds of thousands in
the future lives. Encouraging every American to wear a mask.
Now, the Director of the CDC Robert Redfield said that this is
the most important, powerful public health tool that we have,
encouraging everyone to wear a mask, but the President attacked
Dr. Redfield for that.
President Trump said there's a lot of problems with masks,
and maybe they're not so good. He's mocked people who wear
masks. In fact, he mocked Vice President Biden at the debate
for wearing a mask. He said: Every time you see him, he's got a
mask. He shows up with the biggest mask you ever saw.
Do you agree with the President that there are a lot of
problems with masks, or do you agree with the CDC Director that
this is a powerful and necessary public health tool?
Mr. Azar. I've been very clear ever since our scientists
began recommending mask wearing, especially in April in the
reopening guidance that the President published, that mask
wearing is an important public health tool.
Mr. Raskin. OK. If you look at the chart behind me, the
Institute for Health Metrics, University of Washington, has
calculated that if 95 percent of Americans wear masks, we'll
save roughly 96,000 American lives by the end of this year,
compared to the current path we're on where there continues to
be sinister disinformation and propaganda against masks.
The administration has turned masks into a partisan symbol,
discouraging many Americans from wearing them. We spent several
meetings of this committee designed to combat the coronavirus
epidemic fighting about whether Members should wear masks when
they're not speaking in the committee, this committee, if you
recall back to the early days.
This morning the select subcommittee released a report
detailing dozens of times when there was political interference
with the pandemic response. One time involved a plan to have
the U.S. Post Service mail a mask to every American household,
but the White House stopped it and used the masks for other
purposes.
An administration official told The Washington Post that
the plan to send every American a mask was blocked due to,
quote, concern from some in the White House domestic policy
council and the Office of the Vice President that households
receiving masks might create panic.
Mr. Secretary, were you aware that the White House
intervened to stop the plan to send a mask to every American?
Mr. Azar. So, thanks to the great work of Dr. Bob Kadlec,
our Assistant Secretary for Preparedness and Response, in
February he worked with Hanes and Fruit of the Loom to get this
retooling of cloth manufacturing for reusable masks, and we
were able to get over 600 million of these. The initial plan
was to send them by the postal service, packets of five, to
every household. There was pushback saying why don't we send
them where we needed most, where we have the outbreaks, and
that's what ended up happening. They went out, but they went
out targeted----
Mr. Raskin. Do you favor sending the mask now to every
American household?
Mr. Azar. What?
Mr. Raskin. Do you favor sending masks to every American
household now?
Mr. Azar. I don't know that that's needed. We've all
figured out how to make masks. We have great mask
accessibility. We've actually served I think 60 million masks
to schools, and we've got smaller sized ones that we've
developed, we're going to send out to schools, especially for
our younger kids to make sure underserved have access to them.
Mr. Raskin. OK. My time is expired, but I do want to ask
you about the concept of herd immunity. So, that's what I'm
going to be doing in the next round. Thank you.
Mr. Chairman, I yield back.
Chairman Clyburn. Thank you.
The chair now recognizes Mr. Kim for five minutes.
Mr. Kim. Thank you, Mr. Chairman.
Thank you, Mr. Secretary, for coming and talking with us
today. When I go to my district and I'm talking to the
constituents there, some of the toughest conversations that
I've had are with people that have lost their health insurance
since the start of the pandemic. You are our Nation's top
health official, and I want to ask you, how many Americans have
lost their health insurance since the start of the pandemic?
Mr. Azar. So, Congressman, I know it's several million, but
I would want to get that back to you in writing because I don't
have that at my fingertips. I want to make sure you have
accurate information.
Mr. Kim. I would appreciate that. I would like to hear what
your assessment is on that. I've heard numbers that are
staggering, anywhere from 5 million so far up to 11 to 12
million by the end of the year, and I urge you to get very
familiar with that because I feel like that is a major part of
your job.
Would you consider that having more and more Americans be
able to have access to healthcare is a critical part of your
job?
Mr. Azar. We want to make sure people have access to
affordable healthcare and, if they would like, affordable
access to health insurance, and that's why ObamaCare, of
course, has a special enrollment period if anyone loses their
employer-sponsored insurance, they actually can immediately
enroll in the individual market in an ObamaCare plan at that
time.
Mr. Kim. Would you support opening up ObamaCare, the ACA,
right now for those that maybe didn't lose it based off of
employment, but people who didn't have--the tens of millions
that didn't have insurance prior to this pandemic, would you
consider opening it up for them?
Mr. Azar. No, we don't because we think that, right now,
through the Provider Relief Fund, what we've done is provide
insurance--we've actually paid first dollar coverage for people
who are uninsured, which is even better for COVID. So, this
means you don't have a deductible, you don't have a copayment,
and you don't have premiums. If you have COVID, you seek
treatment, we pay first dollar coverage for that. And we've
been processing claims for the uninsured individuals to ensure
they get their COVID treatment.
Mr. Kim. So, when it comes to those that have lost their
health insurance, what would you say to those constituents of
mine, what specifically have you worked on to help them get
their health insurance back?
Mr. Azar. Again, if you have lost your insurance because
you lost your job, you have a special enrollment period and you
may enroll in an ObamaCare plan.
Mr. Kim. OK. Well, look, what I'm worried about right here
is both in terms of having the staggering number of millions of
Americans who have lost healthcare but also we now face this
great threat in terms of having millions more. I wanted to ask
you: We're in the middle of this pandemic here, would you think
that now is a good time for people for millions of Americans to
lose their healthcare during the middle of a pandemic? Is that
a good idea or a bad idea?
Mr. Azar. Well, I know what you're getting to. You're
getting to the Texas litigation and the Supreme Court, the
question of the Affordable Care Act. If the Court were to rule
against the statute in large part or in its entirety, we're
going to work with Congress, and we're certainly going to
replace it. The President has never supported repeal only. He
wants repealing and replacing. So, we are going to work with
Congress and get people access to affordable health insurance
and affordable healthcare if the Court were to do that. We are
very far away from a final Court resolution on that. And
nobody--if anyone tells you they know how the Supreme Court
will rule on a case before they rule, they don't know what
they're talking about.
Mr. Kim. Well, I guess I was asking you directly, and I
appreciate a yes-or-no answer. Do you think the ACA that it
should be repealed if the Supreme Court were to move forward on
that decision?
Mr. Azar. Well, it would be a question of if--the Supreme
Court would make the decision, my views aren't really relevant
to that. If the Supreme Court finds that the individual mandate
that taxed, which the President worked with Congress to get rid
of, that by removing that it creates a position where the rest
of the statute is unconstitutional and can't be severed, then
we will work with Congress to replace it with access to real
healthcare. You know, we've got to stop--I know we have a
difference of opinion on this, but this notion that the ACA is
the land of milk and honey where for somebody who makes $70,000
a year in Missouri is paying--they're 55 years old, a couple,
they're spending 30,000 plus bucks on their premiums. They're
having a $12,000 deductible. That's not access to affordable
healthcare for them, and we want to work with Congress to
actually get them access to affordable healthcare.
Mr. Kim. Well, I agree with you in terms of wanting to
improve our healthcare. I hope that is something that all of us
care about, but if you say that the President is committed to
not repealing the ACA and, instead, reforming or replacing it,
why then is the administration moving forward with this effort
in front of the Supreme Court that would do exactly that, it
would repeal without replacing?
Mr. Azar. Well, the litigation position that the Attorney
General's advocated there in the Supreme Court is a statutory
construction, a constitutional position. The policy position,
which I can speak to, is we want people to have a good system
with affordable access to health insurance and affordable
healthcare, and we're going to work in Congress. If the Court
creates the situation where we need to replace it, we're going
to work to get that.
Mr. Kim. Were you consulted by the President or by anyone
else in the Cabinet or the Justice Department before the
Justice Department of this administration moved forward with
this effort with the Supreme Court?
Mr. Azar. Well, again, I'm not going to discuss my
consultations with the President or Cabinet level
consultations. I can't do that, as you know.
Mr. Kim. Mr. Chairman, I yield back.
Chairman Clyburn. I thank the gentleman for yielding back.
I think that completes the first round of questions. Now
vote is on, but I think we'll monitor that so that we can--OK.
Very good. We'll now go to a second round, and I will yield
myself five minutes.
Mr. Secretary, the website of the Department of Health and
Human Services states in its mission, and I'm quoting here,
``is to enhance the health and well-being of all Americans, by
providing for effective health and human services and by
fostering sound, sustained advances in the sciences underlying
medicine, public health, and social services,'' end of quote.
I wholeheartedly endorse this mission. HHS must use sound
science and sound science alone to enhance Americans' health
and well-being. Do you, Mr. Secretary, believe that you and the
other political appointees in this administration have
fulfilled this mission during this pandemic?
Mr. Azar. I do believe so, yes. I believe that--I've stood
up for science, data evidence. We've made these--these doctors
have become household names, Fauci, Redfield, Hahn, Birx, made
direct access to the American people in ways that have never
been done before to ensure they hear right out of these
scientists' mouths the best information that they have.
We've made sure those people have direct access to the
President, and he's speaking with them and he's hearing from a
multitude of the best science voices. I ensure that. I don't
like to meet with the President without one of those top
scientists being there or all of them being there. I try to
always encourage science data-driven deliberations. That
doesn't mean that our scientists and doctors can't have debate.
There is debate in science. That's a core part of the peer-
review process. It's one of the hall marks of scientific
enterprise, and I encourage and sponsor that.
Chairman Clyburn. Very good. So, you think you're doing it.
OK.
Regrettably, the science-based mission of the Department
was betrayed by senior political appointees like Assistant
Secretary of Public Affairs Michael Caputo, who reports to you
directly, and his former adviser Dr. Paul Alexander.
I want you to take a look at this poster here. We've
received emails that clearly show that Mr. Caputo and Dr.
Alexander bullied and overruled CDC scientists who tried to
inform the public of the risks of the coronavirus. On June 6--
I'm sorry--on June 30, after the CDC's Principal Deputy
Director said people should wear masks, Dr. Alexander wrote,
and I'm quoting here, her aim is to embarrass the President
here because this career scientist disingenuous and
duplicitous. On August 8, after the CDC reported that children
could spread coronavirus, Dr. Alexander wrote, and I'm quoting
here: This is designed to hurt this President for their reasons
for which I am not interested in.
In that same email, Dr. Alexander told CDC's Director:
Nothing is to go out unless I read and agree with the findings
how the CDC wrote it and I tweak it to ensure that it's fair
and balanced and complete.
These emails show clear the political interference in the
CDC's efforts to carry out the Department's science-based
mission.
Mr. Secretary, will you renounce this kind of political
interference and commit that it will not happen again?
Mr. Azar. Mr. Chairman, as I said, I support debate. I
support discussion. I support challenging each other. I do not
support those statements. Dr. Alexander is no longer employed
at this Department, and I won't get into personnel matters, but
there is a way to have discussion and debate that is proper,
respectful, appropriate.
And let me be clear, especially about that second quotation
there: I do not know of any circumstance where anybody other
than Dr. Redfield and Dr. Birx would have authority over
determining the final publication of an MMWR, which is that
issue. Dr. Alexander, to my knowledge, never had that
authority. I would never have supported that, but I do not find
that tone and tenor of discussion to be acceptable in my
Department.
Chairman Clyburn. Well, thank you, Mr. Secretary. You may
recall when these statements came out, I wrote you a letter
asking that these people appear before our select subcommittee.
Mr. Secretary, not a single staff had been made available
to appear before this subcommittee, not a single one. I would
hope that you will agree and begin producing the documents and
allowing these witnesses to come forward next week. I'll be
glad to come back up here, and I'm sure my ranking member will
participate.
Will you do that?
Mr. Azar. Our staffs are working to secure the agreements
on the procedures to make that happen. We want to make that
happen. We're working on the final arrangements on that.
Chairman Clyburn. Thank you. I took that as a yes.
Mr. Azar. Well, they need to get to agreement on
appropriate procedures to protect individuals. Some of these
are some of our career CDC officials, for instance, and as you
know, Mr. Caputo's on medical leave right now with a very
serious medical condition.
Dr. Alexander no longer works at the Department or the U.S.
Government, but we're working with your staff to get to
agreement on how this can be facilitated.
Chairman Clyburn. Well, I think that, if my memory serves,
that I'm here in person and you're here in person, but the
ranking member has on occasion participated virtually and we'll
be pleased to have virtual testimony from them if they will
agree to appear so we don't have to come back if necessary. I
think we are doing that because of you and me, but we can do it
virtually. OK?
Mr. Azar. So, we'll get our--I think they're in the final
stages of getting things arranged.
Chairman Clyburn. Thank you very much. I'll yield to the
ranking member five minutes.
Mr. Scalise. Thank you, Mr. Chairman.
Chairman Clyburn. Maybe 30 seconds more, five minutes and
30 seconds.
Mr. Scalise. We're good, and I appreciate the second round.
Secretary, thank you for continuing to answer these questions.
And when we talk about vaccine advancement as well as other
therapies--you talked about Remdesivir, hydroxychloroquine.
I've talked to internalist doctors who are using it
effectively. Of course, a doctor is the one who knows what's
best for them and their patient. Hopefully, we continue to make
as many options available that are safe to doctors so that they
can continue to help treat patients.
Are you seeing an increase and an improvement in the
ability to effectively treat people who are COVID positive
compared to where we were a few months ago when this disease
came from China?
Mr. Azar. Congressman, the advances in our ability to care
for people and help them recover who suffer from serious
consequences from COVID have been nothing short of
revolutionary, as I think I mentioned earlier. Just to take one
data point, in April, an individual aged 70 or above who
contracted COVID would have a 30 percent chance of dying. Today
that's about 5.7 percent chance. That's thanks to the
President's efforts to get Remdesivir approved and have
supplies, steroids for lung injury, now convalescent plasma in
over 80,000 patients. Just even as we've learned about how--you
mentioned earlier how to use ventilators better, when you use
them, how to use forced oxygen better, how to use proning and
quality of care. And my Department's played a vital role in
educating providers across the country as they've seen surges
in declines in cases to enhance knowledge among providers.
Mr. Scalise. And that's something I've seen directly. In
fact, we've here in Congress passed some of the money to give
the Department the ability to respond even more effectively to
come up with and produce vials of vaccine. As these companies
are in the final stages of testing, we're not waiting for one
to be approved to start manufacturing the vaccine. It's part of
Operation Warp Speed. In the old days, they would say, well, if
one clears through the final stage, then they'll start
producing it, and, of course, that would be months later.
We're actually making those now. Now, obviously, if they're
not approved, then those go in the trash can, but if they're
approved, that saves us vital months. Is that part of President
Trump's plan that we're doing that, or is that how it's always
been done?
Mr. Azar. No. This is historic and unprecedented that we
are--at the same time that we're advancing the development to
demonstrate safety and efficacy, we're literally making, as we
speak, we have millions of doses of vaccine, and we're making
them in industrial scale across six manufacturers right now,
something no drug company ever would have been able to do on
their own without the support of the U.S. Government. That was
the innovation President Trump created in Operation Warp Speed.
Mr. Scalise. And with any other virus, have you seen a
vaccine potentially created within a year of a virus being
known to mankind?
Mr. Azar. Never, never. I worked very hard on the Ebola
vaccine. I played a critical role in the Democratic Republic of
the Congo on eradicating Ebola in the 10th outbreak in the
eastern DRC and they're--thanks to America, we had a Merck
vaccine. We had various monoclonal antibodies, but those took
years to get. We're talking months.
Mr. Scalise. And this is another story again that's not
told because, unfortunately, some people want to just not
politicize everything. And, you know, if the vaccines not a
week later after the virus is known, then it's all the
President's fault. And, you know, we see this, yet we're
literally on the verge of four potential vaccines less than a
year later with millions of vials already being mass produced
in part using the Defense Production Act, which the President
has been very effective at using as well.
Let me ask you about New York because this is very, very
concerning, again. As you see some people trying to plant seeds
of doubt in a vaccine, which would be deadly if they did it,
deadly. New York's saying that they will not allow their
citizens to have access to the vaccine until they have some
other approval process.
Have you seen New York's approval process? Do you know how
long it would take? How many months would people in New York be
denied a vaccine if the Governor gets his way?
Mr. Azar. I have been unbelievably distressed by the
remarks of the Governor. It undermines public health. It
undermines confidence in vaccines, not just for COVID but for
kids getting their MMR vaccines. And New York has been a hot
bed of the antivax movement.
Mr. Scalise. Right. Does New York have their own testing
process that you know of, Secretary?
Mr. Azar. I'm sorry?
Mr. Scalise. Do you know if New York even has a testing
process like Governor Cuomo talks about?
Mr. Azar. Of course, they don't. We have a single Federal--
--
Mr. Scalise. I mean, how many months would the citizens of
New York be denied the ability to save their own lives if
Governor Cuomo gets his way, God help us. Hopefully he doesn't
get his way. But it's a ludicrous statement, and again, these
are the kind of statements that undermine public confidence. I
know you said that you agree with that as well.
I do want to jump to China real quick because,
unfortunately, this is not an area where the committee has
gone, and we need to go there further, but I was in some of
those meetings in the White House months ago when we were
trying to find out more when we knew nothing about this virus.
Chinese health officials wanted to let us in. Our top
health officials wanted to go in. Wasn't it the Chinese
Communist Party that stopped us from going in and that
corrupted the World Health Organization from, at least, being
honest about the human-to-human transmission?
Mr. Azar. The Chinese Communist Party delayed by month and
a half the CDC or WHO teams getting into China. I offered that
on January 6----
Mr. Scalise. Do you know how many lives we could have saved
if the Chinese Communist Party didn't deny?
Mr. Azar. Countless lives there and here from what we would
have learned. We ended up learning a great information for
being able to be there about how to care for patients, but that
was a month and a half delayed.
Mr. Scalise. So, lives would have been saved. Thank you,
Mr. Secretary.
And I yield back, Mr. Chairman.
Chairman Clyburn. Thank you, Mr. Ranking Member.
The chair now recognizes Ms. Velazquez for five minutes.
Ms. Velazquez. Thank you, Mr. Chairman.
Secretary Azar, early this summer, CDC's guidance on
schools clearly stated that fully reopening created the highest
risk. In July, the CDC released new guidance substantially
edited by White House officials that downplayed the risks of
reopening schools.
Secretary Azar, were you involved in instructing the CDC to
issue new guidance?
Mr. Azar. I'm not aware of an instruction for CDC to issue.
They update their guidance, and there is a collaborative
interagency process as there would have been, I assume, under
President Obama with the Ebola response or H1N1. It's quite
normal that you have a White House coordinated guidance review
process.
Ms. Velazquez. OK. And you believe, and it is your opinion,
that it's not appropriate for political advisers to write
public health guidance?
Mr. Azar. I believe it's perfectly appropriate for all
individuals who have competence and expertise to contribute,
whether politically appointed or career officials. Dr. Redfield
is politically appointed. He runs the CDC. He is the final
signoff on CDC guidance.
Ms. Velazquez. But political advisers such as Jared
Kushner?
Mr. Azar. I'm sorry. Who?
Ms. Velazquez. Jared Kushner.
Mr. Azar. I'm not aware Mr. Kushner's involvement, but I
don't know that I'm aware of that. But it's perfectly normal
for there to be--all guidance is required to go through a White
House process. That's Presidential executive order. Significant
guidance has to go through White House review, and who sees it
there, I don't know. But I want to be very clear about that: At
the end of the day, the CDC Director must agree with it or it
does not go out--any edits, any changes, any suggestions.
And I'll back them up on that.
. The CDC, the CDC reports that over 40 percent of all
COVID cases between the ages of 5 and 17 are Latinos. Isn't it
true that there's evidence that young children can transmit the
virus?
Mr. Azar. Oh, yes, children can transmit----
Ms. Velazquez. OK. Thank you.
And you agree that transmission of COVID is higher in
poorly ventilated or enclosed areas?
Mr. Azar. Congresswoman, on that issue, I just want to be
careful to--I want to defer to the experts at CDC in terms of
if they--I believe that to be the case, but I would want to
refer you to CDC guidance on that rather than speculating on
that front.
Ms. Velazquez. OK. So, are you aware that a recent GAO
report found that 36,000 schools nationwide need ventilation
upgrades?
Mr. Azar. And that's what, you know, we have--I think
there's in Congress's statute that you passed, I think, $13
billion of funding for schools. I do believe there are some
issues on ventilation systems that can be good upgrades to
freshen the air and keep it going and also keep adequate
humidity levels, which is going to be important----
Ms. Velazquez. I understand.
Mr. Azar [continuing]. In terms of the dehydration of the
product.
Ms. Velazquez. Do you think it's right? You know, we need
to give peace of mind to the parents in this country that it's
safe to send kids, especially in low-income communities where
the schools and the infrastructure is old and it hasn't been
upgraded, do you think it's right to say that we should fully
reopen the schools in those areas?
Mr. Azar. We do believe we can reopen. Fully is a question.
The question is there are steps you can take, cohorting kids,
creating social distance, moving teachers from classroom to
classroom, delivering meals to the kids, social distance in the
classroom, of course, face covering wearing, and also, at all
points, the individual making decisions what's right--for the
parent and the guardian deciding what's right for their kid and
what vulnerabilities they or other household members have.
That's vital they be in the driver seat.
Ms. Velazquez. And do you think that we have enough money
nationwide to be able to upgrade all of those schools?
Mr. Azar. I haven't looked at that issue of funding.
Ms. Velazquez. Well, you should because you are----
Mr. Azar. Well, there's $13 billion of Department of
Education funding that I don't believe has been fully allocated
or pulled down by the school districts.
Ms. Velazquez. OK. It hasn't been fully allocated. But my
question to you is, given the GAO report and the thousands of
schools nationwide that need ventilation upgrades, my question
to you--you are the Secretary of Health. You are the one saying
that presumption should be we get our kids back to school.
So, do you feel confident that having 36,000 schools
nationwide in need of ventilation upgrades, that the money that
is there that has been allocated is appropriate.
Mr. Azar. Well, there's several assumptions there in your
multiple questions. The key point is the presumption is kids
should be back in a physical environment. They're not being
there, Dr. Redfield, Dr. McCance-Katz have made it clear, is
destructive to children's physical, emotional, mental health,
and their development.
It can be done safely, but we always have to look at the
individual circumstances to make sure it's safe in any
particular school or situation and an adequate plan to make
that happen.
Ms. Velazquez. The fact of the matter is that there are
36,000, according to the GAO report, in need of upgrades. And,
therefore, to make such a statement as ``Let's send the kids
back to school'' doesn't provide the peace of mind to the
parents of this country.
Reports indicate that White House pushed for testing
guidelines to be changed to recommend that people without
COVID-19 symptoms abstain from testing. But 16 percent of kids
with COVID-19 are asymptomatic. So, what testing guidelines are
you recommending for schools, especially knowing the
significant impact COVID-19 is having on children of color?
Mr. Azar. So, we recommend the testing of asymptomatic
close contact. So, in a disease tracking situation, that's why
we work to get BinaxNOW testing out, a hundred million of those
tests that we've asked the Governors to prioritize for the K-12
kids, to do contact tracing, as well as to assist with
surveillance because, in addition to close contacts, we want to
ensure that we have adequate surveillance systems to identify
if we're seeing emerging disease outbreaks.
Ms. Velazquez. Thank you. I yield back.
Ms. Waters. Mr. Luetkemeyer, you're recognized for five
minutes.
Mr. Luetkemeyer. Thank you, Madam Chair.
Secretary Azar, I live in a very rural area, and a big
chunk of my district is very rural. I know throughout this
pandemic a lot of the healthcare services have been delivered
by the telehealth way of going about it. And to me this is
extremely important, going into the future, that we allow this
to continue to happen. I know there's been some rules and
regulations that have been probably waived or changed to be
able to accommodate.
I would like to give you a few minutes to talk about some
of the rules, regulations, problems, the things that we can
implement, you know, suggestions for Congress on how we can
make this a better service between the healthcare professionals
and the constituents and customers of this country for the
betterment of their healthcare.
Would you like to comment just for a few minutes on that?
Mr. Azar. Well, absolutely.
Thanks to the national emergency powers of the President,
we've been able to for the first time ever really be able to
release the power of telehealth. We've brought healthcare into
the 2lst century for the first time. And when you go out and
visit hospitals and doctors and community health centers, as I
have done, you see that it has been a truly patient-centered
change in healthcare. And it's bringing overall healthcare
costs down and creating a better experience.
I've been to community health centers which treat the
underserved, and they're delivering 90-plus percent of their
care by telehealth now and having drive-through lab testing,
and sample taking, vaccinations, et cetera. So, they are
combining them.
Past assumptions were that telehealth would be additive and
just add cost to the healthcare system, but we're seeing it
actually improves quality and decreases costs. We need Congress
to act, though, on this because we can't enshrine in regulation
everything we've been able to do. We can do much more in rural
America under statute. We can't do that in urban.
In addition, in rural, you still have to, under the
statute, show up at a doctor's office. You can't do it from
home. You have to have a preexisting relationship with a doctor
or hospital before. We've waived all of these things, thanks to
President Trump, under the emergency powers. But Congress will
have to act to make those flexibilities permanent, so we really
hope that Congress will act. I don't think you can walk this
backward, nor should you.
Mr. Luetkemeyer. Well, I appreciate that because I think
what we really need to do is, as we wind down from this thing
at some point, we need to get together and figure out the
rules, regulations, what it's going to take to implement this
on a national basis, on a permanent basis to be able to be
helpful to both the healthcare professionals and the
improvement of health for our citizens. So, I thank you for
that.
I know I saw this week, I think it was Wednesday, September
30, in, I think it's the Wall Street Journal here, there was an
article with regards to Regeneron and their--the medication
that they're coming up with. It looks like they're well on the
way to perhaps by the end of the year have this drug, RGN
COVID-2, that could be helpful to produce antibodies. Would you
be willing to talk about that today? I realize that we're not
there yet, but this really sounds good.
I know it's an article in the paper, so there's public
awareness of it. So, I think, you know, to let people know that
there are--besides vaccines, there are therapeutics that are in
the pipeline that could be beneficial as well, that are being
tested and being worked on as we speak.
Mr. Azar. Yes. And I actually think you saw that--that's an
initial phase one dose range and clinical trial data for
Regeneron. These are called monoclonal antibodies.
So, you remember we authorized convalescent plasma, which
is the plasma from a survivor patient. You have antibodies in
your body. We can actually synthetically make those antibodies
at ranges that could be a thousand times more potent than what
we can get out of an individual's plasma and synthetically
produce in mass quantities, be thinking hundreds and hundreds
of thousands of doses in very short order.
And we have manufacturers in the country, such as Eli
Lilly, Regeneron, Astra-Zeneca, who have significant monoclonal
antibody programs. We're seeing very promising early data that
has been made public. We could be literally many weeks to a
month or two away from having data to support emergency
authorizations in these if the data proves that they're safe as
well as effective.
Mr. Luetkemeyer. Now, you mentioned a couple of times today
emergency authorization. We had--I think Dr. Fauci has made a
comment on this before. Would you like to explain to us what
emergency authorization actually is?
Mr. Azar. Yes, so especially with vaccine, if I could. So,
when we think about therapeutics, we might approve, authorize a
vaccine for--a therapeutic for emergency use on a more limited
data set as we continue to do trials. For a vaccine, because
somebody is healthy and you're putting a vaccine to them, the
FDA is requiring here 30,000-person clinical trials, so 15,000
placebo, 15,000 active, and demonstrating statistically
significant results.
That's the same for emergency or full on licensure of the
vaccine. The only real changes that happen with an emergency
use, are you would have ongoing safety data collection through
a massive national pharma vigilance program, and you would have
ongoing--there are three validation lots needed for inspection
of the manufacturing facility. But the actual data package,
other than that longer term safety net, is the same.
Mr. Luetkemeyer. Well, Dr. Fauci made the comment that the
emergency authorization could be--is probably necessary
whenever you see the data is so overwhelming that it would be
unethical and immoral to withhold those vaccines or those drugs
from people because it could be saving lives while you're
sitting there continuing to I dot and T cross.
Mr. Azar. Right, especially when you have safety. If you've
got like with convalescent plasma, you see well demonstrated
safety, and then you see clear trend of efficacy, it becomes an
ethical question, shouldn't you allow people to try that.
Mr. Luetkemeyer. OK. Very good. My time is up.
I yield back. Thank you.
Ms. Waters. Thank you very much.
I now yield myself five minutes for questioning.
Mr. Secretary, I was reviewing comments made by the
President at a Labor Day press conference where he gave this
rosy prediction. He said, one, a vaccine would be available
very soon. You could have a very big surprise coming up. You
will be very happy, the people will be happy, the world will be
happy, the people of the world, everybody is going to be happy,
and you know what I'm talking about, before that very special
date.
Then we have, you know, companies that are involved with
the development, like Moderna, who said they would not be ready
to seek Emergency Use Authorization from FDA before November 25
at the earliest.
Now, when you have the President of the United States
making these rosy predictions, and you have contradictions
about those who are responsible for the development, what do
you think that does to your credibility and the credibility of
FDA?
Mr. Azar. I think the President is trying to be hopeful,
put out hope for individuals. But I want to be very clear, this
will be determined by data and independent processes.
So, for instance, we don't even see data on these clinical
trial programs until an independent data and safety monitoring
board determines that the data in the clinical trial has
achieved pre-specified statistical end points, and then it goes
to the----
Ms. Waters. Reclaiming my time. Do you think--you just
described the President's rosy predictions as being hopeful.
There's a difference, you know, between being hopeful and
misleading the people of this country.
Do you think it's helpful to you when the President is out
making these kinds of predictions?
Mr. Azar. The results will be driven by data. If a company
produces data that's independent, that in the beginning of
October determines a vaccine is safe and effective and submits
it to FDA and FDA's career scientists through an advisory board
process determine it's safe and effective----
Ms. Waters. Reclaiming my time.
Mr. Azar [continuing]. Then that's what it is.
Ms. Waters. Reclaiming my time.
Do you believe Moderna when it says it will not be ready to
seek Emergency Use Authorization from FDA before the latter
part of November?
Mr. Azar. Well, what Moderna was saying with November 25 is
that's based on the guidance that they received from FDA.
Ms. Waters. Whatever it's based on, do you believe them?
Mr. Azar. Well, you need to have the context. Their
guidance was they need to have 60 days from the median patient
completion in the clinical trial, and that would calculate out
to November 25----
Ms. Waters. Let me just try and frame this question, these
questions a little bit differently.
Do you believe that there is a contradiction between this
hopefulness that you describe, that I describe as a prediction,
and what Moderna is saying and others are saying about the
readiness, when a vaccine will be ready?
Mr. Azar. No, because the----
Ms. Waters. Is there a contradiction?
Mr. Azar. No, because the CEOs of Moderna and Pfizer I
believe both have said that we may see data in October. It's
event driven. It's data and science and event driven. Nobody
controls when we see data and whether we hit results----
Ms. Waters. So, do you think that the--what you call
hopefulness by the President is helpful and it builds
confidence when the American people see that what he is
predicting has no credibility and it is contradicted by those
who are responsible for the development?
Mr. Azar. What the President----
Ms. Waters. Is that a problem?
Mr. Azar. Well, you're incorrect. What the President has
been saying, in terms of inspiring hope, is within the range of
possibilities of vaccine development, but it----
Ms. Waters. No, no, no. Excuse me. Reclaiming my time.
He didn't say there is a possibility. This is more than
what you're describing as hope. This is the President of the
United States of America, the leader of the greatest Nation in
the world, and should be, in addition to being a role model,
which of course, we question, we should be able to rely on what
he says.
We should be able to have confidence that he is giving us
good information, correct information. And as you know, as you
sit here, no matter how you try to frame it, the President of
the United States has not been the kind of role model that
could create confidence in your agencies, what he has in
himself, et cetera, et cetera.
And I know that you said you will not reveal whether or not
you have any conversations with the President about whether or
not he's holding mass rallies where people are not safely
distanced or wearing a mask, or what have you. It would be very
helpful to know that at least you have the strength and the
ability to talk with the President of the United States and
speak the truth about what he is doing or what he is not doing.
I am absolutely, absolutely surprised at the lack of
strength of many of the people in this Administration. But for
you, with the responsibility that you have, I would expect that
you would stand up to the President any time of day and say,
Mr. President, please, you could be helpful if you support
wearing masks everywhere you go, if it was a national plan that
said everybody must wear a mask, everybody must be socially
distanced, and I'm not going to have a rally where people are
jammed in and packed in.
Why can't you say that to the President?
Mr. Azar. I'm not going to discuss my conversations with
you with the President. But what I would ask, you're a very
influential Member, if you could please inspire vaccine
confidence, it's critical. It's critical for the entire vaccine
process----
Ms. Waters. Excuse me. Reclaiming my time, and I know
they'll say I won't let you answer the question. But you're
going to come here and tell me to inspire confidence----
Mr. Azar. We all need to----
Ms. Waters. And you cannot tell me whether or not you'll
tell the President to do that?
Mr. Azar. I have made very clear the independent processes
for vaccine approval. If you would have let me speak, I
actually could have walked you through the four independent
steps on vaccine data and approval and consideration that would
give people confidence any vaccine will be safe and effective.
Ms. Waters. Well, thank you.
Mr. Azar. I will take it, my family will take it----
Ms. Waters. Thank you.
Mr. Azar [continuing]. As soon as we're indicated and
prioritized.
Ms. Waters. Thank you.
Thank you very much. Reclaiming my time.
I would ask you to think about it when you leave here. I
ask you to think about it before you go to bed at night. When
you get up and look at yourself in the mirror the next day, I
want you to think about whether or not you have the strength
and the ability to say to the President what he should and
should not be doing.
And I think he should respect your advice and the advice of
the experts.
With that, I will yield to Ms. Maloney the next five
minutes.
Thank you.
Mrs. Maloney. Thank you.
Mr. Secretary, the Select Subcommittee put out a memo this
morning in which they identified in this report at least 47
incidents in which political officials have intervened in the
Nation's pandemic's response.
Your Department recently awarded two contracts to public
relation firms to launch a coronavirus advertising campaign
that is intended, according to the contract, quote, to defeat
despair and inspire hope, exactly what Congresswoman Waters was
speaking about.
Now, Mr. Secretary, the reason so many people feel despair
right now is because more than 207,000 people are dead, and
this administration's response to this crisis has been worse
than almost any other country. It would have been much more
effective if President Trump had listened to the experts, if he
had actually believed in science. Or if he had come up with a
real plan before today to combat this crisis.
Instead this administration is spending more than a quarter
of a billion dollars in taxpayer funds to make videos with
senior officials and celebrities in a massive ad blitz right
before the election.
In order to fund these videos, HHS diverted $265 million
from CDC and FDA, even as both agencies are fighting, fighting
this pandemic. This campaign was spearheaded by Assistant
Secretary for Public Affairs, Michael Caputo. He said these
contracts were--and I quote--``demanded of me by the President
of the United States personally,'' end quote.
Mr. Secretary, is that true?
Mr. Azar. So, I want to provide an update on this topic
because I take seriously the value of public health
communications efforts. First----
Mrs. Maloney. Well, you're not--I want to hear your
response--reclaiming my time, Mr. Secretary.
I want to hear your response and an update on it, but I
also want to know, is that true? Have you spoken to anyone
about this ad campaign?
Mr. Azar. I was literally going to answer your question----
Mrs. Maloney [continuing]. Whose idea was this? Tell me
where it came from. Whose idea was it? Was it your idea? Whose
idea was it.
Mr. Azar. I have ordered a strategic review of this public
health education campaign that will be led by our top public
health and communications experts to determine whether the
campaign serves important public health purposes.
I also have taken steps to ensure that any products coming
out of this campaign will be reviewed and approved by career
public health officials, including from the CDC.
There are three key elements to this. What's already
happened is the Surgeon General has done ads to encourage
people to practice the three Ws, to donate convalescent plasma,
and to encourage minority group enrollment in vaccine clinical
trials.
The next way will be to inspire flu vaccination as we enter
into the flu season, and the third phase would be around COVID
vaccination if we are fortunate enough to have an approved
vaccine.
But I will ensure----
Mrs. Maloney. Reclaiming my time, reclaiming my time.
Part of this committee's oversight is procurement. So, this
contract, I'm incredibly interested in it, as one of them was
awarded to a company called Atlas Research. And according to a
press report this week, someone--we don't know who--recommended
that Atlas use a subcontractor called DDT, which just happens
to be run by Mr. Caputo's former business partner. And
according to this report, DDT has zero public health experience
and has been, quote, overwhelmed by the project.
So, Mr. Secretary, do you agree that it's highly
inappropriate for any political appointees to push for their
own business partners to get lucrative government contracts
when they have zero experience in the area that the contract
covers?
Many people in your Department appear to have serious
concerns with these actions. Politico quotes one current
official who said this--and I quote--this is a boondoggle.
We're in the middle of a pandemic. We could use that quarter of
a billion dollars on buying PPE, not promoting PSA's with
celebrities.
Do you agree with that statement, Secretary Azar?
Mr. Azar. Well, I disagree firmly with your last statement.
The FDA's real cost campaign about the dangers of tobacco cost
$250 million. The Affordable Care Act outreach cost $280
million. This is important public health messaging about--
around good community mitigation steps, around flu
vaccinations, including----
Mrs. Maloney. Excuse me. Reclaiming my time, reclaiming my
time, reclaiming my time, reclaiming my time, Secretary Azar.
This contract, I agree, there's certain health reasons that
we should be reaching out to the public, and those that you
expressed on flu and vaccine and other items are--and the three
Ws are very important things. But this was not. This was about
feeling good, being positive. It had nothing to do with health
from the press reports that I read. And right now----
Mrs. Walorski. Madam Chairman----
Mrs. Maloney [continuing]. Why are we having this blitz
right before the election? There are a lot of troubling
questions about it, but I know my time has expired.
Ms. Waters. The gentlelady's time has expired.
Mrs. Maloney. I would like to present some more questions
to you in writing, Secretary Azar.
And I yield back.
Ms. Waters. Thank you.
I now yield to Mrs. Walorski five minutes.
Mrs. Walorski. Thank you, Madam Chair.
Secretary Azar, if China shared the virus sequence earlier,
would fewer Americans have died?
Mr. Azar. Yes. We would have advanced faster.
Mrs. Walorski. If China didn't lie about human
transmission, would fewer Americans have died?
Mr. Azar. That's correct.
Mrs. Walorski. If China didn't hoard PPE, would fewer
Americans have died?
Mr. Azar. Absolutely.
Mrs. Walorski. If China didn't corrupt the World Health
Organization, would fewer Americans have died?
Mr. Azar. Yes.
Mrs. Walorski. If China had not let American scientists
into the country, would fewer Americans have died?
Mr. Azar. That's correct.
Mrs. Walorski. If China hadn't put export controls on PPE,
would fewer Americans have died?
Mr. Azar. Correct.
Mrs. Walorski. Thank you.
I yield back.
Ms. Waters. I yield five minutes to Mr. Foster.
Mr. Foster. Thank you, Madam Chair.
And if those--the last questions you just got, if it were
applied to Korea--my wife is Korean, and she looks at the
contrast between the response. They got hit harder earlier than
we got hit and have had, by contrast, a negligible number of
events.
So, all of the last questions that you just answered apply
equally to South Korea, correct.
Mr. Azar. I would be glad to discuss the difference between
the U.S. and South Korea in detail if you would like.
Mr. Foster. I think the largest single factor, frankly, is
that they have leaders who listen to the scientists and
policies that followed that.
Now, a point of clarification. Last month the FDA
commissioner issued new guidance settling the criteria for
Emergency Use Authorization for coronavirus vaccines. You know,
I applaud that decision and the transparency. But,
unfortunately, President Trump called this guidance, quote,
political, and he said, quote, that has to be approved by the
White House. We may or may not approve it.
So, my question is, what is the signature chain on this
document? Is it the FDA commissioner? Do you have final
approval, or does the President have final say and final edit
on this document?
Mr. Azar. So, you made a mistake in your statement there.
Several months ago the FDA issued vaccine guidance, and that
went through the full interagency process as is required under
Executive Order before coming out of FDA. That's what requires
the 30,000 people in clinical trials, et cetera.
Mr. Foster. Yes.
Mr. Azar. The FDA has sent letters to vaccine manufacturers
stating what they would ask for in the EUA.
Mr. Foster. OK. Who has final say on the specifications for
an acceptable vaccine? Is it the President or is it HHS career
people?
Mr. Azar. So, this is--what the commissioner is proposing
to put out is public Emergency Use Authorization guidance on a
vaccine that would be consistent with letters already sent to
the manufacturers and just doing that publicly. That does
require White House----
Mr. Foster. OK. So, your answer is that President Trump has
the final say on these documents. And he was correct when he
said that has to be approved by the White House, we may or may
not approve it?
Mr. Azar. I think this is a mountain out of a molehill
because they've already--FDA has already--Peter Marks said
yesterday the FDA has already told the manufacturers what
they're going to look for, and that is what it is.
Mr. Foster. Did you see the debate on Tuesday?
Mr. Azar. I did, parts of it.
Mr. Foster. OK. So, I would like to enter into the record,
it's been distributed to Members, an open letter that was sent
last night from the chairman and CEO of Pfizer--Pfizer-
BioNTech, as you're aware, is one of the vaccine participants
in OWS--a gentleman by the name of Dr. Albert Bourla, which was
sent to his U.S. colleagues.
I would just like to read the first paragraph of that, of
that letter. Tuesday night I was joined--I joined the millions
of Americans who tuned in to the Presidential debate. Once more
I was disappointed that the prevention of deadly disease was
discussed in political terms rather than scientific facts.
People who are understandably confused don't know whom or
what to believe. Global health has too much at stake and the
public trust and acceptance of a vaccine is so important to me
that I'm writing to explain the principles that we are using at
Pfizer today.
He goes on in his letter to explain why Pfizer refused to
accept, you know, money or guidance from Operation Warp Speed.
Alright,he will accept a production contract but not the
oversight because, frankly, he didn't want the disturbance in
confidence in his product that would result from that.
So, as I say, I enter that into the record.
Mr. Foster. Another thing, you know, I would like to talk a
little bit about the timeline that you talk about in your
testimony here. You know, as you know, if you exceed, I think
it's warp factor ten, you go backward in time, which allows you
to rewrite history, which seems to be a fair part of what
you're trying to accomplish here.
Many of the milestones that you list here occurred before
Operation Warp Speed was even announced and was the result of
the efforts of scientists, career professionals at HHS, rather
than anything coming out of the White House and Operation Warp
Speed.
And in fact, if you click on the therapeutic development
link in your testimony, you're led to a press release and a
discussion by Rick Bright, who's the very scientist who, in
fact, pulled the whistleblower complaint over political
interference.
So, you know, giving credit to the leadership of President
Trump is, I think, a little bit problematic here.
I would also like to enter into the record three reports on
the President's budget cuts proposed year after year after
year.
Mr. Foster. As soon as Trump entered office, he proposed a
22 percent budget cut to the NIH and other health--other HHS.
He then had double digit budget cuts even after President
Trump knew that the coronavirus was--had been briefed on how
deadly it was. In February 2020, he proposed a seven percent
cut to the NIH.
So, how do you give credit to President Trump for any of
this, the achievements of his scientists, when he has cut their
budgets, proposed cuts to their budgets year after year after
year?
Mr. Azar. President Trump is the one who actually has
backed this historic effort. It pains me that you denigrate
Operation Warp Speed and the effort that's happening there.
These are career people from the Defense Department, from HHS,
from NIH driving this.
Mr. Foster. Correct. It is the White House oversight that I
give no credit to.
Thank you, and I yield back.
Ms. Waters. The gentleman's time has expired.
Mr. Raskin, you're recognized for five minutes.
Mr. Raskin. Thank you very much, Madam Chair.
Secretary Azar, tell me if you agree with this statement:
When younger, healthier people get infected, that's a good
thing because that's exactly the way that population immunity
develops.
Mr. Azar. I don't want anyone to get infected, Congressman.
Mr. Raskin. So, you disagree with that statement?
Mr. Azar. I am not a physician. I am not an epidemiologist.
Mr. Raskin. You're the Secretary of HHS.
Mr. Azar. I'm going to tell you, my mission is going to
keep people from getting infected with coronavirus, as few as
possible.
Mr. Raskin. OK, OK. Reclaiming my time.
The quote comes from Scott Atlas, who is a top member of
the White House Coronavirus Task Force, who has been promoting
the ideology of herd immunity, which seems to have affected the
President who said on September 15 that the coronavirus is
going to disappear, even without a vaccine, because people
would develop, quote, a herd mentality, which is a telling
Freudian slip. But, in any event, he seems to have adopted it.
Here's Paul Alexander who, I think, works for you, a senior
advisor at HHS. He wrote to Michael Caputo the following:
Importantly, having the virus spread among the young and
healthy is one of the methods to drive herd immunity. This was
not--he said the original, this was not the intended strategy,
but all must be on deck now and it is contributing positively
at some level.
Do you agree with what your employee, Paul Alexander wrote
to Michael Caputo about herd immunity being a positive factor
in your plan for combating the disease?
Mr. Azar. Dr. Alexander, you may have missed this, does not
work at HHS anymore.
Mr. Raskin. Did you fire him for that statement?
Mr. Azar. I'm not going to discuss the personnel matters,
but he does not work at this Department or in the U.S.
Government at this point.
Mr. Raskin. OK. Well, Secretary, I don't know why you need
to be illusive about it. This is a dangerous concept. Herd
immunity, if this is gaining traction within the White House
and with the President, will end up costing hundreds of
thousands, if not millions, of American lives because the
theory is that you essentially let the disease wash over the
population and then you end up with 60 or 70 percent immunity
among the people.
But right now the studies show it's below 10 percent. That
means 90 percent of the people don't have it. So, we would have
to infect tens of millions more people in order to create this
herd immunity.
And I'm wondering if you can break through the herd
mentality of the thinking within the top circles at the White
House to oppose herd immunity publicly, articulately, and
forcefully today.
Mr. Azar. Herd immunity is not the strategy of the U.S.
Government with regard to coronavirus. We may get there as
other countries get. We may get herd slowing of transmission,
as we perhaps have seen in the New York area and other
concentrated areas. Our mission is to reduce fatalities,
protect the vulnerable, keep coronavirus cases down to the
lowest level possible----
Mr. Raskin. How about beat the disease? How about vanquish
the disease?
Mr. Azar. That's literally what I was just saying we would
be doing.
Mr. Raskin. You know herd immunity has been tried in Sweden
and it failed. The death toll there is ten times its neighbor
Finland and other Scandinavian countries. It doesn't work. It's
killing people. That is a policy of mass human sacrifice. And I
hope that as other people pop up throughout the administration
arguing for herd immunity and the idea that the spread of the
disease is a positive thing, you, as the Secretary of the HHS,
will be a forceful voice combating that sinister view.
Mr. Secretary, can you give us any further updates on the
President's health today, whether anyone else at the White
House has tested positive or has any symptoms of the virus and
what precautions are being taken through contact tracing to get
in touch with people that the President has interacted with in
the last several days?
Mr. Azar. Well, I'm sorry, but I've been both preparing to
be here and sitting here in front of you the entire time, so
I'm not----
Mr. Raskin. OK. I have another question for you then.
There's been a lot of talk about China today, and I'm
always baffled when my colleagues brings it up, because
President Trump praised President Xi and the Chinese Communist
Party on 37 different occasions, and I have submitted them for
the record.
I have distributed them to my colleagues, and I can do it
again, Mr. Chairman, if you think I should submit it again. I
would love nothing more than to have a hearing about the
President's complicity with covering up China's early lies
about the disease. And for the life of me, I can't understand
why my colleagues bring it up, and I hope it's not contributing
to bias in the country.
But I know you don't want to talk about your specific
conversations with the President, but have you, either in
writing or in conversation or at meetings, ever told the
President to stop praising President Xi and the Chinese
Communist Party for its performance on COVID-19? We have
records of him doing that in February, in March, in April.
Did you ever tell him to stop doing that?
Mr. Azar. So, again, I'm not going to talk about what I
said with the President, but what the President was doing then
with China, it's a difficult matter. You have carrot and stick.
We're trying to get viral isolates----
Mr. Raskin. Did they play him for a sucker? Did they play
him for a sucker? Is that why we're in this situation?
Mr. Azar. We got viral sequencing in. I had to force them
to get----
Mr. Raskin. My time is up. Mr. Chair, I yield back.
Chairman Clyburn. I thank the gentleman for yielding back.
The Chair now recognizes Mr. Kim for five minutes.
Mr. Kim. Thank you, Mr. Chairman. Thank you again, Mr.
Secretary, for coming.
I want to just pick up where we left off before. So, what I
thought I understood you saying was that we'll see what happens
with the Supreme Court and then, based off of that, then there
will be sort of a--you know, an effort to create a plan to
replace the ACA if the Supreme Court strikes it down. Is that
what you were saying?
Mr. Azar. So, obviously, there are many different
scenarios. First, we're going to, no matter what, protect
people with preexisting conditions. He's not going--the
President will not sign any piece of legislation that doesn't
do that. But there are many ways to protect people with
preexisting conditions and also ways to set up affordable
mechanism for insurance.
Mr. Kim. I get that, but it sounded like when I asked you
if there was a plan to replace, you know, in regards to whether
the Supreme Court moves forward, it sounded like you were
saying that there's not right now. Is that correct?
Mr. Azar. We have a range of approaches, and it will depend
on the composition of Congress at the time, because, of course,
dealing with Nancy Pelosi is different than otherwise, and what
one could pass through Congress to replace Obamacare.
Mr. Kim. The reason why I asked you that is because two
weeks ago I heard a clip that just kind of struck me. It was
the President talking, and he said, We're going to be doing a
healthcare plan very strongly. I have it all ready and it's a
much better plan for you.
So, I guess I'm just trying to get a sense of that because
it sounds like it kind of contradicts what you're saying, like
the President is saying he has a plan ready to go, you're
saying that we're not there, it's going to be something we're
thinking through.
So, can you explain that to me.
Mr. Azar. I think you and the President are using the word
``plan'' differently. What the President rolled out last
Thursday was his healthcare plan for 331 million Americans.
You're speaking about this small sliver, which is Obamacare, in
the hypothetical that the Supreme Court strikes down all or a
large part of it.
The President is focused on delivering better care, lower
cost, and more choices for 331 million Americans, not just
those who are trapped and/or excluded from Obamacare.
Mr. Kim. OK. Well, look, I remember you're referring to the
Executive Order on the preexisting conditions and other
aspects. Is that correct?
Mr. Azar. Well, the broader framework actually is about how
we--the fact that we've brought transparency in price and
quality for the first time ever, lowering drug prices.
I now have signed the first ever certification for
importation of drugs to lower costs here in the United States
under the President's direction. We've brought interoperable
health IT to enable you to shop among providers and not be
locked into one system. We're tackling kidney disease for the
first time since President Nixon.
We're ending the HIV epidemic in the United States. We're
tackling the most contractible healthcare problems, improving
healthcare for all 331 million Americans. That's the
President's plan for healthcare.
Mr. Kim. I get that, but I also get, you know, kind of
concerned when I hear that, you know, for instance, the
American Enterprise Institute when they were taking a look at
the Executive Order on preexisting conditions, what they said
is, quote, ``all it really is, is a statement that he wants one
or more of his departments to come up with a plan and that he
doesn't give any guidance or the vaguest outline of what that
plan should be,'' end quote.
So, look, we'll move on from here, but I just feel like
this is an enormously dangerous situation where we already have
millions of Americans who have lost healthcare during this
pandemic, potentially millions more that will lose their
healthcare.
And the best that I kind of hear is just that we'll see
what happens at that time, you know, and that's just not
reassuring to people in my district who are very, very
concerned about what happens next.
But I want to just switch gears here because there was a
lot of talk about vaccine approvals, but one thing I wanted to
get to is about the distribution of the vaccine. I saw the From
the Factories to the Frontline document and some of the
different efforts in there.
But one thing that was concerning to me is that it was
saying that 64 different CDC jurisdictions around this country,
you're asking them to be able to come back to you with their
plans, different states, different territories. How is that not
saying that we don't have--basically that indicates to me that
we don't have a singular strategy but rather 64 different
strategies. How is this not just the testing debacle all over
again.
Mr. Azar. No. So, what it is with the 64 jurisdictions is
working in partnership with the states. We're going to have a
centralized distribution system. We're going to rely on
McKesson, which does the Vaccines for Children program out of
the CDC, does 80 to 90 million vaccines a year. We have cold
chain storage set up through that.
They'll partner with Cardinal and AmerisourceBergen as
needed to reach to our pharmacies and community health centers
for actual vaccination programs. But we need the states to be
partnered with us because they know where the vaccine should go
locally to hit target populations.
So, if say, we're dealing with nursing homes and the
vulnerable people, the states will tell us which--how they want
to administer that, do they want to use a CVS, do they want to
use a Rite Aid, do they want to use their public health
department. That's why we're partnering with them.
Mr. Kim. So, that's helpful, and I want to make sure we
work together on this. It's so incredibly important.
Just the last thing, as you said, you know, you corrected
the ranking member, you're a J.D., not a doctor, and you said
that we're going to be grounded in science and evidence and
career scientists for the approval of the vaccine. I also want
to see the confidence in the American people on vaccines. I
want us to work together on that.
Does that mean that you will not play a role in the
approval, like you're not going to be providing inputs or
recommendations to the FDA commissioner for this? I just want
to hear your explanation.
Mr. Azar. Well, I want to be very clear. When we talk
about--there's all of this talk today about political, quote,
``interference.'' OK. We harness the best minds, scientific
data. I have--I'm the Secretary. I bring 20 years of
experience. I was one of the architects of the pandemic flu
planning in the Bush Administration that helped create our
novel pandemic flu vaccines and our vaccine capacity here in
the United States.
We have many people who bring a lot of expertise and
knowledge to the table. Those people can participate. Those
people can contribute. They can challenge. They can ensure good
decisions are made.
What I'm telling you is that, at the end of the day, it
will be the FDA career scientist, Dr. Peter Marks, is going to
make the decision whether a vaccine is safe and effective.
Mr. Kim. That's all I wanted to hear.
Thank you so much.
Chairman Clyburn. Thank you very much.
I think we have concluded this second round of questions,
and I'm prepared to yield to the ranking member for any closing
comments he may want to make.
Mr. Scalise. Thank you, Mr. Chairman, and, again, thank
you, Secretary Azar, for coming and having two rounds of
questions where we can really try to get some of the facts out
there about where we are, what's happening with the response to
COVID, what's happening with the economic and, hopefully, the
educational recovery of this country.
One of the things we wanted to do is get out as many facts
as possible. And, again, there has been a plan that started
early off in this pandemic, and it continues to grow and change
as we learn more about the disease, as we learn more about
things that we're doing and we need to do to give guidance to
states to safely reopen different parts of their economy. But
we put this report together, to give everybody that guide map
for those who either are denying that there's a plan or want to
ignore that there's a plan, it's out here. It's on the
internet. You can go see it, tens of thousands of pages. But we
put together a summary to make it easier for some folks that
maybe are having trouble understanding that plan.
But the basics of this plan are, No. 1, China lied and
caused a global pandemic. I know the Secretary talked about
some of these challenges as China was withholding information,
not just from us, but from the entire world. That cost--China's
lies cost tens of thousands of lives. This committee ought to
look into that and hold them accountable.
No. 2, President Trump responded immediately. First
decision that every scientist that's testified before this
committee said was the right decision was to ban flights from
China. President Trump's decision saved American lives.
There were some people who criticize that decision, who
claim there would have been no deaths if their mysterious plan
that doesn't exist would have been in place. But, in fact,
there would have been more deaths if they would have gotten
their way.
Fortunately, they didn't. President Trump took that action
that Dr. Fauci, on down, including yourself, all testified was
not only the right decision, saved thousands of American lives.
No. 3, President Trump made tough science-based decisions
that did save hundreds of thousands of lives, not just China
and Europe ban, 15 days to slow the spread, 30 more days,
continuing to get guidance out there, guidance on how, as
you've talked about Mr. Secretary, properly taking care of
people in nursing homes.
Forty-five Governors followed those guidelines. Five
Governors didn't. And 25,000 minimum seniors died that
shouldn't have died in those states, and those Governors
continue to hide the facts from the families of those who died.
And we're going to keep pressing. If everyone doesn't join us,
those of us that actually want to get those answers will keep
pressing for those answers.
No. 4, President Trump is developing a safe, effective
vaccine, working through all the FDA protocols, which are the
gold standard, and it's happening faster than ever before.
These are the four American companies, teams that have
partnered up in some cases to get to the final stage of FDA
approval.
And if they get through, they have got to meet the rigors,
as Secretary Azar has testified, of the gold standard of the
world, the FDA approval process. And if they do, the Trump
administration, through Operation Warp Speed, is actually
manufacturing the vials of that vaccine now, not waiting until
the end, but actually manufacturing it now while it's being
tested on tens of thousands of Americans to see if it is a safe
and effective drug. And if it is, it will be ready and
available the very next day.
Anyone who undermines public confidence in that vaccine and
that process will be costing American lives. Any Governor who
tries to deny their own constituents of their state that
vaccine would be costing lives.
How barbaric and crude would that be for a Governor to say
they're not going to let the citizens of their state have an
FDA-approved drug to save lives? I don't think even think
that's legal. But we will continue to press on, and I know
President Trump continues to press on.
And I appreciate, again, the work of the 80-plus thousand
men and women in your agency who are working on that. They are
not just working on the vaccine. They are delivering billions
of PPE.
Again, China hoarded the PPE. Most of it was made there. We
know we need to make it here now. We ought to be doing more to
push to help make more of that PPE here in America so we don't
have to be relying on China when they lie and hoard the PPE.
But we're doing more of that now. Billions are now being
sent out through the President's initiative. And, of course,
building the largest testing system in the world, we're testing
more people in the world, more capabilities, nursing homes are
getting tests, the testing capabilities continue going forward.
And, finally, point five, President Trump prioritized the
elderly while some of those Governors continued to put their
seniors at risk. This President has taken decisive action to
save American lives. We wish there were no lives lost. This is
a global pandemic. Every country in the world is experiencing
loss of lives.
If you look at this list, we wouldn't even be on this top
ten if those five Governors would have complied, but,
obviously, that's not where we are. China and Russia, by the
way, aren't on these list. Why? Because they won't even share
with the world their data. They might be at the top.
But regardless of that, we need to keep working to save
American lives.
I thank you for the work you and your team are doing and
President Trump for the work he's doing on behalf of the
American people to finally get our economy back open as we
defeat this evil virus.
With that, Mr. Chairman, I yield back.
Chairman Clyburn. Thank you very much.
Before closing, without objections, I would like to
introduce into the record a research letter published by the
Journal of American Medical Association entitled ``Mortality,
Admissions and Patient Census at Skilled Nursing Facilities in
Three United States Cities during the COVID-19 Pandemic.''
Chairman Clyburn. According to this study, the severity of
nursing home outbreaks mirrored the outbreaks in their
communities. New York had a much worse outbreak than Florida,
especially at the beginning of the pandemic.
The claim my Republican colleagues made that Democratic
Governors are responsible for nursing home outbreaks is just
wrong. The problem of outbreaks in nursing homes is a national
problem and, as this study shows, tracks the outbreaks in
communities.
I should also note that Florida has 27,365 cases of the
coronavirus in nursing homes. This is the fifth highest in the
entire country. The state has had 5,266 deaths in nursing
homes, which is the sixth highest in the entire country.
Now, before we close, I would also like to enter into the
record letters the committee has received from the National
Association of County and City Health Officials, the Infectious
Disease Society of America, and HIV Medicine Association.
I am asking for unanimous consent that all of these be
entered into the record.
Mr. Scalise. No objection.
Chairman Clyburn. Thank you, Mr. Ranking Member.
In closing, I want to thank you, Mr. Secretary, for being
here today.
Sir, it is pretty clear that the Trump administration's
approach to this virus since January has not worked. That is
why more people in America have died from the coronavirus than
in any other country and why the virus is still surging in many
states.
But I do not believe that it is too late to turn things
around if the Administration will finally lead with the science
instead of politics. That means committing today to end the
political meddling and allowing our scientists and public
health experts to do their jobs, allow the CDC to put out
accurate public health guidance, let the FDA approve treatments
and vaccines when they are proven safe and effective, not when
they are politically convenient and in the constant stream of
disinformation coming from the White House.
To control this virus, we also need the administration to
finally put in place a coordinated national strategy to respond
to the pandemic, a strategy I have been calling for since this
subcommittee's very first briefing in May.
This national plan must include a strategy to increase
testing, end chronic shortages in swabs and other supplies, and
more effectively, efficiently, and equitably target the tests
we have.
The Federal Government must also use its resources to
procure and distribute masks. And I would much rather see, and
I would be hopeful, that the White House would send--go back to
that plan and send a mask to everybody.
And I would be pleased for the President to insert a letter
with his signature on it. I would much rather see that than
these box lunches that he is now requiring that his name be--a
letter signed by him be in every one of those boxes. Let's have
a letter signed by him in a box with a mask going into every
home. That to me would be contributing to the preservation of
life.
A national plan to me must include clear and consistent
public health measures across all 50 states, include uniform
use of masks in public places, and strict limits on large
gatherings, especially in areas with high rates of community
transmission.
Mr. Secretary, it is too late to save the 207,000 Americans
who have already died from this virus, let alone, so let us
work together to make sure we don't lose another 207,000 lives.
Without objections, all members will have five days from
today within which to submit additional written questions for
the witness to the chair. This will be forwarded to the witness
for their response. I ask the witness to please respond as
promptly as possible.
With that, this hearing is adjourned.
[Whereupon, at 12:03 p.m., the subcommittee was adjourned.]
[all]