Thread by @Brandi_Buchman

TODAY at 10AM ET, Dr. Fauci, CDC director Redfield, FDA chief Hahn & from HHS, Adm. Brett Giror, testify before the Senate. They are providing an update on the federal response to the Covid-19 pandemic which has killed 200,000 Americans, a prediction Fauci made in March.

I will live-tweet their testimony today for @CourthouseNews and you watch here: help.senate.gov/hearings/covid…

Live-tweet thread will start here.
Links to watch here: help.senate.gov/hearings/covid…
and here: c-span.org/video/?475449-…

And away we go.

Senator Lamar Alexander, R-TN, says since lawmakers are six feet apart, they do not need to wear a mask - if they do not wish to - for testimony today.
This is Alexander's final hearing as chair of the Senate HELP cmte (He's been in the role for 6 yrs, planned rtrmnt in '18)

Alexander opens his remarks by saying the Trump administration vax program, Operation Warp Speed is "on track" for success and it is "likely to produce its first tens of millions of doses within one year."
The U.S. has never produced a vax this rapidly, he points out.

He, like Fauci and others have done in the past, credit the speed of vax development to parallel R&D/testing happening. If the FDA doesn't approve the vax, it will not be distributed. So the risk is taxpayer money, not the safety/efficacy of the vaccine, Alexander says

The HHS, DoD, private sector and public health and medical professionals are already working together to lay the groundwork for deciding who gets the first doses, i.e. health care workers, and high risk pops, he says.
Plans on starting vax distro requested by mid-October.

Administration officials are also optimistic that more treatments will also be identified or
developed and in clinics this fall. Alexander says there's a potential for approval or authorization by the end of the
year.
This is arguably very optimistic but Fauci will discuss later

Alexander notes 3 companies are in clinical trial for
antibody cocktail and then adds "Knowing that there is some medicine that will help treat COVID-19 should greatly relieve the anxiety Americans feel about going back to school, college, work, and out to eat."

Senator Alexander: "Until vaccines and treatments are widely distributed, the explosion of many cheap, reliable, rapid diagnostic tests is our best weapon to build confidence."

Warp Speed's principal adviser Dr. Moncef Slaoui told Alexander the gov't couldn't be manufacturing 4 of the vax now developed if Congress hadn't provided HHS w/funding to make awards in '12 to build 3 manufacturing plants that would be on standby for the next epidemic.

"The decision to look ahead then to the next pandemic he said was 'visionary.'"

You can read Senator Alexander's full opening statement here: documentcloud.org/documents/7216…

The next pandemic could be around the corner so Congress should "take stock now," the senator says. What steps to take:
1) sustain onshore manufacturing of vax
2) create and maintain stockpile of supplies
3) strengthen the strategic nat'l stockpile

Attention spans are short. We must act now to stop the cycle of panic, neglect, panic, Alexander says.

Now we go to opening statement Senator Patty Murray, D-Wash. She begins by commenting on RBG's death and the noms process.

"We are in the middle of a pandemic that has cost over 200k lives on this admin's watch, left nearly 7M w/new preexisting conditions & 5.4M w/o coverage. Yet none of that has stopped GOP from using every tool at their disposal, including SCOTUS, to attack Americans healthcare."

Murray says she will not vote for a nominee that will tip the court toward ending ACA.
"The American people should have a voice in selecting the next justice. The entire country will hear what another SCOTUS nom handpicked by Trump will mean for their healthcare and rights."

In Jan. Murray organized the 1st bipartisan briefings w/admin officials about Covid threat. She wrote to HHS Secy Azar at the time asking him about testing. She pressed him at a hearing in Feb. And asked him point-blank if our country was ready.

Tragically, she says, the clearest answer to that Q came back not from the Trump admin but from families in her state. "We had a window to prepare for this and the administration missed it. We had a pandemic playbook warn of the problems we are facing, they ignored it."

Senator Murray: "We had a clear warning on how dangerous the disease could be and they downplayed it. Now the number of people infected has passed 6.5M. The number of people dead over 200k. The number of ppl without a job or health insurance has skyrocketed."

The Trump admin has taken 100s of millions out of its budget for a "feel good ad campaign" on Covid-19 while inserting itself politically into all aspects of public health information.

On Mon. CDC put out new guidance on how virus is transmitted only to immediately reverse course and pull it down.

The Trump admin didn't just start its political interference yesterday and we don't expect them to cut it out tomorrow. So Congress has to make it stop, Murray says

You cannot stand for science if you will not stand against political interference, Senator Patty Murray tells Dr. Fauci, Dr. Redfield, Adm. Giroir and FDA chief Hahn.

I'm not done pushing for Republicans to come back to the table for a new Covid-19 relief response, she adds.

And now we get into openings statements from Fauci, Redfield et al

Fauci begins and his voice sounds clearer than I have ever heard it since his vocal cord surgery.

There have been a # of important clinical observations NIAID is pursuing, Fauci says.
A number of people who have recovered from the virus are still experiencing symptoms months later that doesn't appear to be the virus itself. They are "long haulers."

These people have exhibited fatigue, body pain, inability to concentrate.
They also found, to their dismay, a number of ppl who have completely recovered and are asymptomatic but when exposed to sensitive imaging technology or MRIs...

"There is a disturbing number of individuals who have inflammation fo the heart. These are the things that tell us we must be humble and don't completely understand the nature of this virus," Dr. Fauci says.

Regret the typo above. That should be "of the heart."

On vax, Fauci says work is based on a strategic approach to development. There are 6 companies that are "harmonizing" so info from one can be applicable to another. Currently there are 3 platform candidate vax that have entered into Ph.III trial. Very soon there will be a fourth.

But he is also taking pains to remind lawmakers, there's no guarantee on efficacy.
But he predicts by the end of this year we could know what will be safe and effective.

Fauci: "We feel strongly if we have a combination of adherence to the public health measures together w/a vax that will be distributed here and worldwide, we may be able to turn around this terrible pandemic that we have been experiencing."

CDC director Redfield begins his opening remarks and I could be mistaken, but he looks very tan today.

Understanding which populations are most at risk and how the virus spreads in various settings is critical in developing guidance and protecting the health of Americans. In the U.S., he says, we're approaching nearly 7M and over 200K deaths but there's some progress to report.

CDC encourages all Americans to:
Wear a mask
Maintain social distance
Practice routine handwashing
Be smart about crowds
Stay home when sick
Heading into the fall - get your flu shot.
9.3M additional doses for adult flu purchased and 18.5M more doses for children.

Redfield: An additional $200M from the CARES Act will be used as a first step to help the jurisdictions complete individual plans and implement further Covid vaccination in follow-up to the playbook we released last week."

Lawmakers have their work cut out for them today.

Adm. Brett Giroir: We are an inflection point on testing. We have 3M tests per day, nearly half of which are rapid care. We've been building toward this point, he says.
He lauds the administration's efforts towards "protecting the elderly."

FDA chief Hahn in his remarks: FDA and other agencies like it can't do their job "without inviting controversy" but that "shouldn't shake any faith in the agency's commitment to protecting the public health.

Hahn says every decision reached @US_FDA has been made by career scientists "based on science and data not politics." Often we must make realtime decisions based on ever-evolving data concerning a prev. unknown highly contagious virus. Sometimes it is nec. to reverse decisions.

When a vax sponsor reaches the conclusion that data from a Ph. III trial is adequate to submit to FDA, they will decide whether to apply for approval or for emergency use authorization that will be based on prespecified criteria established by the sponsor.

Career scientists will review that data, its safety and quality.
They will also work to provide additional info on what they expect to see should a sponsor choose to submit an emergency use autho application.

They will seek advice from vax and related products advisory cmte, comprised of independent members screened for ethics conflicts. The safety and effectiveness data will be public though confidentiality req's will still be upheld.

The public will have a chance to comment. Cmte input will be considered as FDA makes its decision on emergency use. But before that were to happen, FDA would have to determine that the statutory standard is met.

Hahn: And that would be based on adequate manufacturing data to ensure its quality/consistency. And data from at least one well-designed phase 3 trial that demonstrates safety/efficacy in a clear and compelling manner.

Hahn said if a vaccine was produced by FDA today, he would take, and he would encourage his family to take it.

Sen. Alexander: We're risking taxpayers money but not safety and efficacy?
Fauci: That is absolutely correct.

Alexander: Should colleges send students home when they experience outbreaks?
Fauci says absolutely not, they should be quarantined in a separate dorm or floor. If you send them back, they increase the likelihood of spreading infection.

Sen. Alexander: Was it political to have states prepare to distribute vax in October, is that true or false?
Fauci: "That is false. They want to be sure when a decision was made, they would be ready to distribute the vaccine."

Senator Murray: We know a lot of patients avoid getting a test or treatment because of cost. I've been pushing to make sure this is no cost. But Trump is fighting to overturn ACA that would leave millions without health insurance and discrim. against ppl w/preexisting condition.

Covid-19 could be a preexisting condition.
Will increasing the # of tens of millions and increasing costs with preexisting condition make it easier or harder to contain this pandemic?

Redfield: Access to timely healthcare is critically important in terms of public health. In terms of this pandemic, it's also true - access to timely, effective healthcare remains an important public health measure.

Murray: We have to understand what happened to CDC testing guidance on asymptomatic testing.
She says she is concerned that modified guidance was not drafted by CDC scientists and didn't follow general CDC scientific guidance.

Redfield says the original testing guidance had full engagement of CDC in August.
"I will say the intent of that document was never to limit testing, never to limit the testing of asymptomatic individuals."

"The attempt was to reengage the medical and public health community... It became aggressively apparent that the guidelines were not interpreted n the manner in which we intended them to be interpreted. That's why we put out a clarification...

Redfield continues: "...to make it explicitly clear that we believe asymptomatic transmission is an important part of the transmission cycle of this virus."
Sen. Murray says Redfield isn't answering q. She goes to Adm. Giror.

Giroir says he coordinated the editing of guidance.
Murray asks, but on what scientific basis did members of the task force take a different tack then AMA or other major medical orgs that said, clearly, asymptomatic spread was a problem.

Giroir: "The orig. guidance published by the CDC w/the approval of Dr. Redfield and senior scientists did not recommend against testing asymptomatic individuals. In fact, there were multiple sentences saying it was important to test them..."

Giroir continues "It was widely misrepresented."
Murray: On Friday, CDC updated guidance on aerosols as a common route of transmission but on Monday, CDC reversed course.

Redfield told her the earlier guidance was posted in error, she notes, but "given the Trump admin's track record, the reversal raises red flags," Murray says.

Murray: IIf I want the best guidance on the latest science so I can protect myself & my family, can I trust CDC's website to give me that information?"
Redfield: Yes, and I'll say it again, my agency and myself are committed to data and science.

Sen. Bob Casey: Will all members of the panel commit to receiving the Covid-19 vaccine in public view once one becomes available and is authorized and approved by the FDA?
Fauci, Giroir, Redfield say they will.
@CourthouseNews

Fauci on Q re: how can two people live together and one is positive and one isn't?
Fauci says that happens all the time with viruses. There's a great degree of variability of a person's natural resistance to a particular type of infection.

So although it has an attack rate that is high, we see all the time people exposed to someone with infection who do not get an infection. If you look at the pop as a whole, you still see it is highly contagious.

Fauci: You had the same situation with HIV. We had individuals who were living w/someone they had sex with regularly who had HIV and never got infected whereas another person could have sex one time with the infected, and the outcome would be different.
Premise here similar.

Sen. Tammy Baldwin now grills CDC dir. Redfield.
In April, CDC investigated a Covid-19 outbreak at a meatpacking plant in South Dakota. Following the probe, CDC staff sent a report to the state's dept of health incl. strong safety recs CDC determined could stem transmission

Baldwin: That report was dated April 21.
Last night, it was reported that CDC intervened and ordered that safety recommendations be watered down.
The next version of the CDC memo, dated April 22, essentially adds the words "if feasible" to the strong safety protocols

Over and over again, telling the plant, essentially, these recommendations were voluntary or optional.

Workers continue to work shoulder to shoulder at that plant and the plant ignored the guidelines. To date, 1200 workers from that very plant infected. 34 hospitalized. 4 dead

In that same period, on April 28, that's when Trump issued his executive order basically naming meatpacking as an essential industry and meatpacking workers as essential workers.

Redfield said he wouldn't characterize it as a "watering down" info.
The field teams investigating the Smithfield plant shared it w/the local South Dakota health department and one critical thing to stress in that report is CDC is not a regulatory authority, Redfield says.

Redfield: These were in fact recommendations. The DOL and OSHA have regulatory oversight and their report can direct that oversight. Our report was recommendations and as the document was reviewed, we wanted to make that clarification.

Sen. Baldwin says she will note that OSHA and DOL have failed to issue anything but voluntary guidance. There are no pandemic emergency standards in place for workplaces even though they've had months to work on this.

Did CDC have contact w/Smithfield foods, Dept of Agriculture or WH on this memo before it was edited?
Redfield says no, not at that time.
"The purpose was to stress clarity that we are not a regulatory agency."

Baldwin says given that, she'd ask him to consider changing the meatpacking guidance to say "We aren't a regulatory agency but these are the safety protocols we recommend" not have 'if feasible, if feasible, if feasible."

It makes it sound like recs are not partic. important, Baldwin says. You can say these are our safety recs w/o it being construed as an OSHA standard. She asks him to change that meatpacking guidance in light of the death toll and harm.
Redfield:"I appreciate your comment Sen."

In remarks that run contrary to scientific evidence, recorded fact, public health guidance of pandemics past, and cold reality on transmission: Sen. Rand Paul insinuates that with or without a lockdown, the number of deaths would be the same.

Paul grills Fauci and Fauci shoots back: "I'd be happy at a different time to sit down & go over this detail. You've compared us to Sweden and there's a lot of differences. But compare Sweden's death rate to other comparable Scandinavian countries - it's worse."

Fauci continues to Sen. Paul: "So I don't think it's appropriate to compare Sweden with us. In the beginning, we've done things with the knowledge we had at the time and I am and my colleagues are humble enough to realize as new data comes, you make diff. recommendations.

Fauci: "But I don't regret saying the only way we could have stopped the explosion of infection was by shutting down.
Essentially having the physical separation and recommendations we've made was crucial he says.

Sen. Paul laments praise for NY or Cuomo "when they had the worse death rate in the world."
Fauci, holding nothing back: "You've misconstrued that and you've done that repetitively in the past."

Fauci: "Right now if you look at what's going on in NY to get their test positivity to 1% or less is because they are looking at the guidelines we put together on masks, social distancing outdoors and indoors, avoiding crowds and washing hands.

Paul cuts in "or they've developed enough immunity to stop the pandemic"
Fauci: "I challenge that."
He adds, "This happens with Sen. Paul all the time.
You are not listening to what the director of the CDC has said."

Fauci to Sen. Paul: "If you believe 22 percent is herd immunity [in New York], I believe you're alone in that."

Sen Paul says "there's also preexisting immunity of those who have cross-reactivity."
Fauci cuts in: "I'd like to talk to you about that also because a study recently came out showing preexisting immunity to Covid-19 DO NOT cross react with Covid-19."

Senator Susan Collins says to panelists today: "While I appreciate your assurances, if everything is going to have to flow up to the [HHS] secy, it seems inevitable that it will create delays and doubts and neither of those are helpful as we deal with this pandemic."

Sen. Elizabeth Warren asks Fauci, Giroir, Hahn and Redfield, do they hold stocks in any companies developing Covid-19 vaccines?

They all say they do not.

Federal law prevents that and that's exactly how it should be, Warren says.

Warren: But the man Trump selected as the govt's vax czar is a former drug company executive. He owns $10M in GlaxoSmithKline, which is working on a vax. Docs released by the House yesterday indicate he may own stocks in Lonza Group, which is tied to Moderna company making a vax.

Why does this matter? Warren asks.
Because Warp Speed, the project Slaoui heads up, has invested billions in companies he could hold stock in.
Fauci, Redfield, Giroir, Hahn, they uphold the law on conflicts. Warren: Why should Dr. Slaoui get to play by a different set of rules?

Hahn says he can't answer & doesn't have more info but "they follow a bright line at the FDA" on conflict.
Warren: All due respect, you told me conflicts of interest undermine trust in a vax & Dr. Slaoui has conflicts of interest.

Sen. Warren: To boost public confidence, shouldn't he eliminate those conflicts?
Hahn again says he doesn't know about the conflicts.
Warren says OK, but if there's proof that they exist, hypothetically, shouldn't it be expected that Slaoui would resign?

FDA chief Hahn said he can't comment because he doesn't know the facts but he does take seriously the issues that might affect public trust.

Warren says Congress can strengthen fed ethics laws to root out this corruption, says pass the Covid Recovery & Ethics Act which she intro'ed to prohibit conflicts of interest.

"The first person to be fired should be Dr. Slaoui."

More on CORE ACT: warren.senate.gov/imo/media/doc/…

VA Sen. Tim Kaine brings up the changes to asymptomatic guidance/aerosol issued by CDC

On the left, on Sept 18 CDC put up new guidance on ongoing analysis of this crisis and how it is transmitted.
Then, almost immediately reversed it.
Kaine: What in Sept. 18 version incorrect?

Redfield says this was a first draft document but Kaine cuts in and says, yeah, but what about it was incorrect?
Redfield says it's looking at the balance aerosolized transmission plays compared to droplet transmission

The version on the 18th says ppl who are infected but dont show symptoms can spread the virus to others.
But CDC changed it back to 'some ppl without symptoms may be able to spread the virus.'

Kaine: That phrase, 'people who are infected but do not show symptoms but can spread the virus to others' - is that inaccurate?
Redfield says it is accurate to say people who dont show symptoms can spread the virus.

Kaine: The CDC said particles sprayed in air or in droplets can remain suspended in air and travel distances beyond 6 feet, like in restaurants - is that accurate?
Redfield: There's definitely evidence of that sir.
Kaine: That's accurate?
Redfield: There's evidence of that.

Redfield, more defensively: It's not that anything was removed. The technically cleared document that went through the proper channels is what was put up.
All these decisions on aerosolized were made by career officials.

He suggests again scientists took issue with aerosol studies at CDC and that's why online doc was altered.
"That document that went up was a draft, had not been technically reviewed by CDC, so the agency reverted to the doc that was tech. reviewed"

Then Redfield says there will be another new technically reviewed document soon posted on the CDC website. "The one posted on Friday was not technically reviewed and as consequence, senior scientists at CDC took it down."

Are you a senior scientist at the CDC and have information that could verify or challenge this? I would like to hear from you. Email me at Virginia @ courthousenews dot com

I have to pull back from live-tweeting for a moment.

Sen. Doug Jones asks FDA chief Hahn about Trump stmt that the FDA wanted to limit use of convalescent plasma until after the election then he tweeted that there is a "Deep state" within FDA preventing test of vax. Trump said he wanted FDA to "feel the heat"

FDA chief Hahn has said he has every confidence in scientists and staff. Jones asks, So, is there a "deep state" that is trying to do anything other than quickly get a vax/therapeutics to American public?

Hahn: I have 100% confidence in outstanding drs, nurses, pharmacists at FDA who have remarkably stood up during this pandemic to help expedite getting medical products to the American people. I have complete confidence in their decisions and actions taken to date.

Redfield says he has been disappointed personally when people at HHS have made comments "that there is a deep state down at CDC."
He says: These are men and women facing the greatest public health crisis of our time. It is offensive to me when I hear this type of comment.

Redfield:"In my 22 years in the military, you never knew people's political perspective. It's the same at the CDC,
People don't understand the ability to suck energy out of people working 24/7 when they get unfairly criticized or characterized That's the real harm in all of this"

Fauci emphasizes that it is critical not to conflate the symptoms or effects of the common flu with Covid-19 and that it is crucial for people to get their flu shots this year.

If there's a way to combine common flu and Covid-19 vax, then hopefully, there would be a lower level of flu and it would not complicate the challenge of a winter with Covid-19, Fauci says.

The hearing will close shortly and I will have a full report up for @CourthouseNews soon.

STORY. Grab your afternoon coffee or beverage of choice and dig in.

https://twitter.com/BBuchman_CNS/status/1308867014715416576?s=19