Via Teleconference

11:10 A.M. EST

MR. ZIENTS:  Good morning, and thanks for joining us.

Today, we’ll start with Drs. Walensky and Fauci for an update on the Omicron variant. 

Over to you, Dr. Walensky.

DR. WALENSKY:  Good morning.  I’d like to start by walking you through today’s data.  The current seven-day daily average of cases is about 86,400.  The seven-day average of hospital admissions is about 6,300 per day.  And the seven-day average of daily deaths is at about 860 per day.

I’m going to focus my comments today on the state of the Omicron variant.

Around the world, we’ve seen cases in about 40 countries.  And on Wednesday, the first confirmed case was detected in the United States, in California.

Since then, additional states including Minnesota, Colorado, Hawaii, and New York have reported cases.  And we are working closely with state and local public health authorities to investigate suspect cases in other states.

As I mentioned on Tuesday, we are prepared and ready to rapidly recognize the Omicron variant. 

The first case reported by the California and San Francisco Departments of Public Health was identified quickly through genomic sequencing conducted at the University of California San Francisco, a laboratory that is funded by CDC using resources from the American Rescue Plan.

And the sequences from the first three U.S. cases were confirmed at the CDC within hours after their detection by the states.

The rapid turnaround and sequence analysis is an example of the importance of our investments this year to expand genomic sequencing across the country, and to build a system that is prepared to swiftly respond to new and emerging COVID variants.

Once these cases were identified, CDC staff began working with state and local public health authorities to do contact tracing and investigation.

Across the country, public health departments are looking at sequence data, at travel histories and epidemiologic indicators, at diagnostic data to identify possible cases of Omicron.

CDC will continue our robust collaborations with state and local public health authorities to identify cases that — as they emerge, to support contact tracing of those newly diagnosed cases of Omicron, to encourage post-arrival testing of international travelers, and to assist with all implementation of prevention strategies.

We are equipped and prepared to fight the Omicron variant head on.  We’re actively taking steps to stay ahead of Omicron.

Yesterday, CDC issued a health advisory through our Health Alert Network to provide recommendations to public health departments and jurisdictions, laboratories, healthcare providers, and the public in light of the new Omicron variant and what actions are needed now, including testing protocols and guidance for cased investigations.

Notably, we are urging providers to get all eligible Americans boosted right away.

Additionally, CDC is providing support to enhance and streamline genomic sequencing nationally, and is expanding surveillance of international travelers.

Our CDC laboratories are working in collaboration with public health and academic partners, and across agencies to understand the science of this new variant, assessing its susceptibility to therapeutics and vaccines.

We are continuously monitoring vaccine effectiveness in our real-world surveillance studies and publicly reporting those data.  And we are doing an in-depth investigation of the first initial cases of Omicron so that we can understand transmission and severity of Omicron disease.

I know that the news is focused on Omicron, but we should remember that 99.9 percent of cases in the country right now are from the Delta variant.

Delta continues to drive cases across the country, especially in those who are unvaccinated.

So, here’s what’s important to know: Our recommendations for protecting against COVID remain the same, regardless of the variant. 

Our best protection against COVID-19 is our proven layered prevention strategies.  This includes getting vaccinated if you have not already and getting a booster dose if you are eligible, along with wearing a mask in public indoor areas, frequently washing your hands, improving ventilation, physical distancing, and increased testing to slow transmission of the virus.

I want to take a moment to emphasize the importance of staying vigilant.  There is still a lot to learn about Omicron, and we will be transparent and share the updated science with you as soon as it becomes available.

As you have heard me say earlier this week, we are in a far better position now than we were at this time last year.

Not only do we now have knowledge and experience from addressing other variants, such as Delta, we also have far more tools with proven prevention methods and more treatment options to fight the virus than we had at this time last year.

Thank you.  I’ll now turn things over to Dr. Fauci.

DR. FAUCI:  Thank you very much, Dr. Walensky.  What I’d like to do now is to spend a short amount of time on discussing the potential role of our boosting in addressing the Omicron variant.

If I could have the first slide, please.

Just to orient people — when we always talk about spike proteins and variants — on the left-hand part of the slide is the spike protein of the Delta.  And on the right, is the Omicron.

You see those red numbers and letters on the left with Delta.  And the thing that is striking right off is the fact that those represent amino acid substitutions as a result of mutations.  And notice how many more there are on the Omicron side.

So, just to orient you, what that means — for example, if you look on the left, with Delta, on the very top, you see T478K.  All that means is that there is a amino acid substitution of a threonine is substituted by a lysine.  The “T” is the threonine, the “K” is the lysine.  And on and on it goes throughout the spike protein.

So — next slide — Dr. Walensky has mentioned to you that we have many unanswered questions and we are looking into them.  And in real-time, at a matter of days to weeks, we’ll know more about transmission, immune evasion, and severity of disease.

But what can we do right now? 

Next slide.

There are a number of things that we can do.  Dr. Walensky mentioned several of them.  I want to focus just for a minute or two on two of those – namely, getting vaccinated and getting boosted.

Next slide.

So, let’s take Look at the data when it comes to another variant — in fact, the variant that we are dealing with right now in our own country — with Delta.

In September of this year, unvaccinated people in the United States had almost a six percent increased risk of getting infected and getting COVID-19 compared to fully vaccinated, and about 11-fold increased risk of being hospitalized, and a 14 increase of dying when you compare individuals who are fully vaccinated versus unvaccinated.  And this is Delta.

Next slide.

However, in vitro studies now indicate that booster shots markedly increased the antibody titers against a wide range of variants.

Next slide.

So, if you look at this, right now remember we were all vaccinated — those who were vaccinated — against the ancestral, or “Wuhan,” strain.

Yet, when you look on this slide of the effective booster, in the light blue, in younger individuals, is what the level of antibody titer is prior to the third shot boost.  It was 55.

Twenty-eight days after the boost — in this case, a third shot of the mRNA-1273 — it goes way up to 872 — much higher than the actual peak following the second dose.

And this is reflected also in individuals greater than 65, as shown on the right-hand part of the slide. 

Next slide.

The same holds true for the Pfizer BioNTech. And on this, you see, again — on the left — one month after the second dose, take the blue column.  There’s 241 as the 50 percent serum neutralization.

One month after the third dose, it goes way up to 1321. 

And then when you go to the elderly, it goes from 123 to 1495.

Next slide.

One of the things we now know, and it’s becoming increasingly apparent, that when you get a high level of antibody — and as shown in this slide in an animal model, done by Drs. Seder and Corbett here at the NIH — when you look at the third dose, you increase the levels of neutralizing antibodies against all the variants. 

And this also has an increase in levels of memory B cells and T cells, which strongly suggest that boosters will give you cross-protection against a number of variants.

Although we haven’t proven it yet, there’s every reason to believe that if you get vaccinated and boosted that you would have at least some degree of cross-protection, very likely against severe disease, even against the Omicron variant.

And so, in the final slide, my message reflects that of Dr. Walensky: Get vaccinated and get boosted. 

You can visit, you can text your ZIP Code to that number there, or you can call and find out where vaccines and boosters are available.

Back to you, Jeff.

MR. ZIENTS:  Well, thank you Dr. Walensky and Dr. Fauci.

So, as you just heard from both doctors and as the President said yesterday, the Omicron variant is a cause for concern, not panic.

Nearly 200 million Americans have done their part by getting fully vaccinated.  And we have the tools and the know-how we need to keep people safe.

Vaccines clearly remain our most important tool, and the doctors’ message is crystal clear: If you are fully vaccinated before June, it’s time for you to go get your booster.  If you’re unvaccinated, go get your first shot today.  And if your kids are five years or older and not yet vaccinated, get them the protection of the vaccine as well.

Join your fellow Americans who are rolling up their sleeves.

Just yesterday, we reported getting 2.2 million shots in arms, including over 1 million booster shots –- 2.2 million shots.  That’s our highest single-day total since May.

This is important progress, and the President’s plan to combat COVID-19 and confront the Omicron variant this winter uses all of the tools at our disposal to build on this progress.

Yesterday, the President outlined five areas where we are taking action.

First, getting the roughly 100 million eligible Americans their booster shots.

Second, helping more parents vaccinate their kids and keeping our schools open.

Third, making at-home tests free to Americans.

Fourth, increasing surge response teams to support communities with rising cases.

And fifth, accelerating our efforts to vaccinate the rest of the world and strengthening travel rules for people coming into the United States.

The President’s plan is robust.  We’re using every tool at our disposal with more than a dozen specific actions that will get Americans maximum protection as we head into the winter months, and keep people safe, schools open, and our economy growing.

Today, we want to provide additional detail on three specific actions in our fight against the virus this winter. 

First, launching a public education campaign for boosters. 

Second, reimbursing doctors for COVID-19 vaccine counseling. 

And third, expanding teams of emergency volunteers to help treat COVID patients around the country.

Let me turn to Dr. Murthy to provide more on these three actions.  


SURGEON GENERAL MURTHY:  Well, thank you so much, Jeff.  And it’s good to be with all of you again today. 

In the midst of all the uncertainty around Omicron, what you’re hearing from Dr. Walensky and Dr. Fauci is that there is a global community of scientists that are doing as much as possible as quickly as possible to learn more about the variant.  We are part of that global community, and we are optimistic that we will learn much more in the weeks ahead. 

And as we learn more, our administration is doubling down on its support for communities that need it the most.  Today I want to talk about three ways that we’re providing that support: through boosters, through children’s vaccines, and through medical response teams across the country. 

First is, so far, 41 million Americans have gotten a booster shot.  But we know that there are still millions of Americans more who need to get a booster shot.  And so, as we think about this, we recognize several things: Number one, there are still people who don’t know that they’re eligible.  Number two, there are seniors who may not realize the benefit of the boosters.  Number three, there are also just people working two or three jobs who haven’t had time to get boosted. 

And that’s why we’re working to meet Americans right where they are with information about booster shots and easy access to get them.  To do that, we’ve created a booster information toolkit and distributed it far and wide.  And we’re gearing up to share versions in Spanish, Mandarin, Cantonese, Vietnamese, Korean, Tagalog, Haitian Creole, Arabic, and Russian. 

We’re doing this because we want to make sure that vaccine information is available in the language that people understand best.  We’re also reaching out to communities of color and Native communities by hosting health fairs, webinars, and virtual town halls. 

We’re working through all channels where people get information: email, phone banking, text banking, podcasts, letters, social media, postcards, leaflets, and newspaper ads — just about everything short of carrier pigeons.  Our goal is really to leave no stone unturned as we seek to reach people with lifesaving information. 

And some of the many organizations we’re working with in this outreach include Jack and Jill of America, the Divine Nine sororities and fraternities, Corazón Latino, and more than 1,200 faith leaders.  Each of these partnerships will help us ensure that more people extend and enhance our protection against COVID, especially as we look forward to gathering for the holidays. 

Second, I want to share more about how we’re supporting children and families when it comes to COVID vaccines for kids.  We want to help more parents make informed decisions about vaccination.  That’s why Medicaid will begin to pay healthcare providers to talk to families about the importance of vaccines for kids.  This is a move that will be backed by a 100 percent federal funding. 

Now, Medicaid and the Children’s Health Insurance Program provide insurance coverage to over 40 percent of all children in the United States.  And they’re a significant source of healthcare for children of color.  This support will help more families get connected to the personalized, trusted medical advice that they need and deserve. 

Now, this is an issue that’s near and dear to me, because last week I was able to take my five-year-old son to get vaccinated.  Now, he was a little nervous, and when the time came to roll up his sleeve, you know, I had to be right there with him to make sure he didn’t run away.  But he was all smiles afterwards.  And he’s been proudly showing off his “I’m vaccinated” sticker to family and to friends. 

And my wife and I are just two of the millions of parents out there who have been waiting for months for the opportunity to protect our children.  There are few things that feel better than knowing your child is safer. 

And now, the parents of over 4 million children ages 5 through 11 are feeling that relief.  And that number will continue to grow in the coming weeks. 

The last investment I want to talk about is our support for emergency medical response teams as we head into the winter and face the Omicron variant. 

Yesterday the President announced $20 million in funding to strengthen the Medical Reserve Corps.  This is a network of medical and public health volunteers who support understaffed hospitals and healthcare facilities across the country. 

Together, the Medical Reserve Corps — or MRC — has dedicated more than 2 million hours to their local COVID-19 response, often working tirelessly in under-resourced health centers and often without much recognition.  This funding will provide the support they need to continue their heroic work. 

The President’s plan will also create over 60 emergency medical response teams to ensure that hospitals across the country have the help they need to battle rising cases in the winter. 

In closing, I just want to remind all of us that at this time last year, we were in a very different position.  Vaccines were not yet available to anyone, let alone booster shots.  Rapid tests were not yet on the market. 

As a father, I was worried about the health of my children.  And as a son, I was worried about my parents.  I did not know when they’d be able to get vaccinated against COVID. 

So, I remained immensely encouraged for the extraordinary strides that we made in the past year.  Yes, Omicron is concerning.  And yes, we’re still working toward better understanding it.  But there is enough progress behind us to feel both cautious and hopeful. 

We are on the right track and we’re learning more about how to stay on the right track. 

Thanks for your time.  And I’ll turn it back to you, Jeff.

MR. ZIENTS:  Thanks, Doctor.  Before we open up for questions, let me briefly touch on our efforts to vaccinate the rest of the world. 

The President has been clear from the start: To protect the American people and our economy, we must defeat the virus everywhere.  That means we must ensure the rest of the world gets vaccinated.  It’s in our self-interest and it’s our moral obligation. 

And under President Biden’s leadership, the United States is leading the way.  We’ve committed to donate 1.2 billion doses to the world. 

For context, that means for every one shot the Biden administration has administered here in the U.S. to vaccinate Americans, we’re donating about three doses to people around the world. 

Already we have shipped, for free, with no strings attached, 291 million doses to 110 different countries.  That’s more vaccines donated and shipped by the United States than all other countries in the world combined.

Yesterday, the President announced we’re accelerating the delivery of more vaccines around the globe — 200 million doses in the next 100 days.  And just today, we are shipping 11 million doses — 11 million doses in one day.  That’s more doses shipped by the U.S. in a single day than what all but seven other countries have delivered in total since the start of this pandemic.

Of the 11 million, 9 million are shipping to Africa, bringing our total doses donated to Africa to 100 million.  That’s American leadership.  And we are calling on the rest of the world to step up and join us. 

We’re also continuing to work with partners around the world to turn those vaccines into vaccinations.  From supporting communication campaigns to build vaccine confidence, to funding for vaccinators on the frontline, we are leading the global vaccination effort.

With that, let’s open it up for some questions.

MODERATOR:  Thanks, Jeff.  First question, let’s go to Dan Vergano at BuzzFeed.

Q    Thanks.  I guess this is for Dr. Walensky or Dr. Fauci.  What is the point at which we’ll know how transmissible or immune-evasive the Omicron variant is?  Is there a certain data point or is there a certain number — the share of infections — we should be seeing?  When does that become clear just how bad this thing is? 

Thank you.

MR. ZIENTS:  Dr. Fauci, why don’t we start with you?

DR. FAUCI:  Yeah, there are two phases to that, Dan.  One is to take a look when we get the virus in a form to be able to use it as a parameter of antibody neutralization.  The other is a much more easily usable one called a “pseudovirus.”  And what you do is you get the sera from people who’ve been vaccinated, people who have convalescent plasma or monoclonal antibodies, and you measure the capability of those to actually neutralize the virus. 

Then there will be the clinical indication.  That would give you a laboratory prognostication of what you might expect.

But then, clinically, when you follow — and right now the South Africans, as we mentioned, because of the volume of cases that they have thus far, are ahead of us in the sense of being able to take a look at differences in protection, immune evasion, severity of disease in people who have either been vaccinated, people who have been unvaccinated, or people who have recovered from prior infection.

That’s all going to take a matter of maybe a week or two more to get the in vitro data and maybe another additional week or so to get the clinical data. 

So, we expect we’re going to have that information to you over the next few weeks.

MR. ZIENTS:  Next question, please.

MODERATOR:  Cheyenne Haslett, ABC News.

Q    Hi, thank you.  Along the lines of the last question, are we setting people up for sort of a false deadline?  Do you think that there will be a moment in the next few weeks where we really have a clearer picture?  Or is it going to take months before we know if Omicron is going to become a dominant variant in the U.S.?

MR. ZIENTS:  Dr. Fauci.

DR. FAUCI:  Well, you have a couple of questions there.  The first is: It’s going to take a while for us to know what the impact is going to be globally and for people who are infected with Omicron. 

The way you find out whether it’s going to be dominant — and the CDC will be able to do that as they continue to follow the percentage of the isolates that are Omicron and the doubling time of that percentage. 

You might recall, months ago, when we had 1, 2, 3, 4 percent of our isolates were Delta, and then we were able to project — and the CDC did do that accurately — to project how long it would take for it to become the dominant one. 

So, we really don’t know what’s going to happen, how well it is going to compete or not compete with Delta.  But we will know as more cases occur and what the doubling time of the relative percentage of Omicron versus Delta will be.

MR. ZIENTS:  Next question.

MODERATOR:  Let’s go to Rachael Levy at Politico.

Q    Hi, thank you.  This is a question on our — the new rules are on testing and insurance reimbursement.  I’m wondering if you could clarify essentially why we are going to have Americans getting reimbursed by insurance.  And especially, you know, after the holiday surge, wouldn’t it make more sense to have the testings actually be free — you know, the rapid tests that we can buy at the store now are quite expensive — ahead of the holiday season and increased travel?

MR. ZIENTS:  So, the core of our strategy here is convenient tests where and when they are needed.  And we want to make sure we get Americans tested in the most efficient, convenient, and effective way.  And thanks to the strong actions that we’ve taken across the last several months, we have plenty of testing capacity, including increasing availability of quality free tests — at-home tests; these are available now.

And yesterday, the President announced additional actions as you mentioned.  More than 150 million Americans on private health insurance will be able to submit receipts for at-home tests directly to their health insurance plans, so they can go to their local pharmacy, they can order online, and then get reimbursed.  For those that don’t have private insurance, we are making available, starting this month, free tests at convenient places in their communities, like health clinics and community centers.

On top of that, we have 20,000 sites around the country — many pharmacies, schools, libraries, health clinics — where people can walk in and get a free test. 

Since September, supply is really cranked up.  We’ve quadrupled the supply of at-home tests.  The FDA has, in fact, authorized five new over-the-counter tests, so we now have a total of eight on the market.  So, there’s consumer choice and prices are starting to come down.  That’s up from zero tests that were on the market when the President took office.

So, the bottom line here is hundreds of millions of Americans have access to free tests through their insurance, pharmacies, schools, libraries, and community health centers.  And the core of the strategy is to make sure the tests are where they are needed and when — and available when they’re needed at convenient locations.

Next question, please.

MODERATOR:  Let’s go to Meg Tirrell at CNBC.

Q    Well, thanks.  I’m wondering — obviously, it’s too soon to know if we’ll need to update the vaccines, but in the event that we do, do you anticipate that the new vaccines would be the Omicron spike, or would they be some sort of combination designed to confer broader immunity toward potential multiple variants?  And how would that be decided? 

You know, would it be similar to flu vaccines where the strains are given to the manufacturers, they’re told what to put in the vaccine so it’s uniform?  Or would the manufacturers be making these decisions themselves, and therefore it could be potentially different? 

And then what does the regulatory process look like?  Would it be similar to boosters, where they can be cleared based on antibody data?

MR. ZIENTS:  So, Dr. Fauci, why don’t you get us started there.  And I think it’s important, Meg, to understand that this is a contingency plan that is being developed that — in case we do need an update to the booster of the vaccine, but it is very much a contingency plan. 

Dr. Fauci?

DR. FAUCI:  Yeah, Meg, so the situation is going to be actually multifaceted.  And by that, I mean, the data I showed you on my brief presentation indicated that we could probably get a good bit of mileage just from boosting with the ancestral strain vaccine that we already have for the reasons that I gave in my presentation.

But having said that, we are working with the pharmaceutical companies, particularly, obviously, Moderna, Pfizer, and J&J on what their plans are.  And they do have plans that have multiple contingency.

One, is to rev up the production of the vaccines that they already have. 

The next is to make, for example, a bivalent, where you have the vaccine against both the ancestral strain and the new variant. 

And the other is to make a variant-specific boost.  The degree to which they’re going to be doing that, they are now assuming they may have to do that and are being prepared for that.

With regard to the regulatory issues there, I would have to defer that to the FDA.  But in general, it could — and I say “could” — fall under the same situation as we do with a strain change for influenza, but I would have to leave that determination to the FDA.

MR. ZIENTS:  And just to build a little bit on that, the FDA has laid out guidance for the manufacturers — the vaccine manufacturers to understand how the agency will evaluate and expeditiously address the potential impacts of a variant on the vaccines and how the FDA will move quickly and at the same time maintain its rigorous scientific standards.

Next question.

MODERATOR:  Last question.  Let’s go to Nate Weixel at The Hill.

Q    Hey, thanks for doing this.  Just to — I’m curious about the timeline on the travel restrictions so far.  It seems like there is community spread right now in the U.S.  It seems like some of these cases were here before the restrictions on the African countries were put in place.

Is there a timeline for lifting them?  Is there, you know, any sort of — what’s the next step there?

MR. ZIENTS:  So, you know, as we’ve talked about throughout today’s briefing, we are actively monitoring the new variant, addressing the questions that have been raised about transmissibility, severity, and vaccine effectiveness. 

And as we learn more about the variant over the coming days, on all of these fronts, decisions on changes to travel policy will be based on the advice, as they always are, of our health and medical experts.  We’ll continue to rely on their expertise regarding how we make sure that we keep the American people safe, and that will directly impact the duration of these travel restrictions.

Thank you, everybody, for today’s briefing.  We look forward to seeing you next week.

11:41 A.M. EST

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