Transcript

Department of Defense Leaders Update Reporters on COVID-19 Efforts

June 30, 2021
Acting Assistant Secretary Of Defense For Health Affairs Dr. Terry Adirim; Army Lieutenant General Ronald J. Place, Director, Defense Health Agency; Senior Advisor to the Secretary of Defense on COVID-19 Max Rose

SENIOR ADVISOR MAX ROSE: Good afternoon, everybody.

So let me just start off by saying what an absolute honor and a privilege it has been to support the department's response to the COVID pandemic over this past year. I have the utmost regard for our people in uniform, civilians, contractors who have worked tirelessly to get through this pandemic.

From testing to providing medical care to vaccinations, the men and women of the Department of Defense, around the world, they've answered the call and they've really led the way in terms of moving our country through this pandemic.

You know, on Secretary Austin's first day, he delivered a very clear message to not just me but to the entire department -- COVID-19 was the greatest approximate challenge to our nation's security and we would act boldly, we would act quickly to support the federal response and to bring an end to this pandemic.

With Deputy Secretary Hicks and the Vice Chairman, General Hyten's leadership, the absolutely tremendous leadership of the COVID-19 Task Force and the people who supported this effort, we've remained steadfast in our commitment to meet this unprecedented task and to accomplish many milestones along the way, some of which I'm honored to be sharing with you today.

As I stated, our people are at so many of the different front lines of the pandemic. They continue to be at those front lines today, from developing and distribution of lifesaving vaccines through administering those vaccines all around the country.

Specifically, I would like to take a moment to express our appreciation for General Gus Perna and his leadership and his extraordinary team. Millions upon millions of doses of safe and effective vaccines and therapeutics have been made available to the American people and in support of the country's global donations. Thanks to him and his team, Secretary Austin's leadership, and of course the President's leadership.

We wish him a happy retirement and are forever grateful for his incredible service to the nation and for his historic role in this fight and for the thousands of others, including the active duty and the National Guard, tens of thousands who have answered the call to support vaccination efforts and to get a shot themselves.

As a department today, over 68 percent of our active duty service members have received at least one does -- over 68 percent. This is an amazing feat, considering that the majority of our people represent a younger and healthier demographic, as well as considering the complex global position of our forces and our DOD personnel in over 40 different countries.

For the nation, as a whole, we've supported over 17 million vaccinations to the American people, as well as, on top of that, an additional four million to DOD personnel. That's over 21 million shots in arms towards the President's goal of vaccinating as many people as possible.

You know, I visited several of these sites, from L.A. to New York City, and let me just tell you that these sites were true, whole of country feats, in collaboration with FEMA and so many other entities. One colonel I remember remarked to Secretary Austin -- he was a -- a leader at one of these sites -- he said "sir, it's not lost on us the incredible trust that the nation is putting in us."

The DOD team has, every single step of the way, risen to the challenge in absolutely awe-inspiring ways. Our DODEA schools, for instance, across the Pacific, the Americas, Europe, roughly three quarters of our teachers and school staff are vaccinated, making it possible to safely reopen all schools and child development centers for in-person learning.

The COVID Task Force has also spearheaded the department's efforts to accurately track COVID-19 data, including cases, and later, vaccination rates. Through the Advana system, originally, actually, meant for audit reporting, the Task Force has been able to more accurately compile COVID data and provide timely and critical data to DOD leaders, as well as to the American public.

On the testing front, just this year alone, DOD has performed over 1.26 million tests for the novel coronavirus that causes COVID-19. We've continued to bolster our testing foundation to ensure that this absolutely irreplaceable tool of public health surveillance and force protection is here to stay for the long term, and that is to include the latest in genomic sequencing.

At Secretary Austin's direction, we have conducted a full strategic review and reissuance of all COVID-19 policy documents in order to ensure that all of our guidance, irrespective of who it touches, from force health protection guidance to so much else, that it reflects the latest in medical guidance and medical science from public health officials, data scientists and laboratories, and of course, yes, the CDC. We're proud to be offering the department's unprecedented, unmatched logistical expertise as part of the interagency effort to support our allies and partners by delivering millions of doses of vaccines, critical supplies like oxygen cylinders and regulators, N-95 masks, COVID-19 rapid diagnostic test kits, as well as continuing the support of the acquisition of billions of dollars in critical pandemic supplies and resources.

And as many of you have noted or have seen earlier this month, President Biden announced that the United States is donating another 500 million vaccine doses to nations around the world, and DOD is proud to continue supporting this interagency effort however we can because, as Secretary Austin has said, that's what friends do.

As the department continues to transition, to fortify its pandemic preparedness and to support vaccination efforts across the country and the globe, I could not be any more confident today that we are -- are on, as a department, and yes, as a nation, a solid path. In the coming days, the functions of the COVID-19 Task Force will transition to normal operations. By no sense of the word are we spiking the football right now. Our work as a department will continue until we see this global pandemic come to an end.

It's truly been an honor and a privilege to serve among the men and women in this department. I look forward to supporting whatever they do in the future, as I will be moving on from my post as senior advisor to the secretary of defense in the coming weeks. My sincere gratitude first and foremost to Secretary Austin for his incredible, his incredible, visionary leadership, to Deputy Secretary Hicks for incredible fortitude and leadership of the COVID-19 Task Force, and everyone I have served with on the COVID Task Force. The urgency and precision that they have applied to this Herculean mission is a testament to our ability to enter a new normal way of life.

I'm now going to turn it over to two absolutely incredible -- incredible individuals who have also been critical to this operation every step of the way, and who will certainly continue in their leadership public health roles on this mission, Dr. Terry Adirim and Lieutenant General Ron Place. Thank you again.

ACTING ASSISTANT SECRETARY OF DEFENSE DR. TERRY ADIRIM: OK. All right. Thank you for joining us here today. We appreciate your coverage of the issue.

Before I proceed with my opening remarks on behalf of the entire department, but in particular, those of us within the Office of the Assistant Secretary of Defense for Health Affairs, I want to extend a tremendous thank you to Max Rose, over there. Max and I arrived on the first day of this administration, and I've seen him work tirelessly to support the president's efforts to defeat COVID-19. Under Max's leadership, the department made an incredible amount of progress in halting the spread of COVID-19 and in support of the department's whole-of-government approach. We are in a better position today to continue our efforts, so thank you for that.

But I also want to acknowledge the amazing work over the last 16 months of our medical professionals, our scientists, logisticians, data analysts and public health experts in uniform and civilians whose works have -- work has saved lives and allowed us to complete our national security missions.

As Max mentioned, we are at 68 percent of active duty who are vaccinated with at least one dose, and we continue our efforts to encourage our servicemembers, families and beneficiaries to become vaccinated. And I don't want to put too fine a point on this, but 31 (*Correction- 81, See ‘Editor’s Note’) percent of our active duty are under the age of 35, which is one of the populations that's perhaps the toughest to -- to have vaccinated nationally. So this is really incredible work that's been done by the department. And as a pediatrician, I want to note that our families overseas for which we have accurate data, they -- they've done a great job accepting vaccination, with 77.4 percent of 16- to 17-year-olds vaccinated and 62.3 of 12- to 15-year-olds. Yeah, wow. I'm -- I'm very pleased as a pediatrician.

As briefed in our last press conference, we've centered our vaccination campaign around the principles of increasing accessibility to vaccines, providing opportunities for education, leveraging our active-duty personnel policies to promote vaccination and ensuring engagement at the lowest level to acknowledge and address individual concerns. The pandemic is not over, and we are not done with our all-out efforts to encourage vaccination.

Through the course of the pandemic, our force health protection measures have been effective at preventing infections, hospitalizations and death, and importantly, our science-based and evidence-informed approach has allowed our service members to continue their missions. Our health protection conditions framework, or HPCon for short, has led to lower incidents of COVID-19 in military installations than in their surrounding communities.

With the success of the vaccination campaign and declining case counts around the country, we see many installations make their HPCONs more permissive as we've begun to return to normal. However, the Delta variant poses a threat to that return to normal. We are particularly concerned with the impact of the Delta variant on our unvaccinated or partially-vaccinated population and its potential spread at installations that are located in parts of the country with low vaccination rates. We have an active whole genome sequencing program to identify and track variants, and we're closely watching our DOD case counts, positivity rates and the prevalence of the Delta variant, among all the other variants of concern.

We anticipate that health protection conditions could change at some of our installations in the future based on outbreaks that result from the high transmissibility of the Delta variant. It's spreading rapidly across communities with lower vaccination rates and will likely become the predominant variant in the United States. Therefore, the Delta variant poses a threat to our service members who are not fully-vaccinated. There is emerging evidence that the Delta variant may cause more serious disease, but even mild infections that do not result in hospitalizations are threat because they can cause long-term aftereffects.

So the best way to beat the Delta variant is to be fully-vaccinated, and that's the message that I hope that you all convey. Studies have shown that one dose of the mNRA vaccines are only 33 percent effective against the Delta variant, whereas two are at least 88 percent effective, so we are investing great effort into ensuring our service members and other beneficiaries get both doses. So the bottom line is get vaccinated. They are safe and effective.

General Place

LIEUTENANT GENERAL RONALD J. PLACE: Well, thanks, Dr. Adirim, and good afternoon to everyone here in the room and those on the phone. I'll briefly expand on just a few points.

First, regarding the effectiveness of our COVID vaccines, I'm happy to report that the number of individuals hospitalized in DOD hospitals with COVID have significantly declined. As of today we have 21 COVID-positive individuals hospitalized. As demonstrated on the chart that you will see over my left shoulder, this is a decline from a peak of 240 inpatients on January 8th of this year. Essentially, the lowest point we have had since the earliest days of the pandemic. The benefits of vaccination are remarkably clear.

Second, if individuals need further evidence of why they should get vaccinated, I have one additional data point. Of those 21 COVID-positive individuals in DOD hospitals yesterday, my current records indicate that none were vaccinated.

Dr. Adirim noted the increasing prevalence of the Delta variant and the gap in the effectiveness of one dose of mRNA vaccines versus the complete two-dose series. It's compelling evidence. For those who receive their first dose in our system, we're following up with each of them to ensure that they get their second dose or at least significantly offer that opportunity.

Finally, we continue to closely monitor suspected cases, myocarditis and pericarditis associated among our vaccinated population. As you are aware, the Advisory Committee on Immunization Practices met last week to review the issue. They concluded the benefits of mRNA COVID-19 vaccination greatly outweigh the potential risks. Most cases of myocarditis are generally mild and resolved quickly. Within the DOD, our experience is that all individuals who experience myocarditis or pericarditis received brief supportive care and have recovered or are recovering.

Now as we approach Independence Day, all indicators within the Department of Defense are moving in a positive direction. We thank our service members and DOD personnel who have been vaccinated and continue to strongly encourage our remaining service members, DOD retirees, all of their families, and DOD staff to get vaccinated for themselves, for their families, and for the community.

Thanks, again, for joining us today. And together with Mr. Rose and Dr. Adirim, I look forward to your questions.

STAFF: Thank you very much.

So our first question, let's go to Meghann Myers.

Q: So in light of your concerns about the Delta variant, and this could be for either of you guys, is there a possibility that more installations could start going into lockdown based on what's going on in their areas, even if people on-base are like largely vaccinated?

DR. ADIRIM: Yes, I would be careful about using the term "lockdown," because we're not -- we're not pursuing lockdowns. But we do have an HPCON framework that is used at the local level, and it's based on what is going on at the local level that an installation commander could either increase or decrease where they are.

So a lot of installations right now are at HPCON.

GEN. PLACE: Bravo.

DR. ADIRIM: Brave. Thank you. I keep getting (inaudible).

Bravo. But if they're in a state or a county that is seeing, you know, increased numbers of cases, they could then increase the HPCON level. So to answer your question, we have a system in place that helps guide local communities in making those decisions.

Q: Sure, but the crux of my question is, if there are most people or the predominance of people on-base are vaccinated, how does that play into whether they're going to change the health protection level based on what's going on? If they're in a town that is under-vaccinated, for instance?

DR. ADIRIM: Right. Well, the -- it's really based on what the conditions are in the community, right? So if we're at 68 percent of active duty being vaccinated, then there is 32 percent that are not vaccinated. So those people are at risk. So, again, it's based on what the conditions are in the local community, in the county. And, you know, a commander could make a decision about what kind of protection that's needed.

GEN. PLACE: Yes, if I could add just a little bit more to that. Vaccination is just one of the factors that the local commander would take into consideration, as we've already mentioned. What's the positivity rate? What's the total numbers? What's the vaccination rate in that community versus that that's -- that's on the installation? It's a multifactorial decision.

The health protection condition guidance that Health Affairs has written in policy gives all of those factors for the local commander to use in that decision-making process.

STAFF: Very good. Caitlin, Stars and Stripes.

Q: Yes, thank you. About that data, you mentioned earlier that those installations that were under HPCON conditions had significantly lower rates, in some cases and certain communities. Do you have any of that data available for us to show the difference?

DR. ADIRIM: There's a lot of local communities, so I...

Q: Well, I'm sure. You mentioned that though. So I mean...

(CROSSTALK)

DR. ADIRIM: Right, just -- I mean the installations have this information on their website, so -- right?

Q: I don't know if they do. For instance, I just came from Yokosuka, Japan, what would be the installation difference between, you know, on base versus in that surrounding community? That's not something that they would be forthcoming with. And they were banned from sharing that information.

GEN. PLACE: Yes, so at the local -- so -- so we do have that information internally. We have not shared it. We continue to monitor it on a weekly basis.

The -- the overall communities have largely, over the last five months, been declining. But within -- I mean, you can tell from the spikes -- my chart's not up anymore -- but on the little spikes in the charts that even though the general direction is down, there are some increasing little spikes even while the direction is down. And sometimes that's because a community has a particular challenge.

So -- so we do follow the local community, we make that information available to the local leaders. Whether they choose to share broadly or just with the public health community, that's up to the local leaders.

Q: It would just be great to be able to show whether or not those HPCON conditions are actually making a difference with data, or if there's an example. Like, you know, Killeen had a huge spike but Fort Hood did not have, you know, that same spike. So just a request that you can take.

GEN. PLACE: We'll -- we'll take it to see what's -- what we can release and what we can't.

Q: Maybe rates on the bigger bases. Like, you know, look at five of the bigger bases in the U.S. and...

DR. ADIRIM: Right.

Q: ... what is the number of positive.

GEN. PLACE: We'll see how we can do it to answer your question and -- and yet still be with what's releasable.

Q: Thank you.

STAFF: Very good. Let's -- let's go to the phone to Paul Shinkman, U.S. News.

Q: Yes, hi. Thanks for doing this. Army Secretary Wormuth said yesterday that only 55 percent of the Army has -- has received the COVID vaccine, which is pretty far below the national average for Americans who are eligible. Do you have those percentages for each of the services that you can provide us? And then (inaudible) follow up questions.

DR. ADIRIM: That 55 percent, did she say active duty, all service members or all Army service members, employees? So we have to know what -- what that is.

Q: Yes, I -- I -- I don't have that right now. Do you have that that you can provide to us, at least the active duty for each of the services?

DR. ADIRIM: Yes, wait.

GEN. PLACE: Sir, I -- I don't want to speak for any of the services.

DR. ADIRIM: Right, right.

(CROSSTALK)

GEN. PLACE: my based conjecture based on the data that we have is that for active-duty Army, 70 percent have received at least one dose. My suspicion -- although, I don't want to speculate -- that she may have been talking about either total, right, full vaccination of the active Army or perhaps some semblance of the total Army. But without context...

DR. ADIRIM: Right.

GEN. PLACE: we really can't help reframe her statement.

Q: Yeah, fair enough. Can you just give us what the active duty percentages are for each of the services? Do you have that now or can you get that back to us?

DR. ADIRIM: Yeah, I -- well, I can give you the -- the -- at least one dose data. That's what I track every single day -- and the -- at least one dose of the active duty force for the Navy -- active duty Navy, at least one dose, 77 percent. At least one dose, active duty Army, is 70 percent. At least one dose, active duty Air Force, is 61 percent. At least one dose, active duty Marine Corps, is 58 percent.

I'll -- I'll ask for your indulgences as we're managing who's in the Space Force and how do we manage that. We don't track that on an everyday basis, so I don't have that one. I apologize.

STAFF: Sir, thanks a lot. Let's go back here in the room. Courtney, NBC?

Q: Do you -- is there any way -- is there any way to know how many of -- how many active duty service members have had the first dose and not the second? Like, is there a big gulf, or a big break in the ones who are not getting their second dose? Are there any numbers on that?

DR. ADIRIM: We do have that data.

GEN. PLACE: Yeah, the -- the challenge with it is...

(CROSSTALK)

GEN. PLACE: For all service members, we -- we do have it on the site. The -- the challenge...

DR. ADIRIM: (Inaudible) partially.

GEN. PLACE: Right. For those who are in -- who are in a vaccine series that requires two, those are the ones that we track as partially vaccinated. And it is in the tens of thousands for those who are due for a second dose who have not yet received a second dose.

And in my prepared comments, that's the Delta that I was talking about. Those are the ones we are actively communicating with -- was there a barrier? Was there -- were you deployed? Were you given another mission? Were you sick? What was the reason for it and is there anything that we can do to help facilitate you getting your second dose?

Q: And then two other (members' ?) questions. Do you have -- how many active duty service members have gotten myocarditis -- or is it pericarditis or -- I'm...

(CROSSTALK)

Q: Do you have how many have gotten it and -- and can be tied to the vaccine?

DR. ADIRIM: Yeah, the number -- well, the numbers that we have as of June 9th were 30 -- it's active duty and retirees. I -- I don't have the break out of that particular number. In the JAMA Cardiology paper, it was 23 between January and April, and it was all but one were active duty.

The -- we work with and collaborate with the CDC on this particular issue and they're the ones who make the determination -- you know, in the investigation to determine whether or not it was just an association versus causation. So we're calling it an association.

The good news is that all of those service members have either fully recovered or recovered and it was a fairly benign, short-lived condition. But any cases that come to our attention, we do investigate, and I think it demonstrates that we have very sensitive and very good safety systems in place, not only within DOD but, you know, within CDC, as well.

Q: And the number of -- of service members who tested positive for the Delta variant, do you have that, as well?

GEN. PLACE: Well, for those that -- remember, we -- we -- the -- the numbers that we do genomic sequencing on is a very small number. So far, through the pandemic, we've done genomic sequencing -- at least a report that I got on Friday, of 6,409 different cases. Of those 6,409 different cases, there have been 25 that were the Delta variant. Of those 6,409, just over 1,800 were a variant of concern. By far and away, the majority were the Alpha variant, which is the UK variant.

But I'll -- I'll -- I'll give you a caveat to this -- 22 of those 25 were positive Deltas in the last two weeks, and it takes approximately two weeks to do genomic sequencing. So it -- we're always going to have a little bit of data lag when it comes to variants of concern, but so far, the majority are not the Delta variant, but we are now starting to see it in our population.

DR. ADIRIM: Right, and we do monitor, you know, just all of the whole genomic sequencing -- you know, the numbers and where the Delta variant seems to be transmitted. It's super important that people get vaccinated to stop that transmission, so.

Q: Do you think that is where it's transmitting more -- Delta...

DR. ADIRIM: No, the CDC has that data.

Q: What -- what -- what about active duty? They -- they have the active duty available...

DR. ADIRIM: I -- I don't...

(CROSSTALK)

GEN. PLACE: Yeah, I don't know how many of those 25 were active component versus family members versus retirees. This is the total of everybody that we're sequencing.

DR. ADIRIM: Right. We do a certain percent of the positive COVID test -- PCR tests, you know, and -- and then do the whole genomic sequencing. So...

GEN. PLACE: They're not all on one side, either. The -- the -- the -- even though it -- the number's very, very small, we're seeing very small numbers, one or two or -- or maybe three, at several different locations. So we're not seeing spikes of Delta anywhere. Again, data lag. This is -- they're at least two weeks old, these data points.

And if I could add a -- a -- an additional point to the -- Dr. Adirim's answer to your question about pericarditis and myocarditis, I'll remind all of us that we've seen, in the DOD, at least, hundreds of cases of myocarditis and pericarditis for those who were COVID infected.

So when we're talking about relative risk here, that risk to the heart is markedly higher from an infection than it is from a vaccination. And anybody who's going to be doing a risk-based decision making should have both pieces of that information.

DR. ADIRIM: Right. And I would add to that the ill effects of COVID overall, not just the heart effects of COVID, are just far greater than the tiny numbers that we're seeing post-vaccination, so.

STAFF: OK, any -- any additional questions?

Q: Yeah, I (inaudible) come back to the -- those pediatric numbers that you mentioned earlier. I was impressed by those. Are -- can -- do you think it's because that they're overseas? Do you have any understanding of why it's so high?

DR. ADIRIM: I don't think we really know exactly why, and we really don't have the numbers CONUS either because people can get vaccinated, you know, at Walgreens, right, and we may not have that data, but -- so I -- I don't think we can really say why. I'm just glad that they are...

(CROSSTALK)

Q: ... higher than the national rate, it seems? I don't know if you know that information.

DR. ADIRIM: I think -- I don't think I have that off the top of my head.

GEN. PLACE: I don't.

DR. ADIRIM: Yeah.

Q: (Inaudible).

DR. ADIRIM: Yeah, no, that's a great question, though. Yeah.

STAFF: OK, and (Todd Lopez ?)?

Q: Good morning -- or good afternoon. I -- I assume that service members on installations would prefer the -- the -- the health protection condition doesn't go up because it reduces their freedom of movement?

Is it fair to say that a service member's failure to get vaccinated increases the chances that the health protection conditions might go up for their fellow service members?

DR. ADIRIM: I would say increasing -- increasing rates of COVID-19 infection increases -- you know, in a local community increases the chance that a local commander -- a local installation commander would decide to change the HPCON level.

Getting vaccinated prevents that transmission. So I wouldn't directly say one individual, you know, is at fault but -- so.

STAFF: OK, I think that's it for questions. So General Place, Dr. Adirim, Mr. Rose, thank you all very, very much, and this concludes today's briefing.


*EDITOR’s NOTE: Acting Assistant Secretary of Defense for Health Affairs, Dr. 
Terry Adirim inadvertently cited 31 percent of our active duty are under the 
age of 35. Correct percentage of active duty service members under the age of 
35 is 81 percent.