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CDC Press Conference 01-07-2010 – Rough Transcript
NOTE: This is a rough, unedited transcript and transcription errors may appear
Operator: Welcome and thank you all for standing by. At this time, I would like to remind parties
that your lines are in a listen only mode until the question and answer session at which time you
may press star 1 to ask a question. Enough any objections, you may disconnect at this time. I will
now turn the meeting over to Glen. Thank you.
Glen Nowak: Thank you and thank you for coming here today or calling in for this update on h1n1
influenza and h1n1 influenza vaccine. Dr. Schuchat is with the centers for immunizations and
respiratory diseases.
Anne Schuchat: Good afternoon, everyone, and happy New Year. It’s great to see some of you
back and have some of you on the phone. The h1n1 virus is still circulating and it is still causing
disease, hospitalizations and deaths. Many people are still susceptible to this virus. And would
benefit from vaccination. We want to avoid complacency. Today I’m happy to say that we have a
very good supply of the h1n1 vaccine all around the country. Many people have gotten the vaccine
already. Many more people want to get the vaccine and we want more people to get the vaccine.
As of today, 136 million doses of h1n1 vaccine are available for ordering by the states. There are
ample supplies of h1n1 vaccine in most of the country. The vaccine should be easily available
pretty much anywhere you live, whether it's at your doctor's office, through the health department,
through the clinics that are being arranged for the community, school clinics that are being held at
pharmacies and retail centers. We believe there are vaccines all around the country right now.
Most states have opened up vaccination to anyone who wants it. More places and more providers
are offering vaccines, making it even easier for those of you who want to be vaccinated to protect
yourself and your families to be able to do that. I want to briefly mention flu activity. We don't
have a new report today. Tomorrow, the flu view information will be coming out. But since we
didn't hold one of these last weeks, I want to remind you where we are.
The h1n1 virus is still circulating. We have an uncertain future.
We want and need to avoid complacency. As of this
past week, four states continue to report widespread activity. Those states are Delaware, Maine,
New Jersey and Virginia. We’re seeing drops in laboratory confirmed hospitalizations and deaths.
But we actually did see activity increasing in a few other indicators. We still have more activity
than we usually have this time of year, though it's certainly much below where it was several weeks
ago.
All the virus that we're seeing right now is the h1n1 virus. We haven't yet seen the emergence
of seasonal flu strains in any numbers at all.
We saw a slight uptick in the last week's reporting in
the influenza-like illnesses to the doctors or emergency departments. That can sometimes happen
right around Christmas, so we don't know if that will persist.
We also saw an uptick in pneumonia or influenza deaths in this past week. And that isn't something that we necessarily see around the
Christmas holiday.
So that is something that we're really keeping our eye on. People are still
becoming ill, though the numbers are down from the past, they are still happening and it's an
important opportunity for us to do something about that. I’m going to talk about a graph that those
who are in the room will be able to see up here and those of you on the phone or looking at this
online. If you go to CDC's website after the press conference, the media part of the website will
show this graph.
This was the mortality graph in 1957. This is really a reminder of why we are
saying that we need to remain vigilant. This is why my colleagues and I in public health are
encouraging people to be vaccinated, especially those who are at risk of complications. None of us
can predict what's going to happen. But if you look at this graph, the bottom part of that curve, you
know, the -- there's the camel hump and then it comes down to that valley. Well, that's where we
are right now in that valley. We don't know what's going to happen over the next several weeks or
months. But in 1957, this essentially gave the all clear whistle in that December/January time
period. They had vaccines, but they didn't encourage its use and yet they did go on to see that
increase in mortality.
Experts disagree about the probability of that additional amount of illness
and particularly severe illness occurring. But the best thing for us to do is not focus on the
probability and really focus on the idea that vaccine is the best way for us to reduce the chances
that we will have ongoing disease, hospitalizations and deaths. As long as this virus is circulating,
it has the potential to cause illness. This next week, or beginning this weekend, we're going to kick
off the national influenza vaccination week. This is a converted effort that the CDC, health and
human services and all of our partners to encourage vaccination.
It includes a focus on people at high risk for complications, adults with emphysema, pregnant women, seniors, children, really
encouraging vaccination for anyone who hasn't yet been vaccinated and wants to be. Vaccination is
especially helpful for adults with those chronic conditions. They have a higher risk of being
hospitalized. And we know right now that they're less likely to have been vaccinated than our
children. Vaccine is still important for pregnant women and postpartum women. They’ve had
terrible complications from this virus. We do encourage vaccination of pregnant and postpartum
women. We think it's the time now for seniors who have wanted to be vaccinated but have stepped
aside so younger, higher risk people could be vaccinated. This is your time, too, to come and get
the vaccine. It should be available in much more places near you. There’s lots of information at
flu.gov about the national influenza vaccination week and where to find vaccination near you.
Going forward, the h1n1 virus is still circulating in the U.S. and we expect it to circulate for some
time. We need to stay vigilant. One piece of that vigilance is good surveillance. As such, we are
urging doctors to continue to test patients with severe respiratory illness. People who are
hospitalized with suspected flu northeast need to be tested. We’d like to know whether they
definitely have flu and which type. So this is a call out for docs to keep testing your patients with
severe flu-like illness. We need to continue our efforts to get vaccinations. More people are
susceptible and need to be protected to reduce their risk of getting this virus. Having as many
people vaccinated as possible is our best course of action, even if we can't read the tea lives of the
future. The illness is down. There’s plenty of vaccine. It’s a key window of opportunity. We
don't want to repeat the story from 1957. I hope that is the update for today and let's turn to the
questions. We can start with a question from the room. Mike. Happy New Year.
Mike Stobbe: Happy New Year, doctor. Thanks for doing this. I want to follow up on something
you said about an indicator being of flu activity, the pneumonia and influenza deaths. The last flu
view it looked it, it seemed like it was going down. Do you mind offering some numbers?
Anne Schuchat: The week before it was down and then it went up again. So in the flu view that
came out Friday. Oh, the actual numbers, I don't have them. We can get you the percentages. Its 7
point something, but I’m not sure. Essentially what we track is the -- we look at 122 city that's
track pneumonia and influenza deaths among all deaths. They look at death certificates and what
number of those is caused by pneumonia or influenza conditions. There’s an expected number and
there's an amount above the epidemic threshold. For much of this fall continuing to now, we have
been over the epidemic threshold. But the percents we'll give you afterwards when we look them
up. Let’s go to a question from the phone.
Operator: If you have a question over the phone, you may press star 1 on your touch tone phone
and record your name. Our first question is from Daniel DeNoon.
Daniel DeNoon: Thanks for taking my question. Two questions, they're kind of related. One is
would you see a little more about the uptick we saw this week on that ILI. It did look like things
were trending down precipitously and suddenly in many areas of the country sort of jagged back up
and I wonder if you could comment further on that. Secondly, do you have a number on how many
people you estimate have received the h1n1 vaccine?
Anne Schuchat: Thanks for both of those questions and happy New Year to you, as well.
Influenza-like illness is measured through visits to doctors and visits to emergency departments.
And we track the percentage of those visits to either the doctor or the emergency room that are
caused by influenza-like illness with a case definition that involves temperature and respiratory
symptoms. What we saw was things were trending downward and went down as low as 2.7% of
visits. And then this past week they went up to 3.2% of visits. A little bit of an uptick and again,
above that expected threshold. Now, that could be because flu is getting worse, but it could also
people that people aren't making doctor's visits for other things. It was the holiday season during
the period when that number came in and that may have been because the routine, preventive and
nonemergent visits weren't happening. So that is why we're not really sure that that means a whole
lot yet. You also asked about how many people do we think have been vaccinated. Our best guess
right now is at least 60 million people have been vaccinated. We are getting more information and
we're hoping in the next near future to be able to update you in more detail about the coverage and
vaccination. We know a large proportion of the vaccine given out has gone to children and that's
one of the reasons we're focusing on the message for adults who really were waiting for their kids
or kids in the neighborhood to get vaccinated. It’s the time now for adults and seniors to be
vaccinated. Do we have another question from the phone?
Operator: Heidi Splete, internal medical news, your line is open.
Heidi Splete: Hi, Dr. Schuchat, thank you for taking my question. I was wondering, since this
started last spring, usually flu season goes through the spring. Are you at all thinking in terms of an
end to this flu season or are you thinking more in terms of this is just going to be sort of a chronic
flu season? And are there any thoughts about that and how doctors should think about this flu
season?
Anne Schuchat: We need to stay vigilant. The community and, doctors are used to the idea that
flu season can last through April into the beginning of May. This past year, we had that surprise.
We think 2 next few months will be very important ones to understand whether seasonal influence
strains start to circulate and cause disease and to understand how many more of this h1n1 virus
circulation occur. So I can't -- I wish I could tell you exactly when this particular strain will stop
circulating, but we don't know that. Next question from the phone.
Operator: The next is from Helen Branswell, the Canadian press. Your line is open.
Helen Branswell: Hi. Thanks very much for taking my question. I’m at a disadvantage because I
didn't see the graph that you're pointing to or the slide that you have there, but I’m wondering, can
you refresh my memory, in '57, that second dip that you're talking about, was that the second wave?
And if so, is that situation actually analogous to the one that we're in now? Because most of North
America has been through two waves.
Anne Schuchat: Thanks, Helen. It’s a graph looking mortality and it's different than the one that
looks at influenza like illness. In 1957, there were summer outbreaks of disease particularly in one
Boy Scout jamboree and then there was an additional mortality wave in the spring or winter/spring
in 1958 that was seen. No pandemic is identical to any other pandemic. I think we try to learn
from the past, but we have to be careful about being confident or overconfident about what to
expect. So I do not know that the 1957 story is what we're looking at today. But I do know we
have a lot of vaccine and we have a chance to not have to repeat history if that is the particular
history that this strain has in store for us. Next question from the phone.
Operator: Again, if you have a question, press star 1 and record your name. Next, Hiran
Ratnayake from Delaware news journal. Your line is open.
Hiran Ratnayake: Hello. Thanks for taking my question. I have a question, it has to do with the
flu activity levels, as you've mentioned earlier, Delaware is one of four states that's considered
widespread. And I want to know if public health officials from each state are required by the CDC
to take their baseline flu activity level in their region into consideration when they decide to
classify their level each week as either widespread, sporadic, local or regional.
Anne Schuchat: I will answer as best I can. We may need someone more close to the surveillance
to give you a better answer. the state level leaders have some flexibility in how they interpret the
data for their state in order to classify disease as widespread, regional, sporadic or local, or local or
sporadic, I guess, or no disease. That said, each of the states tends to use a similar system over
time. So we have looked at the state public health official classifications to see how well they
correlate with what we see from other surveillance systems in terms of influenza like illness
activity against their baseline or the 122 cities or other systems that we have that can be linked to
states and we see good correlation. So while we give flexibility to the state authorities to give the
best information they have available, we believe they're doing a pretty good job of designating the
category for the state. Let’s go a question in the room. Beth, happy new year to you.
Beth Galvin: Happy New Year, doctor. Do you have any new numbers, maybe an estimate of how
many Americans have been sickened by this virus? And also, are you concerned that Americans
are going to think that the threat is over because we're not seeing so much right now and so it's not
necessary to get vaccinated?
Anne Schuchat: We're hoping by next week we'll be able to update the numbers that have gotten
ill, who have been hospitalized and who have died to add on to the estimates that we provided
about a month or so ago. So we're working hard to get that estimate updated. I am concerned that
people may be complacent, that people may think this is all over. I would hate for people to make
decisions thinking this is over and then make get sick or severely ill. We have the chance for
people to protect themselves and reduce the risk of serious calculations. So I think complacency is
probably our top enemy right now. Is there another question from the phone?
Operator: Bob Roos, CIDRAP news, your line is open.
Bob Roos: Thank you. dr. Schuchat, I wonder if you have any idea of the -- or idea of the demand
for vaccine at this point and is there concern that there will be vaccine left over, some vaccine
doses that are available will expire before they can be used? I understand some of those have a
shelf life of three months.
Anne Schuchat: We've been tracking demand both quantitatively and qualitatively. We continue
to have demand, but we know people are changing their opinions week by week. There’s been a
pretty stable amount of demand among people who are definitely sure they want to be vaccinated.
That’s been a pretty stable pattern. But among people who think they probably want to get the
vaccine, that's slipping down. And I think it gets to the last question about complacency. Am I out
of the woods, or not? So we are seeing a drop in those that are certain they want to get the vaccine.
Still, there are a lot of people who want to get the vaccine who haven't and there are a lot of
vaccines. So there's plenty available for those who want to be vaccinated and there's a chance for
everyone to talk to their loved ones about the chance to be protected. The question about expiration
dates and throwing out vaccines, we're to the point where we want to make the vaccine available.
We believe right now we have ample supply that will be vaccine that is good through the next
several months that will be active and effective in people. The vaccine that we have right now is a
perfect match with the virus strains that are circulating. More than 60 million people have gotten
this vaccine and we think it was a great safety experience. So everything we know says we have
lots of vaccine now that's available for people to protect themselves and a lot more people can take
advantage of that. We have time for two more questions. Let’s go to the phone.
Operator: Tom Randall, Bloomberg News. Your line is open.
Tom Randall: Hi, Dr. Schuchat. I was wondering if you could talk more about the uptick in
mortality. Specifically, I’m curious if historically there's been any correlation between weather and
pneumonia and mortality. I know we've seen some unusually cold temperatures across a very wide
swap of the U.S. in recent weeks.
Anne Schuchat: Yeah. There’s a tremendous seasonality to pneumonia and influenza mortality
and pneumonia in general as well as flu in general. The seasonality patterns have been ones that
scientists have been fascinated by. Lots of speculation about humidity and crowding and the life
cycle, maybe that short daylight has some effect. We don't know. We do know that sometimes
after the holidays, we see an increase in respiratory illness including pneumonia and influenza,
possibly related to everybody who got together over the holidays and possibly completely
unrelated. So we don't know whether this incredible weather that some of the country is
experiencing will lead to changes in the influenza transmission. But we know there's a lot of
vaccine and a chance for us to interfere with those trends by reducing the risk that people will get
sick. So let's go to the last question from the phone.
Operator: Joanne Allen from Reuters, your line is open.
Joanne Allen: In my position today by Germany and other countries in Europe sort of giving back
supplies or canceling orders, wondering if the U.S. has any plans to do that or if there's been any
discussion given that we have a plentiful supply. Is it an oversupply?
Anne Schuchat: We are actively encouraging cancellation right now. As you've seen in the past
few months, demand has been a challenging thing to predict and we've had supply and demand
mismatches at various points in this virus's trajectory. Right now, we're at a point where we have
ample supply and we're encouraging people to be vaccinated.
So we haven't made decisions here in the U.S. like some of the ones people have mentioned in Europe about giving back vaccines, where
we are right now focused is on vaccination and making opportunities available for people to be
vaccinated. Thanks everybody for participating and we'll see you soon. Thank you.
NOTE: This is a rough, unedited transcript and transcription errors may appear
Operator: Welcome and thank you all for standing by. At this time, I would like to remind parties
that your lines are in a listen only mode until the question and answer session at which time you
may press star 1 to ask a question. Enough any objections, you may disconnect at this time. I will
now turn the meeting over to Glen. Thank you.
Glen Nowak: Thank you and thank you for coming here today or calling in for this update on h1n1
influenza and h1n1 influenza vaccine. Dr. Schuchat is with the centers for immunizations and
respiratory diseases.
Anne Schuchat: Good afternoon, everyone, and happy New Year. It’s great to see some of you
back and have some of you on the phone. The h1n1 virus is still circulating and it is still causing
disease, hospitalizations and deaths. Many people are still susceptible to this virus. And would
benefit from vaccination. We want to avoid complacency. Today I’m happy to say that we have a
very good supply of the h1n1 vaccine all around the country. Many people have gotten the vaccine
already. Many more people want to get the vaccine and we want more people to get the vaccine.
As of today, 136 million doses of h1n1 vaccine are available for ordering by the states. There are
ample supplies of h1n1 vaccine in most of the country. The vaccine should be easily available
pretty much anywhere you live, whether it's at your doctor's office, through the health department,
through the clinics that are being arranged for the community, school clinics that are being held at
pharmacies and retail centers. We believe there are vaccines all around the country right now.
Most states have opened up vaccination to anyone who wants it. More places and more providers
are offering vaccines, making it even easier for those of you who want to be vaccinated to protect
yourself and your families to be able to do that. I want to briefly mention flu activity. We don't
have a new report today. Tomorrow, the flu view information will be coming out. But since we
didn't hold one of these last weeks, I want to remind you where we are.
The h1n1 virus is still circulating. We have an uncertain future.
We want and need to avoid complacency. As of this
past week, four states continue to report widespread activity. Those states are Delaware, Maine,
New Jersey and Virginia. We’re seeing drops in laboratory confirmed hospitalizations and deaths.
But we actually did see activity increasing in a few other indicators. We still have more activity
than we usually have this time of year, though it's certainly much below where it was several weeks
ago.
All the virus that we're seeing right now is the h1n1 virus. We haven't yet seen the emergence
of seasonal flu strains in any numbers at all.
We saw a slight uptick in the last week's reporting in
the influenza-like illnesses to the doctors or emergency departments. That can sometimes happen
right around Christmas, so we don't know if that will persist.
We also saw an uptick in pneumonia or influenza deaths in this past week. And that isn't something that we necessarily see around the
Christmas holiday.
So that is something that we're really keeping our eye on. People are still
becoming ill, though the numbers are down from the past, they are still happening and it's an
important opportunity for us to do something about that. I’m going to talk about a graph that those
who are in the room will be able to see up here and those of you on the phone or looking at this
online. If you go to CDC's website after the press conference, the media part of the website will
show this graph.
This was the mortality graph in 1957. This is really a reminder of why we are
saying that we need to remain vigilant. This is why my colleagues and I in public health are
encouraging people to be vaccinated, especially those who are at risk of complications. None of us
can predict what's going to happen. But if you look at this graph, the bottom part of that curve, you
know, the -- there's the camel hump and then it comes down to that valley. Well, that's where we
are right now in that valley. We don't know what's going to happen over the next several weeks or
months. But in 1957, this essentially gave the all clear whistle in that December/January time
period. They had vaccines, but they didn't encourage its use and yet they did go on to see that
increase in mortality.
Experts disagree about the probability of that additional amount of illness
and particularly severe illness occurring. But the best thing for us to do is not focus on the
probability and really focus on the idea that vaccine is the best way for us to reduce the chances
that we will have ongoing disease, hospitalizations and deaths. As long as this virus is circulating,
it has the potential to cause illness. This next week, or beginning this weekend, we're going to kick
off the national influenza vaccination week. This is a converted effort that the CDC, health and
human services and all of our partners to encourage vaccination.
It includes a focus on people at high risk for complications, adults with emphysema, pregnant women, seniors, children, really
encouraging vaccination for anyone who hasn't yet been vaccinated and wants to be. Vaccination is
especially helpful for adults with those chronic conditions. They have a higher risk of being
hospitalized. And we know right now that they're less likely to have been vaccinated than our
children. Vaccine is still important for pregnant women and postpartum women. They’ve had
terrible complications from this virus. We do encourage vaccination of pregnant and postpartum
women. We think it's the time now for seniors who have wanted to be vaccinated but have stepped
aside so younger, higher risk people could be vaccinated. This is your time, too, to come and get
the vaccine. It should be available in much more places near you. There’s lots of information at
flu.gov about the national influenza vaccination week and where to find vaccination near you.
Going forward, the h1n1 virus is still circulating in the U.S. and we expect it to circulate for some
time. We need to stay vigilant. One piece of that vigilance is good surveillance. As such, we are
urging doctors to continue to test patients with severe respiratory illness. People who are
hospitalized with suspected flu northeast need to be tested. We’d like to know whether they
definitely have flu and which type. So this is a call out for docs to keep testing your patients with
severe flu-like illness. We need to continue our efforts to get vaccinations. More people are
susceptible and need to be protected to reduce their risk of getting this virus. Having as many
people vaccinated as possible is our best course of action, even if we can't read the tea lives of the
future. The illness is down. There’s plenty of vaccine. It’s a key window of opportunity. We
don't want to repeat the story from 1957. I hope that is the update for today and let's turn to the
questions. We can start with a question from the room. Mike. Happy New Year.
Mike Stobbe: Happy New Year, doctor. Thanks for doing this. I want to follow up on something
you said about an indicator being of flu activity, the pneumonia and influenza deaths. The last flu
view it looked it, it seemed like it was going down. Do you mind offering some numbers?
Anne Schuchat: The week before it was down and then it went up again. So in the flu view that
came out Friday. Oh, the actual numbers, I don't have them. We can get you the percentages. Its 7
point something, but I’m not sure. Essentially what we track is the -- we look at 122 city that's
track pneumonia and influenza deaths among all deaths. They look at death certificates and what
number of those is caused by pneumonia or influenza conditions. There’s an expected number and
there's an amount above the epidemic threshold. For much of this fall continuing to now, we have
been over the epidemic threshold. But the percents we'll give you afterwards when we look them
up. Let’s go to a question from the phone.
Operator: If you have a question over the phone, you may press star 1 on your touch tone phone
and record your name. Our first question is from Daniel DeNoon.
Daniel DeNoon: Thanks for taking my question. Two questions, they're kind of related. One is
would you see a little more about the uptick we saw this week on that ILI. It did look like things
were trending down precipitously and suddenly in many areas of the country sort of jagged back up
and I wonder if you could comment further on that. Secondly, do you have a number on how many
people you estimate have received the h1n1 vaccine?
Anne Schuchat: Thanks for both of those questions and happy New Year to you, as well.
Influenza-like illness is measured through visits to doctors and visits to emergency departments.
And we track the percentage of those visits to either the doctor or the emergency room that are
caused by influenza-like illness with a case definition that involves temperature and respiratory
symptoms. What we saw was things were trending downward and went down as low as 2.7% of
visits. And then this past week they went up to 3.2% of visits. A little bit of an uptick and again,
above that expected threshold. Now, that could be because flu is getting worse, but it could also
people that people aren't making doctor's visits for other things. It was the holiday season during
the period when that number came in and that may have been because the routine, preventive and
nonemergent visits weren't happening. So that is why we're not really sure that that means a whole
lot yet. You also asked about how many people do we think have been vaccinated. Our best guess
right now is at least 60 million people have been vaccinated. We are getting more information and
we're hoping in the next near future to be able to update you in more detail about the coverage and
vaccination. We know a large proportion of the vaccine given out has gone to children and that's
one of the reasons we're focusing on the message for adults who really were waiting for their kids
or kids in the neighborhood to get vaccinated. It’s the time now for adults and seniors to be
vaccinated. Do we have another question from the phone?
Operator: Heidi Splete, internal medical news, your line is open.
Heidi Splete: Hi, Dr. Schuchat, thank you for taking my question. I was wondering, since this
started last spring, usually flu season goes through the spring. Are you at all thinking in terms of an
end to this flu season or are you thinking more in terms of this is just going to be sort of a chronic
flu season? And are there any thoughts about that and how doctors should think about this flu
season?
Anne Schuchat: We need to stay vigilant. The community and, doctors are used to the idea that
flu season can last through April into the beginning of May. This past year, we had that surprise.
We think 2 next few months will be very important ones to understand whether seasonal influence
strains start to circulate and cause disease and to understand how many more of this h1n1 virus
circulation occur. So I can't -- I wish I could tell you exactly when this particular strain will stop
circulating, but we don't know that. Next question from the phone.
Operator: The next is from Helen Branswell, the Canadian press. Your line is open.
Helen Branswell: Hi. Thanks very much for taking my question. I’m at a disadvantage because I
didn't see the graph that you're pointing to or the slide that you have there, but I’m wondering, can
you refresh my memory, in '57, that second dip that you're talking about, was that the second wave?
And if so, is that situation actually analogous to the one that we're in now? Because most of North
America has been through two waves.
Anne Schuchat: Thanks, Helen. It’s a graph looking mortality and it's different than the one that
looks at influenza like illness. In 1957, there were summer outbreaks of disease particularly in one
Boy Scout jamboree and then there was an additional mortality wave in the spring or winter/spring
in 1958 that was seen. No pandemic is identical to any other pandemic. I think we try to learn
from the past, but we have to be careful about being confident or overconfident about what to
expect. So I do not know that the 1957 story is what we're looking at today. But I do know we
have a lot of vaccine and we have a chance to not have to repeat history if that is the particular
history that this strain has in store for us. Next question from the phone.
Operator: Again, if you have a question, press star 1 and record your name. Next, Hiran
Ratnayake from Delaware news journal. Your line is open.
Hiran Ratnayake: Hello. Thanks for taking my question. I have a question, it has to do with the
flu activity levels, as you've mentioned earlier, Delaware is one of four states that's considered
widespread. And I want to know if public health officials from each state are required by the CDC
to take their baseline flu activity level in their region into consideration when they decide to
classify their level each week as either widespread, sporadic, local or regional.
Anne Schuchat: I will answer as best I can. We may need someone more close to the surveillance
to give you a better answer. the state level leaders have some flexibility in how they interpret the
data for their state in order to classify disease as widespread, regional, sporadic or local, or local or
sporadic, I guess, or no disease. That said, each of the states tends to use a similar system over
time. So we have looked at the state public health official classifications to see how well they
correlate with what we see from other surveillance systems in terms of influenza like illness
activity against their baseline or the 122 cities or other systems that we have that can be linked to
states and we see good correlation. So while we give flexibility to the state authorities to give the
best information they have available, we believe they're doing a pretty good job of designating the
category for the state. Let’s go a question in the room. Beth, happy new year to you.
Beth Galvin: Happy New Year, doctor. Do you have any new numbers, maybe an estimate of how
many Americans have been sickened by this virus? And also, are you concerned that Americans
are going to think that the threat is over because we're not seeing so much right now and so it's not
necessary to get vaccinated?
Anne Schuchat: We're hoping by next week we'll be able to update the numbers that have gotten
ill, who have been hospitalized and who have died to add on to the estimates that we provided
about a month or so ago. So we're working hard to get that estimate updated. I am concerned that
people may be complacent, that people may think this is all over. I would hate for people to make
decisions thinking this is over and then make get sick or severely ill. We have the chance for
people to protect themselves and reduce the risk of serious calculations. So I think complacency is
probably our top enemy right now. Is there another question from the phone?
Operator: Bob Roos, CIDRAP news, your line is open.
Bob Roos: Thank you. dr. Schuchat, I wonder if you have any idea of the -- or idea of the demand
for vaccine at this point and is there concern that there will be vaccine left over, some vaccine
doses that are available will expire before they can be used? I understand some of those have a
shelf life of three months.
Anne Schuchat: We've been tracking demand both quantitatively and qualitatively. We continue
to have demand, but we know people are changing their opinions week by week. There’s been a
pretty stable amount of demand among people who are definitely sure they want to be vaccinated.
That’s been a pretty stable pattern. But among people who think they probably want to get the
vaccine, that's slipping down. And I think it gets to the last question about complacency. Am I out
of the woods, or not? So we are seeing a drop in those that are certain they want to get the vaccine.
Still, there are a lot of people who want to get the vaccine who haven't and there are a lot of
vaccines. So there's plenty available for those who want to be vaccinated and there's a chance for
everyone to talk to their loved ones about the chance to be protected. The question about expiration
dates and throwing out vaccines, we're to the point where we want to make the vaccine available.
We believe right now we have ample supply that will be vaccine that is good through the next
several months that will be active and effective in people. The vaccine that we have right now is a
perfect match with the virus strains that are circulating. More than 60 million people have gotten
this vaccine and we think it was a great safety experience. So everything we know says we have
lots of vaccine now that's available for people to protect themselves and a lot more people can take
advantage of that. We have time for two more questions. Let’s go to the phone.
Operator: Tom Randall, Bloomberg News. Your line is open.
Tom Randall: Hi, Dr. Schuchat. I was wondering if you could talk more about the uptick in
mortality. Specifically, I’m curious if historically there's been any correlation between weather and
pneumonia and mortality. I know we've seen some unusually cold temperatures across a very wide
swap of the U.S. in recent weeks.
Anne Schuchat: Yeah. There’s a tremendous seasonality to pneumonia and influenza mortality
and pneumonia in general as well as flu in general. The seasonality patterns have been ones that
scientists have been fascinated by. Lots of speculation about humidity and crowding and the life
cycle, maybe that short daylight has some effect. We don't know. We do know that sometimes
after the holidays, we see an increase in respiratory illness including pneumonia and influenza,
possibly related to everybody who got together over the holidays and possibly completely
unrelated. So we don't know whether this incredible weather that some of the country is
experiencing will lead to changes in the influenza transmission. But we know there's a lot of
vaccine and a chance for us to interfere with those trends by reducing the risk that people will get
sick. So let's go to the last question from the phone.
Operator: Joanne Allen from Reuters, your line is open.
Joanne Allen: In my position today by Germany and other countries in Europe sort of giving back
supplies or canceling orders, wondering if the U.S. has any plans to do that or if there's been any
discussion given that we have a plentiful supply. Is it an oversupply?
Anne Schuchat: We are actively encouraging cancellation right now. As you've seen in the past
few months, demand has been a challenging thing to predict and we've had supply and demand
mismatches at various points in this virus's trajectory. Right now, we're at a point where we have
ample supply and we're encouraging people to be vaccinated.
So we haven't made decisions here in the U.S. like some of the ones people have mentioned in Europe about giving back vaccines, where
we are right now focused is on vaccination and making opportunities available for people to be
vaccinated. Thanks everybody for participating and we'll see you soon. Thank you.
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