The Hill’s Steve Clemons interviews Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Read excerpts from the interview below.
{mosads}Clemons: What is the state of play as you see it in the most candid terms for the United States right now?
Fauci: We’re still in a significant problem. As you know, we’ve been hit harder than any country in the world, and what has happened is that we peaked and then came down to a level instead of going all the way down to baseline the way many of the European countries did. For a number of complicated reasons which we can discuss, we stayed at a certain level of about 20,000 cases per day until recently, when, unfortunately, southern states, which had not been previously impacted to a great degree — California, Texas, Florida, Arizona — are now experiencing surges of infections that have gone up to 30,000, 40,000, 50,000 and most recently a total of 60,000 new cases per day. We need to get our arms around that, Steve, and we need to do something about it quickly. Because if we don’t there’s a possibility we may be seeing surges in another area. So we’re in a very difficult, challenging period right now as we speak.
Clemons: Look, you have dealt with HIV/AIDS, Ebola, Zika, H1N1, and so many other epidemics out there and you’ve worked with the communities that have been impacted and those communities that might be vulnerable. What is not clicking in this case?
Fauci: Well, first of all, the nature of the microbe itself, the pathogen. This is something that I’ve often described, Steve, and not to be hyperbolic about it, it really is the perfect storm and an infectious disease and public health person’s worst nightmare. It’s a spectacularly transmissible virus, the efficiency with which this transmit is really striking. In addition, despite the wide degree of variability from a certain proportion up to 40 percent of people who get no symptoms, up through and including people who get sick enough to require intensive care and dying. That is a very complex situation to really get control of. In addition, given the efficiency of the spread, we have to have in place the capability of going from containment and keeping it contained, and if in fact we can contain it, to go to mitigation. And in some respects we’ve been successful. I mean, if you look at the curve, for example, in New York City, which was hit harder than any place in the world, really, has been able to successfully bring down the number of new infections, hospitalizations and deaths to an extremely low level. So now what we need to do in this country is to successfully make that transition from baseline control to safely reopening the country and following the guidelines are gonna be critical, Steve, and I think what we’ve seen, unfortunately, is that in some of the southern states, the states have not really followed those guidelines in some respects and jumped over the benchmarks and the points that needed to be checkpoints. We’ve got to do better than that.
Clemons: You have said that the states that have the most severe outbreaks right now really ought to consider shutting down again, that the stakes for public health are so high right now that we might now have to reverse that. Tell us more about that.
Fauci: Well, Steve, I would hope we don’t have to result to shut down. I think that would be something that is obviously an extreme. I think it would not be viewed very, very favorably, even by the states and the cities involved. So rather than think in terms of reverting back down to a complete shutdown, I would think we need to get the states pausing in their opening process, looking at what did not work well and try to mitigate that. I don’t think we need to go back to an extreme of shutting down. So if you look at the states that are most heavily involved, and for a while there even up to the present time. When you look at California, Arizona, Texas and Florida, they’re accounting for 50 percent of the new infections. So we know what the target is right now. We’ve got to get them to do very fundamental things. Closing bars, avoiding congregations of large numbers of people, getting the citizenry in those states to wear masks, maintain 6 foot distance, washing hands. The fundamentals that we’ve been talking about all along, that’s where we got to start. If we can do that consistently, I will tell you almost certainly you’re going to see a down curve in those infections. But we’ve got to go to that. We can’t just say, all or none, which is what happened. We went from shutting down to, opening up in a way that essentially skipped over all the guideposts.
Clemons: How confident are you that vaccines are going to ride to the rescue?
Fauci: You know, Steve, I think the durable solution to what we’re in right now clearly has to be a vaccine. I mean, there’s no doubt that public health measures are critically important. But I think if you combine the public health measures with a vaccine and just to comment about that since you brought it up, we’re really cautiously optimistic that things are moving along quite well with more than one candidate. There are a number of candidates that are in various stages of development. The one that you mentioned, Steve, the Moderna one that was helped developed here at NIH will very likely be going into advanced, phase three, clinical trials by the end of this month of July. And then there were other candidates equally as promising, in many respects that’ll be coming in a little bit later. We do hope, given the favorable data that we’ve seen out of the phase one trials and in the animal data that we will be able to induce a response that you would predict would be protective. Obviously, as you well know, Steve, with any vaccine development program, you never can guarantee success of safety and efficacy, but the early signs are proving favorable. So we hope that by the end of this calendar year, in the beginning of 2021 that we will have a vaccine that will be able to begin to deploy to people who need it, obviously the entire population, but with priorities for those who are most vulnerable.
Clemons: You said last year that we needed to stop being reactive, that we needed to be proactive and begin thinking about platform responses that anticipate the kind of zoonotic transfers from animals to humans and begin thinking more proactively. Is this the time, while we’re fighting this pandemic, to also make the case that we should be putting money and resources behind more proactive concerns about the next wave, if you will, the next wave, the next virus?
Fauci: Well, yeah. I’m so sorry that I was so prescient when we had our last interview, Steve, I really am very sorry about that. But you’re absolutely right. In fact, we did do some of that proactive platform development which actually allowed us to essentially enter into the development of a vaccine and enter phase one, phase two and now coming up phase three trials at an absolute record speed. It was the things that we did last year, the year before, the year before, that allowed us to move very quickly. And to your specific question, Steve, we still need to get better at that and do even more. So even as we’re getting through this — and there’ll be many, many lessons learned — we’ve got to, for the future, make sure that we don’t lose this corporate memory of what we’re going through. Because we need obviously to be better prepared. We clearly, we’re much better prepared now for this onslaught than we were 10 years ago, but we’ve got to take it a step even further to be better prepared for the next onslaught, which inevitably will occur.
Clemons: What do you believe needs to happen here in Washington to get consistent messaging from the federal government?
Fauci: There needs to be a realization of the importance of what you’re pointing out. You know, we are all in this together. One of the problems we’re facing is that in the middle of trying to fight an unprecedented historic pandemic, there is still divisiveness. There’s divisiveness politically. we can see that when we look at the different viewpoints that people take towards this. We are all in this together and we can get through this. We can be part of the solution and not part of the problem of divisiveness. And that’s something that I hope now that we’re so deeply involved in this, that as a country we realize that. And one of the things that’s so disturbing is that this issue, particularly now with the resurgences of young people who feel that because statistically it is less likely that they’re going to get into significant difficulty from a health standpoint, namely, negative consequences or getting severely ill. That they’re getting infected doesn’t make that much difference. It really does Steve, because not only do they owe it to themselves or their individual responsibility because they can get severely ill from this, young people can get severely ill. But by getting infected, Steve, they’re propagating the pandemic, they’re part of the evolution of the pandemic because even though innocently and inadvertently they may infect someone else, who then will infect someone else. And then you get a vulnerable person who has a very dire consequence. So you can’t assume that you’re in a vacuum. And it’s only about you. And for that reason, we call for and encourage people to really take the personal responsibility, which actually becomes a societal responsibility.