Fauci: ‘We are not going in the right direction’

The nation’s top infectious disease expert said Thursday he is growing increasingly concerned with the number of coronavirus infections in the United States as cases grow at an unprecedented rate even after months of lockdowns.

A day after the country confirmed more than 50,000 new cases of coronavirus in a single 24-hour period, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID), said younger people are now accounting for a much greater share of the pandemic.

“I think it’s pretty obvious, Howard, that we are not going in the right direction,” Fauci said in an interview with Howard Bauchner, editor-in-chief of the Journal of the American Medical Association. “We need to realize that if we do not adhere to the guidelines as we’re trying to open, and I don’t mean officially, I mean the citizenry, the people that are out there, we’re going to be in some serious difficulty.”

Fauci pointed to Arizona, California, Florida and Texas, four states that have accounted for about half the new cases in the country this year. Hospital systems in Arizona and Texas are beginning to report they are running out of bed space for patients, while hospitalizations are rising in other parts of the country.

Those mass outbreaks, he warned, threaten to overwhelm even areas that have the virus under control.

“The whole enterprise could be at risk,” Fauci said.

But he said the number of vaccine candidates in various stages of development give him hope that several different drugs might prove effective. Several companies have already begun manufacturing vaccines at scale, even before they have been proven effective, with hundreds of millions or billions of dollars in support from the federal government.

The goal, Fauci said, is to have hundreds of millions of doses of vaccine by early 2021, and a billion or more doses by this time next year.

“When you have two or three companies which you hope will be successful, they are going to be making vaccine not only for their own country, but availability in other countries,” Fauci said. “There’s this misperception that everybody’s racing to be the winner. There’s not going to be a winner. I would imagine from what we see that several of these vaccines are going to be very similar in their effect, and hopefully more than one of them will be successful.”

Fauci declined to name the companies that have already begun production.

As school districts and colleges make plans to reopen their doors in the late summer or the fall, Fauci said education officials are thinking through ways to open and operate safely.

“When you look at schools, there really is a delicate balance there, because obviously if you have massive, massive outbreaks where you have an exponential elevation of a curve of new infections in a particular area, you really don’t want to have the kids go to school there. But we really need to be much more flexible in what we can do to get the children back to school,” he said. “A fundamental principle is, within the realm of some prudent evaluation of the safety to the children and the impact on the community, we should try as best as possible to get the kids back to school.”

“In certain circumstances where you get them back but there are still viral dynamics in the community, there are a lot of creative ways that superintendents of schools are thinking seriously about how you can mitigate the possibility of there being children being the vehicles of spread: Alternating days of classes, morning versus afternoon, the wearing of masks for children who are old enough to understand what it means to wear a mask, having capabilities of online for children who have underlying conditions that might put them at risk, protecting the teachers,” he said. “The principle should be, how can we prudently, with sensitivity to the safety of the kids, get the children back to school?”

Fauci has become a totem for Americans across the political spectrum, a hero to some and a villain to others in a way he has not over the course of an almost 40-year career in the public spotlight. He has marveled at the role he now plays in the public conversation, most recently during a run-in with Sen. Rand Paul (R-Ky.), who seemed to suggest that Fauci was standing in the way of allowing professional sports leagues to start their seasons anew.

“I do not make any determinations about what sport can or should be played,” Fauci told Bauchner. “What I do is I answer questions based on scientific evidence and public health judgement. I don’t tell anybody whether they should or could or might or not play a season or not play a season. And yet that has somehow, beyond me, gotten to the point where all of a sudden I’ve become like a gatekeeper for professional sports.”

Fauci has testified before Congress hundreds of times during his tenure at NIAID, through the AIDS epidemic, the September 11 terror attacks and the anthrax attacks soon after, through influenza and Ebola outbreaks and now during the coronavirus case. Asked who his favorite members of Congress had been, Fauci said he would not name names of current members, for fear of landing himself in hot water.

Instead, he pointed to Sen. Edward Kennedy (D-Mass.), who was sharply critical of the Reagan administration’s efforts in the early fight against AIDS. Fauci said Kennedy would “rake me over the coals” when the cameras were on, then put an arm around Fauci when they stopped rolling.

“It was always a thrill testifying before Ted Kennedy. He was somebody with such a passion for the health and the welfare of the country,” Fauci said.