Podcast: Dr. Fauci's Pandemic Prognosis

TRANSCRIPT: Dr. Fauci's Pandemic Prognosis

Anthony Fauci:

Could you imagine what things would be like if we did not have a vaccine? There would not be a light at the end of the tunnel right now. And right now there is.

Ian Bremmer:

Hello, and welcome to the GZERO World Podcast. Here you'll find extended versions of the interviews from my show on public television. I'm Ian Bremmer, and it's been nearly a year since the World Health Organization officially declared the coronavirus outbreak a pandemic. I know it feels like so much longer. Globally, more than 110 million people have been infected that we know of, and approximately 2.5 million have died. The United States leads the world in both overall cases and deaths. My guest today is Dr. Anthony Fauci, who has been a tireless leader of pandemic response since the beginning. We'll talk about vaccine rollout, the long-term impact of coronavirus infections, and how to safely get America and the world back to normal. Let's get right to it.

Announcer:

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Ian Bremmer:

Dr. Anthony Fauci, thank you so much for coming back to join us.

Anthony Fauci:

Thank you. It's good to be with you.

Ian Bremmer:

So let me say that in the fall of 2019, I mean literally weeks before the pandemic hit, when I asked you what kept you up at night, your response to me was-

Anthony Fauci:

I mean, obviously the evolution of a pandemic like respiratory infection, likely influenza.

Ian Bremmer:

How close are we to having lived through your worst nightmare?

Anthony Fauci:

I think we are living through much of that worst nightmare. I had said, when asked in more detail, I remember multiple times responding a respiratory illness that jumps species from an animal host that has a high degree of efficiency and transmitting from person-to-person and has the high degree of morbidity and mortality either on the general population or in certain groups of people. And in this case, we know as unusual as it is in that it generally spares younger people, it nonetheless, we're at that landmark right now of 500,000 deaths, which is historic and horrible in its proportion. I mean, people are going to be talking about what we've been through over the last year in decades and decades to come in the similar manner that we would often reference the 1918 pandemic flu.

Ian Bremmer:

So we appear right now to be in a race between vaccinations and virus variants. And even as case rates are plummeting right now, health officials are getting increasingly alarmed that variants could lead to another surge even in the coming weeks. What's your best sense right now of whether we are winning that race?

Anthony Fauci:

You know, we are in a race for sure. The thing that's encouraging is that sharp slope of the downward trajectory of not only the daily cases, but the weekly averages. As you said, I think appropriately, we know that we have a variant that is now taking hold in the United States that has already shown in the UK that it has an enhanced capability compared to the wild type virus of transmitting from person-to-person. And likely also it's a bit more virulent. That virus, if you do modeling, tells us that it will be dominant in this country probably by the end of March. So a race, if you want to call it, between a dominant virus that is clearly sensitive to the vaccine that we're using, but has a very strong capability of spreading and transmitting from person to person. So we have two major tools in our arsenal.

One is a vaccine, which as the weeks and the months go by, we get more and more available to put in people's arms and unfortunately, I mean fortunately, we have a very good set of vaccines. We have two at least and one soon to join that armamentarium of tools that we have against the virus. We have a significant discrepancy between supply and demand. If we had all the vaccine that we would need right now, when we did mass vaccinations, I believe our chances of winning this war, as you're saying metaphorically between the virus and ourselves, we would have a distinct advantage. But we have two tools, one of which is immediately available to us, and that is everybody doing the kinds of public health measures that we've been talking about constantly. The universal wearing of masks, the avoiding close contact, the avoiding congregate settings, particularly indoors, the washing of hands.

If we did that in a very assiduous way that everyone pulls together, even without a vaccine, you could be a pretty good defense against the spread. Superimpose upon that the fact that as every week goes by we get more and more people vaccinated, that is, as you said, it's a work in progress. I mean, a dynamic situation between what we are doing to halt the virus and the virus's capability of continuing to spread. It is conceivable that if we fall short that we will have a surge, an additional surge.

It's also conceivable if we do this correctly and everyone pulls together, everyone in the country, I mean all regions, all states do it together, that we could suppress this to a very, very low level. And once you get the dynamics of the outbreak to a very, very low level, even when you get additional surges, it becomes much more effective to be able to identify, isolate, contact trace. It's very difficult to effectively do that when you have 100, 200, 300,000 cases a day, it becomes virtually impossible to do identification, isolation, and contact tracing. So that's what we're looking forward now, to get that level of virus extremely low in society.

Ian Bremmer:

What's your best sense now, I know, and you've acknowledged that there's been some confusion around this, around when healthy Americans are going to be able to get vaccinated?

Anthony Fauci:

When you say healthy Americans, you mean people who are not in any of the priority groups?

Ian Bremmer:

Exactly. Exactly.

Anthony Fauci:

So I mean, just so that the listeners would understand, and now most people appreciate that when you have a discrepancy between supply and demand and you have to prioritize people, that you have to put various levels of priority. The first 1A were people who were healthcare providers and people in nursing homes, and then 1B, people who have essential jobs in society as well as the elderly and on and on and on. So you're asking when do you get to a healthy young person who has no priority?

Ian Bremmer:

Right.

Anthony Fauci:

Well, I had originally said April. I think that's probably too early because I believe given the pace at which vaccines are coming in now, by the time we get the elderly and those with underlying conditions and the other people in society, it probably won't be until May or June before we can at least start to get the normal non-prioritized person vaccinated. As the president said correctly, by July we will have enough vaccines to vaccinate everybody in the country and it would merely be a logistic challenge of getting vaccines efficiently into the arms of individuals. And that's when you'll start seeing the kinds of vaccine programs where you may open up a big auditorium or a stadium and have people lined up to come in where it's just a question of getting a lot of vaccinate tours.

Ian Bremmer:

So that is relatively soon and certainly a great story compared to where we were three months ago, six months ago. I'm wondering from a science perspective, taking the politics away, once we've gotten to the point that we're able to vaccinate people outside of priorities in the US, would you say it would be better to also be able to export vaccines globally to the priority groups in other countries around the world?

Anthony Fauci:

Well, certainly if you have enough vaccine to do that, we are part of what's called COVAX, which is that consortium of countries and organizations like Gavi and CEPI. The president just a few days ago has indicated that we'll be giving a total of $4 billion, $2 billion essentially right away and $2 billion a little bit later. So we are importantly part of that global effort to get vaccines to people in the developing world. The reason for that is multi, certainly more than one reason. There's what I consider the important humanitarian reason, just the same as we did with HIV and PEPFAR, that we made a commitment that we have an obligation as a rich country, as well as other rich countries, that we don't have people throughout the world who are suffering and dying merely because of where they live or where they were born.

There's also another reason, is that this is a global pandemic and you control a global pandemic by having a global response. If we and some other developed countries are the only ones that are actually putting all of our effort in getting the particular epidemic in our own country under control, as long as there's outbreaks anywhere in the world, everywhere in the world is in danger. And that's the reason why we have to have a global pandemic response so that we get all the countries, even countries who can't afford or don't have the resources to get vaccine, need to be helped out. And that's why we have COVAX and other approaches that will be taken.

Ian Bremmer:

So global coordination and US export as quickly as we can is what we should be shooting for?

Anthony Fauci:

Well, I'm not so sure export of vaccines because we don't have enough vaccines right now here. I'm talking about we can financially, what the president is doing is talking about $2 billion now and $2 billion in a bit. Yeah.

Ian Bremmer:

So let me ask you, I mean, a lot of people have been frustrated about school reopenings. Lord knows it's a difficult topic for people that are trying to juggle everything once they have kids at home as well. Can you explain to frustrated parents who are watching gyms reopen and restaurants reopen, why so many schools are still closed across the country? I mean, how much of this is teachers unions? How much of this is politics?

Anthony Fauci:

It's a combination of so many things. I wouldn't say it's politics, but it is a concern on the part of the teachers, a concern on the part of the parents often. I know many parents do want their children to get back in school. It's a complicated issue. So what I would say, and I've said this well before the guidelines that the CDC came out with were actually out, that the default position should be that we do whatever we can as best as we can to get the children back in school and staying in school to the extent we can possibly do this. That should be a very high priority. And what we would have to do in order to reach that priority would be to put the resources in to be able to have a situation where getting them back to school pays a great deal of attention to the safety and the welfare of the children, of the teachers, and of the other educational personnel in the school.

That includes doing things like prioritizing teachers to get vaccinated. I'm not saying that it has to be a sine qua non where you don't go back to teaching unless you're vaccinated, but we should be making them in our prioritization a very high priority among essential personnel. And the guidelines are really a layered mitigation description, which, if followed, I believe will make it safer and easier to get the kids back to school.

Ian Bremmer:

Now remember again, the last time we spoke, we talked a little bit about anti-vax sentiment and it was seen as more of a fringe issue. Increasingly it's becoming more significant. Obviously it's more of a priority given what's happening in the world, but also becoming more of a partisan issue. So many more Republicans saying that they are not prepared to get vaccinated. Now, given the success even under President Trump of Operation Warp Speed, why do you think that we have seen the politicization of vaccines and anti-vax sentiment?

Anthony Fauci:

Well, the vaccine hesitancy is a multifactorial issue. It's not explained by one thing. I believe that there certainly is an element of politicization of public health measures. I believe that's less a case of getting vaccinated. Namely, people might not want to wear masks because that can be a political statement, as we know. Unfortunately, what we've experienced over the past year. But people getting vaccinated are a number of reasons. Some people are fundamentally anti-vax, anti-science, that's the first thing. Others have misperceptions about the safety of the vaccine. Others like minority populations historically have not been treated well by federally backed health systems. That infamous many decade ago issue with Tuskegee.

Ian Bremmer:

Tuskegee, yeah.

Anthony Fauci:

Well, which most of the young African-American individuals today weren't even born that during that time. But it gets passed down generation to generation about not trusting the federal government. And that's the reason why when people are hesitant for that reason, you should respect their hesitancy and explain that what we have in place now are ethical guidelines and ethical constraints that would never allow that to happen again. And then answer the questions of why many people are hesitant or reluctant to get vaccinated.

One of the most common is they say, "Well, it was so fast." We always talk about vaccines requiring years to develop. We just found out about this virus in January of 2020 and in less than a year you're putting vaccine doses into people's arms. It must have been cutting corners or sacrificing safety. And when you explain to people that this is just a reflection of the exquisite advances in the science of vaccine platform technology and immunogen technology that had gone over for years and years before this outbreak. And I think if you go step by step and explain to people, we can win more people over than you can imagine. There will always be a hardcore group of people who would not want to be vaccinated. But I think so many people, their hesitancy can be overcome by reaching out to them in a respectful way.

Ian Bremmer:

So as you said, Dr. Fauci, we have two major tools, one that everyone has right now, which is their personal behavior, one that we're rolling out as fast as humanly possible, which are these vaccines and doing a better job in the US than most countries around the world to be sure. There has been a lot of questions and a lack of clarity around once you get your second jab and you wait a few days and you've got your level of immunity, Moderna, Pfizer, how can you change your behavior at that point? What's it like for an American who's now gone through their two vaccine jabs, they've done everything they're supposed to do, they've been under lockdowns, they've had the mask on, they've been socially distancing, they've been not living life the way we'd like to for a year now, how does it change once they've gotten their second jab?

Anthony Fauci:

It'll change gradually because you want to accumulate data to make sure that, in fact, the society, there are two elements here, there are you, yourself and the danger to you if you are vaccinated versus what is outside and the dynamics of the outbreak outside of your own individual situation. Because if you are vaccinated and you're like five to 10% of the country's vaccinated, 15%, and there's still an average of 68,000 infections a day, what you can do outside, what society will allow you to do. Just because you are vaccinated, restaurants are not going to open. Ball games are not going to be played, necessarily. Theaters are not going to be open. So what you are going to be able to do is really going to be reflective of what your own degree of safety, what you yourself can do. You can be in your house, your members of your family are also doubly vaccinated.

You can very likely put the kinds of public health measures that you would do if it were complete stranger when we're very likely going to get there. There haven't been a formal recommendation yet to say that. We're looking at that because people are asking that question continually, particularly as every day and week goes by, more and more people get vaccinated. So what we're going to be trying to do very soon, I hope, is to come out with some specific statements about if you are in this category, this is what you likely can do. But right now, the way things are right now, given the degree of infection and the dynamics of the virus in the community, that's the reason why we say you still have to wear a mask even though you're vaccinated because you could get infected, not know it and be completely without symptoms because the vaccine is preventing you from getting symptoms. But you can have virus in your nasopharynx and then inadvertently and innocently pass it on to someone else who's not vaccinated. That's the problem we're facing.

Ian Bremmer:

And that's likely, those rules for individuals being vaccinated are some basic guidelines for all of them that will be clear around behavior, a matter of days, weeks? Do you have a sense of when that's going to be?

Anthony Fauci:

I think as we start to get a substantial proportion, I don't want to give a date on it, then someone will call back and say, "You gave the wrong date." I think I hope it's soon. I hope it's within the matter of several weeks to a month or more. So that when you start to get really a larger proportion of the population vaccinated, people are going to say more and more, "Hey, wait a minute, what can I do and what can't I do now that I'm vaccinated?" It's a very reasonable question.

Ian Bremmer:

So just looking forward a little bit before we close, I mean, how does this movie end in your view, is this something that becomes endemic? Is it probable that we have annual boosters? What does it look like after everyone is vaccinated in the country?

Anthony Fauci:

To be honest with you, Ian, we don't know. We can't be certain. If we nail this down in the sense of getting the overwhelming proportion of the population vaccinated and we get herd immunity within our country, things could change dramatically, at least for the time being in our country. The wild card in all of this is that if we don't control it at the global level, there's always the danger of outside world where there's a lot more virus. If we don't get the world and the global response, that we can get variants that could come back into the country and regenerate outbreaks. Which gets to what your question is, are we going to have a cyclic problem here that every year we got to worry about variants coming in from other country?

The answer is, I don't know. But I believe the more aggressive we are in vaccinating ourselves, in contributing to the global effort to suppress this globally, not only within our own country, the adherence to public health measures that are so important, it is possible that we could do with this virus what we did with polio, what we did with smallpox and what we did with measles, which it was essentially eliminated as we did with measles in this country and eradicate it as we did with smallpox. That's conceivable, but we've got to put a lot of effort into that.

Ian Bremmer:

And I know this has been a horrible year to live through, but on the back of it, do you think we are better prepared for the next pandemic when it comes as a consequence?

Anthony Fauci:

Well, we have seen the things that we have got to do. We've seen what doesn't work. We've seen the importance of cooperation and collaboration at the state and federal level, the importance of local public health systems, the importance of transparency. Importantly, the one thing that was and is a resounding success in this terrible year that we've been through is the biomedical research enterprise, which gave us in record time vaccines that are not only safe, but they're highly efficacious. Could you imagine what things would be like if we did not have a vaccine? There would not be a light at the end of the tunnel right now. And right now there is. If we go at it, get people vaccinated and abide by public health measures.

Ian Bremmer:

Dr. Anthony Fauci is one of the busiest men in America. I really appreciate you joining us today.

Anthony Fauci:

Good to be with you. Thank you for having me.

Ian Bremmer:

That's it for today's edition of the GZERO World Podcast. Like what you've heard? Come check us out at gzeromedia.com and sign up for our newsletter Signal.

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The GZERO World Podcast is brought to you by our founding sponsor, First Republic. First Republic, a private bank and wealth management company, places clients' needs first by providing responsive, relevant, and customized solutions. Visit firstrepublic.com to learn more.

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