Oct. 22, 2020 -- With cases continuing to rise in many states and a vaccine yet to come, Americans should prepare to wear masks and social distance for quite a while.

People will likely need to wear masks and follow social distancing guidelines through the end of 2021 and into 2022, one of the nation’s top infectious disease experts said during a recent meeting, according to The Philadelphia Inquirer.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, spoke about the future of COVID-19 during a virtual meeting with doctors and students at Thomas Jefferson University in Philadelphia last week.

“I feel very strongly that we’re going to need to have some degree of public health measures to continue,” he said.

“It’s not going to be the way it was with polio and measles, where you get a vaccine, case closed, it’s done,” Fauci said. “It’s going to be public health measures that linger for months and months.”

Coronavirus vaccines -- once approved and distributed widely to the public -- won’t be a “knockout punch” that eradicates the virus, he said. Instead, he expects the process to take time and anticipates a 70% effectiveness rate for an approved vaccine. Public precautions such as face masks and social distancing will need to continue during the distribution process.

“I think we’ve got to set reasonable expectations,” Fauci said. “If I’m surprised pleasantly, so be it.”

At least one of the COVID-19 vaccine candidates will likely have enough data about its safety and how well it works to pursue an emergency use authorization from the FDA by the end of this year, he said. Full approval would come after that, and distribution would start in the first quarter of 2021.

Dr. Fauci: Not Caring Means You Are Propagating a PandemicWebMD's Chief Medical Officer, John Whyte, speaks with Anthony S. Fauci, MD, Director, National Institute of Allergy and Infectious Diseases (NIAID), about how not caring means you are propagating a pandemic.1167

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JOHN WHYTE: You're watching

Coronavirus in Context.

I'm Dr. John Whyte, Chief

Medical Officer at WebMD.

Today I have a very

special guest.

A man who needs no introduction.

Dr. Anthony Fauci, the world's

leading authority

on infectious disease

and the director of the National

Institute of Allergy

and Infectious Diseases

for more than 35 years.

Dr. Fauci, thanks for joining

us.



ANTHONY FAUCI: Good

to be with you.

Thank you for having me.



JOHN WHYTE: I want to start off

with, you had said a couple

of weeks

ago that we might see 100,000

cases a day.

Do you think, given the surge

of 60,000, 70,000 plus cases

a day, that we're headed

in that direction?



ANTHONY FAUCI: You know,

unfortunately, we might be.

I do hope, uh, and I would like

to say, I expect that we won't

if we handle this properly

by really turning on, you know,

putting our foot

on the accelerator for the kind

of things

that we need to do

with regard to mask wearing,

physical separation, staying

away from crowds, et cetera.



I think we can turn this around.

But when I said I was concerned

that we might be heading

towards 100,000 per day,

you know, I--

I didn't want to, you know,

inappropriately scare anybody.

But if you just take a look

at what's actually happened,

at that time,

we went from 20 to 30,

and then we doubled it.

We went to 40, and then 50, 60,

and now we're at 70.



You know, I don't like to be

prophetic.

But I do hope we don't reach

that and that we actually turn

it around in time.

But, you know, the virus is-- is

a very formidable foe here.

And the only way we're going

to get our arms around it

is by doing the things that we

know work.



And we do know that avoiding

physical contact,

putting masks on,

not going to crowds,

closing the bars, that's

the answer.

It really is.

So we can do it.

There's nothing about this

that we can't do to turn it

around.



JOHN WHYTE: So why aren't

the public health guidances

working in some populations,

particularly a younger

population, which is attributing

for some of that surge in cases?

Is it-- is it a failure

of effective communication?

Wh-- what's going wrong here?



ANTHONY FAUCI: No, I think

they're--

I think it's multifaceted.

I don't think you could put

your finger on one thing.

But the one thing that I think

is important,

and I've been analyzing this,

really, for quite a while,

is that, particularly

with young people, and clearly

young people are driving

this new surge.



Because if you go back and look

at the demography

of the new infections,

the age group is at least 15

years younger than what we were

seeing a few months ago when

things were surging in New

York when they got

hit very badly.

So what happens

is that younger individuals who

generally, statistically,

are not going to have symptoms

to the frequency

that elderly people do.



They're not going to get very

sick.

They know that.

So what I think is happening

is that, understandably,

innocently,

but not correctly, the younger

individuals are saying, well,

if I get infected,

so the chances of it

is that I won't even have

any symptoms, so who cares?

That's a big mistake.



Because by allowing yourself

to getting infected or not

caring if you do get infected,

you are propagating a pandemic.

Because it doesn't end with you.

You get infected and have

no symptoms.

The chances are you're going

to infect someone else, who will

then infect someone else.



And then someone who's

vulnerable

to severe consequences

will get infected.

That could be somebody father,

mother, or grandmother.

It could be a sick child who's

an immunodeficient child.

It could be a woman who's

on chemotherapy for breast

cancer.

Then all of a sudden, you're not

operating in a vacuum.

You're part of the problem as

opposed to being part

of the solution.



So somehow, we've got to keep

getting that message across.

And I don't mean in the sense

of blaming anybody.

Because these are people

that are doing this innocently

and inadvertently.



JOHN WHYTE: Do you think

language comes into it?

You know, we're

both interested

in the public health.

We're using words

like asymptomatic,

presymptomatic.

Those aren't terms

that the public knows.

And often, different groups

have used them

in different ways.



ANTHONY FAUCI: You know, you had

a very good point there.

We have got to outreach

to the individuals involved

in a manner in which they pay

attention and can understand.

And that's the reason why I

often do discussions

and podcasts with groups

that they listen to,

as opposed to,

you know, an old guy in a suit

like me, who is not, you know,

really, statistically, why they

would want to listen to somebody

like that.



And get rap groups and--

and people that they look up

to in the entertainment

field to help out.

You know, I've done Instagrams

with people like Julia Roberts,

and--

and podcasts with rap groups

like Lil Wayne and others.

I think those are the ones that

are going to get

to the young people.



JOHN WHYTE: Is there a distrust

of science?

You've talked a little bit

about that.

Have people lost their way?

I was saying to a friend

earlier,

as-- as I'm sure you know,

sometimes you're referred to

as St. Anthony.

He's that patron saint of lost

things, as I'm sure you know.

My mother loved St. Anthony.

But have the public lost

their faith in science?



ANTHONY FAUCI: Well, I think

we have to face the reality

that we do have an anti science

trend in this country that mixes

with an anti authority trend.

And scientists and regulators

are often equated

with authority.

And there is that pushback,

particularly on the part

of young people,

maybe for some good reasons,

that they've been disappointed

in authority

and have been disappointed

in government.



And they get disillusioned.

And that kind of translates

or measures into an anti science

attitude, which is very

unfortunate, particularly when

you're in the middle

of a pandemic and you're

trying to deal with it.

There isn't anything worse

that you have as someone who

doesn't care about the science,

which is clearly trying to tell

you to act in a certain way.



JOHN WHYTE: It seems as

if almost everyone is

their own expert.

From the perspective of,

you have your opinion as a--

as a, you know,

infectious disease expert.

And someone else will say, well,

that's your opinion, Dr. Fauci.

I have mine.

Isn't that part of the problem?



ANTHONY FAUCI: Yeah.

I mean, people's opinions

are a fact of life.

What gets,

um, I think troublesome,

is when people develop

their own set of facts.

Facts don't change.

So you can have

a different opinion,

but facts are consistent.

That's the problem.



JOHN WHYTE: All right.

Well, let's talk about facts

and vaccines,

because you've been very

positive about having a vaccine

very soon.

And I want to ask you

about that.

I don't know if you saw

an article by the CEO of Merck,

who he talked about

that the vaccine hype is doing

a disservice to the public.

How confident are you, Dr.

Fauci, that-- that we're going

to have a safe and effective

vaccine

within the next few months?



ANTHONY FAUCI: Well, I--

I wouldn't say

the next few months.

But let me tell you what

the timetable is.

I-- I wouldn't call it hype.

I think what it is is utilizing

the current 21st century

technology, platform technology

that we have,

to really make advances quickly

in ways that would have taken

years before that now takes

weeks to months.



And we've already shown that

by going from the sequence

of the virus in early January

when it was put

on a public database,

to go literally, within days,

within days into a vaccine

trial, because you could put it

into an mRNA platform

or another platform.

And then 62 days later, enter

into a phase one trial.



That is amazingly

unprecedented in every respect.

Right now, we're going to go

into a phase III trial

at the end of Ju--

July.

And there are several candidates

that are also lined up

to go into a phase III trial

soon thereafter.



JOHN WHYTE: At least four

candidates.



ANTHONY FAUCI: Yes.

Yes, at least four.

At least four

that the NIH

and the federal government

is helping to subsidize

and to collaborate

with with regard

to clinical sites.

So, you know, I--

I don't think that it's hype.

It's real.

There is risks to be taking,

but they're financial risks.



They're not risks to safety.

They're not compromising

scientific integrity.

So if things turn out the way we

would hope they do, and--

and whoever makes that comment

is right that you can never

guarantee something.

I would use the words that I'm

cautiously optimistic that we're

going to get there.



Anyone who guarantees something

when it comes to vaccine

hasn't been involved

in developing vaccines,

because we know we can't

guarantee it.

But we can be pretty optimistic

that we're on a timeline

that we should know by the end

of this calendar

year, the beginning of 2021,

whether we have

a safe and effective vaccine.



And looking

at the preliminary data

of immunogenicity

from the phase I study, which

showed levels, robust levels

of neutralizing antibodies,

even with the moderate dose

of the vaccine, again, makes me

cautiously optimistic

that we will get there.

So that's something that I think

we don't--

we really don't think is hype.

We think it's realistic, as long

as you don't feel that you're

going to guarantee something

but you're optimistic that we're

going to get there.



JOHN WHYTE: This is a little bit

in the weeds.

But do you expect it to be

a full approval by the FDA

that it's safe and effective,

or do you think it'll

be utilized under an emergency

use authorization?



ANTHONY FAUCI: You know, that's

a good question.

And it's really going to depend

on the level of infection

in the community.

Right now, there's

enough infections going around

in the United States,

and we even have sites

in other countries like Brazil

and South Africa,

that if you get enough hits,

in other words,

enough infections,

and you have enough people

on the trial

and it's 30,000 people

per trial, that you likely would

get an efficacy signal.



And if you get

an efficacy signal, then you

will get a full approval

by the FDA.

If you don't get that,

because the cases tend to simmer

down a bit, then you're thinking

maybe in terms of an emergency

use authorization.

I don't want to get ahead of

nor speak for the FDA.

But generally, they are--

we're working very closely

with the FDA, and they are

telling us that they want to see

a safety and efficacy signal

on the vaccine as opposed

to anything less than that.



JOHN WHYTE: And back

to this infection rate

in the community.

The CDC director has talked

about if we would all just wear

a mask for three to four weeks,

we could decrease incidents

dramatically.

What's your thoughts

about the need

for a full lockdown for a couple

of weeks

to truly stop the spread

of the virus?



ANTHONY FAUCI: We would like

to avoid a full lockdown if we

possibly can.

What we feel we have to do

is pull back a little.

You know, in the guidelines

that we put out some time ago,

we said there's a gateway, which

means a preliminary look to keep

the infections going down for 14

days.

Then you go to phase I. And then

if that works,

you go to phase II, then

to phase III.



What states and cities might

have to do is to backtrack a bit

and come back a little.

That doesn't mean you have to go

all the way back to lockdown,

but you need to pause and take

a look at what's going on

and why it's not working.

And what you do,

you may need to pull back

a little on the phase you're in

and then say, OK, we have

a problem.



Close the bars.

Everybody wear a mask.

Physical distancing.

No crowds.

Wash your hands.

And I agree completely with Bob

Redfield, the CDC director,

when he says that--

that if we do that, we can turn

this around.

We can turn it around.



JOHN WHYTE: You know, part

of the challenge of getting

people to adopt these behaviors

is misinformation.

You know, how do we counter

that misinformation out there?

That masks don't work,

that physical distancing doesn't

work.

How do we be more

effective in getting people

to adopt these strategies

through communication?



ANTHONY FAUCI: It's not easy,

but we've got to counter it

by pounding away

at the real truth.

So when you have misperceptions,

let's get the right perceptions

there.

Just need to keep going out

and talking about it

more and more, very much

like we're doing right now.



JOHN WHYTE: You know, what's

on everyone's mind right

now is the reopening of schools

and having to make decisions now

when they don't know what things

are going to look

like in late August

or September.

Can you talk a little bit about,

you know,

what we know about COVID

in children, and how parents, we

have a lot of parents

that-- that watch the show, how

parents can make decisions

about whether

or not to send their kids back

to school?



ANTHONY FAUCI: Great.

That's a critical question,

because it's on everybody's

minds right now.

So the way I look at it,

I want to go to 40,000 feet

and say, let's take a concept.

And in my mind and the mind

of-- of people who really care

about this, like representatives

in the American Academy

of Pediatrics,

who say the default position is

that we should try

to the best of our ability

to get the children back

to school and keep the schools

open because

of the considerable deleterious

downstream ripple effect

negative consequences of keeping

the kids out of school.



That's a default. But it really

is going to depend on what

the viral activity is

in the place

that you are right now.

So there are some counties,

you know, we have 3,007 counties

in the United States.

Google it.

I didn't know that.



JOHN WHYTE: I did not know that.

That's good to know.

All right.



ANTHONY FAUCI: And as a matter

of fact, as a matter of fact,

there are some counties where

there's

so little viral activity, you

could just say,

don't worry about it.

Go back to school.

But there are others,

and I think these are the ones

that you're referring to,

where there's enough activity

where you've got to make

a choice.



And the choice can either be,

don't bring the kids back

or, preferably, bring them back

in a way that is very, very

geared towards guaranteeing

their safety, and their welfare,

and the safety and the welfare

of the teachers.

And that might be

simple logistic things,

like spacing of desks,

alternating schedules,

and cleaning down the classes.



Outside as much as you possibly

can versus inside.

There are creative ways of doing

that.

I think to say it's

unidimensional is missing

the point.

To say, we are going to open up

schools in the United States

or not.

That doesn't make any sense,

because we're

such a big, big country,

that things are going to be

different in one

region versus the other.

But getting back to what I said.

The default should be, try

as best as possible to get

the children back to school.



JOHN WHYTE: Does it matter

by age?

We need to be more focused

on our younger kids

getting back to school

because there may be less

transmission, they don't really

serve as a vector as opposed

to some of the older kids?



ANTHONY FAUCI: Well, you know,

that's a good point.

And-- and we, you know, there's

not a lot of data,

even though there's a lot

of anecdotes.

There's not a lot of data

on the infection susceptibility

of kids and how well or not they

transmit to adults.

That's the big question.



We're doing a study at NIH

that we started on May 1

called the HERO study, which

is Human Epidemiology,

et cetera, et cetera, looking

at 6,000 people in 2,000

families

to look at the incidence

and the prevalence of infection

in children.



What the relationship

between their infection

and family members,

do they transmit it

to the family or does the family

transmitted to them, what

is the impact of having

underlying asthma

and underlying

allergic conditions, et cetera.

So this is an ongoing study

that's going to answer

the questions that you and I are

asking but we don't have

an answer to.



JOHN WHYTE: Now Dr. Fauci,

at WebMD, we're seeing a lot

of traffic in terms of anxiety

and stress.

And one of the things that we've

been talking about to people

that come to our site

is, you know, taking care

of their mental health,

taking a break from the news.

So I know a lot of folks

want to know what does

Dr. Fauci do to take a break.



And I saw that, you know,

you've been an avid jogger.

Now you're a power walker.

Some of my colleagues said, I

must ask you what's

on your playlist.

If you have one, or do

you walk in silence when you're

power walking?



ANTHONY FAUCI: No, I walk

with my wife and my daughter's

dog.

And I-- and I use it

as to have--

you know, it's interesting.

I would love it to be

some conversations that I have

with my wife, who's the closest

person in the world to me.

But we're so busy, both of us,

that we often don't have

a chance to talk.



But when we're out on a three

and a half, four mile walks,

it's a wonderful time.

It's wonderful because I get

a chance to talk to my wife.

But it's also wonderful

because we love the dog

and it's nice being

with the dog.



JOHN WHYTE: What kind of dog

is it?



ANTHONY FAUCI: You know,

it's a mutt,

but it's-- it's very heavily

genetically programmed towards

being a Rhodesian Ridgeback.

A nice dog.

A very kind and very lovely dog.



JOHN WHYTE: And finally, what--

what are you hopeful for, Dr.

Fauci?



ANTHONY FAUCI: You know, I'm--

I'm hopeful to what I think

we all all are,

that we're going

through a terrible experience

right now.

We've got to get control of it,

get it behind us,

and keep it behind us.

And we're going to do it

with a combination

of public health measures

and scientific advances,

like vaccines and therapeutics.

This will end.

Doesn't seem that way now

because we've been immersed

in it for the last five to six

months, but it will end

and we will get back to normal.



JOHN WHYTE: When's it going

to end?



ANTHONY FAUCI: You know, I hope

sooner rather than later.

I don't think it's going to be

next month, and it may not

be for another year.

But it's going end.



JOHN WHYTE: Dr. Fauci, I want

to thank you for taking the time

today, as well as all you're

doing to keep America

and the entire world safe.

You truly are a hero.

Thank you.



ANTHONY FAUCI: Thank you very

much, John.

It's good to be with you.

Take care.

John Whyte, MD, MPH. Chief Medical Officer, WebMD, Anthony S. Fauci, MD, Director, National Institute of Allergy and Infectious Diseases (NIAID)/delivery/aws/b9/09/b909485e-f78b-332b-bd9d-d41c76d75385/Fauci_071720b_,4500k,2500k,1000k,750k,400k,.mp407/17/2020 23:30:0018001200Fauci_071720_1800x1200_WebMD/webmd/consumer_assets/site_images/article_thumbnails/video/covid19-images/Fauci_071720_1800x1200_WebMD.jpg091e9c5e81f6b635

Fauci also pushed against the idea of “focused protection,” or an approach to herd immunity that protects older adults and vulnerable groups but lifts restrictions for everyone else. Although more older adults die from the coronavirus, people of various ages and health conditions have contracted severe COVID-19, he said, and it remains a “puzzle” why about 40% of people are susceptible to severe forms of the disease.

“We shouldn’t be lulled into complacency that this is only an old person disease,” Fauci said.

The best way to achieve herd immunity is through a vaccine, he said. Otherwise, a large number of people will die by simply allowing everyone to become infected with the coronavirus. A “profound degree” of herd immunity won’t likely happen until the end of 2021 or beginning of 2022, he said, which is why he predicts public health measures such as face masks and social distancing will continue until then.

Those public health measures are particularly important now as coronavirus cases continue to increase across the country, especially in the Midwest, CDC officials said Wednesday.

“Unfortunately, we’re seeing a distressing trend here in the United States, with COVID-19 cases increasing in nearly 75% of the country,” Jay Butler, MD, the deputy director for infectious diseases at the CDC, said at a media briefing at CDC headquarters in Atlanta, according to CNBC.

“Smaller, more intimate gatherings of family, friends, and neighbors may be driving transmission as well, especially as they move indoors,” he said.

Butler said COVID-19 cases are growing “really in all parts of the country,” and although people are growing tired of the safety precautions, they’re still important.

“We’re tired of wearing masks, but it continues to be as important as it has ever been, and I would say even more important than ever as we move into the fall season,” he said.

The U.S. is now reporting about 60,000 new daily cases, according to a CNBC analysis, which is up about 17% compared to a week ago. The country has now reported more than 8.3 million cases and more than 222,000 deaths as of Thursday morning, according to data from Johns Hopkins University.

Butler said that a safe and effective vaccine would be ready “very soon” and that he is “cautiously optimistic” that one will be available in limited numbers by the end of the year. Alex Azar, the secretary of Health and Human Services, said two companies making vaccines -- Pfizer and Moderna -- are “very close, if not fully enrolled in their trials.”

Every state has now submitted plans for vaccine distribution, Butler said. The CDC will provide feedback during the next 2 weeks, and then states will be directed to set up distribution centers. The vaccine will be released in stages, likely to front-line health care workers and older adults in long-term care facilities.

“There is hope on the way, in the form of safe and effective vaccines, in a matter of weeks or months,” Azar said.

Show Sources

The Philadelphia Inquirer: “Anthony Fauci talks with Jefferson doctors about coronavirus vaccines, herd immunity, and how long we’ll need masks.”

CNBC: “CDC says the U.S. is now seeing a ‘distressing trend’ in coronavirus outbreak.”

Johns Hopkins University: “COVID-19 Dashboard.”

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