Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), joins Yahoo Finance's All Markets Summit.
ANJALEE KHEMLANI: I'm Anjalee Khemlani, senior reporter here covering all things health care, which means everything COVID as well. And that gives me the responsibility and the pleasure to introduce you to someone who needs no introduction, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Dr. Fauci, thank you so much for joining us today.
ANTHONY FAUCI: Good to be with you. Thank you for having me.
ANJALEE KHEMLANI: I'd like to start off with a debate I'd like you to settle for me, please. And that is, right now, we're looking at skyrocketing cases across the country, setting daily records at more than 80,000 cases per day. You know, people are saying that this is a third wave, but I seemed to have missed that. So I'd like to-- I'd like for you to settle this for me. We're in the third peak, clearly. What wave are we in? Is this an elongated first, a second, a third, please?
ANTHONY FAUCI: You know, I look at it more as an elongated and an exacerbation of the original first wave. If you look at when we got hit badly, which was dominated early on by the Northeastern corridor, particularly the New York metropolitan area, the cases went way up and then came back down to a baseline of about 20,000 cases. So we never really cleared and got down to a very low baseline, which I would consider to be less than 10,000 per day, maybe just a couple of thousand per day. So we stayed at 20.
Then you remember, when we tried to, quote, "open up the economy again" and open up the country, there were several states that did that in a somewhat varied way. Some did not adhere very well to the proposed guidelines. And what you saw, particularly along the southern states-- Florida, Georgia, Texas, Southern California, Arizona-- we started to see a peak that brought us up to around 70,000 per day then it came back down, again, only to about 30,000 to 40,000 and was stuck at around 40,000 for several weeks to if not a month or more. And now, as we're getting into the cold weather, we came back up again to the worst that we've ever had, which was over 80,000 per day.
So if you look at the chart, which you just showed, we've never really had waves in the sense of up and then down to a good baseline. It's been up and wavering up and down until now, we're at the highest baseline we've ever been, which is really quite precarious. So you know, it's kind of semantics. You want to call the third wave or an extended first wave. Number matter how you look at it, it's not good news.
ANJALEE KHEMLANI: That's very sobering, and thank you for settling that. We look at you for guidance for all of what is going on and the advice that you've given, the mitigation strategies. And it seems like you've been able to really get that message out there and directed it to a number of very segmented audiences.
We've seen just how insulated some populations are in this country as a result of this pandemic. How do you decide to, you know, take on some of the media requests when it comes to, you know, shows with celebrities or children's shows? I've seen you on a couple of these. And you make all the time for it, but what goes into that decision of targeting these specific groups?
ANTHONY FAUCI: Well, I try and my colleagues also. I believe that public communication, when you're in the middle of as serious a situation as we are now with this historic pandemic, is absolutely essential. And you try to get to various segments of society. So I mean, yeah, I think you brought up a good point.
I've done things where you appeal to children to try to get them to understand, without frightening them, the crisis that we're going through. You also want to get to the people who are out in the front lines, who are putting themselves at risk. You also want to make sure that the health care providers appreciate-- or realize how much we appreciate them and the risks that they're taking.
But you also have to get to another group that I think is a bit more problematic, the people who, for one reason or other, are getting the misinterpretation that public health measures are in conflict with a healthy society, in the sense of economically. It's kind of pinning the economic interests against the health interests. And I try and get a point-- the point across as often as I possibly can that we shouldn't look at public health measures as something that's an obstacle to the economy. It's a safe and prudent way to get the economy open again.
We're not talking about shutting anything down. Because often, when people hear you want to implement things like universal wearing of masks, physical distance, avoiding crowds, that we're talking about the extreme of shutting society down. We absolutely are not talking about that. We want public health measures to be the gateway or the roadway to safely and prudently opening up the economy again.
So you could have both. You could have good public health measures, and you could still leave the economy open. But when you do extremes, when you either shut down or do anything you want to do, it doesn't work that way. There's got to be a mean in the middle there where you can do both.
ANJALEE KHEMLANI: And that's a message that you've definitely been driving in. And unfortunately, you know, against your best efforts, you've also met with some pushback, either from the public or even from the president. And so I wonder, you know, as you continue to tirelessly send out these messages, you're also met with having lived through, unfortunately, a very public experience of what many of us fear, which is a toxic work environment. And you've said you've stuck strictly to business on this front, but I wonder, does it undermine your message to have the president constantly say things that are the exact opposite of what you're saying?
ANTHONY FAUCI: Well, I would say it's certainly not helpful, but that's something that I really don't think I should be, you know, wringing my hands about what I do since there's a limited amount of time in the day and to just get your energy focused, as I say, like a laser on what you know the proper and appropriate public health measure is and hope that people hear you and understand that adhering to public health measures now is going to make it easier-- and more quickly getting to where we want to go is to approaching some form of normality.
Luckily, despite the fact that we're dealing with a very, very challenging period right now, even more so as we enter the cooler months of the fall and the colder months of the winter, that vaccines are proceeding at a very good pace. And we should be on time to get an answer-- and I think it will be a positive answer-- by the end of this year-- the end of November, the beginning of December-- so that we can start distributing vaccine to those who are most in need, particularly health care workers and the vulnerable among us in the population.
So that will help a lot, but it's not going to be solving the problem by itself. We will not be able to abandon prudent public health measures for quite some time right now. We've got to make sure that's going to be part of what we do without closing the country and without closing the economy. We can do this. I'm absolutely convinced. If, as a nation, we pull together and do some fundamental, common-denominator public health measures, that we can get through this with a lot of help in the future from vaccines and adequate therapies.
ANJALEE KHEMLANI: I'm glad you brought up the vaccines because that's definitely something, you know, everyone is focused on, especially, as we know, the deadline is coming to get some of those interim results and first looks at the data. I wonder about the effectiveness. That's something that has been a topic of conversation, and I've heard a broad range of commentary from, you know, it will block the virus entirely to it will simply diminish, you know, the most severe cases. And if anyone experiences the virus, it will actually just be a sort of milder version. So based on what you know right now and what you're seeing, do you anticipate that the first sets of vaccines out the door will be more of a less effective blocker of the virus?
ANTHONY FAUCI: Well, that's the primary-- it's a great question, and that's the primary endpoint of most of the virus is to prevent clinical disease, to prevent symptomatic disease, not necessarily to prevent infection. That's a secondary endpoint. But the primary thing you want to do is that if people get infected, prevent them from getting sick. And if you prevent them from getting sick, you will ultimately prevent them from getting seriously ill. So that's what we want to do.
The first point, which we call a primary endpoint, is that. If the vaccine also allows you to prevent initial infection, that would be great. But what I would settle for-- and all of my colleagues would settle for-- is the primary endpoint, to prevent clinically-recognizable disease. And that's what we hope happens. And if we do, that will go a long way to diffusing this very difficult crisis that we're in.
ANJALEE KHEMLANI: Of course. And going to the point that you've made that the vaccine won't be the end of the story, definitely mitigation tactics will remain in place for some time. Going onto the trials themselves, it seems like the UK is setting up to do a challenge trial. And while we already have some vaccines in late-stage trials here, it does seem that with the number of candidates out there, there's some room for using this strategy. Is the US setting up to do a challenge trial as well?
ANTHONY FAUCI: You know, we really don't think that that's necessary. When you have so many infections-- I mean, we are having in this country, as we started the discussion off, with over 80,000 infections per day. Fundamentally, when you do challenge studies, are a number of reasons, one of the most important of which is that there's not enough disease activity out there for your vaccine trial to give you a definitive answer.
And even though challenge studies may have a place under certain circumstances, it's not the same as the actual circumstances with which a person gets naturally infected. So although you can get some good information from a challenge trial, the real-world information that you want is out in the field when someone is actually being exposed to natural infection and to determine if the vaccine prevents against that.
So right now, we're not planning any challenge studies because we have so much infection going on. We have five or six vaccines that will be in trial in the midst of these 80,000 per day infection. I think we're going to get enough information that we need to make a decision as to the safety and the efficacy of a vaccine without resorting to a challenge trial.
ANJALEE KHEMLANI: OK. And speaking of that unfortunate number of cases in the country, we know that with the cases rising, you know, being in contact with people is getting more dangerous. When we look at sort of the political climate we're in, having to deal with the campaigning, we still see rallies happening. And I just wonder, you know, with the recent reports of aides to Vice President Mike Pence being positive, should these rallies be canceled at this point, this close to the election day?
ANTHONY FAUCI: Well, you know, I'm not going to comment on whether this or that rally should be canceled except to repeat what I've said many, many times-- and I'll repeat it here-- that we should avoid as best as possible congregate settings, where you have people who are crowded together. If that happens, it should be outdoors. And if that happens, it should be with virtually everybody wearing a mask.
So you know, there are five things that I talk about all the time-- universe wearing of masks, keeping distance, avoiding congregate settings, avoiding as best as possible indoor things, where there are crowded people indoors, and wash your hands as often as possible. That goes for any circumstance, no matter where it is and who's doing it.
ANJALEE KHEMLANI: Speaking of the campaigns, we know that Election Day is near, and there is either going to be a continuation of this administration or a change. I just wonder what that means for you and your work, what a continuation of the Trump administration means versus what expectations you have of a Biden administration, when it comes to dealing with the coronavirus?
ANTHONY FAUCI: Well, from my standpoint, I'm going to be continuing to do exactly the same things that I'm doing right now-- putting a lot of effort into getting safe and effective vaccines as well as better treatments. We have some good treatments. We can do better. We have a number of clinical trials that are going on, for early infection, to prevent the need for hospitalization. That's not going to change no matter what administration is in.
And my message, which is a consistent message, will not change because it really transcends whatever administration. The message is the same. The kind of prudent and careful public health measures that I believe will be able to contain the surges is that we're seeing right now-- none of that's going to change.
ANJALEE KHEMLANI: It seems like whatever you do does have some level of insulation from some outside forces. We've, unfortunately, not seen that with the FDA and CDC. And going global, we've also seen the US sort of miss out in participation with some of these vaccine efforts and other responses. I just wonder-- you know, we heard Bill Gates earlier talking about how China is not, in fact, in the driver's seat when it comes to the vaccine-- but when it comes to the work that your agency can do, if a country like China does, in fact, get more attention, does that sway the ability of the US, and your agency specifically, to do research going forward, to have a commanding voice on the response to the virus?
ANTHONY FAUCI: Not at all. I mean, we-- the NIH and our biomedical research community has always been, is now, and I hope will always be the dominating biomedical research force in the world, and just about everybody admits that. That's not changed. Whether China does what China wants to do or Russia does what Russia wants to do, what we do with regard to science, the development of therapeutics, the development of vaccines is something that the world has always looked upon us for leadership, and it continues to this day.
ANJALEE KHEMLANI: When you talk to some of your foreign peers-- I'm sure you're in constant contact-- is there anything that we could be doing better and should be implementing or other strategies that we haven't tried yet?
ANTHONY FAUCI: Well, I mean, you're absolutely correct. I am in close contact with my scientific colleagues and my public health colleagues, which long, long, long antedated COVID-19, so those relationships stay the same. The part of your question-- when you look at what we've done, could we have done anything different-- it really depends on what you mean.
From a scientific standpoint, I think what is going to turn out-- and I hope so. I don't want to get overconfident in it. But I think one of the real successes that we're going to see over the next couple of months is what's happened in the arena of vaccines, as well as, in some extent, newer and better therapeutics. So I think we can look forward to something positive there.
Could we have done things better from a public health standpoint? Of course. Whenever you're dealing with a very difficult situation like that, you can always look back and say there were things that we could have done better and that we should have done better, but that's just the nature of the situation we're in. I think anyone who says, well, we've done everything perfectly is really not looking at the reality of the fact that when you have such challenges like that, whether you're in Europe or in Asia or in the United States, we can always look back and say we could have done a better job.
ANJALEE KHEMLANI: Certainly. And with the changing information, I've said often, we are watching the scientific process, you know, in a-- under a very public light in a way we never have before. And I think everyone is privy to that now.
Looking at some of the things we've learned, I think this is something that still weighs on some people's minds, where what exactly should we be doing? So for example, bringing your groceries in, is that something that you should still be wiping down, your mail? What do you do, Dr. Fauci?
ANTHONY FAUCI: I get asked that question all the time. Well, we know that this virus overwhelmingly, predominantly, is transmitted by the respiratory route, by either droplets that are large enough, essentially, to travel to get to someone's nose, eyes, mouth or aerosol a little bit. We don't know exactly what the extent of the aerosol is. We know it does play a role. Exactly how much is still being worked out.
We also know that the virus can live on inanimate objects. But if you look at the transmissibility, the epidemiology that we have a lot of experience now, that is very likely a very, very minor, minor aspect of transmissibility. It's-- it-- we can't say it's zero. It certainly is real and it's finite, but it's minor.
So I think we should spend less time worrying about wiping down a grocery bag than we should about just washing our hands frequently. So you ask me what I do when I come from the grocery store or when someone gives me a takeout bag, which I do a lot now because I don't go into restaurants and sit down. I want to keep them going financially, so I do a lot of takeout. So I do have a bag that I bring into my house.
Instead of worrying about the bag, I'll open the bag, and then I'll just wash my hands thoroughly, which is what you should do. I think doing that natural public health measure and not worrying about touching things, things that might or might not have anything to do with transmissibility, just focus on washing your hands.
ANJALEE KHEMLANI: Well, thank you for answering that one. That was a personal one for me. Dr. Anthony Fauci, thank you again for your time, director of the National Institute of Allergy and Infectious Diseases and the US's top epidemiologist. Thank you again.
ANTHONY FAUCI: Good to be with you. Thank you for having me.