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Dr. Fauci: ‘We’re not going to eradicate’ COVID-19

Chief Medical Advisor to the President of United States Dr. Fauci speaks with Yahoo Finance’s Anjalee Khemlani about the state of the pandemic, the response to COVID-19 and its lasting impacts, monkeypox, disease prevention, and stepping down from all positions.

Video Transcript

BRIAN SOZZI: Dr. Anthony Fauci announced he is stepping down at the end of the year. Fauci has been working at the National Institute of Allergy and Infectious Diseases since the Reagan administration, capping off a 38-year career. Joining us now is Yahoo Finance senior health care reporter Anjalee Khemlani, who sat down with Dr. Fauci this morning. Anjalee?

ANJALEE KHEMLANI: That's right. Yeah, Dr. Fauci really had a lot to say about, of course, the ongoing pandemic and all the stuff that we really have to continue to pay attention to, and most notably the fact that living with this virus is something that is truly here to stay. Here's what he had to say.

ANTHONY FAUCI: We are a very big country, a diverse country. We have 50 states and additional territories. And what had happened, right from the very beginning, has been a little bit of a discordance in response of different states and different regions of the country to what should have been somewhat of a more unified response in addressing how we are going to try and control this outbreak from the standpoint, if you look at everything from the willingness to abide by public health recommendations, mask-wearing and avoiding congregate indoor settings, to the willingness of people to get vaccinated, it is really unfortunate.

We, as a rich country, have the accessibility of as much vaccine as we need and want. And yet we only have 67% of the population vaccinated. And only 1/2 of those have received a booster. If you're dealing with the common enemy of a deadly virus that has already killed over 1 million people in this country, I would have hoped that there would have been much more of a unified response directing all of our efforts against what I call the common enemy, the virus, as opposed to the divisiveness that we've unfortunately experienced in this country, which I believe has hindered the most effective response to this outbreak.

ANJALEE KHEMLANI: To that point, I remember early on, the World Health Organization saying that we're going to be living with this virus, at the least, until 2024. Where do we stand on those predictions? And are we still waiting for that mother of all immuno-escaping variants?

ANTHONY FAUCI: Well, I think we're going to be, quote, "living with this virus" well beyond 2024. I would hope that as we approach 2024, we will get much, much more of a control over it so that the level of virus that circulates in the community is at such a low level that it does not disrupt what I refer to as the social order, namely the economy, our ability to interact socially with each other, schools, and things like that.

But we're not going to eradicate the virus from the face of the Earth. We've only done that with one virus in history, one human virus, and that's smallpox. I don't believe we're even going to eliminate it from this country to the tune of getting zero cases, like we see often with measles and with polio, because the viruses are fundamentally different.

Those viruses that I referred to are ones in which, if you get infected or vaccinated, the durability of protection following either infection or vaccination is measured in decades, if not for the lifetime of a person. In addition, those viruses are very stable. Smallpox doesn't change over decades and decades, nor does measles or polio, while we're dealing with a virus that already historically has shown us over the two and a half years that we've been dealing with it that it continues to change with new variants.

And so I don't believe we're going to ultimately truly eliminate it. But what I do believe we'll be able to do, if we get more people vaccinated and pay attention to public health measures, is that we'll be able to get the virus to a low enough level that it doesn't disrupt us. And that may go on for years and years.

ANJALEE KHEMLANI: I'm glad you brought up that point because I want to use the vaccines as an example of just how challenging this virus has been because I think people don't quite understand how much they had a front row seat to the changing of science and the changing of the data. And so initially, you were very excited about the mRNA platform and the protection that it gave us in terms of protecting us against infection, period.

And now with omicron, we can't even get that guarantee of not being infected. But we do still have that guarantee against, at the least, death and in some cases severe cases. So I wonder if you can explain what happened. Why do we have to understand and accept that protection against infection is no longer the baseline?

ANTHONY FAUCI: Well, there are a couple of reasons. One relates to the durability of protection. That wanes over a period of time. The other is that, although these vaccines that are systemically administered protect you against significant, systemic disease, the most important component of which with COVID is lung disease, pulmonary disease, which is the most important pathogenic process when you deal with COVID because the immunity that you get systemically will protect you against systemic involvement.

But the immunity to protect you in the upper airway against initial infection, the best way to do that is what we're trying to do with the next generation of vaccines, which are what we call mucosally administered, namely either with a nasal mist that you spray in through the nose and the upper airway that would give you protection right at the site of entry of the virus. When we get that, I believe the protection against infection will be much greater than we are currently experiencing. [CLEARS THROAT] Excuse me.

ANJALEE KHEMLANI: Another part of this virus being a challenge was initially just how many organs it attacked and how many different symptoms we saw. I wonder, when it comes to long COVID and what we're seeing the Brookings Institute just saying that we have 2 to 4 million people out of work right now because of long COVID how should employers be thinking about that? Is this a mass disability event that we're going to be needing to pay attention to for a long time to come?

ANTHONY FAUCI: Well, we certainly need to pay attention to long COVID because it's a real phenomenon. We are still learning a lot about it, such as what the true prevalence of it is and how long it would last because we don't have long-range experience. We know that a disturbing percentage of people, when they recover from the acute phase of COVID-19, even if they don't necessarily have overly severe symptoms, they still can be afflicted with long COVID, which is very variable in its manifestations, from anything from mild to moderate fatigue upon exercising to, in some cases, rather significant incapacitation on the part of people. We're studying it intensively.

In order to do something about it, you have to understand what the underlying pathogenic mechanisms are. And when you do, and hopefully we ultimately will understand that, then we could talk about more specific ways to both prevent it as well as to treat it when it occurs.

ANJALEE KHEMLANI: Absolutely. And one of the things I want to pivot to is misinformation and disinformation, something that you have really had to fight more so than ever before in this pandemic, going into the political divisiveness but beyond that as well. I wonder, looking to the future and when you do step down, what are some notes you would have for your successor? What are some skills that they're really going to need to have in order to thrive in this environment?

ANTHONY FAUCI: Well, they're going to need some skills. But also what happens is also going to depend on what happens on the outside, the degree of pushback against science. The advice I strongly would give is stick with the science and the evidence and the facts. And realize that, as you learn more and more-- and we are still learning every day, every week, every month-- that things change, the evidence changes, the data change.

And you've got to be flexible enough to be able to appropriately and adequately communicate to the American public, without confusing them, how your recommendations or the things that you are providing for guidelines or what have you could actually change over time, depending upon the evolution of the scientific data.

ANJALEE KHEMLANI: Right. I wonder, with all of that under your belt and all of that reflection, do you think we're ready for the next pandemic?

ANTHONY FAUCI: Well, we thought we were ready for this pandemic, and we were judged by independent organizations that the United States was the best prepared for a pandemic. And yet when you look at what happened to us as a country, we were as severely or more severely hit than many, many other countries. And the deaths per million population in the United States is higher than any country in the world.

So there's a lot that we need to do to improve not only the preparedness but the response. And hopefully, you do that by learning lessons from what you have experienced in the past. And we've had some very painful experience over the last 2 and 1/2 years.

ANJALEE KHEMLANI: Truly painful experience. And something, we're not quite sure if we're ready for the next one. He wasn't quite confident about that.

BRAD SMITH: Yeah, seriously. Anjalee Khemlani, amazing interview there, wide-ranging, and so much depth to really break down from that. Appreciate it.