Dr. Anthony Fauci’s Predictions For Coronavirus

Anthony FAUCI

CNBC Transcript: Dr. Anthony Fauci speaks with CNBC ’s Meg Tirrell live during the CNBC Healthy Returns Livestream today and gives his predictions for coronavirus after Christmas.

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Interview with Dr. Anthony Fauci

MEG TIRRELL: Welcome everybody and thanks for joining us for this very special Healthy Returns live stream. I’m Meg Terrell CNBC Senior Health and Science reporter and on this live stream series throughout this year we’ve talked with public health experts, researchers the people that are really helping us understand and get through this pandemic. And nobody has done that more than our guest today Dr. Anthony Fauci is Director of course at the National Institute of Allergy and Infectious Diseases Dr. Fauci, thanks so much for being with us.

DR. ANTHONY FAUCI: Good to be with you thank you for having me.

TIRRELL: I want to start out talking about next week. It’s your birthday, we understand you’re turning 35. But you know as we’re gearing up for this holiday season. Can you tell us about what you’re seeing from the impact of Thanksgiving, and how you think that bodes for what’s going to happen with this pandemic as we go into the holidays at the end of the year?

DR. FAUCI: Well, the numbers speak for themselves Meg, we are in a very difficult situation as you can see, just a few days ago. We reached the, the landmark of now 300,000 total deaths. We still have between 200 and 300,000 new cases, a day with anywhere between, you know, one and a half to two and a half 1000 deaths per day, hospitals and now about 115 118,000 hospital beds are occupied by people with COVID-19. So we are in a surge that’s rather steep when you look at the inflection of it. There are certain parts of the country.

That seemed to be leveling off a bit, but there are as many that are still surging when we have the Thanksgiving holiday, the travel associated with as well as the socialization of gatherings of family and friends, things that people naturally would do on Thanksgiving, you know you can have you know 10 15, 20 people in your home for a dinner. That’s something that puts one at higher risk. Right now we are probably seeing in some sections of the country, the brunt of the effect of the travel and the congregating for Thanksgiving. That’s going to get now superimposed upon the additional travel that will very soon beginning of the weekend and beyond the travel for Christmas and the same sort of congregating that one does for Christmas.

Those are things that we all love to do it’s part of our tradition. It’s part of things that we enjoy so much with family and friends. But we really really have to realize that puts us in a precarious risky situation. So to the extent possible, we encourage people to curtail the travel that you would normally do under normal circumstances. Keep the gatherings, even family friends to as small a gathering as possible, preferably with people that you’re very familiar with that maybe are in the same household, or have created their own bubble of safety.

So then it is very unlikely that they, would be infected, because otherwise what we will see as we go from December, the end of the month. New Year’s and into January, we may yet see again a surge upon a surge.

So you know we’re going through a very bittersweet period right now Meg because we have the results of at least one and soon two vaccines that are highly efficacious that show promise over a period of several months to really turn around the dynamics of this outbreak. But that’s not going to happen for a while so that would be almost a greater incentive for us to double down and adhere to the public health measures that would prevent further infection until the time when the vaccine actually does have a significant impact on the dynamics of the outbreak.

TIRRELL: Can you help us with some predictions but specifics on what a surge on a surge looks like we’re already at more than 200,000 cases being reported per day, hospitals, more than 100,000 people in the hospital with COVID-19, right now, how much worse does this get after Christmas if we see the same patterns that we saw over Thanksgiving.

DR. FAUCI: Well, you know, not to frighten people Meg but it’s the truth that you can see what I have referred to as a surge upon a surge because if you look at the inflection of the curve of things that they’ve gone up over the last few weeks, as we got into the cold weather, people stayed indoors, they congregated indoors sometimes without masks, the inflection of the curve was like this. It then went like that. So when I say a surge upon a surge.

I mean, instead of leveling off and coming down, it actually continues to go up. And that’s one of the things that we put ourselves in somewhat of a precarious situation, if we don’t take a look at the situation and say, you know, we really need to pull back a little bit, and maybe not do the things that otherwise at this part of the season of the year would be considered normal and do things to a lesser extent, less travel, less congregating less social interaction. We all know how difficult that is because we’ve been under this situation of COVID fatigue, as we call it, everyone is fatigued about this.

We’ve been going through this now for almost a year. But now’s not the time to say you know I’m just so tired of all of that would only make matters worse.

TIRRELL: I mean are you talking about 300,000 cases getting diagnosed today Do we have the testing capacity to diagnose them and are we talking about hospitals rationing care.

DR. FAUCI: Yeah, well that is conceivable if we don’t do something about what’s happening we already are seeing in certain regions of the country, that the health care system the hospital beds, the number of trained personnel, particularly individuals who are trained in intensive care that is stretching to the limit in some places.

And in fact, if you look at the rationale that the health authorities in California gave is that they were perilously close to having a real strain on the healthcare delivery system which forced them to do things like shut down in a number of areas they didn’t want to do that they didn’t they felt that they just had to do it because if they didn’t the increase in the number of cases would take the healthcare system over the limit of what they could tolerate. So those are the kind of decisions that are being forced by this very difficult situation that we’re going through.

TIRRELL: How many more states do you think, are you observing are in that situation right now and that sort of precipice.

DR. FAUCI: You know several. I don’t want to speak for them because they have to make their own mind about it, they’re very very aware of it. We have as members of the task force, at least once a week, we have a governors call in which we interact, virtually like you and I are with the governors of the states, and we find out that you know, although some of them are doing better. Many of them are still in that phase where they continue to accumulate cases that are stretching the healthcare system.

TIRRELL: I want to turn to the vaccine, because it is sort of that, that dawn after the darkest part of the of this pandemic which we’re in right now, but morning is coming. There’s so many questions for you about the vaccine I wanted to start with doing sort of a lightning round, or a little thing I want to call factor fiction with Dr. Fauci and ask you a couple of these myths we’ve kind of been hearing about the vaccine and asked you to tell us are they myths are they true. One of the things we hear from a lot of folks about the COVID vaccines, is people are worried they can get COVID from the vaccine kind of like we hear can you get flu from the flu vaccine, can you get COVID from the vaccine Dr Fauci?

DR. FAUCI: Myth absolutely impossible.

TIRRELL: Okay. With these vaccines that are delivered. What’s that?

DR. FAUCI: But let’s do bullet questions I’ll give you bullet answers. Okay.

TIRRELL: All right, let’s do it. So, these vaccines deliver genetic material messenger RNA or with the next one’s DNA for the spike protein, can they alter your own DNA.

DR. FAUCI: Absolutely not. That is not they’re getting a snippet of RNA which is coding for a protein. It has nothing to do with your own genetic material. It gets injected, it gets into a cell, and it starts pumping out the spike protein that you want the body to make an immune response. And it doesn’t integrate into any aspect of your own genetic material. It’s totally separate from your own genetic material.

TIRRELL: Okay, here’s another thing we hear a lot. This is the fastest development of vaccine in history, it cannot possibly be safe or proven safe in that short amount of time. What do you say,

DR. FAUCI: That’s not true. The speed of it is a reflection of the extraordinary scientific advances that have been made in platform technologies for vaccines. It was not at the expense of safety, nor was it at the expense of scientific integrity. It was purely a reflection of years of work, which antedated this outbreak, which allowed us to do things in a matter of months that formerly a decade ago would have taken several years. In addition, an enormous amount of money.

Hundreds of millions if not billions of dollars were put into the development and the production of vaccine doses, so that they would be ready to give to people. As soon as the vaccine was shown to be safe and effective. So people need to understand speed reflects extraordinary investments in science and has nothing to do with compromising safety or scientific integrity.

TIRRELL: Okay, last question from the lightning round of them we’ve got a slew of amazing viewer questions for you. Fact or fiction, I can stop wearing masks and social distancing once I get my vaccine

DR. FAUCI: Fiction, you need to keep wearing masks and doing the fundamental public health measures. You have to do that until we get enough people vaccinated in this country, so that the level of virus the viral dynamics is so exceedingly low, that it would be extremely unlikely that you would acquire or transmit the infection. So a vaccine should not be a substitute for public health measures. It should be a complement to public health measures. And only after this virus is really under extraordinarily good control, can you start pulling back on public health measures.

TIRRELL: I’m going to get some viewer questions that I’m going to start with one from Hung Tran because it directly follows up with what you were just talking about what percent of the population needs to get vaccinated before people can move around freely without precaution?

DR. FAUCI: Yeah, I would think in order to get herd immunity which is what I believe the questioner is referring to, namely a degree of protection in society that the virus really has no place to go. I would think that you would need somewhere between 70, 75, maybe 80%. of the population vaccinated, the number that I’ve been using again it’s a it’s an estimate. You can make an extrapolation from other infections. I say between 75 and 80 85% of the population.

If we get that we would develop a umbrella of immunity. That would be able to protect, even the vulnerables, who have not been vaccinated, or those in which the vaccine has not been effective, you can get that kind of immunity with that percentage of people, which is the reason why we’re being very enthusiastic in reaching out to the community to convince people of the importance of getting vaccinated, not only for their own safety, but for that of their family as well as for society in general.

TIRRELL: And how do you think about the number of people who’ve already had this disease in terms of them being protected and having immunity from getting it again.

DR. FAUCI: One thing we’re not certain of Meg is what the duration of immunity following infection is, We don’t know that because we’ve only been dealing with this particular virus for 10 to 11 months. And so we don’t know whether if you get infected, that you have immunity for a year or two, or three, or maybe even less than a year. That is going to be determined as we follow people over the subsequent years. So that’s what we mean when we say we’re uncertain as to how long a person is protected following the time they get infected and recover from infection.

TIRRELL: Now we’ve got a lot of questions for you here from folks who want to know if the vaccine is safe for them. I’m going to sort of put them all together here but they’re from Sushma Bhatt who asks, as we know there are multiple companies developing vaccines and will be distributing them for the general population very soon.

What is Dr. Fauci his recommendation in decision making, of which vaccine is more effective to take, especially for high risk individuals like me, who have an autoimmune disease such as lupus, and then I’m going to go right into Sam Burnett’s question who asks about side effects for patients with Parkinson’s, should they get the vaccine or wait. Michelle Lock asks, Is the vaccine safe for women who are breastfeeding Mia Lee asks, penicillin allergy bee sting allergy, and we take the vaccine. I know I just put a lot on either Dr. Fauci but do we have answers for these groups.

DR. FAUCI: Well we have answers for some that are clear answers and some that would have to await further information. So right now, there is a single vaccine that is available for people it’s the Pfizer messenger RNA vaccine. Tomorrow, the FDA will hopefully make a decision regarding whether or not the Moderna messenger RNA vaccine will get an emergency use authorization.

So the recommendation is that, look at the vaccines that are available. The availability and the prioritization will be made according to the recommendation of the Advisory Committee on Immunization Practices working with the CDC, the ultimate recommendation of the prioritization the first round is health care providers, and those in nursing homes and extended care facility.

So if someone is not in that category. Right now it is unlikely, you’re going to get access to any vaccine. As we vaccinate more people, the second, third and fourth tier of people who would be getting the vaccine would we make it available. So when you say what vaccine should you take, you should take the vaccine that is available to you in your area your region your city your state at the time that your turn comes up to get vaccinated.

The two vaccines right now Modena and Pfizer that are available, Moderna certainly will be available soon have the same level of efficacy, the same safety profile and virtually everything the same about that so it wouldn’t make much difference which of those, you take as new vaccines, come out, namely those that are different with different platforms like the adenovirus vector vaccines or the solid proteins, you’ll have to wait to see what the profile of efficacy is in those vaccines. So when we reach a point.

After several months when the high priority people get vaccinated, and it’s opened up, sort of like Open Season anybody, doesn’t matter what the priority group, anybody in the normal population or any part of the population can get vaccinated, then you might have a choice that maybe there are three or four different vaccines, there might be recommendations within the context of that vaccine that this one might be better for the elderly so if you’re older you might want to take that one.

Well this one might be better for children, you might want to take that one. We’re not there yet. So that’s what I meant when I said we will likely within a period of time, get the information that was asked on that series of questions.

TIRRELL: Can you spell out for us kind of the timeline that you’re looking at. For how long it will take for the priority groups to first get the vaccine. And then for everybody else to get access and I wonder if you could share any reflections, even just from the last two days of distribution of the Pfizer vaccine for how quickly we can actually vaccinate that many people.

DR. FAUCI: Yeah, well, what happened a couple of days ago is that 2.9 million doses was sent out to 145 locations, and over the next few days to weeks, there’ll be more and more doses to you, ultimately, we hope, with a combination of Pfizer and moderna if moderna gets the UAE, which I hope they will that you will by the time you get to the end of December, have 40 million doses for 20 million people to be able to administer then as you get into January and February and March. If you look at the cadence of the vaccinations in different priority groups. We hope that by the time we get to march early April, we will have gotten through the group so that anybody who wants a vaccine can get a vaccine.

And then as the supply increases over the months, you would hope that when you get into the second quarter of 2021, April, May, June, that by the time you get to the end of the second quarter into the third quarter of the year, you will have as many people vaccinated, as you need to get vaccinated. I hope that that number is 75 to 80 plus percent of the population, but then Meg it’ll probably take a few months to get the highest priority people vaccinated. And then when you open that up for anybody. I imagine that somewhere, we’re going to be around April, maybe a little bit sooner.

TIRRELL: I want to ask you also about some news that came out you know just before we jumped on this livestream from The New York Times. they reported that a health care worker in Alaska had a severe allergic reaction after taking the Pfizer bioNTech vaccine, similar to what we saw from the two health care workers in the UK. How do you react to that news, and how should people be thinking about this as this vaccine gets used more?

DR. FAUCI: Well, that’s the reason why I think people need to understand that the issue of the safety goes well beyond the confines of a clinical trial. Because when you’re in a clinical trial, you’re giving it for example, the Pfizer trial was 44,000 people. Once you decide to dispense the vaccine widely, you’re talking about millions and tens of millions and ultimately, hundreds of millions of doses.

So you may see reactions that you didn’t see in the clinical trial. So we had the two in the UK. And now what you just reported, someone in Alaska. So with the Pfizer people are saying that if you have a history of a severe allergic reaction, you should either not take this vaccine, or if you do take it, take it in the context of a place where if you do develop an allergic reaction, it could be readily and effectively treated.

TIRRELL: Well, two other questions that we got from viewers on the question of transmissibility. One is from Omar, and the other is actually from my mother and father-in-law, Fred and Nancy, so thank you for submitting this question. They asked, what will we be looking for to understand if vaccine recipients can still transmit COVID-19 and Omar asked, where are we in our understanding of that?

DR. FAUCI: Okay. Right now the primary endpoint of the vaccine trial for both the Moderna and the Pfizer product is the prevention of clinically recognizable disease. The secondary endpoint is the prevention of severe disease, as well as a secondary endpoint of preventing infection.

We do not know now whether or not you prevent a person from getting infected. We know for sure that the vaccine is highly efficacious in preventing the clinical disease. As we get further into the trial and follow people for longer and then do follow up studies, we may get the answer to that. But right now, we do not definitively know whether or not the vaccine prevents you from getting infected and transmitting it to others. One of the reasons why we say you still should wear a mask, even though you’ve been vaccinated.

TIRRELL: I’ve got two great questions here for you from Tracy Doyle from Mass General and from Nick Robinson, who’s a science teacher. Tracy asks, what are your thoughts on long-term investment in science literacy for the general public? How can we improve the average person’s understanding of viral transmission and personal responsibility in disease and pandemic response? While, Nick asks, how can science teachers help play a role in promoting scientific literacy in their communities, surrounding vaccination, and properly empower and encourage members of their local public to confidently choose to receive their vaccine when it becomes available to them?

DR. FAUCI: I think the investment in science literacy is very important, as well as the responsibility and the capability of people like science teachers to speak out, to have discussions, workshops or what have you, to get people a little bit more attune to the fundamental scientific basis of what we’re talking about.

You know, if you do some surveys, the scientific literacy in this country is not at a level that I think is optimal and I think we can do by investment in types of educational campaigns to get people to understand a bit more about the science behind what you and I are talking about right now. Short answer to the question from this questioner is that it is really very important to promote science literacy, particularly when you’re in a situation as we are right now.

TIRRELL: I’m sensitive to your time. I know you have to run, literally, so I’ll ask you my last two questions. One is of course everybody wants to know when we get back to normal, Dr. Fauci, and the second one, everybody wants to know is, when are you going to get your shot and which one is it going to be?

DR. FAUCI: Okay. So getting back to normal I think relates to my answer to a few of the very good questions you asked me, Meg, which is that, when are we going to get a certain level of the population, a certain percentage vaccinated. When we get, and it’s really up to us, and that’s the reason why we want to put a lot of effort into reaching out to the community to convince them of the importance of getting vaccinated, not only for themselves, their family, but for the community in general.

So if we can get the overwhelming proportion of the population vaccinated by let’s say the end of the second, the beginning of the third quarter – by the time we get into mid Fall of 2021, we can be approaching, some level of normality. I would think that would be things like being able to go to theaters, clearly feeling much more comfortable about school, having restaurants open to indoor dining.

I believe that if we get that level of protection, as we get into the Fall, we can do that safely. But again, it’s going to depend on what proportion of the population gets vaccinated. For myself, like I said, I want to get vaccinated and I will do it publicly to serve as an example of the importance of getting vaccinated.

I will do that as soon as we get doses of vaccination. We’re waiting to get a supply here at the NIH where I work. When we do, I will be right there getting vaccinated publicly to demonstrate to people my confidence in the safety and the efficacy of the vaccine.

TIRRELL: And I know you guys had a big role in the Moderna vaccine. I assume – is that the shot you’re going to be getting? Could you tell us which one?

DR. FAUCI: You know, Meg, I honestly can’t tell you because the one that gets here first. I will do. Whatever one that is. If it’s Moderna, if it’s Pfizer – whichever one.

TIRRELL: All right. We’ll be watching, Dr. Fauci, and we really appreciate your time today. Thank you so much.

DR. FAUCI: It’s always good to be with you thank you for having me.


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