Is the pandemic actually over? It's complicated | Anthony Fauci - Transcripts

September 22, 2022

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Is the pandemic actually over? It's complicated | Anthony Fauci


you're listening to Ted talks daily I mean if you so when can we declare the covert pandemic over a consecutive pandemics humanity's new reality here from someone who knows a thing or two about public health Dr Anthony Fauci he sits down for a special Ted membership conversation with Ted science curator David de ello to discuss health healing and what's next for him to learn more and become a ten member check out Ted dot com slash membership Hey I'm Dr Jen Gunter host of a podcast from Ted called body stuff on this show I debunk medical myths and explore some of the bodies most fascinating mysteries next up testing work even after you introduce sex scenes you know we have to follow them for years and years and years and the fact that ongoing cross check help body stuff on apple podcasts Spotify or wherever you listen support for Ted talks daily comes from in the rock are you craving sugar but looking to cut the calories our friends at in the wrong which you know because of the makers of our favorite little brown sugar packet have just what you're looking for all purpose in the rod is an all natural zero calorie sweetener blend that looks tastes and crunches just like sugar it's a perfect blend of four ingredients found in nature so you can use this all purpose sweetener anywhere you would normally use sugar as sweet as that by all purpose in the rock on Amazon in taste the magic today fall is here along with the stress that comes a school deadlines and holiday planning yanks support your wellness with plant CBD only at the vitamin Shoppe this line of full spectrum liquid extracts and capsules made with one hundred percent U. S. grown non GMO him making it mother nature approved choose from formulas combined with traditional herbs like CBD ashwagandha for stress management CBD only products like forty milligram CBD liquid extract and more treat yourself at vitaminshoppe dot com or the vitamin shop store near you in the wake of Dr Anthony Fauci announcement that he will be retiring as the head of the National Institute of allergy and infectious diseases at the end of the year I've invited him to join me for a conversation on the future of the covered nineteen pandemic reflections on his career and the future of public health please welcome Brooklyn's own doctor felt she

hi David nice to see you thank you for having me

thank you for joining us so my first question is very simple is the code nineteen pandemic over

you know David there's a lot of misinterpretation about what that meaning of the word over is it means different things to different people I'm sure you're referring to the comment made by the president a day or two ago if you're talking about the full minute phase of the outbreak when we were having anywhere from eight hundred thousand to nine hundred thousand inspections a day and three to four thousand deaths per day that was several months ago we are much much better off now than we were then so in that case that moment in phase of the outbreak is behind us but as the president made very clear on the second half of his sentence is that which they don't seem to show is that he actually said we still have a lot of work to do this still a challenge ahead we've got to get people vaccinated we still have a number of cases we have four hundred deaths per day that's an unacceptably high level so again it depends on the semantics of what your definition is we don't want anyone to get the impression that we don't have a lot of work to do we've got to get the level of infection considerably lower than it is and we've certainly got the we got to get the level of deaths lower than it is so again it depends on the semantics of what you mean by and

well let's get into those semantics them what conditions would need to exist for the pandemic to be over

you know that's coal that officially is made by the World Health Organization you know my colleagues in our high I must've been more than ten years ago because of the lack of clarity on what can they make means to one person versus another we wrote a paper in the journal of infectious diseases in which we talked about all the different variations of interpretations is that a widespread phenomenon that is that the widespread nature throughout the world that makes it officially a pandemic or is it widespread and accelerating or is it widespread causing serious disease it means different things to different people so rather than try and give a definition that's my definition versus another we should stick with what the W. H. O. is saying and as Dr Ted rose said that we're seeing the light at the end of the tunnel on that so again you might interpret that well if that's the case is it over well again what does over me there's a lot of semantics there David the easiest way not to confuse people is to say we still have a lot of cases we still have four hundred deaths we only have sixty seven percent of the population vaccinated we gotta do better than that of those only one half of gotten a single boost and as a nation we lag behind other developed countries and even some low and middle income countries in the level of vaccinations that we've been able to implement so if you want to look at that way we have a lot of work to do and that's exactly what the president said

so speaking of vaccines what's your advice we I know we have the bivalent available now what is your advice on on which vaccines to gap and and when that's appropriate

well first you've got to get your primary series so I mean that's the one where I said only sixty seven percent of the country has gotten their primary series which for the most part with some exceptions is an mRNA vaccine either mow down Fizer given anywhere from three to four weeks apart as the primary then the issue is about giving people booster


so right now if you're asking a clear question of today with the bivalent D. A. four five boosters or updated vaccines is a better terminology to use they are available now throughout the country we've ordered a hundred and seventy one million doses who should get it anyone who is vaccinated with the primary series and has not received a shot longer than two months ago should get it so if I got my last shot let's say in July August September two months later you should get the bivalent if you were infected three months or more ago you should then get the updated vaccine let me give you an example for clarity for the audience I was infected in the end of June of this year even though I have been vaccinated that fortunately because I was vaccinated I had a relatively mild illness at my age had I not been vaccinated the chances are I could have had a real severe outcome because the elderly are more prone to get severity of disease so if you take the end of June take the end of July the end of August the end of September I plan to get my updated B. A. four five by valence at the end of September the first week in October

I think that's a very useful advice and actually I will be doing the same how are you personally navigating the stage in the in the pandemic what precautions are you taking if if any

well I certainly continue to take precautions and I think it's important that you ask me personally that question because people have different levels of risk of severity of disease I am a person who is relatively healthy but I met an elderly age I'm eighty one years old so I'm going to be eighty two in December so I statistically would have more of a risk so the big questions I take I stay up to date on my vaccinations number one and when I go to a place that's a congregate indoor setting where there are a lot of people and I don't know the status of their infection their vaccination or what have you I would for the most part wear a mask when I'm with people who I know what their status is people who were recently vaccinated or people who come in and test before they come in I could have a dinner in my home or in the home of a friend without any concern but if I go to a crowded places certainly on an airplane even though it isn't required anymore if I go on a prolonged or even a short airplane trip again because it might increase risk as an elderly person I wear a mask on the plane

so switching gears a little better or taking a step back are consecutive pandemics kind of our new reality we obviously had the the monkey pox outbreak and and if that is the case how do we cope with consecutive pandemics

well you know we have had probably without the general public noticing it much we have had in the history of our civilization outbreaks of emerging infections some of which turned into pandemics we've had them before recorded history we've had them in the lifetime of some of us you want all right arm we're going through one right now so given the fact that most of the outbreaks of new infections come from the animal human interface which is sometimes intruded upon as it were where people either by climate change by intruding on forests

uninhabited by humans places in the world you're gonna get jumping of species or in markets where you put animals from the wild in contact with humans which is exactly what happened with saws Colby one in highly likely happened with saws Kobe to we will continue to get out breaks pandemic flu generally comes from a situation where you have the the animal species that harbor influenza caves fowl birds and humans together in that environment that's how you get the bird flu that tend to challenge us a fair amount or the swine flu so the short answer to your question David is that we will continue to get out breaks of new infections the critical issue is how do you prevent them from becoming pandemics and that's what Cole pandemic preparedness which is a combination of scientific preparedness like we did with the rapid development of vaccines for covert nineteen which was a highly successful scientific endeavor matched with a public health response which we didn't do as well in the public health response because we had the spread of infection in a way that we could have done better in controlling it

so speaking of that this is not your first epidemic and but you've made historic contributions to the aids epidemic and and now covert nineteen but is there anything you wish you had done differently and in those cases

well there always is I mean it's a question of when you're involved with and now nobody is perfect certainly not on your any of my colleagues but when you're dealing with an emerging moving dynamic


which by definition is what a pandemic is particularly if it's with a pathogen that you've never had experience with like H. I. V. in the very early nineteen eighties or the covert nineteen pandemic in the first months of twenty twenty you could always say if we knew then what we know now and there was a lot of things that we didn't know we certainly would have done things differently and that's why you have to be humble and modest to realize if you are going to be following the science the science which gives you data and information and evidence is going to change particularly in the early phases of the outbreak did we know how easily it was spread from human to human no did we know that it was era souls spread no we thought in the beginning it was like influenza mostly droplets from a sick person did we know that fifty to sixty percent of the transmissions well for someone who had no symptoms at all which clearly impact how you approach an outbreak did we realize that instead of the typical outbreak word goes up it comes down and then you're done with it we had no concept that you be seeing different waves in different variants that came along so the answer to your question if we knew all of that from the beginning we certainly would have done things differently but unfortunately we didn't and you try to be flexible enough and humble enough to change and modify how you approach things based on the recent data that's not flip flopping that is truly following the evidence and following

the data right that's just how science works since it's constantly updating and especially in a a real time situation like this pandemic but are there any I don't know specific regrets you have something you would take back if you could

well it depends yeah I mean obviously in the beginning when we were under the impression or didn't fully realize that there was ever a soul spread we were under the impression which was true because we were told that that there weren't enough mask for the health care providers and if we started everybody porting masks they wouldn't be masks available to the health care providers we didn't realize that out of the health care setting like the hospital setting that masks were effective in preventing acquisition and transmission we didn't know that we know it now for sure but we didn't know it then we didn't know that the silence read from people who are without symptoms and that meant we didn't know that while we were looking for sick people there were many many many more people without symptoms that were in society spreading the infection in a way that was not detectable below the radar screen had we known that I absolutely would have said right from the beginning everybody wear a mask all the time in an indoor setting but we didn't say that there was only one it became obvious so if we had known that early on we would have told people to wear a mask however I must say David given the reluctance of people to wear masks even now that we know all that stuff I'm wondering how well that would have been received if at a time when there were ten or so documented infections if you told the country that everybody should wear a mask in an indoor setting not so sure that would have been broadly accepted

yeah and this seems to be something that the United States anyway has has been through before with the Spanish flu and maschine and an anti mask protests and it seems to be in our our let's say societal immune response to these pandemics flipping it a little bit how do we make sure we're not caught so sort of I'm prepared next time

well you know it's interesting they be what you mean by unprepared because the Johns Hopkins school of public health evaluated different countries preparedness for pandemic and guess who was evaluated to be first in the world the United States of America yes who has the most deaths per population the United States of America so you know this preparedness in this response there's execution of your preparedness plans that we did not do so well for any of a number of complicated reasons one of which was the fact any is


this outbreak occurred at a time a really profound and deep divisiveness in our own country


where we had something we hadn't seen before where political ideology played a role in whether you did or did not accept the recommended public health countermeasures be it wearing a mask indoor settings quarantining taking a vaccine getting a boost if you look at the country and look at the demography of the country with regard to ideology he there should never be that red states vaccinate much less than blue states there is no reason for that at all because public health risks and public health implementation should be uniform throughout N. we didn't see that

yeah let's talk about that a little bit more because obviously you've had to cope with and incredibly polarized response to eat to your work in which not just ordinary citizens but even politicians have called for your resignation and various other things how do you deal with that how do you cool you're quite cool about this

well calling for your resignation is mild compared to having somebody arrested who was trying to kill you so I mean

they they

there there's a big spectrum of pushing back against public health people and that's one of the really unfortunate things I mean you I mean I keep my cool because that's just the nature of the kind of person that I am when you're dealing with a very very difficult situation you've got to keep your cool I mean I learned that in my early training in medicine when you're in the middle of emergency somebody is dying in front of you you you've got to keep your cool all the time and that's something that's just part of my inherent training as a physician and as a person but what we faced was well beyond that I mean public health officials not only myself I'm a very visible one but many of my colleagues are being threatened and hassled and harassed themselves and their families the way my family is being harassed merely because of saying things that are purely

public health

common sense tried and true principles of how to keep people safe that is really extraordinary that that's going on in our country

yeah I'm also going to ascribe it to the Brooklyn upbringing that's that that that gave you some cool to at but a quick follow up how do you like with all that going on with those horrifying threats how do you unwind from all this how do you you know keep it together and and give yourself some space to breathe

well I have a an extraordinarily supportive family my wife who's with me my children are grown and live in different parts of the country but they are very supportive of me with texts and calls and knowing what I'm going through so I have three daughters which they they you know they try to take care of their Daddy so would repeat it really helps but my wife is extremely supportive N. and we do things together I mean I work in a preposterous amount of hours a day but every day I try to get some exercise in and it's usually a few mile walk with my wife whether that's on the weekends very early in the morning or during the week late at night when I come home we try to get some form of exercise and to defuse the tension

up hopefully every day and we

look pretty successful at that well

well good for you so you're retiring after a very long and distinguished career congratulations you will have successors what lessons would you want to offer your successors based on your tenure

first of all I'm not retiring in the classic sense my wife says David requiring not tiring because I do intend to be very active in that was one of the reasons why I stepped down at this point in time because while I still have the enthusiasm the energy and thank goodness the good health to be able to do something else for the next few years I want to use the benefit of my experience of being at the NIH for almost sixty years for being the director of the institute for thirty eight years and for having the privilege of advising seven presidents of the United States on public health issues to use that experience to hopefully inspire by writing reading traveling and lecturing inspiring the younger generation of scientists and would be scientists to at least consider a career in public service particularly in the arena of public health in science and medicine having said that my advice to the person who will ultimately replace me would be to focus on the science and be consistent with the science and do not get distracted by a lot of the peripheral things the disinformation the misinformation the attacks on medicine and science and public health focus like a laser beam on what your job is and don't get distracted by all the other noise that's out there because there is a lot more noise now then there was a few decades ago and by noise I mean misinformation and disinformation about science

for sure I've definitely noticed that as the as the science curator but having a bad day let's talk about hope

what what

what gives you hope

about the future are there treatments or or other things that coming down the pipeline that you're excited about

well science is an absolutely phenomenal discipline it's discovery it's it's brand new knowledge pushing back the frontiers of knowledge that we would not have imagined we would be and if you look at medicine and science how it's changed in a very very positive way from the time I stepped into a medical school in nineteen sixty two to the time now of the things that are available to me as a position as a scientist I have great hope that if we continue the investments in basic and applied science that we will be able to accomplish things

in the arena

of health individual health and public health and global held double really unimaginable just decades ago so I have a great deal of optimism about what the future holds for science and medicine and that's the reason why one of the things I'm going to try and do in my required post government life is to encourage young individuals to consider a career in medicine science and public health because the opportunities are really limitless we are at a stage now the likes of which people who ante dated us never would have imagined the opportunities in science that we have so I'm very optimistic about where we're going

me too but you mentioned earlier how climate change is affecting pandemics what what worries you about the about the future that we're facing

well just some of the things that you mentioned

we do have



elements of anti science in society disturbingly growing in the United States and when I talked to my colleagues internationally depending upon the country

that they live in

to a greater or lesser degree there are some elements of that the thing that bothers me is a denial of science and with science is showing us a denial of the issues of climate and the environment a denial of scientific principles and conspiracy theories about things that push people away I mean some of them all laughable but you would be astounded David at the number of people who believe it the vaccines were made by Bill Gates and I and we put a chip in it so that we could follow people around and know what they're doing and get into their head of the idea that this conspiracy that we're making billions of dollars on vaccines and that's that's why people are promoting vaccines so that people like me and others who are public figures can my mean but but based on data but once it gets into the social media it explodes and conspiracy theories explode even though all the evidence proves it wrong proving something wrong today doesn't seem to matter much is it that's really strange and weird isn't it David

yeah yeah well it's a I think a an old phenomenon what that there's there's a famous saying that I'm gonna mangle about by the time the truth gets out of the barn the lies halfway around the world

right right

so that's definitely the world we're we're living in I do know you have to go and you know finish out your tenure and and and then get ready for your requiring which I'm excited about I'm excited to see what's next but do you have a last bit of advice for for the public one thing you hope everyone takes away from from your time as as director in your time and and public health


a David I

did there are so many things but I think one thing that stands out particularly in the climate and the environment that we're in right now is that people need to get involved in an in a proactive way in spreading the truth about what scientific principles are and what they mean and how they can be of great benefit to society and to try and make our population more science literate than it is right now by talking about things the truth you know the easiest way to counter misinformation and disinformation is to be enthusiastic about spreading correct information a little bit about the metaphor that you said about the truth and analyze the that the spreaders of facts and truth everybody's got to be a contributed to that and that's one of the things I think we can do better

yeah I would agree and we're we're definitely trying here at Ted well doctor felt she I know our members are incredibly thankful and I personally am incredibly thankful so thank you so much for your work and for joining us today

my pleasure David thank you so much for having me

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