Six months into the US response to the Covid-19 pandemic, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, remains one of the most visible and steadfast defenders of science in an increasingly politicized environment.<\/p>\n
On Thursday, Vox and Today, Explained<\/em> <\/em>host <\/em>Sean Rameswaram spoke to Fauci about calling out Sen. Rand Paul at a Wednesday Senate hearing; his projections for when vaccines may be ready to distribute; his concerns about public mistrust in the vaccine approval process; and telling political appointees at the Centers for Disease Control and Prevention to \u201ctake a walk.\u201d He also detailed who the real enemy is and what he would ask for if he could wave a magic wand right now. <\/p>\n \u201cThe public health response and the public health activities, in fact, have become politicized, which is so unfortunate,\u201d he told Rameswaram. <\/p>\n The transcript has been edited for clarity and length.<\/p>\n To hear <\/em>Today, Explained\u2019s full conversation with Fauci, listen to the episode below or wherever you get your podcasts, including <\/em>Apple Podcasts<\/em>, <\/em>Google Podcasts<\/em>, <\/em>Spotify<\/em>, and <\/em>Stitcher<\/em>. <\/em><\/p>\n \n The University of Washington\u2019s Covid-19 model is now saying we may see nearly 400,000 deaths by the end of the year. Is that a realistic estimate? <\/p>\n Anthony Fauci<\/p>\n We really have got to be careful because those are models. Models are based on the assumptions that you make to put into the model. Certainly if things go poorly \u2014 if, in fact, we do not get control and people do not cooperate in some of the public health measures \u2014 that could happen. <\/p>\n Hopefully, as we get toward the end of the year, we\u2019ll know that we have a vaccine, or more than one vaccine, that\u2019s safe and effective. So if we could start vaccinating at least the high-risk people, as well as the front-line responders, by the end of this calendar year and into 2021, we could prevent that surge that everyone is concerned about. <\/p>\n But we can\u2019t just rely on a vaccine. We\u2019ve got to rely on [people\u2019s adherence] to the simple recommended public health measures, particularly mask-wearing when you\u2019re inside and may not be able to keep the physical distance that we\u2019d like to see. <\/p>\n Sean Rameswaram<\/p>\n What is the latest on a vaccine being available in the United States? What do you think the timeline is? <\/p>\n Anthony Fauci<\/p>\n We don\u2019t know. So when you hear people make projections, they are merely projections. The vaccines that are currently in advanced trials \u2014 the Pfizer, Moderna, and now the JNJ Janssen products \u2014 are in play. (A fourth [AstraZeneca] is on hold because of an adverse event that took place.)<\/p>\n They have anywhere from 30,000 to 60,000 people [enrolled] per trial. And given the enrollment and the number of infections, I would project … that by the end of the year, let\u2019s say November or December, we will know whether the vaccines, plural, are safe and effective. <\/p>\n It could be earlier. I mean, if there are enough infections in the trial and you could distinguish between the placebo and the vaccine limb of the trial, you may be able to make a determination early. But let\u2019s assume that it\u2019s November and December. <\/p>\n You could ask, what do you think the chances are of it being safe and effective? The first honest thing to say is that you don\u2019t know. But based on the preliminary data that we\u2019ve seen in animal studies, as well as in the phase 1 studies, the vaccines appear to induce a response that\u2019s comparable to a good response to natural infection, which traditionally is always a good sign that you\u2019re going in the right direction. <\/p>\n But the proof of the pudding is going to be the result of the [phase 3] trials. Now, if, in fact, it shows to be safe and effective and you start vaccinating people, you could do that as early as the end of this year. <\/p>\n We\u2019ve taken a major financial risk of producing vaccines even before we know that they work, which means if they do work, you saved a lot of months. If they don\u2019t work, the only thing you\u2019ve lost is money. And right now, we feel that the investment is really worth the risk financially, because we want to do things as safely but as quickly as possible.<\/p>\n Sean Rameswaram <\/p>\n Once we have a vaccine in the United States, do we have a plan for how it will be distributed across the country? <\/p>\n Anthony Fauci<\/p>\n Yes, yes. Traditionally, the final decision on that is with the CDC … and they rely heavily on the advice of a committee called the Advisory Committee on Immunization Practices. With regard to Covid-19 vaccines, we\u2019ve added an extra layer to that. The National Academy of Medicine is putting together a group of scientists, ethicists, and others to map out what we think is the most appropriate, fair, and ethical way to distribute vaccines in a greater fashion. <\/p>\n Traditionally, you start off vaccinating the health care providers and front-line individuals who are putting themselves at risk to take care of sick patients. The other [group] is those at high risk, such as the elderly, those who have underlying conditions and people like that. The final determination has not been made, but that will be coming very soon. <\/p>\n Sean Rameswaram<\/p>\n How worried are you about faith in the vaccine? Are you concerned that people might not trust a vaccine produced in this country? <\/p>\n
\nSean Rameswaram<\/p>\n