States, have gotten hit worse than virtually any other country when you talk about cases and deaths. So this is a real important challenge for us. There is a lot we have to discuss here and not a lot of time. I should say that when we are done, i will be joined by the dean of school of Public Health and the director of the school of Public Affairs to build on your comments, but i want to die ve right in. I should also say that we got 100 questions from faculty and students. Im going to do my best to weave those in. I saw a story the other day about boston. The pandemic you just referenced. Different time, different science, but the headline haunted me. The headline said, boston refused to close schools during the 1918 flu. Then children began to die. Is history about to repeat itself as we head to the School Season . I think there is a difference. I think that if you look at the situation with regards to the current pandemic, is that children clearly have much less of a chance of having a serious outcome when you look at hospitalization rates per 100,000 than adults. And in fact, if you look at the graph, it literally gradually goes up until you get a very high hospitalization rate among the elderly. So, age is an issue. However, we should not neglect the fact that children, some, can get seriously ill. Much lesser likelihood than the adults. There are other syndromes that we are just starting to see, inflammatory syndromes that children have. We do not know the extent of that. It seems to be unusual, but we do not know the full extent. But the issue is we are starting to learn a lot about children getting infected. They clearly do, and there have been some studies to show that children from 10 to 19 can transmit to adults as easily as adults transmit to adults. So, some schools are opening. Some schools are not. Some schools are going hybrid. But it is patchwork, and left to local decisionmakers, some of whom may have direct Public Health and the latest guidance, and some not. Are you concerned about the way this is being done . Of course. Not only for the children, but children as transmitters of this. That is the point i was trying to make talking about the chances of a child transmitting this to an adult. Even Young Children have a high degree of virus. So they certainly are capable of transmitting. The degree to which they do i think we are going to learn a lot about in the coming weeks and months. We would like to see, i would like to see a consistent message about schooling, consistent to guide the local authorities who make the decisions about school. Where should that consistent message come from . Well, it could come from the federal Health Authorities like myself, and i have said it and will say it right here to you. That we live in a big country that is very heterogeneous with regard to the level of virus. And you have got to look at what is going on in the community. If you are in a green zone where you have literally less than 10 per 100,000cases, population, you could probably open the schools with a considerable degree of impunity. When you to the yellow zone that has 10 to 100 cases per 100,000, where theres virus in the community, you might want to modify the things you do. Have some physical separation, mask wearing, outdoor classes if possible. Situations where you have hybrids, some online, some in person. When you get to the red zone, a zone where there clearly is over 100 cases per 100,000, and there is a lot of virus activity, you really want to think twice before you get the children back to school. I do not think it should be all or none. All the kids go back, or all the kids stay locked in. You have got to look at extenuating circumstances and you have got to look at the location where the school is. Sure. Part of the schooling discussion of course extends to colleges and universities. George Washington University fully intended to bring people back in a hybrid and careful way, and then had to change that posture, and it is now going to be virtual. Today, as we speak, Michigan State university has said it is going to go virtual for the semester. Notre dame says it is going to do it for two weeks, bring people back. But if there are clusters and it cannot do it, it will not. Unc had to flip on this. Dr. Fauci, as you are seeing schools grapple with this decision and try to reconvene, what is reasonable . Is there anyway to bring students back from all parts of the country, have them gather in dorms and classrooms and hallways, deal with the reality of campus life, and be able to safely reopen . So, we want to make sure now dr. Fauci we want to make sure now that the viewers know we are no longer talking about elementary and middle school. It is a big difference. Fraternities and parties and other things. [laughter] dr. Fauci it is a big difference. That cannot address the concern i have about what the level of infection is any particular in any particular place, because people are coming from all over the country. You have people coming from red zones, yellow zones, and green zones. It varies. There are some universities and colleges that have a set up where they test virtually everybody that comes in for they get there. Before they get there. Then screen individuals and have situations if you have facilities and resources to do it, where you might have an empty dorm where if someone tests positive, you can safely isolate them. And if they need medical care, you can get the medical care. If you have capability of doing that, it is conceivable that you may be able to successfully bring people back to colleges and universities. It is conceivable, but is it feasible . Dr. Fauci in some cases, it might be. In most cases, you are skeptical. Dr. Fauci i cannot say most pure and you have to go university by university. Where they are, what resources they have to be able to do some of the things that universities are already showing they are doing. You can test everybody before they come in. You can do intermittent surveillance testing. You need the capability of identifying, isolating, and contact tracing. If you can do that, you may be able to open colleges and universities. If you cannot, it would be more problematic. Let me ask you about health effects. Youre watching this closely as a doctor, scientist, researcher. Immunologist. A New York Times story recently talked about covid creating a wave of potentially heart disease, myocarditis, inflammation of the heart muscle. Another study out of germany looked at a high rate of people who have been suffering from that. Other studies are looking at potential brain damage. There was a study i was reading in the lancet about potential structural damage. What more, what new do we know about the effects of this disease among those who have had it at a fairly serious level . Dr. Fauci is a work in progress. Literally, every week and every month. You named some of the reports accurately that have come out. There are now others in progress that a lot of different groups are looking into. You bring up an important point. Let me explain why. If you say that you worry about people as long as you want to make sure we decrease the deaths, that is important. We already have well over 160,000 deaths, close to 170,000 deaths. However, if it turns out people, even some who do not require hospitalization, because in some of the studies you just quoted, they were in individuals who were sick at home for maybe a couple weeks at a time that were not even sick enough to go to the hospital, yet when you look at the percentage of them to actually recover and recover within two to three weeks, a substantial portion of them do not feel right. Fatigue, muscle aches, brain fog. The thing that worries me more is what we are seeing about the subtle, insidious effects on the cardiovascular system and nervous system, namely m. R. I. s that show abnormalities of inflammatory processes in the brain and heart of some individuals. It is not 1 or 2 . It is individuals where it could even be doubledigit percents. They may be reversible, but we do not know that. So we have to be careful that just because a person survives, and obviously, the overwhelming amount of people do survive, that there may be a certain percentage of people who might have serious residual effects. You need to follow that. It seems to me that that is a vital part of the messaging. And it is often not getting out. It is about dying or not dying, opening or not opening, as opposed to how brutal this illness can be to get it and the potential of longlasting effects in ways we do not even know. There are layers of risk. Vaccine. Sputnik 5. Putin says he has a vaccine. Bogus or credible . What do you think . Dr. Fauci it is not bogus, because he has a vaccine. What is bogus is to say the vaccine is safe and effective. There is a difference between having a vaccine and proving in trials that are well designed, randomized trials, that we start to give it widely to hundreds of millions of people, that you are giving a safe and effective vaccine. The russians, to my knowledge, and im pretty sure i am correct, have not been studying this intensively in very large, randomized trials. I am sure Vladimir Putin will be happy to hear you say it is bogus. Dr. Fauci i am not calling him bogus. I am saying that having a vaccine is very different from proving that a vaccine is safe and effective. For that matter, we have six vaccines now. We have not proven them yet to be safe and effective. When we do, then we can accurately say we feel comfortable with distributing a vaccine to hundreds of millions of people. But before and until you prove it is safe and effective, you really do not want to be talking about having a vaccine. The question you are probably asked most, which is, when . Today, your answer is what . Dr. Fauci we have three, at least two and probably a third soon, already in phase three trials to determine safety and efficacy. Two of them started on july 27. Ofeady enrolling thousands individuals. The trials are large. One of them is a 30,000 person trial. Another is aiming at 60,000 people. We will likely know within a period of several months, which takes us to the end of this calendar year, and may be to the beginning of 21, whether or not 2021, whether or not we have a candidate. I believe we can be cautiously optimistic. Based on the preliminary data that we have. No guarantee, drank. You never can guarantee you have a vaccine, but we feel cautiously optimistic that we will have one that will be safe and effective. We know that from preliminary i studies, that it reduces neutralizing antibodies comparable to or even better than convalescent plasma of people who have recovered. So we are feeling good about it, even though one cannot guarantee it. Let me ask you a question very closely related to that in that, and the question itself comes from one of the students at the school of Public Health at george Washington University. It is about people getting the vaccine. Gallup had a poll that 35 of that said that 35 of respondents said they would not get vaccinated. When a vaccine does become available to the public, how can providers combat Vaccine Hesitancy . I might throw in their vaccine disinformation. Dr. Fauci vaccine disinformation can lead clearly to Vaccine Hesitancy, but there is Vaccine Hesitancy that is fundamental without necessarily misinformation. What we need to do is what we have done whenever we see a situation where people are hesitant to get a vaccine that they really need. They need it for themselves and they need it for the protection of the community. That is not criticizing people for that, but trying to engage them. You do that through community engagement, particularly when you are dealing with minority communities who often and understandably are reluctant to believe what authorities tell them about health. You get out there, and you get Community Representatives to engage them, to try to be as transparent as you can with the data, answer the questions they have, and try to convince them that vaccinations in general, particularly a safe and effective vaccine for covid19, is something that is import and important for them, their families, and society in general. Would you support a nationwide mandate of the Covid Vaccine . Dr. Fauci definitely not. You do not want to force anyone to take a vaccine. We have never done that. You can mandate for certain groups of people, like health workers, but for the general population, you cannot. Here, at my own hospital, at the nih, we get influenza vaccines. If you refuse with no good reason other than you do not want to take it, we do not allow you to take care of patients on the wards during influenza season. That is a mandate. But we do not want to be mandating from the federal government to the general population. It would be unenforceable and not appropriate. Lets talk about how we do get out of this. One of the things youre tracking closely is a rapid test. I have a question from a faculty member. Could dr. Fauci explain the bottlenecks making it so difficult to ramp up productions fastresult, selfadministered tests that would allow the country to more safely reopen . I am referring to the sorts of tests that have been discussed, rapid diagnostic tests. Dr. Fauci already, there is a considerable amount of growing enthusiasm, so we are going to see that relatively soon. The critical issue is to make sure, when we get those tests, they have a degree of sensitivity which is appropriate. When you doing general when you are doing general screening, you do not need a 98 , 99 sensitivity, which the pcr molecular tests give you. When you absolutely need to know if this person is infected or not. If you are screening, you are looking at the penetrance of the infection in any given group, any given population. So you can live with one that is less than 90 effective, one that might be 85 effective, because even though you may miss some, if you do the test enough and repeat it enough, you will make up for the lack of sensitivity. Those tests can be available. Right now, what we are seeing is that the private sector is gearing up to really make them available to the tune of many millions. There is a lot of concern, a lot of focus on these tests and whether these tests are going to be equally distributed. To the people most in need. That includes people of color, people who are disproportionately carrying the cost of this disease on their backs. What is being done to address that serious problem . Very serious attention to that is being paid. We have an entire group of people committed to making sure that happens. One of the first things you do is that, whenever you have early on, which will be the case as the vaccine starts to roll out by the end of 2021, we are told by manufacturers that there will be enough vaccine for everybody in the country. But before then will be prioritization. When you prioritize, what you do is you get an independent group, in this case the Advisory Committee of immunization practices, which traditionally has advised the cdc, which has a responsibility, that is going to be complemented this year by another independent group to get the prioritization such that you will see publicly published what we call a prioritization range. I cannot tell you what that is going to be now, but i can tell you, if it is similar to what it we have seen in the past, you will probably see a high priority to Health Care Providers and First Responders because they are putting themselves in harms way to take care of people. Likely, it will then be individuals who would benefit the most, the elderly and those with underlying conditions. Another question from a colleague of mine, who has among other things, looked at covid disinformation that we have experienced and other disinformation. He writes, as scientists, we are trained to communicate just the facts. The past several months have demonstrated those facts are prone to interpretation and malicious actors will intentionally distort and misinterpret those facts to support their preferred narratives. Some are injurious to Public Health. What do you see as the role of top experts such as yourself and many others to help people understand how to correctly interpret the facts in their correct context . You are out there and sometimes you get attacked by the president of the United States. This is not an easy thing. Dr. Fauci we stand by certain fundamental principles. That you make recommendations and policies based on data and evidence. Speculation, anecdotal, those kinds of opinions really need to be put aside. Everything we are talking about in the arena of Public Health, particularly recommendations and policy regarding any information any intervention, it could be a diagnostic, a vaccine, or therapy, it has to be made on the basis of sound Scientific Data and evidence. That is the kind of thing i do and my colleagues, who are Public Health officials out there, like me, do the same thing. Make statements based on solid Scientific Data. I mentioned at the outset, you have been in this job since 1984. You and i first met when aids was exploding. I remember, i was a young guy at the white house, and you were a young guy at nih. I remember that first briefing that you did, and the incredible Politics Around that. The collision of pandemic and politics as we have seen here is amazing, but not the first time medicine and politics have collided. You have been through hivaids. You have been through sars. You have been through anthrax. You have been through zika. You have been through all of these things. Have you ever seen anything like this . What you make of the great Political Division . Every poll shows this in the country, whether it is masks, to actually believing whether this whole thing is somehow a hoax. Dr. Fauci you are right in your description of my experiences. Even back in the early days of hiv, there was a stigma associated. It was not really hardcore politics. It was different ideologies about how much attention you pay to disenfranchised groups like the gay population, which were really obviously did not get the attention they deserved until the activists demanded it and appropriate league got it. And appropriately got it. That is different what we are seeing now. What we are seeing now is intense divisiveness that transcends covid19. It is there even without covid19. And the perfect negative storm that makes it difficult and problematic when you try to deal with a Public Health challenge is that you have that divisiveness that makes the politicization of the response, which we are seeing very, very difficult. Where we have people who are on political different sides of whatever a particular issue is, but it gets thrown into Public Health. It is a statement. Masks, no masks. This or not that. It should not be that way. The Public Health challenge is a challenge for everybody. It does not make any difference what your political ideology is. Or what you feel strongly about. We should be completely in line with each other that this is a serious Public Health problem. Have you tried saying that to the president of the United States . To conservatives on the hill that grilled you for your congressional testimony . Dr. Fauci yeah. All you need to do is look at my record, look at the testimony. I say the same thing im telling you right now. I dont change what i say. We need to pull together. We are all in this together. We have to work together. If you dont have complete consistency in what you do, the weak links then a chain of a Public Health crisis will make it difficult to get your arms around it and suppress this, which is what we are trying to do. I want to ask one more question from a student, which i think is important. Many of us in the masters in Public Health program here at george Washington University work in Public Health and many of us are faced with issue asians in this pandemic to test our ethics, education, and training. My question to you, from this student, how do you maintain your ethics and values during such a challenging Political Climate . Dr. Fauci i have to tell you, it is very easy. [laughter] because you dont change your ethics because of the situation you are in. There are certain things that are constant. Science, and data. Science, data, and a constant. If the situation changes, the data may change and you make a decision. What does not change, our ethical principles. They are clear and immutable. Areightning round and you done. Just to show there is humanity, here is a question. Which was scarier for you, testifying at congress, or throwing out the first pitch at the park . Dr. Fauci the first pitch at the park. As you look forward and think about the immense challenges we have amid this environment, political environments, now i campaign. A campaign. The pandemic on a rise in some places and disputed in others, some control elsewhere, conclude with what concerns you the most and what encourages you the most. Dr. Fauci what concerns me the most is what is going on right now throughout the world, but even in our own country, that we want to make sure we all abide by certain fundamental principles that can get us out of that. It is completely in our power, even prior to a vaccine, to control this outbreak. If we abide by the certain fundamental Health Principles we talk about. Wearing a mask, physical distancing, avoiding crowds, outdoor more than indoor, sanitation, washing hands with soap and water. If you could do that, you could influence the cause of the outbreak. What i would love to see is the United States, as a country, pulling together in a consistent way, and realize that Public Health measure is the gateway and the rode, and path, to road, and path to opening up the economy and getting jobs back. It is not an obstacle in the way of opening the economy. If what we do in the proper Public Health, careful way, we both, we can have control of the outbreak and carefully and prudently open up the economy to get back to normal. That is what i would like to see everyone realize, and we can do it. It is within our power to do. To do it. When we get a vaccine, it will be much easier, but we can start on that road right now, even before we have a vaccine. Dr. Fauci, i know you have to run. Thank you for your time, for your generosity of spirit, incredible and intrepid attitude as you encounter all of this. Thank you very much, and we wish you, on behalf of george Washington University and all of us, the best of luck and a speedy result in the work you are doing on behalf of the rest of us. Dr. Fauci thank you, frank. As always, over many years of with you, it is great to be with you. I look forward to doing it again. Thank you. Dr. Fauci thank you. Tonight, catherine gale, with her book, the politics industry. The division that we see, the gridlocks that we see as a our incentive to keep , incentivelse out not to compromise ever, because it works better for them to leave a problem unsolved than to compromise and give a little on either side. They would rather leave the problem unsolved and keep it is an issue for the next election. Announcer tonight, at 8 00 p. M. Eastern on cspans q a. Announcer this week, it is the republicans turn starting monday and for four days. Republican national convention. Here their vision for the future and priorities for the next four years. Watch President Trump and Vice President pence except their partys nomination. Aginning monday at 10 00 9 00 apm 9 00 p. M. Eastern. Watch live on cspan, Live Streaming and ondemand at cspan. Org, or listen with the free cspan radio app. Before the conventions evening session, watch cspan at 6 00 p. M. Eastern for past Convention Speeches by prominent politicians. Watch past Convention Speeches at the start of the Republican National convention monday, only on cspan, your unfiltered view of politics. Announcer