Dr. Fauci it is a mixed bag. You can look at the numbers and they are very serious and concerning. Weve had over 185,000 deaths, six plus million infections. If you look at the country, a large heterogeneous country, some areas are doing really very well right now. Particularly those hit badly early on. The new york city metropolitan area has at least for a month now have less than 1 test positivity. In contrast, in other parts of the country, but we saw and some of the Southern States that had big surges where they tried to open up the economy, that brought the baseline number of daily infections up from 20,000 to as high as 70,000. We are back down now to between 30,000 and 40,000. And just as those states are starting to level off and come down which is a good sign, we , are starting to see the beginning of surges in places like montana, the dakotas, michigan, minnesota, iowa. So it is really a mixed bag. Some areas are doing really well. Some are still threatening to have surges. It is not an easy situation for us. Judy if someone said we are rounding the final curve on this, what would you say . Dr. Fauci if you pick a location in the country and say that could be true, but if you look at the country as a whole, we need to be doing better than we are doing. Thats for sure. Judy this month, as you know, its on the mind of so many families. Students are returning to school. If people are worried about their children i want to ask you about colleges. There has been a lot of focus on those. You advised last week schools not send students back home if they test positive. What are you concerned about with colleges, and why did you make that recommendation . Dr. Fauci i made that recommendation because when you bring in college and university students, if they get infected, you should try to have the capability, the facility to sequester them from the rest of the student body so they dont infect other students. What you should you shouldnt send them home because you are getting kids from all over the country. You send them back to their communities, you will in essence be reseeding individuals capable of transmitting infection to many communities throughout the country. It is much better to have the capability to put them in a place where they can comfortably recover. Hopefully that can be a floor of a dorm, or an entire dorm dedicated to people who you want to segregate from the rest of the student body. Judy how are american colleges and universities handling this . Dr. Fauci in different ways. Some are going virtual and online completely. Several ive had the opportunity to speak with are doing testing on everybody that comes in to the campus for the first time once. Starting off with the baseline that is essentially zero. Then they are doing surveillance testing at various intervals. The ones doing that, who have the capability of handling students who ultimately get infected seem to be successfully being able to open. Unfortunately some colleges dont have that capability of being able to sequester people. They are tending to do more virtual or online teaching. Judy what about the public schools, k12 . What is your concern there . How worried should parents be right now . Dr. Fauci in contrast to what i just mentioned regarding colleges and universities where young people are coming in from all parts of the country, when you are dealing with k12, it is a local issue. Being a local issue, what i and others have said and i think is prudent is we have green, yellow, and red zones. The green zone has little infection activity. In those cases you can open up the school in person the person person to person teaching with relative impunity as long as you are able to identify students who get infected and make the appropriate accommodations for them. When you get into the yellow zone and you have a degree of infections in the community, you have to be able to adjust and adapt to that. You have to be prepared. You look at the cdc guidelines, but you might want to modify your schedule. Morning versus afternoon every other day, separating desks. If you can physically do that. If you are in the red zone, you have to be very careful before you bring the children back. You dont want to create a situation where you have a hyper spreading event in the school. Judy lets turn to the big question, the vaccine. As you know, theres a lot of speculation about when we will have a safe and effective vaccine available to everyone who needs it. What do you know about it right now . Dr. Fauci right now there are six or seven candidates the u. S. Government is helping to facilitate either by developing with them or by repurchasing prepurchasing doses or allowing Clinical Trial network to be available for them. Three of those candidates are already in phase three trials. Which means you will enroll tens of thousands people, volunteers, to determine if it is safe and effective. Phase three trials, the first two got started on july 27. Your prime and boost dose. Right now the trials are about two thirds enrolled. We project by the end of september they will be fully enrolled. Then you add another month to a month and a half to get the second dose. That is the reason why i have projected by the end of the year, by november, december we will know if we have a safe and effective vaccine. I feel cautiously optimistic that we will, given the preliminary data we have seen. There are a couple of other vaccines going into phase three trial at the end of september and then october. Sequentially we have 11 candidates in play which is the reason why we are optimistic we will be successful with one or more. That will likely start taking place by the end of the calendar year 2020. Judy the idea that we will have a vaccine by november 3, how realistic . Dr. Fauci i find it unlikely. The only way you can see that scenario come true is if there were so many infections in the Clinical Trial sites that you get an efficacy answer sooner than you wouldve projected. Like i said, it is not impossible, judy, but it is unlikely we will have a definitive answer at that time. More likely by the end of the year. Judy we know with regard to the publics confidence in the vaccine, polls are showing perhaps a third of americans are not confident enough and are not going to take the vaccine at first. That is a pretty high percentage. At what point does this become a problem . Dr. Fauci i think it already is a looming problem. One of the ways we can mitigate against that is by being very transparent in our outreach to the community about what the data are, what they show, and what criteria youre using in order to make a decision about the vaccine being safe and effective and making it available. We have got to regain the trust of the community about when we Say Something is safe and effective they can be confident it is safe and effective. That is the reason why we have to be very transparent with the data, as well as what it is that goes into the decisionmaking process about approving a vaccine. Judy are we on track to do that right now, to be transparent . Dr. Fauci we are, judy. One thing we need to do better on, we have got to get a higher percentage of minorities into the Clinical Trial so that when we get the data we can say it applies equally to the minority community. Africanamerican, latino, native american and others. When we Say Something is safe and effective, we mean it is safe and effective to everyone. That we need to do a little better on. Judy in the fall with the onset of flu season, dr. Fauci, you and others have raised concerns about the convergence of the flu and covid. We have seen in the Southern Hemisphere somewhat milder flu outbreaks than they mightve been. Does that give you more hope for the fall here or not . Dr. Fauci it does. I never take anything for granted. That is dangerous, particularly when youre dealing with Public Health. We should continue to encourage people to get vaccinated with the influenza vaccine. But if what happens in the Southern Hemisphere happens here, that would be a very good and favorable thing. What we think has happened we think because people have done Public Health measures to avoid infection with the coronavirus, namely masks, distancing, avoiding crowds, washing hands, we had a secondary effect that there is less influenza infections. In fact in australia this year, for their influenza season, which goes from april to september, they have had one of the lowest rates of influenza infections in memory. If we can do that, i think that would be very favorable. Judy what do you know about the coexistence, if that is the right word, of flu and covid . What is it about having the two or being exposed to the two . Dr. Fauci there are several issues. It is the wintertime. When you have winter indoors, you can expect enough uptick of respiratory illnesses. If we do have a fullblown flu season, which i hope we dont, and we do not get control over the coronavirus, you can have several challenges. One is differentiating between covid and flu. There are medications for flu. We are getting more and more medications for covid. Number two, we would not want to see an overwhelming of the Health Care Delivery system. For example, hospital beds and intensive care unit beds. Even health care personnel. That would be really a very serious issue if we begin to see any overwhelming of that. That is the reason why when you have two coexisting infections during the winter months it becomes problematic. Judy do you already know how effective the flu vaccine will be this year . Do you just have to watch that play out . Dr. Fauci you definitely have to watch that play out. You dont know from yeartoyear how effective that will be. Judy is there a sufficient supply of the flu vaccine . There has been so much focus on covid. Dr. Fauci yes. We have been vaccinating more and more people with the influenza vaccine as the years go by. Last year, it was Something Like 170 million doses were distributed. We want to do at least that amount and hopefully more this year. Judy do you have concern about the publics reluctance to have the flu vaccine this year simply because covid is out there and they are just worried about any kind of vaccine . Dr. Fauci that is something that bothers me continually, the people who have reluctance to get vaccinated. Particularly you know a vaccine would be of such considerable benefit. We have to fight the classic antibacks group. Antivax. When people have doubt about the efficacy and the safety, which is what we are seeing with covid, you have to do an extra special effort to engage the community and outreach to them to give them the data they can make an informed decision. Judy you mentioned a moment ago, dr. Fauci, you want to make sure that minority racial minorities are addressed, whether it is the manufacturing, the distribution of the covid vaccine. How do you do that . How do you go about making sure this is distributed equitably . Dr. Fauci it is all community outreach. We have done that back in the day with hiv, with prevention, and with treatment measures. You have to engage the community. Both getting the appropriate demographic groups involved in the Clinical Trial. You prove it is safe and effective. Once you do that, you engage the community in an active way. That is with psas, getting out in the community yourself, boots on the ground, speaking to people, getting them involved. It is not an easy process but definitely worthwhile. Judy are there strategies in place to do that right now . Dr. Fauci absolutely. We have been planning for this for a few months. Judy that is underway. I wanted to ask you about the effect covid has had on other health risks and frankly on our Research Infrastructure in this country . Dr. Fauci unfortunately it has been disrupted across the board. Not only in the United States, but globally because of the shutdown and the diversions of resources and attention away from other diseases and covid. The typical type of screening for things you need to Pay Attention to, screening for breast cancer, for prostate cancer, getting people following up on things that were suggestive of an issue you asked for a followup and it was delayed by months, you can wind up getting to a situation where diseases that have nothing to do with covid, diseases of different types, infections, cancer, autoimmune, they might get neglected. Routine checkups you would need tend to get neglected. We know in the Hiv Community the disruption of services and the disruption of availability of drugs can actually really be a problem. Bottom line is it is quite disruptive and has deleterious effects on how we handle other diseases. Judy is there evidence that has happened . Dr. Fauci absolutely. You are seeing upticks in things he would not have had if you have the appropriate screening and appropriate followup. Judy how important is it, and maybe this is a self answering question, there has been a hold hold up of congressional funding. How important is it that funding continue . Dr. Fauci its extremely important. We, fortunately, being a health sciencebased institution has been treated with considerable degree of generosity by the congress. They have given us the kinds of funds we need to be able to do our duty and mandate with regard particularly to covid. Judy you are not involved maybe you are an lobbying for funds. Is it your sense that funding is going to be forthcoming to bolster the research . Dr. Fauci yes. We have gotten a considerable amount already. We have not been disappointed every time we have asked. They ask us what it is we actually need. We give them an honest assessment of our needs. Thus far they have been met. Judy how do you people talk about pandemic fatigue, if you will. We have been at this now for more than six months. How do you ensure the American People stay vigilant . Stay mindful of this . The numbers are mindnumbing. We are at 190,000 americans dead. Millions have been infected. The numbers just keep coming at us. People are still gathering. Sometimes wearing masks, sometimes not. How do you keep people vigilant . Dr. Fauci you have to keep reminding them of the importance of being vigilant. It is clearly a risk when you have been exhaustively involved in something now for eight months. One of the things i do, and i believe it can be effective, is remind people there will be an end to this. We will end this crisis we are in right now, both from a Public Health standpoint and from a scientific standpoint. For example with vaccines and treatments. When people know there is an end in sight, they can hang on a bit longer. It is when they throw their hands up in exasperation and say this is never going to end so the heck with it. Why dont we just get on with our lives and do what we want to do. That can be a very dangerous conclusion to arrive at. It leads to carelessness and even more infections in the propagation of the pandemic. When people see if they just hang in there a little bit more, we will come to a natural end to this. That is what i try to emphasize to people when i speak. Judy what do you worry the most about at this point . Is it the vaccine or Something Else . Dr. Fauci i dont worry about it but im cautiously optimistic we will get a vaccine. I think we will not really return with ease to a degree of normality we all seek until we do get a safe and effective vaccine. And as i mentioned, i believe we will have that by the end of this year, the beginning of the next calendar year of 2021. Lets hope i am correct and it will be available. I think that will really be a game changer for us. Judy im looking at a couple of audience questions. One of them is, if there is a choice of vaccines for people to have access to, is that possible there will be several vaccines . Available to people . Can they make a decision about which one to choose . Dr. Fauci i think it is eminently possible. It is not likely we will have more than one candidate. Like i mentioned there are six , or seven we ourselves in the United States are directly or indirectly involved in. That is not even counting the vaccines that are being aid by Foreign Countries like russia and china and the u. K. And others. I would be surprised if he only if we only had one vaccine. I think there will be more than one available. Judy how do people make the decision about which one is the right one for them . Dr. Fauci the companies are going to be advertising as to the specifics and specifications of their product. I think it will be more or less something less sophisticated than this one is available in the supply place where youre getting your vaccine as opposed to you pick the one you want. If a certain pharmacy chain buys out and they become the once a the ones that distribute it fine. , if there was another the governments were deeply involved with, that is the one youre going to get. You will not be able to pick and choose like in a candy store. Judy in terms of political influence rushing a vaccine, how , could you assure americans there will not be a political thumb on the scale . Dr. Fauci there are several issues i think will mitigate against that. The data will go to an independent data and safety monitoring board who then make the recommendations as to whether or not the vaccine is effective or not, whether it is harmful or not. When that data is available, it will ultimately become public. The fda has publicly promised they would not allow Political Considerations to get involved in their decision. And in addition when they do , make a decision they get input from an outside Advisory Group who will be involved in looking at the data and making recommendations about a decision. There will be a couple of levels of control over the decision. Judy you mentioned the fda. I know we only have a few minutes left. It was the fda that rolled out original information about the socalled convalescent plasma, where they came back and said later it was overstated. When you have Something Like that happen isnt it natural for people to be skeptical . Dr. Fauci you are right. I dont want to deny that that , is reality. They likely will be skeptical. What were trying to do now is correct that and get them to understand there will be multiple layers of checkpoints before this type of decision is made. There are a lot of people looking at this, a lot of people in the scientific community. Myself included. We are looking at this to try to make sure it gets done in a way that is scientifically sound. Judy i should say not just the fda but there has been some backandforth at the cdc where there has been guidance that has then been pulled back and questions raised. I have to ask the question again. How can the American People be sure they are getting straight science from these Government Agencies . Dr. Fauci again, it is not going to be easy given what has gone on before. We just have to keep being quite transparent. I have been from the beginning always quite clear in how i feel about the importance of the integrity of the science and the integrity of the decisionmaking process. I and many of my colleagues will continue to be very vigilant about that. Judy someone asks just before we wrap up, i mentioned convalescent plasma. The original recommendation from the fda. It was reported in the New York Times that nih did not support that recommendation. Can you shed any light on what happened inside the administration . Dr. Fauci we looked at the data and it was not really very clear cut whether or not this was effective. The rules are loose in the sense of being able say there has to be a chance of efficacy. There was a bit of a discussion backandforth about how tight the data was indicate that. At the end of the day when the , randomized placebocontrolled trials come out, we will know what the right answer was. Judy finally, we have a couple of minutes. When we think about americans who are going to most need a vaccine first, clearly frontline workers, people with compromised immune systems, perhaps the elderly, how do you think about that and is that all decided right now about what groups of americans need to get the vaccine first . Dr. Fauci that is decided by an Advisory Committee on amortization practices, which reports to the cdc. Ultimately the cdc is involved in the final responsibility of distribution. This year the National Academy , of medicine, whose recommendations came out literally a day or two ago, is called in to complement that decisionmaking process. As you said, i think you called it correctly, it is not unexpected that frontline workers, health care workers, and those who get it first, those with essential jobs, those that would benefit most, namely with underlying conditions including the elderly. It looks like it will play out that way with the covid vaccine. Judy any final message you want to give to the community . Dr. Fauci it is what i said before. To essentially get people through the frustrations of having been in this for so many months. We need to hang in there together. This will end. It will end even sooner if we go by Public Health measures that have been recommended time and again for so many months. Judy dr. Fauci, thank you so much. I will turn the program back over to derek. Thank you. Dr. Fauci good to be with you as always. Had a surveyng we were people were asked, what is the most important thing to accept in the advance in science and trust in science will was what far and away came through is the most selected answer. Dr. Fauci, youre doing just that, so thank you very, very much. On theident trump goes campaign trail this evening. He will be in winstonsalem, north carolina, to speak to supporters there. You can watch live coverage on cspan starting at 7 00 eastern, also Available Online at cspan. Org, or listen on the free cspan radio app. Cspan, yourching unfiltered view of government, created by americas Cable Television companies as a public service, and brought to you today by your television provider. Traveled to trump deliver remarks about his administrations environmental policy and later signed an executive order announcing he is
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