With six president s on some of the most difficult Challenging Health crisis to confront humanity. Hivaids, ebola, topeka will probably nothing on the dangerous disruption, divisive as covid19. His claimed more than 170,000 lives in the u. S. Alone. 5. 4 million cases here. I first covered and interviewed him when i was a White House Correspondent seen in the 1980s and hivaids was exploding first on the scene. Good to be with you. Let me start by saying thank you for your time again and how are you doing in the middle of all of this . This is insanity. You are right. It is really surreal but im fine, it is very intense. Obviously we are working 16 and 17 hours a day on this. It is something we have to do. It is a challenge as you all know, is historic, we havent seen anything like this in 102 years. Since the 1918 pandemic. Its challenging to the entire world and we, the u. S. Has been hit worse than virtually any other country when you talk about cases and deaths so its a real important challenge for us. Theres a lot we have to discuss here and not a lot of time. We are done, ill be joined by the dean of the school of Public Health, dean of the medical school and director of the school to build on some of your comments but i do want to dive in, we have over 100 questions from faculty and students so im going to do my best to leave those in. I saw a story the other day about boston, different time and different signs but the headline haunted me. Boston refused to close schools during the 1918 flu and children began to die. The history is about to repeat itself . I think theres a difference there, if you look at the situation in regards to the current pandemic is that children really have much less of a chance of having a serious outcome when you look at hospitalization rates for 100,000 people. If you look at the graph, it literally gradually goes up into you get very high hospitalization rates, 100,000 among the elderly. So age is an issue. However, we should not neglect the fact that children are seriously ill, a lesser likelihood than adults. There are other symptoms we are starting to see right now, inflammatory symptoms children have, we dont know the extent of that, it seems to be unusual we dont know the full extent. But the issue is, we are learning about children getting infected. Children from ten to 19 and transmit to adult as easily as adults transmit to adult. Some schools are opening, some are not. Up to local decision makers, some have medical guidance, the latest clients and some not. Are you concerned about the way this is being done . Children as transmitters of this. Thats what i was trying to say i was talking about the child transmitting it to adults. Even very Young Children have a high degree of virus when you look at the titers. There certainly capable of transmitting. The degree to which they do, i think we will learn about in the coming weeks and months. We would like to see consistency about schooling, consistent to guide the local authorities who make the decisions about school. Where should that come from . It could come from the Health Authorities like myself and al said here, we live in a big country that is heterogeneous in regard to the level of virus and youve got to look at what is going on in the community. If youre in a green zone where you have less then ten for 100,000 cases to 100,000 population, you could probably open the schools to a considerable degree of impunity. When you get to the yellow zone ten to 100 cases. 100,000 with the virus in the community, you might want to modify the things you do. Physical separation, mask wearing, outdoor classes when possible, situations we have hybrid, some online, some in person. When you get to the grade zone from zone where its clearly over 100 cases are 100,000 and theres a lot of virus activity, you really want to think twice before you get the children back to school. All the kids go back or they stay locked in. Look at extenuating circumstances and the location where the school is. Ahead of the schooling discussion extends to colleges and universities. Dr. Fauci schools are grappling with this decision. What is anyway bring students back from all parts of the country and have them gather in the dorms and classrooms in the hallways. Deal with reality and be able to safely reopen. Dr. Fauci so we want to make sure now that the viewers know there were no longer talking about middle school. Talk about, is a big difference. Fraternities and parties. Dr. Fauci and that sort of really cannot address the concerns i have about what the level is because people are coming from all over the country. Coming from red zones and thousands results. It really varies. There are some universities and colleges that have a system set up and they test virtually everybody who comes in before they even get there. To make sure you dont introduce into the community, and to the dorms in the college. Infected individuals and screen individuals who have situations if you have the facilities and resources to do it. You might have an empty dorm where someone has tested positive, you can safely isolate them there. That they need medical care, you can get the the medical care. If you have the capability of doing that it is conceivable that you can successfully bring people back to the colleges and universities. Host conceivable but is it feasible. Dr. Fauci in some cases it might be. Host it sounds me like youre saying most cases your skeptical pretty. Dr. Fauci impetigo university by university. Where they are what resources do they have to be able to do some of the things they universities are already showing what theyre doing. You can test everybody before they come in. You can have the surveillance testing and the capabilities of identifying with the Contact Tracing. If you can do that, they knew very well may be able to open up the colleges and universities. If you cannot, it would be more problematic. Host let me ask you about the health effects. Youre the frontlines in your watching this very closely as his doctor to scientists in a researcher. He recently talked about this covid19 potentially targeting micro colitis, myocarditis. Information of the heart muscle. Another study germany looked at a very high rate of people who have been suffering from that. Rather studies are looking at potential brain damage. The study that i was reading, a potential brain micro structural damage. Whats new do we know about the effects of this disease among those who have had very separate Entrance Service level in terms of persistence to the bodies. Dr. Fauci is a work in progress. Literally every week and month, you name some of the reports accurately. If come out and there are now others in progress, there are a lot of different groups looking at this. You bring up my mind, a very important point and let me explain why. If you say you were about people as well as will be sure you increase that is very important for the very reason that we are ready have well over 160,000 deaths. Close to. However, if it turns out that people even some who do not require hospitalization. Some of the studies that you just quoted, they were from individuals who were second on, or maybe a couple weeks at a time the bernanke been sick enough to go to the hospital. Yes, when you look at the percentage of them, and actually recover, and recover within two to three weeks. A portion of the do not feel the fatigue or muscle aches or rain fog spring thing that worries me more with what we have seen about the subtle insidious effects on the cardiovascular system and nervous system mainly the mris scans the show abnormalities of inflammatory processes, and the brain and in heart, of some individuals. It is like 1 percent or 2 percent. If you look at it, it could even be several digits of the percent received this. They may be reversible the make a completely clear after a while. But we dont know that. So we better be careful that just because a person survives and obviously the overwhelming amount of people to survive. That there may be a certain percentage of people who might have serious effects. We need to follow that pretty. Guest . Host seems to be this vl part of the messaging and often not getting out. It is about buying or not dying horribly are not opening. As opposed to how brutal this could be just to get it, the potential of longlasting effects in place that we dont even know. Layers of risks. Vaccine, vladimir putin, and the daughter got vaccine, bogus or dangerous or credible start. Dr. Fauci is not bogus. Whats bogus is that you say you have a vaccine. Theres a big difference having vaccine and then proven in trials that you have a really well designed randomized trial that when you start to give it, widely to hundreds of millions of people that your giving it is safe vaccine. The russians my knowledge of not beens dallying this in very large randomized trials. Guest . Hosthost im sure the vladimirr that youre calling him bogus. Dr. Fauci thats not what i said. What im saying is that having vaccine is very different than proving that a vaccine is safe and effective. For that matter, we have six vaccines now. We havent proven them yet. That they are safe and effective but when we do, then we can act as we say. They were comfortable with distributing it to hundreds of millions of people. But before and until we prove that is safe and effective, we really dont want to be talking about having a vaccine. Host and the question you probably asked most which is when, your answer is what pretty. Dr. Fauci right now we have at least three. Thats already in phase three trials. Two of them started on july 27th. And are already been ruled out to thousands of individuals. One of them is a 30000 person trial and another one is aiming at 60000 people. We will likely no within a period of several months which takes us to the end of this calendar year and maybe to the beginning of 2021. Whether or not will have a safe and effective vaccine. I believe based on the preliminary data that we have, that we can be cautiously optimistic. No guarantee. Theres never a guarantee. But we feel cautiously office optimistic that we will have one that will be safe and effective. We know that from preliminary data. In phase one studies, neutralizing antibodies arrival level possibly to better in some respects then con. Convalescent plasma of people have actually had it. We feel good about it. Host let me ask you a question very closely related to that the question itself actually comes from one of the students at the school of Public Health at George Washington university. It is about people getting the vaccine. The gallup medical that they conducted that the end of july and early august 35 for percent of the respondents, the question is. When a vaccine does become available, how can providers about the vaccine presidencies. I might fall in there, vaccine disinformation. Dr. Fauci will vaccine in disinformation, but there is Vaccine Hesitancy this fundamental without necessarily disinformation. So what we need to do is what weve done whenever we have seen a situation where people are hesitant to get a vaccine they really need. The need for themselves, and for the protection of the community. That is definitely not criticizing that or people for that. Trying to engage them. And you do that through community engagement. Particularly with minority communities who often pulled often understandably reluctant to believe what authorities tell them about health. That you get out there and you get Community Representatives to engage them and try to be as transparent as you possibly can with the data. Answer the questions they have and try to convince them that vaccinations in general particularly are safe and effective vaccine of the covid19 is something that is important to them, their families and society in general. Host another question from another student. Would you support a nationwide mandate of the covid19 vaccine. Dr. Fauci no, definitely not pretty dont want to mandate and force anyone to take the vaccine. Weve never done that. You can mandate certain groups of people like Health Workers that but the general population you cannot. Here at the nih, we get people in for vaccines. And if they refuse, other than the you just dont want take it and we dont allow you to take your patience. So that is a mandate. But we dont want to be mandating from the federal government to the general public. It would be unenforceable and not appropriate pretty. Host so lets talk about how we do get out of this. One of the things in the new year talking about is there a protest free to have a question from a faculty member about that. Doctor can you explain the bottlenecks and making it so difficult to ramp up fast results for self administered test things that would enable the country to more safely reopen before vaccine is available. From Harvard Department of health, they have discussed this. Cross diagnostic testing pretty. Dr. Fauci considerable amount of growing enthusiasm. You see that relatively soon. The critical issue is to make sure that we get those tests, there have to be at degree of sensitivity which is appropriate. Need to general spending, when 99 percent, which the main molecular test gives you, when you absolutely need to know if this person is infected or not. Because screening, the penetrance of the infection is in any given group of population. You can look with one that is less than 98 or 99 percent effective. When that might be 85 percent effective. Because even though you may miss some, if you do the test enough and repeated enough, you will make up for the lack of sensitivity spread bus test to be available right now. Forcing is the private sector staring up to make them available to many millions. Host theres a lot of concern and focus on hesitancy of vaccine was out rated the test of the resources are going to be equitably start distributed and including lower income people, people of color, people who are disproportionately caring the cost of this disease in the back. What is being done to address that very serious problem. Dr. Fauci there very serious attention to that being paid. Mandatory group of people who are committed to making sure that happens. One of the first things we do is that whenever you have early on, which will be the case as the vaccine start to rule out. By the end of 2021, were told by the manufacturers that there will be enough vaccines potentially for ever been in but before then, there will be prioritization. And when you prioritize. An independent growth, this case have the advising committee and the practices pretty they have traditionally advised the cdc for the responsibility. That will be complemented by another independent group from the National Academy medicine. To get the prioritization such as that you can see publicly published what we call prioritization rights. I can tell you that weve seen similar what was seen in the past with highpriority some of the Healthcare Providers and first responders. Because they are putting themselves in harms way to take your people. The likely be the ones who get the most. Host another question like a plan. Who has looked at the covid19 disinformation and experience. He writes, a scientist we are trained to communicate just the facts. Best of months, beyond a shadow of a doubt those facts are prone to interpretation. They will potentially distort and misinterpret those facts to support their narratives. When you see is World Health Experts such as yourself. To help people understand the facts in the correct contents. Sometimes you get attacked by the president of the United States. Dr. Fauci the thing that we stand by such a fundamental principle that you make recommendations and policies based on data and evidence, speculation and struggle, those kinds of opinions really need to be put aside. Everything they are talking about, in the arena of Public Health. Particularly recommendations and policies regarding any entered, diagnostic vaccine that have to be made on the basis of sound, Scientific Data and evidence and a trend that is the kind of thing that i do in my colleagues do for Public Health officials do the same thing. Based on solid Scientific Data. Host as i mentioned on the outside, even in this job since 1984. You and i first met when aids was exploding. I remember as a young guy at the white house, and i remember the first briefing. And i remember the incredible Politics Around it. The collision the pandemic and politics as we have seen here is amazing but is not the first time the politics and this is delighted pretty youve been through anthrax and sars and aids and you see god in all of these things. Have you ever seen anything like this. What you make of this political division. Every poll shows this is country whether it is masks, whether this whole thing is a hoax. Dr. Fauci you right in the description of my experiences. Even back in the early days of hiv, there was stigma associated with it. It wasnt take are politics, is different ideologies about how much attention paid to disenfranchised groups like the gay population. Which was really obviously did not get the attention that they deserved rated for the actavis demanded it. Inappropriately they got it. This very different than what we are seeing now. Overseeing now is this divisiveness, that transcends the covid19. Is there even without covid19. And the perfect negative storms that really makes it very difficult and problematic need try to do this Public Health challenges that you have this divisiveness that makes the polarization of the response which we are saying very difficult. We have people who follow politically different signs of whatever particular issue is, is thrown into the Public Health. Mask or no mask. This or not that. It shall be that way. Public Health Challenge is a challenge that everybody, does not make any difference what your political ideology is. Or what you feel strongly about one way or the other. We should be completely in line with each other. That this is a serious Public Health problem. Host are tracing that to the president of the United States. Our conservatives on hill who drilled you on the congressional testimony. Dr. Fauci look at the record. Unrighteous money. I said same thing that im telling you