0 the president was asked about this earlier this week and he said that had not been recommended to him. you're his chief medical adviser. do you think that's something the country should adopt? >> i'm not so sure we should say that should be a requirement. we have 60 million people in this country who are not vaccinated, who are eligible to be vaccinated. let's get them vaccinated, let's get the people who are vaccinated boosted, let's get the children vaccinated. that's where we want to go as opposed to a requirement. >> reporter: some people say you have extinguished many of your options to get those people vaccinated and this is one of the ways, as the osha mandate is held up in court, this would be a way to get more people -- >> you know, that's a possibility. but for the people who are listening to this, we talk about why it's important to get vaccinated. i think what's happening now is another example of why it's important for people to get vaccinated who have not been vaccinated, but also boosting. boosting is really very important, because the data that we get on boosting, if you look at the level, for example, of an antibody, a neutralizing antibody, the peak following a second dose of a two-dose mrna, it's like at this level. if you look at the peak involving the third shot boost, it goes way up here. people ask, why is that important? because our experience with variants such as the delta variant is that even though the vaccine isn't specifically targeted to the delta variant, when you get a high enough level of an immune response, you get spillover protection, even against the variant that the vaccine wasn't specifically directed at. and that's the reason why we feel, even though we don't have a lot of data on it, there's every reason to believe that that kind of increase you get with the boost would be helpful at least in preventing severe disease of a variant like omicron. >> reporter: dr. fauci, as you know, a lot of americans are shopping for the best sort of booster they can get. given that manufacturers and scientists are racing to learn more about this variant and modify a vaccine that will directly combat it, for those who have received a boost, how long would it be before conceivably they could have a new modified booster would target this, and is there any reason why americans should wait until we have a more modified vaccine that more directly targets it? >> great question, we get asked that a lot. right now i would not be waiting. people say if we're going to have a booster-specific vaccine, should we wait. if you're eligible, namely six months with a double mrna dose or two months with the j&j, get boosted now. we may not need a variant-specific boost. we're preparing for the possibility that we need a variant-specific boost. and that's what the companies are doing. we have been -- the administration has been in contact with the pharmaceutical companies to go ahead and take the steps in case we need it. but the mistake people would make is to say, let me wait and see if we get one. if you're eligible to get boosted, get boosted right now. >> reporter: there is screening in place for international travel but we've seen how quickly variants can spread once they reach our shores. does the science not suggest there should at minimum be a testing requirement for domestic air travel? and if not, why not? >> again, these kind of things we always talk about and consider. but right now, i'm not so sure we need a testing for air travel in this country. i always get back to the fact that people should wind up getting vaccinated and boosted if they're eligible for a boost. i keep coming back to that because that's really the solution to this problem. >> reporter: two quick ones. a moderna executive has said in the past couple of days that this variant appears threatening and may demand new vaccines. what do you make of those remarks that seem a lot more alarmist than the administration's view or that of other vaccine makers? >> i think -- i know that we don't have enough information right now. as we know, and you've said that, that the molecular profile of the kinds of mutations that you see would suggest, a, that it might be more transmissible, and that it might elude some of the protection of vaccines. but we don't know that now. we don't know what the constellation of mutations are actually going to be. we have to be prepared that there's going to be a diminution in protection, which is the reason why i keep getting back over and over again to say why it's so important to get boosted. but i think any declaration of what will or will not happen with this variant, it is too early to say. and i think we need to be careful, because i know you're going to be reading a lot of tweets and a lot of comments about this. we're really very early in the process. >> reporter: say, though, this proves more transmissible but less virulent than delta. would there be any public health benefit to furthering its spread by lifting travel restrictions, for example, so it can outcompete the delta variant? >> you're talking about something really dangerous. you're talking about, let a lot of people get infected to see if in fact you get protected. that's something that all infectious disease people with any knowledge of infectious disease would say that's not a good idea. >> reporter: dr. fauci, we're firmly in the holiday season and a lot of americans are wondering if it's safe, even if vaccinated, to go to a cocktail party, without a mask, with a glass of eggnog in their hand. what's your advice? >> my advice is what i do myself and tell people to do, which is to get vaccinated -- i'll get to your question, i'm not eluding it -- to get vaccinated, number one. if you're eligible for a boost, get boosted. and in a situation with the holiday season, indoor typesetings with family that you know is vaccinated, people that you know, you can feel safe with not wearing a mask and having a dinner, having a reception. but when you are in a public congregate setting in which you do not know the status of the vaccination of the people involved, it is very prudent to wear a mask. and that's what i do. >> reporter: despite the eggnog? >> you know, obviously unless you have a special kind of mask that i don't know about. the fact is, sure, when you're eating and drinking, take the mask down. but to the extent possible, keep it on when you're in an indoor congregate setting. >> reporter: dr. fauci, as you have advised the president about the possibility of new testing requirements for people coming into this country, does that include everybody? >> the answer is yes, because you know that the new regulation, if you want to call it that, is that anybody and everybody who is coming into the country needs to get a test within 24 hours of getting on the plane to come here. >> reporter: what about people who don't take a plane and just these border crossers coming in in huge numbers? >> that's a different issue. for example, we still have title 42 with regard to protection at the border. so there are protection at the border, that you don't have the capability, as you know, of somebody getting on a plane, getting checked, looking at a passport. we don't have that there. we can get some degree of mitigation. >> reporter: something to do to test these people somewhere else? >> there is testing at the border under certain circumstances, as you know. >> reporter: doctor, two questions. first, for folks in california, i know this is only one case, but what's your message to them? should they be particularly concerned? secondly, with your emphasis on boosters, why not make a determination that it's in the interests of public health for the definition of fully vaccinated to include that additional dose? >> okay. so for the people in california, we've been in contact with the public health officials in california. i'm not sure exactly what they're going to say but i'm pretty sure they're going to say just do all of the mitigation, all the things we have been talking about up to now. for those who have not been doing that, start doing that. for those who have been, continue doing that. >> reporter: and in terms of making a determination that being vaccinated -- >> again, there's the official determination of what something is for a variety of reasons. for example, employment and getting vaccinated, what is the definition. that will stay that way. for optimal protection, i'm talking about what your personal effort to be optimally protected, that's why i say we should all get boosters. >> reporter: what about in tells me of the mandate? you have a vaccine mandate. at what point does the booster become part of the mandate? >> i can't answer that right now. but i know that for the time being, the official definition of fully vaccinated is two. >> reporter: we see that changing. >> it could change. it could change, yes. >> reporter: do you recommend that change? >> i don't know, let's see what rolls out now. if i say it's going to change, that will get spread out, that that's it. we don't know now whether that will change, but it might. >> do you think visitors should quarantine on arrival for seven days, regardless of vaccination status? >> you're talking about foreign visitors? >> reporter: yes. >> obviously they are, they have to get tested within 24 hours. when they come back, if they're not vaccinated, they have to be in quarantine, they're recommended to be quarantined and recommended to get a test within three days. >> reporter: if they are vaccinated, should they be quarantined? >> again, we're going to get confused here. are you talking about united states citizens or anybody that comes into the country? >> reporter: anybody. >> i'm not sure what that's going to be, we'll have to check with the cdc. >> reporter: dr. fauci, there are reports that in a new book, former president trump's chief of staff mark meadows says that the president, the then-president, tested positive for covid three days before the debate with president biden. were you aware of that positive test at the time and do you think that he put then-candidate biden at risk in that debate? >> i certainly was not aware of his test positivity or negativity. >> reporter: do you think that he put then-candidate biden -- >> for anybody, if you test positive, you should be quarantining on yourself. >> reporter: if i may, president trump's doctor, who you worked with at the time, dr. sean conley, was aware that, according to mark meadows, yet former president trump continued to go out in public events. based on your medical advice is that something you would have recommended if he had tested positive? >> i would recommend to anyone, whether it's the president or any of my patients or any of the people that i deal with, that if you test positive, you should be prudent and quarantine yourself. >> reporter: dr. fauci, there are zero cases of omicron in zimbabwe, in mozambique. what justifies imposing a travel ban on countries that have zero cases of the omicron variant? >> you know, that's a very good question, an important question. and we did struggle with that. we wanted to see if we could buy time temporarily. i do hope that this gets sorted out and lifted before it has any significant impact on your country. >> reporter: thank you, dr. fauci. last week the governor of new york signed an executive order to postpone elective hospital surgeries to prepare for the omicron variant. i know you and your team are being proactive as we try and learn more about this. but do you believe some states might be going too far, too quickly, before we know too much? >> you know, i don't really want to comment on the situation in individual states, because there are so many factors from state to state that are different. i don't think it would be appropriate for me to comment whether a state should or should not postpone elective surgeries. >> reporter: and the president said that we will defeat this variant of the coronavirus, not with lockdowns or shutdowns, but based off of the tools that we have now. is there anything that we are taking into this new variant experience based on off of some of the adverse effects of some of those lockdowns? we just passed 100,000 overdose deaths for the first time ever. >> yeah, i mean, first of all, we always discuss things that we might do to better our preparation, better our response. that's something we discuss every single day. but right now, what i've always said, and i'll continue to say, let's utilize and implement the tools that we have, because if we had done that, if we had the overwhelming majority of people in this country vaccinated, and those who needed to be boosted, boosted, our vulnerability would be much less than it is right now. >> reporter: what do you see as an end game? 1917, 1918 flu pandemic, it eventually evolved to be less lethal. but there are those who say we're never going to get that far with this virus because we need more people vaccinated. what do you see as the end game? >> i mean, the end game which we hope and i think will occur is that as we get more people vaccinated not only in this country but globally, we will see a situation where viruses will not have the opportunity that they have right now, to essentially freely distribute and freely circulate in society, both domestic society and global society. the more protection you get with vaccines, the less likelihood a virus has to do that, the less likelihood a virus has to mutate, the less likely you're going to get a variant. so one of the things we need to do about our long end game is to do the things we've been saying every single day. not only for ourselves but internationally. and you know, we have done a lot and we'll continue to do a lot to get lower and middle income countries vaccinated. [ inaudible question ] oh, absolutely. there's no doubt that this will end, i promise you that. this will end. >> i'm sorry, we have to let dr. fauci go. thank you for coming. appreciate it. they're going to be doing a press conference in california where they may have additional details to share. i know we have a bit of a crowded day today, so we'll get to as many people as possible. we'll let people know when they need to gather. so just a couple of light things -- not light, but a few things at the top. i'm sure everyone saw the red ribbon on the north portico marking world aids day. >> we're listening to press secretary psaki. let's get you updated on what we just heard from dr. fauci. it is now confirmed, the first case of omicron has been detected in the united states. it's detected in san francisco by the university of california at san francisco. it was an individual traveler who came from south africa, got here on november 22nd, tested positive on november 29th. all of that person's close contacts have now been tested. they have tested negative. they are all quarantining. this person was fully vaccinated. but they were not boosted. this person has mild symptoms and is getting better, according to dr. fauci. let us keep in mind, health officials have been saying repeatedly that this was going to be here, the travel ban from south africa, as dr. fauci just said, was put in place not because they didn't want it to get here, they knew it was going to be here, but to buy this country some time to get prepared and to get as many people vaccinated and then boosted as possible before it did get here. so far, they are trying to contain the spread. but it does likely appear, according to health officials, that the cat was always going to be out of the bag on this. joining me now to discuss further is nbc news white house correspondent monica alba, nbc news correspondent erin mclaughlin from los angeles, nbc news medical correspondent dr. john torres, and the co-director for the center for vaccine development at texas children's hospital, dr. peter hotez. dr. hotez, what is your reaction to what we just heard from dr. fauci? >> as you said, katy, this was both predicted and predictable. and the point is, it's not a cause for alarm, really, because if you think about it, just about every variant that we've seen since the beginning of this pandemic, the way it's worked is, by the time we identify the variant, we already know it's in multiple european countries, in australia, in asia, and in north america. and the same is true of this virus. so the fact that it's in the united states now was predicted. the fact that it's in multiple countries does not in itself mean anything particularly ominous. so the key to focus on is what are the unique properties of this virus that give us pause, and in terms of its transmissibility and its ability to resist current vaccines, and i'm happy to discuss that in more detail. >> i would love to hear more from you, i would also love to hear from you, dr. hotez, on the subject of vaccines, because i'm sure there are people who are out there who will say to themselves, this person was vaccinated, why should i get vaccinated if i'm still going to get the disease? what is your response to that? >> well, you know, i think in time we're going to have to change the definition of "fully vaccinated." what we've seen, if individuals get that third immunization, that booster, that gives you a 30 to 40-fold rise in your virus neutralizing antibodies. and we know from other partial vaccine resistant variants like the beta variant that was first identified in south africa last year and the lambda variant, when you have high virus neutralizing antibodies, you have spillover or cross protection against the variant of concern. i am hoping that for those people who have had that third immunization, that that will be the case, they won't get infected or sick from the omicron variant. what may have happened in this individual that tony alluded to, although i wasn't too clear on the specifics, this individual may have gotten two doses and subsequently had waning immunity. and those individuals should be considered partially protected against a highly -- a partial vaccine resistant variant like omicron. and i think this is the pattern that we're going to see, katy. what i think is a possibility is that we're going to see a twin epidemic now in the united states. it's going to go something like this, that the delta variant, which looks like it's still more transmissible, is going to continue to accelerate among the unvaccinated, those who have not gotten any vaccines. and for those who are infected and resistant -- i'm sorry, those who are infected and recovered but have chosen not to get vaccinated or those who only have waning immunity, those with the ones who may be susceptible to reinfection by the omicron variant. and so we may see those two patterns with two variants, one disproportionately affecting a different population. delta among the entirely unvaccinated, and omicron among the partially resistant, either because they didn't get vaccinated after infection or because they did not get the booster. >> are you worried, dr. hotez? >> well, you know, i'm always worried. and let me tell you the reason why i'm worried. i'm worried because we still have too many people who are refusing to get vaccinated. we have tony says 60 million, it's basically 41% of the population. really, i think it's more than 60 million who are refusing to get vaccinated. and we still have not done well in terms of individuals who are eligible to get that third immunization, who have not gotten it. and we still have too many unvaccinated kids who are eligible. so if we're ultimately going to end this pandemic, we're going to have to vaccinate our way out of it. and i think we can. but the bar is high. when you have a highly transmissible variant both like delta and omicron, it means 85% of the entire population needs to be vaccinated. not 85% of the adults, but 85% of the whole population. that means