Hi everyone, I'm Katie Curic and welcome to Next Question. For a special edition of Next Question, I had a wonderful conversation with Dr Anthony Faucci. Dr Faucci, how are you fine? Thank you? How are you? This has been an unprecedented time in our nation's history. The country, and in fact the world, was already losing faith in science. But Dr Faucci has been a much needed bomb, a sav of sorts for our wounded spirit, and he has helped emphasize the importance of science and facts. The nation's top infectious disease expert has also become something of a celebrity. You can buy Dr Fauci mugs, t shirt, socks, bobble heads, you name it. Brad Pitt even landed an Emmy nomination for playing him on SNL. And when I hear things like the virus can be cured if everyone takes the tide Pod challenge, I'll be there to say please don't. So far, the coronavirus has infected more than six million Americans and killed one hundred and eighty seven thousand, and As we head into the fall, health officials are bracing to battle what could be in fact a twin demic as the virus outbreak collides with blue season. I spoke with Dr Fauci about how we can best protect ourselves, where we are in the race to find a vaccine, what you should know about sending your kids to school, and whether the world has entered a pandemic era. But first he explained why our behavior through Labor Day weekend could have a real impact on how the coronavirus spreads throughout the next few months. We're approaching Labor Day, and I know you've urged people to continue to exercise caution and not to have sort of pandemic fatigue. We saw surge after Memorial Day and the Fourth of July holiday weekends. But you've also said, Dr Vauchi, the way we handle Labor Day will determine what the virus does over the fall months. What exactly did you mean by that? When you go into the fall, as the weather starts to chill and more people will be spending indoors, then that is a perfect setup for a resurgence of cases. The point that I was making, Katie is that right now we are at a baseline that in my mind is unacceptably high, where at about forty cases per day. If you look at some of the European countries and even some states and cities in the United States, when you peaked up and you come down to a very low baseline, when you get individual cases, you can much better control them then when you have twenty cases. So the point I was making about Labor Day is that if we can prevent the surge of Labor Day and keep the cases coming down and down, which if you look at the map of the country, for the most part, we've got hit badly, and then we turned it around. We got hit badly, and then the most recent one as you well know, we're in the southern states of Florida, Texas, California, and Arizona. We've now turned that around. What we do not need is another surge. So if we can get through the Labor Day weekend and not be up, but actually continue to go down, that would be momentum as we get into the full of going in the right direction. So that's really what I meant by that statement. And so you were worried that if people get complacent that the numbers will go up. Is that what happened in Europe, Dr Fauci, because they're reporting the highest numbers or the highest number of cases they've seen since March. Right, Yeah, that's true. And what happened is that they actually, interestingly, did a really good job of locking down much more thoroughly actually than we did, which may be the reason why when they went down to a baseline, they were way lower than we were. What we have to worry about and guard against is what's happening right now in some countries in Europe, and that is, you know, shut down fatigue. They just felt they were shut down so long that instead of prudently and carefully trying to open up their economy, they did what many of us in the United States did when you looked at the pictures of people crowding around bars, they went to the other extreme. So, getting back to what you just asked me a little while ago about the Labor Day weekend, we don't want people to lock themselves in a closet for Labor Day weekend at all. You want to get outside. You can have fun as long as you do some fundamental public health principles. Wearing a mask, physical distance, avoid crowd, and for goodness sakes, anything that you could possibly do outside as opposed to inside keep it outside. If you do that, we know from experience that you won't see surges, you will be able to contain any outbreak. The CDC has asked states to prepare for a coronavirus vaccine to be ready to distribute by November, and I'm wondering, Dr Faucer, are you concerned about fast tracking a vaccine before clinical trials are completed. I wouldn't say I'm concerned. I'm I'm I'm I'm fairly certain that that's not going to happen, because we know I mean, and I've made this statement, Katie multiple times over the months, that it is likely that we will know if we have a safe and effective vaccine by the end of this coundar year November or December, so that we could have vaccine doses by the end, and as we go into one, it is conceivable that we may do it earlier. I mean, there's no you can't rule that out, because if you have a lot of infections within an area where they're actually testing the vaccine, you could get an answer earlier than November and December. So I'm not ruling out the possibility that we might know at the end of October. But there's no guarantee. In fact, if I would predict, I would say that that is unlikely. It's not impossible, but unlikely. So the CDC saying they're preparing for that eventuality, I don't think that should be interpreted that anything is going to be rushed. I think it should be interpreted that just in case we're lucky enough to get an early answer, we want to be ready for it. That's really what they meant, even if it indicates so Dr Fauci, it might be effective. I mean, there's a reason there's a phase one, two, and three clinical trial right our process, and and shouldn't all those phases be completed? I mean, do you think it's okay to put a drug on the marketplace of phase three clinical trials have not been not taken place? Well, you know, there is a little bit of a nuance and a subtlety there that I think people need to understand. First of all, I completely agree with you, and I'll confirm what I've said before. I will not be satisfied until our vaccine that we allow to be distributed among the American public has to be both safe and effective. Both safe and effective, but A potential scenario would be is that as you're testing the vaccine, we have a data and safety Monitoring board, which is an independent board of people who incommittently look at the data to see if it is too bad or too good. Namely, you might want to interrupt the trial before you finished the actual um observation over the predetermined time. So what could happen is that you look at the data and the independent group may say, you know, we have enough data to know that this is actually an effective vaccine and it looks pretty safe, so let's get it to the American people by mechanism called by an emergency use authorization. That doesn't mean you stop the trial. It means that you could make the vaccine available to certain people who could benefit from it the most, like first line responders or healthcare workers or people at the same time as you're gathering additional safety information. So you don't have to call the trial off. But that would be a very special situation. I'd want to make sure that when that decision is made, it's made really on the basis of efficacy. A lot of people say they would not take the vaccine um that that they just don't feel comfortable, and I'm curious would you take it? And what about the people who say they're not interested in taking it? And are you worried this is going to fuel the anti vax movement? Dr Kalki. Okay, so let's start off with your first question, Katie, if if if the vaccine, which in my mind, it would have to be the following if we if we allow it to be given to the American public, it would have to be proven and scientifically sound study to be both safe and effective. If that occurs, and I'm cautiously optimistic that it will, I would readily take the vacccine, and I would recommend that my family takes the vaccine. The second question that you have is am I concerned about people not wanting to take the vaccine? I am, because you know there is an underlying current in this country that goes back to measles and other vaccines that people are skeptical about taking a vaccine. And I think the best way to get around that is to do good community outreach, be very transparent about the data, Let all the decision making process be open and easily discussed, so people can see that when we say it's safe and effective. It really is safe and effective. And what are you hearing about it? Dr Fauci. Obviously you're talking to some of these companies. Are you hearing that it's it's very promising? Are you hearing that it's going to work on everyone? Will there have to be a booster shot? Can you give us some insight into those questions? Yeah? No, Well I'm very heavily involved in that, Katie, because I mean, at least a couple of the vaccines, we were very much involved in developing and implementing the clinical trial. So if you, for example, the trials that are in phase three now, particularly the MODERNA trial and the trial from Fiser and to some extent the trial from from a Z that when you look at the phase one trial, now, phase one is a relatively small number of people. That's the reason why, as you said, correctly, you want to go to phase two and phase three. But in the phase one trial, I looked at the data very carefully, and it's published now in the medical literature that the induction of a response in the volunteers was really quite promising. It was a robust response, that it was at least as good or even better than the kind of response you get from natural infection, and one of the tenants of vaccine development is that you'd like to do as well as natural infection does in inducing a protective response. Still, at least with that limited amount of data, I would say that I'm cautiously optimistic that we're on a good path to getting to where we want to be. We'll have more with Dr Anthony Fauci right after this. You know, it seems that people of color are not being uh shown, are not being represented in the current US vaccine trials Black and Latino people, despite the fact that those communities, as you well know, Dr Fauci, have been hardest hit by this virus. Is there any way to remedy that late in the process. It's not too late. The trials are more than half enrolled. We know that they're close to twenty thousand out of the thirty thousand individuals in the trials. You know, for goodness sakes and the Lord knows that we're trying, we really do want to get African Americans and Latin X and other minorities in the trial. We're doing better with Latino X than we all with African Americans. I still want to get the percentage in the trial of African Americans higher than it is right now. You know, there's understandable skepticism on the part of that demographic group when it comes to vaccines. They have not historically been treated well by government research endeavors. We know that that's a sad part of our history. We have to get over that, and that's the reason why we're employing every manner of community outreach to get the African American population to appreciate that they need to get vaccinated for precisely the reasons you just mentioned. A. They have a greater chance of getting infected by the basis of the jobs that they find themselves in. It's much less likely they're going to be sitting in front of a computer. They likely will be in first line jobs where they're in physical contact with people. So they have a risk that's greater than the general population of getting infected. And importantly, when they do get infected, they have the underlying conditions to a greater extent than the rest of the population, which makes it more likely that they will have a severe outcome of infection, and that's hypertension, obesity, diabetes, chronic renal disease, chronic lung disease. It's very unfortunate. Those are social determinants of health that are decades in the making. We can't do anything about that. But what we can do apropos of what you just asked, is we can get them vaccinated to prevent that from happening to them. Stand Up to Cancer, which I founded twelve years ago, has a whole new health equity initiative where we're trying to get more people of color involved in clinical cancer clinical trials. And I think it's the medical community really is has just woken up, I think, to this disparity and how critically it important it is to have representation in these clinical trials. So if we can just make sure that people, let you know, people of color, know that these trials are happening and encourage them to participate, that would be a really positive thing for for everyone. Are you concerned that the US has decided not to not to cooperate with the WHO to equitably distribute this vaccine? Uh? You know, I mean, obviously I have been a proponent for decades of equitable distribution of vaccine. I think that is going to happen, and in fact, we will almost certainly, Katie, participate in that distribution to other countries, even though it isn't part of the official WHO effort, because if you look at the dosage is that we have pre purchased, it goes well beyond the number required for the United States. So the end of the day, what's going to functionally happen anyway, is that we're going to be participating in that type of distribution. You know, this has been such a stressful time, Dr Fauci. I know you've you've addressed this in other interviews for parents and for students, whether they're in kindergarten or headed off to college. And I know that your alma mater, Holy Cross, decided to go entirely online after previously creating an in person back to school plan, And I'm just curious, did you help advise the university and is that an indicator in your mind that other colleges and university should follow their lead. You know it's going to be but that's a great question, and it's really going to be different, and from university to university, depending upon the capability of a particularly institution to be able to handle students who ultimately get infected. So, for example, several of the universities, some of which I've actually had the opportunity to be an informal adviser, to have a system where they essentially test everybody before they come in. Then they do intermittent surveillance testing. The critical issue that we're emphasizing now that some universities have done it, not optimally and not I don't mean to blame them, but now we know what to do is that when the students at the university level get infected, you don't want to send them home, because when you send them home, they essentially go into a house, infect their family, go and infect their community. Because university students, as we all know, come from all different parts of the country. So if you bring them in they get infected, then you send them home, you're essentially spreading it. So what many of the universities they're doing now are providing for places either a dorm, an entire dorm, or a couple of fours for a dorm, so that when a student gets infected, you could safely and comfortably sequester them from the rest of the student body without necessarily sending them home. I mean, I just had a conversation a little while ago as did Dr Burghs with Tommy Thompson, who's the president of the University of Wisconsin and exactly my former boss for several years. And what Tommy has done is a really very interesting way of testing the students, having surveillance and if you get infected, putting them in a sequested way where you don't have to send them home. Many of the colleges are doing that. That's interesting. So the latter thing is actually as important as the testing protocol itself, to make sure you have a place to put infected students where they're not going to affect other students or return to their homes. That's exactly correct, and I think that's a really important point. You know, when it comes to K through twelve, Dr Fauci, it seems like there aren't clear procedures across the board for for returning to in person learning. And I just feel like through this whole pandemic there's been it's been so inconsistent, and I realized certain situations call for different measures, but without kind of these broad guidelines, it seems like that could be a recipe for disaster. No, uh, indeed, So let's try and see if you and I can be some consistent here and see if we could help out. So I think one of the reasons for this perception of inconsistency, if not reality of inconsistency, is that we live in a really big country and it's very heater a genious with regard to the level of infection activity. If you look at the map, we have these heat maps Katie, which you know, light up of its red, it's green, it's yellow. So if you're in a part of the country where you're what we call a green zone, which means the level of infection is really quite low, you can proceed with relative impunity and in person teaching in the elementary and middle schools with the children. You have to have a plan of what you're going to do when children get infected, because no matter where you are, they are going to get infected. So you don't want to open up and then have to close right down. You want to have a plan. When you get into the yellow zone, it becomes a little bit more problematic, which means that you may have to do some mitigation. You might have to alternate morning afternoon every other day, part online, part in person. When you get to a red zone, then that becomes really problematic for a number of reasons. The level of infection may be so high in the community that it would really be imprudent to just say, Okay, everybody go back to school. And what we're seeing, Katie is something really interesting is that the parents and the teachers are really talking with their feet. They're not showing up. They're saying, you know, I don't really want to go in to a school in a red zone. When I'm a teacher that might have an underlying condition, I'll do it by virtual, but I don't really want to come in. And that's what's actually happening. You can understand that though, right Dr Fauci, I totally empathize with them doing that. I mean, there's no doubt about that. You really got to respect teachers who are either in a certain age group or who have an underlying condition that would put them at risk if you want them to go to to teach in person in a place where you have a very high level of infection in that particular community, that is understandable. We'll have more with Dr Anthony Fauci right after this. So when it comes to testing, and I'm just curious, Dr Fauci. A lot of my followers and I wondered this as well. If if a lot of people are asymptomatic, what about does it make sense to take people's temperatures because they could be without a temperature right if there without a fever, if there is symptomatic. Well, this may have some people disagree with me, but I do not put much uh stock in temperature taking. I would much rather when someone walks into a place, asked them a few key questions. In fact, right here at the NIH where I'm sitting right now, and out right across like a hundred feet from where we are right now is the NIH Clinical Center hospital where I work, we got rid of temperature taking going in right now. We just asked questions to screen people for the simple reason of what you exactly said about asymptomatic, but also the inaccuracy sometimes of temperature. Where you put something next to somebody's head, particularly if they come out from outside when it's nine three degrees outside, you can get some of those positives. The government, as you know, is sending out and estimated a hundred and fifty million Abbot laboratory rapid COVID nineteen tests. But FDA experts say in some cases the results may need to be confirmed with the second test, like a nasal swab. So um, can you just give us some insight about the effectiveness of these fast COVID tests. They're good, Yeah, they are good, Katie, I mean, and in fact, it is a nasal swab, the new Abbott bin ax that you're referring to, the hundred and fifty million you're taking nasal swab. You stick it in a little well, you put the card down and it reads out with the band. It's not only quite specific like nine seven point two, it's sensitive. That's pretty good. That's good. Why did the FDA say that? Then? Dr falc know, you know, I can't address that, kid, because I'm not certain what they said and why they said it, So I better not comment. I'll get myself in trouble. You don't want to do that. How worried are you, by the way, about flu season and about handling both a flu epidemic and continuing to deal with COVID nineteen. Well, what I'm hoping for is two things. One extension of what you and I spoke about a few minutes ago about as we get into the full do it on a down slope of COVID as opposed to an upstill. But the other thing that I'm hoping for is that the very public health measures that have been targeted to COVID nineteen, I'm gonna mitigate the impact of a flu season, namely masks, distancing, avoiding crowds, staying outside to the extent possible, particularly as we get into the winter, and washing hands. An interesting fact, Katie, is that Australia, which is as you know, in the Southern Hemisphere and has their flu season during our summer, have had a very very light flu season and the Australian health authorities, many of whom are my friends and colleagues. I feel that the reason for that is that they were practicing public health measures to avoid the coronavirus and they had the secondary effect you bet, you know, just an unintended positive consequence. But haven't said that. I just want to make sure we're not discouraging people from getting flu shots. Dr Fauci, absolutely not. As soon as the flu vaccines become available right here on campus, I will be first in line to get one, and I encourage everyone six months of age or over to get a flu vaccine. I'm gonna get mine what as soon as I can, to believe in next week. What do you think when you look back at this whole unique chapter in our history, Dr Fauci, what do you think, uh, the government could have done better? What were the lessons learned? And what might have done been done faster and better to really keep the number of cases and saddling mortalities down. Well, you know, having been in the position I'm in now for the last thirty six years as the head of this institute, I had the opportunity to be involved in a number of outbreaks, from HIV in the eighties, you know, to pandemic flu in two thousand nine, to Zeka to Ebola. You could always say you could have done something better. So I mean the blanket answer to your question, and I don't even I don't mean to be facetious at all. Hetty is is we could have done everything better, you know, a little bit better. You could always do better. I mean we have shut down earlier, well retrospectively, of course, But if you turn the clock back and say when we had one infection in the United States at the time that underneath the radar screen it was spreading when we had one infection, if we had called to shut the country down, what kind of response do you think we could have had? Oftenmalia would have been great. If we shut it down, then we likely would have avoided a lot of infections. But it wasn't really feasible to do it. So in some respects we could have done better by doing that, but in some respects it likely would not have been feasible. So I mean, as as a health official being involved in this, you know, I'm humble enough to say we could have done a lot of things better, but it's just the way it is. We need to look ahead and maybe not closing down the country, Dr Fauci. And and you know early on when there was one case, but certainly you know in March, when the case cases were climbing traumatically and the month of February, perhaps more could have been done as you watched it, Yeah, I mean that must have been really, really worrisome for you as a public health expert. Of course it was. I was pained. I was paining. I mean, also, we could have done much better with testing, Katie. I mean testing situation early on was not optimal. What happened there. Did the CDC just come out with a lousy test initially? Well, it was just one of those unfortunate glitches that was technical that led to the having to recall a number of cases and losing the heads thought that we would have liked to have gotten. Well, I know that you've said that humanity has quote entered a pandemic era with the coronavirus outbreat likely just the first of accelerating epidemics to come. Just so we can end on a positive note, Dr Fauci, can you explain what is driving this new era and what we might expect in the coming years. Well, I'm pleased to see that you read my paper that I wrote in cell Stollowly Cave. Very good. I do, I knew do know a bit about medicine at this point. Dr, I'm very very pleased to see that that's a that's a scholarly paper. What what I What we said my colleague David Morris and I Mourns and I in that it really is a reflection of how we as the human species interact with our environment. Because if you look at the outbreaks of new infections, particularly new viruses, seventy of them are zoonotic or infections that have jumped species from an animal reservoir into humans, and the kinds of things that perturb the animal human interface a major drivers of outbreaks. You know, it was HIV from a chimpanzee bush meat slaughtering them, getting it into the American population. It was influenza where you have chickens and pigs and people in the agricultural situation that you usually see in the in the Far East, particularly now even with COVID, not only COVID now that we're seeing, but the original Stars in two thousand and two where the wet markets where people bring in animals from the wild, put them in a market and people come in shop, usually for festive meals during festivals. Things like civic cats and bats and other animals that have these viruses. You're almost asking for trouble when you do that. So what we said in the paper, we really need to rethink how we interact with the environment and how we interact with the animal species if we really want to avoid outbreaks in the future. And and it seems that when it comes to mitigating these pandemics, the Internet is not the friend of of the public health official. There's been so much misinformation coupled with polarization, it makes it very very difficult, Dr Fauci to get information to the public, not only that, but get them to believe that information. Yeah, it is true. It's become particularly difficult and problematic when you're trying to get a public health message across and you live right now in a time in our great country in which is very very divisive, and when you politicize and make divisive things that should be pure public health, it really makes it that much more difficult. Did you ever think about having your own daily briefings that would be completely devoid of politics, Dr Fauci, Yeah, that would be nice, wouldn't it. Would you not be allowed to do that? I don't have total control over those things. I don't. I guess if you need to keep your job, you wouldn't be able to do that. Yeah. Well, I don't think anybody is trying to get rid of me. But but what we're trying to do right now, which is the reason why I enthusiastically said yes to your request to talk to you, because they think things like our discussion that we just have now go a long way to really clarifying the real true public health message. Well, I really really appreciate your time, Dr Fauci, and again on behalf of all my followers, thank you very very much for your service, and thank you for all you do. To Katie, it's a pleasure and a privilege to be with you. Thank you for having me, Thanks for listening to the special edition of the Next Question, and I'm very excited in the upcoming weeks we'll be doing a special podcast series called Turnout focused on voting, why it's important to get out the vote, who isn't voting, and the systemic structures that have been in place that have suppressed so many American citizens. So stay tuned for that. In the meantime, thanks so much for listening. I'm Katie Curik and I'll talk to you next time. Next Question with Katie Couric is a production of I Heart Radio and Katie Kurik Media. The executive producers are Katie Curic, Courtney Litz, and Tyler Klang. The supervising producer is Lauren Hansen. Our show producer is Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements. Editing by Derrek Clements, Dylan Fagan and Lowell Berlante, mixing by Dylan Fagan. Our researcher is Gabriel Loser. For more information on today's episode, go to Katie curik dot com and follow us on Twitter and Instagram at Katie Kurik. For more podcasts for my heart Radio, visit the I Heart Radio app, Apple podcast, or wherever you listen to your favorite shows,

Hi everyone, I'm Katie Curic and welcome to Next Question. For a special edition of Next Question, I had a wonderful conversation with Dr Anthony Faucci. Dr Faucci, how are you fine? Thank you? How are you? This has been an unprecedented time in our nation's history. The country, and in fact the world, was already losing faith in science. But Dr Faucci has been a much needed bomb, a sav of sorts for our wounded spirit, and he has helped emphasize the importance of science and facts. The nation's top infectious disease expert has also become something of a celebrity. You can buy Dr Fauci mugs, t shirt, socks, bobble heads, you name it. Brad Pitt even landed an Emmy nomination for playing him on SNL. And when I hear things like the virus can be cured if everyone takes the tide Pod challenge, I'll be there to say please don't. So far, the coronavirus has infected more than six million Americans and killed one hundred and eighty seven thousand, and As we head into the fall, health officials are bracing to battle what could be in fact a twin demic as the virus outbreak collides with blue season. I spoke with Dr Fauci about how we can best protect ourselves, where we are in the race to find a vaccine, what you should know about sending your kids to school, and whether the world has entered a pandemic era. But first he explained why our behavior through Labor Day weekend could have a real impact on how the coronavirus spreads throughout the next few months. We're approaching Labor Day, and I know you've urged people to continue to exercise caution and not to have sort of pandemic fatigue. We saw surge after Memorial Day and the Fourth of July holiday weekends. But you've also said, Dr Vauchi, the way we handle Labor Day will determine what the virus does over the fall months. What exactly did you mean by that? When you go into the fall, as the weather starts to chill and more people will be spending indoors, then that is a perfect setup for a resurgence of cases. The point that I was making, Katie is that right now we are at a baseline that in my mind is unacceptably high, where at about forty cases per day. If you look at some of the European countries and even some states and cities in the United States, when you peaked up and you come down to a very low baseline, when you get individual cases, you can much better control them then when you have twenty cases. So the point I was making about Labor Day is that if we can prevent the surge of Labor Day and keep the cases coming down and down, which if you look at the map of the country, for the most part, we've got hit badly, and then we turned it around. We got hit badly, and then the most recent one as you well know, we're in the southern states of Florida, Texas, California, and Arizona. We've now turned that around. What we do not need is another surge. So if we can get through the Labor Day weekend and not be up, but actually continue to go down, that would be momentum as we get into the full of going in the right direction. So that's really what I meant by that statement. And so you were worried that if people get complacent that the numbers will go up. Is that what happened in Europe, Dr Fauci, because they're reporting the highest numbers or the highest number of cases they've seen since March. Right, Yeah, that's true. And what happened is that they actually, interestingly, did a really good job of locking down much more thoroughly actually than we did, which may be the reason why when they went down to a baseline, they were way lower than we were. What we have to worry about and guard against is what's happening right now in some countries in Europe, and that is, you know, shut down fatigue. They just felt they were shut down so long that instead of prudently and carefully trying to open up their economy, they did what many of us in the United States did when you looked at the pictures of people crowding around bars, they went to the other extreme. So, getting back to what you just asked me a little while ago about the Labor Day weekend, we don't want people to lock themselves in a closet for Labor Day weekend at all. You want to get outside. You can have fun as long as you do some fundamental public health principles. Wearing a mask, physical distance, avoid crowd, and for goodness sakes, anything that you could possibly do outside as opposed to inside keep it outside. If you do that, we know from experience that you won't see surges, you will be able to contain any outbreak. The CDC has asked states to prepare for a coronavirus vaccine to be ready to distribute by November, and I'm wondering, Dr Faucer, are you concerned about fast tracking a vaccine before clinical trials are completed. I wouldn't say I'm concerned. I'm I'm I'm I'm fairly certain that that's not going to happen, because we know I mean, and I've made this statement, Katie multiple times over the months, that it is likely that we will know if we have a safe and effective vaccine by the end of this coundar year November or December, so that we could have vaccine doses by the end, and as we go into one, it is conceivable that we may do it earlier. I mean, there's no you can't rule that out, because if you have a lot of infections within an area where they're actually testing the vaccine, you could get an answer earlier than November and December. So I'm not ruling out the possibility that we might know at the end of October. But there's no guarantee. In fact, if I would predict, I would say that that is unlikely. It's not impossible, but unlikely. So the CDC saying they're preparing for that eventuality, I don't think that should be interpreted that anything is going to be rushed. I think it should be interpreted that just in case we're lucky enough to get an early answer, we want to be ready for it. That's really what they meant, even if it indicates so Dr Fauci, it might be effective. I mean, there's a reason there's a phase one, two, and three clinical trial right our process, and and shouldn't all those phases be completed? I mean, do you think it's okay to put a drug on the marketplace of phase three clinical trials have not been not taken place? Well, you know, there is a little bit of a nuance and a subtlety there that I think people need to understand. First of all, I completely agree with you, and I'll confirm what I've said before. I will not be satisfied until our vaccine that we allow to be distributed among the American public has to be both safe and effective. Both safe and effective, but A potential scenario would be is that as you're testing the vaccine, we have a data and safety Monitoring board, which is an independent board of people who incommittently look at the data to see if it is too bad or too good. Namely, you might want to interrupt the trial before you finished the actual um observation over the predetermined time. So what could happen is that you look at the data and the independent group may say, you know, we have enough data to know that this is actually an effective vaccine and it looks pretty safe, so let's get it to the American people by mechanism called by an emergency use authorization. That doesn't mean you stop the trial. It means that you could make the vaccine available to certain people who could benefit from it the most, like first line responders or healthcare workers or people at the same time as you're gathering additional safety information. So you don't have to call the trial off. But that would be a very special situation. I'd want to make sure that when that decision is made, it's made really on the basis of efficacy. A lot of people say they would not take the vaccine um that that they just don't feel comfortable, and I'm curious would you take it? And what about the people who say they're not interested in taking it? And are you worried this is going to fuel the anti vax movement? Dr Kalki. Okay, so let's start off with your first question, Katie, if if if the vaccine, which in my mind, it would have to be the following if we if we allow it to be given to the American public, it would have to be proven and scientifically sound study to be both safe and effective. If that occurs, and I'm cautiously optimistic that it will, I would readily take the vacccine, and I would recommend that my family takes the vaccine. The second question that you have is am I concerned about people not wanting to take the vaccine? I am, because you know there is an underlying current in this country that goes back to measles and other vaccines that people are skeptical about taking a vaccine. And I think the best way to get around that is to do good community outreach, be very transparent about the data, Let all the decision making process be open and easily discussed, so people can see that when we say it's safe and effective. It really is safe and effective. And what are you hearing about it? Dr Fauci. Obviously you're talking to some of these companies. Are you hearing that it's it's very promising? Are you hearing that it's going to work on everyone? Will there have to be a booster shot? Can you give us some insight into those questions? Yeah? No, Well I'm very heavily involved in that, Katie, because I mean, at least a couple of the vaccines, we were very much involved in developing and implementing the clinical trial. So if you, for example, the trials that are in phase three now, particularly the MODERNA trial and the trial from Fiser and to some extent the trial from from a Z that when you look at the phase one trial, now, phase one is a relatively small number of people. That's the reason why, as you said, correctly, you want to go to phase two and phase three. But in the phase one trial, I looked at the data very carefully, and it's published now in the medical literature that the induction of a response in the volunteers was really quite promising. It was a robust response, that it was at least as good or even better than the kind of response you get from natural infection, and one of the tenants of vaccine development is that you'd like to do as well as natural infection does in inducing a protective response. Still, at least with that limited amount of data, I would say that I'm cautiously optimistic that we're on a good path to getting to where we want to be. We'll have more with Dr Anthony Fauci right after this. You know, it seems that people of color are not being uh shown, are not being represented in the current US vaccine trials Black and Latino people, despite the fact that those communities, as you well know, Dr Fauci, have been hardest hit by this virus. Is there any way to remedy that late in the process. It's not too late. The trials are more than half enrolled. We know that they're close to twenty thousand out of the thirty thousand individuals in the trials. You know, for goodness sakes and the Lord knows that we're trying, we really do want to get African Americans and Latin X and other minorities in the trial. We're doing better with Latino X than we all with African Americans. I still want to get the percentage in the trial of African Americans higher than it is right now. You know, there's understandable skepticism on the part of that demographic group when it comes to vaccines. They have not historically been treated well by government research endeavors. We know that that's a sad part of our history. We have to get over that, and that's the reason why we're employing every manner of community outreach to get the African American population to appreciate that they need to get vaccinated for precisely the reasons you just mentioned. A. They have a greater chance of getting infected by the basis of the jobs that they find themselves in. It's much less likely they're going to be sitting in front of a computer. They likely will be in first line jobs where they're in physical contact with people. So they have a risk that's greater than the general population of getting infected. And importantly, when they do get infected, they have the underlying conditions to a greater extent than the rest of the population, which makes it more likely that they will have a severe outcome of infection, and that's hypertension, obesity, diabetes, chronic renal disease, chronic lung disease. It's very unfortunate. Those are social determinants of health that are decades in the making. We can't do anything about that. But what we can do apropos of what you just asked, is we can get them vaccinated to prevent that from happening to them. Stand Up to Cancer, which I founded twelve years ago, has a whole new health equity initiative where we're trying to get more people of color involved in clinical cancer clinical trials. And I think it's the medical community really is has just woken up, I think, to this disparity and how critically it important it is to have representation in these clinical trials. So if we can just make sure that people, let you know, people of color, know that these trials are happening and encourage them to participate, that would be a really positive thing for for everyone. Are you concerned that the US has decided not to not to cooperate with the WHO to equitably distribute this vaccine? Uh? You know, I mean, obviously I have been a proponent for decades of equitable distribution of vaccine. I think that is going to happen, and in fact, we will almost certainly, Katie, participate in that distribution to other countries, even though it isn't part of the official WHO effort, because if you look at the dosage is that we have pre purchased, it goes well beyond the number required for the United States. So the end of the day, what's going to functionally happen anyway, is that we're going to be participating in that type of distribution. You know, this has been such a stressful time, Dr Fauci. I know you've you've addressed this in other interviews for parents and for students, whether they're in kindergarten or headed off to college. And I know that your alma mater, Holy Cross, decided to go entirely online after previously creating an in person back to school plan, And I'm just curious, did you help advise the university and is that an indicator in your mind that other colleges and university should follow their lead. You know it's going to be but that's a great question, and it's really going to be different, and from university to university, depending upon the capability of a particularly institution to be able to handle students who ultimately get infected. So, for example, several of the universities, some of which I've actually had the opportunity to be an informal adviser, to have a system where they essentially test everybody before they come in. Then they do intermittent surveillance testing. The critical issue that we're emphasizing now that some universities have done it, not optimally and not I don't mean to blame them, but now we know what to do is that when the students at the university level get infected, you don't want to send them home, because when you send them home, they essentially go into a house, infect their family, go and infect their community. Because university students, as we all know, come from all different parts of the country. So if you bring them in they get infected, then you send them home, you're essentially spreading it. So what many of the universities they're doing now are providing for places either a dorm, an entire dorm, or a couple of fours for a dorm, so that when a student gets infected, you could safely and comfortably sequester them from the rest of the student body without necessarily sending them home. I mean, I just had a conversation a little while ago as did Dr Burghs with Tommy Thompson, who's the president of the University of Wisconsin and exactly my former boss for several years. And what Tommy has done is a really very interesting way of testing the students, having surveillance and if you get infected, putting them in a sequested way where you don't have to send them home. Many of the colleges are doing that. That's interesting. So the latter thing is actually as important as the testing protocol itself, to make sure you have a place to put infected students where they're not going to affect other students or return to their homes. That's exactly correct, and I think that's a really important point. You know, when it comes to K through twelve, Dr Fauci, it seems like there aren't clear procedures across the board for for returning to in person learning. And I just feel like through this whole pandemic there's been it's been so inconsistent, and I realized certain situations call for different measures, but without kind of these broad guidelines, it seems like that could be a recipe for disaster. No, uh, indeed, So let's try and see if you and I can be some consistent here and see if we could help out. So I think one of the reasons for this perception of inconsistency, if not reality of inconsistency, is that we live in a really big country and it's very heater a genious with regard to the level of infection activity. If you look at the map, we have these heat maps Katie, which you know, light up of its red, it's green, it's yellow. So if you're in a part of the country where you're what we call a green zone, which means the level of infection is really quite low, you can proceed with relative impunity and in person teaching in the elementary and middle schools with the children. You have to have a plan of what you're going to do when children get infected, because no matter where you are, they are going to get infected. So you don't want to open up and then have to close right down. You want to have a plan. When you get into the yellow zone, it becomes a little bit more problematic, which means that you may have to do some mitigation. You might have to alternate morning afternoon every other day, part online, part in person. When you get to a red zone, then that becomes really problematic for a number of reasons. The level of infection may be so high in the community that it would really be imprudent to just say, Okay, everybody go back to school. And what we're seeing, Katie is something really interesting is that the parents and the teachers are really talking with their feet. They're not showing up. They're saying, you know, I don't really want to go in to a school in a red zone. When I'm a teacher that might have an underlying condition, I'll do it by virtual, but I don't really want to come in. And that's what's actually happening. You can understand that though, right Dr Fauci, I totally empathize with them doing that. I mean, there's no doubt about that. You really got to respect teachers who are either in a certain age group or who have an underlying condition that would put them at risk if you want them to go to to teach in person in a place where you have a very high level of infection in that particular community, that is understandable. We'll have more with Dr Anthony Fauci right after this. So when it comes to testing, and I'm just curious, Dr Fauci. A lot of my followers and I wondered this as well. If if a lot of people are asymptomatic, what about does it make sense to take people's temperatures because they could be without a temperature right if there without a fever, if there is symptomatic. Well, this may have some people disagree with me, but I do not put much uh stock in temperature taking. I would much rather when someone walks into a place, asked them a few key questions. In fact, right here at the NIH where I'm sitting right now, and out right across like a hundred feet from where we are right now is the NIH Clinical Center hospital where I work, we got rid of temperature taking going in right now. We just asked questions to screen people for the simple reason of what you exactly said about asymptomatic, but also the inaccuracy sometimes of temperature. Where you put something next to somebody's head, particularly if they come out from outside when it's nine three degrees outside, you can get some of those positives. The government, as you know, is sending out and estimated a hundred and fifty million Abbot laboratory rapid COVID nineteen tests. But FDA experts say in some cases the results may need to be confirmed with the second test, like a nasal swab. So um, can you just give us some insight about the effectiveness of these fast COVID tests. They're good, Yeah, they are good, Katie, I mean, and in fact, it is a nasal swab, the new Abbott bin ax that you're referring to, the hundred and fifty million you're taking nasal swab. You stick it in a little well, you put the card down and it reads out with the band. It's not only quite specific like nine seven point two, it's sensitive. That's pretty good. That's good. Why did the FDA say that? Then? Dr falc know, you know, I can't address that, kid, because I'm not certain what they said and why they said it, So I better not comment. I'll get myself in trouble. You don't want to do that. How worried are you, by the way, about flu season and about handling both a flu epidemic and continuing to deal with COVID nineteen. Well, what I'm hoping for is two things. One extension of what you and I spoke about a few minutes ago about as we get into the full do it on a down slope of COVID as opposed to an upstill. But the other thing that I'm hoping for is that the very public health measures that have been targeted to COVID nineteen, I'm gonna mitigate the impact of a flu season, namely masks, distancing, avoiding crowds, staying outside to the extent possible, particularly as we get into the winter, and washing hands. An interesting fact, Katie, is that Australia, which is as you know, in the Southern Hemisphere and has their flu season during our summer, have had a very very light flu season and the Australian health authorities, many of whom are my friends and colleagues. I feel that the reason for that is that they were practicing public health measures to avoid the coronavirus and they had the secondary effect you bet, you know, just an unintended positive consequence. But haven't said that. I just want to make sure we're not discouraging people from getting flu shots. Dr Fauci, absolutely not. As soon as the flu vaccines become available right here on campus, I will be first in line to get one, and I encourage everyone six months of age or over to get a flu vaccine. I'm gonna get mine what as soon as I can, to believe in next week. What do you think when you look back at this whole unique chapter in our history, Dr Fauci, what do you think, uh, the government could have done better? What were the lessons learned? And what might have done been done faster and better to really keep the number of cases and saddling mortalities down. Well, you know, having been in the position I'm in now for the last thirty six years as the head of this institute, I had the opportunity to be involved in a number of outbreaks, from HIV in the eighties, you know, to pandemic flu in two thousand nine, to Zeka to Ebola. You could always say you could have done something better. So I mean the blanket answer to your question, and I don't even I don't mean to be facetious at all. Hetty is is we could have done everything better, you know, a little bit better. You could always do better. I mean we have shut down earlier, well retrospectively, of course, But if you turn the clock back and say when we had one infection in the United States at the time that underneath the radar screen it was spreading when we had one infection, if we had called to shut the country down, what kind of response do you think we could have had? Oftenmalia would have been great. If we shut it down, then we likely would have avoided a lot of infections. But it wasn't really feasible to do it. So in some respects we could have done better by doing that, but in some respects it likely would not have been feasible. So I mean, as as a health official being involved in this, you know, I'm humble enough to say we could have done a lot of things better, but it's just the way it is. We need to look ahead and maybe not closing down the country, Dr Fauci. And and you know early on when there was one case, but certainly you know in March, when the case cases were climbing traumatically and the month of February, perhaps more could have been done as you watched it, Yeah, I mean that must have been really, really worrisome for you as a public health expert. Of course it was. I was pained. I was paining. I mean, also, we could have done much better with testing, Katie. I mean testing situation early on was not optimal. What happened there. Did the CDC just come out with a lousy test initially? Well, it was just one of those unfortunate glitches that was technical that led to the having to recall a number of cases and losing the heads thought that we would have liked to have gotten. Well, I know that you've said that humanity has quote entered a pandemic era with the coronavirus outbreat likely just the first of accelerating epidemics to come. Just so we can end on a positive note, Dr Fauci, can you explain what is driving this new era and what we might expect in the coming years. Well, I'm pleased to see that you read my paper that I wrote in cell Stollowly Cave. Very good. I do, I knew do know a bit about medicine at this point. Dr, I'm very very pleased to see that that's a that's a scholarly paper. What what I What we said my colleague David Morris and I Mourns and I in that it really is a reflection of how we as the human species interact with our environment. Because if you look at the outbreaks of new infections, particularly new viruses, seventy of them are zoonotic or infections that have jumped species from an animal reservoir into humans, and the kinds of things that perturb the animal human interface a major drivers of outbreaks. You know, it was HIV from a chimpanzee bush meat slaughtering them, getting it into the American population. It was influenza where you have chickens and pigs and people in the agricultural situation that you usually see in the in the Far East, particularly now even with COVID, not only COVID now that we're seeing, but the original Stars in two thousand and two where the wet markets where people bring in animals from the wild, put them in a market and people come in shop, usually for festive meals during festivals. Things like civic cats and bats and other animals that have these viruses. You're almost asking for trouble when you do that. So what we said in the paper, we really need to rethink how we interact with the environment and how we interact with the animal species if we really want to avoid outbreaks in the future. And and it seems that when it comes to mitigating these pandemics, the Internet is not the friend of of the public health official. There's been so much misinformation coupled with polarization, it makes it very very difficult, Dr Fauci to get information to the public, not only that, but get them to believe that information. Yeah, it is true. It's become particularly difficult and problematic when you're trying to get a public health message across and you live right now in a time in our great country in which is very very divisive, and when you politicize and make divisive things that should be pure public health, it really makes it that much more difficult. Did you ever think about having your own daily briefings that would be completely devoid of politics, Dr Fauci, Yeah, that would be nice, wouldn't it. Would you not be allowed to do that? I don't have total control over those things. I don't. I guess if you need to keep your job, you wouldn't be able to do that. Yeah. Well, I don't think anybody is trying to get rid of me. But but what we're trying to do right now, which is the reason why I enthusiastically said yes to your request to talk to you, because they think things like our discussion that we just have now go a long way to really clarifying the real true public health message. Well, I really really appreciate your time, Dr Fauci, and again on behalf of all my followers, thank you very very much for your service, and thank you for all you do. To Katie, it's a pleasure and a privilege to be with you. Thank you for having me, Thanks for listening to the special edition of the Next Question, and I'm very excited in the upcoming weeks we'll be doing a special podcast series called Turnout focused on voting, why it's important to get out the vote, who isn't voting, and the systemic structures that have been in place that have suppressed so many American citizens. So stay tuned for that. In the meantime, thanks so much for listening. I'm Katie Curik and I'll talk to you next time. Next Question with Katie Couric is a production of I Heart Radio and Katie Kurik Media. The executive producers are Katie Curic, Courtney Litz, and Tyler Klang. The supervising producer is Lauren Hansen. Our show producer is Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements. Editing by Derrek Clements, Dylan Fagan and Lowell Berlante, mixing by Dylan Fagan. Our researcher is Gabriel Loser. For more information on today's episode, go to Katie curik dot com and follow us on Twitter and Instagram at Katie Kurik. For more podcasts for my heart Radio, visit the I Heart Radio app, Apple podcast, or wherever you listen to your favorite shows,