Transcript for An interview with Dr. Anthony Fauci | FiveThirtyEight
And undergraduates get started entering your appetite scans and burn and duke. Early on in the pandemic you know New York got hit really hard and the time. We didn't know much about the virus but now we're seeing new spikes in places Florida and Arizona. So six and what we learned about treating patients that might eat you know seeing my Annie from being the next New York. Well there a couple of things you mentioned what do we know by treating patients and I think it's important to separate. What we know that treating patients once you identify. A patient has inspecting verses why are we having blips and surges. In Florida in California in Texas and Arizona. In answer to your first question. We do we are much better now actually patients. As you know being in new York and New York you really really badly worse than virtually any place in the world. A couple of months ago. They had a lot of debts a lot of inspections. Ultimately got the infection rate down and the deaths. Dramatically down during that appeared on. Just get better in treating patient you get more experience. You know about what to do what not to do. And in addition we have a couple of drugs and Endesa beer and exit met zone. Got a very helpful in people with advanced. Disease. Particularly with decks and met his own people on ventilated. With our guests of the it would people who who hospitalized. And have lung disease. So that looks at the tree. Now what is going on with the resurgence is of infection in what I think is going on there. In fact that say I know what's going on there are obvious. Is that in some of the states. The governor is of the mayor's. Essentially jumped over the guidelines. And to check warnings and opened up. A little bit too soon. And they were not prepared to deal. With the resurgence is that they so in other states. The governors. And the mayor's actually abided by the guidelines and restrictions but the people in the state. Particularly the young people. Through cautions that the wind and you see the films of people. Very densely congregated at bars. And in areas where they getting together not looking at social distancing not wearing mask so I think what we're seeing right now. The results of that. In those states those forced aids that are counting of about 50%. Of all the new infections. That was seeing in the United States. You say that it's a mix. Politicians not following god guns and and people not following. Orders or. What do you. As well I mean it it's not a unique dimensional is complicated. There are some governor dozens and and and and mayors Ed did it perfectly correctly they stayed exactly. They wanted to open now. So they went through the guidelines are opening up the estate. But what happens is that many of the citizenship. Said you know well meaning going to be locked down or are gonna let it all ripped. And and you could see from just looking documented. On TV and in the papers of still photos of people at bars and congregations. Which are her and set up particularly if you don't have a mass then there's sometimes. When despite. The the guidelines. And recommendations. Are open up cheerfully. And prudently. Some states give don't widows and just opened up too quickly. You think that Florida and Arizona opened up too quickly. You know I I think in some respects in some cases they did not always. But I think that that certainly is contributing to that certainly Florida I know. You know acting jumped over a couple of Stewart points. I interviewed you back in the spring of 2019 in and at the time this was way before covered with even on anyone's radar at the time asked you what keeps you up at night. That the body has no background CO and highly transmissible and high degree. Morbidity and mortality and you you be ethically described something I think that like a pandemic flu course ours. And just like Asean's audio. But you know UN and other public health officials out there knew that something like this pandemic with us. Soon after the beginning of this pandemic. What would you do differently would you encourage the United States. Well you know it's always easy to go back in the richest spank the scope and saying. Yeah I could done things to of course. Now you know. That when you shut down you dramatically diminished spread. Yes well the logical conclusion is she'd you have share our early well if I knew at that time. Then. Shutting down would have such a dramatic effect. And controlling the spread obviously we would have shut down early. If we knew that the trouble was coming from China even though we shut down traveled from China relatively early. Still perhaps we could have done it even sooner I mean those are just things that he always try to out guess yourself. That when something works there is always the question. Should you have done it early. You know and it's something doesn't work should you not have done and that's just the way retrospective analysis is so. I'm sure we could have done that we knew we would be presumption was say that we did everything perfectly. You know. For a few months and masks were quite a partisan issue and do in the past few weeks politicians on both sides have advocated Fuller. For there use. Do you think America's hyper partisan environment has made it more difficult to suppress the parents. You know I think you'd have to admit that that's the case. We live I mean you have to be having blindfold design and covering your ears. Good thing that we don't live in them very divisive. Society now from a political standpoint. I mean it's just unfortunate. But it is what it is. And you know from experience. Historically. That when you don't have unanimity in an approached some. You're not as of active in how you handle it. So I think you have to make the assumption. That if there wasn't such divisiveness. That we would have a more coordinated approach. We're at this moment where it's it's still the summer but we're looking ahead to the fall and schools that are you know. Getting set to reopen in September. Many parents and students still don't really know how that's gonna work. Do you think we have enough information about the virus to make an educated decision out schools right now. You know I think that it's less that we don't have enough information about the virus. Then we don't know what the virus is gonna do in any given community. As we get towards the end of August and beginning and so I would like to stay a principle so that people. Would understand it. That obviously we're gonna be influenced by the dynamics of an outbreak in a particular region but in general. We should try out best. With ample consideration for the safety. Of the students. And their parents. We should try and possibly care. To keep schools open. And the reason is. There are secondary. Spit all consequences. Oh closing schools. That leads to unintended consequences. Of a ripple effect. On what the parents do with regard to work about getting back to work. And what you do about gay cares it's what you do the lunches to children who we lie on school. Again maybe at least one good meal the day having said that. That doesn't mean if you have a big outbreak that you keep schools open you might have to reconsider. But the one thing that we do know. That we live in a country that's very large very heterogeneous. And begin to be some Caribbean and some states that have so little viral activity that you would have no trouble completely keeping the schools open. With doing nothing different than he would do the normal circumstance. Where is and other places the activity of the virus may be such. As you might want to modify schedule. Things that many principals. And others are doing you know morning afternoon. Asked the class at one time if declares the other. You know sometimes that's workable sometimes that's not. But at least it needs to be seriously considered. I I mean do you think that there are different decisions that need to be made for kids of different agents. Oh yes I mean obviously mask wearing. Very clearly. If you can get away. When you have viral activity. And you make a decision. To keep school open. The children who were old enough to be able to Wear a mask you're gonna want them to Wear a mask. There is some children at certain ages. That you know I've had children at those ages I know how difficult it would be to get them to keep her man has gone they probably would be fiddling it enough. That the touching a bit and their base is probably more detrimental. Than not having a mask on at all. And US is doing. Just an. If you're looking across the world what are your feelings Howard. Well let me say there us lots of the United States. Like where you live right now. At a doing really well that you've been through something really bad. And you have things under control and you have me. Governor and mayor in the city. Who understand what it means. To go by the guidelines for the gateway phase weren't based in eastern so you're doing well the cities are doing well as a culturally. When you compare us to other countries. I don't think you can say it would doing great and you will we're just not because if you look at the curbs. Of what happened and the European Union. It's infections are now they came all the way down to baseline. And then they are there even though as they try to open there were more cases. In the United States as a concert with the exceptions of those areas that did well we came up. We came error but we Platt road at 20004. Weeks and weeks and weeks. And now the last couple of weeks we've gone back is our is at 8000. New cases per day. And now like yesterday was 43000. But 43 and fifty is twice what your baseline news. So I think you have to say we've got to do better I don't think we should be congratulating ourselves about how well we're dealing. We've got to do that even though some parts of the country are indeed doing very well. The EU and some other European countries opening their borders. Are still Manning travel from the united. Unjustified decision. You know and I wouldn't use the wood just a bite I would say is understandable. Because. You know when we saw that there were many cases in Europe and in China. We dance rabble on the European union of the UK us. So right now they have did detection rate very low much lower than we do. So they're looking at us. In this saying the same thing that we said to them I wish that would not the case. I wouldn't be recommending that I think we need to get back some saw it. Of normality. Just the same as they are saying to us. Why he's still being any traveled from Europe. Which we are a means so dear to me. I'm and I'm all for AmeriCares and an and I back what we do that if our European. And I'd be looking at us. I'd say why he's will be any Europeans have governed to the United States. Without the work and eat sort. Ability to go. You know I think we may be able to do that but this steel. As long as there is a dynamics of an active outbreak. It's going to be very difficult to get back to wait true normal. If you super impose upon. Very good public health issues and superimpose a vaccine on. Even if the vaccine. Is not a 100% protective let's say it's 7075%. Protect if you can do that. Combined with public health measure. I think we can get pretty close to some form of normality. And without a vaccine how. I think we can get it under control. But keeping it under control is going to be the real problem. Because. This virus. Is not like other viruses that we. 2002. That was a corona virus. Caused an outbreak. Of pandemic. 8000 cases and 800 deaths so in magnitude alone you see how different it is on what we're doing now but. It was not really very well and efficiently. Transmissible. Whereas this virus. To our dismay. Is beleaguered nations in transmitting. From person dupers. So that makes me skeptical whether we would get. Herman and sustained. Control. Of this without having a vaccine. So on the subject of vaccines how hopeful are you that we'll actually have a working vaccine within that twelve to eighteen month timeframe that you and other public health officials quoted at the beginning of the anti. Well giving caviar and then I'll give you my opinion. The caviar is that whenever you're dealing with a vaccine. There's never a guarantee. That if all the wins you gonna get a safe and affect the next because there are so many. Bumps in the road and potholes will be trying to blow backs. Let me said that. Looking at the preliminary information. That we have in the animal models. As well as the original phase one study. Look at safety in the beginnings. Of the ability to Wendy's a good response. I say on it I'm cautiously optimistic. That with a number of candidates. That are being pursued and boom relatively soon. But winds with phase three trial to determine efficacy. I think we have a pretty good chance as we end this year and get into 20/20 one. That will have a safe and effective vaccine or more than more. I will able to be distributed. I mean you know. Just because a vaccine is approved. And doesn't mean that the next day every when it's gonna be able to go out and get it all at once so. You know. This might be hard to estimate what percentage of the country do you ink will be able to get the vaccine an insane like. First three. Okay. So. Let me tell you what the company is promising. Because we can help development they manufacture. So. We're hearing from more than one company. That bailed them already this summer stall manufacturing. Doses. So that when true or not. Of safety net Nicosia cars. They will be able to immediately. Start distributing. Substantial. Numbers of doses which means. At some companies are saying. As we get into the first quarter. Well first of 20/20 one. The deal and hundreds of millions of doses and within a year might even have a billion doses. So I would think. As we going to 20/20 one and I'm telling you. What the companies are. Because I don't own the companies and I don't have anything to do with them except we're collaborating with them in the developing a vaccine. I would imagine. That as we get to the beginning of winning 21. That there will be tens of millions of doses to distribute. And likely as you get into the first half with when he when he won. He'll likely will be hundreds of millions knows. Now that's that's pretty fast. Pretty. We think I'm thinking a lot about is that you know would any vaccine in. Even after it goes through extensive clinical trials there is always some risk of adverse of facts. And and even if if the this side effects that that. Kobe vaccine whenever it made being are extremely small it's gonna get more media attention than probably any other vaccine in history. And at the same time we also have a growing anti vaccine movement in this country and around the world. Still I'm wondering whether you and other other public health officials are concerned about kind of the long term impact at this moment on act in except. It's. That's a great question arm because what it really tells us is that we got to get it right. We really do because if we don't it might have a real negative impact in the long range and long term. On how people approach and east arms to the need for vaccination. Which is the reason why. We taken so seriously. That even though we're doing this quickly. We're not compromising the safety. And nor are we compromising the scientific integrity. So as we go into the face me trials. Not only a guru will really be looking. At efficacy. Well we're going to be really paying attention. Is there anything there that was seeing this even suggested. On the negative news that's going to be really very important so that's a really important question hours. Do you have any guesses about how me people made. Actually end up. Opting not to get the vaccine. You know. I'm hearing reports I don't know what the accuracy of the reports. But they're saying that as many as 25%. Of the people might not want the vaccine even if we saved and prove that its statement. Which means. That we have a task cut out for those we've got to do what's called community engagement. We did that. With treatments. And prevention HRD. By engaging. The community. On the ground boots on the ground community engagement. We realize now that we have to do. With a cold vaccine and we're already starting. The process of planning. How we are going to do. So right now that's the ball is in our court. We really have to extend ourselves. Engage that community. You know you just mentioned are HAB response which as you know. Outbreak that where you first kind of emerged in the public sphere in America. I'm. Do you see any similarities between how the United States addressed that very different type of pandemic. And what we're seeing now. You know there are probably. What differences and similarities. But there are some similarities. You know it was an outbreak. Yet when we first. Soul are here. It was combined this is HIV was confined. To what appeared to be a very restricted demographic group. The gay population in this country and later injection drug users and then we knew by transfusions and mother. And hemophiliacs. In the beginning. It was felt to be a very restricted. ZI action voted paper about that in 1981. About how we really got to be careful because this is not gonna be restricted disease. Unfortunately when people read that April listened to a I was saying. Any insidious they snuck up on we've really under estimate. What was gonna happen with a HIV we being a global. Community. Not necessarily we dehumanize. But including. You and on when you you would too young at the time but we under estimated it. Same sort of thing happen now. Except it was an insidious. It didn't creek well on this week's loaded on house. And it sent us a while to realize that is what's happening around us that we are dealing with the really really serious situation. And it was quick. We realized that it was series with the HIV kinda snuck up honors over a myriad of months. Years. Where is what we see now with cold it is like a weeks to months. We realized who are in trouble. I mean it might think we sort of did what you are calling on the grounds. Response in the first couple. Couple weeks Wednesday night's series. Yeah. Because the boots on the ground. That I mentioned was to get people do appreciate. That they need to get vaccinated we did ebony vaccine only knew a lot of people we getting infected. So by by the time we realized. This was such an missions. Spread the press person. That's when you kept hearing about social distancing watch our own web man asks. So that happen pretty quickly what is your advice for how country. And by best advice. And I said so many times and thank you for giving me the opportunity to say it again on is that. You've really got to look. And abide by the guidelines. When we put the guidelines together. And I later world together would be Burks and others in getting the guidelines together. That we abide by the gateway. Restriction. Fourteen days of divination. And go to phase one. If you feel the criteria of the phase one go to space to get that they'll go to pastry. So that you've got to examine where you live. You'd the citizenry brings it is and the leaders governors mayors. Examine way you all are and don't jump over any. Of the check points do it in a measured. Prudent way. That's the leadership and the citizen. Of the content of the current. Oh by eight by the guidelines. Of where you live Ed as an individual. No matter where you all are given what's going on in rock country. Physical distance in six feet away where a man asked. Wash your avoid crap and those of the things that everybody should be dealing. So right now was still in the middle and as you know. It's become well known now that people ask. Are you worried about second wave house save TUR and as he says it many times where right smack in the middle of the first wave. So before we start worrying about the second wave let's get Eric Allard the first wave which is what we really need to do. Thank you so much doctor about gee I really appreciate you taking the time to speak my pleasure seeing you again then and thank you through the eleven and beyond your program.
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