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Widely considered the United States’ leading epidemiologist, Dr. Fauci has been the director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984.
As the NIAID website explains, “Dr. Fauci has advised six Presidents on [HIV or AIDS] and many other domestic and global health issues.”
His extensive work in immunology has helped bring to fruition therapies for conditions that were once fatal, such as polyarteritis nodosa, granulomatosis with polyangiitis, and lymphomatoid granulomatosis.
Now, with COVID-19 at the forefront of everyone’s mind, he has become a figurehead for robust science during dark times.
Among other topics covered at the Healthline Town Hall meeting, he spoke about returning to school and the ongoing social and scientific challenges presented by COVID-19.
Joining Dr. Fauci on the virtual stage were Dr. Elaine Hanh Le, Chief Medical Officer at Healthline, and two Healthline advisors: mental health specialist Dr. Timothy Legg, and pulmonologist and front-line physician Dr. Raj Dasgupta.
Setting the scene for the discussion, Dr. Dasgupta spoke about the range of emotions he experienced working on the front-line during a pandemic, his overarching drive to remain positive, and how his family tested positive for COVID-19.
Dr. Legg talked about the wave of anxiety impacting many of his patients in recent months: anxieties based around health and the health of loved ones, school closures, returning to school, childcare, anxieties about job security and financial concerns, and the increase in intimate partner violence.
As an expert in substance abuse, he also mentions the difficulties some of his clients have experienced with abstinence during the pandemic.
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Dr. Dasgupta, a parent with young children, confirms the stress that surrounds this question for both parents and children, and the importance of social interaction.
As Dr. Hahn Le says, this issue has many layers of complexity and “has been hotly debated.” Given the same data, people come to opposite conclusions about whether going back to school is the best course of action.
Dr. Fauci acknowledges the complex set of factors that people must consider when determining whether children can return to schools. Overall, he explains:
“The general default position to reopen schools should be to try as best as you can to open up schools for the psychological health of the children and the secondary downstream ripple effects of the family that might have to interrupt work to take care of kids.”
However, Dr. Fauci also makes it clear that “you have to pay attention to the safety and health and welfare of the children and teachers as well as the parents and relatives. With that as a background, we live in a big country that has different levels of infections.”
Because of this variation between regions, he says, “you can’t take a unidirectional approach. We’ve got to realize there has to be flexibility about where you are and how prepared you are to respond.[…] Taking the country as a whole won’t work.”
Speaking about vaccines, Dr. Fauci says he remains “cautiously optimistic” about the possibility of a vaccine being developed within the next 12 months.
Experimental vaccines in phase 1 studies induce neutralizing antibodies that are “equivalent to or better than” those in people who have recovered. He believes that this is a “good predictor” that things will go well.
Currently, there are three vaccines in phase 3 trials. For one of these, Dr. Fauci believes we will “know whether it is safe and effective” by the end of this year or the beginning of 2021.
However, he reminds us that developing a vaccine is a complex process, and there may be many bumps along the road.
When asked about the vaccine that Russian officials recently announced, Dr. Fauci says they “could not have adequately tested it yet.” He explains the important distinction between having a vaccine that looks like it works and proving that it is safe, saying:
“For all practical purposes, I could say we have six vaccines, but [we] wouldn’t give [them] to anyone yet without a clinical trial.”
Another hot topic on social media is whether a COVID-19 vaccine would ever be mandated. Dr. Fauci says he “doesn’t think you’ll ever see a mandating of vaccines for the general public.”
In a hospital setting, he explains, staff may be required to take a vaccine if they are likely to have contact with patients. However, for the U.S. public, he believes it is unlikely to be a legal requirement.
When asked about treatments for COVID-19, Dr. Fauci explains how remdesivir and dexamethasone benefit people with severe symptoms of COVID-19. These are both now recommended by the Clinical Guidelines Committee.
Scientists are currently investigating a range of other interventions that might help treat people in the disease’s initial phase. These include antivirals, monoclonal antibodies, and convalescent plasma.
When Dr. Dasgupta asked about contact tracing, Dr. Fauci explained how the U.S. now performs well for small outbreaks of COVID-19. However, when there is community spread, it is still challenging; and these difficulties are exacerbated by long wait times of 5–7 days for a test result.
Finally, Dr. Hahn Le asked how we should define success — how will we know we are winning. Dr. Fauci replied:
“When the percent positivity of the tests you do go way, way down. For instance, New York City is less than 1%, that’s what you want the whole of the country to be. Some parts are still 15–20%, and that’s really high. The percent of positive tests needs to be a really low number.”
Watch the full discussion on YouTube or Facebook.
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