Science Friday - Anthony Fauci On The Pandemic’s Future. June 12, 2020, Part 1

Episode Date: June 12, 2020

During the pandemic, immunologist Anthony Fauci has gained fame as “America’s doctor.” He’s a leading scientist in the government’s response to COVID-19, and a celebrated teller of truths—uncomfortable as they may be—like how long the world may have to wait for a vaccine, or the lack of evidence for using the malaria drug hydroxychloroquine on COVID-19 patients. He’s also not new to public health crises created by new pathogens. If history is any indicator, it is not a matter of if, but when another outbreak of disease will come, Fauci says. “There will be emerging and re-emerging infections in our history, it’s been that way forever. We’re seeing it now. And we will continue to see emerging and re-emerging infections,” Fauci tells Ira during the interview. “We can expect, but you can’t predict when. It may be well beyond the lifespan of you and I. But sooner or later, we’re going to get other serious outbreaks. So we have to maintain the memory of a degree of preparedness that would allow us to respond in an effective way the next time we get something like this.” He and Ira reflect on the AIDS epidemic, lessons learned from past pandemics, and what the path out of the COVID-19 crisis may look like. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. I want to talk about something for a few minutes before we get started today. Here at Team Cy Fry, we support the protests demanding racial justice because Black Lives Matter. We know in the long history of Science Friday, we haven't included diverse voices as much as we should have. As a media platform with a large audience, we recognize our equally large responsibility to act in certain, of social good. We're sorry and we know we can do better. A few years ago, we made it a mission to seek out the voices of black and minority scientists to show you our listeners a wider range of perspectives that a lot of times is missing from science news. We made talking about racial disparity research, a focus for our radio and digital reporting. We aired stories about

how black communities have unequal access to health care, how climate change harms the communities disproportionately and the unfair and racist hiring practices in academia. But we fell short and need to do more. So we're doubling down on elevating and amplifying black voices and experiences in science. It's our duty as journalists to represent black perspectives in science. And I know you would expect nothing less from us. Now back to the program. Later in the hour, we'll talk to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, about the future of the pandemic and why so many states are seeing spikes in cases. But first here to talk about scientists going on strike around the world, and other news headlines is Sarah Zang,

staff writer at the Atlantic based in Washington. Welcome back to Science Friday, Sarah. Thanks, Ira. Nice to be here. I want to start by reading this astounding headline in the journal Nature, is the most prestigious journal, I think, in the world. And it said earlier this week, thousands of scientists worldwide will go on strike for black lives. How well did that strike go on Wednesday and tell us why they did this? Yeah, exactly. There's a strike has kind of gone by a couple of different names. As you say, strike for black lives, also shut down STEM or shut down academia.

And they're all, as you say, taking the same action, which is stopping work for a day to get educated on, to reflect on and to talk about racism inside and outside of academia, which is, of course, a feel that is still very disproportionately white and disproportionately male. So what does this strike mean, right? What does this mean concretely? It meant no classes, no lectures, no research, no business as usual, which I think is a phrase that is pretty key. You are kind of living through this fairly extraordinary moment of reckoning with racial injustice

in our country, and whether that's in policing or in the media, industry and I think science is no exception. And you were reading a headline from nature. I think it was fairly extraordinary to see that nature as a journal also came out and said that they were not going to publish. They were going to Jay as an institution we're going to join in and on this strike. Yeah, I think that's what was so surprising for me is that they would join in. And obviously, thousands of scientists did join in this week. It was a success. Yeah, yeah, I would say so. I think Nearly 6,000 scientists signed a petition saying that they would join in, and scientists were talking about, you know, canceling seminars,

canceling virtual sessions and classes. A lot of the initial activism came from the physics community. So you saw a lot of also the physics associations in the U.S. and the UK and Canada canceling events and closing their offices. But also nature and also science, another big journal, they all decided to join in on this. Very interesting. Let's move on to some other pieces of news from the tech world.

IBM announced their shutting down research and development of facial recognition technology. Big step. What prompted this move? Yeah, that's right. I think this is connected to everything else they're talking about, which is that IBM sent a letter to Congress saying that they would stop developing this technology as part of a larger letter on reforms about racial injustice and policing, right? And so the reason that facial recognition is sort of especially tied to this issue is that for the past few years, researchers have really found that facial recognition is not very accurate when it comes to identifying black and brown faces. These algorithms are kind of trained on a data set of thousands and thousands of images, and they're kind of only as good as the data that you feed it. So there have been studies in the past where, for example, the ACLU, which has been a critic of facial recognition technology, they've run the pictures of members of Congress through these algorithms and found that,

28 members of Congress who are all people of color. They were mistakenly mad to people who had been arrested for crimes. These are actually members of Congress, of course. So it's not very accurate, though I would think it's also a point to point out that critics of the technology, they're not looking for more accurate facial recognition for black people, for example. They're saying take a step back. Let's think about how this technology is being used. And we know policing already disproportionately impacts black communities.

So let's take a step back and think about how their technology is actually being used. And facial recognition technology is also made by Amazon, right? And other smaller companies, is there any other indication that giant Amazon would follow IBM's lead? Yeah, that's a great question. So on Wednesday, Amazon actually came out with this statement as well, saying that they would stop selling this technology to law enforcement for a year. So when IBM first came out, you know, there's some critics who are saying, you know, it's easy for them to make this decision.

They weren't really a big player in facial recognition, so it's good PR for them, right? I think Amazon coming out and saying this, I think it really is telling us that there's a moment where we're really rethinking how to use facial recognition. Though, you know, Amazon is a year, who knows what's going to have after that. And I think those who want to, you know, talk about regulating facial recognition,

which is a conversation that's happening on the local, state, and federal level, maybe this is a time to do that. Let's move on to some other COVID-adjacent news related to something most people would rather ignore. And I'm talking about some cities are using sewage to track coronavirus cases. We have heard a bit about this in the past. This is getting serious now. Yeah, it has a name. It's sewer epidemiology.

So a couple of cities like New Haven, Connecticut and Carmel, Indiana, they started taking kind of daily samples of the sewage sludge to look for. evidence of coronavirus. So the idea is that, you know, when you are trying to track coronavirus cases, you can really only do it when people get sick enough that they come in to get tested. There have been some studies, though, that show that yes, coronavirus is fecaly expelled. So you can't go in and, you know, everyone's house and test everyone. But maybe if you just collect everyone's toilet flushes, essentially, it's what you're doing. This is kind of a way to maybe as a leading aid in cater. So before, you just... people start showing up the hospital, before people start showing up for tests, cities can kind of maybe

be ready for uptick in cases. In other moderately strange COVID news, horseshoe crabs are going to be a key part of developing a vaccine. Tell us why that is. This is one of those really wild stories. So horseshoe cabs have been really important part of the farmer's surgical industry for decades. And that's because their blood, which is this kind of bright blue color, has this really special property where it kind of coagulates, turns solid right away when it encounters bacteria or bacterial toxins. For horseshoe crabs, this is part of their immune system. But for humans, we found that this is a great way to test to make sure that vaccines, for example, are not contaminated.

So if you go back decades, it used to be not uncommon that if you got a vaccine, you get a little bit of a fever. That was because the vaccine itself was maybe not entirely pure. So now, you know, every year, almost half a million crabs are bled, essentially, for their blood. so that our vaccine is going to be tested, and the coronavirus vaccine will be no exception. And is there any possible, I guess, backup to the horseshoe crabs, anything that we could substitute any chemical that might work? Yeah, so there have actually been a lot of efforts to develop a kind of lab-based alternative,

and there actually is one, and pharmaceutical companies have kind of been working towards that, especially in Europe. But recently a group in the U.S. They set the standards for our pharmaceutical industry. They actually decided we don't have a pharmaceutical industry. enough data on the synthetic alternative yet. So for the foreseeable future, we're still going to be using blood from horseshoe crops. Okay, let's move on to a pretty disturbing study that came out this week. It turns out that microplastics have been found in unexpected places. What kind of places

are we talking about? Yeah, so these scientists went out into pretty remote places in the American West and National Parks, such as Joshua Tree, and Grand Canyon and Bryce Canyon. And they essentially set up collection boxes and waited and saw what deposited in these boxes. And so when we're talking about microplastics, we're talking about really, really tiny pieces of plastic, less than five millimeters in size. So really the size of dust. And what they found is that, yes, you can find microplastics in these places where you don't really have people walking around. And the reason they're getting here is actually probably through the rain and through the atmosphere. Because microplastics are so tiny, they can basically travel through the air and the water cycle.

You know how there's a layer of dust on Earth where the meteor struck us and killed all the dinosaurs? I think a few thousand years from now when other civilizations come and dig up our geology, they're going to find that layer of dust of plastics. Yeah, like the plasticine or something that we're living in, right? The plasticine. It's a great word. Let's end with a story you reported for the Atlantic, and that is with all of the us inside during lockdown, animals are behaving differently than we've seen before. Yeah, so one animal if I Kistan is, of course, the rat. So I spoke to some past management

experts who told me about what it was like when restaurants shut down at the beginning of our shelter and place orders. And one of the management experts, she actually services a lot of kind of fancy high-end restaurants in Chicago. She was saying right when they shut down, she went to go check them out. And they had dumped a lot of their produce that couldn't be eaten. So she just found these like boxes and boxes of avocados are just like gnawed by rats and and teeming with the rats. So they kind of got this like one final buffet before everything shut down. And since then, she's been finding fewer rats in those kind of restaurant locations. On the other hand, restaurants that have stayed open, they've kind of been the ones that have been generating more of the

trash. So they've, sometimes they've seen it influx at rats, unfortunately. So they're seeing like an infestation of rats from the places that are open and they, the rats are fighting. And they, the rats are each other in places that are not open. Yeah, exactly. So, you know, rats, they're going to go where the food is. So if you are, for example, the only restaurant open in a block, they're all going to be coming to your dumpster. You know, there's a famous picture of a rat years ago in New York City dragging a pizza slice down the subway steps. And maybe now they'll be fighting over that.

Yeah, it might be like three rats dragging the pizza. Did the experts you talk to have predictions about what's going to happen when things go back to normal for the human population? Oh, yes, the rat population will go back right away. Rats are able to have dozens of baby rats every, you know, in a single year. So don't worry, they'll be back. Yeah, and maybe we'll see other animals. I know in my neighborhood we're seeing all kinds of other animals that are coming out

from the wild. Thank you very much, Sarah. All right, good to be here. Sarah Zang, staff writer at the Atlantic based in Washington. We're going to take a break. And when we come back, we're going to talk to Dr. Anthony Fauci, who, as they say these days, is America's doctor. Stay with us.

We'll be right back after this break. This is Science Friday. I'm Ira Flato. I am having a deja vu all over again. Almost 40 years ago in 1981, I began covering a strange outbreak in New York City of a rare form of cancer among young gay men. It was mysterious and baffling to scientists who would take years to get a handle on what would be later called AIDS and the virus HIV, and it was at that time that I began

interviewing a young NIH disease expert name, Dr. Anthony Fauci. And since then, over the last 30 years on Science Friday, Dr. Fauci has joined us to explain disease outbreaks all over the world, like Ebola, SARS, swine flu, and now the COVID-19 virus. And just this week, he warned a conference of biotech executives that the pandemic was far from over. And lots of questions about the disease remain unanswered and baffling as they were with AIDS. Thus my deja vu moment. Dr. Fauci is the director of the National Institute of Allergy and Infectious Diseases and the recipient of the Presidential Medal of Freedom.

He joins us to talk about where we go from here and how does this disease intersect with a public health crisis impacted by racism and anti-vaccine sentiments. Welcome back to Science Friday, Tony. Thank you, R.R. It's good to be with you. Can you blame me for having that deja vu moment? Does it happen to you at all about AIDS? Oh, my goodness. There's so many things that are analogous to what was going on when you and I were talking about it back in the early 80s. The mysterious nature, the protean manifestations of disease, the more we learn about it, the more we realize how little we know. I mean, it's just striking. You know, except in the meantime, I'm still just a radio talk show host, and you're now America's doctor.

We haven't changed that much, all right. Let's begin. There's so much to talk about. Let's begin, I'm quoting the New York Post of all papers today, a headline that says Dr. Anthony Fauci on Tuesday called the coronavirus, his quote, worst nightmare, and warned that the fight against its spread is far from over. Yes, it is an accurate quote, Ira. And the reason I say that is that, you know, we often get asked that, what is the thing you worry about the most? And I've said that so many times over the years. It's the evolution or the appearance in the human society of a new virus that generally would

jump species from an animal to a human. That would be a respiratory-borne virus that would have the combination of a very efficient capability of spreading from human to human, at the same time having a high degree of morbidity and mortality. And that's unfortunately what's happened here, because remember, when we had the bird flu, it jumped from a chicken to a human, had a high degree of mortality, but it was very poorly efficient in spreading from human to human. So it never went anywhere. And then we had the H5N1, H7, and 9. But to have the combination of both, something that's highly, highly efficient in spreading from human to human, and yet has a significant degree of morbidity and mortality, is in fact the worst case scenario you would expect

with a respiratory virus. Is this virus still evolving and mutating? Well, it's an RNA virus. And RNA viruses mutate all the time. The issue is, is it mutating in a way that is influencing or impacting its functional capabilities, like its virulence or its ability to spread from human to human? The answer is we don't have any evidence that that's occurring. Certainly, we're observing mutations, which is expected when you have a virus that's widely disseminated throughout the population and is an RNA virus. But so far, it has not changed significantly to our knowledge. Why are we seeing record-breaking spikes in the numbers of cases and hospitalizations in recently open states like Texas, Arizona, Utah, North Carolina, and Florida?

Well, it's not unexpected, Ira. And the reason is that this virus was so easily transmissible that the best way that we did, and we successfully did it, we mitigated it by essentially shutting down the country, going into lockdown. It wasn't just us, the rest of the world did the same thing. And you know, there's a recent paper that came out just yesterday of the day before showing that that closing down of society globally has saved hundreds of millions of infections and at least a few million deaths. So we know that mitigation works. When you pull back and try to reenter a degree of normality, you can expect that there will be blips of infection. Whether those infections become real rebounds is going to depend on how effectively you address

it by identification, isolation, and contact tracing. So you are correct, Ira, that we are seeing these little blips now in several states throughout the United States. I hope that we can contain them effectively with the tools that we have. If there were a spike in new cases, how would we know if they were due to the opening of the states or due to the masses of protesters? You know, I think it's going to probably be a combination of both. Whenever you get a congregation of people together, hopefully everyone will be wearing a mask. But even with a mask, there's still a risk when you have crowds. It was just reported yesterday evening that certain members of the D.C. National Guard

who are involved in trying to contain the demonstrations in my city of Washington, D.C., have tested positive. Again, that's unfortunate, but not surprising, because when you have the congregation of people in a crowd, that's when you get spread, and that's the thing we're concerned about. There have been calls from Governor Andrew Cuomo of New York and others asking for everyone who participated in the marches to be tested. What's your view on that? Well, I mean, obviously, if you have the capability and the facilities to do that, you could get a good feel for exactly what impact, if any, that congregation of people during the demonstrations.

So I would agree that if you're able to do that, you would get important information. And are there enough tests out there? I mean, that's a question we keep hearing over and over. is that a correct question to ask? You know, yes. Right now, if you look at the situation with testing, Ira, obviously, we got off to a slow start in the very early weeks of the outbreak as it was recognized here in the United States. But right now, the testing numbers and capability and capacity is significantly better than it was. And as we're looking forward, as we enter into the next weeks and months into

the summer, it should get even better. So I do not believe that testing will continue to be a problem going forward. All right. We opened the phones. Actually, we're not on the phone during our place staying at home, but actually we have our Voxpop app, Twitter, and Facebook, and we've asked our listeners to ask questions. And let me begin with an AIDS-related question. A listener on Twitter wanted to know why, if we still don't have a vaccine for HIV after 30-plus years, why can we expect a COVID vaccine in fewer than two years? That's a very good question, ARA, and the explanation is really rather simple. With HIV, it's such a unique virus.

The body does not make an adequate response against natural infection. And we know that, and that's the reason why they're essentially, despite the tens of millions of cases of HIV infection. There are really no documented situations where someone's immune system completely clears the virus. There's a group of elite controllers that can suppress the virus well, but there's no evidence at all that the body makes an adequate response to natural infection. And when the body doesn't make a natural good response,

that means that it's going to be very difficult for a vaccine to do something that the body naturally cannot do. With coronavirus, it's different. If you look at the situation with coronaviruses, the majority of people spontaneously recover and clear the virus, which means we already know that the body is capable of doing that. So the proof of concept is already there. So we feel if we can respond to natural infection with a good immune response, that a vaccine can also do that. So they are really fundamentally very different viruses. And that's the reason why we feel that we can be cautiously optimistic about our capability of developing successfully a safe and effective vaccine for coronavirus. There have been some recent reports that

Remdesivir may have some positive effect against the virus. Is it possible that we might have a treatment, like an AIDS, we might have a treatment before we have a vaccine. Ira, I would not be surprised if what you said is absolutely correct. Well, remdesivir was a drug that was put into a placebo control randomized trial in hospitalized patients with COVID-19 who have lung disease. It was a statistically significant but modest positive effect of about 32% diminution in the amount of time it takes to recover. That's the first step towards developing better drugs

and drugs in combination, not only antiviral drugs, but also things like monoclonal antibodies, passive transfer of convalescent plasma, hyperimmune globulin, and even some therapies that blunt the aberrant, overactive inflammatory syndrome that we see sometimes in people later in the course of. of their disease. So there's a lot of activity going on into development of countermeasures in the form of therapeutics.

Let me begin going back to our Voxpap. A science writer colleague of ours had this question for you. Hi, Dr. Fauci. My name is Omer Erfond, and I'm a staff writer at Vox. My colleagues and I would like to know, given that many states are pursuing different strategies, how do you anticipate the outbreak will play out in the United States over the next? year. If infections rise again, can we count on shutdowns being as effective a second time? Well, yes. I hope that we don't get into that situation where when we get infections, we cannot contain them with an adequate degree of identification, isolation, and contact

tracing. We know as we start to open up the country to try and get back to some degree of normality, that there will be blips of infection. That's going to be inevitable. whether those infections turn into a real resurgence of infections and a rebound will depend on how effectively we're able to identify isolating contact trace. If we don't do that effectively, we may need to pull back from containment back into mitigation, which we know is effective because we clearly have proof that that did blunt the outbreak. Are we sort of in a whole national experiment on this now? You know, in some respects, we are, Ira, because if you look at the history of our response

to infectious diseases, outbreaks over the decades well, well, well back in history, we have never had to essentially lock down not only an entire country, but if you look at what the other nations of the world did, we kind of locked down the entire. planet for a while. And that certainly contained what would have been a much more massive global outbreak, but you can't stay locked down forever. And that's the reason why we're trying to carefully and prudently with guidelines get back to a degree of normality. And we've never, ever had that situation before. Just a quick break. I'm Ira Flato, and this is Science Friday from WNYC Studios.

Let's go to a scientist who is a recent guest on the show. Dr. Uche Blackstock had this question for you. Hello, I'm Dr. Uche Blackstock. I'm founder and CEO of Advancing Health Equity, which works with healthcare organizations to close the gap and racialized health disparities. In April at a press conference, with respect to racial health disparities in this pandemic, you said,

so when all this is over and, as we said, it will end, we will get coronavirus, but there will still be health disparities, which we really do need to address in the African American community. However, right now, black people are still dying at highly disproportionate rates. More than 1 in 2,000 black people have died from coronavirus. 13,000 black Americans would still be alive if black people had died at the same rates as white Americans. What specifically would you recommend the federal government do right now to address these racial disparities? Thank you for that question.

And I like the point that you said right now because there are the chronic persistent issues of social determinants of health and disparities in health in the African American population that we need to maintain a commitment to not forget about that. But right now, we have a situation where we've got to concentrate the resources in areas we have a high density demographically of African Americans to be able to. to provide them when you do see these blips of infections that we've been talking about, that we can adequately and effectively identify, isolate, contact, trace, and get into care as quickly as possible, these individuals who do become infected because we do know that not only did they

have an increased incidence of getting infected because of the situation economically and otherwise where they find themselves, but once infected, the prevalence and the incidence of the comorbidities that lead to a poor outcome clearly are disproportionately higher in the African American population, including hypertension, diabetes, obesity, and others. So we can do something about that now, both with protecting them from infection, identifying it as soon as they get infected, and getting them into care as quickly as possible.

And what would the long-term plan be then? Well, you know, Ira, that's something that we have to have a decades-long commitment because if you look at the things, the social determinants of health, the situations that African-Americans and other minorities are put in with regard to the availability of things like a good diet that prevents things like obesity and diabetes, the access to health care to allow them to get under control any indication of hypertension. Those are the kind of things that we need a long-term commitment to because they're not going to go away spontaneously.

And as I've said, you know, one of the things that might be a positive in a real issue of a lot of concerning issues is that this is shedding a very bright light on the disparities that we've known about so long and how destructive and harmful to the African-American population that these disparities can be. So I would hope that this would re-energize us in a commitment to do something about that. We're going to take a break, and afterwards we're going to come back and talk more with Dr. Anthony Fauci, more on the pandemic and with the end. might look like. This is Science Friday.

I'm Ira Plato. We're talking this hour about the coronavirus pandemic with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and now a household name as the nation's leading scientific voice during this crisis.

Let's turn now towards the search for a vaccine, when we couldn't expect a vaccine, and has your view changed on this? No, my book. My view hasn't changed, so let me just reiterate it again. We're going to go into an advanced phase three trial in the beginning of the summer with more than one candidate. And it's going to be a very large trial involving tens of thousands of individuals. And we hope that by the time we get into the mid to late fall, if things work out okay and we don't get into any unanticipated speed bumps,

that by the end of this calendar year and the beginning of 2021, that we will have a vaccine, or maybe more than one vaccine, that we would be able to deploy and utilize to protect people. Are you worried that we will see hesitancy from people about getting the vaccine, driven by misinformation that seems to be proliferating already? Yeah, that's always a worry that I have, Ira. you know, it dates back to the vaccine hesitancy around measles that we saw resulted in the unfortunate rebound and resurgence of measles in a country that had essentially eliminated measles. I'm always concerned about the general anti-science attitude and particularly the anti-vaccine attitude.

So what we have to do is we have to intensify what we call community outreach to be very transparent with the community, to talk to them about the trials, to ensure that in the conduct of trials, we don't compromise safety and we don't compromise scientific integrity. We've got to be very open and honest and transparent about that and reach out to the community so they won't be hesitant to take a vaccine, which could be life-saving for them. A question from another researcher, Columbia University virologist, Dr. Angela Rasmussen. Dr. Fauci, I'd like to know specifically what kind of evidence of vaccine efficacy would meaningfully accelerate vaccine approval in the U.S.

I'd also like to know if trial enrollment is sufficient to get that evidence by the fall. Can you explain what she's asking? Yeah, she wants to know what level of efficacy is going to be adequate. I mean, obviously what we would like to see is something that approaches 70 percent. Because if you do the calculations of modeling, 70% protection of the community would give you what we call herd immunity. We're hoping for that. She also asked the question that's important is that what about the amount of enrollment? I don't have any difficulty in thinking that we're going to enroll 30,000 people per vaccine, 15,000 in the control arm and 15,000 in the experimental.

So all you need is a certain number of infections in the trial, and you have a statistical projection of how many infections you need to be able to determine if the vaccine works or not. If we get those number of infections, we should be able to have a determination of whether or not the vaccine is effective. And obviously throughout the entire trial, you're looking at safety. When we talked about medical disparities on this program, especially when it comes to testing out new candidate medicines, we've had experts from African-American communities also point to a reason people of color may not wish to participate. And it's really a question of trust. They point to the Tuskegee syphilis experiments, the exploitation of people like Henrietta Lacks.

Is this a part of the problem of testing and something that NIH can fix? I don't think NIH can fix it alone, but we certainly can pay attention to an IRA. And that's what I mean about community outreach. We're doing that already right now. We're reaching out to communities of different demographic groups, but particularly focusing on those who have a reason for distrust because of the history of being mistreated. So we have a very special effort to do outreach to minority communities, not only African-Americans, but Latinx as well as Native Americans, because those are the minority populations that always seem to get the short end of the stick on things. We want to make sure they understand that this is something that could be very beneficial to them, particularly since as we know so well that with coronavirus, there's a disproportionate burden.

of infection and complications leading to serious outcomes among the minority populations, particularly African Americans. So we really do want to get them into the vaccine trials because we need to know if it does work in them in a safe way so that when a vaccine becomes available, we can make sure it's equitably distributed to the people who need it the most. In an interview recently with the AMA editor, Howard Bouchner, you said that research shows that even with a vaccine, immunization will not grant people long-lasting protection and we could still be reinfected. Yeah, I want to make sure that that's not taken out of context. So let me clarify it because there was some misunderstanding with that statement.

what I was saying is that the normal type of common cold coronaviruses that we have decades and decades of experience with, the ones that are relatively trivial in their clinical effect, the common cold. Immunity to those generally doesn't last 10, 20 years. It generally lasts about a year. We do not know at this point, and I emphasize, we do not know. how long protection would last after someone recovers from infection. We do know that we can induce a good response with a vaccine, at least in the phase one studies that we've done. The question is, how long is that protection going to last?

If it lasts a year or more or two or three or four, that would be great. We don't know that. But if it does have a finite, limited amount of durability, we could always boost it. So I'm really not concerned about the durability. I just want to get to step one, which is that it does protect at least for a reasonable period of time. A question from the science communication world, Scientific American editor, Tanya Lewis. Do you think the pandemic is likely to continue spreading until a vaccine is ready? Or could it burn out on its own with possible later spikes of reinfection?

Or are we just going to see infections plateau at a very high rate? And lastly, how optimistic are you? Well, I'm always cautiously optimistic about these things because I feel that we can put an effort that could contain it. I mean, the virus if left to its own devices would be out of control, but that's not happening because we're doing something to contain it. You asked about different potential scenarios. You know, all of the above are possible. I do not think, and one of the things I'm fairly certain about, is that this virus is not

going to disappear from the planet the way SARS did because it is such a highly efficient spreader from human to human. that somewhere, someplace on the planet, we're always going to have infection. It's going to be up to us to contain it. If we get a successful vaccine, obviously, as with other viral infections, we will be able to control and maybe even eliminate it in certain countries and certain regions of the world. I do believe that for some time we will see continued infections,

whether those infections become true outbreaks again is going to really depend on our ability to identify, isolate, and contact trace so that blips of infection don't turn out to be true rebounding and resurging of a lot of infections. Should we expect this to be the new normal viruses like these popping up now? and how do we prepare for that? Well, you and I have been talking about this, as you said, at the beginning of the program for now, you know, like almost 40 years. There will be emerging and reemerging infections in our history.

I've been that way forever. And we will continue to see emerging and reemerging infections. What we need to do is learn the lesson that now that we've seen this, We've been through pandemic flu of 2009 H1N1. We have seen the outbreaks of Ebola, of Zika, of HIV. We always have the threat of a pandemic flu, and now we have a pandemic in something that isn't the flu. It's another virus.

We can expect, but you can't predict when. It may be well beyond the lifespan of you and I, but sooner or later, we're going to get other serious outbreaks. So we have to maintain the corporate memory of a degree of preparedness that would allow us to respond in an effective way the next time we get something like this. Do we have to restrainthen our international cooperation and conferencing with other nations to head off a future pandemic? The answer is yes.

We were going in that direction and still are with the global health security net. and the security agenda, where you have communication connection and interdigitation of the health components of nations throughout the world to be transparent when there's an outbreak, to share samples, to talk about the kind of surveillance that can detect something well before it gets out of control. So the short answer to your question is absolutely yes. You've often been seen as the voice of reason in the White House Pandemic Task Force, especially when it comes to advice about social distancing and tempering some of the effusive praise for the untested hydroxychloroquine. What do you believe your role is in making sure outright falsehoods don't perpetuate?

Well, the only thing I can do, Ira, is continue to make any statement in policy and suggestions and advice that, as a scientist, as a physician, to do it the way I've been doing it my entire career, is that use evidence-based and data. And if you don't know the answer to something, admit it, if you do, make sure your statements are based on data and evidence. And that's all you can do. If you consistently do that, then I think you're going to be in good shape. And that's what we've been doing all along. I'm Ira Flato, and this is Science Friday from WNYC, Studio. I was shocked and saddened to learn last week. I know, as you were, about the death of Larry Kramer. I remember in 1981, Larry Kramer was my guide through the AIDS epidemic in New York, taking me around and showing me everything I needed to know about the spread, introducing me to the founders of the gay men's health crisis. And I know you and he had your ups and downs over his career and your career. We did. I mean, we had a what I would, and both Larry and I have described it independently as a very interesting, complicated relationship, which ultimately eventuated into a deep bond, friendship, and even love for each other. He started off, as you know, you were there in a very confrontative way. The government authorities, scientists, regulators, the public in general, even the

media were not treating HIV AIDS with the seriousness in which it deserved. Larry recognized that, and he tried to call attention to that, but he did it in a very confrontative, incontoclastic, and sometimes even outrageous way. I being a government official was the target of that. So our first interaction was one in which he was very abusive, in fact, attacking me an extraordinary ways. And then I did something that I think was a good decision on my part. Rather than get blinded by the confrontational nature and the theatrics of it, I decided to listen to what he was trying to say. And he made sense. And that's when I developed a relationship that went from adversaries to acquaintances, to friends, to good friends, to really very good friends. And at the end of the

day, we realized throughout many years that our goals were common goals, we wanted to get to the same endpoint. He had his way of doing it, and I had my way of doing it. But Larry Kramer was an iconic figure. I mean, there's no doubt about it. He was just an extraordinary person who transformed the way the community interacts with the so-called authoritative scientific regulatory government and established community, to get the people who are involved, the people who are at risk or who actually have a particular disease, to have a major say in the development of the research agenda and the implementation of things like clinical trials. Larry changed all that, and that's why he's really a historic figure, and I feel very privileged to have had him as a very dear friend.

You know, hearing you say that and watching your actions, it almost appears to me like you're, you're channeling a little bit of Larry Kramer during this pandemic. Well, you know, in some respects, Larry would speak the truth and you have to speak the truth. And that's what we're doing. One last question, because I just have to ask you this question because it's something that's been bugging me on and off watching you on television. And all those times I saw you standing up on the podium with the president and other officials all huddled together while you were asking the country to socially distance. And I would yell at the screen sometimes and say, Tony, why don't you insist that they all do what they say they want you to do and spread out before they go to the microphone? Yeah, we ultimately did that. We finally got it to be.

And now, if you look at a conference, they've spread them out. So we finally got that goal accomplished. Well, I finally got my goal accomplished of getting you to appear on Science Friday after three months. So I want to thank you very, very much for taking time to be with us today. It's always good to be with you, any time. It's always good. It's always good to see you and talk to you. Stay well.

We'll talk again. You too. Thank you. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. Charles Berkwurst is our director. Our producers are Alexa Lim. Taylor, Katie Feather, and Kathleen Davis. BJ Leatherman composed our theme

music, and if you missed any part of this program or you'd like to hear it again, subscribe to our podcasts and ask your smart speaker to play Science Friday. And we have a new question this week up on our Science Friday Vox Pop app. We want to know,

are you a health care worker feeling burnt out right now? There's a lot happening in the world. If your job is taking care of other people physically and mentally, how are you doing? Tell us on the Science Friday Vox Pop app wherever you get your apps. You can email us to our address is SciFri at ScienceFri.com. Have a great and safe weekend. I'm Ira Flato.