Science Vs - Fauci! He’s Back!

Episode Date: June 23, 2020

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, member of the White House Coronavirus Task Force and America's favorite nerd joins Science Vs again. Wendy chats with Dr. Fauci about the pandemic’s past, present and future.  Here’s a link to our transcript: https://bit.ly/2V82uQg This episode was produced by Wendy Zukerman, Meryl Horn, Rose Rimler, Michelle Dang, Mathilde Urfalino and Sinduja Srinivasan. We’re edited by Blythe Terrell and Caitlin Kenney. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Emma Munger, and Bobby Lord. And special thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. Today, we have a special treat for you. We wanted to get the inside scoop on how one of our oldest pals is thinking about this pandemic. So we called him up, Dr. Anthony Fauci. Anthony is the head of the National Institute of

Allergy and Infectious Diseases. He's on the White House Coronavirus Task Force. He spent hours today talking with Congress about how this virus isn't going anywhere. But before he spoke to the pollies, he spoke to us. She's Australian. What? Australian. Okay. Hey, Anthony. Hi. Okay, so the last time we talked to Anthony, it was late January. The US had just a handful of confirmed coronavirus cases. Obviously, a lot has happened since then. And Anthony just couldn't wait to tell us all about it. How long is this going to be? I think it's going to be about half an hour, if that's all right.

So let's go. I'm a quick speaker. Yes, I know. I know. All right. So let's jump in. So late last year, the Yankees had just signed Garrett Cole, you know, arguably the best pitcher in baseball, one of the biggest deals of

all time. Then the pandemic happened, but Cuomo just announced that the Yankees are back in training. I know you're a Yankees fan. Are you excited about what the Yankees could do this season? Well, first of all, we got to get the record straight, Wendy. I am a Washington Nationals fan. I was born in New York, in Brooklyn, and I was, throughout my entire youth, I was a New York Yankees fan, even though I was living in Brooklyn. But yes, I'm obviously hope that we will get some aspect of the baseball season in, but we're living through a moving target. So, you know, it's going to be very difficult to predict where we're going to be in the next month or two, but we're hoping for the best.

So I spoke to you back in January when the coronavirus was kind of rearing its head. And I asked you if you were worried back then and like classic, what we've come to know as classic Fauci style, you said, I don't worry. I either get prepared or I do something about it. But as this pandemic has unfolded, was there a moment where you were worried? Wendy, I don't like to tag emotional responses to things, but I would say I had considerable concern. And the considerable concern was as this evolved, it became clear that we were having serious community spread. You know, it wasn't just one-offs where you would have a case

that you couldn't link to something identifiable. So this was when these cases were popping up and we could no longer link it to someone who was travelling back from China or Europe, as it would be. Right, right. It went to springing up in the community in a way that we were not keeping up with. And at that point, when it became clear

that we were dealing with a virus that had a very efficient way of spreading from human to human, it became quite concerning. And then you look from within and you find out that you have a really terrible problem. So it was an evolution, but an evolution getting darker and darker and darker. The United States now has about 120,000 deaths and well over 2 million infections. And, you know, as of yesterday, we had 30,000 new cases in the United States. That's serious stuff. You know, obviously, back in January, you know, we didn't know anything about this virus. It was new. And we've learned so much in the last six months. The science is moving at an unprecedented rate or what feels like an

unprecedented rate. If you could go back in time and tell past Anthony in January, just one thing about the biology of this coronavirus, what would it be? Well, there are a lot of things that I would have liked to known back then. But one of the things that is striking to me as a scientist who has been involved in studying how viruses interact with the host and the way they damage and cause illness, morbidity and mortality of all the viruses I've dealt with in my now four-decade career is that I've never seen anything closely resemble this virus in the spectrum of what it can do. Whenever did we see a virus that in 20 to 45% of people gives no symptoms at all. And then in some, it gives mild symptoms, enough to make you feel badly but not interfere with you.

To some who have to stay home for a few days because they're ill. To some who are just confined to bed for weeks and weeks. They don't have to go to the hospital, but they're knocked out completely. To those who require hospitalization, and then some go on to death. It is just completely unprecedented that so many people have no problem with it, and some people, because of underlying conditions or the age bracket that they're in, they're at a very high risk of serious consequences. And now we're starting to see that even young people who we thought was

somewhat protected from this are also starting to get these deleterious consequences. So the range of no symptoms to death, we've never had that before. I know age is just a number, but Anthony, you're in that high risk category. How do you feel about that? Well, I know I am in a high risk category, but the nature of my work and I've made my choices in life, this is the life I've chosen. I have to be not locked in. I can't be. I am not cavalier. I'm not foolish. You know, I spend the mornings here, which is my office where I am right now, very few people around, working via virtual. And then I spend the other half down at the White House interacting with the coronavirus task force, the White House task force. Sure, there's a risk there.

The safest thing for me to do would be to lock myself in my house and do nothing. But I can't do that. But you're right. I'm in my late 70s and I am at risk. But, you know, you got to do what you got to do. So then just zooming out from what we know now about the biology of this virus, but also how various nations tried to tackle it. How did this coronavirus manage to basically take over the world? Well, it was able to take over the world because it had a characteristic. You know, I always get asked throughout my career, what is your worst nightmare as an infectious diseases person? And I always answer consistently.

I say it's when you have a confluence of factors that come together all at once. And that is a brand new virus that jumps species from an animal reservoir and for the first time infects humans. That's respiratory spread that is highly efficient in going from human to human and that has a significant degree of morbidity and mortality. We've had outbreaks that had one or the other of those characteristics, but except for the 1918 pandemic flu, we've never had one until now that's had all of those characteristics. So for example, you had something like the chicken virus. You remember the H5N1? Yeah, yeah, yeah. It jumped from the chicken to the human,

had a high degree of mortality, but it was very, very inefficient. Barely could go from human to human. Then you had the pandemic of 2009, the swine flu of the H1N1. It spread very rapidly from human to human, but it had a very, very low degree of virulence and morbidity and mortality. Then along comes COVID-19. A, it jumps from an animal to a human, the bat reservoir perhaps to an intermediate host. B, the humans have never experienced it before. C, it is highly, highly transmissible from human to human. And D, it has a considerable degree of morbidity and mortality. All of those things come together, you could describe as the perfect storm. And it is this perfect storm that has essentially thrust itself on our planet and caused most

of it to have to shut down. When I was a kid, I once got a fortune cookie that said, may you live in interesting times. planet and caused most of it to have to shut down. When I was a kid, I once got a fortune cookie that said, may you live in interesting times. Yeah, right. Which I thought was great, but my mom told me that's actually a bad thing. Yes. Is this one of those times? This is one of the times when mothers seem to always be correct.

And your mother was correct. This is, I mean, it's certainly interesting, but it's devastating also. After the break, we talked to Anthony about what could have gone down differently as we tried to tackle this coronavirus. Welcome back. Today, we're talking to Dr. Anthony Fauci. And so, as we were talking, he told us that the tricky situation we're in right now

is that we're trying to keep cases down while getting our lives back. Yeah, to try and get back to some degree of normality, because when you shut down the planet for a considerable period of time, you create such stress on the system from an economic standpoint, you know, other health issues that come up when you're locked down. So you've got to walk that delicate balance. And so, Anthony, on that question of the balance, so, you know, some states that shut down, as you mentioned, had these like huge economic and social implications. Lots of people lost their jobs and they never saw a bump in cases.

I'm thinking of places like Montana, unemployment rate is now at 9% and they've only had some 20 deaths. Do you think we got that balance right everywhere in the US? Well, I think you're hitting on something that's really very important. The United States, it's a gigantic country in size. It's a big place with a lot of differences. So, I mean, the differences between the metropolitan area of New York City and Casper, Wyoming, between San Francisco and Des Moines, Iowa, is extraordinary. So the impact of virus in how it's spread, where it's spread, the impact on society differs greatly. So do you think you got the balance right, everyone?

Well, what do you mean, Wendy, by getting the balance right? I mean, I live in New York. We were about to crash the healthcare system. It felt very obvious that we need to be social distancing and doing it now. And then, you know, I just look at places like Montana and I wonder if they, you know, they locked down, had these huge social consequences. So I wonder if in the race to lock down, we didn't get the balance right. You know, true. The impact on a region, it varies.

New York got hit with an explosive outbreak. They got hit before they knew what happened to them through no fault of their own. They had things that propagate spread. I mean, I grew up in the New York City subway, so I know what a crowd is. I can tell you that. I went to school years through the New York City subway system. You don't have that in a place in Montana. But the important thing is that in those places, if they did not lock down, they may have seen an outbreak. And we are seeing evidence of that right now, because some of the Sunbelt states were asking the same question that you're asking now. Why should we have had to lock down?

We're not New York City. You know, we're Arkansas or we're Texas or we're Arizona or we're Florida with the beaches, everybody's out there. And then you find out what can happen in those places if you just look at what's going on right now. So there is a kernel of truth in what you say, that, you know, if you wanted to do it in a way that was highly specific to each place, maybe you would have been less dramatic in a place that had a lower risk.

But sooner or later, the virus was going to get to you. Viruses don't stop at a small town. And so if you were to pick up your retroscope, as I've heard you call it. Retrospectoscope. Retrospectoscope. What do you think you would have done differently? When you say what I could have done differently, see, I'm responsible for the development of countermeasures.

So I can really, in fairness, only speak for myself. My job was to develop a vaccine. I'll tell you what we did. The Chinese put on the database, the public database, the sequence of the virus on the 10th of January. On the 11th, I called a meeting of my staff and said, we really got to start working on a vaccine. On the 15th, which was four days later, we started on the development of a vaccine. 62 days later, that vaccine went into a phase one trial. So I think I could say pretty comfortably, I wouldn't have done anything different than that. So that's what I do. As a group, could we, we the collective, we in the United States, had done things differently?

I mean, of course, if you did things earlier, et cetera, et cetera. It would have been nice if we had a lot more tests available early on. Obviously, when we shut down, we clearly mitigated and prevented the further spread. So someone could always make the case, well, maybe if you shut down earlier, you would have prevented people from getting sick. But you just told me how negative consequences there are of shutting down prematurely or even shutting down at all. So for every point you make what you could have done, someone will give you a counterpoint of why maybe you shouldn't have done it that way. Isn't that the rule? If you've made both sides angry, you've done a good job. Oh yeah. Well, I make both sides angry every day, Wendy, so don't worry about that. So you've said that one of your dictums when you go into the White House is that you should be prepared that this is the last time you will ever go in.

Correct. So tell me, when was the time in the last few months when you were about to walk into the president's office and you thought, whew, I've got some information here and I might lose my job over this. Yeah. See, I don't think I'm going to lose my job. I have been telling the truth. Sometimes it's met in a way that, you know, is somewhat controversial, as you well know.

I don't need to explain that. But I just keep doing that. I don't worry about that. You know, I think the one thing, in fairness to the White House process, they do listen when I talk about things. But I have no hesitancy, never have, never will, of saying what I think is the appropriate thing based on science and evidence. And I've done that my entire experience with six administrations.

All right, my last question for you. There's, you know, ever since you've, this pandemic has began, there's like Fauci mania. There's Facebook groups about you, your faces on bottle openers, coffee mugs, bumper stickers. There was like a petition to nominate you for the people's sexiest man alive. My mum calls your followers like Fauci-nisters.

Do you think that, I mean, you know, in all seriousness, to me this like Fauci mania speaks to a new love of science and appreciation for your voice being out there. But, you know, to you, do you think this pandemic has created a greater love of science or perhaps flipped us backwards? Well, I think what it has shown is, you know, in some respects, a greater love of science, but also it's created and maybe sharpened the divisiveness that we see both politically and even in our society about the role of science. You know, all of that thing that you mentioned about me has nothing to do with the real Tony Fauci.

I mean, I know who I am and I'm not the things that you mentioned. But in some respects, you know, you don't mind that happening because what it is, it provides for people what they are looking for. They're looking for consistency, for truth, for evidence, for transparency. You know, and the stance I've taken with regard to COVID-19 has made me kind of the representative of that concept. And I think that's the reason why people flock to it. They do it in unusual ways. Like you said, you know, all of the paraphernalia with my name on it and that. And it isn't about me.

It's about the fact that I represent things that mean a lot to people and what they need to hear is truth and science and getting things that are based on evidence. Thank you so much. Thank you so much for your time. It's my pleasure, Wendy. Always good to be with you. That was Dr. Anthony Fauci, America's favorite nerd. We'll be back next week with our final episode of the season. This episode was produced by me, Wendy Zuckerman, Meryl Horne, Rose Rimler, Michelle Dang, Matilde Erfolino, and Sindhuja Srinivasan. We're edited by Blythe Terrell and Caitlin Kenny. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Emma Munger, and Bobby Lord. A special thanks to the Zuckerman family and Joseph Lavelle Wilson. I'm Wendy Zuckerman. I'll fact you next time.