National Institutes of Allergy and Infectious Diseases Director Dr. Anthony Fauci talked with Dr. Carlos del Rio for an Infectious Diseases Society of America podcast, released today, on challenges of, and answers to, the COVID-19 pandemic. The two physician scientists, both IDSA members, discussed the outlook for a safe and effective vaccine, testing strategies needed, the “big gap” in treatment, lessons learned, and more. Here are some of the takeaways from their talk, which can be downloaded from the IDSA COVID-19 Resource Center.
On COVID-19 testing:
“What we need to make sure we do, that we can adequately and effectively do, is strategic testing in addition to, and not in competition with surveillance testing . . .”
The difference, Dr. Fauci notes, is between strategic testing that informs contact tracing, isolation and treatment of individuals who are infected, and surveillance testing to discover levels of infection in specific communities. Surveillance testing, with rapid, on-the-spot results, to determine, for example, whether to let students into a dorm or workers into a factory, while not necessarily as sensitive as tests with a time lag, should be delivered on a broad scale to inform responses, he said.
On the development and deployment of a vaccine against the virus:
“We should know by the end of this calendar year whether or not we have a vaccine that is safe and effective and that we are confident is safe and effective . . . You can never guarantee the efficacy of a vaccine unless you have a clinical trial, however, based on the animal data and on the early Phase 1 data . . . we feel cautiously optimistic that we may be able to have a vaccine that is effective.”
Successfully deploying that vaccine, Dr. Fauci notes, will require community engagement, transparency and strong representation among the people most impacted by the pandemic in the U.S. — including African American, Latinx and Native American populations.
“That is to be very transparent in everything we do — about the data from the trials, what we expect of it, what we’re going to do and to engage the community with people who are trusted in the community to explain the importance not only for your own health but for the health of your family, and the rest of the world . . . why it is important to get vaccinated against COVID-19.”
“A big gap is treatment for outpatients and inpatients with early disease . . to keep people from progressing to the need for hospitalization.”
On re-opening schools:
“I believe, and many of my colleagues also, that a good default principle is to try as best as you possibly can to keep children in school or bring them into school . . . There’s a big however to that — when you try to do that you have to make sure that the primary concern that you pay attention to is the health, the safety and the welfare of the children and the teachers and the spinoffs from those individuals . . . Bottom line is we need to be flexible and one size does not fit all.”
Dr. Fauci differentiates between schools in “green zones” — where infection rates are low, and where schools could open safely, but with a plan in place in the event of an infection, “yellow zones” — where infection rates indicate the need for adaptations, that could include additional spacing, open windows, staggered school hours to keep student populations low, and “red zones,” where community infection rates indicate “you really better think twice before you rush into [opening].”
On lessons learned:
“As scientists and public health officials, we have to be humble and realize that at any given moment there may be a lot that we still do not know — and we’ve got to keep an open mind to absorb all of the new information as it comes in, and to put it into the appropriate context.”
On a career in infectious diseases:
“I cannot think of any subspecialty of medicine that could possibly be more exciting, more challenging, more impactful, than the discipline of infectious diseases.”
For more of Dr. Fauci’s thoughts, including on his first pitch for the Nationals’ opening day, visit the IDSA COVID-19 Resource Center.