MARGARET BRENAN: Thank you Dr. Fauci for taking the time to speak with us.
DR. ANTHONY FAUCI: I am grateful for your presence. It was a pleasure to be here with you.
MARGARET BRENAN: The past two years have been amazing. There is so much to do, and I just want to start at the moment. The number of cases is increasing once more. Is this the fifth wave?
DR. FAUCI (Interview): We certainly have the potential for a fifth wave. The magnitude of any increase or fifth wave, if you wish to call it that, will depend on what we do over the next few weeks or months. We now have 62 million people who are eligible for vaccination, but have not yet been vaccinated. Add to that the fact that we are beginning to notice a decrease in immunity among those who were vaccinated six-, seven, eight, nine and ten months ago. This is called waning immunity and was more evident in other countries than here. Israel is an example of this. It usually takes about a month to see the effects of the outbreak and the administration of vaccines, and then, most recently, boosters. We now know that vaccines are extremely effective and data are clear. However, if you compare unvaccinated people with those who have been vaccinated, the number of deaths, hospitalizations, and infections is dramatically higher in the unvaccinated. Given the decline in immunity, boosters will be crucial. For those who received the J&J and the two mRNAs, there will be a third shot. We can reduce the number of people who do not get vaccinated by combining the two mRNAs with the J&J. We can reduce any increase if we do this in an intensive manner. This is what you and I are seeing right now. We’re beginning to see an increase that was previously at 70, 75,000 per day. It’s now going up.
MARGARET BRENAN: –to 80,000
DR. FAUCI -Yes, up to 80. If we do the same thing in a more intense manner, it may be possible to reduce that. It is possible and likely that we will experience another surge if we fail to do it well. It all depends on how well we manage to mitigate.
DR. FAUCI: Right, yeah. You’re right.
MARGARET BRENNAN: –We’re at 80,000. How can you get down to that level? Is this even possible?
DR. FAUCI (Yes, I believe so). MARGARET: I believe it because we know one thing for certain: 70 to 80,000 per day is unacceptable. We’ve all heard people saying that COVID is a dangerous disease and they want to find a way to show the public. Because I doubt we will eradicate it, I believe this is true. We have only eliminated smallpox. It’s not something I believe we can eliminate. You’ve eradicated polio in the United States. Now you have eliminated malaria. This was decades and decades ago. We used to have malaria in Washington, D.C., but we’ve eradicated it thanks to a very, very, intensive vaccination campaign. We’re now focusing on control. Control has a very broad range. Control should not be at 70-80,000. It is not realistic to expect it to fall below 10,000. But, maybe it will be lower. If you have a high level of infection, such as 20, 30, or 40,000, then even those who are vaccinated secondarily will be more vulnerable. You can reduce the risk of infection to such a level that the virus doesn’t have the chance to infect the most vulnerable people, or those who have never been vaccinated. We have many moving parts. It would be nice to be more arithmetical about it. This is how much we need. This is how long we will take to complete it. When you have all these moving parts, it’s best to say that we are going to vaccinate everyone we can, get as many people boosted, and then we will get down to the lowest level. That number will have to be less than 10,000, I believe.
MARGARET BRENAN: You’ve talked about the difficulties you face convincing people who are anti-vaccine and really hardened. It seems impossible to believe that we can reach 85% of the population to have some sort of herd immunity. It seems impossible.
DR. FAUCI (Margaret): I’ll get to that number because it is so important. It is important to be humble about it. We don’t know the number. The reason for this is that the number is always changing. If someone is vaccinated but then drops below a certain level, you don’t know if that person can be considered a full protected individual. This is why the program combines getting everyone vaccinated, as well as getting people boosted. That’s what I mean when I say “moving target”. I have always maintained, and I hope that we can clarify, that measles is a disease that affects over 90% of the population. It’s because measles is not seen in communities if you are over 90. If you have isolated areas where the temperature drops to the 80s, you can get measles outbreaks. We have learned almost by trial and error what the recommended vaccination level is to achieve herd immunity. This concept basically means that there is no virus. All is protected. It should be called more community immunity than herd immunity. We aren’t there yet with COVID so we don’t know what the number is.
MARGARET BRENNAN Every six to eighteen months, get a boost
DR. FAUCI: Great question. That’s the part we don’t know. And the only way- the important part when you’re dealing with a unique, never-before-experienced outbreak of a new virus, that sometimes you can extrapolate what you know about other viruses because there are some commonalities, but sometimes you have to realize that this may be very unique. If we have a third shot with an MRNA, it is possible that there will be, based immunological memory of T cells and B cells, different types of cells that can protect us. This is what we call maturation. Affinity maturation is when you train your cells to effectively block major disease. While it won’t stop you from getting a little sniffle or other symptoms, it will prevent you from developing serious diseases. The possibility exists that if we get an extra boost, it will increase the durability of our immune system for six months or more. It is possible that we will need to give people intermittent boosts, just like we did with influenza. We don’t know what the course will be at this time. It’s unclear if it will be three shots and you’re done, or three shots every now and again to restart. We will have to wait and see how it turns out. We can’t just say something and then guess about it.
MARGARET BRENNAN – Why doesn’t the CDC track breakthrough infections? If you knew, wouldn’t you be better able to answer this question?
DR. FAUCI (Yes, I mean that they are in many ways). One of the things that is–
MARGARET BRENAN: — Among health care workers.
DR. FAUCI (Yes, yes, there are many things we need to do and the things we have been discussing as recently as yesterday is that when an individual is boosted, how long will that immunity last from both a protection and laboratory perspective. We want to be sure that, as we move into the booster phase, that we understand what it means from a clinical perspective.
MARGARET BRENAN: The public hears that you cite information from Israel and a foreign country. Why isn’t that data collection happening right now?
DR. FAUCI : It is a right thing. It is a right thing to have.
MARGARET BRENAN: Why not?
DR. FAUCI – I can’t-
MARGARET BRENNAN – Why didn’t the United States track these breakthrough infections?
DR. FAUCI : It’s a complicated indication. Please excuse me. It’s very complex. The public often doesn’t know about the data being collected. The CDC is collecting a lot, clearly a lot, of data that the public doesn’t yet know about. We need to ensure that we have access to this data in real-time. If you are not in a pandemic you can still collect data and analyze it. You could also talk about it. Then you could look back at the past and say, “This is what we did.” However, when dealing with a pandemic you need to have that data out immediately so that your policies can be influenced by data that was relatively recent, and not data from four or five years ago.
MARGARET BRENAN: This is the criticism they face for being too academic.
DR. FAUCI: Right, yes.
DR. FAUCI: Yes, yes. Yes. Yes. The CDC collects data.
MARGARET BRENAN: This goes beyond health care workers to everyday people. Do you have an idea about what is happening with breakthrough infections
DR. FAUCI : Unfortunately, I don’t currently have the data. We’ll need to contact the CDC for that information.
MARGARET BRENNAN – Let me ask you how parents should handle the data they have, and especially their children’s data. Recently, the Education Secretary told me that there shouldn’t be any need for hybrid or remote learning. OK. There are many parents who are confused.
DR. FAUCI: Right.
MARGARET BRENAN: Every school seems to have a different approach, whether they mask or not mask it or alert parents. If their child is being sent to school and the person in that classroom tests positive, what should parents do?
DR. FAUCI (Yes, there are many options. You don’t want the CDC guidelines to be followed. These are the kinds of things they have been analysing and trying to find the best approach. There’s always the test to stay. You don’t need to get quarantine if you have a negative test. It is very difficult for a class to function well if there is an outbreak. We need to do multiple things at once. You want to make sure that the children are surrounded by fully vaccinated adults. You should also vaccinate adolescents who have been vaccinated for a while. Vaccinate children aged 5-11 years old. If there is a case at school, you have to do something.
MARGARET BRENAN: Parents sometimes don’t know if their child is in trouble at school.
DR. FAUCI (I know it and it’s-MARGARET), it needs to be more clearly stated so people are clear and understand the situation. If you don’t have the information you need and there is community, the CDC recommends that you mask for your children at school.
MARGARET BRENNAN : These CDC guidelines are a bit confusing. This says to get tested immediately and quarantine anyone who has been exposed. This is only for children. Unless you are given instructions by the school official or public health official, it will be in effect for 14 days. This leaves a lot to interpretation.
DR. FAUCI (I know). That has to change.
MARGARET BRENNAN: Right. Parents who have partially vaccinated their children are going to find it difficult to follow these guidelines.
DR. FAUCI: Right. No. I hope that the guidelines will be followed. I believe the data will change with more experience, especially when more people are vaccinated. You have to make sure that the data matches the recommendation. It can’t be too slow or you’ll fall behind.
MARGARET BRENNAN : This is one of those critiques of the way our country has responded to this. It’s possible that it is due to the federal system. But, district by district, and state by state, there are many things. They then ask you to tell them what to do. Tell me what you should do with my children.
DR. FAUCI: Yes.
MARGARET BRENNAN: Clarity.
DR. FAUCI (Yes, I understand), but we need to have clarity about the situation in the public health. I believe they are doing a lot better than the public believes. We need to get the CDC to be very specific and very precise about what a recommendation should be. If you don’t have the data, I mean when there isn’t any data, you can just make a recommendation based upon your best judgement, if that’s what you want.
MARGARET BRENAN: This has been a problem throughout the years. This is because there’s not enough information being collected in the country. There is not enough surveillance. Do you think that is still the case?
DR. FAUCI – We do, but we must do more. It’s obvious. It is obvious. We must do more surveillance, and more testing.
MARGARET BRENNAN – Would we need to worry about vaccinating toddlers and babies if adults were vaccinated more frequently? According to Pfizer, very young children won’t get a vaccine until 2022.
DR. FAUCI (English): I think it will be in the first quarter 2022. Because studies are currently being conducted on children aged two to five, then six months to two and two years respectively, I would expect it to be in the first quarter. They may take longer as children are more vulnerable the older they get. Children are at risk. Safety is a must. It doesn’t seem like there will be any issues with efficacy. It is not unreasonable to expect it to be effective and ultimately beneficial for children. It’s very sensitive when dealing with children. It’s why it may take me a bit longer. However, I hope that we will be able achieve this goal by the end of the first quarter 2022. People need to understand that COVID 19 is a stressful, unique, and complex situation. When we reflect on it, we will see that this policy has been tested, proven and worked well. For diseases with lower morbidity or mortality than COVID-19, we vaccinate children as young as possible. That’s why I ask people, “Are they sure you want the children vaccinated?” Yes, we want to vaccinate the children, because we want everyone to be protected and vaccinated.
MARGARET BRENNAN : However, the CDC can take years to make a recommendation for vaccines for children. Are you optimistic that it will move quicker?
DR. FAUCI : Yes.
MARGARET BRENAN: Next year, the child enters the classroom. Do you think it will be necessary?
DR. FAUCI – I don’t know whether it will be necessary, but I can say that I have been a person with infectious diseases for as long as I can remember. I am a public health professional. I would advocate for people who are vulnerable and children to be treated as quickly as possible.
MARGARET BRENAN: When can we lift the restrictions on public health for children? Are we supposed to wait until toddlers are vaccinated?
DR. FAUCI (No, I don’t think so. You will likely see a gradual pullback when you get. Children will be vaccinated. Teachers will be vaccinated. If the community level falls, I’m referring to being in a- in an area, a state or a city in which you are considered red hot according to the color code. This is in addition to red, orange yellow, green and et cetera. You won’t want to reduce the effectiveness of mitigation or masking if you live in a hot area. If you are in an area where the dynamics of infection is low and there is a high percentage of children who have been vaccinated, it’s almost certain you will see a decrease in mitigations such as masks.
MARGARET BRENNAN: Mm-Hmm. People find it so moving. They ask, “How do I know my community’s infection level?” How can I tell what’s green? What’s green? What’s OK?
DR. FAUCI (Yes, I do know). It’s easy to click on the CDC website. You can find it in a matter of seconds. Not everyone has the ability to access it, and not all people know how to use it. It will be a mixture of people who have access to the online information and those who are able to get out there would be many PSAs. The Community Public Health Service is one of the topics I have been talking about for a while now. I have divided the discussion into two groups, scientifically preparedness/response and public health preparedness/response. We are fortunate that the response and scientific preparedness has been exceptional, if it is not extraordinary. It was impossible to imagine that a vaccine could be developed within the first 11 months of the virus’s arrival. The science was proven correct. Public health is different. We believed we had a solid system. Our public health infrastructure at local level was just horribly outdated. People were leaving. People were switching to fax machines over online computer programs. We didn’t have the technology to track an outbreak, respond to it, and get messages out to the community.
MARGARET BRENAN: We still don’t have any national surveillance system from the local level upwards.
DR. FAUCI –Not at the level I was designed to be. Right–
MARGARET BRENAN: –is constructed out. You just brought up one of the most serious public failures, as diagnosed by other doctors. I want to- I want to tick through some–
DR. FAUCI: –Alright–
MARGARET BRENAN: –to find out if you are a good fit–
DR. FAUCI: –Sure–
MARGARET BRENAN: –with some criticisms of the public-health response. The U.S. did not have a national surveillance system. Testing was insufficient and data was lacking.
DR. FAUCI: Right.
MARGARET BRENNAN: You agree with that.
DR. FAUCI: Yes.
MARGARET BRENNAN: It was a deadly mistake by the CDC to try to use the flu as a model, according to Dr. Deborah Birx. It meant doctors were looking for spread in the wrong places and did not recognize the possibility of asymptomatic spread. Was that the chief, early on?
DR. FAUCI: Well, you know, I think that some of what you said is correct. The idea about not recognizing that it was spread in a very efficient way, in an asymptomatic situation, was really a problem. Because what it did- it did not allow a testing of the asymptomatic individuals, which should have been done right from the get go.
MARGARET BRENNAN: People were walking through TSA, getting their temperatures, and that meant nothing.
DR. FAUCI: Right. Well, I always said that that was meaningless because I’ve been having my temperature taken and sometimes it’s 32, which means I should be dead.
MARGARET BRENNAN: But it’s the theater of public safety rather than the reality of it.
DR. FAUCI: Yes, yes. I agree. I agree. I mean, clearly we needed to test people who are asymptomatic. No doubt about that. That would have changed a lot of things.
MARGARET BRENNAN: And the flu model being used? Why was it used?
DR. FAUCI: You know, I can’t explain that. That’s not what I do. I’m sorry I have to tell you that.
MARGARET BRENNAN: Wasn’t as discussed at the- at the COVID task force meetings?
DR. FAUCI: No, it was not. It was not. It was just the CDC would do that and that’s the way they looked at respiratory diseases. And it took a while to figure out that this is really, really different from flu, in many respects.
MARGARET BRENNAN: Mm-Hmm. When did you realize that?
DR. FAUCI: Well, Debbie Birx and I realize that right, you know, right in the middle of the outbreak. You know, the- 2020, right in the middle of 2020, it was very, very clear. And if you go back over the history of that, we did, I did certainly, said we need to be testing. I remember the words, if you go back on some of the statements I made at some of those White House press conferences, we need to flood the system with testing, is what I would say very often, flood the system with testing. Which means not just somebody who shows up with symptoms. Mm-Hmm.
MARGARET BRENNAN: But I mean, we looked back at statements and in February of 2020, very early on there, you were still saying it’s certainly a possibility, but it’s extraordinarily unlikely that COVID was spreading in the U.S.
DR. FAUCI: Right, and that’s because we didn’t know it at the time.
MARGARET BRENNAN: Why did you have that blind spot?
DR. FAUCI: Well, it wasn’t a blind spot because we didn’t- we weren’t testing. That was the point. What we were seeing is that the flu model is you look at symptomatic disease, ILIs, flu like illnesses, you know, those were the ones, influenza like illnesses. And influenza like illnesses are not noticed unless you get an influenza like symptom. So the model of using a flu model was never able to get applied until it was clear that it should have been not the ILI, but that the asymptomatic model that when you have a disease in which you have 30 to 40% of the people who get infected have never- no symptoms, then you see transmissibility. 50 to 60% of the transmisabilities occur from someone who has no symptoms, who either never will get symptoms or is in the pre-symptomatic phase. That was unprecedented in respiratory illness. So I guess you could say, well, you should have known that. The CDC should have known that. Well, maybe they should have known it after it happened for a bit, but they couldn’t have known it from day one. You could not have known that from day one. But it should not have taken so long to figure out that, in fact, we have a substantial amount of transmission that’s asymptomatic, which should trigger why you should be testing asymptomatic people. And getting back from things that have been brought up by historians now, because it was a year ago, when that came out of said only testing people with symptoms, Debbie Birx was against that and I was against that. It was very, very clear that we should be testing asymptomatic people.
MARGARET BRENNAN: It also brings us to why people should have been wearing masks earlier. They didn’t know that they were spreading it.
DR. FAUCI: Exactly. And that’s the reason why back in January and February, we’re saying we’re not so sure you really need masks because we didn’t realize at the time that there was being asymptomatic spread. That was one of the real reasons. As soon as that became clear, there was no doubt you should be wearing a mask.
MARGARET BRENNAN: Matt Pottinger, the former deputy national security adviser, brought that up, and he told us that was one of the most costly mistakes. And he brought it up in the context of- he said he was talking to doctors he knew in Asia who were telling him things that the CDC was saying, you’re wrong, that the CDC was telling him he didn’t know what he was talking about. Though he was talking to people on the ground who were telling him firsthand, this is how the virus was spreading.
DR. FAUCI: Right.
MARGARET BRENNAN: Was the masks the costliest mistake? And where do you rank that the lack of informing the public earlier on to wear them?
DR. FAUCI: Well, it was not only the masks. It was not realizing that we had an insidious enemy in the virus that was lurking below the radar screen. And it’s not just a question of wearing a mask, which should have been done at the time had we known that. It was the realization that in crowded places, poor ventilation, congregating together. When you have an infection that 50 to 60% of it is transmitted by an asymptomatic person, a lot of things change, not just masks. Masks are clearly one of the big ones. I mean, I get asked that question all the time about why not mask in the beginning. It was not an appreciation. First of all, besides the fact that we didn’t realize masks outside of the hospital setting work. We didn’t know that. It was said- it was said the data shows it works in the hospital, but we don’t know–
MARGARET BRENNAN: Matt Pottinger was saying he was in the White House telling doctors that you need to wear them. Look at what’s happened in Asia previously and wearing masks.
DR. FAUCI: Right, right. And the fact is, the Asians wear masks is a very important part- long yet- long after COVID leaves us, the Asians are going to be wearing masks.
MARGARET BRENNAN: Will we be wearing masks?
DR. FAUCI: I think we might. I think people are going to realize that one of the things that was noticed, very clearly now, is that when you were wearing a mask, when everybody finally realized it was important to wear a mask, that influenza was sort of off the map. I mean, we didn’t have hardly any influenza last winter. The Australians didn’t have any influenza. So it was very clear, that something that was not fully appreciated. It was somehow dogma, which it was assumed that masks in a hospital setting work, but there’s no evidence that they work outside of the hospital setting. And then when they did better analysis, it became clear that masks do work outside of the hospital setting. There was a feeling that, well, if we wear masks, we’re going to take away from the masks that are needed by the people who were in the hospitals.
MARGARET BRENNAN: Because there wasn’t an adequate stockpile.
DR. FAUCI: There wasn’t an adequate stockpile. So that’s where it was- then not a push for people to wear masks. And then the thing that was the real clincher, for sure, was the realization that you may be standing next to somebody talking to them, they have no symptoms and then they’re infecting you right now. This idea, which was getting back to the incorrect flu model, which was clearly originally extrapolated to COVID, now it’s clear it is not the right model, is that in a flu season, there’s a very, very brief window before you get symptoms that you could transmit it. But you don’t have people who go through the entire flu and- and- and- and don’t get symptoms. So COVID is very different from flu in many respects.
MARGARET BRENNAN: I point some of these specific things out because they don’t- they’re not political. These were public health mistakes.
DR. FAUCI: Right.
MARGARET BRENNAN: That’s almost scarier.
DR. FAUCI: Well, you know, I think to- to defend the CDC, if I could for a moment, is that one can say something is a mistake because, you know now data now that you didn’t know then. So technically it really is a mistake. But if you had–
MARGARET BRENNAN: But then- but then if you look at the news reports, I mean, you look at doctors in China, in hospital wards, in hazmat suits.
DR. FAUCI: Right.
MARGARET BRENNAN: And we’re talking about putting a mask on your face as being ridiculous at the time. I mean, it just in hindsight, it looks so–
DR. FAUCI: –but–
MARGARET BRENNAN: –obvious, but we were not up to the challenge here in getting ahead with such cutting edge medical care in this country. It’s kind of shocking, isn’t it?
DR. FAUCI: Well, you’re right in saying that, but let’s get back to the hazmat suit because I’d like to respectfully correct you for a moment.
MARGARET BRENNAN: Go ahead.
DR. FAUCI: Is that hazmat suits were used by people who were taking care of sick individuals.
MARGARET BRENNAN: Mm-Hmm.
DR. FAUCI: You didn’t see too many people in China wearing hazmat suits walking down the street. They were wearing masks–
MARGARET BRENNAN: –No, in hospitals–
DR. FAUCI: –yeah, in hospitals–
MARGARET BRENNAN: –and our doctors didn’t have adequate care when they needed it.
DR. FAUCI: In the very beginning, we didn’t have- It’s not that we didn’t realize you should wear them. It was that we didn’t have enough PPE right in the beginning.
MARGARET BRENNAN: But my point was, isn’t that a warning–
DR. FAUCI: –Yeah. Yeah–
MARGARET BRENNAN: –when you see it?
DR. FAUCI: Yeah, like I said when I told you a moment ago. It was the scientific approach, preparedness and response, and the public health preparedness and response. I find it interesting that I’m here responsible for this and trying to defend this.
MARGARET BRENNAN: No, I think you’re just- you’re America’s doctor, Dr. Fauci. So everyone looks to you to explain it all.
DR. FAUCI: That’s true, and I try to explain it to the best of my ability. But there are some things that I can’t defend because I’m not responsible for them. Maybe I would have done them differently if I were responsible for them. But if I’m not responsible for them, you want to talk about vaccines. That’s what I did.
MARGARET BRENNAN: But just to button that up. Why aren’t we having a national conversation about what went wrong? I mean, apart from this room right now, why isn’t there a 9/11 type commission?
DR. FAUCI: Yeah, I think what’s going to happen is that you are going to see that for sure, MARGARET. I think the lack of doing that now is because you’re focusing on getting this thing under control. I would be astounded if we didn’t have a very serious look at what went right, what went wrong, from a public health standpoint, from a local standpoint, from a global standpoint. I don’t think that the public should imagine that this is going to go through with already 760,000 Americans dying and 40 plus million at least being infected, close to six million people globally dying. And we’re not going to look back at this and tear it apart, examine it, do an autopsy on it and try and figure out. So people should not think that that’s not going to happen. It’s not happening now because everybody’s focusing on getting this thing under control.
MARGARET BRENNAN: But you want one?
DR. FAUCI: Oh, I absolutely want one.
MARGARET BRENNAN: And do you think the administration will? Well, when will we see that?
DR. FAUCI: Yeah. I think once we get it on the much better control, you’re going to start seeing a real close examination of that.
MARGARET BRENNAN: You- well, in our examination of that, you were quoted as saying it was the worst possible decision for the Trump administration to have left things up to the states.
DR. FAUCI: Yeah.
MARGARET BRENNAN: Where do you rank that?
DR. FAUCI: I rank that right there, maybe a little bit below some of the things you are talking about, but way up there. Because my- as a scientist and a public health person, you know, people always ask if you had the magic wand and did things exactly the way you wanted, what it would be? One of them would be if ever, if ever there was a situation where you needed a synergistic uniform, well-thought-out approach is when you’re dealing with a common enemy of a virus that is a global pandemic, the likes of which we haven’t seen in 100 years, to be able to say if I don’t really want to do this because I want, you know, my own opinion of what it’s going to be with this state versus this state versus this state. To me, that’s one of the antitheses of public health. We know exactly what needs to be done. We know you’ve got to get vaccinated. How can you possibly have a situation where one state says, I’m sorry and you shouldn’t be wearing a mask? In fact, you have executive orders saying you shouldn’t be wearing a mask.
MARGARET BRENNAN: Florida.
DR. FAUCI: You have another state that does not want to get vaccinated because they think it’s a political statement to get vaccinated or not. I mean, we’ve had and I’ve said it many times, and I’ll say for you, the divisiveness in this country to me is the biggest mistake that supersedes everything that we’re talking about, supersedes the mask situation, supersedes everything, have a public health catastrophe and you have divisiveness that is pulling away from doing the right thing to get the outbreak under control. I mean, when we look back historically and look back at this and said we had this devastating plague out there that were killing hundreds of thousands of Americans, and we’re having public health principles being decided on the basis of political ideology. I mean, when I give my history of it, that’s going to be the number one mistake that supersedes all the other things that we’re talking about.
MARGARET BRENNNAN: Public health is often politicized. I mean, you know that so well, from your experience with AIDS, what was the chief lesson you brought into dealing with COVID from that experience with AIDS?
DR. FAUCI: With AIDS? Well, the one thing that- well they were more than one with HIV AIDS is never underestimate infectious disease outbreak because it can be insidious the way AIDS was under the radar screen. And then you find out, you know, 40 years later, it’s killed 37 million people, 77 million people have gotten infected. You learn also to pay attention to what’s going on in the community. And that’s the major lesson I learned. I listened to the people and I wanted to find out what it is that was going on with them. How were they getting infected? Why were they getting infected? What was going on with the circumstances? That’s how you really get your arms around an outbreak. You don’t do it from above and dictate down. You go into the community and you find out maybe some of those lessons about finding out what’s going on in the community with infection would have done us a little bit better.
MARGARET BRENNAN: Was that happening at all in China when this first appeared going back to the fall of 2019?
DR. FAUCI: You know, it was very tough what was going on in China. You know, it’s kind of opaque. Clearly there was infection that was percolating, you know, as early as November, maybe even earlier. And then it was the same sort of thing, you know, back then, you had an infection that emerged almost certainly out of an animal reservoir to a- I mean, the bats there all have viruses that when you- the more you study bats there, the more you see how close some of the viruses are to SARS-CoV-2. Clearly, SARS-CoV-1 was a bat to a civet cat to a human. MERS was a bat to a camel to a human. In the beginning, when it first came out, it was, I remember, very, very clearly. It was the very, very end of December, the beginning of January. There was this outbreak in China. Of some unusual cases that was felt to be well, it looks just like SARS-CoV-1, and SARS-CoV-1 was one that was not spread very readily from human to human. It was spread almost all by symptomatic people, hence the transmissions that occurred in hospital and doctor’s waiting rooms while people were coughing and sneezing. So it was assumed in the beginning, well, this is the coronavirus. We’ve just sequenced it on January 10th. We know what the sequence is. Why it- isn’t it just assumed that it’s SARS-CoV-1, which means it doesn’t transmit very well and it’s going to get controlled by public health measures, which is exactly what happened with SARS-CoV-1. Then you find out that even though it’s SARS-CoV-2, it is a very, very different virus than SARS-CoV-1 because A, it is transmitted spectacularly efficiently from person to person-
MARGARET BRENNAN: Why?
DR. FAUCI: And B, most of it is a- 40 to 50 to 60 percent is asymptomatic.
MARGARET BRENNAN: Why is it so efficient? I’ve heard so many virologists point to that that it was uniquely adapted to be just horrible in a human body. How did it get that efficient?
DR. FAUCI: Well, it evolves in animals, it evolves in humans, and it could just, you know, sometimes viruses jump into humans and they take off and run right away.
MARGARET BRENNAN: But we don’t know what went between the bat and the human. There was something in between?
DR. FAUCI: It was very likely in a host- what the Chinese did, I don’t have firsthand knowledge of that, but the people who were reporting it, who investigated what they did is they cleaned out the markets as soon as it turned out that it was clear that there were clusters coming from the market. Which, you know, in typical fashion, I think trying to make sure that things don’t get pointed to them, they probably got rid of the animals that were the intermediary hosts there. And that’s the reason why it’s very important to continue to get the cooperation of the Chinese in allowing surveillance of the animals that ultimately go into the wet markets, the civet cats, the raccoon dogs and all those other things that clearly the- this virus is a very promiscuous virus in the sense that it can infect animals. Animals can infect humans. There are animals out there, big cats, there are animals in the environment that are getting infected with SARS-CoV-2. It’s a very highly infective- as long as you have that receptor for the virus, it’ll infect you. So that’s what makes it- its capability of binding so well to the receptors in the body.
MARGARET BRENNAN: But Beijing acknowledges now that they don’t think it originated in that market.
DR. FAUCI: Well, it may not have originated in the market, but it certainly could have, I mean, I don’t think that they admitted that it didn’t originate in the market. I think they’re saying they don’t know how it originated.
MARGARET BRENNAN: Well, there were clusters that may have been picked up and transmitted,–
DR, FAUCI: Yeah.
MARGARET BRENNAN: –as I understand it, through the market,–
DR. FAUCI: Yeah.
MARGARET BRENNAN: –the place of origin was not within the market itself.
DR. FAUCI: I don’t think you could say that. I don’t think you can say that. I think you could say we don’t know how and where it originated. There were wet markets in Wuhan that are ample opportunity for a virus to jump from an animal that gets brought in from all parts of China that are very closely related physically to bat enclaves in caves and come to the market. So I don’t think anyone can say that it didn’t come from here or it did come from here.
MARGARET BRENNAN: So it was the end of 2019 when the World Health Organization was first alerted about the strange pneumonia. Doctors, as you just said, had been tracking back to the fall, possibly as early as October. When was the first time that you heard that there was something, some strange pneumonia?
DR. FAUCI: I think it was the very last day it may have been Dec 31 or the 30th or 1st of Jan.
MARGARET BRENNAN: When they informed the World Health Organization?
DR. FAUCI: Yeah, I mean, I got- I got a call from Bob Redfield who said, you know, I just heard from colleagues in China that there’s an unusual pneumonia among people that has been detected. So we just got to stay heads up for that. And then a few days later, I think it was Jan 9th, or 10th the sequence came out. I got- as soon as I heard there was a new pneumonia, I said, well, a new pneumonia, Wuhan, wet market almost certainly it’s going to be a coronavirus. We all thought it would be similar to SARS-CoV-1, and that’s when I got my team organized immediately and said as soon as we get that sequence of what it is, let’s go after that vaccine, let’s plug it into MRNA. We were already collaborating with Moderna with MRNA and let’s do it. And it was rocket speed. I mean, we found out on the 10th of January of what the sequence was. About five or six days later we were starting with the vaccine development with Moderna. Sixty-five days later, we did a phase one trial, and multiple months later, we knew we had a safe and effective vaccine.
MARGARET BRENNAN: And- and that’s incredible speed that you were already there, but it was despite the lack of information being shared. You you mentioned SARS,–
DR. FAUCI: Yeah.
MARGARET BRENNAN: the first version of it, you had experienced–
DR. FAUCI: The only- the only-
MARGARET BRENNAN: –Go ahead.
DR. FAUCI: Again, I’m going to get back to what- what I do and my job was to develop a vaccine. So the only information I needed was the sequence of the virus. And when we got that information, I put my team to work to make a vaccine, which was made in unprecedented record time to be a safe and highly effective vaccine. The antigen that’s used, the immunogen that is used in virtually all the vaccines, regardless of what the platform is, was developed at the Vaccine Research Center by my scientist in the institute. So that’s all I needed was the sequence. I mean, the public health part was handled by the CDC. I just needed the sequence of the virus to make the vaccine.
MARGARET BRENNAN: So the live- live virus samples wouldn’t have had a- it made a difference for you.
DR. FAUCI – I didn’t require it. I needed it to get the vaccine.
MARGARET BRENNAN Bob Redfield, the former head the CDC, stated that – and you are familiar with the story. His Chinese counterpart called him weeping in January, saying that this was out of control.
DR. FAUCI: Right?
MARGARET BRENNAN : Dr. Redfield maintains that their CDC was kept under wraps. This is what happened to these doctors. How is this possible?
DR. FAUCI : I cannot-I can’t comment, because I don’t have the information. Margaret, I don’t know what happened in China. However, the scientists I know were communicating with me to the point where we-we have a problem here. This is terrible. People are getting very, very sick from the virus. It’s not flu-like and it’s unlike anything else we have seen. This is what we got. That was all we received. Then, when the Chinese began building massive hospitals complexes within days, it became apparent that this was a serious problem.
MARGARET BRENAN: When did the alarm go off for your?
DR. FAUCI : They were gradual. It wasn’t like one big revelation or alarm bell. It was a gradual roll out of new information, and it didn’t improve matters every time that new information was available. This made things worse. It was a difficult situation for me. My job was to get the vaccine. I wasn’t certain if it would be one we wouldn’t need, or a vaccine that would save the lives of millions. What happened next? The evolution and dissemination of information. It is a coronavirus, which is good. It’s not like SARS-CoV-1. It could be, but it is possible. Wait a week, it’s transmitted from one person to another. It doesn’t only go from animal to human. It’s not just person to person. It also works pretty well from person to person a week later. You’ll find that there is some transmissibility from people who don’t have symptoms two-three weeks later. A month later, it’s transmissible even without symptoms. Half of all transmissions come from people who do not have symptoms. It was literally a time span of several months, starting from day one. New York was being badly hit by it months later. It was obvious, wait a second, we don’t know what we know now. But every time we receive new information, it gets worse. This is how the pandemic evolves. Because we have never experienced that kind of situation before, you don’t know what will happen in the six months ahead.
MARGARET BRENAN: I’d like to read you something that you said in 2019, when someone asked you what kept you awake at night. You stated that the “thing I am most concerned about” is the emergence a new virus. The body has never had to deal with highly transmissible viruses, which can spread from person to person and cause high levels of morbidity or mortality. A respiratory illness can spread before someone becomes so sick that it is difficult to keep them in bed. This is the thing that most people in public health are concerned about.
DR. FAUCI: Right.
MARGARET BRENNAN: You were describing COVID.
DR. FAUCI : I was. My worst nightmare, which I have been asked multiple times about over the past 37 years of directing the institute, has finally come true. You can see that I have told that statement 50 to 100 times to scientists, journalists, and people in the scientific community. They ask me what I really worry about. That’s what I have said – and I did so to several presidents, starting way back. Reagan was the first person I said it to. That I said to George H.W. Bush, George W. Bush to Clinton to Obama. It’s something I have repeated to everyone. It’s my worst nightmare, which you just described. Unfortunately, it has happened.
MARGARET BRENAN: How often have you thought about that in the last two years? This is something I’ve done.
DR. FAUCI: Yeah. It’s something I think about every day.
MARGARET BRENAN: It’s an amazing description of where we are. What do you think America’s response is to your nightmare scenario?
DR. FAUCI (Yes, I grade): I see a response as a scientist, a doctor, and a public-health person. Indirectly, what I do is that I view preparedness and response from two perspectives. One is scientific and one is for public health. I grade scientific, A+. I grade public health. It is definitely not A.
MARGARET BRENNAN – Do you believe there are lessons to be learned from this? Or are we stuck in a situation where we are not ready for change?
DR. FAUCI (Well, we need to fix ourselves, because it will happen again. Another pandemic is coming. It could be a small blip on our radar, or a new emergence that doesn’t go anywhere. Or it might explode like this. If you look back at history, plagues have been around before scientific methods were developed that could identify the agent. This was a long time ago. We’ve also had epidemics that devastated us in times before history could record them. And then there have been outbreaks that occurred when it was possible to actually document the cause. We are naive to believe that such an event is unlikely to occur in the future. It would be shameful if we didn’t learn the painful lessons we have and use them to make sure they don’t get forgotten or ignored. This is what I hope for.
MARGARET BRENNAN – Sometimes it seems that the public believes the election has changed everything. However, what you are describing is a deep institutional problem and something that needs to be addressed.
DR. FAUCI: Yeah. Yes. Administrations come, they go they, and they all respond differently. Right now, I believe the effort being put in to get vaccines out is worth the attention. This is a great response.
MARGARET BRENNAN – Do you believe there should be stricter regulations for laboratories that work with highly contagious or contagious viruses?
DR. FAUCI. That was years ago. We put a three-year halt to any experiments that could be dangerous. Not only did we do that, but also outside bodies such as the NSABB, National Academy of Science and multiple workshops. This framework would help us determine the type of work that should be done, under what conditions, and the types of things that shouldn’t be done. The public doesn’t seem to be aware of this. These words, such as gain of function, mean nothing to them. What does this mean? They should not be surprised to learn that scientists are always open to discussing what and how they do things.
MARGARET BRENAN: Gain-gain of function for those listening is trying to give viruses new, better abilities.
DR. FAUCI (Right, and- and sometimes it is for a very specific purpose, but sometimes you do it for an entire scientific project. This is because the majority of science involves modifying things, altering cells, and modifying viruses in order to be able study them thoroughly enough to prepare for what’s to come. There are strict guidelines that must be followed that the public doesn’t fully understand. It’s easy to make outrageous statements about things that don’t even exist.
MARGARET BRENNAN – This is a political football right?
DR. FAUCI (Yes, it’s a total political game, total.
MARGARET BRENNAN : You take the fire just for this.
DR. FAUCI : Yes. All the time.
DR. FAUCI: Yes, exactly. It’s not a lot, but it’s a lot.
MARGARET BRENNAN – Finish the thought.
DR. FAUCI: No- no. This is a topic that has been politicized a lot. There’s also a lot of misinformation, disinformation, and outright lies around this topic. This is really sad.
MARGARET BRENNAN : It’s a source of anger.
DR. FAUCI (Well, you know that my concern is that as a scientist, my job is to protect and preserve the health of the American people and indirectly the health of the rest of the world. Our country is a leader of science. Leader in health. Leader in many areas. We are the ones who brought them about. That’s my job. It’s unfortunate that it’s being politicized. I have stayed away form politics all my life. I’m a scientist and health professional who cares only about science and medicine. It’s a disturbing sight when you try to put all your efforts into creating the vaccines and developing the drugs to save millions of people’s lives. Then you have this bizarre politicization. All things are subject to politicization. Politization of everything, including politics of public health and origins, is really a great thing.
DR. FAUCI – I have never spoken to my wife about resigning. They were wrong. I have never considered resigning.
MARGARET BRENNAN – Never thought of it for a second?
DR. FAUCI: Not even a second.
MARGARET BRENAN: Dr. Birx said she considered it every day, but ultimately decided not to.
DR. FAUCI – Dr. Birx is Dr. Birx, and Tony Fauci Is Tony Fauci.
MARGARET BRENNAN : Why are you so passionate about this, about keeping the job even though you have become, I mean personally, not only threatened with your security, safety, or family’s safety? How did that affect you?
DR. FAUCI : I managed it by focusing my attention on my job. From the time I started my career in medicine, to now, at my age, I have been completely focused on my job. I used my talents and influence to make scientific advancements to protect the American people’s health. Anyone who lies, threatens, and does all the other theater with the congressional committees, the investigations, and Rand Paul’s, and all the rest of that nonsense, that is noise, MARGARET. I know what my job entails.
MARGARET BRENNAN – Senator Cruz said to the attorney general that you should be tried.
DR. FAUCI: Yeah. That is hilarious. Should I be tried? What happened Jan. 6, Senator?
MARGARET BRENNAN : Do you believe this is about making you a scapegoat in order to deflect?
DR. FAUCI : Of course!
MARGARET BRENAN: –From President Trump
DR. FAUCI : You have to be asleep to figure that one out.
MARGARET BRENAN: There are many Republican senators who take aim at this. That’s what I meant.
DR. FAUCI (It’s okay, I’m just going about my job and I’m going be saving lives. They’re going be lying.
MARGARET BRENAN: This is just another layer of danger that we use to play politics with life and death.
DR. FAUCI: Right, exactly. Exactly. That’s a shame because I only want to save lives. This is what I’ve done over the past 50 years. 40 of those were as the director of the institute. It is easy to find people and make them targets, because they are what people can concentrate on. But we’re not talking about systems. We’re referring to the CDC, the FDA, and science in general. If they’re interested in this, I mean, anyone who has looked at it carefully will see that there is an anti-science flavor. If they criticize science, no one will be able to understand what they are talking about. If they stand up and aim their guns at Tony Fauci, then people might recognize that there is a person there. You can recognize a face and a voice when you see him on TV. It’s easy to criticize science, but science is what they are really criticizing. That’s dangerous. That’s far more dangerous to me than all the arrows and slings that are thrown at my head. Science will be here forever even though I won’t be around forever. If you do damage to science, it is a very serious offense to society long after my departure. That’s what I worry about.
MARGARET BRENNAN : What does this mean in real-world terms? Do you think that means vaccination rates will fall? Is that a sign that the next national emergency personnel won’t listen? What do you mean?
DR. FAUCI (Yes, I am concerned). If science is ignored and discredited, then you begin to question the reality of what it takes for people to have their health preserved, prevent or treat disease. If you do this, you will disrupt society in many ways. That’s what worries me. Anyone who has looked at the United States will see that there are not many lies. The social media magnifies the normalization of lies. Scientists try to prove that this is the truth based on data. This is what we live by: data, evidence and truth. Then you suddenly become a part of society and it’s okay to say anything that is clearly, clearly wrong. If you repeat it enough times and long enough, and get social media involved with it, then everyone, not just everybody, starts to believe it. Because I have spent my entire life as a scientist, and I identify with science and health, that is what I worry about. If you attack me, then you are really attacking science. Everyone knows that.
DR. FAUCI – That’s correct.
MARGARET BRENAN: How does it look? What does the rear view mirror look?
DR. FAUCI : What does the rearview mirror look like when you and me are having an interview? We’re discussing something and COVID isn’t dominating the economy or the mental framework of society. Fear of not being safe for our children and ourselves. It’s what it looks like in the rearview mirror. We have accepted something that is still horrible, but it’s low enough that we can think about more important things.
MARGARET BRENAN: As a nation, we’ve gone through a lot.
DR. FAUCI: Right.
MARGARET BRENNAN – How have you dealt with the almost two years of pain and suffering you have endured?
DR. FAUCI : It has not been easy. For that, I receive death threats. For that, my family, my spouse, and my three daughters are harassed. This makes me think society is really having a problem. I have never been egocentric and I don’t consider the effect it has on my life. It’s the effect it has on democracy and society that I am most concerned about. You know what? I’m going be fine. People who know me laugh with me. I was raised in Brooklyn’s Bensonhurst area. I will be fine. I don’t worry too much about the lies being spread. It’s my concern about the impact on society.
MARGARET BRENAN: The country isn’t sure how to deal with this right now. Overdose deaths are one thing, but you also have to consider drinking and all the other effects that this country has endured during the pandemic. Is there a plan that you can pass on to the next person at the NIH when you retire?
DR. FAUCI (Yes, that’s the plan for them): Do what I do now, regardless of what nonsense, politics, or everything else is thrown at you. Keep your eyes on the end goal and you will achieve it by using what you have. Science has given us a very effective vaccine, and there are many highly effective drugs in the pipeline. All other things can be phased out. You won’t be able do your job if you get involved in the nonsense of politicization. That’s why, when all these things are in, and they pass a bill with my name on, Joe Schmo suggests that I retire to jail. That’s all I see and I forget it. I know what my job entails.
MARGARET BRENAN: I’m sorry for you and your family. I know that you’ve stated to your daughter that she’s concerned about you being exposed. Last year, you didn’t get together with them around holidays. How do you counsel people this year as they approach the holidays? How can they safely gather with their families? Are you able to gather with your family?
DR. FAUCI I am. I don’t mean for Thanksgiving. It is only for logistical purposes. My three daughters live in different cities and are triangulated across the country. They have jobs and can fly long distances for work. We’ll all be getting together for Christmas. All the family, even the dogs.
MARGARET BRENNAN : How do you safely do that?
DR. FAUCI: When you are vaccinated, you feel energized. When you surround yourself with people who have been vaccinated, you feel boosted. You wear a mask when you are in a group setting that is not your family. So, I will be at home with my wife and my daughters, along with their partners. We’ll be enjoying Christmas Eve and Christmas Day maskless.
MARGARET BRENNAN : Are you able to test the entrance and exit of the gathering? What should people do?
DR. FAUCI: Well, it depends. My daughters are very cautious because of my age, I think. Even though I am vaccinated, they are concerned about me. They will do what they do, and I believe they’ll do it, even though they are vaccinated and boosted.
DR. FAUCI (Yes, I think so). That’s why, going back to 2020 when I stated that we must flood the system of testing, I have said it more than once.
MARGARET BRENNAN : Are we there yet? You hear it often–
DR. FAUCI – No, we’re doing – we’re getting there.
MARGARET BRENAN: It is even more difficult to find the at-home tests.
DR. FAUCI – Now, give credit to President Biden wherever we can. He has invested billions to reach as low as 200,000,000 tests per month and as high at a quarter of a billion tests per month. The Fauci plea to inundate the system with testing will be fulfilled.
MARGARET BRENNAN – Do you feel traumatized from the past two years of your life?
DR. FAUCI: No, no. People who care about me, even well-meaning ones, really make me feel. Perhaps even you are genuinely concerned about me. You don’t need to be traumatized if you are focused on your job and the fact that you have to save lives. I don’t mean to say that I don’t. I simply don’t have the time or energy to traumatize. I work. I haven’t taken a day off for 20 months. It doesn’t bother me that we’re saving lives. This is really important. This is why I went to medical school, and now I am doing it 50 years later.
MARGARET BRENNAN It happens more often. Scientists from the World Health Organization have told me that, due to environmental changes and other factors, there will be more of these coming at you faster.
DR. FAUCI : I believe we will. However, it is impossible to predict. I have been through multiple, multiple emergencies with various diseases. Some were trivial. It doesn’t matter what. You know that if a mutation had been made a little differently, it could have done something different. However, I believe that the concept of the human-animal interface is something we need to tackle. That’s why I refer back to these wet markets, which bring in animals from wherever in Southeast Asia and China.
MARGARET BRENAN: Do you want to see more regulation of these internationally?
DR. FAUCI (in Italian): I want it to be regulated. It is something I truly, sincerely desire. We know that the Chinese tried to regulate this. There were also people breaking the law, and it was documented by people who photographed the situation-that animals were allowed to be brought into the wet market from the wild. They were violating the law. This is why I believe that this happened. I don’t know why, but I think the Chinese completely cleared it out. This is not what we are supposed to do. That is why we aren’t able to determine the source. They may have destroyed some evidence.
MARGARET BRENNAN It’s not about covering up things, it’s simply trying to get rid of the mess as quickly as possible.
DR. FAUCI (Yes, it is true that even when they have nothing, they are suspicious. It is. It’s the truth. That is the truth. They are so convinced that they don’t know the truth. Even if they have done nothing wrong they still act suspicious.
MARGARET BRENAN: Dr. Fauci. I’m sorry, it took a lot of time. We appreciate your time.
DR. FAUCI : It’s my pleasure.