Dr. Anthony Fauci participating in a news briefing with members of the White House Coronavirus Task Force on Thursday, November 19, 2020. Photo Credit: Jabin Botsford/Washington Post
On Monday, December 14th, the Center for Strategic & International Studies (CSIS) hosted a webinar entitled Year-End Reflections on 2020 with Dr. Anthony Fauci. The event was moderated by J. Stephen Morrison, Senior Vice President and Director of the CSIS Global Health Policy Center, who spoke with Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) and member of the White House Coronavirus Task Force, about his key takeaways regarding the tumultuous events of 2020 and the Coronavirus Pandemic.
Morrison started the conversation by congratulating Dr. Fauci on the delivery of the first batch of vaccines to U.S. citizens. Morrison acknowledged the unprecedented nature of 2020, but highlighted the optimism and hope that the vaccine delivery has given many Americans. The vaccine’s 95% effectiveness rate and the fact that it was developed in less than 340 days is certainly a reason to celebrate. Unfortunately, the vaccine’s delivery also coincides with a grim reality: over 300,000 Americans have died from the Coronavirus and the surge is expected to continue for the next 60 to 90 days. The life expectancy of Americans has dropped by an entire year, and the Coronavirus is officially the leading cause of death in the United States. Morrison stated that we are “at risk of straining and breaking our medical system.” Hospital staffs are exhausted and are confronting a shortage of staff and of hospital beds. Coupled with the pandemic, Morrison points out the “deterioration of civility and governance” at home due to the turbulent elections and the “bipartisan antagonism” plaguing Congress. A significant number of Americans continue to deny the existence of the pandemic and the rampant disinformation about the pandemic will only complicate our recovery in 2021.
Morrison prefaced his first question by pointing out Dr. Fauci’s pivotal role “at the center of these rollercoaster dramas;” the politicization of the Coronavirus has put Dr. Fauci in the middle of the drama. Indeed, Dr. Fauci has even been targeted by the White House. Morrison stated that “trust is Dr. Fauci’s currency,” and Fauci has actively defended key health institutions like the CDC and NIH. Morrison then asked Dr. Fauci: “Did you ever in your wildest dreams imagine yourself in this role?” Dr. Fauci responded with a resounding: “No.” He exclaimed, quite frankly, that we are living in his health nightmare. Fauci could not have imagined something this intense just five years ago. There are not many things worse than a respiratory illness with high transmission and high mortality that jumps between species. He highlighted the need to implement the vaccine rollout, which has been shown to be very efficacious in the trial phases.
Morrison then asked Dr. Fauci what his proudest moment from 2020 was. Fauci stated that it was “the fact that we have successfully done what people thought would be unimaginable: having a virus that is brand new from January 2020 and then in December 2020, as we speak, people are being injected with vaccines that are 94-95% effective.” When Morrison asked Fauci if he had any regrets from 2020, Fauci lamented the public health disaster that has resulted from the virus: almost 300,000 dead, 110,000 hospital beds occupied, and nearly 200-300 thousand new cases each day.
Morrison then discussed the partisan divide that has been highlighted and exacerbated during the pandemic; Morrison asked Dr. Fauci how he uses his “good office and good reputation” to bridge the divide between Republicans and Democrats, calling the divide “one of the biggest challenges we will face.” Fauci hesitated and called it “a very difficult situation;” he does not consider himself a political person and tries to focus solely on the public health issues for which he is responsible. Fauci also called himself a realist but has cautious optimism that we can bridge the partisan chasm. Fauci also claimed that there has been more collaboration between the Trump Administration and Biden Administration “than the public realizes.” There have been very productive meetings at the NIH, there have been transition teams formed, and overall “a good degree of cooperation going on.”
Morrison then asked about the virus and US national response and how historians “will make sense of this catastrophe.” Fauci emphasized that “it isn’t over yet.” There are too many factors still at play, but “we will need a scholarly approach to look back at what went wrong.” Fauci does believe we will need to retrospectively decide what the positive and negative factors were. Morrison then suggested having something like the 9/11 Commission except for the Coronavirus Pandemic since the former was so successful in identifying what institutional shortcomings permitted 9/11 to occur. Fauci agreed that there needs to be “a formal retrospective review process;” however, he also expressed skepticism about any bipartisan collaboration in such an approach. Morrison then underlined the “forgetfulness” that occurred after the Spanish Flu Pandemic—675,000 Americans died during the Spanish Flu, but there is only one memorial dedicated to them. Fauci attributed this forgetfulness to “corporate memory,” and he demonstrated the same desire as Morrison to avoid this forgetfulness when it comes to looking back on the Coronavirus in the history books.
Morrison then asked Dr. Fauci about the most important things learned from 2020. Fauci immediately responded by stating that “this is the most unusual virus that any of us have ever dealt with.” He goes on to say that “there’s something strange about a virus [that] barely bothers some” and kills other. Fauci then expressed an urgency to figure out why the virus behaves this way and why some people exhibit no symptoms. Another thing Fauci said that the country has learned in 2020 was the “importance of investing in science to deal with something unprecedented and unimaginable.” He called Operation Warp Speed “quite a success story,” but the success does not surprise Dr. Fauci given the almost $10B invested in the program.
Morrison then continued on by asking Dr. Fauci about the rollout of the vaccine. Morrison asked Fauci how long it will take scientists and doctors to know more about the effectiveness of the vaccine and at what point we will be coming out on the other side of the pandemic. Fauci stated that “if the vaccine rollout works the way it does then we will get the overwhelming majority of people after the second quarter vaccinated.” This will most likely happen at the end of 2021 and even into 2022—at that point medical experts should know more about the durability of the vaccine and “whether or not we are dealing with something that needs to be re-boosted each year.” Essentially, we will know more in a year and “the numbers will guide us.” The less infections we have per day lessens the chance the virus will be able to spread. It will not be a subtle change, either. That being said, when we start to see a decrease in daily caseloads, we should not abandon mitigation efforts.
Morrison closed the discussion by thanking Dr. Fauci for his service, but also by inquiring why we should all remain optimistic. Dr. Fauci stated that his optimism is rooted in science, and he refers to the early years of HIV as a reference point to how far science can push us in the right direction. In the case of HIV and AIDS, science helped doctors and medical researchers understand “the structure of the antiviral design” and “the replication cycle of the virus” to culminate in a series of drugs that have inhibited HIV from turning into AIDS. Nowadays, people with HIV can live a relatively normal life because of “the fruits of science.” Fauci concluded by agreeing that 2020 has been a difficult year, but science “will help us get out of this.”