Anthony Fauci, the nation’s leading infectious disease expert, spoke through screens to the Brown community and the public Friday afternoon, sharing practical public health advice and updates on the nation’s COVID-19 response. Fauci was interviewed by Ashish Jha, the incoming dean of the School of Public Health, who is currently the director of the Harvard Global Health Institute.
Opening the event, President Christina Paxson P’19 introduced Fauci as a member of the White House Coronavirus Task Force, director of the National Institute for Allergy and Infectious Diseases for over 35 years and an advisor to six presidents on domestic global health issues, as well as a principal architect of the AIDS response in the 1980s.
To exemplify Fauci’s commitment to mentoring young scholars, Paxson cited the story of Luke Messac — a current emergency medicine resident at the University — who tweeted in mid-July that as a Harvard undergraduate 13 years ago, he sent Fauci an email “out of the blue,” requesting an interview for his thesis. After the thesis was complete, Fauci read Messac’s work and sent back a glowing response. When Messac posted a screenshot of Fauci’s endorsement to Twitter, the post garnered over 431,000 likes and 51,000 retweets.
Thursday evening before the event, Jha looked forward to his conversation with Fauci, a scientist who he has long considered a personal role model.
“One of the things I really admired about (Fauci) is his ability to communicate effectively to people,” Jha told The Herald. “He doesn’t dumb things down.”
Jha added, “I think it's really important that public health leaders speak up at a moment like this, especially when there's so much misinformation out there … it's particularly important to have credible scientific forces.”
During the event, Fauci addressed a wide range of complex topics, from the development of an efficacious COVID-19 vaccine to his past work combating HIV/AIDS, as well as the policy surrounding states’ closing and reopening plans.
"Anybody who says we are not living in a divisive era in our country is not paying attention,” Fauci told viewers.
“If we can somehow get the country unified together, we could make it into the fall and winter looking good."
“It was as if there's public health principles, and then there's ‘open up the country,’” Fauci said, emphasizing how problems have arisen as reopening plans have not strictly enforced public health guidelines. “One is not the enemy of the other — one is the gateway to get to the other.”
Fauci listed his pillars of proper public health practices: “Universal wearing of a mask, physical distancing, avoid crowds, outdoor better than indoor, washing your hands ... and — if you're in a situation where it applies to you — stay away from bars. Bars are bad news when it comes to the spread.”
“Those things work,” he said. Still, he acknowledged that some states have been better able to enforce these practices than others.
“If we can somehow get the country unified together, we could make it into the fall and winter looking good,” Fauci said.
Jha and Fauci also discussed the process for vaccine creation and implementation. Fauci said he feels “cautiously optimistic” about the vaccine process, citing the results of ongoing vaccine trials.
Fauci explained that phase one clinical trial data as well as research in animal models indicates that the vaccine candidate “induces a response with neutralizing antibodies. That's at least as good, if not better than the plasma of convalescent people, which tells me that's a good start,” Fauci said.
He added: “We know that the body is capable of making a good response … because we have so many people who clear the virus and do well. So the goal of a vaccine is to do as well, or hopefully better than natural infection in inducing a good response.”
But even when a vaccine makes it through all stages of clinical trials, the issue of disseminating the vaccine throughout the population remains. Fauci said that even if a vaccine were ready by early 2021,“we're not going to have 100 million doses — we're going to have tens of millions of doses, which means that we’ve got to prioritize.”
"It’s going to end because of science.”
Fauci said that when a vaccine is released, it doesn’t mean life will automatically return to normal. He advised, “You must never abandon the public health approach. You've got to think of the vaccine as a tool to be able to get a pandemic to no longer be a pandemic, but to be something that's well controlled.”
No vaccine is 100% effective — the common flu vaccine was only 46% effective in preventing the flu during the 2019 - 2020 flu season — but some, like the shot for measles, are around 98% effective.
For COVID-19, Fauci said, “I believe we'll get an effective vaccine. But we don't know if it's going to be 50%, or 60%. Hopefully, I'd like to see 75% or more, but the chances of it being 98% effective is not great.”
To contextualize current scientific efforts to combat COVID-19, Jha and Fauci recalled their own experiences dealing with other highly infectious diseases. Fauci detailed some of his scientific work fighting HIV, while Jha saw pneumocystis pneumonia drastically decrease in severity during his time as a resident at the University of California at San Francisco between the years of 1997 and 2001. “Science, when it works, really is miraculous,” Jha said.
“This is going to end,” Fauci said. “And it’s going to end because of science,” Jha added.
Fauci also brought up the prospect of developing antiviral drugs that could stop the infection as soon as a patient gets a positive test result. “Quite frankly, there really is no reason why we cannot do that. There's no reason why that's not possible. Heck, if we did it for HIV, we can do it for coronavirus,” he said.
After the initial discussion, Jha introduced University students, who posed their own questions for Fauci. The first came from Shekinah Fashaw, a PhD’23 student at the School of Public Health in Health Services Research. She asked Fauci to give his perspective on the impact of the “two pandemics that we’ve seen colliding:” COVID-19 and racism.
“Dr. Fauci is like my Beyonce as a public health student, so it was definitely an amazing experience to be able to ask him that question,” Fashaw told The Herald after the event.
Fashaw's dissertation work focuses on the racial and socioeconomic disparities in access to Medicare home health services, and she has also studied disparities in nursing homes. “I don't think I ever saw my work as timely or important as I see it now,” she added.
“Maybe it will be a wake-up call for society to change."
“COVID-19 didn't create these disparities, it didn't create racism, it didn't create the issues of health equity, but it really did highlight and exacerbate many of the disparities that we see,” Fashaw said. “Racism and residential segregation (are) ... truly the fundamental cause of the health disparities and health inequities that are experienced in this country by Black and brown communities,” she added.
“Maybe it will be a wake-up call for society to change,” Fauci said, referencing this collision of racism and COVID-19. “The thing that you can do now is make sure that resources are concentrated geographically to those demographic groups that are clearly at higher risk for infection,” he said.
Other student questions came from medical student Katie Barry MD’23, who asked for Fauci’s advice for future physicians, Watson Institute Master of Public Affairs student Margaret Elam GS and recent graduate Abdullah Shihipar MPH ’20.
As the event came to a close, Jha asked Fauci: “Have you had a day off since this pandemic began?”
“Not to engender any sympathy — but I have not had a single day off since the very beginning of January when we decided that we were going to start working like crazy on a vaccine,” Fauci said.
He credited his wife with helping him keep up the busy schedule, adding “we also are fortunate in that we are taking care of one of my daughter’s dogs. … That dog never does anything but, just, want to be near me.”
So what is key to Fauci’s consistent engagement at the NIH, at the White House on the Coronavirus Task Force and when responding to the countless emails that flood his inbox?
The simple respite of a long dog walk, he said.
—Additional reporting by Emilija Sagaityte.