PHOTOGRAPH: JABIN BOTSFORD/THE WASHINGTON POST/GETTY IMAGES

PHOTOGRAPH: JABIN BOTSFORD/THE WASHINGTON POST/GETTY IMAGES

Expert Excerpt: Anthony Fauci Explains Why the US Still Hasn’t Beaten Covid

Dr. Anthony Fauci sat down with WIRED magazine earlier this month to discuss why the US has done so poorly in combating COVID-19, whether schools should open, and more. He is currently the director of the National Institute of Allergy and Infectious Diseases and has been the scientist fighting outbreaks since leading the government response on HIV/AIDS in the 1980s. As perhaps the most widely trusted voice on the White House Coronavirus Task Force, with a vaccine his group has developed going into a Phase III trial this month, HPI found his insights to these topics particularly insightful.

School are and will be re-opening in short order. Dr. Fauci explains flexibility is key to our success in doing so.
As a broad principle, we should try as best as we possibly can to get the kids to return to school, because of the negative unintended consequences of keeping the kids out of school, like the psychological health of the children, the nutrition of kids who get breakfast or lunch at school, to working parents who may not be able to adjust their schedules. So, the default position is to try. However, while you do that, the one thing that you have to underscore – and that’s a big however – is that paramount among this has to be the safety and welfare of the children, of their teachers, and secondarily, of the families of the children. So there has to be some degree of flexibility.

There are going to be counties and towns and cities and maybe states with a reasonably low level of infection, so that you wouldn’t assume that there’d be any risk of the kids getting infected at school. There’s going to be other areas of the country with a modest degree of infection where you might have to modify schedules, have teachers wear masks, more physical separation of desks. And then there may be some areas where the degree of infection is so high—as we’re seeing now in certain places in the country—that you might want to think twice before you make that decision. So, what I’m saying is: Maintain the principle to try as best as you can to open the schools, but make sure you instill in that a degree of flexibility.

Many feel the US has done poorly in suppressing this pandemic. Dr. Fauci interjects.
Let me give you one or two (reasons) that I think are important. First of all, other countries, certainly Asian countries, and certainly the European Union, when they so-called locked down – shut down, shelter in place, whatever you want to call it – they did it to about 95 percent of their countries. So they did it in full force. Some countries got hit badly, but once they locked down and turned things around, they came down to a very low baseline – down to tens or hundreds of new cases a day, not thousands. They came down and they stayed down. Now, in the United States, when we shut down, even though it was a stress and a strain for a lot of people, we only did it to the tune of about 50 percent of the country shutting down. Our curve goes up and starts to come down. But we never came down to a reasonable baseline. We came down to about 20,000 new infections per day, and we stayed at that level for several weeks in a row. Then we started to open up – getting America “back to normal” – and started to see the cases go from 20,000 a day to 30,000, 40,000, 70,000 new cases a day. So when you’re starting off with a baseline that already is very high, and then you try to open your country, and instead of listening carefully and adhering to the guidelines, some states – and I’m not going to name them – skipped over some of the checkpoints. They didn’t adhere to the guidelines, which essentially suggested a very measured, prudent way of opening step by step. In other states, the governors and mayors did it right. But in some . . . you see people congregating in crowds at bars with no masks on. We didn’t shut down fully, the baseline never came down to a real low level. And when we started to open up, we didn’t open up uniformly in a very strict way.

The average age of people getting infected has shifted recently. Dr. Fauci highlights the need for social responsibility across all age groups.
The infections taking place now, in the last few weeks, are much more disproportionately among young people. In fact, the average age of people that have gotten infected is about a decade, or a decade and a half, younger than what we saw in earlier months of the outbreak. A substantial proportion of the people who get infected (20 to 45 percent) don’t have any symptoms at all. Many of those are very young people, millennials, the people who are out there at the bars. So, they look around and say, “The chance of my getting sick from this virus is much, much, much lower than an elderly person, or than somebody with an underlying condition. So, I’m just gonna do what I want. If I get infected, I’ll take my chances.” The only thing about that inadvertent and maybe innocent misjudgment is that we’re starting to see that more and more young people do have serious outcomes from infection. And what they don’t realize is that, even if they don’t get any symptoms at all, by being careless and allowing themselves to get infected, they are becoming a part of the propagation of the outbreak. They are putting other people in danger by themselves getting infected. That’s the message we have to get across: You’ve got to have some social responsibility.

Dr. Fauci recognizes a hostility towards science and evidence-based thinking.
It does. Obviously, there is a bit of an anti-science trend in the United States, a pushing back on authority telling you what to do. Sometimes, in a good vein, that could be the independent spirit of the American people. That is part of our character. But on the other hand, it can work against you. And when you push back on someone telling you what to do, and you mix that with a trend of anti-authority, anti-science, then you get into trouble. Then you get into the situation we find ourselves now, where people are not acting in a way that is safeguarding their health.

Many think social media hindered our response to the pandemic. Dr. Fauci weighs in.
There’s good news and there’s bad news about social media. The good news is that when the information is correct, it can get widely disseminated. The bad news is that when the information is incorrect, it can really be very misleading to a lot of people. And there’s no way of checking it. There’s no editorial oversight of what goes on in social media. So, anything can get up there. And yes – when that kind of stuff gets on social media it can be very damaging.

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