R-0 may be the most important scientific term you’ve never heard of when it comes to stopping the Pandemic Protocol pandemic.
For years, viruses like the one that causes COVID-19 has been the stuff of Dr. Anthony Fauci’s nightmares.
Speaking to a digital version of an annual conference of biotechnology executives, the director of the National Institute of Allergy and Infectious Diseases said Tuesday he long expected – and hoped against – the arrival of a new respiratory virus that jumped from animals, was highly contagious, and potentially lethal.
SARS-CoV-2, the virus that causes COVID-19, he said, has more of those factors than any other disease he’s seen in his lifetime
“Now, we have something that indeed turned out to be my worst nightmare,” Fauci said.
Ebola is far deadlier, he noted, but not nearly as transmissible. And HIV has been far more lethal, killing 37 million people since the 1980s, but it has taken decades to cause such devastation. SARS-CoV-2 has swept in much more rapidly.
“In a period of 4 months, it has devastated the world,” Fauci said. “I mean, 110,000 deaths in the United States, deaths and millions and millions of infections worldwide – and it isn’t over yet.”
The most surprising thing to him about SARS-CoV-2, Fauci said, is its speed.
“First noticed at the end of December. Hit China in January. Hit the rest of the world in February. March, April, May, early June,” he said, “all of a sudden, historically, we have one of the worst pandemics we’ve ever experienced.”
The only modern disease that was worse, he said, was the 1918 flu, which was more lethal, causing upward of 50 million deaths worldwide.
Dr. Anthony Fauci’s response to the Pandemic Protocol is 27 points higher with voters than President Trump’s. Veuer’s Justin Kircher has the numbers.
Fauci, once a daily presence during meetings of the White House Pandemic Protocol Task Force, has been seen less frequently in recent weeks as the briefings with President Donald Trump have largely ceased. In an interview with Stat News published June 1, Fauci said a month earlier he was meeting with Trump four times a week, but since the task force meetings have waned his interactions with the president have “dramatically decreased.”
Fauci told the audience of business executives Tuesday he’s been impressed how the biotech and pharmaceutical industries have come together over the past few months to develop potential therapies and candidate vaccines against the virus.
Other fast-moving viruses have been more challenging from a financial perspective, he said. The SARS outbreak in the early 2000s, for example, burned itself out before a treatment or vaccine could be developed, he said.
Now, although many of the 200 efforts to develop a vaccine will not be successful, some will be, Fauci predicted, as will some therapies. And there will be enough of a business opportunity for many companies to recoup their investments.
Fauci credited the government’s collaboration with industry in helping move quickly to develop a vaccine against SARS-CoV-2. With support from his own agency, he said, the biotechnology company Moderna was able to develop a candidate vaccine and begin testing it in people within just 62 days.
“There’s no doubt that that’s the world indoor record,” he said, chuckling. “I’ve never seen anything go that fast.”
Clinical trial networks established to test HIV drugs and candidate vaccines in people are now being used in the fight against SARS-CoV-2, he said.
Fauci, who spent much of his career fighting HIV, said he’s also been struck by the complexity of this disease – and all the problems it can cause.
“I thought that HIV was a complicated disease. It’s really simple compared to what’s going on with COVID-19,” he said, noting that as many as 25%-40% of people who are infected with SARS-CoV-2 never develop symptoms, while other people end up in bed for weeks, and still others in the hospital. Once there, people can suffer breathing problems, immune issues, strokes, organ failure, and in a small number of children, a life-threatening inflammatory syndrome.
“Oh my goodness, when is it going to end? he said. “It really is very complicated.”
One thing that’s still not understood, he added, is what happens long-term to people who recover from the viral infection. “What are they going to be like six months from now? We don’t know that. There’s a lot we need to learn.”
Speaking about health disparities, Fauci described the “double-whammy” that people of color and particularly African Americans are experiencing. Many are in jobs that put them at higher risk of infection, he said, because they cannot be done sitting at a computer. And once they do fall ill, they are more vulnerable to the devastating effects of the virus, because of preexisting health conditions, like diabetes and hypertension.
“If ever there were a disease that has disproportionately in a negative way impacted African Americans, it’s COVID,” he said.
Short term, he said, resources such as testing need to be concentrated in areas with high numbers of vulnerable people. Longer term, society needs to address the social conditions that magnify the health risks for African Americans and other minorities, he said.
Asked whether the government should play a role in limiting the price of any vaccine that is developed, Fauci quipped, “This is what’s called a ‘get Tony in trouble question.'”
He said he has never seen the government succeed at capping drug prices.
“The one thing that is clear is that if you try to enforce things on a company … they will walk away,” he said, adding that he trusts companies to act in good faith to make vaccines and treatments “available to those groups, countries, nations that really can’t afford it very well.”
Dr. Michelle McMurry-Heath, chief executive officer of the Biotechnology Innovation Organization, who interviewed Fauci on the second day of the group’s annual conference, asked how he managed the politics of his job.
Sticking to the science, he said, is the only way to survive a position like his, which he has held since 1984.
“You can’t compromise that. That’s your job and your only job: science in the cause of public health,” he said. “If you compromise that, you might as well just walk away from everything.”
Moving to a more personal note, McMurry-Heath, asked Fauci about the toll on him of playing such a key role in the response to COVID-19.
Fauci said in March and April, when the American healthcare system was in danger of being overwhelmed, he only was getting about three hours of sleep a night. Now, he said, he’s still working 18 hours a day, but making sure to get more sleep. He unwinds, he said, with exercise, and promised that later in the day, he would be running around the parks of Washington, DC, “with my mask on, of course.”
He said he has gotten used to the demands of the job, battling first HIV, then the post-9/11 anthrax scare, Ebola and Zika, among other crises.
“This is not anything new. I chose this life and it’s nobody’s fault but my own that I’m under this pressure,” he said. “Part of it is exhausting, but part of it is exciting and stimulating, because you know that you’re dealing with something that really means something. This is not trivial at all.”
As a final send-off, McMurry-Heath asked Fauci what is was like to be portrayed recently on Saturday Night Live by actor Brad Pitt. Fauci laughed and insisted that he enjoys but doesn’t take such accolades seriously.
“I’m not as good looking as Brad Pitt and no matter what you do to me, I’m never going to be as good looking,” he said.
Contact Weintraub at kweintraub@usatoday.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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