Dr. Anthony Fauci says COVID-19 surges are ‘not inevitable,’ and talks of vaccine progress and baseball

The COVID-19 surges in much of the country were “not inevitable,” and scientists must remain “humble” as they continue learning how to treat the disease that has claimed more than 150,000 U.S. lives and close to 700,000 worldwide, Anthony Fauci, the U.S. government’s chief infectious-disease expert, said on Monday.

Fauci, director of the National Institute of Allergy and Infectious Diseases, was interviewed by Howard Bauchner, editor-in-chief of the Journal of the American Medical Association.

Since the beginning of the pandemic, Bauchner has been conducting periodic live interviews of prominent physicians and scientists, including Fauci on several occasions as well as Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, on June 1.

On Monday, Fauci was asked about progress on vaccines, the evidence for how much children spread the virus, and “positivity rates” — the percentage of those tested who are found to be infected. The World Health Organization has urged that governments strive to keep that rate below 5%, but recently rates have exceeded that threshold in many parts of the country, including Pennsylvania.

Bauchner also asked Fauci about that wild pitch he threw before a Washington Nationals game in July.

Below is a condensed version of Fauci’s responses in the interview.

It’s become clear now if you look back at the states in the southern regions that have surged up, accounting for 60,000 to 70,000 cases per day, that prior to the surging you could detect an early increase in the percent positive for any given state. Even if it goes up by 1 or 1.5 percentage points, and it continues to go up, it generally doesn’t spontaneously come down. It means it’s a good predictor of a surge.

When you see that, you’ve got to take a look at where you are in the process of trying to reopen. I don’t think you necessarily have to revert to going all the way back to closing, but you’ve got to intensify what I consider five or six fundamental things that we know from experience help to blunt resurgences and can prevent resurgences from occurring: Consistent, correct wearing of masks. Avoiding crowds. Physically distance six feet or more. Stay away from places like bars where people congregate, and in some places you’ve even seen authorities closing bars. Outdoor is always better than indoor if you want to do any kind of a function. And simple things like hand hygiene, or washing your hands. It’s not inevitable you’re going to see these resurgences if in fact you handle it properly.

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You read about confrontations that really go bad. You don’t want that to happen. I think what we really need to do is to, just as a nation, show a degree of consistency of everybody doing that. The trouble with mandating is ... people who push back on authority, if you mandate, they may push back even more.

I’m very pleased to see that the president is wearing a mask more now. The vice president, I know I’m with him a fair amount, he wears a mask when he goes out.

Clearly they have much less of a chance of getting sick and of getting a serious outcome. Maybe children don’t get infected as much. We don’t know that yet. We need to do better studies.

Very young children, when you look at the viral load in their nasopharynx, its anywhere from 10 to, in some cases, 100 times more than in older children. You can make a reasonable assumption that if very young children have a high viral load in their nasopharynx, that they’re very capable of transmitting it. The question is how well do they transmit that infection to others.

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Everything needs to be transparent. Clearly if you’re going to gain the confidence of the American people to either engage in a vaccine trial or act upon the results of a vaccine trial, we need to show safety and efficacy.

The reason it’s very important is if a vaccine gets the imprimatur of the FDA, it’s going to be given to millions and millions of people. You want to be sure that you are giving to people who are otherwise well something that has been proven safe and has been proven to be effective. Even a safe but ineffective vaccine could lead to a false sense of security.

There is this urge, understandably, to get the vaccine out to everybody. You’ve really got to be careful because there are a lot of unknowns out there.

You know, Howard, I hesitate to do that, because that then gets distorted as something you’ve done wrong. It becomes a sound bite, a topic of discussion that distracts us from looking ahead. I can tell you in general, we’re not perfect, we did not do everything right. But nobody has done everything right when you’re dealing with this brand new [virus]. Let’s just be humble enough to know that we all could’ve done better.

It was misjudgment on my part. I was practicing from what I thought was 60 feet.

When I got to the rubber on the mound and I looked at Sean Doolittle [the Nationals player who tried to catch the wild throw], he looked like he was about 500 feet away.

I hope baseball is going to be able to successfully keep the season. They’ve gotten challenged with the clusters of players who’ve gotten infected.