Full transcript: Dr. Anthony Fauci on "Face the Nation," Nov. 27, 2022
MARGARET BRENNAN: He has been the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health for almost 40 years and has served seven presidents. Dr. Anthony Fauci is planning to step aside from his day job by the end of the year. He joins us here today. Great to have you here in person again, Dr. Fauci.
DR. ANTHONY FAUCI: It's great to be here in person with you, Margaret. Thank you.
MARGARET BRENNAN: There is a lot circulating these days and I want to get your medical advice off the top. We have this trifecta of RSV, flu, and COVID. So what are the risks for people congregating this season?
DR. FAUCI: Well, the risk depends on what your status of vaccination is. We have two of the three of the trifecta that you're talking about, we have vaccinations for clearly COVID, particularly with the updated boosters that are now available. We have vaccinations for influenza, we're already starting to see an early surge of both flu and RSV. We don't have a vaccine for RSV, this, particularly problematic for children, five years of age and younger and for the elderly. But there are things you can do with RSV, is avoid congregate settings. And particularly if you have a cold or if you have sneezing and stay home, wear a mask, wash your hands. You know, we've kind of forgotten about the washing your hands and things like that, because unlike the other viruses, respiratory syncytial virus can actually remain on hands and on inanimate objects, and then it can be transmitted. So vaccinate for the things you can vaccinate for, and that's flu and COVID. Good respiratory hygiene for RSV and common sense things like when you have congregate settings, and you're in a situation not mandating masks that's got a, you know, radioactive to it. Just use common sense that you might want to in a certain situation, particularly if you're yourself vulnerable, by age or by medical condition, or you have someone in your family. So those are the things you want to do. The other thing that we- we don't want to forget about is testing. And that has a lot to do mostly with- with COVID.
MARGARET BRENNAN: You said last time test going in and test coming out.
DR. FAUCI: Exactly and that's the point. So when you're- when you're going to be congregate setting for family issues, like Thanksgiving, likes Christmas and the holidays, it just makes sense that if you're going to have people coming in, since the tests are widely available, you can get the result in 10 to 15 minutes. Test yourself before you congregate with people, particularly when you're having someone over the dinner, 5,10, 15, 20 people, it's easy to do.
MARGARET BRENNAN: I want to ask about RSV, though, specifically with little kids. These infections are overwhelming pediatric hospital wards around the country. The Children's Hospital Association and the American Academy of Pediatrics say it's a public health emergency. Is it an emergency?
DR. FAUCI: Well, it is if in fact, which in some regions of the country, we're seeing that the hospital system for pediatrics are at the point of almost being overwhelmed. When you have very little wiggle room of intensive care beds, when you have like almost all the intensive care beds that are occupied, it's bad for the children who have RSV and need intensive care. But it also occupies all the beds and children who have a number of other diseases that require intensive care or ICU, they don't have the bed for it. So if you get to that situation that's approaching an emergency. So when the nurses and the pediatric associations are saying this is really critical, it is. Hopefully we're going to see that peak come down because if you look at other countries that have had those kinds of peaks with flu and RSV, it's peaked early, but come down. We're hoping that what's going to happen because both flu and RSV have- have- have come to us earlier than it usually does. If you look at the flu curves, and you look at all the other years, it goes up like this way before it usually goes up over here.
DR. FAUCI: I hope so. I hope so. I think so. But you know, you never want to be overconfident.
MARGARET BRENNAN: More than 100,000 parents last month had to stay home from work to care for kids, according to the Bureau of Labor Statistics. And we've seen schools in Ohio, Kentucky, Tennessee, cancel classes because of these large numbers, so coming out of the holidays, should parents expect schools to shut down?
DR. FAUCI: I don't know. Margaret, I'm not sure. When- when you talk about shutting down schools, there's always the--
DR. FAUCI: Exactly. There's always the collateral issue. So you have to balance, and you do it in real time depending upon the viral load of disease in your region. Whether you know, the upper northeast may be quite different from the southwest, from the- from the- from the Pacific coast, from the upper Northwest. So you have to have the local authorities evaluate on a situation by situation basis, the potential collateral deleterious effects, with the effects of what might happen if you have so many kids getting infected--
MARGARET BRENNAN: Some of these places just didn't even have teachers--
DR. FAUCI: Exactly. Well, that's the local decision you're gonna have to make. It's a local issue. That's the thing that gets lost in the discussion.
MARGARET BRENNAN: So how do people, knowing everything you just laid out, how do they calculate their risk and protect themselves? I mean, for an older person, is it something they need to think twice about when it comes to sitting across from their grandchild at Thanksgiving or Christmas?
DR. FAUCI: Yeah, I mean, it is a judgment call. And one of the things you have to be careful of is that look around not only for your own protection, but for the protection of the people that you're going to be in contact with, particularly, as you mentioned quite correctly, the elderly, those with underlying conditions, particularly those who are immunocompromised because there's underlying conditions, like heart disease and lung disease, that if you do get infected, you have a greater chance of having a deleterious consequence. But there's also something that is even more risky, people who are profoundly immune compromised, people that are on cancer, chemotherapy, people who have a variety of other diseases. So you gotta use common sense. I mean, the idea of coming into a crowded place and you're going home to someone who's immune compromised, it just makes sense to put a mask on. Nobody's mandating anything but use common sense because you don't want to infect yourself, because you're not in a vacuum. You may give it to someone, particularly a loved one, or even somebody you don't know, who has an immune-compromised condition.
MARGARET BRENNAN: I wonder how that changes when you calculate your risk these days and and how long do you think immunity actually lasts?
DR. FAUCI: Well, we know how much antibody immunity lasts because you can measure antibodies, they go up and they come down pretty quickly. This is very interesting with regard to coronavirus infection, or vaccination. Very different from something like measles, if you get infected with or vaccinated with measles. The degree of protection is measured in minimum in decades and optimally for a lifetime. We don't see that with coronaviruses, at least when you're dealing with getting infected. The big unknown which is mandated or controlled by a part of the immune system that's not that easy to measure when you just draw blood, and that's the cell mediated immunity that's systemically in your lungs and in the other organ systems that have lymphoid tissue in it. So it is entirely likely that although you may get infected with mild symptoms, the degree of protection against severe disease may be much more prolonged than the very transient degree of protection against infection. Let me give you an example. You measured me, I'm an elderly person, so my immune system isn't as robust as it was 30-40 years ago. I was vaccinated, doubly boosted, and I got infected. Now, the- the antibodies that were circulating in my body were not enough to protect me from getting infected. But it is very likely that the vaccination and double-boosting that I had protected me from getting a severe outcome that if I didn't have that, I very well might have gotten very seriously ill, and I had a very mild infection. So I think what I'm- what I want people to understand is that although you may get infected with these new variants that are related to the Omicron, you may not be protected against infection. But if you look historically now at the other countries that have surges in these new variants, it's interesting that the cases go up, but the hospitalizations don't, which is a really good indication that although you're not proof- profoundly protecting you against infection, you're doing a pretty good job of protecting you against severe disease.
MARGARET BRENNAN: But- but people think, 'Oh, I got a three month free pass. I just had COVID." But they can still get new variants, they can still get sick in that window of time.
DR. FAUCI: Exactly. Exactly. So you really want to keep up on your boosters. Because the- the protection clearly wanes, it wanes much more for- for infection than it does for severe disease, but it does wane.
MARGARET BRENNAN: So what is the prevalent strain that you think we're going to be facing this winter and does the recent booster shot, the bivalent, protect against it?
DR. FAUCI: Okay, so we a few months ago had BA. 4, 5 totally dominant, ninety-some odd percent. Now, the BA- the BQ. 1 and the BQ. 1.1 is gradually coming up so that it occupies now about 50% of all the isolates. And then you have kind of an alphabet and number soup of the little ones that the B. 7, BA.4.6 and on and on and on. And even I can't keep them together. But the ones that are on our minds right now that you do remember is the BQ. 1 and the BQ 1.1. Off in the distance is this XBB, which was very prevalent in Singapore. It came way up and then came way down. The reason you keep an eye on those is that they have what's called a transmission advantage, in that they are evasive of the protection that you have. So if you look at the BQ. 1, and the BQ 1.1, which was just a couple of percentage a few weeks to a month ago, is now more than 50% total. Those viruses evade the protection of the monoclonal antibodies, Evusheld and some of the other monoclonal antibodies, that are used for treatment as well as prevention. Evusheld is used for prevention, others are used for treatment. It also diminishes the protection that is induced by vaccination and by prior infection. It doesn't disappear, but it brings it down a few fold. So right now, in answer to your question, what am I concentrating on? I'm concentrating predominantly on the BQ. 1 and 1.1 that looks like by the time we get into December, it very likely will be overwhelmingly the dominant strain. What aside look at this XBB, which is not at all prevalent in the United States. In fact, it isn't even measurable in a percent when you look at the chart, but what it's doing in other countries is telling you that it clearly has a transmission advantage. So you have to keep your eye on all of these. Again, that's the bad news or the sobering news. The somewhat encouraging news is that when you're seeing these new variants, you also asked the question, what do they got to do with what we've been dealing with? If you look at the Omicron lineage, there's a BA.2, which is one of the Omicron lineages, and all of the sublineage branches of what I'm talking about. The BA.4.6, the BF.7, the BQ 1.1. All–
DR. FAUCI: They have no way- but they all branch off from that BA.2, which is part of the Omicron lineage.
MARGARET BRENNAN: So are you envisioning that in the spring, we're going to have to get a new sort of cocktail of booster shots to match this new threat?
DR. FAUCI: You know, I don't know. I have to be quite open and honest with you, as I always am, Margaret. I don't know, because it really depends on what is going to happen in the spring. If we get, and this is what I'm hoping for. I'm a cautious optimist. By the time we get to the spring, the level of immunity that's induced by infection, with or without vaccination, with or without boosters, among the entire population is such that the level of severe disease and infection is gonna go way, way down. And you won't require having every four months or so giving somebody a boost. You heard us, we in the public health arena, talk about the likelihood of getting a cadence of maybe once a year, that you get it with the flu shot.
DR. FAUCI: Just like the flu shot, but it's a little bit iffy about that. That's good, because there's a neatness to that, you know, once a year you get it in the fall. But that doesn't take into account that you have to keep up the possibility that we will get a variant that's very different than the variants we have right now that might require a springtime or some summertime boost. If it stays the way it is now, I hope it just gets down to that very low level.
MARGARET BRENNAN: So the White House just asked Congress for another $10 billion in funding.
MARGARET BRENNAN: We're technically still in the middle of a pandemic, even though the President said–
MARGARET BRENNAN: –pandemic's over. Is that the worry? I mean, is that where that funding needs to go? Into the new cocktails?
DR. FAUCI: Yeah, the funding- I mean, we really do need that money. I mean, it- First of all, the Congress has been very, very generous giving a lot of money for COVID. That is true, and we're very grateful for that. But we do need more right now for any of a number of reasons. One of which is a practical thing of- of outreach and PSA campaigns to get people to be vaccinated. If you look at the number of people who are eligible for that updated booster, the BA.4,5 variant–
DR. FAUCI: Yeah it's 11% of the population which is really, really not optimal. You superimpose upon that, that only 68% of the population is vaccinated, and only a half of those have gotten their first boost to begin with, we have a long way to go to optimize our protection against COVID, which is really a shame, somewhat paradoxical, that a rich country with all the vaccines that we need, and we're utilizing them at a much lower level than we should be.
MARGARET BRENNAN: Why do you think that is? Is it- I mean the anti-vaccine movement had existed on the left for a long time, it's now become prevalent among some conservatives in this country. What do you think is feeding that?
DR. FAUCI: I think it's a combination of an expansion and an amplification of the anti-science, anti-vax. There is something I've never seen in my 54 years in medicine at the NIH, is that the acceptance or not of a life-saving intervention is steered very heavily by your political ideology. I mean, why would you ever want to see that red states are undervaccinated and blue states are pretty well vaccinated and there are more deaths among red state Republicans than there are among blue states Democrat? Merely because of the fact that there is less vaccination. You don't want anybody to get sick. I mean, divisions of political ideology are wonderful, because it makes for the diversity of thought in the country. But it shouldn't be a reason why you get sick–
DR. FAUCI: –or you don't get sick. That's- As a public health official and as a physician, mostly, that's what pains me, because you don't want anybody to get sick, no matter what their ideology is, and yet, they're depriving themselves of a life-saving intervention. That plus everybody's got COVID fatigue, including you and I. We have COVID fatigue, and people just want it behind us.
DR. FAUCI: We don't- and people says, Oh, get another booster, an updated booster. There's almost an intuitive feeling of goodness, I really want this over with. We have to fight that until we get it so low, that it's appropriate to say, I don't want to be bothered with it. But it's not- we're not there yet.
MARGARET BRENNAN: Because I asked you a while ago, you're- I know you're planning to retire. And I asked you when you would feel comfortable retiring. And you said not until COVID is in the rearview mirror, you said when COVID doesn't dominate the mental framework of our society. What you're saying is we're choosing not to let it dominate our mental framework.
DR. FAUCI: But it's still there. I mean, there's a difference. And that- And that's an important point that I want to make. If you look at where we were a year ago at this time, when Omicron started to surge, we were having 800 to 900,000 infections and three to 4,000 deaths. Today, we had less than 300 deaths. Yesterday, we had 350 deaths, and we're having about 45,000 or anywhere from 27 to 45,000 cases. That is much, much better than we were a year ago. But if you look at it in a vacuum, it's still not a great place to be.
DR. FAUCI: I don't like reading in the newspapers or getting my report from the COVID team: today we lost 400 people, today we lost 350 people. So it's much, much better than it was, but it is not at a level low enough where we should feel we're done with it completely because we're not.
MARGARET BRENNAN: Since you're retiring, do you think that will change what looked to be a really intense political firestorm aimed at you? There have been all these House Republican calls for investigations into the origins of COVID and saying they're gonna bring you up to Capitol Hill. Do you think that wanes as you step down?
DR. FAUCI: Well, I don't think it's gonna wane for me because they're already saying, the Republicans, that had they won the Senate, they would be bringing me before the committee that Rand Paul would be- likely would be chairing. That's not going to happen because the Senate is not in the Republican control. But the Republican House has said that they're going to- and that's fine with me.
DR. FAUCI: Oh, of course. I mean, I'm very much in favor of- of legitimate oversight. Absolutely. I mean, I've testified before Congress, given the 38 years that I've been director, literally hundreds of times, in many oversight hearings.
MARGARET BRENNAN: It's never been this personal for you, though. And I know when I talked to you a year ago, you were angry. You said I'm just going to do my job and I'm going to be saving lives and they're going to be lying.
DR. FAUCI: Well, you know, it is- it- they've clearly politicized it. You know they say that- I'm not political at all, period. I've never been and anybody who knows anything about me knows that that's the case. But it is very clear when people are running their campaigns with an anti-Fauci element to it. I mean, that's ridiculous. I mean, this is a public health issue. So yeah, it's going to keep going likely much more geared towards me. I mean, it's obviously a political issue. I'm not going to get involved. I didn't get involved before in the politics. And I'm not going to get involved now in the politics, I'd be more than happy to explain publicly or otherwise, everything that we've done, and I could defend and explain everything that we've done from a public health standpoint.
MARGARET BRENNAN: Because there is the political argument. And then there is the intelligence and scientific argument, demanding some more answers about COVID.
MARGARET BRENNAN: And I think you'd agree that those are some legitimate questions there.
MARGARET BRENNAN: And last year, President Biden said the United States is asking China for more data about the origins.
DR. FAUCI: No, you know, one of the- one of the problems is that- and this is historic. It goes way back to bird flu, the H5N1, the H7N9, the original SARS-CoV-1. That the Chinese, not necessarily the scientists that we know and we have dealt with and collaborated with productively for decades, but the whole establishment, a political and other establishment in China, even when there's nothing at all to hide, they act secretive, which absolutely triggers an appropriate suspicion of like, "What the heck is going on over there?" When you had SARS-CoV-1, back in 2002, they were not transparent at all about what the heck was going on in China until–
DR. FAUCI: Right. Until it got into Hong Kong, and then spread to the rest of the world. It has been proven without a doubt that SARS-CoV-1 went from a bat to an intermediate animal host to a human. Didn't come out of any lab, nothing. It was a natural occurrence, yet they were so secretive about it, that you might want to suspect about what they're hiding. So right now, what we would really like to know is all of the details of what went on with the original people who were infected. We keep a completely open mind as to what the origin is. Having said that, if you look at the examination by highly qualified international scientists with no political agendas, they've published in peer reviewed journals, the best of the peer reviewed journals, that all the accumulated evidence, particularly related to the Chinese bringing into the Wuhan market animals from the wild that should not have been there that clearly could have brought in from a bat to them to a human, that the evidence is quite strong that this is a natural occurrence. Does that mean we've ruled out that there was something funny going on at leak? Absolutely. And I, and all of my colleagues, keep an absolutely open mind, we've got to investigate every possibility because this is too important not to do that. That's not incompatible with saying the scientific evidence still weighs much more strongly that this is a natural occurrence. You must keep your mind open that it's something other than that.
MARGARET BRENNAN: But, have you seen anything that Beijing has produced at all in terms of explanation or data?
DR. FAUCI: Well, their explanation is an explanation that they will not allow us to look at the primary information.
DR. FAUCI: They can say, oh, you know, it's in frozen food, or it's in this or it's in that. But there's no primary data. The W.H.O. went in and saw some of the data, which some of which was actually quite helpful. But we- you know what we need, Margaret, we need a transparency and a collaboration to open things up so that we can discuss it in a non-accusatory way.
DR. FAUCI: What happens is that if you look at the anti-China approach, that clearly the Trump administration had right from the very beginning, and the accusatory nature, the Chinese are going to flinch back and say, Oh, I'm sorry, we're not going to talk to you about it, which is not correct. They should be.
MARGARET BRENNAN: But they're not talking to the Biden administration about it either is what you're saying.
DR. FAUCI: Exactly. I think that horse is out of the barn, and they're very suspicious of anybody trying to accuse them. We need to have an open dialogue with their scientists and our scientists, keep the politics out of it. And let the scientists- because these are scientists that we've known for decades, and we've collaborated with them.
MARGARET BRENNAN: The Washington Post editorial board had an interesting piece on this recently. I don't know if you read it–
MARGARET BRENNAN: –but about the secrecy regarding the origins. And it says the world owes those who died, 6 million people, but probably twice that or more to be better prepared in the future. The cover-up is immense and still in place. China should now agree to a full and thorough scientific investigation that returns to Wuhan. Do you agree with that word cover-up? And intentional distortion?
DR. FAUCI: I don't know what that means. No, I- I- it isn't that I agree or disagree. I'm not sure what they're talking about. I mean, if cover-up is not allowing people to come in and look at all the data, that's not a cover, that's not being transparent. To me a cover-up is–
MARGARET BRENNAN: Well, but like the animals being killed before anyone can go into the market to investigate that.
DR. FAUCI: No, no, no. Well- again I don't want to- it's going to be taken out of context by others, for sure, but that's my life. Welcome to it. Cover up means you know something, and you're hiding it, not being transparent and allowing things to open is a little bit of a different. The thing that I- that I'm very concerned about, is that the Chinese knew from the original SARS-CoV-1, that you don't want to bring these exotic animals into a market placed in contact with people. So they supposedly outlawed it, then you get a very competent, high integrity investigator from Australia, goes to China and gets photographs of these animals in the Wuhan market who should not have been there. So that to me is like an example, if you want to call that a cover up, or you want to call that lack of transparency, I don't know what it is. But when you say you're not going to bring animals into a market, and you do, that's bad.
MARGARET BRENNAN: Yeah, and some have argued, it's just that the way the bureaucracy of the communist state works, that it didn't want to allow for embarrassment.
DR. FAUCI: Exactly. It- it- I think you just maybe in two sentences explained a lot that people are spending a half an hour talking about.
MARGARET BRENNAN: Well it's absolutely fascinating be fascinating, frankly, I find it all fascinating.
DR. FAUCI: No, no it's fascinating that, you know, it's the idea of they don't want to be embarrassed. And by not wanting to be embarrassed, it's like shooting yourself in the foot of nobody believing anything you say.
MARGARET BRENNAN: One of the other things that's interesting to us when we watch how the world deals with COVID is the "Zero COVID" policy in China, where they shut down almost fully cities and things, and that impacts the global economy. It's why we're still dealing with this in many ways. Why hasn't Beijing been able to get a really effective vaccine? Why do they still struggle with this like that?
DR. FAUCI: Well, it's the combination of not having an effective vaccine that they themselves made, it just is not nearly at the level of many of the other vaccines, it's just not, and that's unfortunate. And not wanting to bring in vaccines from the very beginning that were highly effective 94-95% effective--
DR. FAUCI: The Moderna, the Pfizer, the- you know, the- the ad vector ones that we've had from J&J and others, as well as locking down almost without a purpose. Whenever you lock down, if you look at the times we had to shut down, because the hospitals were being overwhelmed, and you had to stop the flow, at least temporarily, and then open up, get people vaccinated. So when you put restrictions, you do it, to give you time, to be able to do something productive so you can, you know, unloosen, or loosen up the restrictions. They to at least from what we were seeing, were just rigidly closing things down, which, unless you have a really, really good purpose of preparing yourself for opening, it doesn't seem to make a lot of sense.
MARGARET BRENNAN: And it impacts the global economy and us here in the US. What do you plan to do after you leave NIH in December? What's next for you?
DR. FAUCI: You know, I don't know, Margaret. And and- the reason I don't know is that I want to strictly stick to the- to the ethical guidelines of not negotiating what my next position, wherever that may be in a university or in a foundation or whatever, until I actually step down. Otherwise, there could be considerations of conflict of interest and things like that. I want to stay completely away from that. So I've done none of that. When I step down at the end of the year, then I'll start entertaining venues in which I'm going to operate. I know what I want to do, but the venue and what I want to do it, I don't know what that is. I want to continue to write and to lecture and utilize what I will have outside of a government position. What do I have? I have 54 years of experience as a scientist at the NIH. I have 38 years of experience leading the largest and most important infectious disease research institution in the world, and I've had the privilege of advising seven presidents, I could use that experience, that know how, that judgment, to help others to write about it to, to lecture about it and perhaps, to encourage at a time of anti-science, the best and the brightest among the young to at least consider a career in science and public health and importantly, in public service. If I can do that, after I step down, I think that'll be, you know, something that I would be pleased with.
MARGARET BRENNAN: Dr. Fauci, thank you for your time today, and we'll be right back.