A Few Words from Dr. Anthony Fauci

jeastridge, BSN, RN

A Few Words from Dr. Anthony Fauci

Dr. Fauci is a world-renowned physician. As the head of the National Institute of Allergy and Infectious Diseases, he is an expert on the COVID-19 pandemic. He has served the American public for over 50 years, working with the National Institutes of Health. He was recently named Honorary Fellow of the American Academy of Nursing. “This distinction is only given to top health leaders who have demonstrated a firm commitment to nursing and to transforming health policy.” (American Academy of Nursing, August 2020)

This week, he was interviewed for the American Medical Informatics Association’s (AMIA) annual meeting which took place online. He was interviewed by the head of the National Library of Medicine, Dr. Patricia Flatley Brennan, and the AMIA President, Dr. Eneida Mendonca.

Here are some of the comments excerpted from the interview:

(Not verbatim quotes)

1. What stands out to you about COVID-19?

This outbreak is like none other. Our country and the world has been threatened by several pandemics: 1918, 1957, 1968, 2009, Ebola, Zika. Pandemics happen. But no other virus has behaved like this one. 40% of those who contract it are asymptomatic. Of those with symptoms, 80% recover without medical intervention. But then there are the 15-20% who get sick enough to need treatment and some die. We simply need more data to understand this disease better.

It is important that we follow those who have been sick long term so that we understand the long-term effects of COVID-19. Why is it that some people stay sick for a long time? We need to know more about that and pursue an understanding of the pathophysiology of how the virus affects the human body. It might be that a registry will help us follow patients better long term.

2. What do we need to teach medical professionals that are coming up?

- Be prepared. Pandemics happen.

- Preparation keeps us from chasing after a pandemic which is generally not a good formula for success.

- We need to work to understand the role of science in public health. Science will ultimately help us get out by helping us understand the pathophysiology and by discovering a vaccine.

- Teach science as early as you can. For those who have the inclination, it is so exciting to study science that it is almost love at first sight. Maybe learning science early is like learning a second language early, If young people are so inclined, they get smitten.

3. How do you do research during a pandemic?

We must continue to do research because we have to be careful to do more good than harm. Research and double-blind, case-controlled studies can protect us all. Randomized case-controlled trials are the ethically sound way to get to answers.

When we first heard about COVID-19, it was January 9, 2020. On January 10, we talked with Moderna and now they have the vaccine that is 94% effective. We are very happy about that. We would have been happy with 75% but we got 94%! Ten years ago, it would have taken 3 years to get a vaccine. But because of the technology and research we were already doing, that was already in place, we were able to come out with a vaccine so quickly. Genomic epidemiology helped us trace the origin of the virus that hit New York back to Europe and Italy. Because of science, we knew where to focus our efforts.

4. What are some challenges that we face?

We need to rebuild our public health system.

We need to strengthen the global health surveillance systems that are interconnected and transparent to the world. One thing is for sure: microbes will emerge. 75% of those that afflict humans are zoonotic ( transmitted to humans from animals). We cannot prevent that but we can be ready.

5. How do we combat the mistrust of science?

We must be:

Transparent
Consistent
Honest—like apple pie and motherhood.

What is harmful is something called “false equivalencies.” For example, back when we were working on HIV, a group of scientists and Berkeley came out saying that AIDS was not caused by HIV but by behavior. Because they had credentials, it sounded like they knew what they were talking about but they were wrong. We were speaking the truth. People hearing both sides in the news were confused. This is hard.

6. How do we help people understand the safety and efficacy of the vaccine?

This is an important point. The public needs to understand that the system to approve vaccines cannot be manipulated by business. It is impossible. The data are analyzed independently. It is not beholden to ANYONE. Statisticians look at it and either stop or declare it effective. It is really important to understand that there is no way for a company to manipulate this part of the process. There is also an advisory committee to the FDA. After that all the data is open to the public so that scientists can examine it. The idea that we can “sneak” something through is an impossibility.

The speed did not compromise reliability. It reflects the new technology and the amount of money we put into it. We were doing things in parallel as opposed to sequentially. Normally, you prove it works before you produce. In this case, we took a financial risk and vaccines started production while still in the process of approval. This is because, as a society, we decided it was important enough to do it this way.

7. What are the take-home messages?

- Wear a mask. Do the common sense things to protect yourself and others.

- Wash your hands, stay at a safe distance, don’t gather in groups.

- Skip large groupings this year. We have exciting, impressive vaccine data. Help is on the way but the cavalry is not here yet. We need to take this knowledge and let it motivate us to stay the course. This is not the time for people to travel to large family gatherings. This is a tough time.

- Small gatherings this year so 2021 will be a great year!

Help is on the way but the cavalry is not here yet. Anthony Fauci