Fauci expects threat will stay through 2021
The COVID-19 pandemic could worsen in the winter and continue to be a looming threat through much of 2021.
That is the forecast of Dr. Anthony Fauci, the federal government’s top infectious diseases expert, in a wide-ranging discussion about the pandemic that he delivered this week to the Berkeley Forum.
Fauci warned that a sense of normality post-coronavirus may not come to the U.S. until late 2021, adding that the arrival of a vaccine will not suddenly bring the U. S. lurching back. Rather, it’ll be a gradual transition over a long period of time.
Fauci offered analysis at the Thursday forum about where we stand on the pandemic — from the importance of masks to the mistakes made by colleges, the dangers of internet disinformation and the grim toll COVID-19 is taking on nonwhite communities.
Protections needed
The U.S. faces two problems — the vaccine won’t be 99% effective and a substantial proportion of Americans have indicated they will not take the inoculation.
“So let’s say you have a 75% effective vaccine, and 65% to 80% of the people want to get vaccinated: You still have a lot of people in society ... that are vulnerable to be infected,” Fauci said. That means “we’re going to softly go into a graded degree of normality.”
In this new normal, more types of businesses will be able to reopen. But some pandemic protections may still be needed for a longer period than others.
“Will people have to wear masks? Yes, likely,” Fauci said. “I would imagine that if we get a good vaccine now, thatwe could have some degree of normality in the third quarter to the fourth quarter of 2021.
“I think ultimately, we will get back to normality as we knew it before this. But ... it’s going to be a gradual process, in which the restrictions on things _ restaurant numbers, theater attendance, spectators at sports (events) _ all of that will come back gradually. But it will come back.”
Tough winter
At the moment, the U. S. is still diagnosing about 40,000 new infections of the coronavirus daily — “which is unacceptably high,” Fauci said, as the nation moves into the cooler seasons.
“We’ve got to get that down or otherwise, we’re going to have a very tough winter in the next few months,” Fauci said.
Limited Immunity
Unlike measles, which typically confers lifelong immunity after infection or a vaccination, scientists don’t expect that a coronavirus infection or inoculation will confer immunity that will last for decades.
There are now about eight or nine cases of reinfection that have been reported, Fauci said. “The protection doesn’t last decades and decades. It lasts more (like) many months to a year or two.”
That means even after a vaccine becomes available, a booster shot may need to be required to keep people protected, similar to how people need booster shots to protect against tetanus.
Conspiracy theories
Fauci lamented the role of social media in disseminating false statements about the pandemic.
“Social media ... is an extraordinary way to disseminate information quickly and widely,” Fauci said. But, he added, “when disinformation gets in there, it has a way of self-propagating itself to the point where you don’t know what’s true.”
Some of the dangerous falsehoods include the idea that the pandemic is trivial, even though it is in fact the worst pandemic in more than a century.
More than 212,000 people in the U. S. have died from COVID-19, a number nearly equal to the number of deaths from the last six flu seasons.
“How can it be a trivial outbreak if it’s already killed 210,000 people in the United States and a million people worldwide?” Fauci asked. “But there are people out there that think all of this is a big conspiracy.”
Need for masks
At the Berkeley Forum, Fauci explained that federal officials’ initial comments in February that the public need not wear masks was based on the circumstances at that time: a nationwide shortage of masks and a fear that recommending mask use for the public would worsen the supply of masks for the nation’s first responders, nurses, doctors and other essential workers.
“They were also not recommended because there was not yet enough data to indicate that masks were actually quite effective in preventing the acquisition and transmission of infection,” Fauci said.
Then it became clear that for the public, cloth masks “were just as good as the surgical mask” in interrupting transmission and acquisition of the coronavirus, Fauci said.
It also became clear that about 40% to 50% of all infected people have no symptoms at all. Thatmade it especially important to call for universal masking, as people were spreading the virus even though they had no idea they were infected and contagious.
Cavalier behavior
Fauci said he’s never seen a disease like COVID-19 with such a wide range of clinical outcomes. And the sense of relative safety for some people, such as young adults with no underlying medical conditions, is making it hard to control the pandemic in the U.S.
What they may not realize is that they, in getting infected, may pass it along to vulnerable people who may die from COVID-19. “The extraordinary range that this disease has,” Fauci said, “makes it very confusing.”
College mistakes
Some colleges nationwide havemade what Fauci called dramatic mistakes in inviting students to return to campus, and then when an outbreak happens, sending students all back home, which then seeds the virus in their hometowns.
A tactic that some colleges are taking is to test all students before they come back to living on campus dorms and then conduct surveillance testing every few days, Fauci said.
Colleges should then be able to isolate the sick until they recover, such as on a reserved dorm floor or separate dorm building exclusively for infected students.
“When they get infected, don’t send them home,” Fauci said. “Keep them there, keep them comfortable. When they recover, get them back to class.”
Nonwhite people
In the U. S., residents who are Black, Latino, Native American, Alaskan Native and Pacific Islander have been disproportionately hit hard by COVID-19, Fauci said.
They are more likely to have jobs where they can’t work from home — and are at higher risk for infection — and also have a higher chance of having a chronic or long-term health problem that make them more likely to suffer a worse outcome from COVID-19.
“What the government could do now, and what the population of our country could do, is to realize that COVID-19 is shedding a very bright light on the social determinants of health ... that is, in essence, killing minorities in the context of COVID-19,” Fauci said.
“So what I would hope that the terrible experience that we’re going through now galvanizes and energizes us tomake a decadeslong commitment to doing things about these social determinants of health,” Fauci said.
Health care
Despite the Affordable Care Act signed into law by President Barack Obama in 2010, there remain 11% of people in the U.S. under the age of 65 that gowithout health insurance, according to an estimate from 2018. That translates to more than 30 million people.
Fauci said the nation needs universal health care, which would have helped the country fight the pandemic.
“We have a system in the United States in which a number of people fall between the cracks,” Fauci said. “We’ve got tomake sure that we have a healthcare system where no one can go without necessary health care and quality health care.”
Vaccine critics
Public health experts have long expressed alarm about so- called anti-vaxxers — people opposed to vaccinations who make false statements about vaccine safety.
Fauci said there’s a hardcore group of anti-vaxxers “who, no matter what you do, you’re not going to change their mind.”
But there’s also another group of people who are against vaccines because, Fauci said, “they’ve absorbed misinformation.” Fauci said people should not “denigrate, accuse or disrespect people who don’t want to get vaccinated if you feel you want to convince them to change their minds.”
“If you could, in a way that’s (nonconfrontational), give them the correct information, you may be able to win them over,” Fauci said.