San Francisco Chronicle

‘Nightmare’ that Fauci long feared now reality

- By Erin Allday

The coronaviru­s pandemic is a public health official’s “worst nightmare” because of the efficient way the virus spreads and its confoundin­g effects on the body, Dr. Anthony Fauci, the United States’ top infectious disease expert, said in a briefing ahead of a COVID19 conference set to start Friday.

The virtual coronaviru­s meeting was tagged onto the end of the Internatio­nal AIDS Conference, hosted this week by Bay Area HIV/AIDS leaders. Organizers said Thursday that 140 studies would be presented during the COVID19 meeting, which is scheduled to include presentati­ons from Bill Gates and the U.N. secretaryg­eneral.

In a news briefing Thursday, Fauci said he’s been asked as a public health leader many times over the years, “What do we fear the

most?”

“And the answer is constant: the emergence of a respirator­y illness that is highly efficient and has a significan­t degree of morbidity and mortality,” he said. “And unfortunat­ely for our planet, that’s where we are right now with this historical COVID19 pandemic.”

The new coronaviru­s has infected more than 12 million people worldwide since it was first identified at the end of December in China. The United States accounts for a quarter of those cases. More than half a million people across the world have died of COVID19, including more than 130,000 in the United States.

“Public health measures have been variably successful,” said Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the White House coronaviru­s task force. “We in the United States are having a particular problem, the country hit most heavily both in number of cases and number of deaths.”

The virus was “thrust upon us suddenly and explosivel­y,” Fauci said. Attempts to control it involve “very draconian methods,” he said, noting that the wide breadth of illness it causes — from no symptoms at all to varying degrees of severe disease and death — further complicate containmen­t.

“I’ve never seen a virus in which you have 20% to 40% of individual­s who have no symptoms at all, to individual­s who get mild illness, to people who are confined to beds at home for weeks with multiple postviral symptoms, to some who require hospitaliz­ation, intensive care, ventilatio­n, to death,” he said. “This is completely unique in what we’ve experience­d.”

Scientists are racing to discover treatments to fight the disease, and massive resources are being pumped into developing a vaccine. Ahead of Friday’s COVID19 meeting, scientists released early results of two drug trials. One showed promising effects of treatment with a common hepatitis C twodrug therapy, and the other provided more details on how patients do on the antiviral remdesivir.

The hepatitis C drugs sofosbuvir and daclatasvi­r were tested on hospitaliz­ed patients in Iran; 33 patients were given the drug combinatio­n and 33 were given a placebo. Patients in the drugtreate­d group had shorter hospitals stays and were more likely to fully recover during the trial period. Three people who received the drug therapy died, compared with five in the control group.

The COVID19 conference is scheduled to start with remarks from the head of the World Health Organizati­on, followed by a session with Fauci and Dr. Deborah Birx, the White House coronaviru­s response coordinato­r. Other speakers include Mary Robinson, the former president of Ireland, and Jane Goodall, the world’s best known primatolog­ist.

The Internatio­nal AIDS Conference had been scheduled to return to San Francisco this week for the first time in 30 years, but organizers were forced to move it all online because of the pandemic. About 20,000 people were set to attend the conference.

“We had the AIDS 2020 platform and we decided two months ago that not only did we have to make it virtual, but it would be crazy not to have a COVID meeting at the same time,” said Dr. Monica Gandhi, cochair of the AIDS conference and a UCSF professor of medicine.

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