Dr. Fauci: Well, I think it’s important for our keeping – emphasizing that with all of the suffering and pain that we’ve gone through that the investments in basic and clinical biomedical research over decades, which is difficult to understand if you’re not in the field that investments that were made 20, 10, five years ago eventuated into our ability to respond from a scientific and then, ultimately, translated into a public health standpoint, an intervention that, as bad as things have occurred and what we’ve experienced, they would have been much, much worse had it not been for the unprecedented speed with which science was translated into an actionable intervention in the form of highly effective vaccines to prevent predominantly severe disease.
We need to make sure that in the realm of the complexity of this outbreak, from a public health standpoint, from a policy standpoint, from a scientific standpoint, the one thing that does stand out as a really unprecedented success story is how science has added to our capability in a very, very big way to address this outbreak. And even though it’s been terrible from the standpoint of the toll of human suffering and death both in the United States and globally, it clearly would have been much, much worse had it not been for what science has brought to the table.
Having said that in one breath, we still must be aware of how unusual this virus is and continues to be in its ability to evolve into new variants which defy the standard public health mechanisms of addressing an outbreak where you would expect it that once a certain number of people get infected and/or get vaccinated that you could, essentially, bring an end to the pandemic component of the outbreak.
And we’ve experienced at least five, and, Steve, there will be more, variants. How we respond and how we’re prepared for the evolution of these variants is going to depend on us, and that gets to the other conflicting aspect of this is the lack of a uniform acceptance of the interventions that are available to us in this country where even now, more than two years, close to three years, into the outbreak we have only 67 percent of our population vaccinated and only one-half of those have received a single boost.
Now, for sure the intensity of the outbreak now – even though it is, I believe, unacceptably high, where we’re having 400 deaths per day – when you compare it to the fulminant stages we’ve experienced over the past year or so where we used to have 800(,000) to 900,000 cases per day and over 3,000 deaths per day, we are much better off now for a number of reasons that you mentioned. But we are not where we need to be if we’re going to be able to, quote, “live with the virus” because we know we’re not going to eradicate it. We only did that with one virus, which is smallpox, and that was very different because smallpox doesn’t change from year to year, or decade to decade, or even from century to century. And we have vaccines and infection that imparts immunity that lasts for decades and possibly lifetime.
So, the next question we ask, are we going to be able to eliminate it from our country or from most of the world? And the answer is unlikely because it is highly transmissible, and the immunity that’s induced by vaccine or infection is also transient. And instead of lasting for decades and a lifetime the way it does with measles and polio, immunity – as we know from painful experience – wanes after several months requiring us to give boosters to maintain the durability and the extent of protection.
So, we’re dealing with a very, very complicated situation. The ultimate goal would be – as I mentioned, we’re not going to eradicate it; it’s unlikely we’re going to eliminate it – that we get to a level of control that’s low enough that it doesn’t disrupt our social order and essentially dominate what happens in society. We’re heading in that direction, but we must be aware that it is likely, Steve, that with the combination of the evolution of variants as well as the seasonal aspects that as we get into this coming late fall and winter, it is likely that we will see another variant emerge. And there’s already on the horizon one that looks suspicious that it might start to evolve as another variant, and that’s the BA.2.75.2.
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