EXCLUSIVE: Fauci Has 'Considerable Concern' People Won't Trust Coronavirus Vaccine

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testifies at a hearing of the U.S. House Committee on Energy and Commerce on Capitol Hill on June 23, 2020 in Washington, DC.
Photo credit Kevin Dietsch/Getty Images
By KCBS All News 106.9FM and 740AM

The coronavirus pandemic continues to rage across California and the nation, with the caseload climbing and reopening put on hold in many states.

Here in California, Gov. Gavin Newsom said people largely obeyed the social distancing and mask regulations over the Fourth of July weekend, but the virus is still spreading, with more counties ordered to pull back on reopening Monday.

For more, we spoke about the coronavirus pandemic with Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the NIH, and perhaps the most visible member of President Donald Trump’s Coronavirus Task Force. He joined us live on KCBS Radio’s "The State Of California."

Is the current spike in cases due to community transmission or something else?

Yes. I’m not alone in this. If you look at the situation on how the cases are rising, it isn’t the kind of thing we saw when they were quite focused, traceable increases at the community level. If you look at what’s gone on, Texas, California, Arizona and Florida are accounting for 55% of all the new cases that we’re seeing over the last couple days. It’s really focused in certain states, and it’s almost certainly predominant of community spread, which makes it all the more problematic. It’s much more difficult to do contact tracing, isolation, when you have community spread that is driven in part by people who are asymptomatic. That’s the real issue that we have here, which is obviously very frustrating and, in many respects, very alarming.

The surge seemed to catch everyone off-guard. Where were the models off?

It’s something that’s painful for me to keep reminding is that models are only as good as the assumptions that you put into the model. When the assumptions change and you get them a bit wrong, it can have a real negative effect on the accuracy that you’re projecting. Obviously, what we’ve seen, and you don’t want to have blame on this or pointing fingers. It is what it is. Even when the direction from above, the governors and the mayors, people on their own feel it’s either an all or none phenomenon. I think we need to get away from that and pause and start to really reflect on it. The best tool to a safe opening where we’re seeing resurgence is, and that's really unfortunate. I think you've got to use the public health measures. That's kind of the gateway and the vehicle open up in a prudent way. But when states try to open and California is not alone in this something, it certainly is not a soul California issue. We're seeing the same thing in Florida, the same thing in Arizona, the same thing in Texas. We have to regroup and take a look at why we need to be quite prudent and careful as we do a step by step approach towards opening.

How does the fact this has become so politically charged present a challenge for you?

Yeah, I mean, obviously, it is a challenge. I mean, we try to the best of our ability to get out there. I do, at least spending a lot of time trying to get the facts and the data and the evidence to the American people so that they can see that what we're talking about really does make sense from a public health standpoint. Some of the things that we've got to continue to emphasize is that no matter where you are, at what stage you are in opening the issues that are pretty simple the physical distancing, the avoiding crowds, the six feet distancing the wearing masks at all times. You know outdoors is always better than indoors. You know, when one of the things you risk when you have people congregate in homes or in restaurants with the circulation, which is clearly a contribution to the way viruses are spread. These are the things we've got to be careful of. Yes, it is very frustrating, but we have to try and keep getting the message out.

Is it a mistake to try to have Major League Baseball play a shortened season?

First of all, they are trying to do this with the safety of the players involved. So, this is something that the management of Major League Baseball is struggling with. You know, the situation of creating a bubble where you test everybody and you keep them protected and sequestered from the possibility of exposure inadvertently, particularly from people who are without symptoms. And you continue to monitor them and do surveillance on a regular basis. It could be done. It's tricky, you know. It is tricky. They have come to me and to other health officials to get advice. We give them the facts and they're gonna have to make up their own mind in their own decision of whether this is going to be doable or not. It looks like right now it is on the track of doing the kind of shortened and abbreviated season that they're aiming for. I mean, I hope that they do it and they do it successfully.

Is the advice the same across the board for all sports trying to restart?

Well, you know, there are some common denominators that are the same, but there are some things that are different by the very nature of the sport. I mean, something you could not possibly get a more contact sport than football where literally, on every single play, there’s contact. So that therefore you really got to monitor the play very, very closely and carefully, because that could spread very easily if someone is infected and doesn't realize they're infected. But the whole idea of doing some form of a lockdown where the players are tested very regularly and then you have to ask the questions. It's looking at it from the perspective of the players and those around the players of the managers and those who do the services with the players. What about spectators? That's the other aspect of it. Do you want to have a sport that is only being seen on television? Or do you want to have spectators that are essentially diminished in their numbers so that you could have the proper and safe spacing. All of these things being considered. And they differ from sport to sport, whether you are outdoors, in a stadium or indoors in an arena, such as with basketball games. You know, it gets very complicated as I mentioned, with some common denominators and some commonalities. But other things that are different because it's specific for the given sport that you're talking about.

How does the dynamic of the response change as the average age of those who are confirmed with infections gets lower?

Well, it changes the dynamics because what it (was) back when things were really on fire, particularly in the Northeast, you know, significantly different from what you all have in California. But when that was happening, it was, you know, outbreaks in nursing homes, people of multiple ages, particularly some of the elderly getting infected right now, what you see, you see younger people getting infected as we mentioned the decade and a decade and a half younger, which means that likelihood of they immediately getting ill enough to be quiet hospitalizations is much less likely. We still get young people otherwise healthy, who are getting seriously ill. They're not completely, you know, protected from that. But when you get young people who are getting infected, you may need to see a couple of generations of infections before you get to the vulnerable people. So, assume you have a fundamentally young group at a ball or at a gathering. They could get infected so the numbers of infections go up. What's gonna lag is the hospitalizations and then with the hospitalizations would lag the deaths. So, right now we're seeing a surge of infections. But you know, when you look at the data and examine it carefully, I mean, I'll give you some examples. Like in Texas. We just went over this. I just got back from the White House when we went over the numbers, you know, like, for example, in Texas. In Austin, they were hospitalizations were up 300% and the ICUs were up 270%. So, it isn't without serious illness that some of these people are getting infected. And I guess the question is, we always say protect the vulnerable and the vulnerable are the senior citizens and those of any age who have underlying conditions that predispose them to a serious outcome. and we know what they are. You know, heart disease, hypertension, diabetes, things like that. Ultimately, if those people wind up getting infected as the second or third generation from the initial young people that get infected, then we're gonna have a serious problem again with a degree of morbidity and mortality that we hope does not happen. When you have a young person getting infected, they think it's inconsequential to them because the likelihood that they're not going to be bothered by this, which is true. The fact is. They’re part of the process of the propagation of the outbreak because, innocently and inadvertently, they may be infecting someone else who is vulnerable to the more morbid and more at risk of fatal outcome.

Is it safe to be back at school this fall?

This is a very difficult situation, because we should. We have to try always with safety being paramount in our minds as best as possible to get the schools open again. And the reason is that the unintended secondary consequences of closing schools and then what happens to the children. What happens to the parents, who now have no one to take care of the children? It's a ripple effect that, you know, sometimes you have to just, you know, bite the bullet and bare it. But to the best of our attempts, we should I to get the schools open, not carelessly in the sense of putting anybody at any severe danger. But the question you're talking about really relates to what the level of viral activity is in the school district that you are, and that really varies, particularly state as large as California, where you may have certain counties where there's very little infection activity and if they have very little impact on the schools. But there may be some counties where the activity of virus is such that you might want to pause and think about is there any modification of the school schedule that you're thinking of? I mean, you're right. One of my daughters is a school teacher. She is not in California. She's in New Orleans and they're struggling with same thing that you're saying the safety of the students. What about the teachers? The teachers, some of whom are vulnerable because of age or because of underlying conditions? This is going to get complicated as we approach the school year beginning.

In Texas, 1,300 people tested positive related to hundreds of childcare facilities. Now, most of them were workers. But, there were significant amounts who were kids? How concerned are you about that?

I am concerned about that because any time you have a situation when you have a, you know, a propagation of infection above the ordinary, just, you know, intermittent infections that you might see in a community when you have a focus of a physical location, but you can have the spread of infection. You've got to be very concerned about that. There's ripple effects. Either way, you keep the kids out of school. They either go home. The parents need to stay home with about the childcare centers. It gets very complicated, which gets back down to what we said in an earlier part of the interview. We've all got to take great seriously what we, as individuals can do to stop the spread of infection by essentially adhering to some fundamental public health approaches of the things that we keep talking about over and over again. The physical distancing, washing of hands, wearing a mask. That goes a long way to solve a lot of the problems we're talking about right now.

When will we see a vaccine on the market and available to Americans?

I think what people need to appreciate and understand is that there is never a guarantee that you're gonna have a safe and effective vaccine. I mean, that's just the way vaccine and vaccine development is. However, the early preliminary studies both in animals and in the phase one study in humans of multiple, different candidates. Now remember, there's not just one vaccine that's being developed, you know, here in the United States, there's almost half a dozen at least that are being developed now at various stages of development. If things go the way we hope they do without any glitches. As we proceed from Phase One study, there's vaccines and Phase Two studies. One of the candidates is going to go into what's called Phase Three, namely trying to determine if it's effective or not somewhere at the end of this month of July and another will come in at the end of August and then as we get into September. If all goes well and we do get one that's effective, we should know that it is or is not, and hopefully it will be effective some time by the end of this calendar year, the beginning of 2021. So that's something that we have an aspirational hope for, that there will be a least one candidate. Then after that, maybe and hopefully one or more others. So that as we get into the end of this year and 2021 that the companies that are developing these vaccines with government subsidizing starting to already produce doses that would be used if in fact, the vaccine turns out to be effective so you could get a head start on it so that hopefully, if everything works out all right, that sometime by the end of the year in the beginning of 2021 we’ll have some doses that available. And as we get into 2021 the companies promised that many of them would have hundreds of millions of doses available as we go through 2021. That's all predicated on the fact that was successful in getting a safe and effective vaccine of which I mentioned. There's some cautious optimism about that, but there's never a guarantee which gets us back to what we all left with and will always have is good public health measures, which we need to really focus on and concentrate on.

How concerned are you that when there is a vaccine that a significant percentage of people won't trust it and will refuse to get the shot?

Yeah, well, that's a great question. It is a new area of considerable concern on my part as well as the part of my public health colleagues. So, the way we can hopefully get around that and mitigate that really issue of a push back on the part of a certain segment of our society. You know, it's kind of an anti-authoritative of feeling and anti-science feeling and an anti-government feeling. Whatever you wanna call it, there is a certain segment of society that's very skeptical about vaccines that are being recommended. The way we're already starting to get around that is, you've got to do a very strong effort in what we call community engagement. Get the community involved and meet with them at the level that they trust to get community workers to go out there with us and explain the facts about why it's important to get vaccinated. You know, we have a very strong network throughout the country of commitment and community program that we’ve linked to the now decades-old work that we've done in the treatment and prevention of HIV, and we're gonna leverage some of those assets that were so successful in getting the community involved in the kinds of clinical trials and treatments and preventions that we've done for so many years with HIV. Among other things, we've got engage the minority community because it is very important to get the minority community, African American, Latin and Native Americans to get the vaccine because, as a matter of fact, they on the basis of the morbidity that they have, they are much more likely to have a serious negative outcome where they get infected with this coronavirus. Therefore, it's very important that we protect them with a vaccine, but we've got to convince them that the vaccine is for their benefit and get vaccinated, as opposed to being skeptical and shying away from the vaccine trials.

How concerned are you about whether, in fact, that vaccine will be affordable to everybody and it would be available? How do you go about prioritizing who gets it?

Well, that's a very good point. We are putting together under the auspices of not only our own trialist, but the National Academy of Medicine, to help us to get ethicists together, to get trialist community representatives to work out a way that when the vaccine becomes available and it's not gonna become available all at once, that the people get it who are the highest priority who would need it. And those are predominantly the people who are most vulnerable to the to the negative consequences of getting infected. We know those people are people who are elderly people who have underlying conditions, also health care workers who are going to be putting themselves on the line every day at risk to take care of people who are infected, so the prioritization will be done with all the appropriate ethical considerations.

If the pandemic continues on its present trajectory in California, the way it's been in other places where it's rising Florida, Arizona, Texas and keep spreading like this, what do we do next? Do we go back to sheltering in place? Do we revoke all of the reopening?

Yeah, we hope we don't have to go to a complete lock down again for a number of reasons, because I think that would be, you know, the morale of people would be really very, very clearly negatively impacted by that. It is possible that that may have to come about. But what you're starting to see now in the states that you just mentioned and perhaps even in other states that are now becoming more vulnerable about approaching the kind of thing we're seeing in the states that are being hardest hit is not necessarily a lockdown, but but now being mandated, like mandating masks, closing bars, not allowing congregations of more than a certain number of people before it was left to the discretion of the local leaders to do that. But right now, what we're seeing in several of these states, you've got the governors and the mayors are seeing that it's a serious enough problem that they're now mandating things, as opposed to saying that the discretionary.

How do we best navigate this pandemic as it continues over several weeks and months?

I think one of the things that we need to emphasize more is that we will get through this. This will end. What we want to avoid is people throwing up their hands and saying, well, you know, this is just going to go on and on, and I'm just going to throw caution to the wind, because who cares? That would be very dangerous. We're all in this together. I mean, that's something that sometimes when you as an individual, you kind of think you're operating in a vacuum. We're all interconnected by protecting ourselves. We're protecting society and by society, protecting itself, that protecting us, we're going to get through this. This will end. It will end from public health measures and the science will help us get there with treatments and vaccines. We've just gotta hang in there and just realize that we will get successfully through this. It's gonna take a while. It's not gonna be tomorrow. It's not gonna just disappear. It's gonna be controlled. But we're gonna have to be part of the solution, not part of the problem.

Hear "The State Of California" weekdays at 3:30 p.m. on KCBS Radio.