Read the full heart-to-heart and screen-to-screen chat with Dr. Anthony Fauci below:
Stephen Curry: Dr. Fauci!
Dr. Fauci: Hey Steph!
How are you doing?
I'm good. How are you?
Very good. Sorry for the technical difficulties but I’m glad I got connected with you -- and I like that background too! I appreciate you coming on. I know you are a busy man. Obviously, this time there's a sense of urgency with everything that you're doing. One, I appreciate your commitment to protecting the masses and bringing all your expertise and knowledge of how this virus spreads and informing the people how we should take this seriously. I just want to thank you for your commitment to that because we all know how important it is for all of us to be in the know, to have the right information and be able to act accordingly so thank you for your time, hopping on with me.
I put out the request yesterday - everybody knew that I was gonna be talking to you. I tried to compile as many questions as possible from all of my followers, everybody who wanted to ask you questions directly. We’ll kinda see how that conversation goes and just would love your sound advice.
FLU VS. CORONAVIRUS
I’ll start with a pretty simple one. How is COVID-19 different from the flu in terms of how it interacts with the body and just how it spreads?
It’s similar in some respects, Steph, in that it's a respiratory illness that's transmitted by the respiratory root. It gives a degree of pathology that's mostly pneumonia. The reason it’s different is that it’s very very much more transmissible than flu and more importantly, it’s significantly more serious. Let me give you some very quick numbers: The overall mortality of seasonal flu that you and I confront every year is about 0.1%. The overall mortality of coronavirus is about 1%. Sometimes, like in China, it was up to 2-3%. Which means it's at least ten times more serious than the typical influenza. When people compare it, in some respects, it has some similarities, but it’s really really different in its degree of seriousness.
AGE AND COVID-19
I've been hearing rumors/numbers around. When it showed up in China to other different countries, the discrepancy among ages and how it affects. If you have underlying health conditions or if you're a little older -- that it affects you a little bit more seriously. Has that shown differently here in the states in terms of different age brackets, severity, cases of death vs. intensive care units -- all those types of things?
Mostly the same but with some interesting, maybe disturbing, differences. If you look at China, you look at Europe, you look at South Korea it predominantly is reasonably benign -- if you want to call it that. You get sick but you don’t get into serious trouble if you’re young.
Very heavily weighted towards the elderly and those with underlying conditions - heart disease, lung disease, diabetes, kidney disease -- those are the people who have a higher degree of mortality. We know that for sure we're seeing that a lot now in the United States. But what we are starting to see is that there are some people who are younger -- people your age -- young, healthy, vigorous who don't have any underlying conditions, who are getting seriously ill.
It’s still a very very small minority but it doesn't mean that young people like yourself should say I'm completely exempt from any risk of getting seriously ill. That’s the reason why when we talk about being careful of physical distancing, doing the kind of social separation, it means not only for the elderly, but the young people have to do it do too, for two reasons. One, you need to protect yourself because you are not completely exempt from serious illness. Two, you can become the vector or the carrier of infection -- where you get infected, you feel well and then you inadvertently and innocently pass it on to you grandfather or your grandmother or uncle who's on chemotherapy for cancer. That’s what we gotta be careful of.
That’s one of the reasons that I wanted to have this Q&A and hopefully reach a different demographic of people that are interested in the facts of what's going on. Because you see all the different visuals of people at the beach at parks like in crazy public gatherings and not really adhering to that social distancing kind of concept.
The sense of urgency of what you just said of how that can continue the spread of the virus, but affect people unknowingly, even in their own families. It might show up a little different or lead to some drastic and dire situation that they don’t want to find themselves or anybody in their family in.
You’re absolutely correct. We really do have a responsibility to protect the vulnerable ones. The vulnerables are the elderly and those with underlying conditions. We've gotta make sure they are clearly protected from this which could be very serious for them.
LARGE GATHERINGS AGAIN - WHEN?
We’re going into week 3 since the NBA has been shut down, in terms of postponing the season. Obviously, the Olympics just announced moving to next year to do their part in terms of keeping large gatherings from happening. My question is what needs to happen in terms of the numbers? What metric are you looking at to be able to then determine at mass, that large gatherings, sporting events, those types of things are okay to revisit as not a threat to continue the spread or the virus?
That’s a great question, Steph. That's what we deal with on a daily basis when we sit down in the Situation Room with The White House every day to go over that. What you need is to see the trajectory of the curve start to come down.
We've seen that in China -- they went up and down. They're starting to get back to some normal life. They've gotta be careful they don't reintroduce the virus into China, but they're on the other end of the curve. Korea is doing that. They're starting to come back down. Europe, particularly Italy, is in a terrible situation. They're still going way up.
The United States is a big country. We have so many different regions. New York City, right now, is having a terrible time. Yet there are places in the country that are doing really quite well. You can probably identify people, contact trace and get them out of circulation. Whereas in New York City, it’s doing what's called mitigation, trying to prevent as best you can the spread.
So in direct answer to your question, we could start thinking of getting back to some degree of normality when the county, as a whole, has turned that corner and start coming down. Then, you can pinpoint cases much more easily than getting overwhelmed by cases -- which is what’s going on in New York City.
COVID-19 TEST ACCESSIBILITY
Testing is becoming more accessible than it was three weeks ago. I know that there's different efforts in different parts of the country that are trying to address that issue.
I myself, I had flu-like symptoms two days before the NBA shut down and I got a test pretty much right away. I know that there is a conversation now about the overall accessibility of tests and how those are starting to roll out in different parts of the country.
What's your assessment of that process? How important is that process whether you have symptoms or whether you don't? When it comes to dealing with each individual case, how are we addressing the testing issue?
Great question. That’s been a real issue early on. Several weeks ago, we were not in a place where we needed to be or wanted to be. We did not have as much accessibility of testing as we now have -- and that we will have going forward. Right now, there are literally hundreds of thousands of tests that are out there, mostly because we got the private sector involved. The companies who know how to make it -- and make it well -- make large amounts. We're going very much in the right direction.
In specific answer to your question, you did the right thing. If someone right now gets flu-like symptoms -- a fever, aches and a and bit of a cough -- the first thing you do is stay at home. Don't go to an emergency room because then you might be infecting others. Get on the phone with a physician, a nurse or a healthcare provider. Get instructions from them -- what to do and if available, you can get a test.
But the critical issue is don’t flood the emergency rooms. Stay at home. If you are seriously ill, then you gotta go quickly there -- but if you just have aches pains and a fever, stay where you are but contact your physician.
THE RECOVERY PROCESS AND HERD IMMUNITY
People really want to know -- if you contract the virus, you quarantine yourself, you go through the recovery process and then the symptoms either wane -- or sometimes you might not have symptoms. The virus kind of passes through -- what does it mean to be recovered and can you get the virus a second time?
And if yes or no, does that influence how testing goes in the future? In terms of trying to detect an antibody or even address that conversation around herd immunity? And how to really not let this be a cyclical thing -- or is it a cyclical thing in terms of what to expect in the future?
Ok, Steph, you had three or four or five questions. Let me get to the first one which was also important. So if you're infected and you recover, the question is when can you go out and be safe to not infect others? The general rule is you have to have two cultures, 24 hours apart, that are negative.
As more people get infected, that likely is not gonna be feasible so we're going to have to set up some guidelines up days following the diminution of symptoms. We’re not there yet because we don't know as much about how far out you could be shedding the virus -- first thing.
Second thing, your main question once you get infected can you get reinfected? We haven’t done the specific testing to determine that, but if this acts like every virus similar to it that we know -- the chances are overwhelming that if you get infected, recover from infection -- that you are not going to get infected with the same virus which means you can then safely go out into the community and feel immune. You can not only protect yourself, get back to work, get back to your job -- but you'll be able to have what you referred to as herd immunity. Enough people who have recovered in the community that gives the virus very little chance to spread rapidly -- that's what's referred to as herd immunity.
COVID-19 IN WARMER WEATHER
In terms of timeline that we're in right now, I heard this rumor and/or belief that with the flu -- that in warmer weather, in warmer months over the summer -- that that diminishes the ability for the virus to spread or to act as it's doing right now. Is there any truth to that?
With other viruses like seasonal influenza that we get confronted with every year and other corona viruses that are more benign, typical common cold -- what you said is true.
As the weather gets warmer, viruses tend to do poorly in warm moist weather and do quite well in cold, dry weather. And that's one of the reasons why in addition to the fact that in the warm weather you're more outside and not confined in a room that these kinds of respiratory viruses tend to go down as you get into the summer months.
The only issue is, Steph, we don't know whether this is going to happen with this virus because this is the first time we've ever dealt with this virus. It's not an unreasonable assumption to think that it's gonna go down, but you don't want to count on it.
RISKS: COVID-19 AND ECONOMY
There's people that are in tough situations, having to make tough decisions trying to earn their income -- they're in the essential services category in their industry and they need to go to work.
What is the serious risk of lifting those social distancing or shelter in place or stay-at-home initiatives too early -- and that balance of shutting down the entire economy?
It is not an all or none process. When you’re locking down, the way Governor Newsom did in California and the way Governor Cuomo is doing in New York City, that's the extreme. That's a heavy hammer on something.
Even if you kind of lessen those restrictions, everybody until this is over should practice some degree of physical distancing and care -- not big crowds, wash your hands a lot, be careful. You can do that and still get back to somewhat of a normal life.
There's a big difference between the extreme of locking a city down -- opening it up a bit, but being more careful than you normally would be.
I think there are places in the country now where you want to look at carefully and maybe you want to pull back a little bit on the restriction, so long as you don't let it rip and say I don’t care what happens. You treat New York City a little bit different than the way you treat Nebraska.
We're not overreacting right? I've heard that term -- in terms of people feeling threatened by the change in their reality, but there's no overreaction to this.
You’re absolutely right. We need to make that point. This is serious business. We are not overreacting.
Currently, why is it so challenging to get a test? If you do have the symptoms, or to your point earlier about they're at a level where you feel like you need medical attention immediately vs. your common flu-like symptoms? But if you want to go get a test, what are the things that are inhibiting those being accessible to the masses?
There should be nothing now that's inhibiting it. But originally, the system, the way it was set up, Steph, was not geared to this kind of massive capability of instantaneously safely getting a test -- getting it done in a really good period of time -- not days and days but hours.
Right now, the system is changed predominantly because it's being handed over to the commercial firms who know how to do it. It started off as a public health measure from the CDC. It now needs to be and is being handed over to the commercial group.
COVID-19 TEST TYPES
Is there another process of tests that are being developed to test the development of antibodies so we know if you've gone through the process or not?
Like you said, you built up that immunity. You can start to understand the numbers of how many people have gone through that so you can get back to normal life quicker.
That's exactly what we are doing and what you need to do. There's two types of tests. One, to determine if you are actually now infected. That's the test that people need to get screened.
Another test determines if at some time you were infected. It’s an antibody test. It's much quicker. It's much easier. It's much cheaper. Those are the kinds of tests where you can determine how many people actually did get infected and recovered - a very important piece of information that we need to get.
I know there’s a timeline for developing a vaccine, right? Certain tests and trials have started, different areas. But I heard it's a 12-18-month timeline to be able to even roll that out in any kind of form.
What does that process look like and what is the likelihood that we get to success in a vaccine in that time?
We have started on the development of a vaccine faster than ever in the history of any virus -- from the time it was discovered to the time we actually made it and put it into a trial.
But when you test the vaccine, it's multiple phases. The first thing you gotta do is make sure it is safe. We started that a couple of weeks ago. When you find out its safe and that it induces the kind of response you want it to, then you do it in a lot of people.
The first phase is 45 people. Then, you go into hundreds -- if not thousands of people -- in what's called a phase II/III trial to determine if it works.
That's the thing that is gonna to take an additional 8 months or so. So when you add up the 3 or 4 months from the phase I, plus the 7-8 months, you get about a year to a year and half.
If we really push, we hope that we will know by the time we get into next winter whether or not we have something that works. But the vaccine is going to be totally relevant for if it cycles into another season, which I think it’s gonna do. Because this virus is very, very transmissible and we're seeing it throughout the world. I cannot imagine it’s just gonna disappear, so vaccines are going to be important for the next time around, not for what we're dealing with now.
THE FUTURE OF SOCIAL DISTANCING, LOCKDOWNS
Right now, we're dealing with the first wave. There could be more responsibility for social distancing or shelter in place down the road. That could be a possibility right?
It's a possibility. I think if we do it right, we will get enough experience so that when it does come back, we'll be able to immediately identify, isolate and contact trace.
If you do that effectively, you don't have an outbreak. You contain it at a very low level which would mean we won't have to lockdown again.
We could treat individual ones and prevent the outbreak -- prevent what we're seeing in New York City, prevent what we're starting to see right now in New Orleans. Those are the kinds of things that, if we go around that cycle, I think we can avoid that. We'll be much different than what we're doing right now.
Can you speak on the effectiveness of masks to address the problem? Are we in short supply? Do we need more? How is that process going?
We certainly need more. We have much more supply now than we had a week or two ago.
You have to prioritize who needs the mask and who should wear it. First and foremost, healthcare providers -- doctors, nurses and health providers who are taking care of a person with coronavirus disease -- to protect them from getting infected. Because what's happened in Italy and what happened in China is you can knockout your healthcare force and then you're really in trouble.
The other one is, if you are infected, to put a mask on to prevent you from spreading it to someone else.
The third priority is the general population, who if they wear a mask they may assume that it's 100% protected -- it's just not. It's probably, you can guess that number, maybe 50%. So when we say you don't need to wear a mask, what we're really saying is make sure you prioritize it first for the people who need the mask.
In a perfect world, if you had all the masks you wanted, then you could get some degree of protection, but make sure you prioritize it well.
I heard that a lot of state governments are having to go buy them on their own. Are we going about that the right way in terms of that process?
Steph, there's a stockpile of tens and tens of millions of masks, but we live in a country that we can do things pretty efficiently.
Once you get the private sector, these companies involved, they can whip out millions and millions of masks.
They're willing to do it. It's very interesting. You would think that the federal government would almost have to force them to do it. We're not seeing that. We're seeing they're stepping forward and wanting to do it themselves.
From your vantage point, you've been front and center from the start, spreading accurate truthful information.
I know things change on the daily and you're following that trend.
What's the biggest piece of misinformation that you know that's been out for public consumption -- and what would you say to correct that issue?
I think you brought it up in one the questions that you asked me.
This dichotomy between people who are being frightened to death of it, versus people who don't even believe it and think it's something trivial that you don't have to worry about.
I'd like to get the people in the country to realize that we are dealing with a serious problem. We've modified our lives. It's not convenient to lock yourself in. It's not convenient for you not to be playing basketball. But we're going through a period of time now where we've got to, as a country, pull together.
Don't get frightened. Don't get intimidated. Use the energy to be able to confront it and do the kinds of things that will put an end to it. I want to get rid of that misconception that there's extremes -- either the world in gonna end or we don't want to do anything. It isn't that. It's somewhere in the middle.
I think that's what we all needed to hear. It's the reason I wanted to do this and be able to have this Facetime with you.
When anybody's life is interrupted -- and whether you've been affected personally by COVID or not, from somebody contracting the virus or what have you -- what we're doing is in the right spirit of trying to stop the spread as fast as possible, return people to their normal lives.
But taking this seriously and understand that there is a strategy to doing that and that we all kind of have to adhere to it.
In that respect, where would you send your everyday person to find that information if you can't get on an IG live and ask these questions? Where would you send them to stay in-the-know?
There's a couple of websites coronavirus.gov -- all the information you want is right there.
Perfect. I appreciate you so much for being available and being selfless enough to have this conversation with me. Thank you again for you and your entire team protecting all of us. Can't thank you enough.
Thank you very much, Steph. It's a pleasure being with you. Thank you for giving me the opportunity to be with you.