Dr. Fauci: "You Don't Make The Timeline, The Virus Makes The Timeline" | Video | RealClearPolitics

Dr. Fauci: "You Don't Make The Timeline, The Virus Makes The Timeline"

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In an interview Wednesday night with CNN's Chris Cuomo, Dr. Fauci said if the coronavirus comes back in force in the winter it will be different because we'll be prepared and the response will be very different. Fauci also explained the reality of crafting a timeline to reopen parts of the country amid the coronavirus pandemic.

CUOMO: Straight to Dr. Anthony Fauci. We're lucky to have you back on PRIME TIME tonight, Doctor. I hope you're doing well.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: I'm well. Thank you, Chris. Good to be with you.

CUOMO: Question. You talk to the WHO, the World Health Organization. What perspective did you get, just macro, lessons learned, and also insight into why us, Doctor? Why are we growing faster than other places--

FAUCI: Yes.

CUOMO: --we assume we're better set up than?

FAUCI: Well, you know, the insight you get is when you look at the different patterns of what happened in different countries, China versus South Korea, versus what we're seeing in Northern Italy, it really gives you some interesting insight into things, not only in the explosive nature in certain places versus others, but also as you start to get to your peak, when do you know that you're actually turning the corner.

And the data we went over at the WHO call today, which was representatives from countries all over the world, was that you take a look at the number of new infections on any given day.

So, five days ago, it was 600. And then, four days ago, it was 800. And then, three days ago, it was a 1,000. You're going way, way up.

It's when the new infections each day starts to level off to be the same, and then start going down, then, you see the curve go down. And that's exactly what certain countries like China and South Korea have seen. Italy is not there yet.

Italy got hit really badly, almost certainly, and I think this gets to your question about us here in the United States, is Italy got hit very badly because they had a large number of importations from China by Chinese tourists.

And before they even knew what was going on, there was enough baseline people spreading that essentially got out of hand, and it became difficult for them as good as they are, and they're very good, to be able to contain it in a way that is contact-tracing all that kind of thing.

It was more mitigation, how do we deal with what we have. They're in a very difficult position.

If you go now to the United States, we're a big country, and there are different patterns, Chris. Remember, weeks ago, the hardest-hit part was in the Washington State, and that was a cluster of - of nursing homes and--

CUOMO: Right.

FAUCI: --and extended care homes.

That was a different kind of thing than what you see in New York City, which very likely got seeded because New York City is a hub of influx of travelers, not only originally from China, but also from Europe, which has become the new China in the sense of the number of cases.

So, New York City is dominating the situation in the United States. About 60 percent of the infections are in the New York City Metropolitan area, and 56 percent of the new infections are coming from the New York City Metropolitan area.

So, you guys are getting hit terribly hard, and it's so unfortunate, but that's the reason why it looks like this big explosion, because it is what it is. Whereas other areas of the country, although they're seeing cases, they're at different levels in that curve of kinetics.

CUOMO: Right.

FAUCI: But New York is right in the middle of it.

CUOMO: All right, until Louisiana, and now you have The Big Easy is getting crushed, specifically New Orleans. And all the sudden, they went from like a 100 cases last week to now they're like 10 times that, plus what's going on down there?

FAUCI: It's the same thing. What it is, is that what likely happened, they've done it now.

I mean I have - I have spoken to the political officials in New Orleans and in the State of Louisiana. They're now shutting things down in a very vigorous way. It is likely that that should have been done a little bit sooner.

Not blaming anyone on that, but you get caught unawares because the nature of this outbreak, Chris, that's so frustrating and, in many respects, you know, a bit frightening and intimidating, is what you and I discussed, you know, several shows ago.

It putters along, and you think you're OK, and then it starts to go up a little, and then bingo, it goes up in an exponential way.

CUOMO: So--

FAUCI: That's what's happening in New Orleans now.

CUOMO: So, you got two different points of pressure coming from opposite directions. You have people saying "It's been long enough, Tony. You told me two

weeks. I did two weeks. I can't do this anymore. I want to get back to work. We got to open up. Whatever happens, happens."

And then on the other side, you have this pressure of "Clearly, we have to do this a lot longer because the mitigation efforts aren't working." My brother, every other word out of his mouth is "Accelerating." You know, it's "Blah, blah, blah, accelerating cases, blah, blah, accelerate - accelerating pattern."

So, how do you deal with those opposite interests? "We've done it long enough. We're frustrated. We want to get over this. And what you've told us to do so far, it's still accelerating."

FAUCI: Right. It is there's no - you're absolutely correct, a 100 percent, Chris. It's accelerating.

And what you've got to do is that when you have a big country like this, you've got to look at it in different ways. Right now, you wouldn't even think about not - not putting the damper on what's going on in New York. That would be outlandish, as it's going up, no doubt.

But there are other parts of the country, which we need to get a better feel for what is going on. And the way we do that is by increasing testing, and identifying people, who are infected, isolating them, getting out of circulation, and then do contact tracing.

That's what we call containment. So, you could do containment and maybe ease up a bit in one area, whereas in other areas where it's mitigation, all you got to do is put all your resources in there, to help the people who are under this stressful situation.

CUOMO: So, different solutions for different parts of the country.

FAUCI: The way it is in New York. So, it isn't all or none.

CUOMO: I got you, different strategies for different parts of the country.

FAUCI: I believe, yes - exactly.

CUOMO: I get it.

FAUCI: Exactly.

CUOMO: But then you have like "Well how long?" And I get it. The answer is going to be "Depends where you are." I get it.

But if it's California, and there you have the Governor and the Mayor discussing, the Los Angeles Mayor, that it's going to be months, it's going to take months for them.

And then, you're hearing, here in New York, Andrew says, the Governor here says, "We're two or three weeks from seeing the worst crush at the hospitals." I mean it seems that the timeline is getting extended farther out, not that things are going better--

FAUCI: Right.

CUOMO: --than expected anywhere.

FAUCI: Yes. What you've got to do, Chris, you've got to be realistic, and you've got to understand that you don't make the timeline, the virus makes the timeline. So, you've got to respond in what you see happen.

And if you keep seeing this acceleration, it doesn't matter what you say, one week, two week, three weeks, you've got to go with what the situation on the ground is. So, when people say it may take months, I think what people are talking about is how long it takes to go all the way down.

But you may see, in a relatively shorter period of time, when you're seeing the inkling of the flattening, and coming down. But, you know, you can't make an arbitrary decision until you see--

CUOMO: Right.

FAUCI: --what you're dealing with. You need the data.

CUOMO: All right, so let me ask you some - some quick punch questions here. These - I'm skeptical of these things.

FAUCI: Go ahead.

CUOMO: So, obviously, you'll set it straight about what's true. Vitamin C, Vitamin D, you know, first it was these words I couldn't pronounce, Deoxy-whatever drug, and then we hear somebody dies from the drug.

FAUCI: Yes.

CUOMO: And then there's other drug therapies they're trying. Now, it's Vitamin C, Vitamin D. Are any of these things something that we have any degree of confidence, and by we, I mean you, that can actually work in mitigating the effects--

FAUCI: Right.

CUOMO: --of the extreme cases of this virus?

FAUCI: Yes. I think you have to separate the vitamins from drugs that are being touted as being effective or not. For example, Vitamin C is a pretty good antioxidant.

I mean there are studies that say Vitamin C is very good against mitigating the effects of certain infections, and others say there's no effect. It's essentially totally harmless unless you take in a ridiculous amount. So, I have no problem with Vitamin C. There's some interesting situations about Vitamin D. And, in fact, Tom Frieden who, the former CDC Director, wrote an op-ed, I think, yesterday, when he was talking about some interesting suggestions about various regions of the globe and - and respiratory infections that might be related to Vitamin D. No definite proof. But again, you're not getting hurt.

But when you're talking about a drug that might have some toxicity, that's a different thing. That's why you keep hearing me over and over again saying the best optimal way is to do a randomized control trial to determine as quickly as possible whether something works, and if it does, get it out there. If it doesn't, get it off the table.

CUOMO: So, let me ask you something.

New York, this two to three week window where there's going to be a crush, forget about the timing, forget about the when, let's just deal with the reality, how frightening may it be for people living here, and obviously watching all over the country, of what they see at the hospitals?

Do you think there's a chance that we're going to re-live a Katrina- type event where we were down there reporting, in front of the Superdome, and there were people all lined up outside that place because they couldn't get in, and they were sick and worse.

Is that what overcapacity looks like? Is that what overwhelmed looks like?

FAUCI: You know, overwhelmed looks like that. But Chris, I don't think that's going to happen. I hope not. I mean nothing is impossible. But the reason I say I don't think that's going to happen is because you're right.

And I know that Governor Cuomo was speaking about a certain period of time where he's going to be running out. He's now getting help with ventilators, with masks, and others. Hopefully that will be enough. I think it will be to be able to match what he and others, who are in a stressful situation, as he is, is - are facing.

But that's the reason why you've got to now put all of the cylinders going to try and keep up with this because the one thing you don't want is you don't want a situation where you run out of essential things that you need.

CUOMO: Right.

FAUCI: I don't think that's going to happen. I don't want to scare anybody because, I believe, in the meetings that I've been in, at the Task Force, you're talking about FEMA, you're talking about other organizations that are really geared to try and help out.

You're getting private industry involved in making more of these things that we need. So, we're putting a big push on.

CUOMO: Are you guys on the same page?

FAUCI: Go ahead.

CUOMO: You and Andrew? Because I know that everybody's saying he's the voice of calm.

But, as we both know, he is really concerned that he's not going to have enough to deal with this. I know you talk to him on a regular basis. Are you guys on the same page in terms of what he sees coming his way and what you think he can handle?

FAUCI: Yes. Well, you know, I think - I think the Governor is doing a terrific job. You're right. I do speak to him frequently. He really cares about this. He really wants to do best. And he has to look at what the worst-case scenario is.

But if you look at the negotiations and the discussions that have been going on now, I think he's going to be OK, Chris.

I do think so because every time we sit down at the meeting, we keep hearing about how we're going to be making sure, at the local level and that with the federal help, we're going to try and get him the things he needs.

CUOMO: So, let me ask you something, just opening the curtain for people a little bit. You and I have known each other a very long time. I grew up hearing your name in my house.

Andrew consulted you, and you went against me on where my mother should be. But I hold no umbrage about that, even though you were one of the reasons that my mother got taken out of my house, I do not hold it against you, Dr. Fauci.

I want you to know that, and that's not why I'm asking you the next question. How are you able--

FAUCI: I'm sorry, Chris.

CUOMO: You're not sorry. But that's OK. How do you stay optimistic?

You made the right call. I was being emotional about it. My mother was better off being somewhere else. I'm exposed to too many people. You and Andrew made the right call. Now, you're making those calls all the time.

How do you stay optimistic when all the data is frightening, and then you talk to world officials, and they say it's going to get more frightening, and you look at your capabilities, and where it's popping up, and that seems frightening.

How do you keep optimism about how we get through this in a good way any time soon?

FAUCI: Well, you know, Chris, this is the life I've chosen. I mean I - I know it would be challenging to be in Infectious Disease, but particularly geared towards countering outbreaks like this. You know, I - I stay optimistic but not unrealistically optimistic. The one thing I try very hard, and I think I succeed, is not letting my upbeat optimistic, and I always say cautiously optimistic, my viewpoint on life ever, ever get me to be complacent.

So, I act optimistic. I mean I - I give the appearance of being optimistic. But, deep down, I just do everything I possibly can, assuming that the worst will happen, and I've got to stop the worst from happening.

CUOMO: Can you--

FAUCI: So, you know, it's a little bit of a conflict there.

CUOMO: Well, listen, I mean you got to prepare for the worst, and you got to hope for the best. You're on the "Prepare for the worst" side. We're on the "Hopeful" side.

The next wave, everybody keeps saying there'll be enough - another wave.

Do you think, at this point - you've gotten your colleagues, and the national consciousness to the point where we won't go through this, this way again, that we won't be playing catch-up.

The testing won't be slow, we'll be in front of it, we can contact- trace, we'll have the capabilities better in place if, God forbid, there is another wave as expected?

FAUCI: Yes. Chris, first of all, you know, again, after talking to my colleagues on the WHO call, I think it's more likely than not that this is going to turn around and come back in another season.

Because, right now, in the Southern Hemisphere, in Southern Africa, they're starting to get cases as they go into their winter. And if that happens, this is not going to disappear.

I don't think it will, which makes me more fortified, Chris, when you ask about how I feel about these things of why we got to get that vaccine tested, we got to get it proven to be effective, and we got to get it out.

And we've got to develop drugs, so that when we come around next year, it is not like this again, never again like this, so that we'll be prepared, will be a totally different ballgame if this comes back next winter, next fall, I'll guarantee you they'll be different.

CUOMO: Well, listen, people listen to you. They believe in you. They believe what you're saying. And when they hear you say that you're going to - you believe more likely than not there's another wave coming, they're going to be behind any efforts to prepare.

So, Dr. Anthony Fauci, I promise you. I know you're not a politician. I don't talk politics with you. I talk practicalities. I talk protocols. And I talk about what our path forward is.

I wish you the best. Stay well. God bless you and your family and God bless your efforts. Dr. Anthony Fauci, you're always welcome here.

FAUCI: Thank you very much, and to you too, Chris. It's always a pleasure to be with you.



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