Dr. Fauci, thank you so much for joining us
on The Daily Social Distancing Show.
-How are you? -I'm very well, thank you. Very well.
You are an infectious diseases expert
who has advised six presidents on everything
from SARS to Ebola to the HIV epidemic and Zika.
What makes coronavirus so different?
Well, it's different because, you know,
when people used to ask me over the years,
what is it that I most worry about
with regard to emerging infectious diseases,
is a respiratory borne illness
that easily spreads from person to person,
but that has a high degree of morbidity and mortality.
And unfortunately, that's the worst nightmare
you could have is to have something like that.
I mean, there are other diseases.
Ebola was frightening, but Ebola gets transmitted
only when you're in very close contact
with a person who is very, very ill.
With this disease--
in some respects similar to influenza,
but in some respects, very different--
it spreads very easily.
-Right. -You can even spread it when you're not symptomatic.
So it's insidious and treacherous
in that you could spread it easily.
The other part about it that's really so different
from anything that we've ever faced before,
is that if you look at the mortality of seasonal flu,
the thing you and I go through every season,
-the mortality is about 0.1 percent. -Mm-hmm.
That's a lot.
-And we get used to that morbidity and mortality. -Right.
But the mortality of this is about ten times that.
It's at least one percent.
So, it's a disease that not only is easily spread,
but it can be devastating,
particularly for a certain subset of the population.
Demographically different.
The elderly, those with underlying conditions--
-heart disease, lung disease, diabetes. -Mm-hmm. Mm-hmm.
It can be very serious for them with a high degree of mortality.
Let's-let's talk a little bit about the information
in and around corona that's-that's,
I think, getting people confused.
I-I see so many conflicting ideas online.
And, I guess, the horrible by-product
of having social media and the Internet is,
everyone is now an expert, and everyone has an opinion.
I know this is very basic for you,
but just to help everyone be on the same page,
how can we catch corona and what are the areas
we should be most concerned about?
So we know about human-to-human transmission.
Most people understand that.
But I see people online worried about grocery shopping,
touching packages that they receive from Amazon.
Do people need to wipe them down?
When they're in the grocery store,
can they touch other things?
How long does coronavirus last in the air?
For instance, if you walk into an elevator
after somebody else, can coronavirus still be there?
What do we need to be on the lookout for as individuals?
Okay. There's varied degrees of risk, Trevor, of that
in-in every respect.
But the things that are the most common,
that you really want to latch onto
is that sneezing and coughing.
When someone is ill,
they've got to get themselves out of circulation,
because they can spread by droplets
and even by what we call aerosol,
which means the drop doesn't go down right away.
It hangs around for a bit.
So you could come into a room
thinking everything is all right,
and then you inhale it.
That's likely not the primary way.
The primary way is probably droplets.
But another way that's very important is handshaking.
When people naturally go... (coughs)
Like that, they cough.
And then it's innocent. There's nothing on their hand.
They shake your hand,
or they open a doorknob, and that's the thing.
You don't want to be obsessive-compulsive
about wiping everything down that you go near,
but one of the real bad actors
is somebody who just opens a door,
and then 15 minutes later...
Because we know the virus can live
on inanimate hard objects like steel or plastic
-for at least several hours. -Right.
So that's the thing you got to be careful...
That's one of the reasons why,
if you really want to be careful,
besides the social distancing of six feet,
don't shake anybody's hands.
-Just lose that for a while. -Right.
And wash your hands as often as you can
because you may be inadvertently touching something.
-Oh, I... -Now, your other question, Trevor,
that's important is that I don't think
we need to get completely obsessed
about packages that come in,
because those types of surfaces...
The virus might live there for a very short time,
but people say, "Should I... Should I get a package
from a grocery store that says 'made in China'?"
I-I wouldn't worry about that.
-That's not the issue. -Right.
It's more the close things, the handwashing.
Let's talk a little bit about what you alluded to earlier,
the-the mortality rates of the disease
and how people have misconstrued the numbers.
We know that people who are older
or people who have underlying respiratory infections,
um, have a higher chance of dying from the virus.
But I think people have started to believe
that that means young people are immune
and cannot get sick from coronavirus.
What are people not understanding from the numbers?
Trevor, they're not understanding
two things that are important.
A) Even though you are young,
you are not absolutely invulnerable,
for sure, because we are seeing cases...
Most of them have some underlying disease,
but several don't who are young people.
30s, 40s who are getting sick,
getting into the hospital, requiring intensive care.
Still, the overwhelming proportion
are the elderly with underlying disease.
But every once in a while, you're gonna get a young person.
So if you think you're completely invulnerable,
you're incorrect.
Second issue that's important.
That even though you may not get seriously ill,
you can get infected with relatively few symptoms.
Either asymptomatic or mild, relatively trivial symptoms.
But then you can infect another person
who would then infect a vulnerable person
who would then die.
-Right. -I mean, it's the typical example.
"I'm young. I'm healthy."
But you go home, you infect Grandma,
Grandpa and your sick uncle.
So you have a responsibility
not only to protect yourself
but you are almost have a societal, moral responsibility
to protect other people.
In-in talking about the virus,
it-it feels like, understandably,
everyone is trying to find an answer,
everybody is trying to find their own solution.
Unfortunately, that has bred... Uh, you know,
it's created a breeding ground for misinformation.
For instance, cures that people are touting online, you know,
concoctions of-of different medications, et cetera.
We read about malaria drugs
and chloroquine or whatever it is.
What is the biggest warning you would give
to the general public about trying to self-medicate,
or-or is there any cure that people actually have discovered?
What... As a leading health expert,
what do you say about this issue?
So, right now today, as we speak,
there is no proven, safe and effective
direct therapy for coronavirus disease.
For sure. There are a number of clinical trials
that are trying to-- by randomized control trials--
get a definitive answer as to what works
and what does work... not work, what's safe, what's not safe.
Superimposed upon that, there are drugs
that are already approved for other things,
like hydroxychloroquine for malaria
and for certain autoimmune diseases,
that there have been anecdotal stories.
By "anecdotal," I mean people kind of think they work,
but they haven't really proven they work.
That's really gotten out there on the Internet.
So, people are very enthusiastic
since generally, these drugs appear to be safe,
and they are, but they do have some toxicities.
So, a lot of people want a drug even though it's not proven
just in case it might help them.
You got to be careful about that for a couple of reasons.
You don't want to take that drug off the market
for the people who really need it,
who have the diseases it's used for.
And on the other hand, there may be some toxicity.
That's the reason why we're pushing
to try and get as many good clinical trials as possible
to prove if it works.
If it does,
then get it out there really fast for everybody.
Got it. I have four questions.
Because I know we're gonna run out of time,
but I just want to let you know I have four questions
that I think are really important.
Um, number one. We hear about this clock,
15 days where things will be reassessed,
15 days where people might go back,
15 days, every country... 21 days.
There seems to be a clock. My question is
what is that clock supposed to be?
And is there a certain amount of time
that people can be away from each other
where coronavirus goes away?
And-and the follow-up in that same question
is does the clock start
if people are not completely quarantined
during that period?
Yeah, the virus is the clock, uh, Trevor.
So, people say they... Arbitrarily,
"Well, in two weeks, we're gonna be okay."
It depends on the kinetics of the outbreak.
Right now take New York City.
They are getting hit really hard.
And the kinetics of the outbreak is going there.
You can't predict when it'll make that turnaround
and start coming down.
In general, if you look historically
at-at countries that have been through the whole cycle,
in China, it was about eight weeks or so
before it went way up and then way down.
-Right. -In Korea, the same thing.
So, if you look at each individual country...
And being a big country as we are here in the United States,
we're almost like a lot of little countries.
Like, New York in itself can be considered a country.
-Right. -California can be considered a country.
So, it's unpredictable
about when you can say this cycle...
It's usually measured in several weeks.
Sometimes, when you're into the cycle,
you may only be two to three weeks away
-before it starts to turn around. -Right.
Okay. So, then, to that point,
that's then my second of the four questions.
Second question is
is New York City really harder hit?
Or is New York's testing making the numbers spike up?
And is this something that we're going to see
start trending throughout America?
Well, a couple of good questions right in there.
New York is more hardly hit, for sure.
The nature of the city, the crowding of the city,
the fact that you get the beginning of your outbreak
when you get influx from other countries.
China was the index country that came in.
New York is a travel hub of the country,
so clearly, we had a lot of cases come in.
By the time they realized what they were dealing with,
they had already gotten a sucker punch,
-and they really were playing catch-up. -Right.
They didn't do anything wrong. They're not very different
except that they're a big, robust city,
and because of that, they're getting hit hard.
Okay. And then the second-to-last question is,
with regards to reinfection and immunity,
we talk about people who have it and are asymptomatic,
we talk about people who are recovering
and we're starting to see those numbers grow around the world.
Do we know yet if getting corona and surviving corona
means that you're now immune to the disease
or is there a chance of reinfection?
Uh, we don't know that for 100% certain,
'cause we haven't done the study to see rechallenges,
whether they've been protected.
But I feel really confident that if this virus acts
like every other virus that we know,
once you get infected, get better,
clear the virus, then you'll have immunity
that will protect you against reinfection.
So it's never 100%, but I'd be willing to bet anything
that people who recover
are really protected against reinfection.
Okay, and then our final question--
And thank you so much for your time. I really--
I really hope everyone understands
how important it is to listen to you.
Final question, with regards to the government,
the CDC, the NIH, and all of the units working together,
right now, it feels like there is a-a push and pull,
a tug-of-war between states
and the federal government, et cetera.
For Americans who are out there watching this,
what is the plan and what do you think needs to happen
for the whole unit of the United States
to fight the coronavirus?
You know, implementing different checks and balances
along the way to make sure that everyone fights it
and the numbers go down.
Well, that's a very good question.
Things are implemented at the state and local level.
That's the way this country works so well.
The federal government is a facilitator,
it's a supplier, it's a supporter.
And that's the way things should be going.
And that's what we're starting to see now
as we are catching up on things
that weren't done so well in the beginning.
We now have many, many more tests.
The private industry's getting involved.
The government's not making the test.
The private industry is.
The ventilators that are needed, coming out of the-the stockpile.
Yet companies are starting to make more.
So it really is a marriage between the federal government
as the facilitator and supporter
of where the real action is,
is at the state and local level.
Thank you so much, Dr. Fauci.
Um, you've been amazing.
I could talk to you for an hour on this,
but I know everyone wants your time.
Good luck with what you're doing.
And, um, I hope we're doing our part
to make your job a little bit easier. Thank you.
You are, very much. And I appreciate the opportunity
-to speak with you. -Stay safe and wash your hands
-because of that fake cough you did. -(laughs)
Take care.