Dr. Anthony fauci a member of , the White House Coronavirus task force, discussed the ongoing pandemic area George Washington university hosted the event. Everybody, i will come to a very special edition of healthy you. I am frank sesno. I cohost the series. The school of media and Public Affairs, where i hang out. We are talking to amazing people on the front lines of this pandemic, getting their insights, knowledge and experience about how we survived it. Today , Challenging Health crises to confront humanity. Malaria, tuberculosis but probably nothing as dangerous, disruptive and divisive as covid19, which as we speak has claimed more than 170,000 lives he United States alone, he is a doctor, researcher, immunologist. I first covered and interviewed him when i was a White House Correspondent for cnn in the 1980s and aids was exploding. He was one of the first to see the threat, dedicated himself to resources and research the medicine needed to control it and now covid19. Dr. Fauci, thank you for your time. Welcome. It is great to see you. Dr. Fauci it is good to be with you again. Mr. Sesno well let me first off , start by saying thank you for your time. How are you doing in the middle of all of this . This is insanity. Dr. Fauci you are right. We have not seen anything like this in 102 years since the 1918 pandemic. And it is challenging for the entire world, and we, as you know, the United States, have gotten hit worse than virtually any other country when you talk about cases and deaths. So this is a real important challenge for us. Mr. Sesno there is a lot we have to discuss here and not a lot of time. I should say that when we are done, i will be joined by the dean of school of Public Health and the dean of the medical school and the director of the school of Public Affairs to build on some of your comments, but i do want to dive right in. I should also say that we got 100 questions from faculty and students. Im going to do my best to weave those in in this time. I saw a story the other day that was about boston. This other pandemic you just referenced. Different time, different science, but the headline haunted me. The headline said, boston refused to close schools during the 1918 flu. Then children began to die. Is history about to repeat itself as we head to the School Season . Dr. Fauci i think there is a differences there, frank. I think that if you look at the situation with regards to the current pandemic, is that children clearly have much less of a chance of having a serious outcome when you look at hospitalization rates per 100,000 than adults. However, we should not neglect the fact that children, some, can get seriously ill. Much lesser likelihood than the adults. There are other syndromes that we are just starting to see right now, inflammatory syndromes that children have. We do not know the extent of that. It seems to be unusual, but we do not know the full extent. But the issue is we are starting to learn a lot about children getting infected. They clearly do, and there have been some studies to show that children from 10 to 19 can transmit to adults as easily as adults transmit to adults. Mr. Sesno so, some schools are opening. Dr. Fauci right. Mr. Sesno some schools are going hybrid. But it is patchwork, and left to local decisionmakers, some of whom may have direct Public Health and medical guidance, the latest science and some not. , are you concerned about the way this is being done . Dr. Fauci of course. Mr. Sesno not only for the children, but children as transmitters of this. Dr. Fauci that is the point i was trying to make talking about the chances of a child transmitting it to an adult. Even very Young Children have a high degree of virus. When you look at virus so they certainly are capable of transmitting. The degree to which they do i think is going to learn a lot about in the coming weeks and months. We would like to see, i would like to see a consistent message about schooling, consistent to guide the local authorities who make the decisions about school. Mr. Sesno where should that consistent message come from . Dr. Fauci well, it could come from the federal Health Authorities like myself, and i have said it, and i will say it right here to you, frank. That we live in a big country that is very heterogeneous with regard to the level of virus. And you have got to look at what is going on in the community. If you are in a green zone where you have literally less than 10 per 100,000 cases, per 100,000 population, you could probably open the schools with a considerable degree of impunity. When you get to the yellow zone that has 10 to 100 cases per 100,000, where theres virus in the community, you might want to modify the things you do. Have some physical separation, mask wearing, outdoor classes if possible. Situations where you have hybrids, some online, some in person. When you get to the red zone, a zone where there clearly is over 100 cases per 100,000, and there is a lot of virus activity, you really want to think twice before you get the children back to school. I do not think it should be all or none. All the kids go back, or all the kids stay locked in. You have got to look at extenuating circumstances and you have got to look at the location where the school is. As opposed to mr. Sesno sure. Sure. Part of the schooling discussion of course extends to colleges and universities. This month George Washington university fully intended to bring people back in a hybrid and careful way, and then had to change that posture, and it is now going to be virtual. Today, as we speak, Michigan State university has said it is going to go virtual for the semester. Notre dame says it is going to do it for two weeks, bring people back. But if there are clusters and it cannot do it, it will not. Unc had to flip on this. Dr. Fauci, as you are seeing schools grapple with this decision and try to reconvene across the country, what is reasonable . Is there anyway to bring students back from all parts of the country, have them gather in dorms, and classrooms, and hallways, deal with the reality of campus life, and be able to safely reopen . Dr. Fauci so, we want to make sure now that the viewers know that we are no longer talking about elementary and middle school. We are talking about colleges and universities. It is a big difference. Mr. Sesno fraternities and parties and other things. [laughter] dr. Fauci it is a big difference. That cannot address the concern i have about what the level of infection is in any particular place because people are coming from all over the country. You are having people coming from red zones, yellow zones, and green zones. It really varies. There are some universities and colleges that have a system set up where they test virtually everybody that comes in before they get there. To make sure they dont introduce into the community and dorms and individuals. Then screen individuals and have situations if you have the facilities and the resources to do it where you might have an empty dorm where when someone tests positive, you can safely isolate them. If they need medical care, you can get the medical care. If you have capability of doing that, it is conceivable that you may be able to successfully bring people back to colleges and universities. Dr. Fauci i cant go most. You have got to go university by university. Where they are, what resources they have to be able to do some of the things that universities are already showing they are doing. You can test everybody before they come in. You can then do intermittent surveillance testing. And you need the capability of identifying, isolating, and contact tracing. If you can do that, you may be able to open up the college and the university. If you cannot, it would be more problematic. Mr. Sesno let me ask you about health effects. You are on the front lines of this. You are watching this very closely as a doctor, scientist, immunologist. A New York Times story recently talked about covid creating a wave of potentially heart disease, myocarditis, if i have the right inflammation of the heart muscle. Another study out of germany looked at every high rate of people who have been suffering from that. Other studies are looking at potential brain damage. There was a study i was reading in the lancet that looked at potential structural damage. What new do we know about the effects of this disease among those who have had it at a very serious level in terms of persistent threats to their bodies . Dr. Fauci it is a work in progress. Literally every week and every month. You named some of the reports accurately that have come out. There are now others that are in progress that a lot of different groups are looking at this. You bring up an important point. Let me explain why i believe it is. If you say that you worry about people, keeping them alive, as long as you want to make sure we decrease the deaths, that is very important for the simple reason we already have well over 160,000 deaths, close to 170,000 deaths. However if it turns out that people, even some who do not require hospitalization, because in some studies that you just quoted, they were in individuals who were sick at home for maybe a couple weeks at a time, that were not even sick enough to go to the hospital. Yet when you look at the percentage of them that actually recover and recover within two to three weeks, a substantial portion of them do not feel right. Fatigue, muscle aches, brain fog. The thing that worries me more is what we are seeing about the subtle, insidious effects on the cardiovascular system and nervous system, namely mris s and pet scans that show abnormalities of inflammatory processes in the brain and heart of some individuals. It is not like 1 or 2 . If you look at it it is , individuals where it could even be doubledigit percents. They may be reversible and completely clear in a while but , we do not know that. We have to be careful that just because a person survives, and obviously the overwhelming amount of people do survive, that there may be a certain percentage of people who might have serious residual effects. You need to follow that. Mr. Sesno it seems to me that that is a vital part of the messaging. It is often not getting out. It is about dying or not dying, opening or not opening as opposed to how brutal this illness can be just to get it and the potential of longlasting effects in ways we do not even know. So there is a there are layers of risk. Vaccine. Says he putin, sputnik 5 has a vaccine. His daughter has got the vaccine. Bogus or credible . Dr. Fauci it is not bogus because he has a vaccine. What is bogus is to say you have a vaccine that is safe and effective. There is a difference between having a vaccine and proving in trials that are really well designed, randomized trials that when you are starting to give it widely to hundreds of millions of people that you are giving a safe and effective vaccine. The russians, to my knowledge, and im pretty sure i am correct, have not been studying this intensively in very large, randomized, placebocontrolled trials. Mr. Sesno i am sure Vladimir Putin will be happy to hear you say it is bogus. Dr. Fauci i am not calling him bogus. That is not what i said. I am saying having a vaccine is very different from proving that a vaccine is safe and effective. For that matter, frank, we have six vaccines now. We have not proven them yet to be safe and effective. When we do, then we can accurately say we feel comfortable with distributing a vaccine to hundreds of millions of people. But before and until you prove it is safe and effective, you really do not want to be talking about having a vaccine. Mr. Sesno and the question you are probably asked most, which is when. Today, your answer is what . Dr. Fauci well right now we have three, at least two and probably a third one soon, already in phase three trial to determine safety and efficacy. Two of them started on july 27. And are already enrolling thousands of individuals. The trials are large. One of them is a 30,000 person trial. Another one is aiming at 60,000 people. We will likely know within a period of several months, which takes us to the end of this calendar year, and maybe to the beginning of 2021, whether or not we have a safe and effective candidate. I believe based on the preliminary data we have that we can be cautiously optimistic. No guarantee. You never can guarantee when you have a vaccine, but we feel cautiously optimistic that we will have one that will be safe and effective. We know that from preliminary data on phase one studies that reduces neutralizing antibodies that are at a level comparable to or even better than convalescent plasma of people who have actually recovered. We are feeling good about it, even though one cannot guarantee it. Mr. Sesno let me ask you a question very closely related to that, and the question itself comes from one of the students at the school of Public Health at George Washington university. It is about people getting the vaccine. The question is this, when a vaccine does become available to the public, how can providers combat Vaccine Hesitancy . I might throw in there vaccine disinformation. Dr. Fauci right, well you know vaccine disinformation can lead clearly to Vaccine Hesitancy, but there is no Vaccine Hesitancy that is fundamental without necessarily misinformation. So what we need to do is what we have done whenever we see a situation where people are hesitant to get a vaccine that they really need. They need it for themselves and they need it for the protection of the community. Definitely not criticizing that, criticizing people for that but trying to engage them. You do that through community engagement, particularly when you are dealing with minority communities who often and understandably are reluctant to believe what authorities tell them about health. That you get out there and you get Community Representatives to engage them, to try and be as transparent as you possibly can with the data, answer the questions they have, and try to convince them vaccinations in general, particularly a safe and effective vaccine for covid19, is something that is import and important for them their , families, and society in general. Mr. Sesno another question from a student would you support a , nationwide mandate of the Covid Vaccine . Dr. Fauci no definitely not. ,you dont want to mandate and try to force anyone to take a vaccine. You can mandate for certain groups of people, like health workers, but for the general population, you cannot. I mean here at my own hospital at the nih, we get influenza vaccines. And if you refuse with no good reason other than you just do not want to take it, we do not allow you to take care of patients on the wards during the influenza season. That is a mandate. But we do not want to be mandating from the federal government to the general population. It would be unenforceable and not appropriate. Mr. Sesno so lets talk about how we do get out of this. One of the things i know youre tracking closely is a rapid test. I have a question from a faculty member actually about that. Can dr. Fauci explain the bottlenecks that are making it so difficult to ramp up productions of fast result self administered tests that would allow the country to more safely reopen before a test is available . I am referring to various tests, rapid diagnostic tests. Dr. Fauci that will the coming. Be coming. Already there is a considerable amount of growing enthusiasm, so we are going to see that relatively soon. The critical issue is to make sure, when we get those tests, they have a degree of sensitivity which is appropriate. When you doing general screening, frank you do not need , a 98 , 99 sensitivity, which the pcr molecular tests give you. When you absolutely need to know this person is infected or not. If you are screening, you are really looking at the penetrance of the infection in any given group, any given population. So you could live with one that is less than 99 effective, one that might be 85 effective because even though you may miss some, if you do the test enough and repeat it enough, you will make up for the lack of sensitivity. Those tests can be available. Right now, what we are seeing is that the private sector is gearing up to really make them available to the tune of many , many, many millions. Mr. Sesno there is a lot of concern, a lot of focus on these tests and resources are going to distributed and given to people most in need including lower income people people of color, people who are , disproportionately carrying the cost of this disease on their backs. What is being done to address that very serious problem . Dr. Fauci there are very serious attention to that is being paid. We have an entire group of people who are committed to making sure that happens. One of the first things you do is that, whenever you have early on, which will be the case as the vaccine starts to roll out i mean by the end of 2021, we are told by manufacturers that there will be enough vaccine for everybody in the country. But before then, we need prioritization. And when you prioritize, what you do is you get an independent group. In this case the Advisory Committee of immunization practices which traditionally has advised the cdc, which has a responsibility for making the prioritize asian. Prioritization. That is going to be complemented this year by another independent group to get the prioritization such that you will see publicly published what we call a prioritization range. I cannot tell you what that is going to be now, but i can tell you, if it is similar to what it as seen in the past you will , probably see a high priority to Health Care Providers and First Responders because they are putting themselves in harms way to take care of people. Likely yeah. It will then be individuals who would benefit the most, the elderly and those with underlying conditions. Mr. Sesno another question from a colleague of mine, who has among other things looked at some of the covid disinformation that we have experienced and other disinformation. He writes, as scientists, we are trained to communicate just facts. However the past several months have demonstrated those facts are prone to interpretation and malicious actors will intentionally distort and misinterpret those facts to support their preferred narratives. Some are injurious to Public Health. His question. What do you see as the role of top experts such as yourself and many others i imagine to help , people understand how to correctly interpret the facts in their current context . You are out there and sometimes you get attacked by the president of the United States. This is not an easy thing. Well, the thing that we stand by certain fundamental principles. You make recommendations and policy based on data and evidence. Speculation, anecdotal, those kinds of opinions really need to be put aside. Everything we are talking about in the arena of Public Health, particularly recommendations and policy regarding any intervention it could be a diagnostic, a vaccine, or therapy it has to be made on the basis of sound Scientific Data and evidence. And that is the kind of thing i do and my colleagues, who are Public Health officials out there like me, do the same thing. Make statements based on solid Scientific Data. Mr. Sesno i mentioned at the outset you have been in this job since 1984. You and i first met when aids was exploding. I remember i was a young guy at the white house and you were a young guy at nih. [laughter] and i remember that first briefing that you did, and i remember the incredible Politics Around that. The collision of pandemic and politics as we have seen here is amazing, but it is not the first time medicine and politics have collided. You have been through hivaids. You have been through sars. You have been through anthrax. You have been through zika. You have been through all of these things. Have you ever seen anything like this . What do you make of the great Political Division . Every poll shows this in the country, whether it is masks, to actually believing whether this whole thing is somehow a hoax. Dr. Fauci you are right in your description of my experiences. Even back in the early days of hiv, there was a stigma associated. It wasnt really thick, hardcore politics. It was different ideologies it was different ideologies about how much attention youd pay to disenfranchised groups like the gay population, which were really, obviously did not get the attention they deserved until the activists demanded it and appropriately got it. That is really different from what we are seeing now. What we are seeing now is intense divisiveness that transcends covid19. It is there even without covid19. And the perfect negative storm that really makes it difficult and problematic when you try to deal with a Public Health challenge is that you have that divisiveness that makes the politicization of the response, which we are seeing, very, very difficult. Where you have people who are on political different sides of whatever a particular issue is but it gets thrown into Public Health. It is a statement. Masks, no masks. This or not that. It should not be that way. The Public Health challenge is a challenge for everybody. It does not make difference what your political ideology is or what you feel about one way or the other. We should be completely in line with each other that this is a serious Public Health problem. Mr. Sesno have you tried saying that to the president of the United States . Have you tried saying that to conservatives on the hill that grilled you for your congressional testimony . Dr. Fauci yeah. I mean, all you need to do is look at the testimony. See me on my testimony. I say the same thing im telling you right now. I dont change what i say. We need to pull together. We have to work together. If you dont have complete consistency in what you do, the weak links then a chain of a Public Health crisis will make it very difficult to get your arms around it and ultimately suppress this, which is what we are trying to do. Mr. Sesno i want to ask i know your tight on time another question from a student, which i think is important. Many of us and masters in Public Health program here at George WashingtonUniversity Work in Public Health and many of us are faced with situations in this pandemic to test our ethics, education, and training. My question to you, dr. Fauci, from this student, how do you maintain your ethics and values during such a challenging Political Climate . Dr. Fauci you know i have to , tell you, it is very easy. [laughter] because you dont change your ethics because of the situation you are in. There are certain things that are constant. Science, data and really good evidence are constant. If the situation changes, the data may change and you make a decision. What does not change are ethical principles. They are clear and immutable. Mr. Sesno a lightning round and you are done. Just to show there is humanity, here is a question. What was scarier for you, testifying before congress or throwing out the first pitch . Dr. Fauci unquestionably going out the first pitch. Mr. Sesno as you look forward and think about the immense challenges we have got amid this environment, political environments, now campaign, the pandemic which is on the rise in some places and disputed in others, some control elsewhere, conclude with what concerns you the most and what encourages you the most. Dr. Fauci well, what concerns me the most is what is going on right now, throughout the world country thatur own , we want to make sure we all abide by certain fundamental principles that can get us out of that. It is completely in our power, even prior to a vaccine, to control this outbreak. If we abide by certain fundamental Health Principles we talk about. Wearing a mask, physical distancing, avoiding crowds, outdoor more than indoor, sanitation, washing hands with soap and water. If you could do that, you could definitely influence the course of the outbreak. What i would love to see is the United States, as a country, pull together in a consistent way and realize that Public Health measure is the gateway road, and the path to opening up the economy and getting jobs back. It is not an obstacle in the way of opening the economy. So if what we do in the proper Public Health prudent careful , way, we can have control of the outbreak and carefully and prudently open up the economy to get back to normal. That is what i would like to see everyone realize, that we can do it. It is within our power to do. When we get a vaccine, it will be much easier, but we can start on that road right now, even before we have a vaccine. Mr. Sesno dr. Fauci, i know you have got to run. I want to thank you for your time for your generosity of , spirit, your incredible and intrepid attitude as you encounter all of this stuff. Thank you very much, and we wish you, on behalf of George Washington university and all of us, the very best of luck and a speedy result in the work you are doing on behalf of the rest of us. Dr. Fauci thank you, frank. As always, over many years of you, it is always good to be with you. Mr. Sesno i look forward to doing it again. The sorry we didnt get to 132 questions but perhaps we will have an encore. Thank you. Dr. Fauci thank you. Mr. Sesno ok, well thank you. What we will do now is switch over to a group of people who are able to respond to what we just heard from tony fauci you and more. It is my pleasure to introduce this panel to you. Dr. Lynn goldman, she is the michael and lori milken dean of the Milken Institute school of Public Health. She is a pediatrician, environmental epidemiologist and has had a distinguished career in medicine. Dr. Barbara bass is the dean of the gw she servedto as the chair of the department of expert and leader in academic medicine and surgery. When i mean surgery, i am signing up with you. I hope i dont need it but when , i do, im there. And dr. Sylvia director of gw school of media and Public Affairs. [indiscernible] dr. Goldman, can we start with you . You heard a number of things from tony fauci just now. What we need to communicate for a better Public Health and environment. What do you see as the principal challenge we are up against . I thought dr. Fauci put it very well when he talked about we need to be working together. We need to be unified in our approach to this across our country. What has been the most frustrating for many of us in Public Health is how our inability to do that has allowed the virus to continue to be moving around the country, amplifying, and able to turn back around and come back into areas where we had it under control. It has probably been understandable that, for many communities, until they saw the virus in their communities, they did not see any reason to start staying at home, social distancing using masks. , the problem is, by the time you see the virus, you have way too much of it to be able to control it. When you see it, it is upon you. Because of the fact that so much of the transmission is asymptomatic. I started with tony fauci on schools and reopening schools. I know you were very actively working with the gw community, with the district of columbia, trying to determine whether and how gw could reopen. There was a time you were fairly optimistic about that and things changed. They changed because of the numbers and the incidents of disease. I put that same question to you because also as a pediatrician you have thought about this. As you look across the country and you see what is happening in k12, see what is happening on campuses and universities, what is your feeling about the risks and ability of schools to reopen . Because everybody wants to. Everybody wants to have their kids in school. Everybody wants their kids in school, and we pediatricians believe school is where kids along. It is important mentally as far as the socialization they receive. We know younger children have a hard time learning online. And so we want them to be in school. But as long as you get them to school regardless of being able to make this will save is the problem. As dr. Fauci said, in the states that still have very high transmission of the virus, and where it is maybe not so apparent the kids are transmitting it, but they can transmit it to their families. Here at gw, we did all the things dr. Fauci was talking about in terms of putting in place restructured classrooms, test the kids right when they get back, have a cycle of testing so we can monitor the virus, make sure we dont have outbreaks, and we still could not reopen. Just because of the fact that across our country, so much virus is still circulating. We have kids that would be coming in from georgia, from florida, from california, whereas, in d. C. , we have a good situation. We have been able to keep the transmission below 1 , which means, gradually declining numbers of cases, bringing in students from all across the country, at the end of the day we realized even with all the measures were putting in place, that it would be too risky. How interesting. I am hoping for spring. I look at the outbreaks that had been happening in high schools across the country and the outbreaks in other universities, i am glad we have been cautious. Over too let me come you. As dean of the medical school, what did you hear from tony fauci and what do you think of that is resonating most with you with the crisis . We all came to really admire dr. Fauci during the pandemic. The thing that inspires us the most, clear riots and evolving and evolvingcience evidence. I dont think we have had a more clear spokesperson in any format to remind us of the principles that science is science and evidence is evidence. , both a blessing it is kind of scary a be on the front line of disease we dont know the impact of. E know it is a bad disease as dean goldman has said although we have not been good and that in many parts of our country. See, totement is to become part of the group that is treating it as an entirely new disease and the america that has really transformed both our intervention strategies in terms of broader application and how ridingt our patients this roller coaster. It is really exciting. Mr. Sesno if we had had more time with him, part of the conversation where he talked about the unknown. To figure out what the effects of the disease are. If we have not whether you live or die. Maybe there will be inflammation of the heart. How closely are you watching kind of body of research and how concerned are you this cold, like the flu or there could be permanent, serious lasting things. This is one of the most recognized new diseases. If you think of the pace of publication, this Discovery Science, fundamentals in basic science as well as this disease, it has been extraordinary. We are watching it closely. Already that has changed the way we practice. We learned this massive inflammation that can come with the bad cases is a bad thing. We are learning more and more about the extra pulmonary. All of the systems that are impacted by this inflammatory process. We dont know what the longterm impact will be. We hope it will be fully recovered phenomenon. There is a micro vascular process. It was an unusual pattern of clotting. It can be really dangerous from Central Nervous system to the kidneys and liver. Adapt. Learned how to we are watching this and recording the beauty of being here at the time. We are documenting and recording and saving specimens and i think the amount of Discovery Science will come out of this will translate into opportunities for targeted there is a, more affected targeted therapy, more effective therapy. And it is really extraordinary. The good news is the focus of the nation and actually International Health community, through sharp focus going to make the process a condensed thing. Mr. Sesno for those locked down in their homes, school or work, it is forever. School of Public Affairs, you have studied health communication. We touched with dr. Fauci on unprecedented communication challenges. When he took on aids, there was a social resistance and hostility. There were those who called it the gay plague or gods revenge. It was terrible. He was up against that. That is different from what we are in now. When we sing responses to wearing a mask we see responses to getting a mask, problem that could affect you, there is a political divide. We have got alternate universes of information coming at people. What is your interpretation and how much this couple gave the issue . [indiscernible] the level of political hilarity. For many of us who follow polarization especially a practice the degree to which the responses to the pandemic have quickly [indiscernible] as i was listening, my concern is the fundamentals, the science, communication, might not be [indiscernible] evidence might not be sufficient. The examples are confronting very high resistance. Not just partisan issues. But is something that requires us to have a smarter targeted why ith that release exist believing the pandemic is one of the recommendations dr. Fauci made. We will have a blueprint how to tackle this information that is grounded in a different kind of what could be done differently . Be interested to hear you put some ideas out there. Maybe react to that. Facts, ins of the terms of transmission and mostntion in the language people can understand. That is why that is necessary. It is not sufficient given what we already know about different attitudes. I will make it difficult. We have plenty of evidence to comply with the recommendations. What we need to address head on is studying the reasons why rather than telling people what to we need to do in order to be more effective. We need to be smarter and understand those kinds of considerations. Before you respond, let me share something. A colleague of ours, professor of physics wrote a recent article from his research. He was tracking Public Health, science and all. He was able to map this battlefield of disinformation. Here is what he found. He was looking at the antivax debate. Tendsnd antivaccination to be more numerous and connected to undecided groups. They were targeting undecided. They found they had more messages and more emotion and distrust in conspiracy. And they are reinforced through organizations they would link out to other organizations that may or may not have been related like mothers for breastfeeding. They are everywhere. It sort of suggests this work the intevac servers are out outmaneuvering the others. If you think about what she was saying, how to respond and where this all is coming from, interested in your thoughts. I have several thoughts. One of the greatest challenges we have had is there has been such an evolution of knowledge during this time. We have not had [indiscernible] say this is this disease, this is how it works, this is who dies. It has been an incredible roller coaster of discovery. I think that has made the messaging even for the likes of dr. Fauci more challenging. What you thought was true today actually two years from now might not be true anymore. We have learned a lot, which creates not a consistent message. The notion you have to adapt to evolving science and a rapidly involving evolving disease. We have worked hard to communicate consistently and openly and have people believe. Especially if it is around a part of your life that requires you to change the way you live on a daily basis. Two weeks ago you said i didnt have to do this. Trust just dont have the or dont have the instinct to adapt that rapidly to the evolving guidance that comes with this. I think obviously we cant do this without the world social media at the notion that the sources where people get their information is so subject to error and disinformation, some intentional, some unintentional. Is our sources for providing the information each come from the publics eye with some tainted perspective, which is up to try and address egos so many people distrust different forms of even established main street media. It is a real challenge. Some of that back to you. Dont think there is anything new about public those being encircled by who are putting forth not helpful behaviors. The Tobacco Industry has been productd at marketing a that is of no benefit and has nothing but health risks. We have learned lessons in terms of trying to be smarter on how we understand behavior and communication, investing in the science around that area there is a science area we teach that in the school of Public Health. You can get a doctorate in health communications. We used to call that health education. We used to do faxed sheet fact sheets and thought if we put the facts out, that would be our job. It is not enough. We need to make it interesting and culturally relevant. We need to have two way communication not between Health Experts and communities we are listening to them. I will tell you one thing i think i have heard here is that for many people who live close to the edge financially, staying at home has created a tremendous amount of pain. This pain impacts their sufficiency for their families, their health, has a negative consequence. That can cause people to be anxious, cause depression, anger. It creates a situation where negative communication can tap into that. Why dont understand what i dont understand and maybe your researchers have done this, where is all of the money coming from for the antivax messages . That doesnt happen that is not cheap. I know what they are doing is not cheap. We all have access to the internet and we can all tweet, but these are very sophisticated efforts that are underway. Someone is supporting them. That i do not understand. Looked into isid a lot of it was, frankly, from russia, and it is for no purpose other than to cause confusion and concern. Here is what i would like to do, folks, because we have got so many questions in from people to the audience who wanted to ask dr. Fauci. I got in while i could. But i want to ask each of you, and maybe you can just raise your hand. I have got the gallery up here, so i can see you. Raise your hand, because the questions are fantastic. They came from students, staff, and faculty. And let me just sort of throw it, got, and if you want for it, and if you do not, i will drop it in your lap or something. But how about this one . How will this is from a student. How will covid19 be affected by the flu season . Mean, we do not really know. One thing i think is quite probable is where people are wearing mass, they will have less transmission. We also know that many communities, including our own at gw, are focusing on trying to immunize everybody for flu, and dr. Fauci mentioned how often we target special populations, healthcare workers, the elderly. Getting everybody to take the flu vaccine, it does not provide 100 immunity, but if we could immunize more people, and as people get this and wear masks, we may not see as much flu as we tomally do, but i will turn dr. Bass and see what she thinks. What it would mean to have ,oinfection with flu and covid for sure, it will cause confusion in Public Health and communities. These symptoms for covid19, nearly all of them are similar to covid. Frank is that your nightmare, dr. Bass, having covid existing during flu season . A. Bass i think if you have surge of existing covid in terms of hospital capacity, many of s arespitals and icu already full, so we are concerned about capacity issues during that time. We catchh the flu, if it early, and we do have Rapid Diagnostics for this. We will have our greatest rapidunity with the diagnostics for covid and influenza, and then we have therapy that works. There is the potential harm. , i am hoping that if people are still practicing covid prevention measures, we might have less of a burden of the flu to deal with. That is to be seen. Season,hen does flu when does influenza season, when does that start . Acrosss it is in waves the country, but it starts in october and lasts all of the way into april, april and may, and it moves from north to south through the country. Frank what do we have . 50 , 60 percent of people get a flu vaccine . How many . Not that many . So this year, what is the goal of a flu vaccine with the flu and covid and all of this other stuff . There is a double whammy. Youruld certainly make covid or your flu experience worse, though dr. Fauci would say it is speculation. The case. Hat may be you do not want to have both at the same time. We do not know if you can get them at the same time, but presumably, you can in the right circumstances. Frank it would be very interesting to hear your thoughts on it. This was from a faculty member that came in on the question line. I am concerned about what appears to be questionable information disseminated early on and then seems to change. First, we are told to wear masks, than not, and now it is i ame inconclusive not sure if that is actually accurate or not, but similarly with hydroxychloroquine. This was directed to tony fauci he in front of a critic. To be transparent, you have changed information. What does one believe about Wearing Masks and sticking to the rules and all of the rest. You study this. This level of doubt, and, in fact, tony fauci has changed his position, as have many, and that has led to additional doubt, perhaps, skepticism among many. Yes, things are changing, and this is a very different circumstance. Some messaging we need to do more research. Changes. Ting second, communicating uncertainty. Difficult thane communicating about something we have known for the last two decades about. Injects somethat issues. It is the misinformation suspicion, a lack of trust, and that is just one other element, and dr. Fauci talked about the perfect negative storm, talking about the pandemic and misinformation. We are constantly fighting and trying to pump facts and information into the wider public sphere, and you have suspicions, and that is what really worries me. That they i hope are thinking about strategies that are involving. What we know is coming up, with a vaccine, especially frank silvio, from my perspective as a journalist, i looked closely at science. We are on different planets. The political world, the world of journalism, in many cases, the public. They want to certainty, and they want answers. Partroblem, the delicious of science is it is built all around uncertainty. We know a lot of things we do not know about covid, and we discover as we go, and so what somebody might think about masks one day may actually change another day, but in the public realm, that is seen as a flipflop. That is seen as a change. It is seen as a bad thing as opposed to learning as you go. You are muted, dr. Goldman. Dr. Goldman the message about masks did not work out at all. Questioner hase a bias, because the way i feel is that gradually over time as it has accumulated that masks are beneficial, and some authorities were quicker to glom thatthat and to recommend than others. The last was the who, which was very conservative about a longstanding position they had against masks. But that evidence did not go one way and then the other way. It just gradually accumulated. We found more and more certainty about benefits, including the most recent data that said that you, yourself, are protected by wearing a mask. Up to a week or so ago, i would tell people to wear a mask. It is the type of thing to do for everybody else. Now, it turns out it helps to protect you, as well. I do not buy the idea that it flipflopped. Sometimes helped to create that. I have noticed that each time another country, the White House Task force, the who, each time they changed their position, there was the headline, this is the news. Time for them to change their policy, to assimilate the news the new evidence, review the new evidence. They bring together their own committees. Everyone has their own policy processes. But each time, it was kind of like news alert, and the truth about hydroxychloroquine, but once the actual trials started see thatt, i did not as flipflops. I saw it that every time there was another trial, there would be another headline, oh, now we know about hydroxychloroquine, blah blah, with the clinical evidence. Hydroxychloroquine has taken on a very political place. Getting back to the fundamental value of science and Clinical Trials. A Clinical Trial only answers the question that has been asked, the Clinical Trials that have been done with hydroxychloroquine, it was a very small trial, and none of them have shown evidence that they were effective, and that hydroxychloroquine plus zinc, plus whatever. That is just a trial that has not been done. And is it a trial worth doing . Perhaps. Right now in this wave, where the goal is to save people who are critically dying in the hospital, where the emphasis has been on Clinical Trials and the evidence of the potent antivirals, like remdesivir, antibody mediated therapies, that are really targeting things. Could that hydroxychloroquine trial be a trial in the future . A different answer . Perhaps. But today, the evidence does not support that as a priority for investigation for a scientific community. Thank first of all, everybody who submitted a question for this conversation, and once again, i wish we had more time with dr. Fauci to get more of the questions in. Fromranged tremendously questions around therapeutics and how to treat this to issues around health and contact tracing, mobile technology, this information, and the pains that so have vexed this. But some of this up. Up. Um this what do you think about in your lives on a daily basis, when youre working with clinicians and others, with covid, if youre on the campus, if you can be on the campus of George Washington university, and you consider what institutions like this and others are going to have to see happen before they can reopen, before people can safely gather, before they feel they can go into a restaurant, they can get on an airplane, they can be in a stadium full of 100,000 people, and maybe give us a sense on if you had a scorecard as you are looking forward, what are some of the key indicators of progress that you are going to be looking at in your field . Dr. Bass, let me ask you to go first. Dr. Bass i think we have already seen some of that. Where each person who gets the disease gives it to five people. The infrastructure to really provide that platform for close tracing so that we know and we are getting ready to have an outbreak or a surge in cases. That is so critical to keeping this disease under wraps until, until, we have effective therapies or effective vaccinations, or, heaven forbid, if we live long enough, heard immunity. About or what our campus is wearing about every day, and that is truly the disproportionate burden that this disease has brought to our communities of color, to our workers who provide care for all of every day in terms of the service industries, emts it is the whole nine yards. People who live in multigenerational homes who do not have the privilege of social distancing. And i think it is an awakening that i hope our nation sees, that this pandemic more than any else has an inherent disparity as americans living in this country when it comes to something just like this pandemic, so that is what i worry about. I can tell you that is what a lot of my faculty worry about and student. Thishas not been a fair has not been a fair disease in our country, and we need to be focus aware of that and on those disparities in a really proactive way. So important. Such a vital part of this. Silvio waisbord, your thoughts . Waisbord how the pandemic has revealed and deepened the social inequality that we have. Awareness, butse we need compassion. We need empathy to figure out ways to support those who have been disproportionately affected. I think that institutions, it is important to engage with people. Something else. More at risk. Communication, to figure out the people who are with thisvantaged pandemic. Onesizefitsall does not work. And that is something that we consistently need to remind everybody. Frank one of the things we talked a lot about is trusted sources, and as this issue is communicated, we have to deploy a lot of trusted sources to a lot of different communities. Dr. Goldman, the last question to you with Public Health. Dr. Goldman we need to rebuild our Public Health system, and i agree what i heard before, the need about adequate surveillance, contact tracing, and the care of all of the people who are affected, and assuring that we continue to cover people for health care with the Affordable Care act and other measures and that we protect medicaid and medicare and the aca, and the best thing in the context that covid19 is likely to become a preexisting condition for people, and there are people who are going to need continued care, and we need to take care of the other needs that people have. When i think about the people who are stranded, they are unemployed, the 20 the rate of unemployment in our country. The fact that we are not addressing their needs for Food Security and income, that are people who become homeless because of this, families and children. The fact that there are children who are trying to educate at home and do not have decent Internet Access, we take it for granted, many of us, that maybe we need another device for the child. There are so many families that dont have good enough Internet Access to either do athome education, distanced education, or telehealth, and that is really, really important in going to widen these gaps if children then cannot receive an education, and where that will lead in terms of their futures. It is a big challenge, and i ,hink, you know, this pandemic it exploits the gaps that we have, and we have so many gaps. The income gaps. He health care gaps. The fact that our Public Health care system has been so eroded over time, and then the racial inequities we have in this country. And all of that is a part of what we need to be doing in Public Health, and it certainly is not unconnected to the fact that everybody does need to wear a mask and to socially distance. I am putting mine on. Frank if i had mine, i would put it on, but thank you for that. All, you remind us, you remind us, that we are in a great crisis, and from adversity comes opportunity. From adversity comes awareness. As i heard you speaking, dr. Goldman, i heard you speaking of citizens who live on first tribalreservations, on territories around this country, where in some places, one quarter of the citizens forget internet. They do not have Running Water or electricity. A disproportionate number of Indigenous People who are suffering from this disease compared to others, so we have a lot of work to do, and the first part of that is being aware of it and getting that information out there, and i hope the conversation with dr. Fauci and all of you has contributed to that, so we all think dr. Fauci and what he does, and i would like on behalf of gw and everybody else dr. Bass, dr. Todman, silvio waisbor, thank you for what youre doing with your students and faculty and with the hard work you are doing, perhaps bringing us all together, and some of the research that is happening at gw could help us towards finding a vaccine, towards answering these questions in Public Health. To our audience and all of you who sent in questions, many, many thanks. We used as many as we could get to. We will have more opportunities to do this. On behalf of all of us, we wish you well. We wish you good health. Veryday, and stay very, healthy and strong. Thanks. Thank you. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] following the federal response to the coronavirus outbreak at cspan. Org coronavirus. Watch congress, white house briefings, an update from governors. Track the spread of the virus throughout the u. S. And the world with interactive maps. Watch on demand any time, unfiltered, at cspan. Org coronavirus. And joining us here in washington is Liz Harrington cured she is the National Spokesperson for the Republican National committee to be convention getting underway this week in charlotte, north carolina, and virtually, so walk us through, right now, what will happen each evening. Guest well, good morning, steve. Thank you for having me. We are really excited. We are kicking off four days of what i think will be a big contest. Laste, if they tuned in week to the really down and out, dreary, negative,