[no audio] when a Public Health crisis challenges our very way of life, answers,ound in real hard truths, and data, under microscopes and across global networks. This is where the world turns , the johns, for hope Hopkins Bloomberg school of Public Health. Journey began long before covid19. Originatedanswers over a century go here. Opening our doors days before the outbreak of the spanish flu in 1918, we introduced the fields of biostatistics and epidemiology. We guided the first Clinical Trials of penicillin, creating a Gold Standard for drug development. Our researchers help to be polio, helped to be polio and continue the fight against malaria. We were the first show smoking cut lives short. Our testimony helped break up big tobacco. If theres a threat for Public Health, our faculty and students andworking to understand it show its risks. Answers are sought at 80 Research Facilities across 67 countries. Together, we are addressing some of the biggest, most pressing threats to Public Health as well as issues not yet on anyones radar. John Hopkins Bloomberg school of Public Health joins us by leaving and translating Public Health to the world, we may policy Health Care SystemsWork Together and inspire future researchers, practitioners, and policymakers. I dont think there is any more important job in saving and improving lives. We take what we learn and put those answers into practice. Research becomes tangible. We develop strategies and solutions the world can use and trust. Small,ways big and change the course of history. It is hope and determination, powered by science, because this answers,humanity finds before we even need them, and when we all need the most. John Hopkins School of Public Health, protecting Public Health, saving lives, millions at a time. Dr. Fauci for a while, life is not going to be the way it used to be in the United States. We have to accept that if were gonna do whats best for the american public. No matter where in the world we are right now, meeting our medical challenges requires innovative and thoughtful Public Policy solution. The most effective proposals are those that rely on a multidisciplinary approach, reason, creativity, and evidencebased problemsolving. Here in the policy form, we meet leaders of all levels of government, designing or implementing policies that address our most pressing problem. The covid19 death toll has 200,000assed according to john hopkins university. Remains theny fauci voice for Straight Talk and scientific fact. Sen. Klobuchar covid19 has the potential to make people ill and kill them. Im working directly on a s work spans three decades, six president ial administrations, and multiple health crises. From aids, to ebola, to covid19. Dr. Fauci no one is denying the fact that we are going through a difficult time right now. A pandemic that turned this immunologist into a household name. Dr. Fauci and i have never done anything other than tell the andt Scientific Evidence may policy recommendations based on the science and evidence. You dont want to impress people and razzledazzle them with your knowledge. Just want to understand what youre talking about. Mckenzie. Ellen im honored to be here to launch our John Hopkins Health forum. Due to a scheduling change, president daniels is unable to join us. Are recording this conversation slightly in advance of this october 16 broadcast. We could think of no better person to begin a series of dollars series of dialogues then dr. Anthony fauci, the director of the National Institute of allergy and Infectious Diseases at the National Institute of health. The country across and across the world, dr. Fauci has become a most trusted source and authority of four decades, dr. Fauci during the early years of the aids crisis in the 1980s, dr. Fauci was among the first scientists not only to launch himself into aids research but to collaborate with activists to advance treatments. In the following decade, he advised president s of both pandemics our world has seen from sars to zika and ebola, to ensure science drove effective policy. In the covid area, he continues his commitment to deliver the best information for the policymakers and the public. In 2005 essay, dr. Fauci revealed three Guiding Principles of life, of his life. Day, toand learn every strive for excellence, and to serve humankind. We are profoundly grateful that he has followed all three of these principles throughout his illustrious Public Service career. Our world is better for it and healthier for it. Please join me in welcoming dr. Anthony foxx are Anthony Fauci back to john hopkins university. Dr. Fauci thank you very much. It is a pleasure to be here with you today. Im looking forward to our discussions. This is an extraordinarily important topic. This is a historic pandemic, the seen of which we have not in our civilization for 102 years, since the very historic and memorable 1918 spanish flu. I look forward to the dialogue we will have in discussing various aspects of this i believe are already thats i believe our audience aspect of this i believe our audience will be interested in. Ive been interested in what youre telling the public in your messages so clear. That message is about Public Health. It is that we all need to Pay Attention and follow the simplest of Public Health measures so we can better control the spread of the virus and get our communities and countries on track. We thank you for your unwavering commitment to protecting the Publics Health by always speaking truth to power. Dr. Fauci thank you. Let me just come from a personal perspective. I am very pleased to have the opportunity to host this conversation, and one of my First Official duties as dean was back in 2018 when i presided over the school organized with to Smithsonian Organization discuss responses to the 1918 pandemic. You were our keynote speaker. In response to the symposiums topline question, are you prepared for the next pandemic for when the next pandemic kids, the answer from our audience was no. It was acknowledged we may no progress. Here we are together again today, facing the reality painting for us that afternoon almost three years ago. [inaudible] since that 1918 influenza pandemic when we first admitted our first flu. Translate the research into Public Policies that make a difference in peoples lives. On behalf of my colleagues and legion of alumni around the world who are no will be watching this broadcast, i want to thank you for your tremendous leadership and sharing your perspective, not only during this unprecedented time of Public Health, but on the intersection between science and policy. With that, let me begin, and start by can reflecting on your nearly fourdecade career leading the National Institute of allergy and Infectious Diseases. You led in the response to hiv, aids, and emerging diseases including ebola and zika. What strives you to continue this work and do you see the federal sponsor involved in any way . Dr. Fauci the thing that drives commitment to this whole concept that the john Hopkins School of Public Health stands for, namely Public Health of not only our nation but the world. I am a physician but also a scientist. When i got involved as the director of the institute, i had been an aids researcher before that, fundamentally a chief of a laboratory at the nih, doing Clinical Research on hiv. When i became the director of the National Institute of and Infectious Diseases. It became so clear to me that there were so many problems throughout the world that could be addressed both by science, science application, and good Public Health measures. I became totally committed to that. When you say what drives me, what is the driving force, it is the realization not only of the normative the problem that the fact we can do something about it. It is not an unsolvable series of problems. It is something we can do something about. The second part of your question, the role of government. Government at its best cant be responsible for things that individual, private sector components would not be willing to take up. For example, in the United States, and it is not just confined to the United States, we have the realization that there are the need to develop interventions in the forms of vaccines and therapeutics for diseases that may not be the kind of commercially viable interventions, but the world needs them. We have seen that with many of the things weve done with malaria, tuberculosis, and diseases that are not particularly germane to the people of a given country. But because it is a Global Health problem, if you look at what we have done through the nih, cdc, through other agencies of the federal government, it has been critical to the viability of a good public and Global Health effort. I know is something you do, dean mckenzie, something that i love, something that is a task i wake up every morning feeling that there is a chore ahead and something we can do about it. The stakes are enormous. You are talking about peoples lives and health. I dont want to put down any other profession, but it is a need and you can get much better than that. If that is what you are suited for and that is what you want to do. Dean mackenzie absolutely, and we are so happy you have that drive and commitment to that mission. Yearsntioned your early in fighting hiv and aids. Can you reflect on how the experience in those early years informed your response to the current pandemic . Dr. Fauci there are some similarities and stark differences. As athen, it was perceived restrictive problem. I remember i wrote an article in 1981 the cup published in 1982 that says anyone that thinks this disease will stay does not know ,much about these issue because chances are it will be a global issue. Unfortunately, that was prophetic. We had difficulty getting people globalized to realize the potential impacts of this, because it did not universally affect people in a uniformed way. A behaviorally related disease, whether the behavior was something people could not avoid or was part of the culture, what have you, it was behavior related. What we are dealing with now is a very complicated issue, i must say, dean mckenzie. Isis complicated because it having a global, serious impact, but there is difficulty in relating to the people how serious it is. Because there are so many people who get infected and have no serious consequences. How do you mobilize a uniform message and effort that this is something that is serious, that we need to take seriously, and all you need to do is look the bers 215,000 at sig 200 15 deaths in the United States. Over one Million Deaths worldwide. Understandably, there are people that look at this disease and say if im a young, healthy person, chances are nothing will bother me. So they do not participate in the control of an outbreak that, for some people, the vulnerable people, the elderly, with underlying conditions, disproportionately hit minorities, for those people, this is a very serious threat. I find thats, in both cases, we had messaging difficulty, messaging of getting people to understand what hiv, aids was and what it ultimately would turn out to be. I find we are having the same messaging difficulty right now. Those are the similarities, and those are the differences. Dean mackenzie do you think we will ever learn the general public will ever learn thats message, that it is not just taking care of yourself but of a community . Dr. Fauci i hope so. That is at the essence of Global Health. Are interested only in individual health, youre putting yourself in somewhat of a vacuum, which means if it affects me, and flicks me, bothers me, i worry about it. If it doesnt, who cares. That is the antithesis of someone who is aware of and connected to the concept of public and Global Health. Its what i say when we talk about covid19, its the same theme i mentioned a moment ago, that if a person gets infected and says to themselves, chances are im not going to consequence,rious it doesnt matter to me, ill do whatever i want to do, practice misbehavior, go to bars, be crowded, not wear a mask. Yourwould be fine if infection doesnt ultimately impact other people. But youve got to get the message, people, that if you get even if you dont have a single symptom, you are propagating a pandemic. By getting infected, you are keeping the pandemic alive, so that even without symptoms, you may inadvertently and even use the word innocently affect someone else who will affect someone else, and then you might have someone who is really vulnerable, someones grandparent. Has Breast Cancer and on chemotherapy, someones beloved wife, child with immune deficiency, an africanamerican person with sickle cell disease. Those are the people who will be at high risk of serious consequence. If you think by getting infected and saying poopooing remote pension youre becoming a problem if you are you are becoming the problem while trying to become a solution. To talkkenzie we need about how to get the message out. At the root of things, it is so important. Im hoping this pandemic will change the discourse, but we will see. You have been at an iad for many iad for years. N the would you say about relationship between bias and politics . Dr. Fauci i would get them to understand there is a difference between politics and policy. Science and evidencebased facts that you bring out. Going with the data, going with the science, and being flexible enough when you are dealing with an evolving situation, which we are in the middle of right now. We still do not know everything we need to know from a Public Health, from a clinical, or from a scientific standpoint about covid19. So when youre talking about policy, making policy, what should we doing we should be doing in a Public Health measure . How do we prevent the spread . What do we do about School Opening or not . About business opening or not . Thats based on scientific facts. Politics are different thing. When you do with politics, you have people who, understandably, because politics are good, how countries are run, people have agendas. They may not necessarily coincide with you as a public with what you as a Public Health person sees as using the evidence and facts to guide your policy. My advice to people, unless you want to be a politician, stay away from the politics and let science and good data and good evidence guide your policy. Dean mackenzie and youve done an excellent job on that. I know its not easy all the time. As someone who has had a strong connection to academic edison and ill medical research, what you see is the role of universities on the policymaking process, and how has this role evolved over time, and what july universities to do, what role would you like them to play in the current pandemic . Dr. Fauci the universities, isluding very much your own, really the home of such talentsinary academic of people who come in with an inquisitiveness to learn, to get men to the facts, which to is an indispensable of any effort of science or Global Health. The government itself, the nih, for example, of which i am a member of one of the institutes, has been historically a great supporter of what goes on at universities and schools of Public Health. I think you need to synergize and partner with each other. I do not think the federal government do this by themselves. I do not think the Academic Community would have the support to be able to do it by themselves. And then we want to bring in another component, which is as important as the other, the pharmaceutical companies. Partnership between the pure academics of the university with the mandate that a government has, particularly for Public Health and health of the nation and the world, to develop interventions that are going to get us to that goal, bringing in the pharmaceutical companies. I think the academic institutions, the universities, medical centers, the schools of Public Health, schools of medicine are extremely important to any effort we are going to make an Public Health for our own nation as well as globally. Dean mackenzie so we need to partner more . Dr. Fauci absolutely. You cannot silo at all. Dean mackenzie heres a question our faculty are particularly interested in asking you. Especially our early career faculty are whites worried about the effects of the pandemic, related research delays, and looting reluctant nations to enroll in studies, covid studies , and other issues. While we are grateful the nih allows investigators to draw their grants draw on their grants, we need to backfill those funds. Is, the question especially in the relation to our young investigators, which we worry about more than ever during the pandemic. Dr. Fauci you bring up such an important point that is very troublesome to us. Prior to covid19, we were concerned about the lack of consistency of funding for the nih and young investigators who rely on funding for Institution Managers institutions like the nih does not know what will happen two to three years from now, particularly when they see their mentors being insecure about getting a grant. Fortunate enough that congress, over the last several years, not counting this past year because it has been money into special products special projects for covid19, they have been generous with us, the congress has been extraordinary with their generosity to the nih. Led by heroes on both sides of the aisle in the senate and house. But now, when you have this interaction in the hiatus, the only thing i can say to encourage the young people, so please hang in there and dont give up on what could be a to please hang in there and dont give up on what could be a success at the nih, to go and get resources to backfill on the lost time and experiments. Self tell you, in my own and laboratory at nih, where you have cohorts you are following and you cant bring them into the hospital. And we have Clinical Trials that are two your Clinical Trials that all of a sudden have to stop and pause, and i do my best to encourage the young faculty to just hang in there, its going to get better, i promise you. Dont give up. Dont give up. [laughter] the day will come, i assure you. Dean mackenzie well thats a great message, and i hope our faculty, especially young ulty are you listening faculty, are listening. Our studentst to and asked if they have questions for you. We got a few. One question submitted by a [inaudible] related back to what you are talking about. And the difficulty in enrolling patients to trials and cohort studies and how it might be getting more difficult. The question from the student is, what advice would you have for students concerned about erosion of the general Publics Trust in science, to try to gain that trust back in the future line of work . That is something, as investigators and scientists, we are quite concerned about. Dr. Fauci yes. I think that being strained and stressed right now, what we are going through with covid19, and we are already seeing expression of reluctance in not trusting the scientific establishment, to free themselves of political influence about whether a vaccine is safe or effective. So what we in the scientific community, the young people, people at intermediate levels, and people at my levels, been here for decades, continues to abide strictly by the tenets of science, the honesty, the transparency, the flexibility, the humility of knowing that we dont know everything at any given time. I think when the general public sees that in the scientific community, this we admit we dont know everything and that science is evolving. One of the things i think we need to do a better job at is to get across the concept that science is in so many were spout is in so many respects selfcorrecting, meaning as things evolved, you do an experiment where you gain scientific knowledge, and it might be absolutely true for what the situation is at that given time. But as more data and more knowledge evolves in the situation, you might have to say, you know, we thought it was say, you know, we thought it was this way back then, but we have to know that Scientific Data says it is different than we thought. So it is just pure honesty and transparency that i think will get us out of any skepticism about our motivations and about the scientific community. Dean mackenzie and you think that will translate into the publics acceptance of vaccines, once we have a vaccine . [inaudible] dr. Fauci yeah, but we have to do it correctly. We have to make sure we stick by and insist on the scientific standards that we put forth before we make a decision about whether something is safe and effective. We cant compromise. The public is trusting us, and if we really want to get into a problem of dissolution of trust, it would be to veer from sticking strictly to the Scientific Data and scientific information. So lets take a deeper dive into the current pandemic. The u. S. Is seeing over, by last counts, 50,000 cases, new cases of covid19 per day. What do the Current Trends tell us about the countrys response, and what is ahead for us for the next six months . Dr. Fauci i am concerned about that, dean mackenzie. We have a baseline now. The baseline fluctuated. It never went on to the level i would have hoped it went down to. When we had a big peak in the early spring, driven predominately by the northeast and majority in some respects of the hospitalizations driven by new york and the new york metropolitan area, when it came back down in new york, other states and regions of the country went up. To aaseline never got down few thousand, less than 10,000 per day. Its kind of got stuck at 20,000. Then, when we tried to open up the economy, particularly in the thern states like florida, georgia, texas, southern california, arizona, it was not done uniformly and we saw a surge that came up to about 70,000 per day. It is now starting to come down, but it stuck around 40,000 to 50,000. You cannot enter into the cool months of the fall and cold months of the winter with a high baseline infection. And looking at the map baseline, and looking at the map and seeing the heat map and seeing how it lines up of test positivity is more than 30 plus states going in the wrong direction. Right now, at least where you and i live, we will start doing a lot of things more indoors rather than outdoors, and that is when you have to be particularly careful about the spread of a respiratory borne disease. It is still not too late to vigorously apply good Public Health measures. I emphasize again, without necessarily shutting down the country. , Public Health officials, talk about implementing Public Health measures, people think that we want to shut the country down. We dont want to do that. We want to use Public Health measures in a prudent, careful way to help us to reopen the country, to reopen the economy, to get jobs back. So Public Health measures, as i have said many times, needs to be the vehicle and gateway to opening the economy, not the obstacle to opening the economy. Dean mackenzie for those of us for some of the folks in the audience can you go through what Public Health measures are . Dr. Fauci they are really quite simple but are important, because we know they work. One is uniform wearing of masks or face coverings. Number two is to the extent possible, keeping distant. Mostr three is likely the important, avoid crowded places, congregate situations in which you have a lot of people, predominately indoors, crowded together without wearing masks. Fourth, do things to the extent you can outdoors preferentially you can, outdoors preferentially over indoors. And finally, washing your hands as much as you can. All those go to mitigating a respiratory borne acquisition or transmission of infection. You can do that while you are still marching carefully to opening up the country. It does not mean you have to revert back to closing the country. Dean mackenzie such an important message. Though i suspect many thanksgivings will look a little different this year. Dr. Fauci i think they will, dean mackenzie. I think people will have to make a choice of where they fit in the riskbenefit ratio of having someone come in from out of town who has been through a crowded airport, to come into a home, who do you have in the home . People,e vulnerable elderly, people with underlying conditions . I think each family needs to think about that and make a decision based on the level of risk want to put themselves through. Dean mackenzie the up yep yep. My next question goes off of the answer to our last question. Casesms to be surges of in particular regions of the some regulations are relaxin then numbers escalade. Are relaxed and then numbers escalate. How can we move toward a proactive approach and avoid this . Dr. Fauci i think what you are referring to is a walkable situation. Dean mackenzie yeah. Dr. Fauci i think what it is begging for is a consistent, uniform approach of all of this country pulling together to extinguish this high level of community spread. When you have some elements in some sections, states, cities, counties, what have you, doing it one way and then it dangers other areas, you think about the forest. As a gigantic when theres a fire in one part of the forest, one part of forest, the other part is vulnerable. You have to do things with the ultimate goal of getting over the outbreak. We have not done that as well as we could. Dean mackenzie a related question, i know these are not easy questions, but this is one coming from a student. The student writes my hometown is old people that are not taking the pandemic seriously. Social gatherings without masks. How can we get the word across . Yeah, the sigh as you and the question. I think it is justified because it is frustrating. Unless people can see the devastation and realize it affects them, we see so many examples of people who really take risks because they have a way of disassociating themselves from this problem looking us squarely i. Squarelyn historic in the eye. This is an historic pandemic. We are closing in on 8 Million People have gotten infected. On ais serious business, nonpejorative way, nonconference aid away, to get people to understand what their societal responsibility is. Once theenzie vaccines are available and widely distributed, do you think we will eventually return to normal . Are there aspects of this pandemic that will likely permanently change how we go about the way of things, or will there be a new normal . Dr. Fauci i think we will ultimately get back close to what was formally normal without even considering any of the things we consider right now. I think how quickly we get there and how completely we get there is going to depend on a number of factors that we can to nail down now. First, the efficacy of a vaccine. Effective . 70 , 90 as thective as important uptake of the vaccine. Will people willingly get vaccinated . Will they accept the fact that even after we get the vaccine, we would likely have to implement continued Public Health practices to some extent. We may not, for months and months into 2021 or even beyond, may not be able to, in every section of the country, have theaters that are just completely packed. Events whereorts the spectators are crowding over each other. We may not get there for a while, depending on the factors i mentioned. Vaccine uptake and our ability to implement some form of Public Health measures. Dean mackenzie just a couple other questions. Heres one from a student from the school of medicine. The student writes, this pandemic, and you address this to some extent earlier, but the pandemic is a Global Economic global phenomenon and will be a threat until it is vanquished from all corners of the globe. What can we do to ensure Global Health security . Dr. Fauci there are a lot of attempts to do that. One of the attempts is the Global Health security network, to have a network throughout the world of interaction among countries that would recognize, early on, anything that even resembles the beginning of an to share specimens, to be transparent, and to help each other out, because as i said, it is important to the United States to put together pull together, because we are all in it together. When it comes to a global pandemic, every country on the globe is in it together. Dean mackenzie our last question, i would love to get your thoughts on something on the good lessons we might learn and take away from this moment in history. The public has shown an inrecedented demand data. We see it every day at john day here atour own bloomberg school. What can we do to sustain this in the months and years to come . Dr. Fauci i think it is a realization on the part of people on what counts is facts and truth, and data. As people get more experienced in these arenas, they realize that we are a datadriven discipline. We are. Some other disciplines are driven by artistic creativity. I like that. That is wonderful. That is not what we do. What we do is datadriven things. Mentation cant experimentation to understand disease, to understand local health issues, development of countermeasures, vaccines, diagnostic therapeutics, that is what we are and who we do. I think when you realize who you are in the instruments you have at your disposal, data and facts are our tools. So that is the reason why it is happening, think goodness. Dean mackenzie i think we need to leverage this opportunity so that we do better in the future. Thank you so much, dr. Fauci, for taking the time. I know you are very busy person these days, and we appreciate you being with us, and i personally enjoyed talking with you. Once again, we are so fortunate to have your leadership and insight at this historic time for all of us. Thank you to my cohost,. Resident rhonda he sends his regrets. Event, a be a portal kickoff event, and will be an event hosted at john hopkins medicine. I hope you will join my colleague, dean of the john Hopkins School of medicine, for the next session in the next few months. As we check back on the john hopkins coronavirus resource center, we will have more information on that supposing him and great information and other great information. Thank you again to dr. Fauci and to everybody here in the audience. Stay safe, be well, and have a great afternoon. And q. Dr. Fauci thank you very and thank you. Dr. Fauci thank you very much mackenzie. Dean mackenzie absolutely. Join us this afternoon for remarks from 2020 democratic president ial candidate joe. Hes expected to talk about a an event. And later, more camping 2020 with President Trump traveling to georgia today for a Campaign Rally in macon. Watch that live at 7 00 p. M. Eastern here on cspan and cspan. Org, or listen with the free cspan radio app. We are weeks away from election day, november 3, when control of congress and who occupies the white house next year will be decided. Stay with cspan to hear President Trump and joe biden make their case to the american public, and watch debates in some of the hotly contested house and senate races. Campaign 2020 coverage, every , oron cspan, cspan. Org listen on the free cspan radio app, your place for an unfiltered view of politics. Available inents, paperback, hardcover, and ebook , presents biographies of every president , inspired by conversations with noted historians about the leadership skills that make for a successful presidency. Toa mex as americans go the polls next month to decide who should lead our country, this offers perspective into the lives and events that forged each president ss leadership style. Leadership style. Learn more, visit sidents or thepre wherever books are sold. The contenders, about the men who ran for the president ash butwho ran for presidency lost. Tonight, the arizona senator who paved the way for younger conservatives. At 8 00enders, tonight p. M. Eastern, on American History tv, on cspan3. Now, Washington Post reporters and the columnist preview the 2020 election. The panel talked about the competing townhouse between joe biden and President Trump and this weeks hearings for judge amy coney barrett. Good morning. Im an opinion writer for the Washington Post. Welcome to first look, Washington Post, onestop shop for news and analysis on the most pressing political issues of the day. This morning, we are reviewing an actionpacked week, any coney barrett