Millions across the country and the world, dr. Fauci has emerged in this moment as a trusted source of Scientific Authority and humanity. For four decades, dr. Fauci has exhibit five scientists as public servants. 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 parties on all pandemics our world has seen from sars to zika and ebola, to ensure science drove effective policy. Now, in the covid area, he continues his servants and commitment to deliver the best information for the policymakers and the public. In a 2005 essay, dr. Fauci revealed three Guiding Principles of life, of his life. To seek and learn every day, to 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 fauci back to john hopkins university. Dr. Fauci. Dr. Fauci thank you very much. It is a pleasure to be here with you today and im looking forward to our discussion. This is an extraordinarily important topic. This is a historic pandemic, the likes of which we have not seen in our own 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 that i believe our audience will be interested in. Thank you. Thank you so much. Whate been listening to you have been telling the public and your message is so clear. That message is all 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 back 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. As dean of the school of Public Health, 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 collaboration with the Smithsonian Organization to discuss responses to the 1918 pandemic. You may not remember this, but you were our keynote speaker. In response to the symposiums topline question, are we prepared for when the next pandemic hits, the answer from our experts was a resounding no. Even though it was acknowledged we made lots of progress. Here we are together again today, facing the reality painted for us that afternoon almost three years ago. [inaudible] since that 1918 influenza pandemic when we first admitted our first flu. We continue to pursue the greatest Public Health challenges by doing the research and translating that research into programs and policies that make a difference in peoples lives. On behalf of my colleagues and our legion of alumni around the world who i know 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 perhaps i can start the question by reflecting on your nearly fourdecade career leading the National Institute of allergy and infectious diseases. You have led the United States in its response to hiv, aids, respiratory infections, tuberculosis, and emerging diseases including ebola and zika. My question is, what strives you to continue this work and do you response evolved in any way . Dr. Fauci the thing that drives me is my 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 fundamentally a physician but also a scientist. When i got involved as the director of the institute, i had been an aids researcher for a few years before then, fundamentally a chief of a laboratory at the nih, doing Clinical Research on hiv. When i became the director of the National Institute of allergy 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 really became totally committed to that. When you say what drives me, what is the driving force, it is the realization, not only of the enormity of 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, you mentioned the role of government. Government, at its best, can 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 form 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, with 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, the cdc, through other agencies of the federal government, it has really been critical to the viability of a good public and Global Health effort. It is something that as i know you do, dean mckenzie, something that i love, something that is a task that 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 seems to me that you cant 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. You mentioned your early years in fighting hiv and aids. Can you reflect on how the experience in those early years has informed your response to the current pandemic . Dr. Fauci there are some similarities and some stark differences. Back then, it was perceived as a very restricted problem. I remember i wrote an article in 1981 that got published in 1982 that says anyone that thinks this disease will stay restricted does not know much about these issue, because chances are it will be a global issue. As it turned out, very unfortunately, that was prophetic. But we had difficulty getting mobilized tozed realize the potential impacts of this, because it did not universally affect people in a uniform way. It was a behaviorally related disease, whether the behavior was something people could not avoid or was part of a culture, or what have you, it was behavior related. Whereas what we are dealing with now is a very complicated issue, i must say, dean mckenzie. It is complicated because it is 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, an effort, that this is something that is serious, that we need to take seriously, and all you need to do is look the numbers 215,000 deaths in the United States. 7. 8 million infections. Over one Million Deaths worldwide. And yet, 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 want to participate in the control of an outbreak that, for some people, the vulnerable people, the elderly, those with underlying conditions, disproportionately hitting minorities, for those people, this is a very serious threat. I just find that, 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 that 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. If you are interested only in individual health, youre putting yourself in somewhat of a vacuum, which means if it affects me, aflicts 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 have a deleterious consequence, so it doesnt matter to me, so ill do whatever i want to do, practice misbehavior, go to bars, be crowded, not wear a mask, that would be fine if your infection doesnt ultimately impact other people. But youve got to get the message to people that if you get infected, 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 ill even use the word innocently affect someone else who will affect someone else, and then you might have someone who is really vulnerable, someones grandparents, a woman who has Breast Cancer who is 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 consequences. If you think by getting infected and saying poopooing the prevention modalities, no, you are becoming part of the problem when you should be trying to be part of the solution. Dean mackenzie we need to talk 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. Moving on, you have been at niad for many years. What advice would you give to Aspiring Health policy leaders about the relationship between science and politics . Dr. Fauci i would get them to understand that there is a difference between politics and policy. That means that 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 be doing in a Public Health measure . How do we prevent the spread of infection . What do we do about School Opening or not . About business opening or not . Thats policy based on scientific facts. Politics are different thing. When you deal with politics, you have people who, understandably, because politics are good, politics is how countries are run, but people have agendas. They may not necessarily coincide with what you as a Public Health person sees as using the evidence and facts to guide your policy. My advice to young 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 medicine and medical research, what you what did you see as the role of universities on the policymaking process, and how has this role evolved over time, and what do the universities to do, what role would you like them to play in the current pandemic . Dr. Fauci the universities, including very much your own, is really the home of such extraordinary academic talent of people who come in with an inquisitiveness to learn, to get down to the facts, that is, to me, 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 could 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. You have a 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, which is bringing in the pharmaceutical companies. I think the academic institutions, the universities, the medical centers, the schools of Public Health, schools of medicine are extremely important to any effort we are going to make in 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 that our faculty are particularly interested in asking you. Especially our early career faculty are quite worried about the effects of the pandemic, related research delays, including reluctance of nations to enroll in studies, covid studies, and other issues. While we are grateful the nih allows investigators to draw on their grants, we need to backfill those funds. I guess the question is, how concerned are you about the ,mpact of the pandemic on nih in relation to the advancement of young investigators . We worry about our young investigators more than ever during the pandemic. Dr. Fauci you bring up such an important point that is very troublesome to us. As you know, even prior to covid19, we were concerned about the lack of consistency of funding for the nih and young investigators who rely on funding for institutions like the nih, have an insecurity of knowing what is going to happen two to three years from now, particularly when they see their mentors being insecure about getting grants. We have been fortunate enough that congress, over the last several years, not counting this past year because it has been money put into special projects for covid19, they have been generous with us, the congress has been extraordinary in 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 interruption and the hiatus, the only thing i can say to encourage the young people, please hang in there and dont give up on what could be an enriching career. At the nih, we are trying hard and i think we will be successful to get resources to go and backfill on the essentially lost time, lost experiments. I can tell you, my own self and my own laboratory at nih, where you have cohorts you are following and you cant bring them into the hospital. And we have Clinical Trials are twoyear Clinical Trials that all of a sudden have to stop and pause, and i do my best to encourage the postdocs, 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 faculty are listening to this and hear that message. We reached out to our students and asked if they have questions for you. And we got a few. One question submitted by a back to what you were talking about and the difficulty in enrolling patients into trials and cohort studies and how that might be getting more difficult. The question from the student is, what advice would you have for students concerned about the erosion of the general Publics Trust in science, to try to gain that trust back in the future line of work . Because that is something, as investigators and scientists, we are quite concerned about. Dr. Fauci yes. And i think thats 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, the people at intermediate levels, and people at my levels, at my level, which i have been at for decades, is to continue 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. And i think when the general public sees that in the scientific community, that we admit we dont know everything that science is evolving and one of the things i think we need to do a better job at is to get across the concept that science is really in so many respects selfcorrecting, correcting we mean evolve, 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 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 effective vaccines . 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. Dean mackenzie so lets take a little bit of a deeper dive into the current pandemic. The u. S. Is seeing over, by last 5500 new cases of compared to day a high of 70,000 over the summer. 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. Because we have a baseline now. The baseline fluctuated. It never went down to the level i would have hoped it went down to. When we had the big peak in the early spring, driven predominately by the northeast and the majority, in some respects, of the infections and hospitalizations were driven by new york and the new york new yorkm metropolitan area. When it came back down in new york, other states and regions of the country went up. The baseline never got down to a few thousand, less than 10,000 per day. It kind of got stuck at 20,000. Then, when we tried to open up the economy, particularly in the Southern 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. Now it is now starting to come down, but it stuck around 40,000 to 50,000. It is 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 Community infection baseline. And, looking at the map, and is seen the heat map and seeing the heat map, how it lights up more thanpositivity, 30 plus states are 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. So it is still not too late to vigorously apply good Public Health measures. Again, i emphasize, without necessarily shutting down the country. Because whenever we 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 those folks in the audience, can you go through what Public Health measures are . Methoduch an important message. 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. , number three is likely the most 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 more than indoors. And if it is indoors, good ventilation. And finally, washing your hands as much as you can. All of those are directed 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. Although 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 may be from out of town, who has been through a crowded airport, to come into a home, who do you have in the home . Are there vulnerable people, elderly, people with underlying conditions . I think each family needs to think seriously about that and make a decision based on the level of risk they want to put themselves through. Yep. Mackenzie my next question goes off of the answer to our last question. If you look through the country, it seems to be a cycle where we have a surge of cases in particular regions, they decrease or plateau, restrictions are relaxed, and the numbers escalate. How can we move away from this reactive approach to Public Health and move towards a proactive approach . Dr. Fauci i think what you are referring to is a whack a mole 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 its sort of, in many ,espects, endangers other areas you kind of have to think about the country as a gigantic forest. And when there is fires in one part of the forest, the other part of the forest is vulnerable. You have to be consistent. You have to do things with the ultimate goal of getting over of getting control over the outbreak. Unfortunately, i do not think we have 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. At the school of arts and sciences. The student writes, my hometown is old people that are not my hometown is full of old people that are not taking the pandemic seriously. Social gatherings without masks. How can we get the word across . Dr. Fauci sigh as he read the question. You sigh as you read the question, dean mackenzie. 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 at us square in the i. This is a historic pandemic. 215,000 people have died already and we are closing in on 8 Million People who have gotten infected. That is serious business. We need to keep trying, in a nonpejorative way, nonconfrontational way, to get people to understand what their societal responsibility is. Dean mackenzie once the vaccine or 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 doing things or will there , be a new normal . Dr. Fauci i think we will ultimately get back close to what was formerly 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. That we cannot nail down now. First, the efficacy of a vaccine. Is it 60 , 70 , 90 effective . As important is what is the uptake of the vaccine. Will people willingly get vaccinated . Will they accept the fact that , even after we get a vaccine, we likely would have to extent,t, to some continued Public Health practices. For months and months be able to, beyond in every section of the country, have uninhibited theaters that are just completely packed. Sports events where the spectators are crowded all 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 addressed this to some extent earlier, but the pandemic is a 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 them is the Global Health security network, to have a network throughout the world of transparent interaction among countries that would recognize, early on, anything that even resembles the beginning of an outbreak, to share reagents, to share specimens to be , transparent, and to help each other out, because as i said, it is important for the United States to pull together, because we are all in it together, when it comes to global pandemics every country on the globe is in , it together. Dean mackenzie for sure. Our last question, i would love to get your thoughts on some of the good lessons we might learn and take away from this moment in history. For instance, the public as shown an unprecedented interest in data. We see it every day at john publishing our own channels at the bloomberg school. What can we do to sustain this in the months and years to come . Dr. Fauci, yeah dr. Fauci yeah i think it is , a realization on the part of people on what counts is facts and truth and data. I think as people get more experienced in these arenas, they realize that we are a datadriven discipline. We are. I mean some other disciplines , are driven by artistic creativity. I like that. That is wonderful. But that is not what we do. What we do is datadriven things. Be they experimentation to understand disease, experimentation to understand Global Health issues, development of countermeasures, vaccines, diagnostic therapeutics, that is what we are and what we do. I think when you realize who you are and the instruments you have at your disposal, data and facts are our tools. So that is the reason why it is happening, thank 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 your being with us, and i personally enjoyed talking with you. Once again, we are so fortunate to have your leadership and your insights into this historic time for all of us. Cohost, president ron daniels, in absent for. In absentia. He sends his regrets. This will be a portal event, a be an ongoing event, quarterly a 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 our next session in the next few months. As we check back on the John Hopkins Coronavirus Resource Center for more information on symposia and other information. Thank you again to dr. Fauci and to everybody here in the audience. Stay safe, be well, and have a great afternoon. Thank you. Fauci thank you very much, dean mackenzie. I appreciate you having me on the program. Thank you. Make dochoice to i let my people run it well or badly . If i run it badly, they will blame me, but more importantly i want to help people. He has already cost 10 Million People there health care because of his recession. Their health care because of his recession. The second president ial debate between President Donald Trump and former Vice President joe biden thursday from Beaumont University in nashville, tennessee. Live coverage begins at 8 00 p. M. Eastern on cspan. Watch live on the cspan app. Fouro to the website live or ondemand streaming of cspans debate coverage