Live on c span. Org or listen on the cspan radio app. Dr. Anthony fauci, the chief medical advisor on the white house covid19 response team. He discussed the latesting on vaccine research. His 30 minute conversation with the Washington Post now. David good morning, everyone. Todays guest is one of the most familiar faces in the fight against covid 19, dr. Anthony fauci. Thanks for joining us. Welcome. Dr. Fauci thank you. Good to be with you. David every time we think we see some light at the end they have covid turtle we worry theres another train coming at us. I want to ask you to help us understand what we should worry about, what we should welcome and what we dont know enough about to have a clear view. So let me begin with this issue of the new variants of covid19. You said on friday that these new variants, which appear to be more infectious, maybe more deadly, maybe harder to treat, could outnumber the old virus by march or april. I want to ask how concerned you are about these new variants and about the possibility that they might produce another surge of the virus that will be difficult to handle. Dr. Fauci we take them very seriously, david. Rna viruses, which sars coronavirus 2 is mutate readily and mutate much better when they replicate a lot, like when off lot of infection in the community. What we have seen evolve over the last few months is something that is not unexpected. There were mutations, many of which have no functional relevance at all. They dont change anything functionally about the virus. But every once in a while, if the virus replicates enough, namely when theres a lot of infection in the community and the world, you go mutations that do impact the virus function. For example, could make it more transmissable. Could have an effect on making it more dangerous in the sense of causing more serious illness. But importantly, it could ultimately evade or avoid the protective effect of both monoclonal antibodies and the antibodies induced by vaccine. What we have seen is mutations that are noteworthy. One was first noticed in the u. K. And its a different lineage, referred to as b117. That increased the transmissability of the virus. And just recently, the british colleagues have said that it actually increases somewhat the seriousness of the infection. We have that mutation in the United States now, you know, in several states, over 30 states and well over 400 instances of that. One thing about that, that it doesnt seem to evade very much at all the protection you would expect to get pr the vaccine. A mutation thats a much thats much more concerning and problematic is one that has evolved to be the dominant virus in the republic of south africa, and that is one that has the terminology b351. That one is now has now taken over in south africa and it is concerning because it much more evades the protective effect of antibodies induced by the vaccine, not enough to make the vaccine not effective, but makes them less effective. So rather than really, really, very good protection it diminishes it somewhat but still within the range of protection. We know that from data we got from a recent vaccine study from j j, johnson johnson, and their sub saidary. What we have to be careful is that as the virus continues to replicate it will accumulate more mutations. And even though we still have a degree of protection from the vaccines that are used, there are two issues that need to be addressed. A, weve got to do good surveillance, namely, genomic sequencing surveillance so we know when these mutations arise in our country, and b, we need to be prepared to upgrade the vaccine if it turns out that they evolve more to completely avoid the protective effect of the vaccine. So there are challenges ahead. We can meet them, david, but its something we really do need to take very seriously. David let me just press on on the most worrisome example you cited, the south african variant. How concerned are you that this could get out into the population in the u. S. . And beyond that, dr. Fauci, whats the chance that we could get a superresistant version of this virus . Something thats in effect super drug resistant, very hard to treat . Do you see that as a possibility . What would you recommend if that appeared to be developing . Dr. Fauci let me answer your first question first. We know now that the south african mutant is in this country. There have been two cases recognized in South Carolina and one in maryland. The fact that they are recognized in people who have not had a trip to south africa means that theres Community Spread and more people are infected. You cannot imagine for a moment that its going to be staying essentially restricted to just a few people. So its here, it likely will spread more. In answer to your second question, thats always something you have to consider as a possibility. If you dont, then youre not being realistic. However, experience tells us that we have the the capability from a scientific standpoint of when a virus mutates and does evade, for example, the antibodies that a given vaccine is inducing, that you almost certainly can modify that vaccine to be able to adequately address the new mutant. But its something you have to stay ahead of. You have to stay one or two steps ahead of the game. But you dont want to frighten people but you could say always that this virus which is an extraordinary virus in what it can do, i mean, its capability of extraordinarily efficient spread, understanding when you try to contain a virus, either with a drug or vaccine, what it does, it gets pressure to mutate and the more pressure you put on it, the more it mutates. As i have said many, many times and i would like to say it again oso people can understand it, the best way to prevent the evolution of mutations is to suppress the replication of the virus in the community. Which means that we need to vaccinate as many people as quickly as we possibly can and as efficiently as we possibly can. Because when you suppress this replication that right now is very rampant, when you think of all the new cases every day not only in the United States but in the world, that leaves an open Playing Field for the virus to mutate. You can you constrained it a bit by vaccine vaccinating people, you diminish its ability to mutate, so thats one of the strong reasons we need to push ahead with vaccination. David given that rapid replication and the dangers you discussed, one of your colleagues, michael osterholm, a top epidemiologist, part of President Bidens transition team, says the u. S. Needs to call an audible, as they say in football, with its Vaccination Program and start giving single doses to as many people as possible to get ahead of a likely surge and to do precisely what youre describing, which is to reduce the Playing Field. Is he right . And if not, why not . Dr. Fauci it isnt a question of right or wrong. What michael is saying is that we need to vaccinate as many people as possible with the doses that we have. The science tells us, the clinical trials, the 30,000 people in the moderna trial and the 44,000 people in the trial by pfizer, that the optimum approach to get a really good response is 21 days after the first dose, for pfizer, and 28 days after the first dose for moderna, you should give a boost. We know that. What michael was saying is that you have limited am of vaccines, just get as many people as possible with the first dose and dont worry about the second dose. The difficulty with that, even though you can say it makes some sense, and not completely ignore it, theres a danger there. The danger is that the efficacy following a single dose is not as great as after the second dose. And if you have suboptimum efficacy you could in fact paradoxcally be selecting for more mutations. Thats the danger there. So what were doing right now is trying to get a predictable flow of doses out there so you can get as many people in the first dose and then as the next shipment comes in, to make sure when the second doses do, to give the second dose to people at the same time as you have enough vaccine to go to the next level of giving more people first doses. So its a question of taking a chance, you know, it isnt completely outlandish. But right now what we really do need to do, david, that would solve that and not require getting back pulling away and saying only a single dose, is to ramp up the availability of vaccine doses, not only with moderna and with pfizer, but also with the new candidate for the coming online new candidates that are coming online like the johnson johnson, the novavax and others. If we can get more vaccine into the mix, we could really essentially have it both ways. We can get many more people getting their first dose but also have the capability of getting a second dose. And by the way, david, the j j candidate is only requires a single dose as we know if the recent study. So there are ways around that. But again, what was proposed by dr. Osterholm is not completely outlandish, but we think we can accomplish the goal without doing that. David just to finish this out, dr. Osterholm says he thinks that hes concerned about another wave coming because of these variants in the next six to 14 weeks. He has an urgent time frame. What would it take for you to move to this, lets call an audible . The science tells us two doses of the pfizer and moderna, but lets move to a different approach, what would it take for you to move to that position . Dr. Fauci again, if it was very clear that we really did not have enough vaccine to accomplish what i just explained a few moments ago if there was a situation where the predictable availability was not where we want it to be and we say, well, were in trouble here, weve just got to get as many people with the first dose vaccinated as we possibly can. But as you heard from President Biden a day or so ago, what were doing right now is trying to get a threeweek lead time so that the locals can actually know what to expect and they can do their planning accordingly. David youve been doing this your whole adult life, this treatment of infectious disease. Is this virus unusual in that its its mutating in ways that are difficult to deal with more quickly than youd expect or than would be tipical call typical with other viruss . Dr. Fauci not necessarily, david. There are viruses that mutate much more quickly and easily. What this virus has is a constellation of characteristics that is very problematic. I can say, i mean, you asked me a question of all the viruses that ive had to deal with in my multidecade career of now over 40 years, have i seen viruses that mutate this much . The answer is yes. What i have never seen is the constellation of characteristics of a virus that, if you want to make a metaphor out of it is so nefarious. On the one hand it infects many, many people, has great deal of efficiency of transmission, and yet, maybe 40 or more of people dont get any symptoms at all and 50 of all the infections that are transmitted are transmitted by people who either never will get any symptoms or are presymptomatic. The reason thats so disturbing, because on the one hand if you looked at that and say thats a relatively benign virus. However, it also has the capability of selecting out vulnerables, we know who they are, the elderly, those with underlying conditions, every once in a while, relatively speaking, unusual, it will get a young, healthy person who has no underlying conditions. But it has this nefarious way of really getting to the vulnerables and creating a High Percentage of morbidity and mortality. So you have this unusual virus that for so many people is trivial. It gives them, you know, relatively minor, maybe even no symptoms at all, and on the other hand it has accounted for over 430,000 deaths in the United States in a year. You know, ive never seen anything so di cot mouse as that, where on the one hand looking benign for so many and on the other hand being absolutely deadly for others. David nefarious is the takeaway word of the day. We have a few questions from viewers of this program. Im going to offer you a pretty straightforward one, but its the kind of things lots of folks still worry about. This is from Michael Griffith in maine. He asked, why are n95 masks, or the equivalent for nonhospital use, why are they still so hard to find . Shouldnt we be manufacturing them a lot more . Why do you think people are still having trouble finding those . Dr. Fauci thats a good point. Originally when we were talking about masks, you didnt want to take them out of the availability of the people who really needed them, namely, the people who were being Health Care Providers. But theres no doubt that the classic n95 mask is the best type of mask to use. I mean, when im seeing patients under conditions of containment, i wear it, i have to get fitted for it, david, in order for it to be really effective. You have to have an absolute good fit where you have somebody stick a little tube in there and you start to breathe and realize that nothing is getting in there but it is able to come out when you breathe. Thats a little complicated. But that doesnt necessarily mean that you couldnt have n95. There are different versions, kn95 that isnt a typical n95. But there is a consideration to look now at the relative efficacy of different types of masks with the c. D. C. Starting to look at. They are not easy to wear all day. They can be somewhat uncomfortable, but i think people can get used to it. When i wear it with patients, i have on for maybe 40 minutes at a time, but to wear it all day could be a bit uncomfortable as opposed to the much more smooth type of either cloth or surgical masks. David do you think, on the subject of masks, that the c. D. C. Is likely to move toward a double masking recommendation . Cloth mask outside of a surgical or other mask . Or kn95 mask recommendation . Do you see that coming . Dr. Fauci thats possible. In discussions with my c. D. C. Colleagues yesterday, the c. D. C. Is looking at doing a study of seeing whether or not two masks might be better than one. It makes common sense that you would think, the reason they dont recommend it right now is the sciencebased organization, the c. D. C. , they make recommendations based on data and science. Thats the reason why, theyre going to look at that particular issue. The reason why many people are using double masking and in fact you probably have seen me wearing a double mask, is that you can make a general common sense extrapolation if one mask serves as a physical barrier if you put two on if youre looking for enhancing the physical barrier, it makes common sense that it certainly cant hurt and might help. But it doesnt yet reach the point of an official recommendation from the c. D. C. Because of the lack of data. But when people tell me or ask me, should i be wearing two masks . I say, you know, if it makes you feel better to do two masks, chances are youll get enhanced protection so why not go ahead and do it . David lets talk for a minute about challenges in the distribution of vaccines. As of sunday, the c. D. C. Said that about 25. 2 Million People have received at least one dose of a covid19 vaccine. About 5. 7 Million People have been fully vaccinated. Id be curious, as a scientist, as a researcher, what kind of grade would you give our performance in getting these vaccines into peoples arms . Are we doing a b job . A c job . An a job . What do you think . Dr. Fauci i would take it one step earlier to get the big picture, david. I think when you talk about developing the vaccine and getting a successful vaccine, thats an atripleplus on that, thats record breaking, 11 months to do. Getting them produced, thats good. But youre right, getting them into people, thus far early on, when it was tried at the end of december, got a bit of a shaky start in the sense of the the logistics of that, something new in essence taking on a task thats not been done before, youre right. It has not been perfect. One of the things that President Biden has made very, very clear is that things are not working well, dont deny it, dont try to run away from it, try to fix it. Thats what were trying to do. If you look at the National Strategy for covid19, part of that is try to expedite the distribution. And that would be in the mind of all of us on the team a much better collaboration between the federal government and the locals, particularly the states and the cities. The federal government is not going to fix this alone, nor are the states going to do it if you just leave them on their own without any help. What thats going to be is a cooperation and collaboration an a synergy between the feds and the states. But also, the rolling out of Community Vaccine centers to make it easier to get it done enmeas. Done en masse. Number two to get pharmacies involved. Number three, to use mobile units to get out to relatively inaccessible areas, particularly concentrating on the concept of equity, to get particularly minority populations who may not have as easy access to the vaccine, to get that done. All of that is being implemented now. I believe, david, that you will see in the next few weeks, a much bigger escalation, excuse me, an escalation of the capability of getting vaccine into peoples arms. David i take it this will be federal government led . Youll be working through state and local authorities, state and local pharmacies, etc. , but this will be led now from the center, from washington . Dr. Fauci exactly. Youll see much more involvement of the federal government than we saw in previous months where the states in so many respect were left on their own. Weve got to get the synergy between the feds and the states, particularly some leadership by the federal government. David let me ask you about the priorities for who gets vaccines. In the closing days of the previous administration, an order went out that people 65 and over should be the next traunch of eligible people after health care workers. Thats been implemented in some states, some counties, its a little bit of a hodgepodge. In terms of the basic science and medicine, do you think that makes sense now, to have 65 and older be the next benchmark across the country . Dr. Fauci it depends where youre starting from. The first benchmark was people who are the Health Care Providers and those in Nursing Homes and those taking care of them. Then you went to 65 or 75 or older with the first one, then individuals having essential jobs in society such as teachers. I think thats reasonable to bring it down to 65 and older i think is a reasonable adjustment of that. What were looking for right now is you get into the groups that have a much, much larger proportion of the population of the United States, that would hopefully be at a time when you get much more higher numbers of vaccines available. As we get out of february, into march and april, youre going to see a major escalation of the number of doses that will be available. I think were going to be able to accommodate them. When you get into a group, where the demand within the group exceeds the supply, thats when you have to be very organized in how you roll that out. So that you dont have people expecting that theyre going to show up and get vaccinated and you run out of vaccine or you have inordinate lines and people waiting. If its done in an organized way so people can get a good prediction of when their dose would be available, thats what were striving for. David what about the problem of Vaccine Hesitancy or resistance . There are folks who dont want to take that shot. Other countries have got pretty aggressive programs to deal with that problem. What about here . Are you and your colleagues thinking about some way to speak more direct to the public and say you need to do this . Dr. Fauci were not only thinking about it, were informsing an awful lot of time in that. I would say without hyperbole that a day does not go by when i am not out there in some form of outreach as well as so many of my colleagues, particularly in underserved populations. Spending a lot of time with black churches, black religious groups, brown and black Leadership Groups to be able to talk to them and explain to them why its so important for them and their families to get vaccinated not only for their own safety but the safety of their communitiesful so there is a concerted effort which is considerable in the sense of individuals as well as a group. So thats something we take very seriously because as i mentioned early on in our discussion, if you want to prevent the evolution that of mutations youve got to get as many people vaccinated as quickly as possible and if you have Vaccine Hesitancy or reluctance to get vaccinated youll never get to that overwhelming majority of the population which i estimated should be at least 70 to 85 before you get that blanket or umbrella of what we refer to as herd immunity, which if we do get that, there will be very few mutations because the virus is not going to mutate if it doesnt have a Playing Field to replicate. Vaccine hesitancy is critical and we are addressing it. David given some of the issues weve been talking about this morning, including delay in distributing vaccine in the u. S. , we havent talked about abroad but the problem is the same there, do we need to begin to revise our timetables for when this problem is going to be behind us . The wall street journal ran a story with the headline, vaccination delays put global rebound at risk. Noted that one of the swiss said only 10 of the world will be vaccinated by the end of this year only 25 by the end of 2022. Let me ask you, in conclusion, to address this. When do you think for us here in america life will get back to Something Like normal . Is that septembernovember . Next year . What do you think . Dr. Fauci its a great question, everyone asks it. But they have to be estimates that have contingencies. You cannot give a definite answer when you have so many moving parts. So let me explain what i mean. I think its important for the American Public to appreciate that because when you give a definitive time and it doesnt work out, they say, oh, the scientists were wrong, they gave us wrong information. It depends on so many factors. If you have the overwhelming population, lets say up to 85 , get vaccinated in a very efficient way, so that as you get into the summer, youve essentially vaccinated most of the people you need to vaccinate be that 280 million or 300 million, by the time you get to the end of the summer, you have them vaccinated. Youre going to approach some degree of normality as you get into the fall. But youve got to say, however, and i want to underline however about five times, david, because there are a lot of things that could get in the way of that. For example, we were talking about several of them. If we get a real problem with the mutation and the vaccine is not as effective and we dont address it by upgrading the vaccine, that timetable could change dramatically. Number two, if you have a degree of vaccine efficacy, that excuse me, Vaccine Hesitancy, then you have another problem. If youre striving to get 85 of the people vaccinated and you only get 50 of them vaccinated, then all of a sudden the timetable goes out the window. So you get mutations yao got to deal with. You get Vaccine Hesitancy to deal with. All those things are going to determine. So anybody can make a reasonable prediction of when were going to get back to some form of normality but i think the American Public has to realize that its all contingent on certain things going right. If they do go right then the numbers and the dates that i mentioned will be ok. One final thing that you alluded to a moment ago is that we live in a global community. And if we really want to talk about true approaching normality, then weve got to attack this at the global level. Which is the reason why the programs like covax, the consortium of countries which we recently joined now as President Biden became president , which means were going to help out with other developed nations and other organizations like garvy an other, to try to get as many people in the globe vaccinated vaccinated as quickly as possible. Whenever theres transmission and viral outbreaks throughout the world the United States will always be in danger no matter what we do. So again all of these things are contingencies, david, that will then get us to normal. But theyve all got to fall into place. Otherwise it would be really unpredictable when were going to get back to what we all want is what it was like before this happened, namely, normal existence. David a good point to end it on. The more people that get vaccinated at home and abroad, the safer everybody is going to be. I want to thank dr. Anthony fauci for being with us this halfhour so informative so help to feel all of us. Thank you, dr. Fauci. Dr. Fauci thank you, david, i appreciate you having me on. With the Biden Administration now leading the federal response to the coronavirus pandemic, follow the latest at cspan. Org coronavirus. Surf cspans coverage of news conferences as well as remarks from members of congress. Use the interactive gallery of maps to follow the cases in the u. S. And worldwide. Go to cspan. Org coronavirus. The u. S. House is scheduled to begin work on a covid19 relief plan this afternoon when they meet at about 5 00 eastern time. President bidens proposing a nearly 2 trillion plan. Senate republicans want a smaller aid package. Todays debate will start the process. Its expected to take a couple of days in the house. Well have live, gaveltogavel coverage here on cspan. Tonight at 9 30 eastern, the Police Officer who died in the january 6 attack on the capitol will lie in honor in the capitol rotunda. Well have live coverage of that and the congressional tribute for officer Brian Sicknick wednesday morning at 10 30 eastern time. You can watch live online at cspan. Org or listen to the tribute on the free cspan radio app. Former President Trump became the first president to be impeached twice. Last week house impeachment managers delivered the articles of impeachment against the former president to the senate with Maryland Democratic representative jamie raskin reading the article before the senate. Mr. Raskin Donald John Trump warrants impeach, removal from office and disqualification to hold or enjoy any office of honor, trust or profit in the United States, so help you god. The following day senators were sworn in. Senator paul requested a point of order. Therefore i make a point of order that this proceeding which would try a private citizen, not a president , Vice President or civil officer violates the constitution and is not in order. 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