It makes the world a more inclusive place. The Johns Hopkins school of Public Health i am honored to be here to watch john hopkins policy for him. Due to a lastminute scheduling change the president daniels is unable to join usee now we are recording this in advance for our broadcast we can think of no better person with whom to begin a series of dialogues then doctor b fauci of the National Institute of allergy and Infectious Disease. And those around the world he. Has emerged as a resource of reason and Scientific Authority and humanity and for for decades doctor fauci as a Public Servant and during the early years of the aids crisis doctor fauci was among the first 1 scientist that only to launch himself into research but with advanced treatment in the following decade the president s of both parties for evil a and was sound science and now in the covid era delivering the best information to policymakers and the public and in 2005 essay he revealed those three Guiding Principles of his life to strive for excellence so we are profoundly grateful following all three of these principles throughout his career our world is better for and healthier for you please join me to welcome doctor fauci to Johns Hopkins university. Thank you very much it is a pleasure to be here with you. Im looking forward to our discussion is extraordinary important topic that we are dealing with this is a historic pandemic the likes we have not seen in our own civilization 4102 years since the very historic and memorable 18 spanish flu. And then to discuss. Aspects the audience will be interested in. Thank you. Thank you so much. I had been listening to what you are telling the public but your message is so clear that we Pay Attention to those Public Health measures and get our communities and countries back on track and we thank you for your unwavering commitment to always speak truth to power. Thank you. So on a personal perspectiv perspective, clearly i am very pleased to host this conversation and actually one of my First Official duties is back in 2018 with the collaboration with the Smithsonian Institution with those Lessons Learned from the influenza pandemic and you may not remember this but you were the keynote speaker and with those topline questions are you prepared when the next pandemic it to answer from our experts even was acknowledged in here we are together again facing the reality from that afternoon almost three years ago. Every major Public Health crisis from 1918 influenza pandemic and then we continue to pursue the greatest Public Health challenge and then to translate that into making a difference in peoples lives so that legion of alumni thank you for your tremendous leadership not only on this unprecedented Public Health intersection. So with that let me begin and perhaps i can reflect on the nearly fouran decade career. You have led the United States and its response to hiv, aids and respiratory infections and emerging diseases including ebola. What drives you to continue this work . And has the federal governments policy eve alt . I what drives me is my commitment is the whole concept that of what they stand for Public Health not only of the nation but of the world i am fundamentally a physician but im also a scientist. When i got involved as the director of the institute, i had been and aids researcher a few years before then at the nih doing clinical invasive research with hiv when i became the director of National Institute of allergy and Infectious Diseases i was exposed to Global Health intertwined with hiv and it was so clear to me there were so many many problems throughout there world that could be addressed both by science, science application and good Public Health measureso. I became totally committed to thates so when you say what drives me and what is the driving force it is the realization not only the enormity of the problem but the fact we can do something aboute it. It is not the unsolvable series of problems but something we can do something about and the second part of your question mentioning the role of government inan that , government at its best can be responsible to be the individual private sector component we would not be willing to take up. So in the United States we have the realization there is the need for interventions in the form of vaccines and therapeutics for those that may not be commercially viable but the world needs them. We have seen that with many of the things we have done with malaria, tuberculosis that are not germane to the people of a given country but because it is a Global Healthob problem, if you look at what we have done through the nih and cdc and other agencies of the federal government, has been critical to the publicso Health Efforts that is something that i love and the task you wake up every morning feeling there is something we can do. The stakes are enormous its peoples lives and health. I want to put down any other profession but it just seems to me you cannot get much better than that if thats best for you are suited for and what you want to do. We are so happy you have that drive. So you mentioned your early years with hiv and aids and in those early years with the current pandemic . There are some similarities and some stark differences. Back then it was perceived as a very restrictive problem i wrote an article in 1981 published 1982 saying anyone who thinks this disease will stay restricted to an epidemiological group doesnt know much about Infectious Disease because the chances are it will be a global issue and it turned out very unfortunately, that was prophetic. Clearly had difficulty getting people mobilized to realize the potential impact because it did not universally affect people in a uniform way it was a behaviorally related disease whether something they could not avoid or culture but it was behaviorally related where as now its a very complicated issue i must say because it is having a global serious impact but very difficulty relating to the people how serious it really is because so many people who are infected with no serious consequences how do you mobilize a uniform message this is something that is seriouss and we need to take seriously and just look at the numbers. 215,000 deaths in the United States, seven. 8 million infections in 1 Million Deaths worldwide. Di understandably, people who look at the disease say chances are nothing will bother me so they dont want toou participate in the control of an outbreak for some people that are vulnerable for those with underlying condition on conditions, but for those people it is a very serious threat. So in both cases we have messaging difficulty to get people to understand what hivaids was and i find out where having the same messaging difficulty right now those of the similarities and the tbe differences. Will wefi ever learn that publicic Health Message that is part of the community not just yourself . I hope so because thats at the essence of Global Health if we are interested only in individual health you are putting yourself in a vacuum which means if it affects me or bothers me i will worry about i it, if it doesnt, who cares. That is the antithesis of someone who is aware of and connected to the concept of Global Health so when you talk about covid19 that if a person and gets infected and says that chances are i will not have deleterious consequences, it doesnt matter to me i will practice Risk Behavior go to bars now wear a mask, that would be fine if your infection doesnt intimate on ultimately impact other people but you t that get the message if you get infected, even without a single symptom, what you are doing is propagating a pandemic because by getting infected you are keeping the pandemic alive so even without symptoms you are innocently affecting someone else then you might have someone who is notable like a grandparent or the wife or a woman who has Breast Cancer on chemotherapy or a child with any immunodeficiency were africanamerican was sicklecell disease those are the people who are at very hiatus on very high risk so if you think by getting infected to say that prevention modality here in a vacuum, no you are part of the problem when you should strive to be a part of the solution. So at the root of things that so important and i am hopeful this pandemic will change the discourse but we will see. Moving on your been through many challenging moments as the leader so what advice to give to Aspiring Health policy makers there is a difference between politics and policy and that means science and evidencebased fax you take out and to be flexible enough in this situation which we are in the middle of rightht now, we still do everything we need to know from a clinical or scientific standpoint about covid19 so talking about making policy, how do we prevent the spread of infection what we do about business opening or not . That is policy based on scientific fact and then you people who arere understandably because politics is good people have the agenda and they may not coincide with what you see aser using the evidence to guide you in policies so my advice is, she want to be a politician still politics and let the good data guide your policy. You have done an excellent job of that and that hasnt been easy so touching on the connection what do you see is the role of university and how has this evolved over time and what role would you like to see them play as the current pandemic continues . The universitys including your own, is the home of such extraordinary academic talentedlo people who come in with the inquisitiveness to learn and to get down to the facts. To me, it is an indispensable part of any effort of science in Global Health. The nih of which i am a member of one of the institute institutes, historically has been a great supporter of what goes on at universities and schools of public s health. I thank you need to synergize and partner i think the federal government can do this by themselves. I think the Academic Community would have the support to do it by themselves. And then bring in another component, is the pharmaceutical companies. We have a partnership between the peer academics with the mandate that the government has in particular for Public Health of the nation and the world to develop interventions that will get us to the goal to bring in the pharmaceutical companies so the academic institutions universities and medical centers and schools of Public Health and medicine are extremely important to any effort we will make in Public Health for our own nation as well as globally. We need to partner more. Absolutely you cannot silo. Here is the question the faculty is interested in asking you. Especially with your early career those that are worried of the cascading effects of the pandemic leading to research delays with the studies of other issues. We are all very grateful the nih allows investigatorsor to find most often backfilled the fund. So how concerned are you of the impact of this t pandemic and we worry about the young investigators during the pandemic. You bring up such an important point it is very troublesome to us because even prior to covid19, we were concerned about the lack of consistency offending to the nih and those who rely on funding from institutions like the nih dont know what would happen in two or three years from nowpp particularly when they see their mentors being insecure then you superimpose that we have been fortunate enough with congress over the last several years, not counting this past year because money has been put in for special projects due to covid19 they have been pretty generous they have been extraordinary with their generosity to the nih led by some real heroes on both sides in the senate and the house. Now there is an interruption the only thing i can say to encourage the young people to hang in there and dont give up on what could be potentially and enriching career at the nih. We are trying very hard and i think we will be successful to get resources to backfill essentiallyl the lost time , lost experiments i can tell you my own self at nih with are followingu and we have Clinical Trials that all of a sudden have to stop and pause and i do my very best to encourage the faculty to just hang in there. Will get better. I promise. Dont give up. [laughter] that is a great message and i hope all of our faculty, especially young faculty are a listening to this to hear that message. That is great advice. So we reached out to students and asked them if they had questions for you one relates back to what you are just talking about and the difficulty with the trials and how thats a little more difficult so what advice about the erosion of the trust to gain that back because that something we are quite concerned about. Yes and that is being strained right now were going through with a 19 we are already seeing expressions of reluctance to not trust the scientific establishment to free themselves of political influence whether a vaccine is safe or effective. So what we in the scientific community, those intermediate levels and my level over decades, is to continue to abide strictly, the honesty and transparency and flexibilit flexibility, humility of knowing we dont know anything at any given time. And the general public sees that in the scientificmm community that we dont know everything and science is evolving and one of the things we need to do a better job at is to get across the concept that science is selfcorrecting so that as things evolve you do and experiment gaining scientific knowledge and it might be absolutely true to the situation at that given time , but as more data and knowledge you fall falls, you may have to say we thought it was this way, we have to be humble and honest enough to know that its a little different than what we thought. Its pure honesty and transparency that will get us out of any skepticism about our motivations in the scientific community. That will translate . We have to do it correctly because we have to make sure we stick by and insist on the scientific standards before we make a decision as something is safe and effective. We cannot compromise the public is trusting others and to get into that problem it is veering from the Scientific Data and information. Lets take a deeper divewh into content there is 50000 in cases of covid19 compared to a high of 70000 over the summer what is ahead for the next six months . I am concerned about that because we have a baseline no that fluctuated it never went down to the level i wouldve hopedd that we had a big peak in the early spring driven predominantly by theba northeast and the majority of the infections and hospitalizations driven by new york in the metropolitan area. When i came back down other states and regions went up the baseline never got down less than 10000 per day it was stuck at 20000. That we try to open the economy particularly in the southern i states like florida, georgia, texa florida, georgia, texas, southen california and arizona, it wasnt done uniformly and we started to see a surge that came up about 70000 per day. Now is starting to come down but is stuck around 40 or 50000. You cannot enter into the cool months of the fall in the cold months of the winter with a High Community infection baseline and looking at the map and how it heats up with test positivity thats going in the wrong direction because right now at least where you and i live will start doing things more indoors rather than outdoors. Thats when you have to be careful about the spread of a respiratory born disease. Is still not too late to vigorously apply good Public Health measures. And i emphasize without necessarily shutting down the country because when we talk about implementing Public Health measures, people think we want to shut the country down. We dont want to do that we want to use Public Health measures in a careful way to help us to reopen the country and the economy to get jobs back so Public Health measures needs to be the gateway not the obstacle. So for those in the audience can you go through with those Public Health measures are quick. It sounds simple but they are important because we know theymp work. Where one one is wearing a mask and to the extent possible, keeping distance. Number three is likely the most important, avoid crowded places, and situations people indoors crowded together without wearing masks, do things to the extent that you can outdoors preferentially better and if indoors good ventilation and washing your hands as often as you can. All of those are directed to mitigated against a transmission of infection you can do that while you still march carefully to open the country. Doesnt mean you have to revert back to closing the country. Such an Important Message many peoples thanksgivings will look different this year. I think they will. People have to make a choiceom where they fit in the riskbenefit ratio of have someone coming in from out of town, been through a crowded airport, come into the home of the Vulnerabl