Coronavirus and vaccine. This event hosted by the Washington National cathedral. And welcome to, Washington National cathedral. I am the dean of the cathedral. On behalf of the bishop of the diocese of washington and all of us who serve in his cathedral, welcome. We are so glad you have decided to join us for this important conversation this evening. Convening conversations and bringing people together to discuss some of the most important issues of the day is one of [indiscernible] priorities. And paul8 the Nancy Ignatius program has given his to focus on many important issues, issues that sit at the intersection of faith and public life. The nancy and Paul Ignatius program fund was established by children, their friends, and other relatives, as srecognition of nan and paul service and commitment to Washington National cathedral. While we said goodbye to nan last year, her legacy lives on here at the cathedral, and we are so pleased to have paul as the mainstay of our cathedral community. Not to mention that this years ignatius program is especially important because yesterday, Paul Ignatius celebrated his 100th birthday. Happy birthday, paul, and god bless and thank you for all that you have done. [applause] our topic for tonight could not theore relevant or timely, impact of this pandemic on our nation has been immense. Every week this cathedral holds a service specifically to pray r many of by name fo those who have lost their lives to covid19. Who among us this time last year could have imagined that we would see 230,000 americans who have lost their lives, and the number only growing . Months, past 10 we have experienced a lot of loss and heartbreak. Yet at the same time we have witnessed the selfsacrifice and heroic efforts of First Responders and medical personnel and frontline workers. Moreover, we are beginning to see the fruits of the incredible efforts made by scientists around the world to find a vaccine for this virus and to do before. Never seen the truth is there has been much suffering and loss, but there is also much to be thankful for. So, where do we go from here . And dr. S to dr. Borio Francis Collins and dr. Anthony fauci for being our guests tonight to tackle that question and so many others. If you will permit me, i would like to begin this evening with a prayer. If prayer is meaningful in your life, please join me. Let us pray. O god, our refuge and strength, our help in trouble, we pray for all those affected by covid19 around the world. Remove the presence of a and anxiety from our hearts and heal all of those who are sick with the virus. Give skill, sympathy, and resilience to all those who are caring for the sick, and your wisdom to those searching for a cure. Strengthen them all with your spirit that through their work, many will be restored to health. All of these things we pray in your holy name, amen. Pleasure tos my turn this over to the oldest of the ignatius children, david ignatius. David i am david ignatius, a columnist for the washington post. On behalf of all of the ignatius family, my thanks to this wonderful cathedral, i would like to welcome you to a special discussion of the topic that our nation and the world are thinking about more than any other, covid19, where do we go from here. We have had some hopeful news in the past week with the announcement of the vaccine, whose phase 3 test results our givene speaker, not a man to hyperbole, it is really quite good i mean, extraordinary. And we have had chilling news from what appears to be a winter surge of the virus come with everyion totals rising day and hospitals around the country straining to treat patients. We are blessed tonight to have three of the wisest doctors in america and indeed in the world help us think about where we are going and how to protect our families, and the world from this scourge of the pandemic. A word about our foreman tonight. We will open with a conversation between my brother, the editorinchief of Harvard Business review, and dr. Anthony fauci. Many of you may not have heard of dr. Fauci, so i will explain that he is director of the National Institute of allergy and Infectious Disease and for decades he has been our nations leading expert on Infectious Disease and a person who gives us faith that science and reason will prevail in the end. Following the discussion, my sister amy ignatius, a superior court judge in metric and will moderate a discussion with dr. Francis collins and dr. Luciana borio, who served in the Obama Administration as acting chief scientist at the fda, then directed medical and bio defense preparedness for the Trump Administration from 2017 to 2019 and is now a member of president elect joe bidens Coronavirus Task force. Finally, a word about the ignatius program. As the dean said, my siblings and i helped establish this event 12 years ago to honor our parents, paul and Nancy Ignatius, who have cherished their relationship with this cathedral. Over these dozen years, we have had many important speakers, including spigner brzezinski, brent schoolcraft, john kerry, susan rice, and many others. But we have never had a more important topic or more compelling panelists than tonight. Paulou know from the dean, celebratedur father, his 100th birthday last night. If you want to think about how to stay healthy in these isvid times, he your man. It is fitting that his birthday is veterans day, because he spent a lifetime serving his country, as a combat veteran in world war ii, later as a secretary in the navysecretary of the navy, and truly in everything he does for the adi, myamy brother sarah,amy, and my sister the only ignatius you will not see on stage tonight, we would like to dedicate this program to our father and the memory of his wife of 71 years, our late mother, Nancy Ignatius. Brother,auci and my adi. Adi all right, thank you very much, david, for getting us started. David has introduced a dr. Fauci. Two key things he has a top card and a bobblehead topps Baseball Card and a bobblehead doll. Somehow in 2020 americas leading rockstar is an epidemiologist. President trump suggested he might fire you, president elect biden says he might promote you. You are a 79yearold medford which sounds like the better deal79yearold man. Which sounds like a better deal . Dr. Fauci [laughter] my job as the director of the nah institute and is a Public Health official is to focus entirely on what my mission and goal is, to use science and health to preserve the health, safety, and welfare of the American People regardless of what the administration is. You know and many people know that i have had the privilege of serving six president s since i became director of the niad in 1984. That is what we focus on as scientists. I know we are living in a charge political environment, but that is not primary for us. We continue to do our job to foster Public Health, but also to do the science that leads to the things like the vaccine that you mentioned in the introduction that was just mentioned by the dean in the introduction. That is what i focus on. When you hear those things in the newspapers, many people think i get shook back and forth by that. To be honest with you, i dont. Adi let me followup a little bit on that. If people thought that the programsaw that the program we were going to be future, they great, i love fauci, those people would be democrats. Independent said you are the only person serving under president from whose Approval Ratings have gone up and not down. On a serious note, you and your family have at threats against her life because you defended signs of defending the white house. How did science become so politicized . Dr. Fauci that is an important question, but also sad that you have to ask that question, because that is what we have seen a lot in the United States, but not just restricted to the United States, because we are also seeing it with my colleagues in the u. K. And in europe and in other regions of the world. I dont think there is a simple explanation for it, but i think there has been an antiauthority component to this. People dontax, like to be told to be vaccinated. Scientists are often perceived as authoritarian. They made that perception themselves by the way they act also i think we can improve on that. But right now it has been just lumped into the politics of what is going on. We live in a divisive society, and even if we didnt have a pandemic, it would be a divisive society, and the fact that we do have a pandemic and a pandemic is a Public Health issue and Public Health is intimately related to science, that all of a sudden science gets caught in a lot of this divisiveness. That is unfortunate. What we as the scientists hope i know my colleague francis colleague feels the same way this,hen we get past science will resume its rightful place in being something that is for everyone without divisions. Adi when we get past this, meaning covid19 . Dr. Fauci covid19. When we get out of the charged nature of the stress and strain put upon us by an outbreak, people will realize the importance of science. Adi lets talk about where we are now. It has been a terrifying spike in a new cases, hospitalizations, deaths. As you look at this and the spread of this thing, where are we in the cycle . Dr. Fauci data speaks for itself. We are in a very difficult situation. It is quite problematic. I have said that many times not to scare people, but to bring a reality check to where we are. If you look at it, we have 10 million infections in the United States, almost 250,000 deaths. We have had 60,000 hospitalizations. 100 for count we had the 3000 infections in a single day. 00en i tested 143,0 infections in a single day. When i testified before when gas,i saidbefore congress, people thought i was being hyperbolic. Now look what is happening. That is the bad news. I think think urging news people need to understandthe encouraging news that people need to understand, Public Health measures not knocked out of the country, but Public Health measures that are simple and easy to understand, the universal wearing, physical distancing, avoiding crowded places, outdoors better than indoors, washing hands, it sounds simple in the context of this ominous outbreak, but it can turn it around, and that is what we need to do. Adi to be at this level of this new spike, is that just a lethal pandemic working its way through the country, through the world, or are we doing something historically wrong to be at that place again . Dr. Fauci i wouldnt say it is horribly wrong. I think what we have not done, and it is not just the United States if you look at what is going on in europe and the u. K. Now, they are in many respect in the same boat as we are with major surges. But when you look at what happened in our own country, we did not act in a unified way. I always say one of the wonderful things about our country that i love so much is that we are the United States of america, and we are a federalist country and we have states that are independent and they have in some respects important that they are that way. However, when you are dealing with an Infectious Disease, the Infectious Disease does not know the difference of the border between mississippi and louisiana, or between florida and georgia and south carolina. An Infectious Disease means the entire country. We did not approach it that way. We had too much individual approaches towards how we are going to handle the outbreak. Our baseline never came down to the local level that we wanted it to be, so when Community Spread came in as we try to to open the country, it just soared right out. It is a selfpropagating issue because the more Community Spread we get, the more difficult it is to contain it by identification, isolation, and contact tracing, because there is so much of it going on that it becomes very difficult. That is the problem we are in right now. We have an enormous amount of Community Spread. Adi so if your model was telling you a while back that it would be 100,000 cases a day, what is it telling you now . Do you look forward to the winter, cold weather . Dr. Fauci models are as good as the assumption we put into the model. I have been one to challenge models not challenge the validity of the modeling process, but to challenge the assumptions that are put into it. If we all literally pushed together as a group and did it in a uniform way, we do not necessarily need to see the 1000 day. 00 desperate we dont need to see the 140,000 infections per day. We can turn it around. If we stay the way we are, you do the civil math. 1000 deaths a day can 140,000 cases a day. You multiply it by 31 days in december, two weeks left in november. By the time you get to january 1, we have a really bad situation. So what i am saying as a Public Health official, and as my colleagues say, we dont need to accept that. I want to make one point that is important. I know you will get to it in the questions. But one of the things about a vaccine which is really important not only in and of itself as being a tool that is essential to end this outbreak. When people know that help is on the way and what i mean by help is on the way is we will start giving vaccines in december, and then as we get into january, february, march, we get the privatization of the people who need prioritization of the people who need it the most that there is light at the end of the tunnel, i hope we can get over what we call covid fatigue, where people are so exhausted with the Public Health measures that they really feel like they want to either give up and say lets do what you want to do, which is not the time to do that now. Now we need to double down on the Public Health measures as we are waiting for the vaccine to come and help us out. Adi there is covid fatigue and there is covid resistance, or resistance to taking the measures you are talking about. In your mind, is there hearted data, hard evidence that these behaviors you call reckless big political rallies where people are not wearing masks, motorcycle rallies, whatever is there clear data that those have led to outbreaks . Dr. Fauci i think it is pretty clear when you see congregate settings where people are gathered indoors without a mask, there is no doubt that we have seen that with the sturgis rally, number of other situations. We have seen it in clearcut examples of people getting together in a congregate away, particularly indoor, where you trace after that, there is clear outbreaks. Adi you talk about vaccines. Lets talk about vaccines. Dr. Fauci talk about vaccines. Adi pfizer caught our attention with its announcement recently of 90 efficacy for its trial. There are a lot of tests. You said you thought there would be a vaccine rolled out in december. Talk to me about what you are excited about and specifically what you are seeing. Dr. Fauci if you look at Infectious Diseases in general, what you need to get society projected, you need a certain number of people who are protected because they are immune to the virus. There are a couple of ways to do that. One way is very painful, that everybody gets infected. That leads to a lot of deaths. That is an unacceptable way to get this fire is under control. The other way is to have a highly effective vaccine that the vast majority of the population takes. Have ather words, if you 50 , 60 effective vaccine, even if the majority take it, there is a large segment of the population that is not immune. But we are fortunate, because the first one out of the gate is more than 90 , probably close to 95 effective. What we are hoping is that those who have vaccine hesitancy, who are skeptical about a vaccine, will see that the efficacy of this is so high that they may change their mind about wanting to get vaccinated. The other part of the good news is that there are other vaccines, some that are almost identical, such as the moderna product, which will be evaluated in the next week to a few days, that we anticipate, though you never want to get ahead of yourself, that it will be as good or close to that. That is the case, we have two of them. Whatthe capability science has done in an unprecedented way if this were 15 or 20 years ago, it would have taken a few years to get to where we are now. The idea that you went from a recognition of the virus on july 9 with the sequence to a phase 60someoddterally days later to a phase three trial a few months later to a vaccine that will be getting to peoples month is extraordinarygetting to peoples month is extraordinary. I have been doing this for 40 years, and this is really extraordinary. Is,as extraordinary as it what we dont want people to do is to say, oh, we have a vaccine out, we are done. We are not done. We still need to implement Public Health measures in a very intense way. Adi but when you say the vaccine will be rolled out in december, that means frontline workers, people at risk . Dr. Fauci the standard thing that happens when you have a vaccine that is not readily available to everyone at once is you privatization. Oft is the responsibility the centers for Disease Control and prevention, the cdc. They rely heavily on an Advisory Committee on immunization practices, acip. The cdc makes the ultimate this year we complemented that by asking the