Dr. Anthony Fauci on Childhood Vaccine Delay & Political Divisiveness: ‘We Are at War With a Common Enemy’, Not the Time to Fight With Each Other

Dr. Anthony Fauci

Marianne O’Hare: Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter. This week we welcome Dr. Anthony Fauci in the
second anniversary of his first visit with us discussing a concerning
new epidemic sweeping around the globe.

Dr . Anthony Fauci: As much as this virus is unprecedented, our response with regard to
the development of a vaccine is entirely unprecedented.

Marianne O’Hare: Lori Robertson joins us from FactCheck.org and we end with a bright
idea that’s improving health a nd wellbeing in everyday lives. Now,
here’s Mark Masselli and Margaret Flinter on Conversations on Health
Care.

Mark Masselli: Two years ago at this time Dr. Fauci joined us for a conversation that
was a warning about what was ahead. We discussed what he k new
about COVID - 19 and how to deal with it. Dr. Fauci has continually kept
us updated on Conversations on Health Care about the pandemic.

Margaret Flinter: Now, Dr. Fauci joins us again to share the latest details and his
perspective as the Chief Medical A dvisor to President Biden and as
the long time Director of the NIAIDs, National Institute of Allergy and
Infectious Diseases.

Mark Masselli: Dr. Fauci, welcome. Before we discuss COVID let’s start with the
breaking news on HIV. Doctors reported an American woman is now
the third person ever to be cured of HIV. They used a new transplant
method involving umbilical cord blood. What is your reaction to this
breakthrough, and do you think it opens up the possibility of curing
more people?

Dr. Anthony Fauci : Wel l, it’s going to be really, Mark, the idea of a conceptual issue that
it is possible to rid the body of HIV. The only trouble is that this as it is
right now, giving a transplant of cells from the umbilical cord or a
stem cell transplant or what have you, this is the third such case. As
you know the original one was the famous Berlin patient who actually
unfortunately subsequently expired due to a recurrence of his
leukemia.

This is not applicable to the normal otherwise non - disease outside of
HIV person. T his person happen to have an underlying disease which
required a stem cell transplant, so I don’t want people to think that
now this is something that can be applied to the 36 million people
who are living with HIV. This is much more of a proof of concept that
one can actually get the virus out and be suppressed for a long period
of time. It is not practical to think that this is something that’s going to
be widely available. It’s more of a proof of concept than it’s
something that can be applicable to the many millions of people who
are living with HIV having their virus suppressed by good
antiretroviral.

Dr. Anthony Fauci

I want to just take this opportunity to emphasize that right now we
have therapies and we’ve had them for some time that are really
nothing sort of specta cular in their capability of suppressing virus to
below detectable level for essentially unlimited periods of time. Not
only saving the life and providing a good quality of life for the people
who are being treated, but also making it virtually impossible for them
to transmit the virus to others through sexual contact merely because
their viral load is so low. Having said that, we are always trying to cure
HIV, well you don’t require either daily intermittent therapy.

There’s a lot of research going on with this. This third case, I really
wouldn’t characterized it quite frankly, Mark, as a breakthrough,
because we’ve had two other cases just like this. We know it can
happen, but as I mentioned it’s important to conceptually see this.
But I don’t believe it’s applicable in any way to the millions of people
who’ve actually living with HIV.

Mar garet Flinter : Well, Dr. Fauci that is an incredibly important clarification for all of
our listeners. I do want to stop and take a moment before I turn to
COVID to thank you for your decades 40 plus years of being so
committed to ending the HIV/AIDS epidemic and caring for people
who have HIV, so thank you so much for that work and the work that
you continue to do today on many front. I wanted to ask you, of
course, about COVID.

Last week I would have told you I was sure that we’d be seeing FDA
authorization of the COVID vaccine for the younger children six
months to five years old, that didn’t happen. Reportedly the data was
clear about safety but showed some disappointing effectiveness. I
wonder what your thoughts are on that, what you think we will see
and, I think we’re all grateful that the data is transparent and clear,
but do you think we’re going to see approval for these little kids?

Dr. Anthony Fauci : Well, that’s going to really depend on what the data shows. I mean,
one of the things that important is that you say disappointment, the
disappointment it was that the two doses did not give what was
desired with regard to protection in the children. It was felt it is very
likely would be a three dose vaccination regimen for children, and
that’s what Pfizer is now doing. They are doing the three dose
component on the children from six months to four years. They will
have the accumulation of that data, I would imagine re asonably soon.
I don’t want to get ahead of the FDA and predict when they will be
able to make a determination as to whether or not it’s effective.

You’re absolutely correct Margaret that it is clearly safe. Safety is not
an issue here. The question is, wh at is the proper dose and dose
regimen to give the children the degree of protection that we’re
aiming for? That’s exactly what’s going on right now. The fact that
they didn’t do an EUA or an Emergency Use Authorization for the two

Dr. Anthony Fauci

dose data is that the tw o dose data did not show that it was good
enough to be able to do that. That’s the reason why they were looking
at what three doses will do. Hopefully, three doses will give us the
endpoint that we want. That’s what we’re waiting for.

Mark Masselli: Well, it’s so great to hear that data is driving policy, and I think that’s
a comfort to everybody. We’re also learning more about the new
Omicron variant BA.2, and there’s always reports about possibly new
variants out there. How serious do these situations see m to you,
Doctor?

Dr. Anthony Fauci : Well, Mark let’s take one at a time and compare. We’re having a lot of
experience now, unfortunately with Omicron which is the BA.1 it is a
highly transmissible virus, essentially push Delta off the map.
However, the go od news about that, if you want to call it that, is that
if you look at the ratio of hospitalization to cases that you don’t have
as much of a rate of hospitalization with Omicron I. e. BA.1 than we
saw with Delta. However, it does evades some of the immun e
protection, and that’s the reason why we make a strong push for
people (a) to get vaccinated, and (b) who’ve been vaccinated to get a
boost.

But to your specific question, comparing BA.2 with BA.1, they have
some similarities. BA.2 is likely more transmi ssible than BA.1, we
know that because in Denmark it has essentially had a much, much
greater percentage over a period of time in the context of Omicron,
so it’s kind of pushed Omicron aside. But if you look at its severity, its
ability to evade vaccinatio n protection, they are really about the
same. The only difference that we’re starting to see is that one of the
antibodies that worked against Omicron or BA.1, the Sotrovimab does
not appear to work as well. Yet, there’s a new antibody that just came
out r ight now, the data of which was just released, a Lilly antibody
that looks like it’s quite good against BA.2. Again, likely more
transmissible, not necessarily more severe and likely will start to
maybe takeover a little bit more. But the one good thing th at in the
context of all of this, if you look at the curves of infection crisis and
hospitalizations, they’re rapidly going down not evenly throughout
the country, but now virtually every state is seeing that it’s starting to
come down.

Mark Masselli: Grea t.

Margaret Flinter: We have been saying, dare we say some good news out there and
we’ve learned throughout this pandemic to be cautious about saying
good news, but we’ll take some good news where we see it, and that
is certainly true. But, right along wit h that good news is we also hear
about other variants. We’re hearing more about waning immunity
with the mRNA shot protection and possibly needing that fourth dose
to deal with waning immunity. What are your comments on that,

Dr. Anthony Fauci

would we be looking forward to that do you think in the next several
months, is it recommendation?

Dr. Anthony Fauci : Well, right now we have to look at where we are, where we are right
now. I think people need to understand because when you use the
word fourth dose, there is understan dably some confusion. When
you’re talking about people who are severely immune compromised,
those people really require and is recommended that they get a
fourth dose if in fact they’ve had an mRNA primary series. The reason
is, is in those individuals, fo r example, transplant patients and cancer
chemotherapy patients, they require three doses just to get up to the
level of where two doses are for an individual who has otherwise a
normal immune system. When you say a fourth does, they’re already
recommended to get a fourth dose.

When you look at immunocompetent for whom we recommend a
third dose, we’re following very carefully which, you’re correct, there
is a waning and a diminution. But the latest data at about four or five
months following the third dose boost, it’s still hanging up there
around 78% protection against hospitalization. What we’re following
very carefully is what happens on month six, seven, and eight? If it
starts to go down to a level that’s a bit concerning, then there will be
a strong co nsideration for recommendation of a fourth dose. But right
now today, apart from the immune compromised individuals, the
protection against hospitalization looks pretty strong.

Mark Masselli: Well, thank you for that clarity. It’s interesting to review at our first
COVID conversation with you in February of 2020, two years ago. Lot
of your comments then are still relevant today. You even accurately
predicted a vaccine would be deployed within a year to year and a
half. What have you learn professionally fro m this pandemic, and
anything you might do personally in a different way?

Dr. Anthony Fauci : Well, you can always think of things you would do differently because
no one is perfect than everyone particularly when you have a moving
target like this extraord inarily complicated virus that acts unlike really
any other virus we’ve dealt with. I mean we’ve seen mutations and
drifting of viruses like with Influenza. But the idea that we would have
four and now the fifth wave is something that is completely
unprece dented.

One thing we have learned in addition to the sobering news of the
extraordinary capability of viruses to adapt to us and to escape our
attempts to contain it, the positive aspect that we learned is the
extraordinary positive effect of the investmen t in basic and clinical
biomedical research, because if we had not made that investment
decades before working, for example, with the original work we’ve
done following the original SARS - CoV - 1 in 2002 to develop the proper
immunogen design, the proper plat forms that we did something as

Dr. Anthony Fauci

much as this virus is unprecedented. Our response with regard to the
development of a vaccine is entirely unprecedented. To go from
th
understanding and knowing the sequence of the virus on January 9
th
or 10 to 11 months later have a highly effective and safe vaccine
already going into the arms of individuals 11 months later. Then
multiple months later to have literally billions of doses having been
distributed worldwide and over 200 million people in the United
States having b een fully vaccinated, that is an accomplishment the
likes of which we have never seen, nor would we have imagined that
we could have done that in such a brief period of time.

There’s both aspects of it that there’s the bad news that we’re dealing
with a vi rus that has continued to, in many respects, baffle its ability
to do to allude things. Then we have the extraordinary
accomplishments of the scientific approach and the scientific
enterprise.

Margaret Flinter: Dr. Fauci, I’m not sure if there’s ever been a better case for the need
for ongoing investment in biomedical research. I think we’ve made
our case for the ages about how important it is to do that without the
crisis sitting on your shoulder so you’re ready when it comes. I have a
question for you tha t’s maybe more just historical impact at this point
or importance at this point.

But when we think back to that first conversation that we had with
you, you had mentioned, this is in the early weeks of the outbreak
and the Chinese were incorrectly insistin g that COVID was only spread
from animal to human. I guess I asked, do you think we’re close to
getting to the bottom of how COVID did get started and
understanding why there were so many missteps that let it wreak
such havoc in our world?

Dr. Anthony Fauc i : Well, we want to keep a broad open mind about what people are
referring to as the origin of this. But, if you talk to the people with
experience, the molecular virologist, the viral phylogeneticist, the
people who do this for a living, this really stron gly resembles what
happen with SARS - CoV - 1 where you had viruses out in the animal
kingdom particularly bats interacting with intermediary hosts, with
viruses that can evolve to jump species and infect humans almost
certainly.

But again, always keeping an a bsolutely open mind that it is very likely
that that is what happened. That’s the reason why it’s important to
continue to do research to explore the animal - human interface to
make sure that we know what’s going on out there and that we’re
prepared for it. But one must always keep an absolutely open mind as
to how this thing evolved and what happened.

Mark Masselli: You know, Dr. Fauci, Time Magazine has some good reporting about

Dr. Anthony Fauci

the CDC surveillance programs and criticism that it’s sequencing only
a small percentage of positive cases. And in the single digits each
week only about five countries have sequenced double digit
percentage of their positive cases so far. Should we be doing more
and would it help?

Dr. Anthony Fauci : Well, the CDC has improved great ly on what they have been able to
do since the very beginning when, in fact, you’re right, they are
sequencing themselves with collaboration of senates throughout the
country was at a quite a low level. But they have really made major
steps certainly over the last year to improve on that considerably, and
they’re continuing to do it even better. But you’re right, it’s been an
evolution from a lower level to now a level that we believe is a pretty
good level.

Margaret Flinter: Wonderful. If I could just ask maybe one more question. Your
colleague, Dr. Collins, who just retires, the NIH director says, “It
almost feels like political parties want public health efforts to fail if
they’re being produced by their enemies.” What do you say in
response to that? You’ ve always such a collaborative relationship with
people around the country, but is that your perspective as well?

Dr. Anthony Fauci : Well, I think it’s no secret, Margaret, that we are now living in an
environment of profound divisiveness in our country. W henever you
have something of the magnitude and impact of a global pandemic
that has severely involved our country with now, you know,
approaching a million deaths with a well over 930,000 deaths. We do
see it and you can’t walk away from it a degree of po litical
divisiveness and even hostility that cannot help when you’re trying as
a country in a unified way to respond to an outbreak.

The common enemy is the virus. We should look at this
metaphorically that we are at war with a common enemy. When
you’re at war with a common enemy it’s not time or ever should be
time of fighting with each other. We should be focusing all our efforts
on containing this terribly devastating virus which has done such
destructions throughout the world including in our own countr y. I
wouldn’t want to put words in anybody’s mouth. I’m not going to
comment on what Dr. Collins said. He is a very close dear colleague
and friend in many respects. What I think he was trying to say,
because I know Francis very well, is that he’s very dis mayed at the
degree of divisiveness that’s going on in this country which clearly will
interfere with a good comprehensive response to the pandemic itself.

Mark Masselli: Well, Dr. Fauci it’s always an honor and privilege to have you take the
time to answe r our questions. You can learn more about
Conversations on Health Care and sign up for our emails at
chcradio.com. Again, Doctor, thank you so much for taking the time
today.

Dr. Anthony Fauci

Dr. Anthony Fauci : My pleasure, it’s always good to be with you.

Mark Masselli: A lrighty great. We really appreciate it.

Margaret Flinter: Thank you Dr. Fauci.

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Roberts on is an award winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in US politics. Lori,
what have you got for us this week?

Lori Robertson : In late Januar y, the Food and Drug Administration pulled its
authorization of two COVID - 19 antibody drugs because the
treatments are highly unlikely to work against the Omicron variant.
But Governor Ron DeSantis of Florida misleadingly claimed the
decision had been made , “without a shred of clinical data” to support
it. There may not be data from patients, but lab studies strongly
suggest the treatments will not help Omicron infected people.

Since late January the Centers for Disease Control and Prevention has
estimated Omicron accounts for nearly all the coronavirus infections
in the country. The manufacturers of both antibody drugs in question,
Eli Lilly and the biotech company Regeneron said in statements that
they agreed with the FDA and found the decision appropriate . The
agency said that it would allow the use of the drugs again if another
variant comes along that is susceptible to the treatments.

The FDA point at health care providers to treatments that are
expected to be effective against Omicron, those include two newly
authorized antiviral pills the antiviral Ramdesivir and a different
monoclonal antibody treatment manufactured by Vir Biotechnology
th
and GlaxoSmithKline. On February 11 the FDA authorized a new
monoclonal antibody manufactured by Eli Lilly that doe s retain
activity against the Omicron variant. That means that while the
agency revoked the authorization of two monoclonal antibody
treatments, there are two other monoclonal antibody treatments that
are authorized for use against Omicron.

The state of Fl orida and its Republican governor however were critical
of the FDA’s late January move to revoke the authorization for some
antibody drugs. DeSantis said in a January 25 tweet that the decision
had been made “without a shred of clinical data” calling the d rugs
lifesaving treatments. Again, while there may not be studies in people
demonstrating that the two antibody treatments are now useless,
there’s an abundance of other data including from the companies that
suggest these drugs have little, if any, abilit y to fight off the Omicron

Dr. Anthony Fauci

variant.

Since September the federal government has been supplying COVID -
19 monoclonal therapies to state based on the COVID - 19 caseload
and how much locale has been using the drugs. These synthetic
antibody treatments target the spike protein of the SARS - CoV - 2 virus
and can prevent it from entering cells. Earlier clinical trials showed the
antibody cocktails which are either infused intravenously or injected
under the skin reduced the risk of hospitalization or other negative
out comes in high risk outpatients, that led the FDA to authorize them
for non - hospitalized patients with mild to moderate COVID - 19 who
are at high risk for developing severe disease.

As with any COVID - 19 treatment the monoclonals are not a substitute
for vacc ination, but the shape of the Omicron variant spike protein is
different, and some of the antibody treatments can’t neutralized the
Omicron variant very well if at all as numerous lab studies have
shown. For instance, a January Nature Medicine study found the
Regeneron and Eli Lilly antibody combinations lost all neutralizing
activity against the Omicron virus taken from an infected American.
But as we said, a different monoclonal from Eli Lily has now been
authorized for use against Omicron. Regeneron is p reparing to begin
clinical testing of another antibody treatment. That’s my fact check
for this week. I’m Lori Robertson, Managing Editor of FactCheck.org.

[ Music ]

Margaret Flinter: F act C heck.org is committed to factual accuracy from the country's
major po litical players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com . We'll have
FactCheck.org’s Lori Robe rtson check it out for you here on
Conversations on Health Care.

[ Music ]

M ark Masselli : Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Fitness
trackers have become all the rage espe cially among upwardly mobile
fitness conscious people seeking to monitor their own health and
fitness goals.

But another trend has emerged in the age of wearable devices. After a
few months about a third of user simply stop using them, leaving a lot
of cos tly devices sitting in the shelf and not in use. The reality
captured the imagination of Tufts University School of Medicine,
Professor Dr. Lisa Gualtieri.

Dr. Lisa Gualtieri: I had read about the events and the rage and I thought what if you
could take al l of these abandoned trackers and give them to the

Dr. Anthony Fauci

people who could benefit most from them.

Mark Masselli: She thought what if we could get disinterested owners to donate their
used fitness trackers and wearable devices to be repurposed and
donated to unde rserved populations.

Dr. Lisa Gualtieri: A lot of the work that we’ve been doing has been with alter those
racial and ethnic minorities. For a lot of people they’re quite
interested in owning one of these devices to helps them increased
their fitness. For a lot of people the cost is precipitate so I think that
that’s a barrier for a lot of people.

Mark Masselli: In 2015 she launched her nonprofit enterprise Recycle Health, an
online social media campaign to raise awareness for her program
which seeks donat ed wearable devises no longer in use to provide
these expensive devices for free to those in need.

She partner with organizations working with low income adults in
wellness programs, seniors and fall prevention programs, minorities,
and veterans as well. H er goal is to start collecting vital data on the
deployment of these devices and the impact they maybe having on
behavior change in vulnerable populations.

Dr. Lisa Gualtieri: What we do is talk to people about how access, how sedentary they
are, and comin g up with a reasonable and achievable goal to helping
them to see it as an educational process where they might start off
with 2000, 3000 steps as their goal, but they know how to make that
higher when they’re ready to.

Mark Masselli: So far the numbers of donated devices have numbered in the low
thousands. She’s hoping to scale that number up significantly in the
future, and to expand their data collection on health outcomes for
vulnerable populations who gain access to these wearables. Recycle
Health a si mple repurposing of wearables providing these tools for
free to vulnerable populations empowering them to engage in
activities that can improve their own health, provide useful data and
using these devices to improve population health. Now that’s a bright
idea.

[Music]

Mark Masselli: You’ve been listening to Conversations on Health Care. I’m Mark
Masselli.

Margaret Flinter: And I’m Margaret Flinter.

Mark Masselli: Peace and health.

M ar ianne O’Hare : Conversations on Health Care is recorded at WESU at Wesleya n
University, streaming live at www.chcradio.com , iTu nes, or wherever
you listen to p odcasts. If you have comments, please e - mail us at

Dr. Anthony Fauci

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