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  • Dr. Fauci, thank you so much for joining us

  • on The Daily Social Distancing Show.

  • -How are you? -I'm very well, thank you. Very well.

  • You are an infectious diseases expert

  • who has advised six presidents on everything

  • from SARS to Ebola to the HIV epidemic and Zika.

  • What makes coronavirus so different?

  • Well, it's different because, you know,

  • when people used to ask me over the years,

  • what is it that I most worry about

  • with regard to emerging infectious diseases,

  • is a respiratory borne illness

  • that easily spreads from person to person,

  • but that has a high degree of morbidity and mortality.

  • And unfortunately, that's the worst nightmare

  • you could have is to have something like that.

  • I mean, there are other diseases.

  • Ebola was frightening, but Ebola gets transmitted

  • only when you're in very close contact

  • with a person who is very, very ill.

  • With this disease--

  • in some respects similar to influenza,

  • but in some respects, very different--

  • it spreads very easily.

  • -Right. -You can even spread it when you're not symptomatic.

  • So it's insidious and treacherous

  • in that you could spread it easily.

  • The other part about it that's really so different

  • from anything that we've ever faced before,

  • is that if you look at the mortality of seasonal flu,

  • the thing you and I go through every season,

  • -the mortality is about 0.1 percent. -Mm-hmm.

  • That's a lot.

  • -And we get used to that morbidity and mortality. -Right.

  • But the mortality of this is about ten times that.

  • It's at least one percent.

  • So, it's a disease that not only is easily spread,

  • but it can be devastating,

  • particularly for a certain subset of the population.

  • Demographically different.

  • The elderly, those with underlying conditions--

  • -heart disease, lung disease, diabetes. -Mm-hmm. Mm-hmm.

  • It can be very serious for them with a high degree of mortality.

  • Let's-let's talk a little bit about the information

  • in and around corona that's-that's,

  • I think, getting people confused.

  • I-I see so many conflicting ideas online.

  • And, I guess, the horrible by-product

  • of having social media and the Internet is,

  • everyone is now an expert, and everyone has an opinion.

  • I know this is very basic for you,

  • but just to help everyone be on the same page,

  • how can we catch corona and what are the areas

  • we should be most concerned about?

  • So we know about human-to-human transmission.

  • Most people understand that.

  • But I see people online worried about grocery shopping,

  • touching packages that they receive from Amazon.

  • Do people need to wipe them down?

  • When they're in the grocery store,

  • can they touch other things?

  • How long does coronavirus last in the air?

  • For instance, if you walk into an elevator

  • after somebody else, can coronavirus still be there?

  • What do we need to be on the lookout for as individuals?

  • Okay. There's varied degrees of risk, Trevor, of that

  • in-in every respect.

  • But the things that are the most common,

  • that you really want to latch onto

  • is that sneezing and coughing.

  • When someone is ill,

  • they've got to get themselves out of circulation,

  • because they can spread by droplets

  • and even by what we call aerosol,

  • which means the drop doesn't go down right away.

  • It hangs around for a bit.

  • So you could come into a room

  • thinking everything is all right,

  • and then you inhale it.

  • That's likely not the primary way.

  • The primary way is probably droplets.

  • But another way that's very important is handshaking.

  • When people naturally go... (coughs)

  • Like that, they cough.

  • And then it's innocent. There's nothing on their hand.

  • They shake your hand,

  • or they open a doorknob, and that's the thing.

  • You don't want to be obsessive-compulsive

  • about wiping everything down that you go near,

  • but one of the real bad actors

  • is somebody who just opens a door,

  • and then 15 minutes later...

  • Because we know the virus can live

  • on inanimate hard objects like steel or plastic

  • -for at least several hours. -Right.

  • So that's the thing you got to be careful...

  • That's one of the reasons why,

  • if you really want to be careful,

  • besides the social distancing of six feet,

  • don't shake anybody's hands.

  • -Just lose that for a while. -Right.

  • And wash your hands as often as you can

  • because you may be inadvertently touching something.

  • -Oh, I... -Now, your other question, Trevor,

  • that's important is that I don't think

  • we need to get completely obsessed

  • about packages that come in,

  • because those types of surfaces...

  • The virus might live there for a very short time,

  • but people say, "Should I... Should I get a package

  • from a grocery store that says 'made in China'?"

  • I-I wouldn't worry about that.

  • -That's not the issue. -Right.

  • It's more the close things, the handwashing.

  • Let's talk a little bit about what you alluded to earlier,

  • the-the mortality rates of the disease

  • and how people have misconstrued the numbers.

  • We know that people who are older

  • or people who have underlying respiratory infections,

  • um, have a higher chance of dying from the virus.

  • But I think people have started to believe

  • that that means young people are immune

  • and cannot get sick from coronavirus.

  • What are people not understanding from the numbers?

  • Trevor, they're not understanding

  • two things that are important.

  • A) Even though you are young,

  • you are not absolutely invulnerable,

  • for sure, because we are seeing cases...

  • Most of them have some underlying disease,

  • but several don't who are young people.

  • 30s, 40s who are getting sick,

  • getting into the hospital, requiring intensive care.

  • Still, the overwhelming proportion

  • are the elderly with underlying disease.

  • But every once in a while, you're gonna get a young person.

  • So if you think you're completely invulnerable,

  • you're incorrect.

  • Second issue that's important.

  • That even though you may not get seriously ill,

  • you can get infected with relatively few symptoms.

  • Either asymptomatic or mild, relatively trivial symptoms.

  • But then you can infect another person

  • who would then infect a vulnerable person

  • who would then die.

  • -Right. -I mean, it's the typical example.

  • "I'm young. I'm healthy."

  • But you go home, you infect Grandma,

  • Grandpa and your sick uncle.

  • So you have a responsibility

  • not only to protect yourself

  • but you are almost have a societal, moral responsibility

  • to protect other people.

  • In-in talking about the virus,

  • it-it feels like, understandably,

  • everyone is trying to find an answer,

  • everybody is trying to find their own solution.

  • Unfortunately, that has bred... Uh, you know,

  • it's created a breeding ground for misinformation.

  • For instance, cures that people are touting online, you know,

  • concoctions of-of different medications, et cetera.

  • We read about malaria drugs

  • and chloroquine or whatever it is.

  • What is the biggest warning you would give

  • to the general public about trying to self-medicate,

  • or-or is there any cure that people actually have discovered?

  • What... As a leading health expert,

  • what do you say about this issue?

  • So, right now today, as we speak,

  • there is no proven, safe and effective

  • direct therapy for coronavirus disease.

  • For sure. There are a number of clinical trials

  • that are trying to-- by randomized control trials--

  • get a definitive answer as to what works

  • and what does work... not work, what's safe, what's not safe.

  • Superimposed upon that, there are drugs

  • that are already approved for other things,

  • like hydroxychloroquine for malaria

  • and for certain autoimmune diseases,

  • that there have been anecdotal stories.

  • By "anecdotal," I mean people kind of think they work,

  • but they haven't really proven they work.

  • That's really gotten out there on the Internet.

  • So, people are very enthusiastic

  • since generally, these drugs appear to be safe,

  • and they are, but they do have some toxicities.

  • So, a lot of people want a drug even though it's not proven

  • just in case it might help them.

  • You got to be careful about that for a couple of reasons.

  • You don't want to take that drug off the market

  • for the people who really need it,

  • who have the diseases it's used for.

  • And on the other hand, there may be some toxicity.

  • That's the reason why we're pushing

  • to try and get as many good clinical trials as possible

  • to prove if it works.

  • If it does,

  • then get it out there really fast for everybody.

  • Got it. I have four questions.

  • Because I know we're gonna run out of time,

  • but I just want to let you know I have four questions

  • that I think are really important.

  • Um, number one. We hear about this clock,

  • 15 days where things will be reassessed,

  • 15 days where people might go back,

  • 15 days, every country... 21 days.

  • There seems to be a clock. My question is

  • what is that clock supposed to be?

  • And is there a certain amount of time

  • that people can be away from each other

  • where coronavirus goes away?

  • And-and the follow-up in that same question

  • is does the clock start

  • if people are not completely quarantined

  • during that period?

  • Yeah, the virus is the clock, uh, Trevor.

  • So, people say they... Arbitrarily,

  • "Well, in two weeks, we're gonna be okay."

  • It depends on the kinetics of the outbreak.

  • Right now take New York City.

  • They are getting hit really hard.

  • And the kinetics of the outbreak is going there.

  • You can't predict when it'll make that turnaround

  • and start coming down.

  • In general, if you look historically

  • at-at countries that have been through the whole cycle,

  • in China, it was about eight weeks or so

  • before it went way up and then way down.

  • -Right. -In Korea, the same thing.

  • So, if you look at each individual country...

  • And being a big country as we are here in the United States,

  • we're almost like a lot of little countries.

  • Like, New York in itself can be considered a country.

  • -Right. -California can be considered a country.

  • So, it's unpredictable

  • about when you can say this cycle...

  • It's usually measured in several weeks.

  • Sometimes, when you're into the cycle,

  • you may only be two to three weeks away

  • -before it starts to turn around. -Right.

  • Okay. So, then, to that point,

  • that's then my second of the four questions.

  • Second question is

  • is New York City really harder hit?

  • Or is New York's testing making the numbers spike up?

  • And is this something that we're going to see

  • start trending throughout America?

  • Well, a couple of good questions right in there.

  • New York is more hardly hit, for sure.

  • The nature of the city, the crowding of the city,

  • the fact that you get the beginning of your outbreak

  • when you get influx from other countries.

  • China was the index country that came in.

  • New York is a travel hub of the country,

  • so clearly, we had a lot of cases come in.

  • By the time they realized what they were dealing with,

  • they had already gotten a sucker punch,

  • -and they really were playing catch-up. -Right.

  • They didn't do anything wrong. They're not very different

  • except that they're a big, robust city,

  • and because of that, they're getting hit hard.

  • Okay. And then the second-to-last question is,

  • with regards to reinfection and immunity,

  • we talk about people who have it and are asymptomatic,

  • we talk about people who are recovering

  • and we're starting to see those numbers grow around the world.

  • Do we know yet if getting corona and surviving corona

  • means that you're now immune to the disease

  • or is there a chance of reinfection?

  • Uh, we don't know that for 100% certain,

  • 'cause we haven't done the study to see rechallenges,

  • whether they've been protected.

  • But I feel really confident that if this virus acts

  • like every other virus that we know,

  • once you get infected, get better,

  • clear the virus, then you'll have immunity

  • that will protect you against reinfection.

  • So it's never 100%, but I'd be willing to bet anything

  • that people who recover

  • are really protected against reinfection.

  • Okay, and then our final question--

  • And thank you so much for your time. I really--

  • I really hope everyone understands

  • how important it is to listen to you.

  • Final question, with regards to the government,

  • the CDC, the NIH, and all of the units working together,

  • right now, it feels like there is a-a push and pull,

  • a tug-of-war between states

  • and the federal government, et cetera.

  • For Americans who are out there watching this,

  • what is the plan and what do you think needs to happen

  • for the whole unit of the United States

  • to fight the coronavirus?

  • You know, implementing different checks and balances

  • along the way to make sure that everyone fights it

  • and the numbers go down.

  • Well, that's a very good question.

  • Things are implemented at the state and local level.

  • That's the way this country works so well.

  • The federal government is a facilitator,

  • it's a supplier, it's a supporter.

  • And that's the way things should be going.

  • And that's what we're starting to see now

  • as we are catching up on things

  • that weren't done so well in the beginning.

  • We now have many, many more tests.

  • The private industry's getting involved.

  • The government's not making the test.

  • The private industry is.

  • The ventilators that are needed, coming out of the-the stockpile.

  • Yet companies are starting to make more.

  • So it really is a marriage between the federal government

  • as the facilitator and supporter

  • of where the real action is,

  • is at the state and local level.

  • Thank you so much, Dr. Fauci.

  • Um, you've been amazing.

  • I could talk to you for an hour on this,

  • but I know everyone wants your time.

  • Good luck with what you're doing.

  • And, um, I hope we're doing our part

  • to make your job a little bit easier. Thank you.

  • You are, very much. And I appreciate the opportunity

  • -to speak with you. -Stay safe and wash your hands

  • -because of that fake cough you did. -(laughs)

  • Take care.

Dr. Fauci, thank you so much for joining us

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