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Dr. Fauci's Advice to America on COVID-19

Notes from a virtual appearance on Friday, July 17.

by Eric Holdeman / July 16, 2020

The United States Chamber of Commerce hosted a live virtual conversation with Dr. Fauci where he responded to a series of questions on the current status of the coronavirus and how businesses, individuals and the community should respond.

The following are my notes that I took -- best as I could -- while he was speaking. Or you can actually watch the recorded version above. Compare my notes to the recording and tell me where I screwed up!

Dr. Fauci to the United States Chamber of Commerce

Where are we now in the pandemic? Difficult situation at present. There are some bright spots like the NY Metro area. We have gone through a difficult time, but can still turned it around.

There are sections of the country that have a resurgence of cases. Now up to 70K cases a day. We have to suppress these cases, so we can reopen the country. Open up under certain guidelines that already have been provided by the Coronavirus Task Force.

What does the fall look like? The virus is unpredictable. The evolution and mutation of the virus is still unknown from a practical and clinical status. Nothing different at this point for the fall.

People talk about the second wave in the fall. We need to concentrate on where we are now. We are in the first wave. Focus there now, instead of looking ahead.

Did states open too early or was it the way we opened? It is a mixed bag. The criteria for opening was provided that included the gateway, number of cases per day. There were states that had Phases 1-3 that skipped one or more benchmarks that led to the surge.

Some states and cities did it perfectly correctly, but the citizens did not abide by the guidance, e.g., people in crowded places without masks. These behaviors led to the surge we are seeing now.

Why is it so hard to get the testing in place here in the USA?  We had a slow start. Testing is much better now than before. The projection is for us to get better with availability and the results being provided faster.

What is actionable for us, where do we get information? The CDC is the lead for information on outbreaks. You can get daily information from them state by state and city by city. Look at their website. Other websites, for example, John Hopkins website.

What is the best advice I can give my staff who are fearful? The thing you do is look at the state you are in and follow the guidelines. There are guidelines for opening. Do the minimum things. Wear a mask, maintain six feet, avoid crowds, wash your hands. The virus can be avoided. Wearing the mask is a primary step to take.

Mask-wearing is key. States have certain prerogatives and powers who set the standards. I suggest they be as forceful as possible with mask wearing. For opening up the country, masks are critically important because we can’t always be distant enough from others.

Businesses are the mask police. Confronting patrons. Advice for businesses and staff in addressing the issue of wearing a mask. He is totally aware of the situation of businesses confronting people not wearing masks. You don’t want a hostile environment. Get people to appreciate the individual responsibility to protect themselves and also protect others. Even if you are sick without symptoms, you are propagating the pandemic, it doesn’t just involve you only. The issue is the transmission from person to person who then gets seriously ill, a relative or someone in the general community with a special vulnerability. There is a personal and societal responsibility. I do not want anyone telling me what to do. More people need to understand their social responsibility.

Business leaders are being called on by other community leaders to help decide on opening schools. How should they participate? School openings are being discussed intensively right now. His advice is, look at the big picture. The American Academy of Pediatrics has pointed to the impacts on the kids themselves and parents, the default position must be the best we can possibly do to get the children back to school. We are not uni-dimensional, so there will be areas of the nation where kids can return. But other areas with high infection rates require us to look at alternatives, separating desks, mask wearing, alternating the days at school to lessen density. But first, think safety.

Are schools ever going to go back to “normal?” Yes, eventually it will return to what was. It will end through public health measures and science. Better therapeutics, a vaccine, some favorable results for a few vaccines. I am cautiously optimistic that we will have a vaccine sooner than later.

Role of the private sector in fighting the pandemic? The private sector is key. On the science side of developing drugs to help. It is a marriage between government and the private sector for addressing the medical aspects of the virus fight.

How can the business community best improve the public health structure? One of the most important aspects of responding to the outbreaks is difficult if we don’t have an adequate local public health infrastructure. We have been the victims of our own success by eliminating diseases over the decades that we have atrophied our local public health capability. In the future we need a robust public health apparatus is in place, vital and ready to respond.

There is an international health infrastructure. Explain. A pandemic means all. It is a global infection, especially for something like coronavirus that is respiratory. Our ability to travel around the world has given us global connectivity. The health networks need to be connected and transparent across the board with our international partners. If it is smoldering in another part of the world, the entire globe can be impacted. We need global organizations working together.

What are the odds that we can get the virus over and over again? We don’t know the answer to that question. If you get infected and recover, you should have some immunity. If the virus does not change, for a finite period of time you will have some immunity. We don’t know the length of that immunity for this disease. For vaccination, we don’t know how long the protection will last. If the immunity wanes, then the response will be the need for a booster shot.

Why is COVID-19 impacting minority communities more? What can be done to protect? Yes, these communities are being more impacted. Two things make for that. Generalization, the kinds of jobs that minority populations have mean they are having to be out in the community. This makes their exposure risk higher. Then, the important issue and it will take a long time to address, is the health-care system and the prevalence of certain diseases like diabetes and high blood pressure that lead to a poor outcome when there is an infection. Comorbidity is the issue for minority communities. They need easier access to medical care.

Have you seen any locations that are doing the above in a better way? Organizations like FEMA and the CDC working with state and local health authorities are the example of federal agencies working to reduce impacts of the disease.

What keeps you up at night? Things like this happening have kept me up at night. The emergence of a new virus that is easily transmissible. And, one that has a significant morbidity. I’ve lost sleep about this. Like the bird flu, but it didn’t transmit between people. The 2009 swine flu was a virus that spread human to human, but it did not kill many people.

The coronavirus is very transmittable and has a significant degree of morbidity. We need to get control of the disease. The USA has been hit terribly hard based on the numbers we are seeing. We need to open up the country because of the impacts of being closed, but it is a delicate balance of opening up and while suppressing the disease with the measures we have available.

These pandemics seem to be more frequent. They are likely more possible due to the humans encroaching on the animal population. Zoonotic diseases that jump species and that will happen again. The wet market in China where we have human and animals in direct contact. The same goes for our moving into the rain forest where human and animal contact becomes more possible.

When should I get tested even if I do not have symptoms? There is no reason to get tested just to be tested unless you think you have been exposed. If you have a good reason — get tested. Depending on where you live, you should try, if it is safe to do, do the things you should normally do with going to the doctor. Oral and dental care, normal tests that are given by your medical professional. You want to seek your normal routine medical care.

What statistics should I use to judge the status of my community? Testing and the positivity rate of the tests. The hospitalizations and then the death rate are all good indicators for how your community is doing. 

Final question, give business owners advice for reopening and staying closed. My final reflection is that the business community is essential to what we do, including our health. Try within the framework of business to get back by being prudent, by carefully following the guidelines for phase 1-3 that have been provided. This should be a facilitation for how to open.

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