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December has been gloomy and January looks just as gloomy as the coronavirus continues to ravage California and the country.
In a conversation broadcast online Wednesday, Dr.Anthony Fauci, the U.S. government’s top infectious disease specialist, told Gov. Gavin Newsom why the pandemic was so difficult to control in California and the United States.
But he also offered some hope for the future, describing his latest guess on when things could return to some semblance of normalcy and whether schools can safely reopen.
Here are some thoughts from Fauci on what 2021 could look like:
Fauci said the coronavirus acts very differently from the flu when it comes to children.
With the coronavirus, children appear to have lower infection levels than the wider community.
“It was almost counterintuitive, but it turns out it is,” Fauci said.
“What we must do is do everything to support keeping children in school. … If you really want to bring society back to some form of normalcy, one of the first things we have to do is get the kids back to school.
Vaccines intended for the general public to be distributed in late spring, early summer
The initial vaccine distribution to the priority group, including healthcare workers and people in nursing homes, was slower than initially expected. But Fauci said there was a feeling that by January there will be greater momentum and the pace of vaccinations will pick up.
Before the general public receives the vaccine, however, there are other priority groups which are as follows. It will likely be late March or early April before the vaccine is available to everyone.
At that time, the race will be on to get as many people vaccinated in the spring and summer, with the goal of getting everyone vaccinated before the cooler weather arrives next fall.
‘Much semblance of normalcy’ in early fall – if enough people get vaccinated
If the United States is diligent in getting a lot of people vaccinated between April and July, “I believe … that when we get to early fall, we’ll have enough herd immunity to be able to really come back. to a strong semblance of normalcy – schools, theaters, sporting events, restaurants. I believe if we do it right we will be there in early fall, ”said Fauci.
No one really knows what percentage of the population needs to be vaccinated to stop the spread of the virus, Fauci said. He guessed it would be between 70% and 85%.
“If you have a chance to get the shot, please get the shot,” Fauci said. “It is a safe and highly effective vaccine that could save your life, the life of your family and the community.
“So I believe with those two things – adhering to the kinds of things you talked about in California, public health measures, and as we get more and more people vaccinated, we’re going to examine this. thing in the rearview mirror, ”Fauci told Newsom.
Failure to contain the coronavirus would be disastrous for the economy
Some people believe that the trade restrictions put in place to control the pandemic are too high a price to pay. But Fauci said the pandemic needs to be brought under control in order for the economy to return to normal.
“We need to use public health measures – as a vehicle, a gateway, a tool – to revive the economy. It is not economics against public health. It’s public health that allows you to jumpstart the economy, ”Fauci said.
The economy will reopen “when you reduce the level of infection,” Fauci said. “And the only way to reduce the level of infection before the vaccine goes into effect is through the public health measures you talked about.
Fauci also looked at the challenges of 2020. Here are some key points:
Asymptomatic spread of the virus makes this pandemic much more difficult to control
The first information from China in late 2019 on the coronavirus was misleading, Fauci said.
Initially, the word was that the virus did not spread efficiently between humans, which ended up being wrong. Then the word was that it was mostly transmitted by people who were visibly sick.
The sobering reality was that even people with no visible symptoms transmitted the virus.
“For me, it was something that was a game changer,” Fauci said. “Because you can’t just test people who have symptoms, because you are going to miss asymptomatic people.”
Second, it meant that wearing the mask was becoming very important. “If you don’t know who is infected then everyone should be wearing a mask, which is the real fundamental rationale for saying that we need universal and uniform masks to be worn,” Fauci said.
A wide range of results – from no symptoms to death – made it too easy to get rid of the virus
Fauci said he had never seen a virus like this, where 40% of those infected had no symptoms, while 20 to 25% had symptoms so severe they might need hospitalization or die.
“The mystery of how you can have so many people who are symptom-free, and so many who are severely affected, is one of the reasons we have messaging issues,” Fauci said. “Because most of the successful people are young people, and they say, ‘What should I be worried about?’ … So they say to themselves: “Why do I have to interrupt my life?” “
But this feeling had serious consequences and was a factor in the worst toll of any country in the world – more than 335,000 deaths. And public health activities such as wearing masks have become politicized.
In Los Angeles County, the cumulative number of COVID-19 deaths of more than 10,000 is now triple the cumulative number of deaths from influenza in the last flu season, which was 3,133.
This is the most politicized public health crisis in modern U.S. history
The best public health messages are consistent and straightforward. But the coronavirus pandemic has become so politically controversial that it has been very difficult to get a cohesive public health message, Fauci said.
It was even worse than efforts to raise awareness of HIV and AIDS, public health crises that political leaders did not pay enough attention to in their early years. “It was nothing like the divide we are seeing now, which really makes implementing public health measures and public health messages very difficult,” Fauci said.
The United States should have done much better to control the pandemic
Asked by Newsom if he expected the United States to face a national death toll of over 335,000, Fauci admitted that he believes the United States would be in a much better place now.
Even when New York was hit hard in late winter and early spring 2020, the Fauci expected the country to lower coronavirus levels and public health officials to figure out how to contain the outbreaks. .
But the United States never arrived at a low baseline, Fauci said. Too many states have abandoned stay-at-home orders too soon, so when the cooler weather came with the onset of fall, “we just got off the roof,” Fauci said.
“What surprised me so much and really disappointed me was that I thought if we could go down to a really really low baseline, since we had these little individual issues, we could do the identification, l ‘isolation and contact tracing, and we are in good shape,’ Fauci said.
“The only problem is that when you have … 100,000 community cases on a given day, it is almost impossible to do effective identification, isolation and contact tracing,” he said. he declares. “So we’ve been hit hard, and unfortunately California is currently hit as bad as anyone, if not worse.
We should do some more testing
Looking to the future, Fauci said we should consider flooding schools and bringing living places together with testing, especially with so-called antigen tests which are easier to process and can be widely used in settings. contexts such as schools.
“If we only use these tests very, a lot – in schools for teachers, even ultimately for students, intermittently – you might get a good idea of what the penetration of infection is. and you can do something about it, ”Fauci said.
“We should put a lot more emphasis on community-based surveillance testing, so you get a sense of where you are – where you are with schools, prisons, nursing homes. This is the way to go, ”Fauci said. Because the virus is often transmitted by people who have no signs of illness, “you are not going to get them by testing only people with symptoms.”
Colleges that have implemented this type of routine testing have found this approach to be successful in keeping the level of transmission of the virus low, he said. That’s because this approach identifies people with HIV early and sends them into isolation until they recover, rather than allowing the virus to spread so widely that officials are forced to close the campus.
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