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Dr. Fauci Describes 'Worst Nightmare' Scenario

What you need to know about coronavirus as we head into fall.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the nation's top infectious-disease expert, talked with actor Dennis Quaid on his Dennissance podcast this weekend, breaking some news and helping put the coronavirus pandemic in historical context. On the breaking-news front, Fauci revealed what effect a mutating coronavirus will have on the vaccine and—after advising people to avoid airline travel early in the pandemic—he had some advice that may reassure anxious potential flyers. On the flipside, Fauci described why we're living in his worst professional nightmare (and what we need to do next). Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.


When a Vaccine Is Realistically Coming

Nurse checking a vial of medicine.

Fauci said that as a scientist, "I'm generally conservative when it comes to projections about success. I always hold back a bit." But data from animal studies and early-phase trials of a vaccine have him feeling "cautiously optimistic that we will have a safe and effective vaccine by the end of the year. And we'll be able to be distributing doses in an extensive way as we get into 2021." By mid- to late 2021, he envisions most members of vulnerable groups will be vaccinated.


What Life After a Vaccine Will Look Like

Business woman with face mask because of Covid-19 and corona virus in a meeting or a meeting

Fauci said "we can't go back to being careless about it as long as there's some virus in society." But if a vaccine is developed that's 70% effective, the combination of public health measures and that vaccine will allow "getting out into some form of normality."

He acknowledged the mental-health toll of the past eight months. "We've got to convince everybody to hang in there, because people are getting worn out psychologically with this," he said. "I feel it myself. I could project what other people are experiencing. If we can, as a country, hang in there, pull together until we get a vaccine, I think we can get out of this pretty well."


How to Fly Safely

A young woman wearing face mask is traveling on airplane , New normal travel after covid-19 pandemic

Quaid expressed anxiety about flying to the set of his next movie and asked Fauci how to reduce the risk of contracting coronavirus in a plane. "If you wear a mask, the chances that you're going to [be infected] dramatically diminish," replied Fauci. "Most of the modern planes are the new ones that have … what's called HEPA filters in that the air goes through filters that pull out viral particles. What I would recommend you do is this: It's just wear something as simple as a mask—just like this, bingo, and you're in good shape."


Young People Are Driving the Latest Wave of Infections

People singing in karaoke bar

"The percent positivity of [tests] in the last few weeks has been concentrated in the 19-to-25 year old people," said Fauci. "And that is likely a reflection of the younger people out there during the holidays, out in bars and things like that. But also going back to college and congregating in colleges, and then getting infected and spreading it."


Even If the Virus Has Mutated, It Won't Affect a Vaccine

Antibodies attacking SARS-CoV-2 virus

On scientists' recent findings that an amino acid inside the coronavirus has changed, making it seemingly more contagious: "It doesn't seem to have any influence on whether or not a vaccine would be effective, because the mutation is in a region that doesn't impact the vaccine and where the antibodies bind that are induced by the vaccine."


The Worst-Nightmare Scenario of His Professional Life

"People always have asked me throughout the years, if not the decades: As an infectious disease person, what is my worst nightmare?" said Fauci. "And I always say the same answer: That we get the evolution—usually jumping from an animal to a human species—of a respiratory virus that has two fundamental characteristics. One, it's very efficiently and effectively transmitted from person to person. And two, it has a significant degree of morbidity and mortality, particularly in certain subgroups. We've had experiences with outbreaks that had one but not the other. And they've never been really the nightmare scenario. The bird flu—when it used to jump from a chicken to a human—had killed humans, but it didn't efficiently go from human to human.

"Then we had the pandemic flu of 2009 that spread very, very, very efficiently. The only trouble was, it was like a wimpy virus that didn't kill very many people. So the perfect storm is when you get both of them. That's exactly what we're living through."


Why Our Risk of Pandemics Is Increasing

"If you look at outbreaks of brand-new infections, about 70 to 75% of them are what we call zoonotic—they are namely a virus or a pathogen of any kind whose natural host is an animal that is probably adapted to it over centuries, to the point that the animal generally doesn't get sick," said Fauci. "But once it jumps species to a naive host, like a human, then you can get epidemic and pandemic outbreaks. And if you look at the history of our outbreaks, HIV—from a chimp to a human—devastated certain populations throughout the world. Influenza is fundamentally a disease of wild birds that has adapted itself to humans. Ebola, also the same thing.

"The more we perturb the environment and the human-animal interface, the greater the chance you're going to have of these particular pathogens jumping species and adapting themselves to humans."


What He's Learned From the Pandemic

nurse and man with face masks

"The takeaway for me is that we have a lot of lessons that we better learn from this terrible historic experience we're going through," says Fauci. "This is the worst pandemic that we have had in 102 years, since 1918. The lessons are that our healthcare system was not adequate to address the situation that we faced ourselves in; the other lesson learned is the disparity in people who get seriously ill, the ever-present racial disparities, which are something that we have such an obligation to try and correct in our society."


How You Can Stay Healthy Now

woman receiving a physiotherapeutic shoulder massage

As for yourself, do everything you can to prevent getting—and spreading—COVID-19 in the first place: Mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

Michael Martin
Michael Martin is a New York City-based writer and editor. Read more about Michael
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