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Dr. Fauci Says This is the Scariest Thing About COVID-19

The infectious disease expert reveals what keeps him up at night.
Tired woman lying in bed can't sleep late at night with insomnia

Anthony S. Fauci, MD, has led the National Institute of Allergy and Infectious Diseases for nearly 35 years, but chances are you've heard more from him this week than any other time. That's because he's trying to advise Americans how to survive—and stop—the spread of coronavirus. In an interview with Medscape's Eric J. Topol, MD, and Abraham Verghese, MD, he revealed the scary thing about COVID-19, and how we can all get through it. Here are some important excerpts.

On Why COVID-19 is Unlike Anything He's Ever Seen

"It's very unique. I think that's one of the things that essentially transcends all other aspects of how you address the virus, because it can be really confusing. One of the problems we're having is with certain segments of our population, namely young people not taking it as seriously as they should, for understandable reasons. I've dealt with viruses for the past 40 years, from HIV to Ebola to Zika to chikungunya to all of the others. But I've never seen a pathogen, and in this case a virus, with such an amazing spectrum of disease severity, going from 20% to 40% of the people who are infected having no symptoms, disproportionately leaning toward younger people. But then you have people who get mildly ill, ill enough to stay at home for a few weeks or to the point where it brings them to their knees and they have postviral syndromes, some that require hospitalizations. Some require intensive care, intubation, ventilation, and some die. Usually a virus that is good enough to kill you would make almost everybody at least a little bit sick. So we're dealing with a serious virus here."

On Why This Virus is So Tricky

"You have 20%-40% of the people not even getting any symptoms. And yet vulnerable people, the elderly and those with underlying conditions, can require hospitalization, intensive care, and some will even die. So it's tough to get a consistent message that we've got to stop this virus; it's a pandemic and it's killing people.

Right now in the Southern states that are surging, the average age is 15 years younger than what we saw in the Northeast and in the New York metropolitan area early on in the year. So it's tough when people say, 'Why should I worry about getting infected? The chances are I'm not going to get sick.' We've got to get them to believe that they are part of the propagation of a pandemic, even though they are doing well themselves. And by propagating the pandemic, they're preventing us from getting back to normal and reopening. The virus itself is really, really tricky."

On the Long-Term Symptoms

"You don't want to be scaring people and alarming them, but they really should know that we don't know what the long-term consequences are, even when it looks like a routine infection. We better be careful. Even after you clear the virus, there are postviral symptoms. I know, because I follow on the phone a lot of people who call me up and talk about their course. And it's extraordinary how many people have a postviral syndrome that's very strikingly similar to myalgic encephalomyelitis/chronic fatigue syndrome. They just don't get back to normal energy or normal feeling of good health."

On People Not Wearing Masks

"We have such pushback on people not wanting to wear a mask. I don't know whether that has to do with the American spirit, which in many respects serves us well — that independent drive that brought our ancestors over, leaving whatever country they came from. I don't know what it is, but it's a pushback on authority. And what I think it's linked to is not only anti-authority, but it's a bit linked to the disturbing anti-science trend that we have in this country, like, 'You're telling me it's scientifically sound to do that. Well, I don't want to do it because I want to make up my own mind and not listen to authority.' I can understand that that has a degree of attractiveness, independence. But, boy, when you're in the middle of an outbreak, it's doing such destructive damage. It's time to let that go and join the club and wear a mask. Be a joiner as opposed to an independent entity."

On His Message of Hope—for Physicians and Us All

"Two things. One, I just try to express how much I admire the real heroes on the front line for getting in there every day and essentially putting themselves at risk. I'm operating from a different vantage point where I am, but I almost miss the days of being in the trenches with you. So that's the first thing.

The second thing is that, you know, this is so stressful for all of us. I think we have to remember that we're gonna get through this. This is not something that's gonna be forever. We're gonna get through it. It's gonna be over. And we're going to look back and hopefully say we really gave it our best shot. And it's gonna be over from two standpoints: It's going to be over from a public health standpoint if we get it right, public health–wise.

But I think science and good biomedical research are also going to come to the rescue because we're going to get a vaccine, hopefully sooner rather than later, and we will get effective therapeutics. So for the people on the frontlines and in the trenches, hang in there with us. We're all in it together and we're gonna get through it. So that's my message to them."

So stay healthy during this pandemic: Wear a face mask, avoid crowds (and bars), practice social distancing and to get through this pandemic at your healthiest, don't miss these 37 Places You're Most Likely to Catch Coronavirus.

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