An estimated 6,000 people spent their lunch hour with Dr. Anthony Fauci on Wednesday. Fauci, the nation’s leading infectious disease specialist, headlined a noontime online lecture [full audio] hosted by the University of Montana’s Maureen and Mike Mansfield Center.
Fauci said people are fascinated with worst-case scenarios.
“People have always asked me, what is your worst nightmare as an infectious disease scientist and public health official?” he said.
It turns out his long-standing nightmare sounds a lot like COVID-19: a new, easily transmissible, respiratory-borne pathogen with a relatively high degree of morbidity and mortality. So far, the coronavirus has killed over 1,300 Montanans and 480,000 Americans, and has claimed 2 million people globally.
“This is really, beyond what I imagined," Fauci said.
But the director of the National Institute of Allergy and Infectious Diseases described the 11-month development cycle of COVID-19 vaccines as "beyond unprecedented." Fauci said the vaccines have been proven safe and effective by independent scientists.
He was asked about vaccines skeptics during a question-and-answer segment.
Kaylee Kronsperger is studying Human Biological Science at the University of Montana. She said she has shadowed physicians in her hometown of Eureka. Kronsperger noticed some patients' reluctance to provide their families with even routine vaccinations.
“With this distrust in years of science and research, how do you expect rural physicians to approach the idea of vaccinating the public with a new vaccine, and how do you recommend health care professionals convey the importance of this vaccine when people still refuse to do things like wear masks or socially distance?" she asked.
Fauci urged doctors to respect that hesitancy, listen to patient concerns, and then to explain the science and safety built into this new generation of vaccines.
"And hopefully you’ll win over at least a portion of the people who have hesitancy about vaccinations," Fauci said.
But Shelly Fyant, chairwoman of the Confederated Salish and Kootenai Tribes, pointed out some Native Americans fundamentally don’t trust the government.
"What is your response to tribal community members who ask us, ‘How do you expect us to trust a vaccine sent by the federal government which has systematically decimated our people, experimented on our people, sterilized our mothers and underfunds our only health care system?'” Fyant asked.
Fauci acknowledged the legitimacy of the criticisms. However, he said unethical treatment now would be "impossible to do" thanks to modern institutional review, data and safety monitoring boards.
“It would be doubly tragic if, on the one hand, you suffered disproportionately from the outbreak, but on the other hand you do not allow yourself the advantage of the one intervention that we know absolutely is lifesaving," Fauci said.
He also said the world was unprepared when the pandemic erupted early last year.
“Hopefully the big lesson in this is that we will now have a global health security network where the interactions, communications and collaboration among nations would be such that as soon as something emerges, we’ll be able to communicate with each other about it as quickly as we possibly can," Fauci said.
He called for more investment in the kind of research that led to development of the COVID vaccines, describing them as "the light at the end of the tunnel."
Fauci estimated herd immunity could come with the vaccination of 70-85% of the country. He predicted that immunity could begin to lead us to what he termed a "significant degree of normality," possibly by mid to late fall.
“That doesn’t mean it’s going to be exactly the way it was before," Fauci cautioned.
"It may mean that we still, under certain circumstances, would have to wear a mask. We might get back to activities that we don’t do now, like being in restaurants — maybe not at full capacity — going to the theater, going to a movie."
Or comfortably going back to school.
The one wildcard? The emergence of COVID variants which could possibly elude the protections afforded by the new vaccines. But Fauci said scientists are hard at work preparing vaccine formulations specifically designed to target potential COVID variants.
Ultimately, he said there are no hard and fast answers — there are factors, Fauci said, that we simply do not have control over.