Fauci reiterates ‘cautious optimism’ regarding COVID vaccine
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Speaking at The Liver Meeting Digital Experience, Anthony S. Fauci, MD, restated actions needed to control the current resurgence of COVID-19, recommended treatments and his “cautious optimism” about recently released vaccine study data.
“Here we are now with a global pandemic of historic proportions, the likes of which we have not seen in the last 102 years,” Fauci, director of the National Institutes of Allergy and Infectious Disease said. “In the United States, we have been hit the hardest of any other country with close to 10 million cases and over 230,000 deaths. ... On November 4, we hit 100,000 cases in a single day.”
“We have had experience with coronaviruses now for decades and decades,” Fauci said, referring to the varieties that make up a third of the common cold. With this knowledge, science showed five fundamental actions that could contribute to prevention of acquisition and transmission of SARS-CoV-2: universal wearing of masks, 6 feet of physician distance, avoiding crowds, staying outdoors vs. indoors and frequent handwashing.
“If those five public health measures were adhered to universally and consistently over the country, it is clear from our previous experience with other nations and even regions in our own country, we would not have the degree of surging of cases we are currently seeing,” he said.
Fauci reviewed the facts we know about COVID-19.
- There is a spectrum of disease with 81% of people with confirmed virus showing just mild or moderate symptoms while 14% have severe symptoms and 5% are critical.
- Older age is a “striking” predictor of hospitalization.
- Comorbidities increase risk for severe COVID-19 illness. “Paramount among this is obesity and chronic obstructive pulmonary disease,” he said.
- Racial and ethnic disparities are “quite serious” with Hispanic, Native American and Black populations being infected and hospitalized at much higher rates than white people.
- Post-COVID-19 syndrome is becoming more apparent. “Variable percentages ... of people who have symptomatic disease – be it symptoms that don’t necessarily require hospitalization – ... when they recover virologically, a certain percentage, sometimes as high as one-third experience lingering symptoms for weeks to months,” Fauci said.
Though the NIH has a living document with treatments guidelines, only two – remdesivir (Gilead Sciences) and dexamethasone – are currently recommended for hospitalized patients. Fauci said others are still under investigation, including monoclonal antibodies, which he said are “being very actively pursued.”
Currently, many have their eyes on the six companies in the running for the COVID-19 vaccine.
Fauci described a “strategic approach” to developing a COVID-19 vaccine in which the government worked to “harmonize” protocols for these six companies so they adopted a common safety and data monitoring board and common primary and secondary endpoints and common immunological parameters for easier comparison.
Fauci recounted the “very exciting” recently reported data from Pfizer on its vaccine candidate and said Moderna is also close to reporting their outcomes.
“We now look at this with cautious optimism that by the end of this calendar year and well into 2021, we will be administering doses first to the highest priority and then ultimately to virtually everyone in the United States,” Fauci said.
Editor’s note: This lecture was delivered on November 15, 2020, and we acknowledge the rapid changes in COVID-19, including vaccine development and approvals. Visit Healio.com/Coronavirus for the latest news on COVID-19.
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