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July 22, 2020
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Fauci: ‘We are not winning’ against COVID-19

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Anthony S. Fauci, MD, was asked to compare the COVID-19 pandemic to a baseball game.

Anthony S. Fauci

“We are certainly not at the end of the game. I’m not even sure we’re halfway through,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday during a press briefing hosted by the TB Alliance. “We are not winning the game.”

Globally, there have been more than 15 million total cases of COVID-19 and more than 618,000 deaths. In the United States alone, there have been 3.9 million cases and more than 142,000 deaths.

“The U.S. has gotten hit harder than any other country in terms of cases and deaths,” Fauci said. “What is concerning is that we all tried to open up for economic and other reasons and we have found that as you do that, we’re seeing resurgence of cases, which means we need to do much better to control the outbreak.”

Vaccine development

Early data from clinical trials assessing potential COVID-19 vaccines have been encouraging, experts said. This month, phase 1 trial results from the first COVID-19 vaccine candidate given to people in the U.S. showed that it induced anti-SARS-CoV-2 immune responses in all participants. The vaccine candidate, mRNA-1273, was developed by researchers from the NIAID and Moderna, Inc., and was given to the first trial participants on March 16, a little over 2 months after the SARS-CoV-2 genome was posted publicly. A phase 2 trial testing different doses of the vaccine are already underway, with a phase 3 trial set to begin this summer.

This week, researchers reported more encouraging data from two separate studies examining two COVID-19 vaccine candidates. The first being developed by Oxford University and AstraZeneca induced strong antibody and T-cell immune responses with an acceptable safety profile in a phase 1/2 trial, the researchers reported. The second candidate being developed in Wuhan, China was shown to be safe and induced an immune response in most recipients following a single immunization, according to the study.

Fauci said the U.S. is moving “as fast as we possibly can” to develop a safe and effective vaccine, although he would like to see one with a higher efficacy than the 50% benchmark expected by the FDA.

“I’d like to see upward of 70-plus percent,” he said, adding that “it would be wonderful to have a measles-like vaccine” with efficacy in the high 90s.

“Remember, if you look at the efficacy of flu vaccines, its generally 40% to 50%, which is considered acceptable,” he said. “But we’re shooting for something higher.”

No. 1 ID killer?

At the same briefing, WHO chief scientist Soumya Swaminathan, MD, MNAMS, said COVID-19 could overtake tuberculosis as the world’s top infectious disease killer.

“Temporarily [it is] possible. But I hope not,” she said. “In the long run, tuberculosis is going to be with us. Malaria is with us. So is HIV. We have many, many infectious diseases around, still killing, and I hope in a year or two we have COVID-19 managed.”

The Trump administration’s decision to withdraw the U.S. from WHO could negatively impact global efforts against COVID-19 and other health threats, Fauci and Swaminathan agreed.

According to Swaminathan, there are 80 WHO collaborating centers in the U.S. — programs that will “take a hit” as a result of the U.S. withdrawal.

“It’s hard to imagine what it will be like without U.S. It would be a terrible loss for the world if we lose those links and those collaborations,” she said.

Given that the U.S. contributes so much funding to WHO, Fauci said the move has the potential to be “very disruptive.”

“I hope somehow that gets worked out,” he said.

‘I hope that we do not forget’

Experts, including Fauci, have warned for years that a surprise infectious disease outbreak was inevitable. Fauci said he would like to see more sustained commitment to pandemic responses moving forward.

“I hope that we do not forget that when we get through this, that this will happen again,” he said.

Fauci, who has faced criticism over his role as part of the White House’s COVID-19 task force, said he would not step down as director of the NIAID.

“I would never do that. This is such an important public health challenge that we’re facing,” Fauci said. “This is what I do ... this is what I’ve been training for. It would be unimaginable to me [to step down], no matter what they’re throwing at me.”

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