Bonus: Dr. Fauci answers your questions about COVID, Monkeypox, and more

recent experience with COVID and how he's feeling now. I was very fortunate in that, you know, I really had a minor about with COVID and thankfully, UM, I don't really appear to have any residual symptoms. You know, it's kind of interesting when you're running a hundred miles an hour to determine whether it's fatigued that you would have anyway, or it's fatigue following infection. I'm chronically sleep the price symptoms,

you know, it's interesting. UM. I think it was like on a Wednesday evening, as I was getting ready to go to bed, I felt like a little scratchiness in my throat, and I thought it wasn't a sore throat by any means, And I thought maybe, as you know, with the heat and the air conditioner and the dry air, that it was causing some degree of scratchiness. But then when I woke up in the morning, it was a little bit more severe. So I thought I didn't feel

sick Hettie at all. I just said, let let me take a test, and it took a test and it came out strongly positive. So I went on pack Slovid immediately and over the next eighteen now is I developed a little bit of a sniffle um. I didn't feel great, a bit mostly fatigued, which is very interesting. Fatigue is a very important part of this, right. I went on packs of it and and the symptoms disappeared, like within eighteen hours. Yeah, but I was one of the ones

that had a bit of a rebound. I was going to say, so many people are having this rebound where the symptoms return, you test positive again after testing negative the event, So why is that happening so much? Well, you know, we don't know exactly why, but it may be that when you take packs livid early on which is the time you're supposed to take it, that you don't give the body enough of a chance to respond to the virus immunologically so that when you withdraw the

drug the virus comes back. But the good news about it, and I think we really should and I hope, well, I'm glad I'm talking to you about it too. Really, UM dissolve confusion about this is that the packs of it is doing exactly what you're asking it to do, asking it to prevent you progressing to severe disease leading

to hospitalization. If you get UM laboratory test rebound for a day or two and the re symptoms returned almost invariably, it's very very mild, which means that the drug was successful in doing what it's supposed to do in a certain percentage of people. And we still don't know what percent that is. It really varies. You know, the general study show two and that other studies show maybe eight percent. But when you talk to people, it seems that many

people who you speak to are getting this rebound. So we don't know exactly what it is. But we should not let that be a reason not to take packs Livid, because packs Livid will keep you out of the hospital. Good point. But meanwhile, the latest drain b A five has per than to be not only more contagious, but hospitalizations are on the rise. So how concerned are you about this latest strain? Yeah, we have to be careful about that, Katie, because I think that's a volume quantitative reason.

Let me explain. So, if you have a certain percentage of people yet hospitalized, the hospitalized to total case ratio that could still be very low. But when you get so many more cases because of the inherent increase in transmissibility,

you will, purely by mathematical calculation, get more hospitalizations. So even though they're reporting a hundred and twenty to a hundred and forty thousand new cases per day, it is very likely, in fact, I'm certain that the actual number is much higher because us there are so many people who are home testing. They get a positive test, they either have minimal symptoms or no symptoms at all, but

they don't report the test to anybody. So the hundred and thirty hundred and forty thousand might actually be three or four times that amount. So even though the hospitalizations are going up, which is not an acceptable thing. We don't want hospitalizations to go up, and we certainly don't want deaths to go up. But the thing that's concerning to me is that the deaths are still hanging around

three to four hundred a day. And if you do the math on that, you know you're talking over a hundred thousand deaths per year, which is a very unacceptable number of deaths. So we've got to get that number very much lower than that. And you do that, like the common common sense public health measures. If you're not vaccinated, get vaccinated. If you are not up to date on

your boosts, get boosted. If you're in a setting where you're concerned about whether or not you're infected, even though you don't have symptoms, tests are widely available and free. If you do get infected and a test is positive and you are in a risk category, go on packs a limit. If you're in an indoor congregate setting and you go to the computer and click on the CDC map and you see that the county that you're in is an orange or a red zone, then when you're

in a congregate indoor setting, wear a mask. You know, when we're not talking about you know, the radioactive statements of mask mandates. We're talking about common sense recommendation that if there's a lot of infection dynamics, it's prudent when you're in an indoor congregate settings. Where on that are

most of the hospitalizations involving unvaccinated individuals. Yeah, if you look at the difference between what is the fold increase in in in hospitalizations and death among people who are completely unvaccinated versus people who are vaccinated but not up to date on boosts and people who have vaccinated and up to date on boots, the difference in hospitalization is

overwhelmingly higher proportionately of people who are unvaccinated. Now, some vaccinated people who are at high risk either very elderly, frail, underlying immune compromise. Those people can, in fact and do go on to hospitalization and some of them die. But when you compare on a case by case basis, it's overwhelming evidence is that unvaccinated people are at a multi multi full risk more of a getting getting hospitalization and dying.

A lot of my followers are asking, though Dr Fauci about additional boosters, and they're saying it doesn't seem to be efficacious. Some of against some of these new strains. So what is the point. Well, that's a great question, and that's why we keep and and it's an understandable source of confusion. But look at the data. What are we asking the vaccines to do. We're asking predominantly that they prevent us from getting significantly ill, particularly needing to

go to the hospitalization. Now we're getting people who are vaccinated and boosted who are getting infected, like me, like the President of the United States. But what the vaccine does is really very nicely prevent you from progressing to

severe disease. Now, what we do need and just yesterday you may have heard, we had a vaccine summit at the White House which I talk about what the next generation of vaccines will look like and what we do need all vaccines for the future that will give you a greater breath and durability of infection, as well as a new form of vaccine that you could administer internasally, which will protect you more from getting infected as well

as transmitting sort of a pan coronavirus vaccine. I know you talked about, but that sounds complicated and potentially very difficult. How realistic is that? And when do you think something like that might be available. Well, you know the holy grail of a truly pan corona navirus that means every

type of coronavirus. As I mentioned in my lecture at the Vaccine Summit yesterday, you want to take incremental steps at a time and start off with a pan saws Kobe two vaccine that gets all of the different variants that we've already experienced, as well as any variant of that particular virus that we might experience in the future,

like this fall or this winter. The next step is to get a pan sub eco virus, which is that group of coronaviruses that are clustered around the bad human interface, so that if we get another jumping of the species from an animal to a human, we'll be able to have a vaccine that protects. And then the ultimate holy grail is to get one that includes all coronavirus is including the common cold coronavirus. Now that's aspirational. The first step that I mentioned, I think realistically it's going to

take a couple of years. Really, I think we'd love to have it five months from now. It's to get it proven to be safe and effective in a big study. It's not going to happen in the next few months. So basically it has become what you said, sort of endemic, as something we pretty much just have to live with. And you know, by the way, Dr Fauci, people are getting this like two or three times. I mean, is there any limit to the number of times somebody can

actually get this virus? Yeah? Most of the time, when you get repeated infection with the same or a similar related coronavirus, you have enough infection immunity built up that you may get infected, but it is unlikely, not impossible, but unlikely that you will progress to severe disease. If you look, Katie at the history of common cold coronavirus, is you and I throughout our lives every winter would get infected literally with the same virus we got infected

two years ago or three years ago. I mean not so much now when you're an adult, but even as you're a child and you're building up community kids, well, I know you and I went through the same thing. I mean, there was a period of time when my three daughters were growing up, I spent half my time blowing my nose. Uh. And that's just one of the

things when kids bring home infections. But the encouraging news about that is that the subsequent infections of the same virus in almost invariably in medicine, you never say always, when you never say never, but almost in very able, it's going to be a less severe infection. So what we're trying to do is to get this virus to a low enough level in society that it doesn't dramatically

perturb the social order. And by the social order, I mean the economy, going to school, going to work, you know, worrying and looking over your shoulder that you're gonna inadvertently infect a person who's you know, compromised, and you'll wind up, you know, having someone get ill because of your association

with them. We're not at that level yet, Katie, because I mean, having you know, several hundred thousand infections a day, having three to four hundred deaths, having forty people in the hospital is not the endemic level that we should choose to say we're going to live with it. We've got to get it much lower, and there are things that we can do to get there. Unfortunately, given the fatigue that we have this country from two and a half years of this, everyone is tired of it. So

it's very difficult. Super imposed upon an anti vax type feeling among some, super imposed upon the political divisiveness we have in this country, which you know, and and the social media misinformation and disinformation, it's very difficult to get people to adhere to common sense public health measures. After the break, how concerned should we all be about monkey pops? Right after this, let's move on, by the way, to

monkey pops. I mean, as of right now at the end of July, four thousand cases documented here in the US effect men who have sex with other men. The virus was first discovered in So why are we seeing this now, Well, it's the issue. First of all. Monkey poks is a virus that is endemic in certain Central African and West African countries. It almost invariably goes from an animal jumps to a human and with some exceptions at least up to now, we're investigating if anything has

changed recently. But in sub Saharan Africa, in Central Africa particularly, it usually when it gets into the human host, it is a dead end. It doesn't have a chain of transmission that is prolonged. What looks like it happened, and we have to make sure we nail this down epidemiologically. Is that associated with gay pride, galias and get togethers

that it got inserted. The virus did into a population where the modality of spread, which is close skin to skin contact as you would have in an sexual encounter, not exclusively in the in the sexual encounter, but when you have multiple sexual partners where you don't know the status of that person. That is a very easy way

for a virus to spread within a demographic group. So something happened and it was likely someone who was infected in an African setting got into a setting of a sexual network and then you wind up it now having very much predominantly in menos sex with men. Now, the the issue we face, that's a sensitive issue there is that we want to make sure that we need to do,

you know, four pillars on this. We very unlike the way things were in the early years of HIV when we didn't know what the agent was, We didn't have a diagnostic, we didn't have a therapy, and we still in fact don't have a vaccine. We were like swimming in the dark. Right now, we have a vaccine, we have testing, and we have therapeutics and we've got to reach out into the community to alert both the community and the physicians and healthcare providers that take care of

them that we have a problem now that's spreading. So since we have knowledge of the ideologic agent and we have interventions, the real challenge is to get in an expeditious manner those interventions to the people that need them. We started off with very few tests, six thousand a week. We now have eighty thousand a week. We know, we know we have a vaccine that works. We've got to get it, you know, from where it was stockpiled into the market. Yeah, and and get it distributed. And right

now things are looking much much better. You know, we have three hundred and some a thousand already distributed. We're gonna have another four hundred thousand distributed very soon, and then we have another additional eight hundred thousand that we're gonna be able to get out. We hope, and I think we will do that expeditiously. And we also got to cut down and we are doing that. The CDC

and the FDA are doing that now. Cut down the paperwork and the logistics um hoops that you have to run through to a therapy into someone, right, because according to the CDC, people are expected to survive monkey pops. But but you've said you're worried about children and pregnant women in particular. Why is that Because historically, if you look at what monkey Pops has done in Africa and what monkey pox is capable of doing, the susceptible people

are those who are immune compromised. Young children and pregnant women have a greater likelihood of getting a more severe outcome if they get infected. That's what I was referring to. So a lot of people wanted me to ask you, Dr Fauci, if monkey pox can be transmitted via airborne exposure, how likely is that? And while we're on the subject, if I am in the company of someone who was diagnosed with monkey pox, what are my next steps? Yeah? Well, first of all, you've got to make sure that there's

no misunderstanding. On the one hand, balancing not panicking people and on the other hand, being realistic about what we know. So right now we are studying the CDC together with

the nih IS the natural history of this virus. We generally know how it acts and acted in Southern Africa, but we want to make sure we understand that there's nothing different about this and thus far, thus far, it looks like virtually all of the epidemiological of detective work that has been done indicates that it requires close skin to skin contact with someone who has lesions of the monkey pocks. There's very little, if any, in fact, no data to indicate even though we keep an open mind

that it is spread by any other way. We do know from experience with smallpox and monkey pox that it can be spread through contaminated clothing or or other fomites call it inanimate objects. So right now, if when you say if you get exposed to someone with it, I mean if you're a healthcare provider, you know that's the reason why we want to vaccinate the healthcare providers, because they are exposed to people who come into an emergency room.

Where people who come into a situation. Should you want to isolate a person while they're shedding virus. But the thing we have to be careful of, and that's the reason why we want to get a lot of reaching out into the community, is that not everybody is fully aware. I mean, few have a very painful lesion that spread all over you. It's very clear that you have monkey pocks, but in some cases it may not be so clear. So you want to educate the community of what they

need to look out for. But I would not want to say that people need to worry about being near somebody, because then you get stigma, and stigma is the enemy of public health. So we shouldn't be saying, well, now the entire population is at high risk. It's not. We're going to keep an eye on what we call the natural history and the evolution of this. This is mostly

a CDC issue. The n i H will continue to do research with clinical trials to talk about vaccines and therapies and things like that, but it's going to be mostly trying to track the natural history of this, and the more we track of it, the more knowledge will have, and the more knowledge will have, the more concrete recommendations can be made. And of course we have to have a public health conversation without stigmatizing and ostracizing gay men,

which of course happened during the AIDS. Academic, what are

your biggest concerns about where this outbreak is going? Dr Fauci, Well, I think that really the concern is that you may have a situation where it becomes much more um aggressively spreading within the population at risk, as well as any spillover infections, namely from a person who is infect it who inadvertently would infect someone else, which is the reason why you've got to have an all hands on deck approach to alertness, reaching out into the community and making

available testing, vaccination, and therapy. You just hope COVID fatigue won't prevent people from taking this seriously. Well, you know, we've often heard and I've heard, oh my god, we've had COVID for two and a half years and now we have monkeypox. It's a reality. We've got to deal with it. We just have to deal with it, and and that's it. We can't wish it away. We've got

to address it and deal with it. And that's the reason why, as I mentioned a moment ago, we've got to get the interventions to the people who need them in a very expeditious manner. And we've got to make sure that we don't stigmatize a segment of our population, because, as I've said, way back from the from the early years of HIV and now the enemy here is the virus that's all pulled together to fight the virus and not the pointing fingers or anything like that. Meanwhile, Rampaul

has been such a thorn in your side. Dr Fauci asking questions about gaining a function research the Chinese lab and Wuhan threatening to launch a probe. What is your response to that, you know, I I don't really have any response to that, Katie. I mean a couple of papers have come out now in Science magazine from thirty investigators from twenty countries that have really shown a lot of a lot of very clear scientific data about the evolution and the origin of this. So, you know, we

always keep an open mind. But you know, you could continue to pursue and and and tweet conspiracy theories. But let's look at the science um with regard to what he's going to investigate. I mean, we're an open book. I'm we have been all along. So there's nothing that the scientific community in the United States has to hide at all, that's for sure. After the break, is Dr Fauci really retiring, We'll have some answers right after this. You've announced your stepping down at the end of President

Biden's first term. Gosh, what a career you've had. Dr fauci in public service. When you think back at all the challenges you've faced and everything that you've accomplished, what are you proudest of? Right? Well, first of all, let me make a correction, Katie and you, being a journalist as it were, no this could happen Politico. Yes, no, no, no,

it's a misperception, and I'll clarify it for you. Political asked me, I think it was George Stefanopolis a long time ago, and said, you know you you've been there this a long time. You know when do you think you'll you'll you'll step down? And said, Jesus George, I don't know. I'm just working very hard at it. Then someone asked me after that, because the idea of my stepping down came up. They said, if Donald Trump became

president in January, would you serve under him? And I said, very honestly and innociently, whether Donald Trump or another Republican becomes president or Joe Biden gets a second term, I do not plan to be in this job by January. That headline was I'm staying at the job until January. That's not the case. I said, I will not be at the job on January, which means I will retire from federal service anyway between now and then, and I

haven't made up my mind when that's gonna be. And one little footnote to that, what I jokingly but seriously object to is the word retired, because when I stepped down from federal service, I will continue to do in a different venue the things that you were asking me about in my career. What do I feel the proudest of, Well, certainly there are there are things that that I I

naturally feel proud of. Is that my fifty four years at the n i H, my you know, curing earlier before AIDS diseases that we're rare, but we're quite deadly certain inflammatory diseases, establishing the AIDS program at the ni H, being an important part of the development of therapies that have saved millions of lives, Being the principal architect with the George W. Bush, our president then of the PEPFAR program, which is saved about twenty million lives, and having the

honor and the privilege of serving seven presidents. So those are the things that I've done in the past, and some version of that I will very likely continue in a different venue when I leave the Federal service. What about being a professor at your beloved alma mater, Holy Cross. You know, anything is possible. I'm not thinking about that in any concrete terms right now, Katie, because I'm as you know, I'm not. I'm not fooling you. I'm pretty

busy right now. Well, thank you, Dr Fauci for your time and constant presence and for dealing with all these crises with such equanimity and helping to reassure the American people. We really appreciate it. But I bet you've ever seen such politicization in your job as you have in this most recent round with the coronavirus. And it must cause you to shake your head. And it's very disturbing, Katie.

And the reason it's disturbing because it really is one of the things that you least want to see when you're fighting a global pandemic. If ever there was a time for all of us to pull together, it's when you have a historically deadly pandemic that has killed a million Americans thus far, and we're having such misinformation and disinformation and conspiracy theories and outright untruths being circulated in the social media. That's terrible. That's terrible. We'll keep fighting

the good fight. Dr Fauci, and thanks again for your time anytime, Katie, always get to be with you. Take care, by the way. Next Question listeners on Gary not for season six? Can you believe it? Of my podcast which is coming to you on September twenty nine. But you know me, I just can't stop asking questions. I have a real issue with that. So I'm going to be in and out of this feed throughout August and the early fall sharing any fun or important conversations I'm having.

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