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Dr. Fauci on federal response to monkeypox and COVID

JUANA SUMMERS, HOST:

There are now nearly 3,500 confirmed cases of monkeypox in the U.S. And as those numbers grow, we continue to live with COVID for the third year since the initial outbreak. Joining us today to talk about the federal response to both viruses is Dr. Anthony Fauci, chief medical adviser to the White House.

Dr. Fauci, welcome back to ALL THINGS CONSIDERED.

ANTHONY FAUCI: Thank you for having me - good to be with you.

SUMMERS: We should note here, as we have this conversation, monkeypox is nowhere near as deadly as COVID. Ninety-nine percent of people who get monkeypox can expect to survive. I'd like to ask you, have we learned any lessons from the first COVID outbreak that we should be applying here in the monkeypox outbreak in terms of testing and vaccines?

FAUCI: Yes. What would be - we've got to absolutely implement now is that we now have something that we did not really have early on. We have, right now, vaccines. We have good antivirals. We have tests, and we have an etiologic agent that we have experience with. And as you mentioned, it is important to point out that the mortality of this is really very low. That doesn't mean we don't take it seriously because some of these lesions in monkeypox are really quite painful to the individuals...

SUMMERS: Yes.

FAUCI: ...Who get afflicted with this. And you have to take that seriously even though the mortality of this is really quite low. This is an evolving situation. You know, I think it's an important question you asked when you talked about the early months, as it were, of COVID-19. We need to get our arms around understanding just the extent of the spread, how it's spread, what population. Right now it's focused - because it's about 99% - among men who have sex with men. We've got to understand the modality of transmission, the manifestations, also the risk for people like children and pregnant women. There's really a profound risk. Now, right now, thank goodness, we have a report of only two cases in children, but they're all risk populations. So we've got to reach out to the community, particularly men who have sex with men...

SUMMERS: Right.

FAUCI: ...Get rid of anything that even smacks a little bit of stigma...

SUMMERS: And, Dr. Fauci...

FAUCI: ...And make sure we outreach to them.

SUMMERS: I'd like to ask you about that, though. You were at the forefront of responding to HIV and AIDS as it swept through gay communities in this country in the 1980s. So what can the federal government do to prevent a similar stigma from spreading and occurring?

FAUCI: Well, just concentrate on what the reality is. This is a virus. You fight the virus. You don't stigmatize the people who are inflicted with the virus. You reach out to the community. You make it very easy for them to have access to testing, to treatment and to vaccine as opposed to making it a situation where people are afraid to come forward for those types of things. It's got to be recognized who the enemy is. The enemy is the virus, not anybody who's being afflicted with the virus.

SUMMERS: And I want to turn now to COVID-19 for a moment. The BA.5 omicron variant is still surging. President Biden is recovering from COVID. And we should note that you have also just recovered from it yourself. What phase of the pandemic are we in now?

FAUCI: You know, it's still a moving target. And that's the point because this is such an unprecedented situation we're facing, where you have a virus that continues to evolve with new variants. In the context of vaccines, although they are highly protective against severe disease, the immunity that's induced either by prior infection and/or by vaccination is an immunity that predominantly is against severe disease. But it wanes. That's characteristic of this particular virus. You know that from the experience that we have with the common cold coronaviruses, where you can get reinfected with the same virus eight months a year or so later, which is the reason why now, I just left literally about a half an hour ago a vaccine summit at the White House looking at the next generation of a pan-coronavirus vaccine as well as vaccines that can be administered by the nasal or oral mucosa.

SUMMERS: Any decisions out of that meeting about what could come next? I know a lot of people are wondering what will happen next with new boosters, whether to get a second booster now or to wait...

FAUCI: Yeah.

SUMMERS: ...For new boosters, really...

FAUCI: Well...

SUMMERS: ...That could protect for the omicron variants.

FAUCI: Well, that meeting was directed at the agenda of knowing we need vaccines that have greater durability and breadth and that protect not only against severe disease but that protect against acquisition and transmission. That's a very important aspirational goal that we've got to get to very quickly. With regard to the evolution right now, the FDA has made a decision that the boosts that will be available in the fall will be a bivalent boost, which is made up of a BA.5 and the ancestral strain. Hopefully, that will be close enough to whatever variant evolves as we get into the fall and into the winter. That is a compelling reason why you need a pan-coronavirus vaccine, namely one that gets all of the variants. And by all of the variants, I mean ones that we've already faced and ones that we might face as the virus continues to evolve.

SUMMERS: And, Dr. Fauci, we've got just about less than a minute here left. I wonder, as we look forward to the fall, as you point out, do you and other experts expect another big surge? And will that surge be less deadly than previous surges?

FAUCI: The answer is we don't know. I mean, this virus has told us multiple times over the last 2 1/2 years that it does the unexpected. Remember; we thought when we get to the summer, we were not going to have a situation.

SUMMERS: Right.

FAUCI: And then we had a big outbreak in the summer. Right now, we don't know for sure, but we've got to be prepared for it because whenever you get into cooler weather and people go indoors...

SUMMERS: All right.

FAUCI: ...That's when you get spread of the virus.

SUMMERS: Right. We'll have to leave it there, sir. That is White House chief medical adviser Dr. Anthony Fauci. Thank you.

FAUCI: Good to be with you. Thank you for having me. Transcript provided by NPR, Copyright NPR.

Juana Summers is a political correspondent for NPR covering race, justice and politics. She has covered politics since 2010 for publications including Politico, CNN and The Associated Press. She got her start in public radio at KBIA in Columbia, Mo., and also previously covered Congress for NPR.
Megan Lim
Ashley Brown is a senior editor for All Things Considered.