Anthony S. Fauci, director, National Institute of Allergy and Infectious Diseases, in conversation with Steven Levy, WIRED.

Reprinted for educational purposes and social benefit, not for profit.

THE TIME ELEMENT OF HOW WE WERE ABLE TO GET TO PHASE THREE TRIALS THAT YOU MENTIONED, THERE ARE NOW ACTUALLY FIVE CANDIDATES THAT ARE IN PHASE THREE. ONE IS ON HOLD BECAUSE OF AN ADVERSE EVENT THAT HAS TAKEN PLACE IN THE UK, BUT LET’S SAY FOUR THAT ARE OPERATIONAL. THE REASON WE WERE ABLE TO GET TO THAT IN A MATTER OF MONTHS, AS OPPOSED TO YEARS IS A REFLECTION OF THE EXTRAORDINARY TECHNOLOGICAL ADVANCES IN VACCINOLOGY THAT HAVE ALLOWED US TO DO THAT, TO GO FROM THE SEQUENCE OF A VIRUS ON JANUARY THE 10TH TO STARTING WORK ON A NEW TYPE OF A PLATFORM, TO GOING INTO A PHASE ONE TRIAL IN 60 SOME WHAT DAYS INSTEAD OF A FEW YEARS, TO GOING INTO A PHASE THREE TRIAL, SIX MONTHS LATER THAT WE STARTED THE FIRST ONES ON JULY 27TH WAS NOT COMPROMISING SAFETY. IT WAS NOT COMPROMISING SCIENTIFIC INTEGRITY. IT WAS A REFLECTION OF SCIENTIFIC ADVANCES COUPLED WITH FINANCIAL RISKS.

Transcript

00:01
THANK YOU SO MUCH FOR BEING THERE.
00:02
MY PLEASURE, GOOD TO BE WITH YOU.
00:05
SO, HERE WE ARE,
00:07
OCTOBER IS RIGHT ON US SEVEN MONTHS INTO THIS PANDEMIC
00:13
AND THE NUMBERS ARISING AGAIN.
00:15
AND SOME STATES IT’S THE HIGHEST EVER.
00:19
WE’VE HAD A TERRIBLE TOLL, 200,000 PLUS DEATHS.
00:22
IT’S COUNTING, THE FLU SEASON OF STARTING.
00:26
HOW SHOULD AMERICANS BE LOOKING
00:28
AT THE SITUATION NOW AS THE WEATHER’S GETTING COLD?
00:32
AND, YOU KNOW, AS I MENTIONED, THE FLU SEASON STARTING
00:36
AND WE’RE ENTERING THIS NEW PHASE OF THIS ONGOING PANDEMIC.
00:41
WELL, OBVIOUSLY IF YOU LOOK AT THE NUMBERS,
00:45
IT’S A VERY CHALLENGING
00:47
AND SERIOUS SITUATION BECAUSE THE BASELINE
00:51
OF INFECTIONS EACH DAY ARE STUCK NOW AT AROUND 40,000.
00:57
WHEN WE HAD A BIG SPIKES EARLIER ON MONTHS AGO
01:03
THAT WERE DOMINATED AT FIRST BY THE SITUATION
01:06
IN THE NORTHEAST PART OF THE COUNTRY,
01:08
PARTICULARLY THE NEW YORK METROPOLITAN AREA
01:11
WHEN THAT HIT HARD AND THEN CAME DOWN TO A BASELINE,
01:17
THE BASELINE NEVER GOT DOWN
01:19
TO WHAT I WOULD CONSIDER A REASONABLE LEVEL.
01:21
IT WAS ABOUT 20,000 CASES PER DAY.
01:25
WHEN WE TRY TO SO CALL OPEN UP THE COUNTRY
01:29
TO TRY AND GET THE ECONOMY BACK A COUPLE OF MONTHS AGO,
01:33
PARTICULARLY IN THE SOUTHERN STATES
01:35
THAT WERE VARIABLE IN HOW WELL THEY ABIDED BY THE PRINCIPLES
01:42
OF THE PUBLIC HEALTH MEASURES OF OPENING THE ECONOMY.
01:46
WE GOT INTO TROUBLE.
01:47
AND WE HAD CASES EACH DAY THAT PEAKED AT AROUND 70,000.
01:53
AND NOW, I’VE COME DOWN TO ABOUT 40,000.
01:55
THE REASON I GIVE YOU THOSE NUMBERS IS
01:58
THAT IF YOU’RE GOING TO ENTER THE CHALLENGING SEASON
02:01
OF THE FALL AND THE WINTER, WHERE SOME THINGS
02:04
IF NOT MANY THINGS WILL HAVE TO BE DONE INDOORS RATHER
02:08
THAN OUTDOORS, YOU REALLY INTENSIFY THE PROBLEM
02:12
AS WELL AS THE FACT THAT WE HAVE TO DEAL
02:15
WITH AN INFLUENZA SEASON, AS YOU MENTIONED.
02:18
SO, I WOULD HAVE HOPED THAT WHEN WE GO INTO THE FALL SEASON
02:23
WE WOULD HAVE HAD A BASELINE
02:24
THAT WAS REALLY MUCH MUCH LOWER THAN 40,000 CASES.
02:29
SO, EVEN THOUGH IF YOU LOOK AT THE MAP OF THE COUNTRY,
02:33
THERE ARE SOME AREAS OF THE COUNTRY
02:34
THAT ARE DOING QUITE WELL.
02:36
BUT AS A NATION, WE’RE A VERY DIVERSE,
02:38
WE HAVE MULTIPLE REGIONS, MULTIPLE CLIMATES, DEMOGRAPHIES
02:43
AND THINGS LIKE THAT.
02:46
THERE ARE AREAS OF THE COUNTRY NOW
02:48
THAT WE’RE STARTING TO SEE THE UPTICKS MAYBE
02:51
FROM PEOPLE COMING BACK FROM VACATION,
02:53
MAYBE FROM THE COLLEGE STUDENTS,
02:54
MAYBE FROM THE POST LABOR DAY WEEKEND.
02:57
BUT WE’RE SEEING IN PARTS OF THE COUNTRY,
03:00
UPTICKS IN TEST POSITIVITY
03:03
WHICH IS GENERALLY A BAD PROGNOSTIC SIGN,
03:06
FOR YOU THEN GOING TO START SEEING MORE CASES,
03:09
MORE HOSPITALIZATIONS
03:11
AND THEN THE LATE EFFECTS OF PERHAPS EVEN MORE DEATHS.
03:15
SO, WE HAVE GOT TO NOW
03:16
AND I WANT TO BE CLEAR WITH YOU BECAUSE WHENEVER I SAY THIS,
03:20
PEOPLE SOMETIMES MISINTERPRET
03:22
THAT I’M SAYING WE’VE GOT TO LOCK DOWN THE COUNTRY.
03:24
WE’RE NOT TALKING ABOUT SHUTTING DOWN ANYTHING.
03:27
WE’RE TALKING ABOUT TAKING A VERY PRUDENT, CAREFUL APPROACH
03:32
TO REOPENING THE ECONOMY
03:34
BY THE COMMON FIVE OR SIX THINGS WEARING MASKS UNIFORMLY,
03:40
AVOIDING CROWDS, KEEPING DISTANCE,
03:43
DOING THINGS OUTDOORS ABSOLUTELY MUCH MORE PREFERENTIALLY
03:47
THAN INDOORS AND WASHING YOUR HANDS FREQUENTLY.
03:50
IT SOUNDS LIKE RATHER SIMPLE THINGS,
03:54
BUT THEY DO HAVE A MAJOR IMPACT
03:56
ON WHETHER YOU CAN GET THOSE SURGES TO COME DOWN.
04:00
SO, YOUR QUESTION ABOUT THE FLU SEASON,
04:02
WE NOW HAVE ENOUGH FLU VACCINE
04:04
TO VACCINATE ALMOST 200 MILLION PEOPLE.
04:08
EVERYBODY SIX MONTHS OR OLDER SHOULD GET A FLU SHOT.
04:12
AND IF WE DO AND ABIDE BY THOSE PUBLIC HEALTH MEASURES
04:17
THAT I JUST MENTIONED WE MIGHT MITIGATE WELL THE FLU SEASON.
04:22
AND LET ME SHOW YOU WHY, I THINK THAT’S A POSSIBILITY.
04:26
OUR COLLEAGUES IN THE SOUTHERN HEMISPHERE, IN AUSTRALIA,
04:29
SOUTH AFRICA AND ARGENTINA, PARTICULARLY IN AUSTRALIA
04:34
BECAUSE THEY WERE CAREFUL ABOUT MASK USING DISTANCE CROWDS
04:38
AS THEY ENTERED THEIR WINTER,
04:40
WHICH IS APRIL TO THE END OF AUGUST.
04:43
SO, THEY JUST FINISHING THEIR WINTER NOW,
04:46
THEY HAD ALMOST A NON-EXISTENT FLU SEASON
04:49
THE FIRST TIME IN MEMORY THAT THEY HAD SUCH
04:52
A LOW FLU SEASON.
04:53
AND THE REASON IS THEY ABIDED BY THE PUBLIC HEALTH MEASURES
04:58
THAT I JUST MENTIONED.
04:59
SO, AS WE ENTER THE FLU SEASON, GET YOUR FLU SHOT
05:03
AND PLEASE PAY ATTENTION
05:05
TO THOSE VERY SIMPLE PUBLIC HEALTH RECOMMENDATIONS
05:10
THAT SEGUES INTO A QUESTION WE HAVE
05:12
FROM A FRIEND OF WIRED, BILL GATES.
05:15
YOU KNOW, I KNOW YOU’RE FAMILIAR WITH.
05:17
HE IS A FRIEND. HE THANKS YOU,
05:19
FOR YOUR LEADERSHIP.
05:20
YEAH AND HE HAS A QUESTION FOR YOU.
05:23
HE SAYS, BILL SAYS, MY QUESTION IS WHETHER
05:25
OR NOT YOU’RE SEEING SEASONALITY
05:27
WITH COVID AS WE SEE IN OTHER CORONAVIRUS VIRUSES
05:33
OR SEASONAL INFLUENZA, RIGHT?
05:34
AND YOU TALK ABOUT HOW THE SOUTHERN HEMISPHERE
05:37
HAS DEALT WITH IT THROUGH THEIR WINTER?
05:40
WE HAVEN’T SEEN THAT OR HAVE WE,
05:43
YOU KNOW, SEEING HOW THE NUMBERS WORK
05:44
AND IF NOT, WHY DO YOU THINK THAT IS?
05:47
NO, THE NUMBERS,
05:49
THE NUMBERS ARE TELLING US JUST THE OPPOSITE OF THAT.
05:53
BECAUSE REMEMBER, AS WE WENT FROM THE LATE EARLY SPRING
05:58
OF MARCH, APRIL, MAY, THERE WAS A QUESTION
06:02
THAT AS WE GET INTO THE HOTTER MONTHS
06:05
OF JUNE, JULY AND AUGUST,
06:09
WOULD THERE IN FACT BE A SUBSTANTIAL DIMINUTION
06:13
OF INFECTIONS IN OUR CLIMATE ZONE,
06:16
NAMELY THE NORTHERN HEMISPHERE.
06:18
AND IT’S VERY CLEAR, WE DIDN’T SEE THAT.
06:21
THERE CLEARLY IS SEASONALITY
06:22
OF THE COMMON COLD CORONA VIRUSES
06:25
BUT RIGHT NOW WE SHOULD NOT HAVE AND DID NOT
06:29
AND I THINK THE NUMBERS PROVED IT
06:31
THAT WE DID NOT SEE A MAJOR DIP
06:35
IN THE INFECTION AS WE WENT THROUGH THE SUMMER.
06:37
BECAUSE JUST LIKE I TOLD YOU WE HAD THOSE SURGES IN FLORIDA,
06:42
WHICH WAS HOT AND HUMID DURING THE SUMMER MONTHS.
06:46
AND THAT’S WHEN THEY WENT UP TO THE REALLY BIG SURGE
06:50
THAT ACCOUNTED FOR THE COUNTRYWIDE NUMBERS OF 70,000,
06:55
NEW INFECTIONS THROUGHOUT THE COUNTRY
06:57
AS WE WERE IN THE SUMMER MONTHS.
06:59
SO, THE ANSWER TO MY GOOD FRIEND BILL’S QUESTION IS,
07:02
WE’VE NOT SEEN SEASONALITY WITH THIS PARTICULAR OUTBREAK.
07:07
SO, I UNDERSTAND WITH A NOVEL VIRUS,
07:10
ADVICE CHANGES AS WE LEARN MORE ABOUT IT.
07:13
BUT SOMETIMES IN THIS CASE
07:15
IT’S DIFFICULT TO NAIL DOWN WHAT WE KNOW AT A GIVEN MOMENT.
07:18
CAN YOU PUT THE REST OF THE CONFUSION ABOUT WHETHER
07:21
THE VIRUS SPREADS BY AEROSOLS AROUND IN THE AIR
07:24
AS OPPOSED TO DROPLETS THAT ARE PROPELLED
07:26
AND FALL TO THE GROUND OR SURFACES.
07:28
AS YOU KNOW, THE CDC SAID YES AND THEN THEY WALKED IT BACK.
07:32
PEOPLE, SOME PEOPLE THOUGHT POLITICS MIGHT BE INVOLVED.
07:35
CAN YOU TELL US WHAT THE ANSWER TO THAT IS IN TERMS
07:38
OF AEROSOLS. SURE.
07:38
AND WHAT IT MEANS FOR US AS WE TRY
07:40
TO AVOID GETTING INFECTED?
07:42
RIGHT, OKAY SO THERE ARE A COUPLE
07:45
OF THINGS THAT HAVE HELPED TO CLARIFY THE ANSWER
07:47
TO THAT QUESTION PARTIALLY, BUT I THINK SATISFACTORILY
07:52
AND THEN A PART THAT WE CAN’T ANSWER.
07:54
FIRST OF ALL, WHEN YOU TALK ABOUT AEROSOL,
07:57
CLASSICALLY THAT MEANS SOMETHING THAT COMES
08:01
FROM THE RESPIRATORY TRACT.
08:02
AND INSTEAD OF IN THE DROPLETS OF A CERTAIN SIZE,
08:06
FALL TO THE GROUND WITHIN A FEW FEET
08:09
THAT ACCOUNTS FOR THE SIX FOOT DISTANCE RECOMMENDATION.
08:14
THERE ARE PARTICLES THAT ARE SMALL ENOUGH
08:17
OR IN AN AREA WHEN YOU LOOK AT THE DYNAMICS OF AIRFLOW,
08:21
THEY DON’T JUST DROP.
08:22
THEY HANG AROUND FOR A WHILE FOR SEVERAL SECONDS TO MINUTES
08:26
SO THAT YOU DON’T HAVE THAT KIND OF A DYNAMIC
08:31
WHERE ALL YOU NEED TO DO IS TO STAY DISTANT.
08:34
THAT’S ONE OF THE REASONS WHY
08:36
WE’RE GOING TO GET TO IN A SECOND,
08:37
WHY IT’S IMPORTANT TO WEAR MASKS PARTICULARLY
08:40
AND EVEN WHEN YOU ARE INDOORS.
08:43
SO, THE IDEA THAT THERE ARE AEROSOLS
08:46
WHEN YOU TALK TO THE AEROSOL PHYSICISTS
08:48
WHO STUDY THIS, THERE SEEMS TO BE NO QUESTION
08:51
THAT AN ELEMENT OF THE TRANSMISSION IS AEROSOL.
08:57
WHEN YOU LOOK AT SOME OF THE EPIDEMIOLOGICAL STUDIES,
09:01
SUCH AS IN A RESTAURANT
09:03
WHERE YOU HAVE PEOPLE SEATED FAR AWAY FROM EACH OTHER,
09:07
WHO COULD NOT HAVE BEEN IN THE RANGE OF A DROPLET,
09:10
THAT IS GOING TO BE CLOSE ENOUGH TO TRANSMIT,
09:14
WHO’VE ACTUALLY GOTTEN INFECTED
09:16
WHICH IS EPIDEMIOLOGICAL STRONG SUGGESTION
09:19
THAT THERE IS AEROSOL SPREAD.
09:22
SO THE ANSWER, I’LL MAKE IT A TWO PART ANSWER
09:25
TO YOUR QUESTION.
09:26
THE FIRST DO I BELIEVE THAT THERE IS AEROSOL
09:30
THAT IS TRANSMITTING AS PART OF THE TRANSMISSION?
09:34
AND MY ANSWER IS YES,
09:36
BASED ON WHAT WE KNOW ABOUT AEROSOL PHYSICS
09:39
AND WE’RE LEARNING FROM THE PHYSICIST WHO DO THIS FULL TIME
09:43
AS WELL AS EPIDEMIOLOGICAL DATA.
09:45
WHAT WE DON’T KNOW IS TO WHAT PROPORTION
09:49
OF WHAT LEVEL OF IMPACT AEROSOL PLAYS IN TRANSMISSION.
09:54
IT IS LIKELY THAT IT IS NOT THE MAJOR FORM OF TRANSMISSION.
10:00
THAT THE MAJOR FORM IS STILL THAT DROPLET TYPE
10:04
OF TRANSMISSION FROM PERSON TO PERSON IN CLOSE CONTACT.
10:08
BUT THE DATA THAT I SEE GET ME FEEL,
10:11
I BELIEVE PRETTY CONFIDENTLY THAT THERE IS SOME ELEMENT.
10:15
I CAN TELL YOU IF IT’S 2%, 5%, 10%,
10:19
BUT THERE IS AN ELEMENT OF AEROSOL TRANSMISSION
10:22
WHICH I DON’T THINK IS THE DOMINANT FORM OF TRANSMISSION.
10:27
SO, I TAKE IT YOU’RE NOT GOING TO A BAR ANYTIME SOON.
10:31
WELL, NO AND I’M GLAD STEVEN THAT YOU BROUGHT THAT UP,
10:34
BECAUSE WHEN YOU’RE TALKING ABOUT IN A CROWDED PLACE
10:37
WHERE PEOPLE TEND NOT TO WEAR MASKS
10:41
AND YOUR INDOORS THAT’S A PERFECT SETUP
10:45
FOR ANY KIND OF TRANSMISSION.
10:47
LARGER DROPLET TRANSMISSION, AS WELL AS AEROSOL.
10:50
AND IN FACT, WHEN YOU LOOK AT THE HOT SPOTS OF TRANSMISSION
10:55
WHEN YOU’VE SEEN PEOPLE CROWDED AT BARS WITH NO MASKS
11:00
THAT’S WHEN YOU START TO SEE THE UPTICK OF TEST POSITIVITY,
11:04
WHICH LEADS TO INCREASE CASES
11:06
AND THEN INCREASE HOSPITALIZATIONS.
11:08
AND THEN THE VULNERABLE PEOPLE WHO GET SERIOUS ILLNESS,
11:12
GET IN TROUBLE.
11:14
SO, LET’S TALK ABOUT VACCINES FOR A WHILE.
11:17
SO, WE HAVE FOUR VACCINES NOW THAT ARE IN PHASE THREE,
11:22
WHICH MEANS THESE RANDOMIZED CLINICAL TESTS
11:24
WITH TENS OF THOUSANDS OF HUMAN VOLUNTEERS.
11:28
BUT, WELL, THE SPEED IS UNPRECEDENTED.
11:31
IT’S ALSO CAUSING SOME DISQUIET,
11:34
LIKE THE NAME OF THE PROGRAM ITSELF IS OPERATION WARP SPEED
11:37
WHICH IS NAMED AFTER THEY BELIEVE FORM OF TRANSPORTATION
11:40
THAT VIOLATES THE LAWS OF PHYSICS, RIGHT?
11:43
I THINK YOU’VE [LAUGHING DROWNS OUT SPEAKER].
11:47
SO, I’M TOTALLY IN ON VACCINES IN GENERAL.
11:50
AND GOD KNOWS I AM DESPERATE FOR PROTECTION,
11:52
BUT I CONFESS PERSONALLY I’M AMONG THE PEOPLE
11:55
WHO THE POLLS SAY IS NOW OVER HALF THE POPULATION THAT FEARS
11:59
THAT THE FIRST VACCINE COMING ALONG WILL BE RELEASED,
12:03
BECAUSE OF MAYBE POLITICAL CONCERNS RATHER THAN SCIENCE.
12:05
YEAH, YEAH.
12:06
IS THAT FEAR REASONABLE?
12:09
WELL, THE FEAR IS UNDERSTANDABLE
12:13
BUT IF I GIVE YOU THE FACTS,
12:15
I WOULD HOPE THAT YOU WOULD SEE
12:17
THAT IN MANY RESPECTS IT’S NOT REASONABLE,
12:19
BUT IT’S UNDERSTANDABLE BASED
12:21
ON SOMETIMES CONFUSING MESSAGES THAT GO OUT THERE.
12:25
SO, THANK YOU
12:27
FOR GIVING ME THE OPPORTUNITY TO TRY AND CLARIFY IT.
12:30
SO, FIRST OF ALL, GETTING BACK TO WHAT YOU SAID, STEVEN.
12:33
I AGREE WHEN I HEARD THE WORD WARP SPEED,
12:36
I KIND OF WINCED BECAUSE THAT CAN SUGGEST
12:40
TO SOME IRRESPONSIBLE SPEED, BUT IT’S NOT.
12:44
SO, THE TIME ELEMENT OF HOW WE WERE ABLE TO GET
12:48
TO PHASE THREE TRIALS THAT YOU MENTIONED,
12:51
THERE ARE NOW ACTUALLY FIVE CANDIDATES
12:53
THAT ARE IN PHASE THREE.
12:54
ONE IS ON HOLD BECAUSE OF AN ADVERSE EVENT
12:58
THAT HAS TAKEN PLACE IN THE UK,
13:00
BUT LET’S SAY FOUR THAT ARE OPERATIONAL.
13:04
THE REASON WE WERE ABLE TO GET TO THAT
13:07
IN A MATTER OF MONTHS, AS OPPOSED TO YEARS IS A REFLECTION
13:12
OF THE EXTRAORDINARY TECHNOLOGICAL ADVANCES
13:16
IN VACCINOLOGY THAT HAVE ALLOWED US TO DO THAT,
13:20
TO GO FROM THE SEQUENCE OF A VIRUS ON JANUARY THE 10TH
13:25
TO STARTING WORK ON A NEW TYPE OF A PLATFORM,
13:28
TO GOING INTO A PHASE ONE TRIAL IN 60 SOME WHAT DAYS
13:32
INSTEAD OF A FEW YEARS, TO GOING INTO A PHASE THREE TRIAL,
13:36
SIX MONTHS LATER THAT WE STARTED THE FIRST ONES
13:40
ON JULY 27TH WAS NOT COMPROMISING SAFETY.
13:45
IT WAS NOT COMPROMISING SCIENTIFIC INTEGRITY.
13:49
IT WAS A REFLECTION OF SCIENTIFIC ADVANCES COUPLED
13:53
WITH FINANCIAL RISKS.
13:56
SO, WHAT DO I SAY?
13:58
WHAT DO I MEAN WHEN I SAY FINANCIAL RISKS?
14:00
SO, IN GENERAL VACCINOLOGY, WHEN THE COMPANIES DO THIS
14:05
THEY CAUTIOUSLY DO ONE STEP AFTER THE OTHER,
14:08
AFTER THE OTHER IN SEQUENCE,
14:11
WE WERE DOING THINGS IN PARALLEL.
14:13
SO, BEFORE WE HAVE THE ANSWER TO A,
14:16
WE INVEST THE MONEY IN B AND BEFORE WE GET THE ANSWER TO B,
14:19
WE INVEST MONEY IN C, THAT’S CALLED AT RISK,
14:26
AGAIN A BAD TERMINOLOGY,
14:28
BECAUSE IT ISN’T RISK TO THE PATIENT.
14:31
IT’S RISK TO THE MONEY,
14:33
SO THAT YOU START PREPARING FOR A TRIAL LONG BEFORE
14:37
THE PREVIOUS TRIAL IS PROVEN TO BE SUCCESSFUL.
14:42
YOU START MAKING DOSES OF VACCINE BEFORE YOU EVEN KNOW
14:48
IT WORKS.
14:49
SO, IF IT DOES WORK, YOU SAVE MONTHS.
14:53
IF IT DOESN’T WORK, YOU’LL LOSE A LOT OF MONEY.
14:57
AND THE THOUGHT BEING THAT THE FEDERAL GOVERNMENT
15:00
IS SAYING, WE’LL TAKE THE CHANCE OF A FINANCIAL LOSS
15:05
IN ORDER TO GET THE PROCESS TO BE DONE
15:08
IN A SPEEDY BUT MEASURED WAY,
15:12
SO THAT YOU DON’T CUT CORNERS ON SAFETY
15:15
AND YOU DON’T CUT CORNERS ON SCIENTIFIC INTEGRITY.
15:19
THAT’S THE SPEED, BUT THERE’S ANOTHER QUESTION THAT,
15:23
WELL, I KNOW YOU WANT TO ASK IT.
15:24
SO, LET ME GO IN, IS THAT, WHAT ABOUT THE DECISION
15:27
OF WHETHER OR NOT IT’S SAFE AND EFFECTIVE?
15:30
THE BIG ELEPHANT IN THE ROOM, STEVEN
15:32
IS THEIR POLITICAL INFLUENCE SAYING GET SOMETHING OUT
15:36
THAT ISN’T NECESSARILY SAFE
15:38
OR THAT ISN’T NECESSARILY EFFECTIVE.
15:40
THE WAY THE SYSTEM IS SET UP,
15:42
THERE IS INDEPENDENT BODIES THAT HAVE ACCESS TO THE DATA
15:48
THAT NO ONE ELSE HAS ACCESS TO.
15:50
AND THEY MAKE THE DECISION BASED ON THE SCIENTIFIC DATA,
15:55
WHETHER THE VACCINE IS SAFE AND EFFECTIVE,
15:57
THAT’S CALLED A DATA AND SAFETY MONITORING BOARD,
16:01
THAT IS A BOARD MADE UP OF CLINICIANS, VACCINOLOGIST,
16:05
STATISTICIANS, ETHICISTS.
16:07
THEY ARE THE ONLY ONES IN THE FORM OF THE UNBLINDED,
16:11
AS IT WERE STATISTICIAN WHO INTERMITTENTLY LOOK AT THE DATA
16:16
AND THEY CAN COME TO ANY OF A NUMBER OF CONCLUSIONS.
16:20
THEY CAN SAY AT A PREDETERMINED TIME
16:22
BY LOOKING AT THE DATA,
16:23
IT HASN’T MET THE SPECIFICATIONS IN THE PROTOCOL
16:27
FOR EFFICACY.
16:28
SO, CONTINUE THE STUDY FOR ANOTHER X NUMBER OF MONTHS
16:33
OR IT CAN LOOK AT THE DATA AND SAY,
16:35
MY GOODNESS, THERE ARE MORE INFECTIONS
16:38
IN THE VACCINE LIMB OF THE PROTOCOL, THAT THE PLACEBO LIMB,
16:42
YOU BETTER STOP THE STUDY BECAUSE IT’S DANGEROUS.
16:46
OR THEY’LL SAY, WE’VE LOOKED AT THE DATA.
16:49
AND IN FACT, THE VACCINE IS INDEED PROVIDING
16:54
THE KIND OF PROTECTION THAT’S STATISTICALLY SIGNIFICANT.
16:58
SO, NOW THE COMPANY GETS ACCESS TO THE DATA.
17:02
THEY GO TO THE FDA AND THE FDA EXAMINES IT,
17:06
INDEPENDENT SCIENTISTS EXAMINE IT TOGETHER
17:10
WITH THEIR ADVISORY COMMITTEE
17:11
WHICH IS ANOTHER INDEPENDENT COMMITTEE.
17:14
AND THEN THEY MAKE A RECOMMENDATION,
17:16
WHETHER THEY HAVE AN EMERGENCY USE AUTHORIZATION
17:19
OR A BLA, WHICH IS A BIOLOGICAL LICENSE APPLICATION.
17:23
NOW, IF THEY’RE TRIED TO BE AN END RUN AROUND
17:26
THAT POLITICALLY, THAT WILL BE SO TRANSPARENT,
17:30
BECAUSE ALL OF THAT INFORMATION WILL BE AVAILABLE
17:34
TO THE SCIENTIFIC COMMUNITY
17:37
TO PEOPLE LIKE MYSELF AND ALL OF MY SCIENTIFIC COLLEAGUES.
17:40
SO, THERE’S A LOT OF FAIL SAFE ISSUES IN THERE
17:43
THAT ARE GONNA PREVENT GOING TOO FAST,
17:47
GOING TOO RECKLESSLY OR DOING SOMETHING PREMATURELY.
17:52
SO, WHEN IS YOUR EXPECTATION THAT THIS IS GOING TO HAPPEN?
17:57
SOME OF THEM,
17:58
THE OPTIMISTIC, MAYBE OVEROPTIMISTIC EXPECTATIONS
18:04
WE’VE BEEN HEARING FROM THE ADMINISTRATION IS
18:06
IN A FEW WEEKS IN OCTOBER.
18:09
YEAH.
18:10
YOU KNOW, MAYBE WE’LL START GETTING INOCULATED BEFORE
18:12
THE END OF THE YEAR.
18:14
OTHER PEOPLE IN THE GOVERNMENT ARE SAYING,
18:17
REALLY NOT UNTIL NEXT SUMMER,
18:18
CAN WE REALLY EXPECT THAT TO HAPPEN, WHAT’S YOUR GUESS?
18:21
NO, NO, ACTUALLY STEPHEN,
18:22
I’M GLAD YOU BROUGHT THAT UP,
18:23
BECAUSE THERE’S SOME CONFUSING MESSAGES THERE.
18:26
LET ME MARCH THROUGH IT WITH YOU.
18:28
SURE.
18:29
IF YOU’LL ALLOW ME TO DO IT.
18:30
SO, RIGHT NOW WITH THE VACCINES.
18:31
OKAY.
18:32
THAT ARE IN ADVANCED PHASE THREE CLINICAL TRIAL,
18:36
THERE’S A LOT OF PEOPLE IN THOSE TRIALS.
18:38
I MEAN, THE MEDANTA TRIAL HAS 30,000 PEOPLE.
18:42
THE PFIZER TRIAL HAS 44,000.
18:45
THE JOHNSON TRIAL HAS 60,000.
18:47
SO, THERE ARE A LOT OF TESTING GOING ON THERE.
18:51
WE’RE PROJECTING THAT,
18:53
GIVEN THE LEVEL OF INFECTION THAT WE’RE SEEING IN THE SITES
18:58
IN THIS COUNTRY AND IN SOME CASES INTERNATIONALLY
19:02
WHERE INFECTION IS ONGOING THAT MY PROJECTION
19:06
AND THAT OF MY COLLEAGUES IS THAT IT IS LIKELY
19:09
THAT WE WILL KNOW WHETHER WE HAVE A SAFE
19:13
AND EFFECTIVE VACCINE SOMEWHERE AROUND,
19:16
NOVEMBER AND DECEMBER.
19:18
IS IT CONCEIVABLE THAT THAT MIGHT BE BEFORE THEN,
19:22
NAMELY OCTOBER?
19:24
IT IS CONCEIVABLE,
19:25
I BELIEVE UNLIKELY, BUT I WOULDN’T BE THAT SURPRISED
19:29
IF IT WERE BECAUSE THE ANSWER TO THE TRIAL IS BASED ON
19:34
HOW MANY INFECTIONS TAKE PLACE IN THE CONTEXT OF THE TRIAL
19:39
AND WHETHER THE VACCINE IS QUITE PROTECTIVE VERSUS OBVIOUSLY
19:45
THE PLACEBO WHICH YOU WOULDN’T EXPECT TO BE PROTECTIVE.
19:48
SO, LET’S ASSUME THAT WE GET AN ANSWER
19:51
IN NOVEMBER AND DECEMBER.
19:53
AS I MENTIONED A LITTLE WHILE AGO
19:55
THE GOVERNMENT HAS ALREADY INVESTED
19:58
IN MAKING HUNDREDS OF MILLIONS OF DOSES ALREADY.
20:02
THEY’RE WORKING ON IT NOW.
20:04
SO, THERE WILL BE AVAILABLE AT THE END OF THE YEAR
20:07
IN DECEMBER, YOU KNOW, ABOUT A HUNDRED MILLION DOSES.
20:10
AS YOU GET INTO JANUARY, FEBRUARY, MARCH, APRIL
20:15
IT’LL BE UP TO 700 MILLION DOSES BY THE END OF APRIL.
20:20
SO, IF WE HAVE,
20:22
IF, BECAUSE REMEMBER, WE’VE GOT TO PROVE IT FIRST
20:25
BUT IF WE HAVE A SUCCESSFUL VACCINE AT THE END OF THE YEAR,
20:29
WE WOULD BE ABLE TO START ADMINISTERING VACCINE
20:33
TO THE PEOPLE WHO ARE AT THE HIGHEST PRIORITY
20:37
WHICH IS DETERMINED BY AN INDEPENDENT BOARD.
20:41
BY THE TIME YOU GET TO APRIL, YOU WILL HAVE ENOUGH VACCINE
20:46
FROM ALL OF THE COMPANIES,
20:48
TO BE ABLE TO ADMINISTER ESSENTIALLY
20:50
TO EVERYBODY IN THE COUNTRY.
20:52
PRACTICALLY SPEAKING,
20:55
WHEN DO WE THINK WE ACTUALLY WILL LOGISTICALLY GET
20:59
THE VACCINE INTO PEOPLE WHO WANT TO GET THE VACCINE
21:03
OR WHO MIGHT WANT TO WAIT AND SEE HOW THE TRIALS GO,
21:07
PRACTICALLY SPEAKING STEVEN
21:08
AND LIKELY WILL BE THE SECOND, THIRD QUARTER OF 2021,
21:13
BUT THE BEGINNING OF THE ADMINISTRATION
21:15
OF THE VACCINES LIKELY COULD TAKE PLACE
21:19
AT THE END OF THIS YEAR OR THE BEGINNING OF NEXT YEAR.
21:23
OKAY, WE HAVE AN AUDIENCE QUESTION FROM STEVE STONEBERG.
21:27
WERE VIEWERS WELL SERVED OR POORLY SERVED
21:30
BY THE COVERT Q AND A AT LAST NIGHT’S DEBATE?
21:38
WELL, [LAUGHING] I THINK THAT THE VIEWERS
21:43
OF THAT WOULD LIKELY NOT REALLY HAVE A CLEAR CUT PICTURE
21:47
OF WHAT WAS GOING ON.
21:48
I DON’T THINK, I MEAN,
21:50
I DON’T WANNA START GETTING INTO SOUND BYTES
21:53
BUT THAT WAS AN UNUSUAL EXPERIENCE THAT DEBATE.
21:57
WAS YOUR, YOU KNOW, YOUR NAME WAS INVOKED SEVERAL TIMES.
22:01
RIGHT.
22:02
WERE YOU COMFORTABLE WITH THE CATEGORIZATION
22:03
OF THE PRESIDENT, TALKED TO YOU ABOUT YOU?
22:07
HE SAID AT ONE POINT YOU CONGRATULATED HIM
22:09
FOR SAVING YOU KNOW, A HUNDRED THOUSAND LIVES
22:13
BY YOU KNOW, THE LIMITED TRAVEL FROM CHINA.
22:17
THEN HE SAID THAT YOU CHANGED YOUR MINDS ABOUT MASK.
22:19
YOU SAID MYTHS ARE NOT GOOD.
22:21
AND THEN YOU SAID MASKS ARE GOOD
22:23
AND HE SITED YOU SPECIFICALLY IN THAT,
22:26
YOU WANNA CLARIFY ANYTHING? ALL RIGHT.
22:28
WELL, I COULD CLARIFY THAT, BUT LET ME FIRST SAY
22:32
THAT YOU’VE PROBABLY HEARD ME SPEAK A LOT, STEVEN
22:36
YOU KNOW, TV AND RADIO AND PRESS.
22:40
SURE.
22:41
I MUST HAVE SAID MAYBE SEVERAL TENS OF THOUSANDS
22:45
OF TIMES THE IMPORTANCE OF WEARING MASKS.
22:48
IT’S LIKE WHEN PEOPLE SEE ME,
22:51
WHEN I’M WALKING OR RUNNING IN THE STREET WITH MY WIFE
22:53
AND I HAVE MY MASK ON THEY SEE ME
22:55
THEY PUT THEIR MASK UP BECAUSE THEY KNOW IT’S ME.
22:58
SO, I’M THE MASK GUY, ALL RIGHT.
23:01
YEAH, YEAH.
23:02
I DON’T THINK THERE’S ANY DOUBT ABOUT THAT.
23:03
SO, IF THERE WAS AN INTERPRETATION THAT I’M NOT FOR MASKS
23:08
THAT’S A MISINTERPRETATION, BUT LET ME GET TO YOUR QUESTION.
23:11
SO, THERE WERE TWO AREAS THAT WERE BROUGHT UP,
23:14
THE FIRST WAS THE PRESIDENT SAID THAT
23:17
WHEN HE SHUT DOWN CHINA, THAT HE DEFINITELY SAVED A LOT
23:22
OF INFECTIONS HERE IN THE COUNTRY.
23:24
AND HE’S ABSOLUTELY CORRECT
23:27
THAT HE MADE A DECISION TO SHUT DOWN TRAVEL TO CHINA.
23:31
AND THAT WAS A GOOD DECISION THAT RESULTED
23:34
IN THE SAVING OF LIVES AND THE SAVING OF INFECTIONS.
23:37
THE ISSUE WITH THE MASK IS THAT
23:40
WHEN WE IN THE BEGINNING
23:42
AND I’LL SAY IT NOW FOR THE MULTIPLE TIME,
23:44
I’LL TRY TO DO QUICKLY BACK IN FEBRUARY, MARCH,
23:48
WHEN THERE WERE VERY FEW INFECTIONS IN THIS COUNTRY,
23:52
THERE WAS A SHORTAGE OF MASKS FOR THE HEALTHCARE PROVIDERS
23:57
THAT NEEDED IT.
23:59
NUMBER ONE, WE DID NOT WANT TO ALL OF A SUDDEN HOARD MASKS
24:04
AND TAKE IT AWAY FROM THE PEOPLE WHO WERE PREPARING
24:06
FOR THE ONSLAUGHT OF CASES.
24:09
NUMBER TWO, THE DATA OF THE EFFICACY OF MASKS
24:14
WERE NOT AS CLEAR THEN,
24:16
SUBSEQUENTLY STUDIES HAVE COME OUT
24:18
AND EXPERIENCE FROM OTHER COUNTRIES THAT MADE IT VERY CLEAR
24:22
THAT MASKS ARE EFFECTIVE.
24:24
NUMBER THREE, WE FOUND OUT THAT COTTON CLOTH COVERINGS
24:30
WERE JUST AS GOOD AS THE SURGICAL MASK.
24:33
AND SO, WHAT WAS TAKEN OFF THE TABLE WAS THE SHORTAGE.
24:39
THERE’S NO LONGER A SHORTAGE OF MASKS.
24:41
NUMBER ONE, NUMBER TWO, THE DATA THAT SHOW
24:45
THAT MASS WORKS ARE NOW VERY, VERY CLEAR.
24:49
AND NUMBER THREE,
24:50
WHEN WE REALIZED A VERY IMPORTANT EPIDEMIOLOGICAL FACT
24:55
THAT 40 TO 45% OF THE INFECTIONS ARE WITHOUT SYMPTOMS.
25:00
PEOPLE HAVE NO SYMPTOMS.
25:01
SO, THEY DON’T KNOW THEY’RE INFECTED.
25:03
AND MODELING SHOWS THAT A SUBSTANTIAL PROPORTION
25:08
OF TRANSMISSIONS OCCUR FROM PERSON WHO IS ASYMPTOMATIC
25:13
AND DOESN’T KNOW THEY’RE INFECTED TO AN UNINFECTED PERSON.
25:17
THEREFORE EVERYONE SHOULD ASSUME THAT YOU MIGHT BE INFECTED.
25:22
THEREFORE WE WENT FROM SAYING,
25:25
WE REALLY SHOULDN’T BE DOING MASK
25:27
TO ABSOLUTELY PEOPLE SHOULD BE WEARING MASKS.
25:31
SO, THAT GETS DISTORTED BECAUSE WE ACTED ACCORDING
25:35
TO THE SITUATION AT THE TIME,
25:38
EARLY ON, IT WASN’T A SITUATION BASED ON OUR KNOWLEDGE
25:42
THAT WOULD HAVE MANDATED OR GIVEN US A STRONG INDICATION
25:46
FOR MASKS.
25:47
RIGHT NOW, LET THERE BE NO CONFUSION BY ANYBODY.
25:52
YOU SHOULD BE WEARING A MASK, KEEPING DISTANCE,
25:56
AVOIDING CROWDS, DOING THINGS OUTDOOR MORE
25:59
THAN INDOOR AND WASHING YOUR HANDS.
26:02
I CANNOT BE MORE CLEAR THAN THAT.
26:06
SO, HOW DID YOU FEEL WHEN THE PRESIDENT SORT OF MADE FUN
26:10
OF VICE PRESIDENT BIDEN FOR WEARING A BIG MASK?
26:17
YOU KNOW, I CAN’T COMMENT ON THAT STEVE
26:19
AND I JUST DON’T WANT TO GO THERE ABOUT CRITIQUING
26:21
THE PRESIDENT OF THE UNITED STATES.
26:25
OKAY, WELL, WE HAVE ONE MORE AUDIENCE QUESTION,
26:27
WE WANNA FINISH OUT ON, IT’S A LITTLE DIFFERENT SPIN THERE.
26:30
OSCAR WEINFURTER ASKS, WHAT IS A BELIEF THAT YOU HOLD
26:35
THAT MANY OTHERS DON’T APPRECIATE YET?
26:42
YOU KNOW, THE BELIEF THAT I HOLD,
26:44
THAT IF WE PULL TOGETHER AS A NATION
26:48
IN A UNIFIED WAY TO ADDRESS THIS OUTBREAK,
26:53
BY ADHERING TO THE PRUDENT
26:56
AND CAREFUL PUBLIC HEALTH PRINCIPLES
26:58
THAT WILL ALLOW US TO CONTINUE TO OPEN UP THE ECONOMY
27:04
AND NOT SHUT DOWN.
27:06
WE’RE SAYING NOT SHUT DOWN,
27:09
BUT CONTINUE TO OPEN UP THE ECONOMY IN A CAREFUL PRUDENT WAY
27:14
THAT THIS OUTBREAK WILL END.
27:16
WE WILL GET A VACCINE.
27:19
I SPOKE ABOUT THAT A FEW MOMENTS AGO
27:22
AND IF WE COMBINE A VACCINE
27:25
WITH PRUDENT PUBLIC HEALTH MEASURES
27:28
WE CAN PUT THIS OUTBREAK BEHIND US.
27:30
AND THAT’S THE REASON WHY WE SHOULD NOT DESPAIR,
27:34
BECAUSE DESPAIR MAKES YOU THROW YOUR HANDS UP AND SAY,
27:37
IT DOESN’T MATTER WHAT I DO,
27:39
WHAT’S GOING TO HAPPEN IS GOING TO HAPPEN.
27:41
THAT IS INCORRECT.
27:43
IT DOES MATTER WHAT WE DO.
27:46
AND IF WE DO IT FOR A WHILE LONGER
27:48
WE WILL LOOK BEHIND US AND THE OUTBREAK WILL BE BEHIND US.
27:53
NOT AMONG US.
27:55
WELL, I CERTAINLY HOPE YOU’RE RIGHT.
27:58
AND I THANK YOU AGAIN FOR SPENDING YOUR TIME WITH US.
28:01
I KNOW YOU’RE A VERY BUSY GUY.
28:03
STAY SAFE.
28:05
THANK YOU VERY MUCH STEVEN.
28:06
GOOD TO BE WITH YOU.