STEVE INSKEEP, HOST:
Just as this country is moving into a colder season, coronavirus cases are rising. New cases are up 30% from two weeks ago. States mainly in the Midwest and Great Plains posted new daily records last week. Dr. Brad Burmeister is one of those dealing with that. He's an emergency physician at Bellin Hospital in Green Bay, Wis.
BRAD BURMEISTER: Our hospital is very full right now with a lot of coronavirus cases. Looking back a few months ago, we thought we were really busy then. And it's just crazy how many multiple times more busy we are now. The concerning thing is the trends that we're seeing. Our positivity rate continues to be very high, greater than 20%.
INSKEEP: In North Dakota, we reached Renae Moch, the public health director in Bismarck-Burleigh.
RENAE MOCH: Here in the Bismarck area, we had over the weekend just one bed available for ICU. And so if you had a severe illness that required more critical care, likely you may have to be transported to another area of the state. Some have gone even outside state lines to be able to get hospital care that they have needed.
INSKEEP: So that's the backdrop as we bring in the doctor who is overseeing the search for a vaccine here in the United States. Dr. Francis Collins is director of the National Institutes of Health. Dr. Collins, welcome to the program.
FRANCIS COLLINS: Thank you. Good morning, Steve.
INSKEEP: I want people to know that you said about a month ago that you had three vaccines that had made it to phase-three testing, meaning really widespread testing, tens of thousands of people taking them in areas where they would be exposed to coronavirus. How would you describe the status of the search for a vaccine as of today?
COLLINS: I think it continues to be absolutely breathtaking the pace that has been achieved here, recognizing that most vaccine development in the past has been a matter of multiple years - four years, six years, sometimes 10 years. The fact that we knew about this virus and its particular genome sequence in January, and we now have four phase-three trials in the United States that have gotten launched, two of which are very close to completing their enrollment of 30,000 or more participants each - it's pretty amazing that that's been accomplished. But before anybody starts to worry, I also want to reassure everybody we are not doing this by cutting corners. These will be vaccines that are tested with the most rigorous standards for safety and efficacy. If we get to the point by some time maybe the end of this year where one or more of those is judged to be safe and effective, it will be because it's safe and effective.
INSKEEP: And you said if we get to that point, so you see the end of the year is within the realm of possibility but not anything we should plan on?
COLLINS: Again, this is a really tough scientific challenge. We are doing everything possible to try to develop and test the vaccines in the most rigorous way. But you never know. Anybody who's worked on vaccines before will tell you the things that happen. By the way, two of these trials are currently on hold because of a concern about a possible safety issue. People should be reassured by that - that that means we're really looking at the safety issues with great scrutiny. But that does say that those two trials are of somewhat uncertain status. And we'll have to see what happens in the coming days about reactivating those if they are judged to be safe after all. So yeah, many uncertainties here, but I am guardedly optimistic, as I think are most of the experts who are watching over this, including Dr. Fauci, who I talk to every day about this 'cause he works for me - that we will have by the end of the year one or more of these that will pass this very high standard of safety and efficacy.
INSKEEP: Probably not in the next couple of weeks, though, we would assume, right?
COLLINS: I would think it's very unlikely, given the timetables and the standards that have to be followed that you will hear about an emergency-use authorization before late November at the earliest.
INSKEEP: OK, that's useful to know, of course, since Election Day is two weeks away. And there had been much talk about some kind of vaccine announcement before the election. You're giving us the facts here and telling us that the timetable is a little bit longer than that. I want people to know that you're part of the Coronavirus Task Force that has been advising the White House, advising the president. From our perspective, as laymen looking from the outside, the task force is much less public than it was, less visible than it was. And there's more prominence for a new member, Dr. Scott Atlas, who's not an infectious disease expert. What is your impression? Is the president still listening to experts who know what they're talking about?
COLLINS: The task force continues to meet regularly at least once a week and to wrestle with a whole lot of the issues, especially now that we see the worsening of the pandemic in the middle of the country, which is really quite a serious concern. And the vice president presides over all of those task force meetings and is incredibly engaged with all of these questions and deliberations and decisions that have to be made. We have not met with the president in quite some time.
INSKEEP: You have not met with the president in quite some time. Is that a matter of concern?
COLLINS: I think the president primarily is getting his information from the vice president, from Dr. Atlas. Obviously, it's a bit of a chaotic time with the election. So yeah, there's not a direct connection between the task force members and the president, as there was a few months ago. But this seems to be a different time with different priorities.
INSKEEP: Is that unusual? You said you feel the president is primarily getting information from the vice president and Dr. Atlas. OK, the vice president is the vice president, close adviser and head of the task force. But neither of the two people you named is an expert in infectious diseases. Should we be concerned?
COLLINS: You know, Steve, I don't think I want to delve too deeply into the political side of this. As a scientist, as a physician, I'm trying to do everything I can to oversee the science going forward. And the political part of this tends to be a little bit harder for me to understand.
INSKEEP: OK. There's another aspect of what we might consider political, but it seems to me to be in the realm of public health because it involves someone who, as you said, Dr. Collins, works for you. Dr. Anthony Fauci runs an institute that is part of the NIH that is under your oversight. And the president, according to multiple reports and audio published by Fox News, described Dr. Fauci in a certain way in a call to his campaign. He was talking about the campaign with people in his campaign yesterday, and he said people are tired of hearing Fauci and these idiots. And let's listen to a little bit of that audio.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: People are tired of hearing Fauci and all these idiots, these people, these people that have gotten it wrong.
INSKEEP: I can't believe I'm even asking this, Dr. Collins, but those are the words of the president of the United States. Do you regard Dr. Fauci in those terms?
COLLINS: Tony Fauci is probably the most highly respected infectious disease expert in the world. He's also a terrific communicator. And I think the public has actually been greatly benefited by hearing his unvarnished, unflinching descriptions of what's happening with this worst pandemic in more than 100 years. I have great confidence in him.
COLLINS: How clear do you think public health messaging has been in this crisis, and how clear has it continued to be? Dr. Fauci has one particular message. The president has a different set of messages. They don't always disagree. We can always point to occasions where the president has said the same thing as Dr. Fauci. But there are so many times that there are clashing messages that it's - you have to wonder how that affects the public.
COLLINS: Well, I think the public does sometimes get confused about exactly what's going on here. And it doesn't help that social media plays its role, spreading around a whole lot of conspiracy theories that sometimes are absolutely outrageous but seem to capture people's attention. I would just urge people listening to our conversation right now, trust the public health experts. They don't really have an axe to grind. Trust CDC. Trust Fauci. Trust the folks at the FDA who are trying to do their jobs. They don't have any particular reason to spin the information. They're going to try to do their best to share with you what we know and what we don't know. So, yeah, consider the source. If you're trying to get public health information, it's probably good to listen to a public health expert.
INSKEEP: Well, let's - since you are a public health expert, let's circle back to the science here for a moment. We said at the beginning that there has been a surge in cases, especially in the Midwest and Plains states. Do you feel you understand why that would be?
COLLINS: I'm afraid I do. And I'm afraid it was all sadly somewhat predictable. People are talking about, is this the second wave? We never got over the first wave, Steve. You know, we had terrible outbreaks that affected particularly New York City and its surroundings. But we never really drove the cases down to the baseline. It continued. We had another big, terrible burst in the summer, taking the lives of tens of thousands of people in the Southeast. Here we are now with 220,000 dead. And we're going straight up again with the number of cases that are happening each day. Hospitalizations are up, as we heard in those clips from our emergency rooms. And I'm afraid, inevitably, that is going to result in an increase in deaths 'cause that's what happens every time with about a two- or three-week delay between those curves moving upward.
And all of this, I'm afraid, happens because we have not succeeded in this country in introducing really effective public health measures, those simple things that we all could be doing. Wear your mask. Keep that 6-foot distance. And don't congregate indoors, whatever you do. And wash your hands. It's so simple. And yet people are tired of it. And yet the virus is not tired of us.
INSKEEP: And I'd like to ask about one aspect of that. You mentioned, don't congregate indoors. Staying outdoors has felt in many ways to be the safest thing to do, almost the easiest thing to do. Any time that we are around people, to do it outdoors seems better. But here we are heading into the cold weather, especially in those Midwestern and Plains states that are being especially affected right now. What would you advise people to do as the weather gets colder and colder?
COLLINS: Well, again, if it's not possible to be outdoors and you have to be indoors, then definitely stick around with your family members if you're in a bubble with your small group. That's about it. Otherwise, I'm sorry. I had to have a family Zoom call with my family on Sunday and conclude that for the first time in 27 years, there will be no family Thanksgiving. It is just not safe to take that kind of chance with people coming from different parts of the country of uncertain status. The problem with this disease is it is so easy for people to be infected and not know it and then spread it to the ones next to them without realizing it. That's why we wear masks - not because we're basically trying to protect ourselves but to protect other people from us in case one of us turns out to be that super spreader who has no symptoms.
INSKEEP: Dr. Collins, thanks very much, really appreciate it.
COLLINS: Always good to talk to you, Steve. You're most welcome.
INSKEEP: Good to talk to you. Dr. Francis Collins is director of the National Institutes of Health.
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