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Fauci On The Biden Administration's COVID-19 Strategy

MARY LOUISE KELLY, HOST:

A wartime undertaking - that is how President Biden has described the work ahead to contain the pandemic. And we know the virus is taking a wartime toll. More than 410,000 dead in this country from COVID-19 - that's more than the U.S. lost in World War II. Vaccine distribution remains a mess, to put it bluntly. And new variants threaten to make things worse before they get better.

Well, Dr. Anthony Fauci is here to discuss all of this with us. He is back in the White House, serving as Biden's chief medical adviser. Dr. Fauci, welcome back. Good to speak with you.

ANTHONY FAUCI: Thank you very much. Good to be with you.

KELLY: I heard you just got your second dose of the vaccine. How are you feeling?

FAUCI: OK. I had a bit of a sore arm for the first 24 to 36 hours, and I did have, which I did not have in the primary, in the first dose - I did have a degree of achiness and maybe feeling a little chilly. And the thing that I think was the most about it - I felt quite fatigued. But the good news about it - it lasted for no more than maybe 24 to 36 hours. And by 36 hours, it was gone completely. So right now I just feel perfectly back to normal.

KELLY: Which one did you get, by the way - Moderna or Pfizer?

FAUCI: I got the Moderna, yeah. That was...

KELLY: OK.

FAUCI: ...The one that was available to us here at the NIH.

KELLY: Got it. Now, I want to ask you about the goal that, as you know, President Biden has set - 100 million shots in 100 days. Is that ambitious enough, given that we are actually at or close to hitting a million shots a day right now?

FAUCI: Well, again, that question gets asked a lot. And when you set goals - at the time that the goal was set, it seemed like a reasonable goal. Remember, we were well, well below that at the time.

KELLY: Yeah, it seemed ambitious. The question is, should you be adjusting up?

FAUCI: Well, I think goals are there to be met and perhaps even surpassed. Put a goal out there. Put a marker out there. Go for it. If you surpass it, that's wonderful.

KELLY: What do you think the goal should be out there?

FAUCI: You know, I don't want to say a number of what the goal is. My goal - and this is consistent with what I've been saying all along - to get as many people as possible, as quickly as possible, as diverse as possible that we can get. The ultimate goal is to get the overwhelming proportion of the population - in my estimate, that would be 70% to 85% - to get this umbrella of herd immunity that, I think, is attainable after several months, if the supply of vaccine keeps coming in in a regular, predictable way, which I believe it will. There always can be glitches, and you've got to learn how to respond to them and fix them when they occur.

KELLY: Well, let's talk about what is getting in the way of getting us to that herd immunity point. You will have heard the stories that I'm hearing, that I think everybody's hearing, about problems people are having trying to get the vaccine. I will share. I got an email this week from an urgent care clinic that I had visited last year in Atlanta, and the email said they have doses of the Moderna vaccine, the one you just got, but they do not have enough staff to administer the vaccine. And they were putting out a call for volunteers who they could deputize to help. I read that, and I thought, this is crazy. I mean, Dr. Fauci, what is happening that that is the situation?

FAUCI: Well, you know what we need to do? We need to realize and admit that it is a problem, and we need to make sure we do something to fix it. I think one of the things that we want to get away from is that we can't deny that there's a problem there. If things go wrong and they don't work the way we want it to, we can't blame anybody. We just got to go try and fix it.

KELLY: But - absolutely. But what is going wrong?

FAUCI: Well...

KELLY: Is it not enough vaccines, not enough staff?

FAUCI: Well, you know, I think if you analyze it and take a look, clearly the discovery, the science of it, has been breathtaking and spectacular, record-breaking, unimaginably quick, effective. The idea of getting it produced - it looks like we're now on a pretty good flow. We're going to get more companies involved. Doesn't seem to be the problem there. The transportation seems to be OK. Clearly, when you talk about glitches and you talk about things that are not going uniformly smoothly...

KELLY: Yeah.

FAUCI: ...They're what you just described. Sometimes you have not enough people to administer it. And sometimes, in some places, you have a lot of people there, but you don't have enough vaccine. We've got to fix that.

KELLY: Dr. Fauci, let me turn you to new strains. We know there are new strains of the coronavirus from the U.K., South Africa, Brazil. What is most worrying as you scan the horizon?

FAUCI: Well, first, let's go to the big picture quickly.

KELLY: Sure.

FAUCI: These types of viruses that are RNA viruses, they mutate all the time. The majority of times, most of the times, the mutations are not associated with any relevant, functional change in the virus. We know that. But every once in a while, you get either a mutation or a constellation of mutations that does have an impact. Well, that's happened. So let's explain what it is and what we know now in what is an evolving situation. The U.K. mutant is in the United States, in multiple states. It has not become dominant yet. It might not ever. But we need to be prepared that it might. So we might have a strain after a month or two or more that could be more transmissible. We just have to stay heads up.

But the issue that I would say we need to take really seriously is that when you look at the effect of the mutant on the ability of the available vaccines and the antibodies that are induced by those vaccines to contain and suppress the mutant, there is some diminution in that ability. It is not enough, with regard to the U.K., to really have any significant impact on the efficacy of the vaccines that we're using. So even though...

KELLY: So - sorry to jump in, but let me just make sure I understand. You're saying that the vaccines that we currently have appear to still be effective against these new mutant strains?

FAUCI: Yes. But I want to distinguish, Mary Louise, between the U.K. and the South African, which is somewhat similar in many respects to one that's in Brazil. They are more troublesome because when you look at them, again, they likely make transmission much more efficient because it's spreading very robustly in South Africa and to some extent a similar one in Brazil. But what we're noticing with that is that it is changed enough that many of the monoclonal antibodies that we use for treatment really get knocked out in their ability to protect because of the changes in the virus. So it's having a rather profound effect on some of the monoclonal antibodies. But importantly...

KELLY: Let me pause you, if I may, there. Is what you're saying that the treatments we have, which have appeared to be effective against the - let's call it the original coronavirus, may be less effective against these new ones, South Africa, Brazil?

FAUCI: Right. Yeah. In fact...

KELLY: OK. What about the vaccine? Does the vaccine work, or do we know?

FAUCI: Well, here's the rub on this. Even though I said there's a minor, minor effect on the U.K. one, where you might diminish slightly the impact of the vaccine - nothing to even worry about - the situation with the South Africa isolate is a little bit more ominous because it diminishes much more the efficacy. But it still hasn't gone below the critical issue where the vaccines would be ineffective.

KELLY: OK.

FAUCI: So we still know that our vaccines are good, but we need to be thinking ahead and preparing that if these mutants continue to evolve and ultimately have a significant impact on the vaccines, we need to be prepared - and by the way, we're already moving in that direction - to be able to modify a bit the vaccines so that they would be much more amenable to controlling these types of mutants were they to arrive and evolve even more than they've evolved.

So the best way to prevent mutations from evolving is to prevent the replication of the virus. And you do that by getting as many people vaccinated as you possibly can. So rather than saying, wait a minute, if these mutations might have a negative effect on the ability of the vaccine to protect, why should we be vaccinating people? No, it's the opposite. It's the good reason to why we should be vaccinating people.

KELLY: One more thing to ask you about, Dr. Fauci, and it's this.

FAUCI: Sure.

KELLY: At yesterday's White House briefing, you talked about working in the Biden administration, and you described a liberating feeling. You said you can now, quote, "let the science speak." So I have to ask, is there something you are free to say now that you were not before?

FAUCI: No, not at all. See - the difference with me, as you probably know, Mary Louise, is that I said exactly what the science spoke in the last administration. It got me into a little bit of trouble - not really trouble because it didn't bother me. But it did get a bit of pushback from people in the White House, including the president. When I spoke - and I didn't change anything I would have done. I have always spoken according to what the scientific data and the scientific evidence allowed me to say. But that wasn't always the case for everybody else.

So what I'm saying right now is when the president - in this case, Biden - sat down with us literally a few minutes before I got on the podium in the White House press room and reiterated something he had already told us. He said, right now everything we do is going to be based on science and truth, and if things go wrong and we make mistakes, we admit them, and we try and fix them.

KELLY: And what went through your head when you heard that?

FAUCI: I said hallelujah, you know? (Laughter) That's a very liberating feeling, where people don't have to be worried about when you're saying something, that you're going to get pushback from your own team. There never will be pushback on scientific data. The president himself has told us that he wants nothing but the truth based on science and good evidence.

KELLY: Dr. Anthony Fauci - he is now chief medical adviser to President Biden, and he remains the nation's top infectious disease doctor. Thank you so much for your time, Dr. Fauci. Good to talk to you.

FAUCI: Thank you for having me. I appreciate it.

(SOUNDBITE OF TYCHO'S "GLIDER") Transcript provided by NPR, Copyright NPR.