As a health journalist, doctor, and former correspondent who lived through SARS in Beijing, I receive questions from friends, colleagues, and people I don’t even know about how to live during a pandemic. Do I think it is safe to plan a wedding in person next June? Would I send my children to school with the proper precautions? When will I trust a vaccine?
To the last question, I always answer: when I see Anthony Fauci receive one.
Like many Americans, I follow the word of Dr. Fauci, the nation’s leading infectious disease expert and a member of the White House task force on coronavirus.
When he told The Washington Post that he was not cleaning the packages but was letting them sit for a couple of days, I started to do the same. In October, she commented that the market bags were already entering her house. You just wash your hands after taking the products out. (I also!)
We are now in a dangerous political transition, with cases skyrocketing across the country, and Fauci and the original task force largely marginalized.
President-elect Joe Biden has appointed his team, but he can’t do much until the General Services Administration (GSA) accepts the election results. And Fauci told me that he hasn’t spoken to Biden’s task force yet.
President Donald Trump has resisted transitional government rules, in which new and outgoing teams coordinate with each other.
The tumultuous months past have been filled with information gaps (we’re still learning about the new coronavirus), misleading data (often from the president), and a host of “experts”: public health personnel, mathematicians, cardiologists, and doctors from emergencies, like me, offering opinions on television.
But all this time, the person I’ve wanted to know the most about is Fauci. It’s straightforward, with no apparent conflicts of interest, political or financial, or, at 79, career ambitions. Apparently he has no other interests than yours and mine.
So I asked him how Americans could expect to live in the next six to nine months. How should we behave? And what should the next administration do? Some responses have been edited for clarity and brevity.
Question: What two or three things do you think the Biden administration should do on the first day of government?
Response: Some states and regions appear not to have learned the lessons that could or should have been learned when New York City and other large cities were affected. How to implement some basic public health measures.
I want to be really explicit about this, because whenever I talk about simple things like consistently wearing face masks, keeping physical distance, avoiding crowds (particularly indoors), doing things outside if the weather permits, and washing hands frequently, that does not mean closing the country.
You can still have considerable scope for business, for economic recovery, if you do those simple things. But what we are seeing, unfortunately, is a very mixed response. And that inevitably leads to the kind of waves [de nuevos casos] that we see now.
Q: Do you think we need a standard as a national mask mandate? The current administration has delegated much of the management of COVID-19 to the states.
A: I think there should be a universal use of masks. It is ideal to achieve this with mayors, governors, local authorities. If not, we should seriously consider the national standard. The only reason I avoid making a strong recommendation in that regard is that things that come down from the national level generally generate a bit of pushback from a population already reluctant to be told what to do. So it could end up having the opposite effect – pushing you back even further.
Q: What would a mandatory use of masks look like at the national level?
A: It would mean different things in different states. Many states require that the person cover their face, but not specifically that they wear a face mask. Many twentysomethings wear only a scarf.
I think it is unlikely that there is a substantial difference. I mean, the common type of mask is the surgical mask. It is not an N95 mask. A thick fabric can be just as effective. We think there may be some small differences, but the main goal is to avoid infecting others. Recent studies have shown that [usar una máscara] it also has the good effect of partially protecting you. Therefore, the benefit is both ways.
Q: Many places that have mask wear mandates have had trouble enforcing them.
A: That is really one of the reasons why there is a reluctance on the part of many people, including myself [a apoyar un mandato nacional]. If you have a mandate, you must enforce it. And hopefully we can convince people when they see what is happening in the country. But I have to tell you, I was surprised by the fact that in certain areas of the country, although the devastation of the outbreak is clear, some people still say it is fake news. That is a very difficult thing to overcome: why do people still insist that something they have under their noses is not real.
Q: People often think of zippers as black or white. You are open or you are closed. I’d like to hear Dr. Fauci’s hierarchy of “it is safe and important to stay open with precautions” and “things that are not safe under any circumstances.”
A: The reason I respond with a degree of concern is because the people who own these businesses get very angry with me. There are some essential businesses that you want to keep open. You want to keep supermarkets open, things that people need for their livelihood. Done correctly, you may be able to keep some non-essential businesses open, such as clothing stores or department stores.
Q: Winter is coming. You could maintain social distance in a restaurant or indoor gathering. But would it feel good to be there without a mask?
A: If we are in a delicate moment like we are now, where there are so many infections around, I would feel quite uncomfortable even just being in a restaurant. Especially if it is running at full capacity.
Q: I see you have cut your hair. What do you think of barbershops and salons?
A: Again, it depends. I used to cut my hair every five weeks. Now I cut it every 12, using a mask, me and the hairdresser, of course.
Q: Transportation? Trains? Planes? Meter? What is the situation?
A: It depends on your individual circumstances. If you are someone who is in the highest risk category, it is best not to travel anywhere. Or if you have a car, better than getting on a crowded subway, bus or plane. Now if you are 25 years old and you have no underlying conditions, it is very different.
A: Bars are really troublesome. If you look at some of the breakouts, they happen when people walk into crowded bars. I used to go to a bar myself. I liked to sit at the bar, have a beer, and have a hamburger. But when you’re in a bar, people lean over your shoulder to order a drink, they’re glued to each other. It’s fun because it’s social, but it’s not fun when this virus is in the air. So I think that if there is something to avoid, for the moment, it is the bars.
Q: Some airlines and some states tell people to get tested for coronavirus before getting on the plane or visiting another state. Does that make any medical sense?
A: If you are negative when you get on the plane, except in the rare circumstance that you are in that small incubation window before turning positive, it is a good thing.
Q: If you had a national test plan, what would it be?
A: Surveillance tests. Literally flooding the system with tests. Get a home test that you can do yourself that is very sensitive and specific. Do you know why it would be great? Because if you decided that you want to have a little meeting with your in-laws and a couple of kids, you can get tested right then. It is not 100%. Don’t let the perfect be the enemy of the good. But your risk is dramatically reduced if everyone gets tested before meeting for dinner. It may never be zero, but, you know, we don’t live in a completely risk-free society.
Q: There are several candidate vaccines that show promise. But there is also a lot of skepticism because we have seen the FDA come under both commercial and, increasingly, political pressure. When will we know that it is okay to get a vaccine? And what?
A: It is quite easy when there are vaccines that are 95% effective. There is nothing better than that. I think what people should appreciate, and that’s why I’ve said it maybe 100 times in the last few weeks, is the process by which a decision is made. The company analyzes the data. I look at the data. Then they are sent to the FDA. The FDA will make the decision to conduct an emergency use authorization or license application approval. And they have career scientists who are really independent. They don’t owe anything to anyone. Then there’s another independent group, the Vaccine and Related Biologics Advisory Committee. The FDA commissioner has publicly promised that he will act on the advice of career scientists and the advisory council.
Q: Do you think professional scientists will have the last word?
A: Yes. Yes.
Q: And will the decisions being made in this transition period, such as the vaccine distribution plan, in any way limit the options for a new administration?
A: No, I don’t think so. I believe that a new administration will have the option to do what they feel like. But I can tell you what’s going to happen, regardless of the transition or not, because we have people totally committed to doing this right who are going to be involved in the process. I have faith.
Q: When do you think we can all throw away our masks?
A: I think we are going to have some degree of public health measures alongside the vaccine for a considerable period of time. But we will begin to get closer to normal, if the vast majority of people get vaccinated, as we move into the third or fourth trimester. [de 2021].
By Elisabeth Rosenthal, Editor-in-Chief, KHN
KHN (Kaiser Health News) is a non-profit news service that covers health topics. It is an editorially independent program from KFF (Kaiser Family Foundation) that is not related to Kaiser Permanente.
Original English version: https://bit.ly/35J1Tdq