What Fauci can't tell you

A bakery in Rochester, New York, offers doughnuts printed with Dr. Anthony Fauci's image. Photo credit: Rochester Democrat and Chronicle

Dr. Anthony Fauci, veteran director of the National Institute of Allergy and Infectious Diseases, is one recommendation (we need to shut down—) away from POTUS’ dog house.

But I have no dog in the fight; I’ll tell you straight what Fauci can’t say.

1. How long will COVID-19 last?

Fauci: “Unclear.”

Me: Some experts predict another year or two. Others think it can become endemic like HIV and TB. The pandemic impacts each community differently. Our state has acted responsibly. I expect to wear a mask next year, but easier days are ahead.

2. When will a vaccine be ready?

Fauci: “We are cautiously optimistic that we will have a vaccine by the end of this year and as we go into 2021."

Me: Definitely not by Nov. 3.

Operation Warp Speed – the name given to the $10 billion vaccine project – aims to reduce vaccine development time from 15-20 years to one to 1.5 years. The first one(s) will probably come out next year. But the manufacturing/distribution processes, and public acceptance are entirely different beasts. Vaccine won’t be a quick fix.

3. How good is this vaccine?

Fauci: “The chances of it being 98% effective [are] not great.”

Me: It’s great if it’s somewhat effective and lasts just long enough to make a difference. On June 30, the FDA announced it would approve a coronavirus vaccine that’s 50% effective or better in preventing or relieving the disease.

It’s a low bar. But for coronavirus, herd immunity is estimated to be between 30% and 70%. (Herd immunity means a sufficient fraction of the population is immune so that the disease is unable to spread further.) With diligent public health precautions, a half-decent vaccine might get us there.

4. Treatments for COVID-19?

Fauci: “[T]rials that are valid … show consistently that hydroxychloroquine is not effective in the treatment of coronavirus disease.”

Me: What he says.

Two treatments – remdesivir (an antiviral) and dexamethasone (a steroid) – might work in advanced cases. But it’s too early to tell if convalescent plasma or any other treatments work.

You may wonder if a single penicillin shot can cure syphilis (a bacterial infection), why are viruses so hard to treat? Because: Viruses are structurally simple and theoretically “not alive.”

Viruses are coated strand(s) of simple genetic material. They don’t breathe, eat, poop, move, grow or multiply until they’re integrated into the host cell of susceptible animals, plants, yeasts or bacteria. The viral genes then dictate the host to produce more viruses.  

Many drugs like hydroxychloroquine, which can stop viral replication in a lab, don’t work in real life. 

Of all the viral infections, I can count with two hands the viruses we have proven treatments for. Some (HIV, hepatitis C) respond extremely well to antiviral drugs. Others (flu, herpes) so-so. To end this pandemic, Fauci suggests a combination of consistent public health measures, and hopefully, in the future, effective antivirals and vaccines.

I feel for Fauci, who seems to have a worse day every day. His face has been put on doughnuts, socks, I-need-a-hero fleece blankets, and he's also received death threats and unjust criticism. To that he said, “It’s my job.”

And to his advice on public health and social measures, I say, “It’s all of our jobs.”

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Volume 12, Issue 17, Posted 9:35 AM, 09.01.2020