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Dr. Anthony Fauci Answers Coronavirus Questions; Investors on Edge as Stimulus Talks Stall. Aired 9:30-10a ET

Aired September 22, 2020 - 09:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[09:30:00]

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: And the things that we did not know a few months ago allowed us to -- at the time use the scientific information to make recommendations that were appropriate at the time because the data were telling us at the time.

As we learned more, things changed. It's appropriate to make changes in recommendations based on the additional knowledge that you know.

A classic example of that, Sanjay, that you know very well is that back then we were not aware that 40 percent to 45 percent of people were asymptomatic, nor were we aware that a substantial proportion of people who get infected get infected from people who are without symptoms. That makes it overwhelmingly important for everyone to wear a mask.

So when people say, well, why did you change your stance and why are you emphasizing masks so much now when back then you didn't and, in fact, you said you shouldn't because there was a shortage of masks, well, the data now are very, very clear, and that's why we have to act on the data.

So we need to put that nonsense behind us about, well, they keep changing their minds. Masks work. Physical distancing works. Avoiding crowds work. Thank you, Sanjay, for giving me the opportunity to be on television now to say that. That is the fact.

So people should not worry that that's wrong or worry that that's something that's going to change. This is where we are and it's based on fact.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: We are all learning together and there's a certain amount of humility that I think needs to accompany a novel virus. I mean it's something we really didn't know about prior -- you know, at this time last year certainly.

You know, I do want to ask about this idea of how the virus is transmitted. You know, people learn that someone coughs or sneezes that's how we typically think of the virus being transmitted. It's these respiratory droplets. But they're kind of heavy. They may fall to ground or onto some surface. Can't really jump more than six feet or so. You could get it from surfaces potentially, but that was less likely, although possible.

But now there's this -- this conversation, I think a significant and important one, Dr. Fauci, around aerosols. This idea that the virus itself, because it is so tiny, the genetic material of the virus could sort of stay suspended in air, could linger for a long time and could travel much further than six feet, especially in indoor, poorly ventilated places.

The science seems like it's been pretty clear on this for a while. I went back and looked at the data last night. Even back, going to June, there was some pretty significant papers written saying this can travel and infect via aerosol.

The CDC seemed to agree on Friday, and then they took it down off their website yesterday.

What's the truth? Can this virus travel and infect people via an aerosol kind of like smoke in the air might travel?

FAUCI: Sanjay, the evidence I've seen, and the conversations I've had for people who understand aerosol particle physics, more than I do, say that there's no doubt that what you talk about of various size particles, that they can stay in the air.

Now, the question is, what is the extent, what is the contribution of aerosol, namely, so that people understand, a particle that isn't aerosolized is one that is in a large enough particle that it will essentially drop and go down to the ground before it travels for a while or hangs around in a room and recirculate. The definition of what people call aerosol means that it doesn't, because of its weight, go right down. I can hang around for a while and recirculate.

So when you look at what's gone on and the evidence we've seen so far, you can assume that a component -- and we don't know -- and here's where you've got to be humble enough and honest enough that we don't know the extent to which the aerosol component is contributing to transmission. You can make a reasonable assumption, Sanjay, that some aspect of transmission can be and is by aerosol.

The interesting thing about that, it doesn't change anything that we have been saying. It means wear your mask. It means avoid close contact. It means avoid crowd. And it means what we've been saying the third or the fourth thing that I mentioned to you just a little while ago is that outdoors is better than indoors because if you have aerosol indoor, you can have some recirculation.

And there have been some case reports in the literature of situations, for example, in restaurants where it looks like it almost had to be an aerosol spread.

[09:35:00]

Whether or not that's 3 percent, 5 percent, 10 percent of the spread, we don't know. But in some respects, Sanjay, it doesn't matter because the things that you want to do to avoid that, make sure there's good ventilation. When you're indoors, keeping the windows open. Wearing a mask indoor. When you're outdoor, do all of things I've said.

So rather than bending ourselves out of shape trying to figure out what percentage it is or is not, or how well it's proven, make an assumption that some component of it is aerosol, and act accordingly. Which means, do what we have been telling you to do all along. It doesn't change what you're doing.

GUPTA: Right. Yes, no, it's a good point.

I mean I -- you know, I think the CDC, you know, having put that on the website and then taking it down, not mentioning aerosols at all as things stand right now is part of the issue because I think it, again, it's -- I'm glad we're clarifying this because bottom line is that people should wear masks because you have to assume that there could be virus potentially in the air and you have to assume that you could potentially be carrying the virus. You know, so all of that, I think, is an important point.

But, you know, I think, again, going back to 1918, what sort of created that huge spike in the fall, people starting to cluster indoors. So schools, Dr. Fauci, kids, my kids, you know, as you know, we've talked about this, started the year learning virtually. But restaurants, bars, places that are indoors where you have to take off your mask presumably to eat or drink. If the aerosol sort of mode of transmission is possible and even likely, is it reasonable at all that those types of places should be open right now? How could you possibly keep people safe if this could be transmitted through the air the way that you just described?

FAUCI: Yes. You know, Sanjay, it gets back to what I've said multiple times before, and that is it really depends upon the level of virus in the community that you're in. And that's where, I think, we get a lot of pushback and concern of people think that our recommendations are being too stringent and we're interfering with people's freedom to do what they want to do, or getting in the way of opening up the economy. That's not the case at all. You've got to adjust your public health measures in the context of the situation you're in.

There are areas that, you know, we call them green zones, yellow zones, red zones, and then there's even a dark green zone, which means it's really, really good when you look at the level of test positivity that's very, very low. Under those circumstances, you can have a degree of indoor restaurants, sitting down, somewhat to normality, wearing masks if you can, taking them off when you eat, doing things like that.

When you're in a yellow zone, you have to be a little bit more careful. You might want to have, you know, good, better ventilation, distancing of chairs or what have you.

When you're in a red zone, you've got to really be careful. And, in fact, just go back to something that hasn't changed. When we were talking about how to open the economy, which we all want to do, you can do that through the implementation of good, public health measures. Public health measures don't need to be the obstacle to opening the economy, as I've said so often, they should be the gateway and the roadway to get to opening the economy.

So if you go through what we did from the White House press conferences, when we had the gateway, we had the phase one, phase two, phase three, all of that was dependent upon what the level of infection was in the community you're in. So if you're in a situation where the level of infection is going down, you could make the progression from one to the other to the other. If we do that carefully, and abide by it in a universal way, where everybody does that, not only would you prevent the surges, but the place where you have levels you could bring them down by doing that.

And if we had done that universally and you see what happened when we went to the surges that went up to 70,000. Our baseline was 20,000, Sanjay. We went up to about 70,000.

GUPTA: Yes.

FAUCI: When certain states understandably tried to open up. Some did it well. Some did not. The doing not led to the surge. Now we're up there. We're down to around 30,000 to 40,000 new cases. We've got to keep that slope coming down. And you do that by looking at where you are, in what region of the country, and acting accordingly, according to the guidelines.

You know, Sanjay, that's not rocket science, it's pretty clear. But we've got to do it together. We've got to be in this together.

[09:40:03]

When you have weak links in the chain and some components of society are not doing it, it just makes it very difficult for the rest. So if we want to enter the fall and the winter at a really low level, we've got to start acting now to do the things that we've all been saying.

GUPTA: Yes, I mean, we're -- you know, we're almost at the end of September already. So, I mean, these -- these things have to -- as you point out, have to happen now.

A lot of -- a lot of people sort of banking on the vaccine it seems, Dr. Fauci. I mean, you know, we don't really need to do these public health measures. The vaccine is coming.

You know, I've done a lot of reporting on this and you've been kind enough to give me some of your time to talk about this. What strikes me is that we -- we just don't know at all, in terms of what the data is showing, and, frankly, we shouldn't know because it's a blinded study, so the data really is blinded except this -- for this independent review body. I mean how are people making all these projections about the calendar, it's going to come out by April or by -- you know, we don't even know what the data shows yet. Am I wrong?

FAUCI: Right. No, you are perfectly correct, Sanjay, and I think people can have projections of what they think might happen. No one knows. The system is a double blind placebo controlled system, which means that there's an independent data and safety monitoring board that has nothing to do with politics or politicians, that has nothing to do essentially with the company or the FDA or the people who are doing the trial. It's an independent group that at predetermined times looks at the data.

You have one unblinded or two unblinded statisticians. They look at the data. If the data say that it has reached a predetermined state of infection, namely all of the infections in one, or the other, or divided between the two, between placebo and vaccine group, if it looks like you don't have an answer, they'll say, thank you very much, continue the trial. If it looks like things are going badly, that more people are getting infected in one, they would say, wait a minute, you've got a problem, stop the trial, it's not working. Or if it looks like, my goodness, the data really look good, that there are many more infections in the placebo group versus the vaccine group and, in fact, it has reached that point in the trial where the original design of the trial says you're good to go, you can now stop.

At that point, the person who is the statistician in the data and safety monitoring board makes that known to the company who then looks at the data and says, should I or should I not submit it to the FDA for whatever they're going to submit it with. Either an Emergency Use Authorization or directly go for a license.

But today, Sanjay, nobody knows what those data are because no one has looked at them. They're blinded.

Having said that, I have said that I'm cautiously optimistic from what I have seen of the preliminary studies that we did know, namely the small number that were in the phase one and the phase two trial, that I'm cautiously optimistic that we will have a positive effect.

Now, I don't know when we're going to be able to say that. My projection is that it likely would be November and December. It is conceivable that it could be October. I mean there's no doubt that that could happen. I think more likely it would be November and December.

And then at that point, if one or more vaccines reaches that critical point, then the FDA will make their decision and then we can start rolling out the vaccines because right now the thing that people need to understand is that even though we don't know what works and what doesn't work, the vaccines are being produced to be ready to administer if we get a good signal that it works.

GUPTA: So many more questions about that. Our time is running low, Dr. Fauci. But I do want to get to a viewer question. This one comes and says, President Trump says he would give the federal government an A or a B in his handling of the pandemic response. What grade would you give the response? I know you don't like these sorts of questions, Dr. Fauci.

FAUCI: No.

GUPTA: But --

FAUCI: I really don't, Sanjay. They're not helpful.

Take a look at the numbers and make up your own mind. I mean, you know, we don't need a sound bite from me. Take a look at the numbers.

GUPTA: What -- here's another viewer question. When/what month should I get a flu shot, Dr. Fauci?

[09:45:02]

FAUCI: Yes, you should get it no later than the end of October. If it's available now, you should get it now. But don't wait until any beyond October. The reason we -- the CDC says that and they have a good point is that sometimes people wait because they feel, well, maybe the immunity will wane as we get into the winter and then you wind up -- that flu comes and you're not protected and you wind up getting the flu. So the CDC has always said sometime in September and October, but no later than October 31st.

GUPTA: And, finally, just -- you know, this is a conversation that comes up in my family all the time. I always tell people, young or old, you don't want this disease because sometimes there is this perception, I'll just get it, I'll get through it and then I'll be good to go, especially if I'm a young person. You don't want this disease. I mean, you know, people -- you know, you heard even the president saying it's just elderly people with heart disease that get this.

By the way, my father, who's probably watching right now, is in his late 70s and has heart disease and I -- it always hurts me when people say, well, just the elderly with heart disease get this because I find it disrespectful, frankly. But it's not just them as well, right, Dr. Fauci?

FAUCI: No, it's not. Well, two answers to your question, you know, it's very disrespectful to me because I'm in my 70s. I'm like your father. I -- I could be your father, Sanjay. But it isn't just the elderly and those with underlying conditions because there -- it can be serious in young people.

Quantitatively, for sure, it's much, much, much less a serious as a group in young individuals.

But the thing we need to remember, Sanjay, that there are a number of people in our society of substantial proportion who have underlying conditions. And if you look at the two groups that are at risk for serious conditions, is the elderly and people at any age with underlying conditions, underlying any age. So if you're a younger person, you know, 20s, 30s, 40s, 50s and you have diabetes, obesity, hypertension, heart disease, you are in a risk category for a serious disease. And if you look at the number of Americans, and it's stunning who have these underlying conditions, such as obesity, you know, there are, you know, somewhat, 25 percent, 30 percent of the population can fall into that.

GUPTA: Right.

FAUCI: Those people who have other underlying conditions are a substantial proportion of the population. So don't just think the elderly are the problem. True, people with underlying conditions, but those are not just isolated to the elderly. There are plenty of younger people who have underlying conditions that put them at risk.

GUPTA: Dr. Fauci, thank you so much for your guidance through all this. We really appreciate your time. And hope to speak to you soon. Thank you, sir.

FAUCI: Same here, Sanjay. Thank you for having me.

POPPY HARLOW, CNN ANCHOR: All right, that was our very own Dr. Sanjay Gupta speaking with Dr. Anthony Fauci live. This is all part of our CNN "Citizen by CNN" virtual conference.

What struck you, Jim?

JIM SCIUTTO, CNN ANCHOR: Well, that final answer there, right? I mean you had the president yesterday claiming that Covid-19 affects virtually nobody.

HARLOW: Right.

SCIUTTO: In very clear terms, Dr. Fauci says it isn't just the elderly and those with underlying conditions, it can be serious for young people. That's in the data there. So an important message, I think, four our audience who might think that they're somehow immune to this if they're -- if they're not older and don't have a serious underlying condition.

HARLOW: I mean you've interviewed Dr. Fauci a number of times and he's made a lot of news in his interviews with you. And I think one of the pieces of news he made there was the vaccine timeline, right? Sanjay said, well, how do we know that, you know, it's going to be widely available by April, and he basically said, you're absolutely right, Sanjay.

SCIUTTO: It is. I mean, listen, he -- he has said consistently, trust the scientists on this, right?

HARLOW: Yes. Yes.

SCIUTTO: And they are working hard, as opposed to what you might hear from politicians, et cetera.

Although it should be noted, and you and I have talked about this Poppy, that Dr. Fauci has been fairly sanguine about the timeline for a vaccine for some time.

HARLOW: Yes.

SCIUTTO: For weeks, for months he's said, it is possible by the end of this year if the data shows that it is ready. He has not, of course, said ready by November 3rd, but that it is coming soon. I think that that is something that we should take some hope and confidence from.

HARLOW: Yes. A hundred percent.

OK, great interview, Sanjay. If you missed some of it, you can see it all online shortly. We are also -- it's a busy day -- moments away from the president's address to the U.N. General Assembly. We'll bring you those remarks live.

Stay with us.

(COMMERCIAL BREAK)

[09:54:03]

HARLOW: All right, welcome back.

Right now millions of Americans are still out of work, still struggling to make ends meet, and stimulus talks on Capitol Hill are continuing to fail as the pandemic enters what could be a grueling fall and winter season. That also has, by the way, the markets on edge.

SCIUTTO: CNN's chief business correspondent Christine Romans joins us now.

So, Christine, obviously Congress is going to be dealing a lot with the Senate nominee going forward.

CHRISTINE ROMANS, CNN CHIEF BUSINESS CORRESPONDENT: Yes.

SCIUTTO: If the stimulus bill keeps failing, they can't reach agreement there --

ROMANS: Yes.

SCIUTTO: What does that mean for a recovery?

ROMANS: It means that summer recovery stalls, and you're already seeing signs of that.

You'll recall in the spring, guys, we had a huge crash in the economy and then in the summer maybe half of that decline was crawled out of, right? And so there's more work to go to get back to pre-pandemic levels.

And, honestly, all that stimulus was a shock absorber for millions of American families. It went right out back into the economy and helped that recovery. Well, that money is now gone.

At the same time you're heading into the flu season.

[09:55:00]

The U.S. coronavirus numbers are not good. They're going in the wrong direction. In Europe you're seeing flare-ups in the U.K. and in western Europe. That could lead to lockdowns there. So there's just this sense of unease that after some progress in the economy overall in the summer, that in the fall that's going to peter out.

HARLOW: Christine, there's also the debate that rages on about, you know, unemployment.

ROMANS: Right.

HARLOW: And how much of an increase in benefits do you need. And there's a new study now from the San Francisco Federal Reserve that seems to strike right against the White House and the GOP argument that extending those $600 a week unemployment assistance actually hampers employment.

Here's Larry Kudlow to us just last month.

(BEGIN VIDEO CLIP)

LARRY KUDLOW, DIRECTOR, NATIONAL ECONOMIC COUNCIL: I think it is a disincentive to go back to work.

We think we can create a much better balance to provide incentives to come back to work.

(END VIDEO CLIP)

HARLOW: So it's not a disincentive?

ROMANS: So economists at the San Francisco Fed really looked at this and they found some really important angles of this. They called it essentially this money went right into American households and paid the bills and went right out into the economy. So this was an important stimulus. A much-needed stimulus. Again, a shock absorber for American families.

They said that the $600 was temporary and that the job offers weren't there. So people really couldn't be choosey, the San Francisco Fed economists said, about not taking a job. If a job was offered, they needed to take it. Job seekers did not have the luxury of being choosey and delay accepting a job in favor of continuing to receive benefits.

You guys, we've said this a million times, in the normal times you can argue about whether these benefits would keep somebody from looking for a job in a healthy labor market. This is not a healthy labor market. There weren't jobs to take. And so this was an important shock absorber for millions of families. And that shock absorber is gone.

SCIUTTO: Yes, it's why you look for the data on a lot of claims you hear about this kind of stuff and the data shows otherwise.

Christine Romans, thanks very much.

ROMANS: You're welcome.

SCIUTTO: Well, Any minute now President Trump will speak at the United Nations General Assembly. His comments, just ahead.

(COMMERCIAL BREAK)

SCIUTTO: Senator Romney, he's just announced he will support a vote on a nominee before the election.

Have a listen.

(BEGIN VIDEO CLIP)

SEN. MITT ROMNEY (R-UT): On the other hand, when there's a nominee of a party that is in the same -- in the same party as the Senate, then typically they do confirm. So the Garland decision was consistent with that and the decision to proceed now with the -- President Trump's nominee is also consistent with history.

[10:00:04]