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BILL MOYERS:
How can people find out more from the National Institutes of Health?
DR. ANTHONY FAUCI:
Well, we and the CDC also --
BILL MOYERS:
Centers for Disease Control.
DR. ANTHONY FAUCI:
Yeah. The Centers for Disease Control is a very big player in this, in surveillance and letting the American public know where we stand. It's very easy. They have a wonderful website.
BILL MOYERS:
What is it? Do you know?
DR. ANTHONY FAUCI:
It's www.cdc.gov. You click on there and they have an influenza -- a pandemic flu -- subcomponent on their website. You get all the information you need.
BILL MOYERS:
So the first thing I can do is go to www --
DR. ANTHONY FAUCI:
-- .CDC.gov.
BILL MOYERS:
And it'll give me some basic information about it.
DR. ANTHONY FAUCI:
It will give you the fundamental, basic information.
BILL MOYERS:
When you saw that film, did you think that what you posted there, what CDC's posted there, is pretty consistent with the reality that's happened?
DR. ANTHONY FAUCI:
But CDC, to their credit, is all over what's going on in Southeast Asia. They have people there on the ground and collaborating. The NIH, my area of responsibility, we have scientists who are working with the Vietnamese, to try and take a very careful monitoring of what we call the molecular evolution of the virus, because remember, in its present state, this virus is inefficient in going from chicken to human, and very inefficient from human to human. You periodically sample the virus to see how it's evolving and you can get a big heads up if it starts to change its molecular confirmation, as it were, its molecular makeup, that might predict that it's now going to be more efficient. So, not only do you have the CDC surveillance as to what's going on there, but you have scientists who are continually sampling the viruses.
BILL MOYERS:
If the virus is steadily changing, if every experience it endures creates a new virus in a way, changes its identity, changes its appeal, how can you produce the vaccine?
DR. ANTHONY FAUCI:
Well that's a very good point and that's the reason why it is not only just isolating a virus and making a vaccine, it's building up the capacity to surge up when you get in your hand what's the real culprit. For example, it may be that the virus that's there right now, even as it changes to become more efficient in its spread, doesn't change so much as to elude or escape protection from the vaccine. But it is entirely conceivable that as it does evolve it will elude or escape protection from the vaccine. But if you're building the capacity to make pandemic flu vaccine, as we are doing, and the virus changes enough and starts spreading from human to human, and you say that's the culprit, that's the one we want to make a vaccine against, you plug that into your system and if you have the surge capacity to really ramp it up, within a period of six months, you could probably get enough vaccine that you need for this country.
BILL MOYERS:
So it's not a situation that you could produce 50 million vials and put them in the cold storage and just take them out and use them?
DR. ANTHONY FAUCI:
It might be. It might be, but you got to be ready to move. You've got to be nimble. So we are assuming now, we're going to make a significant amount, not necessarily three hundred million doses. We're going to make a significant amount in partnership with the companies of the vaccine that we already have against the H5N1 that is now circulating in Southeast Asia. As we do that, we're building the capacity so that if and when it changes, we can then take the new virus that's evolved, and plug that into the vaccine manufacturing system to be able to make doses of that vaccine.
BILL MOYERS:
You scared the -- boy I can't say that on public broadcasting... You scared me, but you also make me feel better because I know that you and your team are on top of this. But I have to come back as a journalist with the reality and say we knew the terrorists were coming. There were plenty of intelligence warnings. I did a broadcast three years ago that anticipated what's happened in Katrina.
DR. ANTHONY FAUCI:
Right.
BILL MOYERS:
Nothing happened. We Americans seem to wait until they strike Pearl Harbor or they strike the World Trade Center or the flu epidemic takes us down.
DR. ANTHONY FAUCI:
We have our eye on this terrorist, and nature can be the worst terrorist. We're watching that virus. It may not be the virus that is the cause of the next pandemic. It may dead end itself or we may have something else a year from now that becomes a pandemic flu. But the one thing that we can promise you and the American public -- not necessarily there's 100 percent guarantee we'll be able to stop this in its tracks -- but the one thing we can guarantee is that we have our eye on and we're following it very carefully.
BILL MOYERS:
So the best case scenario is that you spend $2-3 billion to produce this vaccine and a sneeze is just a sneeze.
DR. ANTHONY FAUCI:
Exactly. Would that we waste, as they say, and -- and not really waste -- would it be the best thing that we spend money to have a vaccine for pandemic flu that never happened? That would be a great outcome as far as I'm concerned.
BILL MOYERS:
Well, suppose the worst case scenario happens and a pandemic strikes. What would be the total impact, the overall impact on our economy, on our education, on the workplace?
DR. ANTHONY FAUCI:
If we have a pandemic that is truly a pandemic, that is truly a devastating pandemic with tens of millions of people getting sick and hundreds of thousands of people dying, we will have a situation in this country. And again hopefully it will never come to that, and we'll have the countermeasures, the vaccines and the drugs to prevent that. But if that happens, the effect broadly on society is multifaceted and potentially devastating. Because when you have such illness, you can rapidly overcome and supercede the capability of your hospitals and your clinics to be able to take care of patients.
You have an economic issue, not only an economic issue of work lost from people who are sick, but the communications and transportation among countries might be closed down or broken down. Normal healthcare systems will strain under this terribly. So there are so many implications -- economic, healthcare interactions, global considerations when countries throughout the world also have a devastating impact.
Take a look at what happened with SARS to Canada and SARS in Hong Kong. I mean, just what turned out to be not a lot of deaths and relatively few cases had an enormous negative impact on the economy in Canada, and Toronto particularly, as well as in Hong Kong and in China. So when you have a disease with the potential of the pandemic flu, the consequences go well beyond the purely health issues.
BILL MOYERS:
Yeah, people died and people got sick, from the Gulf Coast to New Orleans, but the whole infrastructure of the region was totally wiped out.
DR. ANTHONY FAUCI:
Right.
BILL MOYERS:
Are you saying that a true pandemic of avian flu could do what happened there in a widespread area?
DR. ANTHONY FAUCI:
Well, what happened there was destruction of existing infrastructure. When you have a pandemic flu it would be more likely to overwhelm the existing infrastructure rather than destroy it, yes.
BILL MOYERS:
In your 30 years as a public health physician, have you seen anything as scary as this?
DR. ANTHONY FAUCI:
Again, I tend not to describe things as scary, but as really challenging and potentially devastating.
BILL MOYERS:
Bigger threat than most?
DR. ANTHONY FAUCI:
Well, HIV is a big one. That's something that even though it has a well defined, more limited way of spreading than influenza, which spreads very easily, if you look at the impact of over 20 million people having died already, 40 million people living with HIV, I would think that HIV right now is something that trumps everything.
The potential for a pandemic flu is there and the implications are really fuzzy. Because you don't know whether it can be something like we had in 1968, which serious as it was, it was not a public health catastrophe, or if it's going to be an 1918. Sitting here talking with you, Bill, we can't predict what's going to happen. But since the potential for something very devastating is there, I would say that it's something that I take very, very seriously.
BILL MOYERS:
It's scary just thinking that a conversation like this where we're feet apart, or when I shake your hand and say good night that that moment could become a fatal moment.
DR. ANTHONY FAUCI:
Respiratory diseases that have the potential to kill are indeed frightening.
BILL MOYERS:
Dr. Anthony Fauci, thank you very much for joining us on "Wide Angle."
DR. ANTHONY FAUCI:
Good to be here.
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Dr. Anthony Fauci, director of the Institute for Allergy and Infectious Diseases at the National Institutes of Health
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