Fauci on the uncertain future of COVID-19 amid changing public health guidelines

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• Judy Woodruff:

  The very worst of COVID-19's Omicron surge appears to be behind us.

  The World Health Organization reported that infections are down globally. In the U.S., new cases are down by more than 60 percent over the past two weeks. A number of states and cities are lifting masking requirements.

  But the WHO and many others are still warning of letting down our guard too soon. In the last week, there were more than 70,000 deaths globally, in the U.S., more than 2,100 deaths a day.

  We look at where we stand with Dr. Anthony Fauci. He is the chief medical adviser to the president.

  I spoke with him a short time ago.

  Dr. Fauci, welcome back to the "NewsHour."

  Let me begin by asking you where we are as a country with regard to COVID. There is a new modeling study out today that says something like three-quarters of the country is protected, either by virtue of the vaccine or having been infected with COVID.

  And then you look at other statistics that say only about half of eligible Americans have been vaccinated and boosted. So, if people want to understand how safe we should feel, are we overestimating that?

  Dr. Anthony Fauci, Chief Medical Adviser to President Biden: Well, I'm not so sure if it is an over- or under-estimation, Judy.

  I think it is the reality that, if you look at where we are right now, clearly, there is a sharp decrement in the cases and in the hospitalizations, with a little bit less of a lagging or more of a lagging with deaths.

  But, every day, when you look at the data, and you do weekly averages, you're seeing the cases and the hospitalizations go down. That's very good news. However, when you look at the CDC map of high and substantial activity, it's still really mostly red or orange, which means that it's right up there where a lot of activity.

  The good news, Judy, is that we're going in the right direction. There's no doubt about it.

  Now, getting to your original question. When you look at what people are referring to as the degree of immunity in the community, that means a combination of people who've been vaccinated, as well as those who've been infected and recovered.

  The only confounding issue with that is the durability of protection. And when you have variants like Omicron, which can evade the immunity, the number of people who are so-called seropositive, which means they have either been infected or they have been vaccinated, sometimes can be misleading with regard to the vulnerability, because you could get infected, recover, be protected for a while, and then your immunity wanes.

  You get vaccinated, and we already know that, after a while, your immunity wanes and you need to get boostered.

• Judy Woodruff:

  There are several things I want to ask you about, Dr. Fauci.

  One is, as you know, mask mandates around the country, they seem to be dropping like flies. I mean, we're almost at a point where the vast majority of states will have dropped mask mandates. But, at the same time, the CDC is saying to Americans, it's too soon to take off the mask, citing the kind of evidence you were quoting just a moment ago.

  Americans, frankly, are confused and wondering, how can you lead — leave this decision up to individual Americans, when the guidance they're getting is conflicting?

• Dr. Anthony Fauci:

  Well, I think what it is, Judy, is a reflection of the need, and an understandable need, for people to get back to some form of normality, all the stresses and all of those things that go into people just being so tired of this.

  That's totally understandable. What the CDC is doing is giving you the data as it exists and the recommendation, based on where we are now. The thing that's important is that many of those locations are likely, in some respects, anticipating what's going to happen.

• Judy Woodruff:

  But you can understand why people are confused at this point…

• Dr. Anthony Fauci:

  Oh, of course.

• Judy Woodruff:

  … I mean, that the signals are different.

• Dr. Anthony Fauci:

  Yes, of course.

  What there is — and I hope that this helps to explain it, Judy — there's a public health recommendation that is a broad recommendation. Clearly, the implementation of those is always left to the local level, what the conditions on the ground are locally, what the community can and cannot tolerate.

  So you have to understand, the recommendations that the CDC made are based on the science, the epidemiology, what they're observing. That doesn't mean that that's going to apply absolutely to every single different location in a different way. And that's why they always say, they make the recommendation, but the ultimate decision is at the level of the local authorities.

• Judy Woodruff:

  Which is put — again, putting a lot on people's shoulders to follow all this, as much as they want to do it.

  Let me ask about boosters, Dr. Fauci. New information came out not too many days ago from the CDC that there appears to be a waning of protection from the boosters after four months or so. So, people are asking, do we need to think about a next — the next booster? When, six months, five months?

  What's the best guidance on that, on how to think about that?

• Dr. Anthony Fauci:

  You have to look at where we are now, Judy, and where we might be a couple of months from now.

  So, where we are now, if you look at the waning, there's no doubt there is substantial waning when it comes to what's called symptomatically recognizable disease. But when you look at severe disease, as reflected by hospitalization, at four to five months, you still see about a 78 percent protection overall against hospitalization.

  And in the world of vaccination, that's pretty good. And that's the reason why the CDC is saying, if you are an immune-compromised person, cancer chemotherapy, transplant, or what have you, get your fourth shot now. If you're in the general population of immunocompetent people, you're pretty good now, but we — and we meaning they, the CDC, with their large cohorts — are following the durability of that protection.

  If it goes down over the next couple of months, then they will modify the recommendation of when and who should get now the fourth shot. But, in general, for the population level, 78 percent is pretty good. It likely will go down sometime. We don't know for sure. We're hoping it'll hold tight up there.

  But if it does go down, I think you can expect some modification of the recommendation.

• Judy Woodruff:

  Part of the reason I'm asking is because you do hear from people who are so-called immunocompromised. Their immune systems are weakened. There are millions of people who fall in that category.

• And they’re wondering:

  What about us? What about me?

  One other question in connection with that, Dr. Fauci, is the people who've had the Johnson & Johnson vaccine. There's something like, what, 15, 16 million Americans. They have had the shot. They have had the booster, but they have been told that's not as much protection as those who have received the mRNA vaccine.

• Dr. Anthony Fauci:

  Yes.

• Judy Woodruff:

  Some of them are saying, we have just been left out and forgotten.

• Dr. Anthony Fauci:

  Well, that's understandable because that kind of word is going around.

  But if you look at the recent data and studies that have looked at the durability of protection, it was that one shot of J&J would be equivalent to the two-shot regimen of mRNA. If you give a third shot boost, which is what the J&J people are concerned about, they get either another shot of J&J or a mix-match boost with an mRNA.

  And they have already — recommendation to do that. So, it's not that that's not available. If you look at the data, the level of protection against a J&J person who gets either another J&J or an mRNA is right up there as good as someone who gets three mRNA.

  So, people who've gotten J&J, it's understandable there's maybe some confusion out there, but they're pretty well-protected if they get the second J&J or an mRNA after the J&J original.

• Judy Woodruff:

  Well, that may well be reassuring for them.

  I also want to ask you, Dr. Fauci, about children under the age of 5. As you know, the FDA had originally sent the signal that we were close to approving the vaccine, a lower-dose vaccine for children under 5. And then it turned around — they turned around and said, no, we need more time. We want more studying done.

  You're hearing from a number of parents of these young children. They feel the rug was pulled out from underneath them. They thought it was about to happen. It's not happening. They're told it's soon, but they don't know when.

  Did the government let these families, these — and children down?

• Dr. Anthony Fauci:

  No, no, no, Judy, not at all, not even close.

  And let me explain why. When you get an approval from the FDA, which is the gold standard for efficacy and safety determination, what they originally thought, when the studies were done by the company, that this was going to be a two-dose vaccine for the children. It became very clear that, across the board, from children from 6 months over and above up to 5 years, that it did not meet the efficacy standard that they thought.

  So, it now is a three-dose vaccine. There is no doubt about the safety. So parents should not be concerned about safety. What's coming on now are data, what the third dose does.

  So it isn't that anyone was let down, because the FDA, and then, ultimately, with the CDC, with their Advisory Committee on Immunization Practices and the recommendation, they will be receiving the data, at least according to what we heard from Pfizer, somewhere around April. They will be getting the data to the FDA, who will look at it.

  And if it is effective, they will then give an EUA for its use. But you don't want to do that until you are sure it's safe and effective. We know it's safe now. We're going to get information as to whether it's effective.

  So it isn't really a question, Judy, of anyone being let down. You want to make sure that, when you recommend a vaccine for your child, you want to make sure it's safe and it works.

• Judy Woodruff:

  And, finally, Dr. Fauci, for all the Americans who are listening to you, watching you who want to know, when is my life going to get back to something like normal, what are you saying to them right now?

• Dr. Anthony Fauci:

  We're saying, it's going in the right direction, Judy.

  But, as you know, we're dealing with a very formidable virus. We — if we keep going in this direction, there are things that we can do to make it much more likely that we will get back to some degree of normality.

  And it's something that I have said over and over again. We know the vaccines work. We know that, when the immunity wanes, the boosters work. We know that masks, particularly high-quality masks, work. We know, when you test someone and find out they're infected, if you keep them out of circulation, they don't infect anyone else.

  If we implement the known interventions, it will be much more likely that we will get back to normal and that, when those cases keep coming down and down, provided we don't get surprised by another variant — and I have to be perfectly honest with you, Judy. That's possible. You can't walk away from that possibility. We hope it doesn't happen.

  We can help it from not happening by getting more people vaccinated.

• Judy Woodruff:

  Dr. Anthony Fauci, we thank you so much for joining us.

  Dr. Anthony Fauci My pleasure, Judy. Good to be with you, as always.