Dr. Anthony Fauci, Holy Cross Class of '62, Answers Students' Questions

well good afternoon everyone and welcome dr anthony fauci uh and welcome holy cross colleagues and students i’m tom landy i’m the director of the mcfarland center for religion ethics and culture at the college of the holy cross i know that my students and my colleagues are absolutely delighted by the chance to talk to dr fauci today we have so many students and staff online today that it would dwarf the capacity by several fold of the largest academic venues that we have on campus so i dare say that this is almost certainly the best attended academic event in the college’s history certainly in my time there i’ve been working with the committee of 13 great students to prepare for it uh sifting through their questions and those of 85 others from campus who submitted online this is an event that’s online live for the holy cross campus community only faculty and students and staff i know that we’ll hear from dr fauci before we ask any questions but first i’d like to introduce father phil burroughs of the society of jesus 32nd president of the college of the holy cross to welcome dr tony fauci of the class of 1962 it’s an honor to welcome you back to the college dr fauci and i hope that you have fully recovered from your surgery and that you and your family are well and safe thank you again for your surprise address to our seniors at their virtual celebration last may and for generously agreeing to meet with our students today as the most recognized and trusted physician in the country you have served as the director of the national institute of allergy and infectious diseases at the national institute of health since 1984 and advised the past six presidents of the united states in the face of significant opposition your leadership and compassion during the hiv aids crisis in the 80s were critical in refocusing the treatment of those with this disease as you have been with your subsequent work to respond to sars the swine flu mares ebola and now covet 19 as one of the world’s most cited scientists you have received 45 honorary doctoral degrees from universities in the united states and abroad including one from your alma mater the college of the holy cross and i hear that recently you were named federal employee of the year the power of your personal ethics and your liberal arts education is always on display when you thoughtfully address complicated issues of national health with clarity when you respond to contentious interviewers with logic and restraint when you quietly reflect honesty and integrity in the midst of conflicted politics and when you consistently address the american public with the professional care of a dedicated physician it’s always good to see you tony and to welcome you back to mount st james even if virtually thank you very much father it’s a real pleasure to be with you very much so i uh i’m looking forward to the discussion thank you for having me thank you too father burroughs uh dr fauci there are so many good questions that holy cross students will want to ask but i also know that it’s important uh for you to get your own message out to the holy cross students and maybe through them to other students what’s the most important thing you’d like them to take home today well i’m sure we’ll get into it with the questions but let me just say it’s stated so that it is clearly explicit that we are living really through history right now this is really the most extraordinary uh devastating respiratory disease pandemic in the last 102 years since the now you know historic and iconic 1918 so-called spanish flu which devastated the globe with oh between 50 and 100 million deaths we are still in the middle of this unfortunately the united states of america has gotten hit worse than any other country in the world which is somewhat paradoxical because we were judged by johns hopkins that does that kind of raiding as the best prepared for a pandemic of any country in the world we are in the middle of it right now we’re having about 4000 new infections a day it’s sort of stuck at that level which is a completely unacceptable baseline to be at particularly as we enter into the fall and the winter months where people will be doing things more indoor rather than outdoor which when you have a respiratory borne virus it always makes it that much more problematic to control it because of the ease of transmissibility this virus you know people have always

asked me and i’ll stop after this statement what i mean over the decades they would ask me what keeps you up at night what is your worst nightmare and you know i’ve written about this election about this so if anybody wants to check the record they could just go back and i said the thing that keeps me up at night is a brand new virus that jumps species from an animal to a human that is a respiratory borne virus and has two conflating characteristics one that it is highly transmissible from human to human and two that it has the capability and the characteristic of a high degree of morbidity and mortality either for the population in general or for a subset of the population in this case it’s the elderly and those with underlying conditions including young people who have underlying conditions and unfortunately i’m living now this so-called nightmare and worst case scenario because that’s exactly what we have we have an unprecedented virus that is extremely efficient in going from human to human and that has the capability of killing even though most of the people who get infected have no problem with it and that’s one of the things i’d like to get into in the discussion with the students about how young people now in our country are the drivers of the outbreak i think because of a lack of a complete understanding that even though you may be asymptomatic you are part of the driving force of the outbreak if you let yourself get infected but we can talk about that during the question and answer period so why don’t i stop there and get to the fun part which is questions good so we’ll go straight to the student questions then let’s um let’s start with um monica nakla who is a biology and deaf studies biology major deaf studies minor in massachusetts and she’s in the class of 22. monica hi dr fauci it’s really exciting to get to talk to you today um so there are discussions of more virulent strains of covenanting in some parts of the country uh what strains are out there now and do they have variable virulence and if so how do these how are these strains going to affect vaccine development okay good question so simple answer no there are not more virulence strains out there this is an rna virus and rna viruses have a tendency to mutate because they don’t have good proofreading mechanisms when they when they replicate so there have been a number of mutations that have been documented and they mutate all the time the question is is there a functional change in the mutation the only functional change of any relevance to what we’re interested in is that there is a strain of virus that originated in china which was the origin of this that mutated at amino acid number 614 and it mutated uh from a g to a d and when the scientists examined that they found that that new strain which is now prevalent throughout the world it kind of bumped the original strain out it in vitro namely not in a person yet but in vitro replicates better and binds more efficiently to the receptor on a variety of cells that were grown in culture and so there’s the assumption though not completely proven yet that if anything this is more transmissible but there’s no evidence whatsoever that it’s more virulent so viruses when they permeate society rarely become more virulent they generally become less virulent as they adapt themselves with greater transmissibility so i don’t think that is that’s the case but that remains to be seen i’d worry more i wouldn’t worry i i just think what you’re going to see is it might be a bit more transmissible uh at least according to the receptor binding but we need to take a look at that in a more physiological way experiments are being done in transmission models and animals right now to see if it in fact is more transmissible thank you charlie millard is a biology major with a biochemistry concentration in connecticut charlie hi dr farci thanks so much for uh taking the time to meet with us today due to your extensive experience researching hiv you know better than anyone that there’s no guarantee that we can develop an effective vaccine what’s unique about sars kobe 2 that makes you optimistic our efforts to develop a vaccine will succeed yeah that’s a great question see hiv is

an entirely different virus when you are trying to predict whether or not you’re going to be successful in developing a vaccine what you generally do is look at natural infection and ask yourself a fundamental conceptual question is the body capable of mounting an adequate immune response that would ultimately protect you and if you look at all of the viruses that we have had vaccines against look at what happens with natural infection many of these viruses can be devastating to a certain portion of the population either with morbidity or mortality but ultimately the body of the population in question recovered so smallpox measles polio they’re very serious diseases but the overwhelming majority of people who get infected sorry for the unfortunate the group that either dies or gets into difficulty the overwhelming majority respond because their immune system essentially mounts a response that clears the virus and that protects you against subsequent exposure to the same virus that’s the same reason why when you get measles and you recover you’re not going to get measles again you get smallpox you recover you’re not going to get smallpox again that made it very clear that by mimicking natural infection we could get successful vaccines and in fact we have successful vaccines against all of those hiv is different because the body does not mount an adequate immune response to hiv which is the reason why despite the 70 plus million people who’ve been infected with hiv there’s not one single documented case of someone who’s completely cleared the virus on their own so it’s going to be really difficult to make a vaccine not impossible but difficult whereas with coronaviruses we know that most of the people who get infected with coronaviruses clear the virus by their own immune response so since the body’s capable of doing it it is a pretty good proof of concept that if you make a vaccine that mimics natural infection and in the case of covid 19 it’s the spike protein that binds to the receptor in the body which is the ac2 receptor so you never want to be overconfident but i’m sure those of you have seen me on tv or on radio say the famous words that i use that i’m cautiously optimistic that we’ll have a vaccine likely by november december the beginning of the year because the body is going to make a good response and we and it’s relatively easy to induce that so i think we’re going to get there likely by the end of the year i know there’s some other good uh epidemiological scientific questions but i’m going to shift gear a little bit and uh chris lee who is a um philosophy major from shanghai china although he’s on mount st james at the moment has a question for you hi dr fauci it’s an honor to speak with you my question is the chief of the who says cooperation is our only choice again against kobe 19 but we live in a time when international cooperation is diminishing so how is that affecting your work or how can we improve international cooperation to fight this disease such as coven 19 well uh dr tedros who’s a good friend of mine is absolutely correct when he says that international cooperation particularly transparency sharing of information sharing of reagents is essential when you’re dealing with infectious diseases and the response to a pandemic simply because pandemics are global there’s no such thing as a provincial pandemic for those of us who have spent these years studying latin and greek which i always pull out my holy cross card on people when i talk you know pan means all it’s it’s everybody it’s it’s a pandemic throughout the world so countries have to cooperate and we’ve had variable degrees of cooperation and i think the unfortunate situation with china this time around was really unfortunate because they knew right away that this was highly transmissible from human to human and for at least a few weeks they said that this was merely jumping species from an animal to a human i mean i’ve had great collaborations with my friends in china for decades and they were telling us under the radar hey this is really bad and some of them actually wound up getting temporarily arrested for a while for saying that you can’t have that when you have a

global pandemic you’ve got to be transparent right from the beginning because you can’t lose any time and in fact we did lose some precious weeks because of that misinformation so tedros is correct we’ve got to have absolute cooperation globally thank you uh ship patel who is a second year biology major from new hampshire exciting to be here you dr fauci my question for you is if and when the coven 19 vaccination is made available to the general public will the people of this country have a moral obligation to take it a moral obligation to take it you know that’s interesting when you use the word moral obligation um i think it would ease i i would feel more comfortable in saying you have a moral obligation to wear a mask than necessarily a moral obligation to have something injected into your own body i think you have a societal responsibility to protect yourself as well as the people around you to me i think it’s highly recommended and desirable that you take a vaccine but when you’re dealing with an intervention that could have a possible side effect i think we need to stay away from the word moral obligation uh you know it’s my i the reason i say that i i i’m married to the chairperson of the department of bioethics at the at the nih and every time i use terminology incorrectly i get a hammer over the head for that so i would be careful by about saying that it’s the same reason why you really can’t compel people to take vaccines uh like mandate if they don’t you’re gonna do something to them you can do that in schools i mean for children because you don’t mind if you don’t have a measles vaccine often in the public schools you’re not allowed to come in unless you get a um a uh a vaccine against measles mumps rebeller and the others but i would probably use the terminology that we have a societal responsibility to do that thank you uh matthew sedano who’s an honors program member from delray beach florida and it’s a pleasure to speak with you dr fauci um i’m one of many student athletes in this country curious about this if a strategy of just relying on covid testing presumably with access to unlimited resources without also relying on mask wearing has not worked in the white house does that suggest that those of us playing sports cannot safely rely on testing alone and trying to live in bubbles no i i i think that comparing the unfortunate situation that happened in the white house i don’t think you can extrapolate that to other situations where people are really very careful in the kinds of things that have been put together for sports i mean i have consulted with the nba the national football league and major league baseball etcetera everything that was done there even though it is not foolproof was responsible and based on science to the extent that you could implement it in the in the setting of a con are you are you a football player i am indeed yeah okay i can’t tell how big you are from the screen but you got that football player attitude about you which is a positive thing so yeah i think you guys have been responsible about how you how you want to do that um what went on in the white house you know i don’t want them every time i say something that’s an issue i wind up spending a lot of time answering phone calls and emails i should say it was not done according to what i would have recommended i mean what you saw there in the white house i don’t know if you saw the sometime that picture from above of everybody crowded together with no masks i think if you look at the protocols in football when you’re not on the field you wear a mask when you go in the field you do testing on everybody and then you do surveillance testing that’s very similar in many respects to what many of the colleges are doing even outside of sports so let me ask you a question when uh are you involved in football practice yet unfortunately i’m not i wasn’t able to uh return to campus but yeah but if you were if you were involved it likely would have been everyone would have been tested and then people would have been put in a situation

where they are not in contact with others without a mask and then every couple of week or twice a week you would do surveillance testing of the team i think that’s responsible having everybody with no masks congregated in a closed place is a different story than what many of the sports teams are doing but it was a good question because i think people would ask that if you can’t be protected in a bubble type setting in the white house how can you expect to be protected in a somewhat similar bubble situation outside but to be honest with you it’s a bit of apples and oranges compared to what you are describing versus what happened in the white house great uh alfonso del aguila has a question alfonso is a psych major on the pre-dental track thank you for joining us today dr fauci my question for you is what was the most crucial decision you had to make during the pandemic and what was the critical thought process that took you through it yeah the most crucial it was a decision to make a recommendation to the president it wasn’t my decision that i could implement and when it became clear that when we had um community spread in the country with a few cases of community spread this was way before there was a major explosion like we saw in the northeastern corridor driven by new york city metropolitan area i recommended to the president that we shut the country down and that was very difficult decision because i knew it would have serious economic consequences which it did um but there was no way to stop the explosive spread that we knew would occur if we didn’t do that and unfortunately since we actually did not shut down completely the way china did the way korea did the way taiwan did uh we actually did see spread even though we shut down and i know for those of you who follow this in the media if you look at the things that for example have happened in the southern part of the country in florida texas georgia arizona and california where they had a big spike in infection when they tried a so-called open up carefully there were so many people in society who were just not paying attention to the public health guidelines and you saw the pictures in the media of crowded bars no masks indoors i mean that’s a perfect recipe for disaster great i’m trying to uh serbia diani who’s a senior biology natural major uh who’s actually living in worcester like many of our students uh staying in worcester is as close to the college as they can thank you dr faji it’s such an honor to be here with you today as an anthropology student uh with a large passion for social justice i know that this pandemic has worsened so many economic and social inequalities in the world how can epidemiologists and other individuals work to prevent disproportionate impact on marginalized groups you know your question is a great question i would pull one word out and say epidemiologists because i don’t think epidemiologists can do anything i think what this outbreak has has shown a very bright painful light for me on something that i’ve known for years and years particularly from the early years of hiv and that is the the somewhat shameful disparities in health among our minority population brown and black people and that is the situation we saw with hiv 13 of the population is african-american 43 of all the new infections are among african americans with covet 19 there are two things that are happening simultaneously that are really as i say you know in many respects shameful one if you don’t like to generalize but as a demographic group brown and black people have jobs that put them in the front line getting exposed in real time to people most of the time as a demographic group and there are times when you should generalize there are times when generalizing is bad here you should generalize because as a demographic group they don’t have the advantage of being able to do what we’re doing now doing things virtually most of them are outside doing the gardening doing the construction doing the kinds of physical jobs that put them face to face

with other people so they have a greater chance of getting infected the double whammy for them is that when they do get infected they have a higher incidence and prevalence of the comorbidities that make it highly likely that they will have a serious outcome of their disease such as hospitalization intubation intensive care and and needing a ventilator that’s likely what will happen so what are you going to do about both of these things you can immediately get resources available like testing to the people who are in a demographic group where you have a disproportionate number of african-american and latinx but the thing that will only take decades is to finally realize that the social determinants of health are absolutely critical because african americans and latinx but particularly among the african-americans it isn’t genetic it’s the fact that from the time they were born the access to healthy food the economic conditions that they were in make them more likely to have diabetes hypertension obesity chronic lung disease and kidney disease through no fault of their own except the social determinants of health that started when they were born so when this outbreak is over you said what should epidemiologists do what should everybody do to realize that we can’t forget this we can’t go on and say well let’s look at the next thing we’ve got to say that we’ve got to do something in society to get rid of that enormous disparity the problem with that is that that takes decades so if somebody thinks they’re going to do it overnight or in a year you have to have a societal commitment that you’re going to change that around and there are ways to do that but we have to realize that this is an enormous problem that has always been there but it it it it rears its ugly head when you get something as dramatic as an outbreak so we should all commit ourselves that no matter where we are or what we do that’s an unacceptable state to be in where you have a certain proportion of the population through no fault of their own are going to get hit much more badly with diseases like this thank you uh jenny gonzalez who’s a health studies major double major international studies in health studies has a question that’s on many students minds thank you for sharing the space with us today dr fauci almost all of us at holy cross are quite eager to get back on campus and if all of us are there we’ll be in shared rooms as well as shared bathrooms in our residence halls what have you learned from best practices at other campuses that will help us to get back in february best testing protocols living situations are there covert prevalence or vaccine thresholds you’d apply what can make it possible for us to get back on the hill yeah there are a number of good protocols that’s a very important question there are a number of good protocols that some of the colleges and universities throughout the country have implemented the first is getting the capability of doing universal testing of everybody before they even start off then have a situation where you could sample test maybe twice a week try to get separate pods where you have situations where you arrange the rooms where you don’t have complete interaction with all of the people on campus but you have a set group that you can know and control you wear masks you wash your hands you do things in a way that would not allow spread among you now obviously you can’t do that because you have to go to class and you would you have to interact you have to have a capability on campus that if if a student gets infected that in a number of colleges have done that i’m sure that holy cross could figure this out is that you have either a dorm or a floor in a dorm that when a student gets infected you don’t close the school down you don’t want to do that what you do is you put that person in an isolated comfortable place where they can do things virtually until the 10 days or so are over when they can go back into the community but you’ve got to separate them from the student body the one thing you don’t want to do is you don’t want to send them home because when you send them home not only are you interrupting the flow of the school work that they need to do but you’re reseeding the community from which they’ve come

so universal testing intermittent surveillance facilities to deal with students who get infected and don’t send them home thanks very much um i’ll turn to um chances who is a sophomore from georgia pursuing biology and health studies dr fauci uh is this holy cross is where many of us myself included first committed ourselves to being men and women foreign with others as you have but through the many crises that you’ve seen from hiv aids to covet 19 i can’t imagine that that was an easy decision to make so what prompted you to pursue a career in serving humanity and how do you remain steadfast in that resolve even when times are bleak well i get asked that question a lot i think it it really relates back to my family upbringing my family was uh always had an attitude that was there like from the beginning it was part of you know getting up in the morning and having breakfast is that you have a responsibility to society and material things should be very secondary or tertiary in your consideration that you’re here you’re lucky you’re here you’re lucky or healthy you sort of owe the world something as opposed to the world owes you something and then i cultivated that um through the years and it was really cemented in me when i went to a re uh a jesuit high school i went to regis high school in manhattan and that at the time it wasn’t men and women for others it wasn’t all an old boys school so it was men for others and even when i got the holy cross there was still men for others because that was a long time ago but it was really fortified and underscored in me and um you know as i’ve often described many many times i found myself more interested because of the classics you know i took that that that unusual pre-med course at holy cross which was labeled at the time a b greek comma pre-med in which i took more philosophy courses than i took uh science courses so i always felt that i was more interested in human nature than i was in human uh physiology so even though i did the science to become a physician and i ultimately became a physician scientist i still always felt i was more interested in the humanities and in human nature versus human physiology and i have to tell you that really started from the time i was a child where the the the vibrations that i would get from my mother and my father i wasn’t quite sure what it meant until it became really explicit with a jesuit education both at regis and at holy cross i’ll ask a question somewhat related to that or ask celia jarmak who’s from connecticut um senior psychology major i’m so excited to have the opportunity to talk with you today dr fauci my question is if one of my holy cross classmates in this zoo meeting was to step into your shoes one day what advice would you have for her about what it takes to succeed in your job well my job is has is multifaceted i’m glad you said what she would do because i hope it’s a she the next one here is is as a scientist particularly when you’re in a job like i have which is not only hardcore science and hardcore public health but it is related to policy that influences you know hundreds of millions of people because what happens in the united states often spills over to other countries and one of the things that i had to deal with right from the very beginning was that if you are in science you’ve got to direct what you do what you recommend your policies based on scientific data and evidence and you’ve got to be consistent and you’ve always got to be truthful and not be afraid to tell people what they may not like to hear and i don’t know how closely you all are following the relationship i have with the president of the united states but that is something that is a day by day i would say challenge um but it’s working as as complicated as it is you should never ever veer away from being transparent being consistent and being truthful and and don’t guess at things when you’re dealing with science

and don’t ever ever be afraid of saying you don’t know something because in the fields that i’m involved in that hopefully some of you will be involved in maybe you yourself you’re not going to ever know everything so you’ve got to be able to act on what you know at the time and as things evolve science will give you information that may get you to change your stance to change your recommendation be modest enough and humble enough to do that and realize that you don’t know everything at any given time there’s always more to learn so you know being in a position where you have a lot of influence people sometimes think that you well i certainly am not that way but some people say well you’re up there on the top you really you’re on the top of the world you you know everything you know i have you wake up in the morning and what i worry about is the things that i don’t know i don’t wake up in the morning say wow i’m on a hot shot i know everything it’s like oh my god there’s so much that i don’t know and that’s what drives a gink a good scientist and a good policy person great thank you karim hamada from the class of 21 a psych major in the pre-med track uh who actually did an article as an article impressed on the impact on of cover 19 on individuals with serious mental illness hi dr fauci thank you for taking the time to be with us today the covid19 pandemic can exacerbate symptoms for individuals with mental illness and social distancing at times can lead to social isolation and loneliness what measures should we implement during this pandemic to prevent this and do you have any advice for students who may be completing their fall semester from home yeah i think we need to intensify the outreach and help for people who are in those positions where they’re particularly vulnerable i mean even people who don’t have an underlying propensity to any kind of mental health issue are really stressed and strained by everything we’re going through i mean this is a truly unusual situation i mean i live it intensely 18 hours a day seven days a week and it takes someone like my more philosophical wife um you know who also had a jesuit education at georgetown to remind me about how abnormal this situation is so you should not expect everybody to just adjust to this in such an easy way but particularly when you have people who have underlying stress and strain of because of an underlying mental disorder you have to pay strict attention to them and mobilize all the mental health resources that you possibly can so whenever we sit down with omb of the congress about resources that we need we talk about vaccines we talk about therapeutics we talk about this you always have to throw in there the mental health issues are extremely important extremely important so i’m i’m really glad you brought that up because a lot of people you know don’t appreciate when i say you know comorbid conditions that make you have a severe outcome of covid 19 disease and that’s all the things i mentioned but there’s another comorbidity that may have you have a severe outcome of your own underlying illness so it may not be covid19 that does you in but it’s an exacerbation of your own underlying illness that does dr patrick i know we’re near the end of your time uh do i have a couple more questions or if you have a summary statement whichever you’d like to do or summary comment well i i think my summary comment was my my opening comment so i and and really that is this is historic the thing that we got to make sure we appreciate is that this is going to end one of the things we have to be careful about is despair you know we went through a terrible late winter early spring there was hope that when the summer came it would get better in fact it got worse and now we’re entering into another darker period uh you know i know what it feels like getting up in the morning from wheeler going down the stairs you know when everything is dark and really really cold so you superimpose upon that the situation that we’re living in a really really difficult situation don’t give up hope it’s going to end we’re going to get a vaccine we’re going to get it within a reasonable period of time and when we do that together with good public health measures we’re going to be fine we’ve got to guard against throwing our hands up and saying my goodness there’s no end to this so it

doesn’t make any difference what we do and then you get into really better bigger trouble than we’re already in right now well dr fauci the whole holy cross community i know our students here are really extraordinarily grateful to you for your leadership during the crisis and through the really many infectious disease challenges before it as a scientist as a public intellectual and really as a model citizen and holy cross graduate we’re really grateful for the chance to spend time with you today and uh so anyway thank you very much and uh thank you from all of our our our students here well thank you for having me and good luck thank you uh father burrows and thanks an awful lot uh tom take care of yourselves guys and ladies okay yourself too we need that all right bye-bye