ウィスパリング同時通訳研究会コミュのWhite House press conference with Press Secretary Jen Psaki. +Dr. Fauci

Jen Psaki: (00:31)
Good afternoon, I don’t mean to interrupt your live shot with Dr. Fauci. Good afternoon. Thank you for joining us today, many familiar faces from yesterday back again. We are pleased to have Dr. Fauci here with us as part of the President’s commitment to have public health experts lead our communication with the American people about the pandemic. Just to give you a bit of a run of show here, Dr. Fauci will speak at the top about the state of the pandemic, the status of vaccines. He’ll take some of your questions. I will play the role of the bad cop when it’s time for him to go and get to the work of the American people. And then I will do a topper and I’ll answer a bunch of your questions as well. So there’s lots to come after this, with that, I will turn it over to Dr. Fauci.

Dr. Fauci: (01:24)
Thank you very much and I’m going to just spend a couple of minutes just summarizing the status of where we are, and then maybe addressing some of the things that I know are on people’s minds. So, first of all, obviously we are still in a very serious situation. I mean, to have over 400,000 deaths is something that is unfortunately historic in the very bad sense. When you look at the number of new infections that we have, it’s still at a very, very high rate. Hospitalizations are up there are certain areas of the country, as I think you’re all familiar with, which are really stressed from the standpoint of beds, from the standpoint of the stress on the healthcare system. However, when you look more recently at the seven day average of cases, remember we were going between three and 400,000 and two and 300,000.
(02:16) Right now, it looks like it might actually be plateauing in the sense of turning around. Now, there’s good news in that, but you have to be careful that we may not be seeing perhaps an artifact, an artifact of a slowing down following the holidays. So when we see that, we think it’s real. But one of the things, and it’s interesting, I’m sorting getting a deja vu standing up here because I said something like this almost a little bit less than a year ago when we were talking about the acceleration of cases in the late winter, early spring of 2020, when we were having New York City metropolitan area being the epicenter of what was going on, that they are always lags, so please be aware of that. That when you have cases and then a couple of weeks later you’ll see it represented in hospitalizations, intensive care and then a couple of weeks later in deaths.
(03:11) So you have almost a paradoxical curves, where you see something plateauing and maybe coming down at the same time as hospitalizations and deaths might actually be going up. So this is something that I just put on your radar screen. It is not an unusual thing to see that sort of thing. The other point I want to make is one that we’re getting asked a lot regarding questions. That is, what is it about these mutants that you’re hearing about. The mutants in the U.K., which we know are in about 20 plus states, the mutants that we’re seeing in South Africa and in Brazil. First of all, we need to understand that RNA viruses like coronaviruses mutate all the time. Most of the mutations don’t have any physiological relevance with regard to the function of the virus itself.
(04:05) However, every once in a while you get mutations, either singly or clustered in combinations, which do have an impact. So what have we learned thus far? And I want to emphasize thus far because we’re paying very, very careful attention to this, and we take it very seriously. At least from the experience that our colleagues in the U.K. have had, the one that is in the U.K. appears to have a greater degree of transmissibility, about twice as much as what we call the “wild type” original virus. The one that is in South Africa is a bit different and I’ll get to that in a second. So it does look like it increases the transmissibility. They say correctly on a one-to-one basis, it doesn’t seem to make the virus more virulent or have a greater chance of making you seriously ill or killing you. However, we shouldn’t be lulled into complacency about that because if you have a virus that is more transmissible, you’re going to get more cases. When you get more cases, you’re going to get more hospitalizations, and when you get more hospitalizations, you ultimately are going to get more deaths.
(05:17) So even though the virus on a one-to-one basis isn’t more serious, the “phenomenon” of a more transmissible virus is something that you take seriously. The next thing is, does it change enough to interfere with the efficacy of a whole group of monoclonal antibodies that many of you are aware of. The monoclonal antibodies that are being used for treatment in some cases and prevention. Since monoclonal antibodies bind to a very specific part of the virus, when there’s a mutation there, it has much greater a chance of obliterating the efficacy of a monoclonal antibody. And we’re seeing in the much concerning mutations that are in South Africa and in some respects, Brazil, which is similar to South Africa, that is having an effect on the monoclonal antibodies. The real question that people are quite clearly interested in is, what is the impact on the vaccine? And so far, literally we have this new phenomenon that are pre-print journals, where, where people get data and they put it into a “pre-print” server where it hasn’t yet been peer reviewed. But you have to pay attention to it because it gives you good information quickly, ultimately it gets confirmed.
(06:37) And we’re seeing them coming out over the last few days. And what they’re saying is that what we likely will be seeing is a diminution, more South Africa than U.K., U.K., is that diminution in what would be the efficacy of the vaccine induced antibodies. Now that does not mean that the vaccines will not be effective and let me explain why. There’s a thing called a cushion effect. So if you have a vaccine like the Moderna and the Pfizer vaccine that can suppress the virus at a dilution, let’s say of one to 1,000, and the mutant influences it by bringing it down to maybe one to 800 or something like that. You’re still well above the line of not being effective. So there’s that cushion that even though it’s diminished somewhat, it still is effective. That’s what we’re seeing both certainly with the U.K,, which has very minimal effect. We’re following very carefully the one in South Africa, which is a little bit more concerning, but nonetheless, not something that we don’t think that we can handle.
(07:48) What is the message? Because someone could say, now, wait a minute, if you have the possibility that the vaccines are diminishing in their impact, why are we vaccinating people? No, it is all the more reason why we should be vaccinating as many people as you possibly can, because as long as the virus is out there replicating, viruses don’t mutate unless they replicate. And if you can suppress that by a very good vaccine campaign, then you could actually avoid this deleterious effect that you might get from the mutations. Bottom line, we’re paying very close attention to it. There are alternative plans, if we ever have to modify the vaccine. That is not something that is a very onerous thing, we can do that given the platforms we have. But right now, from the reports we have, literally as of today, it appears that the vaccines will still be effective against them. With the caveat in mind, you want to pay close attention to it. So Jen, why don’t I just stop there and then maybe just answer some questions on anything else that I said. So, yeah.
Speaker 1: (08:57)How helpful would it have been if Amazon got involved with the federal response to COVID-19 before Biden took office? And do you know about any plans or discussions ahead of yesterday?
Dr. Fauci: (09:12)
No, I don’t think I could answer that question. I’d be waving my hands about that, sorry. But one of the new things in this administration is, if you don’t know the answer, don’t guess, just say you don’t know the answer. Yeah, yes.
Speaker 2: (09:26)
Dr. Fauci, a couple of other questions if I might. I’d like to follow up with you on what you just said about this strain in South Africa. Has that strain made its way to the United States and what if any concerns do you have? How much do we understand about that?
Dr. Fauci: (09:41)
Great question. Thus far, it does not appear at all that the South African strain is in the United States. However, we must be honest and say that the level of comprehensive sequenced surveillance thus far is not at the level that we would have liked. So we’re going to be looking very, very carefully for it. But given the information we have today, it doesn’t appear that the South African strain is here.
Speaker 2: (10:07)
Okay, and if I could just ask you about the effort to distribute the vaccines, because of course, that’s what most people want to know, when are they going to get a vaccine? Is the Biden administration starting from scratch with the vaccine distribution effort? Or, are you picking up where the Trump administration left off?
Dr. Fauci: (10:27)
No, I mean, we certainly are not starting from scratch because there is activity going on in the distribution. But if you look at the plan that the President has put forth about the things that he is going to do, namely get community vaccine centers up, get pharmacies more involved, where appropriate, get the defense production act involved, not only perhaps with getting more vaccine, but even the things you need to get a good vaccine program. For example, needles and syringes, that might be more useful in that. So it’s taking what’s gone on, but amplifying it in a big way.
Speaker 2: (11:05)
President Biden said that what was left was abysmal, essentially. I mean, is there anything actionable that you’re taking from the previous administration? And does that delay your efforts to get the vaccine? I mean, that’s the question.
Dr. Fauci: (11:18)
No, I mean, we’re coming in with fresh ideas, but also some ideas that were not bad ideas with the previous administration. You can’t say it was absolutely not usable at all. So we are continuing but you’re going to see a real ramping up of it.
Speaker 2: (11:35)
One more final question, you had said that most people will be vaccinated by the middle of 2021. Is that still your expectation?
Dr. Fauci: (11:42)
Yes, it is. I mean, I believe that the goal that was set by the President of getting 100 million people vaccinated in the first 100 days is quite a reasonable goal. And when you get to the point, and one of the things that I think is something we need to pay attention to, and I quite frankly have been spending a considerable amount of my own time is outreaching, particularly to minority communities to make sure that you get them to be vaccinated. And you explain why it’s so important for themselves, their family, and their community. If we get 70 to 85% of the country vaccinated, let’s say by the end of the summer, middle of the summer, I believe by the time we get to the fall, we will be approaching a degree of normality. It’s not going to be perfectly normal, but one that I think will take a lot of pressure off the American public.
Speaker 4: (12:35)
Dr. Fauci, you’re one of the few holdovers from the previous administration to this current one, what has been your experience with this new team? And in your view, what would have been different in terms of the trajectory of this outbreak from the start had a team like this in place at the beginning?
Dr. Fauci: (12:52)
Well, I can tell you my impression of what’s going on right now, the team, I don’t now if I can extrapolate other things. But one of the things that was very clear as recently as about 15 minutes ago when I was with the President, is that one of the things that we’re going to do is to be completely transparent, open, and honest. If things go wrong, not point fingers but to correct them, and to make everything we do be based on science and evidence. I mean, that was literally a conversation I had 15 minutes ago with the President and he has said that multiple times.
Speaker 4: (13:29)
That’s very interesting, you looking back on your comments over the last 10 or 12 months, would like to now with that sort of license to amend or clarify?
Dr. Fauci: (13:39)
No, I mean, I always said everything on the base. That’s why I got in trouble sometimes, right?
Speaker 5: (13:46)
You mentioned pharmacies, the new CDC director said today that the goal of getting vaccinations into pharmacies by the end of next month isn’t realistic as had been previously suggested. When will most Americans be able to get a vaccination in their neighborhood pharmacy?
Dr. Fauci: (14:02)
Well, I didn’t hear that comment. Are you talking about Dr. Walensky’s comment? I didn’t hear that comment so I don’t really want to comment on the comment. But what she may be saying is that for many people in this country who don’t have access to a pharmacy, they may not be able to utilize getting things in the pharmacy. I’m not sure, I want to be careful because I’m not sure that’s what she said. We just had a conversation about how we’re going to get vaccines to people who are in pharmacy desert areas, where they don’t have easy access to a pharmacy. And that’s something we’re working on and taking very seriously.
Speaker 5: (14:38)
But just to be clear, if you are in an area where you do have access to a CVS or a Walgreens, when will you be able to get access to this vaccine like you would a flu vaccine?
Dr. Fauci: (14:46)
The spirit of not guessing, I really, I’m not quite sure when that will be but we can get back to you on that.
Speaker 5: (14:52)
And just on the broader timeline, you mentioned the fall, we just heard the President say, the brutal truth is that it is going to be several more months. Just to be clear, you’re saying by the fall the majority of Americans you think will be vaccinated?
Dr. Fauci: (15:03)
No, I didn’t say that, I said, if we get the majority of Americans 70 to 85% vaccinated by then we could have a degree of herd immunity that would get us back to normal. The concern I have and something we’re working on is getting people who have vaccine hesitancy, who don’t want to get vaccinated. Because many people are skeptical about that. So we really need to do a lot of good outreach for that. I mean, I don’t know what the best case … the best case scenario for me is that we’d get 85% of the people vaccinated by the end of the summer. If we do, then by the time we get to the fall, I think we can approach a degree of normality.
Speaker 6: (15:43) Dr. Fauci, on that mutations that you were talking about. A question about how exactly they increased transmissibility, does it take less exposure time to get-
Dr. Fauci: (15:52)
No, what it is, is that you can do in-vitro in a test tube setting, binding an affinity to the receptors, which you have in your nose, in your lung, in your GI tract. The receptor for- (16:03)… what you have in your nose, in your lung and your GI track, the receptor for the virus is called an ACE2 receptor and the facility or affinity with which a virus binds to that, means that it very likely will have a better efficiency of infection and replicate more in the nasal pharynx. So, that’s how you make that determination, in the test tube. Then you look epidemiologically, and you see a spike going up in the sense of number of cases, and they match each other. A virus that has the ability to easily bind to and replicate with your receptors, is one that likely will spread easily.
Speaker 7: (16:39) So, it doesn’t mean that you’d have more viral load?
Dr. Fauci: (16:42)
Oh, you could. Yes. In fact, it would mean because if it binds more easily, it could replicate in the nasal pharynx more easily, and it is likely that you would have a higher viral load.
Speaker 7: (16:53) Does it make masks less effective, in that case?
Dr. Fauci: (16:55)
No, it makes it the reason why you absolutely should be wearing a mask. It doesn’t necessarily make it less effective. If you properly wear a mask, then you’ll be okay.
Speaker 7: (17:04)
What about the UK strain? Do you have any data on how widespread that strain is in the United-
Dr. Fauci: (17:09)
Well, I think it’s in at least 20 states, that people have mentioned, exactly. The real question that’s going to be asked, is it going to become the dominant strain, or will the strains we already have prevent it from flourishing and being in the more dominant strain? But, it is here, for sure.
Speaker 7: (17:26)　crosstalk 00:01:29].
Speaker 8: (17:26)
Yeah. Just a follow up on vaccines. Some state and local authorities are saying that they would be able to distribute more vaccines if they had more. Is the Biden administration now trying to increase production by Moderna and Pfizer in the next six weeks?
Dr. Fauci: (17:46)
Yeah. As well as to utilize what we hope will be another player in the field, the J&J, Janssen, as well as other of the companies. But also, as the president has said in his plan to do whatever he can to expand the availability of vaccines, whatever that is. I mean, he said that he’s going to just use every possibility, including the Defense Production Act.
Speaker 8: (18:11)
Can you explain the discrepancy between what some states are saying about needing more vaccines and the CDC saying that a lot of vaccine is still remaining on people’s… or on their shelves?
Dr. Fauci: (18:22)
Yeah. I think that that is something that we need to really take a close look at, because that is an inconsistent discrepancy, and one of the things we want to do is to find out why that’s the case. And, if it is the case, particularly the thing that would be most disturbing if there’s vaccine laying around and people are not using it, when others would need it. But I don’t know the answer to that question, but we need to look into it.