First on CNBC: CNBC Transcript: Dr. Anthony Fauci Speaks with CNBC’s “Closing Bell” Today

Published Wed, Jul 21 20215:50 PM EDT

WHEN: Today, Wednesday, July 21, 2021

WHERE: CNBC's "Closing Bell"

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SARA EISEN: COVID cases spiking across the US with a seven-day average now at nearly 37,000, a more than 50% jump week-over-week. The Delta variant driving the move higher now accounting for 83% of new cases according to the CDC. Joining us here for more for a first on CNBC interview is Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, Chief Medical Advisor to President Biden. Welcome back to the show Dr. Fauci, it's good to see you.

DR. ANTHONY FAUCI: Thank you. Good to be with you.

EISEN: So clearly, these cases, deaths and hospitalizations are rising predominantly in unvaccinated individuals but there is growing evidence of these breakthrough infections for vaccinated people. How concerned are you especially in light of some new questions about the J&J shot effectiveness against Delta, about the vaccinated people getting the Delta COVID-19 variant?

DR. FAUCI: Well, the good news about vaccinated people are, if you look at the protection against severe disease leading to hospitalization and unfortunately sometimes death, the vaccines still work really quite well against the Delta variant. We are concerned that we are seeing more so called breakthrough infections. That's something we obviously don't want to see we're dealing with a highly transmissible virus. This virus is clearly different than the viruses and the variants that we've had experience with before. It has an extraordinary capability of transmitting from person to person. Fortunately, if you look at these so called breakthrough infections which by definition means an infection in someone who has been fully vaccinated, that usually the overwhelmingly vast majority of these infections are either asymptomatic or mildly symptomatic which is compatible with the fact that it looks very much like the vaccines do continue to protect quite well against hospitalization and death, even against the Delta variant.

EISEN: But what about transmission? What do you do, what do you do if you're someone like me with two toddlers at home and I've been going out to restaurants and going back to work. Do we need to change our behavior because we're seeing breakthrough infections on the possibility that we could transmit them to unvaccinated kids?

DR. FAUCI: Well that's a question that is very appropriate and keeps getting asked over and over again. The broad overall CDC recommendation is that if you are vaccinated, you are protected and you don't need to wear a mask indoor or outdoors but many local authorities and I think the prototype example of that is LA County, Los Angeles County, which because of the high level of transmission and infection there, they are saying that if you are fully vaccinated, even if you're vaccinated, it's suggested that you wear a mask when you are indoors in a situation where you have a level of dynamics a virus in the community that's high. So I'm not sure exactly where you are or what the dynamics are in the region that you are but you might want to consider if you want to go the extra mile of safety, even though you're vaccinated when you're indoors, particularly in crowded places, you might want to consider wearing a mask.

EISEN: Why shouldn't we just have a national mask mandate again if cases are spreading in every state in this country among the vaccinated and unvaccinated in particular?

DR. FAUCI: Well you know that's a question that is asked frequently and appropriately. I don't believe that we're going to see a central mandate for masking because there will be a lot of pushback on that. What I do think you will be seeing is that there will be local mandating, namely situations like colleges and universities saying unless you want to be excluded from coming in, you've got to get vaccinated or even business enterprises might be saying that. I think as the vaccine gets fully approved by the FDA, as opposed to just the emergency use authorization, that you are going to see a lot more local mandates. It's really unfortunate about people sometimes say, well, it hasn't been fully approved. The data is so overwhelmingly positive for these vaccines that I would be astounded if they're not approved. So I mean you never want to get ahead of the FDA that's their decision, but I would imagine that we're going to see approval of these within a reasonable period of time.

WILFRED FROST: So possible to see more local mandates when it comes to mask wearing over the months ahead. What about stricter measures than that? Do, what are the chances that we go into more forms of lockdown again?

DR. FAUCI: You know I don't really see that Wilfred. I don't see that on the horizon right now. What I do see is increased testing and increased local mandates and a big push to get people vaccinated. The frustrating part about this from a public health standpoint is that we have the tools to stop this and if we do get more people vaccinated, you are going to start seeing a downtick again in the infections. It's really quite frustrating these vaccines work well against this virus, including the Delta variant. We just need to get more and more people vaccinated and hopefully we're starting to see perhaps a change in that people be they people on TV and others who've been saying that they're not particularly enthusiastic about vaccination are now starting to change a bit and starting to recommend to people to get vaccinated.

FROST: With that in mind, Dr. Fauci, I mean you use the term there public health, does it become actually a private health issue for those that have chosen not to get vaccinated such that if we do see deaths pick up later in the year, we shouldn't react to them in the same way that we did last year before it was just broadly a public issue and there was no real debate as to the decision making of individuals.

DR. FAUCI: Well you don't want to see anyone get seriously ill and die and, you know, you don't want to say well I told you so, you should have got vaccinated. That's certainly not what I would consider an appropriate public health attitude. What we try to do is get people to look at the data and the data are really striking. In the United States, 99.5% of the deaths from COVID-19 are among unvaccinated people. That is a statistic that just speaks for itself that if you are vaccinated, you'll, you are accounting for an extremely small proportion of the people that are vaccinated. If you are unvaccinated, you're accounting for 99.5% of the people who die from this virus.

EISEN: Where are you Dr. Fauci on how urgently we might need a third shot or a second shot if you've got the J&J vaccine and whether it's the same one you got or something that directly targets Delta?

DR. FAUCI: Well, again, that's a question that's being frequently asked. We are looking now at the data of what we call the durability of protection. You, what, you're talking about boosters under two scenarios. One is a person who's had initially a very good immune response but you want to make sure that it lasts and you don't know whether it's going to be eight months, a year, a year and a half, so you follow individuals both from the laboratory data that can serve as a surrogate or parameter of immunity and protection, or you look clinically, as to whether or not you're getting more and more breakthrough infections. The other reason for a booster, which is being considered and being tested, is that those people who have underlying conditions of being a low immune response, namely transplant recipients or people receiving therapy for underlying diseases like cancer or autoimmune disease. Those individuals may not have had a very adequate immune response to begin with and what you need for them is maybe an additional shot that is part of the total part of their regimen. So there are two reasons for that. Both of them we are pursuing in trying to find out to whom, when, and if they should be given a boost vaccine so that's a work that's in active progress right now.

FROST: Dr. Fauci, what's relatively speaking more important, helping the developing world get their first shots or making sure Americans have the option to have a booster shot when necessary?

DR. FAUCI: Well, you know, I get asked that question a lot. It's an obvious question and I think we are capable of doing both. I think if we put resources into it and all of the countries who have resources, the developing world puts in enough resources to help the low- and middle-income countries to get vaccinated. I think you can do both. I don't think it has to be a choice one or the other.

EISEN: What happened to herd immunity, Dr. Fauci, or did that just go away with it, with these new Delta variants?

DR. FAUCI: No, I mean when you have one half of the entire total population of the United States that's been vaccinated, meaning the other half is not, even when you include in the other half people who might have been infected and might have some degree of protection, we still have not reached that critical area where you have a comfortable blanket of protection over the community and that's the reason why it isn't whatever happened to herd immunity, it's why are not people more of them getting vaccinated so that we can reach herd immunity. The easiest way to get to herd immunity is to get the overwhelming proportion of the population vaccinated.

EISEN: So, did you have a projection for when we might see that, given what we're seeing with Delta?

DR. FAUCI: You know, I think it's impossible to project, you know, we've done very well with vaccines, particularly among the elderly. More than 85% of individuals 65 years of age or older have received at least one dose. We know when you look at adults that we are now close to 70% of 18 years of age and older who have received at least one shot so in some respects, we're doing very well but we've really got to do better and I can't project when we're going to get there because we still have to get to the point where we're convincing a lot of people who are being recalcitrant to getting vaccinated to turn around and get vaccinated.

FROST: If we were to rewind the clock, Dr. Fauci, let's say six months or so when you when you knew that the other variants to come but you didn't know precisely what their characteristics would be, how bad are the characteristics of the Delta variant relative to your worst fears, six to 12 months ago, and do you think there will be almost inevitably another worst style variant to come down the line or if we do manage to reach herd immunity in the months ahead against this variant and others, could we be home and dry before that kind of worst scenario emerges?

DR. FAUCI: You know, all very appropriate and good questions. The fact is that this is a nasty virus. It has the capability of very efficiently spreading from person to person. So six months, a year ago, we were in the situation where we say we hope we don't get a variant like that. Unfortunately, we do. The second part of your question is what about additional variants that might be even worse. Well, there's a very, very important tenet in virology and that is that viruses don't mutate unless you allow them to replicate and spread in the community. You give them ample room, ample time, ample opportunity to mutate and get a new variant. So, the easiest and best and most effective way that we can prevent the emergence of a new variant and crush the already existing Delta variant is to get everybody vaccinated. So as I've said before, we have the solution within our grasp. We've just got to go for it.

FROST: Have you with all of that in mind at any point advised the President to mandate vaccinations?

DR. FAUCI: I don't think you're gonna see a central mandate. I think there will be a reflex pushback from that. But what I do see in the future are local mandates, local businesses, local universities and colleges so that if people want to do things and be able to participate in activities, they will get vaccinated by a mandate but I don't believe that it will come centrally from the federal government.

EISEN: Do you think COVID will ever become less virulent and become something like the common cold in the future or is it always going to be a dangerous and aggressive virus?

DR. FAUCI: I think within the immediate future and within our future, I would say within my lifetime, it would likely is not going to all of a sudden piddle out and be the common cold. You know, if you look back at the history of viruses, it is entirely conceivable that the four common cold corona viruses that we've been dealing with with decades before we ever had SARS, that at one time in the history of civilization, they broke out as a pandemic and then over many, many, many, many years, adapted to the point where they're relatively benign. It is conceivable that this will happen but I think it's going to take more than a year or two.

EISEN: To that point, I guess my final question. They're monitoring 200 people for Monkeypox and I know there's only one case in this country but the CDC is obviously following it. Are we in a new normal where we have to worry about more aggressive and more deadly viruses than we have in the past?

DR. FAUCI: Well, you know, as you know that's been what I have been doing for the last 40 years is responding to and preparing for the outbreak of emerging infections and we will continue to see emerging infections whether it's something like Monkeypox or influenza or SARS or Ebola. Those things happen so that's the reason why you've got to be prepared for it and you've got to be able to adequately respond to it.

FROST: In terms of more opening up, Dr. Fauci, whether it's international travel or any local rules and regulations, what would you advise people to hit pause on that for the, for the months ahead whilst we fully grasp what is going on with Delta or do you think in fact as you've outlined that depending on your phraseology and you're spinning of it, the vaccines are working against a variant that's much worse than we feared in the first place, which is, which is a great place to be.

DR. FAUCI: Yes, no, in some respects, it's a good place to be. But in other respects, we are dealing with a formidable virus. So, you know, we really do have a choice I keep saying it every which way because it's true. We have the capability of crushing this virus if we, in fact, get the overwhelming proportion of the population vaccinated. I mean there are certain things that we certainly can do right now. We are much, much better off than we were when we had that extraordinary spike in the late winter and early spring of last year, of this particular year, when in the fall and the winter the end of 2020 and the beginning of 2021. We're not anywhere near there. But in order to keep us even more safe, we've got to do better with vaccination. That's the solution.

EISEN: Any vaccination or would you tell people to choose one over the other, given what we're seeing in the real-world setting?

DR. FAUCI: You know, any vaccination, the three vaccines that have received emergency use authorization in my mind are all effective vaccines.

EISEN: Are you doing anything differently now with these breakthrough cases Dr. Fauci?

DR. FAUCI: Well, you know, you're asking for somebody who's got a very restricted existence here. I mean, I come to the NIH every day I don't travel. We're too busy doing the things that we're doing so I don't think I'm the typical person. But, so I don't think I'm a good example.

FROST: So, can you confirm for us exclusively that you have not been to any nightclubs lately, Dr. Fauci.

DR. FAUCI: Indeed, I've not been to bars and nightclubs, I can assure you of that.

EISEN: Mask on or off.

FROST: I would love to kick back and have a beer at a bar with Dr. Fauci.

EISEN: Maybe one day, Dr. Fauci, that would be a good indicator. Thank, thank you for joining us and for taking the time.

DR. FAUCI: My pleasure, thank you for having me.

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