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    Anthony Fauci, MD, sees a return to “a considerable degree of normality” by fall 2021

    Speaking at the AAMC’s annual conference, the acclaimed infectious disease doctor shared news about the vaccines in development but cautioned against abandoning public health measures as the vaccines roll out.

    Dr. Anthony Fauci speaks during Learn Serve Lead 2020.
    Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, speaks at Learn Serve Lead 2020.
    Photo by Laura Zelaya

    Anthony Fauci, MD, the nation’s top infectious disease expert, offered an aggressive timeline for the rollout of vaccines to prevent COVID-19, but he cautioned that ending the pandemic will depend on high uptake of the vaccines and strict adherence to public health guidelines until a majority of the population is vaccinated.

    With the announcement on Nov. 16 of preliminary results from Moderna’s Phase 3 trials showing that its mRNA vaccine was almost 95% effective in preventing symptomatic COVID-19, coupled with a similar announcement on Nov. 9 from Pfizer and BioNTech, Fauci told attendees at Learn Serve Lead 2020: The Virtual Experience that at least one crucial element to ending the pandemic had very likely been met.

    “The two components of a vaccine are how effective it is and how many people will take it,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “The first thing we have, beyond expectations, are two vaccines that are close to 90%-95% effective. … Now we’ve got to convince people to get vaccinated. And we can’t abandon our public health measures during this transition period. We’ve got to actually double down on public health measures. … Paramount among these are the universal wearing of masks, maintaining physical distances, avoiding crowds and congregate settings, outdoors is always better than indoors, and frequent washing of hands.”

    Moderna and Pfizer have both announced plans to apply for emergency use authorization from the Food and Drug Administration in the next few weeks. Fauci predicted that front-line providers could be vaccinated “toward the end of December, beginning of January; then from January to April, we’ll get those people that fall into the high priority groups. By the time you get to April  end of April, May, June, we’ll have the people in the general population. … As we approach the third and fourth quarters of 2021, I think we can get back to a considerable degree of normality, but it’s going to depend on the uptake of the vaccine.”

    Fauci told attendees that he was likewise encouraged by the data around side effects for Moderna’s vaccine  which were mild and included arm soreness, headache, and fatigue. The side effects “are by no means going to be a showstopper,” he said. “It’s going to be one of those things where you say, ‘The value of it certainly overrides the inconvenience of feeling poorly for awhile.’”

    Moderna’s vaccine must be given in two doses, but it can be stored in an ordinary refrigerator for up to 30 days. Pfizer’s two-dose vaccine must be stored at a much colder temperature, which could pose a technical challenge in some areas of the country that don’t have facilities with cold storage capacity, said AAMC Chief Scientific Officer Ross McKinney Jr., MD, who moderated the panel with Fauci.

    Fauci and McKinney also outlined for attendees the scientific evolution of the disease, its transmission, its clinical manifestations, and the therapeutics that have been developed to treat it — primarily remdesivir and the steroid dexamethasone. Other investigational therapies, including monoclonal antibodies developed by Eli Lilly and Regeneron, could help prevent severe disease and hospitalization if given early in the course of disease.

    But it is the vaccines that offer the brightest hope for moving beyond the pandemic  and with preliminary results from two vaccines, plus at least six others in Stage 3 trials, we might even soon know if certain vaccines work better for certain groups, Fauci said.

    “When you really hone in on the data, does it look like one might be better for the elderly versus kids? Is one better for people with underlying conditions? What about young people in their 20s, 30s, 40s? I think those data are going to start to trickle in,” he explained.