Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the USA said NZ was the best of any western country at managing Covid-19
That's what Dr Anthony Fauci told me when we chatted about Covid. Fauci is the United States' top infectious disease expert. When we chatted, he had also just been appointed President-elect Joe Biden's Chief Medical Advisor.
He and Donald Trump have often clashed over the American response to Covid-19. The outgoing president had even threatened to fire him at one point - difficult when he is a public servant and not a political appointee.
"New Zealand should feel good about the fact that they were so successful from a public health standpoint in containing the outbreak in their own country," Fauci said. "So kudos to New Zealand."
Fauci said New Zealand had done better than any western country in battling the virus. Just 25 deaths (vs 280,000 in the US and climbing fast toward perhaps 400,000 before the vaccines turn the tide).
Fauci said New Zealand benefited from both its isolation and its people. "They have the ability to shut things down and open things up quickly. They have a population that has done very well in listening to the kinds of public health messages that have come from the central authorities," Fauci said.
"So when you talk about who's done well and who's not done as well, New Zealand always rises to the top as a country that has actually done really quite well."
We talked on Friday by Zoom. He was in his Washington DC office. He does several similar video meetings a day. He even has a Zoom assistant to help. They use two laptops, so Fauci can chat with me on one while his aide readies the next chat on the other laptop. There's no time to waste when more than 2600 Americans are now dying from Covid daily.
Fauci has been at the forefront of the battle against infectious disease in America since he took on Aids for the US Government in the early 1980s.
In addition to his new role for Biden, Fauci said, "I've been Director of the National Institute of Allergy and Infectious Diseases for the last 36 years." He will be 80 in three weeks.
Thin, amiable, with a recognisable New York accent, Fauci is regarded as a national treasure by many Americans. But he and his family now need security protection from death threats because he disagreed at times with Trump's handling of the pandemic.
Dr. Fauci speaks during a press briefing with President Donald Trump about coronavirus. Photo / AP
He told me some interesting things:
• The US is now considering adopting a more active, co-ordinated strategy of virus suppression, perhaps somewhat more similar to New Zealand's approach than the chaotic mix of policies that now exist in the US. But any such effort would have to be tailored to America's unusual national situation. "The United States?" he said. "One of its greatest strengths and its beauties is its diversity — geographically, demographically, economically, climate-wise, everything. It's just a large country: 330-plus million people. A very independent, entrepreneurial spirit of doing things the way you want to do it. Not wanting to be told how to do things. That works great under certain circumstances. It doesn't work as great when you're trying to get a uniform response to a pandemic that is threatening the entire country. So that's why we were a bit more challenged than a smaller country with a smaller population, an island that has the capability of responding in a unified manner."
• Because many US cities may be forced to lock down soon anyway simply to protect their hospital systems from collapse, these cities could conceivably use their lockdowns as a necessary prerequisite to suppression, as New Zealand did. "You know, that is something that is being very actively discussed now," Fauci said.
• Fauci confirmed there has already been a noticeable change in America's Covid response, even before the arrival of the new Biden Administration here on January 20. He said transition meetings between the Biden and Trump Covid teams had begun after a delay. "Today I met with a core transition team from the Biden Administration. So we're already seeing co-operation between the Trump Administration and the Biden administration."
• There has been a visible change in messaging, too. Top government experts like Fauci and several others have returned to the talk show circuit. During the campaign, these important medical leaders were rarely seen. Now, expert medical leadership is much more visible. "Well, you know, it certainly appears that way," Fauci agreed. "Because the doctors — myself and Dr Birx and Dr Adams and Dr Hahn and Dr Giroir — seem to be out there more, more exposed and talking about important issues. So that's a very positive thing, I believe. So I think you're on to something. I think you're right. There has been more of a loosening up of the communications to communicate to the American people what they need to do to stay safe."
Dr. Fauci speaks to Dick Brass on ZOOM video. Photo / NZ Herald
• Fauci was "surprised" by the high success rate of the Covid vaccine results. "I have to be honest. I was very pleasantly surprised. I was expecting that at best we would do 70 per cent. I would've loved 75. I didn't imagine we would do any better than 75. I didn't imagine in my wildest dreams that we would get almost as good as what you get with measles, which is the gold standard of efficacy at 97 to 98 per cent efficacy." Test results suggest the Pfizer vaccine will be as high as 95 per cent effective. New Zealand has purchased 1.5 million doses of it.
• Those numbers convince Fauci that we are not likely to be disappointed later. The vaccines will almost certainly work well. "I think that even though we don't know what the durability of the protection is, that it's going to be long enough to at least get us through a cycle or two of seasons. And if we need a booster, fine. But I think the data showing the 95 per cent efficacy and the extraordinary efficacy against severe disease makes me pretty confident that this is really a home run," Fauci told me.
• He had some high words of praise not only for New Zealand's response, not only for President-elect Biden, but also for the Trump Administration's Operation Warp Speed vaccine plan. It funded the development of vaccines and vaccine manufacturing before any approval or demonstration of efficacy, thereby saving valuable months. "One of the things that the United States really got right — and I think it should be a credit to the Trump Administration — was Operation Warp Speed," Fauci explained. "That's a roaring success. We were able to do it because we have a lot of scientific firepower and we have a lot of resources. I don't think New Zealand could be expected to do that. They're a smaller country and they don't have as much resources."
Dr. Fauci has been appointed President-elect Joe Biden's Chief Medical Advisor. Photo / AP
Full transcript:
Dick Brass: So you're staying on? The majority of America that you don't need protection from is delighted. Is this a true thing? Or just a press story that you're going to be staying on?
Anthony Fauci: No, I actually - I think it's important to clarify that I've been the Director of the National Institute of Allergy and Infectious Diseases for the last 36 years. That is a civil service, you know, permanent position. So yes, I'm staying on. But now I've been formally invited in the sense by the Biden team to continue in my position, which I would've expected to do anyway. And we had a very good conversation. It was the first official transition-type meeting. Which was very productive. We spoke about substantive issues like vaccines and communication and the surges we're seeing. And this was a team of people who are the Agency Review Team — ART it's called — which is really kind of like the landing team for the transition to prep the way for the takeover on January 20.
DB: Do you think there's been something of a change in the administration's outward ... position? I noticed for example that last week you, Dr Birx, the Admiral, were all very much in appearance. Dr Atlas has left. We're facing a horrible, horrible winter. Would it be fair to say that something has changed? That there's a new attitude of some sort that's occurring slightly underneath the surface since the election?
AF: Well, you know, it certainly appears that way. Because the doctors — myself and Dr Birx and Dr Adams and Dr Hahn and Dr Giroir — seem to be out there more, more exposed and talking about important issues. So that's a very positive thing, I believe. So I think you're on to something. I think you're right. There has been more of a loosening up of the communications to communicate to the American people what they need to do to stay safe?.
DB: Do you have a lot of familiarity with the New Zealand approach to managing the pandemic?
AF: I do. I wouldn't say a lot but I have discussed it a couple of times with New Zealand authorities and I've interacted with New Zealand press a fair amount. You know, it's a unique situation. It's an island. They have the ability to shut things down and open things up quickly. They have a population that has done very well in listening to the kinds of public health messages that have come from the central authorities. So when you talk about who's done well and who's not done as well, New Zealand always rises to the top as a country that has actually done really quite well.
DB: It's probably the best among western countries?
AF: Yes, I think so. Yeah. Yeah.
Dr Fauci says New Zealand should feel good that they were so successful from a public health standpoint in containing the virus. Photo / NZ Herald
DB: I think Taiwan would be the gold "gold standard" and then among western countries New Zealand the lead? Both islands, I agree. But did you ever contemplate a full suppression or even eliminationist strategy for the virus? Was it possible? Was it discussed?
AF: Everything was discussed. Everything is always on the table for discussion. But the United States? One of its greatest strengths and its beauties is its diversity — geographically, demographically, economically, climate-wise, everything. It's just a large country: 330-plus million people. A very independent, entrepreneurial spirit of doing things the way you want to do it. Not wanting to be told how to do things. That works great under certain circumstances. It doesn't work as great when you're trying to get a uniform response to a pandemic that is threatening the entire country. So that's why we were a bit more challenged than a smaller country with a smaller population, an island that has the capability of responding in a unified manner. So we're obviously very different.
DB: Are we going to have to do lockdowns [in the USA ] in order to preserve our hospital and medical systems in certain cities? And if so, could we not then move toward a more eliminationist strategy as long as we have to do the lockdowns to save the hospitals anyway?
AF: You know, that is something that is being very actively discussed now. Because there are certain cities, certain regions of the country, which are in a very precarious position when it comes to over-running or essentially overwhelming the healthcare delivery system. Where there are more intensive-care patients than there are intensive-care beds in certain cities, in certain towns, in certain regions. That means that you have to at least consider the possibility that in some places in this country they may have to temporarily lock down. We don't want to see that. But that is a possibility if things keep going in the direction they're going.
DB: Are you thinking if you have to do the lockdown anyway, you can then pursue a suppression strategy based on a four-week or six-week [lockdown]?
AF: Yeah.
DB: Take advantage of the fact that you have to lock down to save the hospitals and now lock down to suppress the disease?
AF: Absolutely.
DB: Oh good. Oh. I didn't know this. This is very exciting.
DB: Can we wait until January 20 to begin to implement these policies?
AF: Well, you know, right now I think people need to understand: policies are going to be implemented at the local level anytime, anyplace. It could happen now. It could happen at the end of December. It could happen early January. It could happen after January 20. I mean, you know, California right now is in the process, literally as we speak, of contemplating doing some lockdowns at various parts of the state. So that really doesn't have that much to do [with] what goes on in Washington. The Governor and the health authorities in California have examined their particular situation and are going to be making up their minds about what they're going to do. I think that's the thing people need to understand. I talk to other countries a lot. And they don't fully appreciate how diverse and how independent different elements of our country are. Fifty states can function in a pretty independent way.
Dr. Fauci, in discussion with Dick Brass from ZOOM video. Photo / NZ Herald
DB: Would it be possible for the Trump Administration to co-operate with the Biden Administration in face of the terrible death toll that's likely to occur in the next month or two?
AF: I think you are already seeing co-operation. For example, right now the Trump Administration is allowing the activities of transition. Today I met with a core transition team from the Biden Administration. So we're already seeing co-operation between the Trump Administration and the Biden Administration.
DB: I had a chat last night with Michael Baker, professor at Otago University who I think knows you or at least has met you a few times. But you've met a lot of people. And he was the principal architect of the eliminationist strategy in New Zealand. And one of the things he pointed out was the need, in order to motivate people and keep them focused, for a single authoritative daily spokesperson. Places and venues that have done this, like Bonnie Henry nearby in Vancouver or Prime Minister Arden in New Zealand, the results have been better than when there's been a variety of non-regularly scheduled spokespeople. Is there any chance there will be a resumption of a single daily corona briefing as we head toward the darkest days of this pandemic?
AF: Well, there certainly is that possibility. I don't want to get ahead of anyone and say what the Biden Administration will do. But even here, currently in the Trump Administration we will likely see more briefings from the CDC. They've already started some briefings. They had one the other day. When you have a crisis like this — I know we did that with pandemic flu during the Obama Administration, with Ebola and with Zika — that we would have daily briefings. It wouldn't necessarily be from one person. It would be from one organisation. Like the CDC would give a briefing every day and then there would be several of us, myself included, that would go out and amplify and underscore and confirm what we said at the original briefing.
DB: The thought was that there's a need for that 15 minutes a day from one particular familiar source, in addition to the many different experts fanning out among the talk show circuit. Supposedly, the Prime Minister and Vice-President Biden had a conversation about the virus and working together to help each other. Mostly, I think, New Zealand helping United States at this point. Are you privy to that conversation or about the results of it?
AF: No I'm not. Sorry.
DB: That's an easy one. Why did Scott Atlas leave, if ever I may ask?
AF: I think he signed up for a limited term and the term was over and ended and he left. I think that's what it was. Simple as that.
DB: Is there anything that New Zealand could learn from the United States' experience, except not to do certain things? Are there aspects of things that we've done well that New Zealand might learn from.
AF: No. You know, we are so different from New Zealand in size and resources. That one of the things that the United States really got right — and I think it should be a credit to the Trump Administration — was Operation Warp Speed.
DB: The vaccines?
AF: That's a roaring success. We were able to do it because we have a lot of scientific firepower and we have a lot of resources. I don't think New Zealand could be expected to do that. They're a smaller country and they don't have as much resources. So I can't say they can learn that from us because they're not in a position to have been able to do that because of their size and their resources. I think one can say that New Zealand should feel good about the fact that they were so successful from a public health standpoint in containing the outbreak in their own country. So kudos to New Zealand!
DB: Did the success of the vaccine in terms of its efficacy numbers surprise you? Were you expecting 90-95 [per cent]?
AF: No, I have to be honest. I was very pleasantly surprised. I was expecting that at best we would do 70 per cent. I would've loved 75. I didn't imagine we would do any better than 75. I didn't imagine in my wildest dreams that we would get almost as good as what you get with measles, which is the gold standard of efficacy at 97 to 98 per cent efficacy.
Dr. Fauci was full of praise about New Zealand's on going fight against Covid-19. Photo / AP
DB: Is there any chance that we'll yet be disappointed in the vaccine results? Or is it pretty clear that this is, unlike HIV, this is a virus that can be protected against?
AF: I think that even though we don't know what the durability of the protection is, that it's going to be long enough to at least get us through a cycle or two of seasons. And if we need a booster, fine. But I think the data showing the 95 per cent efficacy and the extraordinary efficacy against severe disease makes me pretty confident that this is really a home run.
• Dick Brass was vice-president of Microsoft and Oracle for almost two decades. His firm Dictronics developed the first modern dictionary-based spellcheck and he was an editor at the Daily News, NY
