Photo courtesy of the National Institute of Allergy and Infectious Diseases

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to President Biden, sat down for an interview with Jeanne Pinder, founder and CEO of ClearHealthCosts, a partner with Epicenter-NYC in the Vaccine Equity Partner Engagement grant program with the Fund for Public Health of New York City. 

The following has been edited for clarity.

Jeanne Pinder: If we wanted to encourage vaccine uptake, what are the best ways to fight against this “the pandemic is over” messaging?

Dr. Fauci: Well, I think it’s by getting the correct information out there. It’s understandable that people want to put the outbreak behind us. Everyone is fatigued with this almost three-year journey that we’ve all been through —  a very difficult journey. I think it’s the question of doing what you and I are doing right now. And what so many people are doing —  by getting people to understand the reality of where we are.

We’re doing much better now than we were several months to a year ago when we were getting 800- to 900,000 infections a day nationally, and 3,000 to 4,000 deaths. Now we’re down to 40- to 50,000 cases a day and about 350 to 400 deaths per day. Even though that’s much better than where we were before, it is still an unacceptably high number of deaths per day. That’s like one and a half jumbo jets each day crashing. 

We’ve got to stay out there, you and I and everybody else, telling people you don’t want to panic. But you don’t want to be cavalier and say, ‘It’s all over, and we don’t need to do anything.” Because there are things we can do, particularly getting the unvaccinated people vaccinated and getting people who are vaccinated and not yet boosted to go get their boosters, since we have a very good updated bivalent booster that’s directed against the major variant that’s out there. So there are a lot of things we can do.

Jeanne Pinder: The administration has relied on pharmacies for much of the vaccine rollout, and will continue to do so. Have you given thought to allowing walk ups or methods of scheduling that are not tethered to their online scheduling systems? We’ve seen with our own vaccine and now testing van in Queens that there are a lot of cases in our immigrant neighborhoods of people who are turned away and told to go register on a site — or encounter limited hours at these sites with onerous work schedules as essential workers perhaps.

Dr. Fauci: Yeah, there is a major effort that President Biden actually initiated the day before yesterday, when we were down at the White House with him at the time he got his booster shot. We spoke to the CEOs of four major pharmacies, speaking about what they can do to be more flexible. 

First of all, they’re doing a good job. I mean, a lot of what we’re getting done is getting done through the pharmacies. So they are really very important in our effort. But the President was encouraging them to do even more—to be more flexible in allowing people to more easily get vaccinated, as well as a number of other efforts in the community to make sure we do it in a user-friendly way. It’s got to be done in a way so that people don’t have to jump through hoops to get a vaccine. We’ve got to make it as easy as possible. So we’re very aware of it and the President himself is promoting that. I think it’s going to improve.

Jeanne Pinder: Why are white people now the largest unvaccinated group? In New York City, we also continue to struggle in some parts with young Black men not being vaccinated. What becomes of the unvaccinated in this next version of the rollout?

Dr. Fauci: This is a reflection, unfortunately, of the political divisiveness we have in our country. Because if you look at the map of the country and look at the red states, versus the blue states, the red states, which are Republican states, are much more under-vaccinated than the blue states. And as you know, the demography of the red states in the Republican areas is predominantly white individuals. And whereas it’s not the case, if you look at the blue states, it should never be that a person is vaccinated or not vaccinated on the basis of their political ideology. But that seems to be the case. 

And that’s just not an opinion. It’s an unfortunate reality. And that’s why we would like very much to get as many people vaccinated as we possibly can, regardless of what their political ideology is, and regardless of their race or ethnicity or gender or whatever it is. They need to get vaccinated.

Jeanne Pinder: Along that line, we hear that the vaccine soon will no longer be free, that people will be charged for them. That puts yet another barrier between people and vaccines when we already have resistance, even with free vaccines. So how does that square with good public health policy — charging for vaccines?

Dr. Fauci: Well, I mean, you know, it’s a necessity, you’re going to have to switch over to commercial sometime. And the decision was to do it now. But as you know, also with that, there’s been a big push on the part of the government to make sure insurances cover that, and the under- or uninsured have some pathway to get vaccinated for free. So even though it’s going to be commercialized, as it were, there’s still going to be a lot of avenues of people getting it either through their insurance or through certain mechanisms for the under- or uninsured.

Jeanne Pinder: In that vein, we also heard that the money for testing is running out. At our Covid testing van in Queens, we hear a lot of people say, there’s no place to get tested for free, I have to get tested and you’re the only place that I can get tested for free. So people are finding themselves in a position where they’re not getting tested because they have to pay for it. That seems to us to be bad public health policy.

Dr. Fauci: It can be corrected by getting Congress to give the resources that the President is asking for. And again, another point he made in his briefing at the time of his booster vaccination a couple of days ago, is that we are running out of money to do the things we need to do at the community level, including free testing, as well as a variety of other services that we formerly had enough resources for. What we need now is to get relief from Congress to appropriate money that the administration is asking for.

Jeanne Pinder: Is Congress going to do that?

Dr. Fauci: I hope so. I hope they hear our conversation.

Jeanne Pinder: There’s also a lot of mixed messaging on masking. We think that masking should actually be something that’s more pervasive. We’ve noticed that people are starting to ask for masks again, as the surge comes on. People are more willing to wear masks, but there’s still mixed messaging on that. Can you speak to that?

Dr. Fauci: The message shouldn’t be mixed. It’s that masks are generally not required, or mandated. But under certain circumstances, they’re recommended. So that if you are in a congregate indoor setting, and you are in an area where there is clearly a higher degree of infection dynamics, it is recommended you wear a mask. If you are a vulnerable person, or you live in a household with a vulnerable person, even if the level of infection is not high, you might want to go the extra step to protect yourself and members of your family.

What people get confused about is what’s required or what’s mandated. We’re not talking about mandates. That’s a radioactive word for so many people. We’re talking about common sense. So if you’re an elderly person, you have an underlying condition, you have someone at home who is on cancer chemotherapy — or if you’re in a crowded indoor place, wear a mask. It makes good sense.

Jeanne Pinder: Last question. Why do you think long Covid has been lost in the national conversation?

Dr. Fauci: Well, it hasn’t been lost in the conversation that we at the White House, and the President’s team are talking about. We’re very well aware of long Covid. We have a number of programs. One led here at the National Institutes of Health, our RECOVER program. One at the CDC, and the Assistant Secretary for Health, Admiral Rachel L. Levine, MD, is a major player in the activities in long Covid. It is right at the very top priority.

There are about 7 to 20 million people in this country who have been infected, who have persistence of symptoms, several weeks to months beyond the acute infection. And of those, one million of those people are incapacitated enough that they cannot work. So we’re very well aware that the public may not be talking a lot about it. But we certainly are very well aware of it.

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Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York...

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