Dr. Fauci "not naming names", but clearly not pulling punches. Thinks strategy of protecting nursing homes alone exposes large proportion of susceptible Americans at risk for severe infection.
Gov't has bought 150 million of the rapid Abbott antigen test, will be distributing to schools etc.
Trials ongoing testing remdesivir vs. remdesivir plus. 
News trials for antibody treatments
Unprecedented collaboration in vaccine development. Common DSMB, shared protocols and trial infrastructure.
3 in Phase III.
"By Nov/Dec, we will know we whether we have effective vaccines." Nothing guaranteed, but trials over > 2/3 enrolled.
3 in Phase III.
"By Nov/Dec, we will know we whether we have effective vaccines." Nothing guaranteed, but trials over > 2/3 enrolled.
Thousands of questions rolling in on Zoom per MGH Chief of Medicine @katrinarmstrong.... but a large number just wanting to thank Dr. Fauci for his incredible service.
Fauci: The wide variation in presentation (40-50% of asymptomatic indviduals) unlikely related to differences in immune responses.
Believes it is more likely related to heterogeneity in the relative density of ACE-2 receptors.
Acknowledges this is really not known.
Believes it is more likely related to heterogeneity in the relative density of ACE-2 receptors.
Acknowledges this is really not known.
"I don't talk about second surges because we're still in the first surge."
On influenza season: In Australia, "they've had the lightest influenza season in memory" - due to masking/distancing/vaccination. Hopes we see that here as well.
On influenza season: In Australia, "they've had the lightest influenza season in memory" - due to masking/distancing/vaccination. Hopes we see that here as well.
"This has really been like a depressing game of whack-a-mole. I think we need to hunker down and get through this fall and winter"
Thinks we'll get a vaccine by Jan/Feb and that will be our exit.
Thinks we'll get a vaccine by Jan/Feb and that will be our exit.
@RWalensky: distribution of vaccines won't be trivial.
- Some require multiple doses.
- Some require substantial cold chain
- Critical to ensure trust in a "vaccine-hesitant society"
- Challenges of distributing in vulnerable communities
- Some require multiple doses.
- Some require substantial cold chain
- Critical to ensure trust in a "vaccine-hesitant society"
- Challenges of distributing in vulnerable communities
Fauci:
- Local public health systems have deteriorated over decades.
- Supply chain and distribution being put in hands of military which is atypical - usually a CDC job.
- Concerned about getting the vulnerable groups vaccinated, but they are not the ones getting into trials.
- Local public health systems have deteriorated over decades.
- Supply chain and distribution being put in hands of military which is atypical - usually a CDC job.
- Concerned about getting the vulnerable groups vaccinated, but they are not the ones getting into trials.
Fauci:
- Low enrollment of African Americans in trials thus far.
- Surveys showing large number not wanting to get vaccinated are disturbing. Have our work cut out for us to build trust.
- Low enrollment of African Americans in trials thus far.
- Surveys showing large number not wanting to get vaccinated are disturbing. Have our work cut out for us to build trust.
On sports leagues:
- Baseball - tried hard to do it right. Have had challenges, pleasantly surprised they are still playing, but sad National's are in last place.
- Sports important to the American psyche. Thinks "bubble strategy" should be effective to allow it safely.
- Baseball - tried hard to do it right. Have had challenges, pleasantly surprised they are still playing, but sad National's are in last place.
- Sports important to the American psyche. Thinks "bubble strategy" should be effective to allow it safely.
Lessons:
@DrAnthonyF: Humility is the theme.
- Don't ever underestimate a pandemic.
- We can do ethically sound research DURING an outbreak. Controlled clinical trials are needed.
@DrAnthonyF: Humility is the theme.
- Don't ever underestimate a pandemic.
- We can do ethically sound research DURING an outbreak. Controlled clinical trials are needed.
(cont)
- Need to be mentally flexible, guidelines can change based on data that evolves. We don't know all at the start
- Need to make a commitment to address social determinants of health now. Has to be a catalyzing event for this.
- Need to be mentally flexible, guidelines can change based on data that evolves. We don't know all at the start
- Need to make a commitment to address social determinants of health now. Has to be a catalyzing event for this.
Public accessible resources and all talks in the HMS Grand Rounds series on #COVID19 can be found here. See links below provided by @EileenEReynolds
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