While COVID-19 continues to confound the nation’s best efforts to contain it, the country’s leading scientific expert on the pandemic expressed confidence that SARS-CoV-2 variants can be addressed through vaccination.

What doctors wish patients knew

Keep patients up-to-date on how to safely navigate the pandemic with insights from physician colleagues in this special edition of AMA Moving Medicine.

In a freewheeling 45-minute conversation, Biden administration Chief Medical Adviser Anthony S. Fauci, MD, also discussed the need to end the “stunning” divisiveness that has hindered pandemic-control efforts, and he explained how vaccines could bring herd immunity despite the variants.

“I have never seen anything like this particular virus, in its complexity and its ability to elude what we're trying to do to contain it,” said Dr. Fauci, longtime director of the National Institute of Allergy and Infectious Diseases.

He spoke during an online program entitled “COVID-19 Action in the Biden Era: A Fireside Chat with Dr. Fauci,” sponsored by the COVID Collaborative, an organization that has brought together experts in health, education and the economy to support state and local leaders in battling the pandemic. The group has also partnered with the Ad Council on a vaccine education campaign.

AMA Executive Vice President and CEO James L. Madara, MD, is on the collaborative’s national advisory council. The council’s co-chairs Dirk Kempthorne, a Republican and former Idaho governor, and Deval Patrick, a Democratic former Massachusetts governor, moderated the program.


Kempthorne noted that there are skeptics who don’t want to wear masks or get vaccinated and believe the death toll is overstated because they believe many died from their underlying comorbidities and not from COVID-19.

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“It is definitely real,” Dr. Fauci replied. “When you look at the deaths and the cases and the hospitalizations, it's like nothing we've ever seen before.”

“The idea of thinking that this is a hoax is stunning to me,” Dr. Fauci said, adding that this thinking exists in areas where hospitals are overrun and the need for intensive-care beds is more than double the capacity.

“Even in that setting … they still think it's a hoax,” he said. “They think it's fake news.”

This has added to the persistence of the pandemic, Dr. Fauci said, because “if ever there was a time when you needed everyone to be uniformly pulling together,” it would be during a pandemic.

The good news has been on the vaccine front.

“The ultimate control of pandemics of this type will always rest in the development of a highly effective and safe vaccine,” Dr. Fauci said. “We do have at least two, going on three—and probably closer to four or five in the United States alone.”

The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee will meet Feb. 26 to discuss emergency use authorization for a COVID-19 vaccine from Janssen Biotech Inc.

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SARS-CoV-2 continually mutates, with most of these mutations not having any “functional relevance,” Dr. Fauci said. “But every once in a while, a combination of mutations occur that create what's called a ‘variant’ or a ‘new lineage,’ which does have functional consequences.”

These include the B.1.1.7 variant first identified in the United Kingdom and the B.1.351 variant that emerged from South Africa that are more transmissible than versions for which vaccines were developed.

While existing vaccines may offer less protection against infection from these variants, the Pfizer-BioNTech and Moderna vaccines still protect against severe disease that could result in hospitalization or death, Dr. Fauci said.

He noted, however, that a booster shot may eventually be required to specifically address these variants. But that shouldn’t require a major retooling of vaccine production and may not be necessary if vaccinations are done quickly and public health measures are maintained.

Stay updated with the AMA on COVID-19 and vaccine development.

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