The U.S. remains “right in the middle of the first wave” of the COVID-19 pandemic, with national case counts hovering around 50,000–60,000 per day and more than 1,000 people dying daily, Anthony S. Fauci, MD, explained during a JAMA Network™ livestreamed video interview.

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“We’ve got to get those numbers down,” stressed Dr. Fauci, a member of the White House coronavirus task force and director of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID). “If we don’t get them down, we’re going to have a really bad situation in the fall ... as you get indoors and you get the complications of influenza season.”

The goal is to get the daily nationwide caseload below 10,000 before September. In the interview with JAMA Editor-in-Chief Howard Bauchner, MD, Dr. Fauci detailed these five keys physicians should be stressing with patients to protect themselves, their families and their communities from the deadly, contagious respiratory illness.

“We need, as a nation, to show a degree of consistency of everybody” following public-health recommendations on wearing masks or other face coverings, said Dr. Fauci.

“What we need is to get the message across that we are all in this together. And it’s important because one of the purposes of the masks is that if you may be inadvertently walking around not knowing you’re infected—to protect others from getting infected,” Dr. Fauci said. “We have to keep hammering home with that message.”

Dr. Fauci said he’s “very pleased to see the president is wearing masks more often now,” and added that Vice President Mike Pence “wears masks when he goes out and is in situations where masks are needed.”

The nation “needs more of that consistency,” he said. The goal, Dr. Fauci added later in the interview, should be “universal wearing of masks.”

Learn from AMA President Susan R. Bailey, MD, about why it’s time to #MaskUp.

Coronavirus Q and A with Anthony Fauci, MD

A major of vector of the surging case counts has been crowded spaces—large house parties or nightspots, for example—where people gather and can easily spread COVID-19.

“You want to stay away from places like bars where people congregate—and in some places you’re even seeing authorities closing bars,” he said.

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Wearing masks and avoiding crowds are two keys to stopping COVID-19’s spread, but even smaller gatherings can be a problem if physical distancing of six feet or more isn’t observed.

The emerging evidence is clearly showing that “outdoor is always better than indoor if you want to do any kind of a function,” Dr. Fauci said.

Keeping your hands clean is essential because of how often people touch their faces or rub their eyes, giving virus particles their pathway into the body.

“That sounds really simple. It’s not rocket science, but it can really be effective,” Dr. Fauci said. “It’s in our hands. ... You have the dynamics of the virus which, if left to its own devices, will keep resurging. The only way to stop it is what we do as a countermeasure. It can be done.”

Dr. Fauci added that these recommendations are reinforced by new information emerging about how SARS-CoV-2 may be transmitted through the air.

“We usually say that regular particles from coughing and sneezing that are greater than 5 micrometers fall to the ground within three to six feet,” Dr. Fauci noted. “But what you find out from aerosol particle scholars is they say, ‘You know, there are particles that are larger than that that are floating around a lot longer and don’t always fall to the ground.’”

The notion is “something we need to reexamine,” Dr. Fauci said, noting that he and his colleagues are looking to learn more from these scholars about SARS-CoV-2 airborne transmission.

“The one thing it really does tell us that you really better wear a mask,” Dr. Fauci said. “It also tells us something about the indoors versus outdoors. It tells us something about the circulation, or recirculation, of air. If you have any degree of aerosolization, then if you’re in an indoor space where the air is being recirculated it makes sense to assume that that is a much greater risk than if you are inside.”

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The whole issue, as with so many other elements of the emerging science of COVID-19, is “something we have be humble about as new knowledge” emerges, Dr. Fauci said.

These two articles published in JAMA shed further light on the matter:

Subscribe to the “Conversations with Dr. Bauchner” podcast. Each week, he interviews leading researchers and thinkers in health care about their recent JAMA articles. Go beyond an article recap, and delve into the background, context and implications of the study or editorial.

You can stay up to speed on the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network, the Centers for Disease Control and Prevention, and the World Health Organization.

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