Dr. Anthony Fauci On Vaccine Messaging And CDC’s Isolation Guidance

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Following is the unofficial transcript of a CNBC interview with National Institute of Allergy and Infectious Diseases Director & White House Chief Medical Advisor Dr. Anthony Fauci on CNBC’s “Closing Bell” (M-F, 3PM-5PM ET) today, Wednesday, December 29th. Following are links to video on CNBC.com:

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Dr. Fauci Says CDC's Isolation Guidance Was Made With Science As The Driving Force

Dr. Fauci Defends Vaccine Messaging And Discusses When Omicron Surge Could Peak In U.S.

SARA EISEN: The seven-day average of COVID-19 cases, increasing nearly 73% over the week hitting a record of more than 260,000 cases. Meantime, the seven-day average of hospitalizations hitting its highest level since back in October but some good news out of South Africa and Britain. Data from those studies of those countries showing a reduced risk for hospitalization with the Omicron variant compared to Delta. Here to break it all down is White House Chief Medical Advisor Dr. Anthony Fauci. Dr. Fauci, welcome back to the show. It's good to have you.

DR. ANTHONY FAUCI: Thank you. Thank you for having me.

EISEN: I did want to begin with the new CDC guidance around isolation, cutting the time for COVID positives to five days from 10. Obviously huge issue for business as they try to get people back to work and I've listened to some of your interviews and the CDC director’s interviews about why this decision was made and I still think there's some confusion and questions that I was hoping you could address, Dr. Fauci, about whether this decision was made based on the medical research, the studies, the science and keeping people safe.

EISEN: Well, certainly that's the primary reason why you make any decision related to public health. The CDC decision was made on the basis of the fact that when you have an asymptomatic person, the standard prior recommendation or guideline was to keep people isolated for 10 days. When you're dealing now with an outbreak with a volume of new cases is very disruptive of society. You just gave a moment ago showing that about 30% of the New York City fire force is out sick that we need to keep society running in the sense of there are many other deleterious effects, health wise effects if society is crippled in the sense of being functioning to keeping critical things going. So, in order to address that, they looked for a balance between what is safe and scientifically based and what can get us to keep society running. And it was felt that if you look at the likelihood of there being spread of infection from an infected person in the first five days is much, much more risky as you get into the second half of the 10 day period, day 6, 7, 8, 9, the chances of transmitting is very, very low. And for that reason, the decision was made to strike a balance, keep people isolated for five days and if they remain without symptoms to go back to their normal function with the absolute requirement of wearing a mask at all times for those second five days of the 10-day framework.

EISEN: And not have to take a test and I know there's been a lot of criticism and a lot of health professionals, Dr. Fauci, have come out and said it should have included a negative test after that fifth day and I know you addressed that the antigen test we just don't know how accurate or precise they are after five days but would you feel comfortable sitting next to someone in a meeting that after five days still test positive on a rapid antigen test for COVID?

FAUCI: You know, nothing is risk free when you're dealing with COVID but the risk is extremely low and as the CDC director said at the press conference today, if you look at the predictive value that you might act on and result, it is not a predictive value that you can act on. Because if it's negative, it doesn't really necessarily tell you whether you're transmissible or not and if it's positive, we don't know what that means for transmissibility. So, if the end game is to prevent transmissibility in that second half of the 10-day period, wearing a mask consistently is the best way to do that.

WILFRED FROST: You mentioned the CDC director there, Dr. Fauci. I mean, Dr. Walensky also said that the shortening of the quarantine period quote, “Really had a lot to do with what we thought people would be able to tolerate,” end quote. Was that comment a mistake? Does it suggest that you're no longer being guided just by the science?

FAUCI: No, what Dr. Walensky was referring to is that when you want to get effectiveness of a particularly intervention, there are a lot of considerations. You always make science the major driving force, but you have to have a situation where people will be doing what it is what you want them to do and what's best for them. So, science is always the dominant driving force but she was referring to other considerations such as many people even when they know they're infected don't isolate. So, what she was saying, let's have a balance of making sure the science is solid but something that people will be able to implement. That's what she was referring to.

FROST: Switching focus a little bit, Dr. Fauci, I wondered whether you felt there had been a communication error from government officials throughout this pandemic by suggesting initially that the primary reason to get vaccinated was to prevent you getting COVID at all as opposed to reducing the severity if you do or when you do catch it and whether we're now in rather an awkward position given that earlier comms that so many people are catching COVID whether they've been, if they have already received the vaccine even if they've received the booster, it kind of puts quite an awkward spin on things now.

FAUCI: Well, I think it was the question of what people interpreted. If you looked at the clinical trial, the tens of thousands of people in the original clinical trials, for example with Moderna and Pfizer, the primary endpoint that led to the 94% and 95% efficacy in those trials was prevention of symptomatic disease, not prevention of infection. So, although you're absolutely correct, there was a lot of people understandably felt that I’m not going to get infected at all. The primary reason is to prevent you from getting symptomatic disease, but importantly, to prevent you from getting serious disease. Now that could have been done better communicating to the public, I admit, but that is where we stand. The goal is to make sure people don't get sick, getting a positive test and being asymptomatic so long as you don't spread it to someone else is a reasonably good outcome of getting vaccinated when you don't get sick.

FROST: Thus Dr. Fauci can you understand why some people are anti-vaxxers? Given how they first understood the communication and the results that you see today. Can you, can you understand—


FROST: How it's possible for some people to have reached, reached that conclusion whether, whether it was incorrect interpretation of your messaging in the first place or not?

FAUCI: I would have to beg to differ with you. I believe when you look at the people who are anti-vax, they are fundamentally anti-vax saying, I don't want anybody to tell me what I can do with my body. It is not because there's a difference between getting infected and getting symptoms. I'm very sorry, sir. I would have to disagree with you on that. If you go and do a survey of anti-vaxxers, they don't tell you that's the reason why they don't want to get vaccinated. They tell you they don't want to get vaccinated because they're fundamentally against vaccination, particularly when the government tells you it's something that you should be doing.

EISEN: In the meantime, here in New York City, I can't find a test still in the drugstores and this is obviously a big problem that's spreading around the country. I know you guys are working to address this. What I think is a question though Dr. Fauci is, how are we this unprepared two years into the pandemic when we have known from very early on that testing is such a critical part of controlling this pandemic?

FAUCI: Well, you know, when, when a year ago, in the beginning of the administration, there were no rapid tests, zero. Now there are eight and likely will be nine and 10 soon. But your point is well taken. We have a rush now on tests that in some respects is a good thing because we want people to get tested. But you're right, we need to do better. It will get much, much better in January where there will be 500 million tests available within the first couple of weeks in January, followed by the availability of 200 million to 500 million tests per month, together with about 10,000 testing centers, as well as the ability to go online order a test and have it be delivered to your home free. So right now, at this moment, we're not where we want to be for sure. But this is going to change pretty quickly as we go into January.

EISEN: Also, wanted to ask you about another key topic for business and the economy, getting it open and controlling the spread which is this potential of a domestic travel vaccine mandate. It’s something you've talked about. It was shot down a little bit by the CDC director recently. Where are you on recommending that to President Biden, why wouldn't you recommend that at this point?

FAUCI: Well I think, why don't we get it straight, nothing was said and nothing was shot down. Here's the situation. When you talk about different interventions, one of which would be a requirement for vaccination for travel, I had said and I'll say it again to you for clarity, that that is something that is on the table that we consider. We consider all possible interventions and to whether or not it's appropriate to make that implementation of that intervention. If things change and the situation changes that would warrant making requirement on a plane domestically being a requirement and the data shows that that would be helpful, we would do it. Right now the most important way to keep yourself safe on a plane is to wear a mask, which is actually a requirement on a plane. That's very different from a requirement internationally with a fundamental reason for having people have a requirement for a vaccination when they want to enter the country is to keep out of the country infected people particularly who might be bearing a new variant. So there really is a difference between international and domestic in the fundamental reason why you do or do not require a mask.

FROST: Dr. Fauci, I wanted to ask what your take was on the way in which Omicron is clearly spreading fast and daily case numbers are very high, even in the countries that have taken more stringent lockdown measures that during this latest spike, Continental Europe I guess is a particular example. Does it make you reassess the effectiveness of lockdown, stringent lockdowns as a tool to contain not just this spike, but any potential future spike?

FAUCI: Well, first of all, let's make it straight. We are not contemplating a lockdown. And I think when you look at countries that so-called lock down, the lockdowns are not really complete. I don't know of any country right now that unless there is, you know, one or two exceptions that are completely locked down, they're making restrictions greater but not completely locking down.

EISEN: A new study Dr. Fauci out of South Africa indicated that Omicron could displace Delta and, and likely has immune protection or antibody protection against Delta. If that proves to be true, how likely is it that this surge that we are seeing right now of Omicron in the US could ultimately result in the end of the pandemic?

FAUCI: Well, I would hope that that's the case. There's no guarantee that that would happen. But if you have a very transmissible virus that replaces another virus and that virus has less of a degree of severity, that would be a positive outcome, but you can never guarantee. This virus has fooled us before. Remember, we thought with the vaccines, everything was going to be fine and along came Delta, which threw a monkey wrench into everything. Then we were going along with Delta and then we have a new variant of Omicron. So, although we're pleased to see that the results from South Africa and now the UK and to some extent in our own country, that it appears to be less severe and we would rather have a less severe situation than one in which there is a great degree of severity, what you say is possible that that would happen. But there's no guarantee that that would mean the end of a serious outbreak. I hope that's, that's what's being foreshown that right that we're going to be seeing that—

EISEN: Me too.

FAUCI: Yeah, hope so but can't guarantee it.

EISEN: Any sense of when this is going to peak? This surge?

FAUCI: You know, it's tough to say it's certainly peaked pretty quickly in South Africa. It went up almost vertically and turned around very quickly. I would imagine given the size of our country and the diversity of vaccination versus not vaccination, that it likely will be more than a couple of weeks, probably by the end of January I would think.

EISEN: End of January. Alright, Dr. Fauci, thank you for joining us with an update.

FAUCI: My pleasure. Yeah, good to be with you.

EISEN: Appreciate the time.