Dr. Fauci: Merck Anti-Viral Covid Drug Is An ‘Important Advance’

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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, Friday, October 1st. Following are links to video on CNBC.com:

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Merck Anti-Viral Covid Drug Is An 'Important Advance,' Says Dr. Fauci

Dr. Fauci On Boosters And Monoclonal Antibody Treatments

SARA EISEN: Joining us now to discuss the latest developments, Dr. Anthony Fauci, Chief Medical Adviser to President Biden. Welcome back, it's great to have you Dr. Fauci.

DR. ANTHONY FAUCI: Thank you very much. Good to be with you.

EISEN: So clearly the stock market celebrated this. Groups like casinos and hotels and airlines all rallied, how do you see this antiviral pill being used and how fast can we get there?

FAUCI: Well this is certainly an important advance. There's no doubt about that. Whenever you have an orally administered medical intervention that directly attacks the virus and has the kind of data that Merck & Co., Inc. (NYSE:MRK) announced with their announcement where they had a 50% decrease in the hospitalization. The trial was designed to be given to people early in the course of infection. It's an orally administered drug that's really very important. It was compared to a placebo and the endpoint that does it reduce the risk of hospitalization or death, the results are really quite good. Importantly in the placebo group, there were eight deaths and in the treatment drug group, there was zero death so that adds a bit more of an importance to the study. You asked the question of when can it get approved by the FDA. Well, the company had mentioned that they would imminently literally within a day or so be sending the data to the FDA. So, you've got to make sure you give the FDA the time to very carefully go over the data and make the kind of determinations for emergency use authorization. So, I don't want to get ahead of them. I can't predict when it will be but I can tell you one thing they will do it as quickly as they possibly can so rather than give a deadline know that they are working very hard to get this done in an expeditious manner.

EISEN: The trial Dr. Fauci was done on unvaccinated individuals, is this something that vaccinated individuals will be able to qualify for as the, as the number of breakthroughs continues to grow?

FAUCI: Well, this is a treatment for infection. So, whether you get infected the, following a breakthrough from a vaccination or infected without getting vaccinated, the treatment is for infected individuals. I am not going to get ahead and I shouldn't get ahead of what the FDA will be authorizing it for but I would assume that if you're infected, you're infected, doesn't really matter whether you've been vaccinated or not. I mean a person who's infected would be somebody I would imagine who would be eligible, but again, let's leave that to the regulatory authorities to talk about what the indications would be.

WILFRED FROST: Dr. Fauci, does it, whether significantly or at the margin, lower the need for those who are fighting against getting vaccinated, refusing to get vaccinated, does it reduce the need for them to get vaccinated?

FAUCI: In my opinion as a public health person, absolutely not. It is always better to not get infected than to get infected and rely on a drug to protect you from getting advanced disease. I mean it just doesn't make any sense to say, it doesn't matter I get infected, I get a drug. No drug by any means is 100% effective and look at the study that went into the Merck drug, it’s a quite good result, which is a 50% protection. So, a 50% decrease in the, in the incidence of getting into a severe situation requiring hospitalization and may leading to death. Remember, there were people on the treatment arm who actually did not have a successful result. The best way to avoid getting into a hospital is to don’t get infected. The best way to not get infected is to get vaccinated.

EISEN: Dr. Fauci, you guys have been pushing the vaccine and I obviously understand why. I'm vaccinated but I also have COVID and it spread through my entire family in the past few weeks. That's why I'm doing the show from home today and I just wonder about the public messaging around vaccinations. Three vaccinated people got COVID in my house, two unvaccinated children got it. Are you too casual about the limitations of the vaccine because it does feel to me that these breakthroughs are happening, they're happening regularly, and we haven't really seen the government pay that much attention to them or warn about them too much. The bottom line is we were still able to get it and transmit it. Thank god we're not in the hospital, I get it, I'm vaccinated, but you can get it and transmit it and the government hasn’t been warning about that.

FAUCI: Oh yes I am, we have. And we've said that and let me just give you the science and the facts. If you are an unvaccinated person, you have five times the likelihood of getting infected, 11 times the likelihood of being hospitalized and 11 times the likelihood of dying, compared to someone who's been vaccinated. So, the data showing the benefit of vaccines is incontrovertible. If you look at the people who have died from COVID-19, overwhelmingly 90 plus percent of them are unvaccinated. Vaccination protects you against severe disease and even when you get breakthrough infections because remember no vaccine is 100%, protected, but what we do know is that if you get vaccinated and get a breakthrough infection, you are much less likely of getting a severe outcome. It is much more likely that you in fact would either be without symptoms or be mildly symptomatic so you should not confuse the very important data that we now have a drug that can diminish hospitalization and death by 50%. You should not confuse that with the overwhelming benefits of the protection of vaccines. Those should not be confused.

EISEN: 100%. But it says on the CDC website, Dr. Fauci, that infections happen in only a small proportion of people who are fully vaccinated and when these infections occur among the vaccinated, they tend to be mild, but the CDC doesn't even track the breakthrough infections. So how do we know that they're happening to a small proportion and how do we know that they are tending to be mild? It's not a question of whether hospitalizations and death, we know that benefit, it's just public messaging and being transparent about the risk for vaccinated people.

FAUCI: Well, in the past, the CDC has not, you're quite correct, tracked all real and potential asymptomatic infections. They are modifying that right now in the studies that are being done that would give the kind of information that you're talking about. Also, it's very important to know that with the booster rollout that we've been talking about, we are anticipating that we will get an extra added boost in the sense of clinical effect. The Israelis themselves are now showing very, very clearly, that when you give a person who's received two doses of an mRNA in this case, Pfizer, when you give that person a boost, you dramatically diminish the infection, you dramatically diminish the likelihood of getting a severe outcome, and importantly, there are early data that are now showing that you actually begin to show a diminution in the transmission itself. So, in answer to your very appropriate question about if you get vaccinated and you get infected, is there less of a chance that you will be transmitting it to someone who is unvaccinated or someone who is vulnerable, the chances of doing that are diminished by being vaccinated and even further diminished, according to preliminary data we'll wait to see the real fundamental core of the data, but it looks like that extra added of protection from a boost will be very valuable. Again, we're talking about data that's being rolled out in real time and that's why when I'm using terminology that we're having strong suggestions, we want to wait until we get a lot of data to be able to say that with a degree of confidence.

FROST: So on that, on that note, Dr. Fauci, I mean, how close are we to having clear guidelines, being given clear guidelines on what boosters people should take and when because as I understand it, there is data that you've seen on Moderna and mix and match in terms of which booster people should take, but we haven't seen it yet so what's the timeline there?

FAUCI: Okay, that's a really good question. The timeline is as follows. We have conducted at my institute, a nine part grid study in which we looked at the three vaccines that have been either approved or giving an EU, J&J, Moderna and Pfizer. And we've given as a third boost either Moderna to those groups or J&J to those groups or Pfizer to those groups. The data on the Moderna boost have already been looked at, given to the company and analyzed. The data to the J&J as a boost actually I believe is finished right now and also being analyzed. The data from the Pfizer as the boost will likely be available in the next couple of weeks and when I say available, I mean the data will be given from a clinical trial list to the companies. The companies will then go over their data and make a decision of submitting it to the FDA for their regulatory approval. So, the only thing I can give you is a timeline, which is what we’re responsible, we being the clinical research community and the NIH, is get that data to the company. That is again, to repeat, part of it is already at some of the companies and the other will be available to the company literally within a week or two.

FROST: Wow. Well we look forward to getting past that, that date and maybe that being shared once it's, once it's submitted to the FDA. My other question Dr. Fauci was how confident, I asked you about this last time a month or two ago, how confident you are now that Delta will prove to be the worst variant that we face of this and a two-part question, to what level you're worried about the weather getting colder and it kind of pushing socializing and all the other related factors indoors?

FAUCI: Well I'll give an answer that's totally consistent with what I've said before that the likelihood of there being something worse is totally within our own domain and our own capabilities. We have 70 million people in this country who are eligible to be vaccinated who have not been vaccinated. The more people that we get vaccinated, the less likelihood there will be the opportunity of the emergence of another variant. Delta is a variant whose characteristic predominantly that's allowed it to dominate has been its extraordinary capability of transmitting from person to person. If we allow the virus to freely circulate, particularly among unvaccinated people, you give the virus a greater opportunity to mutate to the point of possibly getting a variant that would be troublesome even in the context of our vaccines. Why it's so important not only for the individual to protect themselves, their family and their environment in the sense of their social interactions, but it's really important for the entire program of getting this virus under control, not only here in the United States, but also our responsibility, I believe and we're doing a lot in that regard, we're doing more than all the other countries combined, is to get doses of vaccine to the rest of the world, particularly the low- and middle-income countries, so that we don't have virus circulating there that can then evolve into a variant of concern.

EISEN: Yeah because that's where they've come from. My final question, Dr. Fauci, also has to do with my experience over the last few weeks. I have a whole new perspective. And, and that is a question about monoclonal antibodies. I feel like there has been almost zero public health guidance on this, on who can receive them, on when people can receive them on how they can receive them. I mean the best I found out is you basically have to go to an ER and see whether they're only giving it to 65 and older, or high risk, or whether you can get it as a vaccinated infectious person. I don't think people know that you have to get it within the first 10 days and there's just lots of stories about these, these treatments being underused and I just wonder why that hasn't been promoted more as a tool transparently by the administration beyond just telling people to get vaccinated.

FAUCI: Yeah well, I did a special press conference several weeks ago in which the topic of my presentation was the importance of the utilization of monoclonal antibodies, that's the first thing. The second thing, they are being so utilized now that the supply is trying to keep up with the demand. So, there is a major increase in the utilization of monoclonal antibodies. And if you want information about that, it's a click away. Go to NIH.gov and search on the NIH treatment guidelines and you will find delineated there, the precise recommendations and utilizations for monoclonal antibodies.

EISEN: But who should get them? Only high-risk people who have been infected?

FAUCI: Well, according to the guidelines, it is individuals who would be at high risk but right now there's a lot of good data coming out in other areas including pre-exposure prophylaxis, that is all delineated in the treatment guidelines so if you or others feel you want to learn about that it really is a click away. Just go to NIH.gov, type in search treatment guidelines.

EISEN: No, I think that people should. Dr. Fauci, it's great to have you. Thank you so much for coming on and taking all our questions.

FAUCI: Alright, good to be with you. Thank you for having me.