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Mark Zuckerberg Tells Fauci He’s ‘Disappointed’ by U.S. on Covid-19 — Transcript

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0:00peak and they locked down they locked
0:03down to the tune of about 90 to 95% of
0:06the country truly locked down so they
0:09went up and then they came down to
0:11baseline then when I say baseline I mean
0:15literally handfuls of new cases tens
0:18twenties 30s not hundreds and thousands
0:21when if you look at the United States as
0:24a whole when we went up and peaked and
0:27started to come down we never really
0:29went down to baseline we plateaued at
0:32around 20,000 cases a day each day until
0:36we got into the resurgence which then
0:38came back up to 30 40 50 and 60 so
0:42because of that would I think we need to
0:44do and my colleagues agree is that we
0:47really got omus regroup call a timeout
0:50not necessarily lock down again but say
0:54we've got to do this in a more measured
0:56way we've got to get our arms around
0:58this and we've got to get this control
1:00if we don't do that mark we're gonna
1:02wind up getting a situation where in
1:04other states we may be seeing the same
1:07thing so it's a mixed bag in this
1:09country some areas doing well but some
1:12really we've got to really pay attention
1:13to and do something about it
1:17alright well doctor I strongly agree
1:20that we need somewhat of a reset here
1:23you know is someone running a business
1:25now I've said that I believe the best
1:29way to improve both public health and
1:31economic opportunity in this country is
1:33to focus on beating this virus first and
1:35I also have to say I think you might be
1:39quite generous in your description of
1:41bomb of the the government's response
1:44here I'm you know I was certainly
1:45sympathetic early on when it was clear
1:47that there would be some outbreaks no
1:49matter how well we handled this but you
1:52know now that we're here in July I just
1:55think that it was avoidable and it's
1:58really disappointing that we still don't
2:00have adequate testing the credibility of
2:03our top scientists like yourself and the
2:06CDC are being undermined then until
2:08recently that parts of the
2:11administration we're calling into
2:12question whether people should even
2:13basic best practices like wearing masks
2:16but but look the u.s. is a resilient
2:19country with a lot of ingenuity as you
2:21say and we can't forget the u.s. is
2:23helping to lead the way on that scene
2:24research which I want to make sure we
2:25get to in a bit and also get that our
2:28understanding of facts changes as time
2:30goes on and we all the opportunity to
2:32reassess what we've learned and change
2:35course going forward and you know I know
2:37I tried to do that personally and I hope
2:39that we as a country can do that now -
2:41and I know that you've also faced some
2:44critique that your guidance has evolved
2:47as we've learned more so I'm hoping that
2:50you can tell us a bit more about how
2:52your understanding of what we should do
2:54has evolved and maybe some of the areas
2:57where where your guidance for people
2:59around the country has changed yeah I
3:02mean obviously when you're dealing with
3:04with with something that's changing in
3:06real time mark that's really the nature
3:09of science you you look at the data and
3:12the information you have at any given
3:13time and you make a decision with regard
3:16to policy based on that information as
3:18the information changes then you have to
3:22be flexible enough and humble enough to
3:24be able to change how you think about
3:26things and I think you know one of the
3:28important things that were emphasizing
3:30right now that really evolved from a
3:35situation that did change is our
3:37insistence now on wearing masks I mean
3:41masks are very important they protect
3:44you from giving infection to someone
3:47else if you happen to be inadvertently
3:49infected and I'll get back to that in a
3:51moment because there's such a
3:53significant percentage of the cases that
3:56are actually without symptoms so anyone
3:59at any given time could be infected
4:01don't even know it and feel perfectly
4:03well so you have a responsibility
4:08you can get protected now early on when
4:11we were in a situation in which there
4:13was a real concern about the lack of
4:15personal protective equipment on the
4:18part of the health providers who needed
4:21it who put themselves in harm's way
4:23every day to take care of people who
4:27were ill with this virus that we were
4:30thinking we would run out of masks and
4:32other things for them so the
4:33recommendation was not to wear a mask
4:36because of the shortage of it two things
4:38happened one it became clear that we had
4:42enough of equipment so there was no
4:44shortage it became clear that cloth
4:46coverings though you didn't have to buy
4:48in a store that you could make yourself
4:50were adequate and thirdly and probably
4:54the most compelling thing is when it
4:56became very clear that anywhere from
4:59twenty to forty five percent of people
5:01who were infected didn't have any
5:03symptoms so the risk of your being in
5:07contact with somebody said well you look
5:08good I look good we're not infected was
5:11not the case that you could be spreading
5:14at a symptomatically you put all of
5:16those things together which had us
5:18evolved from saying maybe we should hold
5:20off on masks because we needed them for
5:23the healthcare work as to saying now
5:25everybody should be wearing a mask when
5:28they're outside and should be trying to
5:29distance that's one example of evolving
5:33as you get more data and you get more
5:35information that makes sense I'd like to
5:40dig a bit deeper into this idea what
5:43doing a reset now entail and to be clear
5:47you're not suggesting that we do another
5:48lockdown so what steps do you think we
5:52need to take to get this under control
5:54now okay so if you looked at had things
5:58been done perfectly it should have been
6:01that wherever you were a state or a city
6:05in a particular dynamics of infection of
6:08where you are you could judge where you
6:12should be
6:13should you be at the Gateway waiting for
6:1614 days going down if so could you go to
6:19phase 1 could you go then to
6:21phase two and then to phase three when I
6:24see a reset button I say okay timeout
6:27let's everybody regroup because if you
6:31are in a situation where you should not
6:33have jumped over one of the one of the
6:37the checkpoints you got to think about
6:39pulling back starting all over again and
6:42doing the gradual entry into quota
6:46normality in a way that's in accordance
6:49with the guidelines number two if in
6:53fact you are in that you've got to be
6:56really very careful that your citizenry
6:59understands the importance of abiding by
7:02these guidelines you have to wear a mask
7:04whether that mask is mandated whether it
7:07can be feasibly locally mandated I would
7:11recommend as strong as you possibly can
7:14to get people to wear masks so avoid
7:17crowds to keep distances outdoors always
7:22better than indoors so when you're
7:24talking about the kinds of
7:25recommendations that's what you've got
7:27to do and quite frankly mark if you look
7:29at it that hasn't been done in every
7:33single instant so we've got to go back
7:36and relook at what we're doing and
7:38re-enter the most important thing is
7:41that there has been this unusual and
7:44unfortunate mindset of these public
7:47health measures and there's getting the
7:50economy back and these are two opposing
7:52forces as I've said so often and I want
7:56to repeat it with you here mark is that
7:58we should be looking at public health
8:00measures as a vehicle or a gateway to
8:04opening the country again to getting the
8:06economy back not as the obstacle in the
8:09way but as a gateway and if we do it in
8:12a measured way I strongly believe we can
8:16turn this around in the southern states
8:18that are getting hit right now and we
8:21can prevent it from happening in states
8:24that are still at that point of trying
8:26to open up you've got to do it correctly
8:29you can't jump over steps which is very
8:34perilous when you think about
8:35rebound and the proof of the pudding is
8:37look what's happened there really is no
8:41reason why we're having 40 50 60
8:44thousand other than the fact that we're
8:46not doing something correctly yeah that
8:51makes a lot of sense so I want to make
8:55sure that I want to get to your guidance
8:59for young people specifically who are a
9:01very important part of how we slow the
9:05spread of this and I know a lot of
9:06younger people are watching this right
9:07now and I know this because the last
9:10time we did a live video I think all the
9:13streams were viewed I think more than 50
9:15million times including by a lot of
9:18young people and young people are gonna
9:20be really critical to getting this right
9:21because right now a lot of the new cases
9:23are younger folks so what should young
9:27people be doing to stay healthy and and
9:31to make sure that they can keep the
9:32people around them healthy mark thank
9:35you very much for asking that question
9:37because I think it's critical so
9:39everything that's going on right now in
9:40the country if you look at what's going
9:43on with the new infections the age range
9:45of the infection the median age is about
9:49a decade and a half younger today than
9:52it was a few months ago so you're
9:54absolutely right
9:56young people are intimately and heavily
9:59involved in what's going on now with
10:01this pandemic so let me just say one
10:04thing and I do address it to the young
10:06people who are watching this it's
10:09totally understandable that you see the
10:12data young people are smart they know
10:15what data means and the data tells us
10:17that if you're a young person the
10:19likelihood when you get infected of
10:22getting seriously ill is much less than
10:25an older person the elderly or people
10:29with underlying conditions that's just
10:31the truth that doesn't mean that some
10:34young people and we have ample examples
10:36of that who are young and otherwise
10:37healthy can get seriously ill I mean
10:41really seriously ill or can be knocked
10:44out on their back and brought to their
10:46knees pretty quickly but let's
10:49take the majority of young people who
10:51get infected and don't even know they're
10:53infected you can get the mindset well
10:56listen if I'm infected
10:58I don't know I'm infected I'm not
10:59feeling sick who cares I'm not bothering
11:02anybody else that is incorrect because
11:06by allowing yourself to get infected you
11:09are propagating the pandemic and let me
11:13explain what I mean by propagating it
11:15you can't think of yourself in a vacuum
11:17because if you get infected and you
11:19don't know it then you're gonna make
11:22innocently and I'll use the word
11:23innocently because I don't think there's
11:25any malice here you can innocently
11:28infect someone else who then might
11:31infect someone else and then all of a
11:33sudden a vulnerable person an elderly
11:36person the person who's immunosuppressed
11:38a child with cancer on chemotherapy when
11:41they get infected then you you have this
11:44serious problem so what I would urge and
11:47almost plead with the younger people
11:49because I know if they really understood
11:51this they would take it seriously that
11:53you have to have responsibility for
11:55yourself but also a societal
11:58responsibility that you're getting
12:01infected is not just you in a vacuum
12:04you're propagating a pandemic so when I
12:08see the pictures of people at bars you
12:10know enjoying themselves totally
12:12understandable I get that I was there at
12:14one point in my life was see people in
12:17crowds and you say well you know they
12:21think they're not doing anything that is
12:23particularly harmful but they might be
12:25so my message to young people is
12:28consider your responsibility to yourself
12:31but also the societal responsibility
12:34because the sooner we put this down the
12:37sooner you're gonna get back to normal
12:40and you'll be able to freely have fun go
12:43to the bars go in crowds but not now
12:46now's not the time to do that yeah and I
12:52want to push from this point a bit more
12:53because you know you mentioned that
12:55young folks can get sick too but you're
12:58focusing a lot on how young people risk
13:00spreading over to more people but
13:02you know for the people I know it seems
13:05like getting coded even if you're young
13:07is an absolutely brutal experience you
13:10know a lot of people get sick for weeks
13:11or can be sick for months at a time and
13:15we don't know yet what the long-term
13:16side effects are and so I'm curious if
13:19you can just talk about that a little
13:20bit more about that part of it for young
13:23folks as well oh so far about October
13:27defects younger people and yeah maybe
13:31maybe just address that set of issues a
13:33little bit more as well I mean there are
13:36countless examples I'm glad thank you
13:38for bringing that up mark because you
13:40know as I've often said I've been
13:41chasing viruses and looking about and
13:44and going after outbreaks for decades
13:47I've never seen an infection with this
13:49broad range of manifestations from
13:53nothing in 20 to 40 percent 45 percent
13:55to getting sick for a few days to
13:58getting knocked out literally at home in
14:00bed feeling horrible with and even post
14:04infection syndromes so maybe in the
14:07hospital intensive care and death if you
14:10look at that statistics like you said
14:11the young people are heavily weighed so
14:14it's not getting seriously impacted but
14:16be careful when you talk about what do
14:19you mean by seriously ill there are many
14:21many young people who get infected they
14:24get sick they feel horrible for weeks
14:27and weeks and then one thing they notice
14:29and we're getting a lot more information
14:31on this that even when they clear the
14:33virus and they test negative and they
14:36don't have any virus they can feel out
14:39of sorts for weeks and weeks almost
14:43similar to a my algae can settle itis
14:46chronic fatigue syndrome thing where
14:49they just don't feel right for weeks and
14:52weeks and weeks so this is not an
14:54infection to take lightly
14:57even with young people even with young
15:00people and what do we know so far about
15:03long-term side effects do we know
15:06anything about this yet or do we just
15:07simply need to watch how this plays out
15:09for longer before we're gonna we're
15:11going to know if there's significant
15:14damage to organs or
15:16anything else that we need to worry
15:17about yeah yeah I think you hit the nail
15:21on the head it's gonna be time we've got
15:23to wait and see in the long range now if
15:26you look at likelihood an initial
15:29experience for people who get sick and
15:32maybe are out for a few days they get a
15:35sniff a little sore throat
15:37the virus tends to stay in the upper
15:40airway maybe a little short of breath
15:42and then they're good they get better
15:44and they're fine it is very unlikely
15:46mark that those individuals are gonna
15:48have any chronic long-term issue it's
15:51the people who really get knocked out
15:54badly particularly those who might
15:56require hospitalization that it's gonna
15:59probably take months to a year or more
16:02to determine if there are any long
16:05lasting deleterious consequences of the
16:08infection we just don't know that now we
16:11haven't had enough time okay you made a
16:15comment recently comparing the severity
16:18of kovat to the 1918 pandemic um can you
16:23say more about that yeah I'm glad you
16:26brought that up because I want to
16:27clarify that I had used the word
16:29comparable and I think that may have
16:31been taken out of context because people
16:34would have thought my goodness
16:35we're having this now is it going to be
16:38the 50 to 100 million people in 1918
16:41that no they're not comparable in that
16:43way at all in severity they're very very
16:46different I was just talking about a
16:48hundred and two years then where
16:51historically now looking at historically
16:53important outbreak because we haven't
16:55had anything like this really for 102
16:59years but I don't want anybody to think
17:01this severity comparability because of
17:05what was experienced in 1918 which just
17:08I mean if you look at it it was 50 to
17:10100 million deaths in a population
17:13one-third the size now so I wanted to
17:16clarify that thank you for giving me the
17:18opportunity this is a serious situation
17:20we're facing now but it's not 1918 yeah
17:26that makes sense now a lot of the
17:28comments
17:29people have written in our about asking
17:32about reopening schools right so how
17:34should we be thinking about reopening
17:35schools what is the science tell us on
17:38this issue what is your view of the
17:41appropriate threshold in terms of
17:43deciding when to reopen and a lot of
17:45parents just want to know how they
17:46personally should be thinking about this
17:48so I'd love to hear you talk about that
17:50not so issues yeah yeah thanks mark a
17:53great question because it's something
17:55that we're addressing now as we're into
17:57the summer getting ready to opening the
17:59schools so I think as a default I have a
18:02general concept and then I'll fill in
18:04the blanks
18:05the general concept is that to the
18:08extent possible our default should be to
18:12try and get the children back to school
18:14the reason I say that is that the
18:17unintended ripple effects downstream
18:21consequences of keeping the children out
18:23of school can be profound the American
18:26Academy of Pediatrics has spoken about
18:28that the deleterious effects on children
18:31the impact on parents who have to modify
18:34their work schedule if their children
18:36stay home there are a lot of unintended
18:39negative consequences having said that
18:42with the thought that the default should
18:44be to try and get kids to school you've
18:46got to look at where you are location
18:50wise because as I said off in the United
18:53States is a large country geographically
18:56and demographically quite different and
18:58varied you could be in a part of the
19:00country a County a city a state in which
19:04the level of virus infection the
19:06dynamics is so low you could send kids
19:08back to school without any modification
19:10or any worry but there are also some
19:13areas when you look in the dynamics of
19:15the infection they're so intense you
19:17have to say wait a minute let me think
19:19about it do I have to close the school
19:22for now or can I go back but in order to
19:26be safe do I need to do it in a modified
19:28way all in the day's morning afternoon
19:32however because paramount to drive it is
19:35the safety and the health of the
19:38children as well as the safety and
19:41health of the teacher
19:43so you've really got to make sure that's
19:45a driving force in your decision so a
19:48wide degree of variability default
19:51always try to get the schools open if
19:53you can't do it in a natural way do a
19:56modification and some of the school
19:59principals and the superintendent's have
20:01very creative ways of doing that of
20:04modifying the class structure outdoors
20:06maybe a little bit more protecting the
20:09vulnerable it can be done it can be done
20:13okay and is there anything else that
20:15you'd say to parents who are worried
20:17about either having schools reopen or
20:21the safety of sending your kids to
20:23schools yeah I mean I think they have to
20:26I mean I know parents at least I as
20:29apparel and my children we're at that
20:30age I certainly be concerned is to
20:32listen to the recommendations you know
20:35the CDC has guidelines the health
20:37officials locally will make a decision
20:40hopefully and I cannot imagine they
20:43won't based on a concern for the safety
20:45at the same time as the need to get the
20:48children back to school CDC guidelines
20:51are there they can be used very well
20:53yeah so I want to talk about the racial
20:58disparities here which I think are
21:00really troubling the CDC has reported
21:04that black latinus and Native Americans
21:06are four times as likely to be infected
21:09with co-head and twice as likely to die
21:12as white American so what can you tell
21:15us about what we're seeing here and and
21:18what is being done by the government to
21:21address this yeah that that's a very
21:25good question walking a very disturbing
21:27phenomenon that is a reality and and and
21:30there's an explanation for it and there
21:33are things that we can do about it
21:34immediately but things that are going to
21:37take decades for us to correct
21:39so if you look at the fact that if you
21:42look at minorities as you mentioned
21:44African Americans latina X native Native
21:47Americans and Alaskan Americans if you
21:50look at that group although you don't
21:53like to generalize but it is a fact
21:56that as a demographic group the kinds of
21:59jobs that they generally have do not
22:02allow them as much to do the kind of
22:05telecommunication that we're doing right
22:07now that put them in so-called essential
22:10jobs where they're outside in a
22:13situation exposed enough to have a
22:16greater incidence of infection than
22:18someone who could call a timeout and do
22:20work from the quiet and solitude of
22:23their own home so they have a greater
22:25chance of getting infected once they do
22:27get infected as a group if you look at
22:31the underlying conditions that lead to a
22:34high likelihood of a bad outcome those
22:38demographic minority groups have a much
22:41higher incidence of that and I'm talking
22:44about hypertension obesity
22:47cardiovascular disease all the types of
22:51chronic lung disease diabetes those are
22:55the things that put you at a higher risk
22:57so the immediate things that we can do
23:00now is that how do you address that what
23:03you do is you put resources where you
23:06have a demographic concentration of
23:08individuals so they can get tested
23:11easily contact Tracy easily have access
23:14to care get under the care of a health
23:17care provided quickly to try and
23:19mitigate the advancement of disease you
23:21can do that right away we can
23:23concentrate resources in those places
23:26making sure they get things that they
23:28need right away the broader picture of
23:31the social determinants of health that
23:33lead to minority groups having a higher
23:37incidence of diabetes of obesity of lung
23:41disease of heart disease those are the
23:44kind of things that we as a society need
23:47to address and commit to doing over a
23:51period of decades because that's not
23:52gonna change overnight but let's at
23:54least do the things that we can fix now
23:57and we can fix access to care we can fix
24:01ease of testing we could do that now
24:05yeah okay that'sthat's important and I
24:09think it makes sense
24:11I want to make sure we have time to
24:13discuss some of the science and
24:14potential treatments you know earlier on
24:18I know that a lot of scientists were
24:19hopeful that there might be existing
24:21drugs including things like
24:25hydroxychloroquine that might have been
24:27effective against covin but
24:28unfortunately it seems like nothing has
24:30really emerged as a as a clear treatment
24:33of existing drugs that were already on
24:37the market and and had already been
24:38reviewed as safe and even drugs like rum
24:42desi fear which is is is probably one of
24:46the more effective newer medications
24:49doesn't seem to have as huge of a
24:51positive impact as we might have hoped
24:54what's your take on the drugs that we've
24:56found so far that we've tested and are
24:59there any treatments that you're
25:00optimistic about over the coming months
25:03good okay great question thanks mark so
25:06if you look at advanced disease and
25:08early disease we have had two advances
25:11and and this was in a randomized
25:14placebo-controlled trial not those other
25:17types of anecdotal things which give you
25:19information that generally confuses
25:22people if you look at REM desappear in
25:25individuals who are hospitalized with
25:28lung involvement and you look at the
25:30impact of REM desapear there was a
25:33highly significant but modest effect in
25:37diminishing the time to recovery so
25:40that's one well proven good drug
25:43dexamethasone which is a glucocorticoid
25:45an anti-inflammatory steroid clearly
25:49showed in hospitalized patients on
25:51ventilators or requiring oxygen but not
25:55people with early disease that if you
25:57gave it six milligrams a day for up to
26:00ten days you significantly diminished
26:03the death rate in ventilated patients in
26:06patients requiring oxygen but not in
26:09early patients which is interesting
26:10because it goes along with what we know
26:13of the pathogenesis of the disease that
26:16when you have early disease you want to
26:18block the virus and keep the immune
26:20system revved up and working
26:23you have late disease it's less the
26:26virus doing damage than the aberrant
26:28inflammatory response which is the
26:30reason why dexamethasone works so we
26:33have two good things going what we
26:35really need is your question about what
26:38do we have in the mix right now what we
26:41really need are drugs that when given
26:43early can prevent a symptomatic person
26:46from requiring hospitalization or very
26:49dramatically diminished the time that
26:52the symptomatic and some of the
26:54promising ones are other direct
26:57antiviral drugs which we're screening
26:59and targeting also convalescent plasma
27:04which we're doing at trial to see if it
27:05works hard for immune globulin and
27:07importantly monoclonal antibodies
27:10monoclonal antibodies are very precise
27:13bullets that you have by developing from
27:17a person who's been infected or
27:19vaccinated making antibodies clone their
27:22b-cells and give it to people early on
27:25you can do it as an outpatient you can
27:28do it as an inpatient all of those
27:30things are being geared up now and are
27:32either in clinical trial or will soon be
27:35going into clinical trial so when you
27:39talk about things like monoclonal
27:40antibodies how would that be
27:42administered and who could get that who
27:44is the audience that might be helpful
27:46for it yeah well first of all it can be
27:50administered intravenously once you get
27:53the right titration you can do that
27:55subcutaneously or intramuscularly it's
27:58what you can do it finish your families
27:59mark
28:00excuse me yeah you yeah yeah throw a
28:04shot yeah either right through the vein
28:06or just like you get a gamma globulin
28:09shot you could do it that way now that
28:12can be done either for prophylaxis or
28:15for treatment so for example if you're
28:18in a situation where you have a nursing
28:20home situation where there's an outbreak
28:22and you want to prevent people from
28:23getting ill you can just do it that way
28:25or after a person is infected you can
28:28give it to them as a treatment this was
28:32very successfully done in a randomized
28:35placebo-controlled trial
28:37I wasn't a placebo it was a drug that
28:40we're serving as the control you might
28:42remember mark of Ebola in West Africa
28:45where we showed that two types of
28:48different monoclonal antibodies were
28:50very effective in Ebola and we hope
28:54we're gonna see the same thing now with
28:56Kovac and what do you think the time
29:00frame for something like that might be
29:01well the trials have already started
29:04mark I would hope that as we get to the
29:06late summer and early fall we'd be able
29:09to have enough efficacy data because
29:11remember whenever you do this they may
29:13look promising in an animal model
29:15you always gotta be concerned about
29:17safety and you got to be concerned about
29:19are you really giving someone something
29:21that works so the clinical trials are
29:24underway for some and will soon start in
29:27another I hope by the end of the summer
29:29we'll have enough information as we get
29:31into the fall that we might be able to
29:33utilize these they'll be really good if
29:36we have bookends drugs for advanced
29:38disease and drugs for early disease to
29:40prevent advanced disease yeah got it
29:45that makes sense and if that's coming
29:46over the next few months I mean that
29:49that's a good cause for some optimism of
29:55course developing a vaccine is going to
29:57be critical so I'm hoping that you can
30:00talk a bit through where we are in that
30:03process at this point and what the
30:08process from getting from where we are
30:09now is to having a vaccine that could be
30:12given to people broadly and when the
30:14soonest would be that that kind of
30:16vaccine might be available yeah yeah I'm
30:20actually cautiously optimistic about
30:23this mark because of what we've seen as
30:25you probably know given the technologies
30:27we have in the different platforms we
30:29moved from the literally the day that
30:33that sequence was put on a public
30:35database to getting that sequence
30:38pulling the gene and sticking it into a
30:40platform to make a vaccine was measured
30:43in days and then sixty two days later we
30:45were in a phase one trial so where are
30:47we right now there are multiple
30:48candidates not only one
30:51so I might talk as the prototype of one
30:54but there are more than one that will be
30:56going into advanced trials sort of in
30:58tandem sequentially one right now that
31:02two days ago it was published in the New
31:05England Journal of Medicine the phase
31:06one data which we did some time ago
31:09for safety and to see what kind of
31:11response it was induced the thing that
31:13makes me optimistic about this whole
31:16enterprise is that this vaccine which
31:19was an mRNA vaccine for moderna that was
31:22developed here at the nih but as I
31:23mentioned it's not the only one that
31:26induced in the people who are in the
31:29phase one trial levels of neutralizing
31:32antibodies which are the anybodies that
31:35are the real bullets to stop the virus
31:39that is the gold standard of protection
31:42is neutralizing anybody's it induced it
31:45at levels at a moderate dose of the
31:47vaccine that were as high or higher than
31:51what you see with convalescent plasma
31:55after natural infection and one of the
31:58hallmarks of vaccinology is when you get
32:01a vaccine you'd like it to induce a
32:03response that's at least as good as
32:06natural infection which would predict
32:09that the vaccine would likely be
32:12successful even though the proof of the
32:13pudding is always you got to do the big
32:17efficacy trial for safety and for
32:19efficacy at the end of this month July
32:22we're gonna be starting the phase 3
32:25trial of this candidate and as we get
32:28into the summer a month later another
32:30candidate will go into phase 3 trial
32:32then a month later another so that over
32:35the next four to five months you're
32:37gonna see sequentially these candidates
32:40going into clinical trial having said
32:42that if everything works out the way we
32:45hope and we don't get any unpredictable
32:47potholes and bumps in the road we should
32:50know as we get into the mid to late fall
32:53early winter but probably late fall
32:57whether we have candidates that really
32:59are safe and effective and I hope and
33:02anticipate that we will have one or more
33:05if that's the case by the time we get to
33:08the end of this year the beginning of
33:11calendar year 2021
33:13we may have vaccine one or more
33:15candidate that is actually safe and
33:18effective that being the case we can
33:21start distributing doses widely at that
33:24time and the reason why I think we can
33:26do it is that even as we're doing the
33:29clinical trials now we we being the
33:32enterprise the companies are going to
33:34already start making doses at risk which
33:38means they're going to make doses even
33:41before they know the vaccine works which
33:43means if it works
33:45they've saves months if it doesn't work
33:48we've lost a lot of money but we figure
33:52it's worth the risk so the risk is not
33:55in safety and the risk is not in
33:57scientific integrity the risk is
34:00financially to try and make these steps
34:03truncated so that's where I think we are
34:05so I'm really quite cautiously
34:07optimistic that we'll be able to have
34:10something as we get into the end of this
34:12year in the beginning of next year yeah
34:16that's that's a good note of optimism I
34:19think it might be useful to talk through
34:22the process of vetting a vaccine both so
34:27that people have some sense of what it
34:29takes to get from an initial candidate
34:32to to just something that's ready to go
34:35but also because you know well I know
34:38that the vast majority of people would
34:40be very excited and optimistic if they
34:44could get a vaccine that would prevent
34:47them from getting kovat today I know
34:50there are some people it's a fringe but
34:52it's unfortunate who question the the
34:56overwhelming scientific evidence on the
35:00safety of of these so I just think going
35:05through the process and showing how
35:07overwhelmingly focused it is on making
35:09sure that these vaccines are safe would
35:12would be helpful to go through as well
35:14sure very good I'll do it succinctly
35:18well
35:19you get a candidate like the one we did
35:21you you you get it you put it in the
35:24form to be administered and you put it
35:26through animal studies animal talk
35:29studies animal affective efficacy
35:32studies so before you even think about
35:34going into a phase one in humans you
35:37gotta have is there a reason to believe
35:38that this is gonna induce a response you
35:41gotta see it induced in an animal before
35:43you see it induced in human and does it
35:46protect in disease in an animal then you
35:49get that candidate and you go into phase
35:50one very limited number of people off
35:53phase one at forty five people 15 at
35:56each dose you want to see is there any
35:58immediate safety signals and you want to
36:00see if induces the kind of response that
36:03you would predict would be protective
36:04then you go to the next phase so if
36:07phase one is 45 people phase two is
36:10hundreds of people you get there you
36:13continue safety you continue Amanda
36:16janessa t if it looks good you then move
36:19to phase three phase three goes from
36:22hundreds of people to thousands of
36:24people the trial we're gonna start at
36:26the end of July is gonna involve 30,000
36:30people so when you have that many people
36:33in a trial not only are you looking to
36:36see if it works but you're constantly
36:38keeping your eye on safety to make sure
36:42that a vaccine actually doesn't enhance
36:45disease and make people work once you do
36:49that at every given point in the trial
36:52an independent group called the data and
36:56safety monitoring board looks at the
36:58data and says trials going okay you can
37:02continue looks next month of the month
37:04later trials going okay you continue or
37:07wait a minute
37:09it looks like you're never gonna really
37:11get an answer because nothing looks like
37:13it's working you have futility stop the
37:15trial or what we hoping for mark that
37:19they look at the data and say wow this
37:22looks good enough that ethically you
37:25can't continue with a placebo you've got
37:28to say this works let's start
37:30distributing it those are the
37:32individuals
37:33of developing a vaccine okay that's
37:37that's very helpful to go through while
37:40we're on kind of the baked basic safety
37:43measures for some of the common-sense
37:46things that were that we're hoping to
37:48roll out I have a question here asking
37:52if there are any known adverse effects
37:54about wearing a mask at all you know
37:57there are some memes that go around
37:58around you know are people breathing in
38:01more carbon dioxide or they're any
38:03issues like that I'm from all the
38:05studies around this has anything
38:06negative been found no not at all mark
38:10there has not been any indication that
38:13putting a mask on and wearing a mask for
38:15a considerable period of time as any
38:17deleterious effects on oxygen exchange
38:21or anything like that
38:22not at all yeah and my understanding is
38:26this has also been studied even in
38:27people when they're running and
38:28exercising and things like that and and
38:30and I haven't seen that suggest that
38:33there would be any issue but I mean you
38:34you obviously are the expert on us well
38:37no I mean I mean I wear a mask when I'm
38:39outside all the time particularly making
38:42sure that I don't remove it when I'm
38:44close to people and you know it doesn't
38:47bother me I'm I even run with a mask on
38:50sometimes he gets a little moist there
38:53depending on the cloth that you're
38:54wearing but there's nothing to indicate
38:57that wearing a mask has deleterious
39:00effects okay well it's good to just get
39:03a chance to make sure that that is
39:05crystal clear for everyone and just
39:09reading a few more questions from from
39:11the threaded here you know one that has
39:15come up a bunch is you know some people
39:18are wondering if somebody's been showing
39:21symptoms then how is it that they could
39:24be contagious I mean I kind of get why
39:27that might why that might not be obvious
39:29to it to a lot of folks who it's
39:31probably worth just taking a few minutes
39:32to talk through that and how that works
39:34know that that's a great question hook
39:37I'm glad you asked that
39:38yes and the reason you can be contagious
39:40if you look at how you transmit from one
39:44person to another the virus resort
39:47in the nasopharynx in the back of the
39:49throat so that's the reason why when you
39:51say when you speak or call or sing the
39:55virus in droplets comes out you may not
39:58see it but when you do certain
40:00Lighting's and blazes you can see it
40:02what we have found out that when you
40:04measure the level of virus in the
40:07nasopharynx of asymptomatic people
40:10compared to people who are symptomatic
40:12it doesn't seem to be any difference
40:14which means there's as much virus in the
40:18nose of a person who's asymptomatic as
40:20there isn't a symptomatic person which
40:23means it is very very likely that when
40:26that person talks or or are sneezes or
40:30whatever that enough virus will come out
40:33to infect someone else so there is not a
40:35lot of difference in virus load even
40:38though people can be very different with
40:41regard to their symptoms yeah so related
40:46to your point about droplets there's a
40:49you know some recent pieces that I've
40:52seen suggesting that or wondering
40:55whether to the extent to which this is
40:57aerosol or droplet there's a question
41:00from the thread about do we have any
41:03data on how this moves around
41:05differently inside versus outside or how
41:08long this can linger in the air for yeah
41:11okay so the linger in the air question
41:14relates to whether or not it's
41:17aerosolized or another word people use
41:19is airborne
41:21so there are different types of droplets
41:23so most of the droplets when people
41:27speak and you see that little spray come
41:29out Oh greater than five micrometers
41:32those are the kind that they're heavy
41:36enough mark they don't go any more than
41:38three feet at the most six feet which is
41:40why we say when you're outside stay at
41:44least six feet apart from someone there
41:47are other droplets that are less than
41:50five micrometers those are the ones that
41:52can quote aerosol eyes and aerosol eyes
41:55means instead of coming out from your
41:58mouth and dropping within
42:00three to six feet it can kind of float
42:03around the air and stay in the air for a
42:06period of time right now it is unclear
42:10and it is because we don't have enough
42:13data that there is likely some aerosol
42:16that comes out and you could show that
42:18by these lasers and lights we don't know
42:22the extent to which aerosolized or virus
42:27that stays in the air for a long period
42:29of time is involved in the transmission
42:32we certainly would like to know that but
42:35it's very difficult to determine that
42:37even though we know that some degree of
42:39air civilization does occur if you turn
42:42back the clock and go to SARS back in
42:462002 and 2003 there was a clear-cut
42:49instance in a Hong Kong hotel where air
42:55civilization
42:56absolutely occurred spread through
42:58different floors and infected
43:00individuals why that person who was the
43:03source of the aerosol eyes or whatever
43:06the source was we still haven't figured
43:08out but that was a good example of a
43:11corona virus spreading to aerosol but
43:14right now today well I can't tell you
43:17with scientific certitude what
43:19proportion is spread through aerosol
43:21that's one of the unknowns we're just
43:23gonna have to work out got it okay maybe
43:29you go back to vaccines for um for one
43:32more minute I mean we're trying some
43:34some novel strategies with some of these
43:38vaccines like the RNA vaccine I think is
43:40it the moderna candidate might be an RNA
43:43vaccine no I'm not sure if there are any
43:45this might be the first kind of major
43:48RNA vaccine so I'm curious to just hear
43:50you talk about the advantages and
43:53disadvantages of the different
43:54strategies for types of vaccines that
43:57can get develop maybe even beyond the
44:00Kovan if an RNA vaccine ends up being
44:03possible and working what are some of
44:05the advantages for treating future
44:07outbreaks and things like that in the
44:09future yeah good question so there are
44:13multiple we
44:14we refer to them for your listeners and
44:16viewers as platforms so our mRNA is a
44:20platform viral vectors are different
44:23platform soluble proteins recombinant
44:26proteins killed and activated is another
44:30platform so we we had multiple platforms
44:34there are three that are being actively
44:35done one is the the the mRNA the other
44:40is viral vectors where you take a virus
44:43stick the gene of the Spike proteins so
44:46that it expresses itself and then you
44:48get in an immune response when you
44:50inject that the other is just taking a
44:52protein and inject it with an adjuvant
44:55the reason that the novel technologies
44:58were used that were very easy to just
45:00get out of the blocks and go with it
45:02test assess what I explained to you the
45:04time table we went from a couple of days
45:06bingo into a vaccine done so if it works
45:10which we believe it will it would be a
45:12major advance of ease a facility of
45:16scale-up and ultimately of cost will do
45:19it it hasn't been proven the way some of
45:22the others have done by years and years
45:25of experience so that's one of the
45:27things if it works which I hope it will
45:30I think it will people be saying wow we
45:32have a red-hot platform here we're gonna
45:35start using that for a lot of other
45:36vaccines the other ones that we have the
45:39viral vector ones the ones I described
45:42be an ad no vector a vesicular
45:44stomatitis vector that's another one
45:46that we've had some experience with
45:48particularly with Ebola in which it
45:51worked very well and then there's the
45:52ones that have been used more commonly
45:54which is the soluble proteins that you
45:57could make with recombinant DNA
45:59technology so there's multiple platforms
46:02we're hoping and I believe will be
46:05successful I hope we are that more than
46:07one of them will prove to be safe and
46:09effective it'll be good for the effort
46:12and it'll be good for the field of axon
46:14ology because this is really
46:16unprecedented that we have so many
46:18different platforms going on at the same
46:21time to determine safety and efficacy
46:24yeah all right so I think we're almost
46:27out of time so I wanted to check in and
46:29see if there's anything else that you
46:31wanted to cover or are there any other
46:33thoughts that you'd like to leave this
46:36community with yeah I just want to
46:39reiterate what I said before mark and
46:42and thank you for giving me the
46:44opportunity to say it that we are all in
46:46this together we are gonna get through
46:48it we will get through this difficult
46:52situation and at best it's difficult at
46:59we're dealing with right now but we've
47:00all got to do it together we're in it
47:03together and since I I know we're
47:06looking disproportionately to a lot of
47:08young people that are watching this
47:10please assume the societal
47:13responsibility of being part of the
47:15solution and not part of the problem of
47:18course we're gonna get through it we're
47:19gonna get this under control in the
47:21southern states and hopefully we're not
47:23gonna see these kind of surges so that
47:26we do get down to the baseline that we
47:29hope we would because once we're down to
47:32that baseline mark it's gonna be so much
47:34more easy when you open up the country
47:38as it were to put your clamps on when
47:42you get individual infections they don't
47:44soar off the ceiling they stay clamp
47:48down that's the message I want to get
47:50one last time great well thank you
47:54doctor foul cheap I think I say this on
47:56behalf of millions of Americans who will
48:00watch this we appreciate your leadership
48:02and your dedication to helping us
48:05navigate this you you have a lot of
48:09people's confidence who we and a lot of
48:11people out there continue to have faith
48:14in in in science and want to make sure
48:16that this has led that that our response
48:18is led by science so thank you for
48:21everything that you are doing in in what
48:24are some some trying circumstances and
48:27please stay healthy and good and thank
48:30you to everyone out there for tuning in
48:32today I hope you all stay good as well
48:35and I'm looking forward to seeing you
48:37all soon thank you Mark you me thank you
48:40for giving me the
48:41to be with you I really appreciate it
48:43thanks

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