Six months since Covid-19 was declared a pandemic, the world has learned difficult lessons on how to respond — and not respond — to such a crisis.
Anthony Fauci, who has spent nearly 40 years at the helm of the National Institute of Allergy and Infectious Diseases, is particularly well-suited to weigh in on what we’ve learned so far. He has helped steer the government response to a number of outbreaks, including the HIV/AIDS epidemic, and has now become one of the most prominent voices in the U.S. response to the coronavirus pandemic.
In a Harvard Medical School Grand Rounds session on Thursday, Fauci shared his takeaways on how Covid-19 has been handled and what this crisis can tell us about how to combat the next one. His remarks have been lightly edited for clarity.
Don’t underestimate its impact
When you’re experiencing an outbreak, don’t ever, ever underestimate the potential of the pandemic. We’ve been through this before. Remember HIV. Five gay men, then 26 gay men, and then it’s only a gay man’s disease and then it’s this and then it’s that. And then fast-forward a few decades. You have 78 million people who have been infected, and 28, 30, 30-plus million have died. Don’t ever estimate [an outbreak] as it evolves and don’t try to look at the rosy side of things.
Stick to the science
Number two, we can do and should always do good, ethically sound, scientifically sound research during the outbreak. This idea of throwing everything to somebody because it’s desperate doesn’t work. It’s gotten us into trouble with other diseases. So let’s not forget the fact that although you want to get the best intervention to someone as quickly as possible, that there is a major role for ethically sound, controlled clinical trials. We have to do that.
Adapt to new information
The other one is …. We’ve really got to realize that, from day one, you don’t know it all. And you’ve got to be flexible enough to change your recommendations, your guidelines, your policies, depending upon the information and the data as it evolves. If you look at what we knew in February compared to what we know now [about Covid-19], there really are a lot of differences. The role of masks, the role of aerosol, the role of indoor vs. outdoors, closed spaces. You’ve just got to be humble enough to realize that we don’t know it all from the get-go and even as we get into it.
Address existing health care disparities
And finally … if ever there is going to be a real incentive for us to now make a commitment to address the social determinants of health, it’s got to be now. We’ve seen it with HIV. … We have 13% African Americans and close to 50% of new [Covid-19] infections in the United States are African Americans. We have 13% African Americans and now look at the number of hospitalizations with Covid with African Americans and Latinx. We have got to address that. This has to be a real eye-opener for us to do that.
I’m sure there are many more lessons, but those are just a few.