Fauci Addresses Pharmacists at ASHP Midyear

Despite positive news around an effective vaccine, Americans should prepare for a difficult winter ahead amid the coronavirus disease 2019 (COVID-19) pandemic, warned Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), during a session at the ASHP Midyear 2020 Clinical Meeting & Exhibition.

While growing up, Fauci was first introduced to health care through his father, who owned a neighborhood pharmacy in Brooklyn, New York. Fauci would often help deliver prescriptions to patients by bicycle.

After launching into a successful career as a physician and scientist, Fauci initially aspired to ultimately return to New York as part of the teaching faculty at Weill Cornell Medicine. “I didn’t plan to be the director of a big infectious disease institute,” he quipped during the session. However, Fauci became interested with the concept of biomedical research and developed a broader interest in global health issues, and in 1981 he switched the direction of his research to focus on studying patients with the disease now known as HIV/AIDS. He was appointed director of NIAID in 1984.

“With that, my scope expanded considerably to include all infectious diseases, and particularly global health issues,” he said.

When asked about similarities between HIV/AIDS and the COVID-19 pandemic, Fauci noted that both diseases are unique in their own way. Although both emerged as brand new diseases during their respective times, the explosive nature of the COVID-19 pandemic is what really sets it apart from anything else.

“In that respect it’s very different from HIV,” Fauci said, recounting how the emergence of COVID-19 immobilized the entire world within a matter of months. One of the main differences with COVID-19 is that the entire population is susceptible.

“Of all the infections that I’ve dealt with in 36 years, I’ve never seen anything comparable to this,” Fauci said, in which 40-45% of individuals who are infected with virus are asymptomatic, approximately 80% of those with symptoms have mild disease, and 15-20% of individuals develop severe disease that can result in death. 

Fauci explained that, with such inconsistent messaging, it makes it difficult to convince the public, especially younger individuals, of the seriousness of the virus.

“The public health message is that we’re all in this together. You can’t operate in a vacuum,” he said. “What you want is to be a dead end for the virus, not a vehicle to spread to someone else.”

Minority communities, in particular, have been disproportionately affected by COVID-19. Fauci advised pharmacists to do their part in ensuring that the right message reaches these communities, while working to improve access to testing, counseling, and overall, more accessible health care services for this population.

“Minority communities, well before COVID-19, have always been in the compromised position of not having as much access to quality health care,” he said.

When asked about the pharmacists’ role in the pandemic, Fauci acknowledged their importance in upcoming vaccination efforts, as pharmacist buy in and cooperation is critical to the successful and equitable distribution of the vaccine. He pointed to the likelihood that, once the vaccine becomes available to the general public, patients will be able to visit their neighborhood pharmacy to receive their vaccination.

“Once you get to the general population, I believe it is going to be very similar to going to a pharmacy to get a flu shot,” he said.

Still, Fauci said that the country should heed warnings of the difficult journey ahead, especially during the winter months. “We have a precarious situation ahead of us,” he said, alluding to circumstances of holiday travel and gatherings that are likely to spread infection. He suspects that cases will continue to surge in the coming weeks. And even with an effective vaccine on the horizon, Fauci cautioned that “you cannot substitute a vaccine for public health measures.” Until a substantial portion of the population is immunized, other preventive measures, such as mask wearing and social distancing, will be crucial to mitigating the spread.

In bracing themselves for the months ahead, Facui noted that pharmacists should remember that their role is critical to addressing this outbreak.

“[Pharmacists] should be proud of the fact that they belong to a group of heroes,” he said.

Reference:

1. Fauci A. Wednesday Wisdom with Dr. Anthony Fauci. Presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; virtual; December 9, 2020.