The United States has been averaging 1,000 coronavirus related deaths per day for nine straight days as of August 4. Schools are starting to reopen (and positive tests are already popping up) as new data on how children may spread coronavirus is published. It's been a tough week for Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who opened up about receiving death threats to himself and his family.
Meanwhile Fauci spoke out to news organizations and medical journals on the state of the US coronavirus outbreak, children and coronavirus, mask etiquette , and why we need to pull together right now.
Inverse is aggregating Fauci's comments regularly in the "Fauci Dispatch" series, as the White House has severely limited his visibility to the public.
Fauci on the United States coronavirus outbreak – Speaking to CNN, Fauci had some dire news. When asked if the United States has the worst coronavirus outbreak in the world, he agreed.
"Yeah, it is quantitatively if you look at it, it is," Fauci said. "I mean the numbers don’t lie."
The Backdrop – A spicy interview between Axios’ Jonathan Swan and President Donald Trump captivated the internet this week. Swan pointed to the fact that the US has recently averaged 1,000 coronavirus deaths per day. Trump maintained that the US is “lower than the world” in “numerous categories.”
The United States makes up for less than 5 percent of the World’s population, but we've had the most coronavirus deaths, with over 157,000 as of August 5. In coronavirus deaths per 100,000 people, the US ranks fourth behind the UK, Peru, and Chile with about 47 coronavirus deaths for every 100,000 people in the population.
Fauci on kids and Covid-19– Speaking with the scientific journal JAMA, Fauci said we can’t discount the idea that children can help spread coronavirus in the community, even if they don’t come away with severe illness themselves.
“We need to assume that we know that they don’t get seriously ill, but they clearly can get infected. The question is how well do they transmit that question to others?”
The backdrop – This summer, research on whether children spread coronavirus has started to accumulate. The results have historically been mixed, but new research is suggesting that caution is warranted.
A research letter published July 30 in JAMA Pediatrics looked at how much viral RNA was detectable in nasal swabs from 145 people with mild-to-moderate symptoms and then compared the levels of viral RNA in children’s nasal swabs to those from adults.
Children younger than 5 had up to 100 times more viral RNA in their swabs compared to older adults and children between five and 17 that study reports.
This study only looked for the virus’ genetic material, not for the virus itself so the results aren’t conclusive. It also can’t prove that children are spreading the virus, but the results are suggestive that children may play a role in spreading it.
That said, a larger study published in Emerging Infectious Diseases complicates things. That study analyzed 59,073 contacts from 5,706 coronavirus patients in Korea. Households with children aged 10-19 had the highest rates of Covid-19 (18.6 percent of household contacts had the virus). Meanwhile, only 5.3 percent of household contacts among with children younger than 10 had the virus.
As Fauci notes, we still don’t know how big a role children play in transmission within the community but the idea that children don't seem to play a role in transmission may be waning.
Fauci on mask etiquette – In that same JAMA interview, Fauci addressed concerns over whether you should confront someone who is not wearing a mask in an indoor setting. Fauci warned “you read about confrontations that go really bad.” Instead he suggests that we need to act collectively and set an example:
"I think what we really need to do is just as a nation show a degree of consistency," he said.
The Backdrop – Fauci warned that "people who push back on authority, if you mandate, may push back even more.” It's unclear whether that would actually happen, but it is clear that citizen-led mask movements have been powerful in other places around the world, even when mandates had yet to take effect.
From the outset, mask-wearing has been a grassroots movement. One of the first widespread examples of mask-used controlling Covid-19 was seen in the Czech Republic when a social media movement captured the attention of the Prime Minister. Mask-wearing soon became the country’s official policy.
When Carrie Lam Hong Kong’s chief executive floundered on whether mask-wearing was important and ordered civil servants not to wear them, people mobilized and wore masks anyway. A survey of over 3,000 Hong Kong citizens showed that 74.5 percent reported wearing masks despite no government guidance to do so.
In the US, there were mixed messages on masks at the outset – now the message is clear (wear one). Yet there’s still mixed compliance: a late June Gallup panel report showed that 44 percent of 100,000 Americans said they always wear masks outside their homes.
Should the US federally mandate masks? States have imposed their own mandates and CDC leaders have written editorials calling mask wearing a "civic duty" though they stopped short of advocating for a federal mandate. Likewise, Fauci waffles on the idea in the JAMA interview, as he has done before.
Fauci on propagating the outbreak – Fauci has spoken on the role of young people spreading Covid-19 before. In an interview with Bloomberg, he spells out the importance of not getting Covid-19, even for young healthy people with low, but not zero, risk of severe disease.
“Even though you may not get any symptoms what you’re doing is that you’re propagating the outbreak. You will almost certainly, or one of your colleagues will infect someone else, who will infect someone else who will infect somebody who really really gets sick,” he said.
The backdrop – Fauci’s take here isn’t especially new, but it is one of his clearest explanations of what the chain of consequences that come from just one infection.
In some states, new coronavirus cases trended younger over the summer compared with the winter, and it may not be those people who face the most dire consequences, but others in the community. As Fauci went on to tell CNN on Wednesday beating the virus means that everyone works together, even those who won't get very sick.