23 July 2020
The unique characteristics of this pandemic may not allow people to completely eradicate it, but public health measures and good vaccines should bring "very good control," NIAID director Anthony Fauci said Wednesday.
Driving the news: "We are living, right now, through a historic pandemic outbreak. And, we are, right now, in a situation where we do not see any particular end in sight," Fauci told a panel hosted by the not-for-profit TB Alliance.
"It's the perfect storm," Fauci says. "We often talk about outbreaks and pandemics, be they influenza or other pathogens, that have to have a few characteristics that make them particularly formidable. Well, this particular virus has that."
- For a public health official, this is "almost your worst nightmare," Fauci adds.
- He points out that SARS-CoV-2 jumps species, is a new pathogen with no known innate human immunity, and is a respiratory-borne virus that is "spectacularly efficient" at spreading from human to human and has a "substantial degree of morbidity and mortality, particularly in certain populations of people."
Plus, "the spectrum of involvement with the same pathogen is very unique," Fauci says.
- "I've never seen an infection in which you have such a broad range — of literally nothing, namely no symptoms at all, in a substantial proportion of the population; to some who get ill with minor symptoms; to some who get ill enough to be in bed for weeks and have post-viral syndromes; [to] others [who] get hospitalized, require oxygen, intensive care, ventilation and death."
- From what doctors can tell right now, Fauci says the pathogenesis of the disease indicates "you want to block the virus and keep the immune systems intact early on. But, you want to block inflammation later on, because that assumes a much greater role."
What to watch: Several vaccines are in or will soon be entering phase 3 clinical testing, Fauci says. While the FDA gave a 50% efficacy benchmark for the vaccine, "they're shooting" for a vaccine with 70% or higher effectiveness.
- One safety concern they're watching for during phase 3 trials are for possible "vaccine-induced immune enhancement" that can sometimes occur if there's suboptimal antibodies in a vaccine that actually enhance the infection once you're exposed later.
- While there is no "particular reason" to believe this will happen with COVID-19 vaccines, there had been issues before with animals tested with the SARS vaccine, so "we want to pay attention to it."
Fauci says he's "cautiously optimistic" a good vaccine will be available soon.
- "I don't really see us eradicating it. I think with a combination of good public health measures, a degree of global herd immunity, and a good vaccine ... I think we'll get very good control of this. Whether it's this year or next year, I'm not certain," Fauci says.
Meanwhile, other panel members also expressed concern that the pandemic may cause an uptick in diseases like tuberculosis, HIV and malaria.
- Soumya Swaminathan, chief scientist for the World Health Organization, pointed out that there's a need to continually address those devastating diseases as well as work on developing new antibiotics.
- TB Alliance founding board member Ariel Pablos-Mendez, who has worked with both COVID-19 patients and multidrug resistant TB patients, says "I have seen firsthand how deadly diseases are, and the threats they pose to global health and stability."
- "But I also see signs of hope," Pablos-Mendez added, such as with India's recent approval of Mylan's pretomanid drug to be included in a regime to fight multidrug-resistant TB.
Transcripts show George Floyd told police "I can't breathe" over 20 times
Section2Newly released transcripts of bodycam footage from the Minneapolis Police Department show that George Floyd told officers he could not breathe more than 20 times in the moments leading up to his death.
Why it matters: Floyd's killing sparked a national wave of Black Lives Matter protests and an ongoing reckoning over systemic racism in the United States. The transcripts "offer one the most thorough and dramatic accounts" before Floyd's death, The New York Times writes.
The state of play: The transcripts were released as former officer Thomas Lane seeks to have the charges that he aided in Floyd's death thrown out in court, per the Times. He is one of four officers who have been charged.
- The filings also include a 60-page transcript of an interview with Lane. He said he "felt maybe that something was going on" when asked if he believed that Floyd was having a medical emergency at the time.
What the transcripts say:
- Floyd told the officers he was claustrophobic as they tried to get him into the squad car.
- The transcripts also show Floyd saying, "Momma, I love you. Tell my kids I love them. I'm dead."
- Former officer Derek Chauvin, who had his knee on Floyd's neck for over eight minutes, told Floyd, "Then stop talking, stop yelling, it takes a heck of a lot of oxygen to talk."
Read the transcripts via DocumentCloud.