1 00:00:05,480 --> 00:00:08,320 >> HELLO, EVERYONE. 2 00:00:08,320 --> 00:00:09,960 JUST AS COVID-19 ISN'T OVER, 3 00:00:09,960 --> 00:00:11,960 NEITHER IS THE SEMINAR SERIES. 4 00:00:11,960 --> 00:00:14,000 WE'VE STILL GOT LOTS OF COVID-19 5 00:00:14,000 --> 00:00:15,960 SCIENCE TO TALK ABOUT IN THIS 6 00:00:15,960 --> 00:00:17,960 WORST PANDEMIC IN MORE THAN 100 7 00:00:17,960 --> 00:00:18,160 YEARS. 8 00:00:18,160 --> 00:00:20,160 SO I'M SURE YOU WILL WANT TO 9 00:00:20,160 --> 00:00:23,400 SIGN UP AND WATCH EVERY EPISODE 10 00:00:23,400 --> 00:00:24,960 OF THIS FALL'S SERIES. 11 00:00:24,960 --> 00:00:31,480 FOR THOSE LOOKING FOR CME 12 00:00:31,480 --> 00:00:32,600 TODAY'S CODE IS 43927. 13 00:00:32,600 --> 00:00:34,240 WHO WOULD BE BETTER TO START 14 00:00:34,240 --> 00:00:40,800 THIS OFF THAN OUR OWN TONY 15 00:00:40,800 --> 00:00:42,000 FAUCI, LEGENDARY EXPERT IN 16 00:00:42,000 --> 00:00:44,560 INFECTIOUS DISEASE, DIRECTOR OF 17 00:00:44,560 --> 00:00:47,920 NIAID SINCE 1984, CHIEF MEDICAL 18 00:00:47,920 --> 00:00:50,000 CENTER TO THE PRESIDENT, 19 00:00:50,000 --> 00:00:52,760 CONSUMMATE SCIENTIST, WISE AND 20 00:00:52,760 --> 00:00:53,760 COMPASSIONATE PHYSICIAN, 21 00:00:53,760 --> 00:00:54,960 VISIONARY MANAGER OF RESOURCES, 22 00:00:54,960 --> 00:00:59,160 WORLD CLASS COMMUNICATOR TO ALL 23 00:00:59,160 --> 00:01:00,520 AUDIENCES, HE SERVED SEVEN 24 00:01:00,520 --> 00:01:05,560 PRESIDENTS AS HE LED RESEARCH ON 25 00:01:05,560 --> 00:01:07,360 HIV, INFLUENZA, EBOLA, ZIKA, AND 26 00:01:07,360 --> 00:01:08,600 MUCH, MUCH MORE. 27 00:01:08,600 --> 00:01:10,560 HE WAS A MAJOR ARCHITECT OF WHAT 28 00:01:10,560 --> 00:01:13,720 MIGHT BE CONSIDERED THE MOST 29 00:01:13,720 --> 00:01:15,640 AMBITIOUS AND COMPASSIONATE 30 00:01:15,640 --> 00:01:17,840 PROGRAM EVER ACROSS THE WORLD, 31 00:01:17,840 --> 00:01:18,200 PEPFAR. 32 00:01:18,200 --> 00:01:20,440 NOW ESTIMATED TO HAVE SAVED OVER 33 00:01:20,440 --> 00:01:23,120 20 MILLION LIVES, BY PROVIDING 34 00:01:23,120 --> 00:01:26,560 ACCESS TO ANTIRETROVIRAL THERAPY 35 00:01:26,560 --> 00:01:27,440 FOR HIV. 36 00:01:27,440 --> 00:01:29,680 AND OF COURSE SINCE JANUARY 2020 37 00:01:29,680 --> 00:01:32,240 HE HAS BEEN THE WORLD'S MOST 38 00:01:32,240 --> 00:01:34,360 RESPECTED LEADER IN THE RESEARCH 39 00:01:34,360 --> 00:01:38,920 EFFORT TO ADDRESS THE COVID-19 40 00:01:38,920 --> 00:01:39,160 PANDEMIC. 41 00:01:39,160 --> 00:01:40,920 DURING 2020 AND 2021, TONY WAS 42 00:01:40,920 --> 00:01:44,960 MY DAILY AND OFTEN ALSO NIGHTLY 43 00:01:44,960 --> 00:01:47,480 TELEPHONE PARTNER IN INSTITUTING 44 00:01:47,480 --> 00:01:49,440 A 24/7 ALL-HANDS ON DECK TO 45 00:01:49,440 --> 00:01:51,160 BRING THE POWER TO SCIENCE TO 46 00:01:51,160 --> 00:01:53,280 BEAR ON THIS CRY IS. 47 00:01:53,280 --> 00:01:55,480 I BELIEVE THE RESULTS FOR WHICH 48 00:01:55,480 --> 00:01:58,320 ALL OF YOU AND NIH SHOULD TAKE 49 00:01:58,320 --> 00:02:00,720 PARTICULAR PRIDE WILL BE 50 00:02:00,720 --> 00:02:04,120 RECORDED LIE HISTORIANS OF YOU 51 00:02:04,120 --> 00:02:07,080 AN OF SCIENCES FINAL HOURS, 52 00:02:07,080 --> 00:02:12,200 INCLUDING DEVELOPMENT, TESTING, 53 00:02:12,200 --> 00:02:14,360 APPROVAL OF mRNA VACCINE IN 11 54 00:02:14,360 --> 00:02:14,800 MONTHS. 55 00:02:14,800 --> 00:02:17,080 IF IT'S FOUR MONTHS OR MORE 56 00:02:17,080 --> 00:02:22,360 SINCE YOUR LAST BOOSTER, GET 57 00:02:22,360 --> 00:02:24,520 YOUR NEW BIVALENT BOOSTER NOW. 58 00:02:24,520 --> 00:02:26,920 TONY HAS BEEN THE VOICE OF TRUTH 59 00:02:26,920 --> 00:02:29,880 ABOUT THE PANDEMIC THROUGH THE 60 00:02:29,880 --> 00:02:31,560 TUMULTUOUS TWO YEARS, NEVER ONE 61 00:02:31,560 --> 00:02:33,280 TO SUGARCOAT, GAVE IT TO US 62 00:02:33,280 --> 00:02:35,160 STRAIGHT, MOST AMERICANS 63 00:02:35,160 --> 00:02:35,880 APPRECIATED THAT. 64 00:02:35,880 --> 00:02:41,840 ON THE SILLY SIDE THAT LED TO 65 00:02:41,840 --> 00:02:42,440 FAUCI BOBBLEHEADS AND FAUCI 66 00:02:42,440 --> 00:02:42,960 DOUGHNUTS. 67 00:02:42,960 --> 00:02:44,760 BUT ON THE MORE DISTURBING SIDE 68 00:02:44,760 --> 00:02:46,840 THAT LET TO ATTACKS BY 69 00:02:46,840 --> 00:02:47,560 POLITICALLY MOTIVATED 70 00:02:47,560 --> 00:02:48,760 INDIVIDUALS WHO CHOSE TO 71 00:02:48,760 --> 00:02:50,440 DISTRACT FROM THEIR OWN FAILINGS 72 00:02:50,440 --> 00:02:52,760 BY SEEKING TO DEMONIZE THE 73 00:02:52,760 --> 00:02:55,880 DEVOTED PUBLIC SERVANT. 74 00:02:55,880 --> 00:02:59,000 I TRUST THAT HISTORY WILL JUDGE 75 00:02:59,000 --> 00:03:00,480 VITRIOLIC CRITICS APPROPRIATELY 76 00:03:00,480 --> 00:03:02,000 AS THE SELF-SERVING DISTORTERS 77 00:03:02,000 --> 00:03:07,160 OF THE TRUTH THAT THEY HAVE 78 00:03:07,160 --> 00:03:07,360 BECOME. 79 00:03:07,360 --> 00:03:08,920 DESPITE THOSE ATTACKS ON HIM AND 80 00:03:08,920 --> 00:03:13,480 HIS FAMILY THAT REQUIRE ARMED 81 00:03:13,480 --> 00:03:14,360 SECURITY DETAIL TONY CONTINUES 82 00:03:14,360 --> 00:03:16,400 TO LEAD WITH VISION AND DETAIL, 83 00:03:16,400 --> 00:03:18,080 ANNOUNCED HIS INTENTIONS TO STEP 84 00:03:18,080 --> 00:03:18,960 DOWN FROM HIS GOVERNMENT 85 00:03:18,960 --> 00:03:20,920 RESPONSIBILITIES BY THE END OF 86 00:03:20,920 --> 00:03:21,880 THIS YEAR. 87 00:03:21,880 --> 00:03:25,280 THAT IS HARD FOR ALL OF US TO 88 00:03:25,280 --> 00:03:26,160 IMAGINE, ME ESPECIALLY. 89 00:03:26,160 --> 00:03:28,240 BUT AS THE PRESIDENT TOLD HIM, 90 00:03:28,240 --> 00:03:30,760 NO ONE HAS EARNED THE RIGHT MORE 91 00:03:30,760 --> 00:03:33,600 TO STEP BACK FROM SUCH SUPER 92 00:03:33,600 --> 00:03:34,360 HUMAN DUTIES. 93 00:03:34,360 --> 00:03:37,200 FOR ME IT'S BEEN A PRIVILEGE TO 94 00:03:37,200 --> 00:03:40,400 BE TONY'S COLLEAGUE AND HIS 95 00:03:40,400 --> 00:03:41,680 FRIEND OVER MANY DECADES. 96 00:03:41,680 --> 00:03:44,080 AND IT DOES MAKE ME SMILE THAT 97 00:03:44,080 --> 00:03:48,920 WHEN I, AS NIH DIRECTOR FOR 12 98 00:03:48,920 --> 00:03:50,480 YEARS, WOULD OCCASIONALLY BE 99 00:03:50,480 --> 00:03:52,200 ASKED BY SOMEONE WHO DIDN'T KNOW 100 00:03:52,200 --> 00:03:55,040 A LOT BEFORE INSTITUTION TO 101 00:03:55,040 --> 00:04:00,200 DESCRIBE WHAT IS IT, DR. 102 00:04:00,200 --> 00:04:02,000 COLLINS, YOU DO, WHAT IS THE 103 00:04:02,000 --> 00:04:04,440 RANGE OF YOUR RESPONSIBILITIES. 104 00:04:04,440 --> 00:04:05,800 I WOULD GO THROUGH THE MAIN 105 00:04:05,800 --> 00:04:06,480 THINGS. 106 00:04:06,480 --> 00:04:08,400 THE LISTENER WOULD LISTENED 107 00:04:08,400 --> 00:04:09,760 SURPRISED, MAYBE NOT ENTIRELY 108 00:04:09,760 --> 00:04:12,040 COMPELLED BY THE RESPONSE, OH, 109 00:04:12,040 --> 00:04:15,840 YOU OVERSEE 27 INSTITUTES? 110 00:04:15,840 --> 00:04:16,080 UH-HUH. 111 00:04:16,080 --> 00:04:17,120 A BUDGET OF $45 BILLION? 112 00:04:17,120 --> 00:04:20,520 WELSHING THAT'S A LOT DID -- 113 00:04:20,520 --> 00:04:23,920 WELL, THAT'S A LOT, UH-HUH. 114 00:04:23,920 --> 00:04:24,920 PROJECTS ON ALZHEIMER'S, CANCER, 115 00:04:24,920 --> 00:04:26,160 SICKLE CELL DISEASE, SOUNDS 116 00:04:26,160 --> 00:04:26,360 GOOD. 117 00:04:26,360 --> 00:04:28,960 BUT WAIT WHAT? 118 00:04:28,960 --> 00:04:30,480 YOU'RE TONY FAUCI'S BOSS? 119 00:04:30,480 --> 00:04:30,680 HA! 120 00:04:30,680 --> 00:04:34,760 THAT ALWAYS GOT THE BIGGEST 121 00:04:34,760 --> 00:04:35,000 RESPONSE. 122 00:04:35,000 --> 00:04:39,320 WELL, AS IF TONY NEEDED A BOSS, 123 00:04:39,320 --> 00:04:40,600 WE'RE ALL GOING TO BE INTERESTED 124 00:04:40,600 --> 00:04:46,320 TO SEE WHAT THE NEXT CHAPTER 125 00:04:46,320 --> 00:04:46,560 BRINGS. 126 00:04:46,560 --> 00:04:48,360 FOR TONY, 81 IS THE NEW 41. 127 00:04:48,360 --> 00:04:53,160 YOU'RE ABOUT TO HEAR FROM THIS 128 00:04:53,160 --> 00:04:55,640 REMARKABLE LEADER IN THIS FIRST 129 00:04:55,640 --> 00:05:00,640 LECTURE OF THE FALL SERIES ON 130 00:05:00,640 --> 00:05:03,720 COVID SCIENCE, SO JOIN ME IN 131 00:05:03,720 --> 00:05:05,560 WELCOMING THE MOST DEDICATED 132 00:05:05,560 --> 00:05:06,720 PUBLIC SERVICE I'VE KNOWN, TONY 133 00:05:06,720 --> 00:05:06,960 FAUCI. 134 00:05:06,960 --> 00:05:08,560 >> THANK YOU FOR THE KIND 135 00:05:08,560 --> 00:05:08,960 INTRODUCTION. 136 00:05:08,960 --> 00:05:11,480 I THANK THE ORGANIZERS OF THE 137 00:05:11,480 --> 00:05:12,680 SIG LECTURE SERIES FOR GIVING ME 138 00:05:12,680 --> 00:05:14,400 THE OPPORTUNITY TO MAKE THIS 139 00:05:14,400 --> 00:05:15,160 PRESENTATION TODAY. 140 00:05:15,160 --> 00:05:16,720 I'LL BE TALKING ABOUT COVID-19 141 00:05:16,720 --> 00:05:19,440 UPDATE BUT ALSO FOCUSING ON SOME 142 00:05:19,440 --> 00:05:21,560 OF THE LESSONS LEARNED THROUGH 143 00:05:21,560 --> 00:05:24,360 OUR EXPERIENCE OVER THE LAST 2 144 00:05:24,360 --> 00:05:25,160 1/2 YEARS. 145 00:05:25,160 --> 00:05:27,120 THE PRESENTATION OBJECTIVES ARE 146 00:05:27,120 --> 00:05:28,760 TO REVIEW THE CURRENT STATE OF 147 00:05:28,760 --> 00:05:31,000 THE PANDEMIC, AS I MENTIONED TO 148 00:05:31,000 --> 00:05:33,800 PRESENT LESSONS LEARNED, BUT 149 00:05:33,800 --> 00:05:35,280 ALSO TO DISCUSS THE PRO-ACTIVE 150 00:05:35,280 --> 00:05:37,360 RESEARCH AIMED AT PREPARING FOR 151 00:05:37,360 --> 00:05:39,120 FUTURE SURGES WITHIN THIS 152 00:05:39,120 --> 00:05:41,960 OUTBREAK AS WELL AS OTHER FUTURE 153 00:05:41,960 --> 00:05:44,280 PANDEMICS OF THIS OR OTHER 154 00:05:44,280 --> 00:05:44,720 PATHOGENS. 155 00:05:44,720 --> 00:05:47,600 FIRST, A QUICK LOOK AT THE 156 00:05:47,600 --> 00:05:48,960 CURRENT STATE OF COVID-19. 157 00:05:48,960 --> 00:05:51,760 JUST HISTORICALLY TO BRING US 158 00:05:51,760 --> 00:05:55,360 BACK 2 1/2+ YEARS, TO THE FIRST 159 00:05:55,360 --> 00:05:56,960 AWARENESS OF AN UNUSUAL VIRUS 160 00:05:56,960 --> 00:06:00,000 THAT HAD EMERGED OUT OF THE 161 00:06:00,000 --> 00:06:00,960 CORONAVIRUS FAMILY, FROM A 162 00:06:00,960 --> 00:06:03,320 MARKET IN THE CENTRAL PART OF 163 00:06:03,320 --> 00:06:06,560 CHINA, IN THE WUHAN DISTRICT 164 00:06:06,560 --> 00:06:07,120 CITY. 165 00:06:07,120 --> 00:06:10,840 IT BEGAN AS A CLUSTER OF CASES 166 00:06:10,840 --> 00:06:14,200 WHICH AS WE FAST FORWARD TO 167 00:06:14,200 --> 00:06:15,400 TODAY SEE WE'VE BEEN 168 00:06:15,400 --> 00:06:16,760 EXPERIENCING OVER THE LAST 2 1/2 169 00:06:16,760 --> 00:06:19,360 YEARS THE MOST IMPACTFUL AND 170 00:06:19,360 --> 00:06:21,200 DEVASTATING PANDEMIC OF A 171 00:06:21,200 --> 00:06:22,640 RESPIRATORY DISEASE THAT THE 172 00:06:22,640 --> 00:06:24,280 WORLD HAS EXPERIENCED IN WELL 173 00:06:24,280 --> 00:06:27,560 OVER 100 YEARS WITH A GLOBAL 174 00:06:27,560 --> 00:06:31,520 NUMBER OF OVER 600 MILLION 175 00:06:31,520 --> 00:06:33,640 CASES, DEATHS ABOUT 6.5 MILLION 176 00:06:33,640 --> 00:06:36,880 WHICH IS LIKELY A SIGNIFICANT 177 00:06:36,880 --> 00:06:38,920 UNDERCOUNT OF DEATHS ASSOCIATED 178 00:06:38,920 --> 00:06:41,400 WITH THIS PANDEMIC, THE UNITED 179 00:06:41,400 --> 00:06:42,960 STATES UNFORTUNATELY AND 180 00:06:42,960 --> 00:06:43,800 PAINFULLY HAS SUFFERED 181 00:06:43,800 --> 00:06:45,560 DISPROPORTIONATELY GREATER THAN 182 00:06:45,560 --> 00:06:47,960 MOST ANY OTHER COUNTRY WITH 183 00:06:47,960 --> 00:06:49,600 ABOUT 100 MILLION CASES, AND NOW 184 00:06:49,600 --> 00:06:53,560 2 1/2 YEARS IN, OVER ONE MILLION 185 00:06:53,560 --> 00:06:54,280 DEATHS. 186 00:06:54,280 --> 00:06:58,560 AGAIN, WHICH IS LIKELY A BIT OF 187 00:06:58,560 --> 00:06:59,680 AN UNDERCOUNT. 188 00:06:59,680 --> 00:07:01,560 THE SARS-COV-2 FAMILY HAS 189 00:07:01,560 --> 00:07:04,480 EMERGED OVER THE LAST 2 1/2 190 00:07:04,480 --> 00:07:06,560 YEARS HAS BEEN EXTRAORDINARY IN 191 00:07:06,560 --> 00:07:09,760 THE NUMBER OF VARIANTS THAT HAVE 192 00:07:09,760 --> 00:07:10,760 SEQUENTIALLY PRESENTED 193 00:07:10,760 --> 00:07:12,520 THEMSELVES TO THE COMMUNITY 194 00:07:12,520 --> 00:07:16,160 LIKELY THROUGH A SERIES OF 195 00:07:16,160 --> 00:07:17,680 SELECTIVE PRESSURES. 196 00:07:17,680 --> 00:07:20,320 I CIRCLE IN RED WHERE WE 197 00:07:20,320 --> 00:07:21,760 CURRENTLY ON, THE OMICRON 198 00:07:21,760 --> 00:07:23,680 VARIANT, AS I'LL SHOW IN THE 199 00:07:23,680 --> 00:07:27,440 NEXT SLIDE HAS A NUMBER OF 200 00:07:27,440 --> 00:07:28,640 SUBVARIANTS, STARTING OFF WITH 201 00:07:28,640 --> 00:07:43,480 BA .1 AND GOING TO BA.2, 2.12.1 202 00:07:43,480 --> 00:07:44,040 AND BA.5/4. 203 00:07:44,040 --> 00:07:46,880 IF YOU LOOK AT CASES IN THE 204 00:07:46,880 --> 00:07:50,160 UNITED STATES, WE HAVE HAD 205 00:07:50,160 --> 00:07:53,760 VARIOUS SURGES OVER THE 2 1/2 206 00:07:53,760 --> 00:07:55,200 YEARS THAT HAVE BEEN REFLECTIVE 207 00:07:55,200 --> 00:07:58,600 OF NEW VARIANTS THAT HAVE 208 00:07:58,600 --> 00:08:01,320 OBSERVED, ALPHA, AND THEN DELTA 209 00:08:01,320 --> 00:08:11,360 YOU REMEMBER IN THE SUMMER OF 210 00:08:11,360 --> 00:08:12,360 2021, FOLLOWED BY OMICRON. 211 00:08:12,360 --> 00:08:15,120 AT THE PEAK OF JANUARY THIS YEAR 212 00:08:15,120 --> 00:08:16,760 WE WERE APPROACHING ONE MILLION 213 00:08:16,760 --> 00:08:18,840 CASES A YEAR. 214 00:08:18,840 --> 00:08:22,440 NOW ALTHOUGH YEAR NOT AT A LEVEL 215 00:08:22,440 --> 00:08:24,520 THAT IS ACCEPTABLE, IT HAS GONE 216 00:08:24,520 --> 00:08:27,840 DOWN TO BETWEEN 75 AND 100,000 217 00:08:27,840 --> 00:08:28,720 CASES A DAY. 218 00:08:28,720 --> 00:08:32,680 IF YOU LOOK AT DEATHS, IN THE 219 00:08:32,680 --> 00:08:37,400 UNITED STATES, AGAIN IF YOU LOOK 220 00:08:37,400 --> 00:08:38,360 AT THE SEVEN-DAY ROLLING 221 00:08:38,360 --> 00:08:40,760 AVERAGES AND PEAK OF THE 222 00:08:40,760 --> 00:08:43,920 OMICRON, IN JANUARY OF THIS 223 00:08:43,920 --> 00:08:47,320 YEAR, WE HAD OVER 3,000 DEATHS 224 00:08:47,320 --> 00:08:47,800 PER DAY. 225 00:08:47,800 --> 00:08:51,400 AGAIN, IF YOU LOOK AT WHERE WE 226 00:08:51,400 --> 00:08:56,360 ARE NOW, BETWEEN 350 AND 450 227 00:08:56,360 --> 00:08:57,160 DEATHS PER DAY, SUBSTANTIALLY 228 00:08:57,160 --> 00:09:01,760 LOWER THAN WHAT WE EXPERIENCED 229 00:09:01,760 --> 00:09:03,520 BEFORE. 230 00:09:03,520 --> 00:09:04,880 HOWEVER, STILL AN UNACCEPTABLY 231 00:09:04,880 --> 00:09:06,040 HIGH LEVEL OF DEATHS. 232 00:09:06,040 --> 00:09:09,680 SO WHEN PEOPLE ASK US WHERE ARE 233 00:09:09,680 --> 00:09:12,520 WE IN THE OUTBREAK, WE'RE NOT IN 234 00:09:12,520 --> 00:09:14,320 THE FULMINANT STAGE WE 235 00:09:14,320 --> 00:09:17,800 EXPERIENCED AT THE PEAK OF THE 236 00:09:17,800 --> 00:09:20,880 OMICRON SURGE, BUT WITH MULTIPLE 237 00:09:20,880 --> 00:09:22,080 SUBVARIANTS WHAT WE'RE TALKING 238 00:09:22,080 --> 00:09:24,760 ABOUT WE STILL HAVE A 239 00:09:24,760 --> 00:09:26,360 CONSIDERABLE NUMBER OF CASES. 240 00:09:26,360 --> 00:09:28,120 NOW, THIS SLIDE IS A COMPLICATED 241 00:09:28,120 --> 00:09:29,320 SLIDE BUT IT'S REALLY IMPORTANT 242 00:09:29,320 --> 00:09:32,080 BECAUSE IF YOU GO FROM LEFT TO 243 00:09:32,080 --> 00:09:36,320 RIGHT, AND YOU LOOK AT THE 244 00:09:36,320 --> 00:09:37,400 VARIOUS COLOR CODES REPRESENTING 245 00:09:37,400 --> 00:09:41,040 THE VARIANTS, YOU CAN SEE HOW 246 00:09:41,040 --> 00:09:45,680 ONE VARIANT OVER TIME BECAUSE OF 247 00:09:45,680 --> 00:09:48,360 A TRANSMISSION ADVANTAGE OVER 248 00:09:48,360 --> 00:09:52,560 THE PRIOR VARIANT ESSENTIALLY 249 00:09:52,560 --> 00:09:55,680 PUSHES OFF THE SCENE THE PRIOR 250 00:09:55,680 --> 00:09:57,200 VARIANT THAT GETS REPLACED BY 251 00:09:57,200 --> 00:09:58,160 THE CURRENT VARIANT. 252 00:09:58,160 --> 00:10:00,920 AS YOU CAN SEE TO THE FAR 253 00:10:00,920 --> 00:10:05,200 RIGHT-HAND PART OF THE SLIDE, 254 00:10:05,200 --> 00:10:07,520 WHAT THE MEDIAN DENSITY PURPLE, 255 00:10:07,520 --> 00:10:13,360 YOU HAVE BA.5 AT 88.6, AND BA .4 256 00:10:13,360 --> 00:10:19,760 AT 2.8, AND 4.6 AND .4. 257 00:10:19,760 --> 00:10:23,120 BA .4.5, IT'S WELL OVER 90% OF 258 00:10:23,120 --> 00:10:26,240 VARIANTS CIRCULATING IN THE 259 00:10:26,240 --> 00:10:28,000 UNITED STATES, ALSO RELATIVELY 260 00:10:28,000 --> 00:10:30,040 SPEAKING RIGHT REFLECTIVE IN THE 261 00:10:30,040 --> 00:10:32,120 REST OF THE WORLD. 262 00:10:32,120 --> 00:10:35,520 WE ALL KNOW OF THE SUCCESS OF 263 00:10:35,520 --> 00:10:35,840 THE VACCINES. 264 00:10:35,840 --> 00:10:42,080 THESE ARE THE THREE PLATFORMS. 265 00:10:42,080 --> 00:10:45,920 mRNA, ADENO, AND RECOMBINANT 266 00:10:45,920 --> 00:10:47,560 WITH ADJUVANT. 267 00:10:47,560 --> 00:10:49,080 IMMUNOGEN DISCOVERED HERE BY 268 00:10:49,080 --> 00:10:51,000 BONNIE GRAHAM AND KIZZY CORBETT, 269 00:10:51,000 --> 00:10:55,640 AND THE GROUP AT THE VRC, THE 270 00:10:55,640 --> 00:10:56,960 STABILIZED PRE-FUSION SPIKE 271 00:10:56,960 --> 00:10:59,040 PROTEIN, WE HAVE MULTIPLE 272 00:10:59,040 --> 00:11:00,160 COMPANIES INVOLVED, AND THE 273 00:11:00,160 --> 00:11:02,960 VACCINES AS YOU SEE ON THE RIGHT 274 00:11:02,960 --> 00:11:04,520 HAVE EITHER RECEIVED FULL 275 00:11:04,520 --> 00:11:08,560 APPROVAL AS WITH MODERNA AND 276 00:11:08,560 --> 00:11:11,600 BioNTech, OR AN EUA AS SHOWN 277 00:11:11,600 --> 00:11:14,440 WITH THE REST OF THE VACCINES ON 278 00:11:14,440 --> 00:11:15,520 THE SLIDE HERE. 279 00:11:15,520 --> 00:11:17,560 THESE ARE NOT THE ONLY VACCINES 280 00:11:17,560 --> 00:11:18,360 THAT ARE USED. 281 00:11:18,360 --> 00:11:20,560 MANY OTHERS ARE USED THROUGHOUT 282 00:11:20,560 --> 00:11:21,080 THE WORLD. 283 00:11:21,080 --> 00:11:23,000 BUT THESE ARE THE ONES THAT ARE 284 00:11:23,000 --> 00:11:24,960 CURRENTLY BEING DISTRIBUTED IN 285 00:11:24,960 --> 00:11:27,600 THE UNITED STATES. 286 00:11:27,600 --> 00:11:30,160 WE'VE DEVELOPED A SUCCESSFUL 287 00:11:30,160 --> 00:11:31,720 THERAPEUTIC TOOLKIT 288 00:11:31,720 --> 00:11:34,000 PREDOMINANTLY FOR OUTPATIENTS TO 289 00:11:34,000 --> 00:11:37,360 KEEP THEM FROM PROGRESSING TO 290 00:11:37,360 --> 00:11:38,520 ADVANCED DISEASE REQUIRING 291 00:11:38,520 --> 00:11:38,960 HOSPITALIZATION. 292 00:11:38,960 --> 00:11:41,560 THE MOST IMPORTANT OF WHICH THAT 293 00:11:41,560 --> 00:11:47,040 IS USED WIDELY NOW IS PAXLOVID, 294 00:11:47,040 --> 00:11:47,880 A PROTEASE INHIBITOR, ALSO 295 00:11:47,880 --> 00:11:52,800 CLINICAL TRIALS HAVE SHOWN 296 00:11:52,800 --> 00:12:04,840 BENEFIT OF REMDESIVIR, 297 00:12:04,840 --> 00:12:07,040 M ALNOPIRAVR, AND NOW BEBTELOVIM 298 00:12:07,040 --> 00:12:11,200 ARCB, EFFECTIVE AGAINST THE BA 299 00:12:11,200 --> 00:12:12,080 .4.5. 300 00:12:12,080 --> 00:12:15,960 WE HAVE PROPHYLAXIS WITH A 301 00:12:15,960 --> 00:12:16,760 MONOCLONAL ANTIBODY WHICH REDUCE 302 00:12:16,760 --> 00:12:19,560 THE 80% RISK OF DEVELOPING 303 00:12:19,560 --> 00:12:21,880 SYMPTOMATIC DISEASE AT SIX 304 00:12:21,880 --> 00:12:25,640 MONTHS COMPARED TO A PLACEBO IN 305 00:12:25,640 --> 00:12:27,760 A WELL-CONDUCTED CLINICAL TRIAL. 306 00:12:27,760 --> 00:12:31,760 SO THE QUESTION IS, WHY DO WE 307 00:12:31,760 --> 00:12:34,480 HAVE THE PERSISTENCE OF DAILY 308 00:12:34,480 --> 00:12:35,560 COVID-19 CASES THAT EVEN THOUGH 309 00:12:35,560 --> 00:12:38,160 THEY ARE LOWER THAN THEY WERE 310 00:12:38,160 --> 00:12:40,680 BEFORE, THEY ARE, AS SHOWN ON A 311 00:12:40,680 --> 00:12:43,640 COUPLE PREVIOUS SLIDES, THAT I 312 00:12:43,640 --> 00:12:45,720 SHOWED YOU, STILL AT A RATHER 313 00:12:45,720 --> 00:12:46,480 DISTURBING LEVEL. 314 00:12:46,480 --> 00:12:53,760 IT HAS TO DO WITH THE INCREASED 315 00:12:53,760 --> 00:12:55,000 TRANSMISSIBILITY OF THE CURRENT 316 00:12:55,000 --> 00:12:57,320 VARIANT, BA.5, THE MOST 317 00:12:57,320 --> 00:12:58,360 IMPORTANT IS WANING IMMUNITY, 318 00:12:58,360 --> 00:13:02,960 BOTH TO THE PRIOR INFECTION 319 00:13:02,960 --> 00:13:05,600 AND/OR TO VACCINATION. 320 00:13:05,600 --> 00:13:08,680 TOGETHER WITH THE RELAXATION OF 321 00:13:08,680 --> 00:13:10,280 MITIGATIONS THAT WE COMMONLY SEE 322 00:13:10,280 --> 00:13:13,800 WITH THE DECREASE IN THE USE OF 323 00:13:13,800 --> 00:13:18,400 MASKING, AND INCREASE IN USE OF 324 00:13:18,400 --> 00:13:22,360 INDOOR CONGREGATING EVENTS SUCH 325 00:13:22,360 --> 00:13:23,360 AS WEDDINGS, PARTIES, AND 326 00:13:23,360 --> 00:13:23,560 DINNERS. 327 00:13:23,560 --> 00:13:27,120 NOW, IF YOU LOOK TO WHERE WE ARE 328 00:13:27,120 --> 00:13:30,960 RIGHT NOW, THE CDC HAS 329 00:13:30,960 --> 00:13:34,480 RECOMMENDED THE FIRST UPDATED 330 00:13:34,480 --> 00:13:40,400 COVID-19 VACCINE WHICH IS A 331 00:13:40,400 --> 00:13:43,040 BIVALENT BA .4/5 COMPONENT 332 00:13:43,040 --> 00:13:44,080 AUTHORIZED FOR PEOPLE OVER 12 333 00:13:44,080 --> 00:13:48,160 YEARS OLD, IF YOU USE THE PFIZER 334 00:13:48,160 --> 00:13:50,960 OR OVER 18 YEARS OLD, 18 OR 335 00:13:50,960 --> 00:13:53,560 OVER, IF YOU USE THE MODERNA. 336 00:13:53,560 --> 00:13:59,280 AND IN THE COMING WEEKS, THE CDC 337 00:13:59,280 --> 00:14:01,800 EXPECTS WITH THEIR ACIP TO 338 00:14:01,800 --> 00:14:05,520 RECOMMEND UPDATED BOOSTERS FOR 339 00:14:05,520 --> 00:14:07,760 PEDIATRIC GROUPS YOUNGER THAN 12 340 00:14:07,760 --> 00:14:11,120 LIMIT NOW SET BY THE FDA 341 00:14:11,120 --> 00:14:11,880 AUTHORIZATION. 342 00:14:11,880 --> 00:14:14,760 SO LET'S MOVE ON NOW TO TAKE A 343 00:14:14,760 --> 00:14:18,240 LOOK AT SOME LESSONS LEARNED AS 344 00:14:18,240 --> 00:14:19,240 WELL AS THE RESEARCH THAT'S 345 00:14:19,240 --> 00:14:22,640 INVOLVED TOGETHER WITH THESE 346 00:14:22,640 --> 00:14:23,640 LESSONS LEARNED. 347 00:14:23,640 --> 00:14:25,280 THESE ARE THE SEVEN POINTS THAT 348 00:14:25,280 --> 00:14:29,400 I'M GOING TO BRIEFLY MAKE. 349 00:14:29,400 --> 00:14:31,960 FIRST, GLOBAL INFORMATION 350 00:14:31,960 --> 00:14:33,840 SHARING AND COLLABORATIONS ARE 351 00:14:33,840 --> 00:14:36,080 ESSENTIAL TO OUR SUCCESS. 352 00:14:36,080 --> 00:14:38,800 WE KNOW THAT NOW BECAUSE OF THE 353 00:14:38,800 --> 00:14:43,760 FACT THAT THE SHARING OF 354 00:14:43,760 --> 00:14:46,360 REAGENTS, SURVEILLANCE DATA, 355 00:14:46,360 --> 00:14:47,160 CONVALESCENT AND PATIENT 356 00:14:47,160 --> 00:14:49,640 SAMPLES, REAL WORLD CLINICAL 357 00:14:49,640 --> 00:14:52,360 DATA, ISOLATES, GENOMIC DATA 358 00:14:52,360 --> 00:14:54,880 HAVE BEEN EXTREMELY IMPORTANT IN 359 00:14:54,880 --> 00:14:57,400 OUR ABILITY TO ADDRESS THE MANY 360 00:14:57,400 --> 00:14:58,680 PROBLEMS THAT HAVE ARISEN OVER 361 00:14:58,680 --> 00:15:01,760 THE LAST 2 1/2 YEARS, AND THAT'S 362 00:15:01,760 --> 00:15:03,480 INFORMED RESEARCH NOT ONLY HERE 363 00:15:03,480 --> 00:15:06,160 IN THE UNITED STATES BUT 364 00:15:06,160 --> 00:15:10,360 THROUGHOUT THE WORLD. 365 00:15:10,360 --> 00:15:14,320 NEXT, THE EXISTING CLINICAL 366 00:15:14,320 --> 00:15:15,320 TRIAL INFRASTRUCTURE SHOULD BE 367 00:15:15,320 --> 00:15:17,280 UTILIZED. 368 00:15:17,280 --> 00:15:19,680 THIS IS AN EXAMPLE OF USE OF 369 00:15:19,680 --> 00:15:22,760 RESOURCES THAT WERE INVESTED 370 00:15:22,760 --> 00:15:25,680 DECADES AGO, WITH THE HIV 371 00:15:25,680 --> 00:15:27,200 CLINICAL TRIALS AND LEVERAGING 372 00:15:27,200 --> 00:15:31,920 THESE TO BE USED NOW TO TEST THE 373 00:15:31,920 --> 00:15:34,120 COVID-19 VACCINES. 374 00:15:34,120 --> 00:15:36,520 I REFER NOW TO THE COVID-19 375 00:15:36,520 --> 00:15:42,360 PREVENTION NETWORK WHICH WE 376 00:15:42,360 --> 00:15:54,480 REFER TO AS COV PN, ESTABLISHED 377 00:15:54,480 --> 00:15:57,120 BY MERGING FOUR NIAID-FUNDED 378 00:15:57,120 --> 00:15:58,040 NETWORKS, SUCCESS UNTIL IN 379 00:15:58,040 --> 00:16:06,360 DEVELOPING DRUGS IN THE ACTG, 380 00:16:06,360 --> 00:16:08,800 PREVENTION TRIALS NETWORK SO 381 00:16:08,800 --> 00:16:10,320 SUCCESSFUL IN THE PRE-EXPOSURE 382 00:16:10,320 --> 00:16:13,280 PROPHYLAXIS WORK AS WELL AS 383 00:16:13,280 --> 00:16:14,360 HIV-INFECTED VACCINE TRIALS 384 00:16:14,360 --> 00:16:14,560 NETWORK. 385 00:16:14,560 --> 00:16:16,160 AS I MENTIONED, THAT'S REFERRED 386 00:16:16,160 --> 00:16:21,240 TO NOW AS THE COV-PN. 387 00:16:21,240 --> 00:16:24,960 IMPORTANTLY, FOR THE BASIC AND 388 00:16:24,960 --> 00:16:26,040 FUNDAMENTAL SCIENTIFIC 389 00:16:26,040 --> 00:16:28,640 COMMUNITY, PRIOR ADVANCES IN 390 00:16:28,640 --> 00:16:31,840 BASIC RESEARCH HAVE ENABLED THE 391 00:16:31,840 --> 00:16:33,920 RAPID VACCINE DEVELOPMENT. 392 00:16:33,920 --> 00:16:35,680 I ARTICULATED THAT IN A 393 00:16:35,680 --> 00:16:38,160 COMMENTARY IN "SCIENCE" IN APRIL 394 00:16:38,160 --> 00:16:38,800 OF 2021. 395 00:16:38,800 --> 00:16:43,320 AS I SAID IN THAT, THE SPEED AND 396 00:16:43,320 --> 00:16:45,600 EFFICIENCY WITH WHICH THESE 397 00:16:45,600 --> 00:16:46,560 HIGHLY EFFICACIOUS VACCINES THAT 398 00:16:46,560 --> 00:16:49,960 I SHOWED ON THE PRIOR SLIDE WERE 399 00:16:49,960 --> 00:16:54,320 DEVELOPED IN THEIR POTENTIAL FOR 400 00:16:54,320 --> 00:16:57,160 SAVING MILLIONS OF LIVES, DUE TO 401 00:16:57,160 --> 00:16:57,560 AN EXTRAORDINARY 402 00:16:57,560 --> 00:16:59,280 MULTI-DISCIPLINARY EFFORT THAT 403 00:16:59,280 --> 00:17:01,280 INVOLVED BASIC PRE-CLINICAL AND 404 00:17:01,280 --> 00:17:02,560 CLINICAL SCIENCE THAT HAD BEEN 405 00:17:02,560 --> 00:17:04,720 UNDERWAY OUT OF THE SPOTLIGHT, 406 00:17:04,720 --> 00:17:07,360 UNDER THE RADAR SCREEN, 407 00:17:07,360 --> 00:17:10,000 LITERALLY FOR DECADES BEFORE THE 408 00:17:10,000 --> 00:17:11,840 UNFOLDING OF THE COVID-19 409 00:17:11,840 --> 00:17:12,280 PANDEMIC. 410 00:17:12,280 --> 00:17:16,520 TO THE POINT WHERE "SCIENCE" 411 00:17:16,520 --> 00:17:19,680 MAGAZINE, YOU MIGHT RECALL, IN 412 00:17:19,680 --> 00:17:23,400 DECEMBER OF 2020 DESIGNATED THE 413 00:17:23,400 --> 00:17:23,960 COVID-19 VACCINES AS THE 414 00:17:23,960 --> 00:17:27,240 BREAKTHROUGH OF THE YEAR OF 415 00:17:27,240 --> 00:17:28,200 2020. 416 00:17:28,200 --> 00:17:31,960 AND, AGAIN, HERE ARE THE SAME 417 00:17:31,960 --> 00:17:34,360 VACCINES THAT WE MENTIONED WHERE 418 00:17:34,360 --> 00:17:36,760 WE HAVE NOW MULTIPLE VACCINES 419 00:17:36,760 --> 00:17:40,760 THAT ARE BEING USED WITH UP TO 420 00:17:40,760 --> 00:17:44,760 94 TO 95% EFFICACY PREVENTING 421 00:17:44,760 --> 00:17:45,480 CLINICALLY RECOGNIZABLE DISEASE 422 00:17:45,480 --> 00:17:47,560 BUT AS I'M GOING TO MENTION IN A 423 00:17:47,560 --> 00:17:49,920 MOMENT, AND AS I MENTIONED 424 00:17:49,920 --> 00:17:52,640 EARLIER, THE ISSUE THAT WE HAVE 425 00:17:52,640 --> 00:17:55,240 IS WANING IMMUNITY WHICH HAS 426 00:17:55,240 --> 00:17:58,360 REQUIRED A VERY UNUSUAL APPROACH 427 00:17:58,360 --> 00:18:00,400 OF MULTIPLE UPDATING BOOSTERS 428 00:18:00,400 --> 00:18:02,240 FOR THE WANING IMMUNITY WHICH 429 00:18:02,240 --> 00:18:07,400 WHEN PRESENT IS REALLY QUITE 430 00:18:07,400 --> 00:18:07,720 SUCCESSFUL. 431 00:18:07,720 --> 00:18:10,560 NEXT, PROTOTYPE AND PRIORITY 432 00:18:10,560 --> 00:18:13,960 PATHOGEN APPROACHES ENABLED OUR 433 00:18:13,960 --> 00:18:15,560 ABILITY TO PREPARE FOR 434 00:18:15,560 --> 00:18:17,840 PANDEMICS, INCLUDING THE PRESENT 435 00:18:17,840 --> 00:18:18,160 ONE. 436 00:18:18,160 --> 00:18:21,560 WHAT DO WE MEAN BY THE EMERGING 437 00:18:21,560 --> 00:18:22,480 INFECTIOUS DISEASE VACCINE 438 00:18:22,480 --> 00:18:24,000 DEVELOPMENT APPROACH? 439 00:18:24,000 --> 00:18:26,360 THERE ARE TWO. 440 00:18:26,360 --> 00:18:28,800 PRIORITY PATHOGENS AND PROTOTYPE 441 00:18:28,800 --> 00:18:29,320 PATHOGENS. 442 00:18:29,320 --> 00:18:31,720 PRIORITY PATHOGENS MEAN YOU 443 00:18:31,720 --> 00:18:34,360 ACTUALLY PICK OUT A PATHOGEN AND 444 00:18:34,360 --> 00:18:35,720 PREEMPTIVELY MAKE A VACCINE FOR 445 00:18:35,720 --> 00:18:36,120 THAT. 446 00:18:36,120 --> 00:18:40,960 AS IS BEING DONE NOW AS WE DID 447 00:18:40,960 --> 00:18:44,560 WITH ZIKA, AS WE'RE DOING WITH 448 00:18:44,560 --> 00:18:46,880 NIPPA, AS WE DID WITH EBOLA. 449 00:18:46,880 --> 00:18:51,360 HOWEVER, THE OTHER IS A 450 00:18:51,360 --> 00:18:53,560 PROTOTYPE PATHOGEN APPROACH, 451 00:18:53,560 --> 00:18:58,280 TAKE FAMILIES OF PATHOGENS AND 452 00:18:58,280 --> 00:19:01,560 AS DESCRIBED, AND THIS CONCEPT 453 00:19:01,560 --> 00:19:03,640 DEVELOPED BY BONNIE GRAHAM FOR 454 00:19:03,640 --> 00:19:06,200 NIAID, IN WHICH MADE THE 455 00:19:06,200 --> 00:19:09,160 PROPOSAL OF LOOKING AT PRIOR 456 00:19:09,160 --> 00:19:11,160 EXPERIENCES WITH DIFFERENT 457 00:19:11,160 --> 00:19:14,680 FAMILIES OF PATHOGENS AND TO USE 458 00:19:14,680 --> 00:19:18,360 THAT EXPERIENCE TO PROVIDE A 459 00:19:18,360 --> 00:19:19,680 COMMONALITY OF KNOWLEDGE WITHIN 460 00:19:19,680 --> 00:19:22,200 THAT FAMILY THAT WOULD ALLOW US 461 00:19:22,200 --> 00:19:24,520 TO MOVE QUICKLY IF WITHIN THAT 462 00:19:24,520 --> 00:19:28,080 FAMILY A NEW PATHOGEN EMERGED. 463 00:19:28,080 --> 00:19:31,560 THERE ARE ABOUT 20 PATHOGEN 464 00:19:31,560 --> 00:19:32,960 FAMILIES OF IMPORTANCE. 465 00:19:32,960 --> 00:19:35,480 SEVEN OR EIGHT OF WHICH ARE OF 466 00:19:35,480 --> 00:19:37,880 THE HIGHEST PRIORITY. 467 00:19:37,880 --> 00:19:40,360 AND SHOWN ON THIS SLIDE WE 468 00:19:40,360 --> 00:19:42,560 ALREADY DID THAT WITH 469 00:19:42,560 --> 00:19:44,120 CORONAVIRUS, FOR EXAMPLE WE HAVE 470 00:19:44,120 --> 00:19:47,120 EXPERIENCE WITH WORK THAT WAS 471 00:19:47,120 --> 00:19:51,000 DONE ON SARS 1 AS WELL AS MERS, 472 00:19:51,000 --> 00:19:58,560 WHICH LED US OVER A PERIOD FROM 473 00:19:58,560 --> 00:20:02,600 2002 TO 2020 TO GIVE US THE 474 00:20:02,600 --> 00:20:06,440 EXPERIENCE TO RESPOND RAPIDLY TO 475 00:20:06,440 --> 00:20:06,880 SARS-COV-2. 476 00:20:06,880 --> 00:20:10,560 AND WHAT YOU DO IS YOU APPLY THE 477 00:20:10,560 --> 00:20:12,760 STRATEGIES AND TOOLS OF ONE 478 00:20:12,760 --> 00:20:16,040 VIRUS WITHIN A FAMILY TO INFORM 479 00:20:16,040 --> 00:20:18,160 VACCINE DESIGN FOR RELATED 480 00:20:18,160 --> 00:20:18,680 VIRUSES. 481 00:20:18,680 --> 00:20:22,200 SAME WHAT WE DID WITH THE EARLY 482 00:20:22,200 --> 00:20:26,160 STUDIES ON CORONAVIRUSES. 483 00:20:26,160 --> 00:20:26,920 BASIC VIROLOGY, ASSAY 484 00:20:26,920 --> 00:20:29,880 DEVELOPMENT, ANIMAL MODELS, 485 00:20:29,880 --> 00:20:31,400 ANTIGENIC TARGETS, OPTIMAL 486 00:20:31,400 --> 00:20:38,080 PLATFORMS, WHETHER IT IS mRNA, 487 00:20:38,080 --> 00:20:40,960 NANOPARTICLE, ADENOVIRUS, AND 488 00:20:40,960 --> 00:20:41,920 OTHER VECTOR EXPRESSED, 489 00:20:41,920 --> 00:20:43,920 POTENTIAL IMMUNE CORRELATES AS 490 00:20:43,920 --> 00:20:45,520 WELL AS MANUFACTURING STRATEGIES 491 00:20:45,520 --> 00:20:47,160 FOR THE VACCINE. 492 00:20:47,160 --> 00:20:49,040 REMEMBER, IF WE DO THIS FOR EACH 493 00:20:49,040 --> 00:20:50,080 OF THOSE FAMILIES, WHICH IS 494 00:20:50,080 --> 00:20:52,560 GOING TO BE A LOT OF RESOURCES, 495 00:20:52,560 --> 00:20:55,800 BUT IT WILL PUT US IN GOOD STEAD 496 00:20:55,800 --> 00:20:59,200 FOR THE NEXT PANDEMIC THAT WE 497 00:20:59,200 --> 00:21:01,160 WILL INEVITABLY FACE. 498 00:21:01,160 --> 00:21:04,000 ANOTHER IMPORTANT LESSON WE MUST 499 00:21:04,000 --> 00:21:07,760 CONTINUE THE SURVEILLANCE OF THE 500 00:21:07,760 --> 00:21:08,280 HUMAN/ANIMAL INTERFACE. 501 00:21:08,280 --> 00:21:10,360 THIS IS CRITICAL. 502 00:21:10,360 --> 00:21:13,520 MY COLLEAGUE DAVID MOREENS AND I 503 00:21:13,520 --> 00:21:18,480 OVER TWO YEARS AGO, ACTUALLY, 504 00:21:18,480 --> 00:21:22,320 WROTE IN "CELL" THAT THE 505 00:21:22,320 --> 00:21:25,160 COVID-19 PANDEMIC IS A TRULY 506 00:21:25,160 --> 00:21:28,560 STARK REMINDER, ADDED TO THE 507 00:21:28,560 --> 00:21:30,760 GROWING RAPIDLY ARCHIVE OF 508 00:21:30,760 --> 00:21:34,880 HISTORICAL REMINDERS THAT IN THE 509 00:21:34,880 --> 00:21:36,960 HUMAN-DOMINATED WORLD IN WHICH 510 00:21:36,960 --> 00:21:38,320 HUMAN ACTIVITIES REPRESENT 511 00:21:38,320 --> 00:21:42,760 AGGRESSIVE DAMAGING, AND AS I 512 00:21:42,760 --> 00:21:43,760 HIGHLIGHT HERE, UNBALANCED 513 00:21:43,760 --> 00:21:46,920 INTERACTIONS WITH NATURE WE WILL 514 00:21:46,920 --> 00:21:48,320 INCREASINGLY PROVOKE NEW DISEASE 515 00:21:48,320 --> 00:21:48,640 EMERGENCES. 516 00:21:48,640 --> 00:21:53,040 AS MOST OF YOU KNOW, ABOUT 75% 517 00:21:53,040 --> 00:21:56,640 OF ALL NEW PATHOGENS IN HUMANS 518 00:21:56,640 --> 00:21:59,360 ARE ZOONOTIC, THEY HAVE EMERGED 519 00:21:59,360 --> 00:22:06,280 FROM AN ANIMAL RESERVOIR SOURCE. 520 00:22:06,280 --> 00:22:10,560 COGENT EXAMPLES, HIV, INFLUENZA, 521 00:22:10,560 --> 00:22:13,920 EBOLA, AND NOW COVID-19. 522 00:22:13,920 --> 00:22:14,480 HUMAN HEALTH IS INEVITABLY 523 00:22:14,480 --> 00:22:16,360 CONNECTED TO THE HEALTH OF 524 00:22:16,360 --> 00:22:18,320 ANIMALS IN OUR SHARED 525 00:22:18,320 --> 00:22:21,800 ENVIRONMENT, AND IN FACT RECENT 526 00:22:21,800 --> 00:22:24,560 STUDIES THAT WERE FIRST IN THE 527 00:22:24,560 --> 00:22:26,960 META ARCHIVE NOW APPEARED IN 528 00:22:26,960 --> 00:22:28,720 "CELL," "SCIENCE," AND PEER 529 00:22:28,720 --> 00:22:31,000 REVIEW, ALTHOUGH WE KEEP AN OPEN 530 00:22:31,000 --> 00:22:33,840 MIND OF THE ORIGIN OF COVID-19 531 00:22:33,840 --> 00:22:38,360 THAT IT MAY HAVE BEEN OUT OF A 532 00:22:38,360 --> 00:22:40,000 LABORATORY ACCIDENT, THE 533 00:22:40,000 --> 00:22:41,520 OVERWHELMING EVIDENCE NOW IS 534 00:22:41,520 --> 00:22:44,280 SHOWING THAT IT WAS A NATURAL 535 00:22:44,280 --> 00:22:46,280 OCCURRENCE THAT WAS CENTERED IN 536 00:22:46,280 --> 00:22:48,760 THE WUHAN MARKET, WHERE EVIDENCE 537 00:22:48,760 --> 00:22:50,600 INDICATES THAT ANIMALS WERE 538 00:22:50,600 --> 00:22:55,440 BROUGHT IN FROM THE WILD THAT 539 00:22:55,440 --> 00:22:58,280 WERE VERY LIKELY INFECTED WITH 540 00:22:58,280 --> 00:23:00,160 SARS-COV-2, AND SPILLED OVER TO 541 00:23:00,160 --> 00:23:06,600 HUMANS IN THE SETTING OF THAT 542 00:23:06,600 --> 00:23:06,840 MARKET. 543 00:23:06,840 --> 00:23:10,320 NEXT, LONGSTANDING SYSTEMIC 544 00:23:10,320 --> 00:23:14,440 HEALTH AND SOCIAL INEQUITIES 545 00:23:14,440 --> 00:23:15,560 DRIVE PANDEMIC DISPARITIES. 546 00:23:15,560 --> 00:23:20,760 THIS IS A JAMA COMMENTARY THAT 547 00:23:20,760 --> 00:23:25,680 OUR COLLEAGUES HERE AT NIH LED 548 00:23:25,680 --> 00:23:27,480 BY ELISEO STABLE-PEREZ INDICATE 549 00:23:27,480 --> 00:23:28,280 WHAT WE HAVE EXPERIENCED 550 00:23:28,280 --> 00:23:31,920 THROUGHOUT THIS AND OTHER 551 00:23:31,920 --> 00:23:32,440 PANDEMICS. 552 00:23:32,440 --> 00:23:34,600 THAT THE MOST PERVASIVE 553 00:23:34,600 --> 00:23:37,600 DISPARITIES IN HEALTH WITHIN A 554 00:23:37,600 --> 00:23:39,560 PANDEMIC SETTING ARE OBSERVED 555 00:23:39,560 --> 00:23:41,720 AMONG AFRICAN AMERICAN AND 556 00:23:41,720 --> 00:23:45,280 LATINO INDIVIDUALS AND WHERE THE 557 00:23:45,280 --> 00:23:47,560 DATA EXISTS ALSO AMONG NATIVE 558 00:23:47,560 --> 00:23:50,160 AMERICANS, ALASKA NATIVES, AND 559 00:23:50,160 --> 00:23:50,760 PACIFIC ISLANDERS. 560 00:23:50,760 --> 00:23:53,960 THAT IS THE RESULT OF 561 00:23:53,960 --> 00:23:56,400 LONGSTANDING SYSTEMIC HEALTH AND 562 00:23:56,400 --> 00:24:00,000 SOCIAL INEQUITIES THAT DRIVE 563 00:24:00,000 --> 00:24:01,960 THESE DISPARITIES. 564 00:24:01,960 --> 00:24:03,200 DISCRIMINATION, LIMITED HEALTH 565 00:24:03,200 --> 00:24:07,880 CARE ACCESS AND USE, THE 566 00:24:07,880 --> 00:24:08,360 OCCUPATIONS OF MINORITY 567 00:24:08,360 --> 00:24:09,560 POPULATIONS THAT 568 00:24:09,560 --> 00:24:12,160 DISPROPORTIONATELY PUT THEM IN 569 00:24:12,160 --> 00:24:14,400 ESSENTIAL WORK SETTINGS WHERE 570 00:24:14,400 --> 00:24:16,600 REMOTE WORK OR PHYSICAL 571 00:24:16,600 --> 00:24:19,440 DISTANCING IS DIFFICULT IF NOT 572 00:24:19,440 --> 00:24:20,760 IMPOSSIBLE. 573 00:24:20,760 --> 00:24:23,000 THERE ARE ALSO EDUCATIONAL, 574 00:24:23,000 --> 00:24:26,200 INCOME, AND WEALTH GAPS, AS WELL 575 00:24:26,200 --> 00:24:27,320 AS ISSUES LIKE HOUSING WHERE 576 00:24:27,320 --> 00:24:30,520 SOME PEOPLE LIVE IN CROWDED 577 00:24:30,520 --> 00:24:32,960 CONDITIONS WHERE IT'S VERY HARD 578 00:24:32,960 --> 00:24:35,880 TO FOLLOW THE PREVENTION 579 00:24:35,880 --> 00:24:38,560 STRATEGIES THAT ARE RECOMMENDED 580 00:24:38,560 --> 00:24:42,360 TO PREVENT COVID-19. 581 00:24:42,360 --> 00:24:43,280 AND FINALLY, MISINFORMATION, 582 00:24:43,280 --> 00:24:47,240 WHICH HAS ALWAYS BEEN AND STILL 583 00:24:47,240 --> 00:24:49,040 IS THE ENEMY OF PUBLIC HEALTH 584 00:24:49,040 --> 00:24:49,520 AND PANDEMIC CONTROL. 585 00:24:49,520 --> 00:24:53,400 AND THESE ARE JUST SOME OF THE 586 00:24:53,400 --> 00:24:56,960 EXAMPLES OF THE EGREGIOUS 587 00:24:56,960 --> 00:24:57,720 MISINFORMATION WHICH HAS 588 00:24:57,720 --> 00:24:58,880 CHARACTERIZED OUR RESPONSE NOT 589 00:24:58,880 --> 00:25:02,640 ONLY IN THE UNITED STATES BUT 590 00:25:02,640 --> 00:25:05,480 THROUGHOUT THE WORLD TO 591 00:25:05,480 --> 00:25:05,920 COVID-19. 592 00:25:05,920 --> 00:25:08,760 FROM CRAZY CONSPIRACY THEORIES 593 00:25:08,760 --> 00:25:12,160 TO JUST FRAUDULENT CLAIMS ABOUT 594 00:25:12,160 --> 00:25:15,040 PRODUCTS SUCH AS 595 00:25:15,040 --> 00:25:17,360 HYDROXYCHLOROQUINE AND OTHERS. 596 00:25:17,360 --> 00:25:18,640 LET'S LOOK AHEAD NOW. 597 00:25:18,640 --> 00:25:23,000 IN JANUARY OF THIS YEAR, MY 598 00:25:23,000 --> 00:25:29,280 COLLEAGUES DAVID WARRENS, JEFF 599 00:25:29,280 --> 00:25:32,360 TAUBENBERGER AND I WROTE IN THE 600 00:25:32,360 --> 00:25:41,160 NEW ENGLAND JOURNAL ON THE 601 00:25:41,160 --> 00:25:41,800 URGENT NEED FOR CORONAVIRUS 602 00:25:41,800 --> 00:25:43,920 VACCINES, IT GOES BEYOND THAT. 603 00:25:43,920 --> 00:25:46,200 FIRST LET'S LOOK AT A PAN 604 00:25:46,200 --> 00:25:47,360 CORONAVIRUS VACCINE. 605 00:25:47,360 --> 00:25:50,280 AS I MENTIONED, WE SAID THERE IS 606 00:25:50,280 --> 00:25:53,080 AN URGENT NEED FOR THIS. 607 00:25:53,080 --> 00:25:57,360 THESE ARE SOME OF THE PAPERS OF 608 00:25:57,360 --> 00:25:58,920 WORK THAT'S ALREADY BEING DONE 609 00:25:58,920 --> 00:26:02,880 BY MANY OF OUR GRANTEES, AS WELL 610 00:26:02,880 --> 00:26:05,520 AS HERE IN THE INTRAMURAL 611 00:26:05,520 --> 00:26:06,000 PROGRAM. 612 00:26:06,000 --> 00:26:08,760 ONE OF THE PAPERS THAT JUST CAME 613 00:26:08,760 --> 00:26:12,840 OUT A FEW WEEKS AGO FROM ONE OF 614 00:26:12,840 --> 00:26:19,000 OUR GRANTEES, PAM BORKMAN, ON AN 615 00:26:19,000 --> 00:26:21,560 EXCITING POTENTIAL CANDIDATE, 616 00:26:21,560 --> 00:26:23,640 MOSAIC NANOPARTICLES THAT 617 00:26:23,640 --> 00:26:25,560 PROTECT AGAINST CHALLENGE BY 618 00:26:25,560 --> 00:26:27,240 DIVERSE VIRUSES IN ANIMAL 619 00:26:27,240 --> 00:26:27,480 MODELS. 620 00:26:27,480 --> 00:26:30,080 THERE ARE ALSO A NUMBER OF OTHER 621 00:26:30,080 --> 00:26:31,800 TRIALS THAT ARE DONE OUTSIDE OF 622 00:26:31,800 --> 00:26:35,120 THE REALM OF NIH FUNDING THAT 623 00:26:35,120 --> 00:26:36,760 ARE ALSO IMPORTANT. 624 00:26:36,760 --> 00:26:41,760 WITHIN THE CONTEXT OF NIH, NIAID 625 00:26:41,760 --> 00:26:45,680 HAS MADE SIX RECENT AWARDS OF 626 00:26:45,680 --> 00:26:49,840 ABOUT $60 MILLION FOR RESEARCH 627 00:26:49,840 --> 00:26:52,040 ON BROADLY PROTECTIVE CROHN 628 00:26:52,040 --> 00:26:53,680 VACCINES AND THESE ARE THE GRANT 629 00:26:53,680 --> 00:26:57,240 THAT HAVE BEEN AWARDED THUS FAR 630 00:26:57,240 --> 00:27:01,960 WITH MORE TO COME. 631 00:27:01,960 --> 00:27:03,400 IMPORTANTLY, MUCOSAL VACCINES 632 00:27:03,400 --> 00:27:06,800 CLEARLY ARE THE VACCINES OF THE 633 00:27:06,800 --> 00:27:09,760 FUTURE TO PREVENT NOT ONLY 634 00:27:09,760 --> 00:27:13,360 AGAINST DISEASE BUT AGAINST 635 00:27:13,360 --> 00:27:15,120 ACQUISITION AND TRANSMISSION, AN 636 00:27:15,120 --> 00:27:17,560 ISSUE THAT HAS BECOME EXTREMELY 637 00:27:17,560 --> 00:27:20,040 IMPORTANT IN THE CONTEXT OF 638 00:27:20,040 --> 00:27:20,440 CORONAVIRUS. 639 00:27:20,440 --> 00:27:23,640 THERE HAVE BEEN A NUMBER OF 640 00:27:23,640 --> 00:27:25,400 DISCUSSIONS ABOUT THIS, MOST 641 00:27:25,400 --> 00:27:30,200 RECENT ONE LAST MONTH IN SCIENCE 642 00:27:30,200 --> 00:27:38,560 IMMUNOLOGY BY ERIC TOPOL AND 643 00:27:38,560 --> 00:27:44,360 IKKAAWASAWI ABOUT NEED FOR NASAL 644 00:27:44,360 --> 00:27:45,360 VACCINES. 645 00:27:45,360 --> 00:27:45,960 THERE'S TRANSFORMATIONAL PROMISE 646 00:27:45,960 --> 00:27:51,000 OF MUCOSAL VACCINES. 647 00:27:51,000 --> 00:27:52,440 ONE, FASTER IMMUNITY RECALL AT 648 00:27:52,440 --> 00:27:57,520 THE SITE OF ENTRY AT THE MUCOSA, 649 00:27:57,520 --> 00:27:58,640 AFTER VIRAL EXPOSURE. 650 00:27:58,640 --> 00:28:01,480 THE IMPORTANCE OF BOTH INFECTION 651 00:28:01,480 --> 00:28:02,400 AND TRANSMISSION BLOCKING AND 652 00:28:02,400 --> 00:28:05,120 THEN AGAIN THE FACT THAT IT'S 653 00:28:05,120 --> 00:28:06,120 NEEDLE-FREE DELIVERY. 654 00:28:06,120 --> 00:28:09,560 YOU KNOW THE EXPERIENCE THAT 655 00:28:09,560 --> 00:28:11,120 WE'RE HAVING NOW WITH COVID-19 656 00:28:11,120 --> 00:28:14,720 THAT EVEN PEOPLE WHO ARE 657 00:28:14,720 --> 00:28:15,760 VACCINATED AND BOOSTED, ALTHOUGH 658 00:28:15,760 --> 00:28:18,960 IT'S VERY CLEAR THAT THE 659 00:28:18,960 --> 00:28:21,160 PROTECTION AGAINST SEVERE 660 00:28:21,160 --> 00:28:24,440 DISEASE LEADING TO 661 00:28:24,440 --> 00:28:26,840 HOSPITALIZATION AND DEATHS, DOES 662 00:28:26,840 --> 00:28:29,800 NOT PROTECT VERY WELL AGAINST 663 00:28:29,800 --> 00:28:30,440 ACTUAL INFECTION. 664 00:28:30,440 --> 00:28:33,280 I MYSELF BEING AN EXAMPLE OF 665 00:28:33,280 --> 00:28:33,480 THAT. 666 00:28:33,480 --> 00:28:36,000 A PERSON WHO WAS VACCINATED, 667 00:28:36,000 --> 00:28:38,800 DOUBLY BOOSTED, WHO GOT INFECTED 668 00:28:38,800 --> 00:28:42,800 DURING THE OUTBREAK OF BA 669 00:28:42,800 --> 00:28:44,520 .1.21.1 IN JUNE OF THIS YEAR. 670 00:28:44,520 --> 00:28:47,040 IT WAS A RELATIVELY MILD 671 00:28:47,040 --> 00:28:47,800 ILLNESS. 672 00:28:47,800 --> 00:28:50,360 THAT WAS THE IMPORTANCE OF THE 673 00:28:50,360 --> 00:28:52,920 VACCINE AND BOOSTER BUT I STILL 674 00:28:52,920 --> 00:28:55,240 INDEED GOT INFECTED AND MAY HAVE 675 00:28:55,240 --> 00:29:00,760 TRANSMITTED IT TO OTHER PEOPLE 676 00:29:00,760 --> 00:29:01,560 INADVERTENTLY. 677 00:29:01,560 --> 00:29:04,280 THERE IS SOME GOOD ACTIVITY IN 678 00:29:04,280 --> 00:29:09,120 THE INTRANASAL WORK, THE BARRATT 679 00:29:09,120 --> 00:29:11,400 BIOTECH IN INDIA RECEIVED 680 00:29:11,400 --> 00:29:14,160 EMERGENCY USE APPROVAL OF 681 00:29:14,160 --> 00:29:16,760 ADENOVIRUS VECTOR THAT WAS A 682 00:29:16,760 --> 00:29:18,520 CONCEPT THAT WAS ORIGINALLY 683 00:29:18,520 --> 00:29:20,160 DEVELOPED THROUGH AN NIH GRANT 684 00:29:20,160 --> 00:29:23,800 TO MIKE DIAMOND AND HIS 685 00:29:23,800 --> 00:29:25,560 COLLEAGUES AT WASHINGTON 686 00:29:25,560 --> 00:29:25,880 UNIVERSITY. 687 00:29:25,880 --> 00:29:28,680 WE CAN'T DISCUSS THIS ABOUT THE 688 00:29:28,680 --> 00:29:30,560 FUTURE OF PANDEMICS WITHOUT 689 00:29:30,560 --> 00:29:37,880 TALKING ABOUT THE IMPORTANCE OF 690 00:29:37,880 --> 00:29:38,160 ANTI-VIRALS. 691 00:29:38,160 --> 00:29:40,800 I MENTIONED THAT IN MY EARLIER 692 00:29:40,800 --> 00:29:42,560 SLIDES TALKING ABOUT THE STATE 693 00:29:42,560 --> 00:29:45,080 OF COVID-19 AND OTHERS WITH 694 00:29:45,080 --> 00:29:47,520 PAXLOVID AND OTHERS BUT WE HAVE 695 00:29:47,520 --> 00:29:52,280 AN ANTI-VIRAL PROGRAM FOR 696 00:29:52,280 --> 00:29:55,640 PANDEMICS AIMED AT CATALYZING 697 00:29:55,640 --> 00:29:57,520 NEW MEDICINES TO COMBAT COVID-19 698 00:29:57,520 --> 00:29:59,160 BUT TO PROTECT FOR OTHER 699 00:29:59,160 --> 00:30:00,680 PANDEMIC THREATS, BASED ON TWO 700 00:30:00,680 --> 00:30:05,040 CONCEPTS, DEVELOPMENT OF DRUGS 701 00:30:05,040 --> 00:30:06,560 AND MOLECULES ALREADY EXISTING, 702 00:30:06,560 --> 00:30:10,840 THE WAY WE DID, FOR EXAMPLE, 703 00:30:10,840 --> 00:30:14,920 WITH AZT DURING THE HIV 704 00:30:14,920 --> 00:30:17,320 SITUATION DECADES AGO, BUT ALSO 705 00:30:17,320 --> 00:30:19,840 THE DISCOVERY OF NEW MOLECULES 706 00:30:19,840 --> 00:30:22,680 BY EXPANDING THE BASIC SCIENCE 707 00:30:22,680 --> 00:30:25,040 KNOWLEDGE AND GETTING NEW 708 00:30:25,040 --> 00:30:27,360 ANTI-VIRAL MEDICINES. 709 00:30:27,360 --> 00:30:32,160 THIS IS A SCHEMATIC OF THE 710 00:30:32,160 --> 00:30:34,800 REPLICATION CYCLE OF SARS-COV-2. 711 00:30:34,800 --> 00:30:37,320 VERY SIMILAR IN THE CONCEPT OF 712 00:30:37,320 --> 00:30:41,080 WHAT WE DID IN THE DISCOVERY OF 713 00:30:41,080 --> 00:30:44,800 ANTIRETROVIRALS FOR HIV. 714 00:30:44,800 --> 00:30:47,160 WHERE YOU TARGET VULNERABLE 715 00:30:47,160 --> 00:30:50,160 AREAS OF REPLICATION CYCLE AND 716 00:30:50,160 --> 00:30:54,320 DEVELOP INHIBITORS SUCH AS 717 00:30:54,320 --> 00:30:55,440 POLYMERASE, PROTEASE INHIBITORS, 718 00:30:55,440 --> 00:30:58,240 ENTRY INHIBITORS, AND THEN GO ON 719 00:30:58,240 --> 00:31:00,000 TO ADVANCE DEVELOPMENT FOR DRUGS 720 00:31:00,000 --> 00:31:03,400 THAT WOULD HOPEFULLY BE 721 00:31:03,400 --> 00:31:05,880 EFFECTIVE AGAINST THIS PATHOGEN 722 00:31:05,880 --> 00:31:08,760 AS WELL AS FUTURE PATHOGENS THAT 723 00:31:08,760 --> 00:31:11,160 USE THIS TARGETED ANTI-VIRAL 724 00:31:11,160 --> 00:31:12,520 APPROACH. 725 00:31:12,520 --> 00:31:15,520 AND IN THIS REGARD, THE SPRING 726 00:31:15,520 --> 00:31:17,760 OF THIS YEAR WE ANNOUNCED A 727 00:31:17,760 --> 00:31:22,360 NUMBER OF AWARDS FOR ANTI-VIRAL 728 00:31:22,360 --> 00:31:25,280 DRUG DEVELOPMENT TO ESTABLISH 729 00:31:25,280 --> 00:31:27,800 NINE CENTERS CALLED ANTI-VIRAL 730 00:31:27,800 --> 00:31:29,440 DRUG DISCOVERY CENTERS, 731 00:31:29,440 --> 00:31:32,960 AVIDDs, LOOKING AT PATHOGENS 732 00:31:32,960 --> 00:31:39,240 OF PANDEMIC CONCERN INCLUDING 733 00:31:39,240 --> 00:31:40,720 PARAMIX VIRUSES, FLAVORY 734 00:31:40,720 --> 00:31:40,960 VIRUSES. 735 00:31:40,960 --> 00:31:45,200 SO WRAPPING UP, WHAT IS THE END 736 00:31:45,200 --> 00:31:48,560 GAME FOR 2022 AND BEYOND WITH 737 00:31:48,560 --> 00:31:49,680 REGARD TO COVID-19? 738 00:31:49,680 --> 00:31:51,720 I THINK WE CAN BEST EXPLAIN IT 739 00:31:51,720 --> 00:31:54,520 BY LOOKING AT THE VARIOUS PHASES 740 00:31:54,520 --> 00:31:57,760 AND ISSUES WHEN YOU'RE DEALING 741 00:31:57,760 --> 00:31:59,760 WITH A PANDEMIC. 742 00:31:59,760 --> 00:32:06,600 WE'VE BEEN THROUGH THE VERY 743 00:32:06,600 --> 00:32:08,160 FULMINANT PANDEMIC PHASE AND 744 00:32:08,160 --> 00:32:09,560 HAVE SEEN DECELERATION OF NEW 745 00:32:09,560 --> 00:32:11,160 CASES BUT HAPPENS AT THE END OF 746 00:32:11,160 --> 00:32:14,560 ALL THIS? 747 00:32:14,560 --> 00:32:15,720 WILL WE ERADICATE SARS-COV-2? 748 00:32:15,720 --> 00:32:17,160 I WOULD SAY WITH SOME CONFIDENCE 749 00:32:17,160 --> 00:32:21,760 THAT THE ANSWER TO THAT IS NO. 750 00:32:21,760 --> 00:32:23,480 BECAUSE WE'VE ONLY ERADICATED 751 00:32:23,480 --> 00:32:25,760 ONE VIRUS IN THE HISTORY OF 752 00:32:25,760 --> 00:32:27,600 HUMAN PUBLIC HEALTH. 753 00:32:27,600 --> 00:32:29,200 AND THAT IS SMALLPOX. 754 00:32:29,200 --> 00:32:30,720 BUT THERE WERE REASONS WE WERE 755 00:32:30,720 --> 00:32:35,480 ABLE TO DO THAT. 756 00:32:35,480 --> 00:32:37,240 THERE'S NO ANIMAL RESERVOIR. 757 00:32:37,240 --> 00:32:39,120 IT'S A PHENOTYPICALLY STABLE 758 00:32:39,120 --> 00:32:41,200 VIRUS. 759 00:32:41,200 --> 00:32:43,360 SMALLPOX THAT AFFLICTED PEOPLE 760 00:32:43,360 --> 00:32:45,160 CENTURIES AGO IS THE SAME I WAS 761 00:32:45,160 --> 00:32:47,000 VACCINATED AGAINST AS A CHILD. 762 00:32:47,000 --> 00:32:50,840 WE HAD A WIDELY ACCEPTABLE 763 00:32:50,840 --> 00:32:54,320 GLOBAL CAMPAIGN OF VACCINATION. 764 00:32:54,320 --> 00:32:57,160 BUT IMPORTANTLY, THIS IS 765 00:32:57,160 --> 00:32:59,360 CRITICAL, THE IMMUNITY THAT'S 766 00:32:59,360 --> 00:33:02,560 INDUCED BY VACCINE OR INFECTION 767 00:33:02,560 --> 00:33:04,920 WITH SMALLPOX, THE DURABILITY IS 768 00:33:04,920 --> 00:33:09,320 MEASURED IN DECADES AND LIKELY 769 00:33:09,320 --> 00:33:11,160 LIFETIME. 770 00:33:11,160 --> 00:33:14,760 NEXT, WHAT ABOUT ELIMINATION? 771 00:33:14,760 --> 00:33:16,080 CAN WE ELIMINATE SARS-COV-2? 772 00:33:16,080 --> 00:33:17,800 I'LL EXPLAIN IN A MOMENT WHY 773 00:33:17,800 --> 00:33:18,360 NOT. 774 00:33:18,360 --> 00:33:22,080 BUT LET'S LOOK AT THE ONES WE 775 00:33:22,080 --> 00:33:23,480 HAD ELIMINATED, POLIO AND 776 00:33:23,480 --> 00:33:24,760 MEASLES IN THE UNITED STATES. 777 00:33:24,760 --> 00:33:28,560 AGAIN, WE'RE DEALING WITH A 778 00:33:28,560 --> 00:33:31,200 PHENOTYPICALLY STABLE VIRUS. 779 00:33:31,200 --> 00:33:32,360 MEASLES OF DECADES AGO IS THE 780 00:33:32,360 --> 00:33:34,560 SAME MEASLES WE'RE SEEING NOW IN 781 00:33:34,560 --> 00:33:36,440 SOME DEVELOPING NATIONS. 782 00:33:36,440 --> 00:33:40,320 IN THE UNITED STATES, WE HAD AND 783 00:33:40,320 --> 00:33:42,920 STILL HAVE A WIDELY ACCEPTED 784 00:33:42,920 --> 00:33:44,800 NATIONAL VACCINATION CAMPAIGN 785 00:33:44,800 --> 00:33:49,360 AND IMPORTANTLY AGAIN FROM AN 786 00:33:49,360 --> 00:33:50,160 IMMUNOLOGICAL STANDPOINT THE 787 00:33:50,160 --> 00:33:53,160 IMMUNITY INDUCED BY EITHER 788 00:33:53,160 --> 00:33:56,480 INFECTION OR VACCINES OF BOTH 789 00:33:56,480 --> 00:33:57,120 POLIO AND MEASLES, THE 790 00:33:57,120 --> 00:34:01,160 DURABILITY IS MEASURED IN 791 00:34:01,160 --> 00:34:03,880 DECADES, AND LIKELY LIFETIME. 792 00:34:03,880 --> 00:34:07,760 BUT WHERE ARE WE WITH 793 00:34:07,760 --> 00:34:08,040 SARS-COV-2? 794 00:34:08,040 --> 00:34:11,760 WE KNOW THERE ARE ESTABLISHED 795 00:34:11,760 --> 00:34:14,040 ANIMAL RESERVOIRS, UNIQUELY 796 00:34:14,040 --> 00:34:18,320 THERE'S THE EVOLUTION OF 797 00:34:18,320 --> 00:34:19,440 GENOTYPICALLY AND PHENOTYPICALLY 798 00:34:19,440 --> 00:34:20,800 DIVERSE VARIANTS, AND WE'VE 799 00:34:20,800 --> 00:34:22,480 EXPERIENCED FIVE OF THESE IN THE 800 00:34:22,480 --> 00:34:26,800 LAST 2 1/2 YEARS. 801 00:34:26,800 --> 00:34:28,840 IMPORTANTLY, AND I MENTIONED 802 00:34:28,840 --> 00:34:31,280 THIS A FEW TIMES, THAT THE 803 00:34:31,280 --> 00:34:36,000 IMMUNITY INDUCED BY EITHER 804 00:34:36,000 --> 00:34:40,480 INFECTION OR VACCINE WANES OVER 805 00:34:40,480 --> 00:34:40,840 TIME. 806 00:34:40,840 --> 00:34:43,440 PARTICULARLY WITH REGARD TO 807 00:34:43,440 --> 00:34:45,960 PROTECTION AGAINST INFECTION. 808 00:34:45,960 --> 00:34:48,040 LESS SO AGAINST PROTECTION 809 00:34:48,040 --> 00:34:50,640 AGAINST SEVERE DISEASE. 810 00:34:50,640 --> 00:34:54,040 AND UNFORTUNATELY FOR US, WITH 811 00:34:54,040 --> 00:34:56,240 THE ANTI-VAX SITUATION IN THIS 812 00:34:56,240 --> 00:35:01,600 COUNTRY AND THE WORLD IS THE 813 00:35:01,600 --> 00:35:03,360 LACK OF WIDE ACCEPTANCE OF SAFE 814 00:35:03,360 --> 00:35:05,480 AND EFFECTIVE VACCINES. 815 00:35:05,480 --> 00:35:06,760 WE'RE DEALING WITH CONTROL. 816 00:35:06,760 --> 00:35:10,000 AND THE LEVEL OF CONTROL IS 817 00:35:10,000 --> 00:35:10,360 IMPORTANT. 818 00:35:10,360 --> 00:35:12,840 TO GET TO A LOW ENOUGH LEVEL, 819 00:35:12,840 --> 00:35:15,440 WHERE IT DOESN'T DISRUPT THE 820 00:35:15,440 --> 00:35:16,760 SOCIAL ORDER, THAT'S WHAT WE 821 00:35:16,760 --> 00:35:25,320 REFER TO WHEN WE SAY A RETURN TO 822 00:35:25,320 --> 00:35:28,480 NORMALCY OR ENDEMICITY, A 823 00:35:28,480 --> 00:35:29,400 DIFFICULT-TO-DESCRIBE SITUATION, 824 00:35:29,400 --> 00:35:32,080 BUT SOMEWHAT SIMILAR TO OTHER 825 00:35:32,080 --> 00:35:33,400 RESPIRATORY VIRUSES THAT DON'T 826 00:35:33,400 --> 00:35:35,600 DISTURB THE SOCIAL ORDER. 827 00:35:35,600 --> 00:35:36,880 IT DOESN'T INTERFERE WITH THE 828 00:35:36,880 --> 00:35:41,360 ECONOMY OR OUR SOCIAL 829 00:35:41,360 --> 00:35:49,000 INTERACTIONS. 830 00:35:49,000 --> 00:35:51,800 AND THAT'S RESPIRATORY VIRUS, 831 00:35:51,800 --> 00:35:52,400 COMMON COLD, INFLUENZA, WE'RE 832 00:35:52,400 --> 00:35:54,320 LOOKING AT A LEVEL THAT DOESN'T 833 00:35:54,320 --> 00:35:56,600 DISTURB OUR SOCIAL INTERACTIONS. 834 00:35:56,600 --> 00:35:59,840 TO GET THERE, WE BELIEVE WE HAVE 835 00:35:59,840 --> 00:36:02,440 TO HAVE THE AVAILABILITY OF 836 00:36:02,440 --> 00:36:04,000 INTERMITTENT VACCINATION, LIKE 837 00:36:04,000 --> 00:36:08,040 WE REFERRED TO JUST RECENTLY 838 00:36:08,040 --> 00:36:08,680 ABOUT GETTING CORONAVIRUS 839 00:36:08,680 --> 00:36:11,200 VACCINE AT LEAST ON A YEARLY 840 00:36:11,200 --> 00:36:12,080 BASIS. 841 00:36:12,080 --> 00:36:15,200 AS WELL AS OTHER THINGS, SUCH AS 842 00:36:15,200 --> 00:36:17,080 RESPIRATORY HYGIENE, ATTENTION 843 00:36:17,080 --> 00:36:19,400 TO VENTILATION IN INDOORS, 844 00:36:19,400 --> 00:36:23,040 MASKING WHERE APPROPRIATE, AND 845 00:36:23,040 --> 00:36:26,400 THE AVAILABILITY OF EFFECTIVE 846 00:36:26,400 --> 00:36:27,880 VIRUS ANTI-VIRALS AND MONOCLONAL 847 00:36:27,880 --> 00:36:28,160 ANTIBODIES. 848 00:36:28,160 --> 00:36:34,280 I WANT TO CLOSE WITH THIS LAST 849 00:36:34,280 --> 00:36:34,840 SLIDE. 850 00:36:34,840 --> 00:36:37,560 AN ARTICLE THAT DAVID MORENS, 851 00:36:37,560 --> 00:36:40,200 GREG FOCUS AND I WROTE IN 852 00:36:40,200 --> 00:36:43,160 "LANCET" 14 YEARS AGO. 853 00:36:43,160 --> 00:36:44,560 THAT MERGING INFECTIOUS DISEASES 854 00:36:44,560 --> 00:36:48,280 HAVE ALWAYS BEEN WITH US BEFORE 855 00:36:48,280 --> 00:36:51,920 WE EVEN RECORDED THEM, IN 856 00:36:51,920 --> 00:36:52,640 RECORDED HISTORY WE'VE 857 00:36:52,640 --> 00:36:53,800 EXPERIENCED THEM OVER OUR 858 00:36:53,800 --> 00:36:56,640 LIFETIME AND WE'RE IN THE MIDDLE 859 00:36:56,640 --> 00:36:58,360 OF ONE RIGHT NOW. 860 00:36:58,360 --> 00:37:00,200 THEY ARE INDEED A PERPETUAL 861 00:37:00,200 --> 00:37:00,560 CHALLENGE. 862 00:37:00,560 --> 00:37:04,000 AND THE ONLY WAY TO ADDRESS THEM 863 00:37:04,000 --> 00:37:07,440 AS A GLOBAL COMMUNITY IS TO BE 864 00:37:07,440 --> 00:37:08,360 PERPETUALLY PREPARED. 865 00:37:08,360 --> 00:37:12,760 AND THAT IS THE REASON WHY WE'RE 866 00:37:12,760 --> 00:37:14,440 SPEAKING TODAY ABOUT THE LESSONS 867 00:37:14,440 --> 00:37:17,360 LEARNED FROM OUR CURRENT VERY 868 00:37:17,360 --> 00:37:18,360 DIFFICULT EXPERIENCE THAT WE'VE 869 00:37:18,360 --> 00:37:21,360 HAD OVER THE LAST TWO YEARS, AND 870 00:37:21,360 --> 00:37:24,040 LET'S HOPE THAT OUR CORPORATE 871 00:37:24,040 --> 00:37:28,760 MEMORY OF THOSE LESSONS DOES NOT 872 00:37:28,760 --> 00:37:31,520 FADE AS WE PUT COVID-19 BEHIND 873 00:37:31,520 --> 00:37:32,920 US IN THE FUTURE YEARS. 874 00:37:32,920 --> 00:37:38,360 THANK YOU. 875 00:37:38,360 --> 00:37:39,000 876 00:37:39,000 --> 00:37:42,160 >> THANK YOU, DR. FAUCI, FOR THE 877 00:37:42,160 --> 00:37:44,280 INSIGHTFUL AND INSPIRING TALK. 878 00:37:44,280 --> 00:37:51,760 I'M PAM SCHWARTZBERG, ON THE 879 00:37:51,760 --> 00:37:52,960 BEHALF OF THE STEERING 880 00:37:52,960 --> 00:37:53,800 COMMITTEE. 881 00:37:53,800 --> 00:37:54,600 I THANK YOU FOR ATTENDING THE 882 00:37:54,600 --> 00:37:56,760 FIRST TALK OF THE SEASON. 883 00:37:56,760 --> 00:37:59,040 IF YOU'RE INTERESTED, 884 00:37:59,040 --> 00:38:01,560 PLEASE JOIN THE COVID-19 885 00:38:01,560 --> 00:38:04,160 SCIENTIFIC INTEREST GROUP, JUST 886 00:38:04,160 --> 00:38:07,960 SEARCH NIH AND COVID-19 SIG AND 887 00:38:07,960 --> 00:38:09,400 YOU'LL FIND OUT OUR WEBSITE WITH 888 00:38:09,400 --> 00:38:11,280 INSTRUCTIONS ON HOW TO JOIN AND 889 00:38:11,280 --> 00:38:14,240 THE LIST OF UPCOMING SEMINARS. 890 00:38:14,240 --> 00:38:17,560 NEXT SEMINAR IS OCTOBER 6. 891 00:38:17,560 --> 00:38:23,280 IT WILL BE MICHELE MINCI FROM 892 00:38:23,280 --> 00:38:26,040 STANFORD SPEAKING ON NEUROCOVID. 893 00:38:26,040 --> 00:38:29,960 YOU'LL FIND INFORMATION ON OUR 894 00:38:29,960 --> 00:38:30,760 COVID-19 SCIENTIFIC RESEARCH 895 00:38:30,760 --> 00:38:33,720 WORKSHOP WHICH WILL BE HELD 896 00:38:33,720 --> 00:38:35,680 DECEMBER 15 AND 16 THIS YEAR. 897 00:38:35,680 --> 00:38:36,960 AND REGISTRATION WILL BE OPENING 898 00:38:36,960 --> 00:38:38,360 IN THE NEXT FEW WEEKS. 899 00:38:38,360 --> 00:38:40,160 AND WE REALLY HOPE YOU CAN ALL 900 00:38:40,160 --> 00:38:43,280 ATTEND WHAT WE THINK WILL BE A 901 00:38:43,280 --> 00:38:45,280 VERY EXCITING AND DIVERSE 902 00:38:45,280 --> 00:38:45,560 WORKSHOP. 903 00:38:45,560 --> 00:38:49,200 AND NOW I'D LIKE TO TURN THE MIC 904 00:38:49,200 --> 00:38:52,160 OVER TO DR. VERONIQUE 905 00:38:52,160 --> 00:38:53,600 NUSSENBLATT, HOSTING QUESTIONS 906 00:38:53,600 --> 00:38:54,360 WITH DR. FAUCI. 907 00:38:54,360 --> 00:39:01,880 THANK YOU AGAIN, DR. FAUCI AND 908 00:39:01,880 --> 00:39:02,880 DR. NEWSEN BACK. 909 00:39:02,880 --> 00:39:05,240 >> WE HAVE SEVERAL QUESTIONS FOR 910 00:39:05,240 --> 00:39:05,600 YOU. 911 00:39:05,600 --> 00:39:08,760 SO, THE FIRST QUESTION HAS TO DO 912 00:39:08,760 --> 00:39:10,400 WITH MUCOSAL VACCINES THAT YOU 913 00:39:10,400 --> 00:39:10,960 DISCUSSED. 914 00:39:10,960 --> 00:39:14,360 SO WHAT ARE THE MAJOR CHALLENGES 915 00:39:14,360 --> 00:39:17,360 ANTICIPATED FOR NEXT GENERATION 916 00:39:17,360 --> 00:39:19,160 COVID-19 MUCOSAL VACCINES? 917 00:39:19,160 --> 00:39:21,160 >> WELL, THERE ARE A COUPLE 918 00:39:21,160 --> 00:39:21,440 CHALLENGES. 919 00:39:21,440 --> 00:39:26,480 THE FIRST IS, YOU KNOW, WE DON'T 920 00:39:26,480 --> 00:39:29,440 HAVE VERY GOOD MUCOSAL VACCINES 921 00:39:29,440 --> 00:39:30,520 FOR RESPIRATORY VIRUSES. 922 00:39:30,520 --> 00:39:33,920 I MEAN, WE DO HAVE THE FLU MIST 923 00:39:33,920 --> 00:39:38,080 FOR FLU, WHICH SEEMS TO BE QUITE 924 00:39:38,080 --> 00:39:38,480 GOOD. 925 00:39:38,480 --> 00:39:43,400 BUT WHAT WE HAVE NOT WORKED OUT 926 00:39:43,400 --> 00:39:45,160 IS THE COMBINATION OF GETTING 927 00:39:45,160 --> 00:39:48,760 GOOD PROTECTION AT THE SOURCE OF 928 00:39:48,760 --> 00:39:50,880 ENTRY IN THE UPPER RESPIRATORY 929 00:39:50,880 --> 00:39:55,360 MUCOSA, AT THE SAME TIME AS 930 00:39:55,360 --> 00:39:57,240 GETTING GOOD SYSTEMIC PROTECTION 931 00:39:57,240 --> 00:39:59,720 AT THE SYSTEMIC LEVEL. 932 00:39:59,720 --> 00:40:02,480 THE OTHER THING IS THAT 933 00:40:02,480 --> 00:40:05,440 SOMETHING THAT PEOPLE DON'T 934 00:40:05,440 --> 00:40:08,160 REALLY APPRECIATE IS THE SAFETY 935 00:40:08,160 --> 00:40:10,800 ISSUES BECAUSE IF YOU'RE TALKING 936 00:40:10,800 --> 00:40:12,960 ABOUT SPIKE PROTEIN, IT'S A VERY 937 00:40:12,960 --> 00:40:17,360 SOMEWHAT OF A MYSTERIOUS 938 00:40:17,360 --> 00:40:19,560 MOLECULE, WHAT WE'RE SEEING 939 00:40:19,560 --> 00:40:22,080 ABOUT SOME OF THE IMPORTANT 940 00:40:22,080 --> 00:40:25,360 ADVERSE EFFECTS FROM THE DISEASE 941 00:40:25,360 --> 00:40:27,760 ITSELF RELATED TO ABERRANT 942 00:40:27,760 --> 00:40:32,160 RESPONSES TO THE SPIKE PROTEIN 943 00:40:32,160 --> 00:40:34,680 AND SPIKE PROTEIN'S ABILITY TO 944 00:40:34,680 --> 00:40:35,640 INFLAME AREAS, FOR EXAMPLE, THAT 945 00:40:35,640 --> 00:40:38,960 HAVE TO DO WITH TASTE AND SMELL, 946 00:40:38,960 --> 00:40:40,840 THERE IS A SUBSTANTIAL SAFETY 947 00:40:40,840 --> 00:40:41,560 ISSUE. 948 00:40:41,560 --> 00:40:41,960 I TAKE THAT BACK. 949 00:40:41,960 --> 00:40:44,960 WE DON'T KNOW WHAT THE SAFETY 950 00:40:44,960 --> 00:40:46,960 ISSUE IS, RATHER THAN TO SAY A 951 00:40:46,960 --> 00:40:49,560 SUBSTANTIAL SAFETY ISSUE, 952 00:40:49,560 --> 00:40:51,960 THERE'S A SUBSTANTIAL SAFETY 953 00:40:51,960 --> 00:40:52,360 QUESTION. 954 00:40:52,360 --> 00:40:54,000 THE OTHER THING IS, YOU KNOW, AS 955 00:40:54,000 --> 00:40:57,160 AN IMMUNOLOGIST, AFTER ALL THESE 956 00:40:57,160 --> 00:41:03,000 YEARS, I'M NOT A MUCOSAL 957 00:41:03,000 --> 00:41:04,080 IMMUNOLOGIST BUT I'M STUNNED HOW 958 00:41:04,080 --> 00:41:07,040 LITTLE WE KNOW ABOUT MUCOSAL 959 00:41:07,040 --> 00:41:09,560 IMMUNITY AFTER SO MANY YEARS OF 960 00:41:09,560 --> 00:41:11,080 GREAT ADVANCES IN IMMUNOLOGY IN 961 00:41:11,080 --> 00:41:14,160 GENERAL, AND THAT MAY BE TO THE 962 00:41:14,160 --> 00:41:15,800 DIFFICULTY IN SAMPLING, IT'S SO 963 00:41:15,800 --> 00:41:18,120 EASY TO SAMPLE BLOOD AND THINGS 964 00:41:18,120 --> 00:41:20,760 LIKE THAT, BUT TO SAMPLE AREAS 965 00:41:20,760 --> 00:41:24,160 OF MUCOSA I THINK IT'S 966 00:41:24,160 --> 00:41:24,400 IMPORTANT. 967 00:41:24,400 --> 00:41:32,240 SO, IT'S LACK OF A TRACK RECORD 968 00:41:32,240 --> 00:41:32,880 OF GOOD MUCOSALLY ADMINISTERED 969 00:41:32,880 --> 00:41:34,000 VACCINES THAT WILL BE THE 970 00:41:34,000 --> 00:41:36,400 BIGGEST PROBLEM AS WELL AS 971 00:41:36,400 --> 00:41:37,720 THEORETICAL AND PERHAPS REAL 972 00:41:37,720 --> 00:41:39,360 SAFETY ISSUE. 973 00:41:39,360 --> 00:41:41,840 WHEN IT COMES TO COVID, NOT WHEN 974 00:41:41,840 --> 00:41:44,120 IT COMES TO OTHER VACCINES LIKE 975 00:41:44,120 --> 00:41:45,920 INFLUENZA WHICH WE'VE ALREADY 976 00:41:45,920 --> 00:41:47,280 DONE THE PROOF-OF-CONCEPT WITH 977 00:41:47,280 --> 00:41:49,760 FLU MIST. 978 00:41:49,760 --> 00:41:50,360 >> GREAT. 979 00:41:50,360 --> 00:41:51,600 THANK YOU. 980 00:41:51,600 --> 00:41:53,920 SO, THERE'S ANOTHER QUESTION 981 00:41:53,920 --> 00:41:54,760 THAT HAS -- THAT'S ALONG THE 982 00:41:54,760 --> 00:41:55,560 SAME LINES. 983 00:41:55,560 --> 00:41:58,960 WHY DON'T WE USE NASAL VACCINES 984 00:41:58,960 --> 00:42:01,560 FOR OTHER RESPIRATORY VIRUSES? 985 00:42:01,560 --> 00:42:03,840 >> YEAH, I JUST ANSWERED IT. 986 00:42:03,840 --> 00:42:07,760 THAT WE JUST HAVE NOT HAD THE -- 987 00:42:07,760 --> 00:42:11,080 YOU SAY WHY DON'T WE USE THEM? 988 00:42:11,080 --> 00:42:13,640 BECAUSE WE HAVEN'T DEVELOPED 989 00:42:13,640 --> 00:42:13,840 THEM. 990 00:42:13,840 --> 00:42:17,520 AND IT'S JUST A SIMPLE ISSUE OF 991 00:42:17,520 --> 00:42:19,600 THE REAL GAPS IN KNOWLEDGE OF 992 00:42:19,600 --> 00:42:20,200 MUCOSAL IMMUNITY. 993 00:42:20,200 --> 00:42:24,240 IF WE HAD A GREATER HANDLE ON 994 00:42:24,240 --> 00:42:25,600 MUCOSAL IMMUNITY I THINK YOU 995 00:42:25,600 --> 00:42:29,640 WOULD SEE A LOT MORE OF THE 996 00:42:29,640 --> 00:42:33,800 EFFORTS THAT ARE GOING TO BE PUT 997 00:42:33,800 --> 00:42:36,560 IN DEVELOPING PRODUCTS THAT 998 00:42:36,560 --> 00:42:38,600 MUCOSALLY ADMINISTERED. 999 00:42:38,600 --> 00:42:45,360 THE ORAL POLIO VACCINE IS A GI 1000 00:42:45,360 --> 00:42:46,440 MUCOSALLY ADMINISTERED AND 1001 00:42:46,440 --> 00:42:48,760 MECHANISM OF ACTION IS NOT TO 1002 00:42:48,760 --> 00:42:49,840 PREVENT REPLICATION IN THE GUT 1003 00:42:49,840 --> 00:42:53,560 BUT FROM MAKING THE NEXT STEP 1004 00:42:53,560 --> 00:42:55,160 ENTERING INTO THE NERVOUS 1005 00:42:55,160 --> 00:42:55,400 SYSTEM. 1006 00:42:55,400 --> 00:42:59,560 WHEREAS IF YOU GET PAST THE 1007 00:42:59,560 --> 00:43:01,680 FIRST STAGE OF A RESPIRATORY 1008 00:43:01,680 --> 00:43:04,040 VIRUS CHALLENGING THE MUCOSA IN 1009 00:43:04,040 --> 00:43:05,160 THE UPPER AIRWAY, THEN THE HORSE 1010 00:43:05,160 --> 00:43:06,840 IS OUT OF THE BARN. 1011 00:43:06,840 --> 00:43:07,760 YOU'RE ALREADY INFECTED. 1012 00:43:07,760 --> 00:43:11,120 YOU REALLY HAVE TO HAVE A VERY 1013 00:43:11,120 --> 00:43:11,960 SUBSTANTIAL DEGREE OF PROTECTIVE 1014 00:43:11,960 --> 00:43:12,360 IMMUNITY. 1015 00:43:12,360 --> 00:43:14,440 WE'VE NOT BEEN ABLE TO ACHIEVE 1016 00:43:14,440 --> 00:43:16,480 THAT VERY WELL WITH MOST 1017 00:43:16,480 --> 00:43:19,520 RESPIRATORY VIRUSES. 1018 00:43:19,520 --> 00:43:20,360 >> THANK YOU. 1019 00:43:20,360 --> 00:43:22,560 SO, THE NEXT QUESTION IS MORE OF 1020 00:43:22,560 --> 00:43:23,240 A PERSONAL QUESTION. 1021 00:43:23,240 --> 00:43:25,640 WHAT ARE YOU MOST PROUD OF FROM 1022 00:43:25,640 --> 00:43:31,640 YOUR TENURE AT NIH? 1023 00:43:31,640 --> 00:43:31,920 >> WOW! 1024 00:43:31,920 --> 00:43:32,920 WELL, THERE ARE A NUMBER OF 1025 00:43:32,920 --> 00:43:33,200 THINGS. 1026 00:43:33,200 --> 00:43:35,800 I DON'T THINK I COULD PICK OUT 1027 00:43:35,800 --> 00:43:38,720 ONE THING. 1028 00:43:38,720 --> 00:43:40,880 CERTAIN THINGS HAVE TO DO WITH 1029 00:43:40,880 --> 00:43:43,880 THE MULTIPLE HATS I WEAR. 1030 00:43:43,880 --> 00:43:46,160 SO IF YOU'LL ALLOW ME A COUPLE 1031 00:43:46,160 --> 00:43:47,520 MINUTES, I CAN EXPAND BECAUSE I 1032 00:43:47,520 --> 00:43:50,280 CAN'T GIVE YOU A TWO-CENT 1033 00:43:50,280 --> 00:43:50,520 ANSWER. 1034 00:43:50,520 --> 00:43:52,000 I'M USUALLY SOMEBODY VERY 1035 00:43:52,000 --> 00:43:53,720 PRECISE IN THEIR ANSWER. 1036 00:43:53,720 --> 00:43:56,640 SO THERE'S CONTRIBUTION AS A 1037 00:43:56,640 --> 00:43:58,200 SCIENTIST WHICH HAS TO DO WITH 1038 00:43:58,200 --> 00:44:00,120 MY TENURE AT NIH BUT NOT 1039 00:44:00,120 --> 00:44:02,000 NECESSARILY AS MY TENURE AS 1040 00:44:02,000 --> 00:44:02,280 DIRECTOR. 1041 00:44:02,280 --> 00:44:04,640 AND THAT IS THE FACT THAT I HAVE 1042 00:44:04,640 --> 00:44:08,680 BEEN INVOLVED NOW FOR OVER 40 1043 00:44:08,680 --> 00:44:12,400 YEARS IN THE STUDY OF THE 1044 00:44:12,400 --> 00:44:15,360 PATHOGENIC MECHANISMS OF HIV, 1045 00:44:15,360 --> 00:44:17,160 AND ALONG WITH OTHER 1046 00:44:17,160 --> 00:44:18,320 INVESTIGATORS INCLUDING HERE AT 1047 00:44:18,320 --> 00:44:20,720 THE NIH I THINK WE'VE MADE A LOT 1048 00:44:20,720 --> 00:44:21,360 OF PROGRESS. 1049 00:44:21,360 --> 00:44:24,320 I'M PROUD OF IT AS A SCIENTIFIC 1050 00:44:24,320 --> 00:44:28,160 ACCOMPLISHMENT AS WELL AS THE 1051 00:44:28,160 --> 00:44:29,040 PRE-AIDS ERA, WHICH ALREADY 1052 00:44:29,040 --> 00:44:31,960 TELLS YOU HOW OLD I AM, THAT I 1053 00:44:31,960 --> 00:44:36,480 DID SOME SIGNIFICANT WORK ON 1054 00:44:36,480 --> 00:44:40,120 AUTO-INFLAMMATORY DISEASES 1055 00:44:40,120 --> 00:44:44,360 DEVELOPING THERAPIES FOR 1056 00:44:44,360 --> 00:44:46,200 VASCULITIES THAT WITH FATAL, 1057 00:44:46,200 --> 00:44:47,400 DEVELOPING THERAPIES THAT 1058 00:44:47,400 --> 00:44:48,160 UTILIZED INFORMATION FROM CANCER 1059 00:44:48,160 --> 00:44:50,360 INSTITUTE WHERE THEY WERE USING 1060 00:44:50,360 --> 00:44:52,280 CHEMOTHERAPIES FOR CANCER, WE 1061 00:44:52,280 --> 00:44:57,800 USED VERY LOW DOSE DRUGS LIKE 1062 00:44:57,800 --> 00:45:08,240 CYCLOFOSIMIDE AND PUT IN 1063 00:45:08,240 --> 00:45:11,240 REMISSION POLYANYITIS. 1064 00:45:11,240 --> 00:45:13,480 WHEN I CAME, IT WASN'T ON THE 1065 00:45:13,480 --> 00:45:14,880 RADAR SCREEN, PEOPLE THOUGHT 1066 00:45:14,880 --> 00:45:15,640 THAT INFECTIONS WERE THINGS OF 1067 00:45:15,640 --> 00:45:18,360 THE PAST AND YOU DIDN'T HAVE TO 1068 00:45:18,360 --> 00:45:24,360 PAY OF ATTENTION -- MUCH 1069 00:45:24,360 --> 00:45:25,040 ATTENTION. 1070 00:45:25,040 --> 00:45:28,000 IT WAS IN INSIPIENT STAGES OF 1071 00:45:28,000 --> 00:45:32,920 IMMUNOLOGY IN HUMANS AND BUILT 1072 00:45:32,920 --> 00:45:33,560 IT INSTITUTE TO A $6 BILLION 1073 00:45:33,560 --> 00:45:36,320 INSTITUTE OVER THE PERIOD I WAS 1074 00:45:36,320 --> 00:45:37,080 DIRECTOR, DEVELOPING THE AIDS 1075 00:45:37,080 --> 00:45:39,480 PROGRAM WHICH I'M PROUD OF, THAT 1076 00:45:39,480 --> 00:45:42,400 LED TO DEVELOPMENT OF DRUGS 1077 00:45:42,400 --> 00:45:45,560 WHICH HAVE BEEN EXTREMELY 1078 00:45:45,560 --> 00:45:47,120 LIFE-SAVING AND TRANSFORMING THE 1079 00:45:47,120 --> 00:45:51,160 CLINICAL COURSE OF PEOPLE WITH 1080 00:45:51,160 --> 00:45:52,720 HIV, THAT HAS TO STAND AS ONE OF 1081 00:45:52,720 --> 00:45:56,200 THE THINGS I FEEL MOST GOOD 1082 00:45:56,200 --> 00:45:57,840 ABOUT. 1083 00:45:57,840 --> 00:45:58,800 THERE WAS RELUCTANCE EARLY ON 1084 00:45:58,800 --> 00:46:01,760 HAVING A SEPARATE AIDS PROGRAM 1085 00:46:01,760 --> 00:46:03,960 BECAUSE PEOPLE FELT IT WOULD 1086 00:46:03,960 --> 00:46:04,960 TAKE ATTENTION FROM OTHER 1087 00:46:04,960 --> 00:46:07,560 DISEASES, WHICH IT DIDN'T. 1088 00:46:07,560 --> 00:46:09,960 IF ANYTHING, I BROUGHT ATTENTION 1089 00:46:09,960 --> 00:46:12,040 TO INFECTIOUS DISEASE. 1090 00:46:12,040 --> 00:46:13,080 AND SOMETHING THAT HAD VERY 1091 00:46:13,080 --> 00:46:17,400 LITTLE TO DO WITH MY LINE ITEM 1092 00:46:17,400 --> 00:46:18,160 RESPONSIBILITIES AS DIRECTOR BUT 1093 00:46:18,160 --> 00:46:21,040 BECAUSE I'VE HAD THE OPPORTUNITY 1094 00:46:21,040 --> 00:46:23,520 TO BE THE ADVISER TO SEVEN 1095 00:46:23,520 --> 00:46:25,760 PRESIDENTS NOW, ONE OF THE 1096 00:46:25,760 --> 00:46:28,120 PRESIDENTS DEVELOPED A VERY 1097 00:46:28,120 --> 00:46:29,120 CLOSE RELATIONSHIP WITH ME, 1098 00:46:29,120 --> 00:46:31,040 SEVERAL DID, BUT ONE WE DID 1099 00:46:31,040 --> 00:46:32,000 SOMETHING VERY IMPORTANT 1100 00:46:32,000 --> 00:46:34,200 TOGETHER, AND THAT WAS THE 1101 00:46:34,200 --> 00:46:36,160 DEVELOPMENT OF THE PEPFAR 1102 00:46:36,160 --> 00:46:37,480 PROGRAM UNDER GEORGE W. BUSH 1103 00:46:37,480 --> 00:46:41,600 WHERE HE GAVE ME THE MANDATE TO 1104 00:46:41,600 --> 00:46:43,240 PUT TOGETHER A PROGRAM WHICH HAS 1105 00:46:43,240 --> 00:46:46,160 NOW LED TO THE SAVING OF ABOUT 1106 00:46:46,160 --> 00:46:47,800 18 MILLION LIVES GLOBALLY. 1107 00:46:47,800 --> 00:46:49,960 SO THAT HAD NOTHING TO DO REALLY 1108 00:46:49,960 --> 00:46:51,160 WITH MY RESEARCH EXCEPT THAT MY 1109 00:46:51,160 --> 00:46:54,680 RESEARCH PUT ME IN A POSITION TO 1110 00:46:54,680 --> 00:46:57,760 GAIN THE TRUST OF THE PRESIDENTS 1111 00:46:57,760 --> 00:46:59,280 AND MY RELATIONSHIP WITH THE 1112 00:46:59,280 --> 00:47:01,480 PRESIDENTS ALLOWED ME TO BE IN A 1113 00:47:01,480 --> 00:47:02,760 POSITION TO PUT THE PEPFAR 1114 00:47:02,760 --> 00:47:03,960 PROGRAM TOGETHER. 1115 00:47:03,960 --> 00:47:05,560 SO I KNOW THAT'S A LONG-WINDED 1116 00:47:05,560 --> 00:47:06,760 ANSWER TO THE QUESTION BUT IT 1117 00:47:06,760 --> 00:47:10,200 HAS TO DO WITH THE THREE HATS AS 1118 00:47:10,200 --> 00:47:14,800 A SCIENTIST, AS AN INSTITUTE 1119 00:47:14,800 --> 00:47:18,080 DIRECTOR, AND AS PUBLIC HEALTH 1120 00:47:18,080 --> 00:47:18,360 OFFICIAL. 1121 00:47:18,360 --> 00:47:20,080 >> DR. FAUCI, YOUR ANSWER IS 1122 00:47:20,080 --> 00:47:23,360 INSPIRING AND LEADS US TO THE 1123 00:47:23,360 --> 00:47:25,000 NEXT QUESTION, WHAT IS YOUR 1124 00:47:25,000 --> 00:47:26,840 PROFESSIONAL ADVICE FOR PEOPLE 1125 00:47:26,840 --> 00:47:28,360 STARTING IN THEIR CAREERS 1126 00:47:28,360 --> 00:47:30,240 INTERESTED IN PUBLIC HEALTH? 1127 00:47:30,240 --> 00:47:34,760 >> YOU KNOW, TO ME, IT'S FOLLOW 1128 00:47:34,760 --> 00:47:35,560 YOUR PASSION. 1129 00:47:35,560 --> 00:47:38,920 FIRST OF ALL, HAVE -- YOU HAVE 1130 00:47:38,920 --> 00:47:40,120 TO BE KEENLY INTERESTED IN 1131 00:47:40,120 --> 00:47:42,440 SOMETHING AND FEEL VERY 1132 00:47:42,440 --> 00:47:43,600 PASSIONATE ABOUT IT BECAUSE THE 1133 00:47:43,600 --> 00:47:46,080 ENERGY THAT YOU NEED TO PUT INTO 1134 00:47:46,080 --> 00:47:47,960 SOMETHING, TO BE SUCCESSFUL WITH 1135 00:47:47,960 --> 00:47:50,960 IT, IT HAS TO BE A PROBLEM, IN 1136 00:47:50,960 --> 00:47:53,840 MY MIND, THAT PICK OUT A PROBLEM 1137 00:47:53,840 --> 00:47:54,600 THAT'S RELEVANT. 1138 00:47:54,600 --> 00:47:56,200 YOU KNOW, THERE ARE SOME 1139 00:47:56,200 --> 00:47:58,480 PROBLEMS THAT YOU CAN DO A LOT 1140 00:47:58,480 --> 00:48:02,040 OF EXPERIMENTS ON THAT ARE NOT 1141 00:48:02,040 --> 00:48:03,880 PARTICULARLY RELEVANT. 1142 00:48:03,880 --> 00:48:05,400 AND THERE ARE OTHERS THAT ARE 1143 00:48:05,400 --> 00:48:07,120 RELEVANT BUT IT'S VERY DIFFICULT 1144 00:48:07,120 --> 00:48:09,160 TO DEVELOP THE RIGHT KIND OF 1145 00:48:09,160 --> 00:48:11,120 QUESTIONS TO ANSWER THEM. 1146 00:48:11,120 --> 00:48:12,960 PICK OUT SOMETHING THAT YOU CAN 1147 00:48:12,960 --> 00:48:16,560 ACTUALLY WORK ON, EVEN IF IT'S 1148 00:48:16,560 --> 00:48:18,560 FUNDAMENTALLY A BASIC SCIENCE 1149 00:48:18,560 --> 00:48:18,880 QUESTION. 1150 00:48:18,880 --> 00:48:20,560 THAT WOULD HAVE SOME CONNECTION 1151 00:48:20,560 --> 00:48:22,480 TO SOMETHING YOU CAN FEEL VERY 1152 00:48:22,480 --> 00:48:23,320 STRONGLY ABOUT. 1153 00:48:23,320 --> 00:48:26,200 AND DON'T WORRY ABOUT WHAT OTHER 1154 00:48:26,200 --> 00:48:29,040 PEOPLE THINK ABOUT WHAT YOU DO. 1155 00:48:29,040 --> 00:48:30,360 I MEAN, OBVIOUSLY WHEN YOU ARE 1156 00:48:30,360 --> 00:48:32,560 TRYING TO GET A GRANT YOU HAVE 1157 00:48:32,560 --> 00:48:34,400 TO WORRY ABOUT WHAT OTHER PEOPLE 1158 00:48:34,400 --> 00:48:35,560 THINK ABOUT IT, BUT YOU'VE GOT 1159 00:48:35,560 --> 00:48:38,000 TO BE THE ONE THAT REALLY FEELS 1160 00:48:38,000 --> 00:48:39,960 VERY STRONGLY ABOUT YOUR WORK 1161 00:48:39,960 --> 00:48:41,600 BECAUSE THAT'S GOING TO DERIVE 1162 00:48:41,600 --> 00:48:44,320 IN YOU THE ENERGY THAT IT TAKES 1163 00:48:44,320 --> 00:48:47,360 TO BE SUCCESSFUL IN IT. 1164 00:48:47,360 --> 00:48:50,520 SO, YOU KNOW, SCIENCE IS AN 1165 00:48:50,520 --> 00:48:51,640 AMAZING PROFESSION. 1166 00:48:51,640 --> 00:48:53,520 WE SHOULD FEEL SO FORTUNATE THAT 1167 00:48:53,520 --> 00:48:54,920 WE'VE HAD THE OPPORTUNITY THAT 1168 00:48:54,920 --> 00:48:56,440 WAS PROBABLY GIVEN TO US BY 1169 00:48:56,440 --> 00:48:58,840 EVERYTHING GOING BACK FROM OUR 1170 00:48:58,840 --> 00:49:00,280 PARENTS TO MENTORS AND OTHERS 1171 00:49:00,280 --> 00:49:02,920 WHO PUT US INTO A POSITION TO BE 1172 00:49:02,920 --> 00:49:04,760 ABLE TO CONDUCT SCIENCE. 1173 00:49:04,760 --> 00:49:09,680 IT'S ONE OF THE MOST 1174 00:49:09,680 --> 00:49:10,320 SELF-FULFILLING, GRATIFYING 1175 00:49:10,320 --> 00:49:12,520 PROFESSIONS WE CAN THINK OF. 1176 00:49:12,520 --> 00:49:16,440 DON'T GET DISCOURAGED BY LACK OF 1177 00:49:16,440 --> 00:49:16,680 SUCCESS. 1178 00:49:16,680 --> 00:49:18,080 YOU KNOW, PEOPLE LOOK AT ME 1179 00:49:18,080 --> 00:49:20,720 BECAUSE I'VE BEEN AROUND A WHILE 1180 00:49:20,720 --> 00:49:21,920 AND I'M VERY WELL KNOWN. 1181 00:49:21,920 --> 00:49:23,760 I HAD AS MANY FAILURES IN THE 1182 00:49:23,760 --> 00:49:25,960 LAB THAT ALL OF YOU NOW ARE 1183 00:49:25,960 --> 00:49:27,160 THINKING ABOUT THE FAILURES IN 1184 00:49:27,160 --> 00:49:28,560 THE LAB. 1185 00:49:28,560 --> 00:49:30,160 YOU KNOW, THE FIRST GROUP OF 1186 00:49:30,160 --> 00:49:32,800 EXPERIMENTS I GOT INVOLVED WITH 1187 00:49:32,800 --> 00:49:34,360 DIDN'T WORK VERY WELL. 1188 00:49:34,360 --> 00:49:36,840 I WAS VERY DEPRESSED, MY FIRST 1189 00:49:36,840 --> 00:49:38,680 PAPER, "JOURNAL OF IMMUNOLOGY," 1190 00:49:38,680 --> 00:49:39,600 I GOT REJECTED. 1191 00:49:39,600 --> 00:49:42,320 YOU KNOW, I THOUGHT MY CAREER 1192 00:49:42,320 --> 00:49:42,600 WAS OVER. 1193 00:49:42,600 --> 00:49:44,560 SO, JUST BECAUSE YOU SEE ME ON 1194 00:49:44,560 --> 00:49:45,880 TV DOESN'T MEAN I DIDN'T GO 1195 00:49:45,880 --> 00:49:47,200 THROUGH THE SAME THING YOU'RE 1196 00:49:47,200 --> 00:49:49,520 ALL GOING THROUGH. 1197 00:49:49,520 --> 00:49:50,000 >> THANK YOU. 1198 00:49:50,000 --> 00:49:51,480 I THINK THAT ANSWER RESONATES 1199 00:49:51,480 --> 00:49:54,160 WITH A LOT OF PEOPLE. 1200 00:49:54,160 --> 00:49:56,720 SO, THE NEXT QUESTION HERE IS, 1201 00:49:56,720 --> 00:49:58,440 WHAT DO YOU FORESEE AS THE 1202 00:49:58,440 --> 00:50:01,320 BIGGEST CHALLENGE IN THE NEXT 1203 00:50:01,320 --> 00:50:02,600 YEAR OF COVID? 1204 00:50:02,600 --> 00:50:05,240 >> YEAH, I THINK THE BIGGEST 1205 00:50:05,240 --> 00:50:08,160 CHALLENGE IS HOW -- IT'S A 1206 00:50:08,160 --> 00:50:11,480 COMBINATION OF A SOCIETAL 1207 00:50:11,480 --> 00:50:13,000 CHALLENGE AND A SCIENTIFIC 1208 00:50:13,000 --> 00:50:13,520 CHALLENGE. 1209 00:50:13,520 --> 00:50:17,720 THE QUESTION IS GOING TO BE, AND 1210 00:50:17,720 --> 00:50:19,680 THAT HAS A LOT TO DO I THINK 1211 00:50:19,680 --> 00:50:21,000 WITH ONE OF YOUR FIRST 1212 00:50:21,000 --> 00:50:24,160 QUESTIONS, IS HOW DO WE GET THE 1213 00:50:24,160 --> 00:50:25,720 PROTECTION OF THE COMMUNITY SUCH 1214 00:50:25,720 --> 00:50:29,640 THAT THE LEVEL OF VIRUS IN THE 1215 00:50:29,640 --> 00:50:32,400 COMMUNITY IS LOW ENOUGH THAT IT 1216 00:50:32,400 --> 00:50:34,560 DOES NOT DISRUPT THE SOCIAL 1217 00:50:34,560 --> 00:50:35,760 ORDER, BECAUSE WE REALLY CAN'T 1218 00:50:35,760 --> 00:50:38,280 GO ON FOR A LONG TIME THE WAY 1219 00:50:38,280 --> 00:50:40,440 WE'VE GONE ON. 1220 00:50:40,440 --> 00:50:44,720 WE'RE ALMOST THREE FULL YEARS 1221 00:50:44,720 --> 00:50:45,560 INTO AN ENTIRELY DISRUPTIVE 1222 00:50:45,560 --> 00:50:46,760 PANDEMIC. 1223 00:50:46,760 --> 00:50:50,360 IF WE HAD A VACCINE THAT WAS, A, 1224 00:50:50,360 --> 00:50:53,880 HIGHLY EFFECTIVE, WHICH WE DO, 1225 00:50:53,880 --> 00:50:56,360 GOOD NEWS, BAD NEWS IT DOESN'T 1226 00:50:56,360 --> 00:50:59,960 PROTECT FOR A DURABLE PERIOD OF 1227 00:50:59,960 --> 00:51:00,320 TIME. 1228 00:51:00,320 --> 00:51:04,040 THE OTHER CHALLENGE IS THE FACT 1229 00:51:04,040 --> 00:51:07,560 THAT UNLIKE THE VIRUSES THAT 1230 00:51:07,560 --> 00:51:09,920 WE'VE CONQUERED, POLIO, 1231 00:51:09,920 --> 00:51:12,040 SMALLPOX, MEASLES, THE ABILITY 1232 00:51:12,040 --> 00:51:16,520 OF THIS VIRUS TO FORM VARIANTS 1233 00:51:16,520 --> 00:51:17,520 THAT ELUDE PROTECTION OF 1234 00:51:17,520 --> 00:51:20,680 VACCINES, MORE SO AGAINST 1235 00:51:20,680 --> 00:51:22,000 INFECTION, THAN AGAINST SEVERE 1236 00:51:22,000 --> 00:51:25,720 DISEASE, IS IN MANY RESPECTS 1237 00:51:25,720 --> 00:51:26,480 UNPRECEDENTED. 1238 00:51:26,480 --> 00:51:30,360 I MEAN, WITHIN ONE SEASON, WE'VE 1239 00:51:30,360 --> 00:51:32,400 GONE FROM WILDTYPE TO ALPHA TO 1240 00:51:32,400 --> 00:51:36,000 DELTA, TO THE END OF THE YEAR 1241 00:51:36,000 --> 00:51:36,240 OMICRON. 1242 00:51:36,240 --> 00:51:39,360 THAT IS A SCIENTIFIC AND PUBLIC 1243 00:51:39,360 --> 00:51:41,120 HEALTH CHALLENGE, THE LIKES OF 1244 00:51:41,120 --> 00:51:43,080 WHICH WE HAVEN'T SEEN, EVER, 1245 00:51:43,080 --> 00:51:44,080 REALLY, WITH ANY PATHOGEN. 1246 00:51:44,080 --> 00:51:47,280 SO THE CHALLENGE IS GOING TO BE 1247 00:51:47,280 --> 00:51:49,960 TO DEVELOP THERAPEUTICS AS WELL 1248 00:51:49,960 --> 00:51:52,240 AS A VACCINE THAT PREVENTS 1249 00:51:52,240 --> 00:51:54,480 AGAINST INFECTION, HENCE YOUR 1250 00:51:54,480 --> 00:51:55,800 QUESTION ABOUT MUCOSAL. 1251 00:51:55,800 --> 00:52:00,160 NUMBER TWO, HAS A DURABILITY OF 1252 00:52:00,160 --> 00:52:01,160 PROTECTION. 1253 00:52:01,160 --> 00:52:02,920 AND THREE, IS BROADLY 1254 00:52:02,920 --> 00:52:03,200 PROTECTIVE. 1255 00:52:03,200 --> 00:52:06,760 SO THAT WE GET A RESPONSE 1256 00:52:06,760 --> 00:52:09,360 AGAINST ANY ASPECT OF A 1257 00:52:09,360 --> 00:52:10,760 SARS-COV-2, ANY VARIANT, THAT 1258 00:52:10,760 --> 00:52:13,600 MAY NOT JUST BE CONCENTRATING ON 1259 00:52:13,600 --> 00:52:14,360 THE SPIKE PROTEIN. 1260 00:52:14,360 --> 00:52:17,160 THERE MAY BE OTHER COMPONENTS OF 1261 00:52:17,160 --> 00:52:18,160 THE ANTIGENIC STRUCTURE OF THE 1262 00:52:18,160 --> 00:52:20,160 VIRUS THAT WE NEED TO AIM AT. 1263 00:52:20,160 --> 00:52:22,760 BUT THAT REALLY IS THE CHALLENGE 1264 00:52:22,760 --> 00:52:25,120 TO ESSENTIALLY GET IT TO SUCH A 1265 00:52:25,120 --> 00:52:29,480 LOW LEVEL IT DOESN'T DISRUPT US. 1266 00:52:29,480 --> 00:52:30,360 >> THANK YOU. 1267 00:52:30,360 --> 00:52:32,920 THERE ACTUALLY IS A QUESTION 1268 00:52:32,920 --> 00:52:34,560 ABOUT -- IF YOU COULD COMMENT ON 1269 00:52:34,560 --> 00:52:36,640 MUTATIONS OUTSIDE OF THE SPIKE 1270 00:52:36,640 --> 00:52:40,880 PROTEIN, AND IF THESE MIGHT LEAD 1271 00:52:40,880 --> 00:52:43,280 TO LONGER INFECTION OR THEIR 1272 00:52:43,280 --> 00:52:43,600 SIGNIFICANCE. 1273 00:52:43,600 --> 00:52:44,600 >> THERE'S A LOT WE DO NOT KNOW. 1274 00:52:44,600 --> 00:52:46,800 WHETHER OR NOT IT'S GOING TO BE 1275 00:52:46,800 --> 00:52:47,880 RELATED TO LONGER INFECTIONS, OR 1276 00:52:47,880 --> 00:52:50,400 WHAT HAVE YOU, WE DON'T KNOW. 1277 00:52:50,400 --> 00:52:53,360 BUT WE DO KNOW THAT, FOR 1278 00:52:53,360 --> 00:52:57,280 EXAMPLE, YOU KNOW, THE BA .4 AND 1279 00:52:57,280 --> 00:52:59,040 BA.5 AND BA .1, ET CETERA, YOU 1280 00:52:59,040 --> 00:53:01,400 LOOK AT THE SPIKE PROTEIN IN 1281 00:53:01,400 --> 00:53:02,880 MANY RESPECTS THEY ARE QUITE 1282 00:53:02,880 --> 00:53:06,520 SIMILAR BUT YET HAVE DIFFERENT 1283 00:53:06,520 --> 00:53:08,120 DEGREES OF TRANSMISSION 1284 00:53:08,120 --> 00:53:08,440 EFFICIENCY. 1285 00:53:08,440 --> 00:53:11,800 THEY HAVE DIFFERENT DEGREES OF 1286 00:53:11,800 --> 00:53:13,320 OTHER PHENOTYPIC ASPECTS OF THE 1287 00:53:13,320 --> 00:53:13,520 VIRUS. 1288 00:53:13,520 --> 00:53:16,080 SO, THERE'S A LOT WE NEED TO 1289 00:53:16,080 --> 00:53:16,400 KNOW. 1290 00:53:16,400 --> 00:53:17,280 THAT'S THE REASON WHY, YOU KNOW, 1291 00:53:17,280 --> 00:53:20,680 WHEN I PUT A RESEARCH AGENDA 1292 00:53:20,680 --> 00:53:21,760 TOGETHER, AND PEOPLE SAY WHAT 1293 00:53:21,760 --> 00:53:24,440 MORE DO YOU NEED TO STUDY ABOUT 1294 00:53:24,440 --> 00:53:25,960 THE VIRUS, THERE'S A LOT. 1295 00:53:25,960 --> 00:53:27,160 WE KNOW A LOT ABOUT THIS VIRUS, 1296 00:53:27,160 --> 00:53:29,560 BUT THERE'S A LOT WE DON'T KNOW. 1297 00:53:29,560 --> 00:53:34,360 WE HAD TO MAKE SOME ASSUMPTIONS 1298 00:53:34,360 --> 00:53:36,360 EARLY ON, WHICH THANK GOODNESS 1299 00:53:36,360 --> 00:53:37,560 WERE ASSUMPTION THAT PAID OFF, 1300 00:53:37,560 --> 00:53:39,160 OF WHAT WE'RE GOING TO PUT IN 1301 00:53:39,160 --> 00:53:40,680 THE VACCINE, AND THE KIND OF 1302 00:53:40,680 --> 00:53:43,080 VACCINE THAT WE'RE GOING TO USE. 1303 00:53:43,080 --> 00:53:44,720 SO, THE TWO QUESTIONS OF A 1304 00:53:44,720 --> 00:53:48,920 VACCINE, THE TWO BIG PILLARS, 1305 00:53:48,920 --> 00:53:51,600 ARE PLATFORM AND IMMUNOGEN. 1306 00:53:51,600 --> 00:53:54,880 SO, THE PLATFORM SERVED US VERY, 1307 00:53:54,880 --> 00:53:55,840 VERY WELL. 1308 00:53:55,840 --> 00:53:58,280 BUT WE PROBABLY NEED TO GRADUATE 1309 00:53:58,280 --> 00:54:00,600 TO OTHER PLATFORMS BECAUSE EVEN 1310 00:54:00,600 --> 00:54:02,880 THOUGH mRNA IS HIGHLY 1311 00:54:02,880 --> 00:54:05,560 ADAPTABLE, AND IT ALLOWED US, 1312 00:54:05,560 --> 00:54:09,040 REMEMBER, TO GO FROM A PLATFORM 1313 00:54:09,040 --> 00:54:14,320 THAT WAS AN ANCESTRAL STRAIN TO 1314 00:54:14,320 --> 00:54:20,760 SWITCH TO A BA .4/5 BIVALENT 1315 00:54:20,760 --> 00:54:23,840 BOOSTER IN TWO MONTHS NO WAY 1316 00:54:23,840 --> 00:54:25,880 COULD WE DO THAT WITH PROTEIN 1317 00:54:25,880 --> 00:54:26,120 VACCINE. 1318 00:54:26,120 --> 00:54:28,360 ONLY mRNA ALLOWS THAT BECAUSE 1319 00:54:28,360 --> 00:54:30,520 OF THE FLEXIBILITY OF INSERTS. 1320 00:54:30,520 --> 00:54:33,320 NOW WE HAVE TO FIGURE OUT CAN WE 1321 00:54:33,320 --> 00:54:34,400 DO BETTER WITH NANOPARTICLE 1322 00:54:34,400 --> 00:54:36,160 VACCINES, FOR EXAMPLE, THAT HAVE 1323 00:54:36,160 --> 00:54:37,920 AN ARRAY OF DIFFERENT ANTIGENIC 1324 00:54:37,920 --> 00:54:38,760 DETERMINANTS ON IT. 1325 00:54:38,760 --> 00:54:41,600 THOSE ARE THE KIND OF QUESTIONS 1326 00:54:41,600 --> 00:54:43,680 THAT STILL REMAIN UNANSWERED. 1327 00:54:43,680 --> 00:54:47,160 SO ANYBODY WHO THINKS THE 1328 00:54:47,160 --> 00:54:49,160 VACCINE STORY IS A CLOSED 1329 00:54:49,160 --> 00:54:52,240 RESEARCH STORY FOR COVID, 1330 00:54:52,240 --> 00:54:55,680 BECAUSE WE HAVE THIS PHENOMENAL 1331 00:54:55,680 --> 00:54:59,080 mRNA 93, 94, 95% EFFICACY, NO, 1332 00:54:59,080 --> 00:55:00,600 THERE'S A LOT OF WORK TO BE DONE 1333 00:55:00,600 --> 00:55:01,400 ON VACCINE DEVELOPMENT FOR 1334 00:55:01,400 --> 00:55:03,120 COVID. 1335 00:55:03,120 --> 00:55:03,440 >> GREAT. 1336 00:55:03,440 --> 00:55:04,760 THANK YOU. 1337 00:55:04,760 --> 00:55:07,280 THE NEXT QUESTION HAS TO DO WITH 1338 00:55:07,280 --> 00:55:09,560 CLINICAL TRIAL NETWORKS. 1339 00:55:09,560 --> 00:55:11,960 YOU MENTIONED IN YOUR TALK THAT 1340 00:55:11,960 --> 00:55:13,400 THE COVID-19 PREVENTION NETWORK 1341 00:55:13,400 --> 00:55:18,640 WAS RAPIDLY CREATED BY MERGING 1342 00:55:18,640 --> 00:55:19,760 FOUR EXISTING NIAID-FUNDED 1343 00:55:19,760 --> 00:55:20,840 CLINICAL TRIAL NETWORKS. 1344 00:55:20,840 --> 00:55:23,240 DO YOU ENVISION A SIMILAR 1345 00:55:23,240 --> 00:55:24,560 APPROACH FOR FUTURE OUTBREAKS 1346 00:55:24,560 --> 00:55:26,440 AND WHAT DO YOU SUGGEST CAN OR 1347 00:55:26,440 --> 00:55:28,160 SHOULD BE DONE TO STRENGTHEN 1348 00:55:28,160 --> 00:55:28,800 U.S. CLINICAL NETWORKS TO 1349 00:55:28,800 --> 00:55:30,760 PREPARE FOR THE NEXT OUTBREAK? 1350 00:55:30,760 --> 00:55:33,880 >> WELL, THE ANSWER IS A 1351 00:55:33,880 --> 00:55:34,400 RESOUNDING YES. 1352 00:55:34,400 --> 00:55:37,160 AND THAT'S ONE OF THE THINGS, 1353 00:55:37,160 --> 00:55:41,280 YOU KNOW, SOMETIMES IT'S VERY 1354 00:55:41,280 --> 00:55:45,560 DIFFICULT TO USE MONEY THAT IS 1355 00:55:45,560 --> 00:55:47,160 DESIGNATED FOR ONE THING, FOR 1356 00:55:47,160 --> 00:55:47,400 ANOTHER. 1357 00:55:47,400 --> 00:55:50,560 ACTUALLY, YOU CAN GET IN SOME 1358 00:55:50,560 --> 00:55:51,920 TROUBLE IF THE APPROPRIATIONS 1359 00:55:51,920 --> 00:55:55,600 LANGUAGE SAYS YOU NEED TO USE IT 1360 00:55:55,600 --> 00:55:57,440 SPECIFICALLY FOR ONE PURPOSE. 1361 00:55:57,440 --> 00:56:00,520 BUT WHEN WE PUT TOGETHER THE 1362 00:56:00,520 --> 00:56:04,760 CLINICAL TRIALS NETWORKS, IT IS 1363 00:56:04,760 --> 00:56:05,760 THE LARGEST GLOBAL CLINICAL 1364 00:56:05,760 --> 00:56:07,920 TRIAL NETWORK EVER PUT TOGETHER 1365 00:56:07,920 --> 00:56:09,480 FOR ANY DISEASE. 1366 00:56:09,480 --> 00:56:13,400 AND YOU KNOW, IT'S THE ACTG, 1367 00:56:13,400 --> 00:56:14,960 AIDS TREATMENT CLINICAL TRIAL 1368 00:56:14,960 --> 00:56:18,600 GROUP, THERE'S THE VACCINE 1369 00:56:18,600 --> 00:56:20,080 PREVENTION, THERE'S THE AIDS 1370 00:56:20,080 --> 00:56:21,760 PREVENTION GROUP, THERE'S A 1371 00:56:21,760 --> 00:56:24,760 WHOLE BUNCH OF THEM. 1372 00:56:24,760 --> 00:56:29,560 WE COMPLETELY PIVOTED THEM TO BE 1373 00:56:29,560 --> 00:56:34,360 USED TO TEST NOT ONLY THE COVID 1374 00:56:34,360 --> 00:56:36,840 VACCINES BUT ALSO SOME OF THE 1375 00:56:36,840 --> 00:56:39,520 THERAPIES THAT WE USE. 1376 00:56:39,520 --> 00:56:41,880 I FORESEE ABSOLUTELY THAT WE'RE 1377 00:56:41,880 --> 00:56:45,600 GOING TO USE THOSE FOR OTHER 1378 00:56:45,600 --> 00:56:46,920 EMERGING INFECTIOUS DISEASES, 1379 00:56:46,920 --> 00:56:50,160 AND I THINK THE PROOF THAT IT 1380 00:56:50,160 --> 00:56:54,120 CAME TO THE RESCUE OF COVID BY 1381 00:56:54,120 --> 00:56:57,040 PROVIDING A READY-MADE HIGHLY 1382 00:56:57,040 --> 00:56:58,120 EXPERIENCED WITH CLINICAL 1383 00:56:58,120 --> 00:56:59,760 INVESTIGATORS WHO REALLY KNEW 1384 00:56:59,760 --> 00:57:01,760 HOW TO CONDUCT A CLINICAL TRIAL, 1385 00:57:01,760 --> 00:57:05,560 AND THAT WAS BECAUSE OF 30 YEARS 1386 00:57:05,560 --> 00:57:07,680 OF EXPERIENCE OF DOING IT. 1387 00:57:07,680 --> 00:57:09,440 AND THE ANSWER IS, WHAT FURTHER 1388 00:57:09,440 --> 00:57:11,120 DO WE HAVE TO DO? 1389 00:57:11,120 --> 00:57:14,680 WHAT WE HAVE TO DO FURTHER IS TO 1390 00:57:14,680 --> 00:57:16,960 MAKE SURE WE KEEP THOSE CLINICAL 1391 00:57:16,960 --> 00:57:18,920 TRIAL NETWORKS WARM. 1392 00:57:18,920 --> 00:57:21,680 WE DON'T LET THEM DISSIPATE. 1393 00:57:21,680 --> 00:57:23,200 SO, YOU KNOW, PEOPLE ALWAYS ASK 1394 00:57:23,200 --> 00:57:24,400 ME WHAT'S THE ADVICE THAT I HAVE 1395 00:57:24,400 --> 00:57:26,800 FOR THE PERSON THAT'S GOING TO 1396 00:57:26,800 --> 00:57:27,880 REPLACE ME. 1397 00:57:27,880 --> 00:57:29,800 I ALWAYS SAY THERE ARE A NUMBER 1398 00:57:29,800 --> 00:57:32,320 OF BITS OF ADVICE BUT ONE OF 1399 00:57:32,320 --> 00:57:35,880 THEM IS MAKE SURE YOU DON'T 1400 00:57:35,880 --> 00:57:36,440 ALLOW THE CLINICAL TRIAL 1401 00:57:36,440 --> 00:57:40,560 APPARATUS TO ALL OF A SUDDEN GO 1402 00:57:40,560 --> 00:57:42,640 INTO ATTRITION BECAUSE YOU DON'T 1403 00:57:42,640 --> 00:57:43,560 HAVE A BIG OUTBREAK BECAUSE 1404 00:57:43,560 --> 00:57:47,000 WE'RE GOING TO NEED THEM TO COME 1405 00:57:47,000 --> 00:57:48,920 BACK AT THE NEXT INEVITABLE 1406 00:57:48,920 --> 00:57:49,960 OUTBREAK THAT WE HAVE. 1407 00:57:49,960 --> 00:57:52,440 WHICH I THINK WAS THE LAST SLIDE 1408 00:57:52,440 --> 00:57:56,680 ON MY TALK. 1409 00:57:56,680 --> 00:57:57,720 >> THANK YOU, DR. FAUCI. 1410 00:57:57,720 --> 00:58:00,280 SO WE WANT TO BE RESPECTFUL OF 1411 00:58:00,280 --> 00:58:01,200 YOUR TIME. 1412 00:58:01,200 --> 00:58:03,080 YOU HAVE MANY COMMITMENTS TODAY. 1413 00:58:03,080 --> 00:58:06,160 BUT AGAIN THANK YOU SO MUCH ON 1414 00:58:06,160 --> 00:58:07,760 BEHALF OF THE COVID-19 SIG 1415 00:58:07,760 --> 00:58:08,880 STEERING COMMITTEE FOR SPEAKING 1416 00:58:08,880 --> 00:58:09,960 WITH US TODAY AND TO THE 1417 00:58:09,960 --> 00:58:11,400 AUDIENCE, THANK YOU FOR JOINING 1418 00:58:11,400 --> 00:58:11,560 US. 1419 00:58:11,560 --> 00:58:12,560 WE LOOK FORWARD TO SEEING YOU AT 1420 00:58:12,560 --> 00:58:13,000 THE NEXT WEBINAR. 1421 00:58:13,000 --> 00:58:14,280 >> YES, THANK YOU FOR HAVING ME. 1422 00:58:14,280 --> 00:58:15,000 IT'S BEEN A PLEASURE. 1423 00:58:15,000 --> 00:00:00,000 TAKE CARE.