Read: Anthony Fauci, lightning rod
Fauci is much more optimistic about the development of a vaccine, which has progressed at an unprecedented speed. He cited the large-scale, Phase 3 clinical trials currently under way in the U.S. “The results that we have actually do look good,” he said. (One trial, AstraZeneca’s, remains partly on hold after two participants developed serious neurological illnesses.)
The federal government’s investments in vaccine development and production are a bright spot in the American response, which otherwise has been uncoordinated, chaotic from the top down, and predicated on pinning blame on individual states. By contrast, Operation Warp Speed, a name Fauci often decries because it sounds reckless, has been well funded, organized, and effective. In normal circumstances, vaccine makers would wait until after clinical trials conclude to begin manufacturing, but government funds have allowed them to begin over the past several months. “If we get an answer, let’s say, November, December—it’s possible it could be earlier, but I think it’s going to be likely November, December,” Fauci said, “we can then start vaccinating people, starting with the health-care workers, … the elderly, and those with underlying conditions.”
The Trump administration’s political rhetoric about vaccine development has raised alarm among other public-health experts. In the lead-up to the election, Trump has begun teasing that a vaccine could be available in weeks. Some have wondered whether the design of the current trials, released after substantial public pressure, will actually reveal the information that’s needed about these new vaccines. “The trials need to focus on the right clinical outcome—whether the vaccines protect against moderate and severe forms of COVID-19—and be fully completed,” wrote Eric Topol, a molecular-medicine professor at Scripps Research, and Peter Doshi, a professor at the University of Maryland School of Pharmacy, in a New York Times op-ed yesterday.
People across the political spectrum also are expressing uncertainty about taking the vaccine, which could blunt the positive effects of its availability.
So, as we approach winter, there are two wildly different stories to tell about what might happen. In the storybook ending, a vaccine becomes available, more testing reduces the number of contagious people, and the country brings the virus under control. In the darker scenario, vaccines are delayed, or even if one arrives, few people accept it as safe. Testing is ineffective, and collapsing social cohesion leads to less adherence to simple, effective public-health measures.
Read: A vaccine reality check
Throw in a presidential election, flu season, climate chaos, rampant misinformation online, and the path the country may end up on is not at all clear. “What the general public needs is a message that’s consistent, and that they can believe,” Fauci said. “And what’s happened, unfortunately—and I think you’d have to be asleep not to realize this—is that we are living in a very divisive society right now; there’s no doubt about that … It’s politically charged, and what’s happened is that public-health issues and public-health recommendations have taken on a we-versus-them approach.”
Can America’s science-and-technology infrastructure save us from a crumbling politics of grievance and anger? Not even a public servant with a record like Fauci’s can predict that.