Fauci Warns Pharmacists of Challenging Months Ahead During Session at ASHP

Pharmacists should be prepared for a challenging few months ahead until the majority of the public can be vaccinated against coronavirus disease 2019 (COVID-19), warned Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), during a session Wednesday at the American Society of Health-System Pharmacists 2020 Meeting.

Fauci said he was first introduced to health care at his father’s pharmacy in Brooklyn, where Fauci would frequently deliver prescriptions. Although his initial aspirations were to be on the teaching faculty at Weill Cornell Medicine, Fauci became director of NIAID in 1986 and got involved in emerging diseases, including Zika, Ebola, and HIV/AIDS.

“Now, I’m totally consumed with the work we’re doing with COVID-19,” Fauci said.

Although he noted some similarities between the HIV/AIDS outbreak and the COVID-19 pandemic, Fauci said COVID-19 is unique because the entire population is susceptible, with no exceptions. Of all the diseases he has researched, he said COVID-19 is unique in that between 40% and 45% of individuals are asymptomatic, and approximately 80% of those with symptoms have mild disease. However, anywhere from 15% to 20% of those with severe disease are in danger of death, he said.

“Interestingly, most of them—not all—are elderly and those with underlying conditions,” Fauci said. “But we’re starting to see now that there’s increasing awareness that people in their 40s and 50s also can get into serious trouble with COVID-19.”

He said one of the major challenges is in public health messaging, because young people do not believe they are at high risk of severe disease. With no uniform message, Fauci said public health professionals should urge unity and remind young people of their “societal responsibility.”

“You don’t want to be the vehicle that the virus uses you to spread to someone else,” Fauci said.

Pharmacists have a major role to play both during and after the pandemic, Fauci said. Although the current vaccine roll-out plan involves transport by the military, Fauci said there are contracts with pharmaceutical corporations to go into nursing homes and provide vaccinations once the vaccines are available locally. For the general public, he said individuals will eventually be able to take a prescription or other documentation to get the vaccine at a neighborhood pharmacy, depending on whether they are in a prioritized group.

Until the vaccines are widely available, however, Fauci said the importance of public health measures cannot be understated. He predicted a “long, cold winter” through at least January, driven largely by holiday travel and gatherings. Although he acknowledged that many people want to see family and friends over the holidays, he said experts anticipate a surge of cases 2 to 3 weeks after Thanksgiving, which will merge with Christmas gatherings.

“We have some precarious situations ahead of us if people continue to do what, unfortunately, they naturally do,” he said.

Finally, Fauci was asked about his own experience of the outbreak. Although he said his highest points were that therapeutics were discovered relatively quickly and vaccines have been developed at record rates, Fauci said the lowest point has been the sheer scope of the disease in the United States.

“Our country has been hit terribly,” he said. “Just think of that—267,000 deaths and it isn’t even 1 full year. That’s unprecedented, the worst we’ve had in over 102 years in this country.”

Still, Fauci said, health care providers should be proud of their work. He believes pharmacists will continue to assume important roles in testing and vaccine delivery and hopes to soon have COVID-19 home tests available in pharmacies. Fauci said he personally has been buoyed by the support from stakeholders, especially health care providers.

“[Pharmacists] should also be proud of the fact that they belong to a group of heroes, because if you want to pick out any heroes in this ordeal that we’re going through, it’s the health care providers, the people who are on the front line,” he said.

When asked about his future plans, Fauci laughed and said he barely has time to consider it.

“This is what I do,” he said. “I chose this life and that’s what I do. There’s no chance that I’m even going to consider slowing down, much less walking away.”

REFERENCE

Fauci A. Wednesday Wisdom with Anthony Fauci. Presented at American Society of Health-Sysem Pharmacists virtual 2020 ASHP Midyear Clinical Meeting and Exhibition; December 9, 2020. Accessed December 9, 2020.