So if you look at the pandemic as a broad 40,000-foot phenomenon, and you have 62 million people, the way we have right now, who are not yet vaccinated — and many more people who might not get boosted — that’s going to have an impact on the broad concept of the outbreak. But if you take people who are vaccinated and boosted, they’re going to be walking through the outbreak and have much less of a risk than anybody else.
Adam: Why have we not seen a major variant since Delta that has really spread through the global population?
Fauci: It’s pure virology. Delta has adapted itself to be a highly, highly transmissible virus that has essentially bumped off the radar screen virtually every other one. We knew that when you look at how rapidly Delta took over the United States. It depends on the fitness of the virus to transmit. And it just so happens that even though there are a lot of other viruses out there that have different variants, Delta has emerged as the big bully on the block.
Jonathan: What do you think the virus becoming endemic looks like and when is this going to happen?
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Fauci: You know, guys, I don’t know. We don’t know. The one thing I’ve said multiple times is that the multiple phases of an outbreak are pandemic deceleration, control, elimination and eradication.
There’s no way we’re going to eradicate, I doubt, because of the transmissibility that we just mentioned. I doubt very seriously whether we’re going to eliminate it, like we’ve eliminated polio, and we’ve eliminated measles, and a century ago we eliminated malaria from the United States. But there’s control and it’s going to be up to us what level of control that we are willing to accept.
If you’re willing to accept control at 70,000 per day, that’s wrong. No way we can accept 70,000, 80,000 infections a day. You have to get it down so low that it doesn’t impact, in a negative way, society. So we don’t worry about getting sick and dying. Our economy is essentially held hostage to it. That’s the control. When we get there, I can’t predict. I hope it’s relatively soon, and it’s going to depend a lot on how well we do in vaccinating the population.
Jonathan: How should people approach the holidays?
Fauci: What an individual can feel comfortable in doing depends on their status. So if you’ve got a family where people are vaccinated — the family’s vaccinated, the children who can be vaccinated are vaccinated, that kind of situation — people should feel very, very free and un-anxious about having an enjoyable Thanksgiving holiday. Those who are unvaccinated, they can also have an enjoyable holiday. They’re just going to do it at a greater risk.