Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to President Biden, said in an interview with ClearHealthCosts on Thursday that the Biden administration is working to improve the performance of the chain pharmacies in Covid vaccine distribution.
In an interview over Zoom with Jeanne Pinder, founder and CEO of ClearHealthCosts, partner with Epicenter-NYC in the Vaccine Equity Partner Engagement grant program with the Fund for Public Health of New York City, Pinder asked Fauci about improving the chain pharmacies’ performance and encouraging them to make it easier for people to get vaccinated.
“We spoke to the CEOs of four major pharmacies, speaking about what they can do to be more flexible,” he said, pointing to talks with the CEOs when President Biden got his booster. ‘First of all, they’re doing a good job — a lot of what we’re getting done is getting done through the pharmacies. So they are really very important in our effort. But the President was encouraging them to do even more — to be more flexible in allowing people to more easily get vaccinated, as well as a number of other efforts in the community to make sure we do it in a user-friendly way. “
The big chains — CVS, Walgreen’s, Rite-Aid and others — got a big role in the Covid vaccine distribution rollout from the Trump administration. While they have done a lot of vaccinating, there are downsides — limited hours, the need for registration in advance, among them. They were also accused in the early rollout of demanding identification papers, which is a downside for some individuals. Also the chains’ business imperatives, for bolstering their bottom line, drive their decisions — not public health imperatives, which seek to expand vaccine access.
When asked why Long Covid is not part of the national discussion, Fauci said he thinks it is, pointing to programs at the National Institutes of Health and the Centers for Disease Control and Prevention.
Here is a transcript of their conversation on Zoom on Thursday, Oct. 27, 2022, lightly edited for clarity.
Jeanne Pinder
If we wanted to encourage vaccine uptake, what are the best ways to fight against this “the pandemic is over” messaging?
Anthony Fauci
Well, I think it’s by getting correct information out there. I mean, it’s understandable that people want to put the outbreak behind us. Everyone is fatigued with this almost three-year journey that we’ve all been through — a very difficult journey. I think it’s the question of getting people to understand the reality of where we are.
We’re doing much better now than we were several months to a year ago, when we were getting 800- to 900,000 infections a day nationally, and 3- to 4,000 deaths. Now we’re down to 40- to 50,000 cases a day, and about 350 to 400 deaths per day.
Even though that’s much better than where we were before, it is still an unacceptably high number of deaths per day. That’s like one and a half jumbo jets each day crashing. And people saying, well, it’s okay to get on a plane and fly. Well, not so.
There are many things that we need to do. And we’ve got to stay out there telling people you don’t want to panic. But you don’t want to be cavalier and say, “It’s all over, and we don’t need to do anything.” Because there are things we can do, particularly getting the unvaccinated people vaccinated, and getting people who are vaccinated and not yet boosted to go get their boosters, particularly since we have a very good updated bivalent booster that’s directed against the major variant that’s out there.
Chain pharmacies and vaccine distribution
JP
The administration has relied on pharmacies for much of the vaccine rollout, and will continue to do so. Have you given thought to allowing walkups or methods of scheduling that are not tethered to their online scheduling systems? We’ve seen with our van on a street in Queens that there are a lot of cases in our immigrant neighborhoods of people who are turned away and told to go register on a site — or encountering limited hours at these sites with onerous work schedules as essential workers perhaps.
AF
Yeah, there is a major effort which President Biden actually initiated the day before yesterday, when we were down at the White House with him at the time that he got his booster shot.
We spoke to the CEOs of four major pharmacies, speaking about what they can do to be more flexible. First of all, they’re doing a good job, as you mentioned. I mean, a lot of what we’re getting done is getting done through the pharmacies. So they are really very important in our effort. But the President was encouraging them to do even more — to be more flexible in allowing people to more easily get vaccinated, as well as a number of other efforts in the community to make sure we do it in a user-friendly way.
That’s really the bottom-line answer. It’s got to be done in a user-friendly way, so that people don’t have to jump through hoops to go get a vaccine. We’ve got to make it as easy as possible. So we’re very aware of it. And the President himself is promoting that. So I think it’s going to improve.
Political divisiveness
JP
Another question. Why are white people now the largest unvaccinated group? In New York City, we also continue to struggle in some parts with young Black men not being vaccinated. What becomes of the unvaccinated in this next version of the rollout?
AF
This is a reflection, unfortunately, of the political divisiveness we have in our country. Because if you look at the map of the country and look at the red states versus the blue states, the red states, which are Republican states, are much more under vaccinated, than the blue states. As you know, the demography of the red states in the Republican areas are predominantly white individuals.
It should never be that person is vaccinated or not vaccinated on the basis of their political ideology. But that seems to be the case. And that’s just not an opinion. It’s an unfortunate reality. And that’s why we would like very much to get as many people vaccinated as we possibly can, regardless of what their political ideology is, and regardless their race or ethnicity or gender or whatever it is. They need to get vaccinated.
JP
On that line, we hear that the vaccine soon will no longer be free, that people will be charged for them. That puts yet another barrier between people and vaccines when we already have resistance, even without even with free vaccines. So how does that square with good public health policy — charging for vaccines?
AF
It’s a necessity — you’re going to have to switch over to commercial sometime. And the decision was to do it now. But as you know, also with that, there’s been a big push on the part of the government to make sure insurances cover that, and the under- or uninsured have some pathway to get that free.
So even though it’s going to be commercialized, as it were, there’s still going to be a lot of avenues of people getting it either through their insurance or through certain mechanisms for the under- or uninsured.
JP
I hope you’re right.
AF
I hope so too. I think it’s going to work, but we’ll see.
Testing funding, and masking
JP
In that vein, we also heard that the money for testing is running out. We’ve seen here over and over again, our van, the van that we have on a street corner in Queens had been vaccinating and testing. Now the vaccine money has dried up so they’re not vaccinating. They are testing. But we’re hearing a lot of people saying, there’s no place to get tested for free, I have to get tested, you’re the only place that I can get tested for free. So so people are finding themselves in a position where they’re not getting tested because they have to pay for it. That seems to us to be bad public health policy.
AF
It can be corrected by getting the Congress to give the resources that the President is asking for. Another point he made in his briefing at the time of his booster vaccination a couple of days ago, is that we are running out of money to do the things we need to do at the community level, including free testing, as well as a variety of other services that we formerly had enough resources for. We need now to get relief from the Congress to appropriate money that the administration is asking for.
JP
Is Congress going to do that?
AF
I hope so. I hope they hear our conversation.
JP
There’s also a lot of mixed messaging on masking. We think that masking should actually be something that’s more pervasive. People are more willing to wear masks, as a surge seems to be starting again, but there’s still mixed messaging. Can you speak to that?
AF
The message shouldn’t be mixed. It’s that masks are generally not required, or mandated. But under certain circumstances, they’re recommended. So that if you are in a congregate indoor setting, and you are in an area where there is clearly a higher degree of infection dynamics, it is recommended you wear a mask, if you are a vulnerable person, or you live in a household with a vulnerable person, even if the level of infection is not high, you might want to go the extra step to protect yourself and members of your family.
What people get confused about is what’s required or what’s mandated. We’re not talking mandates. That’s a radioactive word for so many people. We’re talking about common sense. So if you’re an elderly person, you have an underlying condition, you have someone at home who is on cancer chemotherapy — or If you’re in a crowded indoor place, wear a mask. It makes good sense. Is that a clear enough message?
Long Covid
JP
I don’t think people are hearing you every time every place I go in public. I’m like one of 5% of people wearing a mask. Last question. Why do you think long COVID has been lost in the national conversation?
AF
Well, I it hasn’t been lost in the conversation that we at the White House, and the President’s team is talking about. We’re very well aware of long Covid.
We have a number of programs. One led here at the NIH, our Recover program. One at the CDC, and the Assistant Secretary for Health. Rear Admiral Rachel Levine is a major player in the activities in long Covid. It is right at the very top priority.
There’s about 7 to 20 million people in this country who have been infected, who have persistence of symptoms, several weeks to months beyond the acute infection. And of those, 1 million of those people are incapacitated enough so that they cannot work. So we’re very well aware of that. The public may not be talking a lot about it. But we certainly are very well aware of it.
JP
Thank you very much for for your time.
AF
You’re welcome. Nice talking to you.
