What Dr. Fauci sees coming for the pandemic this winter

The United States has seen a decline in cases and hospitalizations since the summer's delta surge — but the decline is declining.

COVID-19 is still killing more than 1,000 people in the U.S. every day. New cases still hover around 72,000 per day — and infections are actually trending up in some pockets of the country, including parts of the Mountain West and the Northeast.

"Certainly, things are going in the right direction with the diminution of cases, hospitalizations and deaths," Dr. Anthony Fauci, chief medical adviser to the president for COVID-19, told NPR's Mary Louise Kelly. "The steepness of the deflection is not as good as it was, let's say, a month or so ago ... it's down to a lower number."

The concern among health officials like Fauci is that winter holidays and cold weather will soon bring about more travel and indoor gatherings — where a respiratory virus will transmit more easily.

So at this stage of the pandemic, what is the goal? Fauci offered a qualitative assessment.

"We're looking for a level of control ... where the level of infection — due to vaccination predominantly, but also people who may have been infected and have some degree of protection — that doesn't disrupt society the way the COVID-19 outbreak is currently doing with us," Fauci said.

Measuring that goal will be "multiphase," he said. Deaths and hospitalizations are an important indicator, but so is the count of infections — and so is the vaccination rate as a way of helping prevent severe disease.

"We want to do all of the above," Fauci said.

Fauci noted that the country "need[s] to do better" with adolescent vaccination rates and pointed out that over 60 million people in the U.S. have been eligible for vaccination but are not yet vaccinated. But he said "something that's in our favor" is the opportunity to inoculate around 28 million children aged 5 to 11 who became eligible to receive a vaccine this week.

"So as we go into the winter months with the challenge of a respiratory infection being worse in the winter months, we can get through this if we really put a lot of effort into getting as many people vaccinated as we possibly can," Fauci said.

He urged parents to get their 5- to 11-year-old children vaccinated, citing "really good efficacy and really good safety profile."

"I would tell the parents: Although it is less likely for a child to get a serious result from infection than in adults, particularly an elderly adult, it is not something that's trivial with children," he said.

He also commented on the development of anti-COVID pills that may reduce the severity of infections.

An antiviral drug made by Merck also won authorization in the U.K. on Thursday. And the pharmaceutical company Pfizer announced Friday that its antiviral drug reduced the risk of hospitalization or death by 89% in a clinical trial.

"The results were really quite striking," Fauci said of the Pfizer data.

However, he cautioned that the promise of therapeutic drugs were no substitute for vaccinations that would prevent or diminish infections in the first place.

"The best way traditionally — not only with COVID-19, but with any infection — it is always, always better to prevent it than to have to worry about treating it," he said.

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