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U.S. omicron cases are on an upward climb. Fauci hopes to see a turnaround soon

STEVE INSKEEP, HOST:

And we're joined now by President Biden's chief medical adviser, Dr. Anthony Fauci. Dr. Fauci, welcome back to the program.

ANTHONY FAUCI: Thank you. Good to be with you.

INSKEEP: I've been staring at charts of COVID cases for individual cities - and maybe I have a self-interest in this since I'm in Washington, which is one of the worst, if not the very worst. In some places, the chart - there's a straight line upward, off the chart. So how high does this go?

FAUCI: You know, Steve, it's very difficult to predict. As you saw just a bit - a minute ago, it's over 2,000 cases per day right now. We're getting close to the 250,000 peak that we had literally last winter. It's very difficult to tell. Clearly, we're on a vertical climb right up. Hopefully, this will peak and turn around.

What we've seen in other countries, like South Africa - we were on a Zoom call just a day ago with our South African colleagues, and they had the same sort of sharp spike up - almost vertically up. They're starting to see a turnaround now where the cases are coming down, perhaps due to saturation in the sense you hit all the vulnerable targets.

The problem in our own country, Steve, is that we have so many people who are unvaccinated, who are still completely vulnerable. There will be breakthrough infections with vaccinated and even boosted people. But as you just mentioned in the interview prior to this - that there seems to be less of a severity, particularly for those who have been vaccinated and have a breakthrough infection, that it really is less severe. So we're hoping that the less severity will get us through this without having a surge on the hospital system. But it's the unvaccinated that we're really very concerned about. They're really quite vulnerable.

INSKEEP: Couple of things to follow up on there. First, there are parts of the country where it's not a vertical spike going straight up, where cases have remained relatively steady or only gone up a little bit. What would you say to people in those parts of the country who aren't feeling the effects yet?

FAUCI: Yeah, I would say don't get complacent. Please don't let your guard down and feel that because in your region, you're not seeing a high spike. This is an extraordinarily efficient virus in spreading from person to person. It is just something like we've never seen before. The cases - in any place you go, when the virus gets in there, it goes way up. So for those who have not had a severe impact yet, please continue to be prudent about wearing masks. And if you're not vaccinated, get vaccinated. And if you are vaccinated, please go get boosted. Boosting makes a major difference with omicron. We've shown that several times now in different countries. Boosting makes a big difference.

INSKEEP: What is your assessment of what we heard in the earlier report about the possibility that too much boosting could be - could backfire, that perhaps a fourth shot is something to shy away from?

FAUCI: Well, I think what they were referring to is that when you get the benefit of a boost, it's to allow the immune system, in the interval between one injection and another, to give it a chance to what we call get affinity maturation - in other words, to rev itself up to be optimally responsible to the next boost. If you boost too often and too frequently, you don't give the immune system the chance to get that maturity, which we call it, which means it develops a greater breadth and a greater strength.

So right now, we should just do the boosters, and then we'll worry about the next boost if we need it. But right now, get the first boost. That's the most important thing. Don't worry about a fourth boost. We'll worry about that later and maybe never have to worry about it.

INSKEEP: What do you think about this - the plight of many Americans who have wanted to find a test or a bunch of tests for their family over the past week, and they have great difficulty finding it, can't find it at all? I know the administration has promised 500 million tests, but they're not going to be available today. They're not going to be available tomorrow. They're not going to be available in this crisis. Could that have been avoided?

FAUCI: Well, you know, what happened, Steve, is that there was an unprecedented demand. In some respects, that's good because you want people to be testing. But you're right. We did not have enough during the Christmas holiday, and we likely will not have enough for the traveling with New Year's. But in January, we'll have a much, much greater escalation of the availability of testing.

But you're right. We have to admit it. Right now, there have been lines. I've seen lines myself right in my own city. Here in New York City, there have been lines. It's something that is unfortunate, but we just have to do the best that we can until we get the release of a lot more tests coming in January.

INSKEEP: I'd like to hear your assessment of another thing that some officials are doing in this crisis. In New York state, they have said that public health workers who need to quarantine can do it for just five days instead of 10, and that is partly an effort to mitigate the lack of essential health workers. Is five days enough?

FAUCI: I believe it will be, Steve. And I think that's something that we're going to be considering beyond New York City. You need the health care workers. And when you have them out for the full 10 days and you do that over a wide swath of people, you can have a situation where you really do not have enough health care workers. And that's the reason why New York City made that choice. And I think it's a prudent choice. I think you're going to be seeing more of that as more people get infected.

INSKEEP: Is five - just very briefly in a few seconds - is five days also enough for our friends, neighbors, family members who are having to quarantine right now?

FAUCI: You know, that's going to be under consideration of whether or not we want to diminish it. But right now, the essential workers are the ones that we really want to worry about and make sure we get them back to their essential jobs.

INSKEEP: Dr. Anthony Fauci, always a pleasure talking with you. Thank you so much.

FAUCI: Thank you for having me.

INSKEEP: He's President Biden's chief medical adviser. Transcript provided by NPR, Copyright NPR.