Dr. Fauci Just Laid Out the Worst Case Scenario for the End of the Pandemic

Letting things play out this way would be a "terrible tragedy," the COVID expert said.

When exactly will the pandemic be over? It's a question that has plagued us since cases first started piling up in March 2020, and now, 20 months later, we still don't have an exact answer. Certainly things have improved considerably. The Delta variant surge that brought numbers back to disastrous levels this summer appears to have subsided, and the approval of vaccines for children means that more and more people will soon be fully inoculated against COVID. Even with light at the end of the tunnel, however, some experts have cautioned that we're not out of the woods yet—and as White House COVID adviser Anthony Fauci, MD, recently explained, there is a worst case scenario for how this pandemic ends.

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In a Nov. 12 interview on The New York Times' podcast The Daily, Fauci spoke to host Michael Barbaro about the current state of COVID in the U.S., and what happens next as we head into the winter, a time when the virus tends to surge. As Fauci put it, the COVID situation is a "mixed bag" right now, with the country headed in the right direction, but with some clear signs of trouble.

Even though the Delta surge has been on the decline, the numbers are not quite where Fauci and other health officials would like to see them. "The thing that's a bit sobering is when you look at the deflection of the curve, it's starting to plateau," he told Barbaro.

It's not the first time the infectious disease expert has offered this assessment. In an interview on Nov. 8, Fauci told NPR, case numbers are not going down as quickly as they were just a week ago. The Centers for Disease Control and Prevention (CDC) reports that new COVID cases are down 1 percent for the week of Nov. 5, compared to 7 percent the week prior.

"When it starts to not get so steep and then plateau, then you might find yourself in the uncomfortable situation where you plateau where we are right now, which is at about 70 to 73 thousand cases a day, which is obviously not optimal, but also is a set-up to have a resurgence upon that very high baseline," Fauci said on The Daily.

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If the country is indeed headed for another spike, it might feel hard to be hopeful about the pandemic ever being over. But the COVID adviser put it plainly in his conversation with Barbaro: This is not going to go on forever. "Ultimately all pandemics burn themselves out," Fauci said.

That doesn't mean we can just sit back and let it happen, however. Fauci pointed out that the worst case scenario would be simply letting COVID continue to infect and kill without any public health interventions, because while the pandemic would eventually end on its own, it would come at a tremendous cost. "We have a historic pandemic, the likes of which we have not seen in over 100 years, and we have highly effective safe tools to end it," he said on The Daily. "It would be, I think, a terrible tragedy if we let more Americans and more people throughout the world—because I believe that we need to pay attention to [what] goes on in the rest of the world—if we let more people die and more people get very, very ill by not using the tools that we are lucky enough to have."

Those tools are the COVID vaccines, now approved for children as young as five, and the vaccine boosters that many people are now eligible for. While acknowledging the waning immunity of the vaccines on The Daily, Fauci said that ultimately, we may realize "boosting is gonna be an absolutely essential component of our response, not a bonus, not a luxury, but an absolute essential part of the program." Taken as a whole, however, Fauci is confident that vaccination is the way to bring the pandemic to a close without adding a tremendous amount of new deaths to the already staggering numbers.

"We've lost 750,000 Americans thus far, we have 46 million infections, likely more, since many go undetected, and we know what we can do," he told Barbaro.

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As for the immediate future, Fauci said that there may be a spike in the winter, as holiday travel and indoor gatherings increase the chances for spread. At the same time, he maintained the vaccinated people (and particularly those who are boosted) should be able to travel and spend time with vaccinated family and friends. How long the pandemic drags on beyond that, and how many more casualties we have to endure, depends on our ability to make the right choices—even if it would eventually peter out regardless.

"In the modern age of biomedical research and public health interventions, you can mitigate the ultimate negative impact of outbreaks," Fauci reiterated. "In 1918, we had the pandemic flu, it burned itself out ultimately, so you have a choice. Do you want it to burn itself out and kill a lot more people and make a lot more people sick, or do you want to do something about it to prevent further deaths and further illness? At the end of the day, this is gonna end one way or another. The preferable way, if you just think about it for a moment, is to do whatever we can to minimize the suffering and the death. And we have within our power to do it. If we don't utilize it, then bad things are gonna happen."

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