Fauci vs Paul

Sen. Paul: Based on the idea that recovering Corona virus patients are developing immunity and that it can be beneficial as donated. Studies show that the recovering covet 19 patients from the asymptomatic to the very sick are showing significant antibody response. Studies show that SARS and MERS also viruses induce immunity for at least two to three years, and yet the media continues to report that we have no evidence that patients who survive coronavirus have immunity. I think actually the truth is the opposite. We have no evidence that survivors of coronavirus don’t have immunity and a great deal of evidence to suggest that they do. The question of immunity is linked to health policy and that workers who have gained immunity can be a strong part of our economic recovery.

 

The silver lining to so many infections in the meat processing industry is that a large portion of these workers now have immunity. Those workers should be reassured that they likely won’t get it again instead of being alarmed by me or courts, that there is no evidence of immunity. You’ve stated publicly that you’d bet at all that survivors of coronavirus have some form of immunity. Can you help set the record straight that the scientific record as is as being accumulated is supportive that infection with Corona virus likely leads to some form of immunity? Dr. Fauci, right?

Dr. Fauci: Yep. Thank you for the question, Senator Paul. Yes, you’re correct that I have said that given what we know about the recovery from virus such as coronaviruses in general or even any infectious disease, with very few exceptions, that when you have antibody present, it is very likely indicates a degree of protection. I think it’s in the semantics of how this is expressed. When you say has it been formally proven by longterm natural history studies, which is the only way that you can prove one, is it protected, which I said and would repeat is likely that it is, but also what is the degree or tighter of antibody that gives you that critical level of protection and what is the durability? As I’ve often said, you know, again, you can make a reasonable assumption that it would be protective but natural history studies over a period of months to a years will then tell you definitively it’s, that’s the case.

Sen. Paul: And I think that’s important because in all likelihood is a good way of putting it. The vast majority of these people have immunity instead of saying there is no evidence, you know, the who kind of fed into this by saying no evidence of immunity. And in reality there’s every evidence stacking up. And in fact a lot of the different studies have shown that it is very unlikely that you get it again in the short term. With regard to going back to school, one thing that was left out of that discussion is um, mortality. I mean, shouldn’t we at least be discussing what the mortality of children is? Um, this is for Dr. Fauci as well. You know, the mortality between zero and 18 in the New York data zero, it’s not going to be absolutely zero, but it almost approaches zero between 18 and 45. The mortality in New York was a 10 out of 100,000.

So really we do need to be thinking about that. We need to uh, observe with an open mind what went on in Sweden, where the kids kept going to school. The mortality per capita in Sweden is actually less than France, less than Italy, less than Spain, less than Belgium, less than the Netherlands, about the same as Switzerland. But basically I don’t think there’s anybody arguing that what happened in Sweden is an unacceptable result. I think people are intrigued by it and we should be, I don’t think any of us are certain when we do all these modelings, there’ve been more people wrong with modeling than right. We’re opening up a lot of economies around the, around the U S and I hope that people who are predicting doom and gloom and saying, Oh, we can’t do this, there’s going to be, the surge will admit that they were wrong.

If there isn’t a surge, because I think that’s what’s going to happen in rural States. We never really reached any sort of pandemic levels in Kentucky and other States. We have less deaths in Kentucky than we have in an average flu season. It’s not to say this isn’t deadly, but really outside of new England, we’ve had a relatively benign course for this virus nationwide and I think the one size fits all that we’re going to have a national strategy and nobody’s going to go to school is kind of ridiculous.

We really ought to be doing at school, district by school district and the power needs to be dispersed because people make wrong predictions and really the history of this, when we look back, we’ll be of wrong prediction after wrong prediction after wrong prediction. Starting with Ferguson in England. So I think we ought to have a little bit of humility in our belief that we know what’s best for the economy and as much as I respect to Dr. Fauci, I don’t think you’re the end all.

I don’t think you’re the one person that gets to make a decision. We can listen to your advice, but there are people on the other side saying there’s not going to be a surge and that we can safely open the economy and the facts will bear this out. But if we keep kids out of school for another year, what’s going to happen is the poor and underprivileged kids who don’t have a parent that’s able to teach them at home are not going to learn for a full year. And I think we ought to look at the Swedish model and we got to look at letting our kids get back to school. I think it’s a huge mistake if we don’t open the schools in the fall. Thank you.

Dr. Fauci: Mr. Chairman, can I respond to that even though there are only 32 seconds left?

Chairman: Yes. And you might make it clear whether or not you suggested that we shouldn’t go back to school in the fall.

Dr. Fauci: Well, uh, first of all, uh, Senator Paul, thank you for your comments. I have never made myself out to be the end all and only voice in this. I’m a scientist, a physician and a public health official. I give advice according to the best scientific evidence. There are a number of other people who come into that and give advice that are more related to the things that you spoke about, about the need to get the country back open again and economically. I don’t give advice about economic things. I don’t get advice about anything other than public health. So I wanted to respond to the second thing is that you use the word we should be humble about what we don’t know and I think that falls under the fact that we don’t know everything about this virus and we really better be very careful, particularly when it comes to children because the more and more we learn we’re seeing things about with this virus can do that we didn’t see from the studies in China or in Europe for example, right now children presenting with COVID-16 with COVID-19 who actually have a very strange inflammatory syndrome, very similar to Kawasaki syndrome.

I think we’ve got to be careful if we are not cavalier and thinking that children are completely immune to the deleterious effects. So again, you’re right in the numbers that children in general do much, much better than adults and the elderly, and particularly those with underlying conditions. But I am very careful and hopefully humble and knowing that I don’t know everything about this disease. And that’s why I’m very reserved and making broad predictions. Thank you. Thank you, Senator Paul.

I want to focus on a couple of these items here. The first is purely a semantic argument being made between politicians. The fact remains that the way most every virus like this behaves is that people garner immunity to it once they have contracted and beaten it. There is no real argument to be made against the concept that "we don't know what we don't know". But from what we "do know" it would seem that Covid-19 immunity is much like it is with any virus.

What Paul  here is suggesting is simply because we have not had a "year or so" to verify what appears to be the case, doesn't mean that there is no "evidence" that we develop immunity. In fact, all of the evidence so far suggests that Covid-19 immunity will be like any other virus. It would actually be a much better argument to suggest that there is no current evidence to suggest that people are not garnering immunity after contracting Covid-19.

Fauci basically half agrees with Paul on this subject by claiming that it's a reasonable assumption that cannot be "proven" without time. But Paul's point is still valid here. The reports from the media (and Democrats) that there is no evidence of immunity is simply not true. 

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The second issue is Paul's argument that we are ignoring much of the empirical data that suggests that children are not subject to the effects of Covid-19.  As Paul points out the data shows that the rate of death among children approaches zero, and that the rate of death among those between the ages of 18-45 is about 10% of the death rate of the seasonal flu (or about 0.01%).

In this case, Fauci uses the concept that "we don't know what we don't know" to suggest that we should be more careful than "cavalier". I have heard a little about Kawasaki syndrome being tied to Covid-19, but there still appears to be no real medical evidence of the link. Moreover, Kawasaki syndrome is prone to infants and toddlers, not school aged children. Doesn't make it any less dangerous, but it also doesn't really make an argument against reopening schools.

What Fauci is arguing is a careful approach, but on this particular subject I would guess that he will eventually be overruled. Unless there becomes something very defining that changes the reality that school aged children are not being affected by Covid-19, the idea of cancelling school next fall seems more than just a little over-excessive.

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If I was Dr Fauci, I might decide to pick my battles a little more carefully. There needs to be some validation of empirical data and some suggestion that the task force doctors are willing to accept it, rather than just continue to rely on worst case scenarios. There is an issue of credibility and Fauci (like anyone) can lose it as easily as he had earned it.

As Paul stated (very accurately) the models and predictions have been wrong, wrong, and more wrong. Being an expert is generally not associated with being overzealous in your original assumptions without regard to the data.  Being an expert ultimately means making decisions based on the best known information (rather than worst case scenarios) and ultimately being an expert requires being correct more often than not.