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The NIAID head said the COVID-19 pandemic has highlighted the need to address social determinants of health.
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), says that addressing disparities in healthcare access disparities will likely take decades.
Fauci was taking part in a question-and-answer session during the opening plenary of the American College of Physicians (ACP) Internal Medicine Meeting 2021 along with Gregory Kane, MD, treasurer of ACP; and Darilyn Moyer, MD, executive vice president and CEO of ACP.
He said the pandemic has shown a bright light on the inequities of the healthcare system, particularly in the rates of hospitalization seen among racial and ethnic minorities. According to Fauci, these inequities are tied to social determinants of health which sees Black, Hispanic, and Native American citizens put into educational and economic situations which limit their ability to receive medical care.
“We have to start committing now to something that's going to take decades to change,” he says. “Because it took centuries to get here, it’s going to take decades to change. But if we don't make the commitment now to do it, we're never going to do it.”
When asked whether COVID-19 could be eradicated globally, Fauci seemed more confident that it will be eradicated in some countries and controlled in others, but the process will take years and vaccinating a large portion of the world’s population.
“We're going to be continually threatened by variants that will come from other countries, which tells us the obvious solution to that is to make sure that we get the entire world vaccinated against (COVID-19),” Fauci said. “Until we do that, I don't think we're going to eliminate this infection. I think it'll be there at a low level; we'll be protected. We may need to get boosted every once in a while, to keep the level of protection up. But we have to look at it as a global problem, otherwise, we're never going to truly eliminate it.”
Fauci said that early in the pandemic the U.S.’s response was hamstrung by the dismantling of the local health infrastructure, failure to mobilize the private sector early for diagnostics, and the rapidly evolving situation with little transparency from China.The transmission method of the virus also caught the world by surprise.
“We've never had any pathogen of any note of seriousness in which … 50 and 60 percent of the transmissions occur from a person who never will get symptomatic, or who was in the pre-symptomatic stage,” he said. “That broke all the paradigms of infectious disease because, prior to that, transmissions were always a little bit asymptomatic but dominated by the symptomatic person.”
As for the U.S.’s successes in responding to the pandemic, Fauci highlighted the Trump administration’s Operation Warp Speed which invested billions in vaccine development and pre-purchase as well as the Biden administration’s rollout of the vaccines.