What Dr. Fauci wants you to know about face masks and staying home as virus spreads

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• Judy Woodruff:

  As the spread of COVID-19 has increased, there have been significant new questions about stay-at-home orders, whether the public should be wearing masks outside and new findings about how the virus spreads.

  I spoke this afternoon with one of the government's top officials on the public health response, Dr. Anthony Fauci of the National Institutes of Health. He is a key member of the president's Coronavirus Task Force.

  And we spoke before the president announced the recommendation from the CDC that people use a cloth or fabric mask outside.

  Dr. Fauci, thank you very much for joining us.

  You are now saying that you don't understand why all Americans are not staying at home. Have you told the president that you think it's a good idea to order Americans to stay home?

• Anthony Fauci:

  Well, there's always that difficulty of ordering centrally vs. having the states be the major implementers of policy.

  I have said that I feel we should be implementing this social distancing or physical separation, which, in many respects, means staying at home, to the extent possible.

  And I do think we should do it broadly throughout the country, because, although there are hot spots that we see that are very obvious, there is the threat of outbreak virtually everywhere and anywhere within our country.

  So, when we extended the guidelines from the 15-day guidelines to now 30 days towards the end of April, I think this is an opportunity for everyone, every state, every region, every locale, to participate in this very serious physical separation, as delineated very clearly in the guidelines.

  I have articulated this multiple times, as have several of my other colleagues. I'm not alone on this. And we daily brief the president.

• Judy Woodruff:

  But when lives are at stake, why aren't command measures requiring people to do this appropriate now?

• Anthony Fauci:

  I think, if you look at the iterances at the press conferences, when you hear me and others and the vice president and the president speak, it is really the functional equivalent of that.

  I understand what you're talking about, Judy, about making a very explicit statement. But that generally is not the way things operate in the relationship between the federal government and the states.

  I mean, I say out there to all who are listening in all the states that they should be doing this. Even though they feel that, in certain respects, there are relatively few cases in their city, in their town, in their state, that will change.

  There is no region in the country, in my mind, that's going to be exempt from an outbreak, if you do not do the appropriate mitigation issues, namely, the physical separations that are clearly spelled out in the guidelines.

• Judy Woodruff:

  But let me ask you, for those people who are mostly staying at home, but they are going to the grocery store or to the pharmacy or taking a walk, that those guidelines are still appropriate?

• Anthony Fauci:

  Absolutely. Absolutely.

  The guidelines that — you know, often at the press conference, the vice president puts up that card where he talks about the guidelines, and, you know, 30 days to do this now with the extension, they're all spelled out pretty clearly there.

  And I think — I know there's disparity throughout the country, because you look at some of the videos and some of the information you get, and there is disparities. There are still people who are not abiding by that.

  And I would just use my presence here on your program to plead with them to please take seriously those guidelines.

• Judy Woodruff:

  Masks.

  We are told that the Trump administration is on the verge of urging Americans to wear masks when they go out. Tell us about the thinking on that, because, just a few days ago, we were told that the thinking was it wasn't necessary.

• Anthony Fauci:

  It's a great question, Judy.

  And the thinking is really now influenced by information that's coming in. And the information is that more and more accumulation of data indicate that people who are without symptoms at all can transmit the virus.

  But, importantly, they can do it merely by speaking. So, there's been a recent study that came out that said even the force from your voice of speaking, there is a degree of aerosolization. Namely, the virus can come out, not very far, a few feet and down.

  So, even though the perfect solution to this is if everyone at all times could stay six feet separated from another person, but, as you correctly mentioned, this is not always feasible. There are times when you have to do necessary functions.

  You have to get food. You have to get drugs from the pharmacy. And you might inadvertently be in a situation where you're close enough where that kind of transmission can take place.

  And, importantly, I think what people don't fully appreciate is that putting a mask on yourself is more to prevent you from infecting someone else. And if everybody does that, we're each protecting each other, because the data is, it's more efficient to prevent transmitting to others than it is to prevent transmission to yourself.

  But you can completely cover that ballpark if, essentially, universally, when people go out and are in a situation where they might come into closer contact, that they wear that mask.

  So, we have discussed this in detail yesterday. And in today's task force meeting, it will also be discussed in detail. So there may be recommendations coming out. There likely will be.

• Judy Woodruff:

  So, in short, whatever the announcement today is about wearing masks, if people are to wear them, what's the guidance on under what circumstances and what kind of mask?

• Anthony Fauci:

  OK.

  I'm glad you gave me the opportunity to address that, Judy, because the one thing that's paramount here, that we want to make sure that people don't all of a sudden go out, buy and hoard masks that are most appropriately used and necessary for the front-line health care workers, who do need it for the clear and present danger that they find themselves in when they are taking care of people who are actually sick with coronavirus disease.

  So, we want to make sure that this issue of having a broader community approach towards putting on a facial covering doesn't, in fact, get in the way of the primary purpose of masks.

  And in that regard, that's why what we're talking about are things that may not necessarily need to be a classical mask, but could be some sort of facial covering.

  You know, we're pretty good in making things in a way that spontaneously becomes effective just because of your own creativity.

• Judy Woodruff:

  And the same question about masks that I was asking about staying at home. If these are things that save lives, keep people healthy, why not require them to do this?

• Anthony Fauci:

  You know, Judy, I understand where you're coming from, but it becomes difficult.

  When you say require, by what? By penalty? By putting people in jail? That becomes something that really could be counterproductive in the society that we live in, in America. Perhaps you might be able to do that in China, but I think it would be difficult to do it here.

  So what we are relying on is for people to really understand the importance of this.

• Judy Woodruff:

  And going back to what you said was new information about this organism, about how long it lingers in the air, people are asking, is it — does it linger on the handle of a grocery bag, on a piece of paper?

  What is known about that at this time?

• Anthony Fauci:

  Yes.

  Well, studies actually have been done to determine the viability, viable virus, when you measure it on different surfaces, like enamel, stainless steel, plastic or cloth.

  It varies. It generally is measured in a few hours to, in some situations, maybe even a day or two. The titer of it may be so low that, even though it's virus that's alive, it's not really capable of transmissing.

  The bottom line is, there's a great deal of variability. One of the things one can do is, when you have surfaces that you frequently touch, that you might get one of those alcohol swabs or one of the things that can disinfect, and rub it off, clean it.

  That — the most common one are doorknobs. And I think that's the thing that people should be most aware of, is — because people who can get virus on your hands, one of the things you do every day is turn a doorknob.

  But I wouldn't fixate that the virus is going to hang around for weeks and months, and you can't touch anything that is inanimate. That's really not the case. It generally is measured in a couple of hours to maybe a day or two. But, when I say a day or two, I mean probably at a very low titer.

  The most important thing that I think overshadows all of that is to wash your hands as frequently as possible.

  I can tell you, Judy, I wash my hands 50 times a day. So, rather than being concerned if a doorknob that I touch is contaminated, I'll just wash my hands as much as I possibly can. And when I don't have access to a sink and water and soap, I'll just carry around one of those Purell or alcohol things and clean it with that.

  Those are just some of the practical things that you can do.

• Judy Woodruff:

  Dr. Fauci, there are more reports we're hearing now from the heads of hospitals that they're worried about not having enough protective equipment from doctors and nurses worried about equipment, about medications.

  On the other hand, the White House was saying last night that every place where something is needed, they're going to get it. What's the reality here?

• Anthony Fauci:

  Well, certainly, everything that can possibly be done to make sure that no one anywhere in the United States will go without the necessary PPE or personal protective equipment, and certainly not ventilators, that is something that is right up there.

  It is very, very much on the awareness of the task force. FEMA is a major component and agency to see that we don't ever run into that situation where our brave health care workers are put more in harm's way by a lack of equipment.

  And that's what people concentrate on all the time. And, hopefully, we will never get into a situation where they will fall short of that.

• Judy Woodruff:

  And on the question of social distancing and taking all the precautions we should, I just want to be clear. You're saying it's still too early to know when people can begin to relax on this?

• Anthony Fauci:

  You're absolutely correct. Thank you for asking that question.

  As I have said all the time, you can put into place a program where you would project that, after a certain number of weeks, you start to see the bending and the turning of the curve, but the virus determines the timetable, not you or me in a predetermined timetable.

  We adjust the timetable as to what we see happening. And that's why I say, what you need to look at first, will be the first inkling, is the number of new cases each day, the relative proportion.

  If that stabilizes, there's a cascading of events, because, as the number of new cases begin to stabilize, instead of exponentially going up, then the hospitalizations, then the intensive care, and then the deaths will stabilize.

  And what happens is, there's always the lag. You're going to start seeing stabilization of new cases at the same time that you're seeing an increase in deaths. That may seem paradoxical, but it isn't, because, after a while, the deaths catch up with it.

  And the early indications that something is going right will then ultimately be manifested in less deaths. So, that's why what we look at, we look at it in New York, in New Orleans, in Chicago, in Detroit, as we start to see that stabilization, then we will get a more comfortable feel, so that we might be able to turn the corner.

  But, right now, as I mentioned, we're in a very difficult period. It will get worse before it gets better. And I don't want the American public to get too alarmed at that. I mean, obviously, it's concerning. It's not something to just put aside. But things will get better, they will turn around, and we will get out of this.

• Judy Woodruff:

  I know you have said you don't like to look back, but I just have a couple of questions about where this originated.

  When did you first have a sense that this was different, that what had happened was not just another virus, that this one was going to be something more serious, much more serious?

• Anthony Fauci:

  Well, somewhere in the early January, when it became clear that what the Chinese had claimed originally, that this was just a virus that jumped from an animal reservoir to a human, and wasn't being transmitted from human to human, well, it became very clear pretty quickly that that was not the case, that this was a virus that was being transmitted from human to human, but not only that.

  You know, the nightmare that we have is that not only is it transmitted from human to human. It does it very efficiently. And when the numbers started coming in as to what the morbidity and the mortality was, it was during that period in early to mid-January that it became clear to me that this was not just another SARS, it wasn't another MERS, or Middle East Respiratory Syndrome. This was different.

• Judy Woodruff:

  I think you're aware of reporting that the Chinese were not transparent about all this in the very beginning.

  The question now that's arising, though, is, people are asking, if they had been more transparent in the very beginning, would it have prevented the spread of this virus, period, or would it have simply given more countries like the United States more time to prepare?

• Anthony Fauci:

  Well, Judy, I don't think anything would have prevented the spread of this virus. Once it emerged into society, with its capability of efficient spread and morbidity and mortality, that was it.

  But what could have been different — and this is something that people are going to reflect on, you know, when this is all over, as they try and analyze what actually happened — is that, if we had known that this was highly transmissible early on, when it was just in China, I think other countries would have maybe been more quick on the trigger to try and inhibit travel from China to their country, because, remember, it started in China.

  And then China, by the fact that there are so many Chinese people, and travel is part of our daily existence in this planet, that there would maybe have been more attention paid to the possibility that just pure travel from China in general, but certainly from Wuhan and the Hubei district, is something that could start an outbreak throughout the world.

  So, that delay in transparency, I think, likely had an impact on what I just said, the awareness that this could seed the rest of the world.

• Judy Woodruff:

  All that points right back to Chinese officials, doesn't it?

• Anthony Fauci:

  Looks that way.

• Judy Woodruff:

  And I want to be careful about how I ask you this, but there are reports that there have been threats made against you, that security around you has been increased.

  And the question I have is, is this job more than you thought it would be? Is it now something more than you bargained for?

• Anthony Fauci:

  You know, Judy, as I have said often, this is the life that I have chosen, and I accept it. It is what it is.

  The thing that I don't like is the effect that it has on my family.

• Judy Woodruff:

  Well, we know you are working around the clock, and the country is very grateful.

  Dr. Anthony Fauci, thank you very much.

• Anthony Fauci:

  Thank you, Judy. Very good to be with you.