Dr. Fauci in the House

The nation’s top infectious diseases doc looks at public health and scientific challenges associated with the COVID-19 pandemic

Anthony Fauci needs no introduction. Almost every American would agree that the guy has officially reached superstar fame. Even Brad Pitt went live to play the doctor.

Just in case anyone doesn’t have the doctor’s titles memorized, here’s what his business card says: Anthony Fauci, MD, immunologist, director of the National Institute of Allergy and Infectious Diseases.

Anthony Fauci, MD
Anthony Fauci, MD, immunologist, director of the National Institute of Allergy and Infectious Diseases

On Tuesday, November 17, Dr. Fauci virtually addressed American Heart Association (AHA) Scientific Sessions 2020 attendees. His presentation, COVID-19: Public Health and Scientific Challenges, was part of the larger session, Latest Insights on COVID 19 and Cardiovascular Disease.

Slide after slide was packed with stats, data, and study findings – some that were new and some that seemed familiar but worth another shout out. For example, Dr. Fauci gave a proper nod to the magnificent 5 preventative precautions – a topic he appears to feel very strongly about. “If these five public health measures were adhered to, universally and consistently over the country, it is clear from our previous experience with other nations and even regions in our own country, we would not be having the degree of surging cases that we are currently seeing.

Five fundamentals to prevent the spread of COVID-19

Leaning on Experience

America’s experience with coronaviruses isn’t new, Dr. Fauci said. In 2002, there was the SARS coronavirus pandemic, which was essentially extinguished via public health measures, including quarantine and contact tracing. Then, in 2012, MERS appeared, which was predominantly confined to the Middle East but did have some global spread – and still occasionally reemerges in Middle East countries.

Fast forward to today and world’s third pandemic coronavirus, which clinically debuted in China’s Wu Han district in December of 2019. “So here we are now, with a global pandemic of historic proportions the likes of which we have not seen in the last 102 years – since the iconic outbreak of the flu pandemic in 1918,” Dr. Fauci said.

Defining the Culprit

Turning to SARS-CoV-2 virology – perhaps to ensure that everyone was on the same page — Dr. Fauci explained that the culprit is:

  • A beta coronavirus
  • An RNA virus
  • It has a large genome
  • It has multiple structural proteins, with the most important being the S-protein, which stands for the spike protein and has the appearance of a corona or a crown.

Pulling it all together, Dr. Fauci said, “When you look at the protein under an electron microscope, the receptor binding domain of the spike binds to the ACE2 cellular receptor, which is distributed widely in the upper and lower airways as well as the GI tract and other systems of the body, such as the neurological system and the cardiovascular system.”

COVID-19 » CVD

While the initial 5 minutes of Dr. Fauci’s presentation contained vital information that every medical doctor should know, why does COVID-19 deserve top billing at AHA Scientific Sessions 2020? Here’s why.

“In addition to the elderly, people of literally any age with certain underlying medical conditions have an increased risk of severe COVID-19 illness,” Dr. Fauci said.

Certain conditions associated with an increased risk for severe disease include obesity and chronic obstructive pulmonary disease, as well as other conditions such as chronic heart conditions, and hypertension.

A list of underlying medical conditions associated with increased risk for severe covid-19 illness

Then there are certain chronic medical conditions that may increase risk of severe COVID-19 illness.

A list of underlying medical conditions that confer with increased risk for severe covid-19 illness

In addition, Dr. Fauci explained, it is shown that COVID-19 can cause severe cardiovascular complications, manifested by arrhythmia, myocardial injury, thromboembolic phenomenon and cardiomyopathies.

“If you look at the manifestations of severe COVID-19, they are plentiful,” Dr. Fauci continued. “In addition to the cardiac ones, there’s also acute respiratory distress syndrome, kidney injury, neurological injury, a hypercoagulable state manifested by microthrombi in small vessels, and an acute thrombotic phenomenon sometimes seen in otherwise healthy, young individuals. There’s also a curious multi-system inflammatory syndrome, first described in children and resembling Kawasaki syndrome.”

The doctor also devoted time to explaining post-COVID-19 syndrome. “A certain percentage of people who have symptomatic disease and then recover virologically experience lingering symptoms for weeks to months. This percentage could be as high as one third. And the lingering symptoms include profound fatigue, shortness of breath, muscle aches, occasional fever, dysautonomia, and what some describe as “brain fog” – an inability to concentrate.”

Reaching for the High Note

After discussing the world’s limited available therapeutics for SARS-CoV-2 — Remdesivir and Dexamethasone – Dr. Fauci signed off with a note of optimism. “With what’s developing in vaccines, we now look at this with cautious optimism. It is possible that by the end of this calendar year and well into 2021, we will be administering vaccine doses, first to the highest priority and then to everybody in the United States as we get into several months into 2021.”