Fauci gives overview of lessons learned from COVID-19 pandemic at APA annual meeting
Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Disease, provided an overview of lessons learned and remaining challenges at the American Psychiatric Association’s annual meeting.
“We in the United States, now together with India and Brazil, have suffered worse than any other countries in the world,” Fauci said during a presentation. “In the U.S., we now have over 32 million cases and about 570,000 deaths, making this unquestionably the worst pandemic of an infectious disease that the planet has experienced in 100 years. Even though we are now below the late fall extraordinary peak that we saw that went into the early winter of January and February, we are now stuck at a plateau that is precarious at around 60,000 new infections per day.”
Regarding psychiatric outcomes of the COVID-19 pandemic, Fauci referenced a CDC study conducted in June 2020 that surveyed 5,470 U.S. adults and found 41% reported one or more adverse mental or behavioral health condition. These included 31% with anxiety or depression symptoms, 26% with trauma or stressor-related disorder symptoms, 13% who initiated or increased substance use and 11% who seriously considered suicide.
According to Fauci, the B.1.1.7 variant of the SARS-CoV-2 virus, which was originally identified in the United Kingdom, is now becoming dominant in the U.S. The vaccines currently in use in the U.S. “seem to do well” against this variant, Fauci noted. The B.1.351 variant that originated in South Africa is “problematic” and moderately to severely reduces efficacy for some vaccines.
Fauci highlighted data that showed one-third or more of COVID-19 infections are asymptomatic, and longitudinal study results suggested approximately 75% of people with a positive polymerase chain reaction test who were asymptomatic at time of testing remained so afterwards. Further, symptom severity has become clear over time, with 81% of infected individuals exhibiting mild or moderate symptoms, 14% exhibiting severe symptoms and 5% exhibiting critical symptoms, with a case-fatality rate of 2.3%. Manifestations of severe COVID-19 include neurological disorders, hyperinflammation, acute respiratory distress syndrome, cardiac dysfunction, hypercoagulability, acute kidney injury and multisystem inflammatory syndrome in children. Fauci noted approximately 30% of patients enrolled in a study conducted at the University of Washington reported persistent symptoms for up to 9 months after illness, with fatigue the most common.
Fauci noted that data support the efficacy of COVID-19 vaccines in clinical trials, their effectiveness in real-world settings and their safety in both. However, a number of individuals express vaccine hesitancy, citing reasons such as the vaccine is “too new” or that “don’t believe it is effective against COVID-19.” According to Fauci, a public health information campaign is addressing hesitancy “aggressively,” with a COVID-19 community core sending messengers into communities in an attempt to reduce hesitancy.
“We are still in the middle of a considerable challenge with regard to the number of cases per day, but we are doing extraordinarily well in the distribution of vaccines, and we hope in the next few weeks to a month we’ll be starting to see a dramatic diminution in the number of cases per day,” Fauci said.
Fauci, Anthony S. Convocation of distinguished fellows. Presented at: American Psychiatric Association Annual Meeting; May 1-3, 2021 (virtual meeting).