Fauci: COVID is still serious, not yet endemic

Anthony FauciAnthony FauciLet's stop saying 'breakthrough cases' — it isn't helping The Hill's Morning Report - Presented by Facebook - Voting rights week for Democrats (again) Trump-DeSantis tensions ratchet up MORE said COVID-19 in the U.S. will eventually become endemic, but despite increasing vaccinations, it's not there yet.

Fauci, the nation's top infectious disease doctor, on Wednesday said the nation's ultimate goal is not to eliminate COVID-19 but to reduce it to a level where it's not dominating everyday life.

"I don't think we're going to eliminate it completely. We want control and I think the confusion is at what level of control are you going to accept it in its endemicity?" Fauci said during a White House briefing. 

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"We don't know really what that number is, but we will know it when we get there. It certainly is far, far lower, than 80,000 new infections per day, and is far far lower than a thousand deaths per day, and tens of thousands of hospitalizations," Fauci added.

White House officials said 80 percent of Americans over the age of 12 have received at least one shot, adding that 300,000 people get their first dose every day. Nearly 70 percent of that age group is fully vaccinated.

Fauci said the key to reaching endemic levels is to get as many people vaccinated, and boosted, as possible. The vaccines are highly effective at preventing severe disease and hospitalization, though there's evidence the protection against symptomatic infection is waning.

Cases across the country are rising, and even though 70 percent of the eligible population in the U.S. is fully vaccinated, there's a worry that another surge of infections is on the horizon if we don't act to make boosters more widely available than they already are.

"So even though there's a wide bracket under control, we want to get to the lowest possible level that we can get. And rather than picking an arbitrary number, why don't we get as many people as we can get vaccinated, vaccinated as quickly as possible, and get as many people who are eligible for boosters, getting boosted as possible," Fauci said.

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Still, there's been pushback from some infectious disease experts who argue that boosters for younger, relatively healthy people are not going to end the pandemic. They argue the Biden administration's focus on boosters reflects an unrealistic goal of making sure nobody gets sick from COVID-19. 

Some jurisdictions with high adult vaccination rates are ready to move on. Washington, D.C. is lifting its indoor mask mandate beginning on Monday, because officials said residents need to be able to assess their own risks, and make their own decisions about wearing masks. 

Case numbers in D.C. have plateaued for at least a week, remaining at about 80-90 cases a week for every 100,000 residents. According to the Centers for Disease Control and Prevention, that qualifies as "substantial" spread. 

But city officials are making a distinction between mild infections among the vaccinated and serious infections that cause hospitalization among the unvaccinated. Even though infections are still high, they indicated the city's relatively high vaccination rate is a reason to lift restrictions.

Fauci said mild infections still matter. Giving boosters to the people who have been vaccinated for at least six months will increase their antibody levels; with a high level of protection against infection, there's also far less likelihood of transmission.

"I think we better be careful to not make too sharp a distinction between protecting against infection that's symptomatic versus protection against hospitalization and deaths," Fauci said. "I don't know of any other vaccine that we only worry about keeping people out of the hospital. I think an important thing is to prevent people from getting symptomatic disease."