The Fauci interview: How to 'keep your immune system working optimally,' gather safely, and get by until summer 2022

• Dr. Anthony Fauci thinks that we'll probably never get rid of the coronavirus entirely.
• Still, he's pretty confident that by 2022, Americans should be able to resume most aspects of life as we knew it before the pandemic — "if we deploy a vaccine and we implement public-health measures."
• Read our wide-ranging interview below, in which we discuss Fauci's daily routine, his tips for holiday gatherings, his advice for how to keep your immune system "working optimally," and more.

Dr. Anthony Fauci answers the phone at lunchtime while biting into a cold piece of pizza.

The head of the National Institute for Allergy and Infectious Diseases has almost no time to eat these days. He's been in back-to-back videoconferences, he told me. This may be his only chance to grab a bite for a while.

Having counseled the five previous US presidents — on everything from the HIV epidemic to the Ebola outbreak — since he took up his post at the National Institutes of Health in 1984, the doctor was always fairly certain that a public-health emergency of some sort would emerge during President Donald Trump's watch. And when that happened, he'd be called down to the White House.

"Be careful what you wish for," he said.

Though he suspects that we may never eradicate the novel coronavirus, Fauci is confident that by the end of 2020, we'll have some kind of working, effective vaccine — though it won't be available widely. It may be more like late 2021 or early 2022, he suspects, when we'll be able to get together like we did in the pre-coronavirus days of 2019. Well, almost.

Here's what he had to say about what we'll need to do until (and after) a vaccine arrives to curb the virus's spread, and how to get through the pandemic with our mental health intact.

Interview edited for length and clarity.

It's been feeling like everyone is kind of banking on spring 2022 being the end of the coronavirus crisis. People are planning weddings, trips, and belated birthday celebrations. Will we be safe to go party in those ways by summer 2022?

Yeah, I think so. But again, these are all conjectures and guesses.

I believe that by the end of 2021, if we get — and I feel cautiously optimistic that we will have — a safe and effective vaccine by the end of this calendar year. I said November-December, others say October. I think it's unlikely in October, but maybe, you never know. But let's say a safe bet will be the end of this calendar year.

By the time you deploy the vaccines effectively to the hundreds of millions of people in the United States that will need it. And it's not only in the United States. Hopefully there'll be enough vaccines and enough supply in the tune of billions of doses to be able to give equitable distribution of vaccines throughout the world.

But that's a different story. That's not your question. Your question is, what about us, here?

I believe that by the time we get to the end of 2021, if everyone gets vaccinated and we continue to implement the public-health measures that I have been talking about incessantly over the last several months — they're not universally adhered to — if we do that, plus the vaccine, we'll get to the point where the level of virus will be so low, and maybe even, you know, close to absent.

I don't think we're going to eradicate it.

We may not completely eliminate it, but if you get it down to such a very low level, and enough of the population is protected — either by a vaccine or by previously having been infected — then you'll develop a degree of herd immunity that you won't have an outbreak.

So when people say spring of 2022, I think that's quite reasonable, because I think that if we deploy a vaccine and we implement public health measures, I think it might even be sooner than that. But 2022 I think is a pretty good bet.

OK, that's good to hear.

I also wanted to ask in the more immediate term, now that we know a little bit more about how the virus works, have you changed your routines? Like, what kinds of things can we relax about a little, and where and how can we do that safely?

Well, I don't think we need to go by my routine, which is probably unusual.

I'm working seven days a week, 18 hours a day. I'm in my office half the day, I'm in the White House half the day, depending on the day.

I go for my exercise — a three- to four-mile power walk at night with my wife — that's one person who I know is not infected.

She herself has the same routine. She's the head of a department here at the NIH, but she does a considerable amount of her work virtually. So she is in contact with very few people.

I do something socially, and it is usually a dinner outside on the back deck with people who we've known for a long time who are equally as compulsive as we are about trying to protect yourself against infection.

So we have a very regimented, predictable existence of work, work, work, exercise, eat — but do it in a very safe way.

I mean, there's no outside entertainment, there's nothing other than just my relationship with my wife — which is terrific. And my relationship with a couple of very close friends who live nearby, who on a weekend will come over. So the total number of us is never more than four or five.

Sort of related to that, it seems as if people are really eager for some kind of silver-bullet coronavirus prevention. Maybe you noticed that a little bit recently, with the way that people took your comments about vitamins and ran with them, or in the way that people get really excited about low-carb diets and stuff like that.

Is there anything you'd like to clear up about the role that diet and lifestyle can play in immunity and severity of disease?

Yeah, I mean, I had made it very clear when people asked about what vitamins I take, and I try to explain it, but always, always it'll get taken out of context and misconstrued. I've gotten used to living with that. [Laughs.]

Sometimes people, when they don't get out in the sun a lot, they're deficient in vitamin D. So my vitamin-D level was generally low. I started taking vitamin-D supplements, and now my vitamin-D level is normal.

And there is good evidence that if you have a low vitamin-D level, that you have more of a propensity to get infected when there are infections around. Those data are pretty good data.

But when you talk about the multiple multivitamins and the herbs and the things that people do to so-called boost immunity, that really doesn't boost immunity, and may have a better placebo effect than anything else.

If you really want to keep your immune system working optimally, there are things that you do that are normal things: Get a reasonable amount of sleep, get a good diet, try to avoid or alleviate severe stress, which we know can sometimes impact the immune system. That is much more healthy living than giving yourself supplements of anything.

I also wanted to ask — because we've been living in the summertime for a few months now — how do we keep from going insane this winter? You mentioned your dinners outside, and your walks outside. That's going to be a little harder. What's in your wintertime mental-health toolbox? I don't know if you're thinking that far ahead yet.

I am thinking. I don't have any easy answers, but my wife and I actually had a serious conversation last night, as we were sitting out on the deck, about what the heck is going to happen in the winter, you know?

And I'm not sure, to be honest with you.

But certainly we're going to have to do indoor things more than we were able to do before. Because we do almost nothing with people indoors right now.

In fact, I almost can't remember what we did indoors with anybody other than just my wife and I in the house and one of my children. One of my three children visited us — they live in three separate cities. They were careful enough to essentially quarantine themselves in the cellar for 14 days before they interacted with us! [Laughs.]

So we're being very careful for any number of reasons you may want to be careful, but also, you know, I'm not the youngest person in the world. So I'm in a risk category.

That gets into one of my other questions: What are you going to do for the holidays? On Thanksgiving and Christmas, will you get together with people who live in other states, such as your daughters?

You know, that's a good question. We haven't even begun to address it.

We're going to have to do certain things that, I think, you know, maybe when the tests for surveillance are more widely available, you could get tested? Have people get a test that's a 15-minute test, so you'll know when you're good.

It's not a 100% guarantee. Because some of those surveillance tests aren't as sensitive as the PCR tests, but nonetheless, that could be one way to do it.

But that's unfair, because only the people who have access to that are going to be able to do it. So it isn't going to be universally available to people.

So how long do you think we will need the vaccine to exist before we can stand shoulder to shoulder with strangers again? How long will it need be available before we can crowd into bars like the old days?

Well, you know, I don't think you should crowd into bars under any circumstances. [Laughs.] Just joking.

But I just think you have to get it so that most everybody in the population gets vaccinated. Once you've got that, like I said, that gets back to the first question that I answered for you. I think that could be accomplished by the end of 2021.

OK. And sort of similar timelines for crowded restaurants or indoor concerts?

Yep. Yep.

Then my last question for you is, is there a big misconception that you'd like to clear up around the coronavirus vaccine, or how it'll work, or what we'll need to do when it's here?

Well, I don't know if there's a misconception, but there's a real concern that perhaps we're moving too quickly.

And I think people need to understand that speed is not related to a compromise of safety nor to a compromise of scientific integrity. The fact that we've been able to move so fast is a real reflection of the extraordinary technological advances that have been made in the development of vaccines.

Things that would have taken a year to grow a virus or sequence a virus, or get it to the point where you can start making a vaccine. Things that were measured in years are now measured in weeks to months. So the speed should not be interpreted as a reckless speed that compromises safety or efficacy or scientific integrity. There is that misperception.

You can see, there's a lot of skepticism in society about the transparency of this. Is it going to be safe? Is it going to be effective?

There are a lot of checkpoints in the process that ensure that.

Yeah. I was thinking in terms of, even this week, for example, CDC Director Robert Redfield was saying that if a vaccine's immunogenicity is, like, 70%, then you might still want to wear a mask.

Sure. Yeah. Like I said — you have my words recorded.

I said a combination of an effective vaccine and adherence to certain public-health principles will get us to the point where we want to be, by the end of 2021.

I never said just the vaccine.

You never should abandon the public-health measures. And the intensity of the public-health measures would depend on the level of infection in the community.

If there's almost no infection in the community, together with the vaccine, you might want to be able to say "I can safely congregate with people."

You may want to do it with a mask, or without a mask.

It's all going to depend on the level of infection in the community, and how low you got it down with your vaccine.

I think that's a helpful clarifying point for people. I'll let you get back to your pizza because I know you have got a jam-packed schedule.

OK. Very good. Thanks a lot. Nice talking to you. Bye.