Fauci to Medscape: 'We're All In It Together and We're Gonna Get Through It'

; Abraham Verghese, MD; Anthony S. Fauci, MD

Disclosures

July 17, 2020

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

This transcript has been edited for clarity.

Eric J. Topol, MD: Hello. I'm Eric Topol with my partner, Abraham Verghese. We have a special honor of being able to have a podcast today with Anthony Fauci. So, Tony, welcome, and thank you so much for joining us. Moreover, thank you for all you've been doing during this pandemic and for many decades, actually.

Our first question is, how are you holding up?

Anthony S. Fauci, MD: Pretty well, Eric. I say, somewhat facetiously, that I'm running on fumes, but the fumes are really thick, so I'm making good. It's a very unusual situation. I was thinking about what kind of analogy I can make. It's like when I was doing my internship and residency in medicine; it was in an era when you were on every other night and every other weekend. This is kind of like internship on steroids.

Topol: Yeah, with some extra challenges, perhaps.

Let me turn this over to Abraham. I know he has some things he wanted to start with.

Abraham Verghese, MD: I remember some 35 years ago interviewing with you on what was a pretty hectic day for you, I gathered, when I was sitting in your anteroom. You had this wonderful ability to make me feel as though I was the only person on your schedule. Your equanimity then, and your grace, has stayed with me. And I'm not the only one. Legions of us are really admiring your equanimity in what must be very trying times. Do you have a secret formula for the rest of us who decompensate much more readily than you seem to?

Fauci: Well, Abraham, it's a good question because, as you know, I've had to deal with a number of different challenging situations, but this one seems to have reached a new height. What I try to do to the best of my ability is to compartmentalize and focus on what is important. There's a lot of noise, particularly when you have divisiveness and politics involved. Yet the focal thing that is important is a very serious public health challenge. So I try to delete out all the other stuff and keep focusing on what I believe, and what we all believe, is important. Because once you get involved in the noise and the nonsense, it's terribly distracting. And it really takes away from the effectiveness of what you're doing. So I've trained myself and I think I've been successful in being able to really compartmentalize and focus on what's important.

Verghese: I remember from that visit that you had your jogging shoes very strategically in the corner of your office 35 years ago. I suspect your endurance has something to do with your fitness and your commitment to exercise.

Topol: Are you still running? And now with a mask, right?

Fauci: I do. In fact, I've made that a really important part of the things that I absolutely have to do.

You need some sort of a release, particularly with the stress and the tensions that go along not only with the magnitude of the problem but, as I mentioned, all the other noise that gets thrown into it. It makes it difficult. So when I go out in the evening — I used to run during the day, but now I have to do it at night because the day is just completely packed — I go with my wife. She's a great companion. I let off a bunch of steam. I keep my mask on, wave to a few people, and I defuse pretty well.

Topol: That's terrific.

Maybe we can start with the virus per se, SARS-CoV-2. You have the anchoring of all these other viruses that we've lived through, and this one seems, as a virus, quite unique. Does it to you? How do you put it together vs SARS, MERS, Ebola, and all of the other viruses you've had to deal with?

Fauci: Eric, it's very unique. I think that's one of the things that essentially transcends all other aspects of how you address the virus, because it can be really confusing. One of the problems we're having is with certain segments of our population, namely young people not taking it as seriously as they should, for understandable reasons. I've dealt with viruses for the past 40 years, from HIV to Ebola to Zika to chikungunya to all of the others. But I've never seen a pathogen, and in this case a virus, with such an amazing spectrum of disease severity, going from 20% to 40% of the people who are infected having no symptoms, disproportionately leaning toward younger people. But then you have people who get mildly ill, ill enough to stay at home for a few weeks or to the point where it brings them to their knees and they have postviral syndromes, some that require hospitalizations. Some require intensive care, intubation, ventilation, and some die. Usually a virus that is good enough to kill you would make almost everybody at least a little bit sick. So we're dealing with a serious virus here.

You have 20%-40% of the people not even getting any symptoms. And yet vulnerable people, the elderly and those with underlying conditions, can require hospitalization, intensive care, and some will even die. So it's tough to get a consistent message that we've got to stop this virus; it's a pandemic and it's killing people.

We've got to get them to believe that they are part of the propagation of a pandemic, even though they are doing well themselves.

Right now in the Southern states that are surging, the average age is 15 years younger than what we saw in the Northeast and in the New York metropolitan area early on in the year. So it's tough when people say, "Why should I worry about getting infected? The chances are I'm not going to get sick." We've got to get them to believe that they are part of the propagation of a pandemic, even though they are doing well themselves. And by propagating the pandemic, they're preventing us from getting back to normal and reopening. So you're right — the virus itself is really, really tricky.

Topol: Added to that, in this young, asymptomatic group — and separate from the presymptomatic ones — there are the CT scan series showing lung damage in a significant proportion, perhaps even half, although it wasn't a large number of people studied. So it's like a double-silence: They don't even have symptoms and they're having silent hits on their lungs, if not perhaps other organs. So the spectrum is just so extraordinary, as you've been describing.

Fauci: You're absolutely right. You don't want to be scaring people and alarming them, but they really should know that we don't know what the long-term consequences are, even when it looks like a routine infection. We better be careful. Even after you clear the virus, there are postviral symptoms. I know, because I follow on the phone a lot of people who call me up and talk about their course. And it's extraordinary how many people have a postviral syndrome that's very strikingly similar to myalgic encephalomyelitis/chronic fatigue syndrome.

They just don't get back to normal energy or normal feeling of good health.

Verghese: In that vein, can you talk a little bit about personal protection equipment (PPE)? I was attending on the wards last week and we test all our patients as they come in. Obviously we wear masks; they're masked. But we had a patient test negative at admission and subsequently test positive. And because I was only wearing a mask and not a face shield, and because I spent more than 15 minutes at the bedside, I am "exposed." That raises the question of why we're not all wearing the ideal amount of PPE. And I think the answer is that we don't have enough. But why are we still lagging behind in the supply of PPE? I'm not sure that you have much to do with that. But do you have any commentary on that?

Fauci: Abraham, you're right. I don't have much to do with it. The only way that I do is very indirectly in discussions at the coronavirus task force at the White House, which I go to multiple times a week. (I used to go every day, 7 days a week. Now it's down a little to a few days a week.) It is extraordinary how much of PPE is not produced in the United States of America. I was stunned when I first heard that a high percentage of it has to be shipped in, so you don't have immediate control over it. If there are ever lessons learned from this — and it's something that we have spoken about in the past when we've spoken about pandemic preparedness — it is that we really need to get in our own geographic boundaries, things that were absolutely essential to the health of our country. It has to do with everything from PPE to the ingredients of many of the pharmaceuticals we use, which currently come from the outside.

Topol: Along that line, as you know, having been intimately involved with the Ebola outbreak, there was a czar, Ron Klain. Did it make a difference in the management of Ebola to have one person who had decision-making authority? Though obviously it was a very different virus.

Fauci: It was a different virus, Eric. And I believe that there are different successful models. The model that was used in this particular current outbreak is the task force, which is led by the Vice President, who is deeply involved in this in the sense that this is a major thing that he's been doing. In some respects, it's a different model. I worked closely with Ron Klain. I love the guy. He was incredible. He really was quite good to work with. But in the task force, the Vice President, in some respects functionally, has that role and he is very receptive to the kinds of things we're doing.

Topol: Well, that's good.

The other thing that comes up while we're on that is this recent stir about the US Department of Health and Human Services (HHS). Some have said that HHS is hijacking the Centers for Disease Control and Prevention (CDC) data and the dashboard and is having Palantir, a private company, be the custodian of the data. I don't know if that's something that was discussed in the task force or if you have any sense about that.

Fauci: To be honest, Eric, I don't have any sense of it because I found out about it by watching somebody talking about it on television. It never came up.

Topol: It certainly has raised some concerns because the CDC hasn't had the presence it's had in previous outbreaks. I suppose there's not much more you can add on that. But at least just to mention that in recent days, it's certainly been a concern.

Going back to the chronic phase that you alluded to, has there been any definition of the immune response in these folks? We learn through these patient groups, like Long COVID. There have been only minimal formal publications about them. But has there been any extensive or any immune response that might explain why they have these lingering symptoms that go on for months that are quite troubling and sometimes even quite debilitating?

Fauci: People are looking at this area, but with there's not a lot of what I would call clarifying information.

The one thing that we do know is, and I don't even think this clarifies it anymore, is that when they were first looking at people who progressed rapidly — the ones who got sick, went to the hospital, they look like they're okay, and then all of a sudden, dramatically, they just crash and go on ventilators — that was felt to be a hyperactive, aberrant immunologic and inflammatory response. And actually, I think it's at least partially true, based on the data from the UK study in which dexamethasone in individuals on ventilators and those requiring oxygen — but not in early patients — significantly diminished the death rate. So we do know that there's a lot of cytokine secretion. If you measure IL-1 beta, IL-6, TNF, they're all sky-high.

But I'm not so sure that gives you much insight because we know, prior to COVID, that when you get people in dire straits with a lot of inflammation, you get a bit of a cytokine storm anyway. So, yes, the immune system is aberrant.

But I think what you're asking, and this is important, is, what is the nature of the protective immune system? Is it clearing virus and you have a hyperimmune and aberrant cytokine storm that's giving you pathogenic symptomatology at the same time that you're suppressing the virus? We don't know. I have to tell you, I'm humbled by it that we don't know. We have so many people who have gotten sick, and we can't write a really good paper on delineating A-B-C-D or what's going on. We just don't know.

Verghese: The pace of the science is just extraordinary. I was a fellow in infectious disease when HIV came on the horizon and it had no name for about 2 years. We didn't even know what caused this, and to think that we have a vaccine candidate for SARS-CoV-2 already — I have the latest New England Journal of Medicine on my desk — that is just extraordinary. In just a few months. Would you talk a little bit about vaccines and vaccine strategies, and where you see us in about 4 months from now with that?

Fauci: Well, I'm directly involved with the vaccine research, and the speed of it even boggles me to see how fast it's gone. It's technology and technology platforms that have allowed us to go so fast. From the time the Chinese published the sequence on a public database, literally, it's somewhat historic. They put it up on January 10th. On the 11th, in this room that I'm sitting in now, we had a meeting of our crew and said, "Let's get on it. This is all hands on deck." My vaccine research center, led by Dr Barney Graham, 2 days later got the viral sequence, got the gene, and stuck it in an mRNA, and we started developing the vaccine on January 15th — 5 days after the sequence went up. A phase 1 trial started 62 days later. It's mind-boggling. It usually takes a couple of years before you do that. Then at the end of this month, July, we're gonna start the phase 3 trial.

There are certainly multiple candidate vaccines that are revving up to go into phase 3 trials. There are at least five that the NIH is directly involved in, either by collaborating, by providing resources, providing sites, giving money, and subsidizing to a greater or lesser degree. They are going into phase 3 trials sequentially, maybe a month or two after each other. The phase 3 trial for the Moderna mRNA starts at the end of July. A month or so later another will come on, and then another as we get into the fall, and then another as we get into the late fall. We are hopeful, since we're harmonizing the approach, with protocols that are very similar so you don't have completely different things. We're looking at having a common data safety monitoring board, common primary and secondary endpoints, and common immunologic parameters that you measure. Therefore, if one trial is ahead of another and one shows real efficacy, you could bridge it by immunologic compatibility.

Whenever you do vaccine research — you guys know as well as I — you never can guarantee anything because there are always potholes and bumps in the road. But given what the phase 1 data looked like, published 2 days ago in The New England Journal of Medicine, the neutralizing antibodies were at a titer induced by a moderate dose of the vaccine that was comparable to or even better than convalescent plasma. As we all know, the gold standard for a vaccine is to induce a response that's at least as good as natural infection. So if we could mimic that in the field and have a comparable clinical efficacy, I think by the end of this year, the very beginning of 2021, we could have one or more vaccines available for distribution of doses. That's what I'm hoping for.

Topol: It's remarkable. I know that in the editorial accompanying the data on the Moderna vaccine in The New England Journal of Medicine, they said it was the compression of 6 years of work into 6 weeks or something like that. It's just startling. One of the questions it brings up is the dissociation of the antibody IgG potent neutralizing capacity and the T-cell story, which, as you know, this week was somewhat marked by this preprint about the waning, disappearing antibodies in 90-some people in London, which raised concerns. We also have seen multiple papers on T cells characterizing immunotypes and also the very rigorous T-cell response that is somewhat reminiscent of SARS, and how it's present even more than a decade later. Can you comment about how you're trying to simulate with a vaccine what the natural response is, which seems to be heterogeneous and dynamic over time? Can you try to help sort this out?

Fauci: We don't have definitive data. We're going to get a lot of data as we look now at the hundreds of people who are in the phase 2 trial. And in a week or two when we go into phase 3, we're going to start getting some of that data.

The antibody response traditionally in coronaviruses in general is nothing like measles, which lasts essentially for life. It isn't even in the same ballpark. We had a bunch of papers to show that it has a relatively short duration of 6 months to a year or so. We need to get out further with COVID-19 to find out what's applicable there and whether someone who gets infected and gets clinically ill has a much more durable response than someone who gets infected but has isolated replication of the virus in their upper airway. Clearly, there's something going on systemically when people really get sick. What I think is going on, and we're getting hints of this from the vaccine, is that you are getting a not-so-greatly-durable antibody response and a much more durable T-cell response, because if the T cells act the way we know they act in other diseases, they have a degree of durability. And they are interesting because they can essentially get multiple types of the virus that they can cross-react with, which is unlike the antibody, which is much, much more specific.

Topol: It's reassuring, and there's obviously much more to learn. Hopefully, people won't get worried about this idea that disappearing antibodies means that people are subject to reinfection. That's been another controversy: whether people can have reinfection or whether it's just that they never have mounted an adequate response. Can you address that?

Fauci: We need to get out of the anecdotal range and collect some real data because there are a lot of anecdotes about people who believe -- and they might have; I'm not saying they haven't — that they may have gotten reinfected. We have to be careful because what we do see sometimes is that people clear virus. Then they go back and get a PCR test later that's finding residual nucleotides. But when you look at the cycle threshold, it's unlikely that this is replication-competent virus. Other people recover and then get clinically ill, and they come back and it looks like it's a positive test. Is it residual? Is it reinfection or is it exacerbation? The answer is, we don't know. But if you look at the cohorts in general, if it's occurring, Eric, it's not occurring a lot. We're not seeing a lot of people getting relapse or recurrence. So we need to get those people in whom it looks like it might be happening and study them very carefully.

Topol: It would be nice to not just rely on PCR but to see cultures and proof of replication-competent virus. And I haven't seen that yet. So with all the millions of people who have been exposed, and we still don't have one documented real case, hopefully the reinfection thing is not going to become a significant issue.

Fauci: One point, Eric, that I think is important: One of the reasons why we haven't seen a lot of studies on correlating PCR positivity with replication competence is because you've got to be in a biosafety lab-3 (BSL-3) to do that. Not everybody has a BSL-3. That's the problem.

Topol: It's hard to get one of those. Abraham, go ahead.

Verghese: I wanted to ask about mutations. There are a lot of papers on mutations, and yet most of them don't seem to be significant for the vaccine. Is that true?

Fauci: It's an RNA virus, and RNA viruses mutate all the time. So when you have a lot of disease, a lot of replication, it's going to mutate.

Most of the time, it's a mutation that has no phenotypic relevance. It just mutates, doesn't change. There's one interesting mutation that is being studied very carefully. It's a mutation from a D at the 614 amino acid site to a G. People have looked at that, D614G, and have found that that mutation allows the virus to bind much more readily to the ACE2 receptor and therefore is likely associated with a more efficient transmission, though that's an extrapolation that we need to confirm clinically. But the investigators found that the site of that mutation doesn't interfere with the binding site of a neutralizing antibody on the spike. So even though it might actually make the virus more readily transmissible, it doesn't appear to have any impact on what we're doing with vaccines. So thank goodness for now that that's the case.

Topol: It's good that it's a slowly evolving virus. It has enough challenges to deal with as it is. It's a really important distinction you're making about the vaccine, not having to be rebooted regarding the viral changes. You were going to say something, Abraham?

Verghese: If you're a student of pandemics, then you know that the missteps and public reactions are varied and predictable and expected. Can we bring science to the very issues that we're having with the public's lack of acceptance of masks and so on? Looking at the rigorous study that we're bringing to the virus, I think we need an equally rigorous study of our ability to communicate our societal responses. Any thoughts about that?

Fauci: Abraham, I have a lot of thoughts but no solutions. It's really frustrating when you have some public health interventions that historically in this outbreak have shown to be clearly effective, particularly when you don't have any other tools because we don't have a vaccine. You have a couple of therapies, but they're mostly for advanced people. Yet we have such pushback on people not wanting to wear a mask. I don't know whether that has to do with the American spirit, which in many respects serves us well — that independent drive that brought our ancestors over, leaving whatever country they came from. I don't know what it is, but it's a pushback on authority. And what I think it's linked to is not only anti-authority, but it's a bit linked to the disturbing anti-science trend that we have in this country, like, "You're telling me it's scientifically sound to do that. Well, I don't want to do it because I want to make up my own mind and not listen to authority." I can understand that that has a degree of attractiveness, independence. But, boy, when you're in the middle of an outbreak, it's doing such destructive damage. It's time to let that go and join the club and wear a mask. Be a joiner as opposed to an independent entity.

Topol: Well said. One thing that doesn't get a lot of play — and it's also an outgrowth of what you mentioned happened in January when you were taking the sequence and already designing vaccines — is the amazing velocity of structural biology and the atom by atom determination of the virus, per se, and all the different ways to get at epitopes with an antibody. That's also being used for neutralizing antibodies which are being tested in clinical trials. What do you think are the prospects for those in the months ahead? Will that come before a vaccine or around the same time?

Fauci: There's no doubt. The monoclonal antibodies now are going into clinical trials both on an outpatient and an inpatient basis. So that's really good. I'm very pleased to see that because that could be filling in one of the gaps that we have in therapeutics, Eric, because right now we have a couple of drugs for more advanced disease. We don't have anything that we can readily give widespread, inexpensive, to get to somebody who gets symptomatic to prevent them from being hospitalized.

It would be really wonderful. And I think it's doable to get something [that could be administered] either intravenously or even on a subQ or intramuscular injection, to essentially block the progression of the infection that would land a patient in a hospital. Remember — people forget this, but we had two monoclonal antibodies that were highly successful in Ebola. Remember that trial? Monoclonal antibody 114 and the Regeneron product. Both of those products had a highly significant impact on mortality.

Topol: I think that is such a key point because while we can despair, this is not far off on the horizon and it can be used in this early state rather than late in disease, like in the editorial you had today in The New England Journal of Medicine on the dexamethasone trial, where we have made advances with that, and remdesivir for the really critically ill patients. But to have something for early disease is so darn important.

What about if someone does get a monoclonal antibody or they've had the infection and then vaccines become available? Will people all get the same one or are they going to need different assays to know whether they should get this vaccine or that? How complicated is that going to be?

Fauci: I don't think it's going to be complicated, to be honest with you. Those antibodies get cleared and then it's almost as if you didn't get them. It may depend temporally on when you get the vaccine, but I don't think it's going to be prohibitive to do them both.

Verghese: Dr Fauci, you're speaking today to many, many physicians who listen to this podcast. Do you have any message for them specifically? Many of them are on the frontline. Many of them are great admirers of yours and are listening intently to your words. Anything that you'd like to say to them?

Fauci: Abraham, thanks for asking me. Two things. One, I just try to express how much I admire the real heroes on the front line for getting in there every day and essentially putting themselves at risk. I'm operating from a different vantage point where I am, but I almost miss the days of being in the trenches with you. So that's the first thing.

The second thing is that, you know, this is so stressful for all of us. I think we have to remember that we're gonna get through this. This is not something that's gonna be forever. We're gonna get through it. It's gonna be over. And we're going to look back and hopefully say we really gave it our best shot. And it's gonna be over from two standpoints: It's going to be over from a public health standpoint if we get it right, public health–wise.

But I think science and good biomedical research are also going to come to the rescue because we're going to get a vaccine, hopefully sooner rather than later, and we will get effective therapeutics. So for the people on the frontlines and in the trenches, hang in there with us. We're all in it together and we're gonna get through it. So that's my message to them.

Topol: Well, that may be the most important message of all. Before we let you go, one other question: Also exciting and on the frontier are the rapid diagnostic tests, where you can get these at the home or wherever in 20 minutes, 30 minutes, with the answer. What's your sense about how that can be transformative? Do you think that that's going to really come as projected, perhaps this October or November?

Fauci: We've invested a half a billion dollars in the RadX [National Institutes of Health initiative] to get the diagnostics. It's just what you say, Eric. That's what we need. Enough of this nonsense of waiting to get it done and waiting 5 days to get it back. We've really got to have something where you go in, you get it, bingo. Everybody gets it. As many as you want, as quickly as you want. That's the end game that we need. We've got to get much, much better than we are right now. We've got to be able to get tested immediately at the point of care and get back to diagnosis as rapidly and as cheaply as possible. No doubt.

Topol: That's good to hear. We've got a lot of positive things here today, even though we're sitting in the worst pandemic for over a century.

We're very lucky to have you, not just to join us today, but in all the things you're doing. So, Abraham, do you have any closing words?

Verghese: I just want to add my thanks. It's been such a privilege to listen to you and keep up your wonderful work. Don't stop speaking.

Topol: You know, we're all on the older-guy front. But, Tony, if we could do like you do at your age, we would feel very lucky. No, let's just be running at night with a mask for everything you do. We're really appreciative.

I know we're speaking for the entire medical community and it's been challenging in ways that who would ever have forecasted, but thank you for everything you're doing.

Fauci: Thank you, Eric. Thank you, Abraham. I appreciate you giving me the opportunity to be with you. Thanks a lot. Take care.

Concluding Thoughts

Verghese: Eric, what a privilege it was to get to speak to Tony Fauci. The pressure he must be under... I was taken by his good humor, by the breadth of his knowledge, his ability to keep up with all the different things going on. And you know that the next thing he's doing is probably heading to the White House. An extraordinary range of things that this man has to do. So what a privilege that was.

Topol: It really was, Abraham. You know, I've been very depressed and I'm actually kind of an optimistic person. But he's uplifted me from what he had to say. To talk to him directly about the vaccines and how fast it's moving, and the monoclonal antibodies, and the rapid testing and the science... We're living, unfortunately, in an anti-science era, with a lot of noise there, with the mask resistance and people saying it's like the flu and all this other stuff. But to see the acceleration of what's being done on the various frontiers in science and him reviewing that, that was uplifting. I hope the whole Medscape community will feel similarly. This is the most challenging pathogen we've seen in our lifetimes, hopefully for many generations.

It's had radical effects, perhaps more in the US than we ever would have expected or hoped. But it seemed very positive, the messages he was bringing. Don't you think, Abraham?

Verghese: Very much so. And my thoughts right now are with all of our colleagues who are on the front lines — not just here in California, where we've had 100 fatalities a day for the past 3 days in a row, more than 100 today — but with our colleagues all over the world, frontline physicians who are laboring with inadequate protective equipment, with delayed testing, with beds not being available. I don't think that they are getting the direct kind of address and support that they need from the powers-that-be to say what a wonderful job they're doing. I've never been prouder of being a physician, and I just loved what he had to say.

He said, hang in there, we are going to get through this. And, by God, it's really, really difficult. But that is the subtle message that we have to hold on to. Eric, it's just a privilege to be doing this with you. And I'm so glad we got Tony.

Topol: I am too. We've had a chance to interview a lot of people both in the medical community and outside. But the timing and the person here make this one remarkable and unique. I think it's really a matter of patience that we don't lose perspective.

It's all a blur. Ever since March, I can't even keep track of time. I don't know about you, Abraham, but I don't know what day of the week it is. What week it is. All I know is that the months of the calendar change and it's just the year of 2020. It seems like it's going to just be like that. But if we can stick with it, hang in there, hopefully a lot of these great bodies of work are going to turn things around and hopefully get us in a far better position than where we stand right now.

Getting that perspective from the person who's led not just the country but, in many respects, the world through so many other pathogens that were killer pathogens. Not — not at this scale — is really very helpful. It is grounding, in many respects.

Verghese: It sure is. I want to thank all of our listeners for following this podcast. And I hope you'll send us your comments and your reactions. We are very pleased to have you join us for our special guest today, Tony Fauci.

Topol: I want to thank everyone in our Medscape community for joining us. You'll note in our discussion with Tony that we didn't get into politics. Really, that's not our interest; our interest is in the kind of biomedical features of this challenge and of this pandemic. We'll leave others to deal with that aspect.

We thank you. And we will continue our Medicine and the Machine podcasts, where we try to anticipate the future of medicine. It's been taken a little off-course with SARS-CoV-2, but we're going to be staying with it, and with you, in the years ahead. Thank you.

Eric J. Topol, MD, is one of the top 10 most cited researchers in medicine and frequently writes about technology in healthcare, including in his latest book, Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.

Abraham Verghese, MD, is a critically acclaimed best-selling author and a physician with an international reputation for his focus on healing in an era when technology often overwhelms the human side of medicine.

Anthony S. Fauci, MD, has led the National Institute of Allergy and Infectious Diseases since 1984. He has been on the forefront of the efforts to understand and control numerous disease outbreaks, including HIV/AIDS and Ebola. He is known for his calm demeanor and his personal commitment to regular running, even during the current pandemic.

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