Fauci: Masks, Social Distancing Likely Until 2022

Carolyn Crist

October 22, 2020

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

With cases continuing to rise in many states and a vaccine yet to come, Americans should prepare to wear masks and social distance for quite a while.

People will likely need to wear masks and follow social distancing guidelines through the end of 2021 and into 2022, one of the nation's top infectious disease experts said during a recent meeting, according to The Philadelphia Inquirer .

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, spoke about the future of COVID-19 during a virtual meeting with doctors and students at Thomas Jefferson University in Philadelphia last week.

"I feel very strongly that we're going to need to have some degree of public health measures to continue," he said.

"It's not going to be the way it was with polio and measles, where you get a vaccine, case closed, it's done," Fauci said. "It's going to be public health measures that linger for months and months."

Coronavirus vaccines ― once approved and distributed widely to the public ― won't be a "knockout punch" that eradicates the virus, he said. Instead, he expects the process to take time and anticipates a 70% effectiveness rate for an approved vaccine. Public precautions such as face masks and social distancing will need to continue during the distribution process.

"I think we've got to set reasonable expectations," Fauci said. "If I'm surprised pleasantly, so be it."

At least one of the COVID-19 vaccine candidates will likely have enough data about its safety and how well it works to pursue an emergency use authorization from the FDA by the end of this year, he said. Full approval would come after that, and distribution would start in the first quarter of 2021.

Fauci also pushed against the idea of "focused protection," or an approach to herd immunity that protects older adults and vulnerable groups but lifts restrictions for everyone else. Although more older adults die from the coronavirus, people of various ages and health conditions have contracted severe COVID-19, he said, and it remains a "puzzle" why about 40% of people are susceptible to severe forms of the disease.

"We shouldn't be lulled into complacency that this is only an old person disease," Fauci said.

The best way to achieve herd immunity is through a vaccine, he said. Otherwise, a large number of people will die by simply allowing everyone to become infected with the coronavirus. A "profound degree" of herd immunity won't likely happen until the end of 2021 or beginning of 2022, he said, which is why he predicts public health measures such as face masks and social distancing will continue until then.

Those public health measures are particularly important now as coronavirus cases continue to increase across the country, especially in the Midwest, CDC officials said Wednesday.

"Unfortunately, we're seeing a distressing trend here in the United States, with COVID-19 cases increasing in nearly 75% of the country," Jay Butler, MD, the deputy director for infectious diseases at the CDC, said at a media briefing at CDC headquarters in Atlanta, according to CNBC.

"Smaller, more intimate gatherings of family, friends, and neighbors may be driving transmission as well, especially as they move indoors," he said.

Butler said COVID-19 cases are growing "really in all parts of the country," and although people are growing tired of the safety precautions, they're still important.

"We're tired of wearing masks, but it continues to be as important as it has ever been, and I would say even more important than ever as we move into the fall season," he said.

The U.S. is now reporting about 60,000 new daily cases, according to a CNBC analysis, which is up about 17% compared to a week ago. The country has now reported more than 8.3 million cases and more than 222,000 deaths as of Thursday morning, according to data from Johns Hopkins University.

Butler said that a safe and effective vaccine would be ready "very soon" and that he is "cautiously optimistic" that one will be available in limited numbers by the end of the year. Alex Azar, the secretary of Health and Human Services, said two companies making vaccines ― Pfizer and Moderna ― are "very close, if not fully enrolled in their trials."

Every state has now submitted plans for vaccine distribution, Butler said. The CDC will provide feedback during the next 2 weeks, and then states will be directed to set up distribution centers. The vaccine will be released in stages, likely to front-line health care workers and older adults in long-term care facilities.

"There is hope on the way, in the form of safe and effective vaccines, in a matter of weeks or months," Azar said.


The Philadelphia Inquirer: "Anthony Fauci talks with Jefferson doctors about coronavirus vaccines, herd immunity, and how long we'll need masks."

CNBC: "CDC says the U.S. is now seeing a 'distressing trend' in coronavirus outbreak."

Johns Hopkins University: "COVID-19 Dashboard."