How much we can push the mortality down is really the issue: US authorities

Speaker 1: Just to be clear, what is the projected death toll? Should people be reasonably good at following these mitigation measures?

Donald Trump: Well, are they reasonably good? I guess we could say that, I’d like to have maybe Dr Fauci or Deb come up and say, but I have numbers, but I’d rather have them say the numbers if you don’t mind. It’s a big question.

Dr Birx: So of course this is a projection and it’s a projection based on using very much what’s happened in Italy, and then looking at all the models, and so as you saw on that slide, that was our real number, that 100,000 to 200,000, and we think that that is the range. We really believe and hope every day that we can do a lot better than that, because that’s not assuming 100 per cent of every American does everything that they’re supposed to be doing. But I think that’s possible.

Speaker 1: Over the next two weeks, as you said, the next two weeks are going to be very painful as the bulk of it’s going to happen over the next two weeks.

Dr Birx: You know, you’ll have an up slope, so as mortality, the fatalities to this disease will increase and then it will come back down, and it will come back down slower than the rate at which it went up. And so that is really the issue, how much we can push the mortality down.

Dr Fauci: So our hope is to get that down as far as we possibly can. The modeling that Dr Birx showed predicts that number that you saw. We don’t accept that number that that’s what’s going to be. We’re going to be doing everything we can to get it even significantly below that. So, I don’t want it to be a mixed message. This is the thing that we need to anticipate, but that doesn’t mean that that’s what we’re going to accept. We want to do much, much better than that.

Speaker 2: But doctor, when we look at the curve, it goes much further in time. So we would have death and cases for much longer. I mean, we to expect (inaudible).

Dr Birx: So, could you get up slide number two? So that’s a generic, I’m sorry if you can go back to the slides and put up slide two, okay, so what I showed you was a generic picture of what happens in an epidemic when you mitigate, so no mitigation, mitigate. This is based on the experience around the globe with this particular virus, and so it does have a tail, but the peak you can see by this projection, and this is the IHME data, the peak is over the next two weeks, and this is tracking mortality, so the number of fatalities from this virus, and so that’s the part that we think we can still blunt through the superb medical care that every client is receiving, but also even more stringent, people following the guidelines.

Speaker 2: I can’t see the small characters, but are we seeing death until June?

Dr Birx: This is June.

Speaker 2: This is June, so we would still see problems and deaths in June.

Dr Birx: It’s a projection.

Speaker 2: It’s a projection, of course.

Dr Fauci: So, I mean, just getting back to what I said about the stepwise thing, deaths always lag, so you will be seeing deaths at a time when as an epidemic we’re doing really, really well because the deaths will lag.

Jim Acosta: But Dr Fauci, should Americans be prepared for the likelihood that there will be 100,000 Americans who die from this virus?

Dr Fauci: The answer is yes, as sobering a number as that is, we should be prepared for it. Is it going to be that much? I hope not, and I think the more we push on the mitigation, the less likelihood it would be that number, but as being realistic, we need to prepare ourselves that that is a possibility that’s what we will see.

Acosta: That’s a very short period of time for that to happen.

Dr Fauci: Right.

Acosta: Can the country handle that in such a short period of time within a couple of months, 50,000 a month?

Dr Fauci: You know, it will be difficult. I mean no one is denying the fact that we are going through a very, very difficult time right now. I mean, we’re seeing what’s happening in New York. That is really, really tough, and if you extrapolate that to the nation, that will be really tough. But that’s what it is, Jim, and we’re going to have to be prepared for that.

Dr Birx: I think because the model, that model that was from IHME, ...heavily ladened by the data that has come in from New York and New Jersey and Connecticut. So, you know, that can skew to a higher peak and more significant mortality. If all of the other states are able, and all the other metro areas are able to hold that case number down, then it’s a very different picture. But you have to predict on the data you have, which is heavily skewed to New York and New Jersey.

Dr Fauci: Getting back to that, that’s really an important slide that Dr Birx showed. The cluster of other cities that are not New York and New Jersey, if we can suppress that from any kind of a spike, the numbers could be significantly lower than what we’re talking about.

Acosta: (inaudible) Cities that are not following these guidelines...

Dr Fauci: Right, and that’s the reason my plea at the end of my remarks, Jim, that now was the time to put your foot on the accelerator, because that’s the only thing that’s going to stop those peaks.