It's time to "hunker down." Two modes of coronavirus transmission are significantly higher than thought. One underlying health condition is the very worst. And the government isn't handling a few things wisely. The nation's top infectious-disease expert, Dr. Anthony Fauci, spoke with Harvard Medical School for its Grand Rounds video series on Thursday, and he took us all to school by sharing the very latest on the important facts surrounding COVID-19 and what he predicts for this fall and winter. Here's everything he thinks you should know. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
Coronavirus Is "Much More" Aerosolized Than Thought
Theories on the extent to which coronavirus is transmitted through respiratory droplets (the stuff produced by coughing, sneezing and breathing, which quickly drops to the ground) versus aerosols (smaller particles that can linger in the air) are changing. "There was some real misunderstanding about respiratory droplets and so-called aerosolized particles," he said. "The aerosol and particle physicists that have approached us now have told us that we really have gotten it wrong over many, many years. Bottom line is, this is much more aerosol than we thought."
Transmission From Surfaces Isn't Understood
"Infected surfaces clearly occurred," said Fauci. "The degree to which they contribute to transmission is unclear."
Related: Dr. Anthony Fauci on the race for a COVID-19 vaccine
The Virus Isn't Just In Respiratory Droplets
"The virus is in multiple body fluids," said Fauci. "Again, what the role in transmission is unknown."
Animals Can Be Infected
"Animals, both domesticated and zoo animals can be infected," said Fauci. "And yet again, we do not know and doubt whether this is a major source of human infection."
RELATED: COVID Mistakes You Should Never Make
Events, Not One Person, Are Super-Spreaders
"They're really much more super-spread at events than super-spread of people," said Fauci. "We used to think that a single person may be particularly prone to spreading it a lot. It is much more likely it's the circumstance in which that person is, as opposed to anything specific about the specific person."
Asymptomatic Transmission Is Higher Than Previously Thought
"The thing about this outbreak that is very perplexing in being able to track and get our arms around is the fact that about 40 to 50% of the infections are asymptomatic," says Fauci. "If that's not bad enough, we know that now—and there was some doubt about this until it was really clarified—it is likely that up to about 50% of transmissions off of individuals who do not have symptoms."
What's "Most Perplexing" About COVID
"The thing that's most perplexing to me as a physician is the extraordinary range and spectrum of disease severity," said Fauci. "About 80-plus percent of individuals have mild to moderate disease. About 15 to 20% have severe or critical disease. The case fatality rate varies greatly on age and underlying condition."
The Worst Underlying Health Condition To Have
"We're seeing that obesity is probably one of the most important of the conditions that are strongly associated with an increased risk of severe illness," said Fauci.
His Not-So-Subtle Criticism of Washington
"There's been some, I would say disagreement among people who discuss this in Washington, not to be named for today's presentation, who feel that one of the approaches may be just protect the people in the nursing home, because they are the ones that are susceptible to severe disease," said Fauci. "If the others get infected, there may not be a problem. Well, we know that's not the case, because there are enough people who have underlying conditions who are not in nursing homes, who clearly have a predisposition to severe disease."
This Is "The Holy Grail" of COVID
Fauci said that a vaccine is what "we all feel is going to be the Holy Grail and really the intervention that is going to get us back to normal, which we all hope to do."
He Expects Multiple Vaccines
"We project that by the end of this calendar year, let's say November, December, we will know whether we have a safe and effective vaccine, and I would say vaccines, plural," said Fauci. "But again, with vaccines, you never say never. And you never say always, there's nothing guaranteed. We'll just have to see, but these trials are progressing very well."
Why Some People Have Severe COVID and Some Don't
"It's gotta be multifactorial," Fauci said. "It has to have something to do with the person transmitting and the burden of disease and the viral load. It probably has something to do with the host and the recipient and the receptor and the density of receptors in the recipient and then the proximity of contact and how close that contact is."
RELATED: 11 Signs You've Already Had COVID-19
The Number of Cases Depresses Him
"When we get with the task force, we go over the data from the night before, and I keep looking at that curve and I get more depressed and more depressed about the fact that we never really get down to the baseline that I'd like."
These States Are Currently Surging
"If we try to open up and if we don't do it correctly, we're going to see these surges that we've seen in the Southern states and the Midwest," said Fauci. "And now, if you look at the map, it's Montana, North and South Dakota, Michigan, Minnesota, Iowa—those are the ones that are surging. I think, as we get into the fall and we do more indoor things, we are likely going to see upticks in COVID-19."
Why We Want Australia's Recent Flu Season
"I don't know what's going to happen and I'm not predicting, but … what we have said might happen, actually has happened in Australia," said Fauci. "And that is that they have had the lightest influenza season in memory. They can't remember a season this light. And the reason is they're … wearing masks, they're physical distancing, they're washing their hands, and they're avoiding crowds."
It's Time to "Hunker Down"
"I would hope that with a combination of everybody who should be getting vaccinated with influenza, and the public health measures that we do, prevent us from having a bad influenza season and we somehow don't have a massive resurgence of COVID. Because what I would like to see is keeping the lid on it, keeping the baseline down, until we get a vaccine."
He added: "I just think we need to hunker down and get through this fall and winter, because it's not going to be easy."
What "Concerns" Him About Vaccine Distribution
"We have let our local public health system deteriorate over decades and decades. If we had it the way it should be, we would be in a much better position" to distribute the vaccine, said Fauci. "I have a lot of concerns about the vaccine. Right now the issue of supply chain and distribution is being put in the hands of the military. Which is fine because they have a lot of experience in supply chain and whatever. But in general, that's a CDC issue."
What He's Learned From COVID
"Don't ever underestimate as it evolves. And don't try and look at the rosy side of things," said Fauci. "Number two, we can do—and should always do—good, ethically sound, scientifically sound research during the outbreak. This idea of throwing everything to somebody, because it's desperate, doesn't work. It's gotten us into trouble with other diseases. So let's not forget the fact that although you want to get the best intervention to someone as quickly as possible, that there is a major role for ethically sound controlled clinical trials, we have to do that."
As for yourself, do everything you can to prevent getting—and spreading—COVID-19 in the first place: Mask up, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.