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NIH Director On The State Of The Pandemic In The U.S.

MARY LOUISE KELLY, HOST:

As we near 400,000 deaths from COVID-19 - 400,000 - the question on many people's minds is, how long before I can get vaccinated? It has been five weeks since the FDA granted emergency authorization for a COVID vaccine. Fewer than 11 million people have gotten doses. That's according to the latest numbers from the CDC. And the waiting game is playing out as new strains of the virus are popping up. Well, joining us now is Dr. Francis Collins. He is director of the National Institutes of Health.

Dr. Collins, welcome back. Good to speak with you.

FRANCIS COLLINS: Nice to speak with you, too, Mary Louise. Glad to talk about these issues.

KELLY: Yeah. So let me start with this number - 11 million people vaccinated. I'm guessing this is not where you hoped the country might be five weeks after emergency authorization for a vaccine. Are you disappointed by how slowly it's gone so far?

COLLINS: Well, I think everybody is disappointed and frustrated that the initial steps didn't go as smoothly as they had been hoped for, but I think we are beginning to see some of those problems addressed. And, gosh, the last couple of days of last week reached almost 900,000 inoculations per day. So that's getting pretty close to the 1 million a day, which is the goal that we hoped we would get to a little before now. But we're on the path, so watch that space closely. CDC now has the ticker that you can look at every day. And let's whether we might get on the right track...

KELLY: I'm looking at it every day. I think a lot of us have it bookmarked. Yeah.

COLLINS: (Laughter) Yes, we do. (Laughter) I do, too.

KELLY: Can you figure out what the holdup has been? Is it supply? Is it that federal guidance should have been more robust five weeks ago?

COLLINS: I think it is not so much supply. Again, that same CDC website says 31 million doses have been distributed, but only 12 million have been administered. So we still have a problem getting the doses into people's arms. Every state had a plan. And let's be clear. Those plans maybe weren't as effectively administered as they might have been. But I think the time now is coming for this to be more coordinated across the country and certainly beginning to get vaccination programs in large settings like stadiums and certainly in pharmacies, as opposed to having them only in specialized places like hospitals for health care providers. That's where we need to go.

KELLY: Right. This is part of the incoming plan from incoming President-elect Biden. He says he's going to manage the hell out of the vaccination operation. That's a direct quote. And he's talking about what you just nodded to - mass vaccination sites, getting more medical personnel out in the field to get the shots into people's arms. How soon might we see results?

COLLINS: I think already that momentum has been started. Certainly, as somebody who's now bridging between the Trump administration and the Biden administration - and very happy and honored to be able to do so - some of these steps have already gotten started before next Wednesday's inauguration. But I think they'll get an additional push - may I say a shot in the arm - from the enthusiasm of the new president, who is going to manage the hell out of this. And we're ready for that.

KELLY: Let me turn to these reports of new strains of the coronavirus. California is reporting it has found a variant, a different variant than the one we've heard about that has spread through the U.K. In California, they don't know if that one is more contagious than the strain that has been circulating. How worrying is this?

COLLINS: Well, it's another example of the fact that this virus does change over time. It doesn't change with incredible speed, but because there is so much of this virus around the planet that even an occasional change - a mutation, if you will - is likely to turn up. And if it has any kind of advantage in terms of being transmitted a little bit more easily, then we start to see more of it. The one in California - I'm not sure yet whether what they're seeing in terms of the numbers indicates it's more transmissible. This may just be one that ended up in a lot of superspreader events, which means then you're going to see a lot of cases, even though it was more the superspreader event than the transmissibility. But we've got to watch this closely. This one called L452R is now on our radar.

KELLY: Let me ask a question that plays to your specific expertise as a geneticist. Are you concerned that the U.S. is not doing enough genetic sequencing to know which variants are gaining ground, how they're moving from place to place, how fast they may be changing?

COLLINS: I have been quite concerned about that, Mary Louise. And I think CDC is now responding rather rapidly by ramping that up, getting thousands of samples every month from the states. They put out a contract to a couple of companies, Aluma and LabCorp, that basically have the ability to do this very efficiently. You're going to see a big uptick in the amount of data on viral genome sequences, and that's what we need. And then we also need to coordinate all of the functional studies that are done on those variants to see, will this affect the vaccine? Will it affect the monoclonal antibodies? And that is something we are working very hard right now not just to do that work but to correlate and coordinate and put out in a public database all of that information that's being derived by industry, by academic labs and by government. We need to be all over this one.

KELLY: You just touched on, I'm sure, the question that's on a lot of people's minds. Do we know whether the vaccines currently being administered will be effective as the virus mutates?

COLLINS: So a lot of that work is being done. I just saw a paper a couple hours ago that's posted in one of the preprint servers. It is fairly reassuring what we've seen right now about the vaccines and the responsiveness to the U.K. variant, the one that has caused so much concern there, and also to the South African variant, which is another one we're watching very closely.

KELLY: Sure.

COLLINS: And it does look as if there may be a slight downgrading in the vaccine's effectiveness but probably not enough to make a lot of difference. At least that's the data so far. We're pretty reassured about that but lots more to come.

KELLY: We just have a minute or so left. But we have these two vaccines, the Moderna and the Pfizer-BioNTech vaccine. They're out there. They are making their way into people's arms. We're told a third and fourth are coming soon, the Johnson & Johnson and AstraZeneca. How soon? And are they as effective as the ones already out here?

COLLINS: Well, we don't know, that's why we do the phase 3 trials. The Johnson & Johnson-Janssen vaccine is going to be pretty close now to unblinding the data and looking to see exactly how effective was it. We should know something more about that in the next couple of weeks. And we all have our fingers crossed because, boy, it would be great to have another vaccine with very high efficacy, but we don't know yet. AstraZeneca is a bit behind, probably another three or four weeks after that.

KELLY: All right. That is Dr. Francis Collins, director of the National Institutes of Health.

Always good to speak with you. Thanks for your time.

COLLINS: Glad to talk to you. I'm glad to talk about this at any time. It consumes my life and probably consumes the life of a lot of Americans right now.

KELLY: Absolutely. Top of everyone's mind right now. Thanks again. Have a good one.

COLLINS: All right. You too. Transcript provided by NPR, Copyright NPR.