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Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said the U.S. still remains far from controlling the Covid-19 pandemic in a virtual lecture at the Harvard T.H. Chan School of Public Health on Friday afternoon.

Fauci delivered the school’s 173rd Cutter Lecture on Preventive Medicine, this iteration focused on lessons learned and ongoing challenges posed by the pandemic. The Cutter lectures, which are the oldest lecture series in epidemiology and preventive medicine, began in 1912.

Fauci’s address — which was moderated by HSPH Epidemiology chair Albert Hofman — focused on the epidemiology, virology, and transmission of the novel coronavirus, along with his predictions and priorities for containing future viral transmission.

“When you have a pandemic, there are different phases,” Fauci explained. “The pandemic phase — which is the explosion that we’ve all been through — then there ultimately has to be a deceleration in the acceleration of cases. Then there’s control, elimination, or eradication.”

Fauci said the level of viral control necessary for Americans to return to pre-pandemic life is still distant, given the country’s current daily infection rate.

“One thing for sure is that 115,000 cases a day and over 1,000 deaths is not an acceptable level of control,” he said.

Fauci highlighted vaccination mandates as one important strategy to restrain viral transmission going forward.

“A combination of getting more people vaccinated, even if that requires vaccines that have to be required — namely required for employment, required in the federal government, or what have you — we’ve got to do better with vaccines,” he said.

Vaccine hesitancy has held back the U.S.’s efforts to inoculate significant swaths of its population. Fauci acknowledged that some of that hesitancy stems from public concerns over the novelty of mRNA vaccines.

“When we made the decision to make a major investment in mRNA for Covid, we actually got some significant criticism from people who were saying, ‘With such an important, historic outbreak, how could you try a vaccine that has never ever been shown to be effective for anything until now?’,” he said.

Fauci — who has become the federal government’s most recognizable face in its fight against the pandemic — said he has borne the “brunt” of these criticisms, so he “feel[s] really good about celebrating the extraordinary success” of developing reliable and effective mRNA vaccine technology.

“The general public doesn’t know that that platform technology and the immunogen design was the result of two decades of investment in basic biomedical research,” he said. “It wasn’t something that we just decided on at the last minute, that’s for sure.”

With the rise of the Omicron variant, Fauci highlighted the importance of global access to vaccines to diminish the potential for further outbreaks of viral mutations.

“We’ve got to vaccinate the rest of the world, particularly low- and middle-income countries,” he said. “Until we have a truly global response to this global pandemic, we will not be able to control it in a global manner.”