Fauci's comments come as the US passed 7 million confirmed cases of Covid-19, according to data from Johns Hopkins University. More than 203,000 people have died.
Despite the prediction, Fauci says it could still be a while until everything returns to pre-Covid normalcy.
"By the time you get enough people vaccinated so that you can feel you've had an impact enough on the outbreak, so that you can start thinking about maybe getting a little bit more towards normality, that very likely, as I and others have said, will be maybe the third quarter or so of 2021. Maybe even into the fourth quarter," Fauci told Dr. Howard Bauchner, the editor-in-chief of the Journal of the American Medical Association, in an online conversation.
Fauci noted that with the different vaccines being developed, the US could potentially have 700 million doses by April 2021, but the availability of vaccines is not the only factor at play.
"In our society, it likely will be that many people will not want to get the vaccine right away and want to wait to see what happens with the first 10, 20, 30, 40, 50 million people," he said.
It's unlikely that political interference will play a role in the approval process of a Covid-19 vaccine, Fauci said.
"If you look at the standard process of how these things work, I think you could feel comfortable that it is really unlikely that that's going to happen," he said. "I trust the career scientists of FDA, and I certainly trust the commissioner of FDA."
It took the US just 25 days to record another 1 million cases after marking the 6 millionth case on August 31. It's been just over eight months since Johns Hopkins recorded the first US case of Covid-19 on January 22.
Only three other countries in the world have reported more than 1 million Covid-19 cases, according to Johns Hopkins: India with more than 5.8 million, Brazil with more than 4.6 million and Russia with more than 1.1 million.
The US hit 7 million cases the same day that 23 states, most across the US heartland and Midwest, reported an increase of new cases compared to the previous week, according to a CNN analysis of Johns Hopkins data.
Case numbers in about 16 states are holding steady, while 11 -- Arizona, Connecticut, Delaware, Hawaii, Indiana, Maryland, Ohio, Pennsylvania, South Carolina, Vermont and Virginia -- saw a decline.
California became the first state to surpass 800,000 infections, according to Johns Hopkins data. Texas is second, with about 747,500 cases, followed by Florida with some 695,000 cases.
Nationally, the rate of new cases is up 9% from last week, with a seven-day average of more than 43,000 cases nationwide.
Fauci warned that the current level of coronavirus spread could present a challenge heading into the fall and winter.
"You don't want to enter into the fall and winter with a community spread at that level," Fauci told the editor-in-chief of the Journal of American Medical Association in an online conversation Friday. "Because if you do, you got a difficult situation that's going to be really challenging."
That challenge could include surges of Covid-19 cases across the country as more fronts open up, including the many schools and colleges nationwide that have welcomed students back to class. And as the weather gets cooler, more gatherings will move inside, where the virus can spread more easily.
"You're going to have to do a lot of things indoors out of necessity of the temperature, and I'm afraid, with that being the case, if we don't carefully follow the guidelines ... the masking, the distance, the crowds, that we may see another surge," Fauci said.
More than 90% of the population remains susceptible to the virus, US Centers for Disease Control and Prevention Director Dr. Robert Redfield said this week.
States are now seeing a rise in mask usage
Despite his state's rising cases, Florida Gov. Ron DeSantis on Friday announced he had signed an order moving Florida into Phase 3 of its reopening, allowing restaurants and bars to fully reopen at 100% capacity.
"There will not be limitations from the state of Florida," the governor said in a news conference.
Additionally, the governor suspended any outstanding fines and penalties for pandemic-related mandates, like mask requirements.
Elsewhere, New York City Mayor Bill de Blasio announced that the city's outdoor dining would become permanent. The arrangement has allowed restaurants to use sidewalks and streets for seating. New York Deputy Mayor for Operations Laura Anglin credited it with saving jobs and called it a "lifeline" for the struggling restaurant industry.
The announcement comes as indoor dining, with limited capacity, is set to begin next week.
Cities, counties and states that have managed to bring their Covid-19 cases down should now work to prevent "surges that inevitably will occur if you're not doing the kinds of public health measures that we're talking about," according to Fauci.
Those measures include what experts have for months vouched for: face coverings, hand-washing and avoiding crowds.
About 12 states are now seeing mask usage rates above 50%, according to researchers from the University of Washington's Institute for Health Metrics and Evaluation (IHME). Those include California, Colorado, Florida, Maryland, Mississippi, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, Washington and West Virginia.
If 95% of Americans wore masks, more than 95,000 lives could be saved by January, the IHME projects.
And there's another tool that could make the next months easier: the flu shot. The US has ordered about 200 million doses of that vaccine, Fauci said, the highest amount officials have ever tried to vaccinate. Public health officials say fewer people battling the flu this year will reduce that burden on health care professionals that are also trying to treat Covid-19 patients.
"If we listen to the public health measures, not only would we diminish the effect of Covid-19, we might get away with a very, very light flu season if we combine that with getting the flu vaccine," Fauci said.
The continued spread of the coronavirus is driven by young people, Fauci reiterated.
"I don't want to seem preachy about it," he told New Jersey Gov. Phil Murphy during a livestream Thursday on Facebook. "But right now, the infections in the country are driven more by young people, 19 to 25."
"We are all in this together. And we're going to end it together. And when we end it, then you can get back to your normal life. But you got to end it first," he said.
Skepticism of Covid-19 vaccine an 'enormous' problem
While vaccines for Covid-19 are being tested, the growing skepticism around them is becoming an "enormous" problem, according to Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center.
It's a problem, Schaffner says, "because once we do develop a vaccine, obviously we want people to accept it, but there's growing skepticism ... in the general population."
US health experts have previously said it's likely many Americans will opt out of getting the Covid-19 vaccine once one is widely available. Over the summer, former US Surgeon General Dr. Vivek Murthy told CNN if a vaccine was available, half of all Americans wouldn't get it because of a lack of trust.
And now 62% of Americans believe political pressure from the Trump administration will cause the US Food and Drug Administration to rush approval of a Covid-19 vaccine before Election Day, according to a new health tracking poll from the Kaiser Family Foundation. If a Covid-19 vaccine was ready and available for free before the upcoming election, just 54% of respondents said they would not get one and 42% said they would.
Meanwhile, a new study found that as of July only about 9.3% of people in the US had antibodies to the virus. Scientists, led by Stanford University's Dr. Shuchi Anand, looked at blood work from dialysis patients in 46 states.
"The number of people with antibodies is still low and we haven't come close to achieving herd immunity," said Dr. Julie Parsonnet, one of the authors of the study. "Until an effective vaccine is approved, we need to make sure our more vulnerable populations are reached with prevention measures."
The researchers also were able to see who was more likely to have antibodies. The study found that, compared to the White population, residents of predominantly Black and Hispanic neighborhoods were two to three times more likely to have antibodies; people living in poorer areas were two times more likely; and those living in the most densely populated areas were 10 times more likely.
Fauci said Thursday he would back scientists at the FDA on whatever their decision is regarding approving a Covid-19 vaccine or giving it an emergency use authorization.
"These are respected, trained people who are much better at models and statistics and all that other stuff than any of us are," he said during an online conversation with CNN Chief Medical Correspondent Dr. Sanjay Gupta organized by Emory University.
"If they look at it and say, 'We really feel strongly we should go this way,' I would back the scientists. I would have to do that, as a scientist, and I would express that."
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