The No. 1 question for Dr. Anthony Fauci on Wednesday during the 2021 Mansfield Lecture was this: “When are we going to be back to normal?”

Fauci, who spoke to 6,000 people via Zoom during a nearly hour-long question-and-answer session moderated by University of Montana professor Rob Saldin, said he couldn’t offer a precise answer. However, the head of the National Institute of Allergy and Infectious Diseases said fall was a good bet.

“The one wild card in this that I think we need to pay attention to is the emergence of variants that could elude some of the protections of the vaccines,” Fauci said.

Scientists already are preparing to make versions of the coronavirus vaccine that can be specifically directed at those variants, he said. However, if people can overcome their skepticism, and 75 percent to 80 percent of the U.S. population gets vaccinated, life in the country may start to resemble a time before the pandemic upended everything.

“We will be approaching a degree of normality as we go into the fall,” Fauci predicted.

Once the coronavirus hit the United States last January, Fauci quickly became the top scientific voice in the country for a public anxious to hear the latest information on COVID-19. Wednesday, he answered questions from Saldin and community members for the University of Montana’s Maureen and Mike Mansfield Center lecture.

In 2002, Marshall Bloom, associate director for science management at the National Institutes of Health’s Rocky Mountain Laboratories in Hamilton, was appointed to the biomedical research center by Fauci. During the Mansfield Lecture, Bloom said Fauci was a fitting speaker for the event because of similarities he shared with the center’s namesake, Sen. Mike Mansfield, the longest serving U.S. Senate majority leader in history.

“Both of them showed true moral courage,” Bloom said. “They showed integrity — unbelievable integrity, which has followed them for decades — and a desire to really tell it like it is and be very frank about the problems that are facing us.”

During the question-and-answer period, Saldin, a former Robert Wood Johnson Foundation scholar at Harvard University and political science faculty member at UM, said everyone knew coronavirus was on its way, but he personally didn’t anticipate the extent to which it would disrupt people’s lives.

“From your perspective, has this pandemic played out in the U.S. and around the world as you expected, or has it surprised you?” asked Saldin, head of the Mansfield Ethics and Public Affairs Program.

Fauci said the outbreak surprised him. For decades, people have asked him what his worst nightmare would be as an infectious disease scientist. Fauci said he’s consistently responded with these characteristics: a new pathogen, probably a virus; one that jumps from an animal to human; one that’s respiratory-borne; one that transmits efficiently from person to person; and one that is capable of a high degree of morbidity and mortality.

In short, he had been describing the coronavirus. To date, the pandemic has resulted in 480,000 deaths in the United States and 2.4 million deaths worldwide, or the worst respiratory borne pandemic since the 1918 influenza pandemic, he said. Scientists had hoped warm summer weather would have burned out the virus, but the surge has continued, although Fauci said it is turning around “a bit.”

“Unfortunately, we are living through that, quote, worst nightmare,” Fauci said.

Kaylee Kronsperger, a student at UM, said she’s from Eureka and has shadowed doctors who see patients who are skeptical about vaccines. Kronsperger wanted to know how Fauci would recommend rural physicians convey the importance of the vaccine to people who might still refuse to wear face masks.

“There’s not an easy answer to that question,” Fauci said.

First, Fauci said it was important to respect people’s skepticism rather than criticize them. Then, he said it was important to be patient and measured and address people’s concerns step by step. For example, some people are reluctant because a vaccine is new, and in that case, they can be told it has been tested in tens of thousands of people.

Some people worry about how quickly vaccines have been developed, and Fauci attributed the speed of vaccine development — “beyond unprecedented” — to significant advances in science. He also said the process of authorizing vaccines for distribution was transparent and independent, and he noted data show the Pfizer and Moderna vaccines are 94 percent to 95 percent effective after a second dose.

“Hopefully, you will win over at least a portion of the people who have hesitancy about vaccinations,” Fauci said.

Shelly Fyant, chairwoman of the Confederated Salish and Kootenai Tribes, said Native Americans have even more reason to distrust a vaccine sent by the federal government; the government has conducted medical experiments on Native people, sterilized Native mothers, decimated Native populations, and underfunds the Native health care system.

“You have to respect the people who have that skepticism,” Fauci said. “You’re absolutely correct, not only for Native Americans, but also for African Americans and Hispanics.”

But in modern times, he said safeguards are in place to ensure ethical treatment in medicine, such as institutional review boards and data and safety monitoring boards. And Fauci said it’s even more important for Native Americans to be vaccinated because they also suffer disproportionately from COVID-19.

Underlying medical conditions such as diabetes, hypertension, and chronic lung disease mean a Native person who gets infected is more likely to experience a serious outcome, he said. A report from the Montana Department of Public Health and Human Services in December noted Native Americans make up roughly 7 percent of the state population but account for 14 percent of coronavirus infections and 25 percent of COVID-19 related deaths.

“In my mind, as a physician and health care person, it would be doubly tragic that on the one hand, you suffer disproportionately from the outbreak, but on the other hand, you do not allow yourself the advantage of the one intervention that we know absolutely is life saving,” Fauci said.

Greg Holzman, state medical director in Montana, said he has admired Fauci throughout his career. He said he and his colleagues have seen a lot of attrition in critical public health and sciencebased positions in government, and he’s concerned about the loss of people with significant scientific knowledge.

“How would you strategize to rebuild the scientific ranks within governmental public health?” Holzman asked.

Fauci, 80, said he himself still feels excited to wake up in the morning and go to work. One reason is he knows he can make contributions that benefit people in the U.S. and around the world. (Bloom said Fauci’s work on AIDS relief in Africa with U.S. President George W. Bush has saved 17 million lives in sub-Saharan Africa.)

“I think we just need to sell it a little bit better because it’s such an exciting field,” Fauci said.

In reflecting on the lessons he’s learned from the pandemic, he said the speed with which the coronavirus vaccines were developed did not happen by accident, but because of a decade or more of investment in biomedical research.

“We have been through a very, very extraordinary and historic experience that isn’t over yet,” Fauci said.