Aged 79, Anthony S Fauci has run the National Institute of Allergy and Infectious Diseases for 36 years, through six administrations and a long procession of viral epidemics: HIV, SARS, avian influenza, swine flu, Zika, and Ebola among them.
The New Yorker writes that just before midnight on 22 March, the president of the US prepared to tweet. Millions of Americans, in the hope of safeguarding their health and fighting the rapidly escalating spread of COVID-19, had already begun to follow the sober recommendation of Fauci, the country’s leading expert on infectious disease.
Fauci had warned Americans to “hunker down significantly more than we as a country are doing.” Donald Trump disagreed. “I would love to have the country opened up, and just rarin’ to go by Easter,” he said on Fox News. “You’ll have packed churches all over our country. I think it’ll be a beautiful time.”
With the Easter holiday just a few weeks away, there was not a single public health official in the US who appeared to share the president’s rosy surmises. Fauci certainly did not.
As a member of the administration’s coronavirus task force, Fauci seemed to believe that the government’s actions could be directed, even if the president’s pronouncements could not.
The New Yorker report says at White House briefings, it has regularly fallen to Fauci to gently amend Trump’s absurdities, half-truths and outright lies. No, there is no evidence that the malaria drug hydroxychloroquine will provide a “miracle” treatment to stave off the infection. No, there won’t be a vaccine for at least a year. When the president insisted for many weeks on denying the government’s inability to deliver test kits for the virus, Fauci, testifying before Congress, put the matter bluntly. “That’s a failing,” he said. “Let’s admit it.”
Since his days of advising Ronald Reagan and George HW Bush, Fauci has maintained a simple credo: “You stay completely apolitical and non-ideological, and you stick to what it is that you do. I’m a scientist and I’m a physician. And that’s it.”
He learned the value of candour early. “Some wise person who used to be in the White House, in the Nixon Administration, told me a very interesting dictum to live by,” he is quoted as saying in 2016. “He said, ‘When you go into the White House, you should be prepared that that is the last time you will ever go in. Because if you go in saying, I’m going to tell somebody something they want to hear, then you’ve shot yourself in the foot.’ Now everybody knows I’m going to tell them exactly what’s the truth.”
The report says Americans have come to rely on Fauci’s authoritative presence. In one national poll, 78% of participants approved of Fauci’s performance. Only 7% disapproved.
According to David Relman, a microbiologist at Stanford University who for years has advised the government on biological threats: “Tony has essentially become the embodiment of the biomedical and public-health research enterprise in the US. Nobody is a more tireless champion of the truth and the facts. I am not entirely sure what we would do without him.”
According to The New Yorker report, the COVID-19 epidemic will eventually fade, but the public will demand a reckoning. Inevitably, there will be an investigation, along the lines of the 9/11 Commission, to look into the ramifications of the president’s denialism, the shortages in testing and medical equipment, and the dismissal of so many warning signs.
The report says Fauci will not necessarily escape criticism. He is an excellent spokesperson for the value of scientific research, but he runs a single institute, and he lacks the authority to broadly reshape our response to pandemics. “The kinds of things we really desperately need as foundational tools for dealing with this stuff aren’t necessarily research enterprises,” Harold Varmus told me. “Tony isn’t running CDC He’s not running FEMA. To tell him to stockpile defence mechanisms or to move forward surveillance tools into massive operations around the world – that’s just not his remit.”
The report says even Fauci’s current value as a scientific adviser has been limited by the President’s contempt for expertise. Trump’s coronavirus kitchen cabinet consists of people like his son-in-law, Jared Kushner, who has no medical knowledge or experience managing crises – yet has been appointed to direct the response to the biggest medical emergency since the influenza pandemic of 1918. Trump has also turned for advice to Dr Mehmet Oz, who for years has endorsed worthless treatments and used his television show to promote notorious quacks. Trump even seems to think that his trade adviser, Peter Navarro, should debate Fauci about the value of specific drugs. When Navarro, who has a doctoral degree in economics, was asked about his medical qualifications, he said, “I have a PhD And I understand how to read statistical studies, whether it’s in medicine, the law, economics, or whatever.”
The report says to plan a coherent biological future, rather than simply scramble to contain each new pandemic, will require an entirely new kind of political commitment. It would certainly include the creation of a permanent position, a special assistant to the President for biological defence. Similar jobs have existed in the past, but not for long, and not with enough influence to matter. Relman at Stanford says: “This kind of job needs somebody with the authority to preside over domestic and international threats, both natural and deliberate. And that person has to sit in the White House with immediate access to the President. Without that, we will really have nothing that can work.”
Until then, the report says, “we have Fauci, a seventy-nine-year-old infectious-disease expert pinned between Donald Trump and the American people. It can’t be easy. As Fauci recently put it, with characteristic candour: ‘I give the appearance of being optimistic. But, deep down, I just do everything I possibly can, assuming that the worst will happen, and I’ve got to stop the worst from happening.’”Full New Yorker report