On The Unforced Errors of America’s Most Political Doctor
By Michael Brendan Dougherty - May 30, 2021
In mid March of 2020, most Americans, including those in the White House, were still trying to understand the COVID-19 crisis unfolding around them. In a span of 24 hours, the NBA came to a sudden halt when players tested positive for the virus; seemingly minutes later, the American actor Tom Hanks announced from Australia that he and his wife, Rita Wilson, had this mysterious new illness; stock markets crashed around the world; President Donald Trump declared a pause on travel from Europe; and the World Health Organization, belatedly, labeled the spread of the coronavirus a pandemic. On March 16, the Trump White House called for 15 days to slow the spread of the virus — a lockdown.
The White House coronavirus task force was meeting regularly and issuing daily briefings at that time. In the Situation Room, economic advisers began presenting their models and predictions for the economic effects of lockdown to the task force, including its leader, Vice President Mike Pence, and the president. What the advisers reported was shocking. Just four weeks of lockdown would lead to millions of Americans unemployed, extreme burdens on the public purse, and the greatest one-month contraction of the American economy since the Great Depression. A health adviser present said that, as the lights came up following the presentation, the faces of most of the advisers in the room were ashen. The gravity of what had just been said — all of which shortly came to pass — seemed to have stunned everyone into silence.
Except one man. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease (NIAID), immediately turned to Vice President Pence and asked a question that appeared to dismiss not only the imminent miseries of lockdown but the relevance of the entire subject from the proceedings: “I’m still in charge, right?”
More or less, yes, Fauci was still in charge. And he still is. Though he had spent the weeks before that day giving interviews in which he told Americans to be more concerned about the seasonal flu than the coronavirus, and that the wearing of masks by the public would be useless at protecting them from it, Fauci was cast as the face of America’s best pandemic response, the one figure who took it seriously. Fauci was the anti-Trump, possessed of a “quaint fondness for facts and evidence-based science,” according to the New York Times. Trump’s biggest supporters, sensing that Fauci was delighting in this role and despairing as they were of lockdowns, turned on the doctor, demanding he be fired. The White House began treating the administration’s most prominent medical expert as a threat, circulating anti-Fauci talking points. Which made progressives embrace him all the more. On social media your liberal friends call their COVID-19 vaccine shots their “Fauci ouchies.” Fauci became the latest warrior-saint of “the Resistance,” holding aloft the banner of science and reason.
Fauci joined the National Institutes of Health soon after graduating from medical school. He was a pioneering researcher on infectious diseases such as lymphomatoid granulomatosis and polyarteritis nodosa. He then moved into studying AIDS. He became the director of NIAID in 1984 and has held that position ever since.
Fauci first achieved something like a public profile during the AIDS crisis, becoming a hated figure among progressive gay activists who viewed him as an antagonist for his slowness and unwillingness to approve therapeutic drugs. Later, though, after Fauci relented, the playwright and activist Larry Kramer, of the AIDS Coalition to Unleash Power (ACT UP), held him up as a hero and friend. Fauci’s effort to win over activists has been described as a charm offensive that included wine-soaked dinners. The Washington Post said that it was during this phase of his career that Fauci learned his strategy of doing prolonged media blitzes. With Fauci playing a congenial doctor on television and framing all political issues as mere matters of science, politicians could, according to the Post, “launder credibility through him, all the while holding at a distance the more radioactive elements of any crisis.” The doctor said that he learned not to be political. “It’s when you get into the politics that you get in trouble,” Fauci said to the reporter Molly Roberts last year. She summed up his achievement as having “brokered a generational peace between” science and partisan politics.
But there was a price to be paid. In his AIDS memoir, Body Counts, Sean Strub points out that Fauci used his insistence on bulletproof studies to justify his mulish slowness in response to the AIDS crisis, including his fateful hesitancy to authorize therapeutic treatments for the diseases that were killing those who suffered from AIDS. Gay men turned to “buyers’ clubs” to get the drugs that their own desperate research indicated they needed. As Strub notes, by 1989, when the government approved a prophylaxis for pneumocystis carinii pneumonia (PCP), which affects people with weakened immune systems such as those with HIV, 30,534 people in the United States had died from a preventable disease over the previous decade. Michael Callen, an AIDS activist who eventually died of the disease, “estimated 16,929 of them had died between the time he went to plead for Fauci’s support and more than two years later, when the guidelines were finally issued,” Strub writes. Some of the themes Strub delineates in Fauci’s conduct during the AIDS crisis seem to have been repeated in COVID: the prioritization of a vaccine over therapeutic treatments, a refusal to take bold action in the face of a crisis, and a bureaucrat’s comfort with a slow process of updating guidance, even as people languish or die. The saving difference is that this time the vaccines came through remarkably quickly.
Fauci is an unusually hardy and long-lived survivor in Washington. But the people who look up to him as merely “America’s doctor” or a mere public-health adviser may not quite understand the power wielded by the National Institutes of Health and his agency within it. NIH dispenses up to $32 billion a year for biological and medical research, much of the funding in the form of long-term grants that are not just necessary for worthwhile scientific research but desperately needed for researchers’ academic job security. In the United States, biologists and other medical researchers whose grant proposals are approved are usually expected by their universities to cover their own costs, including salary for research teams. The NIH — its decisions about who gets funding and for what — is why, say, worm researchers end up studying worm aging rather than worm evolution . . .