Michael Specter reflects on outgoing Dr. Fauci's career, political battles, and fight for public health
One of the leading figures in America’s response to the coronavirus pandemic will soon leave the federal government. Dr. Anthony Fauci is stepping aside in December. The octogenarian is the nation’s top infectious disease expert and serves as President Biden’s chief medical adviser. Fauci has been the longtime head of the National Institute of Allergy and Infectious Diseases.
And as with his earlier work responding to HIV/AIDS, Fauci has sometimes found himself at the center of a political firestorm during this latest pandemic. Journalist and author Michael Specter, a “New Yorker” staff writer, knows Fauci well, having covered him for decades, including the 2020 audiobook “Fauci.”
Were you at all surprised by Tony Fauci ‘s announcement that he'll leave his position?
No, I mean, honestly, I don't know this for a fact. But I'm pretty sure had there not been a pandemic he would have left a couple of years ago. I think once the pandemic started, he felt committed to seeing it through to the degree that we can ever say it has been seen through.
Do you feel that he's leaving at an appropriate time of the state of COVID-19? I mean, it seems based on his statements that he expects COVID will be with us for a while.
I think, for many reasons, both good and bad, mostly bad, this is becoming a somewhat endemic, infectious disease. So I don't think there'll be any good time for Tony to leave if the requirement is that he stay until it disappears, because that's like saying I'll leave as soon as influenza is no longer an issue. I think he's done what he can do. He's 82. It is also true that he is under constant, vicious, incomprehensibly awful attack. And I think people can only take so much of that.
You've catalogued moments in his career when he was under severe pressure, especially during HIV/AIDS. But is it your sense that this sort of politicization of his job during the pandemic came as a surprise to him?
Yeah, I think it did. And I think it came as a surprise to many people, or at least the ferocity of it. I mean, there's a real difference between — he was hated for a while during the AIDS epidemic, because he was seen somewhat correctly as the sort of tip of the government spear. He was the guy you would attack if you were unhappy with the government and AIDS activists had every reason to be unhappy with the government. But he actually listened to what they said and changed his position 180 degrees, and those people came, and the ones who are still alive, they are his friends, they think highly of Fauci because Fauci looked at the science and said, Wow, we're doing this wrong. I don't think that's what this volley of vicious attacks is about.
Can you remind people who might not remember specifically, which policy he changed during the HIV/AIDS epidemic?
Well, he changed a lot of them. You have to remember at the beginning of the, of the epidemic, it was mostly among gay men. The President of the United States was Ronald Reagan, at the time, he didn't mention the word AIDS until five years into the epidemic after many people were dying. They were not given federal health benefits. If you were the lover of a person with HIV, and that person died, you not only had no spousal rights, you often couldn't go to the funeral, depending upon the parents. And Fauci’s biggest thing was people went to him and said, Look, we're dying. There's nothing for us. But to die and you're testing all these drugs. Once we know that the drugs are safe, maybe before we know they're effective, why can't we at least try them? We have nothing else, everything to lose and there's no reason we shouldn't do that. And Fauci did buy that and he set up a program with a lot of help from the activists called the parallel track, which meant serious testing would go on. But if you were in a situation where you were either gonna die or maybe these drugs would help you, you could take the drugs and that was an absolutely major change in medical attitudes in the way the federal government dealt with experimental drugs.
You know, it's interesting thinking of that example in the context of the COVID-19 pandemic, where a lot of the criticism Fauci has gotten has been about changing guidance or changing his outlook on the state of the pandemic. And he's been labeled as by some people as sort of inconsistent, but it sounds like you're saying being open minded is a big part of his success.
Yeah, I mean, I think one of the problems we have in medicine is in public health, and the medical establishment is somewhat responsible for it, and so is my beloved profession of journalism. We've built this sort of meaning that if a doctor tells you something's wrong, or right, or they can fix it with a mask, or a shot or a drug, we assume that's what will happen. And it's like an on and off switch. But medicine isn’t physics, it doesn't work that way. And usually, you take one step forward, and one step back, then three steps forward and one step back. So early on in the pandemic, he said, there doesn't seem to be a reason why we should wear masks, and he got a lot of crap for that. I know at the time he was right; I think it might have been better for him to say we need those masks for medical personnel and it just isn't clear yet whether they'll be helpful. But the idea that he changed his mind, or depending upon how vicious you are, that he outright lied, that's just not true. I mean, you go along with the best information you have, when you get better information, you use that. That's what the scientific process is.
You know, for a lot of reasons, America's response to COVID has not been perfect. We've lost millions of people, the vaccination numbers have lagged. How would you grade Tony Fauci leading us through this last couple of years?
Oh, that's a really difficult question, because it implies that he had the agency to make all sorts of decisions. I think he was a really powerful leader. And really important early in the pandemic, when we were all frightened before there was a vaccine. We just didn't know what was happening. And most of what we did know was bad. He had to deal with a president who stood before the American people repeatedly and flat out told them lies. And so it's hard to say that you led the response when Donald Trump was saying, there's a miracle drug called hydroxychloroquine, just get that and you'll be fine. When in fact, not only was that drug not helpful, it actually killed some people. So I mean, I'm not trying to give him a pass. I think he could have done some things better. But I think by and large, when he said something, it was believable, because it was based to the best of his knowledge on the truth and the facts.
Let's go back. How did you get to know him in the first place and start writing about him?
I was at the ‘Washington Post’ early in my career, and it was the semi early-days of AIDS. And they asked me if I wanted to sort of be the first beat reporter covering AIDS. That should have happened at places like the ‘Post’ and the ‘Times’ a couple of years before it did, but at least it happened. And when I started, it was about six or eight months into the time that Fauci had become director of the Institute of Allergy and Infectious Diseases, which was the institute that looked at HIV. So he quickly became the spokesperson for a lot of this because he's pretty articulate, and he likes to answer questions. And it's probably not shocking for you to learn that he likes talking to the press. So I got to know him. And then over the years as I switched papers, and then magazines and various pandemics from SARS and bird flu, to H1N1 to COVID, he's been the guy that you talk to for the government point of view.
Do you have any sense of what he plans to do next? He has said he's not really retiring, he's just leaving this position.
I mean, I honestly don't have special sense beyond what he said. I think he is working on a book that's more of a general memoir, rather than sort of scientific text of which he's contributed to many. I imagine he's going to do something crazy, like take the odd vacation, spend some time with his wife, see his children, do what people do after 55 years of working 18 hours a day. And I imagine he'll be out there speaking to some degree. But I don't think he has a like special Plan B, I don't think you'll find him the dean of a medical school or something, because I think he doesn't want to do that anymore.
Is there somebody in America who can take his place as a voice for a lot of people of authority and who brings decades of experience with various diseases? I mean, is there going to be someone else we can look to, heaven forbid, when the next one comes?
Look, replacing someone who has been so out front for so many decades is going to be difficult. He has been in that position through seven presidential administrations. And though he is not a political individual, you don't last that long if you don't have some sophisticated sense of politics. Yeah, I think there are people out there who will be good. Will they be famous instantly? And as believable or hated instantly as Tony? I don't know, I don't think so. But there are lots of talented public health servants who are out there who could do that job well. And you have to remember, his Institute is a very specific one devoted to a particular kind of illness. And he's been throughout his life as a researcher. So one of the things they're going to have to decide is do they want to go that route and have an important person doing research? Or do they want to go more the public health route? And my guess is they'll pick a person who's an outstanding researcher.
Do you worry that our trust in public health institutions, as a country has eroded to the point where people like Tony Fauci who should be listened to or are in positions where they should be listened to just don't have the credibility that they once did going forward?
Worry implies that I wonder if that's happened. Yeah, It bothers me every single day, it's what I do for a living. I wrote a book more than a decade ago called ‘Denialism,’ which was about people turning away from scientific values. I never thought that a decade later things would be much, much worse. But we have a tremendous, tremendous lack of trust and authority. Some of that is obviously warranted. But when you look at our vaccine record, I mean, these vaccines are the most successful vaccines ever developed in the most rapid timescale. And yet, many, many Americans won't get vaccinated, even those who do are not getting boosted. And some of that is because people again, think, Well, I get the vaccine and I still get sick, but they don't go to the hospital and they don't die. And that's the best you can hope. So yeah, I worry about it tremendously, because I kind of feel like if you develop something as good as this vaccine is, and it's still a matter of fierce public debate, or the fact that wearing a mask is some political thing, yeah, we have huge problems. Huge.
It occurs to me to ask a follow up there. We’re both in New York state where a case of polio was confirmed for the first time in about a decade in the country and subsequent wastewater testing around the lower Hudson Valley and New York City has shown further spread of the poliovirus. What's your reaction to that?
Well, I'm appalled. In that book I just mentioned, I sort of say, Gee, we could have polio, again, because polio is an infectious disease. And if you have it in you’re in Pakistan, or some other country, and you get on a plane, and you land in New York 12 hours later, or 18 hours later, you don't know necessarily you're infected. That's how these diseases work. And the way to ward that off is to have a vaccinated population. And the polio vaccine is very powerful. And it changed the way Americans lived when it was introduced. But now people don't remember that. And now polio is back. And I think it's inevitable we'll see more cases of polio, because once the virus is out there, it's out there. And that is a disgrace. Any person who becomes sick from polio, paralyzed or dies, that's just an outrage because it shouldn't happen.
Anything I didn't ask you that you'd like to add?
The only thing I would add is I hate to be negative. And I think there are an enormous number of people doing fantastic medical research and public health work, and we will move forward. I just wish that it was an easier kind of motion than it is.