Dr. Fauci's Legacy
Dr. Marty Makary on the public health risk of putting America's fate in the hands of one doctor.
Anthony Fauci is ending his long and celebrated government career by being widely lauded for getting so much so very wrong on Covid-19.
Now 81 years old, Dr. Fauci has spent 38 years as head of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. He has been rightly honored for his many contributions over the decades, most notably during the fight against AIDS, for which he was awarded a Presidential Medal of Freedom by George W. Bush. But to Covid-19 he brought a monomaniacal focus on vanquishing a single virus, whatever the cost—neglecting the damage that can follow when public health loses sight of the public’s health.
As the lead medical authority to two administrations on Covid-19, Dr. Fauci was unwavering in his advocacy for draconian policies. What were the impact of those policies on millions of Americans? And what would the country look like now had our public health experts taken a different approach? As Dr. Fauci is preparing to leave his post, those are a few of the questions worth asking as we consider his various Covid-19 legacies.
Very early on in this pandemic, we knew that there was an extremely stratified risk from Covid. The elderly and those with co-morbidities were especially vulnerable, while children were extremely unlikely to get dangerously ill.
Instead of acting on the good news for children—or drawing on the ample experience in Scandinavian and European countries where schools were open and students were without masks—American kids were seen as vectors of disease. Young children were forced to wear masks inside school and out, affecting the language and social development of many. The effects of school closures will play out for decades, but we already know that children suffered major learning loss, and many left school never to return. Throughout the pandemic, Dr. Fauci supported the most oppressive restrictions for children, including school closures and mandatory cloth masking.
Yesterday on Fox Neil Cavuto asked Dr. Fauci whether Covid restrictions “went too far” and if they “forever damaged” the children “who couldn’t go to school except remotely.” Dr. Fauci replied: “I don’t think it’s forever irreparably damaged anyone.”
Parents know otherwise.
A generation is coping with learning loss, and the impact has been the worst in poor and minority communities. According to the Brookings Institute, test-score gaps between students in low-poverty and high-poverty elementary schools grew by approximately 20 percent in math and 15 percent in reading over the pandemic. Meantime, anxiety and depression have hit record highs among young Americans, and the surgeon general has described a youth mental health crisis. Of all of Dr. Fauci’s legacies, this might be the gravest.
Dr. Fauci let basic research questions about the nature of the Covid-19 virus go unanswered. Somehow, despite the NIH’s more than $45 billion budget, only 2 percent of grants went to basic Covid research while billions of federal money was invested in developing vaccines, according to a study conducted by my colleagues at Johns Hopkins and I.
The federal government failed to conduct timely studies on the following: masks; the susceptibility of people in nursing homes; natural immunity; wastewater data; vaccine-induced heart injury in young people; and the optimal interval between the first two vaccine doses.
In short, Dr. Fauci didn’t deliver the basic research we needed so that public policy would be shaped by the best science. Because policymakers lacked good evidence to support their dictates, political opinions filled the void. So Covid-19 became a highly politicized health emergency—to all of our detriment.
On Natural Immunity:
One of the most inexplicable decisions by Dr. Fauci and his team was to ignore natural immunity—that is, the immune response generated by contracting Covid-19. As the evidence mounted that having had the virus was as good as—perhaps even better than—a vaccine, Dr. Fauci and his circle ignored it.
When Dr. Sanjay Gupta asked Dr. Fauci in the Fall of 2021 on CNN: “As we talk about vaccine mandates, I get calls all the time, people say I already had Covid, I’m protected, and now the study says even more protected than the vaccine alone. How do you make the case to them?” Dr. Fauci answered: “I don’t have a really firm answer for you on that.”
Hundreds of studies have now shown that natural immunity is better than vaccinated immunity and that the level of protection vaccines have against severe disease is at the same level of natural immunity alone.
But Dr. Fauci didn’t talk about it.
Americans had circulating antibodies against the virus, but they were antibodies that Dr. Fauci seemed to ignore. The upshot was that thousands of Americans lost their jobs for their choice not to get vaccinated. Some of those Americans were nurses, pilots, truck drivers, and dock workers central to the American supply chain of food, medication, and other essential products. This summer, more than 60,000 National Guard and Reserve soldiers who refused the Covid-19 vaccine were not allowed to participate in their military duties and lost pay and benefits. All of these people should have their jobs reinstated.
Any physician who has met Dr. Fauci will agree that he is one of the kindest, most charming human beings you will ever meet. That’s why it was so jarring to witness the way that he and Dr. Francis Collins, his close friend and former director of the NIH, denigrated dissent on Covid-19.
Just ask the authors of the Great Barrington Declaration—the open letter published in October 2020 that called for focused protection of the most vulnerable instead of blanket shutdowns of schools and businesses. It was authored by Dr. Jay Bhattacharya of Stanford, Dr. Sunetra Gupta of Oxford, and Dr. Martin Kulldorff, then of Harvard, and it was signed by tens of thousands of doctors and scientists.
Drs. Fauci and Collins never talked to these prominent authors to discuss their differing points of view. Instead, they criticized them.
Four days after the Great Barrington Declaration was published, Dr. Collins sent an email to Dr. Fauci in which he called the authors “fringe epidemiologists.” “There needs to be a quick and devastating published take down of its premises,” Dr. Collins wrote. “I don’t see anything like that on line yet—is it underway?” Dr. Fauci replied: “Francis: I am pasting in below a piece from Wired that debunks this theory.” Soon after, big tech platforms like Facebook and Google followed suit, suppressing their ideas and falsely deeming them “misinformation.”
The ultimate irony is that federal officials are now endorsing many of the policies the Great Barrington Declaration authors suggested, insisting schools stay open and quietly ending isolation and quarantine requirements. In the end, Sweden, which adopted many principles in the Great Barrington Declaration, had roughly half the Covid deaths as Michigan, despite having the same population, percent of elderly, and climate.
If dissent had been welcomed from the start—which is what science demands—a lot of suffering could have been avoided.
Here’s what Dr. Fauci and other public health authorities could have been saying from the start: We strive to provide you with the best information and recommendations, but in the face of an emergency we will surely make mistakes. We will sometimes change our minds. We may even reverse our guidance. But we will always own up to our mistakes, explain our policy changes and strive to do better. Instead, Dr. Fauci admitted to telling noble lies.
Covid brought us the concept of “The Science.” Dr. Fauci famously said last year: “Attacks on me, quite frankly, are attacks on science.” But no person embodies science. To suggest as much betrays a cast of mind that is entirely at odds with science itself.
George Washington was onto something when he decided to limit his presidency to two terms. New leaders don’t just avoid the risk of too much power concentrated in the hands of one person or group, they also bring new ideas. New perspectives are especially important to accelerating scientific inquiry by challenging deeply held assumptions. In his long tenure, Dr. Fauci made tremendous contributions, but during this crisis we needed someone at the top who took a broad view of how to fight a novel virus, and made recommendations based on weighing the direct and indirect consequences to society.
How to Regain Trust:
We now face the threat of a future pandemic in a country in which a large number of people no longer trust public health authorities. What happens when we have a novel, highly contagious, airborne virus with a much higher fatality rate than that of Covid-19?
We desperately need to rebuild public trust now. That begins by having public health officials apologize for being dogmatic in their pronouncements, when the correct answer should have been: “We don’t know.” One lesson we should all learn from Covid-19 is that we should not put our entire faith and trust in one physician.
Dr. Marty Makary is a public health expert, a professor at the Johns Hopkins University School of Medicine, and the author of the bestselling book The Price We Pay.
His last piece for Common Sense was about top doctors and scientists at the NIH, FDA and CDC who are alarmed at the direction of those institutions. Read it here.
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