In his most extensive interview yet, Anthony Fauci wrestles with the hard lessons of the pandemic — and the decisions that will define his legacy.
It was, perhaps, an impossible job. Make one man the face of public health amid an unprecedented pandemic, in a country as fractious as the United States, and there were bound to be disappointments and frustrations, and they were bound to get personal.
Still, in December, when Elon Musk joked on Twitter that his “pronouns” were “Prosecute/Fauci,” it felt like the cresting of a turning tide against the man who had played essentially that role for the first three years of the pandemic. At least 30 state legislatures have passed laws limiting public-health powers in pandemics. This January, the month after Anthony Fauci retired as the four-decade head of the National Institute of Allergy and Infectious Diseases, barely half of Americans said they trusted the country’s public-health institutions to manage a future pandemic. The Wall Street Journal named that as his legacy — sowing distrust about public health and vaccines. Earlier in the pandemic, the leftist magazine The Drift mocked Fauci as “Doctor Do-Little,” and Representative Matt Gaetz, a Florida Republican, proposed that Fauci had “blood on his hands.” Upon the announcement of Fauci’s retirement, Gov. Ron DeSantis of Florida, also a Republican, celebrated: “Grab that little elf and chuck him across the Potomac.”
Of course, there were mistakes and missteps, including some by Fauci: describing the threat to the country as “minuscule” in February 2020, for instance; or first advising against wearing masks, and moving slowly on aerosol spread; or playing down the risk of what were first called “breakthrough infections” in the summer of 2021. And the broader public-health establishment that Fauci came to embody made other mistakes, too, even if it wasn’t always easy to know at the time or identify later who exactly was responsible. Almost certainly, schools stayed closed longer than they needed to. Very conspicuously, American vaccination rates never approached the levels of peer nations — and the problem wasn’t just the anti-vaccine right. Quarantine guidance was abruptly shortened in the midst of the Omicron variant, when thresholds of community-spread levels were suddenly redefined as well. There was no effective paid sick leave instituted, and the official end of the pandemic emergency on May 11 imperils the Medicaid coverage of 15 million Americans. But three years on, whether you are focused on Covid’s direct carnage or on its collateral damage, it seems irrational to pin the brutality of America’s pandemic on policy failures, however much Americans want to put the blame somewhere. Or on someone.
Over several hours and multiple Zoom and phone calls in April, I spoke with Fauci about that: how he saw the full story of this historic public-health emergency and the role he played in it. At times, he was defensive, even combative, particularly when it came to episodes in which he felt that his own positions had been misconstrued and on the matter of gain-of-function research and the origins of the pandemic. But on the whole, he was reflective, even humble, especially about the way that Covid-19 exposed the limits of public health and, in his telling, kept surprising him and his fellow scientists.
“I’m a physician,” he told me in response to criticism that he had pushed the country too far. “That’s my identity. I’ve taken care of thousands of patients in one period of my life during the early years of H.I.V. I believe that I have seen as much or more suffering and death as anybody has in most careers. I don’t mean to seem preachy, but I don’t want to see people suffer and I don’t want to see people die.”
David Wallace-Wells: Three years ago, in March 2020, you and many others warned that Covid could result in as many as 100,000 or 200,000 American deaths, making the case for quite drastic interventions in the way we lived our daily lives. At the time, you thought “worst-case scenarios” of more than a million deaths were quite unlikely. Now here we are, three years later, and, having done quite a lot to try to stop the spread of the virus, we have passed 1.1 million deaths. What went wrong?
Anthony Fauci: Something clearly went wrong. And I don’t know exactly what it was. But the reason we know it went wrong is that we are the richest country in the world, and on a per-capita basis we’ve done worse than virtually all other countries.1 And there’s no reason that a rich country like ours has to have 1.1 million deaths. Unacceptable.
Wallace-Wells: How do you explain it?
Fauci: The divisiveness was palpable, just in trying to get a coherent message across of following fundamental public-health principles. I understand that there will always be differences of opinion among people saying, “Well, what’s the cost-benefit balance of restriction or of masks?” But when you have fundamental arguments about things like whether to get vaccinated or not — that is extraordinary.
Wallace-Wells: Even now, when we talk about pandemic response, we focus on things like school closures and masks, but it seems to me that Covid mortality has been shaped much more by the country’s vaccination levels. There have been three times as many American deaths since Election Day 2020 as before. And we’ve done much worse, compared with our peers, since vaccination began than we had before.2