Last night one of my friends gave me a votive candle with Dr. Tony Fauci’s picture on it. She said it was to give me inspiration for my blog. Little did I know that I would be using it so soon.
Anthony S. Fauci, MD is one of the foremost immunologists in the country (he is not an infectious disease physician). He has served as the head of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984 and has overseen the growth of that Institute as it worked on AIDS, bioterrorism, SARS and a broad range of infectious and immune diseases.
Even before he became the head of NIAID, Dr. Fauci was responsible for treatments that cured a number of chronic inflammatory disorders. These diseases cause disfigurement as patients developed facial abnormalities and their noses collapsed, but more importantly the illnesses destroyed the lungs and kidneys of patients often causing death. A survey of the American Rheumatism Association membership ranked the work of Dr. Fauci on the treatment of these diseases (called polyarteritis nodosa and Wegener’s granulomatosis) as one of the most important advances in patient management in rheumatology.
His scientific contributions are unquestionable. In 2003, the Institute for Scientific Information, the organization that measures the impact of scientific publications, documented that from 1983 to 2002, “Fauci was the 13th most-cited scientist among the 2.5 to 3 million authors in all disciplines throughout the world who published articles in scientific journals.” He also has won every major award for public service in science and medicine.
Dr. Fauci’s work as a leader in the effort to contain AIDS, Ebola, Influenza (Flu), SARS and other infectious diseases is actually a result of his position as the head of NIAID and not his personal scientific focus. This work has required him to become a public figure with all of the issues that involves. He assumed this responsibility again with COVID-19 despite being a young 79-year-old.
I have to disclose that I have a personal appreciation for Dr. Fauci, as 40 years ago I was able to work for him in my training. He was and remains one of the most remarkable individuals I have ever met. His focus and diligence in addressing medical problems is unmatched. He taught me that determination was the most important quality any professional can possess, and his personal example shaped much of the work I have done since.
Dr. Fauci has been criticized in his career. He was derided during the AIDS epidemic for not doing enough, although his efforts eventually won over most of the activists. This included Larry Kramer who eventually described him as “the only true and great hero among government officials in the AIDS crisis.” He also has been criticized about the funds NIAID has received for bioterrorism and the results of that effort in pandemic preparedness. His role in this COVID-19 task-force has been challenging, and some have taken exception with him. But up to this point the issues raised were scientific and medical; Dr. Fauci has not been personally attacked.
Today, it became clear that Dr. Fauci was being personally criticized by government representatives. A White House official released a statement saying that “several White House officials are concerned about the number of times Dr. Fauci has been wrong on things” and included a lengthy list of his remarks from earlier in the outbreak.
His reported errors include his skepticism that people with no symptoms could play a significant role in spreading the virus — a wrong notion based on outbreaks of other diseases. He also made assurances in late February that “at this moment there is no need to change anything that you’re doing on a day-by-day basis.” Given the lack of knowledge about the pandemic at these time points, the statements were defensible even though they were wrong. I personally disagree with some of his notions on the future of this disease, but admit that only time will tell for sure. His cautious approach is certainly not inappropriate.
We should remember that this is an entirely new virus and infection, and therefore the knowledge base is evolving at a rapid rate. Every aspect of the pandemic has changed, from public health measures to clinical care. We were insisting on having patients placed on ventilators and now know that is often not the best option. Our vaccine program is being done as a multi-technology, almost random process to funding, development and approval, with the hope that some approach will be successful. So mistakes are an inevitable part of the coronavirus pandemic response.
While Dr. Fauci has been wrong about a number of things regarding this pandemic, so has every major health organization in the world, particularly the WHO. Also, other members of the Administration’s COVID-19 task force have made very serious mistakes during this pandemic including the failed start and management of the COVID-19 testing program and shifting instructions on wearing masks. I am especially concerned because Dr. Fauci is being singled out by some in the press who are calling for his resignation.
Given the current situation in the COVID-19 pandemic, the country would be best served in keeping Dr. Fauci in his position.