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It is not easy to secure an interview with Anthony Fauci, America’s foremost infectious disease expert, amid the worst pandemic in a century.
My first appointment with the spry octogenarian was cancelled at the last minute because he had to take a call from the White House. My second was abandoned 15 minutes after it was due to begin because he was tied up with Democratic congressmen.
When we finally come face to face on Zoom, an hour after Donald Trump’s impeachment trial began in the Senate, he apologises. I joke about him having more urgent priorities, like saving the world. ‘Something like that,’ he chuckles from his office in Bethesda, Maryland, munching a cookie by way of a belated lunch and sporting a Stanford University fleece over his shirt and tie.
He appears surprisingly relaxed given his immense responsibilities at this time of crisis, but then it takes a lot to faze Dr Fauci.
The evergreen director of Washington’s National Institute of Allergy and Infectious Diseases (NIAID) has been a medical adviser to seven consecutive US presidents, starting with Ronald Reagan, steering them and his country through outbreaks of Ebola, Sars, Zika, avian flu, swine flu and the threat of biological weapons after 9/11.
He was one of the first scientists to spot the lethal new syndrome that was Aids in the early 1980s. He was initially reviled by a gay community outraged at the Reagan administration’s apparent indifference to its decimation, then hailed as a hero after championing its cause.
Most recently, during almost all of 2020, he watched in horror as President Trump actively undermined his own government’s battle against the Covid-19 pandemic by holding mass rallies, mocking mask wearers, promoting quack remedies and encouraging his supporters to breach lockdowns.
Fauci does not consider this characterisation of Trump’s conduct unfair. ‘No, no, no,’ he says. ‘Unfortunately it’s the truth.’
Donald Trump was initially sceptical of the threat from Covid-19, but Fauci and his fellow scientists did manage to persuade him to back state-by-state lockdowns, and approve social-distancing measures. He also restricted Chinese visitors to the country. By the spring, however, Fauci’s relations with the president had soured as Trump began listening to outsiders with no scientific knowledge and fretting about the damage to the economy and – by extension – his re-election hopes.
Fauci’s challenge was to correct the president’s dangerous falsehoods as diplomatically as possible, often while sharing the stage with him at televised White House briefings, but he says that ‘when it became clear that in order to maintain my integrity and to get the right message [across] I had to publicly disagree with him, he did things – or allowed things to happen – that were terrible.
‘Like he allowed Peter Navarro [Trump’s trade adviser] to write an editorial in USA Today saying that almost everything I’ve ever said was wrong. He allowed the communications department of the White House to send out a list to all of the media, all of the networks, all of the cables, all of the print press, about all of the mistakes I’ve made, which was absolute nonsense because there were no mistakes.’
Trump also began to denigrate Fauci in tweets and press conferences, setting him up as a target for the extreme Right’s hatred. ‘Which I became, to the point that to this day I have to have armed federal agents guarding me all the time,’ Fauci says. And he was not the only target. To his dismay, his wife and three adult daughters were also harassed and threatened.
Liberated under President Biden, Fauci can now speak frankly in a way he couldn’t last year. He tells me that in the final two months of his presidency Trump almost completely abandoned his duty to protect the nation from the pandemic. ‘We [the scientists] were trying, but we were acting almost alone, in the sense of without any direction.’
By the time Biden took office, the pandemic was raging out of control. ‘Oh my goodness, it was,’ Fauci says. ‘When President Biden walked into the White House we were having 300,000 to 400,000 cases per day, 4,000 deaths per day, and our hospitals were on the brink of being overrun.’
Seeing so much sickness and death, and knowing that much of it could have been avoided, was ‘very difficult’, he says, especially ‘when your main job is to save lives and alleviate suffering, and you see some of the things going on around you that are not only not alleviating suffering but are making things worse’.
The US, with four per cent of the world’s population, has now suffered 20 per cent of global deaths from Covid-19 – 475,000 in total, plus nearly 30 million recorded cases. It is ‘the mother of all outbreaks’, says Fauci.
When I ask if Trump thanked him for his efforts before leaving the White House, Fauci laughs out loud. ‘No!’ he exclaims. Did his five predecessors? ‘Very much so.’ One, President George W Bush, even awarded him the Presidential Medal of Freedom, America’s highest civilian honour.
Anthony Stephen Fauci was born on Christmas Eve, 1940. He was raised in blue-collar Brooklyn, and still retains the accent and feistiness of that borough. His family lived above his father’s pharmacy. While his father dispensed drugs, and his mother and sister took the payments, Fauci delivered medicines on his bike.
He went to a Jesuit high school, where by dint of sheer determination he became captain of the basketball team despite being only 5ft 7in tall. He went on to a Jesuit college in Worcester, Massachusetts, where he was taught, he has said, ‘precision of thought, economy of expression’.
During his final college vacation he worked on a construction site at Cornell University’s medical school. One lunchtime he wandered into its auditorium ‘and wondered what it would be like to attend this magnificent institution… A guard came and politely told me to leave since my dirty construction boots were soiling the floor. I looked at him and said proudly that I’d be attending the institution a year from now. He laughed and said, “Right kid, and next year I’m going to be police commissioner.”’
Fauci did win a place at Cornell. In 1966 he graduated top of his year. Rather than serve in Vietnam he joined NIAID. Why specialise in infectious diseases? ‘I wanted something that could make you very sick and kill you unless I intervened,’ he explained to The Journal of Clinical Investigation. By 1984, aged 44, he was NIAID’s director.
Fauci’s promotion coincided with the eruption of Aids. He had spotted its emergence three years earlier, and had conducted groundbreaking research into its causes. Despite this, he became, by virtue of his position, a lightning rod for the fury of a gay community whose members were dying agonising deaths while the Reagan administration barely acknowledged the disease.
In 1990 the AIDS Coalition To Unleash Power (ACT UP) staged a mass demonstration outside NIAID’s Bethesda offices. They chanted ‘F— you, Fauci’, burnt his effigy and carried a mock-up of his bloodied head on a stake – in a foretaste of the hatred he would encounter again in 2020.
Fauci responded by attending hostile meetings of gay activists in New York and San Francisco, and befriending ACT UP’s leaders. ‘We schooled him very hard. We yelled at him,’ one participant recalled. ‘He was awesome. He just took it. He just sat there – a straight white guy with a bunch of queer folk screaming at him.’
And, ultimately, Fauci accepted their arguments and embraced their cause. Crucially, he managed to streamline the interminable approval process for new drugs, making experimental treatments available to Aids patients before their efficacy had been proved. Larry Kramer, the gay rights activist and playwright who had once called Fauci ‘the central focus of all evil in the world’, later described him as the government’s ‘only true and great hero’.
The activists ‘were quite correct’, Fauci says. ‘I think one of the best things I have ever done in my long career was appreciate that behind the drama, the theatrics, the iconoclastic behaviour, they needed to get our attention because what they had to say was important and relevant.
‘The federal government in the form of the scientific and regulatory communities didn’t fully appreciate the unique situation they were in. We were approaching clinical trials and regulatory issues with the standard, somewhat conservative, step-by-slow-step-to-do-it-right [attitude] and they needed to get things done right away because they were in a desperate situation… Everything they said made sense.’
Was there a parallel, I ask, between President Reagan’s reluctance to acknowledge what was known in the 1980s as the ‘gay plague’, and Trump’s failure to address the Covid-19 pandemic?
‘It’s a fair point with what I think were significant differences, in that Ronald Reagan never did anything to obstruct what I was trying to do,’ Fauci replies. ‘He just didn’t want to be utilising the bully pulpit, which was what I wanted him to do, to get out there and use the office of the presidency to call attention to this extraordinary, insidiously emerging outbreak that was not being fully recognised because it was predominantly among gay men.’
Trump, by contrast, ‘was almost a counter-influence to what I was trying to do. I was trying to let science guide our policy, but the president was putting as much stock in anecdotal things that turned out not to be true as he was in what scientists like myself were saying. That caused unnecessary and uncomfortable conflict where I had to essentially correct what he was saying, and put me at great odds with his people.’
According to Peter Staley, an original ACT UP leader, who has remained close to Fauci, the chief medical adviser’s strategy last year was to ‘stay in the room’ as long as he could to try to limit the damage – even if that meant biting his tongue as Trump spouted lies and absurdities at his rambling daily press conferences.
At different times the president called Covid-19 a ‘Democratic hoax’, claimed the virus would magically disappear, and recommended bleach and hydroxychloroquine as cures. A colleague of Fauci’s who asked to remain anonymous recalls him complaining in private: ‘You’ve no idea what sort of bulls— I have to deal with every day.’
Staley reckons Fauci managed to remain influential until late April or early May last year, and probably saved hundreds of thousands of lives by persuading Trump to support state lockdowns, keep them in place beyond last Easter, and accelerate the search for a vaccine. The turning point came around the time in April that Trump started to side with anti-lockdown protesters, tweeting that Michigan, Minnesota and Virginia should be ‘liberated’ from the stay-at-home orders issued by those states’ Democratic governors.
Fauci calls that a fair summary. He says he remained on the White House Coronavirus Task Force, and continued to work with Vice President Mike Pence, who ‘really tried his very best to address the outbreak’ while remaining loyal to Trump. ‘But my influence with [the president] diminished when he decided to essentially act like there was no outbreak and focus on re-election and opening the economy… That’s when he said, “It’s going to go away, it’s magical, don’t worry about it.”’ Thereafter ‘my direct influence on him was negligible. It became more conflictual than productive.’
‘Conflictual’ was an understatement. Fauci became, in his own words, ‘the skunk at the picnic’. Behind the scenes, White House officials pressed him to be more upbeat in his pronouncements, and to stop contradicting the president. By the summer he had largely been barred from White House briefings, giving television interviews or testifying before Congress. Moreover, Trump had begun openly to denigrate him.
‘People are tired of hearing Fauci and all these idiots,’ he declared. ‘He’s been here 500 years,’ he complained. ‘Fauci is a disaster. If I listened to him we would have 500,000 deaths,’ he said last October. He even mocked Fauci for throwing ‘perhaps the worst pitch in the history of baseball’ at the Washington Nationals’ opening game last July.
But despite the president’s antagonism, Fauci – calm, authoritative and reassuring – enjoyed bipartisan support in Congress and remained a hero to millions of Americans. His face appeared on coffee mugs and T-shirts. Brad Pitt played him on Saturday Night Live. Bumper stickers proclaimed in fauci we trust. Washington, DC’s mayor designated last Christmas Eve to be ‘Dr Anthony S Fauci Day’ in honour of his 80th birthday. Opinion polls routinely showed two-thirds of Americans trusted him, compared to barely a quarter who trusted the president. ‘He’s got this high approval rating, so why don’t I have a high approval rating… with respect to the virus?’ Trump complained. ‘Nobody likes me. It can only be my personality.’
But Trump’s antagonism had consequences. In parts of the media, and on QAnon and alt-Right websites, Fauci was accused of having invented Covid-19, of being part of a conspiracy to wreck the economy and destroy Trump’s presidency, of being a ‘Deep State, Hillary Clinton-loving stooge’. He was accused of conspiring with Bill Gates and George Soros, and using Trump’s press conferences to send secret signals through subtle hand gestures. Anti-lockdown protesters chanted ‘Fire Fauci’. Steve Bannon, Trump’s erstwhile strategist, called for his head on a pike.
He received death threats, and in April was given a round-the-clock security detail days after he had covered his face with his hand when Trump mocked the ‘Deep State Department’ at one of his rambling press conferences. A doctor requiring bodyguards? ‘That’s not the kind of thing you think about when you’re going through medical school,’ Fauci observes wryly.
On one occasion Fauci opened a letter and a puff of white powder blew into his face. ‘If it was ricin, I was dead,’ he told The New York Times. He summoned hazmat officials, but the powder proved harmless. The threats to his family seem to distress him more.
Fauci met his wife, Christine Grady, 69, the year he became NIAID director. He needed a translator for a Brazilian patient. She was a nurse who had just returned from working in Brazil, so she helped him out. They married the following year. Grady now heads the bioethics department at the National Institutes of Health Clinical Center. She has also run marathons with her husband, and even now they regularly run along the Potomac River with security agents in tow.
Staley reckons 2020 was ‘by any measure the hardest year of [Fauci’s] life’, adding, ‘I was quite worried about his physical and mental health.’ But somehow, the doctor survived the bile, the presidential jibes and 18-hour days.
An associate of Fauci’s, speaking on condition of anonymity, says that behind his calm persona Fauci is a tough political animal with a hot temper and coarse tongue, who relishes the limelight – his office is covered in photos of himself with presidents and celebrities. Fauci himself says, ‘What I had to do was not to get so caught up in thinking I was a hero or some sort of icon, which I’m not, nor get intimidated by crazy Right-wing maniacs. I had to put blinders on and focus on what my job was.’
He sounds rather more surprised that Trump, rather than himself, survived 2020. He describes his White House as a Covid-19 ‘superspreader’. He believes Trump, given his age and weight, was lucky he did not die when he contracted the virus last October. Indeed, recent reports have revealed that Trump had infiltrates on his lungs, and officials believed he would need ventilating before he was admitted to hospital. ‘He could have gotten into serious trouble. I think he was quite fortunate.’
Fauci is much happier today. The pandemic still rages, but he is back in the fold. He talks frequently to Biden and the new White House Covid-19 task force. He addresses press conferences again. He is delighted not just with Biden’s strategy for defeating the virus, but with his whole approach. Soon after his inauguration Biden told him, ‘We’re going to let science rule. We’re going to go by the data, the evidence and the science. We’re going to make some mistakes, and when we do we’re not going to blame anybody. We’re just going to fix it… That was to me like, “Oh my goodness!”’
He fears Covid-19 will continue to be a global problem, but ‘it ends as an all-consuming crisis for the US, the UK and the EU when we get the overwhelming majority of our population vaccinated and the level of community spread goes to a very low level, because at that point we can return to some form of normality.’ He believes that point could come by late autumn, unless the variants run amok.
Will Fauci then retire? Will he spend more time running, perhaps, or cooking rich Italian dinners as he loves to do? Certainly not. He has unfinished business to attend to – business close to his heart after those terrible early years of Aids when he watched helplessly as hundreds of patients died on his watch. Years that he once called ‘the darkest time of my life’ and which, according to Staley, left him ‘deeply scarred’.
Fauci tells me the proudest achievements of his career have all concerned Aids – his early research, launching NIAID’s programme to develop life-saving drugs for patients with HIV, and helping George W Bush create the President’s Emergency Plan for Aids Relief (PEPFAR), which has saved an estimated 17 million lives in Africa.
His last great ambition is to find a vaccine for Aids, one that could render a disease that has caused more than 30 million deaths worldwide almost as innocuous as measles. It is far from impossible, he says, because a silver lining of the Covid-19 pandemic has been some dramatic advances in vaccinology. ‘I think we might get an imperfect one. That I think would be possible during my continued tenure.’
It would be a brilliant end to a remarkable career.
A timeline of Trump's key Covid denials
22nd January 2020: ‘It’s going to be just fine’
A self-assured Trump told CNBC’s Joe Kernen that the coronavirus was just ‘one person coming in from China. We have it under control. It’s going to be just fine.’
January US deaths: 19
23rd February 2020: ‘We have it very much under control’
The then president held a briefing on the South Lawn of the White House, telling reporters: ‘We're very — very cognizant of everything going on. We have it very much under control in this country,’ Reiterating this same notion - and air of confidence - in a tweet sent the following day, he explained: ‘The Coronavirus is very much under control in the USA.’
February US deaths involving Covid-19: 16
27th February 2020: ‘One day, it’s like a miracle, it will disappear’
Trump told attendees at an African American History Month reception at the White House that ‘like a miracle’ the virus would likely vanish. When? ‘Nobody really knows.’
10th March 2020: ‘It will go away’
As the former President finished up a meeting with Republican senators, he relished bragging to reporters how the US government was ‘doing a great job’ with tackling the virus and, really, we should all just ‘stay calm. It will go away.’
March US deaths involving Covid-19: 7,079
23rd April 2020: ‘I see the disinfectant that knocks it out in a minute... is there a way we can do something like that…’
Another of Trump’s bizarre claims that had scientists up in arms was his ‘disinfectant theory’ floated at a White Conference press conference. Dr Deborah Birx, Trump’s coronavirus task force co-ordinator who was sitting a few feet away, didn’t look too pleased.
April US deaths involving Covid-19: 65,167
29th April 2020: ‘It’s gonna leave. It’s gonna be gone’
On being asked by a reporter why he believed the disease would ‘be gone’, even without a vaccine, Trump replied non-plussed and optimistic as ever: ‘It’s gonna go. It’s gonna leave. It’s gonna be gone. It’s gonna be eradicated.’
17 June 2020: ‘It’s fading away’
In an interview with Fox News, Trump sounded as convinced as ever: ‘It’s fading away. It’s going to fade away. But having a vaccine would be really nice.’
June US deaths involving Covid-19: 17,902
8th October 2020: ‘Now what happens is you get better’
During an appearance on Fox Business' Mornings With Maria, Trump sung the praises of antibody drug Regeneron, along with suggesting that after being ill with Covid-19, ‘Now what happens is you get better, that's what happens you get better.’
October US deaths involving Covid-19: 24,045