WASHINGTON — He knew at once that something was amiss. “Five young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at three different hospitals in Los Angeles, California. Two of the patients died,” read the opening of the now infamous Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention for June 5, 1981.
“I started to get goose pimples,” Dr. Anthony S. Fauci would later recall. Then a young epidemiologist with the National Institute of Allergy and Infectious Diseases, which he now directs, Fauci grasped well before many of his peers that HIV/AIDS, which would kill all five of the men in Los Angeles, was going to kill many more. And even as many in the Reagan administration downplayed the disease as a “gay cancer” that did not deserve the attention of the medical establishment, Fauci understood with tragic clarity that HIV/AIDS was not going to discriminate over its victims.
“I became more convinced that we were dealing with something that was going to be a disaster for society,” he said in a National Institutes of Health oral history of the AIDS/HIV epidemic. Back then, Fauci was known for an intense schedule of 16 hour days, broken up by a 7-mile run at lunchtime.
“If everyone in the world were like Dr. Anthony S. Fauci, there would be no need for Prozac,” the New York Times wrote of him in 1994. “By any sensible reckoning, the man should be wilting around the edges.”
Now 79 years old, Fauci still has not wilted. And, as he told Yahoo News in a recent interview, he is working up to 19 hours a day. The target is no longer HIV/AIDS, which, thanks to efforts by him and his colleagues, is now a manageable condition. The new adversary is COVID-19, a disease that has sickened nearly 200,000 people around the world.
And, yes, he still runs, though his distance has halved to 3.5 miles daily. “It’s kind of tough to fit a run in,” he lamented in a conversation shortly after he’d stood next to President Trump at yet another harrowing White House coronavirus task force briefing. “But hopefully we'll change that, and sometime soon we’ll get back to some normality where I can exercise the way I like to exercise.”
His own regimen aside, Fauci reminds people that even with schools and businesses closed, and Americans asked to refrain from congregating in groups of greater than 10, outdoor exercise is a good way to weather the coronavirus pandemic.
“It’s not only safe,” he says. “It’s healthy.”
To be sure, his new adversary bears little resemblance to his old one.
COVID-19, a respiratory infection caused by a previously unknown coronavirus, is not nearly as deadly as AIDS, which killed 32 million people around the world. So far, the coronavirus has killed about 8,000 since emerging in China last December.
And though there have been some instances of xenophobia toward people of Chinese descent, there has been nothing like the sustained prejudice experienced by members of the LGBT community during the AIDS crisis.
There are similarities, however, the foremost among them a sense of urgency that Fauci is desperate to convey. “If you don’t recognize that you’re dealing with a spreading infection and you don’t put all of your resources and your forces into preventing infections, you could wind up with a large number of people infected.”
To underscore that urgency, Fauci has eagerly given interviews to media outlets, one of the few figures in public life who can appear on MSNBC’s “Morning Joe” and Sean Hannity’s primetime program on Fox News without squandering even slightly his credibility. In the latter appearance, he chided Hannity for comparing the coronavirus to the flu, vowing to give his audience “an accurate idea about what goes on.”
And in conversation with Yahoo News, Fauci expressed dismay at images of crowded restaurants and bars in cities like Washington, D.C., and New York, despite injunctions from both federal and municipal authorities to stay away from large gatherings.
“When I see crowded bars and crowded restaurants, it is a little bit unnerving,” Fauci said. "It’s clear that those are the situations that put people very much at risk.”
Fauci is straightforward but not abrasive, voluble but not glib. And in everything he says, you hear the Brooklyn of his youth. His father’s family came from Sicily, his mother’s from Naples. They settled in the Bensonhurst section of Brooklyn, which remains one of New York’s last authentic Italian enclaves. His father ran a pharmacy, with young Tony delivering prescriptions on his bike.
Fauci excelled at school, first at Regis High School in Manhattan, then at the College of the Holy Cross, where he studied both the classics and the life sciences. From there, he went on to medical school at Cornell, graduating in 1966. He went to the National Institutes of Health, where he would work for his entire career, except for a few stints in New York City.
But more than half a century after he left Brooklyn, more than its accent has stayed with him. The finest points of his Jesuit education — Regis and Holy Cross are both run by the influential Roman Catholic order — have plainly influenced his devotion to intellectual rigor and physical health.
There is also, in Fauci’s approach, a reminder of what the Roman orator Cicero said and, later, the Jesuits adopted as their own unofficial motto: “Non nobis solum nati sumus,” which translates to “We are not born for ourselves alone.” It is something like that imperative that has kept Fauci in public service, even as many others of his stature have cashed out with plum positions with pharmaceutical companies and health networks.
That’s not to say that Fauci is above politics. It would have been impossible to survive in Washington as long as he has without being a deft navigator of political currents. Those currents were especially treacherous during the HIV/AIDS crisis, which many in the Reagan administration — including Reagan himself — minimized, with deadly consequences, as a concern confined to gay men and not requiring a national response. At the same time, activists were frustrated that the Fauci-led response was not aggressive enough.
Fauci never fulminated, but he defended his domain capably, making sure that conservative politicians did not prevent him from conducting pure research into the vexing, complex mechanism through which HIV hijacked the body’s immune system.
In 1985, for example, he asked Congress to more than double the money available for AIDS research to more than $300 million. Fauci was counseled against asking for so much money, according to How to Survive a Plague, a chronicle of the AIDS epidemic by David France. “We’re not backing down,” he said, according to France’s recounting of the budget fight, which ended with Fauci getting the funding he needed.
And he listened to activists, neither dismissing them nor treating them with derision. When they pushed him to approve a drug called AL721, he refused to do so, because he did not believe it would save lives, calling it “useless.” After one protest at NIH headquarters in which demonstrators burned him in effigy, Fauci described their tactic as “interesting” but “not helpful.”
At the same time, he frequently visited with those same activists, including at the Lesbian and Gay Community Center in New York, an important site for organizing around the disease. And he clearly took their concerns seriously. “These are intelligent, gifted, articulate people coming up with good, creative ideas,” Fauci said in 1990, after meeting with activists and agreeing to honor some of their requests about being included in decisions pertaining to drug trials.
Fauci even earned the grudging admiration of Larry Kramer, the writer and activist famously scornful of politicians, excoriating President Reagan and New York City Mayor Ed Koch with particular relish. Fauci earned his share of scorn, too, but also a measure of admiration. “I call him murderer or hero, depending on the week,” Kramer told the Times in 1994.
Kramer’s 1992 play “The Destiny of Me” includes a tyrannical doctor clearly modeled on Fauci. Despite the implicit criticism, there Fauci was, sitting in the audience when the play premiered at a small theater in Greenwich Village.
Fauci’s role in fighting the AIDS virus was downgraded in 1994 after the creation of the Office of AIDS Research and the appointment of Dr. William Paul to head the effort. By that time, however, treatments to mitigate the ravages of HIV/AIDS were becoming more effective and more widely available, and the crisis was soon to subside, at least in the United States. When it had been at its worst, it had been Fauci’s war.
He has fought others since. In 2014, he was on the front lines of the government’s response to the deadly Ebola epidemic, volunteering to personally treat a patient who was infected with the disease. “Ebola’s worst enemy,” Financial Times called him.
He also worked on the response to Zika, the mosquito-borne virus. Asked in 2016 what he learned from the Obama administration’s Zika response, Fauci counseled that readiness is all. “Outbreaks occur,” he said. “And if you find out you’re behind it as opposed to ahead of it, things are worse than they could’ve been.”
The Trump administration has been criticized for not taking the coronavirus outbreak seriously enough until the end of last week, when it finally recognized that the pandemic could wreak havoc in the United States. Fauci appears to have convinced his fellow New Yorker to take the coronavirus more seriously, which Trump has finally done. Even Sean Hannity, who only days before had been arguing with Fauci about morbidity numbers, has been cowed into something approaching solemnity about the potential scope of the pandemic.
Trump and Fauci could not be more different. One is from one of the great ethnic enclaves of Brooklyn, a pharmacist’s studious son. The other was reared by his wealthy real estate developer father in a suburban swath of Queens.
The president is tall and brash, while the doctor is short and cautious. Despite their differences, however, there has been none of the tension that seems to inevitably accompany Trump’s relationships with his top advisers.
That may well be because Trump realizes that having Fauci at his side is not only reassuring — he has served every president since Reagan — but a credit to his newfound faith in scientific expertise. Turning to Fauci at a White House briefing on Tuesday, Trump marveled at how the diminutive epidemiologist — “Anthony,” he called him, with obvious fondness — “has become a major television star, for all the right reasons. He’s just so professional,” Trump gushed, “so good.”
For now, Fauci’s main goal is keep the coronavirus from spreading, giving microbiologists the critical time to develop treatments and vaccines. “We are doing whatever we possibly can to try and blunt the impact of these infections as they emerge in the country,” he said in a conversation with Yahoo News earlier this week, right after the Trump administration unfurled new measures that included a restriction on gatherings of more than 10 people and a strong admonition to work from home.
“I don't think people should be alarmed by those guidelines,” Fauci says. “They are really meant to protect the American public.” At the same time, the guidelines will mean nothing if they are not taken seriously. “People have to adhere to the guidelines to physically separate themselves.”
If they don’t, Fauci’s efforts to fight the coronavirus could fail to prevent a catastrophe. “We have not yet seen the peak,” he warns. “Things will clearly get worse before they get better.” He gently disputed the president's assertion, during a Monday press conference, that the coronavirus outbreak could last until August, calling that the “outer limit” scenario. At the same time, as he well knows, much more dire scenarios have also been proposed, with nearly two million projected dead in the United States.
That’s why he says it’s so important to take measures now. The new guidelines on social distancing, he acknowledges, “may seem like an overreaction — but I don’t think they are.” Most anyone would agree that skipping a restaurant meal is small sacrifice if it means avoiding a prolonged stay in an intensive care unit.
Fauci may not always bring good tidings, but when catastrophe does strike, you want him nearby. Last year, prospective jurors were being interviewed ahead of a trial at a Washington, D.C., courthouse when a woman became sick. It turned out that Fauci was in the jury pool with her and quickly came to her rescue. Later, a journalist asked him about the incident, but Dr. Fauci did not want to talk.
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