Dr. Fauci’s Dismal Last Act

D r. Anthony Fauci has announced that he will be stepping down in December from his positions as director of the National Institute of Allergy and Infectious Diseases (NIAID), chief of the NIAID Laboratory of Immunoregulation, and chief medical adviser to President Joe Biden. He will depart after 50 years of government service — including 38 years as NIAID director. In that position, he has overseen government responses to every major infectious-disease threat of the past four decades, including, of course, the Covid-19 pandemic. Sadly, this last episode of his long and distinguished career was not his finest hour.

Fauci advocated the imposition of severe lockdown measures, including general mask mandates, despite the fact that there was no scientific evidence to support them. An influential 2006 article by D. A. Henderson and his colleagues at the University of Pittsburgh Medical Center concluded that serious mitigation measures such as stay-at-home orders, school closures, and generalized mask wearing were unlikely to make a significant difference in a new pandemic but that they could adversely affect the provision of medical care and other essential services and have serious economic consequences. A pre-pandemic review by the highly regarded Cochrane Library also found that medical/surgical mask-wearing made little or no difference in the outcome of respiratory, influenza-like illnesses compared with not wearing a mask. Multiple pre-2020 pandemic plans prepared by the WHO, the CDC, and the health agencies of Canada, the United Kingdom, and Sweden had rejected lockdowns as a legitimate strategy in the event of a new pandemic.

Hundreds of studies since the pandemic’s onset have failed to document that compulsory measures curtailed Covid deaths. Multiple reviews and econometric studies have shown that the severity of mitigation measures imposed by states and countries had no relation to their health outcomes. And no good studies have demonstrated a benefit for general mask use.

Fauci did not give enough weight to the types of tradeoffs Henderson had warned about — excess mortality from non-Covid causes; economic devastation and resulting decreased quality and length of life; and the educational, psychological, and long-term economic impact of the school closures — that resulted from lockdowns. There have been hundreds of thousands of excess, non-Covid deaths resulting from people who had to forego treatment for their non-Covid ailments and who skipped preventive visits. Alcohol abuse and drug overdoses soared. And children — especially those in vulnerable, lower socioeconomic circumstances whose families were least able to provide other sources of education — will suffer lower achievement and earnings for the rest of their lives because of prolonged school closures that Fauci and company advocated long after it was clear they were unnecessary.

Nevertheless, Fauci remains unrepentant and unreflective. He recently said that there should have been “much, much more stringent restrictions” during the pandemic, despite the accumulated evidence that they were ineffective and had catastrophic side effects.

Perhaps the most important consequence of Fauci’s actions is that he undermined public trust in public-health authorities. In March of 2020, Fauci told a 60 Minutes interviewer that masks could control spread from infected sources but that, “Right now there is no reason to be walking around with a mask,” since masks would not protect you from infection. Three months later, he backtracked, saying that masks could be protective, “so masks work.” He explained his earlier opposition to general mask wearing as an attempt to preserve the limited supply of masks for health-care workers. Five months later, he claimed in a November 2021 interview on Face the Nation that the reason he had not originally advised masking was that no one realized at the time that there was asymptomatic Covid spread. In other words, masks were back to being important for source control, not protection.

These three explanations — masks don’t protect you from infection, masks do work but I wanted to preserve them for health-care workers, and new information makes masks important because everyone, symptomatic or not, could be a source of infection — could all be true, although the way Fauci presented them, they somehow seemed contradictory. The shifting explanations led to confusion in the public: People felt they were being misled for their own good.

In December 2020, Fauci admitted to a New York Times reporter that he intentionally lowballed his public estimate of the population percentage needed for herd immunity to promote vaccine uptake:

“When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent. Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85.”

In addition, Fauci, along with other public-health officials, consistently downplayed the protective effect of natural immunity that results from recovery from infection, in an attempt to boost vaccinations. He finally acknowledged in an April 2022 NPR interview that immunity following infection provides some protection.

These multiple episodes have done much to undermine the trust in public-health authorities that is needed to combat health emergencies. Public belief in and compliance with (hopefully beneficial) public-health advice is needed to put that advice into effect. Voluntary actions are always more important than compulsion, and no public-health emergency can be defeated without them.

Dr. Fauci deserves thanks for his years of public service and scientific contributions. But considering his missteps during the Covid-19 pandemic and his continued insistence, against all the evidence, that lockdowns are effective, it is probably a good thing that he will not be in charge for the next public-health emergency.