Friday, January 28, 2022

Anthony Fauci is up against more than a virus

Two years into the pandemic, the threats and vitriol have not stopped. And the many Americans who still trust him are exhausted.


Anthony S. Fauci, chief medical adviser to the president. (Stephen Voss for The Washington Post)

The doctor opens the front door. Never mind introductions. “I know who you are. Do you think these guys would let you get this close to me, if we didn’t know who you are?” Across the street is a security agent in Nikes, a badge on his belt. He’s not the only one watching.

“I mean, isn’t it amazing?” the doctor says. “Here I am, with cameras around my house.”

The house is modest for Washington: stucco and brick, cozy and cramped. No obvious tokens of celebrity or esteem. Icicles on the dormant hot tub out back. Bottles of red wine and olive oil on the kitchen counter.

“It’s messy because, as you know, in covid times, nobody comes over. So nobody cares.”

People are coming by outside, though. They are snapping photos. Two years into the pandemic Anthony Fauci remains the face of America’s covid response, and on this cold Saturday in January thousands of marchers are descending on the capital to rally against vaccine mandates. Are some of them staking out his home?

The security agents “usually leave at a certain time,” the doctor says. “But tonight they’re going to sleep in our guest room.”

Year 3 of covid times. Nearly 900,000 Americans are dead. An average of 2,000 (mostly unvaccinated) Americans are dying every day now, even though there is a simple measure to limit such suffering — made possible in large part by the Vaccine Research Center founded under Fauci. And yet many Americans would rather take their chances with a virus than a vaccine, because there’s more than just a virus going around. There’s something else in the air. Symptoms include rage, delusion, opportunism and extreme behavior — like comparing Fauci to Nazi doctor Josef Mengele (as Lara Logan did on Fox News in November), or setting out for Washington with an AR-15 and a kill list of “evil” targets that included Fauci (as a California man did last month).

“Surrealistic,” the doctor says.

He has not had a day off since the beginning. “I would say I’m in a state of chronic exhaustion.” He quickly adds: “But it’s not exhaustion that’s interfering with my function.” He is a precise man whose tour in the information war has made him extra-vigilant about his words. “I can just see, you know, Laura Ingraham: ‘He’s exhausted! Get rid of him!’”

Fauci has been a doctor and public servant for more than 50 years. He’s been the country’s top expert on infectious diseases under seven U.S. presidents. George H.W. Bush once called him his personal hero. Under George W. Bush, Fauci became an architect of an AIDS-relief program that has, according to the U.S. government, saved 21 million lives around the world.

He knows how a virus works. He knows how Washington works. He thought he knew how people worked, too — even ones who called him a murderer, as AIDS activists did decades ago because they felt left for dead by a neglectful government. Back then the angry people were motivated by truth and science. Fauci had something to learn from them, and they had something to learn from him. The shared mission was pursuing facts and saving lives. Fear and uncertainty could be eased by data and collaboration. Combatants, however scared or passionate, shared a reality.

Now?

“There is no truth,” Fauci says, for effect. “There is no fact.” People believe hydroxychloroquine works because an Internet charlatan claims it does. People believe the 2020 election was stolen because a former president says so. People believe that Fauci killed millions of people for the good of his stock portfolio because it’s implied by TV pundits, Internet trolls and even elected leaders. Fauci is unnerved by “the almost incomprehensible culture of lies” that has spread among the populace, infected major organs of the government, manifested as ghastly threats against him and his family. His office staff, normally focused on communicating science to the public, has been conscripted into skirmishes over conspiracy theories and misinformation.

“It is very, very upending to live through this,” Fauci says, seated at his kitchen table in the midwinter light. He pauses. “I’m trying to get the right word for it.” He is examining himself now, at 81, in the shadow of the past two years. “It has shaken me a bit.”

The way he can comprehend the situation is in the context of the Jan. 6, 2021, siege of the Capitol. There it was, on live TV, an experiment as clear as day: The abandonment of truth has seismic consequences.

Something has been replicating in the American mind. It is not microbial. It cannot be detected by nasal swab. To treat an affliction, you must first identify it. But you can’t slide a whole country into an MRI machine.

“There’s no diagnosis for this,” Fauci says. “I don’t know what is going on.”

A virus is a terrifying force that hijacks civilization. A bureaucracy, intricate yet imperfect, is what we have to take back control. For better and worse, Fauci became the personification of both. He has been sainted and satanized over the past two years, since he first fact-checked President Donald Trump. His inbox is a cascade of hosannas and go-to-hells. His days often start at 5 a.m. His nights are fitful. What more could he have done today? What fresh horror awaits tomorrow? He is fighting for a best-case scenario, urging preparation for the worst, and fretting that nothing will ever be good enough.

“I do worry about him,” says Francis Collins, until recently the director of the National Institutes of Health. “He’s incredibly frustrated” by the attacks “because it’s a distraction. But there is no part of Tony Fauci that’s ready to give up on a problem just because it’s hard.”

“Being two years into this, and being at the tip of the spear — it takes a certain person to be able to persevere through that,” says Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It’s almost like asking someone to run a marathon every day of their life.”

“He’s always had complete bipartisan support, up until covid,” says AIDS activist Peter Staley, who once picketed NIH and is now a dear friend of Fauci’s. “It’s flat-Earth time. Nothing makes sense. This is a guy who tries to let science dictate what he says and does. Now they’re turning what is a pristine record into something evil. They lie, and repeat the lie 100 times until people think it’s true.”

Staley calls Fauci multiple times a week to check in, ask him how he’s doing, discuss the covid response and the resistance to it.

“What do I tell him?” Staley says. “What kind of advice do I give him to win that war? It’s very frustrating. It’s almost unwinnable.”

Look at Fauci’s Jan. 11 appearance before the Senate Health Committee. Sen. Richard Burr (R-N.C.) chided Fauci and other officials for spreading “skepticism and mass confusion” with mixed messaging on covid guidelines. A harsh but fair criticism. Then two senators — who each happen to have medical degrees — got personal.

“You are the lead architect for the response from the government, and now 800,000 people have died,” said Sen. Rand Paul (R-Ky.).

Fauci scolded Paul that such an “irresponsible” statement “kindles the crazies.” “I have threats upon my life, harassments of my family,” Fauci said, suggesting that the California man targeted him because he “thinks that maybe I’m killing people.”

For years, Fauci had joked that his personal philosophy comes from “The Godfather”: “It’s not personal; it’s strictly business.” The business is science. Science helped him cure vasculitis. Science helped him and others transform HIV from a death sentence to a condition managed by a pill.

What he was facing now felt like it had nothing to do with science.

Later in the hearing, Sen. Roger Marshall (R-Kan.) displayed a giant prop paycheck depicting Fauci’s $400,000-plus salary. Marshall accused Fauci and “Big Tech” of hiding his financial investments, which created an “appearance that maybe some shenanigans are going on.”

Fauci, bewildered and incensed, replied that his assets, which he had disclosed for decades, were available to the public. (While this statement was technically true, his disclosures were not just a Google search away; after the hearing, Marshall’s office requested and received the documents from NIH, then declared that Fauci “lied” about the ease of their availability.)

When Marshall finished his questioning, Fauci let his frustration get the better of him. “What a moron,” he muttered to himself, not intending it for the microphone.

What was going on here? Senators were “trying to troll Fauci, and they’re trying to bring him down to their level,” says Matthew Sheffield, a former conservative activist who now runs a political commentary website called Flux.community. “They know if they can get him to call people a moron, or engage in pettiness the way that they engage in pettiness constantly — if he does it even once, then it’s a victory for them.”

Paul disputes this characterization and claims that Fauci deserves “some culpability” for the pandemic because a grant from his agency funded research in a lab in Wuhan, the Chinese city where the novel coronavirus was first detected (the exact origins of the virus remain unknown, though scientific consensus points to an animal-to-human transfer).

Marshall’s office did not have comment on Sheffield’s theory. After the hearing, the senator’s campaign website did start selling $29 T-shirts, featuring the doctor’s likeness, to commemorate the moment: “Send Fauci a message by getting your own ‘MORON’ t-shirt!”

The way in which the United States funds and manages science provides a solid foundation for skepticism and conspiracy, says University of Pennsylvania professor Kathleen Hall Jamieson, who studies science communication and misinformation.

Yes, scientific recommendations change based on available data, a truth that can be exploited to make responsible leaders appear inconsistent or incompetent.

Yes, Fauci has a high salary by government standards, has been in the same unelected position for 38 years and oversees a budget of $6 billion that flows into grants; those are truths on which a distrusting person could build a theory about corruption, unaccountable elites and a nefarious flow of money from this or that institution to this or that lab.

Yes, the virus seems unaccountable to our best efforts and fueled by our worst instincts. Yes, the ways it has ended and upended people’s lives has been undeserved, tragic, crazy-making. These are scary truths that you can neutralize with a fantasy about how a single human villain is to blame.

The attacks and misinformation seem to be having an effect. Confidence in Fauci is softening, according to polling conducted since April by the Annenberg Public Policy Center. After holding steady last summer and autumn, the percentage of Americans who are confident that Fauci provides trustworthy information about covid-19 is down six points since April, from 71 to 65 percent.

“For the first time in my lifetime — and I am an elderly woman — the voice that speaks on behalf of the best available knowledge in science has weathered sustained attack,” says Jamieson, director of the policy center. “Confidence [in Fauci] remains high despite that attack, but the erosion is worrisome.”

With Trump long gone from the White House and public exhaustion with precautions surging alongside the omicron variant, Fauci may now be more useful to the pundits who need a villain than those who need a hero. “Fauci must go,” the editors of the conservative National Review demanded this month. “I’m over covid,” talk-show host Bill Maher told Deadline before his show last week. His guest, author Bari Weiss, echoed the frustration of millions: We were told “you get the vaccine and you get back to normal. And we haven’t gotten back to normal.”

“The stalwart Fauci was the wise Oracle of Delphi to then-President Donald Trump’s babbling brook about household bleach as an injectable, anti-viral agent,” Washington Post columnist Kathleen Parker wrote this week.

“Maybe it’s my imagination,” she continued, “but Fauci appears less confident of late, perhaps weary of his own voice and exhausted by two years of on-camera appearances.”

Sen. Marshall exaggerated this erosion during the Jan. 11 hearing. “You’ve lost your reputation,” he told Fauci, adding: “The American people don’t trust the words coming out of your mouth.”

“That’s a real distortion of the reality,” Fauci answered.

Marshall replied with a truth from the world outside of medical science: “Perception is reality.”

Fauci is not naive. He gets that a third of the country won’t hear him. He still understands Washington enough to see how it is deteriorating in new and disturbing ways, as fringe thinking spreads to the central organs. As Peter Staley puts it: “Because one party has turned so anti-science, Tony’s power is no longer stable.”

Yet Fauci still thinks he is an effective messenger. And he still hasn’t totally given up on the people who are making his life miserable. After the exchange with Marshall, and a news cycle dominated by “moron” instead of “omicron,” Fauci told his own incredulous staff: Maybe the senator has a point. Maybe my financial investments, though disclosed and available, should be much easier to see.

As for the citizens who wish him harm, he can’t help but search for some signal, some symptom, that could help him understand.

“I’m always looking for the good in people, that kernel of something that’s positive,” Fauci says. “And it’s tough to imagine that that many people are bad people. And, I mean, it’s just — has something been smoldering in their lives? Something that’s sociologically evasive to me?”

He wonders: Does their resentment indicate an underlying issue that needs — for lack of a better term — healing?

“Maybe it’s pain that they’re feeling, that’s driving it?” he says, as if bedside with a patient. “And we’re focusing on the aberrancy of their actions, but we really are not fully appreciating that maybe they’re suffering. And they’re rebelling against a failing of society, maybe, to address some of their needs. Maybe we need, as a nation, to address the fundamental issues that are getting, you know, tens of millions of people to feel a certain way.”

On Sunday, in front of the Lincoln Memorial, thousands of people rallied against vaccine mandates. Fauci’s name was scrawled on many signs. The rhetoric was familiar. “Dr. Fauci is the new Jeff Mengele from World War II,” said a Long Island construction worker named Gio Nicolson, who described Fauci as both “puppet” and “dictator.” A 57-year-old woman named Robin Field drove three hours from Yorktown, Va., to hold up a homemade sign that depicted Fauci’s decapitated head in a noose, under the words “HANG EM HIGH.”

Fauci is guilty of treason, according to Field. She’s done her own research, she says, and it’s clear that his recommendations have both “killed people” and made him money.

The violence of her sign, though — where is that coming from? At a primal level, it seems to convey pain or fear.

“Of co — ” Field starts, then stops. “Well …"

How would she put it?

“I feel so bad that so many people have lost their lives. That hurts, because we all have loved ones that have touched our hearts and passed away.”

Almost no one alive has experienced this kind of sudden mass death, this level of widespread illness, this freezing and fracturing of all life. It hurts. For much of the 1980s, every single one of Fauci’s AIDS patients died. Ugly deaths that he was powerless to prevent. He had to suppress the pain and bury the emotion to get through each day. When he recalls that era, his eyes water and his throat constricts. His self-diagnosis is a quick aside (“post-traumatic stress”) as he bridges the past and the present. In the middle of a cataclysm, it’s hard to see the end. But it does end.

“As a society, when we get out of this, you know, we’re going to look up and say, ‘Oh, my goodness, what we’ve been through,’” he says. “We’ve had an outbreak where we’ve lost close to 900,000 people in the last two years. That’s going to have a long-lasting effect.

In the early ’70s, when he was chief resident in a Manhattan hospital, Fauci remembers glancing out over the East River in the middle of the night, “Saying, you know, I’m tired, but I can’t stop until at least this patient is stabilized. When he was the main attending physician at NIH during the AIDS crisis, he wouldn’t leave the ward until he addressed every patient need. Now he views the entire country as his patient — a patient afflicted by both a virus and an undiagnosed condition that hampers its ability to fight it.

He could spare himself further pain and exhaustion and allow America to see another doctor. He could tag out.

“That’s not my character,” he says. “I don’t do that.”

The patient, you see, is not stabilized yet.

Fauci stares out the kitchen window into his small backyard. Right now he sees a crossroads for America. The best-case scenario: increased vaccination, more immunity, antiviral drugs, a virus under control. If we work together. The worst: a new variant, as transmissible as omicron but more deadly, exacerbated by that comorbidity — the deterioration of our minds and politics.

“It’s like it’s 2 o’clock in the morning, and I’m looking out the window at the East River,” Fauci says, “and I got a patient who’s bleeding, and another patient has a myocardial infarction, and another patient who has septicemia —”

The sense memory prompts a sort of pep talk for the present.

“There’s no time to be exhausted, folks. You got a job to do.”

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