Anthony Fauci, President Biden’s chief medical advisor and a leader of the country’s COVID-19 response, made a pit stop in Seattle for a fireside chat at Fred Hutchinson Cancer Center and to throw the first pitch at Tuesday night’s Mariners game.
Earlier on Tuesday Fauci sat down with Larry Corey, the former Fred Hutch president, for a conversation that covered everything from the country’s COVID-19 response to what keeps the 81-year-old up at night.
“I’m not even worried about my next nightmare. I’m living through my own worst nightmare,” Fauci said of the ongoing pandemic.
Fauci talked about his experience leading the fight against HIV/AIDS and COVID-19, and the response to monkeypox. “Don’t ever underestimate, ever, an emerging infection,” he said. “You never know where it’s going.”
He also talked about combatting vaccine hesitancy and the rash of harassment against health officials. Fauci, a target of vitriol and death threats, was accompanied by several security agents.
Fauci received an honorary award from Fred Hutch called the Hutch Award, which was created in 1965 to honor major league pitcher Fred Hutchinson. His death led to the founding of the institute by his brother Bill Hutchinson, a Seattle surgeon. Fred was known for his service to others, and the award typically goes to a Major League Baseball player who has made an impact on society.
Fauci and Corey have known each other for decades, dating back to when Fauci spearheaded efforts to combat HIV/AIDS at the National Institute of Allergy and Infectious Diseases, which he has led since 1984.
Early in the pandemic, Fauci and his colleagues tapped Corey to run the COVID-19 Prevention Network, which coordinated the massive phase 3 clinical trials for shots made by Moderna, Johnson & Johnson and others. The COVID-19 vaccine group is patterned on the world’s largest publicly-funded network of HIV vaccine trials, also led by Corey.
Corey called Fauci “a great friend” and “an extraordinary human being.” Read on for more highlights from Fauci’s appearance at Fred Hutch. Answers were edited for brevity and clarity.
What keeps you up at night?
I don’t sleep anyway. People would always ask my what is your worst nightmare. If you go back and look at things I’ve written 20-to-30 years ago, it was the emergence of a new virus that’s respiratory-borne, that has a high degree of transmissibility, and that is capable of a high level of morbidity and mortality. I’m not even worried about my next nightmare, I’m living through my own worst nightmare. It’s the terrible gift that keeps giving. We are going into our third year in January. No one in their wildest dreams would have ever thought that we would have a virus that is as uncanny is this, that has already killed a million Americans. …This virus is playing a very cruel and nasty trick on us all.
On what the fall holds for COVID-19
Boosters are going to be extremely important because we know very clearly that immunity — at least against symptomatic infection, maybe not so much against severe disease — wanes at about four or five months. We’re concerned about there being a surge in the fall; we don’t know exactly when it’s going to occur. We will very likely be using a BA.4/BA.5 bivalent booster [against both prevalent strains]. It’s very likely that Pfizer will have it by the first or second week of September and Moderna will likely have it by the end of September, beginning of October.
We have diagnostics, therapeutics, and we have vaccines, so it becomes an implementation issue.
On addressing vaccine hesitancy
This really is a heterogeneous group of people. If you make them unidimensional you’re going to miss the fact that some people don’t want to get vaccinated because they don’t have enough information; others have got so much misinformation thrown at them; and then others are just hardcore, there’s nothing that you’re going to do to change their minds. In the same way misinformation tends to flood the system, we try to flood the system with correct information that’s delivered in a non-pejorative way by trusted messengers. That’s the reason why I’ve done a lot of those public service announcements with rap groups. It works!
On congressional leaders who promote misinformation about COVID-19 and other scientific issues
On what he tells young people in commencement speeches and elsewhere
Don’t accept as normal flagrant distortions of truth and reality. Because once you do that, nothing counts, truth doesn’t mean anything. We’ve got to keep pushing back against the distortions of reality that we see, we can’t give up and say it’s a waste of time.
On the “Fauci effect,” an increase in people pursuing biomedical science and public health
I happen to be a very visible person so it’s called the “Fauci Effect.” Trust me, I don’t get excited about that. In an era of the normalization of untruths and lies, and all the things you’re seeing going on in society from January 6 to everything else, people are craving consistency, integrity, truth, and for people caring about people.
The other side of the coin of that, which is really painful and a shame, is the abuse that public health officials are getting for saying the truth about what’s going on. I’ve never seen in history physicians and public health officials getting harassed and threatened. Not just me, I get that all the time. That’s why I have these guys with things in their ears that are taking care of me. But that’s really horrible for public health when you have physicians and public health officials getting harassed, and their families getting harassed because they’re telling people to do things like get vaccinated or wear a mask.
On what the U.S. could have done differently about the initial COVID response
If we knew in the first weeks what we know now, we would have done everything different. But the country would not have been accepting of what we were saying. What we know now is that as we were looking at one or two cases, there were cases spreading throughout the country that turned into thousands, that turned into millions. Unlike what we originally thought, it isn’t just animal to human, it’s human to human transmission. It’s highly efficient human to human transmission. And it’s transmitted mostly by people with no symptoms. The entire CDC program was what’s called a syndromic program, which means you only tested people who have symptoms, which retrospectively was huge.
If we had said, I know this is going to be tough, but everyone is going to wear a mask and everybody’s going to stay say six feet from each other, people would have said, “But Dr. Fauci, there are only three cases in the country!”. And if I said, “Trust me!” it never would have happened.
On the development of HIV treatments and the origins of the HIV Vaccine Trials Network, which is the model for COVID-19 Prevention Network
We developed an HIV clinical trials network before there were any drugs to test. I got a lot of pushback from people in the academic community. But by the time we got the network going, we had a lot of drugs to test and that was really the success story. So next we said well, we’re going to need a vaccine network. It gets back to that Kevin Costner film: build it and they will come …From 1997 to 2000, we completely transformed HIV. People who previously had an eight-month lifespan were projected to have a normal lifespan.
On the origins of PEPFAR (the United States President’s Emergency Plan for AIDS Relief)
I had known President George W. Bush, because following 9/11 there was the anthrax attacks. I was put in charge of developing medical countermeasures against bioterrorism. We developed a good relationship. I presented to the cabinet, and made the case for a $500 million program to prevent mother-to-child transmission in Africa. He was so excited to actually save so many children from being infected that he said this is not enough, go back and give me something that is totally transforming. …PEPFAR has now saved between 18 and 20 million lives. The credit all goes to George W. Bush.