A10 EZ SU THE WASHINGTON POST.SATURDAy, MARCH 21 , 2020
The Coronavirus Outbreak
vision star.”
When fauci interrupted
Trump during a televised meeting
a few weeks back, Staley — the
AIDS activist and now a friend of
fauci’s — says his facebook feed
lit up with people worried that
fauci would be fired.
“I was like, ‘No, you don’t get i t.
He’s like the only person in Wash-
ington who Trump can’t fire,’ ”
Staley recalls. fauci is politically
invincible, he says, because of
“the wall of bipartisan support
around him. It’s like a moat.”
or an immunity.H
e’s not immune, of course.
Not to illness. Not to fail-
ure.
fauci is nearly 80 years old,
putting him in a danger zone for
potential victims of covid-19 — a
fact not lost on the many anxious
news-watchers who have cringed
to see him arrayed with adminis-
tration officials in a non-social-
distancing way during news
briefings. He may have overtaken
Justice ruth Bader Ginsburg as
the most digitally doted-on senior
citizen in our government.
He’s heard that people across
the country are praying for him,
willing him to stay healthy.
“Well,” he says in response,
“that’s very nice.”
But fauci knows that time is
running out, and not just for him.
Unless the virus’s advance can be
blunted in the coming weeks, the
results could be catastrophic.
He’s not perfect, and neither are
we. from this point on, fauci
says, “it’s going to be a race.”
And so, he seems to transcend
time and space, appearing in all
media at a ll times. on Wednesday
he turned up on “Pardon my
Ta ke,” a sports podcast, albeit
about 45 minutes into an episode
that led with news of To m Brady’s
departure from the New England
Patriots. on Thursday he chatted
with mark Zuckerberg on face-
book Live. He’s been a fixture on
cable news. “I don’t know where
you’re getting the energy from,
doctor,” CNN host Chris Cuomo
told him during an appearance
on Wednesday.
The truth is, he’s been tired.
The coronavirus threat is “driving
me nuts,” h e told The Washington
Post on Tuesday night. He spent
decades preparing for this mo-
ment, yes, but the thought of its
arrival was also the thing that
kept him up at night. And now
that it’s come, fauci is struggling
to get even four hours of sleep a
night.
most people don’t see their
worst dream come true, or have to
keep themselves together under a
national spotlight as the night-
mare unfolds.
“What I do is accept it,” h e says.
“I don’t live for bad things to
happen so that people can suffer.
I live to respond and prevent
suffering and death from some-
thing I know inevitably will hap-
pen.”
[email protected]
[email protected]presidential debate between
George H.W. Bush and Clinton
when Bush was asked to name
one of his modern-day heroes,
and pointed to fauci. “He had this
sterling reputation with both re-
publicans and Democrats. He
seems to be the man for all sea-
sons in these types of situations.”
But storied credibility around
Washington doesn’t necessarily
guarantee survival like it used to.
Trump came to the White House
with a deep skepticism of experts
and government officials who
weren’t willing to change their
way of doing things to better
serve his political interests.
reining in the potential devas-
tation of the coronavirus pan-
demic would rely heavily on buy-
in from the public, which would
rely heavily on buy-in from the
president. fauci had directed his
“SWAT t eam” o f vaccine research-
ers to start working on a vaccine
back in early January, after Chi-
nese officials published the se-
quence of the virus. But as it
spread throughout Asia and Eu-
rope, fauci and his colleagues at
NIH and the Centers for Disease
Control and Prevention faced a
different challenge: preparing
the nation for a potentially cata-
clysmic outbreak while the presi-
dent repeatedly played down the
threat.
“We have it totally under con-
trol,” the president said during a
Jan. 22 interview with CNBC. At a
news conference a month later he
projected that the number of
Americans with the coronavirus
would, within a couple days, be
“going to be down to pretty much
close to zero.” (Neither assess-
ment was shared by scientists
with a deep understanding of
infectious diseases.)
Dithering and denial can have
grave consequences. Though
South Korea detected its first case
of coronavirus on the same day as
the United States, it began devel-
oping a test almost instantly and
as a result has seen a sharp
decline in new cases of the virus.
You can’t stop a pandemic unless
you know where it is.
fauci says he and the other
leading public health officials on
the White House Ta sk force that
was assembled to address the
crisis took a unified approach in
persuading Trump of the situa-
tion’s gravity: “Well, you know,”
fauci says. “If at first you don’t
succeed, try, try again. It’s just
continually giving him the facts.”
Emergency interventions were
sometimes necessary. As the
number of U.S. cases of covid-19,
the illness caused by the corona-
virus, began to increase in the
United States, fauci did two
things that had been taken as
grievous offenses when commit-
ted by other government officials
serving under Trump: He has
publicly corrected him on more
than one occasion; and he has
taken up a lot of the spotlight,
appearing on so many shows that
Trump referred to fauci in a
recent news conference as a “tele-S
peaking truth to power is
recommended, but individu-
al outcomes may vary.
“ Depending upon the charac-
ter of the president, if you give
bad news they may say, ‘I don’t
want this guy around anymore,
he’s causing trouble,’ ” fauci says.
“So the first thing I decided was I
would only speak the truth, based
on the evidence I had and my
purely clinical scientific judg-
ment.”
fauci knew that commitment
would be tested with Trump and
whatever public-health threat
emerged under his watch — just
as it had been with George H.W.
Bush and AIDS, Bill Clinton and
West Nile virus, George W. Bush
and anthrax and Barack obama
and Ebola. After Trump was elect-
ed, fauci wrote papers describing
his work on previous epidemics.
He says the series ended with a
picture of Trump and a question:
“What’s next?”
“Certainly,” he remembers
writing, “this president and this
administration will be challenged
with an outbreak of an infectious
disease, just like every previous
president that I’ve been involved
with.”
“A nd sure enough, to my dis-
may, it’s happened,” fauci says
now. “It’s happened.”
The doctor has been stockpil-
ing capital in Washington for
years. His political superpower,
say those who’ve worked with
him, is his ability to convert who-
ever happens to be in front of him
— a patient, a medical student, a
U.S. president — into an acolyte.
“fauci is sort of like the rolling
Stones, a name that everyone
mentions as the leader in the
field,” says matt Schlapp, chair-
man of the American Conserva-
tive Union and unofficial adviser
to the president.
Schlapp recalls a moment in acials refused to even meet with
patient advocates, fauci not only
welcomed them to his office, he
invited them to dinner parties.
fauci asked his deputy, a gay
man with a well-appointed town-
house on Capitol Hill, to host the
wine-fueled evenings. As the ac-
tivists drove down from New
York, they would remind one an-
other to be firm and focused with
their demands and to be careful
not to fall fully into the To ny fauci
charm vortex, according to Peter
Staley, an activist with a New
York-based group named ACT UP.
They always brought along
mark Harrington, an ACT UP
member who would later win a
macArthur “genius grant,” be-
cause he could press fauci on the
science. “otherwise you’re kind of
in awe of the guy and you kind of
become deferential,” Staley says.
The activists were aware that
the dinner parties were as strate-
gic as they were friendly, he says,
and afterward they would try to
sort out when fauci had been
handling them and what details
he’d been carefully hedging on.
“We knew he was playing a game
of ingratiating, which he has
done with every president that he
has worked under. He’s incredibly
skillful at it.”
fauci had to manage not just
the needs of activists and science
colleagues but also those of his
political superiors. When it came
to dealing with reagan — and
each of the five presidents he’s
served since — the doctor has
heeded the advice of a friend who
spent several years in the Nixon
administration:
“When you go to the White
House, always say, in the back of
your mind, that this may be the
last time I’m going there because
I might have to tell this president
something he doesn’t like.”“one of the reasons everybody
loves this guy is that he combines
this extraordinary intellect with a
demeanor that does not confront
you with, ‘I’m the smartest guy in
the world,’ ” s ays Hoyer, the mary-
land Democrat, who has worked
closely with fauci for decades.
“It’s not fancy words or fancy
concepts, no attempt to awe you,
but to communicate what is seri-
ous and how we ought to re-
spond.”I
n 1984, as the AIDS epidemic
raged, fauci found himself at
the center of his first political
storm. He had made the disease
his urgent focus, both as an ad-
ministrator and scientist; two of
his publications on how HIV af-
fects the body would be among
the most frequently cited papers
in AIDS research. But the scientif-
ic literature was only one front in
that war. People were dying, and
activists were furious with the
government’s response. (Some in
the scientific community were
adamantly opposed to giving
AIDS patients a say in how treat-
ments were pursued. And Presi-
dent ronald reagan hadn’t even
said the name of the disease, even
though it had already killed thou-
sands of Americans.)
fauci, then the newly installed
director of NIAID, the institute
within the National Institutes of
Health that studies allergies and
infectious disease, faced pressure
from all sides. AIDS rights activ-
ists staged elaborate protests de-
manding changes to regulatory
processes that were slowing de-
velopment of new treatments and
more funding to support the
search f or a cure. fauci was called
a murderer in op-eds, and pro-
testers burned him in effigy dur-
ing protests outside NIH head-
quarters.
While other government offi-impossible less than a month ago:
a government expert with an un-
welcome message who is none-
theless regarded as a truth-teller,
if not a godsend, by the president,
Democratic leaders and media
figures alike. Surviving may re-
quire a single set of facts; and
fauci — a slight, bespectacled
man with a Brooklyn accent and
sympathetic eyebrows — has
them.
But are facts enough to sway a
president who often trusts his
own feelings more than other
people’s expertise and who tends
to lash out at those who contra-
dict him? When fauci returned to
the briefing room for friday’s
news conference he was there to
see Trump tout the potential ben-
efits of a malaria drug that is not
yet proved to be an effective
treatment for covid-19 and blow
up at a reporter who asked a
question he considered “nasty.”
Despite his admonitions against
face-touching, fauci rubbed his
forehead.
It fell to the doctor to lower the
temperature in the room, deli-
cately bridging the gap between
Trump’s feelings and his own
scientific approach.
“It’s the hope that it will work
versus proving that it will work,”
fauci said. “So, I don’t see big
differences here.” He yielded the
lectern as Trump chimed in: “I
agree.”
Kellyanne Conway, a senior
counselor to the president, says
her boss is a fan of the even-tem-
pered scientist. “The president
has been very impressed by what
he’s h eard from Dr. fauci. He d oes
like him personally. He respects
him professionally.”
“It’s a shame,” says House ma-
jority Leader rep. Steny H. Hoyer,
a maryland Democrat, “that at
the first hint of this we didn’t just
say to To ny fauci, ‘You’re in
charge, you have all the power
you need, tell us what needs to be
done.’ ”
After all, we weren’t ready for
this, and he was. He’s been pre-
paring for decades.I
f ignorance is bliss, it would
stand to reason that fauci
would be miserable.
He seems restless, at least. for
years he ran seven miles a day.
Lately it’s been more like three-
and-a-half miles, most of them
power-walked, and about five
hours of sleep a night. People
have always asked the scientist —
who’s been at the forefront of
battles against AIDS, West Nile
virus and anthrax — one ques-
tion: “What keeps you up at
night?”
His answer, he says, was always
the same:
“A respiratory-borne illness
that’s easily spread from person
to person that has both a high
degree of morbidity and mortali-
ty,” he said in a phone interview
from his office at the National
Institutes of Health. “A nd unfor-
tunately for us that’s exactly what
we’re dealing with right now.”
The doctor’s mandate now is
not just to help the White House
brace for impact but also to con-
vince all of America to buy into a
terrifying prognosis, along with
prescriptions — washing hands
relentlessly, maintaining dis-
tance from friends and loved ones
— for how to minimize the pain
the virus could inflict on society.
That includes the legions of
Trump supporters who continue
to joke about a “beer virus” —
Corona, har har — and insist that
the whole thing is being inten-
tionally blown out of proportion
to damage the president (who
called the alarm over the corona-
virus threat a Democratic “hoax”
in late february).
It’s a daunting task, but fauci
has a few things going for him:
not just his expertise but his
bedside manner.
The grandson of Italian immi-
grants, fauci was born in New
York the year before the United
States entered World War II and
grew up in an apartment above
his father’s pharmacy. He deliv-
ered prescriptions to customers
and decided to pursue medicine
early on, eventually graduating
first in his class at Cornell medi-
cal College. As a clinical doctor,
caring for patients, he cultivated
perfectionism. “I came to the
conclusion that I owed it to these
people, who were really quite ill,
to give it everything I possibly
could,” he says. “I tried to be as
perfect as I could. Even though I
know I’m not perfect.”
As a researcher, he made waves
in scientific circles for research
on immune regulation that led to
breakthrough advances in the
treatment of rheumatologic dis-
eases. But he never lost his gift for
retail medicine, which has ma-
tured into a straight-talking-un-
cle-from-Brooklyn charisma.fAucI from AFauci’s been working on health crises since the Reagan years
JABIN BOTSFORD/THE WASHINGTON POST
Anthony S. fauci, director of the National Institute for Allergy and Infectious Diseases, listens as President Trump speaks during a news briefing at the White House.ALEX WONG/GETTY IMAGES
Mike Leavitt, left, then-secretary of Health and Human Services, Julie Gerberding, then-director of
centers for Disease control and Prevention, and fauci at a pandemic planning meeting in 2005.