Dr. Fauci Says, “With All Due Modesty, I Think I’m Pretty Effective.”
Dr. Anthony Fauci has been well-respected by the scientific community throughout his more than 35-year career at the National Institutes of Health. As an expert on infectious diseases, he has advised six U.S. presidents on the HIV/AIDS epidemic, and in 2008 he was awarded the Presidential Medal of Freedom by President George W. Bush.
I’ve known Dr. Fauci and his wife, bioethicist Dr. Christine Grady, for years as frequent guests at my husband’s restaurant – these days mostly for takeout. It’s also not uncommon to see them out on their daily walks through the neighborhood. I caught up with Dr. Fauci and Dr. Grady on Tuesday to talk about when he expects a vaccine, his relationship with President Trump, and how the two of them are staying healthy and grounded during the coronavirus pandemic.
Norah O’Donnell: How are you guys?
Dr. Anthony Fauci: Given what’s going on in the world, we’re OK.
Christine Grady: How are you?
NO: I’m doing well! This will be our first time in InStyle magazine together.
A F: Oh, good! Another first!
NO: OK, so let’s get into it. Dr. Fauci, do you still think that we could reach 100,000 infections a day?
A F: You know, Norah, I don’t think we will. I hope not. It is conceivable that if we don’t get good control over the current outbreak and we keep spreading into other regions of the country, we could reach 100,000. If anything, I think you have to at least leave that possibility on the table to get people to realize how important it is for us to get control of this. Remember, we went from 20,000 cases a day to 40,000, and then we went up to 60,000. The last thing in the world I want to see is for us to reach 100,000 per day.
NO: What have we done wrong?
A F: You know, that’s almost an unanswerable question. There are so many possibilities. I don’t like to phrase it in the context of what we’ve done wrong, as opposed to let’s take a look at what happened and maybe we can have lessons learned. We never got it down to baseline for a number of reasons. Perhaps it was the lack of compliance of people in the country or the kinds of restrictions that we felt would be appropriate. If you look at the European curve, they came down essentially to baseline, which is very different than us. So, [they] stomped out the infection pretty well. When they started to open up again, there wasn’t that much infection around. If you look at the European countries, they shut down about 90 to 95 percent of the country. Whereas when we shut down, the calculation is that we shut down about 50 percent. So, put all of those factors together, I can’t say we did anything wrong, you know, but certainly we’ve got to do better.
NO: So how can we do better?
A F: What we need to do now is to learn the lesson of what happened with the recent surges. We’ve got to pause in the opening and maybe even take a step back in our phases, depending upon what state you happen to be in. I don’t want to see [the country] going back down to complete lockdown. I think that it will be very difficult for the States to accept that. As we try to proceed, we need to really take seriously the issue of wearing masks all the time and not congregating in bars. I think we can stop that by just closing them, because they are certainly an important mechanism of this spread. Keep distances, wash hands, avoid crowds, wear a mask … I think if we diligently do those things, we can turn this around.
NO: It’s been recently reminded to us by the White House that you advised against people wearing masks in public, and, of course, that was due to the surge because the concern was about saving PPEs for medical professionals. Do you regret that comment?
A F: No. I don’t regret anything I said then because in the context of the time in which I said it, it was correct. We were told in our task force meetings that we have a serious problem with the lack of PPEs and masks for the health providers who are putting themselves in harm’s way every day to take care of sick people. That’s what the dialogue was in the task force meetings, which led all of us, not just me but also [U.S. Surgeon General] Jerome Adams, to say, “Right now we really need to save the masks for the people who need them most.” When it became clear that the infection could be spread by asymptomatic carriers who don’t know they’re infected, that made it very clear that we had to strongly recommend masks. And also, it soon became clear that we had enough protective equipment and that cloth masks and homemade masks were as good as masks that you would buy from surgical supply stores. So in the context of when we were not strongly recommending it, it was the correct thing. But our knowledge changed and our realization of the state of the outbreak changed.
NO: Do you believe there are enough surgical and N95 masks for health-care professionals for the current surge and for a potential one in the fall?
A F: You’ll have to ask [assistant secretary for health at the U.S. Department of Health and Human Services] Brett Giroir that question, not me, since I’m not responsible for that. I hope we do.
NO: Got it. I saw the promising news today about Moderna [the biotech firm announced on July 14 that its experimental coronavirus vaccine is ready to advance to a final phase of testing]. Where do we stand in terms of when there might be a vaccine available for most of the public?
A F: It was very good news that the New England Journal of Medicine reported that the Phase 1 trial substantial titers of neutralizing antibodies were induced, which is the gold standard for prediction of protection. So that was a very good news story for the day. We’re going to start the Phase 3 trial in the third or fourth week of July. That is going to take place over the rest of the summer and into the fall. If all goes well and there aren’t any unanticipated bumps in the road, hopefully, we should know whether the vaccine is safe and effective by the end of this calendar year, or the beginning of 2021. The companies, both Moderna and other companies that are involved with the development of vaccines, promise that as we get into 2021, there’ll be an ample supply because they’re going to start making the doses imminently. By the beginning of the year we should have the first tens of millions and then hundreds of millions of doses. That being the case, I would think we could vaccinate a substantial portion of the population as we get into 2021 — if the vaccine is safe and effective.
NO: I talked to [National Institutes of Health director] Dr. [Francis] Collins today, and he was telling me about the four different trials that will begin on July 27, but you need 120,000 volunteers.
AF: Exactly. It’s 30,000 volunteers per trial.
NO: That’s a lot, right?
A F: Well, the more people you have in the trial, the more infections there are, and the greater efficacy. All of those things get you an answer quicker.
NO: Do you see yourself as a public-health official?
A F: Yeah! I’m a scientist, I’m a physician, and I’ve been heavily involved in public-health matters for the last 36 to 40 years.
NO: And in your 36 years as a scientist and public-health official, have you ever been denied the ability to speak to a journalist or the American public on broadcast television before?
A F: You know, sometimes they don’t allow you out regardless of what administration you’re in. There were times in every administration where they want to focus on a given message. I’m talking about any administration: Obama, Clinton, Bush, Bush, Reagan. But generally, they don’t have a broad restriction when you’re going on.
NO: The last time you were on the CBS Evening News was April 15. And we’ve asked for you every week repeatedly for the past three months. I mean, more than a dozen times. Is that muzzling?
A F: I don’t want [you] to be putting words in my mouth. That’s only going to be nonproductive.
NO: Well, how important is it for a public-health official to speak to the public?
A F: It is important, and I did that on Tuesday at Georgetown, which was shown widely on C-SPAN and picked up by a number of the networks, so there are other ways of getting out there.
NO: I think you used these words with a colleague of mine, but why do you think you’ve become “persona non grata” in the White House?
A F: Well, you know, that really changes week to week and month to month. Sometimes you say things that are not widely accepted in the White House, and that’s just a fact of life.
NO: How much longer do you see yourself in your current role?
A F: When you said my current role, you mean the coronavirus task force or director of NIAID [the National Institute of Allergy and Infectious Diseases]?
NO: I guess I’ll start with the coronavirus task force! [laughs]
A F: Well, I see myself in that role as long as I feel that I’m being useful, and I’m valued in it, and the White House wants me. If any of the above changes, then I would step down.
NO: And how long do you see yourself at the NIAID?
A F: I don’t see any termination within the near future because I judge [my career] by my energy and my effectiveness. And right now, with all due modesty, I think I’m pretty effective. I certainly am energetic. And I think everybody thinks I’m doing more than an outstanding job. I have a wife with incredibly good judgment, who will probably give me the signal when it’s time to step down. But I don’t think we’re anywhere near that right now.
NO: And is that role determined by the president and the White House?
A F: No.
NO: You can’t be fired from that role?
A F: No.
NO: How would you describe your relationship with President Trump?
A F: You know, it’s complicated. Because in some respects I have a very good relationship with him. During the times that I was seeing him a fair amount, it was quite a collegial relationship. And in many respects, it probably still is, but I don’t see him very much anymore.
NO: Why do you think that is?
A F: I think the tenor of what goes on in the White House has changed a bit. It’s very much now focused on reopening, and there’s a lot of attention being paid to economic and other advisers. So the task force and the doctors still meet regularly, and we have a very close, almost daily relationship with the vice president, and he briefs the president every single day on what we talk about. So in some respects, even though it’s indirect as opposed to direct, we still have access to the president through the vice president.
NO: How much of your day do you spend dedicated to finding a vaccine?
A F: The days vary. I get in there very early, working on NIAID business. It’s more than just coronavirus, but lately it’s been dominated by coronavirus. Then we have a daily meeting about the vaccine and the therapeutics and all the other things that go along with that. Then most days I’ll go down to the White House either to meet with the other doctors, meet with the vice president, talk with the staff, and then come back to the NIAID unit and do the 700 emails that are waiting for me.
NO: [laughs] That’s too many emails. So on to some of the more personal questions. How do you stay healthy?
A F: Well, I make exercise a significant part of my regimen. Christine and I put in 3½ miles of power walking every day. I used to say “run,” but I don’t run very much anymore because at the end of the run, various parts of my body hurt so much. Power walking is very enjoyable and relaxing, and we look forward to it. I must say, Chris is always ahead of me because she’s faster and in better shape.
CG: Since this pandemic began, I think we’ve been trying to walk every day, even if it’s sometimes late in the evening. It’s for mental and physical health.
A F: We’ve been lucky this summer because we have three daughters, who we miss very much. One of our daughters, Megan, is a schoolteacher in New Orleans, and when they shut down the schools there, she drove up here with her dog and stayed with us for a couple of months. And that was fantastic. Not only to see her but to have the dog. That gave us a lot of mental health. [laughs]
NO: Let me ask you, Chris, as a bioethicist, what do you make of this moment we’re in, when even a mask has become more of a divisive issue?
CG: Well, I would say that masks shouldn’t be divisive. It’s a relatively easy way to protect one’s self and others. And so for public health reasons, I think everybody should do it. From an ethical perspective there is always this tension between what you ask people to do that feels like a restriction of their liberty and what is required for public health. And in this case, it seems like a slam dunk. It’s not restricting liberty much, and it’s very helpful for public health.
NO: And how is your work life? Are you also working long hours?
CG: Yeah, we work too much. [laughs] He works more than I do. I have been working at home, and that creates a situation where there are no boundaries. I wake up in the morning and go to my computer first thing, and then I work until night. There is no difference between Monday and Saturday. There is no difference between 10 a.m. and 10 p.m. It’s not a healthy way to live, but…
NO: True. It’s important to have a place to go every day. Your husband has been in the spotlight for a long time, but given the current pandemic that we are in, how have you counseled him on that? How have you viewed it?
CG: Well, I mean, I think the thing that drives Tony is commitment to public health. And if it feels like he’s making a contribution to public health, then he’ll do it. He doesn’t care about stopping to eat or doing other things that are normal. He’s committed, and he works hard. People ask him to do things, and he continues to do it. So when he gets criticized, it feels unfair to me because he is working so hard for the right reasons.
NO: What feels unfair?
CG: That people are looking for things to criticize — I mean, for anything. They are making things up. They are not putting into perspective the contribution that he is making.
NO: What is the message about how you deal with criticism in the face of some very powerful people? What do you do?
CG: I think you stay focused on what your job is. As Tony said before, as long as his perspective is still valued and he’s making a difference, a contribution, then great. If that changes, then he’ll have to change.
NO: What do you think some of the ethical issues are with COVID-19 that we are going to have to focus on?
CG: There are millions of them, and we’ve been focusing on them. Starting with the issues around what do you do when a hospital gets to capacity and has no more beds or no more equipment? What do you do for health-care workers when they don’t have adequate PPE and are putting themselves at risk? Issues around end-of-life care for people who are dying alone and there are no visitors allowed and no extra support for them. Issues around public-health measures that need to be in place and the restrictions quote unquote on individual liberty. Issues around testing and immunity. Issues around distribution of health-care resources. I mean, there are just a million issues that have an ethical string to them.
NO: What would you say is your proudest achievement?
CG: My proudest achievement is probably my kids. And I’m also proud of what I’ve done at work. I’ve come a long way in terms of my career. When I first started, bioethics didn’t really exist. And now I’m the head of the department of bioethics, and I think I have made some useful contributions to the field.
NO: And what advice do you have for young women who might be interested in entering STEM or in bioethics?
CG: I am a big proponent of young people getting involved in science and technology. And especially women — but not only women, young men too. I think there are so many important and interesting things that can be done in science. I find it amazing that more people aren’t interested in finding scientific careers. Bioethics is a wonderful complement to science because all scientific endeavors have interesting bioethical issues. You have to understand the science in order to understand the ethical issues, and then you think about them in a constructive and useful way.
NO: Since you mentioned the lack of boundaries between work and the rest of your life, do you have to remind Tony to eat or stay healthy or drink water or anything like that?
CG: Yes, especially at the beginning — especially when I had to almost put a glass of water in his hands and get him to eat. [laughs] He has gotten better about that, but still, if he’s got too much to do, he’ll just go and go and go. I do have to remind him to eat and sleep and to drink water.
NO: And Tony, what about with Chris?
AF: She’s pretty good. She got more common sense than I do, that’s for sure. She works as hard as I do, but she doesn’t go off on these stretches of just forgetting about everything else except work, which I tend to do. I get distracted and go into a zone.
NO: How and when did you guys meet?
CG: We met at the NIH in 1983. I had just come to work there that summer, and Tony had been there for a while and was an attending on the unit that I was working on. I came on as the clinical nurse specialist. We met over the bed of a patient.
NO: Keep going!
CG: [laughs] I had just come back from spending two years with Project Hope in Brazil and came to work at the NIH. There was a patient, Pedro, on the unit at the time who was Brazilian and didn’t speak English. One day he asked me if I could speak to his doctors about sending him home because he really wanted to go home. So I set up a meeting with the fellows who were taking care of him and Tony, who was the attending physician. I had not met Tony before that. I was the interpreter. And Tony told him, “He may go home and be very careful about taking care of his health and doing his dressings and sitting with his leg up and things like that.” And when I told him that, Pedro said, “There’s no way I’m doing that. I’ve been in the hospital for months. I’m going to the beach, and I’m going dancing at night.” And I sort of in a split second decided to tell Tony, “He said he’d do exactly what you said.”
AF: She lied! [laughs]
CG: I lied! So the next day I was walking down the hall, and Dr. Fauci came by and said, “Can I see you in my office at the end of the day?” I thought I was going to get fired. But he asked me out to dinner. [laughs]
NO: [laughs] Why did you ask her out to dinner?
A F: Cause it was love at first sight. [laughs] She was intelligent, beautiful, spoke multiple languages, and she had a very wonderful bedside manner. I immediately said, “That’s a good start, so I have to go out with her.” That was in 1983, and we got married in 1985.
NO: If you ever get a chance to watch something together or listen to an album, what do you choose to listen or watch?
CG: Well, lately, all we watch is the news. [laughs] But I really like cop shows, like Chicago P.D., for example. It’s a great show, and Tony has come to like it. He likes the action-type shows and movies. The Jason Bourne movies are some of his favorites. But in the last four months I don’t think we’ve watched almost anything.
NO: Yeah, I haven’t either.
A F: I used to read two books a month for a total of about 25 a year. I used to alternate between biographies and history, as well as spy and detective and intrigue novels. And now, ever since coronavirus, I’ve actually stopped reading. I just don’t have time. I really used to enjoy reading in the evening or on a plane or on the treadmill. I don’t go on the treadmill anymore, and I haven’t been on a plane since January. Anyway. Simple life.
NO: I know. You are 79 years old. You are in a high-risk category even though you are healthy, right?
AF: Right, exactly.
NO: What do your daughters make of your job during this pandemic?
AF: My daughters are amazing young ladies. As you would expect, they love and care about their dad but are very worried about me. Worried about…
CG: The stress.
AF: The stress of the work. This real and perceived built-up conflict between me and the president makes them very nervous. They don’t like that. They got upset by the death threats and the harassment that I received early on. So it’s been tough on them; this has been a tough deal for them.
NO: How are you doing now with all of that stuff?
A F: All right. I don’t like the conflict. I’m an apolitical person. I don’t like to be pitted against the president. It’s pretty tough walking a tightrope while trying to get your message out and people are trying to pit you against the president. It's very stressful.
NO: Last question: What is your favorite meal together?
A F: Our favorite meal together has to be pasta … pasta and a glass of wine. [laughs]