Why Anthony Fauci treats every trip to the White House like it’s his last

For much of the past four years, Dr. Anthony Fauci has been the public face of the government’s response to the COVID-19 pandemic — a status that has earned him gratitude from some and condemnation from others.

For Fauci, telling what he calls the “inconvenient truth” is part of the job. He spent 38 years as head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, during which time he advised seven presidents on various diseases, including AIDS, Ebola, SARS and COVID-19 .

Fauci still remembers the advice he received during his first visit to the White House to meet President Reagan: a colleague told him to act as if every visit to the West Wing would be his last.

“And what he meant was you should think maybe I should say something to either the president or the president’s advisors… they might not like to hear,” Fauci says. “And then it could lead to you never being asked again.” But that’s okay, because you should always tell the truth to the best of your ability.

During the COVID-19 pandemic, Fauci clashed repeatedly with President Trump. “He really, understandably, wanted the epidemic to go away,” Fauci says of Trump. “So he started saying things that just weren’t true.”

Fauci says Trump downplayed the severity of the virus, refused to wear a mask and claimed (falsely) that hydroxychloroquine offered protection against COVID-19. “And (that) was the beginning of a situation that put me at odds, not only with the president, but more intensely with his team,” Fauci said. “But… there was no going back. I couldn’t give false information or sanction false information for the American public.”

Fauci retired from the NIH in 2022. In his new memoir, On call: the journey of a doctor in the public servicehe looks back at the COVID-19 pandemic and reflects on decades of public health crisis management.

Interview Highlights

While appearing before the House Select Subcommittee on the Coronavirus Pandemic for answer the questions about the pandemic response

If you look at the hearing itself, it’s unfortunately a very compelling reflection of the divisions in our country. I mean, the purpose of the hearings, or at least the proposed purpose of the hearing, was to determine how we can do better to prepare for and respond to the inevitability of another pandemic, which will almost certainly occur. But if you listened to that hearing… on the Republican side, there was vitriolic ad hominem and misrepresentation of the facts, quite frankly. Instead of trying to really figure out how we can do better in the future. These were simply attacks on things that had no basis in reality.

On his interactions with President Trump regarding COVID-19

He’s a very complicated character. We had a very interesting relationship. …I don’t know if it was the fact that he recognized me as sort of a fellow New Yorker, but he always felt like he wanted to have a good relationship with me. And even when he came in and started saying, “Why do you say these things? You need to be more positive. You need to be more positive. And he would get angry with me. But in the end, he always said, “Everything’s okay, isn’t it?” I mean, we’re fine. It’s all good,” because he didn’t want to leave the conversation thinking that we were at odds with each other, even though many of his team members at the time openly disagreed with me, especially the responsible for communications. …So it was a complicated question. There were times when we thought he was being very supportive, and then he would get angry at some of the things I said, even though they were absolutely true.

Reading reports of a mysterious illness affecting gay men in 1981 (which would later become known as AIDS)

I knew I was dealing with a brand new illness. …What gave me goosebumps was that this was totally new and deadly, because the young men we were seeing were so far along in their illness before they came to the attention of the healthcare system medical, that mortality seemed to approach 100%. So, you know, that inspired me to… completely change my career direction, to dedicate myself to the study of those who were, at the time, almost exclusively young gay men suffering from this devastating disease, mysterious and deadly, which we finally, about a year later, gave the name AIDS.

On the trauma of caring for AIDS patients in the early years of the epidemic

Suddenly I was caring for seriously ill people, mostly young gay men for whom I had a lot of empathy. And what we were doing was metaphorically like putting bandages on hemorrhages, because we didn’t know the etiology until three years later. We didn’t have any therapy until several years later. And even though we were trained to be medical healers, we didn’t heal anyone and almost all of our patients died. …

A lot of my colleagues who were really in the trenches at the time, before we went to therapy, were really suffering from some degree of post-traumatic stress. I describe in my memoir some very, very devastating experiences that you have with patients and become attached to and do your best to help. …It was a very painful experience.

On working with President George W. Bush on the President’s Emergency Plan for AIDS Relief (PEPFAR), which aimed to combat the global HIV/AIDS crisis

The President, to his credit, called me into the Oval Office and told me that we have a moral obligation not to allow people to die from a preventable and treatable disease simply because of where they were born, in a poor country. , and this was at a time when we had developed drugs that were absolutely life-saving for people with HIV, allowing them to continue essentially normal lives here in the United States, in the developed world. So he sent me to Africa to try to determine the feasibility, responsibility and possibility of implementing a program that could prevent, treat and care for people living with HIV. And I worked on it for months and months after my return from Africa, because I was convinced that it was possible, because I was convinced that this disparity in accessibility to medicines between developed countries and developing countries was simply unacceptable. Fortunately, the President of the United States, in the person of George W. Bush, felt this way. And we implemented the PEPFAR program. … We spent $100 billion in 50 countries and it saved 25 million lives, which I think is an amazing example of what presidential leadership can do.

On the personal treatment of two Ebola patients during the 2014 outbreak

The fundamental reason why I wanted to get directly involved in the care of the two Ebola patients who came to the NIH is that if you look at what was happening in West Africa at the time – and it This was during the Ebola epidemic in West Africa. — is that health care providers were at high risk of becoming infected, and hundreds of them had already died on the ground caring for people in Africa – doctors, nurses and other health care providers health. Even though we had very good conditions here in intensive care to wear these spacesuits that would protect you, these highly specialized personal protective equipment, I felt that if I had to ask my staff to take risks by taking caring for people… I wanted to do it myself. I just felt like I had to do this.

We treated a slightly ill patient, with whom we behaved well. But the second patient was desperately ill. We had contact with him and we actually got these bodily fluids containing viruses – from urine to feces to blood to respiratory secretions – we put them all over our personal protective equipment. And that was one of the reasons why you had to very meticulously remove your personal protective equipment so as not to transmit this virus to any part of your body. So the protocols for caring for people with Ebola in this intensive care unit were very, very strict protocols, which we followed very, very carefully. But it was a very tense experience: trying to save the life of a seriously ill person while ensuring that you and your colleagues didn’t get infected in the process.

Sam Briger and Joel Wolfram produced and edited this interview for broadcast. Bridget Bentz and Meghan Sullivan adapted it for the web.