Fauci looks back on the US response to the pandemic

AP Photo/Patrick Semansky

Yesterday the NY Times Magazine published a lengthy interview with Dr. Anthony Fauci titled “Dr. Fauci Looks Back: ‘Something Clearly Went Wrong’.” As the title suggests this is a retrospective and a chance to look at the US reaction to COVID with something like 20-20 hindsight.

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Fauci is always going to be his same prickly, defensive, often self-righteous person, but the interview was interesting (to me anyway) for how much Fauci was willing to step away from defending his record to admitting mistakes were made. More to the point, it’s possible that, given what we know now, things were never really going to go well for anyone anywhere in the world in that first year. Part of the problem is that our expectations for what was possible were probably just too high. We’ll get to that but as you might expect, Fauci starts from the position that the US response has been a failure.

David Wallace-Wells: Three years ago, in March 2020, you and many others warned that Covid could result in as many as 100,000 or 200,000 American deaths, making the case for quite drastic interventions in the way we lived our daily lives. At the time, you thought “worst-case scenarios” of more than a million deaths were quite unlikely. Now here we are, three years later, and, having done quite a lot to try to stop the spread of the virus, we have passed 1.1 million deaths. What went wrong?

Anthony Fauci: Something clearly went wrong. And I don’t know exactly what it was. But the reason we know it went wrong is that we are the richest country in the world, and on a per-capita basis we’ve done worse than virtually all other countries.1 And there’s no reason that a rich country like ours has to have 1.1 million deaths. Unacceptable…

I mean, only 68 percent of the country is vaccinated. If you rank us among both developed and developing countries, we do really poorly. We’re not even in the top 10. We’re way down there.

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There’s a footnote added to Fauci’s answer which points out that the US did worse than some and better than others.

According to Our World in Data, there have been more than 3,300 official deaths per million inhabitants in the United States from Covid-19. In Peru, which had some of the world’s strictest lockdowns, the total is over 6,400 per million inhabitants. In the United Kingdom, the figure is above 3,280. In Brazil, it is above 3,250. Officially, more than 2,700 Russians have died per million, as have more than 2,200 Swedes and 2,000 Germans.

But it’s at this point that the interview takes a turn as Wallace-Wells argues there really weren’t many actual success stories and Fauci agrees.

Wallace-Wells: You called America’s pandemic performance virtually the worst in the world on a per-capita basis. But judging by excess mortality, the U.S. ranks about 40th worst in the world — still much more brutal than you would want from the world’s richest country, but not quite as extreme. When I look around the globe, I guess you could say there were a few relative success stories in East Asia. But everywhere across Europe and the Americas, there are no real successes; it’s just degrees of failure. Policies differed from place to place, but not by that much. And while some managed better than others, everybody suffered.5 Which makes me wonder, was it vanity to believe, as many of us did early in the pandemic, that we had the tools we needed to bring the nightmare to an end?

Fauci: Yeah, you’re probably onto something there, David. I remember a public conversation I was having about the importance of a very effective degree of preparedness — how much it will allow you to escape significant damage from an outbreak. And I remember saying, depending on the transmissibility, morbidity and mortality of a particular pathogen, that sometimes no matter how well you are prepared, you are going to get a lot of hurt. This was one of those outbreaks. And you’re absolutely right. When you look around, nobody did great, except maybe one or two countries. Most everybody did poorly. Even those countries that had no political divisiveness the way we had, they did poorly.

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But we did do some things that helped a lot, like creating a vaccine that reduced mortality in under a year. Fauci allows that the global death toll, officially around 7 million is actually probably closer to 20 million. But he says it would have been double that if not for the vaccines. He also hints that maybe vaccine mandates were counterproductive ultimately, though he doesn’t quite go that far.

Fauci: But right off the bat, we were dealing with a new type of vaccine, an mRNA vaccine. And there was this smoldering level of suspicion and that divisiveness in the country. And then there was the whole idea of people not getting vaccinated, and then came mandating.

Wallace-Wells: You think that was harmful?

Fauci: Man, I think, almost paradoxically, you had people who were on the fence about getting vaccinated thinking, why are they forcing me to do this? And that sometimes-beautiful independent streak in our country becomes counterproductive.

But for me the most revealing part of this was something Fauci said about the early days of the pandemic in January and February. How much better could we have done? Would shutting things down a month sooner have really mattered?

Wallace-Wells: But looking back from the vantage of today, if we had implemented the policies that we implemented in the middle of March instead in the middle of February, would we actually be in a very different place now, in 2023? I don’t want to sound fatalistic, but it has been such a long pandemic. Would moving faster in those first months have made a material difference to our overall response?

Fauci: I don’t know. It is conceivable that we would’ve ultimately been in the same situation. And would we have been able to shut down the economy? Would the country have accepted it, when you had a handful of cases and one death? I’m not saying that’s a reason not to do it — we should have, probably, if we knew what we know now. But with just a few cases, I don’t know if we would’ve gotten the country to shut down.

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This is a moment in time that I think a lot of people, especially people on the left, barely seem to remember now. There really was a time early on when many people were very eager to blame all of our problems on President Trump. Many of those same people cast him as the villain and cast either Fauci or Gov. Cuomo of New York as the hero of the story, the person who was getting it right and following the science.

But looking back with hindsight we can see that for all his faults Trump wasn’t in charge of shutting down cities and states. As I said repeatedly at the time, public health is a state and local issue. Closing schools and businesses is not something a president can do under our system. And the early testing problems we had were mistakes made by the FDA and the CDC not by politicians.

Ultimately, all of the blame game for why we didn’t shut down the country sooner was nonsense that almost certainly never mattered. No one actually stopped this except for a few islands and China who used extreme isolation and mass testing to fend it off until they eventually dropped zero-Covid measures all at once and let the death toll mount.

But I’ll never forget all of the progressives on Twitter in 2020 who were counting out the daily death toll and implicitly or explicitly blaming the president for each and every death. And then Biden was elected and we’ve had about three times as many COVID deaths since he took office and none of those people say a word anymore. The president was 100% to blame and now the president is 0% to blame. The hypocrisy is astounding but not as astounding as the media’s tendency to studiously ignore it.

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By the end of the interview Fauci is back to his prickly, defensive self when talking about the lab leak theory and the funding of the Wuhan Institute of Virology. Click over to the full interview if you’re interested in that.

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