Fauci: I won't work for Trump again

What he really means is that he won’t work for a Republican president again. Because the only two Republicans in America who stand a chance of being president in 2025 are Trump and Ron DeSantis.


And I doubt a guy who’s selling anti-Fauci merchandise as part of his reelection campaign in Florida would be inclined to keep him around at NIH if elected president. Given how perpetually eager DeSantis is to please populists, firing Fauci feels like something he’d do before close of business on January 20, 2025.

In theory, I mean. In reality, Fauci would quit sometime between Election Day 2024 and Inauguration Day. Why give DeSantis the satisfaction of firing him, knowing that it’s coming?

Anyway, Trump now has his next campaign slogan. “Trump 2024: No more Fauci.”

Those with long memories will watch that and think, “Hasn’t he said he’s thinking of retiring but won’t do so until the pandemic ends? He’ll be gone for sure by 2025, since COVID won’t still be raging then.”

Uh, well, about that…

The “mass death” phase of COVID is probably over. Cases have tripled nationally in the past six weeks but deaths have dropped by half over the same span. At an average of 311 per day, we’re approaching the lowest daily death toll of the pandemic, set last July in the first flush of mass vaccination before Delta erupted. Three hundred deaths each day is still many more than the flu but at the moment we’re closer to achieving the “just the flu” aspirations of March 2020 than we ever have been.


The “mass infection” phase of COVID unfortunately is not over, to the dismay of scientists. Omicron continues to evolve and its spinoffs are becoming more contagious, never mind that the original strain of the variant was among the most contagious respiratory viruses ever recorded. What’s new about the current mini-wave gathering force in the U.S. is the extent to which reinfections are driving it, so much so that experts now fear that some people may catch the virus two, three, even four times per year, not unlike the common cold. Being vaccinated does seem to reduce your chances of infection and certainly reduces your chances of becoming severely ill, but the glory days of May 2021 where getting your shots — or getting infected — was supposed to render you immune from future infection are long gone.

How come? Why are people with natural immunity no longer protected from reinfection, even if they caught Omicron this past winter? Scientists are working to better understand the mechanics but it seems that Omicron doesn’t evoke as strong or as durable an immune response as earlier variants did. And surprisingly, subvariants like the B.2.12.1 strain that’s circulating in the northeast are managing to puncture people’s immunity despite the fact that they’re not wildly different genetically from the original Omicron strain. Normally a virus needs to undergo major mutations for a new variant to fool an immune system that’s had prior exposure to a parent strain. (That’s how Omicron went global so quickly.) But that’s not happening with Omicron’s evolutionary spinoffs. They’re infecting people who’ve had Omicron before and should be naturally immune.


Unlike previous variants, Omicron and its many descendants seem to have evolved to partially dodge immunity. That leaves everyone — even those who have been vaccinated multiple times — vulnerable to multiple infections…

“This is actually for me a bit of a surprise,” said Alex Sigal, a virologist at the Africa Health Research Institute. “I thought we’ll need a kind of brand-new variant to escape from this one. But in fact, it seems like you don’t.”

An infection with Omicron produces a weaker immune response, which seems to wane quickly, compared with infections with previous variants. Although the newer versions of the variant are closely related, they vary enough from an immune perspective that infection with one doesn’t leave much protection against the others — and certainly not after three or four months.

“The reality is that things are really not going well at the moment,” said one doctor at a COVID briefing at Harvard last week. “We all thought that we were in for a reprieve after the devastating omicron wave. And that was clearly the case until a few weeks ago.” Bloomberg cites data from Colorado that shows 82 percent of all reinfections recorded in the state since the start of the pandemic happened after Omicron became dominant last winter. More than 16 percent of reinfections came among people with at least three vaccine doses. Combine the rise in reinfections with the fact that Americans are softening on precautions after two years of misery and you see why doctors are worried about a new wave. Especially once B.2.12.1 spreads from the highly vaccinated northeast to less vaccinated parts of the country.


There’s another problem. Vaccine manufacturers are preparing to update their vaccine formulas this year to target the spike protein on Omicron instead of the one on the original Wuhan virus, which is now all but extinct. But … how effective will the vaccines be if Omicron is constantly spinning off new subvariants that excel at puncturing immunity? Eric Topol is worried:

Moreover, a major misconception is that the vaccines are holding steady to protect against severe disease, hospitalizations, and deaths. They are not. When a booster was given during the Delta wave, that fully restored protection against these outcomes, to the level of 95% effectiveness. But for Omicron, with a booster (or second booster) the protection was approximately 80 per cent, while still high, it represents a major, 4-fold (lack of effectiveness of 55 vs 20%) dropdown. Accordingly, the confidence that our vaccines, directed to the original strain from 2019, are highly protective from severe illness is exaggerated. No less are the clear signs that their durability of such protection reduced. All of this is tied to the marked evolution of the virus, and we yet lack any data on vaccine effectiveness versus the BA.2.12.1 variant, soon to be dominant here.

At the rate Omicron is evolving, it’s anyone’s guess when it mutates into a subvariant that reliably causes severe illness, not just infection. And since the entire population is now susceptible to catching strains like B.2.12.1, whether vaccinated or not, it will have no shortage of opportunities.


For the moment, though, if you have some form of immunity and are under 70, COVID may be best thought of as a cross between the common cold and the flu. You probably won’t die if you catch it but you won’t have a fun week. And you should expect to have those not-so-fun weeks multiple times per year. Which means Fauci may still be on the job in 2024 after all.

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David Strom 6:00 PM | May 21, 2024
David Strom 4:30 PM | May 21, 2024