Fauci on What COVID Could Look Like One Year From Now
A conversation with the nation’s top infectious-disease doctor as the U.S. braces for another surge
It was bad enough that the Omicron variant shattered hopes of a normal holiday season, or at least what passes for normal in year two of the pandemic. Now it feels like we’re fated to live with COVID-19 in perpetuity, forever worried that when one variant fades, another will quickly take its place, that we’ll never, once and for all, throw out our face masks.
Anthony Fauci is more upbeat. No, we won’t wipe out the coronavirus, but we will reach a point where it’s tamed, he told me in an interview yesterday. Enough people will reach a level of immunity so that trip cancellations, wild stock-market swings, and self-tests won’t dominate our daily lives the way they do now, he believes.
I’ve been talking with Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases, regularly since the pandemic began. At the time of our first conversation, Donald Trump was president and Fauci was an unexpected pop-culture icon, a trusted voice speaking up for science. Now he works for President Joe Biden, and though he’s no longer a pariah within the White House, he’s a polarizing figure outside it. Right-wing pundits and politicians depict him as an unaccountable bureaucrat bent on curbing America’s freedoms. The Fox News host Jesse Watters spoke at Turning Point USA’s AmericaFest conference yesterday and used lethal imagery to describe how the audience might “ambush” Fauci with questions about research funding that could later be aired as footage on Fox or other conservative platforms. Fauci remains baffled by the hostility: How is he an enemy of freedom by urging Americans to get lifesaving shots?
Our interview has been lightly edited for length and clarity.
Peter Nicholas: Is this the new normal in America? Will we be taking PCR tests and at-home tests next winter?
Anthony Fauci: I do not think it’s going to be the way it is right now. Even with viruses that mutate and change, you reach a steady state where there’s enough infection and/or vaccination in the community that there is enough background immunity that the level of infection is both less in quantity and severe disease.
I don’t think it’s possible that we’re going to eradicate this infection, because we’ve only eradicated one infection in human history, and that’s smallpox. And I don’t think you’re going to eliminate it, because you have to have essentially a universal campaign for vaccination like we did for polio and measles. But what we can do is reach a level of “control” that we can live with—where it doesn’t disrupt society, it doesn’t disrupt the economy, and it doesn’t have us always looking over our shoulder wondering whether we’re going to get infected.
The short answer to your question is: I don’t think by any means we are going to be living with the kind of situation we’re in right now, where everyone is walking around testing themselves and worrying about outbreaks when you go to dinner or a movie. I really don’t see that. I see that there will be persistence of COVID-19, or at least SARS-CoV-2, but there’s not going to be the profound impact that it’s currently having right now in our society. Whether that’s this coming spring and summer or a year from now, I don’t know. But it’s not going to stay the way it is, for sure.
Nicholas: Why is it so difficult to get tested in the U.S. compared with some other countries, and particularly Europe? We’re nearly two years into the pandemic. Shouldn’t we have solved the testing problem by this point?
Fauci: In many respects it is much, much better than it was a year ago, but it still is not at the level that I believe would be optimal. Obviously, if you look at the effort that has been put in over the past year by the administration, it has been substantial. There have been a few billion dollars invested in getting anywhere from 200 million to 500 million tests per month. There are about 10,000 centers that are now going to be giving out totally free tests.
But there is a lot of activity to get to what I hope would be the ultimate endpoint that I’ve been talking about for some time—namely, to flood the system with tests so that anybody can get a point-of-care test anytime you want it. Literally. We’re not there yet.
Nicholas: Should the FDA have a different drug-approval process if we’re confronting such a fast-changing, mutating virus?
Fauci: The FDA has come a long way. Looking back to the days of HIV, when it would take years to get a drug approved, with the help of the AIDS activists we changed that dramatically to be commensurate with the challenge of the disease in question. Most recently, the FDA has gotten better and better at that. Obviously, they continue to reevaluate themselves as to whether or not the process is really appropriate for the nature of the challenge you’re facing. They always can do better, but I think they’ve really done a pretty good job.
Nicholas: The Biden administration has laid blame squarely on the unvaccinated. Here’s what the White House COVID-19 response coordinator, Jeff Zients, said last week: “For the unvaccinated, you’re looking at a winter of severe illness and death for yourselves, your families, and the hospitals you may soon overwhelm.” Is blaming people like this the best way to get them to change behavior and get a shot?
Fauci: I didn’t interpret it as blaming. I interpreted it as saying that the most vulnerable by far are going to be the unvaccinated. I think there are going to be plenty of breakthrough infections in people who have been vaccinated—and even some people who have actually been boosted—but the likelihood of their getting severe disease, all other things being equal, is much, much less than the very vulnerable people who are unvaccinated. So I didn’t interpret that as blaming anyone, but warning them to please get vaccinated because you’re very vulnerable.
Nicholas: Why haven’t the Biden administration’s efforts to get more people vaccinated worked? You’ve been on TikTok and social media urging people to get shots. Former presidents have tried. Why aren’t people listening?
Fauci: You’re right. We have not made a major dent in the 50 million or so people who are eligible to be vaccinated who’ve not been vaccinated. We’ve tried trusted messengers; we’ve tried making vaccines very easily available. And yet we’re not where we want to be. And that’s the reason why the administration has had to resort to requirements, a.k.a. mandates. You don’t want to use the word mandate, because it seems to be radioactive. But with requirements, you don’t have any other choice. I wish we could do it in a way that people of their own accord would decide they want to get vaccinated, if not because of their own health but almost as a societal responsibility. You can get infected and not get sick and yet pass it on to somebody else, and that person might be vulnerable enough to get seriously ill.
Nicholas: How do Biden and Trump differ in their handling of the pandemic response, in your experience?
Fauci: [Long hard laugh] Peter, you know the answer to that.
Let me try it so it doesn’t get too controversial when people read it. When you look at it historically, there were many aspects of what came out of the Trump-administration response that really were not aligned with scientific principles. There are very good examples of that: claiming that certain interventions worked when it was only anecdotal; listening to people who had no experience in public health. There were contradictory statements, like when [the former COVID-19 response coordinator] Debbie Birx and I spent a lot of time putting together a program of how we can slow the spread and the next day the president comes out and says, “Liberate Michigan; liberate Virginia.” Those are not things that are productive in getting control of an outbreak.
Whereas now we’re not doing everything perfectly, but there’s a full commitment on the part of the administration to let scientific principles be the sole guide of what we do. Absolutely, the underlying core basis of what we do is all science. And we have a very competent team of people with multiple areas of expertise and interest who every single day struggle together with how we can make things better. There wasn’t that kind of totally organized scientific team. There were a couple of people there who were health people—like Debbie Birx and I, and to some extent [former CDC Director] Bob Redfield—but there wasn’t a real core team literally devoting every minute of every day to it. So there’s a big difference, a really extraordinary difference.
Nicholas: Various conservative critics have targeted you for criticism, saying you’re trampling on people’s liberties. Just within the past couple of hours, I got a note in my inbox from FreedomWorks saying, “Dr. Fauci is an enduring example that liberty once lost is lost forever.” What do you make of such attacks?
Fauci: It’s unfortunate. I certainly don’t like it. Political divisiveness is the enemy of public health. I’m accused of destroying democracy and taking away people’s liberty. Go back over the record. Look at everything I’ve ever said. The only thing I’ve ever said are things to keep people safe and healthy: “Get vaccinated; wear a mask; avoid congregant settings.” So people are saying I’m destroying their liberty? I don’t get that. Maybe someone else does, but I don’t get that.
Nicholas: Is there anything in particular you’ve learned from COVID-19?
Fauci: The lesson is, when you’re dealing with a public-health crisis that involves everyone, don’t let divisiveness get in the way. Call a peace treaty. Call a time-out. Have your political differences ironed out in a different arena. But don’t apply your political differences to public-health principles. That is very, very destructive.
Nicholas: Are you personally gathering with family members outside your household this Christmas? How will you account for Omicron as you celebrate the holidays?
Fauci: Last year, my children, who live in three separate regions of the country, didn’t come in for Christmas. Mostly because they wanted to protect me because of my vulnerability, of my age. But this year it’s different. I’m vaccinated and boosted. My wife is vaccinated and boosted. And my three children are vaccinated and boosted. And they’re all here now; they just came in over the weekend. And they’ll spend the next few days through Christmas. Before they entered the house, they all got tested just to make sure. So they went the extra mile. So I’m going to have a very relaxed, warm family Christmas celebration the way we used to do, literally every year since they were born. We missed one year but we’re back in action.
Nicholas: What do you want for Christmas? What gift would make you smile?
Fauci: I already have the gift. My children are at home.