[D66] Afscheidsinterview Fauci (Wuhan Coronavirus 2019-nCoV #958)

[Dr. Marc-Alexander Fluks]

Bron:   Los Angeles Times
Datum:  22 december 2022
Auteur: Melissa Healy
URL:    
https://www.latimes.com/science/story/2022-12-22/fauci-warns-america-were-living-in-progressively-anti-science-era-very-dangerous-thing


Fauci's warning to America: 'We're living in a progressively
anti-science era and that's a very dangerous thing'
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Dr. Anthony Fauci, who turns 82 on Saturday, wants the record to reflect 
that he is not retiring. Really, he isn't. It's just that after 54 years 
as a government scientist and advisor to seven presidents, he is leaving 
the National Institutes of Health at the end of the year.

The nation's top infectious disease doctor insists he still wants to 
write, make public appearances and continue to shape research on 
infectious diseases. So he will continue to be a presence in the lives 
of his many fans - and his equally zealous detractors.

As Fauci tells it in his distinctive Brooklyn accent, he drove onto the 
NIH campus in Bethesda, Md., in June 1968, a 27-year-old physician fresh 
out of residency training. He burrowed into the burgeoning field of 
immunology and was well situated to help identify the source of a 
mysterious illness afflicting gay men in the early 1980s.

Fauci went on to lead the federal government's efforts to bring HIV/AIDS 
to heel after becoming director of the National Institute of Allergy and 
Infectious Diseases in 1984. In the decades that followed, he was key to 
shaping the U.S. response to the H1N1 flu pandemic, the Ebola outbreak 
and the Zika virus.

When a mysterious pneumonia-like illness was identified in Wuhan, China, 
in December 2019, Fauci was still at the helm of NIAID. His poker-faced 
visage loomed behind then-President Trump, who was predicting the virus 
would miraculously disappear.

It didn't, prompting Trump to call Fauci a 'disaster' and helping spawn 
a legion of trolls whose violent threats against the doctor and his 
family soon necessitated an armed security detail. Trump even wished 
aloud that he could fire Fauci but ultimately decided that doing so 
would detonate a 'bigger bomb' than keeping him on.

In addition to keeping him on as head of NIAID, President Biden made 
Fauci his chief medical advisor, a valediction to more than half a 
century of public service. Fauci spoke with The Times about his career 
and the continued fight against infectious disease.


Your career has been bookended by the HIV/AIDS and COVID-19 pandemics. 
Both diseases are still with us, and are likely to remain so for some 
time. Do you find that discouraging?

Not at all. The work with HIV is historically transforming. When we 
first started caring for patients, we would give an infected patient a 
life expectancy of eight to 12 to 15 months.
Almost all of my patients died.

Over a period of time, we discovered the virus and developed a 
diagnostic test. And over a few years, we developed a series of 
antiretroviral drugs, then we added the protease inhibitor. Today we can 
tell somebody who's infected with HIV that if they get on therapy, they 
are going to live an essentially normal lifespan.

And now, we have drugs that can 99% prevent infection with HIV. It's 
true we don't have a vaccine yet for HIV/AIDS, but hopefully we'll get 
it.

That's the science thing that I'm responsible for. I'm not responsible 
for the implementation of healthcare systems that don't get people into 
healthcare. I'm not responsible for the fact that there's a lack of 
equity. What I have been responsible for is the science, and the science 
has been an overwhelming success story when it comes to therapy and 
prevention. So am I discouraged? No, I think it's cause for celebration!


The public seems to expect quick, complete solutions. Do they fail to 
appreciate that science doesn't quite work that way?

I think there is a lack of appreciation for that. With HIV it was a 
gradual process of going from a complete lack of interventions in the 
early 1980s, to fielding interventions that proved slightly effective in 
1986-87, then progressively adding medications that were moderately 
effective, and now to having drug combinations that are universally and 
dramatically effective.

I think people think of science as something that you get up at bat and 
you hit a home run the first time around. It isn't that way - it's a 
gradual, iterative process that is cumulative, and that will ultimately 
get you to the endgame you want.


And when the progress of science takes an unexpected turn?

That's another lesson learned. Science collects data, and you act on the 
data that you have at the time.

In January 2020, we were learning about aspects of the coronavirus, and 
we had to, by necessity, make recommendations, make guidelines. We had 
to publicly discuss our understandings of the virus.

But the outbreak was dynamic, and science is self-correcting. So what we 
knew in January was one thing. When we later learned that the virus is 
readily spread by aerosol, and that 50% to 60% of the spread was by 
people who didn't even know they're infected, we had to change our 
recommendations and guidelines.

People sometimes said, 'You're flip-flopping.' It has nothing to do with 
flip-flopping! It was a case of continuing to make decisions based on 
the latest and most accurate data you have. After all, the SARS-CoV-2 
that we were dealing with in January 2020 was very different from the 
SARS-CoV-2 virus that we're dealing with now.

If you stick with the science, you're going to have to be prepared to 
change as the facts evolve.


You've had more experience communicating with the public than most 
scientists will ever have. What has that taught you?

That people don't hear the caveats. They hear the positive aspects of 
what you say.

As we communicate what we know, the only thing we can do better is to 
continue to try to emphasize that we're dealing with a moving target, 
and that what we're telling you now is based on the data as we know it. 
However, this may change, and we may need to change. Yet every time I've 
done that, the headline never includes the 'however.' They never, ever 
include the caveat.


The science of immunology is enormously complex. Yet people without 
science background need to understand enough of it to make sense of your 
recommendations. How do you deal with that?

You have to take special care in articulating its complexity. And you 
just have to keep the 'however' in the explanation.

I don't blame the public. But it is truly complicated - the whole idea 
of antibody immunity that goes up and then goes down, and the T cells 
that persist but are tough to measure, though they're probably the most 
important thing protecting you from severe disease. It's so difficult to 
get that into a soundbite. You can't report immunology in two sentences.


What happens when you add extreme partisanship to the mix?

It makes it untenable. Untenable! It makes people's willingness to 
accept the dynamic nature of the science impossible.

We're living in a progressively anti-science era, and that's a very 
dangerous thing when you're dealing with a very deadly pandemic that has 
already killed more than a million people in this country.


Do you ever ask yourself where we would be now with HIV/AIDS if we had 
today's level of partisanship back then?

I don't think we would be as advanced as we are now.

Ideological differences are a good way of keeping balance in this 
country. But not when it turns into profound divisiveness.

An example is if you look at the number of people vaccinated in red 
states versus blue states. There is absolutely no reason whatever that 
you'd make a decision about whether or not you are going to avail 
yourself of a lifesaving intervention for yourself and your family based 
on your ideological persuasion. It just doesn't make any sense.


You are among the most beloved doctors and scientists in the country and 
also among the most reviled. Are you OK with that?

For me personally, I don't care. But I'm not OK with the country being 
so divisive that they threaten the life and the safety of people like me 
and my family merely because I'm telling people to get vaccinated, to 
wear a mask where appropriate, to avoid indoor settings, and to abide by 
public health principles.

I mean, if that's the reason why I'm hated by people, that's a sorry 
state for the country.

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(c) 2022 Los Angeles Times