A tale of two Fauci's -- Part 1 (Dr. Fauci)

Last update: Saturday 6/26/21

It was the best of times. It was the worst of times. The year 2020 witnessed the most deadly pandemic in over 100 years. This note discusses two doctors named "Fauci" at the center of this tragedy, one a hero to all; the other a villain to many. 

The first Dr. Fauci is a real medical doctor and a brilliant scientist. During 2020, he capped a long stellar career by masterminding the creation of some of the most effective vaccines ever developed for any disease in less than half the time that such developments usually require, thereby saving hundreds of thousands of lives in the U.S. and perhaps ten times that many worldwide eventually. 

The other doctor is an actor who plays "the nation's leading expert on infectious diseases" on reality TV news shows, especially on CNN where he is sometimes cast with another actor who plays one of his biggest fans, a reporter called "Wolf Blitzer" who is forever nodding his head in silent support for the leading actor's aura of infallibility. It's easy to confuse one doctor with the other because the actor's makeup enables him to look remarkably like the real doctor. So in order to avoid possible mixups, this note will always refer to the real doctor as Dr. Fauci and refer to the actor as "Dr. Fauci" in quotes.

Trump's reelection grand strategy

President Trump had been briefed in January 2020 that the coronavirus posed a clear and present danger to the U.S., a threat that he took very seriously. His response to this threat was Operation Warp Speed, a multi-billion dollar initiative to develop effective vaccines by the end of 2020, vaccines that would enable the U.S. population to achieve herd immunity. 

-- "Woodward book: Trump says he knew coronavirus was ‘deadly’ and worse than the flu while intentionally misleading Americans", Robert Costa and Philip Rucker, Washington Post, 9/9/20

Meanwhile, he needed to carry out two holding actions: (1) provide sufficient N95 respirators and other personal protective equipment to health care personnel, and (2) use social mitigation to keep the levels of infections and hospitalizations from overwhelming the U.S. healthcare system. Unfortunately, both holding actions failed. 

• President Trump invoked the the Defense Production Act of 1950 to expand the domestic production of N95 respirators for health care providers just once, a timid action that commanded one company, 3M, to increase its output; but the contracts did not go into effect until May 2021 ... but they were too little, too late. This left the health care providers, governors, mayors, and others to continue competing against one another for still scarce respirators from the usual suppliers in a wasteful bidding war. 
  
  -- "The Defense Production Act Won’t Fix America’s Mask Shortage", Wired, 4/8/20
  -- "3M Awarded Department of Defense Contracts to Further Expand U.S. Production of N95 Respirators", 3M, 5/7/20
  
  
• His efforts to flatten the COVID infections, hospitalizations, and death curves failed because of the irresponsible manner in which President Trump managed his task force, the CDC, and "Dr. Fauci".

Dr. Fauci to the rescue at high warp

Conceived in January 2020, Operation Warp Speed wasn't officially announced until May 2020.

• Official announcement of Operation Warp Speed, HHS, 5/15/20

Although President Trump claims credit for Warp Speed and its success, there are reasons for believing that the real founding father of this impressive initiative was Dr. Fauci: 

• First, any proposal to develop vaccines in nine months rather than the usual 18 months to three years or more would raise insurmountable concerns about risks and financial liability for the pharmaceutical companies who enlisted in this venture.  Doctor Fauci's towering reputation meant that his endorsement was akin to Einstein's 1939 endorsement of the Manhattan project's goal of developing a nuclear bomb as quickly as possible just before the U.S. entry into World War II. If Dr. Fauci said that high speed development was possible in principle, then it must be a considered to be opportunity worth pursuing. Here's a link to an interview with Dr. Fauci wherein he explains that speedy development would not conflict with the application of rigorous statistical measures of effectiveness
  
  -- "Anthony Fauci on Covid-19 reopenings, vaccines, and moving at ‘warp speed’", Helen Branswell, STAT, 6/1/20
  
   Because there was no way to guarantee that the vaccines would be effective, Warp Speed eliminated the financial risks for participating corporations by providing contracts that guaranteed billion dollar purchases of their vaccines by the federal government even if their vaccines failed to demonstrate the required efficacy during clinical trials.
  
  
• Second, Dr. Fauci's extensive professional connections with key players in the biomedical community made him aware of the vaccine technologies most likely to succeed, including mRNA, a new entry. According to Wikipedia, "At the onset of the COVID-19 pandemic, no mRNA drug or vaccine had been licensed for use in humans". Dr. Fauci's encouragement of PfizerBioTech and Moderna led to the development of two of the most effective vaccines (95%) and to their speedy approval in December, 2020.
  
  --"FDA authorizes Pfizer-BioNTech vaccine, first approved in the U.S.",  Carolyn Y. Johnson, Laurie McGinley, Paulina Firozi, Kim Bellware, Erin Cunningham, Hamza Shaban, Miriam Berger and Lateshia Beachum, Washington Post, 12/10/20
  
  -- "F.D.A. Authorizes Moderna Vaccine, Adding Millions of Doses to U.S. Supply", Denise Grady, Abby Goodnough and Noah Weiland, NY Times, 12/19/20

The third person responsible for ending the pandemic via vaccines was newly elected President Joseph Biden. As he had promised, as soon as he was sworn into office in January 2021, he began to "manage the hell" out of the distribution of the vaccines, distribution being a crucial missing component of President Trump's grand strategy. As of 6/26/21, at least 170,216,551 U.S. adults had received at least one dose of either of the two most widely available vaccines, PfizerBioTech's and Moderna's. The vaccines have had a huge impact on COVID related deaths, as evidenced by the following headlines:

• "An incalculable loss -- 100,000 lives", NY Times, 5/27/20
• "With Flags, Crosses and Photos, Mourning 200,000 Dead", Julie Bosman, Serge F. Kovaleski and Jacey Fortin, NY Times, 9/20/20
• "The number of people with the virus who died in the U.S. passes 300,000.", Amy Harmon, NY Times, 12/14/2020
• "The virus death toll in the U.S. has passed 400,000.", Patricia Mazzei, NY Times, 1/19/21
• "Covid-19: U.S. Surpasses 500,000 Covid-19 Deaths, a Monumental Loss", NY Times, 4/12/21
• "Covid has claimed more than 600,000 lives in the U.S.", Dan Levin, NY Times, 6/16/21

Although deaths increased from one news headline to the next, the approximate number of weeks between headlines tells the real story:

• Weeks between 0 in early January 2020 and 100,000 = 22
• Weeks between 100,000 and 200,000 = 17 
• Weeks between 200,000 and 300,000 = 13
• Weeks between 300,000 and 400,000 = 4
• Weeks between 400,000 and 500,000 = 13 ... under Biden
• Weeks between 500,000 and 600,000 = 8 ... under Biden

Before widespread distribution of the vaccines, the virus spread by an exponential process, wherein each increase of 100,000 deaths took fewer weeks than the time required for the previous increase of 100,000.  So the time spans form a decreasing series -- 22, 17, 13, 4 under President Trump, then 13 weeks during the first few months of President Biden's administration as millions of U.S. residents became vaccinated.

That the time span decreased from 13 weeks to 8 weeks for the latest 100,000 instead of increasing may reflect two recent factors: (1) a substantial decline in the rate of new residents receiving at least one injection; and (2) the increasing presence in the U.S. of  the more infectious and deadlier Alpha variant from the United Kingdom, and the even more infectious and even deadlier Delta variant from India

• "Vaccination rates fall off, imperiling Biden’s July Fourth goal", Dan Diamond, Dan Keating and Chris Moody, Washington Post, 6/6/21
• "How the ‘Alpha’ Coronavirus Variant Became So Powerful", Carl Zimmer, NY Times, 6/8/21
• "Spread of delta coronavirus variant exposes poorly vaccinated regions to renewed danger", Ariana Eunjung Cha, Karla Adam, Ben Guarino and Lenny Bernstein, Washington Post, 6/23/21

The moral of these numbers is simple ==> Without the widespread administration of highly effective vaccines, U.S. COVID deaths would probably have increased by 100,000 every few weeks since late January 2021. This would have driven the cumulative death toll from 600,000 in late June with the vaccines to somewhere way north of 1,000,000 in late June without the vaccines. Dr. Fauci deserves much credit for this monumental achievement and the nation's most profound thanks, e.g., another Presidential Medal of Freedom.

A tale of two Fauci's -- Part 2 ("Dr. Fauci")