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

Last update: Tuesday 7/6/21 

Editor's caveat -- Readers are strongly advised to read Part 1 of this pair of notes before reading the following Part 2.

Spoiler alert -- Part 2 will reveal that "Dr. Fauci" is really Dr. Fauci.

Spoiler -- "Dr. Fauci" is really Dr. Fauci ... :-(

Apology -- OK, that was the lamest joke ever told. Readers are asked to accept our sincere apologies. The real Anthony Fauci played overlapping roles throughout the pandemic:

1. As Dr. Fauci, he was the scientific mastermind behind the drive to produce effective COVID vaccines in record time via Operation Warp Speed, the role discussed in Part 1
   
   
2. As "Dr. Fauci", he served on President Trump's task force in 2020 and became a principal adviser to President Biden in 2021 with regards to pandemic management, the roles that will be discussed in this note.

"Dr. Fauci" has a congenial demeanor, a quick wit, and an ability to express his thoughts concisely; the other members of Trump's task force, not so much. He quickly became the star of the task force, its unofficial leader, and its "go to" guy for the media's questions about any and all aspects of the pandemic. Invariably referring to him as "the nation's leading expert on infectious diseases", the media elevated "Dr. Fauci" to a status not unlike that of an infallible pope whose pronouncements were not to be questioned. 

The main point of this note is simple: throughout the pandemic Anthony Fauci deliberately confused the media and the public by conflating these two roles. He was rarely asked about his role as Dr. Fauci, the preeminent scientist behind Operation Warp Speed; but he was frequently questioned about his role as "Dr. Fauci", the policy adviser. Time and again he responded to policy questions by referencing his status as a preeminent scientist. This point is best illustrated by his responses to questions about masks.

A framework for pandemics

Our discussion of the conflated roles of Dr. Fauci and "Dr. Fauci" will be presented within the following framework:

• An administration must conduct two processes during a pandemic: (1) develop and deliver effective vaccines that will end the pandemic, and (2) limit the spread of the virus via social mitigation, especially during the period prior to the development and delivery of the vaccines.
  
  
• Biomedical expertise will be critical during vaccine development, i.e. a deep understanding of how the virus infects people and how to engage the body's immune system to block the virus.
  
  
• The critical expertise during distribution of the vaccines will be crisis management, logistics, and the "people skills" required to induce a super majority of the population (upwards of 70%) to be vaccinated.
  
  
• Biomedical expertise will be required to infer from the vaccine's method of infection the social mitigation guidelines that people should follow in order to limit the spread of the virus, e.g., social distancing, washing hands frequently, wearing masks, etc. 
  
  
• But once the social mitigation guidelines are identified, the most critical expertise will be crisis management and the "people skills" required to persuade a super majority of the population (upwards of 70%) to adhere to the guidelines. "People skills" will be most needed where the guidelines conflict with basic human instincts and/or lifelong habits, e.g., social distancing vs. our need to socialize.

This framework suggests that Dr. Fauci should have been at the center of the Trump administration's intensive efforts to develop vaccines, which he was; it also suggests that he should have minimal involvement in the Biden administration's intensive vaccine delivery efforts, which is what he now seems to have.

The framework suggests that Dr. Fauci should have been at the center of the task force/CDC efforts to develop social mitigation guidelines (including masks), which he was. So the only question is: why did "Dr. Fauci" and the other members of the task force play so large a role in the implementation of those guidelines? As health care professionals, none of them had professional expertise in crisis management nor the "people skills" required to persuade a super majority of the U.S. population to adhere to those guidelines. 

Masks -- Much ado about a change of mind

First, the bottom line .==> "Dr. Fauci" and the task force eventually made the right call about masks: people should wear them. Now for the fuss and bother.

Ideally one would always want to make important decisions based on a substantial body of scientific evidence; but in a fast moving crisis, like a pandemic, relevant scientific studies may not exist yet, and decision makers cannot wait until relevant studies are performed. In such cases one makes judgement calls based on common sense and prior professional experience. Prior experience with other viruses found that wearing masks impeded the spread of the viruses and saved lives; so it was plausible to assume that masks would be also impede the coronavirus and save lives; plausible, but not necessarily true.  

Indeed, the tricky coronavirus quickly demolished two other plausible judgement calls by "Dr. Fauci" and his associates that were based on their prior experience with other viruses: 

• People who are infected are not contagious until a few days after infection
• People who are infected are not contagious until they develop symptoms

Contact tracing soon showed that people who were infected with COVID were immediately contagious even though they didn't show any symptoms yet. Worse still, some people who were infected never developed any symptoms.

Unfortunately, there was no substantial body of scientific evidence for or against masks impeding the spread of the coronavirus in March 2020 when "Dr. Fauci" went along with the task force warnings against wearing masks; and there was no substantial body of scientific evidence or against masks when he flip-flopped with the rest of the task force a few weeks later in April 2020. The following blunt assessment appeared in a comprehensive review of all scientific studies of masks and the coronavirus that was published in Nature, one of the world's most prestigious scientific journals in September 2020. See "Face masks: what the data say", Lynne Peeples, Nature, 10/6/20.

"At the beginning of the pandemic, medical experts lacked good evidence on how SARS-CoV-2 spreads, and they didn’t know enough to make strong public-health recommendations about masks." [bold added by editor] 

A more recent overview of scientific studies was published by the National Academy of Sciences in "An evidence review of face masks against COVID-19", Jeremy Howard et al., PNAS, 1/28/21. Neither of these two comprehensive reviews could cite any studies about masks and the coronavirus that were published before June 2020. 

Returning to the bottom line of this discussion, "Dr. Fauci" and the task force made a judgment call against masks in March 2020; then they made another judgement call in favor of masks a few weeks later in Apri 2020l. Yes, they flip flopped, but so what. The only thing that matters is that their final call proved to be a good call because it subsequently received substantial support from the many studies cited in the comprehensive reviews that were published in Nature and PNAS in September 2010 and January 2021, cited above.

Nevertheless, here's what "Dr. Fauci" said in a recent podcast. A full transcript can be found here ==> "Anthony Fauci on the Lab Leak Theory and Emailing Mark Zuckerberg", Kara Swisher, NY Times, 6/21/21.) 

"First, he ["Dr. Fauci"] said no masks, then he said masks. Well, let me give you a flash. That’s the way science works. You work with the data you have at the time. It is essential as a scientist that you evolve your opinion and your recommendations based on the data, as it evolves. That is the nature of science. It is a self-correcting process. And that’s the reason why I say people who then criticize me about that are actually criticizing science. It was not a change because I felt like flip flopping. It was a change because the evidence changed. The data changed"

No matter what he says, the fact remains that "Dr. Fauci", the task force, and the CDC made two flip flopping judgement calls about masks that were not based on a substantial body of scientific evidence one way or the other. So why does "Dr. Fauci" continue to insist that their judgements were based on science? 

In Part 3 of this discussion, the author of this note will attempt to provide a logical rationale for why Anthony Fauci, a good man who has devoted his entire career to saving lives via the truths revealed by science, would stretch the truth in an effort to support a higher good. Unfortunately, his stretching produced some unanticipated consequences and associations with some very strange bedfellows. Oh what a tangled web we weave when we practice to deceive ... :-(

A tale of two Fauci's -- Part 3