Dr. Fauci’s Legacy of Mistrust

Dr. Fauci just announced his retirement in December from his National Institutes of Health leadership posts, and presumably his position as chief medical advisor to the president. This would barely be a blip on the news radar screen usually, but not for Dr. Fauci.

The Wall Street Journal editorial board says Fauci has led the NIAID since 1984, and his personal research contributions are impressive. He first became known to the public during the early years of the AIDS epidemic, and his agency was an early backer of the mRNA technology that became the platform for two Covid vaccines.

Alas, he should have quit while he was ahead. Like several of the Hebrew kings of the Old Testament, including Saul, Hezekiah and Uzziah, Fauci started well but finished poorly. He let pride influence his judgment and his legacy will forever suffer as a result.

WSJ says the main legacy of his 38-year tenure will be as the public face of government during the Covid pandemic, for better and for worse. His reassuring authority won acclaim in the early weeks of the pandemic as Americans struggled to make sense of the threat. “Fifteen days to slow the spread,” he famously said in March 2020, and the Trump Administration and America picked up his refrain. But two weeks would stretch to two years, and policy recommendations would change with shifts in the political winds more than new scientific evidence.

Fauci and a host of public-health experts used their authority to lobby for broad economic lockdowns that we now know were far more destructive than they needed to be and caused far more harm than can be justified in any circumstance. He lobbied for mask and vaccine mandates that were far less protective than his assertions to the public. His influence was furthermore enhanced because he had an echo chamber in the press corps and among public elites who disdained and ostracized dissenters.

Science is supposed to be about public debate. You put up your scientific theory, based on your scientific data, and other scientists support or refute your conclusions based on theirs. But Fauci wouldn’t tolerate debate. In response to criticism, Fauci replied, “It’s easy to criticize, but they’re really criticizing science because I represent science.” The hubris in that statement is hard to swallow and represents the antithesis of scientific debate.

The integrity of some of his statements also came into question due to his conflicts of interest. WSJ says, “A flagrant example was Dr. Fauci’s refusal even to consider that the novel coronavirus had originated in a lab at the Wuhan Institute of Virology in China. This may have been because the NIH had provided grant money to the nonprofit EcoHealth Alliance, which helped fund “gain of function” virus research at the Wuhan Lab. In a semantic battle with Republicans, Dr. Fauci denied that the NIH funded such research. But his refusal even to consider the possibility that the virus started in a Wuhan lab showed that Dr. Fauci was as much a politician as a scientist.”

Even worse, Fauci smeared other scientists who disagreed with him. The Great Barrington Declaration, founded by acclaimed scientists Jay Bhattacharya of Stanford University, Martin Kulldorff of Harvard University, and Sunetra Gupta of Oxford University opposed blanket lockdowns and endorsed a strategy of “focused protection” on the elderly and those at high risk. It has now been signed by over 930,500 epidemiologists, physicians, and healthcare workers. Yet Fauci and others in government worked to deride that alternative so it never got a truly fair public hearing. “There needs to be a quick and devastating published take down of its premises,” NIH Director Frances Collins wrote to Dr. Fauci. He made sure that others got the message as well.

WSJ says the costs of that mindset have been severe, and not merely economic. We know now that states that locked down fared no better, and sometimes worse, than those that didn’t. (read California v. Florida Showdown) We also know that the vaccines, while invaluable against serious disease, don’t prevent the spread of Covid- even after multiple boosters. Even President Biden recently contracted the disease despite two booster shots and the maximal Covid protection that only a president of the U.S. can enjoy.

In announcing the departure of Dr. Fauci, President Biden recently said, “Whether you’ve met him personally or not, he has touched all Americans’ lives with his work.” That may be true, but more honest candor would have been better for America’s trust in public-health authorities. His legacy, unfortunately, will be that millions of Americans will never trust government health experts in the same way again.

Biden’s Monkeypox Failure

One of the leading assertions of the 2020 Presidential Campaign was that Joe Biden would better handle the Covid pandemic response than Donald Trump. Undoubtedly, many Americans believed, or wanted to believe, that was true.

Allysia Finley, writing for The Wall Street Journal, believes we now know the answer, based on the Biden Administration’s response to the monkeypox outbreak. She says, “Donald Trump was unlucky that a once-in-a-century pandemic struck in his re-election year. And Joe Biden is lucky that the current monkeypox outbreak is relatively mild. But his administration’s bumbling response belies Mr. Biden’s 2020 argument that he would have handled Covid better.”

Monkeypox, unlike Covid-19, has been around a long time. It was first identified in lab animals in 1958 and is a close relative of smallpox, though it is less lethal and contagious. Periodic outbreaks have occurred in Central and West Africa, where the virus is endemic and spreads among wild animals. Humans can catch it through direct contact with the skin lesions of an infected animal or person. A small U.S. outbreak in 2003 was linked to rodents imported from Ghana by an exotic pet dealer. The virus infected 71 Americans, but was quickly contained with the help of the smallpox vaccine. No one died.

This outbreak, coupled with growing concerns about bioterrorism, prompted Washington to seek a safer, more effective vaccine against smallpox and monkeypox. As a result, the federal government began to support the development of a new vaccine by Bavarian Nordic called Jynneos. In 2017, the Trump Administration awarded Bavarian a 10-year contract for freeze-dried vaccines, giving the U.S. rights to an estimated 13 million doses. The Food and Drug Administration approved the vaccine in 2019, and in 2020 the Trump Administration ordered 1.4 million doses in case of an emergency.

So far, so good. The Trump Administration had done its job to prepare the U.S. for the next monkeypox outbreak. Finley says, “So when the first monkeypox cases popped up in mid-May, the U.S. had the benefit of scientific knowledge, experience and a ready-made vaccine. The Centers for Disease Control and Prevention has reported 14,115 cases nationwide as of August 18, probably an underestimate since the virus can look similar to other diseases. No deaths have been reported in the U.S., but Biden officials’ inept response has made the outbreak far worse than it might have been.”

On May 22nd, President Biden said monkeypox was “something that everybody should be concerned about,” although reports indicated that the virus was mainly spreading among gay men. (Epidemiologists report 98% of U.S. cases thus far have been among gay men.) But then officials of the Biden Administration rushed to tamp down a brewing panic. “This is a virus we understand,” White House Covid response coordinator Ashish Jha said. “We have vaccines against it. We have treatments against it. It’s not as contagious as Covid. So I am confident we’re going to be able to keep our arms around it.”

But overconfidence got the better of prudence. At the time, the government had a mere 2,400 usable doses of Jynneos vaccine in its Strategic National Stockpile – enough to inoculate only 1,200 people. The other doses the Trump Administration had ordered earlier were filled at Bavarian’s new “fill and finish” factory in Denmark, which had been operating since early 2021. But the Biden FDA didn’t certify the facility until July 27, meaning that those doses couldn’t be distributed. As cases mounted, the administration ordered millions more doses in late June and July, but they too couldn’t be delivered until later this year or next.

In a vain effort to stretch the government supply, the FDA this month approved a new method for injecting vaccines in the upper skin layer, which would allow each single-dose vial to be split into five doses. Bavarian CEO Paul Chaplin warned officials in a letter that there was “very limited safety data available” to support this method, and local officials complained that healthcare workers weren’t trained in the different technique. Nevertheless, Biden Administration officials last week told states they would send them more doses only if they adopted this protocol!

As if this wasn’t bad enough, doses were misdirected because the administration used antiquated computer systems to distribute them to states, which couldn’t track the shipments. “Our response is completely inefficient and breaking the back of state and local responders,” Claire Hannan, executive director of the Association of Immunization Managers, told the New York Times.

While all this is going on, some 1.7 million courses of smallpox antiviral treatment, which could help patients, sit in Washington’s stockpile. European regulators have approved the drug to treat monkeypox, but the FDA has not, and the CDC is restricting access by requiring doctors to complete mounds of paperwork to prescribe it. The reason for this is that the National Institutes of Health wants to conduct a randomized controlled trial. This could delay treatment for many patients for years to come.

Finley concludes, “The Biden Administration’s haphazard monkeypox response may cause hundreds of thousands of Americans to suffer needlessly. Why should we think Mr. Biden would have done any better with Covid?” The answer is self-evident.


CDC Director’s Mea Culpa

The Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky announced a “restructuring to strengthen its response to public-health threats,” acknowledging shortcomings in its fight against the Covid-19 pandemic.

Brianna Abbott, writing in The Wall Street Journal, said Dr. Walensky intended to improve the agency’s communication, timeliness and accountability. The CDC has at times amended its guidance on masking, isolation and other mitigation efforts in ways that spurred confusion or lagged behind the trajectory of the pandemic. Recently the agency has faced new criticism for its response to the monkeypox outbreak.

“In our big moment, our performance did not reliably meet expectations,” Dr. Walensky said. “I want us all to do better, and it starts with CDC leading the way.” Notice she said “our performance”, not “my performance.” This is no mea culpa. The Wall Street Journal editorial board calls this “a mea minima culpa.”

Ms. Abbott says the CDC has drawn criticism during the pandemic including for changes to guidance on masking and for recommendations on how long to isolate after testing positive for the virus. Dr. Walensky has also drawn criticism for her communication of some CDC policies.

To encourage faster communication, Dr. Walensky wants to deemphasize academic paper publication from the promotion process, create an online mechanism to share findings before they are completely published, and expedite the data-review process to match the needs of the emergency. She wants to reshuffle the bureaucratic deck with an emphasis on ‘’action” and “equity.” In other words, if we have more equity in the CDC, we’ll get better results. This is “wokeness” as an excuse for failure.  She is blaming the process of communicating new scientific information, not the conclusions drawn from that process.

WSJ editors say her diagnosis and prescription are both wrong. The CDC once had a reputation for excellence, but Covid blew that up. Its bureaucracy, with 11,000 employees and some two dozen divisions, impeded a rapid and effective response to the virus. Bureaucracies always seek to expand their power and reach, often at the expense of their core mission. The CDC is certainly guilty of this as it sought to address social and environmental issues that are better left to the states or other agencies. Meantime, it has failed in its core mission, which is to track diseases, collect data to inform decision-making, and deploy resources to support local public-health responses.

Scott Gottlieb, former FDA commissioner under the Trump Administration, says agency scientists took a proprietary interest in their intellectual property: “Companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.”

WSJ says this culture of control has hamstrung the CDC’s response in other ways. During the early months of the pandemic, the CDC struggled to set up technical systems to analyze and share data. Some hospitals had to fax in information. Frustrated by the CDC’s pace, Health and Human Services Department leaders seized control of the Covid data in summer 2020.

WSJ says Democrats accused the Trump Administration of politicizing the CDC, but HHS’s seizure made data more transparent, not less. The CDC now posts more Covid data, but often late and omitting critical information. Instead of publishing raw data for outside scientists to analyze, the CDC often only releases studies that support its policies, such as mask mandates.

In my opinion, this is the heart of the problem – the politicization of the CDC. Just as the politicization of the FBI is destroying its credibility, the same is happening to the CDC. This became apparent early in the Biden Administration when Dr. Walensky announced to the press that studies by the CDC concluded that schools could re-open without the need for teachers to be vaccinated. Here’s what I said in a February, 2021 blog called CDC Director Caves to Politics:

“In an article published January 26th in the Journal of the American Medical Association (JAMA), three researchers from the CDC found “little evidence that schools have contributed meaningfully to increased community transmission” of the coronavirus. The CDC researchers looked at more than 90,000 students in 11 North Carolina districts and found that only 32 students and staff members were infected in school, while 773 got infected during the same period out of school. The science was clear; reopening schools was safe for children and teachers.

Then Dr. Walensky made her big mistake. On February 3rd, she announced these findings to the press. She made it clear that the science supported reopening schools.  In her statement she said, “Vaccination of teachers is not a prerequisite for safe reopening of schools.” This was a direct refutation of the demands being made by teachers unions before they would return to the classrooms. When asked about her statement, White House press secretary Jen Psaki responded Dr. Walensky was speaking “in her personal capacity” and not as the director of the CDC.”


Predictably, Dr. Walensky soon caved to pressure from the Biden White House to retract her statement. In so doing, she made it abundantly clear that keeping her job was more important than maintaining her personal credibility and the credibility of the CDC. What has transpired in the 18 months since that day has predictably been the decline of the CDC and rise of distrust among the American people.

Which brings us to this “restructuring plan.” It is my opinion, and that of many analysts, that this represents simply a public-relations campaign to resurrect the failing image of the CDC and the Biden Administration with less than 90 days until the mid-term elections. The only real way to change this situation is to change the leadership at the top of the CDC – and the White House.