Public Service Exemplars: "A Finer Spirit of Hope and Achievement": Anthony Fauci
Anthony Fauci, a medical doctor specializing in immunology and infectious diseases, became a household name during the COVID-19 outbreak in 2019 and 2020. As director of the National Institute of Allergy and Infectious Diseases (NIAID), one of the 27 centers or institutes within the National Institutes of Health (NIH), he became the face of the U.S. government’s response to the first global pandemic in a century. Later, he served as a medical adviser to President Joe Biden. I discuss Fauci's life and times in my forthcoming book, Public Service Exemplars: "A Finer Spirit of Hope and Achievement."
In these conspicuous roles, he became a polarizing symbol. To some Americans, Dr. Fauci was a genuine American hero, a scientist dedicated to improving human health using rigorous scientific data to guide public health decisions, no matter how inconvenient the data might be. His calm, empathetic demeanor, and willingness to investigate possible solutions to the pandemic helped to mitigate a public health crisis that would have been much worse but for his presence and sage advice. His detractors charged that he bumbled his way through the COVID-19 pandemic, keeping schools and other institutions closed when he should have recommended to policymakers that they open much sooner. His slow, hesitant response led to a catastrophic economic downturn that cost many people their jobs and livelihoods. Fauci’s smug, paternalistic, conflicting medical advice as the pandemic continued may have cost lives as well. He was derided as “Saint Fauci” for his public persona as the wise old man who knew more than anyone else. He claimed to be a man of science and above the political fray, but critics charged that in fact he was a political operative masquerading as an apolitical scientist. One commentator noted that Fauci “is keenly aware that both the hero worship and the scapegoating are a consequence of his becoming a stand-in for the complex fallout of the pandemic.”
Anthony Stephen Fauci was born on Christmas Eve, 1940, in Brooklyn, New York. His father, Stephen A. Fauci, was a pharmacist educated at Columbia University. The family worked in the Fauci pharmacy as the boy came of age. His mother, Eugenia Lillian Abys Fauci, and his sister worked the cash register and stocked shelves. Young Tony delivered prescriptions on his bicycle and occasionally operated the cash register as well. His mother supplemented the family income by also working in a dry-cleaning store. Both sets of grandparents were Italian.
Fauci enjoyed a decidedly middle-class childhood. Raised as a Catholic, he later described himself as a humanist who was not affiliated with any religious denomination. As a boy, he enjoyed playing basketball and baseball and reading books about World War II.
Fauci attended Regis High School on the Upper East Side of Manhattan, graduating in 1958. He decided in high school that he wanted to be a medical doctor. For college, he attended the College of the Holy Cross, a private Jesuit liberal arts college in Worcester, Massachusetts, approximately 45 miles west of Boston. He graduated in 1962 with a degree in classics. He completed pre-med courses as well.
As Fauci told the American Humanist Association in 2021, “the Jesuit education that I had the good fortune to receive in high school and in college inspired my interest in philosophy and imparted important life principles. My outlook has since evolved to align with the concept of making the world a better place rather than being involved in any organized religion.”
He enrolled in the Cornell University Medical College (later named the Joan & Sanford I. Weill Medical College of Cornell University), graduating first in his class with an M.D. degree in 1966. His focus was on adult internal medicine, especially infectious diseases, and the immune system. He completed an internship and residency in internal medicine at New York Hospital-Cornell Medical Center.
Fauci joined NIAID as a clinical associate. He stayed there for his entire career, gaining an understanding of infectious diseases that few other medical professionals possessed. “During my time with NIAID, I wore three hats and was fortunate enough to make contributions in their corresponding areas,” he told an interviewer late in his career. “First, as a basic and clinical scientist where I was able to make individual contributions in inflammatory and autoimmune diseases research. With the NIH, I started out as a fellow in infectious diseases and clinical immunology and between 1972 and 1981, wearing my clinical immunologist hat, I developed highly effective therapies for the vasculitis syndromes such as granulomatosis with polyangiitis and established something of a reputation in that area. I also worked on the immunopathogenic mechanisms of HIV [human immunodeficiency viruses] infection which supported the development of HIV treatments.”
Fauci acknowledged that his career was defined, to some extent, by the acquired immunodeficiency syndrome (AIDS) epidemic. Beginning in 1981, Fauci and his team of scientists began studying this new outbreak, largely thought to be a disease limited to members of the gay community. Owing to this linkage, many citizens attached a stigma to AIDs, fearing that gays would infect heterosexuals if medical doctors did not isolate AIDS patients from those people not yet infected by the disease. Hysteria drove some heterosexuals to discriminate against gays. Reports of violent attacks on lesbian, gay, bisexual, transgender, queer (LGBT+) persons proliferated in the 1980s and 1990s.
By 1984, Fauci had become the NIAID director, and therefore a visible public servant. His visibility made him a frequent target of the LGBT+ community, which believed that the federal government was not acting with requisite speed to investigate AIDS and develop medicines to treat the disease. In October 1988, protestors arrived at the NIAID offices to call for improved research and development efforts.
The prominent AIDS activist Larry Kramer was especially vociferous in his criticism of Fauci, calling the doctor an “incompetent idiot” as well as a “pill-pushing” tool of the medical establishment. It was a foreshadowing of the barrage of criticism that would be aimed at Fauci decades later during the COVID-19 crisis in 2020 and 2021.
Fauci recalled those uncertain days in the early days of the AIDS crisis. “Well, to begin with you have to remember we knew next to nothing about the disease other than the fact that it appeared, initially at least, to affect only young, otherwise healthy men who have sex with men,” he said in an interview. This observation was not meant to add to the stigma. It was an attempt to understand the facts facing medical researchers. “We were convinced that we were dealing with a viral infection, knew that it was transmissible and was destroying people’s immune systems, but we did not know anything about the virus itself.”
It was a turning point in his life and career. “Many of my friends and mentors advised me against pursuing a disease that some thought might actually disappear after a while, especially given that I had already established a reputation as a young researcher in other areas,” he said. It would have been relatively simple to pursue other areas of research, but Fauci was intrigued. He wanted to know more about the origins and characteristics of the disease. “Of course, HIV did not go away, becoming a huge, global public health threat. Engaging with it took me beyond the walls of the lab and the hospital ward into the broader public health space which was all new and very interesting to me.”
NIAID was a small agency in 1984, when Fauci stepped into the director’s position. With a budget of $350 million—a modest amount compared with other public health agency budgets—NIAID had to pick and choose its battles. As he investigated the emerging data on AIDS, Fauci ran up against the limits of his budget as well as his knowledge. His most egregious error occurred in a 1983 academic paper when he observed that the presence of AIDS in infants and children suggested that the disease might be spread through “household contacts of patients with AIDS.” If this observation were true, the implications would be frightening, increasing the stigma associated with the disease. “If routine close contact can spread the disease, AIDS takes on an entirely new dimension,” Fauci concluded.
Members of the gay community were outraged at this conclusion. Their concern was that Fauci’s comments would only increase the hysteria that already surrounded the AIDs virus. Time demonstrated that Fauci was wrong, and he freely admitted the error. As he noted repeatedly throughout his career, medical researchers always face uncertainties when a new disease emerges. Invariably, preliminary data are incomplete, and conclusions reached in the initial stages of research change as the research progresses. Fauci based his 1983 opinion on information available at the time—information that proved to be inaccurate and unreliable.
By the late 1980s, the NIH and other federal agencies were channeling more research dollars into combating AIDS. Fauci made his peace with the LGBT+ community. Even Larry Kramer, Fauci’s most vocal critic, eventually conceded that the good doctor was not the imbecile that Kramer initially thought he was. Kramer subsequently called Fauci “the only true and great hero” in the government’s fight against AIDS and HIV.
During the ensuing the decades, Fauci was at the forefront of every major infectious disease outbreak in the United States. He was involved in the U.S. government’s efforts to handle the swine flu, Middle East respiratory syndrome (MERS), Severe acute respiratory syndrome (SARS), Ebola, and COVID-19. He was also a key participant in preparing the President’s Emergency Plan for AIDS Relief (PEPFAR). As his stature grew, he served as a visiting professor at medical centers and collected numerous honorary doctorates from around the world. By the early twentieth century, Anthony Fauci was well known, at least within the community of medical researchers.
He became most visible to the public beginning in 2020 as the COVID-19 pandemic began. A previously unknown virus arrived in the United States from China late in 2019. Public health professionals were slow to recognize the risks. By March 2020, the virus was infecting Americans at an accelerating rate. News stories proliferated, leading to a shutdown of American institutions unlike anything seen in a century. The National Basketball Association announced that numerous players had tested positive for the virus, and the remainder of the season was canceled. Actor Tom Hanks was in Australia with his wife, Rita Wilson. He announced that they both had tested positive for COVID-19, and they would be quarantined there. Medical professionals recommended that all citizens except for essential personnel shelter at home, avoiding contact with everyone, to the extent possible, outside of their immediate family. Schools shut down, shifting classes from face-to-face instruction to virtual learning. Businesses closed their doors, some permanently. As public and private institutions shut their doors, stock markets across the globe crashed. Political leaders forbade foreigners from entering their borders. The World Health Organization called the spread of the virus a “pandemic.”
President Donald Trump was running for reelection when the pandemic struck. Concerned that a deteriorating economy would imperil his political prospects, Trump reluctantly called for a 15-day lockdown to slow the spread of the virus, but he was reluctant to seek permanent closures. To manage the administration’s response, Trump established a coronavirus task force headed by Vice President Mike Pence. The task force held daily briefings, many of which were televised. The goal was to update the public on the latest news and medical advances in fighting the disease. Medical professionals hoped to provide an apolitical context for discussing COVID-19, but politics always played a part in the disease. The political landscape in the United States during the Trump era was so partisan and polarizing that every issue sooner or later became a political question.
As a member of the White House Coronavirus Task force, Dr. Fauci frequently appeared before the television cameras to discuss the latest research and developments. He had not been a recognizable public figure before the pandemic, but soon he emerged as the calm voice of reason in a hysterical time. His ability to speak in measured, jargon-free prose and his obvious knowledge after decades working in medical research soon made him a media darling. Millions of people around the world came to see the diminutive doctor as a credible expert on COVID-19 even though so little was known about the virus at the outset.
Not everyone was enamored with Fauci. Conservative Republicans, especially President Trump’s most loyal supporters, argued that Fauci was frequently mistaken about the appropriate COVID-19 response, and his advice that the United States should remain in lockdown was not based on sound science. They cited the evolving nature of Fauci’s advice. During an interview on March 8, 2020, the doctor remarked that “right now in the United States, people [who are not infected] should not be walking around with masks,” but “if you want to do it, that’s fine.”
At the time of the interview, the supply of face masks was in short supply throughout the United States. Health care professionals needed the few masks that existed. To avoid a shortage, Fauci warned that citizens should not wear them. Later, as production ramped up and the supply increased, Fauci altered his recommendations, urging Americans to wear masks whenever feasible. They were not always dependable, but masks offered some measure of protection against infection.
As the pandemic progressed and more Americans died, Fauci did not hesitate to criticize the administration. He concluded that if the Trump White House had “started mitigation earlier” that the mortality rate probably would have been lower. “No one is going to deny that,” he said.
Administration supporters were incensed that Dr. Fauci, a member of the coronavirus task force, had changed his advice and then criticized Trump for accepting his original recommendations. Fauci claimed to be a scientist who based his public comments on science and medical data, but in fact he was being disingenuous. In their view, Fauci was engrossed in politics and was changing his advice to hurt Trump politically. President Trump himself eventually reached this same conclusion.
If Republicans were frustrated with Fauci, he was frustrated with them. He believed that Trump and the politicians on the coronavirus task force were unnecessarily politicizing medical science. He acknowledged that his advice had changed, but Fauci argued that this evolution always happens when a new disease emerges. Medical professionals provide the best advice they can, but the advice changes as new information develops. As masks became more plentiful and research suggested that they halted the spread of the disease, he changed his recommendations based on the new data.
Reflecting on the pandemic during a 2023 interview, after he had retired from government service, Fauci explained that “It was challenging, especially in the first several months, and even beyond. It is very difficult to get across the idea that messages you shared in January might have to change in March because of new information. Unfortunately, many people interpret that as flip-flopping and lose confidence in the science underpinning the messages, while the politically minded use it to advance whatever their agenda happens to be.” In Fauci’s view, these people misunderstand the scientific process owing either to ignorance or a desire to score political points. “The truth is that changing positions or the hypotheses on which they are based is an inherent part of the scientific method. Science is a self-correcting discipline, and this self-correction is one of its greatest strengths. So, yes, it was very difficult to communicate around this issue. I did my best but clearly was not completely successful. Going forward, we scientists, especially in the field of public health where so much of what is said is public facing and open to debate regarding different trade-offs, will have to do better at that.”
Fauci was wildly popular in the early stages of the pandemic, but his popularity waned when American grew tired of the restrictions. As the lockdown dragged on for a month, the United States economy contracted more than at any time since the Great Depression in the 1930s. President Trump had been willing to listen to medical advice in the early days of the lockdown, but he grew frustrated with the delays. Fearing that a collapsing economy equaled a collapsing presidential campaign, Trump began calling for the economy to reopen regardless of the public health consequences. As part of the new messaging, he and his supporters openly criticized Dr. Fauci. The doctor became a scapegoat for the ills of the pandemic.
Fauci understood that he had lost the president’s ear. “For the first couple of months, he listened to me, and we had some constructive discussions about what our response should be, but then, unfortunately, he started taking advice from people who were saying things that were demonstrably untrue,” the doctor recalled in an interview. “For example, that drugs such as hydroxychloroquine were effective treatments for the disease. He was also saying that the virus would disappear like magic. I had to tell him that these things were not true. And not just him, I told the whole country, often openly contradicting what he had said.”
Florida Governor Ron DeSantis, preparing for a 2024 presidential bid, seized on the Fauci criticisms and repeated them endlessly, banking on right-wing Republicans’ anger about the coronavirus lockdown. In 2022, DeSantis sponsored a range of merchandise that appealed to COVID-19 deniers and conservatives with an anti-science bent. “Don’t Fauci My Florida” became the governor’s mantra. The slogan appeared on numerous T-shirts, hats, and other memorabilia. Another message asked, “How the hell am I going to be able to drink a beer with a mask on?” DeSantis and his supporters gleefully embraced the idea that the COVID-19 “crisis” was exaggerated even as mortality rate in the United States climbed into the hundreds of thousands.
It was little wonder that at the height of the pandemic, the state of Florida reported daily cases at almost four times the national average and the second-highest number in the nation. The state’s coronavirus death rate was approximately twice the national figure. Florida eventually had the fourth-worst number of current hospitalizations.
Ignoring the ravaging effects of the disease, Governor DeSantis commented on Fauci’s messages about the need for social distancing and the continued lockdown. “I’m just sick of seeing him,” DeSantis said with a sneer during a speech in 2021. “I know he says he’s gonna retire—someone needs to grab that little elf and chuck him across the Potomac.” The crowd cheered his remarks.
Fauci was astonished and disgusted when remarks by Republican elected officials emboldened unstable individuals to utter death threats against the doctor and his family. One man, fifty-six-year-old Thomas Patrick Connally Jr., was sentenced to three years in prison for making threats against a federal official. Connally said that he wanted to break every bone in Fauci’s “disgusting elf skull.” He was one of many unstable individuals who seized on Trump’s and DeSantis’s disdain for Fauci and threatened to kill the man who had become synonymous with the national lockdown.
As the anti-science attitudes of the right-wing Republican crowd intensified, Fauci was bewildered by the hostility toward him. He viewed himself as a public health official acting in good faith to help the citizenry mitigate the effects of a dread disease. Asked in an interview about the threats lodged against him, he confessed that “I was certainly concerned, and not just for myself but for my family. Standing up to the President made me public enemy number one as far as the far-right political elements were concerned. And even to this day I am being attacked viciously by those same elements, which remain completely loyal to him. But I really did not feel I had a choice. The truth is the truth, and the scientific evidence is the evidence. If we lose sight of that, we are all in big trouble.”
Fauci’s troubled relationship with Trump continued through 2020. Many Republicans urged the president to fire Fauci, but Trump resisted. Rather than transform Fauci into a martyr by relieving him of his duties, the president sent out messages undercutting the doctor. Oddly, on social media, especially Twitter, Trump told his supporters to ignore his administration’s public health messages. He said that Fauci was “a nice man” who was mistaken about COVID-19. The president and the doctor were estranged for the rest of Trump’s term in office.
Trump lost the presidential election in November 2020, despite his later claims to the contrary. On December 3, 2020, President-Elect Joe Biden asked Fauci to remain on duty as the NIAID director as well as accept a new role as the medical adviser to the president. Fauci agreed to serve. In 2021, Fauci assisted the administration in rolling out the new COVID vaccines that had been developed during the Trump administration. With Biden in the White House, Fauci remarked that he experienced a “liberating feeling” because he could speak freely without running afoul of the president’s political sensibilities.
On August 22, 2022, Fauci announced that he would retire at the end of the year “to pursue the next chapter” of his career. At the age of 82, he had served in public service for much of his adult life, and he wanted a new challenge. His annual salary at his retirement was more than $480,000, making him the highest paid employee of the United States government at the time.
The following summer, Georgetown University announced that Fauci would join the faculty as a distinguished professor. He was slated to teach classes in both the School of Medicine and the McCourt School of Public Policy.
By the time he left government service in December 2022, the list of Fauci’s awards was long. He received the Arthur S. Flemming Award in 1979 for meritorious service in the federal government. In 1995, he and Samuel A. Wells Jr. shared the Ernst Jung Prize for excellence in biomedical sciences. In 2003, the American Academy of Achievement awarded Dr. Fauci its Golden Plate Award. The Academy recognizes high achievers in public service, business, science and exploration, sports, and the arts. In 2005, President George W. Bush awarded Fauci the National Medal of Science, an honor bestowed to individuals who make important contributions in science and engineering. Three years later, President Bush awarded Fauci the Presidential Medal of Freedom. In 2007, the Association of American Physicians honored Fauci with the George M. Kober Medal for outstanding contributions to medicine or medical science. He won the Robert Koch Gold Medal awarded by the German Robert Koch Foundation for excellence in the biomedical sciences in 2013. That same year, the Prince Mahidol Award Foundation in Thailand bestowed an award on Fauci for outstanding achievements in medicine and public health worldwide In 2020 and 2021, after he had become the face of the U.S. pandemic response, Fauci received several awards, including the Knight Grand Cross of the Order of Merit of the Italian Republic; the John Maddox Prize bestowed by a United Kingdom nonprofit organization, the Sense of Science; a Presidential Citation for Exemplary Leadership from the National Academy of Medicine; the Blessed are the Peacemakers Award from Catholic Theological Union; and the Public Welfare Medal from the National Academy of Sciences. As of this writing, Dr. Fauci has received 45 honorary doctorates from colleges and universities in the United States and around the world.
Fauci also became a cultural figure, with numerous books and articles written about him. In 2021, National Geographic Documentary Films produced a film about his life and career. He was even lampooned on the popular television show Saturday Night Live, with Hollywood leading man Brad Pitt portraying Fauci. The good doctor was in on the joke. In an interview, Fauci laughed. “I think he did great,” he said of Pitt’s impersonation. “I’m a great fan of Brad Pitt, and that’s the reason why when people ask me who I would like to play me, I mention Brad Pitt. He’s one of my favorite actors.”
Fauci waited until relatively late in life to start a family. In 1985, at the age of 44, he married Christine Grady, a nurse and bioethicist with the NIH. They met as they treated a patient. His wife later became chief of the Department of Bioethics at the NIH Clinical Center. The couple had three daughters, Jennifer, Megan, and Alison.