President Biden’s chief medical advisor tells a large Tufts audience about vaccines and why smart public policy is so important for health
Faced with his worst nightmare—the outbreak of a global pandemic—Anthony Fauci said that clear and articulate public health guidance is the best way to overcome the challenges of combatting a deadly disease like COVID-19.
Fauci spoke on March 8 about mentorship, activism, and the stress of managing global pandemics to some 4,000 members of the Tufts University community as part of the Tisch College Distinguished Speaker Series.
As director of the National Institute of Allergy and Infectious Diseases for the past 37 years, Fauci has advised seven U.S. presidents on pandemics such as HIV/AIDS, malaria, tuberculosis, Ebola, Zika, SARS, H1N1 (or swine flu), and COVID-19.
Like many of the medical students listening to his remarks, Fauci got into medicine because of a “dual desire to do something intimately connected with people and the suffering and the joys of the human species,” he said. “There was no other profession I could think of that would combine both of those besides being a physician.”
Below are takeaways from the discussion with Fauci, which was moderated by Alan Solomont, A70, A08P, the Pierre and Pamela Omidyar Dean of the Jonathan M. Tisch College of Civic Life, and sponsored by Tufts University School of Medicine, The Fletcher School, and the Department of Political Science.
COVID-19 is Fauci’s worst nightmare. Over the years, Fauci said, he has been asked the question many times: As an infectious disease and global health expert, what keeps you up at night? His answer: A previously undescribed virus that jumps from an animal to a human, that’s extraordinarily efficient in spreading from person to person through the respiratory system, and has a high degree of morbidity and mortality either generally or for some groups of individuals.
“It turns out that in January 2020, my worst nightmare came true, and we’ve been living it for over a year,” he said. “It’s the only disease in which 30 to 40 percent of the people who get infected have no symptoms at all, yet it can kill so many other people. In this country, 525,000 people have died, we have 28 million infections, and 2.5 million people have died worldwide.”
Fauci, who is the chief medical advisor to President Joe Biden, said 50 to 60 percent of COVID-19 transmissions occur from a person who has no symptoms to a person who is uninfected, which experts didn’t know at the beginning of the pandemic, and which makes isolation and contact tracing difficult.
The way to beat a pandemic is by pulling together. Fauci called for clear, articulate, and rational public health guidance as he shared estimates on the continued rollout of vaccinations. Though vaccine clinical trials in children are ongoing, he said high school students should be eligible for vaccinations this fall, while elementary-aged students likely will be early in 2022.
He said the ideological divisiveness that has consumed the U.S. in recent years made battling the virus more difficult, and likened it to a war, saying “the common enemy is the virus, and when you have a common enemy, the only way you can attack is when everybody pulls together.”
Correcting racial inequity in medicine will take decades of commitment. A student at Tufts University School of Medicine asked Fauci about how the medical community can mitigate the disproportionate effect of chronic and infectious diseases such as COVID-19 in people of color.
“The immediate thing is to make sure you do whatever you can as a health official, as a physician, to provide access and go the extra mile to get access to people of color,” Fauci said.
In the long term, he added, structural racism leads to social determinants of health, such as economic disenfranchisement and lack of accessibility of a good diet. “When this outbreak is over, negative social determinants of health are still going to be there, and it’s going to require a decades-long commitment to get rid of them.”
Get a good mentor and be a good mentor. Fauci said his numerous professional achievements wouldn’t have been possible without strong support early in his career from his mentor, the late Sheldon Wolff, former chair of the Department of Medicine at Tufts University School of Medicine.
Wolff took Fauci under his wing at the National Institutes of Health (NIH) and put him on a project where they developed life-saving therapies for Wegener’s granulomatosis, or granulomatosis with polyangiitis, a disorder that causes inflammation in blood vessels in the nose, sinuses, throat, lungs, and kidneys. It used to be fatal, but Fauci’s treatments under Wolff’s supervision brought remission rates up to 93 percent.
“He put me on a highly successful project and made me the principal person, which was totally unselfish, because he could have made me the gopher boy,” Fauci recalled. “Having an unselfish mentor who cares about you and your career is not only good for you personally, it’ll set an example so that you will be conscious of the importance of mentoring younger people when you reach a level of achievement in your own career.”
The medical community should listen to activists. In the summer of 1981 while at the NIH, Fauci saw the beginning of the HIV/AIDS pandemic in the United States. An advisor to Ronald Reagan at the time, Fauci tried to call national attention to an emerging crisis that mostly was affecting gay men, but the Reagan administration refused to sound the alarm.
Activists for the gay community saw Fauci as the face of a federal government that was ignoring the growing threat to their lives, and they felt excluded from discussions about the direction of AIDS research. Though they stormed the NIH to hang him in effigy, called him a “murderer,” and shut down highways with their protests, Fauci said he was not intimidated.
“I did something which was probably the smartest thing I have ever done in my career. I said, let me listen to these people,” he said. “I invited a handful of them to my office. That started a dialogue that is still going on to this day. They added value to what we did.”
Angela Nelson can be reached at angela.nelson@tufts.edu.
