Dr. Fauci Looks Back: ‘Something Clearly Went Wrong:’ In his most extensive interview yet, Anthony Fauci wrestles with the hard lessons of the pandemic — and the decisions that will define his legacy.

“Over several hours and multiple Zoom and phone calls in April, I spoke with Fauci about that: how he saw the full story of this historic public-health emergency and the role he played in it. At times, he was defensive, even combative, particularly when it came to episodes in which he felt that his own positions had been misconstrued and on the matter of gain-of-function research and the origins of the pandemic. But on the whole, he was reflective, even humble, especially about the way that Covid-19 exposed the limits of public health and, in his telling, kept surprising him and his fellow scientists. [..]

[Wallace-Wells] You called America’s pandemic performance virtually the worst in the world on a per-capita basis. But judging by excess mortality, the U.S. ranks about 40th worst in the world — still much more brutal than you would want from the world’s richest country, but not quite as extreme. When I look around the globe, I guess you could say there were a few relative success stories in East Asia. But everywhere across Europe and the Americas, there are no real successes; it’s just degrees of failure. Policies differed from place to place, but not by that much. And while some managed better than others, everybody suffered. Which makes me wonder, was it vanity to believe, as many of us did early in the pandemic, that we had the tools we needed to bring the nightmare to an end?

[Fauci] [..] I remember a public conversation I was having about the importance of a very effective degree of preparedness — how much it will allow you to escape significant damage from an outbreak. And I remember saying, depending on the transmissibility, morbidity and mortality of a particular pathogen, that sometimes no matter how well you are prepared, you are going to get a lot of hurt. This was one of those outbreaks. And you’re absolutely right. When you look around, nobody did great, except maybe one or two countries. Most everybody did poorly. Even those countries that had no political divisiveness the way we had, they did poorly. There were gaps and inadequacies in both preparedness and response that varied among different nations. [..]

[Wallace-Wells] You see an awful lot of normalization in this pandemic, as well. Is it possible, given that, to cultivate that more sustained commitment?

[Fauci] One of the things I did in my life that I’m most proud of that isn’t purely science was my outreach in the gay community during the early years of H.I.V. Now, the gay community with H.I.V. is very, very different from the ultraright MAGA community with Covid. However, there is a bit of connection there — a segment of society that was bucking against what the government was trying to do.

What the gay population was saying is that you’ve got to take our thoughts into consideration, and that you have a too-rigid clinical-trial apparatus. One of the best things I did in my life was put aside their theatrics and their attacks on me and started listening to what they had to say. And what they had to say was not just a kernel of truth; it was profound truth. It was mostly all true.

So I have always felt when there are people pushing back at you, even though they in many respects are off in left field somewhere, there always appears to be a kernel of truth — maybe a small kernel or a big segment of truth — in what they say. One of the things that we really need to do is we need to reach out now and find out what exactly was it that made them push back. Because so many people cannot be completely wrong.”

Full article, D Wallace-Wells, New York Times Magazine, 2023.4.24