Medical Examiner

The Last “Trusted Doctor”

Anthony Fauci’s credibility did not make it through the pandemic intact. Maybe that’s a good thing.

Dr. Anthony Fauci sitting calmly at a table with his hands folded and a pen between his fingers.
The good doctor. Anna Rose Layden - Pool/Getty Images

After four decades of spearheading America’s responses to infectious disease threats from AIDS to monkeypox, Dr. Anthony Fauci announced on Monday that he plans to step down. Some are toasting the achievements of a towering figure in public health, while others are celebrating the exit of a government official whom they view as having mismanaged the COVID-19 pandemic. Back in April 2020, Fauci was one of the most revered figures in America—the “trusted doctor” so many sought to guide them in uncertain times. But now, Fauci is closer in popularity to the IRS.

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Fauci’s personal achievements as a scientist are indisputable—he’s one of the most-cited living researchers on the planet for his work on HIV and other topics. But his legacy as a government health official will, for better or worse, be more complicated. In a pandemic that was weaponized by a cynical president from the very start, Fauci may have tried to stay above the fray, but now, he’s firmly in the grip of politics. Even on his way out the door, some congressional Republicans still want  to investigate Fauci for his handling of the COVID-19 response (as well as for the conspiracy theory that he indirectly caused a lab leak in Wuhan, China). “Fire Fauci” has become a common refrain on the right. Even some Democrats have grown increasingly tired of the government’s pandemic guidance. Did Fauci fail to rise to the occasion, or did the occasion drag him down?

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Now 81, Fauci has served as head of the National Institute of Allergy and Infectious Disease since 1984, advising every president since Reagan. With President George W. Bush, Fauci developed the global program to fight AIDS known as PEPFAR, which has saved some 21 million lives. During the Ebola crisis in 2015, he donned PPE and helped treat an infected patient in part to show his staff that he wouldn’t ask them to do anything he wouldn’t do himself. Later that year, he hugged a nurse who had recovered from the virus to allay public fears about contagiousness.

Fauci is known as a deft navigator of science and the federal bureaucracy, but his long career hasn’t been without controversy. In 1989, AIDS activists stormed his office, accusing him of not doing enough to stop the epidemic. “He was public enemy number one,” Larry Kramer, the playwright and activist, told the Washington Post in 2007. When the police were about to arrest the demonstrators, Fauci halted the clash. He asked the demonstrators to come into his office, and eventually invited members of the group to serve on committees. “He opened the door for us and let us in, and I called him a hero for that,” Kramer said.

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Fauci had less success winning over his critics during the COVID-19 pandemic. Although he and President Donald Trump seemed to form an uneasy alliance in the pandemic’s early days, the commander-in-chief soon soured. Fauci publicly rebuked the Trump’s endorsements of unproven treatments, and he and the president quickly split ways on measures to contain transmission such as business closures and mask wearing. Eventually, Trump prevented Fauci from speaking, or at the very least, glared at him from behind the podium. Right-wing media and political figures were quick to pile on. Tucker Carlson suggested Fauci should be criminally investigated. Fox News’ Lara Logan compared Fauci to Josef Mengele, the infamous Nazi doctor known as the “Angel of Death.” Republicans in Congress introduced a “Fire Fauci Act” to reduce his salary to zero dollars (a jab, in part, at Fauci being the highest paid federal employee). Florida Gov. Ron DeSantis launched a “Don’t Fauci My Florida” line of beer koozies. As a result, Fauci became a household villain for many on the right.

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As the rhetoric escalated, there was a real danger that this coordinated character assassination was elevating the threat of a real-life assassination. In response to one farcical conspiracy theory about Fauci conducting unethical beagle research, people started leaving him menacing voicemails (“I hope they hang you from the highest tree”). Earlier this month, a man who threatened to kill Fauci was sentenced to three years in federal prison. The AIDS demonstrators of the 1980s had been angry, Fauci has noted, but not like his critics today. “They never threatened us in a serious way,” he told a New Yorker writer in 2020. He currently requires a full-time security detail that will likely be necessary well into his retirement.

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In no way is Fauci to blame for these violent threats, or for the overall heat of a far-right that probably would’ve been hostile to public health officials no matter how they handled the pandemic. Lower down the thermostat, though, it’s easy to see why Fauci, who became the face of the government’s pandemic response, was a lightning rod for more reasonable frustrations over COVID. Like most people in power during a fast-moving pandemic, Fauci has been wrong. Most infamously, he was wrong about masks and asymptomatic transmission early in the pandemic. He was also wrong about vaccines stopping transmission. He was dismissive about the possibility of the lab origins of the virus—which, though increasingly unlikely, could not at the time be completely ruled out—which later raised eyebrows and fed into conspiracy theories because the NIH had provided grant money that indirectly funded virus research in Wuhan. The stress of managing a pandemic in a withering political environment even caused the preternaturally composed Fauci to occasionally give in to the heat of the moment. (“If anybody is lying here, senator, it’s you,” he snapped at Sen. Rand Paul in a testy exchange last summer.) Some of Fauci’s apparent flip-flopping was legitimately due to evolving evidence, but some of them were overconfident predictions. It would be fair to call some of them missteps—but not Nazi-level war crimes. To conflate the two, as figures on the right have done quite casually, is unhinged.

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But a deeper issue, I think, is that the archetype of the “trusted doctor” just did not survive the pandemic. It might be easy to chalk this loss up to a hyperpolarized country that can’t agree about anything. Or to blame decades-long efforts to generally destabilize scientific expertise. These are both factors. But the loss of the trusted doctor is also about a nation confronting a truth easier to ignore before the pandemic: Public health is unavoidably political. Fauci’s strength as a communicator relied on projecting an air of neutral scientific authority, but in reality, that was always a bit of legerdemain—for him, or any scientist. So many of the controversies of this pandemic aren’t about facts, but values. That the mRNA vaccines save lives is an empirical fact. Whether we should mandate them is a political choice. When Fauci advocates for vaccine mandates—even if it’s consistent with the principles of public health—he’s taking a position that elevates collective benefit over individual choice. I happen to share those values, but a large swath of America doesn’t.

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Another factor is that there have always been some deeper flaws with the “trusted doctor” archetype, particularly when it tends toward the paternalistic. In a public health crisis, the CDC’s mantra is “be first, be right, be credible”—a set of goals that are surely admirable but are clearly somewhat in conflict with each other. Fauci was America’s prominent mouthpiece for delivering on this axiom. The problem was that Fauci was not always a straight-shooter. He and many others in the public health profession repeatedly told the public “noble lies”—statements meant to shape public behavior in potentially socially beneficial ways at the expense of the whole truth. In early 2020, Fauci downplayed the value of masks to protect supply for health care workers. In late 2020, in response to public polling, he “nudged up” his estimate of the threshold for herd immunity to motivate people to get vaccinated. It was hubris for Fauci to think that as a medical expert—a class of people notoriously naive about social psychology—he could predict the behavior of the masses, and turn the dial himself.

Yes, the steady dethronement of science has taken a dark and troubling turn, as Fauci’s death threats reveal. This is a menacing social problem, and one that public health alone cannot solve. But if there’s one useful lesson the scientific community can take away from Fauci’s diminished standing, it’s that the CDC’s lauded mantra for crisis communication—“be first, right, be credible”—could use an addendum: “Be transparent.”

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