Fauci v. Fauci: How America’s infectious disease chief evolved his pandemic advice

Dr. Anthony Fauci has been one of the undoubted media stars of the pandemic, so much so that even President Trump has opined the nation’s infectious disease chief should consider running for political office.

So when Fauci professed on Sunday that more lives could have been saved if aggressive social distancing had been enacted earlier in February, many in the media took it as a poke at the president and governors overseeing the pandemic, even suggesting Fauci may have been overruled in private.

“If you had a process that was ongoing and you started mitigation earlier, you could have saved lives," Fauci told CNN's Jake Tapper, suggesting “there was a lot of pushback about shutting things down” early in the pandemic.

But a review of more than three dozen public and media appearances and writings by Fauci, however, shows the nation’s infectious disease chief didn’t embrace — at least not in public — firm social distancing, bans on flights or cruises, or other strict measures during many opportunities in February or March.

In fact, during those two months he called the idea of banning restaurant eating “overkill,” urged healthy people to still go on cruises, and suggested there was no long-term benefit to shutting down domestic air travel, the review showed.

Fauci, for instance, specifically stated on Feb. 25 that it wasn’t “absolutely necessary” to impose social distancing yet. Then two weeks later, he declared he saw no problems with healthy Americans continuing to go on cruise ships, an activity that is hardly conducive to social distancing, as several outbreaks aboard ships have since proved.

“If you are a healthy young person, there is no reason if you want to go on a cruise ship, go on a cruise ship,” Fauci said during a March 8 news conference. “But the fact is that if you have an individual who has an underlying condition, particularly an elderly person who has an underlying condition, I would recommend strongly that they do not go on a cruise ship.”

Fauci gave a similar answer a week later when asked about whether he would like to see a ban on domestic air travel, saying he himself wouldn’t travel for a “pleasure trip” but saw no reason to impose a ban on domestic travel and might travel himself if a serious need arose. “I can tell you that has not been seriously considered,” he said on a Sunday talk show March 15 when asked about a domestic flight ban.

A month earlier, Fauci said even if a pandemic became widespread, restrictions on airline travel would not be helpful, except to provide some temporary delays for hospitals to get ready.

“If there is, and I hope it doesn’t happen, a broad pandemic throughout the world, travel restrictions are not going to help,” he said at a Feb. 7 news conference. “You can’t just travel-restrict everyone.”

Fauci similarly declined on March 15 to urge Americans to stop going to restaurants, saying it would be “overkill,” though he added he himself was avoiding eateries to avoid coming in contact with someone who had the disease.

“You don’t want to make a pronouncement that no one should ever go into a restaurant," he said. "I mean, I think that might be overkill right now, but everything is on the table. It may come to the situation where we strongly recommend — right now, myself, personally, I wouldn’t go to a restaurant. 

"I just wouldn’t, because I don’t want to be in a crowded place, I have an important job to do. I don’t want to be in a situation where I’m going to be all of a sudden self-isolating for 14 days."

Fauci also provided very different answers at different times about U.S. preparedness for the pandemic and the potential lethality of COVID-19.

For instance, Fauci declared on MSNBC on Feb. 25 that “we are reasonably well prepared. We have had a pandemic preparedness plan that we put together years ago.”

In that same interview, Fauci said the plan might eventually require mitigation strategies such as closing schools, teleworking, and imposing social distancing to slow the virus. “We need to start thinking about that now, even though it isn’t absolutely necessary to implement that now,” he said.

By March 12, when he appeared for congressional testimony, Fauci had changed his tune on preparedness, at least when it came to widespread testing for the virus, which he said was a “failing” of the American system.

“We’re not set up for that,” he said. "Do I think we should be? Yes. But we’re not."

By March 23, Fauci went even further, backing away from preparedness, suggesting in Science Magazine a post-mortem of COVID-19 might show the plan crafted over many years was insufficient.

“It’s almost like the fog of war," he said. "After the war is over, you then look back and say, ‘Wow, this plan, as great as it was, didn’t quite work once they started that throwing hand grenades at us.' It really is similar to that.”

Similarly, Fauci has offered two very different assessments of the mortality rate of COVID-19, writing in the New England Journal of Medicine in late March it could be about the same as a bad flu season and telling Congress a few weeks earlier it could be 10 times higher. 

Fauci’s evolution on social distancing, at least in public, is a cogent reminder that the science of infectious diseases is constantly evolving and only as good as the data and assumptions input to make decisions.

On that count, Fauci has been remarkably consistent, telling the news media from the start he doesn’t rely on modeling to predict the outcomes of pandemics. “I have been and still am and will always be somewhat reserved and skeptical about models, because models are only as good as the assumptions that you put into the model,” he told Fox News last week.

In other words, scientists and doctors like Fauci are learning as they go along too.

There will be plenty of post-mortems that will judge Trump, Fauci, Congress, federal scientists, governors, and hospitals after the pandemic ends.

In the meantime, Fauci on Monday made clear he doesn't want his Easter Sunday comments on earlier social distancing to be taken as a swipe at Trump, saying his claim of a pushback was a "poor choice of words."

“The first and only time that I went in and said we should do mitigation strongly, the response was, ‘Yes, we’ll do it,’” Fauci said, explaining Trump's reaction to social distancing.

Meanwhile, Trump said Monday he has no plans to fire Fauci.