Almost everyone has strong opinions about Dr. Anthony Fauci. Broadly speaking, Republicans have expressed criticism for his response to the pandemic. To Democrats, he is the voice of science.

While he has no direct political power, he does have influence.

With respect to Dr. Fauci’s words, while they have influence in decision-making, it is his lack of words that have sewn a larger web of repercussions.

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One job, prepare for a pandemic

When cases emerged in late December 2019, the key to preparedness was to define the mode of transmission. The genetic sequence was released mid-January and confirmed to be a coronavirus like MERS/SARS, with cases of asymptomatic infection documented by the end of January.

The identification of superspreading events, reports of infected health care workers and growing case counts by mid-January pointed to sustained human transmissibility and the potential for aerosol transmission.

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Fauci’s old-school, flawed mentality of not believing something until ample data is produced had profound effects as it cut off the response at the knees, not allowing the U.S. to respond quickly to the emerging threat. This ultimately left hospitals and health care workers underprepared.

Fauci said his mask advice changed with the science, but the science didn’t change

 “There is no reason to be walking around with a mask.” Dr. Fauci said many times in the early months of 2020. He was recently challenged on this statement during an interview on MSNBC, but his answer implied his “wrong” recommendation wasn’t wrong at all, but deception on his part as he assumed people would hoard masks, leaving a limited supply for hospitals. He was also objectively untrue when he claimed substantial data became available within a month regarding asymptomatic transmission and mask effectiveness – it didn’t. It had already been there; he waited for more.

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Ignoring the consequences of profound isolation and missed education

While early in the pandemic little information was known about children and COVID-19, by April 2020 it was becoming clear they were less affected by the illness. Fauci continued espousing that if community transmission was occurring, children could be infected. This kept schools closed despite international experience showing schools were not major contributors to the pandemic. 

Although it is hardly a virologist’s job to address the economic and mental health of the country, when consequences are caused by the very recommendations being made, the absence of acknowledgement is neglectful. Fauci has largely remained a silent party when it comes to admitting the profound losses that have resulted from his words regarding lockdowns and school closures.

It’s not what he says, it’s what he doesn’t say

Fauci is bound by the shackles of cultural norms where one does not overstep or criticize the Food and Drug Administration or the Centers for Disease Control and Prevention. By tiptoeing around these organizations, he misses the mark. Had Fauci spent a minute disparaging the FDA’s restriction on antibody therapy, and the delayed pause on the Johnson & Johnson vaccine, lives would have been saved. If we were to pause distribution on all medications that carry a risk of less than 0.0001% for adverse effects, we would pull nearly all medications from the shelf.

Fauci has repeatedly said up to 90% of Americans need to be vaccinated to reach herd immunity – this is wrong.

Instead, his focus has continued with prolonged isolation while awaiting vaccine induced immunity – a strategy that has never been implemented for a pandemic before.

Ignoring natural immunity while pausing the country to wait for vaccines

Fauci has repeatedly said up to 90% of Americans need to be vaccinated to reach herd immunity – this is wrong. He has walked back his statements to somewhat include natural immunity. There hasn’t been a new study to cause the change, he simply changed his mind as criticism grew.

In a recent interview he said despite being vaccinated he won’t go to restaurants and movie theaters or travel, a continuum of perpetual social isolation.

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The reason Dr. Fauci has remained in his role for decades is because he is a good bystander. He will not tell people to remove their masks until the administrative consensus around him wants it to be so, regardless of how delayed that may be.

To be sure, Dr. Fauci has gotten many things right. He is neither a villain nor a saint. There is a light at the end of the tunnel, but he continues to block it. The best thing he can do is take a rule out of his own playbook, stop being complacent and start following science. 

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