Fauci: The Expert on Top

“Experts should be on tap, not on top,” Winston Churchill advised. The adage leaped to mind while reading the self-indulgent memoir, On Call: A Doctor’s Journey in Public Service, by Anthony Fauci, M.D. Both the book’s title and the degree following the author’s name make it clear Fauci wants to be known as an expert, a professional, one best able to decide.

I confess a similar self-indulgence. I have spent much of my life studying schools and school policy. Whatever the topic, I tend to think, probably too narrowly, “But how about the children? Aren’t they the future?”

Like me, Fauci keeps a single-minded focus on a dimension of great importance to him. Throughout his professional career, he has battled communicable diseases: Legionnaires’ disease, HIV (for many years), smallpox, SARS, bird flu, Ebola, Zika, and, of course, Covid-19. His participation in the war against communicable disease began over fifty years ago in a laboratory at the National Institutes of Health and ended as the world-renowned Director of the National Institute of Allergy and Infectious Diseases who publicly sparred with President Donald Trump and sighed with relief at the election of President Joe Biden.

Few experts are more confident than Dr. Fauci. On Call records very few mistakes throughout the doctor’s long journey through disease-mitigation minefields. He admits to having failed to spell “millennium” in a high school spelling bee. He acknowledges that, early in his career, his treatment of a tear-gassed Vietnam war demonstrator adversely affected bystanders at a nearby church. That’s about it. Certainly, no mistakes can be placed at his door when policymakers had to figure out how to respond to the coronavirus.

The closest to a mea culpa occurs in the passage describing Fauci’s spring 2020 testimony before a Senate committee chaired by the savvy Republican Senator from Tennessee, Lamar Alexander. A vaccine was being rushed through safety and efficacy trials under a program known as Operation Warp Speed, but it was unknown exactly when it would become available. Fauci was reluctant to say whether a vaccine was essential for getting the economy going again. “Am I right, Dr. Fauci?” asked Alexander. “You didn’t say you shouldn’t go back to school because we won’t have a vaccine by the fall?” Fauci replied with a dodge: “What I was referring to is that going back to school would be more in the realm of knowing the landscape of infection with regard to testing.” When some in the media interpreted the circumlocution as saying schools should remain closed, President Trump distanced himself from Fauci’s testimony: “Anthony is a good person. . . . I’ve disagreed with him. We have to get the schools open, we have to get our country open.” In the memoir, Fauci, protesting too much, insists “I did not say ‘do not open the schools.’”

At that point, the schoolhouse door became the pivot upon which the debate between politicians and professionals turned. When can schools open? Must teachers and students wear masks? Must desks be spaced an impossible six feet apart? How many positive tests does it take to shut down a school?

For Fauci, the answer to these questions depended upon biweekly infection rates. Week after week the hospitalization and fatality rate continued to rise. That was the issue. Not on his list of considerations: learning loss, social and emotional distress, a collapsed economy, small business failures, and plummeting stock markets.

Fauci, of course, was only the public face of the public health industry more generally. Professionals everywhere closed ranks behind the new science of masking, distancing, contact-tracing, and isolation.

Only a few were willing to commit professional suicide by signing the Great Barrington Declaration. They declared that social distancing and masks would not retard community spread; for that, vaccines or herd immunity were required. In the meantime, they said, more harm than good comes from shutting down schools and the economy. The virus was ordinarily not fatal for those who did not have co-morbidities or were younger than 80. Hospitalization rates for school-age children were miniscule. Interventions should focus on care for the most vulnerable.

As Fauci continued to insist on social isolation, his relationship with Trump soured, and he became the prime target of a mercurial, loud-mouthed boss unhappy with an underling. Fauci’s Senate testimony was a tipping point. With an election looming, Trump could not afford politically to leave workers unemployed and keep schools, restaurants, and businesses closed. To counter Fauci, he brought to the fore a radiologist at Stanford University, Scott Atlas, whose critiques anticipated the Great Barrington Declaration and who had been recruited as a special White House advisor.

To highlight the costs of school closures, Atlas invited me to a gathering at the White House attended by Trump, Vice President Mike Pence, Secretary of Education Betsy DeVos, Florida’s Commissioner of Education, and concerned parents. I was asked whether schools should open in the fall, vaccine or not. Atlas could anticipate my response, as I had shown in an Education Next article that past school closures had severe academic and social consequences: “Every year—indeed, every month—counts, if students are to fulfill their potential,” I wrote.

That line of thinking did not appeal to Fauci, who “had a lot of worries about the advice Scott was dispensing. Every day more people were getting sick. . . . We simply could not just let the virus do its thing, because people would die. Children could get infected, and some got very ill, and they almost certainly played a role in community spread. . . . Younger people were in fact dying.”

After Atlas arrived, Fauci disappeared from televised press briefings and returned to his day job at NIH. But he got his revenge. The Food and Drug Administration did not approve the long-awaited vaccine until December, though the testing process was showing upbeat results. Days before the election, knowing full well that the vaccine would soon be approved, Fauci nonetheless told the Washington Post, “We’re in for a whole lot of hurt. It’s not a good situation. All the stars are aligned in the wrong place as you go into the fall and winter season. . . . You could not be positioned more poorly.” He could take pride that his thumb on the scale, like any other small thing, could have made the difference in what turned out to be a dramatically close election.

The facts were otherwise. At that moment, the country was “turning the corner,” as Trump was saying on the campaign trial. Operation Warp Speed had proved successful. Within a couple of months, vaccines were being zinged into millions of shoulders, and the number of new infections began to decline. Unfortunately, the issue had become so politicized that many school districts, mostly in blue-shaded areas of the country, left schools closed through the rest of the school year and even into the following fall. All the forecasts of learning loss and social and emotional distress turned out to be roughly as predicted. No less important, community spread of Covid-19 was unrelated to the intensity of school closures.

As On Call draws to a close, the ever confident, unapologetic Dr. Fauci forgets to discuss these facts. Instead, the story ends with expressions of delight the day after the inauguration of the new president, saying “everything we do [is] based on science and evidence.” He admits that the “United States, the richest country in the world, had many more deaths per capita than we should have had.” But other factors are blamed, even though he, under the Biden Administration, had once again become the expert on top. The book closes by saying there is not enough money for the health care system, poor people get inadequate health care, more people in the United States have co-morbidities, and contact tracing was ineffective because of the “lack of a robust local health-care system.” With respect to schools, he never mentions learning loss and regrets only that social isolation had not been even more intense. “Mask wearing, social distancing and ventilation” should have been implemented more quickly and rigidly. The professional proves faithful to his calling.

That’s why Churchill thought political leaders should be “on top.” The political leader may make mistakes and often have narrow political objectives, but to achieve their goals, they must take a broader view than the expert as to what is critical.

Paul E. Peterson is the Henry Lee Shattuck Professor of Government and director of the Program on Education Policy and Governance at Harvard University. He welcomes your reactions to this post by email at paul.peterson@educationnext.org; responses will be curated and shared periodically.