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    Anthony Fauci, MD, on fighting misinformation, inspiring the next generation, and why we still need physician-scientists

    As “America’s doctor” steps down from his long tenure in public service, he reflects on the challenges but also the “satisfaction and gratification” of helping protect and preserve the health of the American people.

    Anthony Fauci, MD

    Credit: NIAID

    After almost six decades in public service, Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases (NIAID) and the public face of the U.S. government’s response to some of the most devastating infectious disease outbreaks of modern times, is stepping down this month to pursue what he has called “the next phase” in a long and distinguished career.

    Fauci joined the NIAID in 1968 as a 27-year-old newly minted physician, and was immediately captivated by the opportunity to do world-class research that he could then apply directly to the care of his patients. He was named director of the Institute in 1984, where he rose to prominence for his role in researching HIV/AIDS and caring for patients with the disease. He has advised seven presidents on such threats as Ebola, Zika, and the H1N1 pandemic flu of 2009.

    But Fauci became a household name only in the last few years, during the COVID-19 pandemic, when millions relied on his expertise to understand the science behind this highly contagious novel coronavirus. He also became a lightning rod for criticism, and he has received death threats even as the newly elected Republican majority in the House of Representatives threatens to investigate him over his handling of the government’s response to the pandemic.

    Fauci sat down with AAMCNews last week to discuss what we need to do to combat misinformation and disinformation, how to cope with a rise in violence against health care workers, and inspiring the next generation of physician-scientists.

    In your final White House press briefing, you urged people to get vaccinated, and yet we know that only about 70% of the population is fully vaccinated. Looking back, was there a moment when you began to realize that this wasn’t going to be a vaccination victory, so to speak, like there has been for smallpox?

    Well, you know, we have been stuck at 68% of the population being fully vaccinated with the primary series. And we realized months ago, literally several months ago, that we were not going to get much past that no matter what we said. So we continue to try to get people who have not been vaccinated at all to get their primary series, but right now we're trying hard to get people who did get vaccinated and maybe have gotten their first and second booster … to get the updated BA4-5 bivalent booster vaccine because we only have 13% of eligible people in this country that have received that booster. That is very discouraging. … The data are so powerful of the difference in hospitalization and deaths between vaccinated and boosted versus unvaccinated, that I just would hope that people would somehow accept these data, which is absolutely, you know, incontrovertible data of the advantage of getting vaccinated. So it is a bit discouraging. But we’re not going to stop trying. We’re going to continue the push of getting people vaccinated before the holiday season. … We now have come out with making vaccines much more easily available. We’ve reactivated the covid.gov/tests website … so now you can still get free tests delivered to your home by just clicking online. We’re trying whatever we can possibly do to get people vaccinated.

    Turning a little bit to that 30% who have not even gotten one vaccine. You know we have a big problem in this country of misinformation and disinformation. In your opinion, how did we get so off course? And do you have any thoughts about how we can get back to an era where people trust the science?

    You know, I really do wish that I had a good answer for you, but I just don’t. I mean, the degree of divisiveness in this country is so deep. And with that comes a mistrust in science, with a flavor of conspiracy theories and antivaxx tendencies. It’s a very difficult problem. You’re asking a very good question. How do we get back on track? Well, I would hope that over time when people see how that approach leads to more hospitalizations and deaths of people, and it hits home to people, that they [will then] understand. We’ve got to get back and realize that the common enemy is the virus, not each other, and that we are all in this together.

    You wrote a guest essay for The New York Times urging the next generation of scientists to speak out against misinformation. But it’s not easy when scientists become targets for violence, as you have been as well. What do you tell people in the field, either the younger generation or those who are in the field, who are facing these threats?

    Obviously, it’s so unfortunate that these threats are going on. But when I talk to young people … serving the public and protecting and preserving the health and the safety of the American public and indirectly the rest of the world, because the United States is such a leader in that area, has so much satisfaction and gratification that … even though we are threatened and we are harassed as public health officials, the ultimate end game of what we do is really worth it. It would be wonderful if we got encouragement instead of pushback, but there are enough people out there who really are very much supportive of the scientific, medical, and public health communities — many, many more so than those who are against it. But those who are against it are very loud about it. They have the megaphone of social media, which amplifies it and makes it look like quantitatively it’s more than [it really is]. But when you look at those who are encouraging of and supportive of the public health community, it far outweighs those who are not.

    You’ve spent a long time in government service and there are millions who are thankful to you for that. Were you ever tempted to go into private practice or into the private sector?

    No, because I’m totally passionate about what I have been doing over the last 54 years, 38 of which were as director of the Institute. I continued to see patients right up until [recently]. I run an active laboratory and I direct an extraordinary institute, you know, the leading infectious disease immunology research institution in the world. So I never was tempted to do something else other than that.

    You’re a physician and a scientist and an educator. Is the so-called triple threat in academic medicine a realistic goal for new physicians?

    You know, it is. It makes it a little bit more difficult because of the increased technical aspect of medicine that people get much more specialized. If you’re really going to be an expert in something, you have to devote [yourself to that specialty] almost full time. But there is still a place for the triple threat. There’s still a place for the physician-scientist and almost by definition the physician-scientist will be a triple threat because it’s science, medicine, and teaching. And that’s really what the physician-scientist does. You know, I don’t think that the days of the physician-scientist are over. I think we need them. They’re a very important component of the entire effort in medicine and health.

    You’ve talked about wanting to spend this next phase of your career inspiring the next generation of scientists. What else are you planning to do?

    I want to be out there lecturing and writing and addressing the current issues of the day, serving to give advice when my advice is sought after. I’m not going to be willy-nilly giving advice to people, but when people feel that they can benefit from my experience, I will be available for them.