He’s not. But his assessment, that we’ll live with Covid-19 for many years to come, is a startling admission from the longtime infectious disease expert who said the country could flatten the curve and achieve herd immunity, first through social distancing and then vaccination.
The ever-mutating, highly contagious coronavirus, which no country has conquered, upended those plans. With his career winding down, Fauci wants to help repair the national bonds that the pandemic shredded, and tamp down the partisan polarization that has turned him, and science itself, into a lightning rod. He’s even finding his commonalities with former President Donald Trump, his nemesis in the pandemic’s first year.
“We developed an interesting relationship,” said the Brooklyn-born Fauci. “Two guys from New York, different in their opinions and their ideology, but still, two guys who grew up in the same environments of this city. I think that we are related to each other in that regard.”
Fauci says he’s prepared for the onslaught of attacks that could come in a Republican-controlled House or Senate next year — with many running in the midterms on campaigns deriding the lockdowns, school closures and masking requirements that Fauci said were necessary pandemic precautions — but insists that is not part of his calculus for retirement.
“They’re going to try and come after me, anyway. I mean, probably less so if I’m not in the job,” he admitted, sitting in his office on the sprawling National Institutes of Health campus in Bethesda, Md. “I don’t make that a consideration in my career decision.”
If called to testify, Fauci will stress the importance of vaccines and boosters, but acknowledge there may never be a definitive moment when the country can claim victory over an evolving virus that has killed more than one million Americans and left thousands with long Covid symptoms.
The disease’s toll has slowed, the result of vaccination, acquired immunity and less-deadly strains. But it continues to kill more than 300 Americans a day, and the fear of a deadlier variant is ever-present.
“What we have right now, I think we’re almost at a steady state,” Fauci said.
The next chapter of the pandemic
Americans are flummoxed by what that means for them, especially as federal officials last week said all adults should get a second booster now — despite pharmaceutical companies estimating that updated shots targeting the latest strains could be available this fall.
At one point, health officials, including Fauci, expressed cautious optimism that the original regimen and one booster could be enough. Now, amid what Fauci says is a combination of fast-evolving variants and stagnating vaccination rates — Americans are left asking when this vaccination cycle ends.
“That’s a reasonable question,” said Fauci. “But the reason not to wait is that we’re not exactly in a lull.”
There are more than 130,000 documented Covid-19 cases a day, a figure that officials and public health experts say could be as much as four or five times lower than the actual infection rate as people take at-home tests or simply do not know they are transmitting the virus.
“I think, although I don’t know for sure, [that] over the next cycle or so, we’ll be getting towards a once a year boost, like flu,” Fauci said, expressing the uncertainty that has plagued scientists and the Biden administration when they contemplate the speed with which a new variant can take hold.
Even with the hope of moving to a flu shot-like schedule, that speed, with new strains sometimes becoming dominant in a matter of weeks, has humbled disease experts and vaccine developers worldwide.
Pfizer-BioNTech and Moderna in late June presented data for updated, Omicron-targeting vaccines to the Food and Drug Administration’s advisory panel and predicted shots could be ready in late August. By that time, Omicron subvariants BA.4 and BA.5 already accounted for more than half of U.S. cases. Reformulating the shots for those strains would push timelines through mid-fall.
It’s “not impossible, but more difficult” to develop vaccines for the next dominant coronavirus strain because of the variants’ pace, said Fauci. A more regular vaccination schedule could be anywhere from six months to two years away, he predicted.
Where Fauci goes from here
The issue now is whether anyone is listening anymore.
Some rejected his recommendations to get vaccinated, mask up or limit social events from the start, Fauci admits. But now even cautious Americans deferential to experts are tired.
“It’s becoming more and more difficult to get people to listen, because even the people who are compliant want this behind them,” Fauci said. That doesn’t mean giving up, he insists. “What I try to convince them [of], with my communication method, is we’re not asking you to dramatically alter your lifestyle. We’re not asking you to really interfere with what you do with your life. We’re just asking you to consider some simple, doable mitigation methods.”
Those methods have been mired in partisan battles. Federal courts have struck Biden administration vaccine-or-test mandates and mask requirements. Vaccination rates have faltered, especially among Republicans. Though nearly 80 percent of eligible Americans have received at least one Covid-19 vaccine, fewer than half have gotten a booster dose. Only 30 percent of kids between five and 11 years old are fully vaccinated, with low expectations for better rates among toddlers and infants.
Sitting in his office in March 2020, days before a federal lockdown would all but end in-person meetups for months, Fauci mulled that partisan divides over the coronavirus response were already more visceral than the early battles of the HIV/AIDS epidemic, when the first president he served, Ronald Reagan, refused to acknowledge the worsening outbreak and many politicians blamed gay men.
Asked about what has changed in more than two years since that conversation, Fauci is focused on how to reinvigorate trust in the science that led his decisions.
“I don’t think they can say anything about the science,” he said about Republicans in Congress calling for probes into his leadership and the Covid-19 response. “If that’s what you want to investigate, be my guest. My telling somebody that it’s important to follow fundamental good public health practices … what are you going to investigate about that?”
Notably, though, when asked what he wants his legacy to be, it’s not the coronavirus response. Fauci points to the virus that originally led him into infectious disease research and the NIAID director role in 1984, HIV/AIDS.
That work, he is quick to point out, always had bipartisan backing outside of Reagan’s hesitation. With Fauci’s urging, Trump pledged in a State of the Union address to end America’s HIV epidemic. President Barack Obama released the federal government’s first national HIV/AIDS strategy in 2010. And with President George W. Bush, Fauci says he accomplished what “may be the most impactful thing I have done in my career” – the founding of the President’s Emergency Plan for AIDS Relief, or PEPFAR, a global program the State Department estimates has saved 21 million lives.
In the decades since Fauci began work on HIV/AIDS, treating and preventing the virus has transformed. People live for years with HIV or can prevent transmission with daily pills and now, injections every few months. But an HIV vaccine remains elusive and, Fauci says, likely many years away.
“I don’t think there is anything else that I, Tony Fauci, can do except leave behind an institution where I have picked the best people in the country, if not the world, who will continue my vision,” he said. “I don’t need to be there for HIV, because we have enough good people that could carry it on.”