US Pandemic Strategy And The Role Of Anthony Fauci And EX-NIH Director

Anthony Fauci and Francis Collins with Hillary Clinton: Credit Wikimedia Commons 

As the Omicron triggers new healthcare threat around the world, in the United States, recently obtained emails through a Freedom of Information Act request—made by the American Institute for Economic Research in the fall of 2020—revealed what is believed to be concerning exchange between Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID) and Francis Collins, MD, former director of the National Institutes of Health (NIH).

The ‘Great Barrington Declaration’, an open letter, was issued in October 2020 and signed by thousands of scientists, including a Nobel Prize winner. It contends that Covid-19 policy should prioritise the protection of the aged and vulnerable while reopening society and schools to the general public.

In an email, dated 8 October 2020, Collins wrote addressing Fauci and others that the ‘Great Barrington Declaration’ from the “three fringe epidemiologists who met with the Secretary seems to be getting a lot attention—and even a co-signature from Nobel Prize winner Mike Levitt at Stanford. There needs to be a quick and devastating published takedown of its premises. I don’t see anything like that online yet—is it underway”.

Collins appeared on television to affirm that the email was genuine and that he stood by his words. He thought the Great Barrington Declaration's philosophy of targeted protection would result in more deaths than the opposite position of one-size-fits-all restrictions at the time. Collins also reiterated his belief that the declaration's three writers were "fringe" scientists.

Collins wrote that email in October 2020, a time when there was a lot of uncertainty. Pfizer's continuing vaccine trials were still four weeks away from yielding positive results. Many Americans were fed up with continual restrictions, whether imposed by the government or enforced by themselves.

The Great Barrington Declaration and the John Snow Memorandum, two competing texts, were released and received thousands of signatures. The proclamation urged for targeted protection and the restoration of the normalcy of many people. Long-term one-size-fits-all restrictions were supported in the memoranda.

However, according to Wall Street Journal, Fauci responded to Collins’ email by saying that the takedown had begun. While citing a Wired article, WSJ wrote that there is no scientific split and it “argued lockdowns were a straw man—they weren't coming back”. The following month, the number of instances increased and restrictions were reinstated.

The retired NIH director also said in December 2021 that he was under political pressure from then-President Donald Trump and other Republicans to support untested Covid-19 treatments like hydroxychloroquine and fire Fauci.

He said: "I have done everything I can to stay out of any kind of political, partisan debates because it is really not a place where medical research belongs. I was not going to compromise scientific principles to just hold onto the job."

Spotlight On Fauci

Fauci’s position and point-of-view have raised questions in the United States. But can he be blamed for everything that went wrong for the country?

He was accused of flip-flopping decisions, also regarding mask usage. So, he clarified it in a June 2021 interview, while saying: “[earlier in pandemic] We were told that there was a shortage of PPE and masks, and we felt that we don’t want to take it away from others. Secondly, there was no data meta-analysis at the time that masks were effective outside of the hospital setting. And then three, importantly, we didn’t fully realize how pervasive asymptomatic spread was.”

“So what changed. It was clear there was no shortage of masks, cloth masks work, meta-analysis showed that in fact even outside of the hospital settings masks work. [Then] We were hit with the realization that anywhere from 50 to 60 per cent of transmissions occur from asymptomatic people. That’s the reason why we went from saying ‘you don’t really need to wear a mask’ to ‘you should really wear a mask’”, he said. 

Fauci then said: “That’s not flip-flopping that’s taking the evolution of data and making your recommendations based on the data.”

According to him, “Anyone who is involved in science to say ‘you should never change your mind’, doesn’t understand what science is…If you really get into and understand the evolving science, you have got to realize that things change.” 

“You have got to be humble enough and flexible enough that when you get new data you then change what you are doing based on the data. If you say, ‘I really want to never change’ because if you change you are flipflopping then you are back here and you don’t take advantage of the new data every week, every month comes by,” he added while saying that this is the thing that “some people don’t seem to understand”.

There were news and videos from last year which showed the flaws inside the Trump administration in terms of handling pandemic. The former President told veteran journalist Bob Woodward that he knew that the coronavirus was ‘deadly’ before it hit the country and worse than the flu but he intentionally misled Americans through his statements.

Trump was quoted as telling Woodward that the virus was "deadly stuff" before the first United States death was confirmed. Additionally, in the United States, a considering number of people are vaccine-hesitant, even to this day. They are against mask usage, they don’t want to take the jabs, and still, believe in conspiracies related to the pandemic—forcing President Joe Biden to release videos or post tweets while requesting people to take the vaccine and booster to save American lives.

But Republicans are still blaming Fauci for his role who has been vocal about the former administration. In November this year, Fauci told CBS news: “It's easy to criticize, but they're really criticizing science because I represent science. That's dangerous. To me, that's more dangerous than the slings and the arrows that get thrown at me. I'm not going to be around here forever, but science is going to be here forever. And if you damage science, you are doing something very detrimental to society long after I leave. And that's what I worry about.”

A Scientific Solution Through Discussion

The worrisome fact about the email from Collins to Fauci, as well as the televised interview, clearly indicates that he was unwilling to engage in the conversation with other experts whom he called “fringe” scientists. Even though Collins is certainly entitled to his opinion on issues of extraordinary pandemic policy, but his voice is just one of many which are also need to be heard.

When it comes to lockdowns or school closings, the answer to whether the benefits outweigh the risks, and if so, under what circumstances, is far from certain, and scientists will continue to investigate this for decades—as the asymptomatic cases and the evolving virus cannot be overlooked.

What to do and how to go about the restrictions or the American healthcare, should have been asked and answered through a series of public discussions and dialogues. Instead of calling for an immediate takedown, Collins and Fauci should have gone for a dialogue with other scientists that might also have led to better strategies for nursing home residents—the group most affected by Covid-19.

Vinay Prasad MD MPH is a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco said, “Jeffrey Flier, the former dean of Harvard Medical School, and I called for dialogue and debate among scientists without demonization in April 2020. I’m disappointed to see a few months later that the NIH director, a man uniquely positioned to foster such a debate, had actively sought to thwart and discredit scientists with alternative ideas to the pandemic response.”

Prasad wrote that Collins’ “ad-hominem comment that the authors were ‘fringe’ was unnecessary and unhelpful.”

According to him, in the weeks that followed, more dirt was thrown at the Authors of the Great Barrington Declaration, as well as experts who held opposing policy views and advocated for greater and harsher restrictions. He said that “the vitriol ensured that the country would not have the dialogue it so desperately needed”.

In an opinion piece at STAT, Prasad said, “I must admit that I don’t know what would have happened had scientists been more willing to talk to each other. I believe that the world of social isolation — a world of seeing each other through the Post-it-sized Zoom squares — led to dehumanization and irrational hatred, which led to two entrenched policy poles with little room for compromise.”

“Had Collins, a man who has contributed greatly to science, chosen dialogue instead of contributing to animosity and combativeness, we might have been in a better place today,” he added.

As of 27 December, the United States has recorded over 53,000,000 Covid-19 cases and more than 837,000 people have lost their lives while fighting the virus. The country has administered at least 500,222,330 doses of Covid-19 doses. According to the Reuters database, it is going at a rate of about 1,246,926 doses per day during the last week, which is about 63 per cent slower than its fastest 7-day pace.