After a lifetime in medicine and public health, and a year trying to curb the worst health crisis the world has seen in a century, Anthony Fauci has some simple advice for policymakers: “Don’t guess.”
That is, experts need to inform the public with confidence and clarity—but they also need to make sure their messages are founded on data. And when there isn’t enough data, they must be transparent about what they don’t know, and make explicit that “you are saying something that is possible, maybe likely, but you do not know for sure.”
Fauci, who has become America’s leading voice during the COVID-19 pandemic, spoke during a March 4 event hosted by the University of Chicago’s Harris School of Public Policy. In the hourlong conversation, he repeatedly discussed the importance of humility, and the willingness to publicly change course when new information emerges.
“You should be flexible enough and humble enough to know that, in fact, you’ve got to go with the data that you have—and if that means changing something that you said, you should not feel badly or even guilty about having to do that,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
“I get more humble as the years go by,” he added later, “because I realize how much I don’t know.”
The COVID-19 pandemic, which has killed more than 500,000 people in the United States and more than 2.5 million worldwide, has only underscored how little Fauci and other leaders knew at the outset. Looking back at the past year, Fauci reflected on the unprecedented challenge that the coronavirus has presented. Most respiratory diseases, he said, are spread by symptomatic individuals. With COVID-19, however, approximately half of all transmissions originate from someone who is not yet showing symptoms—or perhaps never does.
“We’ve been faced with something that is a very, very confounding virus,” said Fauci, who was appointed director of NIAID in 1984 and has served under six presidents. “That’s the, I would say, the very sobering part, and the humiliating part—the things that have made us very humble about this—is what this virus has taught us. It’s been a very painful learning experience.”
Fauci spoke as part of a virtual ceremony for the 2020 Harris Dean’s Award, which he received from Prof. Katherine Baicker, a leading health economist and the dean of Harris Public Policy. The Dean’s Award is given annually to an exceptional leader who has championed analytically rigorous, evidence-based approaches to policy, and who is an example for the next generation of policy leaders and scholars. (The previous winner was the late Supreme Court Justice Ruth Bader Ginsburg.)
During the event, Baicker praised Fauci’s dedication to public service as “a beacon for all of our students” and expressed gratitude for his presence as “an important champion and voice for safety and wisdom.”
Baicker, the Emmett Dedmon Professor at Harris Public Policy, also asked Fauci to discuss a future beyond lockdowns and social distancing. Will the widespread distribution of COVID-19 vaccines allow us to enter a “post-pandemic world”? Or will variants of the virus continue to reemerge, requiring us to remain vigilant through our public health measures and personal behavior?
“I don’t know the answer to that question,” Fauci said. “I just don’t. And the reason I don’t is that there are too many variables in there that I don’t have control over, nor do my public health colleagues.”
Part of the issue, he added, is that “a global pandemic requires a global response.” Even if the United States were to effectively vaccinate its population, variants can emerge in another part of the world and quickly spread. Preventing that sort of future, Fauci said, will require international coordination.
Fractured policy responses also can affect health measures on a more local level. Although a national organization like the Centers for Disease Control and Prevention can offer recommendations on how to prioritize vaccinations, states may decide to issue their own guidelines. In theory, that can allow local governments to better target essential workers and vulnerable populations, such as Black and Latinx communities who have suffered disproportionately.
“There’s a positive aspect to that, because they know better for their state,” Fauci said. “But often, there may be other motives of doing that with influences that are not necessarily directed towards the public health, but more towards influence—that if you have a little influence, you’ll get it first.”
At the end of the evening, Baicker asked Fauci what he looks forward to doing in a post-COVID world, whatever that may look like. He responded by wondering about how long it might take for people to embrace social interactions again—and spoke fondly of a local bar-restaurant that he and his wife loved to visit.
“We know the owners; we know the people,” Fauci said. “We sit down, we have a beer, we have a hamburger, we come home, and we go to bed. We haven’t done that in a year.”
—Prof. Jacqueline Stewart
