March 11, 2020;

In context

A single line often inverts meaning once you see what it answers, so neighbouring messages are always shown.

1. 2020-03-08 00:00 Anthony S. Fauci open
   March 8, 2020, 3:04 p.m. ET • • Dr. Anthony Fauci, the nation's leading expert on infectious diseases, is widely respected for his ability to explain science without talking down to his audience -- and lately, for managing to correct the president's pronouncements without saying he is wrong. President Trump said that drug companies would make a coronavirus vaccine ready "soon." Dr. Fauci has repeatedly stepped up after the president to the lectern during televised briefings or at White House round tables to amend that timetable, giving a more accurate estimate of at least a year or 18 months. Mr. Trump said a "cure" might be possible. Dr. Fauci explained that antiviral drugs were being studied to see if they might make the illness less severe. The president also said the disease would go away in the spring. Dr. Fauci said maybe so, but because it was caused by a new virus, there was no way to tell. Experts like Dr. Fauci should be the ones who speak to the public during epidemics, said Representative Donna E. Shalala of Florida, who was his boss during the Obama administration, when she led the Department of Health and Human Services. "I think Tony is playing the same exact role that he has in the past -- to make sure the science is accurate and clear," Ms. Shalala said. "During a health emergency, it's the scientists and physicians that are the credible people to the American public, not politicians." "I used to make him wear his white coat when talking to the public," she added. "I used to make them all wear their white coats so people were reassured that they are real doctors." On Sunday, Dr. Fauci appeared on at least two television news shows, warning that as the virus spread -- there were more than 450 cases in at least 33 states -- some stricter measures to isolate the infected might be considered. He also offered advice for older adults and those with underlying health conditions who are most at risk, saying they should avoid cruises, flights and large gatherings of people. At a recent Congressional subcommittee hearing, one representative asked Dr. Fauci if he had a twin, because he seemed to be everywhere lately. Another offered medical advice: lemon, honey and bourbon for his voice, which has been hoarse for weeks from endless rounds of talking to lawmakers, scientists, health officials and reporters. If Dr. Fauci has become the explainer-in-chief of the coronavirus epidemic, it is in part because other government scientists have left a vacuum, avoiding the news media spotlight or being reined in by the Trump administration and accused of exaggerating the threat from the virus. When reporters call Dr. Fauci, he calls them back. Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, is famous for being unknown: He has given few interviews or public talks outside those required by administration news conferences. Dr. Nancy Messonnier, director of the C.D.C.'s National Center for Immunization and Respiratory Diseases, who warned on Feb. 25 that the coronavirus was likely to spread in the United States, and that "this could be bad," came under fire from the administration and has toned down her advisories. "Nancy Messonnier told it like it is," said Dr. Thomas Frieden, the former director of the C.D.C. "And she was 100 percent right, and they silenced the messenger." The C.D.C. has made few of its other scientists available for interviews about the coronavirus. And it is now facing sharp criticism for long delays in providing states with kits to test for the virus, and for setting such tight limits on the tests performed at its it by headquarters in Atlanta that some diagnoses were delayed or missed, possibly leaving infected people to spread the virus to others. Dr. Fauci, 79, does not seem to be in the cross hairs. Although he was recently told he must clear his many TV, radio and print interviews through the White House, he has said that he has not been muzzled. "You don't want to go to war with a president," Dr. Fauci told Politico. But he thinks the public needs solid, understandable medical information, especially during crises. He makes a point of not trying to "razzle-dazzle" audiences with his knowledge, he told an interviewer in 2015, adding that his education at a Jesuit high school and college taught him intellectual rigor and the value of public service. As director of the National Institute of Allergy and Infectious Diseases since 1984, Dr. Fauci has lasted through six presidents, and has declined multiple requests to lead his agency's parent organization, the National Institutes of Health. He has led federal efforts to combat diseases caused by emerging viruses, including H.I.V., SARS, the 2009 swine pandemic, MERS, Ebola and now the new coronavirus. He was an architect of the President's Emergency Plan for AIDS Relief, started in 2003 by President George W. Bush, to fight H.I.V. globally. In 2001, after anthrax was mailed to Senator Tom Daschle of South Dakota, the Bush administration tried initially to minimize the threat, but Dr. Fauci was characteristically blunt. "This is material that is quite formidable, that is infecting people with inhalation anthrax, infecting them in the absence of direct contact," he said. "You can call it whatever you want to call it with regard to grade and size or weaponized or not weaponized. The fact is, it is acting like a highly efficient bioterrorist agent." Previous disease outbreaks have kept him on the lookout for new pathogens, and in January, reports of unexplained pneumonia cases in Wuhan, China, set off alarms in his head. "Even before we knew it was a coronavirus, I said it certainly sounds like a coronavirusSARS type thing," he said. "As soon as it was identified, I called a meeting of top-level people and said, 'Let's start working on a vaccine right now.'" He is among the most highly paid federal employees, earning about $400,000 a year, more than the vice president or the chief justice of the Supreme Court. He oversees a 2020 budget of $4.75 billion, which is $769 million less than last year's after being cut by the Trump administration. Unflappable though Dr. Fauci may seem, the new coronavirus worries him, especially its spread in the Seattle area and the toll it is taking in a nursing home there. He said he vitals thought it was still possible to stop the disease, but health authorities would have to know where it was to do that, and he said the lack of testing capacity was a huge obstacle. Test kits sent by the C.D.C. to states were flawed, and it has taken weeks to begin replacing them. And strict regulations from the Food and Drug Administration hampered outside labs' efforts to begin to do their own tests. But Dr. Fauci declined to join the chorus of blame against the C.D.C. "It's so easy to play Monday morning quarterback," he said. "Every element of the federal government was working full-speed to try to get this out and get things going." "What I really want to concentrate on is the idea of getting enough tests out there to get an evidence-based foundation of where we are in this country," he said. "Seattle is of concern. We need to know the extent of the community spread." At times in the past, Dr. Frieden said, Dr. Fauci may have over-promised a bit in his enthusiasm for projects of his that have yet to pan out -- an H.I.V. vaccine, and a universal flu vaccine that would provide long-lasting immunity to multiple strains so that people would not need another shot every year. "It's the role you have to play to get money from the Hill, and the role of a researcher to be eternally optimistic about a cure being around the corner," Dr. Frieden said. "He's very effective at asking for money from Congress." He is also a fair-minded colleague, Dr. Frieden added. During West Africa's Ebola epidemic in 2014, after two nurses treating a patient who had traveled to the United States became infected, the C.D.C. was harshly criticized for not having helped hospitals to prepare better. Dr. Fauci did not pile on. "Not everything we did was perfect," said Dr. Frieden, who then headed the C.D.C. "There are many people in similar roles as Tony who might have taken advantage of that for the interest of their institution, and Tony was always honorable." "If we did something wrong he was frank about that," he continued. "When we were getting attacked unfairly, he defended us. That's very unusual behavior in the bureaucratic situation you see in Washington sometimes. I think that's why Tony is so respected." During the early years of the AIDS epidemic, the U.S. government and its health agencies were a frequent target of criticism and protests, blamed for inaction on potential treatments and inadequate funding for research and medical care. When AIDS activists demonstrated outside his institute in 1988, demanding a chance to try experimental drugs, Dr. Fauci surprised the leaders by inviting them into his office. He wound up working with them to develop new ways to expand access without compromising the clinical trials that were urgently needed to determine which drugs worked -- an approach that was later applied to research in other diseases as well. "There are a lot of world class scientists, but Tony has a special set of skills," Ms. Shalala said. "An ability to communicate, high integrity and an understanding of politics -- and to know to stay out of politics in order to protect scientists." Dr. Fauci acknowledged that his age puts him in one of the groups at highest risk for becoming severely ill from a coronavirus infection. But it has not slowed him down. He sleeps only about five hours a night, works most of his waking hours and jumps on the Metro to get around the Washington, D.C., area, from his office to the Capitol and the White House. Most days, he runs or power walks 3.5 miles. "I'm not worried about myself," he said. "I'm worried about the job I have to do." Andrew Jacobs contributed reporting. Alain Delaqueriere contributed research. Disclaimer: Any third-party material in this email has been shared for internal use under fair use provisions of U.S. copyright law, without further verification of its accuracy/veracity. It does not necessarily represent my views nor those of NIAID, NIH, HHS, or the U.S. government. PRESS: FOX Sunday with Chris Wallace; Meet the Press with Chuck Todd; Appeared on 60 Minutes (CBS) Special on coronavirus
2. 2020-03-09 00:00 Anthony S. Fauci open
   Mar. 9, 2020 - 111,354/3892. Stock market really crashing. Even though we are saying that 1.1 million tests are out there, and millions (4 mill this week) to follow, we still do not know how many tests have been performed and whether anyone can get a test who needs it. hate to say it, but some incompetence at CDC/FDA. We are geeting killed publicly by this vulnerability. Am now told by CDC that we only have 1 million nasal swabs to collect the specimens. And so now we have more tests than swabs! And the limiting factor is the swabs. Gov. Cuomo calls me up and asks my advice on whether to close schools in the orthodox Jewish section of Westchester where they have 90 cases (more than rest of NYC). I tell him yes. He also asks about closing subways. I tell him not yet, but let us stay tuned. I will push for more surveillance testing. Lab Corps and Quest On phone call with VP and all the Govenors. I talk about protecting the vulmerables with co-morbidities, particularly among the elderly I bring Cliff into the group on an almost fulltime basis. Cases in 35 states. >500 cases with 22 deaths Priority 1 is to get people off the Grand Princess. w 712. Deaths 29 Had press conference. POTUS came. Had good conversation with him. He is getting very crummy with me. I sarcastically answered one of the persistent questions about the cruise ship issue by saying I personally would never get on a cruise ship. PRESS: CNN New Day with Alisyn Camerota and John Berman; FOX and Friends.
3. 2020-03-10 00:00 Anthony S. Fauci open
   Mar. 10, 2020 - 116,588/4090. USA cases now 712. Deaths 29 Just signed off on a Level 3 State ("Reconsider Travel") and a Level 3 CDC ("Avoid non-essential travel) for the European Schengen Area This measn that all travelers from this area are required to enact a 14 day voluntary quarantine after arriving to USA. Also will consider an INA Section 212(f) Proclamation banning travel to USA bu any foreign national, with limited exceptions, who has been physically present in Italy in the last 14 days I push hard with Jerome Adams to expand community mitigation. One topic was whether there should be campaign rallies. I insiste that we say all large crowds should be avoided. Marc Short pushes back since the POTUS will be doing rallies. Jerome and I continue to push. I will say that the degree of stopping depends on the area of the country - Washingotn State (bad); Nebraska (probably OK). Chris Liddell becoming a friend and encourages me to stick by my guns - good guy. For better or worse, I am becoming an international celebrity. Calls from all over the world. Am concerned a bit about my health. Having total body pain and will again stop Crestor Reports from Italy are really bad. Running out of equipment and just letting the elderly and frail die without intervention. Katie Miller defending my saying what is my opinion based on good public health principles despite others in the VP's staff wanting me to be a bit more politically sensitive, particularly around campaign rallies. Katie wants to have me do ther "Fauci 5" this coming Sunday. Chatted with Govenor DeSantis (R-FL) who was concerned that I said at Press conference today that Florida had community spread, when in fact Florida just had a big cluster. He was correct, was nice on the phone call arranged by WH after he complained. We came out with a statement correcting. Spoke together with (Bob Redfield)with Nancy Pelosi at the request of VP to convince her to pass a bill to indemnify companies who make the surgical masks. There are 2 categories of masks: 1) medical, and 2) industry. They are really the same with some very minor differences. We do not have enough medical and so we want to sell the (WHO numbers). industrial ones to medical use. The PREP act allows indemnification The companies want indemnification to sell the industrial ones to medical. PRESS: NPR Morning Edition; FOX Hannity
4. 2020-03-11 00:00 Anthony S. Fauci open
   Mar. 11, 2020 - 121,098/4366. >1000 cases in USA - 29 deaths (WHO numbers). Congressional House Energy and Commerce Oversight and Reform Hearing today - Carolyn Maloney (D-NY) Chair AMAZING DAY!! Before Hearing we were told that the POTUS wanted me at the White House at 12:30 PM for a meeting about travel restrictions that we had been discussing and the Hearing was supposed to end at 12;30PM .. I obviously had to leave at 11:45 AM. I left. The chair and committee was very annoyed. The twitter feed blasted that since I was being very forceful in saying that :"Things were going to get worse before they got better" and gave a very serious warning about what was ahead, that the POTUS yanked me out of the hearing (Amazing).. Multiple TV cameras and hundreds of camera clicks followed me out of the Rayburn Building as I had a car waiting for me to take me to the Oval Office. The days discussions were historic. I, Bob Redfield, Deb Birx and Azar argued and discussed for a couple of hours that we should retrict all travel from the Schengen countries (the 26 European countries) similar to what we did with China (see above). USCITS can come back but will be funneled through 1 of 13 airports and when they get here, they must self isolate fo 14 days. Non-USCITs can only come if they had spent the last 14 days outside of the Schengen. Reason was that 70% of all new global infections were in Europe (particularly Italy and France) and 30 of the 35 US States had infections that originated in Europe. Level 3 travel to Europe - only essential travel Steve Mnuchin and Larry Kudlow were against this since they felt it would cause a depression, not just a recession. We went back and forth multiple times. Jared Kushner and Bob O'Brien (NSC) weighed in with me and Bob/Deb. We went in and presented to the POTUS and he asked good questions, many of them to me. He agreed and was clearly concerned more about the health of the American people than he was about the economy, which he said would recover. We then went and asked the opinion of the CEOs of the major banks who were waiting for POTUS in the Cabinet room. We did not them what we had alredy decide, but we asked them what they thought about travel restrictions. They were favorably disposed. Speech written mainly by Steve Miller with help from Jared Kuschner. I helped in reviewing of the Speech which the POTUS gave at 9:00 PM from the Oval. POTUS writers took out some good stuff that I wanted in and kept in some stuff I did not like. However, in all it was a good speech. ses in 44 states. The VP and I called Pelosi, Schumer, Mitch McConnel, and Kevin McCarthy to give them a heads up After I went home and watched on TV, the CNN commentators (Chris Cuomo, Anderson Cooper, David Gergon, David Gregory) all discussed me as the adult in the room and the person wew should all trust. Finally, Nancy Pelosi called me at home and was enraged and yelled at me for about 25 minutes saying that we left out the UK because of Trumps relationship with Boris Johnson. She is completely incorrect. UKwas not part of Schengen. She did not care. She said that I have lost all of my credibility now by saying that I said this was a public health decision when it really was a political decision. Terrible phone call!!! I called up Olivia Troye (Assistant to VP) after the call and explained. We will try to address this tomorrow. Probably should get Steve Beigen (State) to explain Schengen to her. PRESS: WTOP Radio; Clips of me all over all the news on multiple networks/cable.
5. 2020-03-11 00:00 Anthony S. Fauci
   March 11, 2020;
6. 2020-03-12 00:00 Anthony S. Fauci open
   Mar. 12, 2020 - 129,846/4931. 1267 cases in USA, 38 deaths. Cases in 44 states. Italy continues to surge Has House briefing in Capitol and Senate briefing in Dirksen. Then continuation of House Energy and Commerce Hewaring from the other day with Malonet as Chair. Again, they hammered us about testing. The Senators and Congressperrdsons were enraged, especially Patty Murry (D-WA). Steve Redd during the briefings and Bob Redfield during the Hearing continued to be incoherent in explaining about the difficulty regarding testing the "Public health" system that the CDc set up works well in individual small numbes of patient/physician related requests. However, it is not suited to mass screening. Calls with Se. Joe Munchin (x2); Gov. Cuomo; Sen. Rick Scott (R-FL) Very flattering article abpout me in the Washington Post by Karen Tumulty (see below) that explains the above: Anthony Fauci fights outbreaks with the sledgehammer of truth An administration in deep denial. Anthony S. 'of Allergy Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, on Capitol Hill on Thursday. (Joshua Roberts/Reuters) By Karen Tumulty Columnist
7. 2020-03-12 00:00 Anthony S. Fauci open
   March 12, 2020 at 5:32 p.m. EDT A virus that is deadly and little understood. An administration in deep denial. Anthony S. Fauci has been here before. As the coronavirus epidemic escalates, the director of the National Institute of Allergy and Infectious Diseases (NIAID) has become a familiar media presence. Fauci's expertise and credibility shine against the contradictory and false messages coming out of President Trump. The administration has at times sounded more concerned with protecting the president politically than stopping the spread of a potentially lethal disease. While Trump tries to play down the severity of a public health crisis that might affect his reelection prospects, Fauci has laid out the best assessment of the true danger in stark terms. In testimony Wednesday on Capitol Hill, he warned that the coronavirus has a mortality rate 10 times as great as that of the flu, and refuted Trump's rosy promise that a vaccine will be ready "in a fairly quick manner." Fauci also said flatly that the government is "failing" when it comes to the urgent imperative of making widespread testing available. The latest updates on the coronavirus After federal officials gave lawmakers a briefing on Thursday, a frustrated Rep. Anna G. Eshoo (D-Calif.) told me: "Everything was wrapped in confusion. The only one who answers the questions -- he not only gives the science, but then he says, let me explain this in pedestrian language -- is Dr. Fauci." Then again, this is not the first time Fauci has found himself in the position of having to navigate a public health crisis fraught with political land mines. A renowned international expert on the immune system, Fauci took over NIAID in 1984, barely a year and a half after scientists had identified a mysterious retrovirus that was killing thousands of people. It would be nearly another year before President Ronald Reagan would publicly utter the name of the disease it produced: AIDS. Reagan's sluggish handling of the epidemic left one of the deepest scars on his legacy. In 1986, Reagan's surgeon general, C. Everett Koop, produced a report that described in graphic terms the potential toll of AIDS, projecting that 270,000 Americans might contract it by 1991. The report used explicit language, explaining that the disease was transmitted through "semen and vaginal fluids" and during "oral, anal and vaginal intercourse." Conservatives approved of some of what was in Koop's document: It warned against "freewheeling casual sex," and asserted that the surest means of preventing AIDS were through abstinence and monogamy. But they weren't so happy with the surgeon general's recommendation that condoms be used as a fallback. Koop was concerned that his findings were being buried by the Reagan administration, so two years later, he and Fauci cooked up a bold idea: mailing an abridged version of his report to every single one of the 107 million households and postal boxes in the country. The problem, however, was that the surgeon general lacked the budget to do it. As Fauci recounted to me during a 2018 interview, he told Koop: "You know, there is a mechanism called an interagency transfer." Fauci had the authority to provide funds to get the project off the ground, because combating AIDS related to his own agency's core mission. Congress picked up the idea and ordered the largest mass mailing in U.S. history. It also stipulated that the seven-page brochure be "distributed without necessary clearance of the content by any official, organization or office" -- in other words, that it not be edited to suit anyone's political agenda. In addition to being printed in English and Spanish, "Understanding AIDS" went out in Chinese, Portuguese, Haitian-Creole, Vietnamese, Laotian, Cambodian and Braille. It debunked many myths about the disease, for instance stating unequivocally that AIDS is not spread by mosquitoes, and could not be caught through casual contact with saliva, sweat or toilet seats. 'bad Crestor myalgia th care facilities. Subsequent surveys found that nearly 87 million adults perused part or all of the booklet -- making it the most widely read publication in the country in July 1988, with Reader's Digest coming in a distant second with 48.5 million readers. Of course, there are many differences in scale and severity between the AIDS epidemic and the coronavirus threat. While most who contract coronavirus will recover, AIDS during the 1980s was a death sentence wrapped in stigma. But as Fauci well understands, all infectious diseases have something in common: Accurate information is one of the most powerful weapons for fighting them. Fauci has already shown how important it is to hit a microscopic enemy with a sledgehammer of truth. A yet-untold number of Americans will be betting their lives on him to do it again. Looks like I may have Polymyalgia Rheumatica or really bad Crestor myalgia PRESS: On Pebble Beach at the White House after the TF meeting: ABC Evening News; CBS Evening News; NBC Evening News; Then, I did a gaggle of 5 questions on Pebble Beach; CNN Coronavirus Town Hall with Sanjay Guptya and Anderson Cooper; Mar. 213, 2020 - 132,382/4981 USA 1694 Deaths. Primary health care facilities. Hot areas - WA, CA, MA, NYC I thought that it would be a quiet day since the TF meeting was called off. However, at 2:00 PM, I was called down to the White House since the POTUS wanted me next to him at the podium of the Rose Garden as he made the announcement of deckaring at "National Emergency" which would give him and the Secretary of HHS the power to remove many constraints in response to a national emergency. Also on the podium were the CEOs of the major private sector companies that would make tests readily available - CVS, Target, Walmart, etc. I was at the posium and answered many questions of the press in the Rose Garden. I will be on the 5 Sunday Showes 2 days from now (The "Fauci Five"). Prior to that, I was involved in helping to proof the speech he would give. There were some glaring errors in the speech that I corrected. Got to meet Hope Hicks who was very nice. Jared is playing a major role in all of this. After the presser the White House people showe me a minute by minute graph of the stock markert from the time the POTUS went to the podium and it went down to the 45 minutes of the speech and questions. The DOW went up in 45 minutes 1980 points, which was the greatest single increase in the market in history. The POTUS signed a copy of the graph for me and several of the CEOs My tooth crown fell out in flossing this AM and Dr. Eric Hosaka so nicely fixed it for me right away 2 hours after I called him we . (see below): Alex Azar is obviously being pushed aside as he played a very minor role in the Rose garden Presser. PRESS: MSNBC Morning Joe; GMA (ABC);CBS The Morning; FOX and Friends; BBC World News; Rose Garden Presser with many cameras.
8. 2020-03-12 00:00 Anthony S. Fauci open
   Mar 12, 2020 - Feb 17, 2021 15,000 10,000 5,000 Weekly Tests Weekly Cases Avg. Weekly Hospitalized -8.7% From Last Week -25.8% From Last Week -17.6% From Last Week 14.0M ueM 120,000 12.0M 1.4M 100,000 10.0M 1.2M 80,000 8.0M 1.0M 0.8M 60,000 6.0M 0.6M 4.0M 40,000 0.4M 2.0M 20,000 0.2M I cow lil = ete a oe = > -- fae a bo = = a a EST ERESCE CIOS OF STORE SL ST Lee ae 325957235 3523235 Source: The COVID Tracking Project °o Weekly Deaths -20.9% From Last Week " a Apr9 Juni Jul 2 Jul 23 Aug Sep Oct 15 Nov Nov Dec Jan? Jan May Mar stick with the 2 dose since we know from our studies that the 2nd dose increases the response 10fold over the 1st dose. This height of response gives a cushion against the existing variants and also if you have a less-than-optimal response (albeit a good response) to the 1st dose, you may actually "select" for more variants. • Call from Jeff Sachs about the International Monetary Fund (Special Drawing Rights - SDR) and the possibility of a $40-$50 billion dollar program to vaccinate the entire world. He wants me to have a special role. Moe later. • Gave Harvey lecture virtually at Georgetown • Met with Francis C, Carl D, John Martin, and Larry Tabak about the COVID targeted drug development program that I am trying to set up with the $743 million that we put into our total NIH budget request. It will be based in NIAID with Carl as the lead. As usual Francis wants governance to be somewhat under his control. All good. We will get it done. PRESS: Interview with Erin Banco - The Daily Beast; White House Press Conference; ESPN Baseball TV with Buster Olney; interview with Ben Samuels of Haaretz Israel Newspaper (he tried to get me involved with commenting on the policy of Israel and I refused); MSNBC with Joy Reid;
9. 2020-03-14 00:00 Anthony S. Fauci open
   Mar. 14, 2020 (Saturday) - CDC numbers (less than WHO numbers. 142,320/5388. 129 countries involved. China numbers going way down - only 11 new infections. Koreaa flattening out. USA - 2226 cases, 50 deaths, 532 new cases. POTUS came into the TF meeting with "USA" baseball cap on. We spent a lot of time talking about "ratings' of yesterday's press conference and its effect on the stock market. He dwelled on doing more press conferences and how the ratings would be even better than the best fake news TV ratings. He made the right decisions about now doing travel restrictions in UK + Ireland and so what I ma seeing is someone who actually makes decision that are bestr for the public health since he follows what the TF recommends (driven by me and Deb and CDC) but his public expression and even private expression is related to the fluff of ratings and publicity. And so he wants us to do 2 press conferences/day - one in AM and one in PM. Really interesting. We now will have no time to do work. Hope Hicks seems as uncomfortable with this as I am. I see her as a future ally. POTUS Did press conference and Alex Azar was not invited in order to make room for "diversity" on the podium with Ben Carson and Jerome Adams. Death by a 1000 cuts for Azar. I volunteered to Alex that in my introduction I would mention that the Declaration of Natuonal Emergency gacve Azar as Secertary enormous powers and flexibility to unshackle our response. I did so. Mahor positive profile of me in The Atlantic yesterday (03/13/2020) https://www.theatlantic.com/notes/2020/03/time-capsule-2-exceptional-drfauci/607957/?utm_campaign=share&utm_medium=email&utm_source=a (see below): As of today, March 13, 2020--three-plus years into the current administration, three months into public awareness of the coronavirus spread, seven-plus months until before the next election--Anthony Fauci is playing a role in which no previous Trump-era figure has survived. One other person has been in the spot Fauci now occupies. That is, of course, James Mattis, the retired four-star Marine Corps general and former secretary of defense for Trump. Former is the key word here, and the question is whether the change in circumstances between Mattis's time and Fauci's--the public nature of this emergency, the greater proximity of upcoming elections, the apparent verdict from financial markets and both international and domestic leaders that Donald Trump is in deep over his head--will give Fauci the greater leverage he needs, not just to stay at work but also to steer policy away from the abyss. Why is Anthony Fauci now, even more than James Mattis before him, in a different position from any other publicly visible associate of Trump's? 1. Pre-Trump credibility, connections, and respect. Fauci has been head of the National Institute of Allergy and Infectious Diseases, at the National Institutes of Health, since Ronald Reagan's first term, in 1984. (How can he have held the post so long? Although nothing in his look or bearing would suggest it, Fauci is older than either Bernie Sanders or Joe Biden. He recently turned 79.) Through his long tenure at NIH, which spanned the early days of the HIV/AIDS devastation and later experience with the SARS and H1N1 epidemics, Fauci has become a very familiar "public face of science," explaining at congressional hearings and in TV and radio interviews how Americans should think about the latest threat. He has managed to stay apart from any era's partisan-political death struggles. He has received a raft of scientific and civic honors, from the Lasker Award for health leadership, to the Presidential Medal of Freedom, awarded by George W. Bush. Thus, in contrast to virtually all the other figures with whom Trump has surrounded himself, Fauci is by any objective standard the best person for the job -- and is universally seen as such. This distinguishes him from people Trump has favored in his own coterie, from longtime consigliere Michael Cohen to longtime ally Roger Stone to longtime personal physician Harold Bornstein; and from past and present members of his White House staff, like the departed Michael Flynn and the returned Hope Hicks and the sempiternal Jared Kushner; and fish-out-of-water Cabinet appointees, like (to pick one) the neurosurgeon Ben Carson as Secretary of Housing and Urban Development. Put another way: Very plainly, Trump needs Fauci more than Fauci needs Trump. This is not a position Donald Trump has ever felt comfortable in-- witness the denouement with Mattis. 2. The ability not to abase himself before Trump. The first Cabinet meeting Donald Trump held, nearly three years ago, was unlike any other conducted in U.S. history, and very much like subsequent public appearance of Trump in company with his appointees. In that meeting, on June 12, 2017, as TV cameras were rolling, Trump went around the table and one-by-one had his appointees gush about how kind, wise, and far-sighted he was-- failing only to compliment him on his humility. (Tina Nguyen described the meeting at the time in Vanity Fair.) After praising himself, Trump called on others to praise him, starting with the reliable Mike Pence. "It is the greatest privilege of my life to serve as the vice president to a president who is keeping his word to the American people," Pence began. All the others followed his example--with the prominent exception of Mattis. He spent his "praise" time instead complimenting the men and women in uniform he led. No public event like that Cabinet meeting had happened before in the United States, simply because no other president has been as needy for in-public adulation as Trump is. Of course most politicians and all presidents are needy; you could not run for the presidency if you had a normal temperament. (Background reading on this point, while you're "socially isolating": Robert Penn Warren's All the King's Men.) Every political leader eats up the praise in private--"Wonderful job today, Mr. President--you were really connecting!", not to mention Veep--but all the rest of them have been savvy enough to know how tacky this looks in public. The modern exceptionillustrating-the-rule might have been Lyndon Johnson, with enough of the Sun King in his makeup to enjoy having people humble themselves before him. But holding a public adulation-fest? If George W. Bush had heard, say, Karl Rove start in that way, he would likely have said, "OK, Turd Blossom, what are you angling for?" Barack Obama--or John F. Kennedy, or Jimmy Carter-- would have arched an eyebrow as if to ask, "Hey, did you think you were still playing in the minors?" But what we saw in that Cabinet meeting, we have seen again and again from those around Trump. The most humiliating recent examples come from the people in charge of the coronavirus response: Pence again; Alex Azar, head of Health and Human Services; Robert Redfield, head of the Centers for Disease Control; and Seema Verma, in charge of Medicare and Medicaid. The beginnings and endings of their public statements, and the answers to many questions, are larded with praise for Trump and his "decisive and visionary action." (For the latest example, see Verma under questioning from Martha MacCallum of Fox News. Verma repeatedly dodges MacCallum's direct question about whether hospitals have enough ventilators and other supplies (as Fred Barbash laid out in the Washington Post. MacCallum makes one last try-- and Verma seeks refuge in saying, "And that's why the president has taken such a bold and decisive action." That claim made no logical sense to MacCallum or the listeners, but it reflected the inescapable logic of what is expected from members of the Court of Trump.) There is one exception: Anthony Fauci. He has occasionally said that he agrees with aspects of the administration's or the president's policies, but he has avoided the ritual selfabnegation. Of course Fauci held his job long before Trump came to town, and is not part of the normal round of high-level appointments each new administration makes. (To the best of my knowledge, though, directors of NIH institutes, like Fauci, serve "at the pleasure of the president" and so could be removed. If I'm wrong on that, will update. Update: Several NIH veterans have written in to say that Fauci's position is officially different from that of the NIH director, and is not directly a presidential-political appointment. Recent history teaches that a vindictive president can make things difficult even for career civil servants. But I am grateful for the clarification. ) But Fauci's polite but consistent reluctance to grovel cannot have gone unnoticed by the audience-of-one for all the other appointees: Trump himself. BIG DAY! 3. Daring to contradict Trump, in public. This is a step beyond anything Mattis attempted. Through the first two years of the administration, background-sourced stories and reports based on "those in a position to know the Secretary's thinking" laid out the increasing distance between Mattis's view of American interests and what Trump was saying and doing. But there is no precedent, from Mattis or anyone else, for what we have seen these past few weeks from Fauci at the podium. Is the coronavirus problem just going to go away (as Trump had claimed)? No, from Fauci. It is serious, and it is going to get worse. Is the testing system "perfect" (as Trump had claimed)? No, it is not working as it should. Is the U.S. once again the greatest of all nations in its response to the threat? No, it is behind in crucial aspects, and has much to learn from others. Fauci is saying all these things politely and respectfully. As an experienced Washington operator he knows that there is no reason to begin an answer with, "The president is wrong." You just skip to the next sentence, "The reality is..." But his meaning--"the president is wrong"--is unmistakable. Anthony Fauci has earned the presumption-of-credibility for his comments. Donald Trump has earned the presumption that he is lying or confused. A year ago that standoff--the realities, versus Trump-world obeisance--worked out against James Mattis. Will the balance of forces be different for Fauci? As of this writing, no one can know. PRESS: Press conference in WH press room; The Atlantic (see above)

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