 Dr. Anthony Fauci Dr. Fauci has been getting a bad rap lately. His critics claim that he funded the creation of the COVID-19 virus and profited from it. That he conspired with the pharmaceutical industry to discourage the acceptance of cheap effective drugs such as hydroxychloroquine. That he promoted the COVID-19 vaccines which have harmed and killed people. That he pushed for masks, social distancing, lockdowns, and other ineffective measures which caused unnecessary pain. And that while he did this he lied about his true motivations. His critics also point out that Fauci’s support of certain ideas and treatments and his cozying up to the pharma industry also led to the deaths of hundreds of thousands during the AIDS epidemic. To sum it up, they claim he is an evil man who lies constantly and is responsible for untold deaths and suffering from which he profited, and that he belongs in jail. Considering the rapidly evolving nature of the COVID-19 pandemic and the science (and nonscience) behind it, I consider that Dr. Fauci in general did a good job of informing us about the latest developments and measures to stop the spread of COVID-19. And while I also think he made some mistakes (some of which he has acknowledged), I have often defended him in my blog against all the nonsense that people write about him out of either malice, ignorance, or design, including unfounded conspiracy theories and baseless claims. For example, the COVID-19 vaccines and the mitigation measures against the virus saved millions of lives, and hydroxychloroquine does not work against COVID-19. These are solid facts. Fauci’s support of vaccines and mitigation measures as well as his opposition to hydroxychloroquine were grounded in science, evidence, and reason. But I realize that quite a number of people do not know who Anthony Fauci is. In fact, many think he is an uncaring bureaucrat with no specific accomplishments under his belt. In this post I will endeavor to set the record straight.
As a researcher, Dr. Fauci developed successful therapies against the fatal diseases polyarteritis nodosa, granulomatosis with polyangiitis (formerly Wegener's granulomatosis), and lymphomatoid granulomatosis. And in the field of AIDS he made seminal contributions to the understanding of how the disease works and the developing of treatments. By 2022 Fauci was the 44th most cited researcher in the world. In the field of immunology, he was ranked 9th out of 3.3 million authors, in the field of research and experimental medicine he was 22nd out of 3.3 million authors, and in the field of general and internal medicine he was ranked 715th out of 1.4 million authors. Dr. Fauci’s work has clearly captured the attention of his peers who often cite his work. In science this is one of the most common measures of success. Dr. Fauci also has won many prestigious awards such as the National Medal of Science, the Lasker Award for Public Service, and the Robert Koch Gold Medal, and he has more than 50 honorary doctoral degrees. Dr. Fauci has been the head of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, and he has advised seven presidents beginning with Ronald Reagan on matters of public health including working on the federal response to AIDS, Ebola, the Zika virus, Anthrax, and COVID-19. And while Dr. Fauci’s research contribution are important, some of his greatest contributions have taken place at the managerial level. For example, Dr. Fauci was the chief architect of the President’s Emergency Plan for AIDS Relief (PEPFAR) launched in 2003. This program, which provided treatment for people with HIV, prevented new infections, and made possible epidemic control, saved more than 20 million lives. For this accomplishment, President George W. Bush presented Dr. Fauci with the nation’s highest civilian honor, the Presidential Medal of Freedom. But the accomplishment that best describes the type of person Dr. Fauci is, is that which involved the notorious firebrand AIDS activist Larry Kramer. Kramer criticized Dr. Fauci for moving too slowly in finding a treatment for AIDS, and said he was evil and represented a callous government. Kramer called Fauci a pill-pushing tool of the medical establishment, an incompetent idiot, a disgrace, and a murderer who should be put in front of a firing squad. Kramer compared him to a Nazi and even insulted Fauci’s wife. So what did Dr. Fauci do? He talked to Kramer and other AIDS activists, he listened to their concerns and ideas, he realized they had a point, and he pushed for changes in the way clinical trials were conducted, thus expanding access to experimental medicines, speeding up the process, making it more flexible, and giving patients a greater voice. He reached out to those who insulted him and worked with them to change medicine for the better and make history. Eventually, Dr. Fauci and Kramer became good friends. Fauci helped Kramer get medical treatment for his health problems, and Kramer made Fauci a character in one of his award winning plays. This is the man Dr. Fauci is. He is not some cold-hearted bureaucrat. He genuinely cares about people and patients, and those who know him can testify to his empathy for others. On top of this, as I’ve mentioned above, Dr, Fauci is among the best scientists in the world in terms of his research. And finally, Dr. Fauci has achieved what the majority of scientists only dream of. His research and managerial skills have had a real-life impact on the world in terms of saving or improving the lives of tens of millions of people. All of the above is why I will not put up with anyone slandering Dr. Fauci. Sure, we can discuss all you want specific mistakes he has made, and what he could have done better, but he must be treated with the respect he deserves. The image of Dr. Fauci by NIAID is used here under an Attribution 2.0 Generic (CC BY 2.0) license.
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 The Conspiracy Theory that Went Bust Some of the proponents of the drug hydroxychloroquine (HCQ) have put forward a conspiracy theory to explain the negative results for the drug in some clinical trials. They claim that the scientists running the trials have sold out to pharmaceutical companies and designed the trials in such a way as to make HCQ fail the trials. The alleged reason for doing this is to favor more expensive alternatives such as the drug remdesevir from Gilead Sciences and vaccines or antibodies made by other companies. This convoluted conspiracy theory has grown to encompass a worldwide network of scientists that have sold out in this fashion and to even involve organizations such as the Gates Foundation and the World Health Organization that are also allegedly colluding with the pharmaceutical companies. This vast network of colluding scientists from different countries using different sources of funding and engaging in behavior contrary to the principles of the organizations for which they work, is not only very unlikely but the most basic tenets of the conspiracy theory are not even coherent. I have mentioned before that the same trial that found that HCQ was not effective against COVID-19 (the Recovery trial), also found that dexamethasone was effective in advanced cases of the disease. Steroids like dexamethasone are cheap generic drugs. Why would scientists colluding with pharmaceutical companies design the trials to torpedo one cheap drug (HCQ) but not another one (dexamethasone)? But there is more. Recently the results of the Solidarity trial sponsored by the World Health Organization (WHO) were published. It was already known that the trial had not found HCQ to be effective and this fanned the conspiracy theory, but another result of the trial was that remdesivir was not effective too! Why would the WHO betray their pharma overlords by trashing their drug? The answer is that the WHO didn’t because there was no one to betray. The vast majority of scientists involved in this research are honest individuals who are genuinely interested in finding whether these drugs work against a terrible disease. These scientists designed and performed clinical trials to the best of their abilities to obtain answers. This is how science is supposed to work. No ulterior motives, no deceit, and no conspiracy: just the facts, the evidence, and the truth.  Dr. Anthony Fauci The Accusation that Fell Flat The attacks on Dr. Anthony Fauci continue due to his resistance to accept that hydroxychloroquine works. Dr. Fauci has stated: “The point that I think is important, because we all want to keep an open mind, any and all of the randomized placebo-controlled trials, which is the gold standard of determining if something is effective, none of them had shown any efficacy by hydroxychloroquine. Having said that, I will state, when I do see a randomized placebo-controlled trial that looks at any aspect of hydroxychloroquine, either early study, middle study, or late, if that randomized placebo-controlled trial shows efficacy, I would be the first one to admit it and to promote it. But I have not seen yet a randomized placebo-controlled trial that’s done that. And in fact, every randomized placebo-controlled trial that has looked at it, has shown no efficacy. So, I just have to go with the data. I don’t have any horse in the game one way or the other, I just look at the data.” This is the comment we would expect from a scientist like Dr. Fauci, Just show him a well-designed study that shows that HCQ is effective and he will change his mind. Makes sense right? But no, HCQ proponents will have none of it. They claim the evidence for HCQ is overwhelming (it isn’t), but it is being suppressed by a massive disinformation campaign (which is really an attempt by responsible organizations and individuals to counter misinformation about HCQ). And they have found another way to attack Dr. Fauci. They claim that the lack of acceptance of the effectiveness of HCQ by Fauci is killing people! The Yale epidemiologist Harvey Risch and others have stated that back in the 1980s Dr. Fauci refused to issue guidelines for physicians to consider the prophylactic use of an antibiotic (Bactrim) to prevent an opportunistic infection (pneumocystis pneumonia) in AIDS patients because he considered there was not enough data, and this led to the preventable deaths of 17,000 people. They claim that Fauci is doing this again with HCQ and that people who could be saved are dying. This new accusation has reached a fevered pitch with claims that Dr. Fauci is a mass murderer. The notorious HCQ proponent Vladimir Zelenko is circulating a petition to the White House to bring several individuals including Dr. Fauci to justice for “Crimes Against Humanity / Mass Murder”. There are several things that have to be understood by Fauci’s critics. The first is that, as I have explained before, the job of doctors is to save their patients and improve their lives, and doctors have the freedom to treat patients as they see fit. On the other hand, the job of scientists like Fauci is to try to figure out what works and what doesn’t based on the evidence. During times when a disease ravages society, the use of many drugs that may or may not work is often proposed. These drugs can be prescribed by doctors, but they should not be endorsed by scientists. There is a scientific discussion that has to take place and the evidence has to be generated and/or evaluated. Dr. Fauci cannot endorse a drug for which the evidence is deficient. In any case Dr. Fauci himself has stated that he had no authority to issue guidelines, but he offered to help with carrying out a clinical trial. The second thing is that Fauci is not the type of callous person that he is made out to be by HCQ proponents. Just consider that their accusations are remarkably similar to those levied upon Fauci by the notorious AIDS activist Larry Kramer back in the 1980s who besides calling him a murderer also said Fauci was a Nazi who should be put in front of a firing squad. Larry Kramer eventually befriended Fauci and he and other AIDS activists worked together with Fauci to make improvements to the clinical trial system which has saved many lives and given patients more control over the process. And finally, just consider Fauci’s achievements. Apart from what I mentioned above regarding the modification of the clinical trials system, Fauci has not only made many scientific contributions that have advanced our knowledge of disease as well as developing effective therapies against diseases, but he has been among the architects of major programs such as PEPFAR (President's Emergency Plan for AIDS Relief) which has saved the lives of 18 million (!) people in Africa. In recognition for his work in creating the PEPFAR program, President George W. Bush awarded him the Presidential Medal of Freedom in 2008. Fortunately, this accusation by HCQ proponents that Fauci is a murderer has fallen flat. The vast majority of people understand that Dr. Fauci is an exceptional individual both as a scientist and as a person. The vast majority of people also understand that those levying these accusations against Fauci have now pushed themselves further into a fringe and lost all credibility. The image of Dr. Fauci ny NIAID is used here under an Attribution 2.0 Generic (CC BY 2.0) license. The conspiracy sign by Nick Youngson from Picpedia.Org (used here under a Creative Commons 3 - CC BY-SA 3.0 license), the public domain image of hydroxychloroquine by Fvasconcellos, and the public domain coronavirus image by Alissa Eckert, MS; Dan Higgins, MAM, from the CDC's Public Health Image Library were modified and merged.
7/3/2020 Fighting Coronavirus Misinformation and Conspiracy Theories: Fauci, Hydroxychloroquine, and Retracted ArticlesRead Now Dr. Anthony Fauci Oh dear, so much COVID-19 misinformation, and conspiracy theories, and so little time and space. Let’s get started. Dr. Anthony Fauci is receiving a lot of criticism from people, ranging from those who deny the severity of COVID-19 and think he misadvised the president, promoting the interests of political elites and the deep state, to those who think he is denying the efficacy of hydroxychloroquine and promoting the economic interests of pharmaceutical companies to the detriment of the interests of patients. These people question his character, and call him a liar, a fraud, a traitor, and a saboteur who should be fired. As it turns out, these insults are nothing compared to the insults levied against him when he was coordinating the nation’s response to the AIDS epidemic in the 1980s. The notorious firebrand AIDS activist Larry Kramer criticized Dr. Fauci for moving too slowly in finding a treatment for AIDS, and said he was evil and represented a callous government. Kramer called Fauci a pill-pushing tool of the medical establishment, an incompetent idiot, a disgrace, and a murderer who should be put in front of a firing squad. Kramer compared him to a Nazi and even insulted Fauci’s wife! So what did Dr. Fauci do? He talked to Kramer and other AIDS activists, he heard their concerns, he realized they had a point, and he pushed for changes in the way clinical trials were conducted speeding up the process, making it more flexible, and giving patients a greater voice. He reached out to those who insulted him and worked with them to change medicine for the better and make history. Eventually, Dr. Fauci and Kramer became good friends. Fauci helped Kramer get medical treatment for his health problems, and Kramer made Fauci a character in one of his award winning plays. So when critics say Dr. Fauci doesn’t care for patients or is beholden to special interests, I am skeptical of these claims. I think that history so far indicates that this is not who Dr. Fauci is. This is not to say that Fauci doesn’t make mistakes, but I certainly believe that he is acting in the best interest of the American people. But can’t people change? Sure, but as far as I’m concerned, the burden of proof is on the critics to produce exceptional evidence that there is a nefarious intent behind his actions.  Hydroxychloroquine Another conspiracy theory involving Dr. Fauci states that he has known for 15 years that chloroquine (a drug related to hydroxychloroquine) was effective in hindering the spread of a virus, SARS-CoV, which is 79% related to the COVID-19 virus (SARS-CoV-2), in primate cells in culture based on a study published back in 2005. So it is claimed that Fauci is lying when he says that there is no good evidence for the effectiveness of hydroxychloroquine against COVID-19.
Dr. Fauci is a competent scientist, and he knows that cell culture is a very preliminary step when employed to look for effective drugs. He knows that the results obtained with this method may not hold in more complete models that better reflect the complexity of the full organism. For example, hydroxychloroquine did not have either a therapeutic or prophylactic effect in hamsters and monkeys infected with the COVID-19 virus. This agrees with the best human studies so far that indicate that hydroxychloroquine is not effective. Another conspiracy theory that is making the rounds concerns retracted articles published in the scientific journals, The Lancet, and the New England Journal of Medicine (NEJM). These two journals published studies where scientists examined a database of patients treated with hydroxychloroquine and concluded not only that hydroxychloroquine was not effective, but that it was also harmful to the patients. The results of these studies led to a temporary halt of several hydroxychloroquine trials taking place worldwide. However, when the studies were examined by scientists, numerous discrepancies in the data and problems in its analysis were detected. Letters signed by more than one hundred scientists were delivered to the Lancet and to the NEJM outlining these problems. The journals expressed concerns about these discrepancies, and the authors of the articles retracted them when they were not able to dispel these concerns with the company that provided them with the hydroxychloroquine dataset. The conspiracy argument alleges that the publication of these articles proves that there is a concerted campaign by the scientific establishment to discredit hydroxychloroquine at the expense of the lives of people who could benefit from it, just to embarrass president Trump for advocating the use of this drug. The conspiracy theory argues that this scandal demonstrates that scientists have lost all credibility. However, what this argument ignores is that it was scientists who detected these problems and alerted the journals, and the journals proceeded to raise concerns with the authors, and the authors acknowledged those concerns and retracted the articles when they could not address said concerns. That this happened is not a scandal. Scientists make mistakes all the time. In fact, that is the strength of science. The only reason that science can be right is because it can be wrong. In this case, error was detected, addressed, and removed. The scandal would have been if the problems with the articles had not been addressed and the articles had not been retracted. The fact that the opposite happened is an indication that science worked the way it should, and vindicates our confidence in the scientific process. Finally, another conspiracy theory involves the claim that countries that have embraced the use of hydroxychloroquine are doing better than countries that haven’t. Therefore, the unwarranted rejection of hydroxychloroquine by the health care systems of some countries has led to many preventable deaths. Those that espouse this conspiracy theory do not make any efforts to address other variables that could explain these differences. For example, there is the number of infected people that spread the disease initially in the country (more disease spreaders equals more infections and more problems with the health care system). There is the timing of the spread of the disease (earlier spread means less time to adapt). There is the constellation of drugs and procedures that are used to treat patients (how do you separate the effect of hydroxychloroquine from that of other drugs and/or procedures). There is the age and health of the population affected (younger healthier people are less susceptible). There is the strength and effectiveness of the mitigation measures employed (older sicker people could have been protected better in one country than in another another). There are differences in reporting what constitutes a COVID-19 death from one country to another. If these and other variables are not considered and controlled for, the claim does not go beyond a mere anecdote. The misinformation and conspiracy theories I’ve mentioned are but a fraction of all the bilge that’s out there, but what they all have in common is that they are part of an effort to disqualify mainstream science and scientists as they deal with COVID-19 and evaluate hydroxychloroquine and other drugs. The image of Dr. Fauci ny NIAID is used here under an Attribution 2.0 Generic (CC BY 2.0) license. The image of hydroxychloroquine by Fvasconcellos is in the public domain. |
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