As a legislator and as a citizen, I respect our public health leaders and the process they go through to make decisions. I usually trust the conclusions they reach and accept the recommendations that they make. My recent survey about vaccine mandates suggests that most of my constituents feel the same way.
Yet, I never lightly dismiss the views of my constituents who disagree. Two constituents went to the effort to send me copies of Robert F. Kennedy Jr.’s book, The Real Anthony Fauci. I did read the first section of the book, the section that speaks to management of the current pandemic. I skimmed the rest of the book which speaks to older history. I also examined some of the sources that RFK Jr. relies on.
RFK Jr., perceives a malicious conspiracy to promote vaccines over alternative health care methods. The basic narrative is that a vaccine cartel exaggerated the dangers of COVID-19 and discredited lower-cost treatments — like Vitamin D, Ivermectin, and Hydroxychloroquine — with the goal of making profits on vaccines.
The lead villain in the narrative is Dr. Fauci, the head of the National Institute of Allergy and Infectious Diseases. A villain needs to be larger than life. RFK Jr. says that Fauci wields “power enjoyed by few rulers and no doctor in history.” (Page xvi.) Consider that statement in light of the many state and local officials across the country who are bucking federal pandemic advice. The CDC with Dr. Fauci’s support reinstated indoor masking guidelines last July when the Delta variant emerged, advising people to wear masks in indoor public spaces in areas with substantial or high transmission. Now with Omicron, the whole country is a high transmission area. Yet, many states have never required masks or do not currently require masks and some states prevent local governments from requiring them. Would lower level officials respond so casually to the great dictators of history? No. Dr. Fauci is respected by many, but should not be numbered among the most powerful rulers in history.
RFK Jr. points out that Dr. Fauci is “the highest paid of all four million federal employees, including the President.” (Page xvi.) What that observation really speaks to is not how all-powerful Dr. Fauci is, but how low the federal salary scale is. Physicians with research and leadership skills are very marketable in the private sector and the public sector has to pay them well to retain them. The highest paid state employee in Massachusetts is the head of the University of Massachusetts Medical school and he makes more than twice what Dr. Fauci makes. Similarly, all of the top five highest paid state employees in New York are health researchers or executives and they all make more than Dr. Fauci. For a southern example, 11 of the 25 highest paid state employees in Georgia are medical doctors and they all make more than Dr. Fauci. The health care sector employs 22 million people in the United States and includes many centers of power. Dr. Fauci is a visible and important person, but health care leadership is broadly dispersed.
RFK Jr. portrays Dr. Fauci as “cracking down on HCQ [hydrochloroquine] to keep case fatalities high.” (Page 30.) Speaking of federal decisions not to authorize Hydroxychloroquine as a COVID treatment, he says:
Most of my fellow Democrats understand that Dr. Fauci led an effort to deliberately derail America’s access to lifesaving drugs and medicines that might have saved hundreds of thousands of lives and dramatically shortened the pandemic. There is no other aspect of the COVID crisis that more clearly reveals the malicious intentions of a powerful vaccine cartel — led by Dr. Fauci and Bill Gates — to prolong the pandemic and amplify its mortal effects in order to promote their mischievous inoculations.
The Real Anthony Fauci, p.19
The framing, “Most of my fellow Democrats understand . . . ,” is plainly false. As recently as December 2021, Dr. Fauci was one of only three leaders with a positive favorability rating among Americans, and he had an 85% favorable rating among Democrats. In 2020, 79% of Democrats and a majority of Republicans felt Dr. Fauci had done a good job handling the pandemic. He was the fourth most admired man among Americans in 2020, behind three presidents.
But then consider the horrific allegation itself — distorting research results so as to kill people so as to make other people want vaccines. As part of his case for the allegation, RFK Jr. zeros in on one of the clear failures of the research vetting process in 2020. An influential study in Lancet showed that hydrochloroquine was not clinically useful in COVID-19 treatment. However, it swiftly emerged that the study and another study on a different issue that appeared in the New England Journal of Medicine were based on likely non-existent data from a bogus “big data” research company called Surgisphere. RFK Jr. reads the incident as proof of the power of the “cartel”:
The capacity of their Pharma overlords to strong-arm the world’s top two medical journals, the NEJM and The Lancet, into condoning deadly research and to simultaneously publish blatantly fraudulent articles in the middle of a pandemic attests to the cartel’s breathtaking power and ruthlessness.
The Real Anthony Fauci, p. 30
RFK Jr.’s over-the-top word choice is a red flag in itself. But the fundamental problem with his argument is that in the same time frame, Surgisphere also was able to circulate an influential, but fraudulent article supporting Ivermectin. Ivermectin is the other potential treatment for COVID-19 that RFK Jr. believes has been unfairly discredited by Fauci and the “cartel.” Surgisphere’s fraudulent article contributed heavily towards the expansion of Ivermectin as a COVID-19 treatment in Latin America. If the “cartel” is so powerful and ruthless, why did it allow that?
The simpler truth is that in the midst of a rush for cures, a recklessly ambitious company like Surgisphere was able to deceive a number of smart people. Before long, other smart people uncovered the deception, the articles were retracted and Surgisphere was permanently discredited. The Surgisphere scandal shows both the fallibility of the humans doing science and the ability of the scientific process to ultimately correct itself. It is not evidence of a global vaccine cartel.
There can be no question that in some cases pharmaceutical companies are able to steer both the direction of research and physician clinical choices (see Massachusetts gift ban legislation). But I am completely unable to step into RFK Jr.’s worldview. In his world, a few ruthless titans are pulling the strings for profit. I see a world in which a whole lot of mostly decent people with normal levels of self-interest are trying to do their jobs — to create medications and improve public health. People near the center of health policy decisions, like Dr. Fauci, have to sort out a lot of information and maintain awareness of the quality and motivations of their information sources.
Dr. Fauci is 81 years old. He has been well compensated for decades. It appears that he could retire any time to a federal pension equal to roughly 80% of his salary. It seems unlikely he is in his job for the money. Without putting him on a pedestal of infallibility, I trust him to exercise his judgment for the greater good. I expect his views to continue to evolve in good faith as the research accumulates and new virus behavior emerges.
For my summary responses to themes in these comments, please see this post. Comments were closed on this post on January 31.