“We’ve got to be absolutely-transparent in everything we do,” Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Diseases (NIAID), pronounced in a video interview this month. “When you’re dealing with a public health crisis everything has to be done optimally and transparently. There is a building mistrust now in the transparency of what we do — it’s the elephant in the room.”
Dr. Fauci spoke with the Office of the Inspector General on October 13 and made it clear that he believes politics should play no role in a pandemic. “Once you lose the confidence of people, they don’t believe what you’re saying or they believe you’re holding things back or they believe there’s a political motivation to things,” Fauci explained. He is looking to the Inspector General’s office which oversees a number of government departments, to help restore faith in the public health system. “If you go back over outbreaks in the past, the one thing that has always prevailed is when people are open and honest and don’t hold information back. The thing that gets people spooked is when they don’t know what’s going on. We’re a pretty strong country we can handle the truth.”
Dr. Fauci states empathically that this is the worst public health crisis the country has endured in 102 years since the so-called Spanish Flu which broke out in 1918. He has grave concerns about heading into the flu season when COVID-19 cases are spiking. “The thing that is very troublesome to me is that the baseline number of infections that we have is about 40 to 45,000 per day. That is an unacceptable high-level which means that there’s a considerable amount of community spread of infection. When you’re going into a season that respiratory illnesses are more problematic, you’d like to go in at a very low baseline, but we’ve not succeeded in doing that.”
He is also heavily concerned about the impact the novel coronavirus is having on minorities.”I’ve been involved intimately with the response to HIV, to the pandemic, the anthrax attacks, Zika, Ebola and now COVID-19,” Dr. Fauci said in the interview. “And the one thing that seems to loom among all of those is the extraordinary disparities in our society about the burden of disease and the burden of hospitalization and the burden of death that’s disproportionately born by minority communities, particularly African-American, Latinx, Native Americans, Alaskan natives, and others.”
Dr. Facui’s work in HIV where minorities were hit hard, has taught him lessons that can now be applied to the current pandemic. Of specific concern is that minority groups often work on the frontline of the disease. Additionally, the baseline health of minority groups is often not as high as others in the community. “Diabetes, hypertension, obesity, heart disease, chronic lung disease, and kidney disease — and that’s not a racial genetic issue,” Dr. Fauci explains. He points to economic factors and the impact that has on the diet of lower socio-economic groups as contributing to the comorbidities. “It’s a social determinant of health issue — where from the time they were children, they have this greater prevalence and incidence of these underlying conditions.”
He is hopeful that the pandemic can initiate change to rectify societal problems that target minority groups. “If anything comes out of this outbreak, maybe it should jolt us into finally saying we’re going to have a multi-decade commitment to overcome those social determinants of health. If you look at the rate of hospitalization a hundred thousand people, and you compare black and brown people, it’s an enormous disparity,” Dr. Fauci warns. Effecting systemic change is necessary, but is not going to be easy, taking great commitment over decades. “The things we can do immediately is to have the availability of testing so that you can prevent the spread of infection in brown and black people,” he advises. That can be achieved by increasing testing in areas with large minority populations. “We can do that now because we know there are certain areas of cities and counties of states that are demographically over-represented by minority populations. You’ve got to make sure that they have the resources so that when they do have outbreaks they can do the kind of contact tracing that would prevent further spread.”
This is something that needs to be implemented right away, but Dr. Fauci fears the current public health system will not facilitate it optimally. “As usual, when you look at who gets the resources — who gets the housing, who gets the economic benefits — it always slants away from the populations that are vulnerable and we’re trying to protect.”