When it came to approaching the COVID-19 pandemic, Dr. Anthony Fauci compared it to a battle plan.
It is a bit like war, he said, borrowing from the historic comparison of diseases with conflicts. First, the public health officials develop a battle plan. Then, they ad-lib when something inevitably changes.
It was an apt comparison given that Fauci gave the keynote speech virtually at the Naval Academy Foreign Affairs Conference Tuesday morning.
The conference, now in its 61st year, features speakers and conference attendees from around the world discussing a current affairs topic. This year, unsurprisingly, was resilience after the COVID-19 pandemic.
Midshipman 1st Class Laura Spratling interviewed Fauci, who recapped his time leading the United States response to the pandemic. Fauci is the director of the U.S. National Institute of Allergy and Infectious Diseases, and this is not his first pandemic.
New diseases have always emerged, Fauci told Spratling. His first pandemic was HIV. Then came the H1N1 flu pandemic, Ebola, Zika and Chikungunya. But what separated the COVID-19 pandemic was the immobilization of the world for over a year now.
The number of deaths in the United States alone, 554,064 as of April 6, is the worst the country has seen since the influenza pandemic from 1918-1920, Fauci said.
“So the lessons you learn are that outbreaks occur, they are unpredictable, you generally don’t know all you need to know about it right away,” Fauci said. “It evolves.”
Missteps happen, he said. Testing in the country did not work right away. States opened up too quickly allowing for surges.
One of the most difficult aspects of the current pandemic is the number of asymptomatic cases and the number of cases where the transmission came from an asymptomatic person, Fauci said.
Approximately 50% of COVID-19 cases are spread from people who do not have symptoms, Fauci said.
“That makes it very, very difficult to control the respiratory infection because classically, and historically most respiratory infections are spread by people who, with symptoms not without symptoms,” he said.
The Naval Academy had asymptomatic cases, Spratling said, which made it difficult for the institution to control the disease. The Naval Academy spent most of March responding to an outbreak of COVID-19.
Although the academy did not say how many midshipmen were sick, citing operational security, nearly 200 midshipmen were moved to hotels to increase the amount of isolation and quarantine space at Bancroft Hall. Midshipmen are no longer residing at the hotels.
Another difficult aspect is the divisiveness in the country, Fauci said. How an administration reacts to public health varies.
“Generally, when you have an outbreak, by the time it gets bad, everybody understands what they need to do,” Fauci said. “It’s those who understand in the very beginning that this is something that you need to do something about.”
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Take the HIV pandemic. The Reagan administration paid it little attention, in part due to the stigma associated with gay men, those administering injection drugs and the virus, Fauci said. The George W. Bush administration, on the other hand, created the President’s Emergency Plan for AIDS Relief, which helped save lives.
With the COVID-19 pandemic, the Trump administration helped create a more divisive country, Fauci said.
There is an intense hostility surrounding differing opinions, which is not the environment best suited to address a health crisis. Public health measures should not be political, he said.
“So hopefully we will more and more pull together as a nation, and fight the common enemy, which is the virus, not each other,” he said. “But it’s been really a difficult situation over the last year when wearing a mask or not wearing a mask became a political statement, which was very unfortunate.”
Looking back, Fauci said that he stood his ground and told the truth, even if it was inconvenient or put him at odds with the administration.
“When you’re in a position of somewhat semi-authority of being responsible for recommendations and guidelines, the data and the science must drive what you do,” he said. “Anecdotes don’t work. You’ve got to collect data and data means the truth, and you stick by it, and you don’t compromise so that’s the lesson I learned a long time ago that was just confirmed in me during this experience that we’ve had with COVID-19.”