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Dr. Fauci Has Been Dreading A Pandemic Like COVID-19 For Years

Last year, before the COVID-19 pandemic created quarantines, surging unemployment and packed hospitals, I interviewed Dr. Anthony Fauci. Fauci, the director of the National Institute of Allergy and Infectious Diseases, is now essentially omnipresent as part of the White House coronavirus task force. But in the spring of 2019, with COVID-19 nowhere on the horizon, he still had the time to speak with me for over an hour about vaccines. Recently, I was plumbing through my archives and found an excerpt of the interview that stopped me in my tracks.

At the time, with cases of measles on the rise, the anti-vaccination movement was one of the biggest ongoing public health stories. We spent most of the interview talking about vaccine safety for a video series I was making for The Washington Post. But at one point in our chat, I asked him, “What’s the thing that keeps you up at night?”

I don’t know what I assumed Fauci would say, but his response couldn’t have been more prescient.

“Well, I always say something semi-facetious when people ask me that. We worry about so many things when we’re awake that we’re so tired that nothing keeps us up at night. But notwithstanding that, the thing I’m most concerned about as an infectious disease physician and as a public health person is the emergence of a new virus that the body doesn’t have any background experience with, that is very transmissible, highly transmissible from person to person, and has a high degree of morbidity and mortality.

Now what I’ve essentially done is paint the picture of a pandemic influenza. Now it doesn’t have to be influenza. It could be something like SARS. SARS was really quite scary. Thankfully, it kind of burned itself out by good public health measures. But the thing that worries most of us in the field of public health is a respiratory illness that can spread even before someone is so sick that you want to keep them in bed. And that’s really the difference.”

At the time, I didn’t find this quote particularly earth-shattering. It seemed like a reasonable concern, but not newsworthy. After all, Americans have lived through multiple pandemic scares — SARS, MERS, swine flu — and we largely dodged each bullet. This part of the interview was off-topic for the series I was making, and I left it on the cutting room floor.

Reading the transcript almost a year later, I am struck by how clearly Fauci described this current pandemic. Our nation’s top public health officials have known that this outbreak, or something like it, was a serious possibility, and they haven’t been keeping this information to themselves. But it’s hard to find the collective will to prepare for — and stop — a theoretical threat. COVID-19 may be unprecedented, but it wasn’t unpredictable.

Anna Rothschild was FiveThirtyEight’s senior producer for video.