On Call: A Doctor's Journey in Public Service

by Anthony Fauci

Influenza vaccines typically have between 40 and 60 percent effectiveness at best in any given flu season. Often, it is much less. The fact that they were projecting at least 90 percent effectiveness for the COVID vaccine was astonishing.

Everything that Denise and I witnessed in our formative years was geared toward the concept of consideration for and taking care of others. Our father taught us early in life that because we were fortunate, it was our responsibility to help people when we could and making money should not be a primary goal in life.

On September 24, 1982, the CDC used the term “acquired immunodeficiency syndrome” for the first time in describing the case definition of the illness in MMWR.

In 1983, the French scientists Luc Montagnier and Françoise Barré-Sinoussi and their colleagues at the Institut Pasteur in Paris discovered the virus HIV, and in 1984, Gallo definitively showed that it was indeed the cause of the disease AIDS.

Importantly, to win over the skeptics, I learned that the cause for which you are advocating must be legitimate, worthy, and not motivated by self-interest; your arguments must be evidence based; and you must be truthful and consistent in your reasons for asking for resources. People quickly see through anything less than that.

Two of the most important influenza surface proteins are hemagglutinin and neuraminidase, represented by the letters H and N, respectively, together with a number next to each letter. There are eighteen separate H proteins and eleven separate N proteins among influenza A viruses. Each virus has an H with a given number and an N with a given number. The pandemic of 1918 was caused by an influenza virus with the designation of H1N1. Influenza viruses did not start off evolutionarily as human viruses, and only a small proportion of these have infected humans. The remainder are animal influenzas, primarily viruses of wild waterfowl such as ducks.

All these weaknesses in our public health response to COVID were profoundly compounded by one of the true enemies of public health: the spread of egregious misinformation and disinformation enabled by the internet and social media that unfortunately remains with us today.

At times, I am deeply disturbed about the state of our society. But it is not so much about an impending public health disaster. It is about the crisis of truth in my country and to some extent throughout the world, which has the potential to make these disasters so much worse.