Saturday, 11 April 2020

Science and Reason vs Thoughts and Prayers

Donald Trump has tried to reinvent himself as a devout, committed Christian ever since he decided to embark on a new political career.

And over the past four years Trump has had nothing practical to say about tackling America's problem with mass shootings, other than offering his 'thoughts and prayers' when yet another terrible incident unfolds. 

So how it must grate with Trump that America's top medical expert, Dr Anthony Fauci, is leading the fight against Coronavirus using science and reason - instead of demagoguery and mumbo jumbo.

“I Have No Ideology. My Ideology Is Health”: Dr. Anthony Fauci on the Tactics of Dealing With the Novel Coronavirus—And Trump

“We are by no means out of the woods,” Fauci says. But his insistence on facts, and science, may be finally changing the trajectory of the pandemic.



Since mid-January, when it became clear that the novel coronavirus had escaped from Wuhan and would make its way to the United States, Dr. Anthony Fauci has been waging a war—a war of persuasion. He’s had to convince a diverse, federalist, hyper-partisan country to take the threat of the virus seriously. And in order to do that, he’s had to first convince President Donald Trump. This has posed certain challenges, and certain risks. “I take the tack that I will say what’s true and whatever happens, happens,” Fauci told me. And lately, that approach has been winning. On Sunday, Trump extended the national social-distancing guidelines for another 30 days after Fauci showed Trump models that projected 2.2 million Americans could die if nothing was done; Trump had proposed reopening the country for Easter. This morning, Vanity Fair spoke by phone with Fauci from his office at the National Institutes of Health as he raced between meetings. The interview has been edited for space and clarity.

Vanity Fair: Off the top, I wanted to know: Where are we now? How are you feeling about how we've marshaled the response?

Anthony Fauci: Well, I mean, obviously we’re still right in the middle of a very serious situation. The United States is a very large country. We have different levels of activity in different parts of the country. I mean, as you know, New York has been hit particularly hard and they’ve suffered greatly. They’ve responded, I think in an extraordinarily powerful way. We hope—we don’t know for sure—that we’re starting to see the leveling off of new admissions to hospitals. That’s the first sign that we may be making some headway with our mitigation strategies. But multiple cities are at different timing of what their problem is. We have New Orleans now, we have a situation in Detroit and Chicago. So you will see different waves of increases, sharp inflections, peaks, and then turn arounds. I think the most important thing that we need to do as a nation is to very aggressively implement the mitigation strategies.

How has it complicated our response that we’ve had so many different approaches across the states? You have some governors and mayors taking aggressive approaches and then in Florida, until recently, the beaches were open. How would it have helped us if we had a uniform national response?

Well, you know, certainly the recommendations that came out in the original guidelines we put up almost 15 days ago [could have been followed]. We live in a country where there’s a lot of independence. Some governors and states followed the guidelines most times, but sometimes they didn’t. And I think in those situations in which they didn’t, you could have avoided difficulties. But right now, there’s no doubt that even though it’s difficult to quantify precisely, there’s no doubt that the mitigation implementation is having an impact. I cannot imagine anybody disagrees with that. I believe you would be much worse off if we didn’t institute these physical separation guidelines. I think that that is why it is a proper, correct, and prudent decision to extend these another 30 days because we are by no means out of the woods. It’s still very difficult.

I know that it was touch-and-go for a while whether Trump would extend the guidelines. I’m glad that your point of view prevailed. Backing up, when did you first get a call that there was a novel coronavirus outbreak in China? I mean, how early were you attuned to this?

Well, it was the very beginning of January when there was a report from China that there were about 24 cases and it was incorrectly thought to be only animal-to-human spreading. And in Wuhan, as it turned out there, it was very likely that there was human-to-human spreading weeks before the outbreak in the wet market.

Where were you when you first got that report?

Well, I was sitting right where I’m sitting right now, right in my office [at the National Institutes of Health in Bethesda, Maryland].

When did you realize the scale of what we’re facing?

It was really gradually over a period of a few weeks as we began to see the very efficient human-to-human spread, even before the numbers came. When you look at the pattern of the initial infections, we knew from the beginning and we discussed this, that it was very clear that we were going to get cases in the United States for absolutely certain.

You knew that immediately.

Oh yeah. I mean, you know, with the travel that’s going on, I think that’s the thing that spurred me to make a strong recommendation to the president that we block any travel from China. Because it was very clear that that’s where it emerged.

That was the end of January. I know there was debate from the people I talked to at the White House about balancing the public health part of it versus what message shutting down flights would send to the markets. So there was concern that taking such a drastic early step would, you know, have economic consequences.

Well, yeah, I know, but we put the economic consequences behind and the public health mandate prevailed and it prevails to this day, as you can see of what dramatic things have been done with shutting down, you know, a major component of the United States.

Also the World Health Organization put out over the wires in mid-January that there was still no evidence of human-to-human spread, which I think gave people false hope.
Yeah. But as soon as we started to see that there were cases in the United States, and then at the time when it became clear that there was community spread, then we knew that we really were in for a very difficult situation. Once you had community spread, we realized all bets are off. And we knew we were in for a very serious problem.

What was your first meeting with the president like? This was in January. Had you dealt with him on other public health issues or was this a new relationship?
Well, I had some interaction. And now I see him for at least an hour or more every single day.

I mean, you’re a New Yorker. He’s a New Yorker. What was your first real meeting with him? Like what was your impression?
He’s an action person. I mean he likes to get things done. He doesn’t want to waste a lot of time. He wants to just get right to it.

We live in a time now with like hyper-partisan media where both sides have their megaphones. How has that complicated your ability to get a message that’s absorbed by the public?

Well, I just stick very strictly to the science and the evidence base. I’m not new to this. I’ve been doing this now for over 30 years, starting with the HIV/AIDS issues with President [Ronald] Reagan, and I have found, and it’s proven time and time again: stick with the science, stay completely out of the politics. I have no ideology. My ideology is health, public health, and science. You do that. You can make it uncomplicated. If you get involved in political rhetoric, then it gets complicated.

Of course. But, for example, early on you had Fox News downplaying the crisis. Did you go on Fox more to try to get your message out? How do you counter that? Even if you’re not playing politics, other people are.
By just being consistent. One of the great things about messaging is consistency. If you consistently stick with the science, sometimes you might be contradicting something that someone says and sometimes you may be agreeing with it, but as long as you’re consistent with the science then you are fine.

Going back to what you said about when you were concerned early on about community spread. The president and others were saying, Oh, we have 15 cases and we’re going to go to zero. At that moment you were in conflict with him. Other times you’ve been in agreement. I think there are times where your job forces you into difficult positions where you have to speak truth to power.

That is true. And thus far it’s worked. Has it been stressful? Uh, yeah. This is a very, very stressful situation for everybody, including me.

Yeah. I mean, I’ve seen in interviews. You’re sleeping like, four hours a night.

Right. That’s not good.

The press has written a lot about your relationship with Trump and the fears that your contradictions of him would force him to either sideline you or fire you. Have you worried about that? How much has that been on your mind?

Not at all. I take the tack that I will say what’s true and whatever happens, happens. As a matter of fact, in fairness to him, the president has listened very carefully to what I’ve said. He’s taken my recommendations almost invariably, and he has never really contradicted things that I have recommended to him. He listens. I mean, there’s a lot out there in the press about conflict between the both of us. There’s absolutely none. There really isn’t.

But so, even when he’ll say things like, you know, we’ve got this totally contained, it’s going to go to zero. I mean, that’s clearly at odds with the data that you are seeing. That couldn’t have been an easy conversation between you two.
No, but substantively he comes around.

I see. So you just have to stick to your message.

Exactly. As I said, I’ll repeat: It’s consistency, which counts.

The New York Times and others have reported about the quote last month we had between mid-January and mid-February before the task force was convened. I mean, obviously hindsight is 20-20, but I mean, how much did that slow ramp-up set us back in your mind?

I don’t think very much. I mean, there’s understandable Monday morning quarterbacking about what we could have, should have done. I think the important thing is look ahead and you can do all the analysis later on now.

Got it. I’ve read been reading history about the 1918 pandemic and a lot of people are now starting to talk about the quote “second wave” that could be coming our way in the fall. How prepared should we be? Some people have the notion that once the restrictions are lifted, whether it’s in May or June, that we’re going to be out of the woods. Is that true?

As I’ve said at the press conference at the White House yesterday [Monday], I feel that it is highly likely that we will have—I don’t know whether you want to call it a second wave—but we will have a return of infections as we get into the next season. I believe given the fact that we’ll be much, much better prepared, there will be a number of people who have already been infected so that they will be immune. The second iteration of this will very likely be much less severe. That’s for a number of reasons. So I don’t see this coming back and hitting us the way it hit us the first time around.

Well, that's good! What’s been your hardest moment or day so far throughout this? I know every day is hard, but is there one where you look back now and you’re, it really sticks with you?

It wasn’t any particular event that happened. It was just a realization a few weeks ago when the stress was overwhelming. I was getting 3,000 emails, a couple of hundred phone calls, every senator, every governor, every congressman wanted to speak to me and I was getting like two to three hours sleep. I realized then that I could not go on that way. I’m a very conscientious person. I like to answer calls. But I had to get myself used to the fact that I cannot do that. I’ve got to focus on what my primary responsibility is. And if people get upset that I don’t respond to them immediately. So you know…

You were losing your voice. Was your body breaking down a bit?

I was getting very, very fatigued. I’m much better now.

Yeah, you sound better.
Unfortunately I’m having trouble getting my complete voice back, but at least it’s better than it was a couple of weeks ago.

Do you have any personal friends or family that have had COVID-19? The president talked about a real estate friend from New York who has it.
Fortunately, I have not.

That’s great. So, Dr. Deborah Birx has also emerged over the last few days as someone who is very much the face of this crisis. Her style seems to be much more attuned to the politics. Do you guys have like a good cop, bad cop setup where you approach Trump differently but you all want the same goals?

We’re good friends. We’ve been good friends for decades. We’re very comfortable working with each other.

There was that interview she gave a few days ago where she praised Trump and people were saying, Oh, she’s now drinking the Koolaid. Did you guys talk about that?

No, we didn’t talk about it.

I guess you’re probably too busy to actually follow what’s being written about you guys.

I don't read 95% of the things that are written about me because I just don’t have time.

Of course. One last thing: Do you have the kind of relationship with Trump where you can call him directly or do you see him in more structured settings?

I see him so often and for so long I almost never have to call him directly because I know that literally I’m within a few feet of talking to him if I want to anyway.

So when he tweets something like, The cure can’t be worse than the disease, is that something that you can correct or address in real time with him?

You know, we don’t talk about things that he says. He’s always had an open mind to figure out whether it was, whether it was okay or not. He’s open-minded about speaking with us behind closed doors.

You extended the guidelines through the end of April. Should we be prepared that this is a fluid situation and there could be another extension?

That’s possible. I hope not, but it’s certainly possible. As I’ve always said, we’ve got to leave everything on the table. Everything is discussable.

Trump TurningTurtle (03/10/17)

The BBC has a thoughtful piece today on how Donald Trump turned turtle over gun control - from someone one who supported a ban on assault weapons in 2000 to his support for President Obama's call for more firearms regulation in 2012.

Yet in 2017 Trump is now a full-throated supporter of the gun lobby and the NRA which speaks volumes about the state of American politics today.

Trump's new found 'love of the gun' is about opportunism and has nothing to do with the politics of conviction or bringing about much needed social change in the land of the free and the brave.    


America's Dunblane (15/12/12)

There are obvious parallels between the Dunblane massacre in Scotland in 1996 - and the cold-blooded murder of innocent children in Connecticut yesterday.

16 years ago an inadequate man with a grudge and a gun walked into a local school in Dunblane - a nice, middle-class part of Scotland - and deliberately killed 16 young children and the teacher - before the turning the gun on himself. 

In the leafy suburbs of Connecticut yesterday - a young man, armed with a variety of weapons, killed his mother at home before making his way to the school where she had taught - Sandy Hook Elementary - and shot dead 27 people including 20 children aged between 5 and 10.

The response in Scotland was swift and already tight gun controls were tightened even further - so that now you can't even buy an air gun (a BB gun in America) without a licence and a police check.

Now this doesn't make Scotland a better place than America - but it sure as hell makes it a safer one because there hasn't been another similar incident in Scotland since 1996.

Whereas in America these violent shootings seem to occur every few months as disturbed and/or inadequate people - with easy access to a wide array of firearms - decide to settle some score and make a name for themselves.

Now I don't underestimate the difficulty of changing things in America - because I know a few Americans and even some of the more liberal-minded ones buy into this business - about a citizen's right to bear arms.

I can see their point - up to a point - but yet again a major shooting incident has occurred but despite the proliferation of guns in America - the shooter is not stopped dead in his tracks.

Instead he kills himself with his own weapon - or as in previous incidents he is caught by the police after carrying out his foul crime.

The word 'his' I use quite deliberately since men have been responsible for all such incidents as far as I know - from Dunblane to Norway to America.

One thing's for sure, there will now be a big public debate in America - the one that was so noticeably absent from the recent Presidential election - which Barack Obama won, of course,  but by steering well clear of any confrontation with his country's gun lobby - as did his Republican opponent, Mitt Romney, to be fair.

If any progress is to be made, I suspect this will only happen if the politicians avoid the kind of strident behaviour and language - that turns people off and sends them back into their bunkers - instead of encouraging people to think rationally and reflect carefully.

I can understand an argument that says the more people who carry guns - the safer things are for everyone - because the bad guy can be dropped dead with a single shot before he carries out his evil plan.

But that's a recipe for everyone carrying a lethal weapon - even teachers and young children at an elementary school - and sounds like something from the movies not real life.

So let's hear from you President Obama - people say that in American politics 'you campaign in poetry but govern in prose' - but this is a time for the kind of words and leadership which inspire a great country to change.

How Trump turned against gun control

By Anthony Zurcher - BBC North America reporter

Media caption - Trump on Las Vegas shooting: 'It was an act of pure evil'

When attempting to interpret Donald Trump's statements on firearm regulation, and how they could shape a presidential policy response to the Las Vegas mass shooting, the key is to note when he said them.

As with many of his political opinions, Mr Trump's views on gun control have shifted to the right over the years.

In the 1990s and early 2000s, Mr Trump expressed support for a ban on so-called assault weapons - long rifles with military-style features to more easily fire multiple rounds.

"I generally oppose gun control, but I support the ban on assault weapons and I support a slightly longer waiting period to purchase a gun," he wrote in his 2000 book, The America We Deserve.

In 2012 Mr Trump praised Democrat Barack Obama's call for more firearm regulation after the shooting at a Newtown, Connecticut, school that claimed 26 lives, including 20 children.

Conservative bona fides

As Mr Trump began more seriously contemplating a bid for the Republican presidential nomination, however, his views on gun control changed. By the time he announced his entry into the race in 2015, he was well within the mainstream of the Republican Party, which viewed most forms of additional gun regulation as a violation of Second Amendment constitutional protections.

It was Mr Trump's way of establishing his conservative cultural bona fides - proving that he wasn't the big-city liberal he had at times seemed.

In an October 2015 Republican debate, for instance, he boasted that he carried handguns "a lot" and said government-mandated gun-free zones in places like schools, churches and military bases were a "catastrophe" and made for "target practice for the sickos".

Mr Trump would frequently say the answer to mass shootings was having more citizens with firearms - contending that the death toll in the Paris and San Bernardino attacks would have been much lower if bullets had been going "both ways" - towards the victims and the assailants.

The NRA's man
Image copyright - GETTY IMAGES Image caption - Trump at a National Rifle Association event, the largest US gun lobby, in April

To the surprise of many, Mr Trump secured the endorsement of the National Rifle Association in May 2016, at a time when some Republicans were still uncomfortable with the New Yorker as their presumptive nominee.

"Now is the time to unite," NRA Executive Director Chris Cox said at the time. "If your preferred candidate got out of the race, it's time to get over it."

From then on Mr Trump - in his statements and on his campaign website - largely echoed the NRA's hard line on firearm issues. The group would end up spending more than $30m (£22m) to support Mr Trump's presidential bid.

During the general election, Mr Trump attacked Democrat Hillary Clinton as being in favour of stringent gun control and pledged that he was the candidate that would protect the rights of the estimated 55 million Americans who currently own firearms.

There was one moment during last year's campaign, however, when Mr Trump did break with the NRA's line. After the Orlando nightclub shooting in June, he appeared to endorse limiting gun purchase for national security purposes.

"I will be meeting with the NRA, who has endorsed me, about not allowing people on the terrorist watch list, or the no fly list, to buy guns," he tweeted.

Nothing came of that meeting, however, and as president Mr Trump appears to have made little effort to follow through on it.

'If crooked Hillary got elected...'

Mr Trump's only significant action on guns as president has been to sign a law rolling-back Obama-era limitations on the ability of those being treated for mental illness to purchase firearms.

During a recent campaign rally in Alabama, Mr Trump even revisited his old attacks against Mrs Clinton, warning "you'd be handing in your rifles" if she had been elected.

Congress is currently considering legislation that would make it easier for Americans to purchase silencers for their weapons - a proposal Mrs Clinton criticised in a tweet after the Las Vegas attack.

The president, so far, has not commented publicly on the legislation, which was expected to be approved by the House of Representatives but has little chance of passage in the Senate.

Image copyright - EPA

If the legislation becomes the centre of post-Las Vegas political controversy, however, it may be difficult for the White House to stay above of the fray.
A time to heal

In the meantime, Mr Trump now has the unenviable task of trying to heal the nation after yet another "deadliest mass shooting in modern US history" and explaining what - if anything - he proposes to do to stop future tragedies.

George W Bush's turn came in April 2007, as a shocked nation mourned 32 dead on a Virginia college campus.

Barack Obama had his moment in June 2016, following the Orlando Pulse nightclub attack that left 49 dead.

"This massacre is … a further reminder of how easy it is for someone to get their hands on a weapon that lets them shoot people in a school, or in a house of worship, or a movie theatre, or in a nightclub," he said after Orlando.

"And we have to decide if that's the kind of country we want to be. And to actively do nothing is a decision as well."

Media caption - Barack Obama’s mass shooting speeches

No easy answers?

The story of Mr Trump's response is still unfolding. The number of dead has risen to 58, with the estimated number of wounded an astounding, incomprehensible 500.

After tweeting out his "warmest sympathies" to the victims of the Las Vegas shooting on Monday morning, Mr Trump took to the lectern at the White House to deliver a statement heavy on prayers, mourning and calls for unity but light on hints of what comes next.
Image copyright - GETTY IMAGES

During his morning remarks the president said that, in the search for "meaning in the chaos", answers do not come easy.

In coming days and weeks ahead, many answers for how to respond to the bloodshed in Las Vegas will be offered. They're already pouring in from the president's friends and critics.

Many will be policies - often contradictory - that Mr Trump, at one time or another, has supported