One of the central arguments during the COVID-19 pandemic was that public officials were making decisions based on the best information available at the time. Newly released material from Dr. Anthony Fauci’s personal diary is now fueling fresh debate over whether his private assessments always matched his public statements.
The diary, released by Sen. Rand Paul, chairman of the Senate Homeland Security and Governmental Affairs Committee, documents Fauci’s daily activities during the early months of the coronavirus outbreak. Among media schedules and meetings, one February 2020 entry has drawn particular attention because it discusses the virus’s estimated fatality rate.
In that entry, Fauci summarized a conversation with former Centers for Disease Control and Prevention Director Tom Frieden.
“Tom Frieden called me this AM and we discussed various aspects of the outbreak,” Fauci wrote. “He and I are on the same page in thinking tht this is acting like a bad influenza in its transmissibility and that the denominator is much greater than 34,867 (above) making the case fatality rate (CFR) more like 0.2-0.3 % rather than 2.0%.”
The key point was Fauci’s observation that the true number of infections was likely much higher than the confirmed case count. If many infections were going undetected, the infection fatality rate could be substantially lower than the apparent case fatality rate calculated from confirmed cases alone.
Critics argue that the diary shows Fauci privately believed the virus was significantly less deadly than the figures he later presented publicly.
During an appearance on Hannity in March 2020, Fauci said the mortality rate for COVID-19 was “about two, two and a half percent.”
“The mortality for seasonal flu is 0.1. The mortality for this is about two, two and a half percent. It’s probably lower than that. It’s probably closer to one. But even if it’s one, it’s ten times more lethal than the seasonal flu. You got to make sure that people understand,” Fauci said.
Around the same time, Fauci testified before Congress and again described COVID-19 as substantially more lethal than seasonal influenza.
“The stated mortality overall of this, when you look at all the data, including China, is about 3 percent,” he told lawmakers. “It first started off as two, and now three. I think if you count all the cases of minimally symptomatic or asymptomatic infection, that probably brings the mortality rate down to somewhere around one percent.”
He made a similar point during an interview with Trevor Noah on The Daily Show, contrasting seasonal influenza’s mortality rate with what he estimated for COVID-19.
“The mortality of this is about 10 times that. It’s at least 1 percent,” Fauci said.
The apparent gap between Fauci’s private February diary entry and his subsequent public statements has become a focal point for critics, who argue that he overstated the virus’s fatality rate while speaking to the public.
Others note that estimates of COVID-19’s mortality changed rapidly during the opening months of the pandemic as testing expanded and researchers gained a better understanding of asymptomatic infections. Public health officials at the time often distinguished between the case fatality rate—based on confirmed infections—and the infection fatality rate, which attempts to account for undetected cases and was considerably more difficult to estimate early in the outbreak.