with Alexandra Ellerbeck

Early in the coronavirus pandemic, Anthony S. Fauci expressed skepticism that deaths in the United States would top 500,000.

He called the public’s fascination with him “surrealistic.” 

And he assured China’s top public health official that “We will get through this together.”

The exchanges came from emails sent by the director of the National Institute of Allergy and Infectious Diseases.

Hundreds of pages of emails obtained by The Post and BuzzFeed News through Freedom of Information Act requests confirm the way Fauci is already viewed by many — as diplomatic, tactful and responsive to inquiries from the public, a quality which often kept him up late at night answering emails.

“The correspondence from March and April 2020 opens a window to Fauci’s world during some of the most frantic days of the crisis, when the longtime director of the National Institute of Allergy and Infectious Diseases was struggling to bring coherence to the Trump administration’s chaotic response to the virus and President Donald Trump was seeking to minimize its severity,” The Post's Damian Paletta and Yasmeen Abutaleb write.

“Fauci’s actions during that period and beyond remain an intense focus for many Americans and political leaders,” they add. “During daily televised briefings at the White House, Fauci emerged as an at times reluctant — and polarizing — media star: To Trump supporters, he was a contrarian who seemed to undermine the president at every turn, while others viewed him as a reassuring voice of reason.”

“The emails show that he was inundated with correspondence from colleagues, hospital administrators, foreign governments and random strangers — about 1,000 messages a day, he says at one point — writing to seek his advice, solicit his help or simply offer encouragement.”

Here are five takeaways from Fauci’s emails.

1. Fauci stayed far away from any Trump-bashing.

Trump blasted the public health expert throughout the pandemic, at one point threatening to fire him after the November election. And from time to time, Fauci would criticize the administration's response in interviews, although almost always indirectly (in October, he told The Post the country needed an “abrupt change” in public health behaviors).

In Fauci's correspondence, he was even more circumspect.

In April 2020, Marc Short, Vice President Mike Pence’s chief of staff, emailed Fauci about some apparent crossed wires before Easter Sunday. At the time, Trump was starting to butt heads with public health officials as he tried to move on from the pandemic.

“You correctly noticed the symptoms but misdiagnosed the root cause,” Short wrote in a heavily redacted email that closes: “Apologies for a poor poker face.”

Fauci responded: “Thanks for the note. Understood. I wish you a peaceful and enjoyable day with your family.”

In another exchange, a former acquaintance wrote to Fauci that “The leadership from the top is utterly lacking and incompetent and dangerous to the American people.”

“Thank you for your note,” Fauci wrote back. “I hear you!”

2. Fauci didn't like the public adoration.

“Our society is really totally nuts,” Fauci wrote in an email he forwarded, which included the link to an article titled “'Cuomo Crush and Fauci Fever' — Sexualization of These Men Is a Real Thing on the Internet.”

On March 31, a colleague at the National Institutes of Health sent Fauci an article from The Post with the headline, “Fauci socks, Fauci doughnuts, Fauci fan art: The coronavirus expert attracts a cult following.”

“Truly surrealistic. Hopefully, this all stops soon,” Fauci replied. In another note, he added: “It is not at all pleasant, that is for sure.”

3. Fauci accepted a sort-of apology from the director of China's public health agency.

George Gao, director of the Chinese Center for Disease Control and Prevention, had been quoted in Science magazine as saying the United States was making a “big mistake” by not telling people to wear masks in spring 2020.

Gao, who has long been friends with Fauci, reached out personally to clarify his remarks.

“I saw the Science interview, how could I say such a word ‘big mistake’ about others? That was journalist’s wording. Hope you understand,” Gao wrote to Fauci in a March 28 email. “Lets work together to get the virus out of the earth.”

“I understand completely. No problem,” Fauci wrote back. “We will get through this together.”

4. Fauci defended himself to colleagues.

In April 2020, prominent oncologist Ezekiel Emanuel wrote to Fauci that he was “perplexed” by his “seeming strong endorsement” of remdesivir. Fauci had publicly praised the antiviral drug, which had appeared effective in treating coronavirus patients.

“Was it just a bit forced?” Emanuel wrote. “My reading was the data was weak and in normal times for normal disease it is not enough to approve. And very unlikely to really impact COVID-19 disease pattern--regardless of supply issues.”

Fauci resisted the characterization, replying that he didn't “'strongly' endorse it.”

“I specifically said it was not a knockout drug and was only a baby step in the direction of developing more and better drugs,” Fauci wrote. “I said that it was important because it proved in a well-powered, randomized, placebo-controlled clinical trial that one can suppress the virus enough to see a clinical effect, as modest as the effect was. I do not think I forced anything.”

In an email the following day, Emanuel sent another email apologizing to Fauci and inviting him over for dinner “on the porch.”

In another email, Fauci pushed back against Gregg Gonsalves, a prominent Yale School of Public Health epidemiologist, after Gonsalves had appeared to insinuate that Trump was influencing him and other public health leaders.

“Gregg: I am surprised you included me in your note, Fauci wrote. I genuflect to no one but science and always, always speak my mind when it comes to public health. I have consistently corrected misstatements by others and will continue to do so.”

5. Fauci corresponded with a wide array of people.

He didn't just hear from administration and public health officials. The emails also show exchanges with members of Congress and regular citizens. Fauci certainly didn't answer every single email he received, but the tranche shows he made an effort to respond amid the many demands on his time.

“The medical director of the National Football League Players Association asked Fauci for a confidential briefing on how to safely start the next NFL season,” Damian and Yasmeen write. 

“A documentary filmmaker working on a forthcoming Disney-backed biopic asked to ride along as Fauci drove to work. An adviser to Microsoft co-founder Bill Gates expressed concern about Fauci’s health. And a senior House Republican told Fauci to ‘keep being a science truth teller’ despite skepticism about the virus from other GOP lawmakers and Trump himself.”

“I was getting every single kind of question, mostly people who were a little bit confused about the mixed messages that were coming out of the White House and wanted to know what’s the real scoop,” Fauci said in a recent interview. “I have a reputation that I respond to people when they ask for help, even if it takes a long time. And it’s very time consuming, but I do” respond.

Ahh, oof and ouch

AHH: Moderna filed for full FDA authorization of its coronavirus vaccine.

Moderna is the second vaccine maker to request full approval from the Food and Drug Administration. Full approval will allow Moderna to market its shot directly toward consumers and to keep it on the market after the pandemic is over, CNBC's Berkeley Lovelace Jr. reports

The approval could also make it easier for employers, schools and the military to mandate vaccinations. Some legal challenges to employer vaccine mandates have focused on the fact that the coronavirus vaccines in use in the U.S. only have expedited emergency use authorization. 

Full authorization could also increase uptake. A recent Kaiser Family Foundation poll found that nearly a third of unvaccinated adults said that they would be more likely to get a vaccine once it was fully approved by the FDA.

In December, regulators authorized Moderna's two-shot regimen for emergency use, a conditional approval that required two months of data. Full approval requires at least six months of data. Pfizer and BioNTech applied for full authorization of their vaccine last month.

OOF: The coronavirus risk for the unvaccinated remains high.

“Covid-19 cases, deaths and hospitalizations have been declining in the United States. On May 26, the U.S. case rate, or seven-day average of new confirmed cases per 100,000 residents, was lower than at any point in the past 11 months. But in some parts of the country, that rosy picture hides the strength of the pandemic among unvaccinated people,” The Post’s Dan Keating and Leslie Shapiro report.

In Washington state, the case rate among unvaccinated people is as high as it was in late January, during the peak of infections. Nationally, cases have declined among the unvaccinated, but hospitalizations and deaths remain high.

“Adjustments for vaccinations show the [case] rate among susceptible, unvaccinated people is 73 percent higher than the standard figures being publicized. With that adjustment, the national death rate is roughly the same as it was two months ago and is barely inching down. The adjusted hospitalization rate is as high as it was three months ago,” our colleagues report.

OUCH: JAMA’s top editor resigned amid fallout from a podcast on racism in health care.

Howard Bauchner, the chief editor of the Journal of the American Medical Association, has been on leave since March, following backlash against a tweet and podcast that questioned the existence of structural racism in medicine, the New York Times’s Apoorva Mandavilli reports.

The tweet promoted an episode of the journal’s podcast and read in part, “No physician is racist, so how can there be structural racism in health care?” It was later deleted.

The podcast featured a discussion between Edward Livingston, another editor at JAMA, and Mitchell Katz, an editor at JAMA Internal Medicine and CEO of NYC Health + Hospitals. In the episode, Livingston questioned whether socioeconomic factors, rather than structural racism, held back communities of color.

“I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast,” Bauchner said in a statement. “Although I did not write or even see the tweet, or create the podcast, as editor in chief, I am ultimately responsible for them.”

More in coronavirus news

The WHO unveiled a new naming system for coronavirus variants.

Instead of calling the coronavirus variant that was first identified in the United Kingdom, the “British variant,” it will now be Alpha, according to the World Health Organization. The “Indian” and “South African” variants will be Delta and Beta, respectively. The new naming system, based on the Greek alphabet, is meant to provide “non-stigmatising labels” for new variants, the WHO said.

“The WHO’s guidance is intended for the general public: Scientists will continue using traditional (and highly technical) naming conventions. Those names haven’t fully caught on in the wider discourse, because nonscientists can easily get tripped up when trying to remember the difference between the B.1.1.7 strand, which was first detected in Britain, or the B.1.617.2 variant that was initially documented in India,” The Post’s Katerina Ang and Antonia Noori Farzan report.

As new variants of coronavirus continue to be discovered, here's what you need to know about how these mutations work and how they spread. (The Washington Post)

The global health body has warned that naming variants after regions or countries could spur discrimination and also disincentive countries from reporting newly detected variants. Still, it’s unclear if the new names will catch on.

“It would have been good to have thought about this nomenclature early,” Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told CNN. “I think it’s just a lot for people to think about this far down the line.”

Blinken says the Biden administration will distribute doses in Latin America.

Secretary of State Antony Blinken said that the U.S. will soon start delivering coronavirus doses around the world, including in Latin America. The remarks came during Blinken’s first official visit to the region. But questions about which countries will receive the doses and how quickly remain unanswered.

“President Biden promised to provide 80 million doses to other countries by the end of June. But his administration has not provided further details amid a global competition for vaccines that has left many developing countries far behind the industrialized West,” The Post’s John Hudson reports.

The U.S. has delivered just 4 million doses of the AstraZeneca vaccine to Canada and Mexico. In contrast, China has delivered more than 165 million doses of its vaccine to Latin America and the Caribbean.

Elsewhere in health care

HHS will provide $160 million in water assistance for low-income households.

The Department of Health and Human Services announced the launch of a water assistance program aimed at expanding access to affordable water. The money will come from the American Rescue Plan, the coronavirus stimulus package Congress passed in March.

“Having access to affordable, clean, and safe drinking water is essential to everybody’s health and well-being. No family or child should go without access to water because of challenges paying the bills,” Health and Human Services Secretary Xavier Becerra said in a statement.

Sugar rush

The government will soon release a report containing unclassified information about UFOs as part of a provision included in Trump's coronavirus relief package.

From former president Barack Obama to Sen. Marco Rubio (R-Fla.), here's what lawmakers have said about UFOs in the past. (The Washington Post)