I worked through the pandemic. I stood in the hospital while the official voices spoke with a confidence the evidence never earned. I watched patients die, and I watched other patients — the cancer that wasn’t screened, the heart attack that stayed home out of fear — die of the response. So I do not come to this as a spectator. I come to it as a physician who lived it, and who lives now with the wreckage of what it did to my patients’ trust in medicine.
And I need to talk plainly about a document.
In July 2026, Senator Rand Paul released private diary entries kept by Dr. Anthony Fauci from December 2019 through December 2022. One entry, in particular, deserves the full attention of anyone who cares about honesty in public office. Not because it proves a grand conspiracy — it does not, and I won’t pretend otherwise. But because it captures, in his own hand, a gap between what a powerful man believed privately and what he told the country publicly, on the single most consequential number of the entire pandemic.
Let me lay it out exactly as the record shows it.
Two numbers
On February 8, 2020, Fauci’s diary records a phone call with Dr. Tom Frieden, the former director of the CDC. Their private assessment that day: the virus was “acting like a bad influenza in its transmissibility.” And once you accounted for the enormous number of mild and untested cases — the true denominator — the fatality rate was, in the diary’s own words, “more like 0.2-0.3% rather than 2.0%.”
That was the private number. Two to three tenths of one percent.
One month later, on March 11, 2020, testifying under oath before the House Oversight Committee, Fauci told the nation the mortality was around one percent — “ten times more lethal than the seasonal flu.” In public appearances during that same window, figures of two to three percent circulated widely and went uncorrected.
Hold those side by side. In private: 0.2–0.3%. In public and under oath: one percent, framed against a backdrop of two-to-three-percent messaging. The higher number — the frightening one — became a load-bearing pillar of the justification for closing the schools, the businesses, the churches, and the hospital doors that non-COVID patients needed to walk through.
Let me be scrupulously fair, because fairness is the whole point
February and March of 2020 were genuinely uncertain. This matters, and I will not strip it out to make the story cleaner than it was.
When testing is scarce and only the sickest people are counted, the early case-fatality rate always runs artificially high, because the mild cases are invisible. That is real epidemiology, not an excuse. And later analysis — seroprevalence studies, meta-analyses of the pre-vaccine period — landed on a true infection-fatality rate around 0.5 to 0.7% overall, with the risk concentrated brutally in the elderly and near zero in children.
So the honest scorecard is this: Fauci’s private 0.2–0.3% was, in hindsight, too low. The public 1–3% was too high. The truth sat in between, and nobody possessed it with certainty in those first weeks.
I say all of that so you know I am not cherry-picking. But here is what the fairness does not erase.
The diary shows he privately understood the denominator problem. He knew — and wrote down — that the real rate was likely far below the confirmed-case rate everyone was quoting. That understanding, that crucial downward caveat, is precisely what did not come through clearly when he shaped the public’s understanding and testified under oath. The uncertainty ran one direction in his diary and a different direction in front of the cameras and the committee.
When you are the most trusted scientific voice in the country, and your guidance is closing a nation, the distance between what you privately believe and what you publicly declare is not a rounding error. It is the entire question.
The other pages
There is a second thread running through these diaries that I find harder to read than the numbers.
Interleaved with the daily tallies of the dead are entries about his own fame. He describes his national and international recognition as “explosive and really unimaginable.” He notes a “big front page article about me… Very flattering.” There are mentions of the surreal invitations that celebrity brings.
I want to be careful here. Vanity is not a crime. A man can be proud of his moment and still be doing his job. I am not going to stand over these pages and pretend that private human ego is the same as malice.
But there is something that should sit heavily on all of us in the pairing of those two things — the death counts on one line, the flattering press on the next. It is a portrait of a man at the center of a catastrophe who was also, unmistakably, enjoying the center. And when the person enjoying the spotlight is the same person calibrating what the country is told about the danger, we are allowed — we are obligated — to ask whether the two ever influenced each other. Not to assume they did. To ask, under oath, with the documents on the table.
What this is, and what it is not
I will not do to you what too many have done during these years, which is to inflate a real thing into a fake one and lose the whole argument in the process.
This diary does not prove Fauci engineered a virus. It does not prove a plot to steal an election. It does not prove “crimes against humanity,” which is a specific category of international law that policy errors and even bad-faith risk communication simply do not meet. Anyone selling you those claims is handing his defenders the easiest possible victory, because those claims cannot be substantiated and their collapse discredits everything true that stands next to them.
Here is what it is, stated precisely: a documented, contemporaneous inconsistency between a senior official’s private assessment and his sworn public testimony, on the most important quantitative question of the pandemic. That is not nothing. That is, in fact, a great deal. It is exactly the kind of thing a serious republic investigates thoroughly, under oath, with subpoena power — not with a mob and not with a slogan, but with the patient machinery of accountability.
Why I agree with the principle Elon and others are pressing
Elon Musk and many others have argued that Fauci must face accountability. On the underlying principle, I agree — and let me be exact about which principle.
I do not agree with pre-writing a verdict. I am a physician; I believe in evidence before conclusion, and I will hold that discipline even here. But I agree, without reservation, with this: no senior official should be permanently shielded from having to answer, under oath, for the gap between what they knew and what they said.
And that is exactly what a preemptive pardon does.
In the final hours of his administration, President Biden issued a broad, preemptive pardon covering Fauci and others — for acts not charged, not tried, not even fully known. Think about what that means. It is one thing to forgive a proven wrong. It is another to declare, in advance, that a man never has to answer for wrongs not yet examined. That is not mercy. That is a wall built around a question before the question can be asked.
Pardons, once delivered, are final; a successor cannot revoke them. So I am not calling for something the law forbids. I am calling for the thing the law still allows and the moment demands: full, public, sworn testimony. Sunlight. The diaries in the record, the witnesses in the chair, the questions asked and answered on their merits. If the answers exonerate, let them exonerate in the open. If they do not, let the country see that too.
Accountability is not vengeance. It is the minimum a self-governing people owe to themselves.
The bill comes to my exam room
I want to end where this is most real to me, because it is not abstract in my life.
When public health communicates the way this diary suggests it did — projecting more certainty than it holds, adjusting the message to produce a desired behavior — it spends something it cannot easily earn back. It spends trust. And I am the one who gets handed the invoice.
I see it every week. The patient who will not take the statin that would prevent his heart attack, because “they lied about everything.” The woman who will not get the colonoscopy. The family that will not believe a single word a physician says, about anything, because they watched the most famous doctor in the world and concluded he was managing them rather than leveling with them.
That is the true, lasting injury of these years. Not one man’s reputation. The corrosion of the trust that medicine runs on — the trust I need to keep my own patients alive.
And there is exactly one way to begin repairing it. Not with slogans. Not with inflated conspiracy that collapses under its own weight and takes the real grievance down with it. But with the truth — all of it, the private numbers and the public ones, laid side by side, under oath, in the light.
Our world does need to heal. Healing does not come from a mob, and it does not come from a cover-up. It comes from the truth, fully told, and from the confidence that no one — no matter how celebrated — stands above the duty to tell it.
Put it under oath. Let it all out.
Then we can begin to trust again.
Blessings.
Afshine Ash Emrani, M.D., F.A.C.C.
Assistant Clinical Professor, UCLA
David Geffen School of Medicine
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Fauci knew there would be no herd immunity for a mutating virus. He was paid - seemingly in the millions - to ensure that people got the shots, regardless of each person's risk/reward analysis. People had to make life-altering decisions and people experienced vaccine injury and death because he had a monetary interest in pushing the shot. I hope his payday was worth the loss of trust in the field of medicine. I hope someone makes this point to him while he is under oath. His hubris is beyond belief.
I lived through the same period as you. I remember a man who got on TV everyday and did a briefing on Covid, his name was Donald Trump. That man, Donald Trump privately told Journalist Bob Woodward in early 2020 late January/early February that Covid was aerosolized spread and far more lethal than the flu. That same man Donald Trump made himself the briefing point man daily for Covid response. That same man Donald Trump then travelled the country and told America that Covid was no worse than the flu and would be gone by spring. That same man Donald Trump then took the stock piles of PPE and turned it over to middle men to profit off bidding wars between states. That same man Donald Trump dismantled the Pandemic response team upon coming into office in 2017. That same man Donald Trump sent desperately needed ventilators to Russia. Any responsible physician who understands Public Health approaches to slowing aerosolized viral spread knows masking and social distancing do not prevent infection, they dramatically slow the rate of spread and transmission of an aerosolized viral spread. Any one who responsibly understands and educates on Public Health and viral infection transmission knows that school children have very responsive immune systems so have a very low death rate from viruses but are very good vectors of viral transmission to the rest of the community of adults including the elderly and those with chronic illness. As we all, and apparently you as well, witnessed early on was the overwhelming of the medical system due to so many Americans getting critically ill in a very short time frame. The purposes of masking, social distancing, and shutdowns was to slow the spread so our hospitals could do their best to care for the critically ill. As you may or may not know the initial big spread was the choir in Mount Vernon in Washington state and the first big ICU crisis of patients was in Everett Washington and the ICU doctor in that Everett hospital was one of the first to brief Trump and his administration on the severity of Covid and he went on to develop the first testing methods. Here is what I know, my hospital in Montana got totally overwhelmed by Covid, every available space was needed for Covid patients, the hospital gymnasium for the Child and Adolescent psychiatry hospital became a Covid ward. In the outpatient setting out clinic had a U shaped hallway with a door separate the U in half. My half of the U hallway office colleagues all masked and socially distanced the other hallway had two anti-maskers who did not socially distanced. Everyone on that part of the hallway got COVID within a few days and one doctor died. On my side of the U none of us got COVID, though I eventually got Covid in 2022. As you might be aware one man leading the country named Donald Trump made himself the center of the daily briefings and the passing the misinformation on the severity of Covid and its spread and through his personal conduct as President promoting the anti masking campaign the resulted in the United States having the highest death rate from Covid of all the developed countries. One man made himself the front man for America’s Covid response and that man is Donald Trump, the evidence is on tape in the daily briefings and the stump speeches. Donald Trump completely undermined the needed Public Health message that resulted in and estimated 400,000 unnecessary avoidable American deaths. Your bizarre emphasis of a death rate estimate early on by Fauci whether it might be 0.2% or 0.5% or 1% or 2% is ridiculous regarding a once in a century pandemic, people died and hundreds of thousands died unnecessary because science verified Public Health methods of slowing transmission were undermined and ignored by millions of Americans because of one man Donald Trump. Your piece here undermines Public Health and violates the Hippocratic oath as it does harm. As you know trump got antibody treatment early on when he got Covid, a treatment not available and not offered to the rest of Americans. It is irresponsible not to place the blame the Public Health messaging and response issues where it belongs and that is on one man Donald Trump. Your lack of understanding of masking, social distancing, school children as vectors is shocking.