Pivot - Tech Stocks Tumble, Kamala's Momentum, and Guest Dr. Anthony Fauci
Episode Date: July 26, 2024Kara and Scott discuss Kamala Harris's poll numbers in the face of GOP attacks, Biden's farewell speech, and what Taylor Swift will do about it all. Then, tech stocks tumble after underwhelming earnin...gs reports from Tesla and Alphabet. Then we’re joined by our Friend of Pivot, Dr. Anthony Fauci, to talk about his new memoir, “On Call: A Doctor’s Journey in Public Service.” You can find “On Call,” here. Follow us on Instagram and Threads at @pivotpodcastofficial. Follow us on TikTok at @pivotpodcast. Send us your questions by calling us at 855-51-PIVOT, or at nymag.com/pivot. Learn more about your ad choices. Visit podcastchoices.com/adchoices
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Start caring for your home with confidence. Download Thumbtack today. Got trapped on stage with Nancy Pelosi. Well, smell you. Smell me. That wasn't an apology.
That was you being braggadocious.
That's true.
I'm being braggadocious.
I just interviewed her right near Capitol Hill.
It's, I think, one of her first interviews.
It's not appearing for a little while yet.
It's about what she thinks about the future.
And she has a new book out called The Art of Power.
We talked a little bit about that. But she had a lot to say, so we ran a little long. Well, you should probably kick things off with stock tips.
That's correct. That's correct. No, stop it. Don't. No.
I sound like a Republican. I sound like a Republican.
Trade Nancy Pelosi. You know what? She's a legend. You know she's a legend.
She is a legend. I agree. She's a badass.
I think my favorite image of 2022 is a picture of her after flying for nine hours or whatever it was, or 12 hours to Taiwan in her pink pantsuit and heels.
Yeah, I like her with the coat and the sunglasses coming from Trump.
Oh, yeah.
Her mortal enemy is Donald Trump, I think.
away from this interview is that she'll do what she has to do to stop him, including sort of
tossing Joe Biden under the bus, which she was part of and probably a big part of.
Yeah, she's emerging as sort of the central figure that was, you know,
who not only stabbed the prince, but killed him.
Well, you know, I think she feels like Trump is so important that it's important to adjust. I think she used the word adjust.
We need to adjust, which is interesting.
Anyway, it's an interesting time to be in Washington.
I'll tell you that.
I bet.
Washington is boring, but it certainly isn't.
And we've got lots to talk about today.
There's so much going on.
President Biden's first speech after stepping down.
Tech stocks taking a dive.
And we'll speak to our friend of Pivot, Dr. Anthony Fauci, about his new memoir
and more. But first, before that, you were on the Today Show. That was lovely. You looked lovely
with your son and George Hahn, your other son. Oh, it was so nice. First off, Savannah Guthrie
is lovely. She is. You can see why these morning show people are, you know, on what are still some
of the most viewed programs in the world. They're just so likable and lovely.
It was nice for me.
I took my youngest, and they were super cool to him and us.
And then we walked around Times Square in Midtown.
I showed my son 1251 Avenue Americas, where it was my first job at Morgan Stanley.
Yeah, I saw that.
It was nice.
Really nice.
Was he impressed?
It's so fun.
Well, I'm sure you don't feel this way.
The only people who make me deeply insecure are my sons.
And I'm constantly trying to impress them and constantly coming up a little bit short.
Yeah.
You know what?
He just loves walking around New York and everything.
And he loved being at the Today Show.
But I'm not sure he was that impressed.
You looked very smart. Did George Hahn dress you? What happened there? You know, I thought the Today Show, but I'm not sure he was that impressed. You looked very smart.
Did George Hahn dress you?
What happened there?
You know, I thought the Today Show,
I just had to bring it.
Plus all my athleisure is dirty right now.
Yeah, no athleisure for Savannah Guthrie.
I feel like it's like getting older.
I need to step it up a little bit.
Yeah, you look good.
You look like a little George Hahn
that George did your styling for you.
Yeah, but George always comes with me now.
George and my chief of staff, Mary Jean, always come with me to that stuff for emotional support.
They're like my emotional support animals.
Oh, well, you did a great job.
Thanks. Yeah, that one went well. That was easy.
And your book went roaring up the thing. The Today Show has a lot of oomph, doesn't it?
Nipping at JD's heels. I'm coming for you, you fucking weird, like... Ill-bully elegies. I'm a dog-loving father of two that's
coming for your bitch ass, you weirdo. I am just behind him. We're going to call it the dog elegy.
Yeah, the dog elegy. Good for you. Good for you. I'm glad that it worked really well.
But let's get to our first big story.
Scott, President Biden gave his first speech since stepping down on Wednesday, saying, I revere this office, but I love my country more.
So just a couple of things. Meanwhile, Kamala Harris's poll numbers show her performing better against Trump than Biden had.
And it means Trump had to try out a new nickname for her at his North Carolina rally yesterday. Let's listen. So now we have a new
victim to defeat, Lyon Kamala Harris. Lyon, L-Y-I-N, apostrophe. Not his best work, I have to say. He
could do better. He also mispronounces her name. But it doesn't matter. She's doing great. Her
presidential campaign is in full swing.
Harris secured support from a majority of Democratic delegates, all but promising she
will be the nominee. A CNN poll has her at 46% support among registered voters to Trump's 49.
It's within the margin of error, and there's some very promising signs of who's come back on board,
including women and young people. And she's lowered dramatically Trump's appeal to
Hispanics. Harris's campaign says she raised $126 million as of Wednesday morning since Biden
announced his exit from the race. So let's talk a little bit about what's happened. There's
obviously a honeymoon phase, and Trump is sort of struggling to figure out whether to be sexist or racist or whatever his plan is, or just nasty.
Thoughts on how it's going?
There's just no denying it. The amount of momentum and inspiration she's brought to the race is just staggering.
I mean, it's so even those of us who weren't big Kamala boosters are sort of overwhelmed with this sense of enthusiasm and momentum and kind of signing up.
how flat-footed the Republicans and Trump seem right now.
This just feels like what last week felt like you were bereft or resigned to this pick,
and possibly is now seems like the right pick
and what everyone has really got renewed enthusiasm right now.
Why do you think that is?
So let's talk about the messaging,
because this is an area you excel in.
The Democrats are pouncing on viral footage of J.D. Vance in 2021, suggesting that Harris was one of a bunch of childless cat ladies
who were miserable at their own lives running the country. Interestingly, second gentleman Doug
Emhoff's ex-wife leapt to Harris's defense in a statement. Kirsten Emhoff said, these are baseless
attacks for over 10 years since Cole and Ella were teenagers. Kamala has been a co-parent with Doug
and I. She added, I love our blended family and grateful to have her in it. A stepdaughter,
Ella Emhoff, followed up with an Instagram by saying, how can you be childish when you have
cutie pie kids like Cole and I? I love my three parents. So that's part of the messaging. There's
a lot of talk about the messaging. Obviously, the Republicans is about sexism and racism. It seems like she's more into freedom, Beyonce. She's using a lot of Republican words, keep the government out of our lives, freedom, patriotism. It's interesting. It's kind right and I was wrong. I thought J.D. Vance was going to be a good pick. You said he was going to be a terrible pick.
And so far, already, it looks like the wheels are coming off.
And even Republicans, there's all these Republicans going on background saying it was a terrible pick.
She's a difficult candidate for them to criticize.
And what sort of summarizes where the Republican Party is right now is telling Republican surrogates not to attack her based on racist or sexist tropes.
And I thought to myself, what does it mean about your party when you actually have to go out and tell people that?
Tell elected officials not to make racist, sexist remarks. J.D. Vance is going to play,
and I didn't see this, right into the Democrats' hand of, okay, he's the bridge to 2025.
into the Democrats' hand of, okay, he's the bridge to 2025. And 2025 is, you know, Project 2025 is a pretty decent off-Broadway version of The Handmaid's Tale. And to a certain extent,
because she is non-white and a woman, it's more difficult for them in any way to attack her
because it comes off as racist and sexist. It kind of reveals them for many of
their policies, which scares people. So I think they're in a deliciously weird spot. I think the
messaging is going to come down to two things. On the Republican side, they're going to try and go
after you guys constantly accuse us of not being democratic, that you're constantly saying that
Trump is the end of democracy. And then you put up a candidate that never got a single vote or never got a single delegate.
I think that messaging they'll do in the short run. Over the long run, I think they're going
to run video loops of these campus protests and of these democratically run cities on the West Coast,
and that will be their messaging. And then they'll try and make her,
any attempt to make her look bad-
Leftist.
Personally.
Communist.
Yeah. But the reality is that it's going to be difficult to do without, A, she's not. And
her positioning is crystal clear in my mind, because she just needs to say, okay, week by week,
this is how many pedophiles I put in prison. These are the degree mills I shut down in California.
This is Trump University, which was closed down by another. She's just going to go,
she can immediately inoculate herself from the fears that some people, moderates,
might have about a woman or this sexist view that a president needs to be machoed up.
She can be the sheriff in town and the one that was putting these weak criminals,
taking advantage of other people,
such as Donald Trump, in prison.
That's that, in my opinion,
I'm a prosecutor, he's a felon,
is her message.
And their message is going to be,
this is what happens when you let Democrats
get control of institutions and cities.
But you also have to talk about the future, right?
What are you going to do?
I mean, this is something Pelosi just said.
It's not about what you, you never get credit for what you've done.
It's what you're going to do, right?
And you use the what you've done by showing that you can get it done, right?
If you, you know, I think these attacks on her not having a kid is really bad.
Like it's so offensive to women.
That's just dumb, Calla.
It's shockingly offensive.
That's good for us.
They just come across as sexist and weird
and that non-traditional families aren't welcome.
That doesn't work at all.
But I would disagree.
I agree you need to paint a vision for the future,
and that's really nice.
But politics is basically digressed into
how can I make them an even less appealing
version of what I am?
Her messaging around the future is
one thing and one thing only, stay the course. Look at GDP, it's up and to the right. Look at
the markets, it's up and to the right. Look at inflation, it's down and to the right. Let's just
keep this going. I'm the steady hand here. The people are in place. The momentum is good. We
don't want to fuck with it. Just we're going to stay the course. One of them is we're not going back to.
She's using that quite a lot in and freedom, which I think are good, good motto.
The issue I think she should, I mean, let me cosplay economic advisor.
The issue I think she should bring up that would get her a lot of credibility with moderates is if she said she did a speech and a thought piece and outlined a policy and view on we have to get our deficit under control.
That would position her as the adult and win over a lot of moderate Republicans.
That's a great idea. I hadn't even thought of that, Scott Galloway.
There you go. That's why I'm here.
Of course, you know what I'm thinking of.
What are you thinking of? Freedom families?
No. What Taylor Swift song could be the one of Kamala's campaign song?
I like the man. But seriously, brand wise, Taylor Swift, it's easier for her to come out in support of Kamala Harris than it was for her to support Biden, obviously. She's going to be important, correct? Obviously, FYI. There you go. Yeah. Celebrities never seem to have brought the juice that people had hoped.
Celebrities, generally speaking, are supportive of Democrats, other than, you know, like Clint Eastwood and Chuck Norris or Kid Rock or whatever, Ted Nugent, which I think actually hurt their cause.
But Taylor Swift is such a – oh, my God, if you could sign up Taylor Swift, she's just such a phenomenon on her own.
What is she saying?
The star-spangled banner at the Democratic election.
Well, no, if we want to win the election,
we just need to get Taylor Swift on board
and lower the voting age to 14
and boom, it's over.
Boom, it's over.
It's done.
It's done.
Actually, I think in this case,
she is an celebrity
that will matter here.
And I think I suspect
she's going to go right there,
especially because of abortion issues.
All right, Scott,
let's go on a quick break.
When we come back,
we'll talk about the unimpressive earnings
at Alphabet and Tesla
and talk to our friend of Pivot, Dr. Fauci.
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Scott, we're back for our second big story.
The NASDAQ has taken its biggest tumble since 2022,
thanks to earnings reports from Alphabet and Tesla.
Alphabet's quarterly earnings showed a slowing growth in advertising sales,
with ad sales rising 11%, down from 13% in the previous quarter. On top of that,
Wiz, the cybersecurity startup we had talked about, Alphabet planned to acquire,
had decided to turn down the $23 billion offer. Alphabet shares are down almost 5% in the last
five days of time of the taping. I want to talk about this, but I'm going to mention Tesla.
Earnings have showed a 7% decline with auto revenue, with earnings per share coming down below Wall Street estimates.
Tesla shares are down 10% in the last five days, giving up a lot of the gains they've been making.
NASDAQ is down over 3% in the last five days, and the S&P is down 2% because of these tech companies.
I'd love to hear your thoughts on this.
This is your big area of expertise.
Talk a little bit about Alphabet first and then Tesla. Well, Alphabet actually had a decent quarter. It's just that
one, I mean, Alphabet's dealing with this existential issue of having one foot in and
one foot out of AI in the sense that they have Gemini, but Gemini gets about an eighth of the
traffic of open AI or of chat GPT. And when you think about all the head start in the captive
audience across
Google and Android, to have only the eighth of the traffic of what is supposed to be a startup,
but it's really just Microsoft AI, is unusual. And the question is, they're trying to incorporate
AI into their core platform search. And there's still a little bit, people would argue, trapped
in the innovator's dilemma. And that is they don't want to go all in on Gemini at the risk of cannibalizing this quarter of a trillion dollar toll booth, amazing
best business probably in history called Search. So they're still kind of, I would argue, a little
bit one foot in, one foot out, trying to have their cake and eat it too. I understand why they're
doing. People got spooked about YouTube sales slowing. I didn't think it was that big a deal.
And the other thing that's hurting their earnings is like everyone else, except for Apple, they're now in this arms race and their CapEx
was dramatically up, which sort of hit earnings. The bigger story, I think, or what was more like
genuinely bad news was Tesla. And that is the EV market. I think it's interesting, an interesting analogy would
be the streaming market. And that is, it was overinvested because people saw it as the future.
And now there's a bit of a shakeout. And that is, and the way you see the shakeout is in an
intense price competition. A year ago, the equivalent EV was $8,500 more expensive than
its internal combustion peer. Now that number, that margin at premium has dropped to $1,500 more expensive than its internal combustion peer.
Now that number, that margin premium has dropped to $1,500.
And the F-150 Lightning, the EV is actually $10,000 less than its internal combustion counterpart,
probably because they produce too many.
In addition, while the market continues to grow, Tesla has not.
A lot of people would describe its products as a bit tired. Not describe them. They are a bit tired. We've been saying that for
a year. Where's their new stuff except for that heinous hot Cybertruck?
I drove in a... A friend of mine is this master of the universe hedge fund guy. I went
out to the Hamptons to see him. And he has a matte black Cybertruck. And people were stopped
and staring at it. And it's just, I drove in it.
I would describe it as a ridiculous car out of a, out of a Simpsons episode.
I think it's insane.
Were you embarrassed to get in it?
I'd be embarrassed to get in it.
Oh no.
There's a lot of shit I've done that's much more embarrassing.
But what's the problem?
What does he have to do here?
He obviously was, he took a vote on, on Twitter, whether to call it, whether, whether to invest $5 billion in XAI.
I mean, I'm literally like, when is the SEC going to come and arrest this fella?
Well, first, I mean, there's a couple of things.
One, if you listen to the earnings call, the questions were more pointed and more heated
than they've been in a long time.
To this point, the earnings calls have been a bunch of stenographers and sycophants thanking
him for a great quarter. This one was distinctly like, boss earnings calls have been a bunch of stenographers and sycophants thanking him for a great quarter.
This one was distinctly like, boss, we have been waiting for a robo-taxi for five years.
You know how frustrating that is to be on a corner when you call and they say, oh, a robo-taxi is just, it's a minute away.
It's a year away.
He's even saying now that it could be by the end of the year, but it might be 2025.
He said, I think in 2019 or 2020,
we were a year away. And people's patience-
Right. Yeah. Oh, no, no. Constantly. Constantly.
People's patience is really wearing thin. But more than anything, I'm a valuation guy.
If you look at forward earnings, Ford trades at seven times forward earnings. GM trades at five
times forward earnings. Ferrari, an amazing company with You want to talk about a moat. Trades at 50 times, right? Tesla trades at 99 times forward earnings. And the moment you say that, people say, well, it's not a car company. It's an energy company. It's going to be a robo-taxi company. The scariest thing in that earnings call is that their 2030 projected
profits, they're saying 80% of those projected profits will come from its robo-taxi division.
So they are estimating that four-fifths of their profit are going to come from a division in a
technology that they haven't shown an ability to even deliver yet. I know. I need to, I just real quick need to correct myself.
It wasn't the company.
It was our Kathy Woods, which makes it batshit crazy anyways.
But she was saying 90% of Tesla's enterprise value earnings will be attributed to the
robo-taxi business by 2021.
No, she's just a stenographer for Elon Musk.
You know what I was thinking when I heard these?
I was like, this guy had everything.
Like, he had it. Like he could have shifted into new products, new exciting things. He could have owned it, like really been Ferrari, right? And he's just blown it here in a way that it's sort of sad because it was a very good company and it still is in a lot of ways. It's just, I'm just-
And then the corporate governance here, I mean, it's just the idea that you would say
to Tesla shareholders, I'm going to take $5 billion of our hard-earned cash flow
and use it to try and take my other failing company and put on an AI dress. You just,
that wouldn't even be a conversation at a board level at most
companies. They'd be like, no, stay focused on, we do cars, boss. We're not in media and we're
not interested in funding your adventures in AI media with our hard-earned money. And instead,
he takes to a Twitter poll. Like, have you polled your board members that represent the shareholders at Tesla? But again, it is corporate governance is sort of a cute novelty we used to talk about before before.
It is such a waste. I was just thinking, you know, I'm not inclined to him in any way, but I feel bad because it was a really good. You know what I mean? Like, you're like, why did you go out with that girl when you had this girl? Like, I don't know.
Yeah.
Did you see, I'm really remiss to bring, I've always felt that people deserve a pretty wide
berth and privacy around the relationship with their kids.
Did you see his interview with Jordan Peterson?
Yes.
He said a terrible thing about his trans guy.
I was so deeply rattled by that.
Yeah. his transcript. I was so deeply rattled by that. I thought that that was, just to summarize,
he basically, he holds woke ideology responsible for what he describes is the loss of his-
The death of his child.
The death of his child.
He deadnamed the child too.
And I really am remiss to bring up people's relationships with their kids because they're so sacred and it's difficult.
It's, you know, until you walk in those shoes, you don't know the dynamics of the family.
But he made this available for public consumption by going on Jordan Peterson.
This is exactly the opposite of what it means to be a man.
That is correct.
Your absolute first reflex, instinct, response, your muscle memory around being a man, is you move to
protection. And if any group in the world you want to protect, it's your kids. And internally,
you might fight like hell to try and convince your child not to go through gender affirmation.
I think that is up to a family and their doctor and the individual.
Keep it to yourself, son of a bitch.
But for God's sakes,
to go on television
and describe your child as dead to you?
He talks a lot about his father being demonic.
He's a demonic parent.
I have to say, he's done it a lot.
There's so much anti-trans stuff he puts out there.
It's crazy.
Just, you know, that was his being, like, subtle, his anti-trans stuff. And this was explicitly awful. You know, I don't care what happened to you as a child, Elon. You're keeping up with your dad in that regard and being a bad, bad parent. I agree with you. It was very rattling. I'm shocked every time it happens.
Okay, Scott, let's bring in our friend of Pivot.
Dr. Anthony Fauci is the former director of the National Institute of Allergy and Infectious
Diseases. He's also the author of a new memoir on call, A Doctor's Journey in Public Service.
There's been a little news since your book came out. It's kind of drowned out. We've had a lot of things happening. And we'll get to those in a second. But let's talk
about where we are right now. It's been a little over four years since COVID upended our lives.
Looking back, let's talk about what you wish you'd known or done differently back in 2020,
because you write in the book about initially giving guidance not to wear masks, but you later
said those words got twisted by extreme elements later. You also acknowledged in a recent interview
that keeping schools closed for an extended period of time was not a good idea. Talk a little bit
about your reflections about COVID, although a lot of the book is about AIDS, which is, of course,
you played a major role in dealing with that. Yeah, I think it's important to emphasize for the listener that this is a
memoir of my 55 years, 54 years in public service, only two or three of which was COVID. So COVID is
a minor fraction of my memoir, but everybody obviously focuses on the last couple of chapters
because that's fresh in their mind. But getting to your specific
question, I mean, obviously the point that I was making in the memoir and I continue to make
is that we were dealing, and in some respects we still are, dealing with a moving target.
If you have a static situation, you could make recommendations and guidelines and transfer information to the public that is very firm and
doesn't change. But when you're dealing with a moving target where what you know about COVID
in January and early February is different than what you know in March and April, not only is the
information changing, but the virus itself is changing. I mean,
we would have never imagined that in one single outbreak, we would have multiple variants that
we would have to deal with that would have varying degrees of escape from already existing immunity.
We didn't know in the beginning that the virus was transmitted predominantly by people who don't have any symptoms, which was one of the reasons why there was a confusion.
One of the several reasons why there was some confusion about whethergeon General, the CDC, and I obviously supported them, that we didn't necessarily need to wear masks is that there wasn't any strong indications that masks were effective outside of the clinical setting, number one. Number two,
we didn't appreciate fully at all that asymptomatic spread was important. We were
thinking about the influenza model where people sneezing and coughing. Once it became clear
that A, it was spread by asymptomatic people, and that masks actually do work outside
of the setting. We made our change, and we said, wait a minute, there is a very good reason to be
wearing masks, and that's the reason why the recommendation changed. That, understandably,
could be interpreted as scientists flip-flopping. But it really isn't flip-flopping
when you use the data that is available to make the real-time changes in your recommendations,
because science is self-correcting, and this is one of the examples when it's self-corrected.
Except in an era where self-correcting is not allowed, because you would enter, now you,
of course, your career, and we'll talk about the AIDS crisis in a minute, you've dealt with political issues, of course, like political, angry, emotional, things like that. But in this point, changing your mind is a political act, right? I mean, you've worked with seven presidents, but you had Donald Trump in this case to deal with. And you get into the drama in the book in a chapter titled, He Loves Me, He Loves Me Not. You reflect on the moment you realize you'd have to refute him
publicly. Talk a little bit about the politicization because you've become not a person,
but a political, you know, football among people. Why did you feel important to refute him publicly?
And how do you manage that as a scientist?
Presumably, you don't want to become political because it gets in the way of just making a mistake and then correcting it.
Well, of course.
I certainly have tried throughout my more than a half a century career and my 38 years as the director of the Institute, NIAID.
years as the director of the Institute, NIAID, I tried very assiduously to stay out of things that were frankly political. But in answer to your specific question, I was not comfortable in
having to publicly disagree with and contradict the president of the United States for a number
of reasons. One, I didn't want to get into a
political issue. And number two, I have a great deal of respect for the office of the presidency
of the United States. But when the president began publicly saying things that were frankly
and clearly incorrect, and then I was asked to comment on that mostly by the press. I just felt it was critical
in order to maintain my own personal and professional integrity, but even more important
to fulfill my primary responsibility, which is to the American public.
My responsibility is not and has never been to any particular administration. It's been
to the general public. And I felt as a public health official, as a scientist and a public
servant, that I absolutely had to be totally honest. And honesty meant publicly contradicting
what the president was saying, because he was desperately hoping that the
outbreak would disappear at the end of March, just the way flu in a seasonal manner generally
diminishes and essentially disappears as you enter into the early spring months of April and May.
When he saw that was not happening, he started to say things that were
not true, like saying it was going to disappear like magic. When it became patently obvious
that not only was it not disappearing, it was actually getting worse, then he started to invoke
magical elixirs like hydroxychloroquine was going to be the cure for this.
And then when he started to say that, I felt obligated to say, no, that's not the case.
There's no scientific indication that hydroxychloroquine works.
And in fact, there is some indication that it could be harmful.
So when that didn't work, then he started bringing in people who started telling him things
he wanted to hear, like Scott Atlas, who came in and started to say that we didn't need to worry
about it. It was okay. Just let it rip and let people get infected and herd immunity will come
in, which was clearly incorrect, both conceptually and was proven to be incorrect practically. So again, that was the
difficult situation I was in. I didn't relish it. The people who are very strong supporters
of the president misinterpreted that I was doing that to undermine the president, which I certainly did not want to do at all. That was not my purpose, but that
unleashed a sort of a tsunami of antagonism against me, mostly on the part of the staff at
the White House, people like the communications staff, people like Peter Navarro and others
who are much more vehement against me than was the
president himself. He was less phased by that than they were. In fact, we, even to the very end,
had somewhat of a frayed, but nonetheless still a reasonably good relationship.
It's nice to meet you, Dr. Fauci.
Thank you, Scott.
So, part of science is being open to iterating and trying to find the best ideas and incorporating them into the science.
When you look at so many nations took a different approach to how to handle the pandemic.
Some wanted to let herd immunity, you know, see if that worked.
Others had sort of this authoritative or authoritarian lockdown.
Distinct to the U.S., which unfortunately just feels like every discussion around this has been so deeply politicized here.
When you look at other nations and their approach to the pandemic,
who do you think got it most right and what can be learned from that?
You know, Scott, if all nations were equal and some did it one way and some did it the other, you could
accurately tell whether one thing worked versus another.
But there's a big difference between an island nation like New Zealand and Australia, who
clearly had the capability of effectively keeping out the flow of infections
and when they were in the country to control them.
You had other societies that readily accepted
the government decision that everybody needs to wear a mask
and everybody needs to lock down.
And they would not essentially having
a paradoxically negative reaction against
it. So again, if you were in a country where you were accepting of the authority of the government,
people like those in Korea and Taiwan and places like that did relatively well. That was part of their culture. I mean, in Japan and certain Asian
countries, they wear masks all winter anyway, even without there being COVID. So the idea of
saying wear a mask, whereas in the United States, when the CDC recommended in the peak of the
outbreak that we wear masks, You have the President of the United
States getting up and saying, well, the CDC recommends it, but me personally, I don't think
I'm going to wear one. That immediately made masks become a political issue, when it never should
have been a political issue. Right. Well, it was about a lot more things. So one of the things,
as you said, you've been involved in public health for decades, many decades. And a big part of this book focuses
on your work, which I think you were most known for. You were not known for COVID or anything
else. Now you shall go down in history as the COVID person. But your work during the AIDS crisis
in the 80s and 90s, you call that time the dark years of your medical career. You know, obviously prepared
you for dealing with things during COVID, but talk a little bit about that period and where we are
now with the AIDS crisis. It seems so far away. It seems a million years away. And in that case,
you managed to forge alliances with people such as Larry Kramer, who were adamantly attacking you, like very much so
at the time, as I recall. So talk a little bit about that experience, because it probably is
the most important part of your career historically. Well, it is. It's a 43-year part of my career,
as opposed to a three-year part of my career, which was COVID. Well, let me take each of the points that you make,
Kara, and very briefly address them. When I've said it was the dark years of my medical career,
it was because I was personally, on a daily basis, taking care of desperately ill, young,
mostly men who have sex with men, who had a terrible disease that inevitably
was killing almost all of them with few exceptions.
And there was a period from 1981 until we developed the effective therapies that really
most of my patients, with very few exceptions, died, no matter what we did.
And I had been, the prior 10 years, had developed some very effective therapies for autoimmune
inflammatory diseases where most of the patients expected they were going to die from these fatal diseases. And I was fortunate enough
to have developed therapeutic protocols that led to more than a 90% remission in these individuals.
So I was used to success after success after success. Then along comes HIV. And right through 1981, until we developed therapies in the mid-90s, that my
patients were suffering terribly and dying. That, as I described, not only for me, but for my
colleagues who were doing the same things that I was doing, trying to do meaningful research
at the same time of taking care of patients was really something that led
to a bit of post-traumatic stress. Because it's not easy to every single day when you're trained
as a healer and find out that no matter what you do, you're not really healing anybody.
So that's what I meant by the dark years. The point you make about interacting with the activists, people like Larry Kramer and Peter Staley and Mark Harrington and people like that, that was one of the scientific and regulatory community to make the point that
the standard approach of the design of clinical trials, the entry and exclusion criteria,
the rigidity of the regulatory process of taking seven to 10 years to get an approval was just very ill-fitted and ill-related in the sense of being able to
adequately address a disease that was killing most people in 10 months. So they wanted to be part
of the discussion of how we can make this type of an approach more adapted to their particular situation. And now, unfortunately, the scientific community and the regulatory community had the attitude,
which worked well for other diseases, but retrospectively was totally inappropriate
for HIV, was saying, we know what's best for you, do it our way.
And their response was, no,
this is a very unique situation. So when the scientific and regulatory community did not listen to them, they became very provocative, iconoclastic, disruptive,
and theatrical. And since I was a very visible person out there taking care of people with HIV and being
the government face of the response, I became the target of the attacks.
And one of the best things I've ever done was to drop back and put aside the theatrics
and listen to what they were saying.
And when you listen to what they were saying and put aside
the provocative behavior, what they were saying was making perfectly sense. And I came to the
immediate conclusion that if I were in their shoes, I would be doing exactly what they were doing.
And that's when I brought them in and I myself became an AIDS activist and I became an
advocate for them. And that was a process that didn't turn around overnight. It took weeks and
months and years to finally get to the point where their contribution was much value added. And to this day, you know, fast forward 43 years,
those people are now literally some of my closest friends and colleagues. And in fact,
as I described in the memoir, you know, people like Peter Staley and David Barr,
all my closest advisors now, and they were my antagonists back then. tied to the investigation into COVID's origins. And you had Congresswoman Marjorie Taylor Greene, who seems to have a particular interest in you,
got particularly fired up saying that you should be jailed
for repulsive evil science.
Do you see that happening here years from now?
Well, Cara, as I say when people ask that,
it is completely inappropriate to compare
the confrontation of the activists with the
vitriol and ad hominem that's going on right now. Because back then, I invoke the iconic
civil rights leader, John Lewis, who said in the civil rights movement, we made trouble, but it was good trouble. You know,
the activists, the AIDS activists were making good trouble because quite frankly, they were correct.
What's going on now where you have the extremists, you know, mostly far right Republicans in those
committees and the right wing media like Fox News and others, to them, it's pure attack.
It's ad hominem and vitriol.
It isn't a question of, let's work together to see how we can make things better.
If you go back to that committee hearing that I testified as the sole witness in June,
you're absolutely correct.
as the sole witness in June, you're absolutely correct. The purported purpose of the hearing was how can we look forward and make things better to help us prepare better for the next
pandemic. There was nothing about that hearing that resembled that. It was all attack, attack. In fact, and if you look at some of the members on the GOP side,
like Marjorie Taylor Greene and Ronnie Jackson and Jim Jordan, they didn't ask any questions.
They just spent their entire five minutes attacking. So I don't think that that is an
indication that they want to gain our attention to make things better. So I don't think that that is an indication that they want to gain our attention
to make things better. So I think it's very, it's totally different than the AIDS activists. I mean,
it's like cherries and watermelons. Can I follow up on that? Yeah, please.
So I don't think young people realize, you know, we're hoping that COVID is the health crisis of their age. But for those of us living in San godfather, my oldest, was diagnosed as HIV positive after his partner died.
And he was starting to get his affairs in order.
And then science lifted him up.
Science caught him.
And now he's a spin instructor, thriving career, married again.
When you look out there, I mean, people just don't realize what a miracle this has been.
look out there, I mean, people just don't realize what a miracle this has been. When you look out there on the horizon, because I want to be a little bit more optimistic, what kind of potential
do you see? What disease category or what types of different breakthroughs do you think we're
closest to that might provide the type of miracle that the AIDS cocktails provided in the earlier
part of the millennium? Yeah. Well, Scott, thank you for bringing that up. And it gets back to what I just mentioned to
Kara a little bit ago, that my book is 40% or maybe 50% HIV because of the reason that you
pointed out. It is a miracle of biomedical research where I was taking care of people from 81, 2, 3, 4, 5, 6, 7 that were all dying.
And now all of my patients I see in the outpatient department who come in just to say hello.
Just incredible.
I mean, that's all they come by is to say, I'm doing fine.
And they're productive.
They have families.
They're just, they're leading essentially normal lives.
But jumping ahead to your question is that I think that there is the possibility that
advances in biomedical research will continue to allow us to meet the challenges of new
emerging diseases.
And I think what we did with the COVID vaccine is a classic example of that. The idea of the
decades of investment in basic and clinical biomedical research that led to the mRNA
technology, which is an extremely adaptable vaccine platform, and the immunogen design
that really started off decades earlier in the attempts to make an HIV vaccine,
led to a vaccine that was unprecedented in the speed in which you had a safe and effective
vaccine. Eleven months from the time that the sequence of the virus
was put on a public database to the time an effective and safe vaccine was going into
the arms of individuals.
If we continue that kind of support of basic and clinical biomedical research, we can essentially affect the same sort of miracles in the future
for emerging infections similar to what we've seen with COVID. The one thing that we need to
work a lot on that did not serve us so well was the local public health infrastructure and the relationship between the central public health process and the
local identification, isolation, contact tracing, it was very fragmented. And cities and states
did it differently as opposed to a uniform, well-thought-out response that everyone could
benefit from. There was a lot of political influence on whether or
not you decided to get vaccinated or not, which is so tragic that people decided not to utilize
a life-saving intervention merely based on ideological considerations. I mean,
that should never enter into a public health arena.
But it has, obviously. I mean, do you feel like it's done in that regard? Because,
look, there's all this misinformation. People say, I know better. You know, you have a candidate
running for office, a third-party candidate in RFK Jr. who is just insisting, and also his running mate, that it causes autism vaccines.
I have people who I never thought would tell me idiotic things like that, tell me things like that constantly.
And it's often very liberal people, which it's not necessarily, you know, Trump voters or anybody else. And it's a really interesting shift in attitude towards public health, which
is distrustful, that there's nobody knows the heart stuff, everything else. And it's by prominent
figures. This is not a this is not sort of a group of wacky people who would just do this.
And then you have it fueled by online, you know, misinformation and personal attacks on you to try to denigrate you,
to make you into something you're not. Is there any way to put it back that you get trust in
public health going forward? Or, you know, a lot of people feel like public health has done a
disservice to itself by not being more flexible or open-minded towards people with questions.
No, I think obviously we always have to be open-minded towards people with questions. No, I think obviously we always have to be
open-minded towards people with legitimate questions. But you know, Cara, it's sometimes
really very difficult to counter absolute frank conspiracy theories that are totally
unfounded in facts. I mean, the data to show that not only does vaccines not cause autism, but that is no
relationship whatsoever between back and the data are overwhelming.
And it's just, you know, I don't want to be being pejorative about people like RFK
Jr., but unless he's got a scrambled brain, I mean, he can't be a stupid guy. And he's
got to realize that the data are overwhelming. And if he wants to really make a decision based
on information and evidence, it's inconceivable that he's still talking about autism.
But he is. I've seen dozens of people who should know better.
Should know better doesn't seem to be working anymore.
No, it doesn't.
It doesn't.
So what happens to public health in that regard?
Well, public health suffers, Karen. The social media ability to spread misinformation and disinformation is something in 2024 and
recent years much, much different than what I faced as a young physician back in the 1970s
and 1980s.
It's just that it appears that those who spread misinformation and disinformation
are extremely energetic about it.
It's almost as if they don't have a day job, you know, and the people who are, who are
no better and are trying to spread correct evidence-based information have a lot of other
things to do with themselves,
and they can't be spending all their time trying to counter people who seem to do nothing
but spread misinformation and disinformation by the social media. So it's almost like
we're being out-energized by the people who are spreading false information. And I guess,
energized by the people who are spreading false information. And I guess, you know, my only solution, I wouldn't even call it a solution, but my only option, I would think, would be to get
people who care about the truth to put a little bit more energy in spreading correct information.
Although they see what happens to you and don't really want to do that, right?
Well, you know, that's true.
don't really want to do that, right? Well, you know, that's true.
I mean, you get death threats. You are constantly, you've become an icon to the right in not a good way. You know, it has personal prices to pay for that. It does. But, you know, when people ask me,
is that a disincentive to go into public health and public service, my response is always that the gratification
and the positive impact you can have by going into public health and public service far
outweighs the negative aspects that people throw at you, even though it's uncomfortable
that we have to put up with that, the positive aspects of public service and public health.
They must be very positive because I wouldn't want to be you, I think.
So, doctor, it feels as if, unfortunately, masks and vaccines were somewhat, not somewhat,
were politicized, even weaponized, mostly on the far right. But I would argue on the far left,
we, in a weird way, politicized obesity. And that is, we didn't want to have an honest
conversation about it because we saw it as fat shaming. Weren't most of the deaths somewhat directly or indirectly related to
this other pandemic in the U.S. that continues to rage on, and that is obesity? One, do you agree
with that? And two, I would just love to get your thoughts on GLP-1 drugs.
Yeah, well, Scott, good point. You're absolutely correct. If you look at the two or three conditions that would put someone at a higher risk if they were infected of progressing to a severe outcome with hospitalizations and deaths, obesity is at the top of the list.
the top of the list, obesity, and obesity is associated with diabetes. Diabetes is the other one at the top of the list. Obesity is associated with hypertension. Hypertension is also one of the
top three or four. So obesity is really a very, very high risk. Now, you're asking what my opinion is of the glucagon peptide one. Every bit of data that I
see about that is a positive impact, not only on diminishing the amount of obesity that an
individual would have, but also diminishing some of the other risks,
heart disease or hypertension or what have you. So I think we're still in the early phases
of the GLP-1, but I would like to watch it carefully and think that ultimately it's going to be a very positive impact on a lot of different people who cannot control their obesity for the normal ways of just saying, you know, stop eating so much.
Which, you know, in someone who's morbidly and chronically obese, that is not a good answer.
No, not at all. And it leads to so many other outcomes.
No, not at all. And it leads to so many other outcomes. When you're thinking right now, obviously, health, mental health is something that's also been a big deal. When you look at all the swirl around both Donald Trump and Joe Biden around their cognitive abilities, it seems like medicine is something that is just, nothing, there is nothing. Everyone's a doctor. Everybody knows what they're talking about. Everyone comments on it. And yet we're going to have a next pandemic. We're going
to have a next healthcare crisis. How do you change that? When you think about that dynamic,
when everybody is an expert, does that have a deleterious effect on health, public health?
Well, yeah, because everyone thinks they're an expert. I think I would correct what you were
saying. If everyone was an expert, there would be no problem. We'd have a lot of expertise floating
around. But it's just that everybody thinks they're an expert. And that's when you get into
a problem, because then people can't determine the difference
between one and another. Do you look at, do anything around AI? A lot of people I talk to
in Silicon Valley are, you know, they talk about the possibilities of AI helping healthcare,
drug discovery, drug interaction, cancer research. How are you approaching that?
Well, I don't, I mean, I'm in a position now of not utilizing AI, but I observe
from my perch of experience in medicine for over 50 years that there are many, many positive
aspects of AI. Obviously, there were those who were concerned about the negative aspects of AI, but the ones that are obvious, like, for example, with all of the information you put into things like reading x-rays or reading skin biopsies or reading visual imaging of retina or CT scans or MRI scans, AI can have a very positive effect. I think we obviously have to have the
proper control so that it isn't used inappropriately. But I myself, that's not my
lane. I don't utilize that. You were demonized. I mean, and I wonder, all right, you've got a very
distinct career. You've highly credentialed. You've earned your accolades, your titles,
and you're demonized. You're working your ass off and people are demonizing you. There's just
no way they can't take a toll on you mentally and emotionally. I'm just curious what practices or
what you did to kind of manage your own mental health. You know, Scott, that's a great question. And
I have the ability, and I've developed it over the years, to compartmentalize and to focus like
a laser beam on what my goals are, what my function is. You know, as a physician, it was
taking care of patients and everything else gets shielded out. As a scientist, it's to do the best possible science.
And as a public health official, to keep my eye on the ball of my goal and my function
is to preserve and protect the health of the American public.
And since the United States, you know, is such a leader in public health indirectly
for the rest of the world, all of the other stuff, although, you know, when you look at it at face value, it's, you know,
nobody likes to be demonized, but I try and I believe succeed in filtering that stuff out
and realizing that it's just one of the, you know, the liabilities of our society today. The other thing is, I have an
amazing support structure. I describe it in my memoir. My wife, Christine, is just an amazing
person with rock solid person in being able to just always keep me grounded in reality of
who I am and never let me forget about who I am and what
I should be doing. So support structures are really, really important. And I'm fortunate enough
to have someone who's lived through it with me and is a very wise person whose counsel I hold
very, very dear. So what's next for you? What is your next move? Well, you know, one of the
reasons I stepped down besides wanting to go ahead and write my memoir, which I've now finished and
it's out, so that's behind me, was I wanted to use my many decades of experience to perhaps inspire
younger people who might be thinking about getting into public health or
public service or who are already in public health and public service. So I now am a distinguished
university professor in a dual appointment in the School of Medicine and the School of Public Policy
at Georgetown, and I enjoy very much the interaction with students. When I was at the NIH for more than 50 years, it was mostly interacting with doctoral level
and senior scientists and others.
Here, when you're dealing with 19, 20, 21-year-old, 25-year-old students, there's a whole different
milieu that you have there that is really very gratifying to be able to help them,
advise them, inspire them. That's what I'm doing now, and I'm enjoying it very much.
If Donald Trump wins, there are threats to you and others.
Are you worried in any way? They have made threats, a lot of them.
You know, Cara, the answer is I don't want to seem like I'm the brave hero, but no, I'm not worried about it. What is going to be is going to be. If they do the ridiculous thing of retribution and revenge, I don't know what to have a revenge about. What have I done that you want to have revenge against me? But if you do well, I don't know what to say, except I'm not going to let it against me. But, you know, if you do well, you know, well, I don't know what to say,
except I'm not going to let it bother me. All right. Well, keep teaching. We really
appreciate it. Dr. Anthony Fauci, again, the book is called On Call, A Doctor's Journey
in Public Service. Thank you, doctor. Thank you.
Scott, one more quick break. We'll be right back for predictions.
predictions. Scott, let's revisit some predictions we got right. Trump media and technology is down almost 70% in the last month, which we predicted would happen. It's just, it's not a company.
Stop it, people. It's a thing on whether Trump is going to be president or not. That's what it is.
It's an indication of whether he is. And as I predicted, J.D. Vance is trying to be a poor choice for the GOP, largely because I know him. So, you know,
I think he's charmless and weird and everything about him is strange. And I think he's actually,
usually vice presidents don't matter. But in this case, what a bad choice. In any case,
I had the nightmare idea that Trump would dump him and then pick Nikki Haley, which would be,
I had the nightmare idea that Trump would dump him and then pick Nikki Haley, which would be, would probably cause him to win in some ways.
But Scott, give us your prediction. Well, I just love correlating a reverse engineering from the financialization and politicization of everything means that what happens in the political spectrum has impact on stocks now.
week was that it went from 46 to 36 and Donald Trump media was going to go below 30. And it's having it about 30 today because it's become a tracking stock for Trump's likelihood of
recapturing the White House. And I think the same thing is going to happen to Tesla.
Tesla is kind of, there are meme stocks. DJT Media is a total meme stock. It's trading on
things that have nothing to do with the underlying valuation.
Companies like AMC and GameStop are pretty close to that.
They've kind of disassociated their valuation from the underlying businesses, which are generally shitty businesses.
A company that's kind of squarely in the middle is Tesla because it is, to be fair, it's a great company. It has incredible products.
It's been incredibly innovative.
It does spin off free cash flow. It's growing. It has incredible products. It's been incredibly innovative. It does spin off free cash flow.
It's growing.
It has marked the EV revolution.
But it trades at kind of a meme stock valuation that is, even with its growth prospects, it's very hard to imagine it ever growing into a valuation of, again, twice the PE ratio of Ferrari, which is kind of a vanity buy.
So I think what's the narrative that's going to
play out is the following. I think we're about to be a bunch of stories saying that all of these
tech libertarian billionaires cozying up to Trump in exchange for political favors
and advantages that would advantage their business. I think there's going to be more
stories about, okay, you've gone all in on Trump and you think it's going to get you business,
which by that logic means that if in fact it's a Harris presidency,
it's going to be really bad for your business.
That it's going to be unlikely she's going to put more tariffs on BYD.
It's going to be unlikely that she puts pressure on the Fed or Janet Yellen
to come up with some batshit crazy lack of regulation that sends crypto through the roof.
Also, it's unlikely she'll stop the SEC from coming after your ass.
That's exactly right. And so I think people at the media is going to start connecting the dots
there. And companies associated with this new techno-libertarian all in on Trump are going to
think this could be bad. I mean, typically speaking, companies wisely, other than behind
the scenes funneling money to people who are behind their interests, do not come out in favor of certain candidates. So I think one,
you're going to see, I think Andrews and Horowitz and Sequoia just did not do the scenario planning
here around giving a full-throated endorsement to Trump. But I think the stock that will,
and this is not financial advice, I've never been more wrong than when I talk about Tesla stock, but I can't help but think people are going to start to write articles on how bad
will a Harris administration be for Tesla? And I think that's going to impact the stock.
As she does better, the stock will do worse. That is absolutely true.
That's exactly right.
DJT is still worth 5.77 billion.
Six billion.
I mean, Jesus.
Yeah.
If that's doing bad.
But Kara,
it's got four million
in revenue.
If loving you is wrong,
I don't want to be right.
Yeah,
it only lost
a third of a billion
on seven million in revenue.
I know.
God,
how can we get
into this racket?
We need to get
into a racket.
How do we?
Kara Media.
Kara Media.
Dog, Jungle, Cat, Social.
Scott and Kara Media.
Truth Kara Media.
Truth.
No, it has to have
your name in it, too.
I know you're going to leave me someday, but that's going to be okay with me.
I'm just the good-looking guy in the background.
I'm just the side piece.
That's how people think of us.
You, the good-looking guy.
I'm just the side piece.
Well, you did look good on the Today Show.
I have to say, you were even handsome.
Thank you for saying that.
That's really all that matters to me.
You looked really good.
I really appreciate it.
Anyway, I love seeing you succeed.
Okay, Scott, that's the show.
We'll be back on Tuesday with more Pivot.
Please read us out.
Today's show was produced by
Larry Naiman, Zoe Marcus, and Taylor Griffin.
Ernie and Todd engineered this episode.
Thanks also to Drew Burrows and Neil Severio.
Nishat Krua is Vox Media's executive producer of audio.
Make sure you're subscribed to the show
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Thanks for listening to Pivot
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We'll be back later this week
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Have a great weekend.