One of the earliest entries, dated June 20, 2020, focuses on then-White House coronavirus response coordinator Deborah Birx. Fauci wrote that he had grown frustrated with what he viewed as support for expanding emergency authorizations instead of relying on traditional clinical trials.
“Deb has ststed [sic] that we should noit [sic] do clinical trials since ‘I want to see every infected person in a nursing home get plasma early on and steroids later. Forget the trial, we need to do this on EUAs. She says the same thing about vaccine trials. Clearly, she is trying to provide Trump with his October surprise. I may need to blow the whistle on her.”
The entry suggests Fauci believed months before Election Day that efforts to accelerate certain medical interventions were politically motivated. He also indicated that he was considering speaking publicly if those efforts continued.
Fauci recorded similar concerns more than a month later. In a July 26 diary entry, he wrote that after watching Mark Meadows on television, he believed the chief of staff was “trying to get an ‘October Surprise'” by encouraging an earlier vaccine authorization. Fauci later noted that after briefing President Donald Trump in the Oval Office, the president acknowledged a vaccine might not be ready before Election Day, although Fauci wrote that “he was not happy about it.”
A July 31 entry details a conversation Fauci said he had with Larry Horowitz regarding a reported White House meeting.
“Important call form [sic] Larry Horowitz who works closely with nancy Pelosi. Apparently, There was a meeting in the WH with Steve Mnuchin, Mark Meadows, Nancy Pelosi and Chuck Schummer. Steve and Mark told Nancy and Chuck that AstraZeneca will have vaccine in September and that it will be given an EUA… Apparently, Peter Marks does not know anything about this and Larry just informed him. Bottom line is that they are going to pressure Steve Han [sic] (who likely will cave in in the idea of an EUA) to issue one even though Peter has serius [sic] issues with this. An EUA will likely get in the way of completing the RCTs that are going on. Clearly. This is politically driven and will be a ploy for Trump to get re-elected.”
According to Fauci’s account, he believed Peter Marks had not been informed of the reported discussions and was concerned that granting an emergency authorization too early could interfere with ongoing randomized clinical trials.
Perhaps the most closely watched diary entry is dated Aug. 7, when Fauci described a discussion involving Marks, Collins, and Lane.
“Call from Larry Horowitz (works with Nancy Pelosi)… He had warned me a few days ago about Meadows trying to pressure Hahn and Marks to grant UA [sic — EUA] (or even BLA) prematurely to vaccines (likely AZ) in time for the election. I called Peter Marks a couple of days ago (together with Collins and Lane) and explained that we would back him if he holds the line. He called the AZ package ‘a hot mess’ and definitely not in shape for an EUA.”
According to the diary, Fauci, Collins, and Lane assured Marks they would support him if he chose not to authorize the AstraZeneca vaccine based on the evidence available at the time. Fauci wrote that Marks believed additional data were needed before any emergency authorization could be justified.
The entries continue with similar concerns throughout August. Fauci wrote that Horowitz warned another FDA official might also require support after Peter Navarro allegedly advocated for an emergency authorization for hydroxychloroquine. Fauci also recorded that Stephen Hahn wanted an FDA official to postpone a decision until he could “speak with Meadows.”
Later that month, Fauci wrote that Pfizer CEO Albert Bourla was concerned AstraZeneca could receive authorization before competing vaccine manufacturers had completed their own clinical trials. After the FDA authorized convalescent plasma on Aug. 26, Fauci wrote that Hahn had “likely caved to Meadows. Who is looking for good news before the election.”
The final notable pre-election entry is dated Oct. 29, 2020, and focuses on emergency authorization requests for monoclonal antibody therapies from Eli Lilly and Regeneron. Fauci highlighted part of the passage in red ink.
“Some potentially nefarious stuff going on. The FDA career scientists are hesitant to grant EUAs to Lilly’s and Regeneron’s mAb based on the current data. Alex Azar is really pushing them and furious because he thinks FDA is ‘slow-walking’ the process so as not to have it out before the election in 5 days. Clearly, Alex wants to please the POTUS so that they can say that they have a breakthrough… right before the election… We encouraged Francis to support the career scientists at FDA since they do not want to rush this through. They need more time to gather important information since what they have now is rather weak.”
Taken together, the diary entries present Fauci’s own contemporaneous account of disagreements within the federal government’s pandemic response. They describe what Fauci viewed as ongoing tension between officials seeking faster emergency authorizations before the 2020 election and FDA career scientists whom he believed wanted additional scientific evidence before approving vaccines and treatments. The diary entries reflect Fauci’s personal perspective on these events and have generated renewed public discussion following their release.
