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In March 2020, as the pandemic began, Anthony Fauci, the chief medical adviser to the president of the United States, explained in a 60 Minutes interview that he felt community use of masks was unnecessary. A few months later, he argued that his statements were not meant to imply that he felt the data to justify the use of cloth masks was insufficient. Rather, he said, had he endorsed mask wearing (of any kind), mass panic would ensue and lead to a surgical and N95 mask shortage among health care workers, who needed the masks more. Yet, emails from a Freedom of Information Act request revealed that Fauci privately gave the same advice?against mask use?suggesting it was not merely his outward stance to the broader public.
Although some have claimed that the evidence changed substantively in the early weeks of March, our assessment of the literature does not concur. We believe the evidence at the time of Fauci's 60 Minutes interview was largely similar to that in April 2020. Thus, there are two ways to consider Fauci's statement. One possibility is, as he says, that his initial statement was dishonest but motivated to avoid a run on masks needed by health care workers. The other is that he believed his initial statements were accurate, and he subsequently decided to advocate for cloth masks to divert attention from surgical or N95 masks, or to provide a sense of hope and control to a fearful and anxious public.
Additional evidence suggests that the second interpretation may be more accurate. In a lengthy commentary from July 2020, COVID expert Michael Osterholm wrote in detail about the continued scientific uncertainty regarding masks?even as he expressed support for their widespread public use as one measure among many. But Fauci's reversal, which came at a time of political polarization, contributed to the evolution of masks from a basic, precautionary mitigation strategy to a badge of political allegiance. President Donald Trump was reluctant to wear a mask and justified his behavior by referring to Fauci's comments from the 60 Minutes interview. The controversy continued into the presidential debates, with Trump mocking Joe Biden for donning the ?biggest mask? he'd ever seen.
One thing is beyond a doubt, however: One of those two statements did not accurately reflect the evidence as Fauci saw it. Such high-profile mixed messages in a short time frame, without substantive new data to justify the change, generated confusion and a backlash from politicians, other experts, and the general public.
When experts or agencies deliver information to the public that they consider possibly or definitively false to further a larger, often well-meaning agenda, they are telling what is called a noble lie. Although the teller's intentions may be pure?for example, a feeling of urgency that behavioral change is needed among the lay public?the consequences can undermine not only those intentions but also public trust in experts and science. During the first year of COVID-19, leaders were faced with an unknown disease amid a politically sensitive election in the era of social media, and the preconditions for noble lies became especially fertile. Not surprisingly, we witnessed several examples. More than anything, these examples illustrate the destructive potential of such lies.
Later in 2020, Fauci participated in a second noble lie. In December, he explained in a phone interview with then?New York Times reporter Donald McNeil that he had been moving the target estimate for herd immunity based in part on emerging studies. But he also said:
When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent. Then, when newer surveys said 60 percent or more would take it, I thought, ?I can nudge this up a bit,? so I went to 80, 85.
In his own words, he ?nudged? his target range for herd immunity to promote vaccine uptake. Even though his comments were made to influence public actions to get more people vaccinated (a noble effort), the central dilemma remains: Do we want public health officials to report facts and uncertainties transparently? Or do we want them to shape information, via nudges, to influence the public to take specific actions? The former fosters an open and honest dialogue with the public to facilitate democratic policymaking. The second subverts the very idea of a democracy and implies that those who set the rules or shape the media narrative are justified in depriving the public of information that they may consider or value differently.
Aside from whether it's right to tell noble lies in the service of eliciting socially beneficial behavior, there is also the question of efficacy. Experts on infectious diseases are not necessarily experts on social behavior. Even if we accept Fauci's claim that he downplayed the importance of wearing masks because he didn't want to unleash a run on masks, we might wonder how he knew that his noble lie would be more effective than simply being honest and explaining to people why it was important to assure an adequate supply of masks for medical workers.
With the arrival of vaccines in early 2021, the potential for such deliberately misleading messages to backfire became more obvious. Key opinion leaders, agencies, and the Centers for Disease Control and Prevention all articulated some version of ?once you are vaccinated, nothing changes,? implying that experts did not know if it was safe to relax precautions and restrictions, such as mask wearing or social distancing, after immunization. But the stance was immediately called into question by others, including epidemiologists, who pointed to the high efficacy of the vaccines and suggested that some, but not all, social distancing measures could be relaxed in certain circumstances. Ultimately, the ?no change? message, which may have been intended to discourage mass gatherings or out of a fear that unvaccinated people would lie about their vaccination status, may itself have been harmful: Surveys find that interest in vaccination increases if people are told that it means they can stop masking.
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