WASHINGTON, D.C.—As head of the National Institute of Allergy and Infectious Diseases (NIAID), Anthony Fauci wields a $4.4 billion research budget and has a punishing schedule. But the past 2 weeks, Fauci, 74, has reserved 2 hours on most days to put on a protective plastic suit and help treat a U.S. health care worker who became infected with Ebola in Sierra Leone.
"I now have a much, much more profound respect for the seriousness of this illness in some patients," says Fauci, who talked about his experiences at a filovirus meeting here yesterday. "Even when you have optimum facilities for replenishment of fluids and things like that, the disease itself is truly devastating."
A medical doctor who has headed NIAID for 30 years, Fauci has treated countless patients at the Clinical Center of the National Institutes of Health (NIH)—of which NIAID is a part—in Bethesda, Maryland. "I do believe that one gets unique insights into disease when you actually physically interact with patients," he says. In the case of Ebola, Fauci says he also wanted to show his staff that he wouldn't ask them to do anything he wouldn't do himself; in addition, "it is very exciting and gratifying to participate in saving someone’s life," he says. Fauci also helped treat Dallas nurse Nina Pham, who was hospitalized at the Clinical Center for 8 days in October and visited President Barack Obama after she recovered.
The current patient, who arrived on 13 March and has not been identified, is much sicker than Pham ever was while at NIH, Fauci says. "I think this was as sick a patient as you can get," Fauci says. (NIH listed the patient's condition as "critical" on 16 March but upgraded it to "serious" yesterday.)
One thing Fauci says he has already learned: Ebola virus disease is much more complex than he previously thought. "This is an amazing disease. It probably has multiple phenotypes," he says. Patient data to be published in the months ahead will show that "there is a spectrum of this disease," says Fauci, who declined to elaborate.
Fauci says he tries to fit in one 2-hour shift in the isolation unit every day, usually mid- or late afternoon, when he is less busy. He is part of a team that includes a senior infectious disease specialist, a senior intensive care specialist, a respiratory therapist, four nurses, and two "WatSans," people who help the others don and doff their suits safely. (WatSan is short for Water and Sanitation.) "The first few days, we didn’t leave; the whole team was essentially there the whole night."
*The Ebola Files: Science and Science Translational Medicine have made a collection of research and news articles on the Ebola virus and the current outbreak freely available to researchers and the general public.
*Clarification, 27 March, 4:24 p.m.: The spelling of WatSans was corrected and a note about the term's origins was added.