New documents and testimony released by a House committee examining the federal government’s early coronavirus response confirm much of what we already knew: There was a concerted effort by political officials to interfere with the independent advice of health officials — often reflecting President Donald Trump’s own efforts to downplay the virus.
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And one particular episode we just learned more about drives that home as well as just about anything.
The examples of this politicization of the pandemic response are myriad. As the new releases from the House committee reinforce, politics infected many aspects of the response. To wit:
Trump has admitted to leaning on officials to approve hydroxychloroquine for emergency use, which the Food and Drug Administration did before soon reversing it. Trump also leaned on the vaccine approval process, obviously hoping the vaccines would come out during his reelection campaign. At one point, he indicated he might also override the FDA’s guidance on releasing the vaccine. Political officials pressured the Centers for Disease Control and Prevention to alter its regular research papers, the Morbidity and Mortality Weekly Reports, to align with a the White House’s more optimistic view of the pandemic. Trump erupted when CDC expert Nancy Messonnier stated in a February 2020 briefing that the virus’s spread in the United States was inevitable. Messonnier detailed in her testimony how this led to a reprimand from Health and Human Services Secretary Alex Azar, and No. 2 CDC official Anne Schuchat said the White House scrambled to schedule a briefing to smooth things over. The new documents also detail the extent to which this led the administration to restrict CDC officials’ briefings and media appearances.
But one episode stands out in the new documents and testimony: The CDC’s August 2020 guidance scaling back its testing recommendations.
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We already knew these were contentious. The CDC at the time, for some reason, watered down its recommendation that asymptomatic people who came in contact with infected people should get tested. It said, “You do not necessarily need a test unless you are a vulnerable individual or your healthcare provider or state or local public health officials recommend you take one.”
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This was one of the earliest instances in which the government’s top infectious-disease expert, Anthony S. Fauci, raised a red flag. Fauci said he had been in surgery when the recommendation was decided upon. He added, “I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern.”
The recommendation, though, did line up with the views of one very prominent official: Trump. For much of the summer, Trump had been questioning the need for doing as much testing as we were — often making clear he was worried about how the resulting case numbers made him look bad ahead of his reelection campaign.
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“Don’t forget: We have more cases than anybody in the world,” Trump said on May 14, 2020. “But why? Because we do more testing.”
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“When you do testing to that extent, you’re going to find more people, you’re going to find more cases,” he added June 20. “So, I said to my people, ‘Slow the testing down, please.’ ”
“With smaller testing we would show fewer cases,” he said June 23.
“You know, there are those that say you can test too much — you do know that,” he added Aug. 3.
And in an Aug. 19 meeting, the New York Times reported Trump told senior White House adviser Jared Kushner: “You’re killing me! This whole thing is! … I want to do what Mexico does. They don’t give you a test till you get to the emergency room and you’re vomiting.”
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The next week, the CDC issued the guidance downplaying the need to test asymptomatic people.
And in new testimony, White House coronavirus adviser Deborah Birx said it basically amounted to exactly what it looked like at the time. She said it reflected “an intent of [White House adviser] Scott Atlas when he came to the White House, to change the testing guidance.” Trump’s coronavirus testing czar Brett Giroir said at the time that the guidance had been reviewed by many experts, including Fauci and Birx, but Birx echoed Fauci that she disagreed with it.
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“And I personally wrote to Brett Giroir after he went out on the press and said that there was consensus,” Birx testified, “because I made it clear in task force that I did not agree with the guidance as it was written.”
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Birx also testified that this had a material impact on the amount of testing that took place.
“After this guidance was posted, of course we were tracking every day the number of tests performed,” Birx said. “We saw a dramatic decline of the number of tests performed during the end of August and the beginning of September. … This document resulted in less testing and less — less aggressive testing of those without symptoms that I believed were the primary reason for the early community spread.”
Birx added that the downgrading of the testing guidance wasn’t based upon any decline in testing capacity; in fact, the opposite was true. She also said that she understood it to be a deliberate attempt to reduce the amount of testing — which Trump had repeatedly indicated he didn’t like.
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As with hydroxychloroquine, this soon led to a reversal that suggested health officials ultimately prevailed.
On Sept. 18, the CDC reversed its testing guidelines to call for testing for anyone with a close contact with someone who had tested positive.
But again, Birx reinforced that this very basic of steps, nine months into the pandemic, came over the continued “objections from senior White House personnel.”
The degree to which any of the above episodes resulted in a negative impact on the coronavirus response is debatable. Recommending an unproven drug that has proved safe in other contexts, or trying to force through a vaccine that has since also proven to be very safe is one thing (even as both risk undermining confidence in treatments and vaccines). But downplaying the risks involved and the need for testing — in official guidance from health officials who are ostensibly independent from political considerations — is quite another.
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And Birx indicated that this did indeed significantly hamper the response in ways that should raise plenty of questions about who and what the administration was looking out for at the time.
“I had seen the dramatic decline in testing at a time when we needed dramatic increase in testing to prevent us from having the depth and breadth of community spread that I knew was coming with the fall surge,” she said.