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Trump coronavirus briefings put health officials in bind
Brett Samuels April 25, 2020, The Hill
Health experts on the White House coronavirus task force increasingly are being put in a tough spot by the president's daily press briefings.
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| Trump coronavirus briefings put health officials in bind |
He then sometimes asks the scientists and doctors around him to weigh in or offer support, putting them in an impossible spot.
It's been an issue throughout the timeline of the briefings, but it has particularly been under a spotlight this week.
Trump on Wednesday urged Robert Redfield, the director of the Centers for Disease Control (CDC), to publicly denounce a Washington Post headline even though Redfield acknowledged he was quoted correctly in the story saying a second wave of coronavirus could prove more difficult for the country.
On Thursday, Trump publicly disagreed with Anthony Fauci, the government's top infectious diseases expert, saying he felt the nation's testing capacity was adequate after the physician said hours earlier that the country needed to "significantly ramp up" its capabilities.
Trump separately on Thursday asked a visibly uneasy Deborah Birx to weigh in on the concept of injecting coronavirus patients with disinfectant or exposing them to ultraviolet light, forcing her to gently explain that she had never heard of such a regimen being used to treat coronavirus.
"I'm not a doctor. But I'm like a person that has a good you-know-what," Trump said Thursday, gesturing to his head.
The remarks were widely refuted and mocked before the White House issued a statement clarifying that Trump has urged Americans to ask their doctors about treatment, and Trump later insisted he was being sarcastic.
Birx also came under some criticism from media figures for not more forcefully pushing back on the president. Throughout Friday, video of her looking uncomfortable as Trump spoke played on cable news. On social media, one account used "Curb Your Enthusiasm" familiar theme as a score for the moment as the camera zoomed in on the coronavirus task force leader.
The moment underscored how the briefings have proven to be minefields for the administration's medical experts as they attempt to deliver data-driven information about the virus without angering the president.
The task has only gotten more difficult as Trump pushes for some states to consider lifting their restrictions meant to curb the spread of the virus in favor of boosting the economy.
After Trump said Tuesday he would defer to the governor of Georgia's decision to reopen businesses like salons and tattoo parlors, Birx said she wouldn't "prejudge" the decision even though it did not comply with the White House guidelines on lifting restrictions.
But Trump reversed course the next day and said he disagreed with the governor's plan, an indication that the health experts had gotten through to him behind closed doors.
Officials close to the administration and medical experts have sympathized with Birx and Fauci, noting that the doctors need to retain Trump's trust so the president will heed their advice.
Public health officials have largely been relegated to the sidelines of the briefings, with Trump typically speaking and fielding questions for close to an hour and others speaking for a fraction of the time.
Fauci described them as "draining" in a recent interview with The Associated Press, saying it would be easier if he could answer a few questions and then leave.
Neither Fauci nor Birx appeared at Friday's briefing, which abruptly ended after 21 minutes when Trump stalked out of the room without taking questions for the first time in weeks.
Some conservatives and those close to the White House acknowledged the briefings are politically perilous for the president. He often veers into fights with reporters or launches barbs at his political opponents at briefings ostensibly meant to inform the public about a deadly virus. His Thursday comments about disinfectants led to 24 hours of negative headlines, making clear the issue with his unscripted style.
The president has led the briefings almost every day since mid-March. He enjoyed an initial bump in polling as Americans rallied around the government response to the pandemic, with a Gallup Poll on March 24 showing Trump matching his highest approval rating at 49 percent.
But as the briefings have become daily theater, the political benefit has faded. The most recent Gallup poll showed Trump's approval rating has sunk back to 43 percent, more in line with the rest of his first term.
"There's definitely value in doing it, but he just doesn't need to do it all the time," Jason Miller, a former Trump campaign communications director, said of the briefings.
"I think President Trump should do them if he has something to announce, but if it's just a check-in then I would defer to Vice President Pence or other members of his task force," added Miller, who co-hosts a radio show focused on the pandemic.
Some of the president's allies see few issues with how he conducts himself at the briefings, which give him a direct line to the public and appeal to his base supporters. They believe he has shown a willingness to listen to his medical team by extending social distancing guidelines and rolling out a phased-in approach to reopening the economy.
"My folks in Missouri love hearing from the president every day. They tune in daily," Rep. Jason Smith (R-Mo.), a member of the GOP leadership team, told The Hill on Friday.
Trump has described himself as a "cheerleader" for the country when asked about why he downplayed the virus in January or played up unproven treatments.
But Trump might eventually have to reckon with the consequences of his free-wheeling medical commentary, even as his experts try to massage his off-the-cuff remarks.
On Friday, the Food and Drug Administration recommended against using the drug outside of hospital settings or clinical trials due to the risk of heart problems. Meanwhile, The Maryland Emergency Management Agency said it had received "several calls regarding questions about disinfectant use and #COVID19."
"This is a reminder that under no circumstances should any disinfectant product be administered into the body through injection, ingestion or any other route," the agency tweeted.
Scott Wong contributed.
===================Under Trump, coronavirus scientists can speak — as long as they mostly toe the line
Ashley Parker, Josh Dawsey, Yasmeen Abutaleb, Lena H. Sun ,
Robert Redfield, director of the Centers for Disease Control and Prevention, issued a candid warning Tuesday in a Washington Post interview: A simultaneous flu and coronavirus outbreak next fall and winter “will actually be even more difficult than the one we just went through,” adding that calls and protests to “liberate” states from stay-at-home orders — as President Trump has tweeted — were “not helpful.”
The next morning, Trump cracked down with a Twitter edict: Redfield had been totally misquoted in a cable news story summarizing the interview, he claimed, and would be putting out a statement shortly.
By Wednesday evening, Redfield appeared at the daily White House briefing — saying he had been accurately quoted after all, while also trying to soften his words as the president glowered next to him.
“I didn’t say that this was going to be worse,” Redfield said. “I said it was going to be more difficult and potentially complicated because we’ll have flu and coronavirus circulating at the same time.”
He added: “ ‘It’s more difficult’ doesn’t mean it’s going to be more impossible.”
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| © Jabin Botsford/The Washington Post President Trump listens as Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, at a coronavirus briefing at the White House Wednesday. |
In a statement Wednesday, for example, Rick Bright — who until recently led the agency working on a coronavirus vaccine — said he was removed from his post for resisting efforts to “provide an unproven drug on demand to the American public.”
The result is a culture in which public health officials find themselves scrambling to appease and placate Trump, a mercurial boss who is focused as much on political and economic considerations as scientific ones.
An internal White House “Covid Mail” email address, for instance, exists to receive queries and suggestions from “friends and family” as well as random individuals — including doctors and business owners — from around the country who have reached out to White House officials. Those emails then get farmed out to the appropriate agencies — from the Food and Drug Administration to the Department of Health and Human Services — but some officials have privately worried that these missives receive priority and distract from more crucial scientific pursuits.
In another instance, Nancy Messonier, the CDC’s director of the National Center for Immunization and Respiratory Diseases, was removed from her post as her agency’s coronavirus response head after sounding early alarms that Americans should begin preparing for “significant disruption” to their lives from a “severe illness.” The CDC held its last daily briefing on March 9 — a forum through which the nation would normally receive critical public health information — in part out of a desire not to provoke the president.
“I think the main media briefing has been the task force briefing,” Redfield said in his interview with The Post on Tuesday, asked about the now-defunct CDC briefing. “A lot of the flow of the briefings probably had to do with where the response was grounded.”
And Surgeon General Jerome Adams seemed to go out of his way to lavish praise on Trump in an interview on CNN last month, claiming the 73-year-old president was “healthier than what I am” — a comment the 45-year-old physician later walked back in a number of tweets.
“We hope that science and the public health experts are leading the politicians, that their voices are in the foreground, and that the politicians follow their advice,” said Matt Seeger, who has researched crisis and emergency risk communication for the past 35 years at Wayne State University. “But in this case, the political agenda seems to be setting the agenda for the subject matter experts, which is exactly the opposite of the way we would expect to have this happen.”
Seeger, who has watched the daily White House briefings and said he has seen some of the administration’s health professionals speak in other forums, added that “it’s very clear the public health professionals have been self-censoring their statements.” They are, he added, “being very thoughtful and measured and probably adjusting their statements they don’t run the risk of running afoul of the political agenda. That’s very problematic.”
The White House dismissed the idea there was any undue pressure on public health officials from the president.
“Despite the media’s ridiculous efforts to somehow create distance between the president and his top health experts, it is simply fake news,” White House spokesman Judd Deere said in a statement. “President Trump has relied on and consulted with Dr. Adams, Dr. Birx, Dr. Fauci, Dr. Hahn, Dr. Redfield, and many others as he has confronted this unforeseen, unprecedented crisis and put the full power of the federal government to work to slow the spread, save lives, and place this great country on a data-driven path to opening up again.”
One senior administration official said Trump is also more receptive to the scientists and doctors in private than his public statements indicate. He is especially respectful of Deborah Birx, who oversees the administration’s coronavirus response, and has figured out a way to gently push back against the president, the official said.
The president has described Birx in positive terms to other confidants and always wants her at the briefing lectern, even as his opinion wavers on other task force members. She regularly spends several hours a day with the president and top aides, including Trump son-in-law and senior adviser Jared Kushner.
During Tuesday’s coronavirus news conference, Birx seemed hesitant to directly contradict Trump — who has made clear he is eager to see states begin to reopen their economy as quickly as possible — when asked about the plans by Georgia’s governor to reopen places like gyms and nail and hair salons.
“So if there’s a way that people can social distance and do those things, then they can do those things,” Birx said. “I don't know how, but people are very creative.”
During Wednesday’s task force meeting, a White House official said, the group discussed Georgia’s plans, as well as their concerns that the state’s proposal does not necessarily allow for safe and responsible distances to be maintained, or for good hygiene practices. And during the briefing Wednesday, Trump also addressed his concerns with the plan, claiming he told Georgia Gov. Brian Kemp (R) he strongly disagrees with his decision, which he called “too soon.”
This month, Anthony S. Fauci, an infectious disease expert and coronavirus task force member, began a briefing by offering a seeming apology for comments he had made to CNN’s Jake Tapper, in which he said that earlier mitigation efforts “could have saved lives.” Fauci said he had not intended to criticize Trump in responding to a hypothetical question with “the wrong choice of words,” but stressed that his clarification was entirely “voluntary.”
On Wednesday, asked if health professionals are unable to speak freely in Trump’s administration, Fauci dismissed the suggestion, saying, “Here I am.”
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| © Jabin Botsford/The Washington Post President Donald J. Trump listens to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, at a coronavirus task force briefing Friday, April 17, 2020. |
Many public health experts, however, say they are frustrated at what they see happening during the daily briefings, with the scientists being sidelined. According to a Post analysis, since the federal guidelines were announced on March 16, Trump has spoken 63 percent of the time, compared with Birx at 10 percent and Fauci at 5 percent.
“For most of us in the field, there’s frustration with the dance that we’re seeing,” said Jeanne Marrazzo, director of the Division of Infectious Diseases at the University of Alabama at Birmingham School of Medicine. “Most of us in the field are incredibly frustrated that they are being put in that position, but also incredibly grateful that they are willing to do it.”
Trump also regularly tells visitors to the Oval Office that he is in touch with doctors in New York — including his own — and many others he knows personally.
Guidelines that were drafted by the CDC and Federal Emergency Management Agency for safely reopening the country were watered down by White House officials before they were published, officials say. A person involved in the White House revision of the guidelines, however, said the goal was simply to make them understandable to the public.
Bright, the former director of the Biomedical Advanced Research and Development Authority who was moved to a narrower role at NIH this week, had expressed opposition to the way hydroxychloroquine was being politicized by the president and others in the administration, according to two people familiar with the discussions. Two senior administration officials said he repeatedly clashed with his boss, Robert Kadlec, the HHS assistant secretary for preparedness and response. One person familiar with the situation said Bright’s departure was long discussed among top HHS officials because of dissatisfaction with his job performance.
In a statement, an HHS spokeswoman seemed to dispute Bright’s assertions that he was removed because of his opposition to the anti-malaria medications chloroquine and hydroxychloroquine. The spokeswoman said Bright requested an authorization from the FDA that enabled officials to add chloroquine to the national stockpile of emergency medical equipment and medications.
An adviser familiar with the virus response said the doctors were attempting to communicate with the country and follow crisis management guidelines. The president, on the other hand, this person said, “is trying to win a political battle.”
“He’s broken every rule of maintaining public trust, if you’re trying to do crisis communications for the entire public,” the adviser said, speaking anonymously to share a candid assessment. “I’m not sure that is what he’s trying to do.”
Health and Human Services Secretary Alex Azar, who once led the coronavirus response meetings as chairman of the task force, attends most in person but sometimes attends via phone or teleconference. An HHS spokeswoman said other officials also sometimes attend remotely.
The White House also recently installed Michael Caputo, a longtime Trump loyalist, to run communications at HHS.
Within the agencies, less public-facing health officials are also struggling with the requests coming from the White House. Ideas passed along through the internal “Covid Mail” email system are routed largely to the health agencies. There have been messages to the FDA on testing, to the CDC on surveillance and epidemiology; and to NIH on vaccines.
Because the missives are coming from the White House, agency officials imbue them with a sense of urgency. “And then everyone has to drop what they’re doing,” a senior administration official said.
ashley.parker@washpost.com
josh.dawsey@washpost.com
yasmeen.abutaleb@washpost.com
lena.sun@washpost.com
Philip Bump contributed to this report.
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