The Washington Post - USA (2020-10-20)

A10 EZ RE THEWASHINGTONPOST.TUESDAY,OCTOBER 20 , 2020

tion WarpSpeed,”the govern-

ment’s initiativetomass-distrib-

uteaneventualvaccine,tospeak

morepositivelyaboutthevaccine,

and sometimeshehas pushed

backontheirtalkingpoints,two

officialssaid.

Tr umproutinelyhastoldhis

politicaladvisersthatavaccine

wouldbereadybythetimehe

standsforreelection.Andhehas

plottedwithhisteamonapre-

election promotional campaign

totrytoconvincevotersavaccine

issafe,approvedandreadyfor

massdistribution—evenif none

ofthatistrueyet.

Thesearesomeoftheingredi-

entsofapublichealthdisaster,

expertssay.

“Theonethingyoucan’t do—

andit’s whateverybodyfears,it’s

whatthepharmaceuticalcompa-

niesfear,it’swhateverybodyon

theinsidefears —isthatthe

governmentwould,becauseofpo-

liticalpurposesorbecauseother

countriesputavaccineoutbefore

us,truncatethenormalprocess

you’dacceptforasafeandeffec-

tivevaccine,”saidPaulA.Offit,

directoroftheVaccineEducation

CenteratChildren’sHospitalof

Philadelphia,aprofessorofvacci-

nologyattheUniversityofPenn-

sylvaniaandamember ofthe

FDA’svaccineadvisorycouncil.

Tr ump’sviewoftheFDAhas

darkenedconsiderablyinrecent

weeks. Thepresident now be-

lieves—despitetheabsenceof

anysuchevidence—thatofficials

thereareworkingagainsthimto

slow-walkvaccine approval as

“somesortof‘deepstate’ pushto

keephimfromwinningreelec-

tion,”accordingtoanadministra-

tionofficial.

Tr umphassaidasmuchhim-

self.

“NewFDARulesmakeitmore

difficultforthemto speedup

vaccinesforapprovalbeforeElec-

tionDay. Just anotherpoliticalhit

job!@SteveFDA,”thepresident

wroteinanOct. 6tweet, tagging

Hahn’s Twitterhandle.

Tr ump’s conspiratorialviewof

theFDAisshapedinpartby

WhiteHousetradeadviserPeter

Navarroandothersinthepresi-

dent’s orbit, bothinsideandout-

sidethegovernment.

SaadB.Omer,directorofthe

YaleInstituteforGlobalHealth,

saidtheatmosphereofpressure

andrecrimination,nurturedby

thepresident,is“veryconcern-

ing.”

“Thesearepeoplewhohave

dedicatedtheirlivestoworkingin

publichealthandmedicineand

research,”hesaid.“Tothinkthat

inthebiggestpublichealthevent

oftheirlivestheywouldsleepan

extrahourorslow-walkthisfor

anyreasonis absurd.”

He added,“It’slikehowan

ambulancedrivesfasterthana

regularcarbecauseit’s anemer-

gency, butevenan ambulance

driveris notfoolhardy.Theydon’t

wanttodriveoverthebridge.”

SEETASKFORCEONA

fairy-taleendingtothispandem-

ic.We’regoingtobedealingwith

itatleastthrough2021,andit’s

likely to have implicationsfor

howwedoeverythingfromwork

toschool,evenwithvaccines.”

Friedenadded:“Remember,we

havevaccinesagainsttheflu,and

westillhaveflu.”

Still,Tr umphasratchetedup

hispushforvaccinesoverthepast

severalmonths,intensifyingthe

pressure on governmentscien-

tists,federalregulatorsandphar-

maceuticalexecutives.Hehashad

oneenddateinmind:Nov. 3,

whichis ElectionDay.

Tr umphasenvisionedagreen-

litvaccineasthekindofbreak-

throughthatcouldpersuadevot-

erstoseehismanagementofthe

pandemicassuccessfulandthus

upendaraceinwhichvirtually all

publicpolls showhim trailing

Democratic nomineeJoeBiden.

Earlierthisfall,Tr umpcalled

AlbertBourla,thechiefexecutive

ofPfizer,andaskedwhethera

vaccinecouldbereadyfordistri-

butionbylateOctober,beforethe

election. Pfizer spokeswoman

SharonCastillosaid executives

have regular communications

withadministrationofficialsona

widerangeofhealthpolicyissues

butthatshecouldnotcomment

onprivateconversations.

OnacallinAugustwithFrancis

Collins,directoroftheNational

InstitutesofHealth,Tr umpac-

cusedtheagencyofmovingtoo

slowlytoapproveavaccineor

othertreatments,includingcon-

valescent plasma, according to

twoofficialsfamiliarwiththecon-

versation. TheNIH,which de-

clinedtocomment,isabiomedi-

calresearchagencyanddoesnot

approvetreatmentsorvaccines.

MatthewsdeniedthatTrump

sees the vaccine timetable

throughtheprismofthecam-

paigncalendar. “Thisis notabout

politics;it’saboutsavinglives,”

shesaid.Sheadded,“anyvaccine

approvalwillmaintaintheFDA’s

goldstandardforsafetyandeffi-

cacyandbeproventosavelives.”

Therelationships between

FDAofficialsandWhiteHouse

staffershavegrownmoreacrimo-

nioussinceSeptember,whende-

tailsofstricterFDAvaccineguid-

ancewerereportedbyThePost.

Tr umpandWhiteHouseChiefof

StaffMarkMeadows—whohas

involvedhimselfintheworkof

healthagenciestoadegreeother

officialsconsiderinappropriate—

haverepeatedlychallengedHahn

overhisagency’sproposalsand

rules,muchtotheFDAcommis-

sioner’s frustration.

Tr umpis assertingcontrolover

themessagingcampaignaround

avaccine.Hispoliticallyminded

aidesintheWhiteHousehave

takenoverthegovernment’s com-

municationseffort,asopposedto

healthorscientificcommunica-

torsattherelevantagencies.

Forexample, White House

aideshave soughtto persuade

MoncefSlaoui,headof“Opera-

“We’dbefoolishtoreentera

situationwhereweknowwhatto

doandwe’renotdoingit,”said

RochelleWalensky,chiefofthe

divisionofinfectiousdiseasesat

MassachusettsGeneralHospital

andaprofessorofmedicineat

HarvardMedical School.“This

thingcantakeoff.All youneedto

doislookatwhat’shappenedat

1600 PennsylvaniaAvenueover

thelasttwoweekstoseethatthis

thing iswayfasterthanwe’re

givingit creditfor.”

‘Thecure’

AfterTrumpcamehomefrom

thehospitalthismonth,heallbut

promised Americansthatthey

couldsoon be cured from the

coronavirusjustasheclaimedto

havebeen.Inavideotapedatthe

WhiteHouseonOct.5,hevowed,

“The vaccinesarecomingmo-

mentarily.”

Then,atarallylastTuesday

nightinJohnstown,Pa., Tr ump

toldsupporters:“Thevaccinesare

coming soon, the therapeutics

and, frankly, thecure.AllIknowis

Itooksomething,whateverthe

hellit was.Ifeltgoodveryquickly.

...IfeltlikeSuperman.”

Tr ump’s miraculous timeline

has run headlong into reality,

however.Onthesamedaythathe

declared “the cure”was near,

Johnson&Johnsonbecamethe

secondpharmaceuticalgiant,af-

terAstraZeneca,tohaltitsvac-

cinetrial.Athirdtrial,agovern-

ment-runtestofamonoclonal

antibodymanufacturedbyEli Lil-

ly&Co.,wasalsopaused.Each

movewas prompted by safety

concerns.

AndonFriday, Pfizersaidit will

notbeabletoseekanemergency

useauthorizationfromtheFDA

untilthethirdweekofNovember,

attheearliest,seeminglymaking

avaccinebeforeElectionDayall

butimpossible.

Tr ump’s notionofavaccineasa

cure-allforthepandemicissimi-

larly miraculous, according to

medicalexperts.

“Thevaccines,althoughthey’re

wonderful,arenotgoingtomake

the virus magically disappear,”

saidTomFrieden,aformerCDC

directorwhoispresidentofRe-

solvetoSaveLives.“There’sno

dramaticallyincreasingthena-

tion’stestingcapacity,especially

asexpertsanticipateadevastat-

ingincreaseincasesthiswinter.

Theyhaveurgedthegovernment

touseunspentmoneyCongress

allocated for testing —which

amountsto$9billion,according

toaDemocraticSenateAppropri-

ationsCommitteeaide—sothat

anyonewhoneedstocangetatest

withresultsreturnedquickly.

ButAtlas,whoisopposedto

surveillancetesting,hasrepeat-

edlyquashedtheseproposals.He

has argued thatyoung and

healthypeopledonotneedtoget

testedandthattestingresources

should beallocatedtonursing

homesandothervulnerableplac-

es,suchasprisonsandmeatpack-

ingplants.

White House spokeswoman

SarahMatthewsdefendedTrump

andtheadministration’s manage-

mentofthecrisis.

“PresidentTr umphasalways

listenedtotheadviceofhistop

publichealthexperts,whohave

diverseareasofexpertise,”Mat-

thewssaidinastatement.“The

Presidentalwaysputsthewell-be-

ingoftheAmericanpeoplefirstas

evidencedbythemanybold,data-

drivendecisionshehasmadeto

savemillionsoflives.Becauseof

hisstrongleadership,ourcountry

cansafelyreopenwithadequate

PPE,treatments, andvaccinesde-

velopedinrecordtime.”

Yetamidapublichealthcrisis

thathasclaimedthelivesofmore

than219,000people intheUnited

States—afarhigherdeathtoll

thananyothernationhasreport-

ed—aconsensus hasformed

within the administration that

somemeasurestomitigatethe

spreadofthevirusmaynotbe

worththetrouble.

Thepresidentgavevoicetothis

mind-setduringanNBCNews

townhallThursdaynight,when

hedeclinedtoanswerwhetherhe

supportedherdimmunity.“The

curecannotbeworsethanthe

problemitself,” Tr umptoldhost

SavannahGuthrie.

Butmedicalexpertsdisagreed,

sayingit isdangerousforgovern-

mentleaderstoadvocateherd

immunityoroppose interven-

tions.

Post’s reportingas“anotherstory

filledwithovertliesanddistor-

tionstounderminethePresident

andtheexpertadviceheisbeing

given.”

Atlas said he has always

stressed“allappropriatemitiga-

tionmeasurestosavelives,”and

herespondedtoaccountsofdis-

sentonthetaskforcebysaying,

“A nypolicydiscussionwheredata

isn’t beingchallengedisn’t apol-

icydiscussion.”

Ontheissueofherdimmunity,

Atlassaid,“Weemphaticallydeny

thattheWhiteHouse,thePresi-

dent,theAdministration,orany-

oneadvisingthePresidenthas

pursuedoradvocatedforawide-

openstrategyofachievingherd

immunitybylettingtheinfection

proceedthroughthecommunity.”

Thedoctor’s denialconflicts

withhispreviouspublicandpri-

vatestatements,includinghisre-

centendorsementofthe“Great

Barrington Declaration,”which

effectivelypromotesaherdim-

munitystrategy.

OnSaturday, Atlaswroteon

Twitterthatmasksdonotwork,

promptingthesocialmediasiteto

removethetweetforviolatingits

safetyrulesforspreadingmisin-

formation.Several medicaland

publichealthexpertsflaggedthe

tweetasdangerousmisinforma-

tioncomingfromaprimaryadvis-

ertothepresident.

“Maskswork?NO,” Atlaswrote

inthetweet,followedbyother

misrepresentationsaboutthesci-

encebehindmasks.Helinkedto

anarticlefromtheAmericanIn-

stituteforEconomicResearch—a

libertarianthinktankbehindthe

Barringtoneffort—thatargued

againstmasksanddismissedthe

threatofthevirusasoverblown.

Tr umpandmanyofhisadvis-

ershavecometobelievethatthe

keytoarevivedeconomyanda

returntonormalcyisavaccine.

“They’vegiven upon every-

thingelse,”saidasenioradminis-

trationofficial involved inthe

pandemicresponse.“It’stoohard

ofaslog.”

Infectious-disease and other

public healthexperts saidthefric-

tioninsidetheWhiteHousehas

impaired the government’s re-

sponse.

“Itseemstomethisispolicy-

based evidence-making rather

thanevidence-basedpolicymak-

ing,” saidMarcLipsitch,director

oftheCenterforCommunicable

DiseaseDynamicsattheHarvard

T.H. Chan School of Public

Health.“Inotherwords,ifyour

goalistodonothing,thenyou

createasituationinwhichit looks

okaytodonothing[and]youfind

someexpertstomakeitcompli-

cated.”

Thesedays,thetaskforceis

dormantrelativetoitsrobustac-

tivityearlier in the pandemic.

Fauci,Birx,SurgeonGeneralJe-

romeAdamsandothermembers

haveconfidedinothersthatthey

aredispirited.

BirxandFaucihaveadvocated

countsshowingotherwise,and
hiswillingnesstotellthepublic
thatavaccinecouldbedeveloped
beforetheNov. 3election,despite
clearindicationsofaslowertime-
table.
Atlas’sascendancywasappar-
entduringarecentOvalOffice
meeting.After Tr ump left the
room,Atlasstartledotheraidesby
walkingbehindtheResoluteDesk
and occupying the president’s
personalspacetokeepthemeet-
inggoing,accordingtoonesenior
administration official. Atlas
called this account “falseand
laughable.”
Discord on the coronavirus
taskforcehasworsenedsincethe
arrivalinlatesummerofAtlas,
whomcolleaguessaidtheyregard
asill-informed,manipulativeand
attimesdishonest. AstheWhite
Housecoronavirusresponsecoor-
dinator,DeborahBirxistasked
withcollectingandanalyzingin-
fectiondataandcompilingcharts
detailing upticks and other
trends.ButAtlasroutinelyhas
challenged Birx’s analysis and
thoseofotherdoctors,including
AnthonyS.Fauci,CentersforDis-
easeControlandPreventionDi-
rectorRobertRedfield,andFood
andDrugAdministrationCom-
missioner Stephen Hahn,with
whattheotherdoctorsconsid-
eredjunkscience,accordingto
threesenioradministrationoffi-
cials.
Birxrecentlyconfronted the
officeof Vice President Pence,
whochairsthetaskforce,about
theacrimony,accordingtotwo
peoplefamiliarwiththemeeting.
Birx,whoseprofileandinfluence
haveerodedconsiderablysince
Atlas’sarrival,toldPence’s office
thatshedoesnottrustAtlas,does
notbelieveheisgivingTr ump
soundadviceandwantshimre-
movedfromthetaskforce,the
twopeoplesaid.
Inonerecentencounter,Pence
didnottakesidesbetweenAtlas
andBirx,butrathertoldthemto
bringdatabolsteringtheirper-
spectivestothetaskforceandto
work out their disagreements
themselves,accordingtotwosen-
ioradministrationofficials.
TheresulthasbeenaU.S.re-
sponse increasinglyplaguedby
distrust,infightingandlethargy,
justasexpertspredictcoronavi-
ruscasescouldsurgethiswinter
anddeathscouldreach400, 000
byyear’s end.
Thisassessmentisbasedon
interviewswith 41 administration
officials,adviserstothepresident,
publichealthleadersandother
peoplewithknowledgeofinter-
nal government deliberations,
someofwhomspokeonthecon-
ditionofanonymitytoprovide
candidassessmentsorconfiden-
tialinformation.
Atlasdefendedhisviewsand
conductinaseriesofstatements
sentthroughaspokespersonand
condemned TheWashington

TASKFORCEFROMA

Trump’s pandemic task force has become aden of dissent

OLIVERCONTRERASFORTHEWASHINGTONPOST

PresidentTrumpandmanyadvisershavecometobelievethatthekeytoareturntonormalcyisacoronavirusvaccine,asenioradministrationofficialsaid,adding,“They’vegivenuponeverythingelse.”

Newcoronaviruscases and deaths in the U.S., by day

Asof8p.m.Monday

0

500

1,

1,

2,

2,

8,179,

Total

Feb.29 Oct.

58,52 2

0

10,

20,

30,

40,

50,

60,

70,

7-day

average

CASES

219,

Total

Feb.29 Oct.

436

7-day

average

DEATHS