Increasingly harsh scrutiny

Trump’s CDC chief faces increasingly harsh scrutiny

Early missteps on coronavirus, lack of a consistent message make the nation's disease-fighting agency a focus of criticism.

By DAN DIAMOND

Robert Redfield was a well-known AIDS researcher and favorite of Christian conservatives when President Donald Trump picked him to lead the Centers for Disease Control and Prevention in 2018, where he has helped implement sweeping plans to fight HIV and opioids in the United States while pushing to tackle Ebola abroad. But confronted by the increasingly global coronavirus outbreak, CDC and Redfield’s actions are now under intense scrutiny — both inside and outside the administration.

Hundreds of Americans were left stuck on a cruise ship that later became the single biggest source of U.S. coronavirus cases — a CDC decision. Dozens of public health labs are still waiting for tests that will allow them to diagnose coronavirus — a CDC responsibility. One of Redfield’s deputies on Monday urged businesses and schools to start preparing for the disease’s inevitable spread — stamping the CDC’s imprint on public fears and irking White House officials who worry about panicking Americans and driving down financial markets.

Defenders of CDC and Redfield, who’s a member of the president’s coronavirus task force and flanked Trump on the White House briefing room podium on Wednesday, argue that the U.S. response is going smoothly. Although there are more than 81,000 confirmed cases and more than 2,700 deaths overseas, there are still no confirmed deaths from coronavirus in the United States. Meanwhile, most of the 60 confirmed U.S. cases of the virus were contracted abroad. Redfield’s supporters also reject the idea that the CDC chief — a trained virologist, who’s battled AIDS in Africa but also had an nontraditional public health career — isn’t the right man for the moment.

“This is what he signed up for. Nobody takes these jobs without a strong understanding that this could happen,” said Bill Pierce, who served as a deputy assistant secretary at the Department of Health and Human Services during the George W. Bush administration and has worked with Redfield over the years. “He’s a public health guy, and this is a public health crisis.”

HHS also praised the work of Redfield’s agency. “The CDC has been at the forefront ably working to protect the American people,” a spokesperson said. “The CDC plans and prepares for just these sorts of public health challenges. This is what they do.”

POLITICO spoke with 10 current and former Trump administration officials, as well as two people close to the administration, who portrayed a leader facing the biggest management challenge of his four-decade career in public health. Several individuals also said that the 68-year-old Redfield — who's working to fend off a virus that the World Health Organization has deemed high risk and that top Trump advisers believe could threaten the president’s reelection — has been relying heavily on his top civil servant deputies as the agency collectively braces for a potential pandemic.

“CDC’s stumbled,” said one official, referencing the agency’s lab-testing failures. “It's too early to tell if those stumbles will mean we miss an outbreak ... It’s a pray-and-see situation.”

Others said Redfield is caught between competing pressures, as he seeks to protect his agency’s career scientists as Trump’s anger over the situation grows, and that HHS Secretary Alex Azar, who pushed to lead the president's coronavirus task force, bears ultimate responsibility for any missteps at CDC, an agency he oversees.

“The buck should stop with Azar, not Redfield,” said one former official, while acknowledging that the CDC chief might be a convenient scapegoat. Although Trump on Wednesday night announced that Vice President Mike Pence would now lead governmentwide coronavirus response efforts, Azar stressed to reporters that he remained in charge of the task force itself.

Trump turned to Redfield to run the CDC in 2018 when the president’s first choice, Brenda Fitzgerald, abruptly resigned after POLITICO reported that Fitzgerald had traded tobacco stocks while running the agency and had other problematic holdings that were forcing recusals. Redfield was a known commodity to Republicans like Azar and other top officials, who had considered Redfield for a senior health care position in the George W. Bush administration.

But Redfield was a controversial figure in the research world in the 1980s and 1990s for overselling the effectiveness of a possible AIDS vaccine, and he was panned by reproductive rights supporters and public health experts for advocating abstinence before marriage to stop HIV rather than tactics like providing free condoms. Redfield was an “abysmal choice” to lead the nation’s public health agency, author Laurie Garrett wrote at CNN in 2018. Redfield has said he has since broadened his views.

The current coronavirus outbreak has tested Redfield and his staff, who have worked around the clock for more than a month to try and fend off the virus, which appears to be spread both by people who are openly ill as well as people with no visible symptoms, can be difficult to detect and poses a considerable risk to older people. Some early studies of the coronavirus outbreak suggest that between 2 percent and 4 percent of the people who contracted the virus at the epicenter in China’s Hubei Province have died, although the coronavirus death rate is significantly lower outside the province and around the world so far.

But inside the health department, officials have complained that Redfield and CDC have been slow to resolve essential problems, like clarifying whether dozens of public health labs around the nation will soon have diagnostics capable of testing for coronavirus. Until then, the labs must currently mail samples to CDC’s Atlanta headquarters, delaying test results. Former Food and Drug Administration Commissioner Scott Gottlieb and some White House officials have warned that without sufficient screening capacity, possible cases of coronavirus might be going undetected.

Azar — Redfield’s boss — told a Senate panel Tuesday that the problem is being investigated. “The diagnostic works at CDC,” Azar stressed, adding that 12 labs around the nation are now using the tests, too. But dozens still are not.

Redfield on Wednesday told a House panel that his agency is working with FDA to release a new version of its test as soon as this week. But the CDC director initially told the panel that he did not know off-hand how many coronavirus samples CDC could screen per day. He clarified later in the hearing that the number is between 350 and 500.

Meanwhile, Trump officials across the administration have been frustrated by CDC staff’s caginess on revising preparedness plans that were supposed to be years in the making or at CDC staff who have produced conflicting data, such as different case counts over how many Americans have been infected. CDC officials also made the decision to support the Japanese health department’s quarantine of thousands of passengers aboard the Diamond Princess cruise ship, which was marooned for days off the coast of Japan, and disagreed with efforts to evacuate the ship even after it became clear that coronavirus infections were spreading aboard the vessel.

CDC also has repeatedly made unilateral decisions without informing other health officials, leaving the rest of HHS scrambling to catch up, such as holding one recent coronavirus briefing with outside groups before the slides had even been vetted. “HHS learned about that information at the same time that outside hospitals did,” said one official.

Nancy Messonnier, who leads CDC’s National Center for Immunization and Respiratory Diseases, on Tuesday also startled HHS and White House officials by elevating the perceived threat of coronavirus in a news briefing with reporters. “We are asking the American public to work with us to prepare for the expectation that this could be bad,” Mesonnier said in the briefing, before walking through possible steps such as encouraging schools to consider closing. Top Trump advisers have worried that panic over a still-unseen U.S. outbreak could threaten the president’s reelection, and Azar and other officials have spent the past two days working to calm the public reaction to Messonnier’s comments.

But Messonnier’s remarks, and her high profile during the coronavirus fight, speak to a reality at CDC: Unlike other parts of the Trump administration, where career civil servants have fled and political appointees have made over operations, the sprawling CDC operation and its global staff have largely retained their independence.

More than 80 percent of CDC scientists polled in 2018 said the agency continued to uphold its scientific principles under Trump, compared with less than 40 percent of scientists at the Environmental Protection Agency. Meanwhile, many longtime CDC staffers have played a key role in fighting the coronavirus outbreak, like principal deputy director Anne Schuchat and Messonnier, who’s become a target for right-wing talk radio because she’s the sister of former Deputy Attorney General Rod Rosenstein.

In front of a Senate appropriations panel on Tuesday, Azar defended the public-health agency for its round-the-clock response to a possible outbreak, arguing that it’s played an essential role in staving off an outbreak that remains largely theoretical in the United States.

“We are now, what, 50 days into it? This is historic,” Azar said. “No administration, no CDC in American history has delivered like this.”

Redfield on Wednesday also sought to quell concerns about an imminent outbreak, telling lawmakers that the risk to Americans remains low and people should continue with their daily lives. “We are encouraging people again to just think about being prepared,” Redfield said.