Report: HHS forced new coronavirus guidance on CDC to make testing asymptomatic people a lower priority

Report: HHS forced new coronavirus guidance on CDC to make testing asymptomatic people a lower priority

This is a perfect topic to follow the post about Biden blaming the entire pandemic on Trump, where I argued that many of the worst chapters of the U.S. response really aren’t the president’s fault. If we had President Ted Cruz instead of President Donald Trump, we might very well still have had a CDC testing disaster in February, foolishness and mendacity from experts about masks early on, and Andrew Cuomo culling New York’s elderly by the thousands with terrible policies as the virus spread throughout NYC.

But some problems really are unique to Trump’s leadership, like the heavy pressure on states to reopen before it was safe to do so. This new NYT expose belongs in that category too. No other candidate in the 2016 field would have tried to politicize the science produced by the federal government’s medical authorities the way Trump has. Read this if you need a reminder about some of the most noteworthy instances; there have been new examples even in the few days since I wrote that. His political cronies at the White House and HHS have strong-armed the FDA and CDC enough times now that it’s no longer outlandish to believe that the feds would try to rush an untested vaccine through before Election Day simply because it would help Trump at the polls. Which is not to say that they *can* successfully rush an untested vaccine through; they’re at the mercy of manufacturers in terms of a timeline, and the manufacturers are behaving more responsibly in not cutting corners than the feds have been with, say, hydroxychloroquine and convalescent plasma.

Think what you want about Ted Cruz but he’s not so much of an amoral narcissist that he’d prioritize his own reelection over scientific rigor in a matter that’ll directly affect 300+ million people.

Which brings us to the Times story. Last month doctors woke up to find new guidance on the CDC website declaring that people who’ve been in close contact for 15 minutes with someone who has COVID *don’t* necessarily need to be tested. They were stunned. By now, we all understand (hopefully) that people with no symptoms may not only have the virus themselves but are able to spread it to others. Asymptomatic carriers are probably the biggest variable in why the virus is so hard to contain, in fact. Untold numbers of Americans are out and about, infecting others without any clue that they’re sick themselves — unless they’re tested. Having the CDC suddenly back off on testing for close contacts of infected people thus seemed inexplicable — scientifically.

Politically, though, it made more sense. Maybe the CDC had changed the guidance on testing possible asymptomatic carriers due to political pressure from Trump’s aides. The president has complained endlessly that the reason the U.S. has so many confirmed cases is only because we do so many tests. Logically he might reason that if fewer tests are performed on asymptomatics in the final weeks before the election, there’ll be fewer confirmed cases — and he’ll be able to claim, however dishonestly, that the pandemic is finally “going away” just in time for Election Day. Sources at the CDC told CNN a few weeks ago that indeed the pressure to change the guidance was “coming from the top down.” Today’s Times story confirms that. It was HHS, where Trump had installed campaign crony Michael Caputo as communications director, that allegedly imposed the guidance downplaying the importance of testing asymptomatics on the CDC. And not just that guidance. Guidance on reopening schools, another Trump political priority, too.

“That was a doc that came from the top down, from the H.H.S. and the task force,” said a federal official with knowledge of the matter, referring to the White House task force on the coronavirus. “That policy does not reflect what many people at the C.D.C. feel should be the policy.”

Similarly, a document, arguing for “the importance of reopening schools,” was also dropped into the C.D.C. website by the Department of Health and Human Services in July and is sharply out of step with the C.D.C.’s usual neutral and scientific tone, the officials said…

“The idea that someone at H.H.S. would write guidelines and have it posted under the C.D.C. banner is absolutely chilling,” said Dr. Richard Besser, who served as acting director at the Centers for Disease Control in 2009…

At least eight versions of the current testing guidance were circulated within the agency in early August, according to officials. But staff scientists’ objections to the document went unheard. A senior C.D.C. official told the scientists, “We do not have the ability to make substantial edits,” according to an email obtained by The Times. The testing guidance was then quietly published on the agency’s website on Aug. 24.

The White House’s defense to this is that drafts of the guidance downplaying testing for asymptomatics went through the task force and received comments from CDC chief Robert Redfield, Fauci, Birx, and Trump-friendly radiologist Scott Atlas, who’s advising the president on a killer infectious disease like COVID for some reason. That makes it sound like all of the most trusted people signed off on this dubious idea. In fact, notes the Times, certain phrases that ended up in the final version on the CDC website suggest that it was written by people who don’t really know what they’re talking about. For instance, the guidance referred to “testing for Covid-19,” which is something a layman like you or I might say but represents a basic error that a scientist who works on this wouldn’t make. COVID-19 is the disease caused by the virus; the virus itself is SARS-CoV-2. (Same difference as between AIDS and HIV, basically.) The guidance also referred to testing for “vulnerable” groups, a term the CDC tends to stay away from. And it was posted in a section of the website designed for health-care providers even though the advice it gives is aimed at the general public. “We just looked so sloppy,” said one source to the Times.

It’s hard to believe that Fauci or Birx or even Redfield would be that sloppy, less hard to believe that political actors would be. So who really wrote the guidance? Atlas? Caputo? Caputo’s “science advisor,” Paul Alexander, who’s now left the government?

Not coincidentally, the Times has a new story out just within the last hour or two with concrete examples of how Caputo and Alexander tried to browbeat the CDC to get them to sound Trumpier about the state of the pandemic:

Dr. Anne Schuchat, a 32-year veteran of the C.D.C. and its principal deputy director, had appealed to Americans to wear masks and warned, “We have way too much virus across the country.” But Dr. Alexander, a part-time assistant professor of health research methods, appeared sure he understood the coronavirus better.

“Her aim is to embarrass the president,” he wrote, commenting on Dr. Schuchat’s appeal for face masks in an interview with the Journal of the American Medical Association.

“She is duplicitous,” he also wrote in an email to his boss, Michael R. Caputo, the Health and Human Services Department’s top spokesman who went on medical leave this week. He asked Mr. Caputo to “remind” Dr. Schuchat that during the H1N1 swine flu outbreak in 2009, thousands of Americans had died “under her work.”

Schuchat made those comments on June 30, right before her predictions were fulfilled with a summer wave of COVID in California and across the Sun Belt. Meanwhile, Caputo was last seen mumbling on Facebook about “sedition” at the CDC and a possible plot to assassinate him. Bad enough that political cronies would be trying to muscle scientists in the middle of a pandemic not to embarrass the president by telling the public the truth, but these aren’t even impressive cronies. Trump might as well have Redditors edit the weekly CDC mortality reports.

Thanks to all of the reporting on this and Caputo’s very public meltdown a few days ago, today the CDC quietly restored the original guidance calling for asymptomatics to get tested if they’ve had prolonged contact with someone who’s tested positive. If this is the sort of madness the CDC is dealing with now about something as anodyne as testing guidance, I can’t imagine the kind of apocalyptic politicized chaos the FDA will be coping with internally circa October 20th if Trump’s still down eight in the polls and there hasn’t been any news on a vaccine. Unquestionably, the president is going to demand that they give him some sort of breakthrough to announce, even if it’s just a very limited emergency-use authorization for whatever the leading vaccine is at the time. And the punchline will be that, by then, public confidence in the integrity of the government’s scientific arms will have eroded so much due to these persistent attempts to politicize them that the news won’t even do much for Trump electorally. People will just assume that he gamed the system to get the vaccine announcement, shrug, and resolve not to get the shot until they’ve seen a lot more evidence that it wasn’t rushed through to suit his election message.

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David Strom 8:41 PM on March 20, 2023