“I am not having the impact on the White House with the current pandemic that I would like,” Birx told Bush, according to her book. “I should focus on the other pandemic. I think I should return full time to my PEPFAR position at the State Department.”

Bush understood what Birx meant, she wrote, and told her: “What you’re saying is you want to quit.”

At the time, the United States had still been reeling from the impact of the pandemic, and was on its way to surpass 200,000 COVID-19 deaths. “We were heading into the worst part of the COVID-19 pandemic,” she wrote in her book.

Bush swiftly shut down the idea of her quitting.

“Nearly chuckling, he said, ‘Well, you know you can’t do that. I know you know that’s right. You’ve got to do this. You need to finish. You can never quit,'” Birx wrote.