‘Like a hand grasping’: Trump appointees describe the crushing of the CDC
Kyle McGowan, a former chief of staff at the Centers for Disease Control and Prevention, and his deputy, Amanda Campbell, were installed in 2018 as two of the youngest political appointees in the history of the world’s premier public health agency, young Republicans returning to their native Georgia to dream jobs.
But what they witnessed during the coronavirus pandemic this year in the
CDC’s leadership suite on the 12-floor headquarters here shook them: Washington’s dismissal of science, the White House’s slow suffocation of the agency’s voice, the meddling in its messages and the siphoning of its budget.
In interviews this fall, the pair decided to go public with their disillusionment: what went wrong, and what they believe needs to be done as the agency girds for what could be a yearslong project of rebuilding its credibility externally while easing ill feelings and selfdoubt internally.
“Everyone wants to describe the day that the light switch flipped and the CDC was sidelined. It didn’t happen that way,” McGowan said. “It was more of like a hand grasping something, and it slowly closes, closes, closes, closes until you realize that, middle of the summer, it has a complete grasp on everything at the CDC.”
Last week, the editor-inchief of the CDC’s flagship weekly disease outbreak reports — once considered untouchable — told House Democrats investigating political interference in the agency’s work that she was ordered to destroy an email showing Trump appointees attempting to meddle with their publication.
The same day, the outlines of the CDC’s future took more shape when President-elect Joe Biden announced a slate of health nominees, including Dr. Rochelle Walensky, the chief of infectious diseases at Massachusetts General Hospital, as the agency’s new director, a move generally greeted with enthusiasm by public health experts.
“We are ready to combat this virus with science and facts,” she wrote on Twitter.
McGowan and Campbell — who joined the CDC in their early 30s, then left together in August — said that mantra was what was most needed after a brutal year that left the agency’s authority crippled.
In November, McGowan held conversations with Biden transition officials reviewing the agency’s response to the pandemic, where he said he was candid about its failures. Among the initiatives he encouraged the new administration to plan for: reviving regular — if not daily — news briefings featuring the agency’s scientists.
McGowan and Campbell, both 34, say they tried to protect their colleagues against political meddling from the White House and Department of Health and Human Services. But an agency created to protect the nation against a public health catastrophe like the coronavirus was largely stifled by the Trump administration.
TheWhite House insisted on reviewing — and often softening — the CDC’s closely guarded coronavirus guidance documents, the most prominent public expression of its latest research and scientific consensus on the spread of the virus. The documents were vetted not only by the White House’s coronavirus task force but by what felt to the agency’s employees like an endless loop of political appointees across Washington.
McGowan recalled a White House fixated on the economic implications of public health. He and Dr. Robert R. Redfield, the CDC director, negotiated with Russell T. Vought, the White House budget director, over social distancing guidelines for restaurants, as Vought argued that specific spacing recommendations would be too onerous for businesses to enforce.
“It is not the CDC’s role to determine the economic viability of a guidance document,” McGowan said.
They compromised anyway, recommending social distancing without a reference to the typical 6-foot measurement.
One of Campbell’s responsibilities was helping clear the agency’s Morbidity and Mortality Weekly Reports, a widely followed and otherwise apolitical guide on infectious disease renowned in the medical community. Over the summer, political appointees at the health department repeatedly asked CDC officials to revise, delay and even scuttle drafts they thought could be viewed, by implication, as criticism of President Donald Trump.
“It wasn’t until something was in the MMWR that was in contradiction to what message the White House and HHS were trying to put forward that they became scrutinized,” Campbell said.
Dr. Tom Frieden, the CDC director under President Barack Obama, said it was typical and “legitimate” to have interagency process for review.
“What’s not legitimate is to overrule science,” he said.
Often, McGowan and Campbell mediated between Redfield and agency scientists when the White House’s requests and dictates would arrive: edits from Vought and Kellyanne Conway, the former White House adviser, on choirs and communion in faith communities, or suggestions from Ivanka Trump, the president’s daughter and aide, on schools.
“Every time that the science clashed with the messaging, messaging won,” McGowan said.
Episodes of meddling sometimes turned absurd, they said. In the spring, the CDC published an app that allowed Americans to screen themselves for symptoms of COVID-19. But the Trump administration decided to develop a similar tool with Apple. White House officials then demanded that the CDC wipe its app off its website, McGowan said.
Campbell said that at the pandemic’s outset, she was confident the agency had the best scientists in the world at its disposal, “just like we had in the past.”
“What was so different, though, was the political involvement, not only from HHS but then the White House, ultimately, that in so many ways hampered what our scientists were able to do,” she said.
Top CDC officials devised workarounds. Instead of posting new guidance for schools and election officials in the spring, they published “updates” to previous guidance that skipped formal review from Washington. That prompted officials in Washington to insist on reviewing updates.
Brian Morgenstern, a White House spokesman, said that “all proposed guidelines and regulations with potentially sweeping effects on our economy, society and constitutional freedoms receive appropriate consultation from all stakeholders, including task force doctors, other experts and administration leaders.”
A CDC spokesman declined to comment.
Agency scientists have privately fretted about the pandemic permanently damaging the CDC’s authority, with the public as well as state and international health partners. The CDC was wounded by its initial struggles to develop reliable tests for the coronavirus. Scientists have discussed resigning, including some in the senior ranks who told McGowan that even though they flirted with leaving, they would have a hard time walking away from the agency at its lowest point.
Frieden said the agency had done “a lot of good work that they haven’t been able to tell anyone about,” including investigating outbreaks in prisons and meatpacking facilities. But he said its leaders had to speak out more.
“CDC has a big podium,”
he said. “You have to tell people what you know, when you know it. Otherwise, you get a lack of alignment. It’s not just the public. When you do those briefings, the public health departments and the doctors also learn.”
This fall, senior CDC officials turned bolder. They resumed regular news media briefings by agency scientists. Without seeking permission from Washington, they revised guidance documents on schools and asymptomatic testing, health officials said.
Dr. Barry R. Bloom, an infectious disease expert and public health professor at Harvard, said the CDC’s money problems could help explain its predicament.
“They track down everything from pollution to outbreaks in prisons,” Bloom said. “That’s the daily work of CDC. If it’s well done and tracked down, it will not appear in the pages of your newspaper.”
The funding the CDC did receive this year was cannibalized. Redfield told lawmakers that $300 million was steered from the CDC’s budget to a vaccine public relations campaign that recently collapsed under scrutiny from reporters and lawmakers.
The redirecting of the funding was just one more blow to an agency brought low by a pandemic it was alerted to only a year ago. McGowan has held on to the email thread from Dec. 31, 2019, about a “cluster of pneumonia cases in Wuhan, China,” a haunting artifact.
“Damage has been done to the CDC that will take years to undo,” McGowansaid. “And that’s terrible to hear, because it happened under my time there.”