Trump called a coronavirus news conference for 6:00 p.m. Redfield was out of town, so his deputy, Anne Schuchat, was due to sub in for him at the event. It would be her first time meeting the president. Azar called her to warn, “Please make sure he knows you’re not Nancy Messonnier or he’s going to scream at you!”
When he arrived at the White House, Azar first went to Mulvaney’s office. The chief told him Trump was thinking of naming Pence as coronavirus czar. Azar had been chairing the task force and had just told Trump that he wasn’t convinced a czar was ideal, so he was a little perplexed. When they joined the president in the Oval, Trump said he was “thinking about” installing the vice president as czar. But within minutes, it was clear this was already cooked and decided. The president announced at the news conference that Pence was taking over the task force. Afterward, Pence asked Azar and other task-force members to follow him.
“Let’s huddle in my office, you can brief me on the process,” Pence said.
Once inside, Pence turned to Azar. “This is a very serious moment in our nation’s history. We should begin with the secretary leading us in prayer,” something the evangelical Christian vice president often did when chairing important meetings.
A devout Catholic and member of an Eastern Orthodox church, Azar wasn’t used to praying in government offices, but said a prayer at the vice president’s urging.
“I think what we have here is a communication discipline issue,” Pence said. “My number one issue is getting a handle on communications.” He talked about the importance of clear, consistent messaging in any crisis, something he had learned firsthand as governor of Indiana.
In consultation with Mulvaney and others, Trump also had considered former Food and Drug Administration commissioner Scott Gottlieb and Christie to lead the task force but settled on Pence. They worried that if the vice president were in charge, the White House would own any problems, but they also felt the crisis had become bigger than Azar seemed able to handle. Mulvaney in particular wanted the coronavirus response to be brought in-house and controlled by the White House, and he thought Pence was the obvious choice. Already peeved with Azar over e-cigarettes and other issues, Trump told other senior officials that he blamed the health secretary for the floundering virus response and a public relations mess.
Kushner would later explain to Azar that Trump picked Pence because he wanted someone to focus solely on telling people the virus was under control, and because the vice president wasn’t particularly busy. Pence had spent much of his time traveling domestically, trying to keep the religious faithful and conservative base engaged for the reelection, but that travel was ending because of coronavirus fears.
“He didn’t have anything else to do,” Kushner told Azar. A senior administration official said Kushner did not recall the conversation.
Pence and his aides moved quickly to take over all communications related to the virus. Mulvaney sent a memo to administration officials instructing that all talking points, press releases, and interview bookings first be approved by Short or Katie Miller, Pence’s communications director, fresh off her wedding less than two weeks earlier to Stephen Miller, Trump’s senior policy adviser and chief speechwriter. Katie Miller and Short wanted every task-force member delivering the same message, and they wanted to avoid another Messonnier incident.
Azar’s press aide Caitlin Oakley called the secretary late that evening. “All your press bookings are cancelled,” she told him.
The health secretary was being put in a closet, effectively demoted and muzzled because a CDC scientist had told the truth.
* * *
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On February 29, Pence convened the coronavirus task-force meeting to order and turned to the agenda. Just then, Trump walked in, surprising those in attendance—not merely because it was a Saturday and Trump was not known to work on weekends, but also because he had shown so little interest in their work before. Pence, seated at the head of the table, welcomed the president and scooched his chair over to the left to let Trump sit at the head. Azar decided to broach the topic of the virus’s spread to all continents. He thought it was past time the World Health Organization declare COVID-19 a pandemic, as it by now had met the criteria for that grim label.
“Mr. President, we need to start calling this a pandemic because it is one,” Azar said. “The WHO is not going to say it now, because they don’t want to embarrass China. The WHO is going to wait until cases are rising in the U.S. Then, Tedros will have air cover to call it a pandemic to embarrass us. We need to get ahead of it and call it a pandemic now.”
Azar was referring to Tedros Adhanom Ghebreyesus, director-general of WHO. While considered the preeminent global health agency, the WHO had also become increasingly sensitive to not alienating the Chinese government, which had dramatically increased its funding of the group in recent years to try to compete with the United States. The WHO had publicly taken China at its word and praised the ruling Communist Party leadership for its work on the virus, even amid growing evidence the Chinese government was concealing information about it.
At hearing Azar’s suggestion about using the p-word, though, Trump blew a gasket. The memory of Messonnier and the precipitous market drop still was fresh.
Trump said no way.
“This will cause panic,” he bellowed. “We will not call it a pandemic.”
Trump had reason to worry. Fabrizio was in Israel around this time advising Prime Minister Benjamin Netanyahu on his election there. Netanyahu was a keen observer of American politics, having spent part of his youth in the Philadelphia area, attended the Massachusetts Institute of Technology, and worked for the Boston Consulting Group. He and Fabrizio got to talking about the Democratic primary campaign, which had been heating up all month.
“Let me tell you something, Tony,” Netanyahu told Trump’s pollster. “None of these Democrats can beat Donald Trump.”
“Really?” Fabrizio said.
“Yeah,” Netanyahu replied. “The only thing that can beat President Trump is coronavirus.”
“Are you serious, Mr. Prime Minister?” Fabrizio asked.
“Yeah,” he said. “If you don’t understand what a pandemic is and the mathematics behind how this will spread if we don’t contain it, it will collapse economies, and that changes the ball game tremendously.”
Four
The P-Word
In February 2020, Dr. Deborah Birx was working in South Africa, meeting with public health experts and other leaders from around the globe to combat the global AIDS epidemic, when she received increasingly worrisome messages from an old contact, Matt Pottinger. At sixty-three, Birx had worked for four decades in immunology, conducting HIV/AIDS vaccine research and developing therapeutics. A physician who began her career in the army, she rose to become an ambassador-at-large and U.S. global AIDS coordinator. She and Pottinger had known each other for years; his wife, Yen, a virologist, once worked in Birx’s lab. Pottinger knew Birx could help steer the administration’s response to the coronavirus, which was fast becoming a catastrophe. Day after day, he appealed to her to come work in the White House.
Although Birx had been appointed to her ambassadorship by President Obama in 2014, she prided herself on remaining apolitical as a civil servant. She knew enough about the daily dramas in Trump’s Washington to want to stay away. As Birx confided to associates, she would have to be an idiot to sign up to work in the White House. Doing so, she figured, could be terminal to her long public health career. Serving Trump was the last thing she wanted to do.
But Pottinger persisted. Birx was studying the infection curves from Wuhan and Italy and was worried about the administration’s approach given this virus had significant asymptomatic spread. She was alarmed by the Trump administration’s initial moves, especially its public statements that the virus posed a very low risk to people’s livelihoods. She started to think she could help
make a difference.
“You can save American lives,” Pottinger told her, appealing to her military background and sense of duty.
By month’s end, Birx was on board, after Robert O’Brien arranged with Mike Pompeo to move her to the White House. She would become the White House coronavirus response coordinator, reporting to Vice President Pence, who now chaired the task force. On the long flight home from Africa the weekend of February 29, Birx wrote an action plan. She wanted to convene immediately a series of meetings with important outside stakeholders, including private-sector labs who could help ramp up testing capacities and medical correspondents in the media, such as CNN’s Sanjay Gupta, to help them communicate the seriousness of the emerging pandemic.
Birx’s first day on the job was March 2. On MSNBC that morning, anchor Chris Jansing told viewers, “We’ve got some breaking news. One of the main people in charge of fighting the deadly coronavirus in the U.S. now says it has indeed reached outbreak proportions and likely pandemic proportions.” The network then rolled tape of correspondent Richard Engel interviewing Anthony Fauci.
“What are we dealing with with this coronavirus, COVID-19?” Engel asked.
“We’re dealing with clearly an emerging infectious disease that has now reached outbreak proportions and likely pandemic proportions,” Fauci said. “If you look at, you know, by multiple definitions of what a pandemic is, the fact is, this is multiple sustained transmissions of a highly infectious agent in multiple regions of the globe.”
Jansing returned to the screen to make the significance clear to viewers. “So Dr. Anthony Fauci, who is widely regarded as the number one expert in the country . . . talking for the first time about a pandemic.”
Within the hour, Marc Short was on the phone to Brian Harrison. Though Short recognized it was just a matter of time before the coronavirus was declared a pandemic, he nonetheless didn’t want Fauci or any other task-force member straying from precoordinated talking points.
“You’ve got to get Fauci on message,” Short told Alex Azar’s chief of staff. “He is saying things that are too extreme.”
Harrison didn’t make any promises, but said he’d relay the message. Short’s call came as a shock at HHS headquarters, in part because the White House had never tried to control Fauci’s comments or interview appearances on public health. But Pence was now leading the task force, and its focus immediately became more political. Azar huddled with Harrison, deputy chief of staff Judy Stecker, and Caitlin Oakley. Azar told his aides they wouldn’t be monkeying with what Fauci had to say because that would only backfire and make them look like tools of the White House.
“We aren’t going to harness or silence CDC or NIH on scientific matters,” Azar said. “It is just stupid.” Some had complained, in fact, that Azar did try to control the scientists’ message when he determined it was important to do so, but he resisted Short’s instruction.
For thirty-six years in his role, Fauci had had the same philosophy on speaking with presidents, from Ronald Reagan to Donald Trump. Each time he walked into the White House, Fauci told himself that this might be his last time doing that, because he might have to tell the president something he didn’t want to hear. Fauci knew that could mean banishment.
On March 2, Trump met with pharmaceutical executives at the White House. With Fauci present, the president predicted a rather optimistic timeline for a coronavirus vaccine.
“So you’re talking over the next few months, you think you can have a vaccine?” Trump asked one of the pharmaceutical executives.
“You won’t have a vaccine,” Fauci interjected. “You’ll have a vaccine to go and get tested.”
When an executive explained the phases of testing would take many months, Trump asked, “All right, so you’re talking within a year?”
“Like I’ve been telling you, Mr. President, a year to a year and a half,” Fauci corrected.
“I like the sound of a couple of months better, let’s be honest,” Trump said.
It was clear to Fauci and other health professionals in the room that Trump did not understand the steps involved in developing, testing, approving, and ultimately injecting into people’s arms a vaccine.
The next day, Trump toured Fauci’s lab, the NIH Vaccine Research Center, as part of the White House effort to showcase the president’s determination to speed up the creation of a vaccine. Fauci again reminded Trump that getting a vaccine in a year was wildly optimistic. At the end of the tour, Fauci and Azar drove with the president across Wisconsin Avenue from the NIH campus to the helipad at Walter Reed National Military Medical Center, where Marine One awaited to fly Trump back to the White House.
“So how’s Francis Collins doing?” the president asked Azar, referring to the NIH director they had just said goodbye to.
“He’s really helped us on the fetal tissue ban,” Azar said. He referred to Trump’s 2019 decision to dramatically cut government funding at NIH and elsewhere for medical research that relied on tissues of aborted fetuses. This was a move to please antiabortion conservatives, a key part of the president’s political base. Collins didn’t agree with the policy, Azar told Trump, but was “being very professional in implementing it.”
Azar was surprised when Trump asked, “Is that fetal tissue issue going to slow down the vaccine and therapies?” When he learned the answer was yes, the president said he wanted them to reverse the ban, but that never happened.
* * *
—
With Pence firmly in charge of the task force the first week of March, priorities shifted noticeably to public relations and election-year politics. As the vice president’s top aide, Short took on an outsized role, setting the agenda and even seating arrangements for meetings. Short was among the most conservative members of the team and felt there should be limits on the role of the government, even in a public health emergency. He worried about Pence being responsible for the coronavirus response, calculating that any missteps could accrue to the political detriment of his boss, who had his eye on a presidential run of his own in 2024. But Pence’s attitude was, okay, this is my job, and I’m going to try to do the best I can.
Short, fifty, formed a power center with Katie Miller, twenty-eight, who was so aggressive in her advocacy for Pence that she would scream at reporters on the phone, sometimes so loudly that other aides had to leave the room because they found her end of the conversations insulting. Short and Miller tightly controlled which task-force members could speak to the media and what they would say, though they did not see their actions as muzzling experts. Their objective was to silence alarmism and to keep Fauci and other health professionals from scaring the public—which in turn could further jolt the already jittery stock markets and weaken the president’s political fortunes—even if it meant shading the truth. When the facts seemed too scary to the public, Miller would ask task-force members, “Can we not word it that way?”
At press briefings, which Pence was leading at the time, Short and Miller would decide which doctors stood at his side and where they would be positioned onstage. Olivia Troye sometimes helped speechwriter Brian Bolduc script the opening remarks Pence would deliver, a daily update on infections and other relevant statistics. Troye was adamant they be entirely factual and apolitical. One day in a workspace off the Situation Room, as Troye was drafting Pence’s remarks on her computer, Miller kicked Troye out of her chair.
“Olivia, move,” Miller said. She had just come down from Pence’s office, where the vice president had given her instructions to add some points to his script. “I’m going to type this,” Miller told Troye. “You don’t know Pence. I know what he wants. He doesn’t even know what he wants. But I know what he needs.”
Keith Kellogg later counseled Troye, “Don’t let her touch the remarks. You should take control of that situation. You know your stuff. [Pence] wants the facts and he trusts you. . . . Don’t let her bully you.�
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Task-force meetings took on a fresh intensity, attracting long-standing members as well as new ones, including Seema Verma. She reported to Azar, her longtime rival, and when he ran the task force he hadn’t included her, arguing that the CMS administrator wasn’t necessary like experts such as Fauci and Redfield. But Verma had deep ties in the White House. From Indiana, she had served as an outside health-care adviser to Pence’s administration when he was governor and advised Trump on his health-care policies during the 2016 campaign. After Pence took over the task force, Verma appealed to Short, explained that her agency regulates nursing homes, where some of the worst outbreaks were occurring, and Pence immediately added her to the task force.
Pence also brought on two other officials who reported to Azar and had been left off the task force when he ran it: Dr. Jerome Adams, the surgeon general, whose job was to serve as a public health spokesperson, who had served as Indiana’s state health commissioner in Pence’s administration; and Dr. Stephen Hahn, the Food and Drug Administration commissioner, who was a radiation oncologist who had just joined the administration in December 2019 and was new not only to Trump World but to politics altogether. Many mornings, Hahn would have 7:00 or 7:30 calls with Joe Grogan for guidance about navigating task-force personalities and political land mines.
Hahn was wise to worry about interpersonal dynamics. Tensions were high among many task-force members, including between Redfield and Azar. The bad blood between them dated to Redfield’s early weeks as CDC director. When he agreed to take the job in March 2018, Redfield gave up a medical professorship that earned him about $700,000 a year. Under a federal salary program called Title 42, which was designed to attract high-earning scientists with unique and critical skills into the government, Redfield was paid $375,000. After news reports later revealed Redfield’s salary, emphasizing that he was making nearly double what his predecessor at the CDC had earned, and more than Azar’s pay of $199,000, Azar confronted Redfield.
I Alone Can Fix It: Donald J. Trump's Catastrophic Final Year Page 8