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For many years, the Centers for Disease Control and Prevention was a respected voice in American public health. Over the course of the pandemic, however, the CDC was pressured by the Trump administration to revise its guidance to the public to satisfy the political needs of the administration, which wanted to minimize the seriousness of the pandemic.
The New York Times published this article by Noah Wieland about the political manipulation of the nation’s premier public health agency and the bald effort to destroy its credibility. If this article doesn’t outrage you, then you should read it again.
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 C.D.C.’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 a series of interviews, the pair has 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 self-doubt internally.
“Everyone wants to describe the day that the light switch flipped and the C.D.C. was sidelined. It didn’t happen that way,” Mr. 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 C.D.C.”
Last week, the editor in chief of the C.D.C.’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 C.D.C.’s future took more shape when President-elect Joseph R. Biden Jr. 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.
Mr. McGowan and Ms. Campbell — who joined the C.D.C. 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, Mr. 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.
Mr. McGowan and Ms. 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.
The White House insisted on reviewing — and often softening — the C.D.C.’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.
Mr. McGowan recalled a White House fixated on the economic implications of public health. He and Dr. Robert R. Redfield, the C.D.C. director, negotiated with Russell T. Vought, the White House budget director, over social distancing guidelines for restaurants, as Mr. Vought argued that specific spacing recommendations would be too onerous for businesses to enforce.
“It is not the C.D.C.’s role to determine the economic viability of a guidance document,” Mr. McGowan said.
They compromised anyway, recommending social distancing without a reference to the typical six-foot measurement.
One of Ms. Campbell’s responsibilities was helping secure approval for 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 C.D.C. officials to revise, delay and even scuttle drafts they thought could be viewed, by implication, as criticism of President Trump.
“It wasn’t until something was in the M.M.W.R. that was in contradiction to what message the White House and H.H.S. were trying to put forward that they became scrutinized,” Ms. Campbell said.
Dr. Tom Frieden, the C.D.C. 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, Mr. McGowan and Ms. Campbell mediated between Dr. Redfield and agency scientists when the White House’s guidance requests and dictates would arrive: edits from Mr. 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,” Mr. McGowan said.
Episodes of meddling sometimes turned absurd, they said. In the spring, the C.D.C. 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 C.D.C. wipe its app off its website, Mr. McGowan said.
Ms. 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 H.H.S. but then the White House, ultimately, that in so many ways hampered what our scientists were able to do,” she said.
Top C.D.C. 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 C.D.C. spokesman declined to comment.
Mr. McGowan and Ms. Campbell both attended the University of Georgia and saw their C.D.C. positions as homecomings. Mr. McGowan said the two institutions he revered most during his Georgia childhood were the C.D.C. and Coca-Cola.
He arrived with a résumé that made the agency’s senior ranks suspicious, he said. Like Ms. Campbell, he worked for former Representative Tom Price, first in his House office, then when he was health secretary under Mr. Trump. When he arrived at the C.D.C., Mr. McGowan told his new colleagues that he was there not to spy on or undermine them, but to support them.
Mr. McGowan and Ms. Campbell, who have since opened a health policy consulting firm, said they saw themselves as keepers of the agency’s senior scientists, whose morale had been sapped. Dr. Redfield, whose leadership has been criticized roundly by public health experts and privately by his own scientists, was rarely in Atlanta, consumed by Washington responsibilities.
That often left Mr. McGowan and Ms. Campbell as the agency’s most senior political appointees in Atlanta — two of only four at an 11,000-person agency.
Mr. McGowan, who talked to Dr. Redfield throughout the day by phone, worked in the office next to Dr. Anne Schuchat, a 32-year career staff member who is the agency’s principal deputy director and one of the country’s most respected scientists, and became a sounding board for her.
Earlier this year, Dr. Schuchat was targeted by political appointees at the health department, who began interrogating C.D.C. officials about her public comments acknowledging the seriousness of the pandemic. Dr. Schuchat asked Mr. McGowan whether she would be fired.
“I don’t know,” Mr. McGowan recalled telling her. “Not yet.”
Mr. McGowan said he was especially unnerved last winter when officials in Washington told the C.D.C. that regular telephone briefings with another senior scientist, Dr. Nancy Messonnier, were no longer needed because Mr. Trump had his own daily briefings. Dr. Messonnier angered the White House in late February when she issued a public warning that the virus was about to change Americans’ lives.
“There’s not a single thing that she said that didn’t come true,” Mr. McGowan said. “Is it more important to have her telling the world and the American public what to be prepared for, or is it just to say, ‘All is well?’”
“It’s demoralizing to spend your entire career preparing for this moment, preparing for a pandemic like this. And then not be able to fully do your job,” Mr. McGowan said. “They need to be allowed to lead.”
Agency scientists have privately fretted about the pandemic permanently damaging the C.D.C.’s authority, with the public as well as state and international health partners. The C.D.C. 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 Mr. McGowan that even though they flirted with leaving, they would have a hard time walking away from the agency at its lowest point.
Dr. 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.
“C.D.C. 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 C.D.C. 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.
Fears of mixing politics and science linger, like when Vice President Mike Pence visited the agency this month with Georgia’s Republican senators, who are in critical runoff campaigns. Dr. Jay Butler, a top agency official, told a colleague that he worried that if Mr. Pence discussed the campaign, C.D.C. employees at the event might violate the law prohibiting federal workers from engaging in political activities on the job, according to someone with knowledge of his concern. A White House lawyer wrote Dr. Butler to say that the event was unrelated to a campaign stop later in the day, and would not be political.
Among the obvious targets for reform is the agency’s budget, which has been micromanaged, especially by Mark Meadows, the White House chief of staff, who has argued against C.D.C. funds in coronavirus stimulus negotiations.
Dr. Barry R. Bloom, an infectious disease expert and public health professor at Harvard, said the C.D.C.’s money problems could help explain its predicament. Unlike some federal health agencies, such at the National Institutes of Health, the C.D.C. typically receives what public health experts see as paltry funding — a reflection of its often low-profile work.
“They track down everything from pollution to outbreaks in prisons,” Dr. Bloom said. “That’s the daily work of C.D.C. If it’s well done and tracked down, it will not appear in the pages of your newspaper.”
The funding the C.D.C. did receive this year was cannibalized. Dr. Redfield told lawmakers that $300 million was steered from the C.D.C.’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. Mr. 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 C.D.C. that will take years to undo,” he said. “And that’s terrible to hear, because it happened under my time there.”
Sharon LaFraniere and Abby Goodnough contributed reporting from Washington, and Apoorva Mandavilli from New York.