HHS political appointees seek greater control over CDC reports on coronavirus
By LENA H. SUN | The Washington Post | Published: September 13, 2020
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WASHINGTON — Political appointees at the Department of Health and Human Services have sought to change, delay and prevent the release of reports about the coronavirus by the Centers for Disease Control and Prevention because they were viewed as undermining President Donald Trump's message that the pandemic is under control.
Michael Caputo, the top HHS spokesman, said in an interview Saturday that he and one of his advisers have been seeking greater scrutiny of the CDC's weekly scientific dispatches, known as the Morbidity and Mortality Weekly Report, for the past 3½ months. The adviser, Paul Alexander, has sent repeated emails to the CDC seeking changes and demanding that the reports be halted until he could make edits.
The emails, first reported late Friday by Politico, describe the CDC documents, widely known as the MMWR, as being "hit pieces on the administration." Caputo confirmed the authenticity of the emails.
The emails echo the sentiments from an earlier attack by Alexander, reported in The Washington Post in July, about an MMWR on the potential risk of the coronavirus to pregnant women. In that email, Alexander also accused the CDC of undermining the president. The emails are the latest evidence of how the nation's top public health agency is coming under intense pressure from Trump and his allies, who are playing down the dangers of the pandemic ahead of the Nov. 3 presidential election.
"Most often, the MMWRs are [issued] for purely scientific reasons," Caputo said Saturday. "But in an election year, and in the time of covid-19, it's no longer unanimously scientific. There's political content."
Caputo said his conclusions are based on reviews by Alexander, an assistant professor at McMaster University in Canada and a specialist in health research methods. Caputo hired him this spring to advise on the science of the pandemic.
Despite the changes to the MMWRs sought by HHS, the requests were "infrequently" accepted by the CDC, Caputo said.
Alexander "gets into productive discussions with the scientists who are open to criticism. They're free to reject them," Caputo said. "I think most of his criticisms are rejected."
He added: "Science is disagreements. It must be difficult for [CDC] to be criticized by an Oxford-educated scientist who has been published in peer-reviewed journals 67 times."
A former administration official with direct knowledge of the communications from HHS said a request that all reports be stopped until Alexander could review them in their entirety was rejected. On other requests, the CDC "put its head down" and did not comply and "continued to get in trouble over and over again" for doing so, the former official said. The person spoke on the condition of anonymity to share sensitive deliberations.
MMWRs are written by career experts for scientists and public health specialists and are considered among the most authoritative public health reports because they provide evidence-based information on a range of health topics. The reports are independent scientific publications that undergo rigorous vetting, often with multiple drafts to check data and methodology. The reports are closely held; few individuals at the CDC have access until just before publication.
The CDC editorial staff that produces the MMWRs typically sends one-paragraph summaries to HHS and other CDC officials a few days before publication.
"Whenever they come out with that list, there's concern across [HHS] that some of the scholarship has been tainted by politics," Caputo said. "That's my opinion."
Over the course of the pandemic, top officials including Deborah Birx, the White House coronavirus task force response coordinator, and HHS Secretary Alex Azar have wanted to have a "more complete picture" of the CDC's activity, according to an HHS official who spoke on the condition of anonymity to share internal deliberations. The MMWRs were the main focus, the official said.
"The future of the agency depends on its ability to disseminate science-based data and recommendations that are science-based," the official said. "Putting a political lens on everything that we say is very concerning," the official. The CDC is not going to do that, the official said. There is no intention or attempt to undermine the president in the publication of CDC reports, the official said, referring to accusations by Alexander as "a paranoid assumption that is not based on anything."
The CDC declined to comment Saturday.
One CDC report that drew particular scrutiny was on hydroxychloroquine. The MMWR urged clinicians to follow long-accepted prescribing guidelines for the malaria drug. Trump favored the drug as a coronavirus treatment despite scant evidence. The CDC was concerned the drug was potentially being misused to treat covid-19, the illness caused by the virus, and affecting supplies of the medication to treat conditions such as rheumatoid arthritis and lupus.
"Current data on treatment and pre- or postexposure prophylaxis for COVID-19 indicate that the potential benefits of these drugs do not appear to outweigh their risks," the report said.
The official said the report had been delayed for weeks, according to a former administration official with direct knowledge of the efforts.
In another instance, a report about the spread of the coronavirus at a Georgia sleep-away camp was also delayed, the former official said. That report, issued July 31, suggested that children of all ages are susceptible to coronavirus infection and may spread it to others — a finding likely to intensify an already fraught discussion about the risks of sending children back to school.
"That report gave them a lot of grief," the former official said. "But you can't change facts." The report likely was delayed, the former official said, to avoid being released around the same time Trump was calling for schools to reopen in person. The changes that were sought were not included, the former official said.
The tone of Alexander's emails is harsh, this person said, because the CDC ignored his requests. In one email, Alexander wrote to CDC Director Robert Redfield asking that the agency modify two already published reports that Alexander said mistakenly inflated the risks of coronavirus to children and undermined Trump's push to reopen schools.
"CDC to me appears to be writing hit pieces on the administration," Alexander wrote in an email. "CDC tried to report as if once kids get together, there will be spread and this will impact school reopening. . . . Very misleading by CDC and shame on them. Their aim is clear."
The interference by HHS political appointees in the MMWR process has infuriated career scientists, who have been frustrated for months over the inability to allow scientists to fully share and explain information.