The novel coronavirus is estimated to have infected at least 7.43 million people in the U.S. and killed nearly 210,000 of them—and the Trump administration has mostly treated it as a political problem rather than one of the most serious health crises to strike the country in decades. The White House in turn has sought to portray the danger of the virus as wildly exaggerated by Democrats, and whenever that narrative is challenged, it’s simply lied about it or pressured federal scientists into cooking the books in their favor.
For example, political appointees at the Department of Health and Human Services tried to force Centers for Disease Control and Prevention researchers into altering findings to conflict less with the president’s insistence that everything is just fine. That includes now-former HHS public affairs official Paul Alexander, who according to a report in Politico on Monday, tried to have the CDC water down epidemiological findings on the coronavirus and its possible impact on children.
Alexander wrote in emails to the editor-in-chief of the CDC’s epidemiological digest—the Morbidity and Mortality Weekly Report (MMWR)—on Sept. 11 ordering changes that would downplay the risks to students and faculty if schools return to in-person classes, as the president has demanded. The requested changes seemed designed to convey a lower level of risk to students if Trump’s orders were acted on, Politico wrote:
For instance, defining teenagers aged 18 and older as “pediatric” patients was “misleading,” Alexander wrote to Charlotte Kent, the editor-in-chief of the CDC’s Morbidity and Mortality Weekly Reports. Alexander also said that the document wrongly conflated the risks of the coronavirus to young children and older adolescents, urging Kent to make multiple changes to the document.
(The American Academy of Pediatrics defines the pediatric population as those up to the age of 21.)
According to Politico, Alexander had already made a “series of demands” at the time of the exchange, including efforts to “retroactively alter several reports or halt the MMWR process altogether.” The Editor-in-Chief, Charlotte Kent, wrote in a subsequent email to CDC Principal Deputy Director Anne Schuchat that if agency officials “change the title and how the cases are described, there could be an erroneous perception that we are being influenced.”
The final version of the report, released on Sept. 15, had several changes in line with Alexander’s demands. Those included changing the wording of the title of the report—“Children, Adolescents, and Young Adults” was replaced with “Persons”—and the removal of the word “pediatric,” which had appeared three times in a draft version. Another section originally said, “Careful monitoring of SARS-CoV-2 infections, deaths, and other severe outcomes among children, adolescents, and young adults aged <21 years remains particularly important as schools reopen in the United States.” The published version simply said “persons aged <21 years”.
Kent told Politico that the changes were based on an “internal clearance process, not based on any comments from outside CDC” and were meant to increase “clarity”:
“This wording issue was flagged by CDC scientific reviewers as part of the routine internal clearance process for MMWR reports,” she said in a statement. “They noted, and MMWR editorial staff agreed, that the change should be made for clarity and to make the wording consistent with other scientific characterizations of age.”
However, one former CDC official described Alexander making contact at all with the journal’s staff as highly “unusual,” as the agency is supposed to be insulated from external interference. Three former MMWR editors-in-chief published a letter in the Journal of the American Medical Association expressing “serious concerns” that even the perception the reports “could be delayed or altered for political purposes is damaging to the reputation of CDC.”
Alexander joined HHS in late March 2020 as a scientific adviser to assistant secretary for public affairs Michael Caputo, whose attempts to muzzle CDC scientists or demands for changes to their reports are well documented. Caputo deleted his Twitter account and took a leave of absence in mid-September after a public meltdown that included tweets calling for reporters to be tear gassed and Facebook videos accusing CDC scientists of harboring a “resistance unit” plotting to undermine Trump. Caputo added, in those videos, that his mental health had failed, suggested that, “hit squads being trained all over this country” were planning to assassinate him, and told Trump supporters to stockpile guns and ammunition. (Caputo later issued a statement that he had been diagnosed with cancer.)
Alexander reportedly took much the same approach as his boss, claiming in emails that the CDC was “writing hit pieces on the administration,” and that weekly reports containing statistics on children and the coronavirus were “very misleading by CDC and shame on them.” He also demanded that the CDC stop issuing the mortality and morbidity reports entirely unless they were personally vetted by him.
“The reports must be read by someone outside of CDC like myself, and we cannot allow the reporting to go on as it has been, for it is outrageous. Its lunacy,” Alexander told CDC director Dr. Robert Redfield in one email obtained by Politico. “Nothing to go out unless I read and agree with the findings how they CDC, wrote it and I tweak it to ensure it is fair and balanced and ‘complete.’”
In other emails, Alexander demanded that National Institute for Allergens and Infectious Diseases director Dr. Anthony Fauci stop recommending that students in schools and universities receive regular virus tests or wear masks. In one message, he demanded Fauci clarify masks only be worn by teachers and lied there is “no data, none, zero, across the entire world” to indicate children can spread the coronavirus and “if it did occur, the risk is essentially zero.” (Neither claim is remotely true.)
Around the same time that the CDC issued absurd testing guidelines stating only those individuals with symptoms should receive tests (rather than anyone exposed to the virus ), Alexander wrote to National Institutes of Health staff that, “testing of asymptomatic people to seek asymptomatic cases is not the point of testing.” The CDC later retracted the guidance. Finally, Alexander also wrote to NIH staff that the policy of considering randomized, controlled trials as the evidentiary standard for coronavirus treatments “must change.”
Alexander left HHS on Sept. 16, the same day Caputo took his “temporary” leave of absence. In a statement, HHS claimed Alexander’s role was never intended to be on anything but a “temporary basis.”
None of the backlash has resulted in the White House aligning its pandemic response any more with reality. On Monday the president, who disclosed he had tested positive for the virus on Friday, said he would be checking out of Walter Reed National Military Medical Center and returning to the White House, where numerous staffers have tested positive for the virus in recent days.