Emerging Secrets of the Coronavirus Task Force

A Look at Remarkable Interviews with Deborah Birx and Anthony Fauci

Yesterday, Dr. Deborah Birx was interviewed on CBS Inside Politics while Dr. Anthony Fauci was interviewed by the New York Times. Their revelations about their time on former President Trump’s Coronavirus Task Force paint a picture of political intrigue, policy chaos and ignored expertise. Here I discuss some key take-aways from these interviews.

While the details will emerge in the fullness of time, already it is clear that even though the Obama administration left the incoming Trump administration a “pandemic playbook,” Trump officials not only “jettisoned” that playbook, but along with it apparently everything we know about securing expertise in times of crisis.

In place of utilizing plans for responding to a pandemic (however imperfect) that gave responsibility for public health officials to lead a pandemic response, the Trump Administration created a new Coronavirus Task Force in the White House comprised entirely (with only one exception, Dr. Fauci) of President Trump’s political appointees. in January, the president initially placed responsibility for leading the federal response with the Department of Health and Human Services (HHS) as was planned in pandemic preparations, then shifted that responsibility to the Vice President in February, then to the Federal Emergency Management Agency (FEMA) in March and then back to HHS in June. By the time the election occurred in November, it was unclear who, if anyone, was leading.

The disjointed policy response was mirrored in the administration’s (non)utilization of expert advisory processes. For instance, the White House initially asked the National Academy of Sciences to advise on the pandemic response, and then ignored the committee once empaneled.

Even insiders were confused. In yesterday’s CBS interview, Birx, the response coordinator on the Task Force, expressed ignorance as to the origins and substance of advice (expert or not) that was being provided to the White House:

There was parallel data streams coming into the White House that were not transparently utilized. And I needed to stop that. Outside advisors coming to inside advisors and to this day – I mean until to the day I left – I am convinced there were parallel data streams. I saw the president presenting graphs that I never made. So I know that someone, someone out there or someone inside was creating a parallel set of data and graphics that were shown to the president. I don’t know to this day who, but I know what I sent up and I know what was in his hands was different than that.

In his interview Fauci explained that he received criticism and hostility from Trump’s political officials for offering his views based on his substantial experience and expertise:

After a TV interview or a story in a major newspaper, someone senior, like Mark Meadows, would call me up expressing concern that I was going out of my way to contradict the president.

The pandemic science advisory shortfalls of the Trump administration mirrored the pandemic policy implementation shortfalls. If key insiders reflect bafflement and confusion on expert advice, there is absolutely no hope for the rest of us.

Fauci continues government service with a high-level appointment in the Biden Administration while Birx is retiring. The different paths each is taking reflects the different nature of their appointments in government. Fauci is a career civil servant whereas Birx was a political appointee. The difference may be invisible to many observers, but understanding these different roles are essential to to understanding different incentives and behaviors of high-level governmental experts who advise elected officials.

Most significantly, a political appointee serves as the pleasure of the president both in terms of politics and policy (with the former sometimes taking priority over the latter), whereas a civil servant is employed to implement policies, and is not expected to be responsible for attending to the president’s political fortunes.

So when asked to weigh in on statements made by the president, Fauci explained that he would diplomatically (and some would surely say excessively so) push back:

I’m not going to proactively go out and volunteer my contradiction of what the president said. But he would say something that clearly was not correct, and then a reporter would say, “Well, let’s hear from Dr. Fauci.” I would have to get up and say, “No, I’m sorry, I do not think that is the case.” It isn’t like I took any pleasure in contradicting the president of the United States. I have a great deal of respect for the office. But I made a decision that I just had to. Otherwise I would be compromising my own integrity, and be giving a false message to the world. If I didn’t speak up, it would be almost tacit approval that what he was saying was OK.

Birx, on the other hand went out of her way to praise President Trump, both obsequiously and unbelievably:

He’s been so attentive to the scientific literature and the details and the data. I think his ability to analyze and integrate data that comes out of his long history in business has really been a real benefit during these discussions about medical issues.

In Brix’s defense, she was placed in a situation that, despite her long and distinguished career she had never been prepared or trained for. Speaking of the infamous “bleach” incident — when President Trump turned to her after suggesting that cleaning chemical injections or light could treat Covid — Birx explained that she simply had no idea how to react:

Was I prepared for that? No, I wasn’t prepared for that. I didn’t even know what to do in that moment.

We scholars of expertise in politics often emphasize the need for decision makers, including elected officials, to become better skilled and prepared to receive expert advice. That is indeed important. But at the same time we should also emphasize the importance of expert advisors becoming better skilled and prepared to offer expert advice in the context of highly politicized situations, often in the public eye. Such situations are commonplace at the highest levels of expert advice.

The key importance of different advisory roles was also emphasized by Fauci when he was asked about the installment of Scott Atlas, of Stanford University, as President Trump’s new pandemic advisor:

Well, Scott Atlas was less a replacement for me than a pushing out of Debbie Birx. My day job is that I’m the director of N.I.A.I.D. [National Institute of Allergy and Infectious Diseases] I would go to the White House, sometimes every day during the intense period, but I was considered an outside person. This is a subtlety that people need to understand… But Debbie Birx had to live with this person in the White House every day, so it was much more of a painful situation for her.

Perhaps offering a rationalization for her actions in the Trump Administration, Birx shared that she saw her role as subverting or compensating for the malign actions of the president with respect to what she believed (correctly) would be more effective actions in response to the pandemic:

You have to figure out how to get that message out when you can’t get it out from the head of the country. And that’s our job. You don’t give up. You don’t say “well that didn’t work” … so of course, you know everything is going to be terrible. You gotta try to make it the least terrible it can be.

Decisions faced by government employees — whether politically appointed or career — in the face of their opposition to the agendas of elected officials can be complicated. Such opposition raises important questions of individual ethics as well as the integrity of democratic governance. If every government employee sought to implement or oppose the policy agendas of democratically-elected officials, then governance would be functionally impossible.

Resigning is always a option for the official who believes that they cannot support government policies, and typically should be prioritized, especially by political appointees. But resigning can be a difficult choice, as explained by J. Patrick Dobel in an article titled, “The Ethics of Resigning”:

[R]esigning poses a high threshold given the economic and reputational costs of leaving a job. Resigning a job without civil service protection or another sure job can be very costly. This can be compounded by family support obligations. Resigning can also affect a person’s reputation and employability. Sometimes it marks them as a person of integrity and worthy of being hired; more often it marks them as a person who is disloyal and not a team player.

Fauci was asked if he ever considered resigning, to which he replied, “Never. Never. Nope.” Birx’s response to the same question was, “Always.” Undoubtedly Birx’s decision not to resign but to work from within will be discussed and debated as a case study in public policy programs.

The revelations of Birx and Fauci yesterday are surely just the tip of a very large iceberg of the experiences of experts in the Trump Administration. Rather than looking at the Trump Administration as an aberration, we should consider it a stress test of science in government, with broad relevance. It is a test that was failed.