A lost summer: How Trump fell short in confronting the virus

WASHINGTON - As the White House chief of staff, Mark Meadows is responsible for coordinating the vast executive branch, including its coronavirus response. But in closed-door meetings, he has revealed his skepticism of the two physicians guiding the anti-pandemic effort, Deborah Birx and Anthony Fauci, routinely questioning their expertise, according to senior administration officials and other people briefed on the internal discussions.

Meadows no longer holds a daily 8 a.m. meeting that includes health professionals to discuss the raging pandemic. Instead, aides said, he huddles in the mornings with a half-dozen politically oriented aides - and when the virus comes up, their focus is more on how to convince the public that President Donald Trump has the crisis under control, rather than on methodically planning ways to contain it.

During coronavirus meetings, Meadows has repeatedly questioned the scientific consensus that wearing masks helps contain the spread of the novel coronavirus, officials said. He has regularly raised with Fauci and others a range of issues on which he thinks Fauci has been wrong, and he personally monitors the infectious-disease expert's media appearances. When he catches Fauci sounding out of sync with Trump, the chief of staff admonishes the doctor to "stay on message," officials said - and he has impressed upon Fauci, Birx and other public health professionals that they should not opine on restrictions or make policy in the media.

In an interview Saturday, Meadows said he has been appropriately skeptical of information presented to him but disputed that he is anti-science.

"My comments to all of our doctors is that they need to stick with the science, comment on the science and do not become media commentators and opine on what may or may not happen," he said. "I've been consistent from the very first day I was here. I want us to question every assumption that we make and rely only on the facts that are before us. When we are communicating to the American people, we need to make sure that any comments that we make are backed up by good modeling, good analysis and are free from commentary."

Meadows is not alone in being skeptical of medical expertise, part of the politics-first, science-second attitude that has become pervasive inside the White House this summer - and which has been championed foremost by Trump.

"It's one thing to question science, and it's another thing to attack science," said a former senior administration official.

If the administration's initial response to the coronavirus was denial, its failure to control the pandemic since then was driven by dysfunction and resulted in a lost summer, according to the portrait that emerges from interviews with 41 senior administration officials and other people directly involved in or briefed on the response efforts. Many of them spoke only on the condition of anonymity to reveal confidential discussions or to offer candid assessments without retribution.

"Right now, we're flying blind," said Thomas Frieden, a former director of the Centers for Disease Control and Prevention. "Public health is not getting in the way of economic recovery and schools reopening. Public health is the means to economic recovery and schools reopening. You don't have to believe me. Look all over the world. The U.S. is a laggard."

Under mounting pressure to improve the president's reelection chances as his poll numbers declined, the White House had what was described as a stand-down order on engaging publicly on the virus through the month of June, part of a deliberate strategy to spotlight other issues even as the contagion spread wildly across the country. A senior administration official said there was a desire to focus on the economy in June.

It was only in July, when case counts began soaring in a trio of populous, Republican-leaning states - Arizona, Florida and Texas - and polls showed a majority of Americans disapproving of Trump's handling of the pandemic, that the president and his top aides renewed their public activity related to the virus.

Some White House officials defended the administration's response to the surge of infections in the summer, describing the current effort as all-hands-on-deck and saying Trump is now heavily engaged personally and holds regular briefings. Aides express confidence that the United States is in a stronger position now than in March or April, with an improved supply chain for ventilators and personal protective equipment, and with advancements in therapeutics and in the development of a vaccine.

"While the media would rather speculate on palace intrigue with anonymous sourcing, President Trump and his entire Administration continue to lead a whole-of-government response to defeat the virus from China, expedite treatments and vaccine development, and reopen our economy safely," White House Deputy Press Secretary Judd Deere said in a statement Saturday. "The President wants to see America healthy, prosperous, and again safely open for business, and that's what we are all working toward."

Trump and many of his top aides talk about the virus not as a contagion that must be controlled through social behavior but rather as a plague that eventually will dissipate on its own. Aides view the coronavirus task force - which includes Fauci, Birx and relevant agency heads - as a burden that has to be managed, officials said.

Yet the virus rages coast to coast, making the United States the world leader, by far, in the number of confirmed coronavirus cases and deaths. An internal model by Trump's Council on Economic Advisers predicts a looming disaster, with the number of infections projected to rise later in August and into September and October in the Midwest and elsewhere, according to people briefed on the data.

The forecast has alarmed the president and his top aides, even as some have chosen not to believe it, arguing that some previous projections did not materialize. Trump, meanwhile, has continued to insist publicly that the virus is "receding," as he described it recently.

Skepticism of scientific projections abounds inside the West Wing. During an Oval Office meeting last month to discuss the Republican National Convention celebration planned for Jacksonville, where coronavirus cases had been surging, advisers informed Trump and other advisers that Birx had warned that they should be prepared for a large percentage of people potentially testing positive.

"Oh, if Doctor Birx says it," Meadows quipped derisively, questioning the assumption that as many people would get the virus as she said, according to people in the room. The Jacksonville celebration ultimately was canceled.

Marc Short, chief of staff to Vice President Mike Pence, who chairs the coronavirus task force, and other administration officials both senior and junior operate with a similarly skeptical attitude toward the administration's scientists, officials say.

These aides serve as Trump's bureaucratic muscle, acting upon the views of a president whose public statements have revealed his ignorance of how the pathogen works, impatience with doctors' recommendations and faith in a "cure" that could soon return life to normal.

Nearly seven months after the first coronavirus case was reported in the United States, there still is no national strategy to contain the outbreak - other than the demands, some of them contradictory, that Trump issues on Twitter or at news conferences. “OPEN THE SCHOOLS!!!” the president decreed in a tweet Monday.

As the nation confronts a once-in-a-century health crisis that has killed at least 158,000 people, infected nearly 5 million and devastated the economy, the atmosphere in the White House is as chaotic as at any other time in Trump's presidency - "an unmitigated disaster," in the words of a second former senior administration official.

In the weeks ahead, the administration plans to draw more attention to the push to develop and test a coronavirus vaccine, and to the government's plan for mass distribution, together dubbed "Operation Warp Speed." Aware that the public could view this as a politicized effort ahead of the November election, the administration plans to use public health professionals to promote the vaccine project and to limit the president's personal involvement in the promotional campaign so that it is not viewed as a "Trump vaccine," according to a senior White House official.

Trump's new campaign manager, Bill Stepien, has argued that Trump and campaign surrogates should talk more forcefully about the virus to help reverse the president's downward polling trend, according to a campaign official.

Sen. Lindsey Graham, R-S.C., who has played golf with Trump throughout the pandemic, argued that the president could change voters' minds about the administration's handling of the crisis by more aggressively blaming the virus on China and stirring hopes for a vaccine.

"He has a better story to tell than he has told so far," Graham said.

Over the past two weeks, the White House communications staff has worked with Birx, Fauci and other public health professionals on what they have deemed an "embers strategy" - a reference to snuffing out an emerging fire - to help prevent spikes in metropolitan areas that internal data project could see a rise in cases. Aides deployed the doctors and other experts to deliver stark warnings and reiterate best practices in local media interviews in an array of such markets, including Indianapolis and Minneapolis, as well as throughout the states of Michigan, Ohio and Wisconsin, which also happen to be election battleground states.

Trump, meanwhile, has tried to project an image of competence and control by resuming regular news briefings in which he reads from a script containing a flurry of statistics and other updates on the virus's spread.

Trump's recent performances have won plaudits from Fauci and others.

"I'm pleased that the president has gone out there and is saying things now that I think are important, that have to do with wearing masks, staying away from crowded places," Fauci said. "Also, they've been short and crisp, which I think is good when you're trying to get a message across."

Former New Jersey governor Chris Christie, a Republican, a Trump confidant who also is a lobbyist for some hospitals, agreed. "I think his focus on encouraging the American people to wear masks, to letting them know that we are going to be in this for a while and we have to remain strong and resolute about it, I think are all things that are very, very important," he said.

But several governors and mayors in some of the nation's hardest-hit areas questioned the president's credibility and the value of his presentations in recent interviews.

"You can be out front, but if you're not providing accurate and truthful information, it can hurt rather than help," said Houston Mayor Sylvester Turner, a Democrat, whose city has been a major hot spot. "Correct information is vital. People are listening, and they will respond based on what they're hearing. And they look to their leaders at all levels of government. . . . That trust factor is critical. If you lose that, it's very difficult to govern."

Jack Chow, a U.S. ambassador for global HIV/AIDS during the George W. Bush administration and a former World Health Organization assistant director general, said, "It's extraordinary that a country that helped eradicate smallpox, promoted HIV/AIDS treatment worldwide and suppressed Ebola - we were the world's leader in public health and medicine, and now we can't even protect our own people from the most devastating epidemic in decades."

House Speaker Nancy Pelosi, D-Calif., said that Trump's push for a speedy return to normal had deadly consequences. Asked who was to blame for the pandemic's dark summer turn, Pelosi said, "1600 Pennsylvania Avenue."

"The delay, the denial . . . the hoax that it's going to go away magically, a miracle is going to happen, we'll be in church together by Easter, caused death," Pelosi added.

In Trump's White House, there is little process that guides decision-making on the pandemic. The president has been focused first and foremost on his reelection chances and reacting to the daily or hourly news cycle as opposed to making long-term strategy, with Meadows and other senior aides indulging his impulses rather than striving to impose discipline.

"Trump likes knocking down dominoes, and there's nobody left to stop the cascade of dominoes," said Anthony Scaramucci, a former White House communications director who has become a Trump critic but remains close to some of Trump's aides. "He sits in the Oval Office and says, 'Do this,' or, 'Do that,' and there was always a domino blocker. It was John Bolton or H.R. McMaster on national security or John Kelly. Now there are no domino blockers."

What's more, with polls showing Trump's popularity on the decline and widespread disapproval of his management of the viral outbreak, staffers have concocted a positive feedback loop for the boss. They present him with fawning media commentary and craft charts with statistics that back up the president's claim that the administration has done a great - even historically excellent - job fighting the virus.

When "Fox News Sunday" anchor Chris Wallace told the president during a recent interview that his claim that the United States had one of the lowest coronavirus mortality rates in the world was "not true," Trump grew agitated and called for White House press secretary Kayleigh McEnany to hand him one of his charts.

"Kayleigh's right here," Trump told Wallace. "I heard we have one of the lowest, maybe the lowest mortality rate anywhere in the world."

A senior administration official involved in the pandemic response said, "Everyone is busy trying to create a Potemkin village for him every day. You're not supposed to see this behavior in liberal democracies that are founded on principles of rule of law. Everyone bends over backwards to create this Potemkin village for him and for his inner circle."

One reason for Trump's long-standing reluctance to wear a mask - although he sported one Thursday during a factory visit in Ohio - is the concern that his prized political base, which has held steady in its approval of him, is not enthusiastic about wearing them. That argument has been made several times privately to the president by Johnny McEntee, his former campaign "body man" who now directs the White House Personnel Office, according to two officials.

McEntee "loves to update the president," as one of them put it, on what his voters are saying about issues, including the pandemic, and has spoken to the president at length about how his base does not trust some members of the task force or the guidance on masks or shutdowns.

Government health officials are wary of saying anything publicly - even if they are merely speaking truth - that might be construed as contradicting the president or countering his rosy assessments.

One of the clearest examples of how fear and loyalty have infected the response came in Trump's decision last month to begin formally withdrawing the United States from the World Health Organization. Many government officials hoped the president would not take this drastic step, but none had the courage to try forcefully to persuade him against a withdrawal by explaining that doing so would risk damaging not only the global response to the virus but also the U.S. response.

"Everybody is too scared of their own shadow to speak the truth," said a senior official involved in the response.

When Fauci was asked in an interview last week whether he would recommend voting by mail because of the pandemic, the doctor demurred because, he said, "that almost certainly is going to be used as a sound bite." As many states ramp up their mail voting systems to provide options for voters who prefer not to physically go to polling sites because of the coronavirus, Trump has been claiming - without evidence - that voting by mail is susceptible to massive fraud.

"It's a sport now in Washington to pit me against the president, and I don't really want to do that," Fauci said. "But someone will take a quote and, bingo, it'll be me against the president, and I don't want to do that."

Birx recently showed what can happen when one speaks truth. Last Sunday on CNN, she said that the United States had entered a "new phase" of the pandemic with the "extraordinarily widespread" outbreak reaching into rural as well as urban areas.

Trump, who had been describing the virus as receding, complained privately for much of that afternoon and the next day that Birx had taken too negative a tone and should have focused instead on the states where case counts are declining, advisers said.

Trump took to Twitter to suggest she "took the bait & hit us" because Pelosi had criticized the doctor for her frequent praise of the administration's coronavirus response. "Pathetic!" he tweeted, though a few hours later, he told reporters of Birx: "She's a person I have a lot of respect for."

In recent weeks, Birx had delivered versions of that message privately to state and local officials during her visits to various states that were in the White House's "red zone" or at risk of slipping into it. Behind closed doors, she bluntly warned elected leaders seeing spikes that their states could quickly become the next Florida or Louisiana, according to officials in Tennessee, Mississippi and Ohio who met with Birx, as well as other people familiar with the discussions.

Birx's private counsel at times stood in contrast to her decidedly less-alarmist public stance. Last week, for instance, Tennessee Gov. Bill Lee, a Republican, gave her the floor during a meeting in Nashville. Birx skipped over pleasantries and told Tennessee's leaders that they were at risk of encountering Florida's fate if they did not mandate masks statewide and shut down bars, according to an official involved in the state's response who learned of the discussions from two participants. A participant in another meeting with Birx and Lee that day also said Birx was unequivocal about the need for a statewide mask mandate.

But during a public news briefing with Lee, Birx hedged when asked directly whether her recommendation was that the governor require face coverings statewide, instead citing bullet points from a federal report. And Lee, left to characterize their conversations, claimed he had her backing for a different approach.

Gillum Ferguson, a spokesman for the governor, did not dispute the characterization of the private meetings but said Lee and Birx were in "broad agreement about the goal, which is to get more Tennesseans to wear masks."

A White House official disputed that Birx had hedged in her recommendation of mask-wearing.

Local officials in other states said Birx took pains to provide off ramps even when issuing forceful recommendations. In Ohio, she advised the closing of bars but said another option would be to limit the hours of operation, said Mysheika W. Roberts, health commissioner in Columbus, Ohio, where Birx participated in meetings at the end of July.

"She comes across as very knowledgeable," Roberts said, "but not pushy."

Although Fauci, Birx and other medical professionals sit on the coronavirus task force, many of the more pressing decisions lately have been made by the smaller group that huddles in the morning and mostly prioritizes politics. The cadre includes Meadows, senior adviser Jared Kushner and strategic communications director Alyssa Farah.

The policy process has fallen apart around Meadows, according to four White House officials, with the chief of staff fixated on preventing leaks and therefore unwilling to expand meetings to include experts or to share documents with senior staffers who had been excluded from discussions. This breakdown in order, for instance, has given room for trade adviser Peter Navarro to push his ideas directly with Trump and to submit an opinion piece to USA Today attacking Fauci.

Asked to grade Meadows's performance, Christie, who resisted Trump's entreaties in 2018 to serve as chief of staff, said, "Incomplete, so far. . . . He's still getting to know the ropes, getting used to everything, and working with this president up close every day is a much different experience than being one of his supporters on Capitol Hill. I'm sure the chief is learning that now."

Health officials said they have been dismayed that there is no consistent message from the White House advising what people should be doing to help stem the tide of coronavirus infections, such as wearing masks and social distancing. Some internal administration models suggest that full adherence to those measures could yield the same result as the shutdown, and officials recognize that it would be better for the public health and psyche of the nation and the economy if the country could avoid another full shutdown.

Luciana Borio, a director for medical and biodefense preparedness at the National Security Council during the first two years of the Trump administration, decried "a response in disarray hampered by a lack of clear, consistent public health-oriented guidance to the public."

"It's very difficult to know who to trust," Borio said. "To expect the public to sort out the facts in a time of tremendous stress leads to inconsistent and disparate actions, and that really hurts our collective effort to fight the virus."

What also has frustrated a number of the president's allies and former aides is that he simply seems uninterested in asserting full leadership over the crisis, instead deferring to state leaders to make the more difficult decisions while using his presidential bully pulpit to critique their performances. He deputizes Pence to handle many of the actual communication with states and other stakeholders in the fight against the virus.

"If we want to return to school safely, we need not only adaptive safety practices at the schools but also lower amounts of virus in each community," said Tom Bossert, a former White House homeland security adviser under Trump. "A suppression-level effort to shrink and not just mitigate the spread of covid requires a national strategy that includes standards and significant federal funding. Such a strategy is lacking right now."

Trump has solicited advice on the virus from a medley of voices, with anyone gaining access to him able to bend his ear about possible treatments. The chorus includes Fox News commentator Laura Ingraham, who has paid regular visits to the Oval Office to discuss hydroxychloroquine, the anti-malarial drug that Trump promoted as a cure-all for coronavirus despite scientific studies showing that the drug if used as a treatment could have deadly side effects.

The president recently hosted Andrew Whitney, a biopharmaceuticals executive on the board of a company called Phoenix, who met in the Oval Office with Trump. Whitney, who has a limited health background, pitched Trump on a botanical extract called oleandrin as a treatment for coronavirus, according to two senior administration officials with knowledge of the discussion.

This official said Mike Lindell, a Trump booster and the chief executive of MyPillow - who stars as pitchman for his product in advertising on some of the Fox News shows Trump watches - helped arrange the meeting. Since then, Whitney has personally made overtures to senior leaders at the Food and Drug Administration, including its commissioner, Stephen Hahn, in an effort to get the agency to approve oleandrin as a treatment for coronavirus.

The agency, which declined to comment, has not made any sort of approval. Whitney and Lindell did not respond to requests for comment.

"If people were left to their own devices, this would be the next hydroxychloroquine," the official said.

Trump's faith in hydroxychloroquine has inspired other Republican politicians to echo his enthusiasm, never mind the dangers raised by medical experts, putting a political gloss on what would otherwise be considered scientific facts.

Asked in an interview last week about the drug, Sen. Ted Cruz, R-Texas, acknowledged that he was not a doctor and had no medical assessment but added, "What's strange about this is, in today's political environment, everything is viewed through a lens of Trump. So, because Trump said positive things about hydroxychloroquine, suddenly a lot of the left, a lot of the media said, 'Oh, my God, it's the worst thing on Earth. You can't prescribe it.' "

Since the start of the pandemic, the U.S. response has been plagued by a chronic shortage of diagnostic tests, the supplies needed to run them and the lab capacity to process them in a reasonable time to maximize their effectiveness, according to state officials.

The Trump administration has resisted devising a national testing program and instead ceded the task to state governments, even as cases of infection average more than 60,000 a day and some people wait 10 days or longer for test results, delays that render the results essentially useless.

State officials, leaders of the American Medical Association and other medical groups as well as some officials in the administration have pushed for a stronger federal solution to the problems of testing.

While some states have been able to largely meet the needs of their populations, the federal government is the only entity with the power to coordinate testing across state lines, push and enable manufacturers to increase production of test kits and supplies, surge those supplies as needed and ensure fair payment. Without federal coordination, states, businesses, hospitals - and soon schools and universities - find themselves competing with each other for limited supplies, often overpaying as a result.

To be sure, the government has succeeded in vastly increasing the nation's testing capacity; there are now about 800,000 tests a day on average. But that is far short of the 5 million tests per day that experts said the country should be able to perform in the summer.

"Even if the government interceded much more aggressively on testing, there's going to be a lag on when that increased manufacturing capacity might come to bear," said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. "We'd really like to scale up and have more effective contact tracing, and we're challenged by the testing right now."

Despite repeated calls to invoke the Defense Production Act to help resolve testing-supply shortages, the administration has resisted doing so. Trump and several White House aides have instead continued to think that it is politically advantageous to cede the issue to the states to avoid taking ownership or blame for the issue, even though testing shortages are largely seen as a federal failure.

"The thing that disturbs me is I think the public has to know it doesn't have to be this way," said Rep. Frank Pallone Jr., D-N.J., said. "Other countries have taken this virus seriously, trusted their public health officials and scientists, and now they've flattened the curve," Pallone said. "Meanwhile, our situation gets worse and worse every day and some Americans think, 'Oh, that's just the way it is.' But that isn't how it has to be."

Even Trump has taken to sounding defeatist at times, as he if had given up trying to save lives. When the president claimed in a recent interview for HBO that the virus was "under control," Axios reporter Jonathan Swan interjected.

"How?" Swan asked. "A thousand Americans are dying a day."

"They are dying, that's true," Trump said. "It is what it is."

Some people familiar with Trump's thinking said the president is preternaturally averse to difficult challenges that don't produce immediate results.

"He's just not oriented towards things that even in the short term look like they're involving something that's hard or negative or that involves sacrifice or pain," a former senior administration official explained. "He is always anxious to get to a place of touting achievements and being the messenger for good news."

- - -

The Washington Post’s Isaac Stanley-Becker contributed to this report.