This summer, President Trump discovered a new tool to conscript into his fight to win re-election: the country’s war against COVID-19. Trump has embarked on an unprecedented campaign to use the infrastructure the country has developed to fight the virus in service of his own re-election.
It is no small irony that Trump is trying to turn the pandemic to his political benefit, having epically downplayed the virus and spectacularly bungled the initial and the ongoing responses. Despite, or maybe because of, the death of more than 180,000 Americans, Trump still seems determined to turn the pandemic to his political advantage.
But there is a consistency to the Trump response both initially and now: it is focused on his political needs, not the exigencies of public health, science, or the sick and dying.
The steps Trump has taken fit a pattern in which through bluster and misconduct, the President and his allies are turning tools meant to fight the disease into a way of fighting the PR problem of the disease, ensuring that there appear to be fewer cases than there are while raising fears about a vaccine being delivered before it’s ready.
HHS Spokesman Michael Caputo told TPM in a statement that “doctors and data are driving the development of all COVID-19 countermeasures.”
“Everybody at H.H.S. hopes Operation Warp Speed will achieve 300 million doses of a safe and effective COVID-19 vaccine for Americans by January 2021,” he said, adding that “I have never heard mention of any other timeline.”
Artificially Lowering Case Counts
Last week, Dr. Tony Fauci had the unpleasant experience of having a key decision made for him while he was unconscious.
Fauci was undergoing surgery for a polyp on his vocal cords last Thursday, as the Trump administration’s coronavirus task force met to approve a serious change to its testing guidance. No longer would the administration recommend testing everyone who has been exposed to someone positive for the virus; now, the Trump administration says that testing for those who have been exposed to the virus, but lack symptoms, is not recommended.
Critics immediately accused the Trump administration of trying to tamp down on testing. The move reportedly came from the “top down,” without clear evidence for why.
Even HHS Assistant Secretary for Health Adm. Brett Giroir would not deny that the policy would reduce testing volume when asked directly on a Wednesday call with reporters; all he had to say was that, “conceptually, we believe there should be more testing.”
The effect of the policy will be to lower case counts.
Adrianne Casalotti, chief of government and public affairs for the National Association of County and City Health Officials, slammed the “politicization of public health,” saying that the policy effectively puts local officials and doctors in a position to contradict the federal government if they want to practice good public health.
“By removing the national recommendation and putting the decision-making squarely on individual leaders, it allows for skeptical elected officials and members of the public to again blame the individual public health leader who is simply trying to protect their health and safety,” Casalotti said in a statement.
Pushing For A Vaccine Before It’s Safe
The political approach has extended to vaccines as well, as Trump has repeatedly called for a vaccine to be ready by the November election.
Officials with Operation Warp Speed – the Trump administration effort to accelerate vaccine development and distribution – have already said that the federal government is planning to “overwhelm” the airwaves with vaccine messaging by November.
But the move faces a key problem: the COVID-19 vaccine candidates undergoing trials right now won’t be complete until, at the earliest, next year, experts say.
Approving a vaccine before the election would require the Food and Drug Administration to issue an Emergency Use Authorization.
Paul Mango, an Operation Warp Speed official, told reporters on Friday that the decision on approval would come down to safety and efficiency data and the FDA. Dr. Robert Redfield, CDC director, added that the administration was “planning for the assumption that it’s” an emergency use authorization.
Emergency use has a far more lenient standard, allowing the government to issue new treatments for diseases that lack any known cure.
But Dr. Doran Fink, deputy director of the FDA’s Division of Vaccines, told a CDC vaccine panel in July that giving doses to millions of people means that the bar is still very hard to clear – the more people who receive a vaccine, the higher the standard for safety.
In spite of that, Trump has pressed forward, accusing the FDA last week of being part of a “deep state” plot to slow down vaccine development.
Noel Brewer, a professor at UNC’s Department of Health Behavior who focuses on why people accept or reject vaccines, expressed concern to TPM that Trump’s comments would already reduce the number of people who choose to get vaccinated, dampening trust in the vaccine on both sides.
“It’s really concerning to see how far public health has been politicized, and polarized,” he told TPM.
It’s not clear what form such a vaccine would take. The push comes as the FDA has already issued emergency approvals for hydroxychloroquine and blood plasma under intense political pressure.
In the case of hydroxychloroquine, the FDA issued the emergency approval for a limited class of patients, a pattern that some say could serve as a blueprint for the vaccine rollout: a limited approval of a small amount of vaccine, in time for the election but not enough to make any difference in fighting the disease.
To Efthimios Parasidis, a professor of health law at Ohio State University, the damage done to the FDA and other public health institutions by the political push is enough.
“Trump has blamed public health officials for recklessly handling the pandemic, and many public health leaders—particularly at the FDA and the CDC—have cowered to Trump’s political, non-evidence-based commands,”Parasidis wrote in Barron’s this week. “Untoward consequences from a few rash decisions can impact a generation’s trust in an agency that is instrumental to the health and welfare of society.”
This story has been updated.