States, cities, and pharmaceutical companies are contradicting or ignoring the Trump administration in responding to COVID-19 as the White House continues to push for responses that could help the President politically while undermining the country’s ability to fight the pandemic.
The Trump administration has issued directives and statements in recent weeks that appear aimed at boosting the President’s chances of re-election, be it predictions of a vaccine in time for Nov. 3, or a change in CDC guidance that, if followed, would reduce the volume tests, resulting in the appearance of fewer cases.
But the administration’s ongoing battle against the political impact of COVID-19 —rather than the disease itself — has lowered confidence in the country’s public health agencies. The loss of influence has meant that states and local governments are far warier of federal public health advice.
Recent events had “really shaken the confidence of health experts and the public alike,” Dr. Howard Koh, a former assistant secretary for health at the Department of Health and Human Services, told TPM.
“If people don’t have trust and confidence in the vaccine and the FDA approval process, and in guidance from the CDC,” Koh added, “this pandemic will go on indefinitely.”
The result is a situation in which the Trump administration issues politically motivated pronouncements that damage the federal government’s ability to fight COVID-19, but which are sometimes so absurd on their face that institutions outside of the President’s chain-of-command won’t participate.
“The political leadership has not been strong and it has tarnished the reputations of both the FDA and the CDC,” Dr. Bill Schaffner, professor of preventative medicine and infectious diseases at Vanderbilt University Medical Center, told TPM.
“The two agencies established to protect the health of the United States population have had their reputations injured, and they have been frequently sidelined by the national political mechanism,” he continued. “That’s painfully sad, and it will take many years for both of these agencies to restore their credibility.”
TPM could identify virtually no body that took the CDC’s recommendation to stop testing those exposed to COVID-19 but who displayed no symptoms. Rather, an array of states and localities across the political landscape said publicly that they would continue to test.
At the same time, President Trump’s attempt to release a COVID-19 vaccine caused even the pharmaceutical firms developing the inoculation to issue an unprecedented statement affirming that they were committed to making sure that a vaccine was safe and effective before asking the government for approval.
The CDC’s recommendation on asymptomatic testing last month came as a shock to many, and provoked an outcry from the public health community that caused the administration to waffle on what exactly the recommendation meant.
Experts voiced their concern that the recommendation would confuse local officials, leading them to reduce testing. But instead, states and localities decided to ignore the CDC.
Texas and Florida declined to change their guidance, and continue to recommend that those exposed to COVID-19 but who show no symptoms get tested.
North Dakota’s Division of Disease Control Chief Kirby Kruger said that the state hasn’t “changed any of our recommendations here in North Dakota and we’re unlikely to because we believe our recommendations make sound public health sense.”
And in Mississippi, State Health Officer Thomas Dobbs described the guidance as outdated and poorly communicated before saying that the state would not change its recommendations.
HHS spokesman Michael Caputo did not reply to a request for comment from TPM regarding examples of states or localities that had taken the CDC’s recommendation.
One shot away
President Trump has repeatedly promised a vaccine by Election Day, and publicly pressured the FDA to approve a vaccine by that time.
That flies in the face of timelines needed for the current vaccine trials to determine safety and efficacy. One government official told CNN that he did not “know any scientist involved in this effort who thinks we will be getting shots into arms any time before Election Day.”
Officials from multiple states have told TPM that they would refuse to distribute a vaccine that received federal approval without completing the necessary trials, or without receiving approval from an independent board of scientists.
“There’s a process for vaccine approval thats been followed for years, and people perceiving that there were shortcuts this time is going to be disastrous,” Koh said. “It just cannot happen.”
The seven pharmaceutical firms involved in developing COVID-19 vaccines issued a joint pledge on Tuesday morning, saying that the firms would only ask for FDA approval following convincing data showing that a vaccine candidate is safe and effective.
Dr. Schaffner, who also serves as a member of the CDC’s Advisory Committee on Immunization Practices, told TPM that the statement is “impressive and unprecedented.”
But, Schaffner added, it falls short of specifying what the firms would do to ensure safety.
“They’re not saying they are committed to running the trial until its completion,” Schaffner said. “They are not saying that they insist on the FDA taking whatever decision they make and bringing it to the advisory committee that the FDA already has.”