January 26, 2021

Sunday School 1/24/21: Extra Credit

I'm sure many of you have heard about Dr. Deborah Birx's interview with Margaret Brennan in the Face the Nation classroom. A few excerpts have been making the rounds, including this one.

I saw the President presenting graphs that I never made. So, I know that someone-- or someone out there or someone inside was creating a parallel set of data and graphics that were shown to the President. I know what I sent up and I know that what was in his hands was different from that. You can't do that.

What else did she have to say? Well, she knew, at the end of last February, that we were going to be facing a pandemic based on what she had seen from China. 

...when you overwhelm your hospitals, you have to know that you have broad-based community spread before that happens. Yet they weren't seeing it. And that really worried me because what we were looking for is people with symptoms. And so, when people were coming into the country, we were looking for people with symptoms...  This is exactly how we missed the HIV pandemic. If you're only looking for sick people, you miss a lot of the-- what is really happening under the surface...So, when we were questioning people who came into this country about symptoms rather than testing everybody who came into the country, that's when I started to get really worried. 

President Obama appointed her for the AIDS effort, but thinking about how she's going to be forever linked to president Trump doesn't sit well with her.

Well, you know, this is what worries me. If we start looking at technical civil servants as belonging to a political party, we will lose the ability for highly qualified civil servants to come and help. If we start saying if you come in and do this, you are then going to be part of the political apparatus, that is going to be very dangerous for this country.

She did say that "pandemics are always political," because to tackle them, you almost always have to change policies. But even with her experience working on AIDS, nothing prepared her for the politics of the coronavirus in the White House.

White Houses function in a pretty-- a pretty bureaucratic way, and most of the agencies function in a very predictable and bureaucratic way. But when you remove the infrastructure of the civil servants, then you end up with a lot more very quick right turns, left turns, right turns, left turns, and that-- that becomes less predictable and less able to manage that kind of response and change. 

When asked whether there were COVID deniers in the White House, she said in the White House and elsewhere, "there were people who definitely believed that this was a hoax." Partly because information was confusing, and because people saw others who got COVID and were fine, and 

When you have a pandemic where you're relying on every American to change their behavior communication is absolutely key. And so, every time a-- a statement was made by a political leader that wasn't consistent with public health needs, that derailed our response. It is also why I went out on the road because I wasn't censored on the road.

Birx noted she wasn't doing national press, and also that she wasn't "going to go outside the chain of command," and ask to go out and talk to the press if she wasn't asked to 

because there was so much leaking and so many parallel stories being leaked to the press that did not have grounding in truth that I didn't want to ever be part of that slippery slope. I know people started it with good intentions of trying to inform the American people, but then it became a way that they could silence those who didn't agree with them. And so I knew that every time I had a significant disagreement in the White House that within days a story would be planted... I think a lot of people were doing that.

She realized that speaking directly to the governors was the best way to get her information out, and that she, former FDA Commissioner Steve Hahn, former FDA chief Robert Redfield, and Dr. Fauci "would make sure we got the information out to the public one way or another." She considered quitting, "Always. I mean, why would you want to put yourself through that, every day?" That didn't get any better after the 'bleach' incident.

When you're a scientist who's grounded themselves in data and combating epidemics and working with communities and working with governments to change the future of people's lives for the better and then you get-- this is what-- when you talked about, was I prepared for that? No, I wasn't prepared for that. I didn't even know what to do in that moment.

That moment included becoming a character in an SNL skit. 

Birx agreed when Brennan asked if the "fundamental question" is whether we should leave it up to the states to handle a pandemic. They talked about some of the governors who not only had to deal with the president not wearing a mask, pushing them to keep everything open, and whatnot, but also with their own state legislators and state parties.

You needed every single level of government then to work together to ensure that, again, we're talking about behavioral change of American citizens.

About that behavior change? Birx said there were only two people at the White House who regularly wore a mask - she and the support person she had from HHS.  No one else. In trying to explain that, Birx said she thought "people believed wrongly that testing would be adequate ...that they believe that testing is a surrogate for a public health intervention." And, she said

There are multiple communications about masking. Remember when I was talking about the stream of data coming in? They were mixing data that didn't have anything to do with the relevance of masking as a public health measure to changing into masking as a personal protective measure.

Birx also said that she knew going to work at the White House to try and coordinate a pandemic response would be a "terminal event" for her career. 

I know that I wouldn't be allowed to really continue successfully within the federal government. You can't go into something that's that polarized and not believe that you won't be tainted by that experience or how people interpret you in that experience. So I knew that part of it. I didn't want that to happen.

Here's Birx's response when Brennan asked if "this will be the end of your federal career."

Yeah. I will need to retire probably within the next four to six weeks from CDC."

Her experience may keep good people from going into public service, which would be a shame.

See you around campus.

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