President Trump stood in the Rose Garden yesterday promising that the states would soon be in a position to deliver fast and reliable coronavirus testing to the masses. The question is why—months after the first case of COVID-19 was diagnosed on American shores, and more than a month after Trump stood in the same place making similar promises—don’t we have fast, reliable, widespread testing already?
While the president has earned plenty of blame for his mismanagement of the COVID-19 crisis, spare some for the director of the Centers for Disease Control and Prevention, Dr. Robert Redfield. An infectious-disease specialist appointed by Trump in 2018, Redfield had one immediate priority once the CDC went into action to fight the spread of the coronavirus: Develop a valid test and deploy it quickly. On that count, the CDC utterly failed when it mattered the most.
As the crisis unfolded in January and February, the CDC insisted on producing its own test, spurning a proven German-produced one in pursuit of its own. Top doctors declared that any lags were in the name of “quality control,” while other countries outpaced the United States in testing. Despite actions in late February to finally allow private U.S. labs to start producing tests, the government never made up the gap. Much of the crisis that followed was related to that initial problem: The scarcity of tests during the critical early weeks resulted in enormous uncertainty and contributed to the unchecked spread of infections. Tests are still so hard to come by that last week, Yumi Hogan, the first lady of Maryland, was credited with securing 500,000 tests from her home country of South Korea.
Over the weekend, unnamed White House officials, no doubt worried about how President Trump’s mismanagement might cripple him in the November election, started floating rumors that Health and Human Services Secretary Alex Azar might be on the chopping block. We’ll return to him in a moment. But first, let’s look at Dr. Redfield’s record.
When comparing the testing outcomes between various countries, a clear pattern emerges. Countries such as Germany, South Korea, and Singapore that deputized private labs to develop and deploy tests performed far better than countries that pursued a top-down, centralized approach, as the United States and Britain did. The World Health Organization relied on German R&D to make and distribute millions of diagnostic tests to poor countries. The question is, why didn’t the United States do the same? How is it that the WHO, an organization the United States provides $400 million a year (more than any other country), was able to send good tests to 60 countries before the United States established a widespread testing regime for its citizens?
The CDC has been reluctant to say what went wrong other than that the testing flaws resulted from “a design and/or manufacturing issue or possible contamination.” This answer is garbled and evasive. How did so many other countries figure it out and America didn’t?
A passage in a Washington Post story documenting the breakdown was especially revealing: The success the CDC had fighting other diseases—Ebola, Zika, H1N1—“fostered an institutional arrogance, a sense that even in the face of a potential crisis there was no pressing need to involve private labs, academic institutions, hospitals and global health organizations also capable of developing tests.” Similarly, the New York Times reported that “the CDC gave little thought to adopting the test being used by the WHO. The CDC’s test was working in its own lab—still processing samples from states—which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the CDC did not think ‘we needed somebody else’s test.’”
While there is surely blame to go around at the CDC, the failures could have been mitigated with better leadership at the top. But even while in the throes of an epic disaster of bureaucracy, Dr. Redfield acted like everything was fine. After a tour of the CDC’s facility in Atlanta with President Trump on March 7, Redfield said “we found that, in some of the states, [the initial CDC test] didn’t work. We figured out why. I don’t consider that a fault. I consider that doing quality control.”
Dr. Redfield didn’t get off so easy when he was grilled on March 12 by House Oversight member Rep. Debbie Wasserman Schultz, who asked him several times who was responsible for making sure Americans could get tested. “Who is that person? Is it you?” she said. “I’m asking for a name.” Dr. Redfield repeatedly dodged before pathetically motioning to another witness, Dr. Anthony Fauci, to respond. “The system is not really geared to what we need right now,” Fauci said. “That is a failing. It is a failing, let’s admit it. . . . The idea of anybody getting it easily, the way people in other countries are doing it, we’re not set up for that. Do I think we should be? Yes. But we’re not.”
Further compounding the problems: The CDC’s leadership naïvely believed that—even aside from the matter of the test’s flaws—the agency would be capable of manufacturing, shipping, and processing the millions of tests and results needed to track the virus. In hindsight, the severe restrictions the CDC placed on who could receive the tests amounted to a shambolic way of rationing the tests—much as the CDC’s early warnings that members of the general public did not need to cover their faces were not based on science about the spread of infections but were rather an effort to preserve the supply of medical masks for healthcare workers.
But given the terrible mistakes the CDC made with testing, it seems odd that President Trump would so openly embrace its director—especially when Vice President Mike Pence has had to use his position on the White House Coronavirus Task Force to directly engage private labs to pick up the slack from the CDC.
For a while, it seemed like Dr. Redfield was able to keep his profile relatively low, but he has since emerged as what Politico recently called a “MAGA whisperer” who uses his faith to connect with conservative-leaning talk radio listeners. In classic Trumpian fashion, however, he got caught sideways last week when he warned the Washington Post about a possible “second wave” of coronavirus this fall that could be compounded by the flu. President Trump claimed Dr. Redfield was “misquoted,” but Redfield confirmed that he was not (although he believed the headline of the story was “inappropriate”).
Unfortunately for Azar, the knives have been out for him for a long time. Hostilities between Azar and the White House Domestic Policy Council are not a secret. At all. And unnamed Trump administration officials who think Azar should take the fall on testing have been pushing the idea since early April. Sadly, Azar lost his father on April 6. While he was away, the Centers for Medicare and Medicaid Administrator Seema Verma, who is reportedly under consideration to replace him and considered one of his internal adversaries, seized the chance to make a showy, public announcement about coronavirus funding.
The leaks against Azar have grown even more pointed and personal in recent days. Last Wednesday, a Wall Street Journal article quoted several unnamed officials blaming Azar for misjudgments and mismanagement. The same day, a Reuters article accused Azar of hiring a “Labradoodle breeder” to handle the pandemic for him. In reality, the official, Brian Harrison, is a longtime Washington hand brought on as Azar’s deputy chief of staff in 2018 and then promoted to be chief of staff in 2019. The Reuters story said that, when “reached by phone, Harrison declined to answer Reuters’ questions.” How could that be? It turns out that Harrison was attending to his newborn baby, who had just been readmitted to the hospital. (I, for one, will not fault him for refusing reporter questions while coping with an infant hospitalization in the middle of COVID. God help those who do.)
The drama roils on. After several outlets reported on Saturday evening that White House officials were preparing a plan to oust Azar, Trump tweeted support for the official on Sunday. “Reports that HHS Secretary @AlexAzar is going to be ‘fired’ by me are Fake News,” the president said. “The Lamestream Media knows this, but they are desperate to create the perception of chaos & havoc in the minds of the public. They never even called to ask. Alex is doing an excellent job!” Azar put out his own tweet bashing the “#FakeNews” and the president again defended Azar in his Rose Garden remarks on Monday.
As if palace intrigue were the thing that really matters here. A document released Monday describing the Trump administration’s latest plans to make tests widely available said that the federal government should only be counted on as the “supplier of last resort.” Don’t we already know it.