New details have come to light about the Trump administration’s handling of the coronavirus and its real threat.
According to emails obtained by POLITICO, Paul Alexander—a senior adviser to Michael Caputo, Department of Health and Human Services assistant secretary of public affairs—instructed press officers and others from the National Institutes of Health on what top infectious disease expert Dr. Anthony Fauci should say during media interviews.
The Trump adviser attempted to put a muzzle on Fauci’s planned responses to media outlets in an attempt to prevent him from speaking about the risk of the virus and its effects on children.
Alexander’s wordy emails, some sent out as recently as this week, were phrased as scientific arguments. However, they often contradicted mainstream science and, instead, fostered political positions taken by the Trump administration on hot-topic issues ranging from the use of convalescent plasma to reopening schools.
The emails are part of wide-ranging evidence that proves the White House and Trump appointees from the HHS are pushing health agencies to spread their political agenda instead of a scientific one.
“I continue to have an issue with kids getting tested and repeatedly and even university students in a widespread manner…and I disagree with Dr. Fauci on this. Vehemently,” Alexander wrote in an Aug. 27 email that was in response to a press office summary of what Fauci intended to tell a Bloomberg reporter.
On Tuesday, Alexander told Fauci’s press team that the expert should not encourage mask-wearing among children during an MSNBC interview, POLITICO reports.
“Can you ensure Dr. Fauci indicates masks are for the teachers in schools. Not for children,” Alexander put in writing. “There is no data, none, zero, across the entire world, that shows children, especially young children, spread this virus to other children, or to adults or to their teachers. None. And if it did occur, the risk is essentially zero,” he said, adding without evidence that children take influenza home, but not the coronavirus.
Although the HHS acknowledged Fauci is an important voice amid the pandemic, Alexander “specializes” in analyzing the work of scientists. Alexander is a part-time professor of health research methods at McMaster University in Canada and was brought on the HHS team in March, appointed by Michael Caputo, a longtime friend of Trump who oversees HHS’s media strategy.
“Dr. Alexander advises me on pandemic policy, and he has been encouraged to share his opinions with other scientists,” Caputo said. “Like all scientists, his advice is heard and taken or rejected by his peers. I hired Dr. Alexander for his expertise and not to simply resonate others’ opinions.”
But apparently, Alexander’s requests held no authority. Fauci, an infectious disease expert who has led the National Institute of Allergy and Infectious Diseases (NIH) for nearly for decades, said he had not seen the emails nor did his staff instruct him to minimize the risk the virus poses to children or the need for kids to wear masks.
“No one tells me what I can say and cannot say,” Fauci said. “I speak on scientific evidence.”
In July, the Washington Post reported that Alexander had cracked down on the CDC after the agency warned pregnant women about the virus. The warning “reads in a way to frighten women . . . as if the President and his administration can’t fix this, and it is getting worse,” Alexander wrote in an email, according to the Post.
Epidemiologists and other public health experts who reviewed the excerpts sent by Alexander to the NIH agree that his advice could harm the public.
“While children may not be the primary drivers of the outbreak, that sort of blanket statement is dangerous,” said Saskia Popescu, an infectious disease epidemiologist at the University of Arizona.
“It’s important to remember that schools have been closed and we’re learning more about child to child transmission, but this statement has been proven wrong by not only the summer camp outbreak [in Georgia] but also household transmission.”
According to a study conducted by The American Academy of Pediatrics and the Children’s Hospital Association, more than 513,000 children in the U.S. have caught the virus since the start of the pandemic, 70,630 of those cases were between Aug. 20 and Sept. 3.
“I am an infectious diseases physician on Dr. Fauci’s staff,” wrote Andrea Lerner, a medical officer in the Office of the Director. “While transmission dynamics of SARS-CoV-2 involving children are not fully understood, potentially complex and probably differ across age groups, I don’t feel it is correct to say there is ‘no evidence, zero, that children spread this virus to children in schools or to adults.’ Or that, ‘They take influenza home but do not take COVID home.’” Lerner cited four studies, each showing the spread among children, including one case studied by the CDC, which showed the virus spread rapidly among children who attended a summer camp in Georgia.
But that didn’t conquer the battle with Alexander. He then countered by saying there is “little if any evidence” that children are at risk of getting and spreading the virus and believes if they were required to wear masks, it would be “traumatic” for them.
The Trump administration appointee also countered the scientific consensus on the necessity for extensive testing to suppress the virus, and randomized, controlled clinical trials to determine whether a drug or vaccine works. In an Aug. 27 email to NIH staff, Alexander wrote there is no reason to test people without coronavirus symptoms—mirroring controversial CDC guidance issued days before. Public health officials promote the testing of people without symptoms as since they can spread the virus to others before they feel ill, or even if they never feel sick.
“Testing of asymptomatic people to seek asymptomatic cases is not the point of testing,” Alexander wrote, adding he agrees with the CDC guidance “to not test asymptomatic people carte blanche as it makes no logical sense.” He said that people who are going into high-risk areas, such as nursing homes, should still be tested.
Lastly, Alexander also gave pushback on NIH’s commitment to randomized, controlled trials, or RCTs in an Aug. 21 email—two days before the FDA authorized the emergency use of convalescent plasma for the patients with the virus over objections from Fauci and NIH Director Francis Collins. The two were vocal about their concerns that the therapy, although safe, did not yet show clear benefits in trials.
“I think over time as I examine the good nonrandomized research, well-conducted, strong methods, then I am saying that RCT evidence should not be considered the gold standard,” Alexander wrote.
Randomized trials have been a longstanding standard for medical research because they help eliminate confounding factors that could actually be causing benefits or harms.
“Consider this as a philosophical sharing and debate to spurn discussion,” Alexander continued. “All this to say that if the NIH’s position is that RCT evidence is your standard, then this must change.” In response, an NIH employee said that an expert panel established by the agency to review potential coronavirus therapies considers a variety of evidence when updating its Covid-19 Treatment Guidelines, but again Alexander responded with criticism.