Revisionism on Deborah Birx, Trump, and the CDC

In October of 2020 Science published a long article by Charles Piller titled Undermining CDC with the subtitle “Deborah Birx, President Donald Trump’s COVID-19 coordinator, helped shake the foundation of a premier public health agency.” The article focuses on a battle between Deborah Birx and the CDC over collecting data from hospitals with the basic message that Birx was an arrogant Trump tool who interfered with the great CDC. One year later, much of the article has a different cast beginning with “premier public health agency”. Hmmpfff. The opening now reads to me as almost laughable:

Zaidi lifted her mask slightly to be heard and delivered a fait accompli: Birx, who was not present, had pulled the plug on the Centers for Disease Control and Prevention’s (CDC’s) system for collecting hospital data and turned much of the responsibility over to a private contractor, Pittsburgh-based TeleTracking Technologies Inc., a hospital data management company. The reason: CDC had not met Birx’s demand that hospitals report 100% of their COVID-19 data every day.

According to two officials in the meeting, one CDC staffer left and immediately began to sob, saying, “I refuse to do this. I cannot work with people like this. It is so toxic.” That person soon resigned from the pandemic data team, sources say.

Other CDC staffers considered the decision arbitrary and destructive. “Anyone who knows the data supply chain in the U.S. knows [getting all the data daily] is impossible” during a pandemic, says one high-level expert at CDC. And they considered Birx’s imperative unnecessary because staffers with decades of experience could confidently estimate missing numbers from partial data.

“Why are they not listening to us?” a CDC official at the meeting recalls thinking. Several CDC staffers predicted the new data system would fail, with ominous implications. “Birx has been on a months long rampage against our data,” one texted to a colleague shortly afterward. “Good f—ing luck getting the hospitals to clean up their data and update daily.”

Scott Gottlieb tells this same story very differently in Uncontrolled Spread (my WSJ review).

Deborah Birx convinced the Coronavirus Task Force to direct money to the CDC to modernize its reporting of the COVID hospital data, but the CDC said no.

…The federal government had bought the entire available supply [of remedsivir], and HHS needed to know where to ship its limited doses [but]…the CDC didn’t have actual data on who was currently hospitalized for COVID, just estimates built off a model….Birx said that the government couldn’t ship scarce doses of the valuable medicine to treat estimated patients that were hypothetically hospitalized according to a mathematical formula. So she gave hospitals an ultimatum. If they wanted to get access to remedsivir, they would need to start reporting real data on the total number of COVID patients that they admitted each day. Hospitals quickly started to comply…Rather than cajole the CDC into fixing its reporting system, Ambassador Birx and Secretary Azar decided to recreate that structure outside the agency. The had concluded that getting the CDC to change its own scheme, and abandon its historical approach to modeling these data, would have been too hard.

…Under the new reporting system, 95% of US hospitals soon provided 100 percent of their daily hospital admission data. In an unfortunate twist, the CDC declined to work with the new data, worrying that since it wasn’t their data, they couldn’t assure its providence and couldn’t fully trust its reliability. As one senior HHS official put it to me, the CDC “took their ball and went home.”

…The cofounders of the COVID Tracking Project, one of the most authoritative and closely watched enterprises to report bottom-line information about the pandemic, would later say of the [HHS/Teletracking data], “the data set that we trust the most–and that we believe dose not come with major questions–is the hospitalization data overseen by the Department of Health and Human Services. At this point, virtually every hospital in America is reporting to the department as required. We now have a good sense of how many patients are hospitalized with COVID-19 around the country.” [Link here, AT]

Gottlieb’s story strikes me as much closer to the truth. Why? Notice that on most of the facts the stories agree. Gottlieb says the CDC refused to work with the HHS data and took their ball and went home. The Piller story has CDC people sobbing, angry, and saying “I refuse to do this.” Check. What differs is the interpretation and everything in Piller’s story is infected by an anti-Trump perspective. I don’t blame Piller for being anti-Trump but Trump plays no role in the story he just hovers in the background like a bogeyman. Piller says, for example:

…Birx’s hospital data takeover fits a pattern in which she opposed CDC guidance, sometimes promoting President Donald Trump’s policies or views against scientific consensus.

“Fits a pattern.” Uh huh.

Birx sometimes “promoted President Donald Trump’s policies.” Promoting the policies of the President of the United States? Why that’s practically treason!

Promoting views that go “against scientific consensus” Yeah, the “scientific consensus” of workers at the CDC.

Trump obviously had no interest in how hospital data was collected yet he is portrayed throughout as the hidden puppeteer behind the story.

Gottlieb’s story removes Trump from the equation and that rings true because we now know that the Biden administration has been as frustrated with the CDC as was the Trump administration. Politico writes, for example:

…senior officials from the White House Covid-19 task force and the Food and Drug Administration have repeatedly accused CDC of withholding critical data needed to develop the booster shot plan…

…the CDC advisory committee episode in late August only reinforced perceptions in the [Biden] White House that the agency represents the weakest link in a Covid-19 response…

The agency has for years struggled with obtaining accurate disease data from state health departments, and the pandemic strained the country’s public health infrastructure, causing massive delays in reporting and case investigation.

Withholding critical data. Struggling to obtain accurate data. Massive delays. Sound familiar? Indeed, if these parallels weren’t enough we even have CDC Director Rochelle Walensky overruling CDC scientists to allow boosters–but Walensky, unlike Birx, gets the benefit of the doubt so the story isn’t sold as Walensky going against scientific consensus to promote President Biden.

Evaluations of Trump colored evaluations of all the people and policies of the Trump administration leading to reporting that was sometimes unjust and inaccurate. It will take time to sort it all out.