In the span of a day, Secretary of Health and Human Services Alex Azar suddenly became the face of the Trump White House’s public response to the Wuhan coronavirus.
He could just as easily become the fall guy if the president grows unhappy with the speed or nature of the virus’ transmission, or the increasingly intense media coverage surrounding the administration’s actions.
Azar‘s elevation to chief responder — and leader of President Donald Trump’s coronavirus task force — comes after a rocky week for him internally as the virus spread globally and triggered worries across financial markets, corporate executive suites and the White House. The virus is expected to spread further and lead to more U.S. cases. The State Department late Thursday issued its most severe travel warning, telling Americans “do not travel” to China due to the coronavirus.
Inside the White House, pressure has been building up throughout the week in the background of the president’s Senate impeachment trial.
On Monday, several senior officials expressed extreme frustration with Azar and the White House's response, feeling that the administration was caught flat-footed. Some specifically criticized Azar for not widely sharing information and being too slow to ramp up the administration’s efforts. The health secretary was chided in at least one meeting and told to get the U.S. response in higher gear and work better alongside staffers from the National Security Council, Domestic Policy Council and various agencies, according to three senior administration officials.
By Wednesday, in a late-night announcement, Azar was publicly named as the chair of a task force to shape the administration’s response.
Acting White House chief of staff Mick Mulvaney this week urged Azar to begin holding a daily briefing to keep the public informed about the virus, officials said. Azar also appeared on Thursday on Fox News, where he told the anchor that the coronavirus “does not at this time pose a risk to the American public.” Later in the day, the Centers for Disease Control and Prevention confirmed the first instance of person-to-person transmission of the virus in the United States.
Inside the health department, both political and career staff defended the health secretary’s response to a mystery outbreak that’s sickened more than 8,000 people around the globe, including six confirmed cases in the United States. “I can say without hesitation that Alex Azar is doing a very good job in a very difficult job,” said Tony Fauci, a civil servant who’s the nation’s top infectious disease doctor.
The White House stressed that Azar would not have been elevated to lead the administration’s response to the coronavirus if the president and top aides did not trust him.
“The president has complete confidence in Secretary Azar which is exactly why he was chosen to lead the President’s Coronavirus Task Force and anyone spreading rumors to the contrary is simply uninformed and misguided,” Mulvaney told POLITICO in a statement.
"Secretary Azar is leading the efforts of the United States’ response to the novel coronavirus, and is the strongest and most competent health secretary I have ever observed," Robert Redfield, the nation’s CDC director, said in a statement.
The health department also dismissed criticism of Azar’s efforts to fight the outbreak, with HHS spokesperson Caitlin Oakley calling assertions of a slow response “the exact opposite of the truth.”
“Secretary Azar has had daily briefings and interactions with the President on Novel Coronavirus,” she said in a statement. “Secretary Azar has directed the Department to transparently communicate updates on the Novel Coronavirus to the American people through every medium available, often many times a day as details develop.”
Trump has been largely restrained in his public comments on the current outbreak — a departure from his repeated, often alarmist tweets during the 2014 Ebola outbreak. Against the advice of public-health leaders, Trump at the time even urged the United States to close its borders to flights from West Africa — which would have locked out two U.S. health workers who’d become ill in Liberia and had to be airlifted to Atlanta for treatment.
“Stop the EBOLA patients from entering the U.S. Treat them, at the highest level, over there. THE UNITED STATES HAS ENOUGH PROBLEMS!” Trump tweeted in August 2014.
By contrast, Trump this week at times appeared to sound unconcerned in the face of escalating risks. On Thursday at a speech at Michigan manufacturing plant, he downplayed any danger and told attendees that the spread of the coronavirus would have “a very good ending for us.” He added the administration was working “closely” with China to fight the virus and said hopefully “it won’t be as bad as some people think it could be.”
In reality, Trump behind the scenes has repeatedly quizzed aides about the coronavirus and its risks to Americans. Officials say Trump wants to project the image of the White House on the offensive toward the coronavirus, which the World Health Organization on Thursday declared a global public health emergency.
Appearing highly responsive on health care is a major White House priority after the president expressed irritation with his own administration’s moves on vaping and drug pricing, in addition to frustration about Republicans’ inability to repeal Obamacare. Health care has generally been a political loser for this administration. Trump’s own recent, internal polling shows it as a weak spot for him, and a strength for Democrats, heading into the 2020 campaign. Trump berated Azar for the bad polling in mid-January, breaking away from a political strategy meeting in order to vent to his health secretary by phone.
White House officials are now holding at least one daily meeting on the coronavirus and convening multiple calls. Trump tweeted photos on Wednesday of one high-powered session in the White House Situation Room, where the president was surrounded by top aides like Mulvaney and Dan Scavino alongside Azar, Redfield and Fauci.
“Just received a briefing on the Coronavirus in China from all of our GREAT agencies, who are also working closely with China. We will continue to monitor the ongoing developments. We have the best experts anywhere in the world, and they are on top of it 24/7!” Trump tweeted on Wednesday night.
With the coronavirus, the White House must fend off a high-pressure and surging global health crisis that has administration officials privately on edge. The crisis also will test Azar’s ability to lead the response effort in a White House where he has few allies and many enemies — including supporters of Seema Verma, another top health official who spent much of 2019 at war with Azar over policy and personnel.
“Key experts who would help lead a response from the National Security Council are gone or divested and the functions collapsed, and so you’re dependent on coordination from a reluctant health secretary,” said one former administration official.
Azar’s own allies argue that he’s adopted a thorough response to the spreading crisis that’s grounded in public-health best practices. Inside the health department, senior health officials like Redfield and Fauci have been empowered to move quickly on preparing for U.S. outbreaks and devising potential treatments. Azar also tapped his department’s emergency-response team to coordinate efforts, a strategy that helped the Trump administration respond to other crises like earthquakes, hurricanes and the rapid effort to reunify migrant families that the administration separated at the border.
The health secretary’s moves have received some bipartisan applause. Ron Klain, who helped lead President Barack Obama’s response to the 2014-2015 Ebola outbreak, has repeatedly praised Azar for taking “wise steps” even as he bashed the president himself for dismantling public-health functions.
In public and in private, Azar has touted his experience fighting an earlier coronavirus outbreak called SARS and other crises as a senior health official during the George W. Bush administration. “He knows the questions to ask,” like whether officials have fully gamed out potential scenarios, said a senior health official who’s been in strategy meetings with Azar this week.
Two Azar allies also argue the secretary’s department has been transparent amid the health crisis, such as providing the White House’s Domestic Policy Council — which traditionally hasn’t played a role in health outbreaks — with additional briefings earlier this month upon request. Meanwhile, Azar has been demanding greater transparency from China, as health officials seek more data about the mystery virus and offer to send international aid workers to help fight the outbreak.
“Alex has pushed to see if we can send some of our people there to not only help the Chinese but also get some information that would inform our strategies and response," said Fauci, the infectious disease doctor.
Meanwhile, Azar opted out of a sought-after trip to Iowa next week where the health secretary was scheduled to join other Cabinet members as one of the president’s surrogates during the Iowa caucuses. “Azar was invited and is no longer going,” said a person familiar with the secretary’s plans. “He’s staying in Washington to lead the charge and response on coronavirus.”
But Azar’s position in the administration remains weakened after his extensive battles with Verma, the nation’s Medicaid and Medicare chief who was previously a consultant for then-Indiana Gov. Mike Pence. Azar and Verma’s battles grew so severe last month that the White House prepared a shortlist of replacements for both officials. Neither Azar nor Verma’s jobs are currently at risk, officials maintain, noting that Verma on Thursday morning rolled out a plan to overhaul the nation’s Medicaid program, with White House support.
Fauci, who’s worked in the health department since 1968 and led the nation’s infectious-disease response since 1984, argued that Azar is striking the right balance of communicating big decisions while trusting the health department’s army of career scientists. “Good secretaries have transcended administrations,” Fauci said. “Alex is clearly right up there.”
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January 31, 2020 at 10:14AM
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