Trump Loyalists Tried to Influence C.D.C. Virus Reports

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Political appointees at the Department of Health and Human Services have repeatedly asked the Centers for Disease Control and Prevention to revise, delay and even scuttle reports on the coronavirus that they believed were unflattering to President Trump.

Current and former senior health officials with direct knowledge of phone calls, emails and other communication between the agencies confirmed on Saturday a report in Politico late Friday that the C.D.C.’s public Morbidity and Mortality Weekly Reports have been targeted by senior officials in the Health and Human Services’ communications office.

The reports, which one former top health official called the “holiest of the holy” in agency literature, are written largely for scientists and public health experts, to update them on trends in infectious diseases, not only the coronavirus but also other outbreaks around the country. They are guarded so closely by agency staff members that political appointees only see them just before they are published.

The reports became the subject of intense scrutiny this summer by Michael Caputo, a Republican political operative and former Trump campaign official the White House installed as the top spokesman at the department in April, despite his having no background in health.

Mr. Caputo himself said on Saturday that Politico’s report was largely accurate, but he denied that there was any overt pressure involved. He said that the primary person involved in critiquing the reports, Paul Alexander, an assistant professor of health research at McMaster University in Canada whom he hired to advise him on the science of the pandemic, simply offered direct reactions to the drafts of the C.D.C.’s Morbidity and Mortality Weekly Reports.

“He digs into these M.M.W.R.s and makes his position known, and his position isn’t popular with the career scientists sometimes,” Mr. Caputo said of Dr. Alexander. “That’s called science. Disagreement is science. Nobody has been ever ordered to do anything. Some changes have been accepted, most have been rejected. It’s my understanding that that’s how science is played.”

In an email obtained by Politico and confirmed to The Times by a health official with direct knowledge of the message, Dr. Alexander accused C.D.C. scientists of trying to “hurt the president,” referring to the weekly reports as “hit pieces on the administration.” Dr. Alexander asked Dr. Robert R. Redfield, the C.D.C. director, to edit reports that had already been published, which he believed overstated the risks of the virus for children and undermined the administration’s efforts to encourage school reopenings.

The meddling from Washington concerned Dr. Redfield, according to one former senior health official, who often pushed back when Mr. Caputo called to pester him about the reports.

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Local health officials on Saturday recommended that all students at Michigan State University immediately begin a two-week self-quarantine as the school struggles to contain a growing outbreak.

At least 342 people affiliated with the university have tested positive since Aug. 24, when students began moving in. In the three weeks before the case surge, only 23 people affiliated with the university had tested positive.

The start of the fall semester has contributed to an increase in virus cases across the United States, including at least 1,638 cases at 32 colleges and universities in Michigan, according to a New York Times survey.

Colleges around the country have run into a host of problems as they have tried to reopen. At the University of North Carolina at Chapel Hill last month, a major outbreak forced classes to move online after a single week, and North Carolina State also went to remote learning when clusters appeared soon after the campus opened.

At least a third of people affiliated with Michigan State who tested positive recently attended social gatherings, a third of them associated with a fraternity or sorority, according to the health department for Ingham County, which encompasses the university’s campus in East Lansing.

“These cases are clusters,” Linda Vail, a county health officer, said in an interview on Saturday evening. “Here, there and everywhere. We have a serious, serious spike in cases all tied to a particular demographic. This is an urgent situation.”

The university, which has an enrollment of about 50,000, announced in mid-August that classes would be remote and asked most students who would have lived on campus to stay home. However, around 35,000 students with off-campus leases returned to East Lansing before the semester began on Sept. 2, said Emily Gerkin Guerrant, a university spokeswoman, and 2,800 students — including athletes, international students or students without stable housing — were allowed to stay in the dorms.

Under the recommended quarantine, students should leave their residences only for in-person classes, or to get food or medicine, Ms. Vail said. Though the quarantine is a recommendation, she said it may be changed to an order for large houses, where groups of more than 10 students live together.

Elsewhere in the state, several students at the University of Michigan recently took to TikTok to voice outrage about campus health policies, including the jury-rigged housing the university has used to quarantine those who test positive. They expressed support for continuing strikes by graduate students, some of whom are instructors and have demanded the right to work remotely, increased testing transparency and other virus protections.

There have been 367 confirmed cases since March, according to the school’s database, and 19 cases since students returned in late August for a mixture of in-person and remote learning.

Students who test positive are not required to use the university’s quarantine housing and can choose to stay in their own housing for quarantine, said Rick Fitzgerald, a University of Michigan spokesman. He added that the single-occupancy apartments used for quarantine included a refrigerator and oven and that the university was trying to find microwaves to give to students so they can heat up meals delivered by the university.

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The pharmaceutical company AstraZeneca said Saturday that it had resumed its virus vaccine trial in Britain after suspending it six days ago over potential safety issues but that its trials in the United States and other countries were still on hold.

The news came the same day that a competitor, Pfizer, said it was expanding the trial of its vaccine to 44,000 people — a big increase from its previous goal of 30,000 — in an effort to recruit a more diverse group of participants and potentially cut down the time needed to get results from the trial.

Together, the developments raised new questions about when a vaccine might be available and showed just how unpredictable vaccine development can be, even as the world is desperately waiting for something that can bring an end to the pandemic.

Both companies’ announcements lacked crucial details, prompting criticism that they were not being open enough about the data they’re collecting. AstraZeneca, a British-Swedish company that is collaborating with Oxford University on development of the vaccine, did not offer any information to support the decision to partly resume trials and would not give any details about the illness of a patient that had led to the suspension. Pfizer did not explain how it would determine the effectiveness of the vaccine in its expanded trials.

AstraZeneca suspended its trial last Sunday after a participant in Britain became seriously ill. The company did not announce the decision. On Wednesday, after the news organization Stat reported that the trial had paused, AstraZeneca released a statement that described it only as a “potentially unexplained illness.”

Dr. Eric Topol, a professor of molecular medicine at the Scripps Research Institute in San Diego and an expert on clinical trials, found both announcements worrisome, contending that the companies were withholding crucial information.

“The public has a right to know what’s going on,” he said. “The future depends on it.”

AstraZeneca and Pfizer are among the three companies that are currently testing their candidates in late-stage clinical trials in the United States — Moderna is the third — in a record-setting race to develop a vaccine. All three have said they expect to have one ready — at least for high-priority groups — before the end of the year.

Michele Meixell, a spokeswoman for AstraZeneca, did not say when she expected the trials in other countries to restart. “AstraZeneca will continue to work with health authorities across the world and be guided as to when other clinical trials can resume,” she said.

Dr. Topol, who has run clinical trials for heart treatments, said it was routine for them to be put on hold and then resumed.

But the public statement about the trial going forward only in Britain left him baffled. “Why would it go forward in one country?” he said. “We’re all people. That’s peculiar.”

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An Aug. 19 phone call to the director of the National Institutes of Health from President Trump demanding approval of a coronavirus therapy has brought into focus the fear that politics could take precedence over science as Election Day nears.

Mr. Trump called Dr. Francis S. Collins, the N.I.H. director, after he and other senior government scientists had stepped in to slow an emergency approval to expand the use of blood plasma from recovered Covid-19 patients to treat new ones. For more than a week, the N.I.H. had held up the emergency authorization, citing concerns over the effectiveness of so-called convalescent plasma.

With White House officials anxious to showcase a step forward in the battle against the virus, Mr. Trump was having none of it: “Get it done by Friday,” he demanded.

That Sunday night, the eve of the Republican National Convention, the president had what he wanted: He announced that plasma therapy had been approved for wider use, and he declared that it could reduce deaths by 35 percent, vastly overstating what the data had shown about the benefits.

Mr. Trump’s call to Dr. Collins was just one in a series of moments that have left scientists and regulators across the public health bureaucracy increasingly worried that the White House could exert even greater pressure to approve a vaccine before Election Day, even in the absence of agreement on its effectiveness and safety.

On the night of the plasma announcement, Dr. Collins was told to show up at the White House, where he was given a coronavirus test and then shunted to the Roosevelt Room as Mr. Trump and others spoke to journalists in the briefing room.

There, Dr. Collins and Dr. Peter Marks, one of the top regulators at the Food and Drug Administration and the person most directly responsible for maintaining the independence and scientific rigor of the vaccine approval process, watched helplessly as the president and other top administration officials oversold plasma’s effectiveness, creating a public relations debacle that reverberated for days.

Dr. Collins left the White House after the announcement. But Dr. Marks, who had pushed for the plasma approval, was escorted to the Oval Office to spend a few minutes with Mr. Trump and his top aides, who were celebrating with cupcakes with white icing. In an interview on Friday, Dr. Marks said he was “a little bit in a state of shock” to find himself there.

Although he described it as “a brief interaction that really didn’t have any substance,” health officials who had heard about the encounter said they feared it could create the impression that the guardrails between politics and science were being further eroded at a time when public confidence in the safety of vaccines and treatments was already fracturing.

At a campaign rally on Saturday night at Minden-Tahoe Airport in Nevada, Mr. Trump said a vaccine would be ready “before the end of the year and maybe much sooner than that,” and that concerns about the speed of vaccine development were politically motivated.

The Trump campaign had planned to hold the Saturday rally at Reno-Tahoe International Airport, but officials there said it could not proceed because it would violate state and local directives limiting outdoor gatherings to 50 people. Several thousand people were estimated to have attended the event in Minden.

GLOBAL ROUNDUP

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Under bright blue skies, nearly 2,000 students gathered this month for the start of school at Hanyang No. 1 High School in Wuhan, the Chinese city where the virus first emerged.

Medical workers stood guard at school entrances, taking temperatures. Administrative officials reviewed the students’ travel histories and coronavirus test results. Local Communist Party cadres kept watch, making sure teachers followed detailed instructions on hygiene and showed an “anti-epidemic spirit.”

“I’m not worried,” a music teacher at the school, Yang Meng, said in an interview. “Wuhan is now the safest place.”

As countries around the world struggle to safely reopen schools, China’s Communist Party is harnessing the power of its authoritarian system to offer in-person learning for about 195 million students in kindergarten through 12th grade at public schools.

In many ways, China is applying the same heavy-handed model to reopen schools that it has used to bring the virus under control. To stop the epidemic, the authorities imposed harsh lockdowns and deployed invasive technologies to track residents, raising public anger in some places and concerns about the erosion of privacy and civil liberties.

China’s leader, Xi Jinping, said in a speech on Tuesday that the country’s progress in fighting the virus, including the opening of schools, had “fully demonstrated the clear superiority of Communist Party leadership and our socialist system.”

Other pandemic developments around the world:

  • Protesters in Melbourne, Australia, clashed with the police on Sunday on the second day of demonstrations against lockdown restrictions. In a tense standoff at Queen Victoria Market, protesters chanting “Freedom!” were greatly outnumbered by police officers, with dozens of people arrested or fined. Fourteen people were also arrested at smaller protests on Saturday. The state of Victoria, the center of Australia’s virus outbreak, has been under strict lockdowns since early August, though restrictions will be slightly eased on Monday with the nightly curfew in Melbourne starting an hour later at 9 p.m. On Sunday, the state reported 41 new cases and seven deaths, continuing a general downward trend.

  • South Korea said on Sunday that it would ease social distancing measures in metropolitan Seoul for the next two weeks, even though daily new cases remain in the triple digits. The easing includes lifting a ban on onsite dining after 9 p.m. and reopening gyms and internet cafes. Officials said stronger measures would return on Sept. 28, ahead of the Chuseok fall harvest holiday during which many people travel. On Sunday, the country reported 121 new infections, bringing the total to 22,176.

  • India reported 94,372 new cases on Sunday, the fourth day in a row new cases have exceeded 90,000, according to a Times database. India has the world’s second-highest number of cases after the United States.

  • Thousands of Israelis gathered outside Prime Minister Benjamin Netanyahu’s official residence in central Jerusalem on Saturday for the latest in a series of weekly protests demanding that Mr. Netanyahu resign over his trial on corruption charges and what is widely seen as his mishandling of the virus crisis, The Associated Press reported. Israel has been reporting record levels of new virus cases each day.

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A report published Friday by the Centers for Disease Control and Prevention found that young children at three child-care facilities in Utah transmitted the virus to staff members, family and the surrounding community.

The findings undermine some previous assertions about the likelihood that the very young could spread the virus. Studies from South Korea and other countries have suggested that children under 10 are less likely to spread the virus than adults.

The new research, published Friday, traced cases at three Salt Lake City facilities, including one in which an 8-month-old contracted the virus and transmitted it to both parents. Some of the children were asymptomatic when they spread the virus.

Researchers reviewed the contact-tracing data related to outbreaks at the child-care facilities between April 1 and July 10. The study found that during that time at least 184 people, 74 adults and 110 children, had been exposed to someone with the virus in those facilities. At two of the facilities, the children were all younger than 10; the third had an age range up to 13.

Of the 184 people exposed, 31 later tested positive for the virus, including 13 children. The study reported that 12 of those children had passed the virus along to at least 12 of their 46 contacts outside the centers. “Six of these cases occurred in mothers and three in siblings of the pediatric patients,” the study said. At least one parent was hospitalized.

The study had several critical limitations:

  • The source of an outbreak at one of the facilities was never found, making it impossible to determine if transmission can be attributed to the facility or to general community spread.

  • The testing strategy changed over time. For at least part of the study only symptomatic individuals were tested, which may have led to an undercount of cases.

  • Each of the three facilities was closed for some portion of the study period, during a statewide lockdown, limiting its use in suggesting patterns for child-care facilities at large.

Between April and July 10, when the study was conducted, guidance from public health experts shifted drastically, most notably regarding face coverings. In Utah, a mask mandate was not issued until July 23 and never applied to “children in a child-care setting.”

The study’s authors recommended that workers at child-care facilities wear masks at all times, especially when children are too young to wear them, and emphasized the importance of regular testing with timely results.

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Credit…Victor J. Blue for The New York Times

During the surge of Covid-19 cases this spring that filled the Brooklyn Hospital Center’s emergency room and intensive care unit with the critically ill and the dying, staff members went in day after day, trying to save as many lives as they could.

A photographer for The Times, Victor J. Blue, created a series of portraits of these hospital workers during that grueling first wave. He and Sheri Fink, the reporter who spent days inside the hospital then, later interviewed them with a colleague, Catrin Einhorn, as they braced for a second wave.

From the doctors and nurses to the workers serving behind the scenes, all understood their roles were both critical and potentially fatal. Fighting the pandemic required sacrifice and courage from workers of all stripes, in the laundry room and the supply depot, the laboratory and the security desk, all the way to the chief executive’s office.

Many spoke in battle metaphors. The virus seemed to come from all sides, they said, and threatened to spare no one. They talked about the front line, and being called to duty, and “training for war.”

“Even when I think about it right now,” said Dr. Kiran Zaman, a critical care fellow, “it gives me goose bumps. It was a very scary, very overwhelming experience. It was a nightmare.”

Sports Roundup

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Credit…Jeffrey Mcwhorter/Associated Press

With its regular season set to end on Sept. 27, Major League Baseball appears poised to move teams into a bubble format for the postseason and World Series.

The league had already moved ahead with plans to hold later-stage playoff games at neutral sites rather than home parks for the first time.

It also appears to have settled on five cities in Southern California and Texas, with those two regions hosting the American League and National League playoffs. The plan has not yet been endorsed by the Major League Baseball Players Association, which must agree to the terms.

If formalized, the plan would follow a path charted by other major sports leagues, including the N.B.A., which has kept players confined to a complex within the Walt Disney World Resort for its playoffs since August. Keeping staff members and players in a bubble has also generally worked out for the W.N.B.A. and the N.H.L.

At the conclusion of the playoffs, the plan would send the last teams standing to a World Series at the Texas Rangers’ new ballpark in Arlington. It would become the first stadium to host the entire World Series since 1944, when Sportsman’s Park in St. Louis hosted both the Cardinals and the Browns.

In others sports news:

  • Naomi Osaka won her second United States Open tennis title on Saturday, defeating Victoria Azarenka, 1-6, 6-3, 6-3, in a final held in an arena that was nearly empty because of the pandemic. For each of her matches at the tournament, Osaka, 22, walked on court wearing a mask bearing the name of a Black victim of violence. On Saturday she honored the memory of Tamir Rice, a 12-year-old boy shot and killed in Cleveland by a white police officer in 2014.

  • A college football game between Army and Brigham Young University scheduled for Sept. 19 has been postponed because of what B.Y.U. described as “a small number of positive Covid-19 test results and the resulting tracing exposures” within its football program.

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Credit…Jose Luis Magana/Associated Press

A recent Brock University study of 451 adults ages 20 to 82 in the United States found that people who believed they had contracted the coronavirus weren’t always honest about it. Thirty-four percent of participants who had tested positive said they had denied having symptoms when asked by others, and 55 percent reported some level of concealment of their symptoms.

Twenty-five percent of participants reported that they had in some way concealed their physical distancing practices. That rate increased among those with Covid-19, according to the study, published last month in The Journal of Health Psychology.

Women were more likely to disclose health symptoms than men were, researchers said, and older adults were more honest about their virus status and behaviors.

But the exact reasoning behind lying during the pandemic is complicated and may be related to the environment, according to David M. Castro, a psychotherapist and adjunct professor of psychology at Adelphi University and the City College of New York.

“I think that so much is barred from someone right now,” Dr. Castro said. “There’s a lot of loneliness, a lot of depression stemming from loneliness.”

Robert Feldman, a professor of psychological and brain sciences at the University of Massachusetts Amherst and author of “The Liar in Your Life: The Way to Truthful Relationships,” said his research showed that people typically tell three lies within the first 10 minutes of meeting someone else.

“It’s part of what we do as members of society,” he said. “We tell people that we’re feeling well when we’re not feeling so well.”

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Credit…Alex Welsh for The New York Times

About 70 cars crammed into a downtown Los Angeles parking lot surrounded by high rises and a smattering of food trucks on Thursday night to watch “Concrete Cowboy,” a father-son film starring Idris Elba and set in North Philadelphia’s Black cowboy community.

In terms of movie premieres, it was unorthodox.

“It is a dream come true,” Ricky Staub, the 37-year-old white filmmaker making his directorial debut, said while standing in front of a huge screen. “I don’t know when you dream of releasing your movie it’s at a drive-in, but I never dreamed that my first movie would be an all-Black western set in Philly.”

Mr. Staub had ambitious plans when “Concrete Cowboy” landed coveted spots in the Telluride and Toronto film festivals. The plans all changed when Telluride was canceled because of the pandemic and Toronto opted for a hybrid model that features in-person screenings for Canadian audiences and a virtual version for everyone else.

For small indie films like “Concrete Cowboy,” the loss of traditional film festivals means not having a chance to build word-of-mouth momentum that could be the difference between becoming an unlikely Oscar darling or another also-ran in the video-on-demand market.

At the Venice Film Festival, held in person with certain safety restrictions, “One Night in Miami” — the directorial debut of the Oscar-winning actress Regina King — has already generated early awards chatter. Amazon recently bought it in a bidding war.

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Credit…Jim Wilson/The New York Times

California is at the center of increasing concerns about extensive fraud in a federal program that provides unemployment benefits to freelancers, part-time workers and others lacking a safety net in the pandemic.

At the same time, there is growing evidence of problems keeping track of how many people are being paid through the program. The Labor Department has reported about 15 million claims for benefits nationwide. A comparison of state and federal records by The New York Times suggests that total may overstate the number of recipients by five million or more.

The program, Pandemic Unemployment Assistance, is part of a $2.2 trillion relief package enacted in March. In the latest Labor Department tally, the program accounted for nearly half the total recipients collecting jobless benefits of any kind.

It appears that nearly seven million people are collecting Pandemic Unemployment Assistance benefits in California alone, far more than its population would suggest. The state’s own data suggests that the number may be less than two million. Experts on the unemployment system say such discrepancies seem to reflect multiple counting of individual applications as states rushed out payments.

But a surge in new claims in California is attributed not to accounting, but to fraud.

Fraud is not uncommon in hastily assembled disaster programs, but signs of trouble with this program have been surfacing for months as people who did not file claims found benefits issued in their names. A growing number of states have signaled that the problems with the program go beyond the routine.

Colorado said on Thursday that in a six-week stretch this summer, 77 percent of new claims under the program were not legitimate.

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Credit…Jim Wilson/The New York Times

The United States should not expect a return to regular life until “well into 2021, maybe even towards the end of 2021,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on Friday.

In an interview with “Andrea Mitchell Reports” on MSNBC, Dr. Fauci addressed a possible timeline for when activities like going to an indoor movie theater “with impunity” might be able to resume. While a vaccine may be available by the end of the year, he said, “by the time you mobilize the distribution of the vaccinations, and you get the majority or more of the population vaccinated and protected, that’s likely not going to happen till the mid or end of 2021.”

Dr. Fauci was also asked about comments he had made on Thursday in a panel discussion at Harvard Medical School, where he said that “we need to hunker down and get through this fall and winter, because it’s not going to be easy.” Ms. Mitchell pointed out that this conflicted with a remark by President Trump at the White House that day, that the country had “rounded the final turn” on the virus.

“I have to disagree,” Dr. Fauci said of Mr. Trump’s read on the situation. “We’re plateauing at around 40,000 cases a day, and the deaths are around 1,000.”

In any case, he said, “what we don’t want to see is going into the fall season when people will be spending more time indoors — and that’s not good for a respiratory-borne virus — you don’t want to start off already with a baseline that’s so high.”

As of Saturday, there were an average of 34,586 cases per day over the previous week, a decrease of 18 percent from two weeks earlier, according to a Times database. Case numbers remain high across much of the country, though reports of new cases have dropped considerably since late July, when the country averaged well over 60,000 per day. On Saturday, North Dakota and West Virginia set daily records for new cases.

Reporting was contributed by Noah Weiland, Sheryl Gay Stolberg, Abby Goodnough, Ben Casselman, Damien Cave, Patricia Cohen, Helene Cooper, Conor Dougherty, Marie Fazio, Rebecca Halleck, Javier C. Hernández, Jonathan Huang, Mike Ives, Jennifer Jett, Annie Karni, Sharon LaFraniere, Apoorva Mandavilli, Zach Montague, Benjamin Mueller, Dan Powell, Nelson D. Schwartz, Nicole Sperling, Jim Tankersley, Derrick Bryson Taylor, Katie Thomas and Carl Zimmer.

Source: nytimes.com

Tags: health

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